bluuebunny/crossref_metadata_2025 huggingface dataset:
An Experimental Apparatus for Bench-Scale Fire Testing Using Electrical Heating Pads
Authors: Seweryn Aleksandra , Lucherini Andrea , Franssen Jean-Marc
Published: December 2023

This research study concerns an experimental, budget-friendly, electricity-powered apparatus for bench-scale fire testing. The apparatus consists of various elements, of which the most important are ceramic heating pads, used to impose heat fluxes on exposed surfaces of specimens. The test method allows to control the heating pads’ temperature and to adjust the distance between the heating pads and the specimen to obtain well-defined heat fluxes up to 50–60 kW/m2. Higher heat fluxes and temperatures can be obtained by setting the heating pads in full power mode, with or without the use of a thermal shield, which can lead to heat fluxes up to 150 kW/m2. The heating and thermal boundary conditions imposed by the apparatus are characterised and discussed, and the thickness of the convective boundary layer at the heating pads’ surface is estimated significantly lower than in the case of gas-fired radiant panels. The performance of the apparatus is analysed for various conditions: controlling the temperature of the heating pads, in an open environment or with the presence of thermal shields, and in full power mode. A few examples of application of the apparatus to fire test typical construction materials (steel and glass) are also presented. These results emphasise the well-defined heating conditions in temperature-controlled mode. The study finally discusses the advantages and limitations of the apparatus, as well as many possibilities of future applications and improvement for future research studies.
Interparental Conflict and Early Adolescent Depressive Symptoms: Parent-Child Triangulation as the Mediator and Grandparent Support as the Moderator
Authors: Wang Meiping , Sun Shan , Liu Xiaojie , Yang Yang , Liu Chunyu , Huang Aodi , Liu Siwei
Published: December 2023

A notable ambiguity persists concerning whether distinct forms of parent-child triangulation (unstable coercive coalition, stable coalition, detouring-attacking, detouring supportive, parentification) might mediate the association between interparental conflict and early adolescent depressive symptoms similarly within the context of Chinese Confucianism. Filling this research gap, this study aimed to examine the mediating role of the five dimensions of parent-child triangulation in the association between interparental conflict and early adolescent depressive symptoms, as well as the moderating effect of grandparent support on this mediating pathway. Data were drawn from a sample of 761 Chinese adolescents (Mage = 12.82 ± 0.47, 49.1% girls). Structural equation model analyses indicated that unstable coercive coalition, stable coalition, and detouring-attacking behaviors partially mediated the association between interparental conflict and adolescent depressive symptoms, while detouring-supportive behaviors and parentification did not demonstrate such mediating effects. Unlike Western societies, a negative correlation was observed between interparental conflict and parentification in the context of China. Grandparent support mitigated the adverse effects of both interparental conflict and the unstable coercive coalition on early adolescent depressive symptoms.
The Terminal Tracking Camera System on the NASA Lucy Trojan Asteroid Discovery Mission
Authors: Bell J. F. , Zhao Y. , Cisneros E. , Beasley M. , Olkin C. , Caplinger M. A. , Ravine M. A. , Schaffner J. A. , Clark M. J. , Shamah J. , Faiks P. , Mottola S. , Adam C. , Lessac-Chenen E. , Bos B. J.
Published: December 2023

The Terminal Tracking Camera system (TTCam) on the NASALucyTrojan asteroid Discovery mission consists of a pair of block redundant cameras and their associated electronics that are mounted on the spacecraft’s Instrument Pointing Platform and co-boresighted with the rest of the mission’s science payload instruments. The primary function of the TTCams is as a navigation system designed to provide an autonomous onboard late pre-encounter update of the location of each asteroid flyby target relative to the spacecraft. However, once the terminal tracking function is complete, the TTCam system will also provide 11.0°×8.2° field of view broadband (425-675 nm) images during the close approach phase of each asteroid flyby that will be used for scientific analyses like shape modeling and assessment of each target’s geology and topography. This paper provides an overview of the TTCam cameras and electronics, the science-focused requirements that the system is designed to meet, pointers to pre-flight calibration and in-flight calibration details for the cameras, as well as a high-level summary of the kinds of science that these images will enable for the mission.
A multimodel meta-analysis assessing moderators of sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories
Authors: Holper Lisa , Habermeyer Elmar , Mokros Andreas
Published: December 2023

Objectives

This meta-analysis tested whether multimodel inference provides more conclusive evidence than traditional single-hypothesis testing regarding predictors that moderate sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories.

Methods

A dataset including 35 studies equivalent to the meta-analysis by Holper et al. (Sex Abuse 2023; 0: 1–37) was used. Multimodel inference based on information theory tested 15 publication-, study-, treatment-, and individual-specific moderators.

Results

Only risk level was related to sexual recidivism. A greater posttreatment reduction in sexual recidivism was apparent in high- and medium- compared to low-risk individuals. This moderator explained 77% of the residual heterogeneity.

Conclusions

Compared to previous reports, the multimodel approach provided clearer evidence on which factors moderate sexual recidivism. Results corroborated the relevance of risk level, which relates to the risk-need-responsivity model. The findings may support treatment recommendations in persons with sexual offense histories in the criminal justice system.
Who Benefits from Guidance Counseling? Insights into Native and Immigrant Students of Low Social Origin
Authors: Pietrzyk Irena , Jacob Marita , Erdmann Melinda
Published: December 2023

Research on educational inequalities has increasingly focused on interventions to increase enrollment in higher education for students of low social origin. However, students of low social origin may not be homogeneous in their need for advice, as natives of low social origin decide less frequently to enter university than their immigrant counterparts in many European countries. Drawing on data from a randomized controlled trial in German schools, we find that counseling in particular does indeed increase the likelihood of enrollment for native students. We then use the results of our empirical analyses to illustrate how an upscaling across schools would affect migration-specific enrollment rates of students of low social origin at the aggregate level. We discuss the implications of our results for research on migration-related inequalities in enrollment as well as for policy regarding program upscaling.
Emotions and transformative learning for sustainability: a systematic review
Authors: Grund Julius , Singer-Brodowski Mandy , Büssing Alexander Georg
Published: December 2023

As multiple global sustainability crises are getting more severe and existential, a better understanding of how people undergo deep personal transformations related to sustainability is needed. In the educational debate on sustainability learning, transformative learning theories are widely used. To analyze specific phases of transformative learning, we derived five meta-phases from the literature (novel experience, reflection, social exchange, shift of action, shift of meaning). Although human emotions often arise during the confrontation with sustainability issues and are central to moral action, no substantial, theorized understanding of the role of emotions within sustainability-related transformative learning exists to date. We conducted a systematic review (following the PRISMA guidelines) and screened 355 publications to close this research gap. After applying the exclusion criteria, the in-depth analysis of 20 studies showed that sound theoretical references to theories of emotion and transformative learning are rare. The review shows clearly that diverse emotions permeate sustainability-related transformative learning processes. Among these are both negative emotions to novel learning experiences concerning sustainability (e.g., sadness, shame, disgust, guilt) as well as positive emotions in the context of social exchange (e.g., awe, gratitude, fun) and associated with newly formed actions (e.g., fulfillment, pride). Accordingly, to enable emotionally positive learning experiences, relationship and action orientation are particularly important within sustainability learning. The analyzed studies call for an educational practice where emotions can be experienced, expressed, and understood in a safe atmosphere. Future research in this area should use more stable theoretical foundations for emotions and transformative learning theory and apply methods that can capture deeper levels of subjective experience.
Surface and subsurface material modifications and graded material properties in sheet steel 1.0338 (DC04) and their influence on forming processes
Authors: Zielinski Tjarden , Zettl Bastian , Lafarge Rémi , Schmid Harald , Riemer Oltmann , Karpuschewski Bernhard , Merklein Marion , Brosius Alexander
Published: December 2023

For bulk material it is very well known, that the material properties differ between the material near the surface and the inner material (i.e. segregations). However, for sheet material a gradient of material properties in depth direction and its influence on forming processes was not yet investigated. Within experiments on sheet steel 1.0338 (DC04) a gradient in material properties was proven by hardness measurements for both unprocessed material as well as after conducting forming and milling processes. The characterisation shows a gradient in material hardness over the entire sheet thickness. The experimental results regarding forming processes, such as rolling and bending, additionally show an increase of the materials hardness due to work hardening. The problem from the inhomogeneous material properties leads to an inaccurate prediction of the forming behaviour of the workpiece in further processing. Machining experiments were conducted for transferring the knowledge of modified surface and subsurface layers onto forming processes and their simulation. The bending experiments and the corresponding process simulation of the spring back behaviour show, that the implementation of an inhomogeneous material property increases the prediction accuracy. Notably the prediction of the spring back behaviour of thinner sheet metals is highly improved. Therefore, an analysis of sheet metal properties in thickness direction and their consideration in forming process simulations is inevitable for the implementation of accurate material models.
Smart Hesperidin/Chitosan Nanogel Mitigates Apoptosis and Endoplasmic Reticulum Stress in Fluoride and Aluminum-Induced Testicular Injury
Authors: Deiab Nora S. , Kodous Ahmad S. , Mahfouz Mohamed K. , Said Alshaimaa M. , Ghobashy Mohamed Mohamady , Abozaid Omayma A. R.
Published: December 2023

Fluoride and aluminum are ubiquitous toxic metals with adverse reproductive effects. The citrus flavonoid hesperidin has protective activities but poor solubility and bioavailability. Nanoparticulate delivery systems can improve flavonoid effectiveness. We conducted this study to prepare a pH-responsive chitosan-based nanogel for hesperidin delivery and evaluate its effectiveness against sodium fluoride (NaF) and aluminum chloride (AlCl3) induced testicular toxicity in mice. The nanogel was synthesized using 2 kGy gamma irradiation, enabling a size under 200 nm and enhanced hesperidin release at pH 6 matching testicular acidity. Male mice received 200 mg/kg AlCl3 and 10 mg/kg NaF daily for 30 days. Hesperidin nanogel at 20 mg/kg was administered orally either prophylactically (pretreatment) or after intoxication (posttreatment). The results showed that AlCl3 + NaF induced severe oxidative stress, hormonal disturbance, apoptosis, and endoplasmic reticulum stress, evidenced by significant changes in the studied parameters and testicular histological damage. Hesperidin nanogel administration significantly inhibited oxidative stress markers, restored luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels, and alleviated tissue damage compared to the intoxicated group. It also downregulated the expression level of pro-apoptotic genes Bax, caspase-3, caspase-9, and P38MAPK, while upregulating the expression level of the anti-apoptotic BCL2 gene. Endoplasmic reticulum stress sensors PERK, ATF6, and IRE-α were also downregulated by the nanogel. The chitosan-based nanogel enhanced the delivery and efficacy of poorly bioavailable hesperidin, exhibiting remarkable protective effects against AlCl3 and NaF reproductive toxicity. This innovative nanosystem represents a promising approach to harnessing bioactive phytochemicals with delivery challenges, enabling protective effects against chemical-induced testicular damage.

Graphical Abstract
Stability analysis of Filippov prey–predator model with fear effect and prey refuge
Authors: Hamdallah Soliman A. A. , Arafa Ayman A.
Published: December 2023

Mathematical ecosystems play a crucial role in our comprehension and conservation of ecology. Within these ecosystems, prey exhibits protective instincts that compel refuging behaviors to avoid predation risk. When the ratio of prey to predators falls below a threshold, prey seeks refuge. However, when prey is abundant relative to predators, these protective instincts are overridden as prey ventures out to forage. Therefore, this study develops a Filippov prey–predator model with fear effect on prey and switching of prey refuge behavior based on the ratio of prey to predators. Analytical and numerical approaches are used to address the dynamic behaviors, bifurcation sets, existence, and stability of various equilibria in this model. Additionally, the regions of sliding and crossing segments are analyzed. The bifurcation sets of pseudo-equilibrium and local and global sliding bifurcations are investigated. The numerical simulations are conducted to investigate the interplay between fear factor and other relevant parameters within the Filippov model, such as the threshold ratio and prey refuge. These investigations shed light on the influence of them in the model. The results indicate that increasing the fear factor results in a decrease in both prey and predator densities, thereby changing the behavior of the dynamics from a limit cycle oscillation to a stable state and vice versa. Notably, despite these population changes, neither species faces complete extinction.
Local measurement of terahertz field-induced second harmonic generation in plasma filaments
Authors: Garriga Francis Kareem J. , Zhang Xi-Cheng
Published: December 2023

The concept of Terahertz Field-Induced Second Harmonic (TFISH) Generation is revisited to introduce a single-shot detection scheme based on third order nonlinearities. Focused specifically on the further development of THz plasma-based sources, we begin our research by reimagining the TFISH system to serve as a direct plasma diagnostic. In this work, an optical probe beam is used to mix directly with the strong ponderomotive current associated with laser-induced ionization. A four-wave mixing (FWM) process then generates a strong second-harmonic optical wave because of the mixing of the probe beam with the nonlinear current components oscillating at THz frequencies. The observed conversion efficiency is high enough that for the first time, the TFISH signal appears visible to the human eye. We perform spectral, spatial, and temporal analysis on the detected second-harmonic frequency and show its direct relationship to the nonlinear current. Further, a method to detect incoherent and coherent THz inside plasma filaments is devised using spatio-temporal couplings. The single-shot detection configurations are theoretically described using a combination of expanded FWM models with Kostenbauder and Gaussian Q-matrices. We show that the retrieved temporal traces for THz radiation from single- and two-color laser-induced air-plasma sources match theoretical descriptions very well. High temporal resolution is shown with a detection bandwidth limited only by the spatial extent of the probe laser beam. Large detection bandwidth and temporal characterization is shown for THz radiation confined to under-dense plasma filaments induced by < 100 fs lasers below the relativistic intensity limit.

Graphical Abstract
Opposing autocratization in Turkey: from exclusionary to inclusive discourse
Authors: Korkmaz Seren Selvin
Published: December 2023

This study explores the changing discourse of the Republican People’s Party (CHP) in Turkey as it confronts a populist authoritarian government. By analyzing and contrasting discourses used in election campaigns and protests and focus group discussions it investigates opposition’s role in fueling or challenging the polarizing populist narrative of the ruling Justice and Development Party (AKP). This paper argues that autocratization is a dynamic process in which opposition parties play an active role, contributing to and opposing autocratization simultaneously, rather than being mere victims of the process. It claims that the CHP’s electoral and discursive strategy has shifted gradually under Kemal Kılıçdaroğlu’s leadership since 2010. Unlike the previous exclusionary discourse that legitimized the AKP’s polarizing, populist narrative, the party has adopted an inclusive discourse that has contributed to its victory in the 2019 local elections.
Preference of Silicon Accumulation on the Shade Foliage of Tree Crown and its Implication in Juniperus chinensis L.
Authors: Zhang Youfu , Chen Chunyan , Zhang Ruiyuan , Chen Tuo
Published: December 2023

Purpose

The passive accumulation of silicon (Si) generally depends on the regulation of plant transpiration rates after its uptake. It is challenging to comprehend how plants use Si to adapt to shady habitats where they have low transpiration rates and photothermal energy. Therefore, we speculated that Si accumulation is not entirely dependent on the transpiration rate.

Methods

To test this speculation, the concentrations of Si and total minerals and water status at various positions of shady shoots (stems and their foliage) and stems within the crown of Juniperus chinensis L. were examined to determine whether shady shoots or stems had a preferred allocation to resist shade.

Results

The concentrations of total minerals and Si in the shoots were consistently higher in shady areas than in areas within the same crown, regardless of the position within the crown or shoot age. However, shoot Si accumulation displayed a greater dependence on available light or photothermal supply, which is linked to crown orientation. Additionally, stem Si accumulation displayed a weak dependence on available light. Compared with the bound water content, the water potential and free water content of shady shoots were higher than those of sunny shoots. In light of the fact that water prefers to move readily towards regions with low water potential, these results demonstrate that the movement of minerals and water is not fully coupled in the same crowns.

Conclusion

Therefore, the accumulation of Si and minerals in shady foliage is partially independent of water flow, which helps to offset the low-carbon supply due to the photothermal decrease in the shady crown area.
Physical exercise and ergonomic workplace interventions for nursing personnel—effects on physical and mental health: a systematic review
Authors: Heuel Luis , Otto Ann-Kathrin , Wollesen Bettina
Published: December 2023

Background

Improving the work ability of nurses is highly important for ensuring a functioning healthcare system, which can be achieved via exercising and enhancing ergonomic work behaviors of the nurses. The objective of this systematic review was to synthesize work ability-enhancing exercise and ergonomic workplace health promotion interventions in different nursing settings and their effects on work ability.

Methods

Intervention studies incorporating at least one component of physical exercise or ergonomic work behavior for nurses were eligible for inclusion. Three electronic databases (Medline, PsycInfo, CINAHL) were searched for studies published until October 2022. The methodological quality of interventions was assessed. Due to intervention and outcome heterogeneity, narrative synthesis was conducted.

Results

The search identified a total of 37 studies. Sample size ranged from 14 to 316 (N = 3487). Overall quality was moderate (M = 0.76). Programs comprised aerobic exercising, “back school,” ergonomics, increasing physical activity, multicomponent programs, physiotherapy, and yoga. Positive effects on work ability (e.g., reduced back pain or stress levels) were reported in 34 studies. However, if follow-up analyses were included, the effects typically diminished. Common training principles and training control mechanisms were applied in studies.

Discussion

The review indicates the efficacy of exercise-based health promotion for increasing nurses’ work ability. However, results are limited by the lack of long-term improvements and scarcity of application of training principles. Therefore, setting-specific interventions, respecting work demands and training principles, are recommended.
Microstructure of conventional/PBF-LB/M 316L stainless steel hybrid joints brazed with nickel-based brazing alloys
Authors: Tillmann W. , Bültena J. , Wojarski L. , Crasmöller A.
Published: December 2023

Due to the additive manufacturing principle, laser-melted materials (PBF-LB/M) such as the austenitic chromium-nickel steel 316L have a different microstructure compared to materials produced by conventional continuous casting. The PBF-LB/M-produced 316L has a thermally metastable, anisotropic microstructure with epitaxially grown grains in which a cellular substructure is located. When brazing hybrid joints from the conventional and additive manufacturing routes with nickel-based brazing alloys, different diffusion mechanisms occur simultaneously in both joining partners. This occurs due to the different microstructural characteristics of the parent materials. The altered diffusion mechanisms lead to a new distinct microstructure in the joining zone, which influences the achievable quality of the brazed joint in a previously unknown way.
A fetus in the world: Physiology, epidemiology, and the making of fetal origins of adult disease
Authors: Buklijas Tatjana , Al-Gailani Salim
Published: December 2023

Since the late 1980s, the fetal origins of adult disease, from 2003 developmental origins of health and disease (DOHaD), has stimulated significant interest in and an efflorescence of research on the long-term effects of the intrauterine environment. From the start, this field has been interdisciplinary, using experimental animal, clinical and epidemiological tools. As the influence of DOHaD on public health and policy expanded, it has drawn criticism for reducing the complex social and physical world of early life to women’s reproductive bodies as drivers of intergenerational ills. This paper explains this narrowing of focus in terms of a formative and consequential exchange between David Barker, the British epidemiologist whose work is credited with establishing the field, and the discipline of fetal physiology. We suggest that fetal physiologists were a crucial constituency of support for Barker’s hypothesis about early life origins of disease. Their collaborations with Barker helped secure and sustain the theory amid considerable controversy. The trajectory of DOHaD and its focus on the maternal body can be understood, we argue, as a consequence of this alliance, which brought together two distinct conceptualizations of the intrauterine environment, one from epidemiology and the other from fetal physiology. Along the way, we trace the histories of these conceptualizations, both of which were products of mid-to-late twentieth century British science, and show how Barker’s early emphasis on social and economic conditions was superseded by a narrower focus on physiological mechanisms acting upon the autonomous fetus.
Driving fiber diameters to the limit: nanoparticle-induced diameter reductions in electrospun photoactive composite nanofibers for organic photovoltaics
Authors: Schofield R. M. , Maciejewska B. M. , Dong S. , Tebbutt G. T. , McGurty D. , Bonilla R. S. , Assender H. E. , Grobert N.
Published: December 2023

Electrospun photoactive nanofibers hold significant potential for enhanced photon absorption and charge transport in organic photovoltaics. However, electrospinning conjugated polymers with fiber diameters comparable to exciton diffusion lengths for efficient dissociation, is difficult. Previously, spinning sub-100 nm poly(3-hexylthiophene) (P3HT) fibers has required the auxiliary polymer, poly(ethylene oxide) (PEO), and large antisolvent additions. Therefore, its success differs considerably across donor polymers, due to variable antisolvent addition limits before precipitation. Herein, plasmonic nanoparticle infusion into P3HT nanofibers is used to modulate viscosity and deliver a novel and unrivaled strategy to achieve reduced fiber diameters. Following PEO removal, the fibers measure 55 nm in diameter, 30% lower than any previous report – providing the shortest exciton diffusion pathways to the heterojunction upon electron acceptor infiltration. The nanoparticle-containing nanofibers present a 58% enhancement over their pristine thin-film counterparts. ~17% is ascribed to plasmonic effects, demonstrated in thin-films, and the remainder to along-fiber polymer chain alignment, introduced by electrospinning. The anisotropy of light absorbed when polarized parallel versus perpendicular to the fibers increases from 0.88 to 0.62, suggesting the diameter reduction improves the alignment, resulting in greater electrospinning-induced enhancements. Controlled by the electrospinning behavior of PEO, our platform may be adapted to contemporary donor-acceptor systems.

Graphical Abstract

A dramatic reduction in the diameters of electrospun photoactive nanofibers is achieved by introducing nanoparticles, offering shorter exciton pathways towards the heterojunction in nanofibrous OPVs. Thinner fiber diameters enhance the alignment of the polymer chains along the fiber, manifesting in greater photon absorption. Alongside plasmonic effects, the dual-mode enhancement within the fibers offers 58% additional light harvesting versus their thin-film counterparts.
Identifying individual and organizational predictors of accidental exposure to blood (AEB) among hospital healthcare workers: A longitudinal study
Authors: Bun René Sosata , Aït Bouziad Karim , Daouda Oumou Salama , Miliani Katiuska , Eworo Anastasia , Espinasse Florence , Seytre Delphine , Casetta Anne , Nérome Simone , Temime Laura , Hocine Mounia N. , Astagneau Pascal
Published: December 2023

Background:

Accidental exposure to blood (AEB) poses a risk of bloodborne infections for healthcare workers (HCWs) during hospital activities. In this study, we identified individual behavioral and organizational predictors of AEB among HCWs.

Methods:

The study was a prospective, 1-year follow-up cohort study conducted in university hospitals in Paris, France. Data were collected from the Stress at Work and Infectious Risk in Patients and Caregivers (STRIPPS) study. Eligible participants included nurses, nursing assistants, midwives, and physicians from 32 randomly selected wards in 4 hospitals. AEB occurrences were reported at baseline, 4 months, 8 months, and 12 months, and descriptive statistical and multilevel risk-factor analyses were performed.

Results:

The study included 730 HCWs from 32 wards, predominantly nurses (52.6%), nursing assistants (41.1%), physicians (4.8%), and midwives (1.5%). The incidence rate of AEB remained stable across the 4 visits. The multilevel longitudinal analysis identified several significant predictors of AEB occurrence. Individual-level predictors included younger age, occupation as nurses or midwives, irregular work schedule, rotating shifts, and lack of support from supervisors. The use of external nurses was the most significant ward-level predictor associated with AEB occurrence.

Conclusions:

AEBs among HCWs are strongly associated with organizational predictors, highlighting the importance of complementing infection control policies with improved staff management and targeted training. This approach can help reduce AEB occurrences and enhance workplace safety for HCWs.
Amgen v. Sanofi: The U.S. Supreme Court Reviews Patent Enablement
Authors: Curfman Gregory , Boumil Marcia M.
Published: December 2023

On June 18, 2023, the U.S. Supreme Court in the matter of Amgen, Inc. et al. v. Sanofi, et al.1 unanimously upheld the 2021 decision of the U.S. Court of Appeals for the Federal Circuit,2 striking down as overbroad Amgen’s patent claim to an entire functional genus of monoclonal antibodies. Amgen’s patent claims were not limited to antibody structure or antibody amino acid sequences. This is significant because Amgen’s patent claims did have amino acid sequences, but they were directed to the epitope.
The Impact of Dobbs on Health Care Beyond Wanted Abortion Care
Authors: Manian Maya
Published: December 2023

While empirical evidence has exposed the harms and health disparities flowing from being denied a wanted abortion, we know less about how anti-abortion laws and policies impact health care more broadly. This article surveys the public health impacts of Dobbs on health care beyond wanted abortion care. The article argues that focusing the public’s attention on the harmful consequences of abortion bans for healthcare beyond wanted abortion care could help to fend off further restrictions on abortion
Prosecutorial Discretion for Self-Managed Abortion Helpers
Authors: Skuster Patty
Published: December 2023

Elected prosecutors have pledged not to enforce abortion laws, in response to state-level abortion bans. For their pledges to be meaningful, prosecutors must exercise their discretion in cases of individuals who face legal risk, including people who help others self-manage their abortions. With a harm-reduction approach to improving abortion access, prosecutors should aim to reduce abortion helpers’ involvement with the criminal justice system.
Global Health Law and the Climate Crisis: An Unfulfilled Opportunity
Authors: Gable Lance
Published: December 2023

The emerging global climate crisis threatens human health in unprecedented ways, yet global health concerns have not been sufficiently considered within international climate change efforts. A more collaborative pathway could advance efforts to mitigate and adapt to climate change while protecting public health and social justice.
Stopping Criminalization at the Bedside
Authors: Bach Wendy A. , Terplan Mishka
Published: December 2023

Low-income women and, disproportionately low-income women of color seeking reproductive and pregnancy care are increasingly subject to what this article terms carceral care – care compromised by its’ proximity to punishment systems. This article identifies the legal and health care practice mechanisms leading to carceral care and proposes solutions designed to stop criminalization at the bedside.
Leveraging the Tools Available: Using the Hyde Amendment to Preserve Minimum Abortion Access and Mitigate Harms in Restrictive States
Authors: Carrión Fabiola , Hasselbacher Lee , Thompson Terri-Ann
Published: December 2023

The overturn of Roe v. Wade has resulted in fewer rights and resources for people seeking abortion care, particularly in the South. The Hyde Amendment has historically restricted abortion access for those enrolled in Medicaid. We argue here that its guarantees of minimum abortion coverage should be leveraged to offset harms where possible.
Ethical and Legal Obligations for Research Involving Pregnant Persons in a Post-Dobbs Context
Authors: Weinmeyer Richard M. , Shah Seema K. , McGowan Michelle L.
Published: December 2023

In light of a history of categorical exclusion, it is critical that pregnant people are included in research to help improve the knowledge base and interventions needed to address public health. Yet the volatile legal landscape around reproductive rights in the United States threatens to undue recent progress made toward the greater inclusion of pregnant people in research. We offer ethical and practical guidance for researchers, sponsors, and institutional review boards to take specific steps to minimize legal risks and ensure the ethical conduct of research with pregnant people in an evolving legal environment.
The incorporation of chlorine and cosmogenic 36Cl into speleothem carbonate
Authors: Johnston Vanessa E. , Frisia Silvia , Borsato Andrea , Woodhead Jon D. , McDermott Frank
Published: December 2023

Cave carbonate mineral deposits (speleothems) contain trace elements that are intensively investigated for their significance as palaeoclimate and environmental proxies. However, chlorine, which is abundant in marine and meteoric waters, has been overlooked as a potential palaeo-proxy, while cosmogenic 36Cl could, in principle, provide a solar irradiance proxy. Here, total Cl concentrations analysed from various speleothems were low (3–14 mg/kg), with variations linked to crystal fabrics. High-resolution synchrotron radiation micro X-ray fluorescence (μ-XRF) trace element mapping showed Cl often associated with Na, Si, and Al. We propose that speleothems incorporate Cl in two fractions: (1) water soluble (e.g., fluid inclusions) and (2) water insoluble and strongly bound (e.g., associated with detrital particulates). However, disparities indicated that alternate unidentified mechanisms for Cl incorporation were present, raising important questions regarding incorporation of many trace elements into speleothems. Our first measurements of 36Cl/Cl ratios in speleothems required large samples due to low Cl concentrations, limiting the potential of 36Cl as a solar irradiance proxy. Critically, our findings highlight a knowledge gap into how Cl and other trace elements are incorporated into speleothems, how the incorporation mechanisms and final elemental concentrations are related to speleothem fabrics, and the significance this may have for how trace elements in speleothems are interpreted as palaeoclimate proxies.
Release trial of captive-bred variable harlequin frogs Atelopus varius shows that frogs disperse rapidly, are difficult to recapture and do not readily regain skin toxicity
Authors: Klocke Blake , Garcés Orlando , Lassiter Elliot , Guerrel Jorge , Hertz Andreas , Illueca Estefany , Klaphake Eric , Linhoff Luke , Minbiole Kevin , Ross Heidi , Tasca Julia A. , Woodhams Douglas C. , Gratwicke Brian , Ibáñez Roberto
Published: December 2023

Variable harlequin frogs Atelopus varius have declined significantly throughout their range as a result of infection with the fungal pathogen Batrachochytrium dendrobatidis (Bd). The Panama Amphibian Rescue and Conservation Project maintains an ex situ population of this Critically Endangered species. We conducted a release trial with surplus captive-bred A. varius individuals to improve our ability to monitor frog populations post-release, observe dispersal patterns after freeing them into the wild and learn about threats to released frogs, as well as to determine whether natural skin toxin defences of frogs could be restored inside mesocosms in the wild and to compare Bd dynamics in natural amphibian communities at the release site vs a non-release site. The 458 released frogs dispersed rapidly and were difficult to re-encounter unless they carried a radio transmitter. No frog was seen after 36 days following release. Thirty frogs were fitted with radio transmitters and only half were trackable by day 10. Tetrodotoxin was not detected in the skins of the frogs inside mesocosms for up to 79 days. Bd loads in other species present at sites were high prior to release and decreased over time in a pattern probably driven by weather. No differences were observed in Bd prevalence between the release and non-release sites. This trial showed that refinements of our methods and approaches are required to study captive Atelopus frogs released into wild conditions. We recommend continuing release trials of captive-bred frogs with post-release monitoring methods, using an adaptive management framework to advance the field of amphibian reintroduction ecology.
Genetic insights to assist management of the Critically Endangered hangul Cervus hanglu hanglu in the Kashmir Himalaya
Authors: Narayan Sneha , Srivastava Tanushree , Sreedharan Gayathri , Panda Bapin K. , Hameed Javaid , Vasudevan Karthikeyan , Reddy P. Anuradha
Published: December 2023

The hangul Cervus hanglu hanglu, a Critically Endangered mountain ungulate of Jammu and Kashmir, India, faces the imminent threat of population loss and extinction. Effective management of its largest viable population in Dachigam National Park in the Kashmir Himalaya requires reliable demographic information. Using 14 microsatellite markers we identified 293 individuals (208 females and 85 males) through faecal analysis, and generated data on the genetic status and population size of the hangul in its winter habitat. The mean expected and observed heterozygosities of 0.62 and 0.59 are comparable to those of several red deer Cervus elaphus populations elsewhere. The effective population sizes were 46.3 and 93.7 when the frequencies of rare alleles were considered to be 0.050 and 0.010, respectively. The average mean kinship of the population was 0.34, and there was no evidence of a recent bottleneck event. In genetic mark–recapture analysis the best model included an effect of sex on both detection and recapture probabilities. Detection of males was highest in November, coinciding with the hangul breeding season, whereas detection of females was highest in December. Our estimate of the hangul population using genetic mark–recapture with bootstrapping was 394 individuals. To our knowledge, this is the first study to use genetic data to estimate the population of the hangul. It will guide future studies of this subspecies and also serve as an impetus for identifying founder animals for captive breeding, and for connecting the population in Dachigam National Park with the other small, isolated populations to ensure the long-term survival of this subspecies.
What is the duration of untreated psychosis worldwide? – A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies
Authors: Salazar de Pablo Gonzalo , Aymerich Claudia , Guinart Daniel , Catalan Ana , Alameda Luis , Trotta Giulia , Armendariz Alvaro , Martinez Baringo Estrella , Soler-Vidal Joan , Rubio Jose M. , Garrido-Torres Nathalia , Gómez-Vallejo Sandra , Kane John M. , Howes Oliver , Fusar-Poli Paolo , Correll Christoph U.
Published: December 2023

Duration of untreated psychosis (DUP) has been associated with poor mental health outcomes. We aimed to meta-analytically estimate the mean and median DUP worldwide, evaluating also the influence of several moderating factors. This PRISMA/MOOSE-compliant meta-analysis searched for non-overlapping individual studies from inception until 9/12/2022, reporting mean ± s.d. or median DUP in patients with first episode psychosis (FEP), without language restrictions. We conducted random-effect meta-analyses, stratified analyses, heterogeneity analyses, meta-regression analyses, and quality assessment (PROSPERO:CRD42020163640). From 12 461 citations, 369 studies were included. The mean DUP was 42.6 weeks (95% confidence interval (CI) 40.6–44.6, k = 283, n = 41 320), varying significantly across continents (p < 0.001). DUP was (in descending order) 70.0 weeks (95% CI 51.6–88.4, k = 11, n = 1508) in Africa; 48.8 weeks (95% CI 43.8–53.9, k = 73, n = 12 223) in Asia; 48.7 weeks (95% CI 43.0–54.4, k = 36, n = 5838) in North America; 38.6 weeks (95% CI 36.0–41.3, k = 145, n = 19 389) in Europe; 34.9 weeks (95% CI 23.0–46.9, k = 11, n = 1159) in South America and 28.0 weeks (95% CI 20.9–35.0, k = 6, n = 1203) in Australasia. There were differences depending on the income of countries: DUP was 48.4 weeks (95% CI 43.0–48.4, k = 58, n = 5635) in middle-low income countries and 41.2 weeks (95% CI 39.0–43.4, k = 222, n = 35 685) in high income countries. Longer DUP was significantly associated with older age (β = 0.836, p < 0.001), older publication year (β = 0.404, p = 0.038) and higher proportion of non-White FEP patients (β = 0.232, p < 0.001). Median DUP was 14 weeks (Interquartile range = 8.8–28.0, k = 206, n = 37 215). In conclusion, DUP is high throughout the world, with marked variation. Efforts to identify and intervene sooner in patients with FEP, and to promote global mental health and access to early intervention services (EIS) are critical, especially in developing countries.
Select or adjust? How information from early treatment stages boosts the prediction of non-response in internet-based depression treatment
Authors: Hammelrath Leona , Hilbert Kevin , Heinrich Manuel , Zagorscak Pavle , Knaevelsrud Christine
Published: December 2023

Background

Internet-based interventions produce comparable effectiveness rates as face-to-face therapy in treating depression. Still, more than half of patients do not respond to treatment. Machine learning (ML) methods could help to overcome these low response rates by predicting therapy outcomes on an individual level and tailoring treatment accordingly. Few studies implemented ML algorithms in internet-based depression treatment using baseline self-report data, but differing results hinder inferences on clinical practicability. This work compares algorithms using features gathered at baseline or early in treatment in their capability to predict non-response to a 6-week online program targeting depression.

Methods

Our training and test sample encompassed 1270 and 318 individuals, respectively. We trained random forest algorithms on self-report and process features gathered at baseline and after 2 weeks of treatment. Non-responders were defined as participants not fulfilling the criteria for reliable and clinically significant change on PHQ-9 post-treatment. Our benchmark models were logistic regressions trained on baseline PHQ-9 sum or PHQ-9 early change, using 100 iterations of randomly sampled 80/20 train-test-splits.

Results

Best performances were reached by our models involving early treatment characteristics (recall: 0.75–0.76; AUC: 0.71–0.77). Therapeutic alliance and early symptom change constituted the most important predictors. Models trained on baseline data were not significantly better than our benchmark.

Conclusions

Fair accuracies were only attainable by involving information from early treatment stages. In-treatment adaptation, instead of a priori selection, might constitute a more feasible approach for improving response when relying on easily accessible self-report features. Implementation trials are needed to determine clinical usefulness.
A cross-cultural perspective on God's personhood
Authors: Gupta Akshay
Published: December 2023

Debates about God's personhood, or lack thereof, are central to philosophy of religion. This article aims to advance these debates by presenting the ‘greatness of personhood argument’ for God's personhood and a dilemma for those who deny God's personhood. I also consider various objections to this argument and this dilemma and argue that they fail. Notably, my reasoning in defence of personal theism is cross-cultural insofar as personal theists across various religious traditions can use it. Thus, this article defends personal theism in a manner that can bring Western and non-Western theists into closer dialogue regarding the topic of God's personhood.
OP104 Pilot Implementation Of Health Technology Assessment Topic Prioritization In The Philippines: Lessons And Plans For Moving Forward
Authors: Samonte Sheena Jasley , Liban Lara Alyssa , Mondala Princess Allyza , Angeles Jason Oliver , Cabus Russell , Reyes Patrick Wincy , Marfori Anne Julienne , Guerrero Anna Melissa ,   Health Technology Assessment Council
Published: December 2023

Introduction

The Health Technology Assessment (HTA) Council in the Philippines carried out its process tracks while the implementing guidelines were being finalized in 2020, due to the urgent need to respond to COVID-19. Two years later, as mandated by the Universal Healthcare (UHC) law, we opened the nominations for the HTA Council’s topic priority list, which will be assessed to inform government financing decisions.

Methods

We adopted the former Philippine National Formulary System (PNFS) but set the prioritization criteria according to the decision framework stipulated by the UHC law and allowed industry submissions. We streamlined dossier completion for topics with numerous proponents, supplemented dossier deficiencies, and adjusted the timelines of crucial steps for better reach, while accounting for possible setbacks during the time periods. We satisfied the prioritization criteria using a Delphi technique at the HTA Council subcommittee and Core Committee levels in conjunction with consultations with the Department of Health and the national payer. We also shared evidence base and topic prioritization criteria scores with stakeholders during the public consultation.

Results

In the pilot implementation, we processed a total of 140 nominations (88 complete submissions) and released the priority list in five months. After processing 31 appeals from all key stakeholder groups, the 2022 priority list covered 31 assessments based on topics from the Department of Health, the national payer, industry, hospitals, and medical societies. Although we found gaps in the set timelines, inadequacy in the prioritization criteria parameters, and the need to increase exposure of the public to the process, we were able to accommodate all stakeholder concerns and maintain flexibility in the process.

Conclusions

We need to update our HTA process guidelines, accept joint dossier submissions, and review our topic prioritization process. The changing health system landscape and transitioning of national health priorities require coordination with the Philippine Food and Drug Administration for horizon scanning, early HTA, and managed entry agreements. Finally, there is a need to create special pathways for rare disease and innovative technologies.
Primary Care Physicians’ and Hospitalists’ Experience with Advance Care Planning with South Asian Canadian Older Adults before and during COVID-19
Authors: Vashisht Avantika , Gutman Gloria , Mackey Dawn , de Vries Brian , Kaur Taranjot , Kwan Helen
Published: December 2023

Few older adults discuss their end-of-life care wishes with their physician, and even fewer minorities do this. We explored physicians’ experience with advance care planning (ACP) including the barriers/facilitating factors encountered when initiating/conducting ACP discussions with South Asians (SA), one of Canada’s largest minorities. Eleven primary care physicians (PC) and 11 hospitalists with ≥ 15 per cent SA patients ≥ 55 years of age were interviewed: 10 in 2020, 12 in 2021. Thematic analysis of transcripts indicated that cultural and communication barriers, physician’s specialization, SA older adults’ lack of ACP awareness, and decision-making deference to family and physicians were barriers to ACP discussions. Although the COVID-19 pandemic impacted physicians’ practices, contrary to our hypothesis most reported no change in frequency of ACP discussions. Although ACP discussions were viewed as best conducted by PC physicians, only 55 per cent had ACP training and only 64 per cent had used ACP tools. Training in ACP facilitation, concerning ACP tool usage, and training in patient–physician communication are recommended.