bluuebunny/crossref_metadata_2025 huggingface dataset:
Women’s Attitudes toward Family Planning in the Postpartum Period and Affecting Factors: Turkiye Sample
Authors: Bilge Çiğdem , Kaydırak Meltem , Altınsoy Büşra , Yakıt Ak Eda , Öztürk Sevdiye
Published: October 2024

Introduction:

Despite declining birth rates and improvements in maternal health care, the number of unwanted pregnancies and unwanted births in Turkiye remains high. The aim of this study was to determine women’s attitudes and preferences regarding family planning and the factors influencing them in the postpartum period.

Method:

A descriptive and correlational study was carried out. Data were collected using a personal information form and the Family Planning Attitude Scale in the online environment.

Results:

According to the results of this study, the number of women who did not receive family planning counseling during pregnancy (42.6%) and the postpartum period (36.9%) was considerably high. Women’s family planning attitudes change positively when they move from the east to the west of Turkiye.

Discussion:

According to the results of the study, it was observed that a person’s education, economic status, and cultural values  are effective in family planning method selection and family planning attitude.
A Novel Labeling Method of Physiological-based Pressure Pain Assessment Among Patients With and Without Chronic Low Back Pain
Authors: Zhu Wenchao , Xiao Yan , Lin Yingzi
Published: October 2024

Pain, especially chronic pain, is a complicated and subjective experience, threatening global healthcare as one of the most severe health problems. Traditionally, pain is assessed by Visual Analog Scale to indicate the pain intensity by the patient’s self-report, causing them to become biased by various psychosocial factors. In this study, we performed two distinct labeling methods to assess the pressure pain in Quantitative Sensory Testing and to differentiate healthy controls and chronic low back pain patients: time period labels and percentage timestamp labels. Physiological signals such as blood volume pulse and galvanic skin response were collected. The time period labeling method was to segment via fixed time windows. The percentage timestamp labeling method was to select the timestamp labels based on the percentage of the threshold or the tolerance time. Both methods demonstrate different advantages when visualizing the information of different pain states and different participant groups.
Perioperative anaesthetic complications in healthy cats undergoing anaesthesia for neutering in first opinion practice
Authors: Brown Jenny F , Murison Pamela J
Published: October 2024

Objectives

The aim of the present study was to identify the incidence of common perioperative anaesthetic complications in cats undergoing anaesthesia for neutering in three UK first opinion practices.

Methods

A retrospective anaesthetic record analysis was performed on cats anaesthetised for neutering at practices 1 and 2 between 9 December 2017 and 2 February 2021 and practice 3 between 9 March 2020 and 7 January 2021. A search of the practice management system identified all cats that had undergone neutering in the selected timeframe. Data from 1019 cats were included in the study. Information relating to patient characteristics and data from the anaesthesia session were extracted from electronic patient records and anaesthesia record charts and entered into an Excel spreadsheet. A definition of the complications was created after reviewing the literature and their incidence determined from the data set. Comparisons between different groups of cats in the study were made using a χ2 test for homogeneity or Fisher’s exact tests to identify factors associated with increased incidence of complications.

Results

The anaesthetic-related mortality was 1/1019 (0.10%). The most common complications were hypotension (22.6%), bradycardia (16.7%) and hypothermia (13.8%). Less common complications were hypocapnia (12.7%), hypercapnia (8.7%), tachycardia (6.6%), apnoea (3.1%), hyperthermia (1.7%), hypertension (1.4%), endotracheal tube obstruction (1.1%), hypoxia (0.3%), undesirable recovery (0.6%) and cardiac arrhythmia (0.2%). Factors associated with increased risk of hypotension were acepromazine pre-anaesthetic medication, higher maximum isoflurane dose, longer anaesthetic duration and lower body weight. Factors associated with increased risk of bradycardia were medetomidine pre-anaesthetic medication, longer anaesthetic duration and higher body weight. Factors associated with increased risk of hypothermia were higher maximum isoflurane dose, increased anaesthetic duration and lower body weight.

Conclusions and relevance

This study showed that anaesthetic complications were frequently observed, with complications documented in 53.4% of the cats in the study. The information in this study may help to guide prioritisation of monitoring in feline anaesthesia.
Recycled PET foam core sandwich panels with reinforced hybrid composite facesheets: A sustainable approach for enhanced impact resistance
Authors: Mandegarian Sepanta , Hojjati Mehdi , Moghaddar Hassan
Published: October 2024

This research explores the Low-Velocity Impact behavior of thermoplastic composite sandwich panels with 100% recycled Polyethylene Terephthalate (PET) foam sourced from post-consumer plastic water bottles. Being recognized as a reliable technique, hybridization using stainless-steel mesh layers was employed to reinforce the panels’ composite facesheets of sandwich panels accessible for modular housing, cold storage rooms and cargo trucks. Adequate impregnation of the reinforcement metallic mesh layer alongside proper skin-to-core adhesion was accomplished by optimizing a two-phase compression molding method. The effect of hybridization on impact response of sandwich panels with two different PET foam core thicknesses, and stacking sequence were evaluated. It was revealed that reinforcing the impacted surface of the composite sandwich panels significantly increased the perforation threshold. Moreover, analyzing the post-impact section view of the samples indicated that hybridization modified the damage propagation response of the PET foam core sandwich composites, through which the energy absorption capacity was improved.
Pediatric limbal stem cell deficiency: An overview of a rarely studied pathology
Authors: Tutas Günaydın Nesrin , Barut Selver Ozlem
Published: October 2024

The cornea is the outermost transparent layer of the eye, and the continuous renewal of the corneal epithelium is important for its transparency. This process is primarily facilitated by corneal stem cells, most of which are found at the limbus. However, any deterioration or damage in this region leads to corneal conjunctivalization and consequent limbal stem cell deficiency (LSCD), which compromises corneal transparency. LSCD is an important condition, especially in the pediatric population, as it can lead to corneal vascularization, opacity and ultimately loss of vision and subsequent amblyopia, unlike adults. Although pediatric LSCD is often due to chemical injuries, as in adults, it is also caused by conditions such as congenital aniridia, Steven Johnson Syndrome and various other immunological disorders. Appropriate and timely treatment in pediatric LSCD is of particular importance in preventing progression to amblyopia, unlike adults. Accurate staging of the disease is essential for the necessary medical and surgical treatment decision. While medical approaches are at the forefront to eliminate the causative agent and improve the ocular surface in reversible cases, it is essential to replace the limbal stem cells lost in advanced disease. For these replacement procedures, it is noteworthy that there is a tendency for minimally invasive methods compared to adults to avoid possible complications due to long life expectancy in children. In conclusion, although there are various reviews on limbal stem cell deficiency (LSCD) in adults, we believe that this review for childhood LSCD will make an important contribution to the literature, since the relevant literature currently reported for the pediatric population is limited.
Pre-school and primary teachers in the process of detecting child maltreatment in Andalusia (Spain) / El profesorado de Infantil y Primaria en el proceso de detección del maltrato infantil en Andalucía (España)
Authors: Pérez-Padilla Javier , Lorence Bárbara , Menéndez Álvarez-Dardet Susana
Published: October 2024

This study analyses teachers’ knowledge about child maltreatment in the family and explores their professional background in dealing with this problem. 227 pre-school and primary teachers from Andalusia (Spain) participated in the study. The majority of the teachers had never reported a case of child maltreatment during their professional background. These situations were experienced by the teachers with high levels of emotional impact, and both they and their schools showed high levels of involvement in cases identified. Three teacher profiles were identified, the group of trained teachers being the most capable of identifying more complex signs of child maltreatment, followed by those with more years of seniority. The process of detection and reporting of child maltreatment in the school setting is complex, and a wide range of elements need to be analysed conjointly.
Prospective Association Between Tobacco Use and at-Risk Alcohol Consumption Among Swedish Adolescents: Outlining the Influence of Tobacco Product, Frequency of Use and Gender in the LoRDIA Cohort
Authors: Andersson Johanna , Berglund Kristina , Irmel Robin , Adermark Louise
Published: October 2024

Introduction: Tobacco use is not only a major risk factor for morbidity and mortality but also associated with alcohol misuse. While personality traits may be driving this association, the psychoactive component of tobacco, nicotine, may also be a major risk factor. The aim with this study was to further assess the prospective association between tobacco use and alcohol consumption, with special emphasis on the role of the tobacco product used (cigarettes and Swedish snus), frequency of use, and gender. Methods: Data was extracted from the prospective cohort Longitudinal Research on Development In Adolescence (LoRDIA), following Swedish adolescents over four waves (∼13 to 17 years of age). Tobacco use was reported with respect to product used and frequency of use, while alcohol use was assessed using AUDIT-C, as well as frequency of use within the last year. Results: Use of tobacco, independent of product used and gender, was associated with increased alcohol consumption. High frequency of use and dual use strengthened to association. Individuals initiating tobacco use during the study period progressively increased their frequency of alcohol consumption compared to non-users during consecutive waves. Furthermore, tobacco use was associated with at-risk consumption of alcohol at follow up, even when adjusting for previous alcohol inebriation, socioeconomical factors, gender and novelty seeking. Conclusions: The data presented here suggests that nicotine use during adolescence, and especially dual use, is a major risk factor for future hazardous alcohol intake. This finding is especially important considering the escalated use of nicotine pouches, which in many ways resembles Swedish snus. From a public health perspective, preventive measures and policies designed to counteract all forms of nicotine use among youths is warranted.
Fishing tourism and the environment: Examining fishing tourists’ resource consumption reduction and recycling behaviors at fishing destinations
Authors: Han Heesup , Kim Seongseop (Sam) , Chiriko Amare Yaekob , Quan Lanji
Published: October 2024

With increasing climate change, it is becoming imperative to implement pro-environmental practices. The present study aimed to delineate the determinants of fishing tourists’ eco-friendly behaviors by adopting a fuzzy-set approach. The results revealed the complex interplay of VBN (value–belief–norm) factors, perceived barriers, and motives in shaping fishing tourists’ environmental behaviors. While no single factor emerged as a necessary condition for pro-environmental behaviors, the findings provide valuable insights for policymakers and tourism professionals seeking to promote sustainability in fishing tourism sites. Moreover, the results offer insights that will help in the understanding of fishing tourists’ underlying psychological structure and in devising tactics to promote pro-environmental measures for recreational wildlife tourists.
Self-efficacy and social support enable women to protect their pelvic floor health: A nonrandomized controlled trial in rural Nepal
Authors: Marie Jelena Jonitz Vica , Shrestha Akina , Luginbuehl Helena , Kasaju Aastha , Scarnato Chiara , Meierhofer Regula , Inauen Jennifer
Published: October 2024

Carrying heavy loads increases the risk of pelvic organ disorders, particularly in low-income countries. Low self-efficacy hampers adoption of pelvic-floor-protective behaviors. The enabling hypothesis suggests that social support may strengthen women’s behavioral self-efficacy. A three-arm parallel non-randomized controlled trial with 300 women and their social partners experimentally examined whether self-efficacy and social support can enable women’s pelvic-floor-protective behaviors in rural Nepal. Three villages received (1) self-efficacy (2) self-efficacy and social support promotion, or (3) information only control. The co-primary outcomes were reduced weight carried and using protective lifting techniques at 2-month follow-up. Self-efficacy promotion increased the use of protective lifting techniques 9% more than information only ( d = 0.28). Weight was reduced by 3 kg more when additionally promoting social support compared to self-efficacy alone ( d = 0.39). Self-efficacy and social support promotion enable women to better protect their pelvic floor health and may complement educational approaches to health behavior change in low-resource populations.
Breakup dynamics in a pressure-swirl injector for urea-water solution applications: A computational study
Authors: Marco-Gimeno Javier , Asztalos Katherine J. , Moon Chi Young , Powell Christopher F. , Martí-Aldaraví Pedro , Nocivelli Lorenzo
Published: October 2024

The co-optimization of in-cylinder combustion and after-treatment technology has become a major aspect in engine design and development, with the goal of meeting the increasingly restrictive emission regulations in the transportation industry. Selective Catalytic Reduction is a robust technology to control the emission of NOx, and the injection of urea in water solution is the exhaust tailpipe is a key aspect of its operation. The proposed work uses high-fidelity Computational Fluid Dynamics to characterize the atomization dynamics of the liquid jet in relevant cross-flow conditions. The study focuses on a commercial low-pressure (9 bar) pressure-swirl injector which is characterized in its internal geometry through high-resolution X-ray micro-computational tomography. The internal two-phase flow has been modeled according to the volume-of-fluid approach in a large eddy simulation framework and validated against near-nozzle X-ray radiography measurement. Moreover, characterizing the breakup dynamics for the swirling hollow cone formation, and assessing the influence of the cross-flow in the breakup dynamics was completed. The results have been reported proposing Re-Oh maps and probability density functions of the spray kinematics. Higher cross-flow momentum generates an increase in the jet intact length and a reduction of the liquid droplet diameters. The axial momentum of the jet is affected by the cross-flow already in the near-nozzle region, determining a relevant deviation of the spray velocities. This work aims to inform the initialization of Eulerian-Lagrangian spray models through the assignment of droplet kinematics and static one-way coupling between volume-of-fluid results and Lagrangian spray parcels, to be used for system-size domain simulations.
Full-field expansion and damage detection from sparse measurements using physics-informed variational autoencoders
Authors: Kulkarni Nitin Nagesh , Sabato Alessandro
Published: October 2024

Recent advancements in machine learning and artificial neural network algorithms have created new opportunities for expanding sparse measurements to full-field representations. However, these methods often face accuracy challenges when used for condition monitoring of physical systems. For example, traditional autoencoders can capture complex phenomena and their underlying physics in the latent space, but due to their frequentist nature, they lack generative and damage detection capabilities. To address these challenges, a novel physics-informed variational autoencoder (PI-VAE) network is proposed for expanding sparse measurements to full-field representations while also detecting damage. The effectiveness of the proposed PI-VAE network is evaluated through analytical and experimental studies on a metal plate under thermal excitation with embedded defects of various sizes and types. In the analytical studies using finite-element model data, the PI-VAE accurately expanded full-field temperature distributions and identified the dimensions of cracks, spalling, and hole-like defects with errors smaller than 5%. When tested with experimental data, the PI-VAE network maintained robust performance, detecting damage with errors smaller than 6%, despite being trained on undamaged data only. These findings demonstrate the PI-VAE’s potential as a reliable tool for full-field expansion and damage detection in structural health monitoring and nondestructive evaluation, even when limited sensors and datasets are available.
Successful management of refractory Cushing’s disease with severe hypercortisolemia using etomidate and temozolomide in post-surgical failure
Authors: Agrawal Neeti , Sarkar Debalina , Chatterjee Subhankar , Sinha Pallab , Bhattacharya Ranita , Ranjan Prabhat , Chakraborty Partha Pratim , Bhattacharjee Rana
Published: October 2024

Corticotropinomas account for 20% of all aggressive pituitary tumors and pituitary carcinomas and are associated with high mortality. These tumors not only cause neurovascular compromise but can also be fatal due to severe hypercortisolemia itself. Although surgery is considered the primary treatment modality, it is often partially successful or unsuccessful. Moreover, these tumors frequently recur and may be resistant to conventional treatments, including surgery and radiotherapy. Therefore, early multimodal treatment and regular follow-up are necessary. We present a case of aggressive Cushing’s disease managed with combined temozolomide therapy and radiotherapy following an unsuccessful transsphenoidal surgery, resulting in significant long-term radiological and biochemical remission. In addition, etomidate infusion was administered to achieve rapid cortisol reduction, highlighting its role as a bridging therapy to other modalities in treating life-threatening and severe hypercortisolemia outside an intensive care setting.
Unveiling power dynamics in Latin American economic education: A Foucauldian analysis of development economics discourses
Authors: Garcia Danny , Ocampo-Salazar Carmen
Published: October 2024

This study explores Latin American perspectives on heterodox economic development by analyzing 23 development economics syllabi and conducting 37 semi-structured interviews with educators and students. Using a Foucauldian framework and an Archaeology of Knowledge approach, this research uncovers regional viewpoints and variations in course content. Results highlight the dominance of the neoclassical paradigm in syllabi and diverse opinions on development. This study provides nuanced insights into the coexistence of orthodox and heterodox paradigms in Latin America, revealing complex dynamics and power relations within economic education and the broader discourse on development in the region.
The Role of Communities in Nurse-Led Clinics, 1965–2000: Lessons From History
Authors: Tobbell Dominique
Published: October 2024

Since the 1960s, nurses have worked to improve access to health care services among underserved communities through the establishment of community-based nurse-led clinics (NLCs). Evidence demonstrates NLCs’ effectiveness in delivering high quality and cost-effective primary care services to underserved communities. However, few studies have analyzed the role and meaning of community within NLCs. This article uses historical research to analyze and evaluate the roles played by communities in three community-based NLCs established between the 1960s and 1990s. This research shows that how nurses entered the communities they intended to provide care, the degree to which they collaborated with community members to conceptualize, operationalize, and maintain NLCs, and how they balanced community needs with academic imperatives are critical to understanding and addressing the difficulties NLCs have encountered delivering sustained, community-centered care. This research also addresses the impact on communities when NLCs fail, making clear the need for policy interventions that address the financial and political factors undermining NLCs’ sustainability, particularly limitations on nurse practitioners’ practice authority and credentialing as Medicaid providers, and reduced reimbursement rates for nurse practitioners. Ultimately, it argues that NLCs’ engagement with underserved communities should be historically informed and integrate community expertise, robust community engagement, and community-centered definitions of quality care.
A Mindfulness-Integrated Therapeutic Approach to Enhance Client Engagement with Prolonged Exposure and Habit Reversal Therapy and Bolster Therapist Trainee Self-Efficacy and Distress Tolerance
Authors: Price Malena M. , Timpano Kiara R. , Freund Blanche , Ironson Gail
Published: October 2024

Despite the established efficacy of exposure-based trauma treatments, such as prolonged exposure (PE), clinicians’ and clients’ concerns about these therapies hinder their widespread implementation. Clinicians report experiencing low self-efficacy and high distress when delivering PE, while patients doubt the credibility of this treatment, contributing to patient dropout. To tackle such challenges, mindfulness-based therapeutic approaches have been used. In the current case involving PTSD due to childhood sexual abuse (CSA) and coercive sex, trichotillomania, excoriation disorder, and depression, mindfulness practices and principles were woven into PE and habit reversal therapy (HRT). The therapist, a trainee with no prior trauma treatment experience, felt that her ability to manage the client’s distress during treatment and her confidence in delivering therapy was enhanced by her own mindfulness practice, and further reinforced by the pervasive integration of mindfulness throughout treatment. Likewise, the client attributed her capacity to engage in PE and HRT to the mindfulness practices and principles woven into treatment. Mindfulness also assisted in coalescing the concomitant delivery of PE and HRT. Following 21 sessions of mindfulness-integrated PE and 17 sessions of mindfulness-integrated HRT, the client no longer met criteria for PTSD and depression, eradicated her body-focused repetitive behaviors (BFRBs), and disclosed her index trauma with loved ones. These improvements were maintained at one-year follow-up, underscoring the potency of mindfulness therapeutic integration to enhance therapists’ distress tolerance and self-efficacy, clients’ treatment engagement, and overall therapeutic outcomes in complex cases.
Embracing Mixed Methods Research in Special Education
Authors: Root Jenny R. , Lindstrӧm Esther
Published: October 2024

This introduction to the special issue on mixed methods research examines guest editor perspectives on the research culture in special education and the broader ecosystem of education research. Articles included in the special issue are used to illustrate how core methodological features and application of a flexible metaparadigm enables mixed methods research to enhance the quality and depth of research findings. Given that the researcher’s role as the instrument is pronounced in mixed methods research, we argue for reflexivity and explicit reporting of how researcher backgrounds shape the questions they ask, methods they use to answer them, and lenses through which they interpret findings. We encourage our colleagues to consider how the integration of numerical and textual data can enable us to ask questions that challenge traditional dichotomies, capture the complexities of human experiences, and generate more nuanced interpretations of findings that acknowledge the inherent limitations of relying on a single methodology or paradigm.
Long-Term Outcomes of Minimally Invasive Endoscopic Versus Sternotomy Surgical Resection of Primary Cardiac Tumors
Authors: Aboelnazar Nader S. , Loshusan Brandon R. , Chu Michael W. A.
Published: October 2024

Objective:

Primary cardiac tumors are uncommon, often benign, but can be potentially life threatening. Minimally invasive endoscopic (ENDO) techniques have been shown to be a feasible alternative for tumor resection compared with conventional sternotomy (CS). This study compared the clinical and surgical outcomes of a small series of patients undergoing cardiac tumor resection operations.

Methods:

Between November 2009 and December 2022, 34 consecutive patients underwent cardiac tumor resection using either ENDO ( n = 21) or CS ( n = 13) techniques. We compared early perioperative outcomes, echocardiographic outcomes, and long-term clinical and tumor recurrence outcomes.

Results:

Baseline characteristics were similar between groups; however, the ENDO group included younger patients (56 ± 16 vs 62 ± 17 years) and more female patients (83% vs 53%). The tumor was located in the left atrium ( n = 19, 56%), right atrium ( n = 5, 15%), or either ventricle ( n = 4, 12%). In-hospital mortality and stroke frequency were similar for both groups ( n = 0). There was no significant difference in cardiopulmonary bypass or cross-clamp times, respiratory or renal failure, or intensive care unit or hospital lengths of stay. At follow-up (ENDO, 42 [2 to 131] months vs CS, 54 [1 to 156] months), there were no deaths in the ENDO group and 2 patients died in the CS group ( P = 0.21). No patients in either group experienced tumor recurrence.

Conclusions:

In selected patients, both ENDO and CS approaches to primary cardiac tumor resection were safe, effective, durable, and associated with similarly good early and late results.
A Risk Prediction Model for Prolonged Length of Stay After Minimally Invasive Valve Surgery
Authors: Bruno Vito D. , Celmeta Bleri , Viva Tommaso , Bisogno Arturo , Miceli Antonio , Glauber Mattia
Published: October 2024

Objective:

Minimally invasive surgery determines shorter postoperative hospital length of stay (LOS) even in cardiac surgery. Potential preoperative factors affecting LOS are still not known in minimally invasive heart valve surgery (MIVS). We aimed to identify preoperative variables influencing prolonged LOS in MIVS.

Methods:

We reviewed 189 patients who underwent MIVS via minithoracotomy at our institution. Prolonged LOS was defined as more than 7 postoperative days. Poisson and logistic regression were used to screen the predictors.

Results:

The mean postoperative LOS was 9.13 days, and 64 patients (33.9%) experienced a prolonged LOS. These patients were older, more frequently in New York Heart Association (NYHA) class III or IV, showed worse left ventricular ejection function (LVEF), and had a higher incidence of reoperation and chronic kidney disease (CKD). At univariate analysis, the most significant preoperative factors affecting prolonged LOS were age (odds ratio [OR] = 1.04), NYHA class III or IV (OR = 3.03), reduced LVEF (OR = 3.22), CKD (OR = 2.7), and redo surgery (OR = 3.6). After adjustment, the most significant preoperative factors predicting prolonged LOS were age (OR = 1.03, 95% CI: 1.01 to 1.06, P = 0.02) and redo surgery (OR = 3.33, 95% CI: 1.29 to 8.9, P = 0.01).

Conclusions:

The most important factors affecting prolonged LOS after MIVS were represented by age and redo surgery, although other preoperative characteristics such as reduced LVEF, NYHA class III or IV, and CKD play a significant role in delaying recovery after MIVS. Further larger studies are needed to better identify potential preoperative predictors of prolonged LOS after MIVS.
“Chopperlysis”: The effect of helicopter transport on reperfusion and outcomes in large vessel occlusion strokes
Authors: Koneru Manisha , Thon Jesse M , Dubinski Michael J , Fornari Caprara Ana Leticia , Brown Danielle C , Yi Zixin , Elgendy Omnea , Ackerman Jiyoun , Penckofer Mary , Shi Rosa , Fang Misa , Garfinkel Lucas , Thomas Tarun , Patel Karan , Frost Emma , Kalladanthyil Abyson , Sprankle Kenyon , Oliveira Renato , Santucci Joshua , Ballout Ahmad A , Siegler James E , Schumacher Hermann C , Hanafy Khalid A , Khalife Jane , Patel Pratit D , Tonetti Daniel A , Thomas Ajith J , Jovin Tudor G , Shaikh Hamza A
Published: October 2024

Background

In large vessel occlusion (LVO) stroke patients transferred to a comprehensive stroke center for thrombectomy, spontaneous reperfusion may occur during transport, and anecdotally more frequently in patients transferred via helicopter than by ground. This pattern has been more often observed in conjunction with tenecteplase (TNK) treatment prior to helicopter transport. We aim to explore the “chopperlysis” effect—how helicopter transport, particularly with thrombolytics, may affect reperfusion and clinical outcomes.

Methods

A single thrombectomy capable center (TCC) registry of stroke patients was retrospectively reviewed. Included LVO patients were those who had been transferred to the TCC and received a digital subtraction angiography (DSA) upon arrival. The outcomes were rates of spontaneous reperfusion, distal clot migration, and 90-day good functional outcome. Data were summarized, and endpoints were compared between patients stratified by transport method and/or TNK treatment.

Results

Of 270 patients included, helicopter transport was associated with a higher rate of spontaneous reperfusion, particularly among patients not treated with TNK ( p < 0.001). There was no significant difference in prevalence of distal clot migration between any subgroups ( p > 0.37). Overall, TNK-treated patients had better functional outcomes, and this difference persisted exclusively in the helicopter-transported patients ( p = 0.02).

Conclusion

Helicopter transport was associated with a higher rate of spontaneous reperfusion. There is a potentially synergistic effect between TNK administration and helicopter transport, augmenting thrombolysis and improving long-term outcomes. Further analyses in larger cohorts may expand our understanding of this “chopperlysis” effect.
Environmental behaviour of synthetic and natural fibre reinforced composites: A review
Authors: Munimathan Arunkumar , Muthu Kannan , Subramani Satheeshkumar , Rajendran Silambarasan
Published: October 2024

There has been an increasing interest in natural fibre-reinforced composites as viable alternatives to typical synthetic fibre composites as a result of increased environmental consciousness, which has led to the quest for materials that are more sustainable. This review paper aims to provide a comprehensive evaluation of the environmental performance of both natural and synthetic fibre-reinforced composites by summarizing relevant information. The article begins by discussing the advantages of natural fibres. These advantages include the fact that natural fibres are eco-friendly, Natural fibre composites demonstrate a significantly reduced carbon footprint and energy usage over their entire life cycle when compared to their glass fibre-reinforced counterparts. Furthermore, the biodegradability of natural fibres provides the opportunity for end-of-life recycling or disposal options that are more ecologically benign than those for synthetic fibre composites. This is because natural fibres are biodegradable and the research acknowledges that various factors, such as the specific fibre and matrix used, and the manufacturing procedures employed, can influence the environmental performance of natural fibre composites. Additionally, further research and development to optimize their performance and ensure their widespread adoption as sustainable alternatives to traditional composite materials. Natural fibre-reinforced composites are more environmentally friendly than traditional composite materials.
Silent Theatres: Dramatising Furniture in the Fictional Interiors of Fin-de-Siècle Exhibitions, Stages, and the Commercial World
Authors: Bessac Barbara
Published: October 2024

Focusing primarily on Paris and London, this essay delves into fictional interiors crafted for exhibitions and commercial displays around 1900, contending that their genesis can be traced back to the practices and methods of theatrical stage design. Nineteenth-century performance, fervently inclined to material realism, established traditions for the staging of domestic objects. Theatres lent their techniques and their professionals to other types of display. From stages to homes, and from bedrooms to period rooms, the dramatisation of domesticity seized both public and private realms. Regardless of the purposes they served, be it memorial, educational, recreational, or promotional, fictional interiors of the turn of the twentieth century capitalised on the emotional resonance of material settings on individual sensibilities, and the ability of the audience to weave narratives from the arrangement of domestic objects.
Enforcement of EU Labour Law: Legal foundations and the role of the CJEU
Authors: Koukiadaki Aristea
Published: October 2024

Labour law enforcement is crucial for achieving its social objectives, yet it often faces significant challenges in terms of its capacity to ensure the effective protection of labour rights. In the EU context, effective enforcement of labour law is further complicated by the absence of a sectoral, i.e., labour-specific, approach and the challenges in implementing EU substantive rules, often stipulated in Directives. The article assesses the enforcement landscape of EU labour law and particularly the legal foundations and the CJEU's role. Focusing on key enforcement issues, the analysis highlights how the constitutional right to an effective judicial remedy, as interpreted by the CJEU, and the inclusion of more comprehensive enforcement provisions in EU Directives are mitigating to some extent the existing fragmentation in the EU regulatory landscape, and concludes with considering future directions in EU labour law enforcement.
Factors contributing to transient-induced fading: Examining the impact of luminance contrasts and subjective contours
Authors: Jiang Moyou , Ito Hiroyuki , Kanematsu Tama
Published: October 2024

Transient-induced fading is a phenomenon where a peripheral target perceptually fades when a surrounding object is flashed. It has been suggested that the transient-induced fading could be affected not only by the lower-level factors such as the luminance contrast change, but also by the higher-level factors such as Gestalt grouping by similarity. In the present study, Experiment 1 investigated whether the perceptual fading of a visual target could be strongly induced when a ring area surrounding the target with high luminance contrast disappeared rather than appeared. Experiment 2 examined the effect of the (dis)appearance of a higher-level object (Kanizsa-type subjective contour) on the fading perception. Experiment 3 further investigated whether the rating of the perceived effortlessness of a subjective contour could be positively correlated with the fading duration of the target. Our results revealed that perceptual fading was mainly induced by the disappearance of fan areas inside black disks producing a subjective contour surrounding the target. Disappearance of a perceptual object at the representation level does not trigger the transient-induced fading even if a higher-level factor (e.g., grouping by similarity) affects the fading objects.
Redeployment experiences of healthcare workers in the UK during COVID-19: a cross-sectional analysis from the nationwide UK-REACH study
Authors: Zuzer Lal Zainab , Martin Christopher A. , Gogoi Mayuri , Qureshi Irtiza , Bryant Luke , Papineni Padmasayee , Lagrata Susie , Nellums Laura B , Al-Oraibi Amani , Chaloner Jonathon , Woolf Katherine , Pareek Manish
Published: October 2024

Objectives

To assess how ethnicity, migration status and occupation are associated with healthcare workers (HCW) redeployment experiences during COVID-19 in a nationwide ethnically diverse sample.

Design

A cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study.

Setting

Healthcare settings.

Participants

Healthcare workers (HCW).

Main Outcome Measures

Outcome measures included redeployment, provision of training and supervision during redeployment, change in patient contact and interaction with COVID-19 patients.

Methods

We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs.

Results

Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04–1.42, p = 0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06–1.49, p = 0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50–0.88, p = 0.005) and Black HCWs (OR 2.02, 95% CI 1.14–3.57, p = 0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07–1.66, p = 0.009) and Asian HCWs (OR 1.30, 95% CI 1.14–1.48, p < 0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs.

Conclusions

Our findings highlight disparities in HCWs’ redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequalities in healthcare.
Computational analysis of long QT syndrome type 2 and the therapeutic effects of KCNQ1 antibodies
Authors: Pan Zhujun , Fu Qi , Jiang Huasen , Wei Zhiqiang , Zhang Shugang
Published: October 2024

Objective

Long QT interval syndrome (LQTS) is a highly dangerous cardiac disease that can lead to sudden cardiac death; however, its underlying mechanism remains largely unknown. This study is conceived to investigate the impact of two general genotypes of LQTS type 2, and also the therapeutic effects of an emerging immunology-based treatment named KCNQ1 antibody.

Methods

A multiscale virtual heart is developed, which contains multiple biological levels ranging from ion channels to a three-dimensional cardiac structure with realistic geometry. Critical biomarkers at different biological levels are monitored to investigate the remodeling of cardiac electrophysiology induced by mutations.

Results

Simulations revealed multiple important mechanisms that are hard to capture via conventional clinical techniques, including the augmented dispersion of repolarization, the increased vulnerability to arrhythmias, the impaired adaptability in tissue to high heart rates, and so on. An emerging KCNQ1 antibody-based therapy could rescue the prolonged QT interval but did not reduce the vulnerable window.

Conclusions

Tiny molecular alterations can lead to cardiac electrophysiological remodeling at multiple biological levels, which in turn contributes to higher susceptibility to lethal arrhythmias in long QT syndrome type 2 patients. The KCNQ1 antibody-based therapy has proarrhythmic risks notwithstanding its QT-rescuing effects.
Promoting Social Participation in the Primary Care Field: An Ecological Study on the Potential Reduction of Multimorbidity Prevalence
Authors: Takahashi Ryota , Okada Tadao , Ide Kazushige , Tsuji Taishi , Kondo Katsunori
Published: October 2024

Background:

No municipal-level study has elucidated the social determinants associated with multimorbidity prevalence (MP).

Objective:

This article aimed to determine the differences in MP among municipalities and investigate factors associated with such differences through an ecological study of data obtained from a nationwide survey. This article focused on social participation and household income, which are associated with single chronic diseases, such as hypertension.

Methods:

Study design was a cross sectional study, which used the data from the Japan Gerontological Evaluation Study, a population-based gerontological study among functionally independent older adults aged ≥65 years in Japan. Overall, 152 212 participants from 2016 to 2017 across 91 municipalities were included in the final analysis. Multiple regression analysis was performed with MP as objective variable; social participation or household income were explanatory variables, and education, population density, and health check-ups were adjustment variables.

Results:

Intermunicipal differences in MP were 28.4% to 43.1% and 23.2% to 38.8% among men and women, respectively. Significant negative correlation was observed between MP and proportion of social participation (non-standardized coefficient [ B] = −.18 for men and women). A significant positive correlation was noted between MP and equivalent household income of ≤2 million yen in women ( B = .21).

Conclusion:

Considerable differences in MP existed among municipalities. Areas with high proportion of social participation showed significantly lower MP. Considering the difficulty in managing multimorbidity within the primary care field and limited evidence on effective interventions, community-level interventions encouraging social participation among older individuals might reduce MP. Primary care physicians should consider a community health approach for multimorbidity.
Combined Norwood and Modified Left-Sided Starnes Procedures for Congenitally Corrected Transposition of the Great Arteries
Authors: Vaidya Yash , Karim Farida , Miyairi Satoshi , Sinha Pranava
Published: October 2024

The combination of congenitally corrected transposition of the great arteries (ccTGA), Ebstein anomaly of the systemic atrioventricular valve, and critical systemic ventricular outflow tract obstruction is extremely rare. Management of a neonate with these lesions in cardiogenic shock is quite challenging. Tricuspid valve exclusion has been increasingly and successfully used to manage neonatal Ebstein anomaly patients. We extended this idea of tricuspid valve exclusion (modified Starnes) combined with a Norwood Stage 1 operation with a modified systemic to pulmonary artery shunt to successfully manage a neonate with ccTGA, severe systemic atrioventricular valve regurgitation, and critical ventricular outflow tract obstruction.
Investigating Factors Responsible for More Boredom in Online Live EFL Classes
Authors: Liu Wen , Xie Zhen-fang
Published: October 2024

Although recent years have seen a growing interest in students’ experiences of boredom in foreign language learning, scant attention has been paid to this negative emotion in online live classes. With a mixed-methods approach, this study investigated what factors were responsible for student boredom in online live classes and what made Chinese students majoring in English more bored in online live classes than in traditional in-person classes. Data were collected through a questionnaire and focus group interviews. Quantitative and qualitative data analyses revealed that the main factors responsible for this negative emotion in online live settings were teacher-centered classes, less engagement and interaction, high task challenges, monotonous and long learning activities, textbook-based activities, students’ lack of self-discipline, peer influences, the absence of emotional support, unreliable internet connection, physical fatigue, a locked-down campus, and a dormitory learning environment. Students’ greater boredom in online live settings than in-person settings arose from student-related factors, technological factors, and environment-related factors. This study sheds light on how to alleviate student boredom in foreign language learning in online live settings.
Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers
Authors: García-Buades M. Esther , Montañez-Juan Maribel , Blahopoulou Joanna , Ortiz-Bonnin Silvia , Chela-Alvarez Xènia , Bulilete Oana , Llobera Joan
Published: October 2024

Background:

Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs’ exposure to psychosocial factors at work and their impact on job stress and self-rated health.

Methods:

A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied.

Results:

The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work–life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work–life conflict, nationality, and weak leader support as key predictors of job stress; and work–life conflict and leadership quality as key predictors of self-rated health.

Conclusion/Application to Practice:

Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs’ job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work–life conflict, and enhance resources such as leader support, sense of community, and leadership quality.
Meta-Analysis of Treatment for Adjacent Two-Segment Cervical Spondylotic Myelopathy: A Comparison Between Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion
Authors: Chen Lei , Zhang Zhongyi , Li Ju , Tong Peijian , Xu Taotao
Published: October 2024

Study Design

A systematic review and meta-analysis comparing the outcomes of Anterior Cervical Discectomy and Fusion (ACDF) vs Anterior Cervical Corpectomy and Fusion (ACCF) in treating adjacent two-segment cervical spondylotic myelopathy.

Objective

To assess the clinical effectiveness and safety of ACDF compared to ACCF.

Methods

A literature search was conducted in Cochrane Library, Web of Science, PubMed, and Embase up to December 2023. Studies included were prospective and observational involving ACDF or ACCF for adjacent two-segment cervical spondylotic myelopathy. Data were analyzed using RevMan 5.4 software.

Results

Ten studies (nine case-control and one RCT) were included. ACDF showed a shorter hospital stay (SMD = −0.29, 95% CI: −0.53 to −0.04, P < 0.05), better Cobb angle (SMD = 0.52, 95% CI: 0.31 to 0.74, P < 0.01), and improved T1S (SMD = 0.54, 95% CI: 0.28 to 0.80, P < 0.01). No significant differences were found in upper limb VAS, neck VAS, JOA scores, NDI, fusion rates, C2-7 SVA, total complications, blood loss, and operation time.

Conclusions

ACDF and ACCF are both effective for adjacent two-segment cervical spondylotic myelopathy, with ACDF offering advantages in hospitalization duration and cervical curvature restoration, making it the preferred surgical approach. Further research is needed to validate these findings.