bluuebunny/crossref_metadata_2025 huggingface dataset:
Farmers’ markets contribution to the resilience of the food systems
Authors: Lucas Agathe , Moruzzo Roberta , Granai Giulia
Published: December 2024

To mitigate the impacts of future shocks and achieve its targets, the Food Summit 2021 advocates for a transition toward more resilient Food systems. Alternative food movements, such as Farmers’ Markets (FM), claim to contribute to this transition by offering a different approach to food consumption (Bilali in Food energy secur 8: e00154, 2019). FM are spaces where producers and consumers interact directly, trading locally grown and fresh products (Chiffoleau in Agric 6:1–18, 2016; Marsden in Sociologia Ruralis 40:424–438, 2000). The European Commission defines these short supply chains as “involving a limited number of economic operators, committed to cooperation, local economic development, and close geographical and social relations between producers, processors and consumers” (Regulation (EU) No 1305/2013 of the European Parliament and of the Council of 17 December 2013 on support for rural development by the European Agricultural Fund for Rural Development (EAFRD) and repealing Council Regulation (EC) No 1698/2005, 2013). The present study examines the mechanisms by which FM contribute to the resilience of Food systems. Qualitative data were collected from a FM worldwide, a case study involving nine members of the World Farmers’ Market Coalition (WFMC). Results indicate FM resilience stems from their structure and unique position as niche markets. Also, their adaptive capacities and innovation are fostered by flexible governance structures and strong agency yet can be variable in degree depending on the context. As a source of innovation, FM can inspire policies and inform models for broader resilience in Food systems. Supportive policies and additional contextual research are crucial for creating an enabling environment for FM to thrive within the Food systems, and for scaling up successful emerging innovations to the whole Food systems.
The multifaceted roles of cathepsins in immune and inflammatory responses: implications for cancer therapy, autoimmune diseases, and infectious diseases
Authors: Zhao Kexin , Sun Yangqing , Zhong Shangwei , Luo Jun-Li
Published: December 2024

The cathepsin family comprises lysosomal proteases that play essential roles in various physiological processes, including protein degradation, antigen presentation, apoptosis, and tissue remodeling. Dysregulation of cathepsin activity has been linked to a variety of pathological conditions, such as cancer, autoimmune diseases, and neurodegenerative disorders. Understanding the functions of cathepsins is crucial for gaining insights into their roles in both health and disease, as well as for developing targeted therapeutic approaches. Emerging research underscores the significant involvement of cathepsins in immune cells, particularly T cells, macrophages, dendritic cells, and neutrophils, as well as their contribution to immune-related diseases. In this review, we systematically examine the impact of cathepsins on the immune system and their mechanistic roles in cancer, infectious diseases, autoimmune and neurodegenerative disorders, with the goal of identifying novel therapeutic strategies for these conditions.
Ecology of endolithic bryozoans: colony development, growth rates and interactions of species in the genus Immergentia
Authors: Johnson Mildred J. , Lemer Sarah , Hirose Masato , Decker Sebastian H. , Schwaha Thomas
Published: December 2024

Boring bryozoans dissolve calcium carbonate substrates, leaving unique borehole traces. Depending on the shell type, borehole apertures and colony morphology can be diagnostic for distinguishing taxa, but to discriminate among species their combination with zooidal morphology is essential. All boring (endolithic) bryozoans are ctenostomes that, along with other boring taxa, are common in benthic communities. The growth rates of such bryozoans, including Immergentiidae, are largely unknown. For the first time laboratory experiments were conducted to determine growth rates and early colony development of the intertidal species Immergentia stephanieae and the subtidal species I. cf. suecica from Roscoff, France. In growth experiment 1, ancestrular growth rates varied, with the highest rates in I. stephanieae at 96.5 µm day−1 and the lowest at 1.1 µm day−1, during the period of August to October, in which the number of reproductive zooids was comparably higher than in other months of the year. Immergentia cf. suecica had a higher proportion of reproductive zooids from December to March compared to other months. In growth experiment 2, the bryozoans were fed a culture mixture of Chaetoceros calcitrans and Tisochrysis lutea which was compared with a control. The growth rate of small colonies of comparable size was greater in the food-enriched samples compared to the control (non-enriched). In larger colonies, the trend differed with greater growth (cystid appendage expansion) rate reported for some samples in the control. In food-enriched samples ancestrulae of I. stephanieae grew at 23 µm day−1 and I. cf. suecica 9.3 µm day−1 while no growth was observed in the control of I. cf. suecica, but 0.4 µm day−1 was reported for I. stephanieae. Growth patterns in the early developmental stages showed that the budding patterns from the ancestrulae were the same for both species, with different enantiomorphic tendencies. Inter- and intraspecific interactions are also discussed. The distribution of immergentiids is presented, as are records from new locations and the greatest subtidal depth of collection reported to date.
Wealth Tax Mobility and Tax Coordination
Authors: Agrawal David R. , Foremny Dirk , Martínez-Toledano Clara
Published: December 2024

We study the effects of decentralized wealth taxation on mobility and the effectiveness of tax coordination at mitigating tax competition. We exploit the reintroduction of the Spanish wealth tax, after which all regions except Madrid levied positive tax rates. We find the mobility responses to wealth taxes are within the range of prior estimates with respect to income taxes. However, wealth tax mobility responses generate losses to personal income tax revenues that are six times larger than the direct losses to wealth taxes. Madrid could achieve higher total regional revenues by agreeing to a harmonized positive tax rate. (JEL D31, G51, H24, H71, H73, H77)
Staggered Difference-in-Differences in Gravity Settings: Revisiting the Effects of Trade Agreements
Authors: Nagengast Arne J. , Yotov Yoto V.
Published: December 2024

We nest an extended two-way fixed effect (ETWFE) estimator for staggered difference-in-differences within the structural gravity model. To test the ETWFE, we estimate the effects of regional trade agreements (RTAs). The results suggest that RTA estimates in the current gravity literature may be biased downward (by more than 50 percent in our sample). Sensitivity analyses confirm the robustness of our main findings and demonstrate the applicability of our methods across settings. We expect the ETWFE methods to have significant implications for estimates of other policy variables in the trade literature and for gravity regressions on migration and foreign direct investment. (JEL C23, F14, F15, F16, J82)
Naser Dumairieh. Intellectual Life in the Ḥijāz before Wahhabism: Ibrāhīm al-Kūrānī’s (d. 1101/1690) Theology of Sufism. Leiden; Boston: Brill, 2022. 361 pages. ix + 361 pages. ISBN: 9789004499041
Authors: Akbulut Didar Ayşe
Published: December 2024

Naser Dumairieh. Intellectual Life in the Ḥijāz before Wahhabism: Ibrāhīm al-Kūrānī’s (d. 1101/1690) Theology of Sufism. Leiden; Boston: Brill, 2022. 361 pages. ix + 361 pages. ISBN: 9789004499041
Realism and Virtues in Ottoman Political Thought
Authors: Fırtın Erol
Published: December 2024

This article presents a novel perspective, arguing for a virtue-based weak version of political realism in Ottoman political thought (OPT). By recognizing realist elements in human nature and poli- tics in OPT tradition, we can gain a deeper understanding of the place of morality in politics. Challeng- ing the common sense understanding of morality that pervades all areas of politics, this paper provides compelling evidence to show how the understanding of the nature of politics in OPT was ever-chang- ing, singular, and, to a certain extent, free of morality. This unique framing of politics and human na- ture in the OPT tradition makes it a realist one. Finally, I delve into the role of universals in explaining the intricate relationship between politics and morality through various analytical distinctions.
Analyzing Alchemical Body and Causality Theories in Islamic Civilization based on Jabir ibn Hayyan’s System
Authors: Şen Musa , Taşkıran Şule
Published: December 2024

The basis of Islamic alchemy and matter theory is found in the works of Jābir ibn Ḥayyān (d. 200/815). Jābir developed an element theory similar to Aristotle’s system. Still, he interpreted matter and substance differently by transferring the basis of the theory from elements to qualities. In Jābir’s system, qualities are more often expressed by the term “natures” (ṭabā’iʻ). In Jābir’s thought, four na- tures precede the four elements, and due to the combination of two different natures with the sub- stance each time, four distinct elements with different qualities occur. In Jābir, the “primary bodies” of the natural world are no longer the four Empedoclean elements but the “four natures”; air, water, earth, and fire are made up of these natures. Thus, Jābir gave the four primary Aristotelian qualities the role of genuine elements by making them tangible, independent, and corporeal entities. According to Jābir, the operation of transforming (transmutation) of ajsād (‘bodies’) such as iron, copper, tin, and lead, which is the primary purpose of the Art of alchemy, into silver and gold is carried out within the framework of the science of mīzān. The core of this transformation is based on an idea of causality in which the four natures and their specific proportions and measures are at the center. With the idea of causality that allows chemical transformation, Jābir also succeeded in extending the possibility of transformation in alchemy from the inorganic world to the organic world to an extensive range of entities. This study will discuss Jābir’s thoughts on body, substance, and experimental causality by ex- amining Jābir’s corpus through primary sources.
Causality and Calculative Thinking: An Avicennian Response to Heidegger
Authors: Varlık Selami
Published: December 2024

Heidegger contrasts meditative thinking, which allows detachment from beings, with calculative thinking, which maintains an instrumental and interested relationship with them. In his view, the principle of reason is the main tool for dominating available things. He also embeds the Medieval essence-existence duality within this framework of causality geared towards manipulating beings, judging that the religious notion of creation failed to distance this duality from Greek essentialism. Now, by appropriating the Islamic notion of creation ex nihilo, Avicenna places an ontological indigence at the heart of the created world. He believes that a being necessary by something other than itself remains contingent in itself, even after being caused. Thus, knowledge of the cause doesn’t grant dominance over the thing but fosters detachment from contingent being, recognizing its dependence on an upstream otherness. Moreover, Meister Eckhart, who according to Heidegger perfectly illustrates meditative thought, is indebted precisely to this ontological poverty established by Avicenna. In addition to describing this possible objection from Avicenna to Heidegger, the more general aim of this study is to explore the possibility of an ethical and disinterested use of the principle of reason.
A Scholar’s Journey from Timurid Khorasan to Mehmed I’s Bursa: A New Version of the Introduction of Haydar al-Harawı’s Shar h al-Kashsh a f and the Construction of al-Harawı’s Biography from the Two Versions of the Introduction
Authors: Boyalık M. Taha
Published: December 2024

Ḥaydar al-Harawī (d. 825/after 1427) was a significant scholar from Khorasan who migrated to the Ottoman lands. A distinguished student of al-Taftazanī, he earned high regard from Mehmed I and received patronage from him. al-Harawī dedicated his commentary on al-Zamakhsharī’s al-Kashshāf to Mehmed I with exaggerated expressions of praise and provided significant details about his biography in the introduction of the work. After spending many years in Ottoman lands, al-Harawī established contact with Shahrukh, the son of Timur. He rewrote the introduction of Sharḥ al-Kashshāf and ded- icated the work to Shahrukh. This new patronage relationship is evident in the second version of the introduction, where not only the dedication part but also the content was rearranged concerning the new patron’s identity. Important biographical details not found in the first version are included in the second version, making it a crucial source for al-Harawī’s biography. This article brings the second version of the introduction to light for the first time, constructing al-Harawī’s biography by compiling information from both versions. While no specific dates are provided in either version, the duration of al-Harawi’s stay in certain cities is mentioned. Gaps in the narrative were filled based on histori- cal events, allowing for accurate dating of approximately forty years of al-Harawī’s life, from Sarakhs through Shiraz, Tabriz, Shirvan, Bursa, Edirne, and back to Khorasan. This comprehensive overview sheds light on the relationship between scholars and rulers, the influence of political developments on scholarly life, and the intellectual world of a scholar dedicated to the pursuit of knowledge.
Hacı Bayram Başer. Sûfîler ve Sultanlar: Klasik Dönemde Tasavvuf-Siyaset İlişkileri [Sufis and Sultans: The Relationship between Sufism and Politics in the Classical Period]
Authors: Orhan Abdullah Taha
Published: December 2024

Hacı Bayram Başer. Sûfîler ve Sultanlar: Klasik Dönemde Tasavvuf-Siyaset İlişkileri [Sufis and Sultans: The Relationship between Sufism and Politics in the Classical Period]
Poets, Oracles, and Nabıs as Messengers: An Evaluation of the Philosophy of al-Farabı and Avicenna
Authors: Kocakaplan Nursema
Published: December 2024

Due to the inequality regarding the susceptibility level of people’s souls as well as their temperamental balance, differences occur in how they accept news containing messages arriving from the celestial realm. People who have a more competent mind, stronger intuition (hadth), and higher imitation (muhākāt) ability compared to others more strongly accept what is revealed from the celestial realm. This article provides information about people who accept what is conveyed from metaphysical substances and who’ve been informed about unknown events in three stages: (i) The place of Plato’s distinction among poets, oracles, and lovers in Aristotelian and Plutarchian philosophy; (ii) the position of poets and oracles in the pre-Islamic period, polytheists’ attribution of both poetry and divination to Prophet Muhammad, and the description of Muhammad as a nabī in the Qur’an; and (iii) the meanings al-Fārābī and Avicenna attributed to oracles, poets, lovers, and nabīs (prophet). In this context, the article attempts to find answers to the questions of what the philosophical basis of both al-Fārābī’s and Avicenna’s ideas is regarding poets and oracles and what the religious basis of their views is regarding the concept of nabī. While trying to find answers to these questions, the study also aims to determine how a nabī differs from poets, oracles, and lovers by considering the superiority nubuwwa (prophecy) has over poetry and divination.
A Few Remarks on the Description of the Baptism of the Emperor Constantine in the Chronicle of George the Monk, Actus Silvestri, and the Byzantine Hagiographical Tradition
Authors: Kosiński Rafał
Published: December 2024

This article focuses on the 9th century accounts of Constantine I’s baptism. Sources from this period strongly reject Eusebius of Caesarea’s account of Constantine’s baptism on his deathbed and promote the tradition of the emperor’s baptism at the hands of Pope Sylvester in Rome in the early years of the emperor’s reign. The acceptance of the legend of Pope Sylvester seems to be connected with the idea of Emperor Constantine’s personal holiness in opposition to the emperors’ promotion of the emperor-priest ideal in the 8th century. However, the acceptance of the legend concerning Pope Sylvester may also be related to the perception – during the iconoclasm period – of the papacy as a bastion of orthodoxy.
Tsakonia as Seen by Travellers
Authors: Nowakowski Marcel
Published: December 2024

Tsakonia is a region in Greece, situated within the borders of the modern municipalities of North and South Kynouria. The local population speaks a distinct language, Tsakonian, which is believed to have evolved from Ancient Doric. From the 1st to the 17th century, there was a dearth of knowledge regarding the region. While Byzantine sources make brief mention of Tsakonia and the Tzacones or Tzecones [Τζάκωνες/Τζέκωνες], an elite Byzantine military unit, there are no descriptions of the local landscape, people, or language. In the 17th century, travellers began to visit Tsakonia, recording their observations in writing. These accounts, which range from admiration of the region’s healthy air and robust population to ridicule of the local attire, provide insight into the perceptions of Tsakonia held by these visitors. In the present paper, I will examine various ravel descriptions of Tsakonia, including those by Pausanias (Ancient Greek), Evliya Çelebi (Ottoman), William Martin Leake (English), and Jean-Baptiste Gaspard d’Ansse de Villoison and François-René de Chateaubriand (French). In addition to these primary sources, I will also examine a few minor mentions, including those by Martin Crusius and Bernard Randolph. My aim is to shed light on the perception of Tsakonia, particularly on the concept of ‘Tsakonia’ itself and on the travelers’ observations regarding the region’s geography, the character of its people and language.
Peripheral Electronic Music
Authors: Magalhães Manoel
Published: December 2024

Tecnobrega is a peripheral electronic music produced since the 2000s in the state of Pará, in northern Brazil. It is marked by the mix of traditional local romantic music, the rhythms from the Caribbean and electronic music globalized by the spread of recording technologies. In the last decade, the tecnobrega unfolded in several rhythm variants. This work presents an ethnography of parties related to new trend called ‘rock doido,’ the main current phenomenon of electronic music in Pará, both due to the size of the parties and the reach in digital media. The article presents the results of field research that were carried out in two events that took place in the city of Belém (capital of Pará state) in 2023. The first experience takes place at the Crocodilo Sound System Party, which focuses on the execution of the repertoire of rock doido. The second is a presentation by DJ Lorran, the main name of the rock doido in Pará today. The research also cross-discusses the spread of Pará production in the context of global-peripheral electronic music, enhanced by digital tools such as YouTube and social media.
A Personalised Optimising Level Adaptation (OLA) Difficulty Algorithm for Scenario Simulations in Professional VR Simulators
Authors: Marcin Wolański Robert  , Karol Jędrasiak
Published: December 2024

Aim: This study introduces the Optimising Level Adaptation (OLA) algorithm, designed to enhance scenario simulations for professional VR training by dynamically adjusting difficulty levels to match user performance, thereby supporting personalised learning and readiness for high-stakes situations such as firefighting and emergency response. Project and methods: The OLA algorithm divides scenario activities into blocks and adjusts their difficulty based on user performance in comparison to a reference group of AI-controlled agents. The algorithm’s efficacy was tested across three proprietary VR simulators covering diverse professional scenarios: public speaking, hydrogen electrolysis and mechanical technician operations. Each scenario was divided into ten blocks of varying difficulty (easy, medium, difficult), dynamically adjusted based on the user's performance. This structure enables rapid adaptation, making it particularly beneficial for fire and rescue training, where realistic, yet scalable, scenario complexity is critical to preparing for unpredictable conditions in the field. Results: Testing with 30 participants per simulator revealed an average final score of approximately 75%, closely aligning with the target success rate of 70%. The average number of difficulty level switches (between 0.8 and 1.16 across scenarios) demonstrated the algorithm’s effective adaptation to user performance, thus ensuring optimal engagement. The OLA algorithm’s capacity to tailor training difficulty in real time reflects its potential to enhance skill retention and readiness in emergency response settings, where maintaining user engagement at appropriate challenge levels is essential for preparedness in life-threatening situations. Conclusions: The OLA algorithm provides significant advancements in personalised VR training, particularly within fire- and rescue-related applications, by maintaining optimal engagement and adaptive challenge levels. The adaptability demonstrated across multiple scenarios indicates its versatility and potential for use in diverse high-risk training applications. Future research could enhance the OLA algorithm’s effectiveness by refining scenario block determination, therefore contributing to improved response times, decision-making and operational efficiency in the emergency services. Keywords: VR training, personalised learning, adaptive difficulty, fire and rescue training, scenario simulation, professional development, Optimising Level Adaptation (OLA), emergency response preparedness
The Effect of an Escape Room in Psychiatric Nursing Education on Knowledge, Proactivity in Problem-solving, Teamwork, and Learning Satisfaction of Nursing students: A Quasi-experimental Study
Authors: Hahn Sukwon , Ryu Young Mi
Published: December 2024

Purpose: This study assessed the effects of a psychiatric nursing class applying an escape room activity on nursing students’ knowledge, proactivity in problem-solving, teamwork, and learning satisfaction.Methods: A non-equivalent control group design with pretest-posttest measures was employed. In total, 82 nursing students taking psychiatric nursing participated in the study, with 39 in the experimental group and 43 in the control group. The experimental group participated in an escape room activity, while the control group engaged in a scenario-based group discussion for 50 minutes. The data were analyzed using the Mann-Whitney U test and the Wilcoxon signed-rank test with SPSS/WIN version 29.Results: No statistically significant differences were identified between the groups in terms of knowledge, proactivity in problem-solving, teamwork, and learning satisfaction. However, proactivity in problem-solving (Z=-3.47, p<.001) and teamwork (Z=-3.55, p<.001) were significantly increased for the experimental group in the post-test, while knowledge (Z=-2.40, p=.027), proactivity in problem-solving (Z=-3.96, p<.001), and teamwork (Z=-2.08, p=.037) were significantly increased in the control group when compared to the pretests.Conclusion: Both the escape room activity and the group discussion were effective in improving proactivity in problem solving and teamwork among nursing students and should therefore be incorporated into classes.
Effects of Depression, Patient Activation, and Family Support on Patient Role Behavior of Elderly Patients with Diabetes Mellitus
Authors: Park Jeong Hyun , Park Jung Suk
Published: December 2024

Purpose: To examine effects of depression, patient activation, and family support on patient role behavior of old adult patients with diabetes mellitus.Methods: A descriptive research design was used with a convenience sample of 131 elderly patients. Data were collected from Feb. 23, 2023 to Apr. 18, 2023 using self-reported questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression analysis.Results: Patient role behavior was negatively correlated with depression (r=-.32, p<.001) but positively correlated with patient activation (r=.55, p<.001) and family support (r=.18, p=.038). The following factors affected the performance of geriatric nursing: patient activation (β=.38, p<.001), sex (β=.30, p<.001), diabetic-educated experience (β=0.26, p<.001), and depression (β=-.19, p=.013). These factors explained 31.0% of the variance.Conclusion: To enhance patient role behavior of old adult patient with diabetes mellitus, developing individualized patient activation intervention programs and a depression prevention program that considers characteristics of patients is necessary.
Factors Influencing Job Embeddedness in Emergency Room Nurses: Focus on Positive Psychological Capital, Gratitude, and Anger Expression
Authors: Joo Sa Rang , Kang Mi-Jung
Published: December 2024

Purpose: This study aimed to identify the effects of positive psychological capital, gratitude, and anger on job embeddedness among emergency room nurses.Methods: A total of 144 participants, nurses with more than 6 months of emergency room work experience, were included. Data collection occurred from July 10 to August 20, 2022. The collected data were subjected to descriptive statistics, t-tests, ANOVA, Scheffé tests, Pearson's correlation coefficient, and multiple regression analysis using the SPSS/WIN 26.0 program.Results: There were statistically significant differences in job embeddedness according to the general characteristics of the participants in terms of age, position, total experience, positive psychological capital, and gratitude. Job embeddedness and positive psychological capital showed a statistically significant correlation (r=.48, p<.001), and job embeddedness also demonstrated a statistically significant positive correlation with gratitude (r=.38, p<.001). But there was no correlation with anger expression. Multiple regression analysis indicated that positive psychological capital and gratitude were factors influencing job embeddedness, with the independent variables explaining 26.6% of the variance in job embeddedness.Conclusion: Based on these results, to increase the job embeddedness of emergency room nurses in the future, it is recommended to offer programs aimed at enhancing levels of positive psychological capital and gratitude.
Literature Review on Non-Pharmacological Intervention for Mild Cognitive Impairment in Korea
Authors: Kim Ok Hee
Published: December 2024

Purpose: Mild Cognitive Impairment (MCI) is one of the risk factors for transition to dementia. This study aimed to review characteristics and results of MCI intervention (non-pharmacological) studies and use them as basic data for effective program development.Methods: This is a literature review on intervention studies of MCI. Search and selection procedure was based on PRIZMA in the Cochran collaboration and NECA. 65 papers were extracted by searching through official domestic journals KISS, Nursing, and DND for the last 10 years (2015~2024) using search words of 'mild cognitive impairment' and 'mild cognitive impairment program'. The suitability of studies was repeatedly verified and 15 papers were finally selected.Results: Cognitive function was significantly improved in all 15 papers and memory was significantly improved in 5 papers. Among them, intervention programs that significantly improved memory were virtual reality based immersion P, computer and workbook, independent board game P, dual-task VR P, and exercise-cognitive combined dual task P.Conclusion: The main symptom of MCI is memory impairment. Interventions used in 15 papers showed significant differences in improving overall cognitive function, with memory improvement verified in only 5 papers. A grounded intervention study on MCI including overseas papers was proposed.
Macroeconomic Security of Ukraine: Analysis of Dynamics and Approach to Defining Key Indicators
Authors: Mazhara G. , Zavalna M.
Published: December 2024

The article is dedicated to highlighting the pressing issues of Ukraine's macroeconomic security, which have become particularly critical due to external economic shocks and the extensive consequences of war. This study conducted a detailed analysis of the dynamics of key macroeconomic security indicators for the period 2013–2023, covering economic crises, the COVID-19 pandemic, and the full-scale invasion by the Russian Federation. The analysis results revealed that most indicators were already at critical and dangerous levels during 2013–2021, with the situation deteriorating significantly in 2022–2023, as most indicators reached their lowest values. The article compares the most common indicators, determining their weight and sensitivity to current economic threats. The list of the most relevant indicators includes the consumer price index, unemployment rate, real GDP growth rates, and the population's propensity to save.
The impact of cold weather on older people and the vital role of community nurses
Authors: Reis da Silva Tiago Horta
Published: December 2024

Over the past 160 years, the UK has experienced significant winter mortality among older people. A quarter of a million older people have died from cold-related illnesses over the past decade, with one older person dying every seven minutes. Misconceptions about winter deaths must be addressed. Evidence shows that winter deaths are avoidable. These deaths are not because of hypothermia and are unlikely to decline with climate change in the future. Improving indoor heating may only partially reduce winter deaths. An integrated policy is needed to reduce all risks equally, with community nursing playing a crucial role in such policies. This article explores the multifaceted impact of cold weather on older individuals and emphasises the crucial role that community nurses play in mitigating the associated challenges. Grounded in advanced concepts and research methodologies, the analysis encompasses physiological, psychological and social dimensions. The integration of primary sources and academic theories aims to provide a comprehensive understanding of the topic. The article also explores the specific responsibilities of community nurses and the evidence-based interventions required to address the unique needs of older individuals during the colder seasons.
Urinary incontinence in older adult women: fighting a rising tide
Authors: Ramadan Francesca
Published: December 2024

The world's population is rapidly ageing, with conditions such as urinary incontinence, which are especially prevalent among older adults, expected to rise in prevalence as a result. Urinary incontinence is particularly common in older women; however, despite its profound impact on every aspect of women's health and wellbeing, it is often minimised by both individual patients and the wider healthcare system. Francesca Ramadan delves into the prevalence of and psychosocial effects and patient-related factors related to urinary incontinence in older women.
Ethics and community nursing
Authors: Dowie Iwan
Published: December 2024

Iwan Dowie explores the critical role of ethics in community nursing, where nurses often make autonomous decisions in the home care of patients. Nurses are tasked with balancing individual patient rights with the broader needs of society, guided by ethical principles such as autonomy, beneficence, nonmaleficence and justice.
How care home staff can help to spot the signs of heart and circulatory disease among residents
Authors: Cowan Helen
Published: December 2024

Helen Cowan discusses how care home staff can help to spot the signs of heart and circulatory disease by looking at residents' faces.
Evaluation of Investigations Suitable to Stop Treatment in Spinal Tuberculosis
Authors:   Department of Orthopaedics, PGIMER, Chandigarh, India, Kumar Vishal , Bansal Parth ,   Department of Orthopaedics, PGIMER, Chandigarh, India, Dhatt Sarvdeep Singh ,   Department of Orthopaedics, PGIMER, Chandigarh, India, Meetei Tensubam Tomthin ,   Department of Orthopaedics, PGIMER, Chandigarh, India, Vatkar Arvind ,   Orthopaedics Department, Fortis Hiranandani Hospital, Vashi, Apollo Hospital, Navi Mumbai, Belapur, Maharashtra, India., Kale Sachin ,   Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Nerul, Navi Mumbai, Maharashtra, India.
Published: December 2024

Spinal tuberculosis is the most common extrapulmonary manifestation of tuberculosis and accounts for half of the cases of skeletal tuberculosis and 2% of all tuberculosis cases. The prevalence of spinal tuberculosis is widespread in an endemic county such as India where many people live under poor socioeconomic demographics. It is still a major cause of morbidity and economic loss as it generally affects the productive age groups and the deformities of spinal tuberculosis can have long-lasting effects on the affected population. Detection of drug-resistant strains is another worrying factor that contributes to the reemergence of spinal tuberculosis as a major cause of concern as it can lead to prolonged treatment and failure if not properly addressed on time. There is no proper gold standard investigation to reliably detect the endpoint of treatment in spinal tuberculosis and there is a lack of consensus regarding the exact duration of antitubercular therapy. This remains a gray area even today. This review article aims to look into some of the investigations that can help determine the endpoint of treatment with a special focus on magnetic resonance imaging (MRI) and positron emission tomography scan (MRI scan).
Keywords: Spinal tuberculosis, magnetic resonance imaging scan, positron emission tomography scan
Chronic Low Back Pain: A Spine Surgeon’s Graveyard
Authors:   Department of orthopedic Spine Surgeon, Namaha Hospital, Mumbai, Maharashtra, India, Shah Pranav , Zaveri Gautam ,   Department of orthopedic Spine Surgeon, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
Published: December 2024

Background: Chronic low back pain (cLBP) is a prevalent and debilitating condition. The World Health Organisation identified it as a major global health concern with the incidence rising by 50% between 1989 and 2019. It is projected that about 843 million people globally will suffer from cLBP by 2050. Despite its prevalence, the pathogenesis of cLBP remains poorly understood and its treatment fragmented. Almost 70% of cases are categorized as non-specific where the pain could likely be arising from dysfunction in ligament, muscles or joints. Degenerative conditions amount to 27% of cases, while non-spinal and sinister causes contribute to a smaller percentage. Psychosocial factors also play a significant role in both the onset and persistence of cLBP.
Discussion: The management of cLBP is multifaceted, focussing on non-surgical interventions such as pharmacological treatment, physical therapy, lifestyle modifications and complementary therapies. While non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants provide symptomatic relief, physical and behavioural therapies are crucial in addressing the chronic nature of the condition. Surgical options are reserved for cases with specific patho-anatomic aetiologies such as spondylolisthesis or spinal stenosis. The management of psychosocial aspects through cognitive behavioural therapy (CBT) is pertinent in enhancing patient outcomes.
Conclusion: This article provides a comprehensive review of cLBP, encompassing its aetiology, natural history, evaluation and management strategies. The role of multi-disciplinary approach, patient education and lifestyle modification is important in treating this complex condition. By integrating evidence-based practices with individualized care, the clinician can improve quality of life of patients affected by cLBP.
Keywords: Chronic low back pain, Non-specific low back pain, Degenerative lumbar spine, Cognitive behavioural therapy, Ergonomics.
Grapefruit Method: Metaphyseal Bone Grafting to Improve Press-fit of Cementless Humeral Stems in Reverse Shoulder Arthroplasty
Authors:   Department of Orthopaedics and Sports Medicine, Fortis Hospital, Mohali, Punjab, India, Arora Manit
Published: December 2024

Reverse shoulder arthroplasty is one of the fastest-growing orthopedic surgeries globally. There exist two options for stemmed humeral components: Cemented and cementless or press-fit designs. In cases of osteoporosis or poor metaphyseal bone stock, generally, the choice is made to opt for the former. We describe a method for metaphyseal bone grafting using the resected humeral head as an autograft to improve metaphyseal bone stock and allow for press-fit humeral component in such cases.
Keywords: Shoulder replacement, Shoulder surgery, Reverse shoulder replacement, Bone grafting
Mucoid Degeneration of Anterior Cruciate Ligament – A Review of Literature
Authors:   Department of Orthopedics, V. N. Desai Hospital, Santacruz East, Mumbai, Maharashtra, India., Korday Sujit , Khandekar Pushkar ,   Department of Orthopedics, V. N. Desai Hospital, Santacruz East, Mumbai, Maharashtra, India., Kantawala Suhail ,   Department of Orthopedics,Holy Spirit Hospital, Mahakali Caves Road, Andheri East, Mumbai, Maharashtra, India., Antao Nicholas ,   Department of Orthopedics,Holy Spirit Hospital, Mahakali Caves Road, Andheri East, Mumbai, Maharashtra, India.
Published: December 2024

Mucoid degeneration of the anterior cruciate ligament (MD-ACL), once thought to be a rare entity, is seen not so uncommonly in present day orthopaedic practice. Several hypotheses attempt to explain this entity. Clinically, it presents as knee pain with limitation of flexion or extension. There is no specific test available to clinically diagnose MD-ACL. Magnetic Resonance Imaging (MRI) remains the imaging modality of choice to diagnose MD-ACL. Therefore, a high index of suspicion is necessary to be able to diagnose this condition. This article reviews the available literature about the etio-pathological aspects of MD-ACL, its clinical features, radiological and arthroscopic findings, as well as various treatment modalities available.
Keywords: Mucoid degeneration, anterior cruciate ligament, knee, arthroscopy, MRI.
Habitual Dislocation of the Patella Managed by a Two-in-One Procedure
Authors:   Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India,, Mittal Ravi , Sai Krishna M L V ,   Department of Orthopaedics, Aayush Hospitals, Eluru, Andhra Pradesh, India
Published: December 2024

Introduction: Habitual dislocation of the patella is a complex pathological condition of the patella which is characterized by lateral dislocation of the patella with flexion and relocation of the same with extension of the knee. There are numerous surgical procedures with various modifications that have been described in the literature based on the origin of pathology (soft tissue or bone). In this case series of 15 children, we described our technique of two-in-one procedure.
Materials and Methods: We included 15 patients with habitual dislocation of the patella between the ages of 5 and 9 years. In all the patients a detailed evaluation was done preoperatively and all of them were managed by a two-in-one procedure and followed up at 3 months and 1 year.
Results: There was no recurrence of dislocation in any of the patients and all the patients had attained their full range of movement by 1 year.
Conclusion: The two-in-one procedure is a simple and reproducible procedure for the treatment of habitual dislocation of the patella without any bony involvement. The procedure included graded lateral soft-tissue release and the Roux Goldthwait procedure. The amount of lateral soft-tissue release required is titrated intraoperatively.
Keywords: Habitual dislocation, Patella, Two in procedure, Knee.
Tackling Post-TKR Complications: Achilles Allografts in Extensor Mechanism Reconstruction
Authors:   [1] Department of Orthopaedics, Sona Medical Centre, Mumbai, Maharashtra, India. [2] Department of Orthopaedics, Saifee Hospital, Mumbai, Maharashtra, India. [3] Department of Orthopaedics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India. [4] Department of Orthopaedics, Breach Candy Hospital Trust, Mumbai, Maharashtra, India., Bhagunde Prasad , Shah Damini ,   Novo Tissue Bank and Research Centre, Mumbai, Maharashtra, India., Modi Nihar ,   [1] Department of Orthopaedics, Sona Medical Centre, Mumbai, Maharashtra, India. [3] Department of Orthopaedics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India. [6] Department of Orthopaedics, Criticare Asia Multispeciality Hospital and Research Centre, Mumbai, Maharashtra, India.
Published: December 2024

Revolutionizing post-TKR care, novel use of Achilles tendon allografts emerge as a game-changer for displaced extensor mechanism, tackling one of the most challenging complications of total knee replacement. By restoring active knee extension and preventing lateral patellar subluxation, this technique empowers patients with improved mobility and independence.
The study included three patients with persistent patellar instability and malalignment were treated with a lateral retinacular release and Achilles tendon allograft fixation around the quadriceps mechanism. At 12 months, functional outcomes improved significantly: the Kujala score increased from 50 to 85, Knee Society Score (KSS) from 60 to 90, and Tegner Activity Level from 2 to 6. Postoperative imaging confirmed successful graft incorporation and alignment correction.
This technique, combining soft-tissue release with robust Achilles tendon allograft reconstruction, offers a promising solution for complex post-TKR patellar maltracking, highlighting the strength and adaptability of the Achilles tendon in restoring knee dynamics.
Overcoming the limitations of autografts and other traditional methods, this novel approach offers unmatched strength and adaptability while addressing critical surgical complexities. Despite potential challenges like stiffness and availability, the outcomes highlight enhanced function, stability, and patient satisfaction. With its innovative approach and tailored rehabilitation protocols, this procedure sets a new benchmark in orthopedic reconstructive surgery, combining precision and patient-centric care to redefine recovery.
Keywords: Quadriceps displacement, extensor mechanism repair, achilles tendon allograft, post-TKR complications
Prevalence and patterns of substance use in West Africa: A systematic review and meta-analysis
Authors: Emmanuel Godwin Omokhagbo , Akinsolu Folahanmi Tomiwa , Abodunrin Olunike Rebecca , Ezechi Oliver Chukwujekwu
Published: December 2024

Introduction

Substance use is a growing public health concern in West Africa, contributing to significant morbidity, mortality, and socioeconomic challenges. Despite the increasing prevalence, comprehensive data on the patterns and factors influencing substance use in the region remain limited. This systematic review and meta-analysis aim to synthesize existing research on the prevalence and patterns of substance use in West Africa, providing critical insights for developing targeted interventions and policies.

Methodology

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. A systematic search was performed across four major databases [PubMed, Web of Science, CINAHL, and Scopus] from January 2000 to June 2024. A total of 22 studies involving 43,145 participants met the inclusion criteria. Multiple reviewers performed data extraction and quality assessment independently, and a random-effects meta-analysis was used to estimate the pooled prevalence of various substances. Sensitivity analysis was conducted using a leave-one-out approach to evaluate the influence of individual studies on the overall prevalence.

Results

The meta-analysis revealed the pooled prevalence rates of alcohol [44%], cannabis [6%], tramadol [30%], codeine [11%], and kolanut [39%]. The analysis identified high heterogeneity across studies [I2 = 98–99%], reflecting diverse substance use patterns and influencing factors, including peer influence, availability of substances, socioeconomic conditions, and demographic characteristics. Sensitivity analysis indicated that no single study significantly impacted the overall prevalence estimates, confirming the robustness of the findings.

Conclusion

Substance use in West Africa is widespread and influenced by complex factors. The high prevalence of alcohol and tramadol use highlights the urgent need for targeted public health interventions, including stricter regulatory frameworks, community-based prevention programs, and comprehensive public education campaigns. This study provides a critical foundation for developing effective strategies to mitigate the escalating substance use crisis in the region.
Efficacy of vaccines based on chimeric or multiepitope antigens for protection against visceral leishmaniasis: A systematic review
Authors: Lopes Karine Ferreira , Freire Mariana Lourenço , Murta Silvane Maria Fonseca , Oliveira Edward
Published: December 2024

Background

Visceral leishmaniasis (VL) is an infectious parasitic disease caused by the species Leishmania (Leishmania) infantum in the Mediterranean Basin, the Middle East, Central Asia, South America, and Central America, and Leishmania (Leishmania) donovani in Asia and Africa. VL represents the most severe and systemic form of the disease and is fatal if left untreated. Vaccines based on chimeric or multiepitope antigens hold significant potential to induce a highly effective and long-lasting immune response against infections by these parasites. This review systematically compiles data on the efficacy and protective capabilities of chimeric and multiepitope antigens, while also identifying potential immunogenic targets for vaccine development.

Methodology

A systematic search was conducted by independent reviewers across four databases to assess the efficacy of vaccines based on chimeric or multiepitope antigens against VL. The review included original studies that reported parasite load or positivity rates in animals immunized with these vaccines and subsequently challenged or exposed to L. infantum infection in preclinical and clinical studies. Key information was extracted, tabulated, and analyzed, with the risk of bias being assessed using the SYRCLE Risk Tool.

Principal findings

A total of 22 studies were selected, with only one being a randomized clinical trial. Most of the studies were conducted with mice, followed by dogs and hamsters. The reduction in parasite load varied from 14% to 99.6% and from 1.7 to 9.0 log orders. Limiting dilution was the most used method for assessing parasite load, followed by quantitative real-time polymerase chain reaction (qPCR). Most domains had an uncertain risk of bias due to insufficient information described.

Conclusions

Vaccine formulations containing various chimeric or multiepitope antigens have been developed and evaluated in different preclinical trials, with only one advancing to clinical trials and commercialization. However, the findings of this review highlight the promising potential of chimeric and multiepitope antigens as vaccine candidates against VL. The evidence presented could play a crucial role in guiding the rational development of new studies focused on using these antigens for vaccination against VL.