bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of Clinically Significant Prostate Cancer Using Multiparametric MRI, Biparametric MRI, and Clinical Parameters
Authors: Oberneder Maximilian , Henzler Thomas , Kriegmair Martin , Vag Tibor , Roethke Matthias , Siegert Sabine , Lang Roland , Lenk Julia , Gawlitza Joshua
Published: September 2024

Introduction: Multiparametric MRI (mpMRI) is gold standard for the primary diagnostic work-up of clinically significant prostate cancer (csPCa). The aim of this study was to assess the benefit of the perfusion sequence and the non-inferiority of an MRI without contrast administration (bpMRI) compared to mpMRI while taking clinical parameters into account. Methods: In this retrospective, non-interventional study we examined MRI data from 355 biopsy-naïve patients, performed on a 3T MRI system, evaluated by a board-certified radiologist with over 10 years of experience with subsequent mpMRI-TRUS fusion biopsy. Discussion: Only 16/355 (4.5%) patients benefited from dynamic contrast enhanced. In only 3/355 (0.8%) patients, csPCa would have been missed in bpMRI. BpMRI provided sensitivity and specificity (81.4%; 79.4%) comparable to mpMRI (75.2%; 81.8%). Additionally, bpMRI and mpMRI were independent predictors for the presence of csPCa, individually (OR: 15.36; p < 0.001 vs. 12.15; p = 0.006) and after accounting for established influencing factors (OR: 12.81; p < 0.001 vs. 6.50; p = 0.012). When clinical parameters were considered, a more balanced diagnostic performance between sensitivity and specificity was found for mpMRI and bpMRI. Overall, PSA density showed the highest diagnostic performance (area under the curve = 0.81) for the detection of csPCa. Conclusion: The premise of the study was confirmed. Therefore, bpMRI should be adopted as soon as existing limitations have been lifted by prospective multi-reader studies.
A indiferença do outro parental: uma figura da violência moral
Authors: Serfaty Patricia Fasuolo
Published: September 2024

Este artigo tem o objetivo de explorar certos aspectos relativos à problemática da violência moral, com o objetivo de compreender melhor algumas de suas modalidades. O foco maior desta investigação se dirige à violência exercida de maneira silenciosa e encoberta, em particular, no contexto da família. Foi examinada, então, a questão da violência exercida por parte do cuidador quando comporta ausência de investimento no infans. O desamor é posto como violência de extrema indiferença praticada por pais gentilmente narcisistas. Trata-se de uma atuação de caráter perverso, que ocorre pela via da indiferença, por uma velada negligência, a qual implica o apagamento silencioso do infans.
As mulheres da ditadura representadas em Cova 312
Authors: Bisol Laísa
Published: September 2024

This research investigates the way in which Brazilian literary journalism represent women, especially considering the issue of violence. For this, a critical reading of the book-reports in the Jabuti Award is presented. After attesting to the small number of female authors and the lack of representation of violence of this group, an analysis of Cova 312, by journalist Daniela Arbex, is developed. Despite focusing on the representation of the Brazilian military dictatorship and exposing a male protagonist, the book-report emphasizes women who belonged to that context, showing the most different possibilities of struggle and confrontation the female figure experienced in that context.
A new species of Cunninghamia (Cupressaceae) from the Upper Cretaceous (Maastrichtian) of Hokkaido, Japan
Authors: JIANG SONGYAO , SHIGETA YASUNARI , MATSUNAGA KELLY K. S. , YAMADA TOSHIHIRO
Published: September 2024

Cunninghamia nakatonbetsuensis sp. nov. is described as a new fossil-species based on a seed cone from the Upper Cretaceous (Maastrichtian) Heitaro-zawa Formation of the Hakobuchi Group, exposed in Heitaro-zawa, Nakatonbetsu Town, Hokkaido, Japan. This newly discovered species has three seeds per the bract-scale complex, a single robust vascular bundle and a resin canal at the base of the bract-scale complex, and a single row of vascular bundles around the middle of the bract-scale complex. These features are shared with other Cunninghamia species. This new species shares many characters with extant C. lanceolata, such as the trilobed ovuliferous scale, which is fused to the bract except for lateral margins, and branching pattern of vascular bundles in the bract-scale complex. However, it is different from extant and fossil Cunninghamia species including C. lanceolata by possessing thicker bract-scale complex.
Anthurium capixaba (Araceae): a new species with cordate leaves from Brazil
Authors: VALADARES RODRIGO THEÓFILO , COUTO DAYVID RODRIGUES , MANHÃES VITOR DA CUNHA , SILVA LUCAS DE ALMEIDA , DUTRA VALQUIRIA FERREIRA
Published: September 2024

A remarkable new species of Anthurium, named A. capixaba, is here described and compared to its closest relatives. We also present an amended description of A. marcusianum based on the recently fruiting specimens collected.
Study of Number of Cotyledons of Placenta in Different Gestational Age Groups of Healthy Pregnant Mother of Bangladesh
Authors: Bose Sanjib , Jabeen Labiba , Shanto Rafuja , Khanam Afsana , Naznin Rawshon , Sumi Sharmin
Published: September 2024

Introduction: The placenta has drawn attention as an important indicator of intrauterine condition of fetus and maternal diseases. The study of number of cotyledons of placenta in different gestational age groups of healthy pregnant mother of Bangladesh is cross sectional descriptive study. Aim of the study: The aim of the study was to study the variation of number of cotyledons of placenta in deferent state of gestational ages of healthy pregnant mother. Methods: This cross sectional descriptive study was conducted in the Department of Anatomy, Mymensingh Medical College, Mymensingh, from January 2018 to December 2018. This study was performed on 80 human placentae. Result: The mean (± SD) number of cotyledon of the placenta was 18.56 (±2.15) in group A, 21.21 (±3.11) in group B and 23.75 (±3.45) in group C. The mean number of cotyledon of the placenta was maximum in group C (23.75) and was minimum in group A (18.56). It was also observed that the mean number of cotyledon of the placenta increased with gestational age. The mean difference of the number of placental cotyledons between groups A and C was statistically moderately significant (p < 0.05) but between A and B and B and C was statistically non-significant (p > 0.05). Conclusion: The placental examination becomes important as it will help in understanding the specific etiologies of adverse outcome. This study has shown that the mean number of cotyledon of the placenta increased with gestational age.
Asymptomatic Cholecystitis Presents a New Challenge for Correcting Treatment Tactics in Patients with Gallstone Disease Rather Than Being an Unsolvable Problem of Biliary Surgery
Authors: Hosseini Seyedmohammadamin , Asadizeidabadi Arya , Tarabrin Evgeny , Muraviev Sergey , Orlushin Denis
Published: September 2024

Gallbladder stones, or cholelithiasis, represent a significant public health concern, particularly in Russia, with an incidence of 5-6 per 1,000 people annually. Western countries report a prevalence of 10%-20%, which has nearly tripled in the last three decades due to advancements in diagnostic techniques. Notably, the condition disproportionately affects women and the elderly, with a marked increase in prevalence after the age of 70. Approximately 80% of cases are asymptomatic, and the clinical manifestations develop in only 1-4% of patients annually. Despite the rising identification of asymptomatic cases through enhanced imaging, management strategies remain unclear, leading to hesitancy among surgeons regarding surgical intervention. Current guidelines from various national and international bodies, including NICE and ESGE, advocate for a watch-and-wait approach for asymptomatic patients, citing spontaneous stone clearance. However, the treatment of asymptomatic choledocholithiasis remains contentious, with some guidelines supporting intervention. This ambiguity is compounded by the recognition that complications can arise from unnecessary cholecystectomy, with 10-40% of patients experiencing ongoing symptoms post-surgery. The article emphasizes the need for a comprehensive understanding of asymptomatic cholecystitis, advocating for a meticulous diagnostic approach that considers the potential underlying causes of gallstone formation. The lack of consensus in current literature regarding management strategies highlights the necessity for further research into the natural history of asymptomatic gallstones and the implications of various treatment options. By addressing these complexities, clinicians can enhance patient outcomes and reduce the incidence of post-cholecystectomy syndrome, ultimately leading to more individualized and effective management strategies for patients with asymptomatic cholecystitis.
Effect of Comprehensive HIV Prevention Information Package on Syphilis Infection Levels Among Youths in Kakamega and Kericho Counties, Kenya
Authors: Khasewa Joab , Mwanzo Isaac , Orago Alloys
Published: September 2024

The world's biggest threat to development and public health is HIV. Youth in sub-Saharan Africa are primarily affected by the HIV epidemic. Despite the availability of HIV prevention options, new infections among youth in Kenya only reduced by 56% between 2015 and 2021. Various HIV prevention interventions have been implemented among youth with little or no assessment of their effectiveness in reducing new HIV infections. The objective of the study was to evaluate the effect comprehensive HIV prevention information package of the package on syphilis infections levels among the youths in Kakamega and Kericho counties, Kenya. A non-randomized control trial was conducted with Kakamega as intervention and Kericho as Comparison County. The pretest questionnaire was administered in both intervention and control counties in December 2001. The posttest questionnaire was administered in both intervention and control counties after nine months of providing HIV prevention information package. Quantitative data was analyzed using descriptive and inferential statistics. Qualitative data was transcribed and analyzed thematically. There was significant increase in knowledge of sexually transmitted infections in intervention county (t = 3.340, P = 0.021). There was significant number of youth in Kakamega county who reported unusual sores in genital area at endline (t = 2.035, P = 0.043). Similarly, more youths sought treatment after experiencing the syphilis symptoms (t = 1.931, P = 0.054) at endline in Kakamega county. There were no significant differences in the number of youths in Kericho county at endline who experienced unusual symptoms, sought treatment and informed their sexual partners (P > 0.05). The findings from the study will inform national rollout of the intervention to contribute to safer sexual behaviors among youth.
A Study on Electronic Marketing and Customer Loyalty of Small and Medium Enterprises in Rwenzori Region
Authors: Thomas Suuna , Nimusima Pereez , Rwambale Kadhiri , Tibihikirra Priscilla , Niwaha Moreen
Published: September 2024

Small and medium enterprises (SMEs) have continued to face customer retention challenge which has been escalated by the changing customer product information needs. This study was conducted to examine the relationship between electronic marketing and customer loyalty among service firms in Rwenzori region. The study took a cross-sectional design which was quantitative in nature. Out of 170 small and medium enterprises operating in Kabarole, and Kyenjojo districts a sample of 118 was determined in accordance with Krejcie & Morgan sample determination table. Data was collected using questionnaires which were self-administered physically by the researchers. Necessary instrument validity and reliability checks were conducted and later subjected data to parametric assumptions’ test which informed the choice of data analysis methods. 110 out of 118 questionnaires distributed were returned but only 78 were error free constituting a 71 percent response rate. Study findings indicate that electronic marketing has a positive and significant relationship with Customer loyalty among service firms in these two districts in Rwenzori region (r = .480, p<.01; r = .616, p< .01; and r = .539, p< .01). This finding implies that the more firms accept, use and adopt latest communication technologies, the more the repurchase effects on the side of their customers. Since customer behaviour differ across industries and in different buying context, future studies should look at antecedents and consequences of customer loyalty in none service setting.
Metal Meets Green: A Multifaceted Exploration of Sustainability Perceptions at Heavy Metal Music Festivals
Authors: Kohlhofer Monika , Soos Franziska , Patsch Ingeborg , Gellweiler Susanne , Romanelli Mark
Published: September 2024

The enduring presence of heavy metal music spanning multiple decades has generated a large global audience of devoted fans. Within Europe, renowned metal music festivals such as Wacken Open Air and Rock am Ring in Germany have solidified the genre's influence. Although scholarly research has explored metal music festivals and their attendees, there has been a noticeable gap in the examination of sustainability aspects within this domain. Consequently, this work undertakes a quantitative investigation into the social, environmental, and economic impacts within the context of metal music festivals, focusing on four key stakeholder groups: festival organizers, attendees, musicians, and volunteer workers (n = 742). To gain insights, an online survey was conducted to respondents, presenting them with questions pertaining to various aspects of environmental, social, and economic sustainability. These stakeholders were asked to assess these issues based on their individual perspectives. Subsequently, the collected data underwent explorative factor analysis utilizing maximum likelihood estimation, leading to the identification of eight distinct factors: perceptions of social behavior at metal music festivals, environmental responsibility, financial responsibility, environmental and social responsibility, sense of community, environmental and economic impacts, perceptions of volunteer work, and economic impacts. This study's findings revealed noteworthy disparities across all sectors, offering a comprehensive perspective on current sustainability practices and challenges within metal music festivals. By highlighting inconsistencies, this research underscores the need for festival organizers to critically evaluate their events and consider avenues for improvement in sustainability practices.
Education Expenses and Their Relationships with the Accounting Indicators of Capixabas Municipalities
Authors: Scopel Danilo
Published: September 2024

Currently, public managers have the challenge of combining intense demand for essential services for the population with limited financial resources. Due to this fact, they submit themselves to gradually seek more efficiency in decision making. The literature shows us that analysis via indicators extracted from accounting balance sheets is one of the vital mechanisms to contribute to this purpose. Thus, the research aimed to answer the following question: Are the accounting indicators, calculated through the balance sheets of the municipalities of Espírito Santo, related to the amount invested in education? Regarding the methodology, it is a bibliographic and quantitative research. To answer the research question, the following statistical methods were used: descriptive statistics, multiple linear regression and Pearson correlation. The results found indicate that some quotients used in the research, such as Budget Result Quotient (BRQ), Current Liquidity (CL) and Debt Composition (DC), showed a statistically significant relationship with the amount invested in education. Through the results, we note the importance of using accounting indicators to suggest ways that can help public managers in making a decision to invest more or not, that is, whether it is better to increase or reduce their assets and liabilities in order to increasingly improve the services provided to society, generating more efficiency and quality for its stakeholders.
Fundamentals to Diagnosing Polycystic Ovary Syndrome in Adolescents: A Critical Literature Review
Authors: Medeiros Sebastião , Medeiros Ana , Magalhães Letícia , Yamamoto Márcia , Medeiros Matheus
Published: September 2024

Background: Because of this prevalence and frequent association with various comorbidites, the diagnosis of polycystic ovary syndrome (PCOS) must be performed as early as possible. Despite conflicting findings, many studies have been published on adolescents with a diagnosis of polycystic ovary syndrome. Methods: The Google Scholar and PubMed data bases were searched for publications in the English language reporting on PCOS diagnosis in adolescents. Results: A comprehensive analysis of data regarding the overlay of physiological ripening of menstrual cycle characteristics, androgen levels, and ovary aspects during puberty with the established criteria to diagnose PCOS in adults revealed that are liable diagnosis of PCOS in adolescence is possibleas soon as 2-3 years postmenarche. Persistant menstrual cycle intervals shorter than 21 days or longer than 45 days, total testosterone levels >1.9-2.0 nmol/l and ovary volume >10cm3 after 15-16 years of age can be used to diagnose PCOS. Conclusion: When combined, any persistent deviation of physiological parameters in adolescents as a criterion to diagnose PCOS in adults allows a certain diagnosis of PCOS in adolescents.
Precision Nutrient Management Amid Climate Change Challenges: A Review
Authors: Nasiro Kalifa , Mohammednur Taju
Published: September 2024

Increasing food demand and climate change present significant challenges to sustainable food production systems and environmental health. Nitrogen, crucial for plant metabolism and growth, also poses risks such as water pollution through nitrate leaching and the emission of nitrous oxide (N2O), a potent greenhouse gas contributing to global warming. Despite ongoing efforts to reduce nitrogen fertilizer application, inefficient use persists. Precision agriculture emphasizes optimizing nitrogen application to mitigate climate change and enhance productivity, sustainability, profitability, and climate resilience. While soil testing has historically improved grain production, focusing on crop nutrient demands rather than soil nutrient levels is gaining traction. This approach synchronizes nutrient supply with plant needs more effectively, ensuring nutrients are applied when and where they are most beneficial. Implementing precision nutrient management enhances efficiency, maintains or increases yields, and minimizes nutrient runoff, safeguarding water supplies. This strategy adheres to the principles of the "4 Rs" – Right rate, Right source, Right application method, and Right timing – to deliver nutrients effectively. Advances in technologies like optical sensors and leaf color charts enable real-time nitrogen application adjustments during the growing season, supporting cost-effective and farmer-friendly practices. While developed countries lead in adopting precision nutrient management for nitrogen and other nutrients, developing nations are increasingly exploring similar strategies. Effective policies and programs are essential to address nitrogen fertilizer use and mitigate its impact on climate change in agriculture.
A Systematic Review: Educational Supervision in Different Countries from Instructional Improvement Perspective
Authors: Regassa Tolcha , Mamo Tadesse
Published: September 2024

The systematic review was based on five different articles focused on educational supervision from five different countries searched and systematically reviewed. The purpose of systematic review was to identify, evaluate and summarize the findings of relevant individual previous studies over the issue related thereby making the available more accessible for decision makers. Twenty one literatures were searched and ten were screened. Five of them had different methods and the date of publication stated in the criteria became outdated. The remaining five articles were qualitatively conducted which were similar in methods included and systematically reviewed. Four important different excel spreadsheet protocol were prepared and attached to the appendix. Four important thematic area of the review selected to be analyzed were purpose of supervision, quality of a good supervisor, problem related to supervision, and approach to educational supervision (clinical supervision, peer supervision, collaborative supervision, self-directed and mentoring). The findings of the review revealed that several important of educational supervision for teachers’ professional development and improvement of teaching-learning process. There are different approaches of educational supervision to support teacher professional development in order to improve teaching learning. The reviewer recommended that teachers to be able to carry out their role effectively, it is necessary to apply appropriate approach of supervision in the schools. Finance and shortage of experienced supervisor have impact on the role of supervision in the school system which proper attention should be given for effective supervision.
Can Mobile Financial Services Influence Financial Behaviour  in India?
Authors: Biswas Shreya
Published: September 2024

The study examines the relationship between mobile financial services and individual financial behaviour in India, wherein a sizeable population is yet to be financially included. The study utilises the nationally representative data from the Financial Inclusion Insights survey conducted during 2018, representing over 45,000 individuals aged 15 years or above for the empirical analysis. The study indicates that the use of mobile financial services improves financial behaviour in India. Specifically, the study finds that using mobile financial services increases the likelihood of investment, having insurance and borrowing from formal financial institutions. Further, to address endogeneity concerns, we also employ Lewbel’s method and propensity score method, and the findings remain qualitatively similar. The empirical results of the study highlight that fastening the pace of access to mobile financial services can improve financial outcomes in developing country settings.

JEL Codes: G51, G52, O16
The Editor’s Note: Connecting over cursive
Authors: Preston Teresa
Published: September 2024

Kappan editor-in-chief Teresa Preston discusses ideas related to public perceptions of schools presented in the September 2024 issue.
What do adults know about public education?
Authors: Rapaport Amie , Saavedra Anna Rosefsky
Published: September 2024

Adults’ beliefs and knowledge about the state of the U.S. education system drive decisions about policy, funding, program adoption, student participation in programs, and the selection of decision makers to elected positions. Amie Rapaport and Anna Rosefsky Saavedra share national survey data showing that U.S. adults have little knowledge about what is being taught in schools, express neutrality about belief systems undergirding education policy, and report experiences misaligned with hard-data trends on student academic progress in recent years. With adults reporting they learn about issues crucial to our education system mainly from “personal experience,” better information has the potential to improve U.S. education.
Career Confidential: Teacher frustrated district ‘undervalues’ the arts
Authors: Fagell Phyllis L.
Published: September 2024

Phyllis Fagell offers advice to educators. In this issue, an art teacher wants to know how she can make sure her students have a fulfilling experience in her class when her budget for supplies has been cut.
Laryngeal Neuromas in a 5-Year-Old With MEN2B: A Case Report and Literature Review
Authors: Abi Zeid Daou Christophe , Yammine Yara , Mourad Marc , Al Barazi Randa
Published: September 2024

Multiple endocrine neoplasia type 2B (MEN2B) syndrome is a rare genetic disorder primarily driven by mutations in the RET proto-oncogene. MEN2B exhibits diverse symptoms affecting multiple organ systems, with mucosal neuromas being a prominent feature. These benign tumors contribute to the syndrome’s clinical variability, alongside medullary thyroid carcinoma and pheochromocytoma. The article presents a case study of a young girl diagnosed with MEN2B, complicated by laryngeal neuromas leading to respiratory distress post-thyroidectomy. Laryngeal neuromas are exceedingly rare, underscoring the importance of recognizing such manifestations for proper airway management, especially during surgical interventions. Despite its rarity, MEN2B presents significant clinical challenges, requiring early detection, genetic counseling, and multidisciplinary management for improved outcomes. Clinicians must remain vigilant for rare manifestations like laryngeal neuromas to prevent serious complications, particularly during surgical procedures.
Why Do People Migrate? Fresh Takes on the Foundational Question of Migration Studies
Authors: Carling Jørgen
Published: September 2024

“Why do people migrate?” is a question that forms the pivot of migration studies, and migration theory in particular. But it has hardly found satisfactory answers. In this article, I reapproach the question from an array of diverse angles and provide eight responses. Some are aligned with recent theoretical developments, others unpack long-standing ideas with evolving significance, and still others are fundamentally atheoretical. Together, they show how the question can be answered, how it is being answered—even inadvertently or misleadingly—and what the implications are of answering the question in different ways. These are the responses, which each initiates a discussion: (1) For the reasons under which they are admitted as immigrants; (2) For reasons that are socially legitimate; (3) Because the sum of push and pull factors is in favor of migration; (4) Because they have the aspiration and the ability to do so; (5) Because an opportunity presents itself; (6) Either because they chose to or because they are forced to; (7) Because they see migration as either intrinsically or instrumentally valuable; (8) To lead a normal life. The discussions demonstrate how theoretical, methodological and political dimensions of migration sway the ways in which reasons for migration are understood and represented. “Why do people migrate?” is slippery as a research question, but its indeterminate nature makes it a guiding light for research that navigates a diversity of perspectives with humility and curiosity.
Extracorporeal membrane oxygenation support in adult patients: Comparing COVID-19- and non-COVID-19-associated respiratory failure
Authors: Oh Tak Kyu , Song In-Ae
Published: September 2024

Introduction

Extracorporeal membrane oxygenation (ECMO) is a vital intervention for acute respiratory distress syndrome (ARDS), yet its efficacy with coronavirus disease 2019 (COVID-19) remains unknown. This study compared the long-term mortality rates of patients receiving ECMO for COVID-19 with those experiencing other respiratory disease-associated ARDS.

Methods

This retrospective cohort study included adults with ARDS receiving ECMO for respiratory disease (COVID-19 and non-COVID-19) based on information collected from the National Health Insurance Service of South Korea from February 1, 2020, to December 31, 2021. The primary outcome was all-cause mortality at 6 months and 1 year post-ECMO initiation.

Results

Data from 3094 patients with COVID-19 ( N = 1095) and non-COVID-19 respiratory disease-associated ARDS ( N = 1999) who received ECMO support were analyzed. Despite a higher Charlson Comorbidity index in the non-COVID group, patients with COVID-19 had higher cumulative mortality rates at 6 months and 1 year post-ECMO initiation compared to those with non-COVID-19 respiratory diseases, after adjusting for confounders. Patients with COVID-19 also experienced longer intensive care unit stays, higher hospitalization costs, longer ECMO and mechanical ventilation durations, and lower intensity coverage.

Conclusions

Patients with COVID-19 requiring ECMO showed higher mortality rates, possibly due to its distinct long-lasting and potentially fatal consequences compared to other respiratory illnesses.
The Assessment of Post-secondary Supports: A New Measure of an Understudied SCCT Construct
Authors: Hardin Erin E. , Murphy Sean , Gibbons Melinda M.
Published: September 2024

We investigated environmental supports, an understudied aspect of Social Cognitive Career Theory (SCCT), with rural Appalachian youth, an understudied population. We developed a new measure of proximal influences that bolster the pursuit of postsecondary education, the Assessment of Postsecondary Supports (APSS). Across 3 studies, we develop and validate the new measure, finding strong internal consistency and construct validity. Moreover, scores on the APSS were positively correlated with college-going self-efficacy (CGSE) and college outcome expectations (COE), explaining more unique variance than a measure of perceived educational barriers.
“How well do we know our patients?”: Further validation of a complexity rating scale for HIV
Authors: Begley Kim , Smith Don , Wand Handan , Chan Derek , Furner Virginia , Kelly Melissa Louise , McGrath Patrick , Hennessy Ruth , Price Anthony , Purnomo Lia , Bowden Bruce Hamish , Bulsara Shiraze M
Published: September 2024

Background

Despite advances in the management and treatment of HIV, identifying risks for disengagement are essential to maximize positive outcomes. The current study investigated the validity of the Clinical Complexity Rating Scale for HIV (CCRS-HIV), a risk-prediction tool, by assessing agreement between patient and clinician scores of patient complexity.

Methods

207 patients completed the patient version of the CCRS-HIV (CCRS-HIVP), and six Attending Medical Officers (AMOs) caring for those individuals completed the original clinician version (CCRS-HIVC). Kappa statistics, sensitivity and specificity were used to assess patient-clinician agreement.

Results

Patient-clinician agreement was highest for problematic crystal methamphetamine use (86%), polypharmacy (84%) and other physical health concerns (67%). Cut-offs of 40 and 45 for the total CCRS-HIV score were identified as most appropriate, with high sensitivity (79.31% and 76.0% respectively).

Conclusions

Overall agreement between the clinician and patient complexity scores was high. These findings provide further evidence of the validity of the scale. The study demonstrates that the unique role of AMOs at the center contributes to them knowing their patients well, allowing them to manage and refer when required for interdisciplinary care which likely contributes to their ongoing engagement in care and may account for the high level of agreement.
Elinor Catherine Hamlin (1924–2020): ‘The beloved daughter of Ethiopia’
Authors: Toodayan Nadeem , Toodayan Zaheer
Published: September 2024

Elinor Catherine Hamlin (1924–2020) was a world-renowned Australian obstetrician and gynaecologist who dedicated almost her entire adult working life to eradicating obstetric fistula in Ethiopia. Leaving behind a comfortable life in Sydney and later Adelaide, she travelled with her husband Reginald Hamlin (1908–1993) to Addis Ababa in 1959, with the view to working there for three years and helping set up a midwifery school at the Princess Tsehai Memorial Hospital. But the couple ended up spending the rest of their lives in Ethiopia, where they revolutionised maternal healthcare services and standardised best practice measures for fistula patient care. In 1975 they jointly opened the Addis Ababa Fistula Hospital – at that time the only operating specialist fistula hospital in the world – which was destined to become a global centre of excellence in obstetric fistula surgery. Today the hospital carries on Catherine Hamlin's legacy as one of Sydney's most impactful medical graduates on the world stage.
Sir Arnold James Knight (1789–1871): Physician, educationist, and founder of Sheffield Medical School
Authors: Cullen Derek R
Published: September 2024

Arnold James Knight was born on the 17th May 1789, the youngest of three sons and seven daughters born to Alexander and Catherine Knight of Sixhills Grange, Market Rasen, Lincolnshire. The Knight family were Catholics and traced their origins to the fifteenth Century. As a child, Arnold Knight was taught by the Rev. James Simkiss, a man of profound learning and scientific knowledge, and aged 10 he was sent to Baddesley Green Academy, Edgbaston, to be taught by the Franciscan Monks. At 16, he went to St Mary's College, Oscott, Birmingham to ‘improve his Latin and Greek’. Oscott College today is a seminary in the Archdiocese of Birmingham but then it was also a lay school where the notable Catholic families sent their sons to be educated. At Oscott, his piety and academic ability so impressed his teachers that they hoped he would study for the priesthood but he decided to study medicine.
Real-World Stairways: Need for Visual Contrast Enhancements to Mitigate the Hazards of Variable Step Geometry
Authors: Harper Sara A. , Brown Chayston B. , Dakin Christopher J.
Published: September 2024

Variation in step dimensions in a stairway can decrease step predictability and increase users’ fall risk. We discuss past stairway dimension irregularities, current stairway design codes, and how visual contrast enhancements may improve stairway safety by drawing stair users’ attention to the steps.
Evaluation of contraception methods in chronic myeloid leukemia patients: A Turkish multicenter study
Authors: Çiftçiler Rafiye , Selim Cem , Cömert Melda , Zengin Haydar , İpek Yıldız , Gürsoy Vildan , Yıldızhan Esra , Yıldız Abdülkerim , Yaman Samet , Elibol Tayfun , Güven Serkan , Arslan Davulcu Eren , Özmen Deniz , Tekinalp Atakan , Narlı Özdemir Zehra , Baysal Mehmet , Mersin Sinan , Güven Zeynep , Pınar İbrahim Ethem , Çelik Serhat , Eşkazan Ahmet Emre
Published: September 2024

Background and Aim

Chronic myeloid leukemia (CML) incidence has recently increased in younger individuals. With time, given the nature of the disease and available therapies, as well as the existing paucity and inconsistency of advice, worries about fertility have surfaced. With all these clear unknowns, we designed this study to raise awareness among both physicians and CML patients about whether male and female patients of childbearing age were using contraception at the time of diagnosis, and if so, which methods they were using. In this context, this study aimed to evaluate the contraception methods in patients with CML.

Materials and Methods

Eighteen centres from Turkey participated in the study. Male and female patients of childbearing age diagnosed with chronic and accelerated phase CML between the years 2000 and 2024 were evaluated retrospectively.

Results

Of the two hundred and thirty-two patients included, one hundred and twenty-five (53.9%) of these patients were female and 107 (46.1%) were male. At diagnosis, all female patients were in the childbearing age, and male patients were sexually active. The median age at diagnosis of the patients was 38 (range, 18–77) years. Eighty-six (68.8%) female patients were using any contraception method, while this was 53.2% (n = 57) among male patients.

Conclusion

In conclusion, since CML patients are diagnosed at an earlier age and the desire of these patients to have children, adequate information and evaluation should be provided regarding fertility and contraception issues, especially in female patients, from the moment of diagnosis.
Traconia Fish Sting in a City without a Sea
Authors: Karahan Mümin , Sahin Levent
Published: September 2024

The traconia fish fish poisons people it comes into contact with using the spiny structure on its back. In this case, we report the exposure of a 62-year-old housewife to a dead traconia fish while cleaning the fish. The patient came to the emergency room with unbearable pain and burning sensation in his hand. He was not relieved by the analgesia given after the examination in the emergency room and the hot water immersion methods applied. Local anesthesia-analgesia was provided by the orthopedist using the regional block technique. It should not be forgotten that such rare cases may occur in places that are not connected to the sea and/or even when the fish is dead.
Competing risk analysis to estimate amputation incidence and risk in lower-extremity peripheral artery disease
Authors: Callegari Santiago , Smolderen Kim G , Cleman Jacob , Mena-Hurtado Carlos , Romain Gaëlle
Published: September 2024

Background: Patients with peripheral artery disease face high amputation and mortality risk. When assessing vascular outcomes, consideration of mortality as a competing risk is not routine. We hypothesize standard time-to-event methods will overestimate major amputation risk in chronic limb-threatening ischemia (CLTI) and non-CLTI. Methods: Patients undergoing peripheral vascular intervention from 2017 to 2018 were abstracted from the Vascular Quality Initiative registry and stratified by mean age (⩾ 75 vs < 75 years). Mortality and amputation data were obtained from Medicare claims. The 2-year cumulative incidence function (CIF) and risk of major amputation from standard time-to-event analysis (1 – Kaplan–Meier and Cox regression) were compared with competing risk analysis (Aalen–Johansen and Fine–Gray model) in CLTI and non-CLTI. Results: A total of 7273 patients with CLTI and 5095 with non-CLTI were included. At 2-year follow up, 13.1% of patients underwent major amputation and 33.4% died without major amputation in the CLTI cohort; 1.3% and 10.7%, respectively, in the non-CLTI cohort. In CLTI, standard time-to-event analysis overestimated the 2-year CIF of major amputation by 20.5% and 13.7%, respectively, in patients ⩾ 75 and < 75 years old compared with competing risk analysis. The standard Cox regression overestimated adjusted 2-year major amputation risk in patients ⩾ 75 versus < 75 years old by 7.0%. In non-CLTI, the CIF was overestimated by 7.1% in patients ⩾ 75 years, and the adjusted risk was overestimated by 5.1% compared with competing risk analysis. Conclusions: Standard time-to-event analysis overestimates the incidence and risk of major amputation, especially in CLTI. Competing risk analyses are alternative approaches to estimate accurately amputation risk in vascular outcomes research.
Accessing the right to vote among system-impacted people
Authors: Sugie Naomi F. , Sandoval Juan R. , Kaiser Daniela E. , Mosca Delaney , Winnen Kyle , Zhang Emily Rong , Zhang Iris H.
Published: September 2024

Recent efforts to dismantle felon disenfranchisement regimes have the potential to substantially expand electoral eligibility among people with criminal records; however, even among those with criminal legal histories who are eligible to vote, voting rates are often extremely low. Analyzing interview, focus group, and text message conversations among a multi-state sample around the November 2022 election, we identify and describe how administrative barriers to voting—including a lack of understanding about the voting process, confusion about legal eligibility, and perceived risks of rearrest of voting while ineligible—pose an access to justice issue among system-impacted people. These barriers are amplified by government mistrust, specifically the perception that barriers are intentionally constructed to suppress voting, and they are potentially mitigated by outreach by community organizations that are viewed as credible. The findings emphasize that legislative reforms repealing disenfranchisement laws must be accompanied by on-the-ground efforts to address administrative burdens to broaden access to the franchise.
Patient Perspectives on Lifestyle Medicine Virtual Group Visits
Authors: Vigue Dana , Mirsky Jacob , Brodney Suzanne , Thorndike Anne N.
Published: September 2024

Lifestyle Medicine Virtual Group Visits (LMVGVs) have potential for providing effective lifestyle education and counseling to patients who have or are at risk for chronic disease. The purpose of this study was to assess primary care patients’ motivations for participation in and preferences for future engagement with LMVGVs. This was a cross-sectional survey conducted in an academic community-based clinic. A total of 111 patients who signed up for LMVGVs between September 2020 and August 2021 completed the survey between February and April 2022. Patient demographics and LMVGV attendance data were collected from the medical record. The most common reported reasons for signing up for LMVGVs were to focus on lifestyle changes and to lower chronic disease risk. The most common reasons for attending subsequent LMVGVs were the focus on healthy lifestyle changes and the positive focus of the groups. Almost all (98%) respondents who attended ≥5 LMVGVs indicated they would recommend LMVGVs to family or friends. Most respondents preferred monthly LMVGVs, including 71% of those who attended ≥5 LMVGVs. These findings inform efforts to develop LMVGVs that are feasible and acceptable to patients, contributing to the promotion of lifestyle behaviors that aid in the prevention and treatment of chronic disease.
The assessment of attentional bias to cleanliness stimuli in different versions of the dot-probe task: Evidence for a motivational account
Authors: Boğa Merve , Wentura Dirk
Published: September 2024

Vogt et al. (2011) investigated the role of goal-relevance in attention. Specifically, they induced the emotional state of disgust and showed an attentional bias (AB) to goal-related stimuli (i.e., cleanliness pictures) using the dot-probe task. In two experiments, we tested (a) an alternative interpretation and (b) the role of an important methodological feature of the dot-probe task. As the effect can be interpreted alternatively as affective counter-regulation (i.e., cleanliness-related pictures attracted attention because they are positive in the negative disgust state), we added positive stimuli to test whether the AB in the disgust state extends to these stimuli. In Experiment 1, we used the location dot-probe task. That is, participants had to categorise the location of the target. It can be argued that this task confounds attentional processes with response priming processes. In Experiment 2, we used a discrimination dot-probe task, that is, participants had to categorise a target feature that varied orthogonally to location, thus eliminating the confound. In Experiment 1, we did not replicate the effect of emotional state on AB for cleanliness stimuli, whereas in Experiment 2, we did. Mean AB scores for positive stimuli were not affected by emotional state. Two conclusions were drawn: First, the result of Experiment 2 supports the motivational account of Vogt and colleagues. Second, the results support the use of the discrimination task for both theoretical reasons (i.e., effects can be more clearly interpreted as based on attentional processes) and empirical reasons (i.e., the location task did not replicate the expected pattern).
Word length and frequency effects in natural Chinese reading: Evidence for character representations in lexical identification
Authors: Fu Ying , Liversedge Simon P , Bai Xuejun , Moosa Maleeha , Zang Chuanli
Published: September 2024

Word length and frequency are two of the “big three” factors that affect eye movements in natural reading. Although these factors have been extensively investigated, all previous studies manipulating word length have been confounded with changes in visual complexity (longer words have more letters and are more visually complex). We controlled stroke complexity across one-character (short) and two-character (long) high- and low-frequency Chinese words (to avoid complexity confounds) and recorded readers’ eye movements during sentence reading. Both word length and frequency yielded strong main effects for fixation time measures. For saccadic targeting and skipping probability, word length effects, but not word frequency effects, occurred. Critically, the interaction was not significant regardless of stroke complexity, indicating that word length and frequency independently influence lexical identification and saccade target selection during Chinese reading. The results provide evidence for character-level representations during Chinese word recognition in natural reading.
Depression influences fatigue in inflammatory bowel disease amongst other factors: a structural modelling approach
Authors: Barnes Alex , Bryant Robert V. , Mukherjee Sutapa , Andrews Jane M. , Bampton Peter , Fraser Robert J. , Mountifield Réme
Published: September 2024

Objectives:

Fatigue is common in people with inflammatory bowel disease (IBD) and is associated with IBD activity, sleep disturbance, anxiety and depression. The relative contribution of these factors to fatigue is unclear. This study aimed to investigate the relationship between fatigue and these factors through a novel approach using structural equation modelling.

Design:

Online questionnaire circulated via three tertiary IBD centres and Crohn’s Colitis Australia.

Methods:

Fatigue was assessed using the Functional assessment of chronic illness measurement system fatigue subscale. Validated measures of sleep, anxiety, depression and IBD activity were included. Following correlation analyses, a structural equation model was developed for the outcome of the fatigue score. Direct and indirect effects were calculated.

Results:

There were 630 complete responses to the online questionnaire. The median age of respondents was 41 with the majority female and over half (52%) on biologic medication. Structural equation models for Crohn’s disease and ulcerative colitis demonstrated a good fit. In Crohn’s disease, the relationship between IBD activity and fatigue was mostly mediated indirectly through the influence of IBD activity on sleep, anxiety and primarily depression. Sleep quality mediated the influence of IBD activity and the indirect effects of depression on fatigue, but not anxiety. Unlike in Crohn’s disease, the direct influence of IBD activity on fatigue in ulcerative colitis was non-negligible, although remained of lesser magnitude than the indirect effect of IBD activity on fatigue. Depression was the primary indirect mediator of the influence of IBD activity on fatigue in ulcerative colitis.

Conclusion:

In Crohn’s disease, IBD activity leads to fatigue through its influence on sleep quality and mental health. The data suggest treatment of clinically significant depression, in both ulcerative colitis and Crohn’s disease, may result in the largest decline in fatigue score compared to other variables. Treatment algorithms for fatigue should consider depression a priority.