bluuebunny/crossref_metadata_2025 huggingface dataset:
Becoming a student: Management of transition to higher education among first-generation students’
Authors: Machovcová Kateřina , Škanderová Taťána , Vengřinová Tereza , Zumrová Barbora
Published: December 2024

This study investigates the identity formation of first-generation students during their transition to university in the Czech Republic, while also reflecting the impact of COVID-19-related distance learning. Drawing upon qualitative interviews ( N = 25), the study explores their relationship with their studies. The findings, presented as identity trajectories, highlight how the formation of the student identity is based upon the interaction of multiple factors. The first trajectory represents students who resist the student identity, the significant reason is that they see being a student in opposition to being an adult. The second trajectory encompasses various student journeys: Some experienced significant shifts from their initial approach to studying, including those who overcommitted and burned out, some became distracted and found it hard to focus and still others found themselves unprepared for the demands of university scholarship. The final trajectory depicts students who smoothly adjusted, facilitated by disciplinary interest and lecturer support. Interestingly, the experience of COVID-19 played an unpredictable role, weakening learning engagement for some but providing time to focus on studies for others, shifting their identity trajectories. Overall, the study underscores the importance of tailored drop-out prevention interventions that acknowledge the diverse pathways through which students navigate their identity formation.
Brain Insights and Resolution of Youth Depression through Neurotechnology
Authors: Ejaz Osama , Hasan Muhammad Abul , Ashraf Mishal , Qazi Saad Ahmed
Published: December 2024

As per United Nations, the youth constitute 16% of total population globally whereas World Health Organization reported that one in every seven young individual suffers from depression. Among various tested therapeutic solutions for depression management, the efficacy of transcranial Direct Current Stimulation (tDCS) is still unexplored specifically in young participants. Therefore, this study aims to investigate the cross hemispheric tDCS intervention with a smaller number of sessions in youth population by means of neurological, neuropsychological, and behavioural measures. A total of 50 young participants were recruited comprising of 25 healthy and 25 depressed individuals. The participants of depressed group were randomly assigned to active tDCS and sham tDCS sub groups and completed 150 min of training over 5 consecutive days. The active tDCS group received stimulation of 2 mA over dorsolateral prefrontal cortex. Unlike healthy individuals, depressed participants demonstrated reduced difference of brain activity between eyes opened and closed resting conditions which gets restored following the intervention in active group. Additionally, the tDCS intervention effectively modified the previously reduced alpha asymmetry observed in depressed participants compared to healthy individuals. These neurological outcomes may also be supported with enhanced neuropsychological score of depression (t = 5.47, P < .01) in active group. The attention score (t = 5.14, P < .01) and reaction time (t = 2.22, P = .02) evaluated through behavioural measure of Stroop task were also significantly improved in active group post tDCS intervention. The reported outcomes of the study highlighted the ability of tDCS for prompt and efficient youth depression management.
A pilot survey of breast cancer survivors’ reporting of palpitations to healthcare providers
Authors: Carpenter Janet S , Sheng Ying , Snyder Morgan , Fagan Rileigh , Ekanayake Vindhya , Elkins Gary R
Published: December 2024

Background:

Breast cancer survivors (BCS) may experience cardiotoxicities from chemotherapy and oral endocrine therapy. Although a few studies have documented that palpitations are prevalent and associated with poorer outcomes, there is limited to no information on BCS’ reporting of palpitations to healthcare providers.

Objectives:

To compare BCS who did and did not report their palpitations to a healthcare provider and describe how those who did report palpitations recalled their provider responding.

Design:

This was a cross-sectional, national, electronic, pilot survey of BCS enrolled in the Love Army of Women registry.

Methods:

Participants ( n = 52 with palpitations) completed standardized and investigator-designed questionnaires. Data were analyzed using frequency and descriptive statistics, chi-square tests, and Mann–Whitney tests. Responses to one open-ended question were analyzed using frequency counts and standard content analysis.

Results:

Compared to BCS who reported palpitations to a provider ( n = 34), BCS who did not report their palpitations ( n = 18) were significantly more anxious ( p = 0.002) and more likely to feel palpitations as an irregular heartbeat (70.6% versus 38.9%, p = 0.027). Among the 34 BCS who reported palpitations to a provider, 32 completed the open-ended question. Of these 32 BCS, a majority ( n = 27, 84%) indicated their provider recommended cardiac testing and/or referral to a cardiologist. Most ( n = 24) reported completing testing. Test results included diagnosis of a new arrhythmia or other cardiac abnormality ( n = 11, 46%), receipt of a new prescription ( n = 5, 21%), or normal results ( n = 5, 21%). Five (16%) of the 32 BCS did not receive recommendations for testing or referral and felt their provider normalized or dismissed their symptoms.

Conclusion:

Palpitations are a salient topic for further research and clinical practice recommendations to address cardiac health in BCS.
Learning new words via reading: The influence of emotional narrative context on learning novel adjectives
Authors: Dong Yuzhen , Mak Matthew HC , Hepach Robert , Nation Kate
Published: December 2024

People learn new words in narrative contexts, but little is known about how the emotional valence of the narrative influences word learning. In a pre-registered experiment, 76 English-speaking adults read 30 novel adjectives embedded in 60 short narratives (20 positive, 20 negative, and 20 neutral valence). Both immediately after and 24 hr later, participants completed a series of post-tests, including speeded recognition, sentence completion, meaning generation, and valence judgement. Results showed that participants learned both the novel word form and its meaning. Compared with novel words experienced in the neutral contexts, those read in the emotional contexts (both positive and negative) showed better learning of orthographic form in the immediate post-test, but only those read in the negative context were recognised with greater accuracy in the delayed post-test. Furthermore, the valence of the context was reflected in the word meanings participants generated for each novel word, suggesting that word valence can be inferred from the valence of the contexts. Results from sentence completion and valence judgement were mixed, depending on the task demands. These findings are discussed with reference to theories of affective embodiment and the implications for learning abstract words are considered.
Adsorption of metomorfin hydrochloride and sodium decofane by grafting of polyacrylic acid/grapheme oxide on the gum ghatti
Authors: Dave Pragnesh N , Chopda Lakha V , Kamaliya Bhagvan P
Published: December 2024

Water is directly or indirectly used in the industry for various processes. As a result, it is contaminated with different kinds of impurities. For the healthy life of all creatures on the earth, water should be free from all types of compounds. Various decontamination methods have so far been reported, but the adsorption process has emerged as the best method for the purification of water. An adsorbent named GG- g-P(AA)/grapheme oxide was prepared by free-radical initiator ammonium persulfate. The prepared adsorbent was utilized for the combined adsorption of metomorfin hydrochloride and sodium decofane drugs. Both drugs were efficiently removed from water by GG- g-P(AA)/GO.
Differences between Australian triathlon coaching practices and evidence-based training load management recommendations
Authors: Wells Leighton A. , Bruce Lyndell , Hoffmann Samantha M. , Kremer Peter , Dwyer Dan B
Published: December 2024

Objectives

The training load practices of triathlon coaches are poorly understood. The aim of this study was to explore and describe these practices to create an opportunity to compare their alignment with evidence-based practices.

Design

The study employs an online survey and descriptive statistical analysis to investigate load practices. Method: 63 Australian triathlon coaches with 12 or more months of experience were surveyed. They held tertiary qualifications (27.7%), were AusTriathlon accredited (25.3%) and coached mainly age-group athletes (94%). Coaches’ use of subjective and objective metrics for prescribing, measuring, and monitoring training load and communication frequency with athletes was examined. The survey investigated use of subjective metrics (e.g., s/RPE) and objective metrics (e.g., Time/Distance/Pace) for prescribing and monitoring load, frequency of monitoring sessions, and communication with athletes.

Results

Most coaches prescribe load using subjective metrics (78% of coaches) and objective metrics (76%). Load is measured/monitored by 81% of coaches using objective metrics, with subjective metrics less commonly used (62%). Less than half (43.5%) monitor every session/day, while most monitor load only weekly (51.6%) or monthly (4.8%). Communication about load occurs mostly every 4 weeks (38.7%).

Conclusions

Coaches’ load practices only partially align with evidence-based recommendations. The use of subjective measures to monitor load is not common, neither is the consideration of acute and chronic loads. Many coaches communicate infrequently with their athletes. The potential consequence is health risks to athletes that could be addressed before they are missed. Coaches can make better use of technology to help them manage load.
On the reliability and the optimal replacement policy of a k-out-of-n system in a discrete shock model
Authors: Lorvand Hamed , Nematollahi Alireza
Published: December 2024

In this paper, we consider a [Formula: see text]-out-of-[Formula: see text] system subjected to shocks arriving through a Bernoulli process, that is, the shocks can change from their initial values to only two possible values. Assume that each input shock to the system can lead to the failure of some components. Two scenarios are examined here, in the first scenario it is assumed that at least one component fails with probability one, and in the second scenario we assume that at least one component fails with probability [Formula: see text]. Then, the reliability and an optimal replacement strategy for a [Formula: see text]-out-of-[Formula: see text] system under these scenarios are investigated. With the proposed scenarios, a closed form for the likelihood function for systems in Markovian and non-Markovian regimes are then derived. A model for the preventive replacement policy of the system is also presented. Numerical examples are also given to illustrate the theoretical results.
It’s Not about the Data: Reflections on the Uses and Abuses of Data Collection from an Applied Research Center
Authors: Senter Mary Scheuer
Published: December 2024

Applied social scientists are committed to improving social life through the appropriate use of data. I found in my work with a university-based applied social science research center that clients engage in data collection efforts for a variety of reasons other than a commitment to using the data that result. This reflection is a cautionary tale to encourage applied social scientists to consider ways of promoting meaningful data use and to avoid compromising professional or ethical standards.
Misoprostol: From cervical softening to coronary stiffening
Authors: Teo Zhongyang , Lim Shu Hui , Ng Mingwei
Published: December 2024

Introduction

This case of misoprostol-induced coronary vasospasm demonstrates the rare but potentially serious cardiac-related adverse events which arose from the use of misoprostol in a young healthy adult with no past cardiac history of note.

Case Presentation

A 37-year-old female with a history of idiopathic vasculitis but no known cardiovascular risk factors was administered misoprostol vaginally for an elective outpatient hysteroscopy. She developed typical cardiac symptoms of severe chest pain and her initial electrocardiogram demonstrated changes mimicking an anterolateral ST-elevation myocardial infarction. Fortunately, her symptoms resolved shortly before her presentation to the Emergency Department, and her cardiac troponin levels were within normal limits. She underwent further workup during her inpatient stay in a Cardiology ward which revealed no evidence of coronary artery disease, and she was discharged with the rare diagnosis of misoprostol-induced coronary vasospasm.

Discussion and Conclusion

This case illustrates the importance of physician awareness to patients who present with cardiac symptoms following misoprostol administration. We recommend that misoprostol be administered with caution in patients with vasculitis or traditional cardiovascular risk factors and that these high-risk patients should be counselled for the potential of rare but serious cardiac-related adverse events arising from coronary vasospasm.
Thoracic combined spinal epidural anaesthesia for exploratory laparoscopy and laparotomy (sigmoidectomy, colostomy): The first case in Palestine for the ASA5 patient
Authors: Maree Samah A , Jadou Anoud , Manasra Mahmoud R , Temezeh Khaled , Ibedo Falah
Published: December 2024

Thoracic combined spinal epidural anaesthesia offers the ideal perioperative anaesthesia and analgesia. A 78-year-old female presented to our hospital with a hypertensive emergency, non-ST elevation myocardial infarction and pulmonary effusion. Then the patient had abdominal pain, constipation and vomiting. When examined, there was significant abdominal distention. During a colonoscopy, there was a fungating mass lesion 20 cm from the anal verge. A biopsy was taken and showed intramucosal adenoma within tubulovillous adenoma with high-grade dysplasia. The patient underwent exploratory laparoscopy and laparotomy (sigmoidectomy, colostomy) under thoracic combined spinal epidural anaesthesia at T9–T10 interspinous space. The patient was classified as ASA5 according to the American Society of Anesthesiologists physical status. The guidelines recommend utilizing regional anaesthesia instead of general anaesthesia for compromised elderly patients. In our case, we report the first case in Palestine of an ASA5 patient who successfully underwent abdominal surgery under thoracic combined spinal epidural anaesthesia.
Benefits and drawbacks of videoconferencing in eldercare from care workers’ perspectives
Authors: Mustola Ville , Oinas Tomi , Leinonen Emilia , Taipale Sakari
Published: December 2024

Objective

The purpose of this study is to examine how care workers’ characteristics are related to the perceived benefits and drawbacks of using videoconferencing in the care of older people. The factors chosen for this study are: age, education, perceived information and communication technology (ICT) support, interest in technology, ICT skills and possible prior experience of using videoconferencing tools.

Methods

Our data source was the second wave (2021) of the University of Jyväskylä survey on elder care work ( N = 3607), collected from four large trade unions in Finland. We used a multinomial logistic regression to group respondents according to their experiences of technology use and a path analysis to estimate the effects of care workers’ characteristics and prior experiences on the perceived benefits of videoconferencing tools in eldercare work.

Results

We found that the personal characteristics of a care worker are associated with both the use of videoconferencing and its perceived benefits and drawbacks. In addition, we discovered that prior use of videoconferencing tools, especially in direct care work, affects the perceived benefits of them. Those who have used videoconferencing in direct care work perceive them as more beneficial for both their own work and for clients.

Conclusions

Based on these results, we suggest that healthcare and social welfare organizations pay attention to the characteristics of care workers, especially when estimating the necessary amount of ICT support. More ICT support should be targeted to those with a lower level of education and higher age.
A mixed methods crossover randomized controlled trial exploring the experiences, perceptions, and usability of artificial intelligence (ChatGPT) in health sciences education
Authors: Veras Mirella , Dyer Joseph-Omer , Shannon Holly , Bogie Bryce J M , Ronney Morgan , Sekhon Harmehr , Rutherford Derek , Silva Paulo Goberlânio Barros , Kairy Dahlia
Published: December 2024

Background

Generative artificial intelligence (AI) integrated programs such as Chat Generative Pre-trained Transformers (ChatGPT) are becoming more widespread in educational settings, with mounting ethical and reliability concerns regarding its usage. This paper explores the experiences, perceptions, and usability of ChatGPT in undergraduate health sciences students.

Methods

Twenty-seven students at Carleton University (Canada) were enrolled in a crossover randomized controlled trial study from a Health Sciences course during the Fall 2023 academic term. The intervention condition involved the use of ChatGPT-3.5, whereas the control condition involved using conventional web-based tools. Technology usability was compared between ChatGPT-3.5 and the traditional tools using questionnaires. Focus group discussions were conducted with seven students to further elaborate on student perceptions and experiences. Reflexive thematic analysis was employed to identify themes from the focus group data.

Results

Easiness of learnability for personal use and a perception of quick learnability towards ChatGPT-3.5 were significantly higher, compared to conventional online tools from the Systems Usability Scale. Qualitative results highlighted strong benefits of ChatGPT-3.5, such as being a tool for increased overall productivity and brainstorming. However, students identified challenges associated with reliability and accuracy, and concerns about academic integrity.

Conclusions

Despite the benefits and positive usability of ChatGPT-3.5 identified by students, an explicit need for the development of policies, procedures and regulations remains. An established framework of best practices for the usage of AI within health science education is necessary. This will ensure accountability of users and lead to a more effective integration of AI technologies into academic settings.
Exploring user engagement with real-time verbal feedback from an exoskeleton-based virtual exercise coach
Authors: Maharjan Raju , Mendu Sanjana , Mariani Milton , Abdullah Saeed , Hansen John Paulin
Published: December 2024

Objective

Engaging users during physical exercise is crucial for fostering long-term commitment, however, sustaining that engagement remains a significant challenge. This study explores the design of a voice-enabled exoskeleton-based virtual exercise coach (VEC) that provides real-time verbal feedback to enhance user engagement. The objectives of this study are twofold: (i) to compare user engagement with real-time verbal feedback from both VEC and human exercise coach (HEC) during physical exercise, and (ii) to understand users’ perceptions and gather their recommendations for improving future VEC technologies.

Methods

We developed an exoskeleton-based VEC that delivers real-time verbal feedback on users’ exercise performance. To evaluate its impact on user engagement, we conducted a lab-based mixed-methods study ([Formula: see text]) over a period of 6 weeks comparing users’ engagement with the VEC and HEC using User Engagement Scale (UES) questionnaire and conducted semi-structured interviews to understand users’ perceptions of the VEC.

Results

Participants in this study found the VEC more engaging than the HEC, in terms of focused attention ([Formula: see text]) and perceived usability ([Formula: see text]). Post-interaction interviews revealed that (i) users found the VEC to be engaging, intuitive, easy to use, and convenient; (ii) users perceived the VEC as a valuable training companion that could help reduce the emotional insecurities often associated with going to the gym; and (iii) users expressed a desire for the VEC to have a personality and embodiment that motivates and supports personalized interactions.

Conclusion

Based on our results, we discuss the challenges and implications for designing future voice-enabled VECs that support engaging physical exercises.
Heterogeneity of aerobic fitness changes with exercise training in progressive multiple sclerosis: Secondary, exploratory analysis of data from the CogEx trial
Authors: Motl Robert W , Sandroff Brian M , Hernandez Roberto S , Amato Maria Pia , Brichetto Giampaolo , Chataway Jeremy , Chiaravalloti Nancy D , Cutter Gary , Dalgas Ulrik , DeLuca John , Farrell Rachel , Feys Peter , Filippi Massimo , Freeman Jennifer , Inglese Matilde , Meza Cecilia , Rocca Maria A , Salter Amber , Feinstein Anthony ,   CogEx Research Team
Published: December 2024

Background

There is heterogeneity of aerobic fitness (VO2peak) changes with a standardized exercise training stimulus in the general population (i.e. some participants demonstrate improvements, others no change, and some a reduction in VO2peak).

Objectives

This secondary, exploratory analysis of data examined the heterogeneity of VO2peak responses and possible correlates among persons with progressive multiple sclerosis (PMS) from the CogEx trial.

Methods

CogEx was a multi-site, multi-arm, randomized, double-blinded, and sham-controlled trial undertaken by 11 sites in six different countries. Participants were randomized into one of four conditions with different combinations of exercise training and cognitive rehabilitation including respective sham conditions. The analysis focuses primarily on VO2peak change for the pooled exercise training intervention conditions compared with the pooled sham exercise control conditions.

Results

Waterfall plots for change in VO2peak suggested greater heterogeneity with exercise training than sham, and the proportions of difference in VO2peak change (i.e. improvement/worsening) were significantly different between exercise training and sham conditions( p < 0.05). The multivariable analysis indicated that lower baseline VO2peak ( p < 0.001) was the only statistically significant correlate of increases in VO2peak with exercise training.

Conclusion

Our results highlight the heterogeneity of change in VO2peak with exercise training that is correlated with initial aerobic capacity in PMS, and such results may inform hypothesis testing in future clinical trials of exercise training.
Subxiphoid Insertion of a Pediatric Implantable Pulse Generator in a Neonate With Congenital Complete Heart Block
Authors: Kirk Benjamin P. , Hale Benjamin , Karimi Mohsen
Published: December 2024

Permanent pacemaker placement is often indicated in newborns with congenital complete heart block (CCHB). The disproportionate size between commercially available devices and the neonate can lead to delayed intervention and high postoperative complication rates. Recently, Medtronic developed a Pediatric Implantable Pulse Generator (IPG); a very small single chamber pacemaker requiring a bipolar lead. This case report describes a minimally invasive approach for the implantation of this Pediatric IPG shortly after birth in a 2.32 kg neonate with CCHB.
A Decade of Business and Professional Communication Quarterly: A PRISMA Guided Systematic Review
Authors: Sharma Daneshwar , Pandey Himanshi , Khandelwal Vinay , Walker Robyn C.
Published: December 2024

This study presents a systematic review of the last decade of research published in Business and Professional Communication Quarterly, using PRISMA guidelines and bibliometric analysis. The review analyzes publication and citation trends, key contributors, and emerging themes. The research highlights how the field has evolved in response to global crises, technological advancements, and shifts in social dynamics. By exploring key themes such as virtual team communication, social presence in online learning, and the integration of emerging technologies, the study provides a comprehensive assessment of the journal’s contributions from 2014 to 2024. It also identifies future research directions.
Hypersensitivity Pneumonia Due to Lentil Aspiration: A Rare but Painstaking Pulmonary Illness
Authors: Mollah Md. Abid Hossain , Nahar Jebun , Purakayostho Priya , Tabassum Nabila , Ahmed Tasnima , Khan Sherin , Jashim Sabrina , Chisti Mohammod Jobayer
Published: December 2024

A 7-month-old girl had been suffering from progressively deteriorating pneumonia despite getting multiple courses of broad-spectrum antibiotics as well as anti-fungal drugs for adequate duration. To find out the cause behind this deterioration, the patient underwent thorough clinical and relevant laboratory evaluation including chest radiology & imaging, screening for primary immune deficiency disorders (PID), cystic fibrosis, tuberculosis, invasive fungal pneumonia, congenital heart disease, covid pneumonia, TORCH etc. but failed to solve the mystery. Upon further detailed re-evaluation, it was discovered that the child had a history of being forcefully fed lentil-based khichuri (a rice-lentil mixed dish) during her weaning process and diagnosis was finally confirmed as hypersensitive pneumonia due to lentil aspiration by a high level of IgG, specific to lentil antigen. Treatment was commenced with prednisolone resulting in significant improvement in her clinical and radiological condition within 72 hours.
The missing pieces: an investigation into the parallels between Charles Bonnet, phantom limb and tinnitus syndromes
Authors: Baffour-Awuah Kwame A. , Bridge Holly , Engward Hilary , MacKinnon Robert C. , Ip I. Betina , Jolly Jasleen K.
Published: December 2024

Charles Bonnet syndrome (CBS) is a condition characterised by visual hallucinations of varying complexity on a background of vision loss. CBS research has gained popularity only in recent decades, despite evidence dating back to 1760. Knowledge of CBS among both the patient and professional populations unfortunately remains poor, and little is known of its underlying pathophysiology. CBS parallels two other better-known conditions that occur as a result of sensory loss: phantom limb syndrome (PLS) (aberrant sensation of the presence of a missing limb) and tinnitus (aberrant sensation of sound). As ‘phantom’ conditions, CBS, PLS and tinnitus share sensory loss as a precipitating factor, and, as subjective perceptual phenomena, face similar challenges to investigations. Thus far, these conditions have been studied separately from each other. This review aims to bridge the conceptual gap between CBS, PLS and tinnitus and seek common lessons between them. It considers the current knowledge base of CBS and explores the extent to which an understanding of PLS and tinnitus could provide valuable insights into the pathology of CBS (including the roles of cortical reorganisation, emotional and cognitive factors), and towards identifying effective potential management for CBS.
Failure to rescue—rapid response systems: A making healthcare safer rapid review
Authors: Winters Bradford D , Rosen Michael , Sharma Ritu , Zhang Allen , Bass Eric B
Published: December 2024

Background

Rapid response systems (RRSs) were developed to respond to early warnings of unexpected deterioration, but their effectiveness may be limited by factors impacting RRS activation (afferent limb) or response (efferent limb). Despite decades of RRS implementation, patients still experience unrecognized deterioration with associated worse outcomes.

Methods

This rapid review used modified search strategies to focus on the most valuable studies performed in the United States. Citations were screened by one reviewer with artificial intelligence as a second reviewer at the title/abstract review stage. The full text of eligible articles was then reviewed by a single team member to confirm eligibility. One reviewer completed the data abstraction, and a second reviewer checked the first reviewer's abstraction.

Results

Three categories of interventions were identified: implementation of a new RRS, and modifications to the afferent limb and/or efferent limb of an existing RRS. RRSs may have a large impact in reducing in-hospital mortality and an even greater impact in reducing cardiorespiratory arrest on hospital general wards in adults but the effect is unclear in children. Their impact on unanticipated intensive care unit admission is unclear. Modifications to the afferent and/or efferent limb were associated with a reduction in mortality and the incidence of cardiorespiratory arrest for adults.

Conclusions

RRS may have a large beneficial effect on hospital mortality and in-hospital cardiorespiratory arrest, but the strength of the evidence is low due to methodological weaknesses of the studies. Innovations in afferent and efferent limb structures show promise for increased benefit.
Scaling up mental health service provision through multisectoral integration: A qualitative analysis of factors shaping delivery and uptake among South Sudanese refugees and healthcare workers in Uganda
Authors: Ndlovu Jacqueline N. , Ouizzane Soukaina , Leku Marx R. , Okware Kenneth K. , Sentongo Hafsa , Nyangwen Bathsheba , Upadhaya Nawaraj , Skovdal Morten , Augustinavicius Jura L. , Tol Wietse A.
Published: December 2024

Background

There is a growing need for mental health and psychosocial support (MHPSS) interventions that can feasibly be provided to larger groups of people, particularly in humanitarian settings. However, scaling up mental health interventions is notoriously difficult. There are therefore growing calls for integrating mental health outside traditional health structures, both to increase reach and to address social determinants of mental health. The objective of this study is to explore barriers and facilitators of Self-Help Plus (SH+), an MHPSS innovation implemented through multisectoral integration. We explore delivery and uptake at the scale of SH+ and aim to understand intervention adaptation needs when integrating SH+ within other health and non-health sectors in Uganda.

Method

We conducted a qualitative study using in-depth interviews in two phases: first for a needs and resource assessment, and second for a process evaluation. We conducted 50 in-depth interviews with BRAC Uganda and MoH partner staff, intervention facilitators, and target impact group members between July and December 2022. A thematic network analysis process was used to identify barriers and facilitators of SH+ delivery and uptake at scale in Uganda.

Results

We identified five major factors that should be considered when scaling through multisectoral integration, namely: (1) adaptivity, (2) funding mechanisms, (3) social capital, (4) participation, and (5) sustainability. Within these factors, there were varying degrees to which a factor was a facilitator or barrier, depending on participants’ perceptions of the intervention.

Conclusions

Our findings suggest that multisectoral integration of SH+ into sectors both inside and outside of health may be a viable means to scale SH+ and increase reach. However, funding, partnerships, co-creation, and adaptability need to be further explored to facilitate better and more sustainable integration.
Sperm morphology value in assisted reproduction: dismantling an enigma and key takeaways for the busy clinician
Authors: Wyns Christine , Vogiatzi Paraskevi , Saleh Ramadan , Shah Rupin , Agarwal Ashok
Published: December 2024

The ideal morphology of the sperm cell was initially described based on the characteristics of sperm able to migrate through the endocervical canal assuming these had the best fertilization potential. Sperm morphology assessment has moved over the years toward stricter criteria based on the findings from studies that underline its value in successful reproductive outcomes. While treatment options are clear for some conditions related to abnormal sperm morphology, the value of sperm morphology in assisted reproduction requires further investigation. The objective of this review is to offer care providers updated guidance for choosing appropriate treatment strategies based on sperm morphology assessment and morphological deviations. Issues to be considered for a reliable determination and interpretation of sperm morphology using the current thresholds and criteria are discussed. In addition, key knowledge on morphological abnormalities relevant to the clinical care of infertile patients, distinguishing between monomorphic and polymorphic forms as well as the isolated or non-isolated occurrence of teratozoospermia in semen is presented. Furthermore, the impact of impaired morphology on assisted reproductive technique outcomes is summarized in light of the latest research.
The interplay between students’ home literacy environment, reading attitudes and comprehension: a serial mediation analysis using PIRLS 2021-data
Authors: Claes Renée , Laga Jana , Denies Katrijn , Bleukx Nele , Dockx Jonas , Van Keer Hilde , Aesaert Koen
Published: December 2024

Background

Providing a rich home literacy environment (HLE) is considered to contribute to the development of students’ reading comprehension. However, less research attention has been given to the underlying mechanisms that influence this relationship, including potential mediating characteristics. The present study aims to assess whether students’ reading enjoyment, reading motivation and reading frequency mediate different aspects of the active and passive HLE and reading comprehension of Grade 4 students in Flanders (Belgium).

Methods

This study uses the Flemish data of the Progress in International Reading Literacy Study (PIRLS) 2021. Participants were 5114 students from 141 schools and their parents. The hypotheses were tested using a serial mediation model implemented through structural equation modelling.

Results

We observed different associations between specific aspects of the HLE and fourth graders’ reading comprehension. Both an active reading climate and the amount of books at home were found to be positively associated with students’ reading comprehension. We found no contributions of parents’ reading enjoyment and their own reading frequency to their child’s reading comprehension. We found significant indirect effects of both the active reading climate and parents' reading enjoyment on students' reading comprehension, mediated through students' reading enjoyment, motivation and reading frequency. Additionally, we found evidence for an indirect pathway from the amount of books at home to students' reading comprehension, mediated by their reading frequency.

Conclusions

Our findings highlight the importance of conceptualizing HLE as a broad construct consisting of multiple components (e.g., activities, beliefs, availability of literacy-related resources at home), as these aspects are related to students’ reading comprehension development in different ways.
Phacovitrectomy vs. consecutive vitrectomy for idiopathic macular holes: short and long-term outcomes and OCT image quality assessment
Authors: Prabhu Vishma , Gandhi Priyanka , Kathare Rupal , Godani Kanika , Hande Prathiba , Yadav Naresh Kumar , Chhablani Jay , Venkatesh Ramesh
Published: December 2024

Purpose

To compare short- and long-term anatomical, functional, and refractive outcomes between combined phacovitrectomy (PVS) and consecutive vitrectomy (CVS) for idiopathic macular holes (MHs). Also, to evaluate the role of preoperative optical coherence tomography (OCT) image quality in guiding surgical selection.

Methods

This retrospective study analyzed 183 phakic MH eyes operated between 2012 and 23, with patients divided into PVS and CVS groups. Demographic and ocular data, MH features, visual acuity (VA), refraction changes and postoperative outcomes, and follow-up details were collected. Pre- and post-operative OCT scans were evaluated for MH characteristics, OCT image quality, and surgical outcomes at short-term (≤ 3 months) and long-term (≥ 5 years) intervals.

Results

The study included 144 eyes in PVS group and 39 in CVS group. Median follow-up duration was 16 months for PVS group and 72 months for CVS group (p < 0.001). Both groups showed significant VA improvements and comparable MH closure rates at short-term follow-up. However, CVS group had significantly better postoperative VA at short-term (p = 0.001) and long-term (p = 0.017) intervals. The preoperative OCT quality index did not significantly differ between groups and was ineffective in assessing cataract grade or guiding surgical decisions. Both groups experienced a myopic refractive shift, with a higher magnitude in the PVS group (p = 0.04). Postoperative complications were similar between the groups.

Conclusion

CVS achieves better long-term VA than PVS following MH repair, despite similar anatomical outcomes. Preoperative OCT quality index is not effective for guiding surgical decisions, and careful refractive planning is essential, especially for PVS patients, to address postoperative myopic shifts.

Clinical trial registration number

Not applicable.
The safety of valproic acid treatment in children with epilepsy: a retrospective real-world research
Authors: Chen Xiner , Zhang Yujie , Liu Xinan , Tan Ruoyu , Cao Dezhi , Chen Li , Hu Yan , Li Bing , Huang Tieshuan , Zhou Qiang , Wen Jialun , Liao Jianxiang
Published: December 2024

Background

Liver damage, coagulopathy, hyperammonemia, fracture, menstrual disorder and amenorrhea are the most concerned adverse drug reactions of valproic acid (VPA). This study was aimed to retrospectively investigate the incidence of adverse drug reactions of VPA in the real world and its association with the age of patients and duration of treatment in order to obtain the safety data of VPA in children with epilepsy.

Methods

A total of 1943 patients diagnosed as epilepsy by the Pediatric Neurology Department of Shenzhen Children’s Hospital between December 2013 and December 2023, were included in the study. They received VPA as an initial treatment, and had followed up examinations over a time span of at least two years focusing on the adverse drug reactions of VPA.

Results

There was no significant difference in the incidence of liver damage, coagulation test abnormalities, and nasal bleeding during VPA monotherapy (30–90 days, 90–180 days, and > 2 years). Adolescent female patients (first visit age ≥ 12 years) showed no significant difference in the incidence of adverse reactions and abnormal ultrasound of the reproductive system pre- versus post-treatment at the first visit, similar for those below 12 years. However, laboratory blood tests revealed significantly age-dependent changes in certain biochemical markers. Two patients stopped VPA treatment due to thrombocytopenia and ovarian cystic mass comorbid with endometrial hyperplasia, recovering after VPA withdrawal.

Conclusions

The initial monotherapy of VPA is generally safe in children with epilepsy of all age ranges. In the real world, VPA does not increase the risk of liver damage, coagulation disorder, elevated blood ammonia, fractures, or low serum sodium, but may significantly decrease the platelet count at 3, 6, 12, and 24 months of treatment. There is no evidence showing that VPA may increase the incidence of impairment of adolescent female reproductive system. Among children under 1 year old, it is recommended to monitor the levels of serum ammonia and aspartate aminotransferase carefully.

Trial registration

ChiCTR2300075115.
Exploiting universal nonlocal dispersion in optically active materials for spectro-polarimetric computational imaging
Authors: Wang Xueji , Van Mechelen Todd , Bharadwaj Sathwik , Roknuzzaman Md , Bao Fanglin , Rahman Rajib , Jacob Zubin
Published: December 2024

Recent years have seen significant advancements in exploring novel light-matter interactions such as hyperbolic dispersion within natural crystals. However, current studies have predominantly concentrated on local optical response of materials characterized by a dielectric tensor without spatial dispersion. Here, we investigate the nonlocal response in optically-active crystals with screw symmetries, revealing their lossless, super-dispersive properties compared to traditional optical response functions. We leverage this universal nonlocal dispersion, i.e. the dispersion of optical rotatory power, to explore a novel spectral de-multiplexing scheme compared to conventional gratings, prisms and metasurfaces. We design and demonstrate an ‘Nonlocal-Cam’ - a camera that exploits nonlocal dispersion through sampling of polarized spectral states and the application of computational spectral reconstruction algorithms. The Nonlocal-Cam captures information in both laboratory and outdoor field experiments which is unavailable to traditional intensity cameras - the spectral texture of polarization. Merging the fields of nonlocal electrodynamics and computational imaging, our work paves the way for exploiting nonlocal optics of optically active materials in a variety of applications, from biological microscopy to physics-driven machine vision and remote sensing.
Validation and Utility of Drug-Nutrient Interaction and Dietary Supplement Mechanistic Activity in the Natural Medicines Database
Authors: Langley Blake O. , Rillamas-Sun Eileen , Huang Yuhan , Indorf Amy , Robles Michael , Feaster Rachel , D'Addario Lia , Ergas Isaac J. , Roh Janise M. , Kushi Lawrence H. , Greenlee Heather
Published: December 2024

PURPOSE

The increasing use of dietary supplements by patients with cancer and other chronic diseases requires the systematized review of potential interactions between prescription drugs and nutrients from supplements by health care and clinical research teams. Dietary supplement interaction databases are positioned to fill a gap in quantifying potential risks for patients, although none have been assessed for reliability in data interpretation. The NatMed database, a source for comprehensive reports on mechanistic and safety data for dietary supplement ingredients, was evaluated for use in future investigations.

METHODS

Data from NatMed were retrieved using licensed end points for ingredient monographs with drug-nutrient interactions with doxorubicin across five pharmacokinetic and metabolic pathways, and for ingredient monographs with antioxidant activity. Interactions between dietary supplements and doxorubicin treatment and antioxidant monographs were independently reviewed and characterized by clinical pharmacists. Cohen's K was used to measure interrater reliability and the degree of agreement between pharmacists.

RESULTS

Three hundred fifteen potential interactions with doxorubicin (n = 115 monographs) and 455 other antioxidant ingredients were identified and reviewed by clinical pharmacists. There was substantial to near-perfect agreement for drug-nutrient interactions with doxorubicin (Cohen's K = 0.64-0.85) and for antioxidants (Cohen's K = 0.84). A small proportion of retrieved monographs were not validated by the clinical pharmacists for interactions with doxorubicin (n = 20 occurrences, 6.4%) or for antioxidant activity (n = 28, 6.2%).

CONCLUSION

A high degree of reliability in data on dietary supplement interactions with doxorubicin and mechanisms of action suggests NatMed may be a dependable source of data for future investigators. Additional procedures including independent data validation and use of multiple dietary supplement interaction databases will strengthen the quality of findings in future studies.
First Reported Case of Hemoglobin Graz in the United States: Implications for Misleading Hemoglobin A1c Results
Authors: Miller Luke , Maddahi Yaniv , Shelly Matthew , Nanda Sudip , Ishaq Arastu Mohammad
Published: December 2024

Routine serum studies in a female patient with sustained prediabetic glycated hemoglobin A1c (HbA1c) levels, controlled on metformin, yielded an unexpected finding: an elevated HbA1c value of ≥14.9% (≥139 mmol/mol) (normal reference range, <5.7% to <39 mmol/mol). Estimated average glucose (EAG) (normal reference range, <126 mg/dL to <7 mmol/L) is a linearly corresponding blood glucose value calculated from HbA1c measurements that reflects the average glycemic status over the preceding 3 months. Caution must be used when the EAG provided by the HbA1c does not align with blood glucose values obtained around the same period. Our patient carries a rare heterozygous pathogenic variant affecting the β subunit called hemoglobin Graz (Hb Graz), characterized by a histidine for leucine substitution, resulting in clinically silent Hb abnormalities. Individuals without diabetes carrying the Hb Graz pathogenic variant exhibit significantly higher HbA1c values when analyzed by high-performance liquid chromatography. Alternative methods of quantifying glycemic control are suggested if the possibility of a confounding variable exists, such as when a HbA1c-blood glucose mismatch occurs or unexplainable HbA1c levels are detected.
Social Democratic Hauntings: On Swedish Dissociation and Melancholia
Authors: Bao Viola
Published: December 2024

Once seen as a Western frontrunner of social progressivism and equality, Sweden has undergone momentous changes since the aggressive neoliberal dismantling of the postwar universal welfare state model started in the 1980s; today it is a stronghold of the European far right and has one of the highest levels of wealth inequality in the world. This essay analyzes the contemporary post–social democratic political landscape in Sweden, arguing that it is characterized by a state of both dissociation and melancholia, interlinked affective responses to the intensifying social pressures and structural crises the country faces. While the Right mobilizes racial melancholia to conjure up the stability of the past, significant segments of the political spectrum—including the Left—have long been demobilized by the stranglehold of a form of tragic optimism produced by a post-1991 fusion between the twentieth-century social democratic construction of Swedish exceptionalism and a neoliberal Fukuyaman triumphalism that disavows history and historical change. The essay traces this crisis of historical consciousness back to the hegemony of the Swedish Social Democratic Party in the twentieth century and the genre of folkhemmet nationalism that underpinned its project and whose affective afterlives continue to inform the political impasses we see today.
Introduction: Organizing Care in Sweden's Crisis
Authors: Mason Elliot C.
Published: December 2024

In this introduction to the dossier, Elliot C. Mason gives an overview of the rise and fall of the welfare state in Sweden throughout the twentieth and twenty-first centuries, from the initial protests and mass demands that led to reforms and a general program of state care, to the privatization of health care and the imposition of private capital as the mediator of all relations of care. Despite the sharp neoliberal turn in its politics since the 1980s, Sweden's international reputation as the ideal welfare state somehow remains. Here Mason studies the ways insurgent groups in Sweden respond to and exceed these contradictory deployments of brutality by continuing to bring out the foundational care of social life. Following Cedric Robinson's theorization of “the ontological totality” as the social modalities in which Black life survives despite the obsessive erasure of Black lives, the author here posits “the caring totality” as the rubric under which insurgent practices of care continue to provide survival despite and against privatization.