bluuebunny/crossref_metadata_2025 huggingface dataset:
Properties characterization and microstructural analysis of alkali-activated solid waste-based materials with sawdust and wastewater integration
Authors: Li Liang , Zhao Xianhui , Wang Haoyu , Cao Jianran , Zhao Xian-en
Published: January 2025

Construction materials are significantly exposed to ecological hazards due to the presence of hazardous chemical constituents found in industrial and agricultural solid wastes. This study aims to investigate the use of sawdust particles (SDPs) and sawdust wastewater (SDW) in alkali-activated composites (AACs) made from a mixture of different silicon-aluminum-based solid wastes (slag powder-SP, red mud-RM, fly ash-FA, and carbide slag-CS). The study examines the impact of SDP content, treated duration of SDPs, and SDW content on both fresh and hardened properties of the AACs, including electrical conductivity, fluidity, density, flexural and compressive strengths, and drying shrinkage. The study also analyzes the microstructures and product compositions of the AACs influenced by SDW through a comprehensive analysis of microstructures and product compositions by using XRD, SEM-EDS, and FTIR. The results show that treating SDPs with a 2.5 mol/L NaOH solution for 12 hours decreases the fluidity and electrical conductivity of the AACs but improves their flexural and compressive strengths. Additionally, in the synthesis of a composite material incorporating binder materials SP, RM, and FA in a mass ratio of 10:3:18, a 2.0 mol/L NaOH solution is employed. The liquid-to-solid ratio is maintained at 20:31, and the sand-to-binder ratio is set at 3:1. The substitution of 12.28% SDW to NaOH solution improves the resistance to drying shrinkage and long-term mechanical strength development of the AACs. Interestingly, the addition of SDW does not affect the product compositions due to the generation and decomposition of organic acid salts from organic impurities in the acidic SDW during long-term curing at room temperature. These findings provide valuable insights for the sustainable recycling of bioresources and solid wastes containing silicon-aluminum in construction materials.
Finite element analysis of the plantar support for the medial longitudinal arch with flexible flatfoot
Authors: Long Xiao , Du Xiangyu , Yuan Chengjie , Xu Jian , Liu Tao , Zhang Yijun
Published: January 2025

Purpose

The present study is to explore the appropriate plantar support force for its effect on improving the collapse of the medial longitudinal arch with flexible flatfoot.

Methods

A finite element model with the plantar fascia attenuation was constructed simulating as flexible flatfoot. The appropriate plantar support force was evaluated. The equivalent stress of the articular surface of the joints in the medial longitudinal arch and the maximum principal stress of the ligaments around the ankle were obtained.

Results

The height fall is smaller when applying 15% of body-weight-bearing force as the plantar support for the medial longitudinal arch compared with 10% of the body-weight-bearing while 20% of body-weight-bearing force is over plantar support. The equivalent stress on the articular surface of each joint is smallest when applying 15% of body-weight-bearing force compared with 10% or 20% of the body-weight-bearing force. The maximum principal stress of the anterior talofibular ligament is decreased while other ligaments increased when the plantar fascia attenuation under loading. The maximum principal stress of the tibiocalcaneal ligament and the posterior tibiotalar ligament are decreasing while other ligaments increased with the force increasing gradually.

Conclusions

Applying 15% of body-weight-bearing to the sole of the foot can restore the height fall of the medial longitudinal arch, and relieve the equivalent articular stress of the talonavicular joint and the talocalcaneal joint as well as the tension stress of the tibiocalcaneal ligament and the posterior tibiotalar ligament.
MARCHF8-mediated ubiquitination via TGFBI regulates NF-κB dependent inflammatory responses and ECM degradation in intervertebral disc degeneration
Authors: Zhang Xingpeng , Li Guang , Tan Fang , Yu Tao , Xu Chengping , Li Kai , Zhang Feng , Zhang Meiyan , Wang Jian
Published: January 2025

Aim

To explore the role of the hub gene Transforming Growth Factor Beta Induced (TGFBI) in Intervertebral disc degeneration (IDD) pathogenesis and its regulatory relationship with Membrane Associated Ring-CH-Type Finger 8 (MARCHF8).

Background

IDD is a prevalent musculoskeletal disorder leading to spinal pathology. Despite its ubiquity and impact, effective therapeutic strategies remain to be explored.

Objective

Identify key modules associated with IDD and understand the impact of TGFBI on nucleus pulposus (NP) cell behavior, extracellular matrix (ECM)-related proteins, and the Nuclear Factor kappa-light-chain-enhancer of Activated B cells (NF-κB) signaling pathway.

Methods

The GSE146904 dataset underwent Weighted Gene Co-Expression Network Analysis (WGCNA) for key module identification and Differentially Expressed Genes (DEGs) screening. Intersection analysis, network analysis, and co-expression identified TGFBI as a hub gene. In vitro experiments delved into the interplay between TGFBI and MARCHF8 and their effects on NP cells.

Results

WGCNA linked the MEturquoise module with IDD samples, revealing 145 shared genes among DEGs. In vitro findings indicated that MARCHF8 determines TGFBI expression. TGFBI boosts apoptosis and ECM breakdown in Lipopolysaccharide-stimulated (LPS-stimulated) NP cells. Altering TGFBI levels modulated these effects and the NF-κB signaling pathway, influencing inflammatory cytokine concentrations. Moreover, MARCHF8 ubiquitination controlled TGFBI expression.

Conclusion

TGFBI, modulated by MARCHF8, significantly influences IDD progression by affecting NP cell apoptosis, ECM degradation, and inflammation through the NF-κB signaling pathway.
Trends in childhood cancer: Incidence and survival analysis over 45 years of SEER data
Authors: Sultan Iyad , Alfaar Ahmad S. , Sultan Yaseen , Salman Zeena , Qaddoumi Ibrahim
Published: January 2025

Background

The SEER Registry contains U.S. cancer statistics. To assess trends in incidence and survival and the impact of demographic factors among pediatric patients with cancer, we assessed nearly 5 decades (1975–2019) of data.

Methods

All patients below the age of 20 with histology-confirmed malignancy were studied. Kaplan-Meier survival curves were generated to evaluate survival trends across treatment periods and ICCC classes. JoinPoint analysis was conducted to identify changes in incidence and survival.

Results

The incidence of childhood cancer increased from 14.23 cases per 100,000 children in 1975–1979 to 18.89 in 2010–2019, with an average annual percent change of 0.73. This rise was more pronounced in several cancers, including leukemias, lymphomas, brain tumors, hepatic tumors, and gonadal germ cell tumors. Age-adjusted cancer mortality decreased from 4.9 to 2.3 per 100,000. Cancer-related mortality was consistently higher in boys than in girls, and in Black children than in White children. Survival significantly improved, with 5- and 10-year survival rates rising from 63.1% to 85.2% and from 58.8% to 82.7%, respectively. Leukemias showed a substantial increase in 5-year survival from 48.2% ± 1.7% to 85.1% ± 0.4% in 2010–2019. Lymphomas also showed significant improvement, with survival increasing from 72.9% ± 1.7% to 94.2% ± 0.3%. Despite these improvements, the survival of CNS tumors, bone tumors, and sarcomas remained suboptimal, with 5-year survival estimates of approximately 60%. Our joinpoint analysis confirmed our findings but revealed an interesting increase in the incidence of lymphomas limited to the years between 2005 and 2014.

Conclusion

This research elucidates advancements in survival among pediatric patients with cancer. The results offer critical perspectives on pediatric oncology, highlighting the imperative for ongoing innovation in therapeutics. Although the increase in incidence may partially stem from enhanced diagnostic capabilities and more comprehensive registration processes, the underlying causes remain unclear.
Networks of care for optimizing Primary Health Care Service Delivery in Ethiopia: Enhancing relational linkages and care coordination
Authors: Tiruneh Gizachew Tadele , Fesseha Nebreed , Ayehu Temesgen , Chitashvili Tamar , Argaw Mesele Damte , Shiferaw Biruhtesfa Bekele , Teferi Mikias , Semahegn Agumasie , Bogale Biruk , Kifle Yibeltal , Tadesse Hillina , Tesfaye Chala , Emaway Dessalew
Published: January 2025

Introduction

Ethiopia has made notable progress in reducing maternal and perinatal mortality, yet challenges remain in meeting the 2030 Sustainable Development Goals. Persistent issues such as low service utilization, coupled with poor quality, fragmented care, and ineffective referral systems hinder progress. The "Improve Primary Health Care Service Delivery (IPHCSD)" project, implemented by JSI and Amref Health Africa since April 2022, seeks to address these gaps through a Networks of Care (NoCs) approach. This paper describes the lessons learned from implementing the NoCs approach to optimize primary health care in Ethiopia.

Methods

The project incorporates embedded implementation science, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Key implementation strategies co-designed included strengthening community engagement, establishing NoCs, and introducing quality improvement initiatives using the Model for Improvement. Routine program monitoring data, NoCs process evaluation, and facility service statistics were utilized for this study. Service statistics were analyzed using Student’s t-test and interrupted time-series analysis to compare maternal and child care outcomes before and after the NoCs intervention, with counterfactual estimates generated to assess the intervention’s impact. Qualitative data from key informant interviews were transcribed, coded, and analyzed to identify themes and patterns using Atlas.ti.

Results

The NoCs approach has significantly enhanced relational linkages between primary health care facilities and health care providers, fostering stronger collaboration and communication. This has fostered trust, improved care coordination, optimized primary health care performance, and increased health service utilization within woreda health systems. The interrupted time series analysis indicated that the rate of ANC 8+ visits was 29.8% per month higher than expected without the NoCs strategy (Coef: 2.39; p-value < 0.01) and an 18.4% increase in obstetric complications managed (Coef: 1.71; p-value = 0.050), with a 43% overall increase. Perinatal mortality decreased by 34%, from 31.3 to 20.1 per 1,000 births [t-test: 2.12; p-value: 0.040)].

Conclusion

The NoCs approach in Ethiopia has proven effective in enhancing the relational elements, care coordination, and quality of primary health care services, leading to better maternal and child health outcomes. The findings expand the existing body of research on NoCs implementation best practices and further confirm that it provides a scalable model for strengthening health services in low-resource settings.
An end-to-end implicit neural representation architecture for medical volume data
Authors: Sheibanifard Armin , Yu Hongchuan , Ruan Zongcai , Zhang Jian J.
Published: January 2025

Medical volume data are rapidly increasing, growing from gigabytes to petabytes, which presents significant challenges in organisation, storage, transmission, manipulation, and rendering. To address the challenges, we propose an end-to-end architecture for data compression, leveraging advanced deep learning technologies. This architecture consists of three key modules: downsampling, implicit neural representation (INR), and super-resolution (SR). We employ a trade-off point method to optimise each module’s performance and achieve the best balance between high compression rates and reconstruction quality. Experimental results on multi-parametric MRI data demonstrate that our method achieves a high compression rate of up to 97.5% while maintaining superior reconstruction accuracy, with a Peak Signal-to-Noise Ratio (PSNR) of 40.05 dB and Structural Similarity Index (SSIM) of 0.96. This approach significantly reduces GPU memory requirements and processing time, making it a practical solution for handling large medical datasets.
Turning the spotlight: Hostile behavior in creative higher education and links to mental health in marginalized groups
Authors: Fischer Marina , Veit Susanne , Buspavanich Pichit , Stadler Gertraud
Published: January 2025

Hostile, discriminatory, and violent behavior within the creative industries has attracted considerable public interest and existing inequalities have been discussed broadly. However, few empirical studies have examined experiences of hostile behavior in creative higher education and associated mental health outcomes of early career artists. To address this gap, we conducted a survey among individuals studying at higher education institutions for art and music (N = 611). In our analyses of different types of hostile behaviors and their associations with mental health and professional thriving, we focused on differences and similarities between marginalized and more privileged groups across multiple diversity domains. A substantial percentage of participants reported hostile behaviors in their creative academic environments. Individuals from marginalized groups reported more hostile behaviors, which partially explained their worse mental health and lower professional thriving. These findings indicate a clear need for the creative sector to implement strategies to create safer environments, particularly for early career artists from specific socio-demographic backgrounds. We conclude by suggesting strategies for prevention in this highly competitive industry.
Bias in adjudication: Investigating the impact of artificial intelligence, media, financial and legal institutions in pursuit of social justice
Authors: Javed Kashif , Li Jianxin
Published: January 2025

The latest global progress report highlights numerous challenges in achieving justice goals, with bias in artificial intelligence (AI) emerging as a significant yet underexplored issue. This paper investigates the role of AI in addressing bias within the judicial system to promote equitable social justice. Analyzing weekly data from January 1, 2019, to December 31, 2023, through wavelet quantile correlation, this study examines the short, medium, and long-term impacts of integrating AI, media, international legal influence (ILI), and international financial institutions (IFI) as crucial factors in achieving Sustainable Development Goal 16 (SDG-16), which focuses on justice. The findings indicate that AI, media, ILI, and IFI can help reduce bias in the medium and long term, although their effects appear mixed and less significant in the short term. Our research proposes a comprehensive policy framework that addresses the complexities of implementing these technologies in the judicial system. We conclude that successfully integrating AI requires a supportive global policy environment that embraces technological innovation, financial backing, and robust regulation to prevent potential disruptions that could reinforce inequalities, perpetuate structural injustices, and exacerbate human rights issues, ultimately leading to more biased outcomes in social justice.
Relationship between oxidative balance indicators and Chronic Kidney Disease
Authors: Chen Xinyun , Shi Fangyu , Yu Wenhui , Gao Chang , Gou Shenju , Fu Ping
Published: January 2025

Introduction

Chronic Kidney Disease (CKD) is a growing global health issue, affecting approximately 9.1% of the world’s population. Oxidative stress is believed to play a key role in CKD development, with indicators such as the Oxidative Balance Score (OBS), Pro-Oxidant-Antioxidant Balance (PAB), and Total Antioxidant Capacity (TAC) being of particular interest. However, their association with CKD remains unclear.

Methods

This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2018. A total of 18,951 participants were included after applying specific inclusion criteria. Logistic regression models and restricted cubic spline regression were employed to examine the associations between these oxidative balance indicators and CKD. Subgroup and interaction analyses were also conducted for further data analyses. Finally, ROC curve analysis was used to assess the predictive performance of these indicators for CKD risk.

Results

After adjusting for various confounding factors, higher levels of OBS and PAB were significantly associated with a reduced risk of CKD (OR = 0.97, 95% CI: 0.96–0.99, P < 0.001; OR = 0.94, 95% CI: 0.92–0.97, P < 0.001, respectively). The ORs for the highest quartiles of OBS and PAB were 0.60 (95% CI: 0.49–0.75, P < 0.001) and 0.77 (95% CI: 0.63–0.94, P = 0.013), respectively. In contrast, TAC showed no significant association with CKD. ROC curve analysis further indicated that OBS had a superior predictive ability for CKD risk (AUC = 0.579) compared to PAB (AUC = 0.519) and TAC (AUC = 0.492).

Conclusion

The study suggests that oxidative balance indicators, particularly OBS and PAB, are inversely associated with CKD risk, while TAC showed no significant link. OBS demonstrated the strongest predictive ability among the indicators. These findings highlight the potential role of oxidative balance in CKD prevention. Further research is needed to confirm these associations in diverse populations and to explore the underlying mechanisms.
Being “resilient” and achieving “resilience”: From governmental discourses to the national research agenda in the contexts of food insecurity and cost of living
Authors: Vilar-Lluch Sara , Clutterbuck Donna , Kranert Michael , Smith Dianna , Nield Sarah , Alwan Nisreen A.
Published: January 2025

The concept of ‘resilience’ is pervasive, permeating academic disciplines and political discourses. This paper considers (i) the construal of ‘resilience’ in the contexts of food insecurity and cost-of-living in governmental discourses in the United Kingdom (UK); (ii) to what extent the political representations are reflected in research funding calls of UK national funding bodies, thus showing possibility of shaping research agendas; and (iii) to what extent official uses of ‘resilience’ reflect lay understandings. We are combining a corpus-based discourse analysis of UK governmental discourses and research funding calls with a study of focus group discussions. Representations of ‘resilience’ are further compared with those available in general English corpora. We are observing a shift in the use of ‘resilience’: from an individual psychological attribute to a primarily socioeconomic and environmental characteristic. Funding calls construe resilience in relation to communities, reflecting economy and environment adaptability, whereas governmental discourses frame references to individuals in terms of ‘vulnerability’. Focus groups reveal divergent conceptions of ‘resilience’, which may lead to potential misunderstandings. While this variety of uses may be productive in political discourses for rhetorical purposes, there is a need for specificity in shaping research and in public-facing communications.
Multi-feature fusion-based consumer perceived risk prediction and its interpretability study
Authors: Qi Lin , Xie Yunjie , Zhang Qianqian , Zhang Jian , Ma Yanhong
Published: January 2025

E-commerce faces challenges such as content homogenization and high perceived risk among users. This paper aims to predict perceived risk in different contexts by analyzing review content and website information. Based on a dataset containing 262,752 online reviews, we employ the KeyBERT-TextCNN model to extract thematic features from the review content. Subsequently, we combine these thematic features with product and merchant characteristics. Using the PCA-K-medoids-XGBoost algorithm, we developed a predictive model for perceived risk. In the feature extraction phase, we identified 11 key features that influence perceived risk in online shopping. During the prediction phase, the model performs excellently across different sample types in the test set, achieving a precision (P) of 84%, a recall (R) of 86%, and an F1 score of 85%. Through the model’s interpretability analysis, we find that quality, functionality, and price are key features affecting perceived risk for electronic products. In the case of skincare products, skin safety is the most critical feature. Additionally, there are significant differences in feature characteristics between high-risk samples and normal samples.
Navigating technological innovation and rising costs: Assessing economic performance in Chinese manufacturing
Authors: Wu Songling , Si Yanqi , Wang Xiaoxiang
Published: January 2025

Economic performance is an important indicator of the efficiency and quality of a company’s production, which is closely related to the profitability of the company and is crucial for the development of the manufacturing industry.This paper aims to develop a theoretical framework for assessing economic performance within the Chinese manufacturing industry. It achieves this by incorporating inputs, outputs, and energy consumption costs into the production function. By analyzing manufacturing data from 2000 to 2021, it quantifies the impact of various factors, including labor costs and technological advancements, on economic performance. The findings highlight technological progress as the primary driver of economic growth within the Chinese manufacturing sector. Notably, there exists a U-shaped relationship between technical progress and economic performance, suggesting nuanced dynamics at play. Contrary to expectations, the rate of change in per capita wages shows no significant positive impact on economic performance. However, technical progress in the eastern and central regions exhibits a capital bias and positively influences economic performance. Similarly, a U-shaped relationship characterizes the relationship between the western region and manufacturing industry performance. These results underscore the crucial role of technological innovation in sustaining economic performance amid challenges such as rising labor and environmental costs. Emphasizing the reliance on scientific and technological progress emerges as imperative for enhancing the industry’s economic resilience and growth.
Age-related disparities in national maternal mortality trends: A population-based study
Authors: Huang Ryan S. , Spence Andrea R. , Abenhaim Haim A.
Published: January 2025

Objective

An upward trend in maternal age has been observed in the United States (US) over the last twenty years. The study objective was to examine the association of maternal age with maternal mortality in the US and examine temporal trends in mortality by maternal age.

Methods

A retrospective population-based analysis in the US between 2000–2019 was conducted using records from the Centers for Disease Control and Prevention’s “Mortality Multiple Cause” and “Birth Data” files. Annual incidence and period trends in maternal deaths were calculated using the annual maternal deaths over annual live births across age groups. Multivariate logistic regression models were used to estimate the association between maternal age and risk of maternal mortality and calculate temporal changes in risk of mortality over the study period.

Results

Between 2000–2019, 21,241 deaths were observed in women during pregnancy and childbirth for an average incidence of 26.3 maternal deaths/100,000 births (95% CI 21.8–31.2). Of all deaths, 6,870 (32.3%) were in women ≥35 years, while only 15.1% of live births were attributed to women ≥35 years. Compared with women 25–29 years of age, there was a significantly greater risk of maternal mortality among women 35–39 (OR 1.60, 1.53–1.67), 40–44 (3.78, 3.60–3.99), 45–49 (28.49, 26.49–30.65) and 50–54 (343.50, 319.44–369.37). Risk of mortality increased over time, with the greatest rise in women ≥35 years.

Conclusion

In the US, maternal mortality increased during the past two decades, especially in women ≥35 years. Given these findings, targeted strategies to reduce the increasing maternal mortality should become a priority.
Relationship between middle school students’ academic stress and physical exercise behavior from the perspective of Self-Determination Theory: The chained mediation of motivation and intention
Authors: Zhao Kegang , Zhao Yichen , Xu Weiqiang
Published: January 2025

Academic stress is associated with lower engagement in healthy behaviors, including physical exercise, among middle school students. Based on Self-Determination Theory, this study examines the association between academic stress and physical exercise behavior among middle school students, exploring the mechanisms through the chained mediation of motivation and intention. Scales used in this study include the Academic Stress Scale, Autonomous and Controlled Motivation Scales, and Physical Exercise Intention and Behavior Scales to measure relevant variables. This cross-sectional study involve 290 middle school students (116 males, age = 13.76±0.96 years, grades 7–9) selected from a middle school in Xiamen, China. Structural equation modeling is used to analyze the data, revealing the following results: (1) Academic stress is significantly associated with middle school students’ exercise behavior through the mediating role of exercise intention; (2) Controlled motivation, autonomous motivation, and exercise intention serve as chained mediators between academic stress and exercise behavior; (3) Academic stress is not associated with exercise intention through the parallel mediation of controlled and autonomous motivations. These findings provide new insights into the relationship between academic stress and physical exercise behavior in middle school students.
How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses
Authors: Seo Mi Hwa , Kim Eun A. , Kim Hae Ran
Published: January 2025

Background

Person-centered care focuses on individualized care that respects patients’ values, preferences, and autonomy. To enhance the quality of critical care nursing, institutions need to identify the factors influencing ICU nurses’ ability to provide person-centered care. This study explored the relationship between clinical judgment ability and person-centered care among intensive care unit (ICU) nurses, emphasizing how the ICU nursing work environment moderates this relation.

Methods

A cross-sectional survey was conducted between September 4 and September 18, 2023, with 192 ICU nurses recruited from four general hospitals with a convenience sample (valid response rate = 97.4%). Participants completed online self-report structured questionnaires. The collected data were analyzed using hierarchical multiple regression and PROCESS macro Model 1, with a 95% bias-corrected bootstrap confidence interval to verify moderating effects.

Results

Clinical judgment ability (β = .24, p < .001) and ICU nursing work environment (β = .50 p < .001) were found to be significant predictors of person-centered care. These two predictors explained the 47.0% of person-centered care in the final hierarchical regression model. Additionally, Clinical judgment (B = 0.28, p < .001, Boot. 95%CI = 0.13~0.42) and the ICU nursing work environment (B = 0.41, p < .001, Boot. 95%CI = 0.30~0.52) positively affected person-centered care, and the interaction term of clinical judgment and ICU nursing work environment (B = 0.16, p = .026, Boot. 95%CI = 0.02~0.30) also positively affected person-centered care. The moderating effect was particularly significant when the ICU nursing work environment score was 2.90 points (below 14.6%, above 85.4%) or higher on a scale of 1–5 and As the ICU nursing work environment score increased, the positive moderating effect also increased.

Conclusions

The ICU nurses’ clinical judgment ability positively affected person-centered care, and the nursing work environment moderated the relationship between clinical judgment ability and person-centered care. Therefore, strategies for enhancing person-centered care among ICU nurses should focus on developing educational programs to improve clinical judgment ability and implementing comprehensive efforts to effectively improve and manage the nursing work environment.
The influence of workload on muscle fatigue, tissue properties, and postural stability in older and younger workers
Authors: Ducas Julien , Mathieu Janny , Drouin Michael , Sobczak Stéphane , Abboud Jacques , Descarreaux Martin
Published: January 2025

Demographic aging and extended working lives have prompted interest in the physiological changes that occur with age, particularly in the lumbar spine. Age-related declines in muscle quality and intervertebral disc alterations may reduce muscular endurance, strength, and postural stability, potentially increasing the risk of musculoskeletal injuries in older workers. As experienced workers play an important role in addressing labor shortages, understanding the impact of age-related physiological changes on the biomechanical properties of the lumbar spine is key to ensure safe and sustainable employment for aging individuals. This study aimed to compare the impact of daily work-related physical efforts on lumbar muscular endurance and fatigue, spine tissue properties, and postural stability between older and younger workers. A total of 40 participants, 20 in Group 1 (young workers: ≤50 years; mean age: 28.89 ± 7.23) and 20 in Group 2 (older workers: >50 years; mean age: 59.40 ± 5.29) were recruited. Measurements taken at the beginning and end of the workday included lumbar muscle endurance, maximal voluntary contraction, disc height and postural stability. Age groups were compared using repeated measures ANOVA across the two measurement times. No significant interaction between age and time of day was observed, indicating that, for similar workload, both age groups experienced similar changes. Despite age-related effects on maximal force production and postural stability, incorporating weight as a covariate revealed that these differences were partially explained by the weight discrepancy between older and younger workers. The study suggests that age may not be the primary determinant of the impact of a workday on older workers.
Unravelling the complexity of the relationship between social support sources and loneliness: A mixed-methods study with older adults
Authors: Sánchez-Moreno Esteban , Gallardo-Peralta Lorena Patricia , Rodríguez-Rodríguez Vicente , de Gea Grela Pablo , García Aguña Sonia
Published: January 2025

Loneliness is an increasingly significant social and public health issue in contemporary societies. The available evidence suggests that social support is one of the key psychosocial processes for the reduction and prevention of loneliness. This study investigated the role played by sources of social support in the experience of social and emotional loneliness, identifying seven sources of support split between family (spouse/partner, children, grandchildren, siblings) and non-family (friends, neighbours). The study population comprised people aged 65 years and over living in Spain, with a partner (without cohabiting children), alone or in a nursing home. A mixed-methods approach was used, combining data from a survey involving 887 participants (quantitative phase) and data from semi-structured interviews with 30 older adults (qualitative phase). The relationship between the various sources and loneliness was analysed using structural equation modelling (SEM) for the survey data and thematic analysis for the qualitative information. The results from both phases of the study suggest different association dynamics between sources of social support and the social and emotional dimensions of loneliness. Lower levels of emotional loneliness were related to support from the following sources: spouse, children, grandchildren, siblings and friends. Lower levels of social loneliness were related to support from the following sources: spouse, grandchildren, siblings and friends. In contrast, greater levels of emotional loneliness were related to support from neighbours and greater levels of social loneliness were related to support from children. The findings of this study contribute to a better understanding of the association between social support and loneliness and suggest that interventions aimed at reducing loneliness could be more effectively targeted by considering the specific effects of support derived from different sources.
Gender disparities in application and admission to the medical residency program in Peru: A cross sectional study from 2016 to 2023
Authors: Medina-Neira Daniel , Caira-Chuquineyra Brenda , Fernandez-Guzman Daniel
Published: January 2025

Objective

To investigate gender disparities in applications and admissions to the medical residency programs in Peru, focusing on differences in application and admission proportions between male and female.

Methods

We conducted a cross-sectional study to assess the proportions of female applicants and admissions to medical residency programs in Peru from 2016 to 2023. Bayesian multilevel linear models were employed, incorporating random intercepts and slopes by specialty to account for variability across specialties. This approach provided initial proportions of female in 2016 (intercepts) and annual percentage changes (beta coefficients) for each specialty. A multilevel Poisson regression model with robust variance was used to determine if being female was associated with higher admission frequency.

Results

Of the 48,013 applicants, 48% were considered female applicants. Most specialties exhibited an increasing trend in female applicants (+0.2% to +2% annually), except for Family Medicine, Hematology, Pediatric Neurology, and Pathological Anatomy (-0.6%, -0.6%, -0.7%, and -0.9% annually, respectively). The specialties with the highest proportions of female admissions were in Physical Medicine and Rehabilitation (71.9%), Dermatology (71.2%), and Pathological Anatomy (71.2%). In contrast, the lowest proportions were observed in Neurosurgery (18.9%), Thoracic and Cardiovascular Surgery (17.7%), and Urology (15.6%). Declining trends in female admissions were noted in Family Medicine, Hematology, and Pathological Anatomy (-0.6%, -0.6%, and -0.8% annually, respectively). In addition, being female was associated with an 18% lower probability of admission to the medical residency program (prevalence ratio: 0.82; 95% CI: 0.78–0.85; p-value: <0.001).

Conclusion

This study identified persistent gender disparities in medical residency programs in Peru, with female applicants facing reduced probabilities of admission and exhibiting specialty-specific trends from 2016 to 2023.
Freshwater dependent livelihood assessment of coastal households in the southwest of Bangladesh
Authors: Khan Md. Shohel , Paul Shitangsu Kumar
Published: January 2025

A crisis in freshwater supplies is now one of the major problems threatening the livelihoods of people living in the coastal regions of Bangladesh. This scarcity of freshwater is inextricably linked to people’s occupations and various forms of capital. This phenomenon intensifies the risk and vulnerability of households and determines their position and power dynamics with reference to caste, religion, community standing and social status. This study used the livelihood assessment index (LAI) to evaluate five livelihood capitals and current livelihood strategies of three purposefully selected coastal regions of Bangladesh. In total, 338 respondents were selected based on simple random sampling method. They were proportionately distributed through multistage samplings selected from Bagerhat, Khulna and Satkhira Districts named, respectively, shoreline (Rajoir), interim (Gangarampur) and inland (Ganapatipur). Data were collected through a semi-structured self-administered questionnaire where (sub)indicators (52/29) were adapted from previous studies and analyzed using SPSS. The study revealed definitive human and natural trends (shoreline>interim>inland). Physical, social and financial capital indices were defined as: inland>interim>shoreline; interim>inland>shoreline; interim>shoreline = inland, respectively. The result found that human capital indicators, quality of education (.472) and water crisis experience (.647) were higher in the shoreline area than the interim and the inland. Natural capital indicators, freshwater availability (.342), fertility of agricultural land (.663), water sufficiency (.334) and access to open sanctuary (.777) were also higher in the shoreline area. LAI highlighted a tendency to increase (.323 < .342 < .344) from the shoreline to the inland area and reported as poor (shoreline) and moderate (interim and inland). The respondents employed different livelihood strategies such as changing occupations over time, changing their agriculture or farming patterns, harvesting rainwater, and increasing their dependence on surface water. Finally, the findings of this research will benefit the households, policymakers and development organizations to formulate policies and projects along the entire coastal regions of Bangladesh.
Efficacy and safety of rituximab in children with steroid- and calcineurin inhibitor-dependent nephrotic syndrome: a systematic review of randomized controlled trials
Authors: Sharon Sharon , Nadhifah Nadhifah , Heriawan Timotius Ivan , Rahmatika Nadya , Zahara Nadia Eva , Purnomo Athaya Febriantyo , Lazarus Gilbert
Published: January 2025

Background Efficacy of rituximab in the management of idiopathic nephrotic syndrome in children is well-established, however there is limited evidence of its efficacy in children with steroid- and calcineurin inhibitor-dependent nephrotic syndrome (CNI-SDNS).
Objective To investigate the efficacy and safety of rituximab in children with CNI-SDNS.
Methods We conducted a comprehensive search for relevant RCTs in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Google Scholar. Eligible RCTs were included, assessed for risk of bias using the Revised Cochrane risk-of-bias tool for randomized trials, and summarized narratively.
Results A total of five RCTs (299 children) were included in the review. Rituximab was effective in maintaining remission and preventing relapse in pediatric CNI-SDNS patients, in a manner potentially superior to conventional therapy. Furthermore, rituximab successfully resulted in a higher rate of steroid and CNI withdrawal, along with prolonged drug-free period. However, the benefits of rituximab in children with focal segmental glomerulosclerosis (FSGS) remains equivocal. The drug was generally well-tolerated, both in the short-term and long-term, with a low incidence of adverse events and infusion reactions, typically of mild and reversible nature.
Conclusion Rituximab appears to be effective and safe in treating children with CNI-SDNS, offering potential benefits in reducing dependence on steroids and CNIs. Larger trials comparing the effectiveness of rituximab specifically between children with minimal change disease (MCD) and FSGS are warranted to further validate and strengthen our findings.
Virtual learning due to covid-19 pandemic and body weight changes in children aged 6-12 years
Authors: Aulia Nadhira Haliza , Santoso Andintia Aisyah , Ramadhanty Mutiara , Wirawan Bintang , Soesanti Frida
Published: January 2025

Background The COVID-19 pandemic has led to school closures and virtual learning implementation. The situation has affected children's lifestyles and created an obesogenic environment.
Objective To evaluate the impact of virtual learning during the pandemic on body weight changes in children.
Methods This cross-sectional study was conducted on 6-12 years age children who experienced virtual school learning in Jakarta, Indonesia. Parents or guardians were asked to complete an online questionnaire about lifestyle changes and children's anthropometric data both before and during the virtual learning period. Changes in the weight-for-age Z-score (WAZ) and BMI Z-score (BMIZ) were analyzed using the Wilcoxon signed-rank test.
Results A total of 206 children were assessed. There was a significant relation between virtual learning due to the COVID-19 pandemic and WAZ and BMIZ changes among children aged 6-12 years. Approximately 64% of the children experienced WAZ decrement (P value = 0.000), and 77.1% experienced BMIZ decrement (P value = 0.000).
Conclusion This study do  not align with existing studies' indicating that the pandemic lead to weight gain in children. Instead, the results shows  that virtual learning period causes both WAZ and BMIZ to decrease.
Improving stunting prevention program through community healthcare workers training and home-based growth monitoring: A quality improvement model
Authors: Miranda Adriana Viola , Nugraha Ryan Rachmad , Sirmareza Trio , Rastuti Maritta , Asmara Rindang , Astuti Sri Puji , Nasytha Safarah Risvie , Petersen Zack
Published: January 2025

Background Over 1.5 million community healthcare workers (CHWs) work in pos pelayanan terpadu (posyandu) in Indonesia. They are in charge of growth monitoring and counseling, as part of a community-based stunting prevention program. Recent literature suggests that the program requires quality improvements to maximize its potential.
Objective To understand the impacts of a quality improvement model comprising capacity building for CHWs and home-based growth monitoring using smart charts on posyandu performance, particularly related on its stunting prevention components.
Methods This cross-sectional study was conducted in two rural villages in Lombok, Indonesia in May 2023. We interviewed 130 CHWs and 317 mothers with children under-five with a pre-validated questionnaire on posyandu performance that was developed using an input-process-output framework. We evaluated the CHWs dan mothers performances in the height measurement and counseling process.
Results Both CHWs and mothers perceived performance improvements in the height measurement and counseling processes, with statistically significant differences between pre- and post-intervention performance scores for height measurement [mean differences of 0.38 points; 95%CI 0.188 to 0.566; P<0.000 (CHWs) and 0.276 points; 95%CI 0.469 to 0.846; P<0.000 (mothers)]; for counseling [mean differences of 0.285 points; 95%CI 0.149 to 0.42; P<0.001 (CHWs) and 0.142 points; 95%CI 0.098 to 0.186; P<0.000 (mothers)]. Performance improvements were also found across all posyandu components, including those related to stunting.
Conclusion Capacity building for CHWs and home-based growth monitoring using smart charts are beneficial in improving community-based stunting prevention programs.
ACG Clinical Guideline: Diagnosis and Management of Eosinophilic Esophagitis
Authors: Dellon Evan S. , Muir Amanda B. , Katzka David A. , Shah Shailja C. , Sauer Bryan G. , Aceves Seema S. , Furuta Glenn T. , Gonsalves Nirmala , Hirano Ikuo
Published: January 2025

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus. It is diagnosed in the setting of symptoms of esophageal dysfunction and an eosinophilic predominant infiltrate in the esophagus. The condition is rapidly increasing in incidence and prevalence and is commonly encountered in gastroenterology and allergy practices, emergency departments, and primary care settings. Over the past decade, there have been paradigm shifts in disease diagnosis and management, increases in knowledge about EoE risk factors, natural history, and pathogenesis, and development of validated outcome metrics. This updated American College of Gastroenterology Clinical Guideline uses Grading of Recommendations, Assessment, Development, and Evaluation methodology to make recommendations across domains of diagnosis, treatment, monitoring and assessment of response, and pediatric-specific considerations. Proton pump inhibitors, topical steroids, empiric diet elimination, a biologic, and esophageal dilation are all recommended treatments; feeding therapy is used adjunctively in children with food aversion or feeding dysfunction. Monitoring with clinical, endoscopic, and histologic assessments is recommended to assess for treatment response and follow patients over time with maintenance therapy. When evaluating and following patients with EoE, consideration should be given to assessing and controlling both the inflammatory and fibrostenotic aspects of disease.
Continuing Medical Education Questions: January 2025
Authors: Horsley-Silva Jennifer
Published: January 2025

Article Title: ACG Clinical Guideline: Diagnosis and Management of Eosinophilic Esophagitis
Innovation of the Internship Program and Its Implications for the Soft Skill Development of Prospective Islamic Religious Education Teachers at Sunan Kalijaga State Islamic University, Yogyakarta
Authors: Sukiman  , RR. Umi Baroroh  , Aninditya Sri Nugraheni  , Abdulrahman Sama-alee
Published: January 2025

Purpose – The objectives of this study are (1) to analyze the innovation in the implementation of internship activities at FITK and (2) to analyze the impact of internships on the soft skill development of prospective PAI teachers.
Design/methods/approach – This study is qualitative research. The background of the research is the PAI Study Program, Faculty of Tarbiyah Sciences, UIN Sunan Kalijaga Yogyakarta. The informants of this research are four (4) laboratory managers, four (4) field supervisors, and 14 students of the PAI Study Program at UIN Sunan Kalijaga Yogyakarta. Data collection techniques used in-depth interviews, FGDs, and documentation. Data analysis techniques included the stages of data condensation, data display, and concluding/verification. The validity test of the data used a triangulation technique, which included two ways, namely source triangulation and technique.
Findings – First, the innovation of the Integrative Internship program at the Faculty of Tarbiyah and Teacher Training has been applied in the form of giving students more freedom to choose a place and formulating the type and form of internship according to the conditions and needs in the field where they are interning. Second, implementing the Integrative Internship program has had advantages in developing students' soft skills. The developed soft skills have included six types, namely communication and relationship-building skills, critical thinking and problem-solving skills, teamwork skills, leadership skills, stress management, and creativity.
Research implications/limitations – Implementing the integrative independent internship program has provided broad authority to students. This authority has implications for developing students' soft skills. Therefore, the granting of this authority can be continued in the future. Improvements must be made by optimizing the role of DPL, pamong teachers, and schools/madrasas in providing services and guidance more optimally so that the development of students' hard skills and soft skills can be maximized.
SURİYE İÇ SAVAŞI BAĞLAMINDA SAVAŞ VE KATASTROFİK DEĞİŞİM
Authors: Ekici Mustafa
Published: January 2025

13 yılı geride bırakan Suriye iç savaşı, yol açtığı bölgesel ve küresel etkilerle sosyal bilimin hemen her alanında araştırılmaya, tartışılmaya devam etmektedir. Bir sosyal değişim etkeni olarak savaş; teknoloji ve sanayide meydana gelen hızlı gelişmeler, siyasal devrimler, sömürgecilik ve emperyalizmin etkileri ile birlikte temel kritik radikal toplumsal değişme evreleri veya uğraklarından biri olarak tanımlanmaktadır. Bu çalışma, savaşın yarattığı yıkım ve toplumsal değişim ilişkisini katastrofi kavramı ile açıklamaya çalışmaktadır. İç savaşların oluşma dinamikleri, süreleri ve yıkıcılıklarının müdahalelere oldukça duyarlı olduğu, büyük çaplı ve katastrofik değişimlere yol açtığı, çatışma verileri ve müdahaleler/değişimler arasında kurulan korelasyonlarla gösterilmeye çalışılmıştır. Suriye iç savaşı verilerinden elde edilen istatistiklerle, savaşın yol açtığı yıkımın toplumsal değişime etkisi, devlet ve kamusal hizmetler, konut ve şehir alt yapıları gibi farklı parametrelerin maruz kaldığı dramatik yıkımlara ait nicel veriler derlenerek Suriye’deki durum katastrofi kavramı ile ele alınmaktadır.