bluuebunny/crossref_metadata_2025 huggingface dataset:
When “the more the better”? Mindfulness enhances the effect of the number of displayed product features in short video ADs on purchase intention
Authors: Su Nan , Feng Shuo , Wang Lei , Wu Yuanzhi
Published: August 2024

In the age of information explosion, consumers may no longer want to be overwhelmed with more information. But marketers are forced to display multiple features of a product in advertisements to fully demonstrate its competitive advantage, especially for a multifunctional product. Based on this, the authors explore when more could be an effective marketing strategy. The results of five studies demonstrated that the more features of multifunctional products displayed in video ads, the lower the processing fluency of consumers when watching the ads, thus reducing their positive emotions, and finally reducing their purchase intention, supporting the negative effect of more features on consumers in the context of marketing and revealed its cognitive and emotional mechanism. More important, we introduce mindfulness, an effective marketing strategy that alleviates the negative effect of too many product features on consumers, into the field of advertising marketing to address this issue. A high level of mindfulness, whether measured by trait scales or manipulated by experimental priming, weakens the negative effects of the number of displayed features. Specifically, when the level of mindfulness is high, the negative effect of displaying more product features on purchase intention is weak. When the level of mindfulness is low, the number of displaying more features has a strong negative impact on purchase intention.
“How will I ever know I didn’t bring it on myself?”: Navigating personal responsibility in public health messaging on dementia risk
Authors: Peckham Allie , Maxfield Molly , James Dara L
Published: August 2024

Background and Objectives

Public health messaging increasingly emphasizes the importance of “lifestyle interventions” to reduce dementia risk. Our study aimed to understand how people interpret and respond to information about dementia risk. In a second sub-aim, we examined how these interpretations may contribute to dementia-related lifestyle stigma.

Research Design and Methods

We engaged in a secondary analysis of 50 semi-structured interviews using a framework approach to understand, from the perspective of community-dwelling middle-aged and older adults, how they may interpret, make sense of, and respond to information about dementia risk and risk reduction. During the interpretive and narrative phase, the authors began to elucidate participant responses analytically and identified that these responses could be interpreted within the health locus of control literature.

Results

Of the 23 participants who discussed dementia risk, 13 felt some sense of personal responsibility and control over their dementia risk. Of those 13, four participants believed they had personal responsibility and control and actively engaged in lifestyle interventions. The remaining nine participants also engaged in lifestyle interventions, aiming to find comfort in knowing they had done what they could to reduce their risk and working to alleviate self-attribution of blame if diagnosed with dementia.

Discussion and Implications

The tendency to internalize responsibility may inadvertently contribute to the stigmatization of dementia as a ‘lifestyle disease’ creating dementia-related lifestyle stigma. Recognizing the multifaceted nature of dementia risk, including environmental and external factors beyond individual control, is essential to combatting the ‘lifestyle stigma’ increasingly associated with the condition.
Optimization of tire-ground performance through meshed belt layer structure
Authors: Mao Rui , Sun Pengfei , Zhou Shuiting , Chen Luwen , Meng Junling , Yang Wenqi , Yang Chenyi , Luo Kejie
Published: August 2024

Using Abaqus finite element software, this study investigates the impact of different carcass belt layer structures on the grounding characteristics of tires. Focusing on the 215/55R17 radial tire, the research proposes a structural optimization scheme and establish a finite element model. The standard tire belt layer structure is replaced with a mesh belt layer structure to achieve optimized performance. Through static loading tests on the tire, the accuracy of the finite element model was validated. By altering the density, number of layers of the mesh belt structure, and radial load of the tire, a simulation analysis is conducted to study the impact on tire deformation and stress on the carcass material. The optimized tire features increased radial stiffness and reduced tread wear. The density of the mesh belt layer in the contact area affects tire deformation as well as the stress on the belt layer and ply layer. The results indicate that the mesh belt layer can effectively absorb the radial load of the tire, optimizing tire deformation by 20% to 30%. Under different loads, the tire with a 70-density mesh belt layer can reduce surface stress by approximately 40%, or around 230J. The mesh belt layer tire can reduce the sensitivity of the tire center to high load stresses, optimizing 25% of the concentrated stress at the shoulder position of the ply layer. When a double-layer belt is used, the strength at the shoulder increases with the number of belt layers, reducing stress by approximately 2-4N. The structural form of the belt layer has little impact on the trend of stored strain energy changes, but the number of belt layers significantly affects the amount of change in the tire’s strain energy. On average, about 10% of the stored strain energy is reduced due to changes in the belt layer structure.
Should they stay or should they go? Stroke transfers across a hospital network pre- and post-implementation of an automated image interpretation and communication platform
Authors: Bonner James , Love Christopher J , Bhat Vipul , Siegler James E
Published: August 2024

Background

A key decision facing nonthrombectomy capable (spoke) hospitals is whether to transfer a suspected large vessel occlusion (LVO) patient to a comprehensive stroke center (CSC). In a retrospective cohort study, we investigated the rate of transfers resulting in endovascular thrombectomy (EVT) and associated costs before and after implementation of an artificial intelligence (AI)-based software.

Methods

All patients with a final diagnosis of acute ischemic stroke presenting across a five-spoke community hospital network in affiliation with a CSC were included. The Viz LVO (Viz.ai, Inc.) software was implemented across the spokes with image sharing and messaging between providers across sites. In a cohort of patients before (pre-AI, December 2018–October 2020) and after (post-AI, October 2020–August 2022) implementation, we compared the EVT rate among ischemic stroke patients transferred out of our health system to the CSC. Secondary outcomes included the EVT rate based on spoke computed tomography angiography (CTA) and estimated transfer costs.

Results

A total of 3113 consecutive eligible patients (mean age 71 years, 50% female) presented to the spoke hospitals with 162 transfers pre-AI and 127 post-AI. The rate of transfers treated with EVT significantly increased (32.1% pre-AI vs. 45.7% post-AI, p = 0.02). There was a sharp increase in CTA use post-AI at the spoke hospitals for all patients and transfers that likely contributed to the increased EVT transfer rate, but prior spoke CTA use alone was not sufficient to account for all improvement in EVT transfer rate (37.2% pre-AI vs. 49.2% post-AI, p = 0.12). In a binary logistic regression model, the odds of an EVT transfer in the intervention period were 1.85 greater as compared to preintervention (adjusted odds ratio 1.85, 95% confidence interval 1.12–3.06). The decrease in non-EVT transfers resulted in an estimated annual benefit of $206,121 in spoke revenue and $119,921 in payor savings (all US dollars).

Conclusions

The implementation of an automated image interpretation and communication platform was associated with increased CTA use, more transfers treated with EVT, and potential economic benefits.
Disinterest, normalisation of gender violence and fear of being cancelled: Mediatised learning on antifeminist and anti-LGBTIQ+ discourses among teenagers in Barcelona
Authors: Iñigo Anna , Fernández Laura , Tomasena José M.
Published: August 2024

This article examines the proliferation of antifeminist and anti-LGBTIQ+ discourses among teenagers in Barcelona (Catalonia) and the role of media and the manosphere – online communities and spaces where discussions about masculinity, anti-feminism, gender relations and men's issues take place – on the pollination of these discourses. Through short-term ethnography conducted in three education centres, involving the collaboration of 59 teenagers between 14 and 18 years old, the study researches the discourses that young people embrace, what mediatised environments are referring to when they speak about gender, feminism and LGBTIQ+ topics, and the meaning young people give to these media content. Findings reveal the manosphere facilitates young people's access to masculinist cultures and point to the urge of addressing the affective dimension of it. To conclude, it highlights the need to challenge these informal learning spaces within contemporary youth culture to promote gender equality and social justice.
The main challenges of gender based international labor mobility: Transnational migrant families from Georgia
Authors: Iashvili Ia , Gogsadze Giorgi , Gvenetadze Tinatin
Published: August 2024

The goal of the paper is to shed light on gendered nature of labor migration in the post-Soviet Georgian transitional families. Based on qualitative research methods, this study tries to identify how both, an immigrant wife and her husband left in Georgia conceptualize their gender roles and functions toward family members amid existing challenges. Our research showed that the both financial and emotional burdens of the family are on the part of immigrant women mainly. In few families, fathers take care of children, but in most cases mother’s role is played by a grandmother. Even though almost all respondents noted improvement of economic conditions, the temporary separation of the family members is seen as a social loss. The vast majority of families have not invested remittances in small businesses. It indicates the stagnation of the process of economic and social development in Georgia that restricts the migrants’ way back to home.
Establishing a Contextualized Intervention Program for Noise Reduction in a Neonatal Intensive Care Unit
Authors: Köse Semra , Sabetsarvestani Raheleh , Geçkil Emine , Tokan Ozkilicaslan Fatma , Karaarslan Fatih , Erturk Tosun Esra , Altunhan Huseyin
Published: August 2024

Objective: This study aimed to examine the effect of a contextualized intervention program on the level of noises in the neonatal intensive care unit (NICU) in Konya, Turkey. Background: For the healthy development of preterm infants, NICUs should have noise levels within safe limits. Methods: A single-center, before-and-after study design was employed. Participants included one head nurse, four physicians, 42 nurses, six physician assistants, and 14 other staff members. The contextualized intervention program involved environmental modification, behavioral modification, and resource management. Sound level measurements were recorded at two-hour intervals over a week before the program's initiation, after the first cycle, and following the installation of central monitor screens. Data analysis utilized SPSS 25, employing percentile calculations, one-way analysis of variance, and Bonferroni tests. Results: The evaluations in the second level of NICU showed that the noise level recorded on weekday mornings and evenings was significantly lower for the third measurement compared to the first and second measurements. However, at the weekend the noise level recorded in the morning was higher in the second measurement than the first, with no significant difference found for the third measurement. The evaluations in the third level of NICU showed that on weekdays the noise level recorded in the third measurement was significantly lower than in the first and second measurements ( p < .05). Conclusion: The implementation of a contextualized noise reduction program in our NICU led to significant improvements in noise levels, particularly during morning and evening shifts.
Looking with or without seeing in an individual with age-related macular degeneration impairing central vision
Authors: Zhaoping Li
Published: August 2024

Looking leads gaze to objects; seeing recognizes them. Visual crowding makes seeing difficult or impossible before looking brings objects to the fovea. Looking before seeing can be guided by saliency mechanisms in the primary visual cortex (V1). We have proposed that looking and seeing are mainly supported by peripheral and central vision, respectively. This proposal is tested in an observer with central vision loss due to macular degeneration, using a visual search task that can be accomplished solely through looking, but is actually impeded through seeing. The search target is an uniquely oriented, salient, bar among identically shaped bars. Each bar, including the target, is part of an “X” shape. The target’s X is identical to, although rotated from, the other X’s in the image, which normally causes confusion. However, this observer exhibits no such confusion, presumably because she cannot see the X’s shape, but can look towards the target. This result demonstrates a critical dichotomy between central and peripheral vision.
Living with my diabetes – introducing eHealth into daily practices of patients with type 2 diabetes mellitus
Authors: van Leersum Catharina M , Konrad Kornelia E , Bults Marloes , den Ouden Marjolein EM
Published: August 2024

Objective

Diabetes patients can draw on an increasing number of eHealth apps to support them in the self-management of their disease. While studies so far have focused on patients with type 1 diabetes, we explored how patients with type 2 diabetes mellitus (T2DM) integrate eHealth apps into their practices aimed at managing and coping with the disease, which aspects were considered particularly valuable and which challenges users encountered.

Methods

Semi-structured interviews and focus group sessions were conducted to explore how patients cope with T2DM in their daily lives and their attitude towards eHealth. In a further step, four eHealth apps were tested by patients and their expectations and experiences studied by way of qualitative interviews and focus groups.

Results

The analysis showed that the study participants valued in particular the possibility to use eHealth apps to sense and gain a better understanding of their own body, to learn about specific responses of their body to nutrition and physical activity, and to support changes in daily routines and lifestyle. Key challenges encountered related to difficulties in interpreting the data, matching the data to other bodily sensations, getting overly occupied with the disease and difficulties in integrating the apps into personal, family, and care practices.

Conclusion

Under certain conditions, eHealth can play an important role for patients in developing a nuanced, personal understanding of their body and coping with T2DM. A prerequisite is that eHealth needs to be fitted into the specific practices of users, and patients desire a strong role by their care professionals in providing support in interpretation of data.
Effectiveness of utilizing step-monitoring devices to prevent and treat obesity in children and adolescents: A systematic review and meta-analysis
Authors: Wang Wentao , Ruan Hongfang , Shen Yi , Cheng Jing , Sun Wei , Huang Cong
Published: August 2024

Background

Children and adolescents who are overweight and obese represent a growing public health issue. The use of step-monitoring devices as an intervention tool may be a simple, cost-effective, and easily replicable solution for addressing obesity in children and adolescents. No prior systematic reviews have evaluated the effectiveness of utilizing step-monitoring devices as an intervention method for obesity in children and adolescents.

Methods

Previous studies on using step-monitoring devices to prevent and treat obesity in children and adolescents were identified in the following databases: Web of Science, EMBASE, PubMed, Cochrane Library, SPORTDiscus, and SCOPUS. The search period for each database ranged from the year of their inception to 8 March 2023 (updated in June 2024). Meta-analyses were performed for mean differences (MDs) in body mass index (BMI), BMI z-score (BMI-Z), body fat, waist circumference, and body weight.

Results

From 12,907 relevant records, 23 studies were included in this meta-analysis. The included studies were mainly at low risk of bias, except for blinding. Step-monitoring device-based interventions had significant effects in reducing BMI-Z (MD −0.06; 95% CI −0.10 to −0.02), body fat (MD −0.95%; 95% CI −1.35 to −0.54), and body weight (MD −1.23 kg; 95% CI −2.36 to −0.10). However, there was no significant effect on BMI (MD −0.16 kg/m2; 95% CI −0.55 to 0.22) and waist circumference (MD −0.33 cm; 95% CI −1.23 to 0.58). Subgroup analyses indicated that participants who were overweight or obese showed greater intervention effects on BMI and BMI-Z compared to participants with normal weight. The programs with an intervention duration of ≤6 months presented a greater intervention effect on BMI-Z than those with an intervention duration of more than 6 months. The programs that established goals had a greater intervention effect on body fat than those that did not.

Conclusions

Step-monitoring devices may be an effective and generalizable intervention tool for the prevention and treatment of obesity in children and adolescents. Future studies should further explore how to set step goals and the duration of interventions to achieve better intervention effects.
How Knowledge Recombination Affect Technology Innovation Quality in Chinese High-Tech Firms: The Role of Relation Dynamics and Knowledge Network Decomposability
Authors: Yu Liangru , Yu Bo
Published: August 2024

Knowledge recombination (KR) and technology innovation quality (TIQ) has received much attention. However, the mechanisms by which KR affects TIQ still lack further exploration. This study aims to explore the mediating role of relation dynamics (RDS) between KR and TIQ, and whether knowledge network decomposability (KND) moderates these relationships. Based on a panel data from 437 Chinese listed high-tech firms during 2000–2017, the hypotheses are tested using negative binomial regression in STATA 16.0. The results show that, first, knowledge recombination creation (KRC) not only directly improves TIQ, but also indirectly improves TIQ by promoting relation expansion (RE). Second, the relationship between knowledge recombination reuse (KRR) and TIQ is inverted U-shaped, which is partially mediated by relation stability (RS). Third, KND strengthens the influence of KRC or KRR on TIQ and the inverted U-shaped relationship between KRR and RS. This study enriches the research on the relationship between KR and TIQ, and provides theoretical support for technology management decisions in high-tech firms.
An Analysis of Hotspots, Subject Structure, and Emerging Trends in Digital Governance Research
Authors: Sun Chuanfeng , Jiang Guihuang , Zhang Jingqiang
Published: August 2024

The widespread adoption of digital technology have catalyzed a surge in digital governance (DG). This paper aims to conduct a systematic analysis of 4,782 documents retrieved from the WOS database. Employing bibliometric methods, we unveil the landscape of hotspots, evolutionary trajectories, and emerging trends in DG research. Our findings indicate that the focal points of DG encompass corporate governance, digital finance governance, digital government governance, smart city governance, and Internet and digital platform governance. These topics exhibit a structural synergy, and interconnectedness, with data serving as the key. While there exist disparities in research emphasis across the evolution of distinct DG topics, the overarching trend suggests a shift in the field from localized to globalized governance. Moreover, the research perspective is transitioning from application-specific inquiries to the establishment of comprehensive governance systems. This transformation extends from singular, fragmented governance modes to innovative, synergistic models. International Internet governance, global digital governance, digital governance analysis framework, smart transformation of urban governance, and multi-dimensional collaborative governance represent pivotal directions for future research. By examining research status and intrinsic connection of each topic in DG, this endeavor aids researchers to grasp its development situation, rectify research gaps, and furnish invaluable references to advance theoretical inquiry and practical applications within the sphere of DG.
The Roles of Collective Teacher Efficacy and Commitment in the Relationship Between Turkish Language Teachers’ Job Satisfaction and School Principal Distributed Leadership
Authors: Kaya Kürşat , Erdoğan Onur , Yeşil Yılmaz , Sezgin Ferudun
Published: August 2024

The purpose of the current study was to investigate the relationship between principal distributed leadership and teacher job satisfaction, with the mediating role of collective teacher efficacy. It also investigated the moderating role of teacher commitment in the link between collective teacher efficacy and teacher job satisfaction. Drawing data from a sample of 338 Turkish language teachers in secondary schools in Turkey, the current study employed a cross-sectional survey design. Moderated mediation structural equation modeling was utilized to analyze the data. Results provided a moderate direct association between distributed leadership and teacher job satisfaction and an indirect relationship mediated by collective teacher efficacy. Researchers also found the moderating role of teacher commitment in the relationship between collective teacher efficacy and teacher job satisfaction to be positive and significant. Results provide evidence from a non-Western developing context and Turkish language teachers, contributing to the global knowledge base by confirming the positive and direct link between distributed leadership and teacher job satisfaction while highlighting the significant mediating role of collective teacher efficacy between these two constructs and the moderating role of teacher commitment in reflecting this role in teacher job satisfaction. Implications for policymakers and practitioners are discussed.
A Qualitative Diagnosis of Factors Influencing Presumptive Tax Collection in Zimbabwe
Authors: Edmore Munjeyi , Houdini Fourie
Published: August 2024

This study aimed to examine the factors influencing presumptive tax collection in Zimbabwe. An interpretivist paradigm was adopted in this study using a qualitative research approach. Primary data were collected through virtual (online) in-depth interviews with 20 participants drawn from the Zimbabwe Revenue Authority, Civic Societies, Parliament of Zimbabwe, Informal Sector Associations and academics. Qualitative data were analysed using thematic analysis. The results of a qualitative analysis of the factors influencing presumptive tax collection in Zimbabwe show that institutional, legal and regulatory frameworks as well as governance and political factors significantly contribute to presumptive tax collection in Zimbabwe. The findings of this study will help ZIMRA and policymakers formulate policy strategies to promote presumptive tax collection and voluntary tax compliance in Zimbabwe.
The Central Sensitization Inventory Measures Thoughts and Emotions
Authors: Ramtin Sina , Ngoue Marielle , Ring David , Teunis Teun
Published: August 2024

To determine if the Central Sensitization Inventory questionnaire (CSI) functions as a mental health measure among a cross-section of people seeking musculoskeletal specialty care, we asked: (1) What is the association of CSI total score and item groupings identified in factor analysis with mental health measures? and (2) What is the association between specific CSI items that represent each factor well and specific mental health measures? One hundred and fifty-seven adults seeking specialty care for musculoskeletal symptoms completed the CSI, a measure of catastrophic thinking, and 3 measures of distress (symptoms of health anxiety, general anxiety, and depression). Exploratory factor analysis was used to identify item groupings. Exploratory factor analysis identified 4 item groupings (factors): (1) thoughts and feelings (mental health), accounting for 52% of the variation in the CSI, (2) urinary and visual symptoms (15%) (3) body aches (10%), and (4) jaw pain (8.1%). More than half the variation in both the CSI total score (51%) and the thoughts and feelings factor (57%) were accounted for by variation in measures of catastrophic thinking and distress. Specific items that account for large amounts of the variation in the CSI also had notable correlations with mental health measures. The strong relationship between the CSI and thoughts and emotions suggests that the CSI functions largely as a mental health measure. If the concept of central sensitization is to help people get and stay healthy, it will depend on evidence that central sensitization can be measured and quantified distinct from mental health.
Follow Informed Patient Consent in Clinical Teaching in Order to Achieve a Truly Patient-Centered Approach
Authors: Ye Hongnan
Published: August 2024

Patient- and disease-focused clinical teaching is considered the cornerstone of medical education. Current clinical teaching is increasingly taking place in outpatient settings, but this can cause discomfort to patients. Although many professional organizations have developed a set of ethical considerations in response to this issue to use these considerations to guide clinics in their outpatient procedures, these guidelines are not well adhered to in outpatient practice. My experience as an eczema patient in a dermatology outpatient is good evidence of this. In my opinion, there is nothing inherently wrong with the pedagogy of medical students observing clinical interactions in outpatient settings; the real problem lies in not informing the patient of the medical student's presence or allowing the patient to exercise his or her right of refusal. Therefore, the following recommendations are made: First, academic medical centers should provide regular training to doctors and medical students to ensure that they are fully aware of what is contained in the ethical guidelines established by the professional organizations and that they recognize the importance of adhering to these guidelines in clinical practice. Second, each clinical teaching activity should have the informed consent of the patient and be based on the patient's wishes. Finally, it is recommended that hospitals establish appropriate evaluation mechanisms to assess doctors’ compliance with the ethical guidelines and provide continuing education and training for doctors and medical students who fail to comply.
The rhythm of risk: Exploring spatio-temporal patterns of urban vulnerability with ambulance calls data
Authors: Sirenko Mikhail , Comes Tina , Verbraeck Alexander
Published: August 2024

Urban vulnerability is affected by changing patterns of hazards due to climate change, increasing inequalities, rapid urban growth and inadequate infrastructure. While we have a relatively good understanding of how urban vulnerability changes in space, we know relatively little about the temporal dynamics of urban vulnerability. This paper presents a framework to assess urban vulnerability over time and space to address this gap. We apply the framework to Amsterdam, Rotterdam, and The Hague, the Netherlands. Using high-resolution, anonymised ambulance calls and socio-economic, built environment, and proximity data, we identify three temporal patterns: ’Midday Peaks’, ’Early Birds’, and ’All-Day All-Night’. Each pattern represents a unique rhythm of risk arising from the interaction of people with diverse demographic and socio-economic backgrounds and the temporal flow of their daily activities within various urban environments. Our findings also highlight the polycentric nature of modern Dutch cities, where similar rhythms emerge in areas with varying population densities. Through these case studies, we demonstrate that our framework uncovers the spatio-temporal dynamics of urban vulnerability. These insights suggest that a more nuanced approach is necessary for assessing urban vulnerability and enhancing preparedness efforts.
Finite element analysis & topology optimization of excavator bucket teeth for optimal performance
Authors: Mohan B. A. Madan , Rahaman Mazen Ur , G Pavan , Madhu Rohan , Khot Mantesh B.
Published: August 2024

In the realm of heavy-duty machinery, excavators hold pivotal roles in construction, mining, and various large-scale projects. The excavator's efficacy relies significantly on its bucket teeth, crafted from robust materials like steel, crucial for soil and rock excavation. However, inadequacies in tooth shape and composition can lead to wear which in turn leads to diminished productivity. Employing finite element analysis, the present research delves into the influence of cantilever profile on TATA Hitachi Ex70 and JCB JS81 bucket teeth, using AISI 4340 and AISI 4140 materials, respectively. Analysing von Mises stress and deformation through Altair HyperMesh, subsequent Altair OptiStruct facilitates topology optimisation aims to reduce tooth mass. It appears that Tooth I (TATA Hitachi Ex70) experienced a decrease in mass, yet an elevation in von Mises stress compared to its initial mass of 2.81 kg and stress level of 1.74 E + 02 MPa. Similarly, Tooth II (JCB JS81) showcased a reduction in mass and a rise in von Mises stress from its original mass of 2.03 kg and stress of 1.038 E + 02 MPa. Validation of optimised designs through the graphs depicting the Factor of Safety (FOS) for both teeth ensures compliance with specified requirements, confirming that optimised excavator bucket teeth designs are safe.
Bilateral Testicular Plasmacytoma Preceding Multiple Myeloma with Extramedullary Renal Involvement: A Case Report
Authors: Kavgaci Gozde , Koksal Baris , Arik Zafer , Barista İbrahim , Akin Serkan
Published: August 2024

Multiple myeloma (MM) is a clonal proliferation of plasma cells in the bone marrow, with criteria including bone marrow plasma cells ≥10% or biopsy-proven plasmacytoma with myeloma-defining events. Solitary plasmacytoma (SP) represents a singular clonal plasma cell lesion without myeloma-defining events, while extramedullary disease (EMD) is an aggressive form of MM characterized by independent growth outside the bone marrow microenvironment. We present a unique case of a 64-year-old patient with bilateral testicular plasmacytoma anteceding the development of Immunoglobulin G (IgG) kappa-type MM, featuring extramedullary renal involvement.
Toward a Sociology of Plasma Products
Authors: Holloway Kelly , Grundy Quinn
Published: August 2024

Over the past 20 years, plasma has become a medical treatment characterized as “liquid gold” to signal its lifesaving potential. Through a manufacturing process termed fractionation, plasma, collected through blood donation, is turned into Plasma Derived Medical Products (PDMPs). The World Health Organization (WHO) has underlined the importance of PDMPs for global health care, including a number of PDMPs on the WHO Model List of Essential Medicines. The process of collecting plasma from a donor, manufacturing plasma derived treatments, and distributing those treatments globally requires the coordination of multiple social actors operating in different social, political and economic contexts, but has received little attention in scholarly literature on public policy or the social sciences. This paper will introduce a set of analytic questions and concepts that can direct a sociology of plasma products. We build on the behavioral turn in the policy sciences to identify relevant policy questions emerging from this field and offer the analytic tools necessary to investigate how different social actors in this space make meaning of plasma. To do this, we will draw on key concepts in the sociology of health and illness.
Hospital referrals, exclusions from hospital care, and deaths among long-term care residents in the Community of Madrid during the March–April 2020 COVID-19 epidemic period: a multivariate time series analysis
Authors: Béland François , Zunzunegui Maria Victoria , López Fernando J. García , Pozo-Rodriguez Francisco
Published: August 2024

Background

From March 7 to April 7, 2020, the Community of Madrid (CoM), Spain, issued interventions in response to the COVID-19 epidemic, including hospital referral triage protocols for long-term care facility (LTCF) residents (March 18–25). Those with moderate to severe physical disability and cognitive impairment were excluded from hospital referral. This research assesses changes in the association between daily hospital referrals and the deaths of LTCF residents attributable to the triage protocols.

Methods

Daily hospital referrals and all-cause mortality from January to June 2020 among LTCF residents and the CoM population aged 65 + were obtained. Significant changes in LTCF resident daily hospital referrals time series, and in-LTCF and in-hospital daily deaths, were examined with tests for breaks and regimes in time series. Multivariate time series analyses were conducted to test changes in the associations between LTCF resident hospital referrals with daily deaths in-hospital and in-LTCF, and in the CoM population aged 65 + when the triage protocols were implemented.

Results

Among LTCF residents, hospital referrals declined sharply from March 6 to March 23, 2020. Increases in LTCF residents' daily deaths occurred from March 7 to April 1, followed by a decrease reaching pre-epidemic levels after April 28. The daily ratio of in-hospital deaths to in-LTCF deaths reached its lowest values from March 9 to April 19, 2020. The four versions of the triage protocol, published from March 18 to March 25 had no impact on further changes in the association of hospital referrals with daily deaths of LTCF residents in-hospital or in-LTCF.

Conclusions

While LTCF residents’ deaths increased, hospital referrals of LTCF residents decreased with the introduction of the CoM governmental interventions on March 7. They were implemented before the enactment of the triage protocols, protecting hospitals from collapse while overlooking the need for standards of care within LTCFs. The CoM triage protocols sanctioned the existing restrictions on hospital referrals of LTCF residents.
Comparison of the clinical performance of self-adhering flowable composite and resin-based pit and fissure sealant: a randomized clinical trial in pediatric patients
Authors: Gisour Elham Farokh , Jahanimoghadam Fatemeh , Aftabi Reyhaneh
Published: August 2024

Background

Self-adhering flowable composites are an innovative step in reducing the chair time of pit and fissure sealant treatment. This study aimed to compare the clinical performance of self-adhering flowable composite (SELF-ADH) and resin-based pit and fissure sealant (RBs).

Methods

This is a double-blinded, randomized, split-mouth clinical trial conducted on 80 fully erupted permanent mandibular first molars from 40 children aged 6 to 12 years. For each participant, two permanent molars were randomly treated with SELF-ADH or RB. All sealants were assessed at 3, 6, and 12-month follow-ups considering retention, marginal integrity, marginal discolouration, colour matching, surface texture, and caries recurrence. To analyse the data, logistic regression and Fisher’s exact tests were used (significance level P < 0.05).

Results

At the 12-month follow-up, the number of fully retained sealants in the SELF-ADH group was significantly higher than that in the RB group (P < 0.001). Also, The success rate of marginal integrity in the SELF-ADH group was significantly greater than the the RB group (P = 0.031), while the rate of sealant marginal discolouration was higher in the RB group (P < 0.001). The incidence of recurrent caries in teeth with partial loss of sealant in both groups (P = 0.004, P < 0.001) increased significantly over time.

Conclusion

The retention and marginal integrity of the self-adhering flowable composite were significantly greater than those of the resin-based sealant. Therefore, due to the small number of work steps, flowable self-adhering composites can be used as alternatives to resin-based pit and fissure sealants.

Trial registration

This study was approved by the Ethics Committee of Kerman University of Medical Sciences with the code IR.KMU.REC.1399.556 and Iraninan Registry of Clinical Trials (IRCT) code IRCT20180521039763N4, as well as full compliance with the Declaration of Helsinki.
The experience of hope in dyads living with advanced chronic illness in Portugal: a longitudinal mixed-methods study
Authors: Befecadu Filipa Baptista Peixoto , Gonçalves Maria , Fernandes Cláudia , Laranjeira Carlos , dos Anjos Dixe Maria , Querido Ana , Pautex Sophie , Larkin Philip J. , Da Rocha Rodrigues Gora
Published: August 2024

Background

Hope is an important resource that helps patients and families thrive during difficult times. Although several studies have highlighted the importance of hope in different contexts, its specific manifestations in the realm of advanced chronic illness need further exploration. In this study, we sought to elucidate the intricate interplay between the construct of hope and the lived experience of advanced chronic illness within patient-caregiver dyads. Our objectives were (a) to explore the dyadic experience of hope as a changing dynamic over time for patients living with advanced chronic illness and their informal caregivers and (b) to evaluate variations of hope and symptom burden across time.

Methods

We conducted a longitudinal mixed-methods study with a convergent design between December 2020 and April 2021. Patients living with advanced chronic illness and informal caregivers participated as a dyad (n = 8). The Herth Hope Index scale was used to measure dyads' level of hope and the Edmonton Symptom Assessment System was used to measure patients’ symptom burden. Descriptive statistics were undertaken. A thematic analysis as described by Braun and Clarke was conducted to analyze dyadic interview data. Dyads' experience of hope was described by using the six dimensions of hope in the Model of Hope of Dufault and Martocchio.

Results

Dyadic scores of hope and patients' symptom burden were stable over time. The constructs of hope in dyads included “Living one day at the time,” “Having inner force/strength,” and “Maintaining good health.” Changes in patterns of hope were captured for each dyad in their transition over time. Data converged for all dyads except one.

Conclusions

The findings of our study show a constant presence of hope even in the face of adversity. Healthcare professionals must find ways to promote hope in dyads of patients living with advanced chronic diseases. Nurses play a pivotal role; dyadic interviews should be promoted to create a safe space for both patients and informal caregivers in order to share experiences. More research is needed to address patients' and informal caregivers' hope in chronic illness because current hope-based interventions primarily target cancer diagnoses.
The mediating role of self-efficacy in the relationship between past professional training and burnout resilience in medical education: a multicentre cross-sectional study
Authors: Erschens Rebecca , Schröpel Carla , Herrmann-Werner Anne , Junne Florian , Listunova Lena , Heinzmann Andrea , Keis Oliver , Schüttpelz-Brauns Katrin , Herpertz Sabine C. , Kunz Kevin , Zipfel Stephan , Festl-Wietek Teresa
Published: August 2024

Background

Meta-analyses indicate a high prevalence of burnout among medical students. Although studies have investigated different coping strategies and health interventions to prevent burnout, professional experience’s influence on burnout resilience as seldom been explored. Therefore, in our study we aimed to examine the self-efficacy’s mediating role in the relationship between past vocational training and burnout resilience. In the process, we also analysed the associations between study-related variables and burnout resilience.

Methods

In our cross-sectional study, we analysed the data of 2217 medical students at different stages of their university education (i.e. 1st, 3rd, 6th, 10th semester, and final year) at five medical faculties in Germany. The questionnaire included items addressing variables related to medical school, previous professional and academic qualifications, and validated instruments for measuring burnout and self-efficacy.

Results

The overall prevalence of burnout was 19.7%, as defined by high scores for emotional exhaustion and notable values in at least one of the other two dimensions (cynicism or academic efficacy). Higher levels for self-efficacy (p < .001), having children (p = .004), and financing education with personal earnings (p = .03) were positively associated with burnout resilience, whereas having education financed by a partner or spouse (p = .04) had a negative association. In a mediation analysis, self-efficacy exerted a suppressor effect on the relationship between vocational training and burnout resilience (indirect effect = 0.11, 95% CI [0.04, 0.19]).

Conclusions

Self-efficacy’s suppressor effect suggests that the positive association between vocational training and burnout resilience identified in the mediation analysis disappears for students who have completed vocational training but do not feel efficacious. Those and other findings provide important insights into the psychological mechanisms underlying the development of burnout resilience in medical students and suggest the promotion of self-efficacy in medical education.
Experiences of informal caregivers supporting individuals with upper gastrointestinal cancers: a systematic review
Authors: Furtado Melinda , Davis Dawn , Groarke Jenny M. , Graham-Wisener Lisa
Published: August 2024

Background

Upper gastrointestinal cancers (UGICs) are increasingly prevalent. With a poor prognosis and significant longer-term effects, UGICs present significant adjustment challenges for individuals with cancer and their informal caregivers. However, the supportive care needs of these informal caregivers are largely unknown. This systematic review of qualitative studies synthesises and critically evaluates the current evidence base on the experience of informal caregivers of individuals with UGIC.

Methods

A Joanna Briggs Institute systematic review was conducted. Searches were performed in four databases (MEDLINE, PsycINFO, Embase, CINAHL) from database inception to February 2021. Included studies explored experiences of informal caregivers of individuals diagnosed with primary cancer of the oesophagus, stomach, pancreas, bile duct, gallbladder, or liver. Studies were independently screened for eligibility and included studies were appraised for quality by two reviewers. Data were extracted and synthesised using meta-aggregation.

Results

19 papers were included in this review, and 328 findings were extracted. These were aggregated into 16 categories across three findings: (1) UGIC caregiver burden; UGIC caregivers undertake extensive responsibilities, especially around patient diet as digestion is severely impacted by UGICs. (2) Mediators of caregiver burden; The nature of UGICs, characterised by disruptive life changes for caregivers, was identified as a mediator for caregiver burden. (3) Consequences of caregiver burden: UGIC caregivers’ experiences were shaped by unmet needs, a lack of information and a general decline in social interaction.

Conclusions

The findings of this review suggest the need for a cultural shift within health services. Caregiving for UGIC patients is suggested to adversely affect caregivers’ quality of life, similarly to other cancer caregiving populations and therefore they should be better incorporated as co-clients in care-planning and execution by including them in discussions about the patient’s diagnosis, treatment options, and potential side effects.
The clinical impacts of lung microbiome in bronchiectasis with fixed airflow obstruction: a prospective cohort study
Authors: Chen Yen-Fu , Hou Hsin-Han , Chien Ning , Lu Kai-Zen , Lin Chieh-Hua , Liao Yu-Chieh , Lor Kuo-Lung , Chien Jung-Yien , Chen Chung-Ming , Chen Chung-Yu , Cheng Shih-Lung , Wang Hao-Chien , Hsueh Po-Ren , Yu Chong-Jen
Published: August 2024

Background

Airflow obstruction is a hallmark of disease severity and prognosis in bronchiectasis. The relationship between lung microbiota, airway inflammation, and outcomes in bronchiectasis with fixed airflow obstruction (FAO) remains unclear. This study explores these interactions in bronchiectasis patients, with and without FAO, and compares them to those diagnosed with chronic obstructive pulmonary disease (COPD).

Methods

This prospective observational study in Taiwan enrolled patients with either bronchiectasis or COPD. To analyze the lung microbiome and assess inflammatory markers, bronchoalveolar lavage (BAL) samples were collected for 16S rRNA gene sequencing. The study cohort comprised 181 patients: 86 with COPD, 46 with bronchiectasis, and 49 with bronchiectasis and FAO, as confirmed by spirometry.

Results

Patients with bronchiectasis, with or without FAO, had similar microbiome profiles characterized by reduced alpha diversity and a predominance of Proteobacteria, distinctly different from COPD patients who exhibited more Firmicutes, greater diversity, and more commensal taxa. Furthermore, compared to COPD and bronchiectasis without FAO, bronchiectasis with FAO showed more severe disease and a higher risk of exacerbations. A significant correlation was found between the presence of Pseudomonas aeruginosa and increased airway neutrophilic inflammation such as Interleukin [IL]-1β, IL-8, and tumor necrosis factor-alpha [TNF]-α, as well as with higher bronchiectasis severity, which might contribute to an increased risk of exacerbations. Moreover, in bronchiectasis patients with FAO, the ROSE (Radiology, Obstruction, Symptoms, and Exposure) criteria were employed to classify individuals as either ROSE (+) or ROSE (−), based on smoking history. This classification highlighted differences in clinical features, inflammatory profiles, and slight microbiome variations between ROSE (−) and ROSE (+) patients, suggesting diverse endotypes within the bronchiectasis with FAO group.

Conclusion

Bronchiectasis patients with FAO may exhibit two distinct endotypes, as defined by ROSE criteria, characterized by greater disease severity and a lung microbiome more similar to bronchiectasis without FAO than to COPD. The significant correlation between Pseudomonas aeruginosa colonization and increased airway neutrophilic inflammation, as well as disease severity, underscores the clinical relevance of microbial patterns. This finding reinforces the potential role of these patterns in the progression and exacerbations of bronchiectasis with FAO.