bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-Term Frequently Relapsing Ischemic Strokes Followed by Rapidly Progressive Dementia in CADASIL
Authors: Geng Yumei , Cai Chang , Li Huimin , Zhou Qing , Wang Mengying , Kang Huicong
Published: November 2024

Introduction:

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease with slow natural progression. Ischemic stroke and cognitive impairment are its most common clinical symptoms. Here, we report a rare 50-year-old woman who had rapid disease progression with c.457C>T, p.Argl53Cys heterozygous mutation in exon 4 of NOTCH3 and discuss the possible reasons. Furthermore, we summarized the clinical and neuroimaging characteristics of 14 CADASIL patients with Arg153Cys mutation in exon 4.

Case Report:

The proband suffered acute ischemic stroke 5 times in 5 months, followed by rapidly progressive dementia (RPD) and inability to live independently, though she didn’t have vascular risk factors and had been under standardized secondary prevention therapy since the first stroke. Magnetic resonance imaging showed extensive white matter hyperintensities, numerous ischemic infarcts and microbleeds, and severe brain atrophy. Her elder brother and other patients with Arg153Cys mutation in exon 4 all did not progress so quickly. Her multiple strokes may be associated with the poor self-regulation of vessels, which may promote the occurrence of RPD. Antiplatelet and anticoagulant drugs were difficult to prevent ischemic strokes. Severe imaging findings may indicate rapid progression of CADASIL. In addition, we found that headache was a very frequent symptom in CADASIL patients with Arg153Cys mutation in exon 4, accounting for 76.9%.

Conclusions:

CADASIL can also appear to have rapid progression, as illustrated by our proband, which is worthy of clinicians’ attention and intervention timely. Headache may present in a relatively higher proportion of CADASIL patients with Arg153Cys mutation in exon 4.
Mesenchymal Tumors of the Tubular Gastrointestinal Tract (Non-GIST): The GI Pathologist’s Approach
Authors: Kővári Bence P. , Lauwers Gregory Y.
Published: November 2024

Mesenchymal neoplasms of the gastrointestinal tract are rare compared with epithelial lesions. However, over the past few decades, the increasing volume of gastrointestinal endoscopy has expedited the recognition of several novel entities with varying clinical significance. Its spectrum extends from reactive changes and benign neoplasms to highly aggressive sarcomas. At the malignant end of the spectrum, the importance of correctly diagnosing these tumors is underscored by the specific therapeutic implications available for some tumor types (eg, tyrosine kinase inhibitors for gastrointestinal stromal tumors) that allow personalized treatments. Benign lesions frequently surface among routine polypectomy specimens, sometimes offering diagnostic challenges. However, precise classification is the only way to avoid prognostic uncertainty and overtreatment, and to recognize possible syndromic associations. Hereby, we offer a pragmatic review of the topic from the gastrointestinal pathologist’s perspective, who, although more accustomed to epithelial neoplasms, can use an algorithmic approach to diagnose mesenchymal entities successfully.
Allopurinol Adherence in US Patients With Gout
Authors: Riggs Kevin R. , Richman Joshua S. , Cherrington Andrea L. , Singh Jasvinder A.
Published: November 2024

Background/Objective

Gout is the most common inflammatory arthritis, and its morbidity can be substantially reduced through urate-lowering therapy. However, adherence to allopurinol—the most common urate-lowering therapy—is notoriously poor. Prior studies have not fully elucidated factors associated with allopurinol adherence, particularly psychosocial factors.

Methods

We used 2018–2021 data from the Medical Expenditure Panel Survey, a national longitudinal survey on health care expenditures and utilization. We calculated the medication possession ratio (MPR) for allopurinol for participants with gout and categorized each as follows: no allopurinol fills, low adherence (MPR ≤0.8), or high adherence (MPR >0.8) to allopurinol. We used multivariable logistic regression to identify factors associated with high adherence, using person-year as the unit of measure and accounting for clustering for participants who contributed more than 1 person-year.

Results

The analyses included 919 respondents (1453 person-years), representing a weighted total of 15,084,439 person-years. Across all years, 27.4% had no allopurinol fills, 37.4% had low adherence, and 35.2% had high adherence. In multivariable models for high adherence, Black race (odds ratio, 0.49; 95% confidence interval, 0.33–0.73, compared with White) and residence in the South US region (odds ratio, 0.54; 95% confidence interval, 0.35–0.82, compared with Northeast) were negatively associated with high adherence.

Conclusions

Black race and residing in the Southern US were associated with lower allopurinol adherence among gout patients. Interventions to improve adherence, particularly among Black patients in the South, are needed to maximize the potential benefits of allopurinol.
Executive Summary: Topical Management of Malignant Cutaneous Wounds
Authors: Johnston Debra , Chaplain Valerie , Kerr Marilyn , Malley Jennifer , Popov Valentina , Ross Dawn , Smart Jordan
Published: November 2024

Malignant cutaneous wounds pose unique challenges in patient care, requiring specialized attention to alleviate local symptoms and enhance health-related quality of life. As the prevalence of these wounds continues to rise with improving cancer survival rates, it is essential to establish comprehensive best practice recommendations for their topical management. To address this need, a task force was assembled from across Canada, consisting of members from Nurses Specialized in Wound, Ostomy, and Continence Canada and the Canadian Palliative Care Nursing Association. The purpose of these recommendations is to provide a framework for the topical management of malignant cutaneous wounds for health care professionals, emphasizing the substantial role of their support persons. Recognizing the impact of cultural humility and the need to deliver care that respects individual beliefs and practices is crucial in providing effective and equitable care. The 23 presented recommendations aim to guide nurses, the interdisciplinary team, and the health system to enhance the overall quality of malignant cutaneous wound care management.
Use of a digital adherence technology for tuberculosis treatment supervision among adolescents
Authors: Schraufnagel Ann M , Crowder Rebecca , Wambi Peter , Nakasendwa Suzan , Kityamuwesi Alex , Jaganath Devan , Musoke Muhammad , Nannozi Joyce , Waswa Joseph , Sanyu Agnes Nakate , Lamunu Maureen , Twinamasiko Amon , Kunihira Tinka Lynn , Oyuku Denis , Babirye Diana , Berger Christopher , Thompson Ryan , Turyahabwe Stavia , Dowdy David , Katamba Achilles , Cattamanchi Adithya , Kiwanuka Noah
Published: November 2024

Background

Adolescents (ages 10-19) affected by tuberculosis (TB) face unique challenges to completing TB treatment, resulting in increased loss to follow-up and mortality as compared to younger children and older adults. Digital adherence technologies (DATs) may be a useful tool for TB treatment monitoring. In this study we aimed to assess whether 99DOTS, a low-cost DAT, could improve treatment outcomes among adolescents with pulmonary TB (PTB).

Methods

We conducted an interrupted time series (ITS) analysis of adolescents initiating treatment for drug susceptible PTB between August 1, 2019 and June 30, 2021 at 30 health facilities in Uganda. ITS analysis was used to model the change in TB treatment outcomes and loss to follow-up in adolescents prior to and after the implementation of a 99DOTS-based intervention. Immediate (level) and trend (slope) changes in outcomes were assessed according to intention-to-treat (ITT) and per protocol (PP) principles.

Findings

630 adolescents were included in the ITT analysis. In the post-intervention period, 78.4% of adolescents were enrolled on 99DOTS. The proportion successfully completing TB treatment was 92.4% (303/328) in the post-intervention period and 87.4% (264/302) in the pre-intervention period. In the adjusted ITT analysis, the proportion treated successfully increased (level change, PR 1.18 95% CI 1.08-1.28) and the proportion lost to follow-up decreased (level change, PR 0.93, 95% CI 0.88-0.98) in the immediate post-intervention period. Both proportions remained similar throughout the post-intervention period (p-value for slope change >0.05).

Interpretation

There was a high uptake of 99DOTS among adolescents with TB, and use of 99DOTS was associated with improved treatment outcomes. DATs should be further explored as a promising adolescent-specific tool for improving treatment outcomes among adolescents with TB.
Comprehensive Transcriptomic Analysis of Hepatocellular Carcinoma: Uncovering Shared and Unique Molecular Signatures Across Diverse Etiologies
Authors: Khorsand Babak , Naderi Nazanin , Karimian Seyedeh Sara , Mohaghegh Maedeh , Aghaahmadi Alireza , Hadisadegh Seyedeh Negin , Owrang Mina , Houri Hamidreza
Published: November 2024

Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, often diagnosed at advanced stages where treatment options are limited. This study undertakes a comprehensive meta-analysis of gene expression profiles from 19 independent datasets sourced from the Gene Expression Omnibus (GEO), encompassing a diverse range of HCC etiologies, including HBV and HCV infections, cirrhosis, and normal liver comparisons. Our analysis identified over 9,000 differentially expressed genes (DEGs), with 125 genes consistently altered across multiple datasets, underscoring their potential as critical biomarkers for HCC. Notably, we observed significant dysregulation in pathways related to cell cycle regulation, immune response, and metabolic processes. The integration of these DEGs across various HCC subtypes provides novel insights into the molecular heterogeneity of HCC, offering promising avenues for the development of targeted therapies and personalized medicine. This extensive repository of DEGs serves as a valuable resource for the scientific community, facilitating further research into the underlying mechanisms of HCC and the pursuit of improved diagnostic and therapeutic strategies.
RetS senses neurotransmitter norepinephrine and adrenergic agents to regulatePseudomonas aeruginosavirulence
Authors: Zhou Yachung , Ren Anming , Wang Chenchen , Zhou Tian , Deng Jie , Huang Yingfeng , Cui Ruiqin , Huang Wei , Feng Youjun , Zheng Weidong , Liang Haihua , Yang Liang
Published: November 2024

Bacterial cells employ diverse mechanisms to perceive and respond to host-associated molecules, coordinate intracellular signal transduction, and engage in interkingdom communications. In this study, we firstly discovered that the adrenergic antagonist dronedarone (DDR) effectively suppresses quorum sensing (QS) and pathogenesis of the opportunistic pathogenP. aeruginosa.Further analysis revealed that DDR targets RetS, an bacterial surface receptor critical for suppressing the GacS/GacA two-component regulatory system (TCS). Interestingly, the adrenergic agonist norepinephrine (NE) was found to exert opposite effects against RetS, thereby reversing DDR-induced phenotypes inP. aeruginosa. Moreover, we identified the hinge region of RetSDISMED2serves as a binding pocket of NE and DDR, which provides potential mechanisms of the antagonistic effect of NE and DDR. Our study demonstrated that NE promotesP. aeruginosainfections while DDR can serve as an anti-virulence compound againstP. aeruginosainfections. Thus, RetS might serve as a bacterial adrenergic receptor which keeps the NE under constant surveillance.

Significance

Sensing and recognition of host-derived molecules, as well as therapeutic drugs, are crucial for the survival of pathogens during infection process. The adrenergic drugs are well known to affect virulence and pathogenesis of the opportunistic pathogenPseudomonas aeruginosa(P. aeruginosa). In this work, we have provided in-depth characterization of a Norepinephrine (NE) receptor inP. aeruginosa, the RetS membrane protein. NE is the-adrenergic agonist known as a stress hormone, exerts its activity through interaction with mammalian adrenergic receptors (AR). It has been shown that increased NE concentration during early sepsis can stimulate the growth of various Gram-negative and Gram-positive bacteria, includingP. aeruginosa. We revealed that both adrenergic agonist NE and another adrenergic antagonist dronedarone (DDR) are able to interfering the RetS-GacS/GacA signaling cascade ofP. aeruginosaand execute opposite impact on the pathogenesis ofP. aeruginosaduring infections.
CHARMER: detecting and harmonizing high-confidence chromatin interactions across tissues and Hi-C protocols
Authors: Cole Simon , Kuksa Pavel P. , Cifello Jeffrey , Valladares Otto , Leung Yuk Yee , Wang Li-San
Published: November 2024

Motivation

Chromatin conformation capture experiments (CCC), such as Hi-C and Capture Hi-C (CHiC) work to elucidate the three-dimensional organization of the genome and the underlying epigenetic regulatory structures within. CCC experiments produce large amounts of FASTQ sequencing data with a substantial amount of technical noise and require sophisticated computational pipelines in order to extract meaningful results. Large-scale CCC data repositories like 4D Nucleome and ENCODE mostly provide raw contact information but lack annotated, statistically significant interaction data suitable for downstream genetic and genomic analyses.

Results

Here, we present CHARMER, an end-to-end pipeline integrated across multiple CCC assay types (HiC, CHiC) which generates statistically significant, harmonized, queryable, chromatin interactions in a consistent BED-like format across cell/tissue types and CCC assays.

Availability

CHARMER is freely available athttps://bitbucket.org/wanglab-upenn/CHARMERand harmonized chromatin interaction data will be available in the upcoming version of the FILER database (https://lisanwanglab.org/FILER).
Quantifying the social loafing led productivity issues in architecture, engineering and construction project teams
Authors: Maqbool Rashid , Shaji Anisha
Published: November 2024

Purpose

Architecture, engineering and construction (AEC) industry is one of the vast industries with a lot of productivity issues within. Teams as an integral part of the industry face many problems, of which social loafing is considered as a barrier. This research deals with a few barriers that contribute to social loafing leading to productivity challenges in the AEC industry. There are three major barriers identified as contributors to social loafing which also induces productivity challenges in the industry, from the literature study: cultural diversity, task invisibility and distributive justice.

Design/methodology/approach

The study adopted the quantitative questionnaire survey method approach, for which the respondents were selected globally through snowball sampling and a total of 443 responses were gathered. Different analysis approaches like the correlation coefficient, and structural equation modeling (SEM), were taken to analyze the survey data.

Findings

The SEM results showed that mediation factor, social loafing, is directly related to AEC productivity challenges and acts as a mediation for barriers like cultural diversity and task invisibility. Distributive justice was not found to have a direct relationship with AEC productivity challenges or even through social loafing.

Originality/value

This study could be beneficial for the CEOs, general managers and directors as they can use this study to encourage an employee friendly environment. Also, industry experts like engineers, architects, project managers can access this study to further improve the organizational culture and instill better employee values.
Navigating the financial frontier: a case of investment decision-making in the wake of Reliance Industries Limited’s demerger
Authors: Vaishali  , Gupta Simran , Kumar Rahul
Published: November 2024

Learning outcomes

This case study aims to equip students with the skills to evaluate the rationale behind a demerger decision, derive the enterprise value and equity value of the conglomerate using the discounted cash flow valuation modelling and assess the company’s value based on qualitative parameters using economy industry company analysis and strengths, weaknesses, opportunities and threats analysis.

Case overview/synopsis

This case study delves into the demerger of the financial services arm of Reliance Industries Limited into a separate unit named Jio Financial Services Limited. The independence of this unit is anticipated to enhance shareholder value and unlock the conglomerate discount. In light of these factors, a fundamental analysis of the firm is conducted to determine whether it presents a viable investment opportunity.

Complexity academic level

This case study is suitable for -graduate and postgraduate courses in financial management.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 1: Accounting and finance.
Enabling circularity in Turkish construction: a case of BIM-based material management utilizing material passports
Authors: Topraklı Abdurrahman Yağmur
Published: November 2024

Purpose

The Turkish construction sector, facing mounting environmental pressures, needs to rapidly adopt circular economy (CE) principles. However, a critical barrier is the lack of accessible and comprehensive material information. This paper investigates how building information modeling (BIM) can facilitate the adoption of material passports (MPs) to overcome this challenge and helps enabling circularity in Turkish construction.

Design/methodology/approach

A case study approach is adopted, focusing on the New Istanbul Esenler Arena, a major sports facility designed with BIM. An in-depth analysis of the project's BIM model and material data was conducted to develop a practical framework for integrating MPs into BIM workflows. The framework outlines a comprehensive MP data structure, addresses technical integration strategies and highlights the importance of stakeholder collaboration.

Findings

The research demonstrates that integrating MPs with BIM has the potential to significantly enhance material tracking throughout the building lifecycle, leading to more informed decision-making regarding material selection, reuse and recycling. This approach can improve material recovery rates, reduce construction waste and minimize the environmental impact of construction projects. The study also identifies key challenges to MP implementation, such as ensuring data accuracy and interoperability, and proposes strategies to overcome these hurdles.

Originality/value

This paper contributes to the limited but growing body of knowledge on the practical implementation of BIM and MPs for circular construction, particularly in the Turkish context. The proposed framework, informed by a real-world case study, provides valuable guidance for construction professionals, policymakers and researchers seeking to accelerate the transition to a circular economy in the built environment.
Influence of patient factors on target plasma volume treated attainment rate during double filtration plasmapheresis in patients with hypertriglyceridemic acute pancreatitis
Authors: Zhang Hui , Zhu Chenqiang , Wu Yunlong
Published: November 2024

Introduction

This study aims to investigate patient factors affecting the rate of plasma volume target attained in hypertriglyceridemic pancreatitis (HTG‐AP) patients undergoing double filtration plasmapheresis (DFPP).

Methods

A retrospective analysis of 82 HTG‐AP‐interpreted patients from January 2019 to April 2024 compared target plasma volume treated between up‐to‐scratch and non‐scratch groups. The group comparison used independent samples t‐test, Mann–Whitney U‐test, and chi‐square test. Binary logistic regression was used to identify independent risk factors for patients' plasma volume target failure. The ROC curve assessed these risk factors' diagnostic efficacy.

Results

Of 82 patients, 52 were classified as belonging to the up‐to‐scratch group, while the remaining 30 were classified as belonging to the non‐to‐scratch group. Statistically significant differences were seen between the groups regarding admission heart rate, triglyceride, calcitonin gene, C‐reactive protein, D‐dimer, and fibrinogen (FIB) levels (p <0.05). The binary logistic regression analysis showed that for every 1 mmol/L increase in triglycerides (TG), the probability of experiencing substandard target plasma handling increased by 5.0% (OR = 1.05, 95%CI 1.01–1.08, p = 0.009). Furthermore, for each g/L rise in FIB, there was a 74% increase in the likelihood of encountering suboptimal target plasma handling (OR = 1.74, 95%CI 1.18–2.56, p = 0.005). The ROC curve study revealed that the AUC for TG was 0.67, for FIB was 0.77, and for the combination of both markers was 0.80; all the p values were below 0.05.

Conclusion

The increased levels of TG and FIB are independent risk factors affecting the target plasma handling achievement rate in HTG‐AP patients undergoing DFPP.
PCAOB inspection deficiencies and future financial reporting quality: Do the types of deficiencies matter?
Authors: Constance Patience , Lennox Clive , Li Chan
Published: November 2024

This study examines whether PCAOB inspection reports are useful for signaling the risk of misstatements in future periods and the extent to which different types of audit deficiencies predict future misstatements. We find that, after the inspection report is issued, PCAOB‐identified audit deficiencies are positively associated with future misstatements for the audit firm's entire client portfolio. When we examine different types of deficiencies, we find that an auditor's failure to understand the client's accounting procedures or policies is the most detrimental type of deficiency for future reporting quality. We also examine the deficiency types for Big 4 versus non–Big 4 firms separately. The results show that an auditor's failure to understand the client's accounting procedures or policies is the only deficiency type that is positively associated with future misstatements for Big 4 firms. For non–Big 4 firms, however, future misstatements are predicted by an auditor's failure to understand the client's accounting procedures or policies, inadequate substantive testing, and inadequate going‐concern assessments. Our study has important implications given the concerns raised by auditors regarding the usefulness of PCAOB inspections.
Major sight‐threatening eye disorders and mental disorders
Authors: Dong Xing‐Xuan , Hu Hui‐Hui , Ying Zhi‐Qi , Chen Dong‐Ling , Xie Jia‐Yu , Li Dan‐Lin , Hu Dan‐Ning , Lanca Carla , Grzybowski Andrzej , Pan Chen‐Wei
Published: November 2024

The purpose of this study was to: (a) investigate the comorbidities of major sight‐threatening eye disorders with mental disorders, (b) investigate the associations and prevalence of reported comorbidities and (c) identify potential influencing factors. A systematic review of the PubMed, Embase, Web of Science and Cochrane Library databases was conducted from inception to 30 December 2023. Studies that presented only laboratory results or used non‐representative sampling methods were excluded. Meta‐analyses were performed using the inverse variance method with a random‐effects model. A total of 67 studies were included in the analysis. The most prevalent comorbidities were diabetic retinopathy (DR) and depression (pooled prevalence of 30%) and DR and anxiety (pooled prevalence of 29%). Significant associations were found between glaucoma and depression (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.21–1.66), glaucoma and anxiety (OR = 2.11, 95% CI = 1.22–3.66), glaucoma and schizophrenia (OR = 1.38, 95% CI = 1.28–1.50), age‐related macular degeneration (AMD) and depression (OR = 1.36, 95% CI = 1.18–1.57), and DR and depression (OR = 1.03, 95% CI = 1.01–1.06). Income was identified as a significant contributing factor to the prevalence of comorbidity between glaucoma and depression. Major sight‐threatening eye disorders were significantly associated with mental disorders, particularly depression and anxiety. The burden of comorbidity between major sight‐threatening eye disorders and mental disorders is not optimistic and may be influenced by income disparities. Healthcare providers are encouraged to assess and manage potential comorbidities to optimize patient outcomes.
Tracking technical change: Past, present and future
Authors: Alexopoulos Michelle , Cohen Jon
Published: November 2024

Productivity growth in many countries has remained low for several years. Whether new technologies can reverse the trend depends on the scope of their impact and scale of their adoption—two dimensions of technical change that are historically difficult to measure. Here, we elaborate on the materials and methods presented in Alexopoulos's presidential address at the 2024 Canadian Economics Association meeting. Specifically, we discuss how applying natural language processing and text mining to library collections and cataloguing materials can help: (i) identify new technologies as they come to market and (ii) track their uses and spread over time. We further describe how our insights can be used to uncover general purpose technologies and macro‐innovations in both the past and the present. An application to current data suggests that AI and robotics are responsible for an increasing share of recent technical change. Moreover, they resemble past early‐stage general purpose technologies and thus do promise a reversal in productivity trends as their adoption increases. Going forward, our new methods should be especially useful to economists and policy‐makers who need to track future development and adoption of key technologies—especially during periods of rapid innovation.
Embedding equity and inclusion in universities through motivational theory and community‐based conservation approaches
Authors: Yasué Maï , Weinstein Netta , Harris Sara E. , Chiang I‐Chant A. , Legate Nicole , Moore Ashley J. , Joe Nadia
Published: November 2024

Despite widespread plans to embed justice, equity, decolonization, indigenization, and inclusion (JEDII) into universities, progress toward deeper, systemic change is slow. Given that many community‐based conservation (CBC) scholars have experience creating enduring social change in diverse communities, they have transferable skills that could help embed JEDII in universities. We synthesized the literature from CBC and examined it through the lens of self‐determination theory to help identify generalizable approaches to create resilient sociocultural change toward JEDII in universities. Fostering autonomous motivation (i.e., behaving because one truly values and identifies with the behavior or finds behavior inherently satisfying) is critical to inspiring enduring change in both CBC and JEDII. Based on theory and our examination of CBC, we provide 5 broad recommendations that helped motivate behavioral change in a way that was self‐sustained (i.e., even without external rewards or pressure). Guiding principles support autonomy by creating meaningful choice and different entry points for JEDII; prioritising relationships; designing payment programs that enhance autonomous motivation; developing meaningful educational opportunities that are relevant, timely, relational, and authentic; and creating institutional change by focusing efforts on critical moments.
Perspectives on inclusion, safety, and belonging from members of the North American LGBTQIA+ conservation community
Authors: Collins Amy C. , Feuka Abigail B. , Nelson Jasmine , Verahrami Anahita K. , Bombaci Sara
Published: November 2024

Conservation scientists work in diverse settings, sometimes requiring them to exist in spaces where they do not feel safe, included, or accepted. This is often the case for the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and others) community, which is frequently marginalized in conservation spaces. We conducted an anonymous, semistructured, online survey of members and nonmembers of the LGBTQIA+ community of conservation students and professionals in North America to explore participants’ lived experiences in conservation. Our 737 responses (response rate 26.8%) included 10% who identified as genderqueer, gender nonconforming, questioning, nonspecific, genderfluid, transgender woman, agender, transgender man, 2‐spirit Indigenous, or intersex (gender expansive), and 29% as bisexual, queer, lesbian, gay, asexual, pansexual, omnisexual, questioning, or nonheterosexual (queer+). We found that non‐LGBTQIA+ respondents overestimated the degree to which LGBTQIA+ respondents felt included in the field of conservation by 5% (sexual orientation) and 18% (gender identity). Respondents’ feelings of safety and belonging were up to 50% lower in most work settings compared with non‐LGBTQIA respondents; the lowest frequencies were reported by gender expansive respondents (40.9–64.4%). Contextual responses indicated that the lack of safety and belonging related to direct experiences of bullying (23 long‐form descriptions out of 73 gender expansive respondents and 15 of 217 queer+ respondents), concerns around safety in rural settings (4 of 73 gender expansive respondents and 20 of 217 queer+ respondents), and concerns around not being able to express their authentic selves (7 of 73 gender expansive respondents and 5 of 217 queer+ respondents). The intersection between gender identity and race also played a role in feelings of safety, belonging, and disclosure of sexual orientation (1 of 73 gender expansive respondents, 6 of 217 queer+ respondents). The most frequent support resources used by LGBTQIA+ conservation scientists included one‐on‐one support from peers, mentors and external collaborators, support group, and wellness and counseling services outside of work.
Cherrapunji, India: a land of waterfalls and speleothems, and the right place to become a UNESCO Global Geopark
Authors: Datta Krishanu
Published: November 2024

Here, I propose that Cherrapunji, one of the wettest places on the planet, should be a potential site as a UNESCO Global Geopark. This location is not only associated with numerous majestic waterfalls, karst topography and multiple natural caves and speleothems with global scientific value, but is also of great significance to local people. These features have made this place an important area for geoscience research, as well as an important area for the development of geotourism. Cherrapunji is also the source of the ‘Meghalayan Age’, the most recent age in the geological timescale, defined by the International Commission on Stratigraphy (ICS) in 2018, for the past 4200 years of the Holocene. This article calls on researchers, government officials as well as the local people to take all the necessary steps to make Cherrapunji a UNESCO Global Geopark.
Work From Home Model: An Exploration Into the Experiences of Working Mothers in the Service Sector: The Case of Nigeria and South Africa
Authors: Echebiri Chukwuemeka , Mathibe Motshedisi , Echebiri Chiaka Martin , Osuigwe Ubochioma Udo S.
Published: November 2024

This study examines the influence of societal norms and maternal duties on the Work‐From‐Home model and the experiences of mothers in the service sector in Sub‐Saharan Africa. While working from home has received attention, there is a lack of understanding regarding the specific challenges working mothers face in this region, which is characterized by gender role expectations. Through qualitative interviews with 15 mothers, balancing work, home responsibilities, and childcare, this research sheds light on the increased tension between work and family when the home becomes the primary workplace, considering cultural norms and expectations. The findings reveal that remote working has disproportionately affected working mothers in Sub‐Saharan Africa, negatively impacting their overall well‐being.
Healthcare Professionals' Views on the Use of Passive Sensing and Machine Learning Approaches in Secondary Mental Healthcare: A Qualitative Study
Authors: Rogan Jessica , Firth Joseph , Bucci Sandra
Published: November 2024

Introduction

Globally, many people experience mental health difficulties, and the current workforce capacity is insufficient to meet this demand, with growth not keeping pace with need. Digital devices that passively collect data and utilise machine learning to generate insights could enhance current mental health practices and help service users manage their mental health. However, little is known about mental healthcare professionals' perspectives on these approaches. This study aims to explore mental health professionals' views on using digital devices to passively collect data and apply machine learning in mental healthcare, as well as the potential barriers and facilitators to their implementation in practice.

Methods

Qualitative semi‐structured interviews were conducted with 15 multidisciplinary staff who work in secondary mental health settings. Interview topics included the use of digital devices for passive sensing, developing machine learning algorithms from this data, the clinician's role, and the barriers and facilitators to their use in practice. Interview data were analysed using reflexive thematic analysis.

Results

Participants noted that digital devices for healthcare can motivate and empower users, but caution is needed to prevent feelings of abandonment and widening inequalities. Passive sensing can enhance assessment objectivity, but it raises concerns about privacy, data storage, consent and data accuracy. Machine learning algorithms may increase awareness of support needs, yet lack context, risking misdiagnosis. Barriers for service users include access, accessibility and the impact of receiving insights from passively collected data. For staff, barriers involve infrastructure and increased workload. Staff support facilitated service users' adoption of digital systems, while for staff, training, ease of use and feeling supported were key enablers.

Conclusions

Several recommendations have arisen from this study, including ensuring devices are user‐friendly and equitably applied in clinical practice. Being with a blended approach to prevent service users from feeling abandoned and provide staff with training and access to technology to enhance uptake.

Patient or Public Contribution

The study design, protocol and topic guide were informed by a lived experience community group that advises on research projects at the authors' affiliation.
Understanding clinical library services as knowledge mobilisation activities: Mixed method evaluation of an Evidence Access service in a mental health trust
Authors: Steele Rachel , Knowles Sarah , Daniel Sarah , Gavaghan Samantha , Churchill Rachel
Published: November 2024

Background

Access to tailored evidence syntheses can support frontline clinical staff to make evidence‐informed care decisions, but evaluation of such services requires understanding of user needs within context.

Objectives

We evaluated an Evidence Access service by clinical librarians in a mental health trust in northern England to assess impacts on staff decision making and identify areas for improvement.

Methods

The evaluation was guided by the integrated Promoting Action on Research in Health Services framework. We evaluated the service through a survey, semi‐structured interviews, and service mapping with the library team.

Results

Staff who used the service valued it highly and particularly appreciated the rapid response and trusting relationships with library staff. Mental health nurses required proactive support to encourage them to access the service.

Discussion

The service could be used to generate clinically relevant research questions in collaboration with researchers, but would require support for the negotiation of the value of different questions and understanding of each other's needs and priorities.

Conclusions

An Evidence Access service provided by a clinical librarian is highly valued by mental health staff. Collaboration between researchers and clinicians to identify and respond to evidence gaps would require commitment to building relationships and capacity.
Trends and disparities in antiretroviral therapy prescription rates among US Medicare beneficiaries with HIV
Authors: Yu Xiaoying , Kuo Yong‐Fang , Dike Ashley A. , Efejuku Tsola , Raji Mukaila A. , Berenson Abbey B. , Giordano Thomas P.
Published: November 2024

Objective

Our objective was to evaluate antiretroviral therapy (ART) prescription rates over time among US Medicare enrolees with HIV and to describe disparities in ART prescription and associated factors.

Method

We constructed successive cross‐sectional cohorts including adult enrollees with HIV and fee‐for‐service coverage and Part D enrolment in US Medicare between 2007 and 2019. We calculated the percentage of receipt of any ART prescription (ART%) in a calendar year by sex, age, and original Medicare entitlement and calculated age–sex standardized ART% over time. We used multivariable logistic regression to assess the association between ART prescription and sociodemographic factors and chronic conditions by age strata (<65, ≥65 years) in 2019.

Results

ART% increased over time and was highest among people with HIV aged 50–64 years in 2019: 95% in males and 92% in females. Multivariable analysis showed that female sex was associated with less ART%, with odds ratios (ORs) of 0.65 (95% confidence interval [CI] 0.60–0.70) and 0.34 (95% CI 0.30–0.39), than male sex in those aged <65 and ≥65 years, respectively. The youngest and oldest enrollees had lower ART use (e.g., OR 0.43 [95% CI 0.34–0.54] for 18–29 vs. 50–64 years; OR 0.34 [95% CI 0.30–0.39] for ≥80 vs. 65–69 years). The top conditions associated with less ART included dementia and alcohol use disorder. Other factors included no Part D low‐income subsidy, non‐Hispanic white race, and Midwest residence.

Conclusions

ART use increased over time in US Medicare enrollees. Non‐Hispanic white, female, and the youngest and oldest enrollees received less ART. Multimorbidity, substance use, and dementia were associated with less ART use. Research to overcome these disparities is needed.
Optimising the Nursing Scope of Practice in a Homeless Health Service: A Qualitative Descriptive Study
Authors: Thompson Cristina , Morris Darcy , Larkin Matthew , McWilliams Lucy , Vasquez‐Hernandez Alejandro , Currie Jane
Published: November 2024

Aim

To explore specialist homeless health professionals' perceptions of gaps in homeless health care and understand whether these might be addressed through existing nursing scopes of practice.

Design

Qualitative descriptive study.

Methods

Semi‐structured interviews and focus groups with a purposive sample of 22 staff in nursing (11) and non‐nursing (11) roles, engaged with a Homeless Health Service. Data were collected via videoconferencing and recordings transcribed verbatim. An exploratory framework guided deductive and inductive thematic analysis.

Results

Service gap themes included the need for integration with mainstream health services, more specialised health professionals, and adaptations to the existing models of care. Addressing these gaps involved enhancements to the broad scope of nursing practice, workforce development by establishing homeless health as a nursing specialty and optimising organisational governance to minimise risk.

Conclusion

The most pressing homeless health service delivery gap was lack of health service integration, and it was unclear how this could be resolved through nursing scopes of practice. Other service gaps could be addressed through skilling nurses to practice preventative health care, as well as crisis management. Enhancing nurses' capability in physical and mental health assessment skills including alcohol and other drugs and procedural skills would support wraparound care for people experiencing homelessness. We conclude that a homeless health nursing specialty could be established that formalises the scope of practice of nurses in this field to ensure future post‐graduate training aligns with service gaps.

Impact

This study identifies opportunities to optimise nursing scopes of practice to address Homeless Health Service gaps through reviewing models of care and nursing practice. For example, enhancing nurses' capability to provide preventative and wraparound care. This research may inform a development pathway to enhance education and training for nurses working with vulnerable populations.

Reporting Methods

COREQ 32‐item checklist.

No patient or public contribution.
The efficacy of behavioral sleep intervention on sleep problems among children with attention‐deficit hyperactivity disorder: A randomized controlled trial
Authors: El‐Monshed Ahmed Hashem , Loutfy Ahmed , El‐Boraie Haitham , El‐Gilany Abdel‐Hady , Fayed Sara Mohamed , Elzeiny Amina , El‐Gazar Heba Emad , Ali Ahmed Salah , Zoromba Mohamed Ali
Published: November 2024

Background

Attention‐deficit hyperactivity disorder (ADHD), affecting 5% of global children, presents inattention, hyperactivity, and impulsivity. Sleep problems, prevalent in 70% of cases, exacerbate long‐term psychosocial challenges.

Aim

This study aimed to assess the efficacy of behavioral sleep intervention in alleviating sleep problems, enhancing quality of life (QoL), and reducing ADHD symptom severity among children diagnosed with ADHD.

Method

A randomized controlled trial was conducted from June 2022 to April 2023. The intervention group (n = 47) engaged in a hybrid approach, participating in both face‐to‐face and Zoom sessions, while the control group (n = 45) received standard care. Data collection involved administering the Children's Sleep Habits Questionnaire (CSHQ), Pediatric Quality of Life Inventory (PedsQL), and ADHD Rating Scale IV (ADHD‐RS‐IV).

Results

Significant enhancements were observed in CSHQ (p ≤ 0.001, effect size = 1.913), PedsQL (p ≤ 0.001, effect size = 1.862), and a notable reduction in ADHD‐RS‐IV (p ≤ 0.001, effect size = 1.548). These findings highlight the intervention's efficacy in improving sleep quality, QoL, and reducing ADHD symptomatology.

Conclusion

This trial contributes substantially to understanding behavioral sleep interventions' impact on ADHD‐affected children, enhancing quality of life and ADHD symptomatology. The study highlights the importance of individualized care for optimal outcomes in children with ADHD.

Clinical Relevance

The study's findings underscore the potential for integrating behavioral sleep interventions into routine nursing practices, offering a valuable approach to address sleep‐related challenges in children with ADHD. By focusing on sleep improvement, nurses can contribute to enhancing overall well‐being and emotional regulation in these children within the context of comprehensive healthcare.
Two in one: A case study of two rhizocephalan species invading the nervous tissue of one host
Authors: Lianguzova A. D. , Poliushkevich L. O. , Laskova E. P. , Golubinskaya D. D. , Arbuzova N. A. , Petruniak A. M. , Miroliubov A. M.
Published: November 2024

Certain parasites can manipulate their hosts to enhance their own fitness and transmission success. Rhizocephalan barnacles are a notable example, inducing significant changes in their crustacean host's morphology, physiology, and behaviour. Until recently, it was believed that the spider crab Scyra aff. ferox is parasitized by a single species Sacculina pilosella in the Sea of Japan. However, previous molecular studies have revealed a complex of unrelated species, Sacculina pugettiae (fam. Sacculinidae) and Parasacculina pilosella (fam. Polyascidae). These rhizocephalans can even parasitize one host specimen simultaneously. Here, we investigated the interaction of S. pugettiae and P. pilosella with the nervous system of their common host. Species were identified based on receptacle morphology, with further validation through 18S gene phylogenetic analysis. The parasites interacted differently with the host nervous system: S. pugettiae had goblet‐shaped organs in the ganglion periphery, while P. pilosella lacked these structures, instead possessing numerous neuropil rootlets. In case of simultaneous infection, both goblet‐shaped organs and neuropil rootlets were present. Histochemistry revealed the presence of muscular rosettes in the rootlets of both species, suggesting a similar organization of the muscular system despite phylogenetic differences. Scanning electron microscopy confirmed the presence of host cell projections enveloping the rootlets. This study provides insights into the morphological features of rhizocephalan‐decapod interaction and highlights differences in their interaction with host nervous tissue between families. Our results also confirmed the loss of the goblet‐shaped organs in Polyascidae.
Isolation and analysis of residual leucocytes from leucoreduced red blood cell units
Authors: Hirani Rena , Dean Melinda M. , Irving David O.
Published: November 2024

Background and Objectives

Leucoreduction is used to remove donor leucocytes during red blood cell (RBC) manufacture. However, not all are removed, and long‐term survival of donor leucocytes, termed transfusion‐associated microchimerism (TAM), has been shown to occur in some patients following RBC transfusion. The mechanism of TAM occurrence is unknown. One hypothesis is that viable donor haematopoietic cells remain within RBC units that could engraft. However, the analysis of cells remaining within leucoreduced RBC units has been minimal. This study aimed to isolate and analyse any residual leucocytes recovered from leucoreduced RBC units.

Materials and Methods

Leucoreduced RBC units were analysed on Day 1 (n = 4) and Day 42 (n = 4) post collection. Residual leucocytes were isolated using the EasySep™ RBC Depletion Reagent. Cell type analysis was conducted by flow cytometry using a leucocount reagent, a viability marker (7‐amino‐actinomycin D [7AAD]) and specific antibodies to CD45 and CD34. A representative ‘pre‐filter’ sample was also obtained at the time of whole‐blood donation to ensure expected cell counts across the donor samples.

Results

Analysis of the pre‐filter sample showed that CD45+/CD34+ cells accounted for 0.02%–0.07% of all leucocytes. Up to 253,850 residual leucocytes were isolated across both storage timepoints, and of these, up to 48 cells were CD45+/CD34+/7AAD–.

Conclusion

Viable CD45+/CD34+ cells were isolated from leucoreduced RBC units, indicating the potential for donor progenitor cells to be present during transfusion. Further characterization of these residual cells is required to explain how TAM may occur in some patients following RBC transfusion.