bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Risk Factors of Postoperative Lower Extremity Deep Venous Thrombosis in Patients With Cervical Cancer
Authors: Cheng Shiyu , Gao Han , Li Yanli , Shi Xiuting , Li Xin , Yang Tianzhuo , Teng Dan , Meng Tingzhu , Shi Jie
Published: March 2024

Deep venous thrombosis (DVT) has a significant negative impact on surgical and tumor patient's safety and quality of life. There was no specific report on the incidence and risk factors of postoperative lower extremity DVT in cervical cancer patients. Analysis of the risk factors of postoperative DVT in patients with cervical cancer is of great clinical significance for prevention and treatment. We retrospectively analyzed 309 cervical cancer patients treated by the Hubei Cervical Cancer Prevention Center and used a logistic regression model to test the risk variables of postoperative lower extremity deep venous thrombosis in cervical cancer patients. By univariate analyses, the results of the study showed that the incidence of postoperative DVT was significantly increased in cervical cancer patients complicated with old age, obesity, high preoperative plasma D-dimer level, increased preoperative triglyceride level, chronic diseases (hypertension, diabetes, and cardiovascular disease), open surgery, long operation time, intraoperative blood transfusion, advanced tumor stage, and preoperative chemotherapy/radiotherapy. Advanced age, obesity, elevated preoperative D-dimer level, high preoperative triglyceride level, and open surgery were independent risk factors for postoperative lower extremity DVT in patients with cervical cancer by multivariate regression analyses (all P < .05). In gynecologic patients with cervical cancer, there is a high incidence of postoperative lower extremity DVT. Clinicians should develop systematic and comprehensive prevention and treatment measures for the risk factors to lower this morbidity and improve patient prognosis.
Stability analysis and vibration suppression in an overhung rotor system using active magnetic damper
Authors: Singh Shashank Shekhar , Kumar Punit
Published: March 2024

The present work demonstrates the effectiveness of an active magnetic damper (AMD) in improving the vibration characteristics of an overhung rotor system (ORS) considering the effects of synchronous mass-unbalance, rotor bow, and viscous internal damping. A finite element-based rotordynamic analysis has been conducted to evaluate the system response using state-space formulation. MATLAB codes are developed for the numerical implementation of the rotordynamic model pertaining to the flexible ORS integrated with an AMD consisting of three parallel feedback loops. The internal damping is found to reduce the vibration amplitudes at the bearing and disk locations. However, it leads to system instability in the absence of AMD beyond the first critical speed (670 RPM) which is indicated by the change in the real part of eigenvalues. Under these circumstances, the use of AMD causes a remarkable improvement and the system stabilizes for almost the entire speed range considered here, 320–10,000 RPM. In addition, the AMD causes a maximum reduction of 95.8%, 96.5%, and 83.3% in the vibration amplitudes at the locations of Bearing 1, Bearing 2, and the overhung disk, respectively. Using an appropriate set of AMD parameters, the system characteristics can be altered effectively as per the requirement.
Assessment of polyethylene wear in dual mobility implant for Asians on various head-to-liner ratios: A finite-element analysis
Authors: Hidayat Taufiq , Ammarullah Muhammad Imam , Ismail Rifky , Tauviqirrahman Mohammad , Saputra Eko , Lamura Muhammad Danny Pratama , KN Chethan , Bayuseno Athanasius Priharyoto , Jamari
Published: March 2024

Based on several references, Asians carry out several daily activities that are different from Westerners, which require a greater range of motion. Because of that, a dual mobility (DM) implant was created that was adapted to the activities of Asian people. One of the factors that might shorten the life of a hip implant is wear. Simulations of wear that are based on computation can guide product design to reduce the amount of adhesive and abrasive wear. Even though advanced modeling approaches have been established, a great deal of wear is still not understood, especially regarding the metal-on-polyethylene articulations found on DM cups. It is critical to examine the wear on the DM cup's head-to-liner ratio to determine the proper head diameter and liner thickness for this DM cup. In this work, wear was analyzed using finite-element analysis and compared between three different femoral head diameters matched with different thicknesses of the polyethylene liner on DM cups. Wear was analyzed throughout the regular walking cycle at each head-to-liner ratio. The findings of this study can be used to develop a dual-mobility artificial hip joint for Asians with the slightest wear.
Investigating the acceptability of a culturally adapted acceptance and commitment therapy group for UK Vietnamese communities: A practice-based feasibility study
Authors: Perry Aradhana , Gardener Chelsea , Shieh Jack , Hồ Quang Tấn , Doan Anh , Bhui Kamaldeep
Published: March 2024

Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy that offers promise for the mental health of minoritised ethnic populations. Given the diversity of those presenting to inner-city services and barriers to accessing appropriate mental healthcare, we sought to develop a culturally syntonic ACT intervention for UK Vietnamese refugee communities in a practice-based partnership project between a National Health Service and local third-sector service in East London. The aim was to explore the feasibility, acceptability and impact of the adapted intervention to inform culturally inclusive clinical practice and future research. We outline key aspects of Vietnamese belief systems and culture, and consider how these might influence the optimisation of group-based ACT. We then present a mixed-method evaluation of the seven-session adapted ACT group for 11 participants (9 male and 5 female, aged between 44 and 73 years). Individual-level change analyses indicated clinically significant improvements in psychological flexibility for the minority of participants and a mixed pattern for impact on well-being. A thematic analysis and descriptive approach examined acceptability, feasibility and narratives of impact. Participants reported positive feedback on group experience, relevance and usefulness, and emergent themes indicate that the group facilitated key acceptance, commitment and behaviour-change processes, promoted social connections and increased engagement in meaningful life activities in relation to new perspectives and values-based action. Limitations are outlined, but overall, findings suggest preliminary support for the potential beneficial effect of the adapted ACT group as a feasible, culturally acceptable therapeutic approach for UK Vietnamese communities that is worthy of further investigation.
Adolescent and caregiver perceptions of addressing mental health in inflammatory bowel disease
Authors: Berenblum Tobi Catalina , Vu Maihan , Díaz-González de Ferris Maria E , Semerzier Sherritta , Kappelman Michael D , deJong Neal A
Published: March 2024

Adolescents with inflammatory bowel disease (IBD) are at an increased risk of anxiety and depression compared to peers, but availability of mental health services in IBD clinics does not meet patients’ needs, and use of primary care services for mental health screening and care is low. This study provides qualitative data regarding adolescent and caregiver perspectives on addressing mental health in IBD. Interviews were conducted with adolescents with IBD and caregivers of adolescents with IBD. Interview transcripts were coded and analyzed for prominent themes. Thirteen adolescents and fourteen caregivers were interviewed. Three primary themes emerged: mental health stigma makes discussing it more difficult, physician–adolescent trust makes conversations about mental health easier, and asking about mental health directly can help adolescents feel comfortable. Adolescents and caregivers highlighted the importance of considering each patient and their family individually when choosing how to discuss mental health. Fostering trust with adolescents with IBD is vital to addressing mental health. While encouraging standardized screening is important, the most patient-centered approach to mental health involves considering families individually to identify and address mental health challenges. Given the increased risk of anxiety and depression in pediatric patients with IBD, all providers encountering these patients should be equipped to discuss mental health non-judgmentally.
Social assistance and the end of poverty
Authors: Jørgensen Stine
Published: March 2024

This article aims to address the stigma and stereotypes inherent in the system of social assistance by addressing poverty as a matter of discrimination. Through the lens of discrimination, the article argues that the welfare system reproduces the very structures it aims to abolish in its alleged care for people living on the margins.
Assisting Healthier and More Sustainable Online Food Choices Through Digital Quality Signals: Exploring Preferences and Segments
Authors: Sigurdsson Valdimar , Menon Ramachandran Girija Vishnu , Larsen Nils Magne , Fagerstrøm Asle
Published: March 2024

The current paper contributes to signalling theory by demonstrating the importance of digital quality signals in influencing consumer preferences for sales and segmentation in the context of marketing fresh fish online. We conducted a choice-based conjoint analysis with a latent class segmentation to analyse the significance of digital quality signals compared to traditional attributes online. The analysis of 1,411 global consumers revealed that product rating was among the most important factors when purchasing fresh salmon fillets online. Latent class segmentation identified four distinct segments, the largest being ‘value for money’, where product rating and pricing were most important. The other segments were ‘environmentally friendly’, prioritising procurement methods and place of origin; ‘want it now’, where delivery was the most important factor; and ‘quality conscious’, which relied on three attributes – origin, delivery, and product rating. This study enhances understanding of the impact of socially mediated stimuli. It demonstrates the ability of digital quality signals to compensate for the absence of sensory evaluation in online store environments or deficiencies in knowledge or experience. The findings will benefit the food industry and online grocery retailers in promoting healthier and more sustainable products such as fish online.
The growing partisan politicization of non-political online spaces: A mixed-method analysis of news app reviews on Google Play between 2009 and 2022
Authors: Wang Rui , Thimmanayakanapalya Sagarika Suresh , Ophir Yotam
Published: March 2024

Drawing on theories of identity politics and partisan polarization, we explored the politicization of Google Play’s news app reviews—an explicitly non-political domain. Using a mixed-methods approach, Analysis of Topic Model Networks (ANTMNs), combining topic modeling, network analysis, community detection, and theory-driven qualitative reading, we analyzed 759,143 reviews from 2009 to 2022 across 46 news apps. Three themes emerged: Technical, Content Quality, and Political. The political discourse in reviews has intensified over the years, with notable spikes around election periods. Accusations of bias were found to correlate most strongly with lower app ratings. The findings provide alarming empirical evidence for the politicization of non-political spaces, such as the app reviews section on app stores. With identity politics on the rise, this study sheds light on the importance of considering non-political online spaces for the study of political discourse.
Emerging regulatory gaps in fracking-specific water security issues in India: Lessons from the United States ‘Shale Revolution’
Authors: Yadav Shashi Kant , Bhardwaj Chhaya , Sarangi Gopal K
Published: March 2024

India has characterised shale gas as a transitional energy source and is planning to commercially scale the extraction of shale gas through hydraulic fracturing (fracking). Currently, India has announced 56 fracking projects spread across six Indian states. In doing so, exploration of shale gas resources has started in India. The regulations that govern conventional extraction processes are also applicable to fracking activities. The conflation of fracking with conventional drilling processes in India's regulatory approach may have implications for the country's water security, given the unique risks that fracking poses to water resources. This article analyses India's regulatory framework applicable to fracking-specific water (FSW) issues. In doing so, this article identifies four key paradigms of water security and maps these key paradigms with the US fracking experience, identifying four key FSW issues. Subsequently, this article evaluates if India's multilevel regulatory system regulates the identified four FSW issues. In conclusion, this research finds that before commercially scaling fracking operations, India must conduct a scientific inquiry on the impact of proposed fracking projects on its water resources. In doing so, it must re-examine its regulations at the federal and state levels to comprehensively cover FSW issues.
Sustainable sides of taxation: An international law approach
Authors: Ng Kenny
Published: March 2024

This article explores from an international law perspective how taxation can be used by states as an instrument to address the mutually reinforcing themes of sustainability and human rights, and to sustain a civilisation. In doing so, the article discusses how far the maximisation of financial resources through a domestic tax system is necessary for the attainment of the United Nations Sustainable Development Goals. It further discusses whether tax avoidance by multinational enterprises is an infringement of the human rights obligations undertaken by states under the International Covenant on Economic, Social and Cultural Rights.
From “wait ‘em out” to push them out: Teachers’ reflections on passive and active modes of racialized school exclusion
Authors: Cruz Kenneth A. , Myers Randy
Published: March 2024

Much has been written about the school-to-prison pipeline and the larger punitive turn within schools in the United States. This research has documented disturbing racialized disparities and disproportionate impacts on youth who are diagnosed with disabilities. While this scholarship has highlighted how marginalized youth encounter exclusionary forms of punishment, what is often missing is an understanding of how practitioners experience the policies, practices, and consequences of the school-prison nexus. In this study, the unique career experiences of individuals who worked as both teachers and juvenile justice practitioners in the Southwestern United States are analyzed. The reflections of practitioners who worked at both ends of the school-to-prison pipeline uncover a range of exclusionary practices in schools that is broader than what current conceptions suggest. This study adds important nuance to the literature by revealing how some educators facilitate school dropout through passive modes of racialized exclusion in addition to those that actively push out minoritized students. The article outlines three distinct categories of racialized school exclusion, examines their impacts, discusses how subtle modes of exclusion may relate to more overt punishments, and explores the broader context under which this range of “passive” to “active” modes of educational exclusion develops and operates.
Compression properties of cellular iron lattice structures used to mimic bone characteristics
Authors: Nogueira Pedro , Magrinho João PG , Silva Maria B , de Deus Augusto M , Vaz Maria F
Published: March 2024

Recently, cellular materials made by the repetition of unit cells, that is, iron lattices have become appealing to mimic the structure of bone. The aim of the study is to choose the most adequate lattice structures, which have the compressive mechanical properties closer to the ones of bone, in the perspective of their use as temporary implants. Five types of unit cells were selected, such as, cubic (C), truncated octahedron (TO), truncated cubic (TC), rhombicuboctahedron (RCO), and rhombitrucated cuboctahedron (RTCO). The mechanical properties were assessed by numerical simulations with a finite-element analysis. The size effect was studied with the comparison of results among samples with different numbers of unit cells. Simulations covered a wide range of relative densities. Graded dense-in and dense-out configurations were constructed with lattices of types RTCO and TO, being the unit cells, themselves graded. Lattice structures RTCO and TO were found to be stable at every relative density studied, while C, TC and RCO lattices are unstable at low densities. The evaluation of size effects was not conclusive, which could be biased by other factors. The Young's modulus of RTCO and TO lattices enable to reproduce the properties of both trabecular and cortical bone, with an appropriate choice of the relative density. To mimic trabecular bone, only RTCO and TO structures with low relative densities, can be used, while arrangements of C, TC and RCO cells can only replicate the properties of cortical bone. Graded cells may have the same properties as non-graded with lower density.
Alcohol Use and Moffitt's Maturity Gap Thesis for Adolescent Offending: An Evolutionary Perspective and Analysis
Authors: Royle Meghan L. , Connolly Eric J.
Published: March 2024

While a wealth of research has focused on testing several arguments from Moffitt's developmental taxonomy of antisocial behavior—mainly the presence of life-course-persistent vs. adolescence-limited offending and predictors of each trajectory—much less attention has been devoted to examining how evolutionarily adaptive lifestyle factors common during adolescence may condition the relationship between the maturity gap and delinquent offending. One factor that may play a role during this period of development is alcohol use, as many adolescents begin to experiment with consuming alcohol in varying degrees in social settings to model adult-like behaviors. Yet presently much is unknown about the role of alcohol use on the association between the maturity gap and delinquency. The current study aims to address this void in the literature by analyzing data from a U.S. sample of adolescent males ( N = 1,276) to assess whether alcohol use moderates the relationship between the maturity gap and delinquent behavior. Findings suggest that the maturity gap is associated with delinquent behavior and that the association becomes weaker at higher levels of alcohol use. The implications of these findings for Moffitt's maturity gap thesis and male offending from an evolutionary perspective are discussed.
Contrast-Free Endovascular Aneurysm Repair Combined With Fibrin Sealant Filling for Treating Abdominal Aortic Aneurysm: Technical Note
Authors: Zhu Longtu , Guo Wenying , Chen Li , Zhang Hao , Xu Bing , Ding Zhichen , Lu Qingsheng , Zhang Lei
Published: March 2024

Introduction:

Endovascular aneurysm repair using iodinated contrast agents risks contrast-induced nephropathy, especially in high-risk patients. This technical note describes a contrast-free endovascular aneurysm repair (EVAR) protocol using preoperative imaging measurement and fibrin sealant (FS) filling.

Technique:

Preoperative imaging measurement and intraoperative guidewire manipulation facilitated anatomical identification without contrast. After endograft deployment, the aneurysm sac was filled with FS if endoleak was indicated by pressure fluctuations.

Result:

Between 2017 and 2020, 6 high-risk patients underwent contrast-free EVAR with FS filling. Complete exclusion was achieved in all cases. Over follow-up, no endoleaks, deterioration in renal function, or other complications were observed.

Conclusion:

Contrast-free EVAR with FS filling shows early feasibility as an alternative technique for contrast-induced nephropathy (CIN) high-risk patients, while larger studies with long-term monitoring are imperative to validate outcomes.

Clinical Impact

This study showcases a contrast-free EVAR technique with fibrin sealant filling for high-risk CIN patients. It offers a safer approach for those with renal challenges, reducing CIN risk. The technique’s feasibility in a small cohort suggests its utility in treating AAA without iodinated contrast, crucial for patients with specific health risks. For clinicians, it introduces a method that decreases nephrotoxic risks, potentially changing practice for vulnerable patients
Monorail snare technique for retrieval of stretched coil
Authors: Cheng Chiu-Shih , Lin Wan-Ching , Lin Pei-Ling , Lee Cheng-Lung , Ou Chang-Hsien
Published: March 2024

Coil stretching is a recognized complication during cerebral aneurysm embolization. 1 , 3 – 5 For over a decade, the microsnare has proven effective in retrieving migrated coils. 1 – 5 Fiorella et al. unveiled the “Monorail Snare Technique” in 2005, offering a specialized approach to stretched coil recovery. 1 However, to gain a complete understanding of this technique, more than just textual descriptions are necessary; a thorough, practical demonstration is essential. In our technical video (video 1), we illustrated an episode of coil stretching during aneurysm embolization, where the “Monorail Snare Technique” was successfully employed to retrieve a stretched coil. Our video emphasizes the meticulous preparation and modification of the microsnare, showcasing enhanced steps to mitigate the potential blood backflow triggered by the exclusive use of one-arm hemostasis valve during the “Monorail Snare Technique.” 1 , 5 This pivotal adjustment substantially lowers the threat of thromboembolic events. We highlighted essential precautions to ensure the procedure's safety and efficacy. 4 , 5
“All I know is that a disabled person is someone who is crippled”: Using narratives of parents to unmask the misconceptions of Mild intellectual disabilities concept as a learning support hindrance
Authors: Mabaso Nancy Phyllis Makhosazane
Published: March 2024

Background: Learning-support provision by parents is key to children’s scholastic success. However, when children are diagnosed with mild intellectual disabilities and in need of additional support, learning support provision is hindered. Aim: The study sought to investigate parents’ experiences when providing learning support to children diagnosed with Mild intellectual disabilities. Setting: Using a phenomenological design and an interpretive paradigm, anchored in a qualitative research approach, data were gathered from parents whose children were diagnosed with Mild intellectual disabilities across three inclusive schools from disadvantaged backgrounds in the Gauteng province, in South Africa. Methods: Twenty-three (23) parents were purposefully selected to participate in the study by sharing their lived experiences. Data was collected using semi-structured interviews and thematic content data analysis methods. Bronfenbrenner’s bio-ecological systems theory underpinned the study. Results: The findings revealed that the parents’ misconception of the mild intellectual disability concept is one of the learning support hindrances. Conclusion: Parental empowerment through psycho-education was highlighted as a need for policy and practice adaptation.
“It saved me”: A thematic analysis of experiences of psychological therapy following critical illness and intensive care
Authors: Clarke Rachel , Weare Victoria , Chow Homen , Bowering-Sheehan Lydia , Hitchcock Clark
Published: March 2024

Background:

ICU-survivors are likely to struggle with psychological wellbeing. Providing post-ICU therapeutic interventions is a relatively novel field and little is known about patients’ experiences.

Methods:

Thematic analysis was used to analyze semi-structured interviews with 20 ICU-survivors who had accessed psychological therapy following discharge from an ICU in the Southwest of Britain. Descriptive statistics were used to summarize data to provide service related contextual information.

Results:

Five themes emerged from the data: the impact of critical illness, value of therapy, accessing therapy, process of therapy and role of psychologist. Psychological therapy is viewed as an important part of recovery. Critical illness is a complex experience. Therapy supported sense-making, acceptance and moving forwards. Although therapy could be initially difficult, there were lasting positive effects. There were different challenges to and facilitators of accessing therapy and offering ongoing support provided reassurance. A safe therapeutic relationship and an ICU-specific service was important.

Conclusion:

Psychological therapy, alongside other rehabilitation interventions, can facilitate recovery. Considerations for local and wider service development are discussed.
Improved visualization of median, ulnar nerves, and small branches in the wrist and palm using contrast-enhanced magnetic resonance neurography
Authors: Kang Jiamin , Wu Wenjun , Kong Xiangchuang , Su Yu , Liu Dingxi , Li Chungao , Gao Nan , Wang Youzhi , Zheng Chuansheng , Weng Yuxiong , Wang Lixia
Published: March 2024

Background:

Magnetic resonance imaging of peripheral nerves in the wrist and palm is challenging due to the small size, tortuous course, complex surrounding tissues, and accompanying blood vessels. The occurrence of carpal palmar lesions leads to edema, swelling, and mass effect, which may further interfere with the display and identification of nerves.

Objective:

To evaluate whether contrast-enhanced magnetic resonance neurography (ceMRN) improves the visualization of the morphology and pathology of the median, ulnar nerves, and their small branches in the wrist and palm.

Design:

An observational study.

Methods:

In total 57 subjects, including 36 volunteers and 21 patients with carpal palmar lesions, were enrolled and underwent ceMRN and non-contrast MRN (ncMRN) examination at 3.0 Tesla. The degree of vascular suppression, nerve visualization, diagnostic confidence, and lesion conspicuity was qualitatively assessed by two radiologists. Kappa statistics were obtained for inter-reader agreement. The signal-to-noise ratio, contrast ratio (CR), and contrast-to-noise ratio (CNR) of the median nerve were measured. The subjective ratings and quantitative measurements were compared between ncMRN and ceMRN.

Results:

The inter-reader agreement was excellent ( k > 0.8) for all qualitative assessments and visualization assessment of each nerve segment. Compared with ncMRN, ceMRN significantly improved vascular suppression in volunteers and patients (both p < 0.001). The ceMRN significantly enhanced nerve visualization of each segment (all p < 0.05) and diagnostic confidence in volunteers and patients (both p < 0.05). The ceMRN improved lesion conspicuity ( p = 0.003) in patients. Quantitatively, ceMRN had significantly higher CRs of nerve versus subcutaneous fat, bone marrow, and vessels and CNR of nerve versus vessel than ncMRN (all p < 0.05).

Conclusion:

The ceMRN significantly improves the visualization of peripheral nerves and pathology in the wrist and palm by robustly suppressing the signals of fat, bone marrow, and especially vessels in volunteers and patients.
Work-based learning: Expansive learning, désoeuvrement, social justice and VET
Authors: Avis James
Published: March 2024

The paper raises important questions about the relationship between Vocational Education and Training (VET), work-based learning (WBL) and social justice. It adopts an analysis that moves beyond conceptualisations that validate WBL as an acknowledgement of the dignity of labour. It seeks to go beyond analyses that mobilise a conventional understanding of expansive learning. How then can we develop a broader understanding of WBL and VET? Such an understanding needs to acknowledge socio-economic contexts are marked by a fluidity and surplus labour and for many worklessness – what some have described as désoeuvrement. Labor can be an expression of our species being and can be found in unwaged work and the activities we engage in to express our humanity. Such labour is external to the oppressions and exploitation that are features of much waged labour. Is it then possible to conceive of an expansive notion of VET that goes beyond wage-based cultures of expansive learning towards a position that has embedded within it a commitment towards collective well-being, social justice and an understanding of the vocational that moves beyond a focus on waged labour and the interests of capital.
Nirmatrelvir/ritonavir and remdesivir against symptomatic treatment in high-risk COVID-19 outpatients to prevent hospitalization or death during the Omicron era: a propensity score-matched study
Authors: Rajme-López Sandra , Martinez-Guerra Bernardo A. , Román-Montes Carla M. , Tamez-Torres Karla M. , Tello-Mercado Andrea C. , Tepo-Ponce Karen M. , Segura-Ortíz Zurisadai , López-Aguirre Abigail , Gutiérrez-Mazariegos Orianlid del Rocío , Lazcano-Delgadillo Oswaldo , Nares-López Rafael , González-Lara María F. , Kershenobich-Stalnikowitz David , Sifuentes-Osornio José , Ponce-de-León Alfredo , Ruíz-Palacios Guillermo M.
Published: March 2024

Background:

Even though worldwide death rates from coronavirus disease 2019 (COVID-19) have decreased, the threat of disease progression and death for high-risk groups continues. Few direct comparisons between the available severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antivirals have been made.

Objective:

We aimed to compare two SARS-CoV-2 antivirals (nirmatrelvir/ritonavir and remdesivir) against all-cause hospitalization or death.

Design:

This is a propensity score-matched cohort study.

Methods:

We included all high-risk outpatients with COVID-19 in a tertiary referral center in Mexico City from 1 January 2022 to 31 July 2023. The primary outcome was all-cause hospitalization or death 28 days after symptom onset. The secondary outcome was COVID-19-associated hospitalization or death 28 days after symptom onset. Logistic regression analysis for characteristics associated with the primary outcome and a multi-group comparison with Kaplan–Meier survival estimates were performed.

Results:

Of 1566 patients analyzed, 783 did not receive antiviral treatment, 451 received remdesivir, and 332 received nirmatrelvir/ritonavir. The median age was 60 years (interquartile range: 46–72), 62.5% were female and 97.8% had at least one comorbidity. The use of nirmatrelvir/ritonavir was associated with an absolute risk reduction of 8.8% and a relative risk reduction of 90% for all-cause hospitalization or death. The use of remdesivir was associated with an absolute risk reduction of 6.4% and a relative risk reduction of 66% for all-cause hospitalization or death. In multivariable analysis, both antivirals reduced the odds of 28-day all-cause hospitalization or death [nirmatrelvir/ritonavir odds ratio (OR) 0.08 – 95% confidence interval (CI): 0.03–0.19, remdesivir OR 0.29 – 95% CI: 0.18–0.45].

Conclusion:

In high-risk COVID-19 outpatients, early antiviral treatment with nirmatrelvir/ritonavir or remdesivir was associated with lower 28-day all-cause hospitalization or death.
Invasive fungal infections in patients with multiple myeloma: a possible growing problem in hematology and infectious diseases
Authors: Valkovic Toni , Marcelic Lucija , Valkovic Frane
Published: March 2024

Multiple myeloma is among the most common hematological malignancies and is characterized by a strong susceptibility to infections primarily bacterial and viral and, to a much lesser extent, fungal. There appears to be a slightly increasing frequency of invasive fungal infections. This is attributed to the use of different combinations of newer drugs and patients’ exposure to increasing therapeutic lines, and thus to risk factors for invasive fungal infections, especially severe and long-term neutropenia. Novel immunotherapy modalities including bispecific antibodies and chimeric antigen receptor T-cell therapy are being introduced for the treatment of relapsing-refractory forms of the disease. Consequently, in the near future, it can be expected that myeloma patients will exhibit a significantly increased frequency of invasive fungal infections. Therefore, we must carefully monitor all epidemiological trends related to invasive fungal infections in patients with multiple myeloma, both in clinical studies and in real life. This will help us learn to prevent fungal infections, as well as quickly recognize and treat them to reduce their impact on patients’ morbidity and mortality. In this review article, we describe in detail the epidemiological characteristics of invasive fungal infections in myeloma patients, the risk factors for these infections, and the treatment and prevention options.
Clients’ knowledge and satisfaction with outpatient pharmacy services and associated factors at Felege Hiwot comprehensive specialized hospital, Ethiopia: A cross-sectional study
Authors: Ergetie Firdawek Shenkute , Kassaw Abebe Tarekegn , Belachew Eyayaw Ashete
Published: March 2024

Objective:

This study aimed to assess patient knowledge and satisfaction and associated factors with outpatient pharmacy service at Felege Hiwot comprehensive specialized hospital.

Design, setting and participants:

An institution-based cross-sectional study was conducted at Felege Hiwot comprehensive specialized hospital on patients getting outpatient Pharmacy service from 01 March 2022 to 30 May 2022. The study participants were selected by simple random sampling method.

Main outcome measured:

Patients’ knowledge and satisfaction with pharmacy service was measured by a structured questionnaire and Data were collected, cleared, and coded, then entered into EPI Info (Epidemiological information. version 7.1.5.2) and analyzed using SPSS (version 25).

Results:

The overall knowledge result of the respondents showed that only 13.3% of individuals have good drug knowledge and 72.01% of respondents were satisfied with the outpatient pharmacy service. Following up on the multivariate analysis of service modality patients by credit (AOR: 5.50 (1.71–17.74), who are with the occupation of merchants (AOR: 0.09 (0.01–0.83)) and labeling (AOR: 3.13 (1.58–6.20) had an association with drug knowledge. Multivariate analysis showed that waiting time, dispensing time and privacy had an association with satisfaction. When we consider waiting time; respondents with 3–6 min, 6.1–9 min and >9 min waiting times are 0.06 times, 0.02 times, and 0.01 less likely satisfied compared with respondents having waiting time <3 min. It shows that as the patient stays without getting serviced for a long time, satisfaction decreases.

Conclusions:

Overall, around three-fourths of the respondents were satisfied with the outpatient pharmacy services which is approaching the national satisfaction assessment result. Respondents were strongly satisfied with Dose, route, frequency, and duration. However, they were strongly dissatisfied with the name of the drug. After the multivariate analysis privacy, waiting time, and dispensing time had an association with patient satisfaction.
An updated review on Guillain-Barré syndrome: Challenges in infection prevention and control in low- and middle-income countries
Authors: Khan Sakif Ahamed , Das Proma Rani , Nahar Zabun , Dewan Syed Masudur Rahman
Published: March 2024

Guillain-Barré syndrome is a rare condition that can be potentially life-threatening. Guillain-Barré syndrome does not have a definitive etiological agent. It is a syndrome that can arise from multiple factors, including various infectious diseases and immunizations. The severity of Guillain-Barré syndrome is exacerbated by these variables, especially in low-income and middle-income countries where healthcare systems are already constrained and struggle to meet the demands of other diseases. The primary aim of our article is to comprehensively examine the life-threatening nature and intensity of Guillain-Barré syndrome by assessing its etiology, progression, and prevalence in low- and middle-income nations while also considering global trends. Furthermore, we proposed the implementation of standard and efficacious treatment and diagnostic resources that are readily accessible and successful in affluent nations and should also be readily accessible in impoverished nations without any unnecessary delay. Our study also emphasized the epidemiological data with molecular epidemiological analysis and the utilization of artificial technology in low- and middle-income nations. The goal was to decrease the incidence of Guillain-Barré syndrome cases and facilitate early detection.
Effects of immersive virtual nature on nature connectedness: A systematic review and meta-analysis
Authors: Brambilla Elena , Petersen Evi , Stendal Karen , Sundling Vibeke , MacIntyre Tadhg E , Calogiuri Giovanna
Published: March 2024

Objective

This study systematically summarizes the extant literature on the impacts of immersive virtual nature (IVN) on nature connectedness in the general population.

Methods

Papers were considered eligible if peer-reviewed, in English language, comprising experimental or quasi-experimental trials, including at least one outcome relative to nature connectedness in the general population. Database search was conducted on Scopus, Web of Science, Google Scholar, Medline, and GreenFILE (22–28 November 2021). Risk of bias was established by the Cochrane RoB 2 tool. Data synthesis was conducted through meta-analysis according with the Cochrane Consumers and Communication Group guidelines.

Results

Six eligible papers (9 studies; n = 730) were selected, in which IVN was compared to (i) non-immersive virtual nature, (ii) immersive virtual built environments, (iii) non-immersive virtual built environments, and (iv) actual nature. The risk of bias was predominantly “low” or of “some concerns.” Meta-analyses showed a statistically significant overall effect for the first ( g = 0.26; 95% CI = 0.06–0.45; I2 = 35%) and fourth group ( g = −1.98; 95% CI = −3.21 to −0.75; I2 = 96%), the former in favor of IVN and the latter in favor of actual nature. Subgroup analyses were conducted for the first and second groups of studies to explore possible sources of heterogeneity. The small number of studies available limits the validity of the outcomes of the meta-analyses.

Conclusion

The findings indicate that IVN may be an effective tool for the promotion of nature connectedness, although the evidence in this field is still limited and largely mixed. Recommendations for future research are discussed.
Visually assessing work performance using a smartwatch via day-to-day fluctuations in heart rate variability
Authors: Okawara Hiroki , Shiraishi Yasuyuki , Sato Kazuki , Nakamura Masaya , Katsumata Yoshinori
Published: March 2024

Objective

To optimize workplace health promotion, a simple method for quantifying allostatic load response is needed. This study examines the feasibility of optimizing objective anxiety and presenteeism monitoring using daily smartwatch-measured ultra-short heart rate variability (HRV).

Methods

Office workers without diagnosed disease prospectively performed 30 s HRV self-measurement each morning for two months and responded to the State-Trait Anxiety Inventory (STAI) and Work Limitation Questionnaire (WLQ). Logistic regression analysis examined daily HRV parameters in the high-trait anxiety group (HTA, STAI ≥ 40) using mean and variance HRV, age, self-reported gender, and body mass index (BMI). The ideal cutoff value enabled comparison of WLQ using the Mann–Whitney U test. Heart rate variability data were collected for 279 participants (male ratio, 83.9%; age, 42 ± 10 years) who completed questionnaires and monitored HRV for 30+ days.

Results

Compared to the low-trait anxiety group, HTA exhibited higher variance of the log-transformed coefficient of component variance of high-frequency component (LnccvHF) and low-frequency per HF (Lnccv L/H), in addition to differences in the means of these HRV parameters. In addition to BMI (odds ratio [OR] = 0.92, p = 0.02) and mean LnccvL/H (OR = 10.75, p < 0.01), the variance of Lnccv L/H was an independent predictor of HTA (OR = 2.39E + 8, p = 0.011). The daily Lnccv L/H dispersion group had a lower WLQ productivity loss score ( p = 0.02, r = 0.17).

Conclusions

By focusing on HRV dispersion status, this simple and instantly applicable daily HRV monitoring system enables optimized quantitative monitoring of anxiety and productivity.
Strategic Environmental Consumer Segmentation: An Exploratory Case Study in Slovakia
Authors: Maťová Hana , Triznová Miroslava Oravcová , Kaputa Vladislav , Loučanová Erika , Vlosky Richard P.
Published: March 2024

The desire to live in a healthy “green” environment is becoming increasingly important to global populations. The term “green” is overused, confusing, and inconsistently used among and between consumers, corporate enterprises, environmental groups, government entities, and other segments globally. Research studies suggest that defining and applying the term “green” to behaviors and decision-making is constantly changing, further complicating the study of corporate and consumer environmental responsibility. In this study, we focus on the consumer. Not all consumers behave the same or have the same beliefs and perceptions regarding what is environmentally “green.” As such, we segmented consumers in Slovakia into unique “green” groups based on behaviors and perceptions. Further, we propose “green” marketing strategies for each unique consumer group. Cluster analysis for 1,061 respondents resulted in four unique clusters or groups of green consumers: “Indifferent Greens,”“Economical Greens,”“Engaged Greens,” and “Image Conscious Greens.” In addition, exploratory factor analysis was used to identify optimal components of the marketing mix that can be used to educate and target each identified green cluster. Results may provide Slovakian companies, or enterprises elsewhere, with a specific set marketing mix tools to enhance reach and profit maximization for their relevant “green” customers.

JEL Classification: M210, M310, M370, Q210, Q560.
Profiles of Black Emerging Adults Exposure to Racism-Based Police Violence and Associated Mental Health Outcomes
Authors: Motley Robert O. , Williamson Eric , Pieterse Alex L. , Harris Madelyn
Published: March 2024

This study characterizes the profile of Black emerging adults aged 18-29 generated from sociodemographic characteristics and indicators of police contact and exposure to racism-based police violence (RPV), and the relationship between profiles and traumatic stress symptoms. A purposive sample of 300 Black emerging adults was recruited for this exploratory study. Cluster analysis (CA) was performed to generate profiles of this sample. Two distinct profiles emerged from the CA. Cluster 1 is characterized by participants with low rates of police contacts and direct RPV exposure, whereas Cluster 2 consists of participants with higher rates of police contacts and direct RPV exposure. Regression analysis revealed that being in Cluster 2, as opposed to Cluster 1, was associated with increased scores for depression, avoidance, and intrusion symptoms. Findings provide guidance for mental health intervention strategies to combat the psychological impact of RPV exposure for Black emerging adults.
Retrospective Comparative Analysis of Neonatal Mortality and Morbidity in Preterm Singleton and Multiple Births -Single Center Experience-
Authors: Alhasoon Mohammad , Alqahtani Bader , Alreefi Mohamad , Homedi Abdulaziz , Alnami Ghadah , Alsaif Saif , Ali Kamal
Published: March 2024

Objective. To compare mortality and major neonatal morbidities between singleton preterm infants and preterm infants of multiple gestations born <33 weeks’ gestation. Method. Case-control study of preterm multiples and singletons <33 weeks’ born at King Abdul-Aziz Medical City Riyadh (KAMC-R) between January 2017 and December 2020. Out-born infants and infants with lethal congenital abnormalities were excluded from the study. Mortality and major neonatal morbidities including bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), sepsis and surgical necrotizing enterocolitis (NEC) were compared between preterm singletons and multiples. Results. A total of 803 preterm infants were included: 567 (70.6%) were singletons, 158 (19.6%) were twins and 36 (4.5%) infants were higher multiples. Adjusted mortality before hospital discharge was significantly higher among preterm infants of multiple gestations compared to preterm singletons (12.3% vs 7.9%; P = .003; AOR, 2.2; 95% CI, 1.3-3.7). Retinopathy of prematurity (ROP) needing treatment was significantly higher among preterm infants of multiple pregnancies compared to preterm singletons (11% vs 6.5%, P = .033, AOR 1.1, 95% CI, 1.04-2.99). In addition, the incidence of bronchopulmonary dysplasia (BPD) at 36 weeks post menstrual age (PMA) (29.7% vs 20.5%; P = .003; AOR, 1.7; 95% CI, 1.2-2.5) and culture positive sepsis (24.2% vs 17.5%; P = .044; AOR, 1.5; 95% CI, 1.01-2.2) were significantly higher among preterm infants of multiple pregnancy. There were no differences in mortality and adverse neonatal outcomes between twins and higher multiples. Conclusion. Preterm infants of multiple gestations suffered higher mortality and neonatal morbidities compared to preterm singleton infants despite a higher utilization of maternal antenatal steroids and better antenatal care.
Ukraine and the global south: The ambiguities of a postcolonial perspective
Authors: Kurnyshova Yuliia
Published: March 2024

With the beginning of Russia’s full-scale invasion Ukraine started actively utilize the trope of postcolonial struggle in its external strategic communication. Such positionality was intended to take relations with the global South to a new level. The aim of this article is twofold: empirically, it seeks to discuss how the idea of postcolonialism in its policy-oriented interpretation contributes to the positional rapprochement of Ukraine and the global South. The author argues that employing such narrative has its logic but also significant limitations. Conceptually, the article unpacks three different interpretations of the concept of post-coloniality in academic literature and analyses how they are applicable to Ukraine’s postcolonial posture.
Regional comparison of socio-demographic variation in urban E-scooter usage
Authors: Verma Priyanka , McKenzie Grant
Published: March 2024

In recent years we have witnessed explosive growth in the shared, free-floating, electric scooter industry. While still controversial in many North American cities, a number of large e-scooter operators have managed to carve out a piece of the urban transportation landscape. As these vehicles shift from novelty services to increasingly reliable modes of short personal travel, the discussion has turned to investigating who exactly benefits from these micromobility services and who are being left behind. Though population surveys have been administered to identify the socio-demographic characteristics of e-scooter riders in the past, little work has linked these characteristics through trips, or investigated the regional variation in these demographic factors. In this work we explore the variability and similarities in e-scooter rider characteristics across three major U.S. cities. To accomplish this, we apply a Moran’s Eigenvector Spatial Filtering linear regression model and compare our results to more commonly used spatial regression approaches. Our results indicate that the spatial filtering approach outperforms other methods in identifying socio-demographic characteristics of e-scooter users, across multiple regions. We find that many socio-demographics associated with e-scooter usage are regionally variant, despite younger users making up the core user base in all cities. There are variations in usage based on gender, income, and race across cities with Black and Hispanic populations remaining underserved. The implications of these findings are discussed.