bluuebunny/crossref_metadata_2025 huggingface dataset:
HbA1c changes in the first year post-kidney transplant and associated risk factors in a Saudi cohort
Authors: Arabi Ziad , Alghamdi Hazim S. , Arabi Tarek , Shafqat Areez , Elwy Badr , Sabbah Belal
Published: November 2024

Background:

There is limited data about the risk factors of clinically significant glycosylated hemoglobin (HbA1c) change and post-transplant diabetes mellitus (PTDM) in the first year post-kidney transplantation (KT), especially in the Middle East.

Objectives:

To determine the trends of HbA1c levels, the risk factors associated with HbA1c increases, and predictors of clinically significant HbA1c change and PTDM in the first year post-KT.

Design:

Retrospective chart review.

Methods:

We included all KT recipients (KTRs) at our center from 2017 until 2020. The study focused on reviewing the patients’ demographic information, cardiovascular risk factors, and HbA1c values at baseline, 6 months, and 12 months.

Results:

A total of 203 KTRs were included. The mean age of the participants was 44.7 ± 15.5 years, 59.1% were men, and 80.3% received living donors. Eighty-two (40.4%) KTRs had pre-KT diabetes. At 12 months post-KT, the total HbA1c change was 0.87 ± 1.6. In total, 130 (64.04%) KTRs demonstrated clinically significant HbA1c change, and 19 (15.7%) nondiabetics developed PTDM. Pre-KT diabetics suffered greater increases than their nondiabetic counterparts (0.8 vs 0.6, p = 0.043). Increased age (adjusted odds ratio (aOR) = 1.053), weight change (aOR = 1.055), pre-KT hypertension (aOR = 3.015), and lower baseline HbA1c (aOR = 0.453) were independently associated with clinically significant HbA1c change. PTDM patients were older ( p = 0.007) and had higher HbA1c levels at baseline ( p = 0.033), 6 months ( p = 0.002), and 1-year post-KT ( p = 0.001). Gender, type of KT, dialysis, and cardiovascular risk factors were not different between PTDM and non-PTDM patients. Abnormal perfusion tests ( p < 0.001) and coronary artery disease on coronary angiogram ( p = 0.046) were more common in PTDM patients. Only age was independently associated with the presence of PTDM at 1-year post-KT (aOR = 1.044).

Conclusion:

The incidence rate of PTDM in Saudi KT patients is similar to that of other populations. Several risk factors, including low baseline HbA1c and pre-KT hypertension, predict a clinically significant change in HbA1c. Patients with these risk factors may require stricter monitoring and control of HbA1c.
Pure yolk sac ovarian tumor in a young female—Case report with brief review of literature
Authors: Sharma Aadhya , Sharma Swati , Usman Nawaz , Kudva Ranjini
Published: November 2024

Yolk sac tumors (YSTs) of the ovary are the second most common primitive germ cell tumors accounting for 20% of malignant ovarian germ cell tumors. They are derived from primitive germ cells of the embryonic gonad and can undergo germinomatous or embryonic differentiation. They commonly affect women in the reproductive age group but have a favorable prognosis due to chemosensitivity. This is a case of pure YST of ovary in a nulliparous 25-year-old woman with a past history of endometriotic cysts.
The Impact of Social Norms on Adolescents’ Self-Presentation Practices on Social Media
Authors: Zillich Arne Freya , Wunderlich Annika
Published: November 2024

Social media platforms such as Instagram and Snapchat offer adolescents many opportunities to control how other users see and perceive them. By observing their peers’ self-presentations and receiving feedback on their own self-presentations from them, adolescents learn what is typical (descriptive norms) and appropriate (injunctive norms) on different social media platforms. Based on computer-assisted face-to-face surveys with German Instagram and/or Snapchat users aged between 14 and 16 years ( N = 1,002), we examined the impact of descriptive and injunctive norms on adolescents’ self-presentation practices on social media. Drawing on the theory of normative social behavior and the affordances approach, we also considered the norm-moderating factors of outcome expectations, group identity, platform differences, and perceived content persistence. We provide evidence that both descriptive and injunctive peer norms influence adolescents’ staged self-presentations, authentic self-presentations, and presentations of everyday life, although none of the moderating factors reached practical significance.
Identifying Factors Associated With Variation in Telemental Health Delivery at Federally Qualified Health Centers
Authors: Lombardi Brianna , Sullivan Connor , Gaiser Maria , Zerden Lisa de Saxe , Galloway Evan , Wright Brad
Published: November 2024

Background:

COVID-19 accelerated federally qualified health centers’ use of telemental health. However, factors associated with telemental health service delivery remain unclear. We examined telemental health delivery by clinician type and mental health workforce composition across the U.S. to understand how staffing and other organizational characteristics are related to telemental health delivery at health centers.

Methods:

Using data from the 2021 Uniform Data System, we characterized the proportion of mental health care delivered via elemental (i.e., virtual visits) at health centers in the U.S. that received HRSA grant funding (n = 1,270) overall and by state and clinician type. Then, we conducted multivariate beta regression analyses to assess the proportion of mental health visits delivered via telemental health at health centers as a function of mental health workforce composition, while adjusting for health center size, patient mix, and state.

Results:

In 2021, health centers delivered 43% of their mental health visits via telemental health, with significant variation by state and clinician type. On average, the proportion of mental health visits delivered via telemental health was greater among psychiatrists (61%, P < .001) than psychologists (49%) and clinical social workers (45%). Factors significantly associated with the increased proportion of telemental health delivered by health centers included a higher supply of psychiatrists per patient, more grant dollars per patient, and a greater proportion of Asian patients served.

Conclusions:

Access to telemental health varies by state and across health centers based on mental health workforce composition. Future work is needed to examine funding and workforce strategies to increase telemental health service availability.
Social Relationships and Mental Health Disparities by Race/Ethnicity in Late-middle-age and Older Adulthood
Authors: Lai Wenhua
Published: November 2024

Social strain and lack of social support are associated with depression, but it remains unclear whether racial/ethnic differences in social relationships shape racial/ethnic disparities in late-middle age and late-life mental health. Using data from Health and Retirement Study 2006–2016 ( N = 5,139), this study estimated negative binomial regressions to examine whether differential exposure to and differential effect of social support and strain with spouses, children, family members, and friends explain Black-White and Latinx-White disparities in depressive symptoms. The findings indicate that minority older adults, especially Latinx, have more depressive symptoms than Whites. Although social support compensates for some mental health gaps, mediation and moderation analyses reveal that such disparities are attributable to Black and Latinx late-middle-aged and older adults’ greater exposure to social strain and diminished returns of social support from spouses and children as compared with Whites. This study offers insights regarding how mental health inequality is impacted by racial/ethnic differences in stress exposure and the protective effect of social relationships.
Unraveling the Factors Influencing Digital Transformation and Technology Adoption in High-Tech Firms: The Moderating Role of Digital Literacy
Authors: Xicang Zhao , Bilal Muhammad , Jiying Wu , Sohu Jan Muhammad , Akhtar Sadaf , Itzaz Ul Hassan Muhammad
Published: November 2024

In an era of rapid technological advancement, digital transformation is crucial for high-tech firms to remain competitive and drive innovation. Digital transformation (DT) necessitates incorporating various technologies to enhance a firm’s capacity to collect, integrate, process, and utilize business data. Therefore, this study aimed to identify the factors influencing DT and the adoption of digital technology in the context of high-tech firm performance (FP) with the moderating role of digital literacy (DL). This study analyses the key factors influencing DT and the adoption of digital technologies, focusing on their impact on FP in high-tech firms, with DL as a moderating factor. The significance of this study lies in its comprehensive analysis of the perceived ease of use, time-saving, security risk, and financial risk, as well as their roles in driving DT. The hypothesis was investigated using the partial least squares structural equation modeling (PLS-SEM) approach. The data was collected from 521 respondents through a self-administered survey of high-tech firms. The results describe that perceived ease of use, time-saving, security risk, and perceived financial risk have a significant and positive relationship with DT. Moreover, DT partially mediates the relationship between perceived time-saving and FP. The study’s practical implications emphasize the need for high-tech firms to address user perceptions and risks associated with digital technologies to implement DT and achieve improved performance successfully.
How and for Whom Academic Stress Causes Problematic Smartphone Use: The Role of Escapism Motivation and Present Hedonistic Time Perspective
Authors: Wong Boon Yew , Jiar Yeo Kee , Lee Shih-Hui
Published: November 2024

Although numerous studies have examined the direct association between academic stress and problematic smartphone use, the empirical evidences for the association are inconsistent. Also, the factors that can mediate or moderate the association remain underexplored. With the aim to address these knowledge gaps, based on 680 undergraduate students recruited from Universiti Teknologi Malaysia (UTM), this study has examined (1) the direct association between academic stress and problematic smartphone use, (2) the mediating role of escapism motivation on the association between academic stress and problematic smartphone use, (3) the moderating role of present hedonistic time perspective on the association between escapism motivation and problematic smartphone use, and (4) the moderating role of present hedonistic time perspective on the indirect association between academic stress and problematic smartphone use through escapism motivation. The findings have shown that (1) the association between academic stress and problematic smartphone use was not statistically significant, (2) the association between academic stress and problematic smartphone use was mediated by escapism motivation, (3) present hedonistic time perspective has positively moderated the association between escapism motivation and problematic smartphone use, and (4) present hedonistic time perspective has positively moderated the indirect association between academic stress and problematic smartphone use through escapism motivation. The current study identified escapism motivation and present hedonistic time perspective as the factors that can explain “how” and “for whom” academic stress causes problematic smartphone use and provided important practical implications for the intervention of problematic smartphone use among undergraduate students.
HR Practices and Employee Engagement: The Mediating Role of Employer Branding
Authors: Sharma Anupama , Raj Rahul , Gupta Ashulekha , Johri Amar , Asif Mohammad
Published: November 2024

The current study, guided by resource-based and signaling theories, investigated the mediator's function of employer branding in the connection between human resources practices and employee engagement. Data analysis for this research employed PLS-SEM, with a sample size comprising 220 individuals employed in various IT companies within the Delhi-NCR region. The restraint to this probe is that it is transverse analysis and employs quantitative research methodologies. The outcomes of the present work unveiled a direct and statistically substantial relationship among human resource practices and employee engagement. Furthermore, employer branding was identified as a mediator in the relationship between human resource practices and engagement among employees. This research provides targeted guidance for HR professionals and leaders in the IT sector, presenting in-depth insights into human resources dynamics, specifically focusing on employee engagement. Emphasizing the intermediary role of employer branding, our study empowers managers with actionable insights to enhance HR strategies, fostering heightened workplace satisfaction and increased employee engagement for a resilient and thriving workforce.
Comparative Analysis of the Effects of Managerial and Performance Dimensions of Rural Producers’ Cooperatives in Iran
Authors: Najafi Maryam , Nouri Hedayat , Amini Amir Mozafar
Published: November 2024

The purpose of this study is to analyze the importance of management dimensions as well as the performance dimensions of rural producers’ cooperatives on the overall performance of rural producers’ cooperatives in Isfahan province. The statistical population of this research is the components of rural producers’ cooperatives in Isfahan province. Required data were collected by completing the questionnaire by 375 persons from rural cooperatives. In this study, principal component analysis (PCA), linear regression analysis, and arithmetic mean method were used. The results of the research indicated that a unit of improvement in cooperative management led to a 67% improvement in cooperatives performance. Among the seven component dimensions of cooperatives performance, the improvement of livelihood (0.852), had the highest factor loading in the performance structure of rural cooperatives. Also, among the four component dimensions of co-operative management, the leading (0.895) has been the most important factor in the management structure of rural producers’ cooperatives.
Danmu as Parasocial Audience Engagement: A Textual Analysis Based on Television Interviews With Women Athletes
Authors: Zhang Zizhong
Published: November 2024

This study examines danmu (bullet screens) as a form of parasocial audience engagement, focusing on two television interviews with women athletes. A textual analysis of 3513 comments identified five types of parasocial interactions: addressing the athletes, the host, other viewers, social issues, and the nation. Danmu fosters multidimensional engagement, enabling audiences to shift roles and adopt diverse communication strategies. Moreover, the scope of these interactions extends beyond the video context to address broader societal and national issues. This study also highlights the concept of parakin interactions as reflected in danmu. It underscores danmu’s potential as a participatory journalism tool that complements mainstream media by fostering emotional resonance and challenging benevolent sexism in coverage. Feminism emerges as a central framework within the danmu discourse surrounding women athletes. As a form of parasocial audience engagement, danmu holds promise for empowering a wider range of marginalized groups.
Who Gets Their First Choice? Race and Class Differences in College Admissions Outcomes
Authors: Kim Sooji , Bastedo Michael N.
Published: November 2024

The debate over race-conscious admissions has gained prominence, notably in cases such as Students for Fair Admissions v. Harvard. In debates on race-conscious admissions, the question is often not whether a student will go to college, but which college the student will attend. Using data from the High School Longitudinal Study of 2009, we examined racial and socioeconomic disparities in the probability of acceptance to a student’s first-choice college based on institutional selectivity. Race was a significant predictor of acceptance to a first-choice college, with Black and Asian students facing odds of acceptance that were 46% to 59% lower than those of White peers. However, at highly competitive or most selective colleges, race was no longer a significant predictor, and racial disparities in acceptance rates diminished. Socioeconomic status had no significant association with the probability of acceptance to a first-choice college.
Polio Survivors’ Experiences of Acute Phase Care After the Isolation Phase in the 1950s and 1960s in Finland
Authors: Elomaa-Krapu Minna , Kaunonen Marja
Published: November 2024

The aim of this study was to describe the childhood experiences of polio patients after the isolation phase of the disease in post-war Finland in the 1950s and 1960s. Qualitative empirical research was conducted. Interview material was gathered through theme-based written interviews, and the data were analyzed using reflective thematic analysis. The analysis resulted in the overarching main theme of “constructing psychological safety,” which reflected the themes “emotionally inadequate care,” “reclaiming physical identity,” and “the need to construct a child’s world.” These themes and their subthemes highlighted children’s experiences of the rules set by adults as well as their subordinate relationships with adults. Polio survivors’ experiences following the isolation phase of the disease were traumatic and demonstrated children’s inferior position in nursing in Finland in the 1950s and 1960s. Specifically, children recovering from polio experienced traumatic treatment and care and loneliness even beyond the isolation phase of the disease.
Problems of Reconstructing Mughal Monetary History: A Study of the Correlation Between Numismatic and Textual Evidence
Authors: Haider Najaf
Published: November 2024

What is offered below is a study of the Mughal currency system during the reigns of Akbar (1556–1605) and Jahāngīr (1605–27). The stream of gold and silver coming to India through the Spanish exploitation of the New World enabled the Mughal Empire to shift from a copper coinage under the Lodis to a monetary system based on the silver rupee under Sher Shah and Akbar. The silver rupee now replaced the copper dām as the main unit of currency though copper coins (dām and tanka) still continued to circulate widely in low monetary transactions. This article traces the story of the evolution of Mughal monetary systems till Jahāngīr’s death (1627). It studies in detail the different problems that beset Mughal monetary policy in the successive stages of its evolution.
Book review: H.A. Qureshi and Shreya Pathak, The Lost Hero of Banaras: Babu Jagat Singh
Authors: Habib S. Irfan
Published: November 2024

H.A. Qureshi and Shreya Pathak, The Lost Hero of Banaras: Babu Jagat Singh (New Delhi: Primus Books), 2024, xxvii + 319 pp., ₹1195 (Hb).
Book review: Joanna Simonow, Ending Famine in India: A Transnational History of Food Aid and Development, ca. 1890–950
Authors: Halder Himanish
Published: November 2024

Joanna Simonow, Ending Famine in India: A Transnational History of Food Aid and Development, ca. 1890–950 (Global Connections: Routes and Roots-7) (Leiden University Press), 2023, 283 pp., Price: N.A.
The March First Independence Movement: Social, Political, and Religious Implications
Authors: Park Yong-ho , Chung Jun-ki
Published: November 2024

This study upgrades outdated data regarding the March First Independence Movement (MFIM) to formulate a true picture of the historical formation of Korea. The purpose of the research is to devote a wider study, paying attention to the new socio-political aspects of the events of the indicated time. While the article shows that Korean Protestants played a significant role in the MFIM, its novelty lies in its examination of the key contribution of the Protestant spirit of the MFIM to the prospective unification of South and North Korea.
Costs during the first year after stroke by degree of functional disability: A societal perspective
Authors: Soler-Font Mercè , Ribera Aida , Aznar-Lou Ignacio , Sánchez-Viñas Alba , Slof John , Vela Emili , Salvat-Plana Mercè , Villa-García Lorena , Serrano-Blanco Antoni , Pérez de la Osa Natàlia , Ribó Marc , Abilleira Sònia
Published: November 2024

Introduction:

The aim of this study was to estimate societal costs during the first year after stroke by degree of functional disability.

Patients and methods:

Descriptive study of the cumulative costs incurred during 1-year follow-up of a cohort of patients with stroke in Catalonia (Spain) participating in a multicentre, population-based, cluster-randomised trial (RACECAT). Patients were recruited between September 2017 and January 2019. Costs were collected for each patient from stroke onset to 1-year follow-up through hospital accounting records, electronic healthcare records and structured telephone-based interviews at 6 and 12-months follow-up. Disability was assessed using the 90-day modified Rankin Scale (mRS). Healthcare, community care, and patient/family costs were included. We used complete data from 567 eligible participants. Cost data were analysed using generalised linear models (GLMs) with gamma distributions and log link functions. For variables with >10% zero values, two-part models were applied. We performed sensitivity analyses modifying unit costs for patient/family costs.

Results:

Of the 567 patients included, 53% had ischaemic large vessel oclusion (LVO) stroke, 24% intracranial haemorrhage and 23% ischaemic non-LVO stroke. Mean cost per patient during the first year after stroke was €29,673 ± 28,632, and increased with degree of disability (mRS 0–2: €18,568 ± 12,244; mRS 3: €38,214 ± 28,172; mRS 4–5: €52,859 ± 36,383). Healthcare costs represented the highest proportion of total costs (63%; €18,724/patient) across all disability levels, with index hospitalisation being the highest (€12,319 ± 17,675); however, community care and patient/family costs represented over 40% of total cost in patients with higher disability levels.

Discussion and conclusion:

Our results are in line with other studies; the costs during the first year after stroke are high and increase with disability. These results are valuable for calculating the cost of severe stroke cases.
Acute treatment and secondary prevention for patients with minor stroke or transient ischemic attack: A Bayesian network meta-analysis
Authors: Guo Sitong , Qin Shiran , Xu Dandan , Chen Chunxia , Chen Xiaoyu
Published: November 2024

Introduction:

The efficacy of different antiplatelet treatment in minor strokes (MSs) or transient ischemic attacks (TIAs) and that of antiplatelet and intravenous thrombolysis (IVT) in MSs remain controversial.

Methods:

We searched PubMed, Embase, Web of Science and the Cochrane Library to identify all eligible articles until April 12, 2024. Efficacy outcomes were all-cause mortality, excellent outcome, functional independence and recurrent stroke. Safety outcomes were any types of bleeding and intracerebral hemorrhage (ICH). The associations were calculated for the overall data by using odds ratios (ORs).

Results:

Twenty three high-quality studies with 10 RCTs and 13 non-RCTs were included, involving 47,135 patients with MSs or TIAs. In MSs or TIAs, dual antiplatelet therapies (DAPTs) significantly improved the modified Rankin Scale (mRS) scores for patients with recurrent stroke, major vascular events and ischemic stroke although it was associated with an increased risk of ICH and bleeding when compared to aspirin. In MSs, compared to IVT, DAPT had a significant advantage in improving the mRMS scores and SAPT and DAPT significantly reduced the risk of any bleeding or sICH. IVT significantly reduced all-cause mortality, although it also increased the risk of sICH and ICH compared to no IVT.

Conclusions:

In MSs or TIAs, compared to aspirin, DAPTs can effectively prevent the recurrence of post-stroke neurological dysfunction and ischemic events, but it may increase the risk of ICH together with moderate or severe bleeding. Dipyridamole + aspirin resulted in the lowest risk of bleeding. In MSs, compared to IVT, DAPT may be associated with better improvements in neurological function, and it may not increase the risk of bleeding.
Nitinol Compression Staples in Foot Orthopaedic Surgery: A Systematic Review
Authors: Reddy Akshay R. , Hampton Hailey , Dzieza Wojciech K. , Toussaint R. James
Published: November 2024

Background:

Nitinol compression staples have been increasingly used in foot and ankle orthopaedic surgery because of simple implantation, reproducibility, and favorable biomechanical features. Compared with traditional implants (i.e., plates and screws), nitinol staple use in foot and ankle orthopaedics has not been extensively described. This systematic review aims to describe the current clinical outcomes of nitinol staple use in forefoot and midfoot surgery.

Methods:

A search was conducted using PubMed, Web of Science, and Embase. All studies that included clinical outcomes of nitinol in foot surgery were evaluated for their demographics, outcome scores, or complication rates. Biomechanical studies and studies investigating nitinol nails in the hindfoot were excluded. Two reviewers screened titles, abstracts, and full texts.

Results:

Of the 198 total articles from the search, 9 articles met the inclusion criteria. Of the 9 articles, 4 articles investigated outcomes of nitinol in the forefoot, 3 articles in the midfoot, 1 article in the forefoot and midfoot, and 1 article in the midfoot and hindfoot. This systematic review included articles that were retrospective in nature and thus subject to selection bias. The mean follow-up ranged from 6 to 35.9 months. The included studies demonstrated significantly improved postoperative visual analog scale pain score ( P < .001), Ankle Osteoarthritis Scale scores ( P < .001), and Foot and Ankle Ability Measure activities of daily living scores ( P < .001). Of the 6 studies that report union for patients receiving purely nitinol staple constructs or nitinol staples in combination with another construct, the overall fusion rate was 94.6% and the overall complication rate was 11.25%.

Conclusion:

This systematic review demonstrates that nitinol staples in foot surgery, whether alone or in combination with another construct, can achieve an acceptable fusion rate. However, currently we found highly limited clinical study data directly comparing nitinol staples to traditional implants. The current literature is heterogenous in its discussion of nitinol staple configurations and designs.

Level of Evidence:

Level IV, Systematic Review.
Focusing on life rather than illness: the lived experience of children with life-threatening and life-limiting conditions—a qualitative study
Authors: Kittelsen Trine Brun , Castor Charlotte , Lee Anja , Kvarme Lisbeth Gravdal , Winger Anette
Published: November 2024

Background:

The perspectives of children with life-threatening or life-limiting (LT/LL) conditions have predominantly been conveyed through their parents rather than heard from the children themselves. Despite an increase in studies focusing on children’s perspectives in pediatric palliative care, this research remains limited, particularly in including children who are unable to express themselves orally.

Objective:

This study seeks to address gaps in existing knowledge, especially the limited inclusion of children’s perspectives and the exclusion of children with communicative and cognitive disabilities. The aim of this study was to explore the lived experiences of children living with LT/LL conditions.

Design:

The study has a qualitative, hermeneutic phenomenological design inspired by van Manen’s phenomenology of practice.

Methods:

Twelve children with cancer or genetic conditions participated. Due to the children’s varying cognitive and communicative abilities, multiple data collection methods were employed to capture the children’s perspectives, including interviews, interactions, descriptions of the children’s non-verbal expressions, and an adapted photo elicitation method. Data were analyzed using thematic analysis.

Results:

The findings showed that the children’s attention revolved around life rather than illness. The analysis revealed the presence of three themes: wanting to engage in life, being dependent on familiar relations, and the importance of cherished items.

Conclusion:

Professionals across various levels within pediatric palliative care should acknowledge children’s desire to engage in life despite serious illness and facilitate participation. Practices should be implemented to support children’s agencies and expressions of what is important to them. This recognition can guide care plans and interventions at all levels of pediatric palliative care when a child is living with an LT/LL condition. The study emphasizes that children with LT/LL conditions are children first and foremost, with a fundamental need to participate in meaningful activity, just like any other child.
An Institution’s Comprehensive Perioperative Management of Cleft-Related Surgeries: Part I—Cleft Lip Repair, Cleft Palate Repair, Pharyngoplasty, & Alveolar Bone Graft
Authors: Hush Stefanie E. , Williams Joseph K. , Brady Colin M. , Soldanska Magdalena , D. Tashima Alexis
Published: November 2024

For patients born with cleft lip and/or cleft palate, surgical reconstruction(s) during early childhood serve as the foundation for attaining more normal anatomy and function of the involved areas. As a longstanding cleft and craniofacial institution, we have experienced significant changes in perioperative care regimens. Most notably, the evolution of enhanced recovery protocols has transformed how we care for our patients in the perioperative period. Part I of this publication provides an overview of our institution’s peri-operative protocols, for various cleft-related surgeries, including cleft lip repair, cleft palate repair, speech pharyngoplasty, and alveolar bone grafting. Part II will focus on orthognathic surgery and cleft lip/nasal revisions. This comprehensive review may serve as a prototypical guide for other institutions.
China’s carbon emission forecasts in different development models
Authors: Huang Chunbo , Gan Xintao , Cheng Jing , Jin Lin , Peng Changhui
Published: November 2024

China is the world's largest carbon emitter, its carbon peaking and carbon neutrality goals significantly reduce climate change and global warming problems. Although the Chinese government proposed carbon emissions will peak by 2030, how do different development models affect carbon emissions in the future? Here, we analyzed the spatial and temporal trends of carbon emissions over the past two decades. Then we constructed the STIRPAT carbon emissions model based on ridge regression analysis. Finally, one national STIRPAT model and eight STIRPAT models at the sub-regional scales were generated because the effects of population, economy, and energy consumption vary significantly across regions and periods. Meanwhile, we established nine different future development models based on various population, economy, and energy consumption levels, and forecast their carbon emissions from 2020 to 2060 by eight sub-region STIRPAT models. Our results documented that (1) China's carbon emissions significantly increased by 445.79 million-ton/yr between 2000 and 2019. Meanwhile, population, total energy consumption, and GDP were growing at a rate of 7.60 million people/yr, 185.37 million-ton/yr, and 4791.74 billion-yuan/yr, respectively. (2) Ridge regression results indicated that carbon emissions are positively influenced by population, economic growth, and energy consumption in all regions, but the degree of influence varies across sub-regions. (3) In 2060, carbon emissions will be lowest across all variables at low levels of development and highest at high levels of development. Meanwhile, low energy consumption and population levels are possibly the main directions for controlling carbon emissions in the future. The findings indicate that the carbon peak target could be achieved by 2030 by controlling population and energy consumption alone. However, relying solely on these strategies may pose significant challenges in meeting the dual carbon targets, which emphasizes the need for a scientific foundation to inform low-carbon development policies. The findings provide a scientific basis and reference for the low-carbon sustainable development in China.
Seizure Susceptibility in E-cigarette Users: Navigating the Clinical Management and Public Health Considerations
Authors: Toluwalashe Soyemi , Aremu Olusola , Ekerin Olabode , Lawal Abdulqudus , Oluwatobi Faniyi , Adebayo Victor , Akingbola Adewunmi , Olaniyan Simon , Progress Agboola , Aborode Abdullahi Tunde
Published: November 2024

E-cigarettes gained popularity globally through the promotion of e-cigarettes as a risk-free way to stop traditional smoking. However, new evidence suggests that they may have a detrimental effect on the nervous system and ultimately adverse neurological manifestations. Seizures have been reported among both new and experienced e-cigarette users. In several cases, the seizure presented immediately after its use, while others reported continuous use for weeks before seizures occurred. This review presents a deeper insight into the clinical management, implications, and public health considerations of seizure susceptibility in e-cigarette users. Using recent case reports, epidemiological studies, and experimental research, we highlight the role of likely etiological mechanisms such as how nicotine’s convulsive effects are linked to α7- nicotinic acetylcholine receptors (nAChRs), the varied clinical presentations, and the potential nicotine toxicity linked to seizures. Furthermore, we discuss the existing debates and controversies, diagnostic directions, and potential role in individual susceptibility to e-cigarette-associated seizures. Importantly, we address how seizures may be accompanied by both physical and psychological sequelae, which may impair the quality of life for individuals presenting for emergency care. We also address the limitations and challenges in the etiology of e-cigarette-associated seizures and the non-criteria for defining seizures caused by e-cigarettes. The review concludes with an insight into public health considerations and policy recommendations by highlighting the importance of mass awareness and clinical considerations that could guide patient management.
A rupture directivity adjustment model and its application in seismic hazard
Authors: Bayless Jeff , Abrahamson Norman A , Somerville Paul G
Published: November 2024

This article contains a rupture directivity adjustment model for strike-slip earthquakes that can be applied to a traditional ground-motion model (GMM; one without explicit treatment of rupture directivity) to incorporate rupture directivity effects in either deterministic or probabilistic seismic hazard analyses. Application of the directivity model requires adjustments to both the GMM median and aleatory variability. The model described herein supersedes the previous models for strike-slip earthquakes developed by the authors of this article (Abrahamson, 2000; Bayless et al., 2020; Somerville, 2003; and Somerville et al., 1997; chapter 2 of Spudich et al., 2013). A key feature of the directivity model is that it is centered because it does not alter the magnitude and distance scaling of the GMM when averaged over uniformly distributed sites at a given rupture distance. Additionally, we address a longstanding issue regarding the directivity condition contained in the NGA-W2 dataset (Ancheta et al., 2014) and conclude that the biases in the mean and standard deviation of directivity effects are small enough to ignore for the purposes of modeling directivity. We provide guidance on the directivity model implementation, including a review of deterministic and probabilistic seismic hazard applications, and recommend methods for modeling hypocenter locations and multisegment ruptures. The model addresses the RotD50 (Boore et al., 2010) horizontal component of 5% damped spectral acceleration. A future update will address directionality and directivity effects for other styles of faulting. Implementations of the model are provided in the electronic supplement.
Chemerin alleviates the placental oxidative stress and improves fetal overgrowth of gestational diabetes mellitus mice induced by high fat diet
Authors: Zhou Xuan , Jiang Yi , Wang Zizhuo , Wei Lijie , Zhang Huiting , Fang Chenyun , Zhu Shenglan , Du Yuanyuan , Su Rui , Li Weikun , He Zhenzhen , Zhang Liangnan , Tan Weidong , He Mengzhou , Yu Jun , Wang Shaoshuai , Ding Wencheng , Feng Ling
Published: November 2024

Background

Evidence has shown that oxidative stress induced by high glucose microenvironment in placenta of gestational diabetes mellitus (GDM) is indispensable to the progression of this condition. Adipokine chemerin was linked with GDM, yet the roles of chemerin in placental oxidative stress and its underlying effects on GDM in vivo remain elusive.

Methods

We firstly analyzed the disparities of oxidative stress levels in placenta between GDM and normoglycaemic pregnant women, and then added recombinant active chemerin to the high-glucose treated human trophoblastic cells to investigate effects of chemerin on reactive oxygen species (ROS), total antioxidant capacity (T-AOC) and intake of glucose. Finally, a GDM animal model induced by high-fat diet (HFD) was established and the impacts of chemerin on oxidative stress of placenta and fetal growth of GDM were explored.

Results

Analysis of human samples showed that the extent of lipid peroxidation in placenta was significantly elevated in GDM patients compared with their normoglycaemic counterparts. In the high glucose cell model, active chemerin lessened the content of ROS, heightened the index of T-AOC and stimulated glucose uptake in a concentration-dependent manner. Importantly, we successfully constructed a GDM mouse model through HFD. The treatment of chemerin was found to alleviate the high blood glucose levels in these HFD-fed pregnant mice and attenuate the excessive growth of their offspring. Our data also revealed that chemerin might counteract placental oxidative stress in HFD mice by improving the activity of superoxide dismutase.

Conclusions

The present study further elucidated the molecular biology of chemerin, which plays a pivotal role in ameliorating oxidative stress and hyperglycemia, resulting in improved fetal overgrowth in GDM.

Graphical abstract
From outsider to participant: a qualitative study about attaining and retaining work among persons with mental illness
Authors: Stangeland Fredrik , Sveinsdottir Vigdis , Ree Eline
Published: November 2024

Background

In Norway, the number of people on sick leave and health-related absence from work has increased over the last few years, and mental illness is one of the main contributing factors. Individual Placement and Support (IPS) and the Qualification Program (QP) are two work-oriented measures offered by Norwegian labor and welfare authorities, aimed at increasing labor market participation among people with health-related problems. The aim of this study was to explore which factors people with mental illnesses found helpful for attaining and retaining work, and their experiences with taking part in IPS and the QP.

Methods

The study had a qualitative explorative design. Eight semi-structured interviews with individuals who had attained and retained work after receiving IPS or taking part in the QP were conducted. The data were analyzed using systematic text condensation, a thematic and descriptive, cross-case analysis strategy.

Results

The analysis revealed three main themes, each related to the contexts of work and daily life: (1) inclusion and support, (2) structure and routines, and (3) motivation and self-confidence. The participants emphasized the importance of feeling included and supported both at work and by their family and friends. Furthermore, structures and routines at work and in the participants’ daily lives kept them engaged and made them feel better, which was important for retaining work. Having the motivation to attain and retain work was essential and seemed to increase over time together with improved self-confidence as a result of being able to stay at work.

Conclusion

Inclusion, support, structure, routines, and motivation are decisive for people with mental illnesses in changing their view of their health and increasing their independence and experiences of coping in work and everyday life. Taking part in work-oriented measures seemed to function as a “gateway” to changing behavior for the participants, both in work situations as well as more generally in life.
Initial clinical evaluation of a novel integrative bone matrix (IBM) in foot and ankle fusion procedures
Authors: Hofmann Kurt J. , Veale Nicholas J. , Veale Matt , Glass Evan , Beckles Matthew
Published: November 2024

Background

Foot and ankle arthrodesis procedures are frequently performed in concert with the utilization of bone grafts. However, the availability of autologous bone is often limited, inaccessible, or not suitable, thus there is a need for bone graft substitutes with equally effective clinical outcomes. A next generation integrative bone matrix (IBM) has been developed that has intrinsic osteogenic, osteoconductive, and osteoinductive characteristics, and is a promising solution to mitigate complications such as nonunion and reduce the need for autologous bone graft harvest.

Methods

The charts of twenty subjects undergoing foot and ankle fusion procedures with INFLUX™ SPARC, a novel IBM, were retrospectively reviewed to determine initial clinical safety and efficacy of this next generation bone graft. Endpoints included the presence of complications or surgical reintervention, fusion rates as determined by standardized radiographic films, and patient-reported outcome measures at various time points up to 24 weeks.

Results

No major complications or surgical reinterventions were observed in this study. Complete radiographic fusion was achieved in all subjects by 24 weeks, with a mean overall fusion time of 8.5 ± 4.8 weeks. Subjective pain, function, and quality of life outcomes showed consistent improvements throughout the follow-up period, and all subjects (100%) achieved the minimum clinically significant mean improvements for all measures by week 24.

Conclusions

This study supports the use of this new IBM as a promising alternative to autologous bone grafting, offering high fusion success rates, low complications, and clinically meaningful improvements in patient-reported outcomes, particularly in higher-risk patient populations. Future investigations are needed to confirm these findings in larger and longer-term studies, and to explore the broader applications of this innovative bone graft.
Supportive and palliative care needs among older adults in India: an estimation using a nationally representative survey
Authors: Immanuel Terrymize , Salins Naveen , M Benson Thomas , Sundararaj Jenifer Jeba , Gursahani Roop
Published: November 2024

Background

One in five people will be older than 60 by the year 2050 in India. This demographic transition demands integration of geriatric and palliative care. The national level burden of palliative and supportive care needs of the older population is largely unknown in India. This study estimates the burden of palliative care needs among the older population in India from a nationally representative survey - Longitudinal Ageing Study of India (LASI).

Methods

The general indicators of poor or deteriorating health from the Supportive and Palliative Care Indicator Tool for Low Income Setting were used to identify older adults with palliative care needs. These indicators were compared with the LASI data and matched with the appropriate variables. Descriptive statistical analysis, chi-square tests and multivariate logistic regression were done to estimate palliative care needs and its association with other characteristics.

Results

12.2% of Indian older adults have supportive and palliative care needs. Among Indian states, highest for West Bengal (17%), Madhya Pradesh (16.9%), and Bihar (16.3%) while lowest in Arunachal Pradesh (2.2%), Nagaland (2.4%), and Mizoram (3%). High needs were found among those aged 70 years and above (AOR-1.86), females (AOR-1.33), Muslim religion (AOR-1.24), rural residents (AOR-1.72), those who experienced ill-treatment (OR-1.75), with cancer (AOR-2.84), respiratory disease (AOR-3.14), and stroke (AOR-2.58). Lower needs were observed with higher education (AOR-0.43) and health insurance (AOR-0.83).

Conclusion

This is the first study in India that estimates the need for supportive and palliative care using a nationally representative sample. One among eight older adults in India has supportive and palliative care needs. The needs are higher among female older adults, rural residents, older adults with chronic diseases, and in poorer States. Screening and early integration of palliative care with routine healthcare care is essential to meet these needs.
Fundamentals of a healthy and sustainable diet
Authors: Lawrence Mark
Published: November 2024

Background

A healthy and sustainable diet is a prerequisite for population and planetary health. The evidence of associations between dietary patterns and health outcomes has now been synthesised to inform more than 100 national dietary guidelines. Yet, people select foods, not whole dietary patterns, even in the context of following specific diets such as a Mediterranean diet, presenting challenges to researchers, policymakers and practitioners wanting to translate dietary guideline recommendations into food-level selection guidance for citizens. Understanding the fundamentals that underpin healthy and sustainable diets provides a scientific basis for helping navigate these challenges. This paper’s aim is to describe the fundamentals of a healthy and sustainable diet.

Results

The scientific rationale underpinning what is a healthy and sustainable diet is universal. Everyone shares a physiological need for energy and adequate amounts, types and combinations of nutrients. People source their energy and nutrient needs from foods that are themselves sourced from food systems. The physiological need and food systems’ sustainability have been shaped through evolutionary and ecological processes, respectively. This physiological need can be met, and food systems’ sustainability protected, by following three interlinked dietary principles: (i) Variety – to help achieve a nutritionally adequate diet and help protect the biodiversity of food systems. (ii) Balance – to help reduce risk of diet-related non-communicable diseases and excessive use of finite environmental resources and production of greenhouse gas emissions. (iii) Moderation – to help achieve a healthy body weight and avoid wasting finite environmental resources used in providing food surplus to nutritional requirements.

Conclusion

The fundamentals of a healthy and sustainable diet are grounded in evolutionary and ecological processes. They are represented by the dietary principles of variety, balance and moderation and can be applied to inform food-level selection guidance for citizens.