bluuebunny/crossref_metadata_2025 huggingface dataset:
Models of integrated care for multi-morbidity assessed in systematic reviews: a scoping review
Authors: Rohwer Anke , Toews Ingrid , Uwimana-Nicol Jeannine , Nyirenda John L.Z. , Niyibizi Jean Berchmans , Akiteng Ann R. , Meerpohl Joerg J. , Bavuma Charlotte M. , Kredo Tamara , Young Taryn
Published: August 2023

Background

The prevalence of multi-morbidity is increasing globally. Integrated models of care present a potential intervention to improve patient and health system outcomes. However, the intervention components and concepts within different models of care vary widely and their effectiveness remains unclear. We aimed to describe and map the definitions, characteristics, components, and reported effects of integrated models of care in systematic reviews (SRs).

Methods

We conducted a scoping review of SRs according to pre-specified methods (PROSPERO 2019 CRD42019119265). Eligible SRs assessed integrated models of care at primary health care level for adults and children with multi-morbidity. We searched in PubMed (MEDLINE), Embase, Cochrane Database of Systematic Reviews, Epistemonikos, and Health Systems Evidence up to 3 May 2022. Two authors independently assessed eligibility of SRs and extracted data. We identified and described common components of integrated care across SRs. We extracted findings of the SRs as presented in the conclusions and reported on these verbatim.

Results

We included 22 SRs, examining data from randomised controlled trials and observational studies conducted across the world. Definitions and descriptions of models of integrated care varied considerably. However, across SRs, we identified and described six common components of integrated care: (1) chronic conditions addressed, (2) where services were provided, (3) the type of services provided, (4) healthcare professionals involved in care, (5) coordination and organisation of care and (6) patient involvement in care. We observed differences in the components of integrated care according to the income setting of the included studies. Some SRs reported that integrated care was beneficial for health and process outcomes, while others found no difference in effect when comparing integrated care to other models of care.

Conclusions

Integrated models of care were heterogeneous within and across SRs. Information that allows the identification of effective components of integrated care was lacking. Detailed, standardised and transparent reporting of the intervention components and their effectiveness on health and process outcomes is needed.
Perspective of healthcare providers on assessing the quality and accessibility of health services for chronic diseases in Jordan during Covid-19: a mixed method study
Authors: Al-Bataineh Raya T. , Al-Hammouri Mohammed M. , Al-Jaraideh Wafa’a K.
Published: August 2023

Background

Hospital services in all parts of the world were severely affected by the crisis caused by the Coronavirus pandemic. This was particularly concerning for patients who suffer from chronic diseases. Aim: This study aimed to: assess the level of quality and accessibility of chronic disease services from the perspectives of healthcare providers, assess the association between healthcare providers’ socio-demographic factors and their perspectives on accessibility and quality level, and explore the providers’ perspectives on the barriers and facilitators of quality and accessibility to chronic disease health services during the COVID -19 pandemic.

Method

Design: An explanatory mixed method design was employed in this study using a questionnaire and focus group discussion approach. The questionnaire consisted of three sections including, demographic, accessibility, and quality. Sample: A convenience sampling approach was used to collect the quantitative from 412 healthcare providers working at public, private, and teaching hospitals. A purposive sample of 12 healthcare providers were interviewed to collect the qualitative data. Analysis: The quantitative data were analyzed using SPSS Statistics Version 25. The qualitative data was analyzed using the thematic analysis approach.

Results

This study found that the quality and accessibility of chronic disease services in northern Jordan were affected during COVID-19. Quantitative: The majority of the participants reported moderate level of accessibility and quality. Qualitative: Four main and six subthemes were identified: 1) Accessibility barriers including transportation and fear of infection; 2) Accessibility facilitators including availability of Personal Protective Equipment (PPE) and Covid-19 vaccination; 3) Quality barriers including staff shortage; 4) Quality facilitators including safety protocol.

Conclusion

The quality and accessibility of chronic disease services were affected due to the healthcare system restating to address the Covid-19 pandemic. Different barriers and facilitators for chronic disease healthcare services accessibility and quality were identified. The findings of this study lay the ground for healthcare decision and policymakers to develop strategies and formulate polices to ensure these patients receive the needed healthcare services, and hence improve their health outcomes.
Alcohol exposure before and during pregnancy is associated with reduced fetal growth: the Safe Passage Study
Authors: Pielage Marin , El Marroun Hanan , Odendaal Hein J. , Willemsen Sten P. , Hillegers Manon H. J. , Steegers Eric A. P. , Rousian Melek
Published: August 2023

Background

Prenatal alcohol exposure (PAE) is a worldwide public health concern. While PAE is known to be associated with low birth weight, little is known about timing and quantity of PAE on fetal growth. This study investigated the association between periconceptional and prenatal alcohol exposure and longitudinal fetal growth, focusing on timing and quantity in a high exposure cohort.

Methods

The Safe Passage Study was a prospective cohort study, including 1698 pregnant women. Two-dimensional transabdominal ultrasound examinations were performed to measure fetal femur length, abdominal and head circumference, and biparietal diameter, at three time points during pregnancy. Estimated fetal weight and Z-scores of all parameters were calculated. Trimester-specific alcohol exposure was assessed using the Timeline Followback method. To investigate the associations of specific timing of PAE and fetal growth, two models were built. One with alcohol exposure as accumulative parameter over the course of pregnancy and one trimester specific model, in which PAE was separately analyzed. Linear mixed models adjusted for potential confounders were applied with repeated assessments of both alcohol exposure and fetal growth outcomes.

Results

This study demonstrated that periconceptional and prenatal alcohol exposure were associated with reduced fetal growth. Effect sizes are displayed as estimated differences (ED) in Z-score and corresponding 95% confidence intervals (95% CIs). When investigated as accumulative parameter, PAE was related to a smaller femur length (ED30; − 0.13 (95% CI; − 0.22; − 0.04), ED36; − 0.14 (95% CI; − 0.25; − 0.04)) and a smaller abdominal circumference (ED36; − 0.09 (95% CI; − 0.18; − 0.01)). Periconceptional alcohol exposure was associated with a smaller abdominal circumference (ED30; − 0.14 (95% CI; − 0.25; − 0.02), ED36; − 0.22 (95% CI; − 0.37; − 0.06)) and a smaller estimated fetal weight (ED36; − 0.22 (95% CI; − 0.38; − 0.05)). Second trimester alcohol exposure was associated with a smaller abdominal circumference (ED30; − 0.49 (95% CI; − 0.86; − 0.12), ED36; − 0.70 (95% CI; − 1.22; − 0.17)) and estimated fetal weight (ED30; − 0.54 (95% CI; − 0.94; − 0.14), ED36; − 0.69 (95% CI; − 1.25; − 0.14)). No additional association of binge drinking was found besides the already observed association of PAE and fetal growth.

Conclusions

This study demonstrated that PAE negatively affects fetal growth, in particular when exposed during the periconception period or in second trimester. Our results indicate that potential negative consequences of PAE are detectable already before birth. Therefore, healthcare providers should actively address and discourage alcohol use during pregnancy.
Pimobendan prevents cardiac dysfunction, mitigates cardiac mitochondrial dysfunction, and preserves myocyte ultrastructure in a rat model of mitral regurgitation
Authors: Boonpala Pakit , Saengklub Nakkawee , Srikam Sirinapa , Ji-au Wilawan , Panyasing Yaowalak , Kumphune Sarawut , Kijtawornrat Anusak
Published: August 2023

Background

Pimobendan has been proven to delay the onset of congestive heart failure (CHF) in dogs with mitral regurgitation (MR); however, molecular underlying mechanisms have not been fully elucidated. This study aimed to investigate (1) the effects of pimobendan on cardiac function, cardiac mitochondrial quality and morphology, and cardiac ultrastructure in a rat model of chronic MR and (2) the direct effect of pimobendan on intracellular reactive oxygen species (ROS) production in cardiac cells. MR was surgically induced in 20 Sprague-Dawley rats, and sham procedures were performed on 10 rats. Eight weeks post-surgery, the MR rats were randomly divided into two groups: the MR group and the MR + pimobendan group. Pimobendan (0.15 mg/kg) was administered twice a day via oral gavage for 4 weeks, whereas the sham and MR groups received equivalent volumes of drinking water. Echocardiography was performed at baseline (8 weeks post-surgery) and at the end of the study (4 weeks after treatment). At the end of the study protocol, all rats were euthanized, and their hearts were immediately collected, weighed, and used for transmission electron microscopy and mitochondrial quality assessments. To evaluate the role of pimobendan on intracellular ROS production, preventive or scavenging properties were tested with H2O2-induced ROS generation in rat cardiac myoblasts (H9c2).

Results

Pimobendan preserved cardiac functions and structure in MR rats. In addition, pimobendan significantly improved mitochondrial quality by attenuating ROS production and depolarization (P < 0.05). The cardiac ultrastructure and mitochondrial morphology were significantly preserved in the MR + pimobendan group. In addition, pimobendan appeared to play as a ROS scavenger, but not as a ROS preventer, in H2O2-induced ROS production in H9c2 cells.

Conclusions

Pimobendan demonstrated cardioprotective effects on cardiac function and ultrastructure by preserving mitochondrial quality and acted as an ROS scavenger in a rat model of MR.
The association between adherence to alternative healthy Diet Index (AHEI) and severity, disability, duration, and frequency of migraine headache among women: a cross-sectional study
Authors: Khalili Pardis , Mirzababaei Atieh , Abaj Faezeh , Ansari Shakila , Harsini Asma Rajabi , Hajmir Mahya Mehri , Clark Cain C. T. , Mirzaei Khadijeh
Published: August 2023

Background

Migraine is a common brain disorder characterized by recurrent seizures lasting between 4 and 72 h. Dietary factors can affect migraine headaches. The Alternative Healthy Diet Index (AHEI) is a measure of diet quality and adherence to healthy dietary patterns. This study aimed to assess the association of adherence to AHEI and severity, disability, duration, and frequency of migraine headaches.

Methods

In this cross-sectional study, 266 women who suffered from migraines were selected. Usual dietary intakes were assessed using a semi-quantitative, 147-item, food frequency questionnaire (FFQ). AHEI was calculated based on FFQ. The Migraine Disability Assessments (MIDAS) and Visual Analog Scale (VAS) questionnaires were used to evaluate migraine disability, severity and the pain, duration and frequency of headaches.

Results

People with high adherence to AHEI, compared with low adherence, had a 43% reduction in headache duration in the crude model (OR = 0.57; 95% CI 0.34, 0.97; P = 0.03), which remained significant after adjusting for potential confounders (OR = 0.56; 95% CI 0.31, 0.99; P = 0.04). No association was found between the frequency of migraine and AHEI in both crude and adjusted models (OR = 1.19; 95% CI 0.66, 2.14; P = 0.55). In addition, no significant association was found between high adherence of AHEI and odds of severe and moderate headaches (P > 0.05).

Conclusion

The results of our study showed that people with high adherence of AHEI had a 43% reduction in duration of migraine. More studies are needed to evaluate and better understand this relationship.
A comparative analyses of lipid ratios representing desaturase enzyme activity between preterm and term infants within the first ten weeks of life
Authors: Kasim Hanis Hidayu , Olga Laurentya , Snowden Stuart , Cropp Eliza , Koulman Albert , Beardsall Kathryn
Published: August 2023

Background

Desaturase enzymes play a key role in several pathways including biosynthesis of poly- and mono- unsaturated fatty acids (PUFAs, MUFA). In preterm infants, desaturase enzyme activity (DA) may be a rate-limiting step in maintaining PUFAs levels during this critical developmental window and impact on long term metabolic health. The study tested the hypothesis that DA is altered in preterm infants compared to term infants in early life and may be a marker of risk or contribute to later alterations in metabolic health.

Methods

Lipidomic analyses were conducted using blood samples from two established UK-based cohorts, involving very preterm (n = 105) and term (n = 259) infants. Blood samples were taken from term infants at birth, two and six weeks and from preterm infants when established on enteral feeds and at term corrected age. DA of the 2 groups of infants were estimated indirectly from product/precursor lipids ratios of phosphatidylcholine (PC) and triglycerides (TG) species and reported according to their postmenstrual and postnatal ages.

Results

There were changes in lipid ratios representing desaturase enzyme activity in preterm infants in the first weeks of life with higher delta 6 desaturases (D6D) triglyceride (TG) indices but significantly lower delta 9 desaturase (D9D) and D6D(PC) indices. In comparison to term infants, preterm have lower delta 5 desaturase (D5D) but higher D6D indices at all postnatal ages. Although point levels of desaturase indices were different, trajectories of changes in these indices over time were similar in preterm and term infants.

Conclusions

This study findings suggest the patterns of desaturase indices in preterm infants differ from that of term infants but their trajectories of change in the first 10 weeks of life were similar. These differences of DA if they persist in later life could contribute to the mechanism of diseases in preterm adulthood and warrant further investigations.
Anlotinib affects systemic lipid metabolism and induces lipid accumulation in human lung cancer cells
Authors: Zhu Zhongling , Xu Shan , Ren Jing , Jiang Teng , Zhang Cai , Yan Zhao
Published: August 2023

Background

Anlotinib has demonstrated encouraging clinical outcomes in the treatment of lung cancer, soft tissue sarcoma and thyroid carcinoma. Several clinical studies have shown a relationship between anlotinib treatment and the occurrence of hyperlipidemia. The fundamental mechanisms, however, are still largely unclear. Here, the effect of anlotinib on lipid metabolism in an animal model and human cancer cells was evaluated and the role of lipid metabolism in the antitumor efficacy of anlotinib was investigated.

Methods

The C57BL/6 J mouse model as well as A549 and H460 human lung cancer cell lines were used to examine the impact of anlotinib on lipid metabolism both in vivo and in vitro. Levels of triglycerides, high-density lipoprotein, low-density lipoprotein (LDL), and total cholesterol in serum or cell samples were determined using assay kits. The expression levels of crucial genes and proteins involved in lipid metabolism were measured by quantitative RT-PCR and Western blotting. Furthermore, exogenous LDL and knockdown of low-density lipoprotein receptor (LDLR) were used in H460 cells to investigate the relevance of lipid metabolism in the anticancer efficacy of anlotinib.

Results

Anlotinib caused hyperlipidemia in C57BL/6 J mice, possibly by downregulating hepatic LDLR-mediated uptake of LDL cholesterol. AMP-activated protein kinase and mammalian target of rapamycin inhibition may also be involved. Additionally, anlotinib enhanced sterol response element binding protein 1/2 nuclear accumulation as well as upregulated LDLR expression in A549 and H460 cells, which may be attributable to intracellular lipid accumulation. Knockdown of LDLR reduced intracellular cholesterol content, but interestingly, anlotinib significantly improved intracellular cholesterol accumulation in LDLR-knockdown cells. Both exogenous LDL and LDLR knockdown decreased the sensitivity of cells to anlotinib.

Conclusions

Anlotinib modulates host lipid metabolism through multiple pathways. Anlotinib also exerts a significant impact on lipid metabolism in cancer cells by regulating key transcription factors and metabolic enzymes. In addition, these findings suggest lipid metabolism is implicated in anlotinib sensitivity.
A multi-functional hypoxia/esterase dual stimulus responsive and hyaluronic acid-based nanomicelle for targeting delivery of chloroethylnitrosouea
Authors: Li Duo , Ren Ting , Ge Yunxuan , Wang Xiaoli , Sun Guohui , Zhang Na , Zhao Lijiao , Zhong Rugang
Published: August 2023

Carmustine (BCNU), a vital type of chloroethylnitrosourea (CENU), inhibits tumor cells growth by inducing DNA damage at O6 position of guanine and eventually forming dG-dC interstrand cross-links (ICLs). However, the clinical application of BCNU is hindered to some extent by the absence of tumor selectivity, poor stability and O6-alkylguanine-DNA alkyltransferase (AGT) mediated drug resistance. In recent years, tumor microenvironment has been widely utilized for advanced drug delivery. In the light of the features of tumor microenvironment, we constructed a multifunctional hypoxia/esterase-degradable nanomicelle with AGT inhibitory activity named HACB NPs for tumor-targeting BCNU delivery and tumor sensitization. HACB NPs was self-assembled from hyaluronic acid azobenzene AGT inhibitor conjugates, in which O6-BG analog acted as an AGT inhibitor, azobenzene acted as a hypoxia-responsive linker and carboxylate ester bond acted as both an esterase-sensitive switch and a connector with hyaluronic acid (HA). The obtained HACB NPs possessed good stability, favorable biosafety and hypoxia/esterase-responsive drug-releasing ability. BCNU-loaded HACB/BCNU NPs exhibited superior cytotoxicity and apoptosis-inducing ability toward the human uterine cervix carcinoma HeLa cells compared with traditional combined medication of BCNU plus O6-BG. In vivo studies further demonstrated that after a selective accumulation in the tumor site, the micelles could respond to hypoxic tumor tissue for rapid drug release to an effective therapeutic dosage. Thus, this multifunctional stimulus-responsive nanocarrier could be a new promising strategy to enhance the anticancer efficacy and reduce the side effects of BCNU and other CENUs.
Clinical characteristics and survival prediction of surgical patients with invasive pancreatic cystic neoplasm: a large retrospective study over two decades
Authors: Song Yanjing , Li Zhe , Cui Hongyuan , Xu Jingyong , Song Jinghai
Published: August 2023

Purposes

Invasive pancreatic cystic neoplasms (iPCNs) are an uncommon and biologically heterogeneous group of malignant neoplasms. We aimed to investigate the clinicopathological characteristics of iPCN patients and to develop nomograms for individual survival prediction after radical surgery.

Methods

Data of patients diagnosed with iPCN and pancreatic ductal adenocarcinoma (PDAC) between 2000 and 2018 from the SEER database were retrieved. The differences in clinical outcomes were evaluated using the Kaplan–Meier analysis. Nomograms were proposed based on the Cox regression model and internally validated by C-index, area under the curve (AUC) value, and calibration plot.

Results

A total of 7777 iPCN patients and 154,336 PDAC patients were enrolled. Most neoplasms were advanced, with 63.1% at stage IV. The 3-year overall survival (OS) and cancer-specific survival (CSS) rates in surgical patients were as follows: 45.7% and 50.1% for invasive intraductal papillary mucinous neoplasm (IPMN), 54.8% and 59.3% for invasive mucinous cystic neoplasm (MCN), 97.8% and 98.2% for invasive solid pseudopapillary neoplasm (SPN), 88.9% and 88.9% for invasive serous cystic neoplasm (SCN), and 27.3% and 30.5% for PDAC. Subgroup analyses showed no clinical benefit from chemotherapy or radiotherapy in lymph node-negative iPCN patients who underwent surgery. The following variables associated with OS and CSS were identified: age, race, chemotherapy, radiotherapy, histologic type, pathological grade, regional nodes examined, and T, N, and M stage. The nomograms had good discrimination and calibration by internal validation, with an AUC value of 0.800 for 3-year OS and 0.814 for 3-year CSS.

Conclusion

Our study showed that the prognosis of iPCN patients was significantly better than PDAC patients. The proposed nomograms demonstrated substantially better discrimination and calibration.
Understanding the healthcare provider role on post abortion contraception adoption in India using National Family Health Survey-5
Authors: Bansal Anjali , Kullu Arpana , Dixit Priyanka
Published: August 2023

Background

Post abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log–log model in India.

Methodology

The study uses the secondary data from the fifth round of the National Family Health Survey conducted during 2019–21. For, the analysis, we have used five-year women’s reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log–log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI).

Results

According to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women’s reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25–3.30)].

Conclusion

This emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods.
Clinical presentation of Warburg effect in aggressive lymphoma: a case report
Authors: Cao Yenong , Liu Margaret C. , Hanlon Emma L. , Chen York , Afzal Muhammad Z. , Hayes Christi A. , Hill John M.
Published: August 2023

Background

The Warburg effect is a rare condition in tumor biology, illustrated by significant lactate production in the presence of oxygen. The Warburg effect is associated with very poor prognosis in patients with malignancy.

Case presentation

We report a 76-year-old Caucasian woman with double-expressor diffuse large B cell lymphoma who presented with severe lactic acidosis and extreme hypoglycemia with normal mentation. Her lactic acidosis was initially controlled with a bicarbonate infusion, and the patient was started promptly on steroids, followed by chemotherapy, but her clinical course was complicated by tumor lysis syndrome, acute renal failure requiring hemodialysis, and progressive liver failure. She manifested a temporary clinical response to chemotherapy but eventually died of complications.

Conclusions

This case demonstrates the importance of prompt recognition of the Warburg effect, aggressive supportive measures, and early initiation of chemotherapy. Future studies are needed to characterize the role of hemodialysis in this setting.
The anxiety associated with COVID-19, general health, spiritual health, and job satisfaction in healthcare providers: a cross-sectional study
Authors: Roshani Daem , Saboni Keivan , Amjadian Mohiadin
Published: August 2023

Background

Previous research has shown the impact of pandemic communicable diseases on the mental health of healthcare providers. This study examined the relationship between general health, spiritual health, anxiety associated with COVID-19, job satisfaction, and the mediating role of sex in healthcare providers in Iran in 2021.

Methods

This was a descriptive-analytical and cross-sectional study performed on 163 healthcare providers of which 71.8% were female and 28.2% were male with an age range between 21 and 58 years, an average work experience of 9.5 years, and working as nurses, doctors, laboratory technicians, etc. in some hospitals in Sanandaj. Data were collected using COVID-19 Anxiety, General Health, job satisfaction, and Spiritual Health questionnaires. Then, the data were analyzed using SPSS-22 software, regression test, and path analysis.

Results

Although women averaged lower levels of general health, job satisfaction, and anxiety associated with COVID-19, and higher scores in spiritual health than men, none of these differences were statistically significant, and sex didn’t play a significant role here. Also, general health and spiritual health could significantly predict 17.1% of the variance in job satisfaction in the path analysis. However, sex and Covid-19 anxiety could not significantly predict this variable.

Conclusion

The results showed that there was not a significant difference between the male and female workers’ general health when facing such pandemics. However, we may prepare interventions to promote their general and spiritual health and to promote healthcare providers’ job satisfaction during such pandemics.
Exploring the emotional impact of axial Spondyloarthritis: a systematic review and thematic synthesis of qualitative studies and a review of social media
Authors: Wilson Nicky , Liu Jia , Adamjee Qainat , Di Giorgio Sonya , Steer Sophia , Hutton Jane , Lempp Heidi
Published: August 2023

Background

The psychological burden in people with inflammatory arthritis is substantial, yet little is known about the disease-related affect experienced by individuals with axial Spondyloarthritis (axial SpA). The aim of this study was to conduct a qualitative evidence synthesis and a review of social media to explore the emotional impact of living with axial SpA.

Methods

We searched nine databases for studies reporting qualitative data about participants’ emotional experience of living with axial SpA. In addition, we searched social media platforms for posts from people with axial SpA based in the UK that offered insights into emotional responses to living with the condition. We employed a thematic approach to synthesise the data.

Results

We included 27 studies (1314 participants; 72% men) in our qualitative evidence synthesis and developed seven descriptive themes from the data: 1) delayed diagnosis: a barrier to emotional wellbeing; 2) disruptive symptoms: a source of mood swings; 3) work disability: a loss of self-esteem; 4) obstacles in interpersonal relationships: a trigger of distress; 5) taking up exercise: personal pride or unwelcomed reminders; 6) anti-TNF therapy: hope reignited despite concerns and 7) a journey of acceptance: worry mixed with hope. Posts extracted from social media fora (537; 48% from women) for the most part supported the seven themes. One additional theme—COVID-19, uncertainty and anxiety during the pandemic, was developed, reflecting common emotions expressed during the UK’s first wave of the coronavirus pandemic.

Conclusion

This study highlights a preponderance of negative affect experienced by people living with axial SpA, conditioned through existing and anticipated symptoms, failed expectations, and lost sense of self. Given the bidirectional relationships between negative emotions and inflammation, negative emotions and perceptions of pain, and the influence of affect in self-care behaviours, this finding has important implications for treatment and management of people with axial SpA.
Evaluation of perception of music, environmental sounds, and speech in right versus left cerebral stroke patients
Authors: Abdel Hady Aisha Fawzy , Shohdi Sahar Saad , Shawky Ayman Mohamed , Abusenna Mohammed Ibrahem
Published: August 2023

Background

Stroke is a leading cause of disability and about a third of stroke survivors have aphasia. Stroke also may affect all levels of the auditory pathway and lead to hearing reception and/or perception deficits for different sound types.

Aim of the work

The aim of the work is to evaluate the perception of music, environmental sounds, and speech in post-stroke patients in order to determine if there is a difference in the basic auditory perceptual abilities in right versus left cerebral stroke.

Subjects and methods

A group of 30 healthy adults and a group of 30 right and left cerebral stroke patients with an age range from 35 to 75 years old were included. The participants were evaluated using a 10-item designed questionnaire for auditory abilities and a test of auditory perceptual/recognition skills. The questionnaire addressed some of the basic auditory skills of attention, discrimination, and recognition of environmental sounds and human voice. The test consisted of non-verbal and verbal domains. The non-verbal domain involved music recognition, discrimination, perception, performance, and environmental sound recognition tasks. While the verbal domain included; recognition of the sound related to speech stimuli and syllable/word recognition tasks.

Results

Better significant scores in right versus left stroke patients regarding questionnaire results for attention to sound sources either near or fear (p value < 0.001) and discriminating prosodic intonation of statement or interrogation (p value =  < 0.001). There was no significant difference between the right cerebral stroke group and the left cerebral stroke group regarding the score of music perception and music performance tasks of the non-verbal domain of the auditory perceptual/recognition skills assessment. Better significant scores were found in the right cerebral stroke patients than the left cerebral stroke patients regarding the scores of both the non-verbal and verbal domains of the auditory perceptual/recognition skills assessment.

Conclusion

Stroke of both right and left cerebral hemispheres has a specific negative effect on some aspects of perception of music, environmental sounds, and speech that need to be addressed in both evaluation protocols and rehabilitation programs.
The Medieval of the Long Now
Authors: Warren Michelle R.
Published: August 2023

As decades turn to centuries to millennia, the contemporary relationship with the past is increasingly medieval. This article takes the perspective of extreme long-term thinking to reexamine how medieval studies can interact with more contemporary fields. How might scholars share the “now” with each other and with their predecessors from other millennia? And how might this perspective transform racial epistemologies? Inspired by the millennial thinker, Henry of Huntingdon (d. 1157), the article connects the Long Now Foundation, the 10,000-Year Clock, the poet T. S. Eliot, and the near future called the “digital Dark Ages.” Henry from the twelfth century provides a recent antecedent for imagining the “long now” wrought by settler colonialism. Undoing periodization directly challenges the colonizing deployment of time itself.
Undoing Medieval Race Studies
Authors: Min Mariah
Published: August 2023

This essay argues that “medieval race”—which has been gaining a recent foothold in medieval studies—is counterproductive as a concept because it occludes the mobility of race. Mobility here refers to the way that race takes on multiple forms within the same historical moment, including skin color, language, religion, ethnicity, and systemic power. “Medieval race” erroneously presumes that there is only one form of race in the Middle Ages, which can be compared to a similarly fictitious singular “modern race.” This inattention to mobility creates misapprehensions about how race functions across time; therefore, race scholars must reach beyond their siloed disciplines to work collaboratively, so that they can articulate and disseminate theorizations of race that are grounded in transhistorical study.
A Part of the Heart Can't Be Eaten
Authors: Taormino Tristan
Published: August 2023

In A Part of the Heart Can't Be Eaten, award-winning author, sex educator, filmmaker, and podcast host Tristan Taormino shares her coming-of-age story, revealing how her radical sexuality and unconventional career grew out of an extraordinary queer father-daughter relationship. Raised by a hard-working single mother on Long Island, Tristan got her sex ed from the 1980s TV show Solid Gold and The Joy of Sex. She spent summers at drag shows in Provincetown with her father, Bill, who had come out as gay in the mid-1970s. Her sexual identity bloomed during her college years at Wesleyan University, where she discovered her desire for butches and kinky sex.

Tristan's world began to fall apart when her dad was diagnosed with AIDS. After a series of devastating events, she moved to the messy, glorious world of 1990s New York City. In the midst of grief and depression, she helped change queer sexual subculture with her zine Pucker Up, her infamous The Village Voice column, and her editorship of legendary lesbian porn magazine On Our Backs. After the publication of her first book, The Ultimate Guide to Anal Sex for Women, Tristan followed her own path that marked the beginning of her work as a trailblazing feminist pornographer.

After a lifetime of outrageous adventures, Tristan reflects on the bonds, loss, and mental-health struggles that shaped her. She weaves together history from her father's unpublished memoir, exploring the surprising ways their personal patterns converge and diverge. Bracingly emotional and erotically charged, A Part of the Heart Can't Be Eaten reveals the transformative power of queer pleasure and defiance.
Identifying and Explaining Gender Peer Effects in Elementary Schools
Authors: Tillmann Eduardo , Comim Flávio V.
Published: August 2023

The aim of this paper is to investigate the casual relationship and the mechanisms behind school gender composition and scholastic achievement. We use four cohorts of 5th grade student’s assessment of Math and Portuguese in Brazilian elementary public schools and apply an identification strategy relying on school level gender peer effects and school fixed effects to control for self-selection of students across schools. We identify a positive relationship between scholastic achievement and the proportion of female students. This effect is underlined by improvements in student behavior, as indicated by teachers’ assessment of student’s academic potential, self-esteem, interest, discipline, absenteeism, and perception about syllabus coverage and school violence. Hence, this research draws attention to gender as an important factor in the allocation of students and teachers within schools. The consideration of our findings in the formulation and execution of policies can result in effective low-cost measures aimed at increasing achievement.
CHOQUES DE RENDA E DESIGUALDADE DE GÊNERO: O CHOQUE CHINÊS E SEUS EFEITOS SOBRE INDICADORES ESCOLARES DOS ADOLESCENTES BRASILEIROS
Authors: Almeida Ana Cecília , Vieira Costa Lorena , Bohn Liana
Published: August 2023

Choques de renda, tais como originados no mercado internacional, fornecem uma oportunidade de se avaliar os efeitos de variações exógenas na renda sobre importantes indicadores microeconômicos das famílias. Nesse contexto, a entrada da China na Organização Mundial do Comércio em 2001 provocou o chamado Choque Chinês. Choques desse tipo podem ter efeitos diferenciais sobre homens e mulheres, visto que podem impactar de maneira adversa os diferentes setores intensivos em mão de obra feminina e masculina. Diante do exposto, neste trabalho buscou-se investigar se esse choque, tanto geral quanto ocorrido em setores especializados em mãos de obra feminina e masculina, impactaria também de maneira adversa a educação dos adolescentes de diferentes sexos. Em todos os resultados, as mulheres ficam numa situação melhor ou igual a dos homens. Ademais, considerando o choque geral, elas passam a ter mais participação em cursos em que eram a minoria, como “Agricultura e Veterinária”.
Occupational Feminization and Pay: The Case of Brazil
Authors: Camargo Botassio Diego , Verzola Vaz Daniela
Published: August 2023

The sex wage gap is widely documented in the literature. Although several theories emerged to explain it, the devaluation and queuing views have been dominant due to women’s concentration in lower-paying occupations. They differ in the direction of thecausal effect: while the devaluation theory predicts lower wages for higher occupation’s female share, the queuing theory predicts causal effect in the opposite direction. No studies to support these theories have been found for developing countries and this paper aims to test them for Brazil. Using Censuses data, three results emerge: 1) negative correlation between sex composition and wages; 2) no evidence to support neither theory; 3) some evidence to support another view: the theory of equalizing differences. This last theory predicts no causal relationship between the occupational share of females and wages because wage differentials would emerge from human capital differences and the value attributed to jobs’ non-monetary advantages.
Los gobiernos locales como actores de la política social - México: entre la coordinación intergubernamental y la acción pública local
Authors: Cabrero Mendoza Enrique
Published: August 2023

.
É tempo de agirmos como seres humanos
Authors: Tonelli Maria José , Wilner Adriana , Dos Santos Aline Lilian
Published: August 2023

Glaucimar Peticov, do BRADESCO, explica como a mudança de paradigma para uma liderança baseada na confiança, no engajamento e no protagonismo dos colaboradores pode potencializar capacidades e tornar o trabalho mais eficiente: “se no mundo existissem mais pessoas como você, ele seria melhor ou pior?”.
Rotas possíveis
Authors: Siccherino Fabio Medrano , Silva Reis Manoel de Andrade e
Published: August 2023

A pandemia afetou de forma expressiva os setores de transporte e logística no Brasil, que doravante necessitam investir na digitalização dos negócios e na diversificação de produtos, clientes e países.
Η συμβολή του Μιστριώτειου Πρώτου Γυμνασίου - Λυκείου Τρίπολης στη διαμόρφωση του κοινωνικού γίγνεσθαι του Ελληνικού Κράτους από την ίδρυσή του έως και τις απαρχές του 20ού αιώνα
Authors: Χριστόπουλος Νικόλαος
Published: August 2023

Η παρούσα διατριβή αξιοποιεί το αρχειακό υλικό του Πρώτου Γυμνασίου Τρίπολης το οποίο ιδρύθηκε το 1851. Μέσα από τις σελίδες των Πρακτικών των Συλλόγων Διδασκόντων, τα Μαθητολόγια και τα Βιβλία Γενικών και Ειδικών Ελέγχων είναι δυνατόν να παρακολουθήσει κανείς την τοπική και εθνική ιστορία, από τα μέσα του 19ου αιώνα και ως τις απαρχές του 20ού όπως αυτή αποτυπώνεται στα στοιχεία φοίτησης των μαθητών, στα επεισόδια της καθημερινότητας, στα δημόσια έγγραφα, στις πρακτικές διαχείρισης των προβλημάτων και τον τρόπο άσκησης της διοίκησης του σχολείου. Οι αριθμοί μιλούν εύγλωττα για την κοινωνική πραγματικότητα και αποκαλύπτουν τόσο την ένδεια και τις ανεπάρκειες μιας κοινωνίας που διανύει τις πρώτες δεκαετίες του ελεύθερου βίου της όσο και τις αρετές των ανθρώπων και τη θέληση για πρόοδο που αναδεικνύονται ισχυρότερες από τις αντιξοότητες.
Brain Drain: Greece’s Open Wound
Authors: Tsertekidis Georgios
Published: August 2023

The phenomenon of brain drain, which refers to the emigration of highly skilled individuals from their home country, has been a long-standing challenge for Greece. After the global financial crisis of 2007 – 2009 struck the country, scholars have observed the escalation of brain drain, the loss of valuable human capital in terms of social and economic growth and development. The current phenomenon is linked throughout the relevant literature with other eras of the Greek past. Of course, beyond the historicity of the phenomenon, there are new factors that affect the current status. This policy brief attempts to work with the existing knowledge on the subject and recommend some policy directions.
Counterterrorism in Syria and Iraq: The Issue of ISIS Captives in Detention. Lessons from the Algerian Experience
Authors: Khelfa Nouha
Published: August 2023

This policy brief aims to re-examine the situation of ISIS captives in detention in Iraq and Syria, and the serious security threat that it might pose on the long term, especially, after the loosening of COVID-19 restrictions on movement. This policy brief proposes to extract lessons from the Algerian experience during the 1990s of counterterrorism. The Algerian approach to counterterrorism relies on both the military and the soft method. The Global War on Terror against ISIS was successful militarily, but it lacks the soft method to deal with what comes next to prevent the recreation of new terrorist groups in ISIS concentrated camps. This brief focuses mainly on the Algerian Charter for Peace and National Reconciliation, rebuilding trust, state’s regulations of religion and border protection as effective ways to counterterrorism that can be reproduced in Iraq and Syria.
A Set of Dead-End and Development in the South China Sea: A 2-Level Game Analysis of the Philippines-China Arbitration Case
Authors: Sudargo Alvin Abdudaya , Manullang Abel Josafat
Published: August 2023

Being the heart of the Indo-Pacific, Southeast Asia has seen numerous regional disputes over the years. One of which has remained a vocal point of dispute between the states in and outside the region, that is the South China Sea dispute. An interesting point of development in the South China Sea dispute can be pointed to the China-Philippines arbitration case. Such is the case as China, despite having its action in the waterway deemed illegal, simply brushed it off and remains insistant on its claim. Through incorporating the qualitative research method and relevant concepts like the 2 level game theory, the article seeks to explain why China made that decision. Along with that, the article also seeks to posit some regional implications that states in the region should take note of. In understanding the first issue, the 2 level game theory fits the bill as it allows the writers to learn the forces behind China’s eventual foreign policy decision. Here, China’s national interest along with its realization over its power standing plays a big part in the eventual outcome. For the latter, should China’s assertiveness be left with no proper response, it may endanger the region’s growth and stability. Not only that, it would also bring into the stage another global power like the US that would again take the spotlight from ASEAN and its member states. Against such consequences, it is important for ASEAN member states, both claimant and non-claimant, to align their view and approach towards the region’s perennial issue.
The Road to Digital Single Market: How the EU Can “Enter That Orbit”?
Authors: Bonis Konstantinos Taxiarchis P.
Published: August 2023

Covid-19 pandemic was the breaking-even point for many of the EU’s orientations. One of them, was the digital agenda of the Union. Deeply inside the mind of the EU’s stakeholders, the transformation of single market, into a digitalized one, was the first step. Despite the ambitious perspective of that incentive, the truth lies elsewhere; In order to digitalize the traditionally lucrative single market, huge effort is required, adequate capitals and on the top of all, the member-states socio-political consent. It is neither an easy nor an ultra-difficult step for the European Union. The proper synergies of supranational and national level will maximize EU’s efficiency and optimality. In that paper, the evolution of Digital Single Market and the right path to achieve that target is being analyzed as thoroughly as possible.
The Role of NGOs in Conflict Management
Authors: Karampini Eleni
Published: August 2023

The changing environment of war and conflicts has exacerbated the need for non-governmental organizations (NGOs) to intervene and play a key role in resolving conflicts and restoring civil society. NGOs are organizations that operate independently of any government and they are responsible for addressing social and political issues. Their role to resolve conflicts has emerged as an additional, yet essential part of the entire procedure of dispute management. This paper examines the place of NGOs in the global environment as well as the more specialized way in which they are involved in the dispute resolution process. It involves the theoretical part and the practical application of dispute management from NGOs in case studies and more specifically Bosnia, Georgia and Afghanistan, examining their degree of success in each of these cases.
Therapeutic Role of Animals: A Comprehensive Literature Review on the Prevalent Forms and Species in Animal-Assisted Interventions
Authors: Szewczyk Dorota , Fiega Jakub , Michalska Milena , Żurek Urszula , Lubaszka Zuzanna , Sikorska Ewa
Published: August 2023

Animals have been valued and used to improve human physical and mental health since ancient times. Animal-assisted therapy (AAT) is a complementary approach to traditional medicine, involving trained animals. AAT can enhance cognition, commitment, character growth, and the learning process. Commonly used species in animal-assisted therapy include cats, dogs, horses, dolphins, and others. Feline-assisted therapy alleviates loneliness and stress, whereas canine-assisted therapy positively impacts emotions and overall well-being. Equine-assisted interventions benefit individuals with cognitive and motor disabilities. Dolphin-assisted therapy shows promise for conditions like autism and cerebral palsy. However, ethical concerns have arisen, particularly in children with behavioral disorders. Safety measures, adult supervision, and proper screening and hygiene practices are crucial in AAT programs. In conclusion, AAIs have a significant potential to enhance well-being and mental health across various contexts, but more research is needed to fully understand their effectiveness and safety in different settings and age groups. The existing literature consists of subjective accounts and inadequate methodologies.
Corruption in Ukraine: Within the Scope of the Martial Situation
Authors: Gasparėnienė Ligita , Remeikienė Rita , Vėbraitė Vigita
Published: August 2023

Ukraine has been facing corruption problems for many years. Their beginning is rooted in the collapse of the planned economy, which was obligatory in the former Soviet Union. During the process of transition from the centralized planned economy with large bureau-cratic institutions for economic planning, management and control to the market economy, in which the market is the main mechanism for regulating economic relations, some for-mer state-owned enterprises went bankrupt, and others were privatized. However, since the legal framework for privatization was imperfect, privatization was conducted in illegal or semi-legal forms; non-transparent privatization procedures led to corruption, allowing for privatization of state assets through the loopholes in laws. This created a favourable envi-ronment for the formation of an oligarchy, which gradually took control of the country’s key economic growth factors, such as the production of various forms of energy and the ex-ploitation of mineral resources.