bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Emotional Coworker Support on Work Engagement Among Pediatric Health Care Providers: The Mediator Role of Emotional Regulation
Authors: Dal Santo Letizia , Michaux Robin , Pohl Sabine
Published: November 2024

Background:

Previous findings demonstrated that healthcare workers with a high level of social support are likely to engage in their work. Healthcare workers are not only engaged in the physical problems of their patients but also in their emotional difficulties. Pediatric professionals must express and regulate their own emotions during their interactions with young patients and their families.

Purpose:

The purpose of this study was to explore the impact of coworkers’ emotional support on healthcare workers’ work engagement in pediatric healthcare settings and the emotional regulation mechanisms by which emotional coworker support leads to work engagement.

Method:

A cross-sectional study was distributed in a Belgian pediatric hospital between October 2021 and December 2021. The sample consisted of 274 healthcare workers who were in direct contact with patients. Participants completed a questionnaire consisting of measures of coworker emotional support, work engagement, emotional suppression, and cognitive reevaluation.

Results:

Emotional suppression partially mediated the effects of perceived emotional coworker support on work engagement. Coworkers’ emotional support fosters work engagement by reducing the negative effects of emotional suppression. Moreover, cognitive evaluation was positively associated with work engagement.

Conclusions:

These results provide insight into the influence of perceived emotional coworkers, emotional suppression, and cognitive reevaluation on work engagement.
Carbon dots nanoparticles derived from showy Asian grapes (Medinilla speciosa) for free radical scavenger
Authors: Aji Mahardika Prasetya , Octaviani Angela Christa , Umar Syafril Rahmat , Arrosyid Moh Harun , Maulina Dianica , Masturi Masturi  , Yulianti Ian , Marwoto Putut , Priyanto Aan , Nuryadin Bebeh Wahid
Published: November 2024

Carbon dot nanoparticles (CNPs) were synthesized from the peels of showy Asian grapes (Medinilla speciosa) using microwave irradiation for free radical scavenging. The optimal emission and absorption intensities were achieved with a 50-min irradiation duration, at wavelengths of 430 nm and 267 nm, respectively. XRD analysis revealed characteristic peaks at angles of 26.37° and 29.63°. FTIR analysis indicated that antioxidant potential is attributed to hydroxyl and carboxyl groups on the CNPs’ surface. TEM images showed diameters ranging from 2 nm to 8 nm. The CNPs exhibited 73.82% antioxidant activity at 5 mg/mL, with an IC50 value of 6.89 ppm, indicating strong antioxidant activity. Additionally, the CNPs demonstrated good storage stability, suggesting potential applications in food supplements and biomedical materials.
A Proposal for a Best-evidence Model of Care and Program Logic for Supported Accommodation for People Released From Prison
Authors: Gibbs Daisy , Shakeshaft Anthony , Walker Shelley , Larney Sarah , Farnbach Sara
Published: November 2024

This paper describes the development of a proposed best-evidence model of care (MoC) and program logic (PL) for supported accommodation (SA) for people released from prison. Evidence from a systematic review, interviews with clients of SA, and consultation with service providers were synthesized to develop a draft MoC that was embedded into a PL. The MoC and PL were refined in a workshop with researchers and SA providers. The MoC comprised five best-evidence core components to be standardized across any SA, operationalized by flexible activities that need to be determined by services to suit their circumstances. The PL comprised client needs that the program targets, a rationale for why core components would be effective and appropriate process and outcome measures. The development and uptake of a best-evidence MoC and clearly defined PL will help engender a larger and more rigorous SA evidence-base, and improve outcomes for people released from prison.
Opportunities for Implementation of Disaster Risk Management Strategies among Public Housing Authorities
Authors: Khan Amber S. , Aurand Andrew , Hamideh Sara , Vickery Jamie , Walter Rebecca J. , Errett Nicole A.
Published: November 2024

Renters living in subsidized housing managed by Public Housing Authorities (PHAs) are vulnerable to disasters. This study aims to describe barriers, facilitators, and opportunities for the implementation of disaster risk management (DRM) strategies at PHAs. Fifteen semi-structured key informant (KI) interviews with federal and state housing officials, PHA leaders, and housing non-profit staff were conducted and thematically analyzed. Interviewees mentioned financial and administrative hindrances, lack of policy, and lack of disaster training among PHA staff as notable barriers to engaging in DRM. Past disaster experience, interagency partnerships, and designated DRM roles at PHAs were introduced as facilitators for implementing DRM strategies.
The Resilience of Retail Stores amid COVID-19
Authors: Fang Li
Published: November 2024

This paper examines the resilience of retail stores—whether they maintain their store visits—during COVID-19 across jurisdictions with different socioeconomic characteristics. Using cell phone locational data, I adopted an event study design to compare visits to retail stores across counties with different mitigation policies and socioeconomic characteristics. I found a significant decline in-store visits by 16 percent after three rounds of community mitigation strategies, which shows a lack of resilience. Meanwhile, the distribution of resilience was unequal across jurisdictions with different socioeconomic profiles. Policy recommendations are made to support retail businesses and promote inclusive development.
Pulse Wave Doppler Ultrasound in Unmasking of Venous Obstructions Highlighting Diagnostic Utility and Clinical Implications
Authors: Usman Shaheryar , Cheema Muhammad , Mustafa Saleem , Khan Muhammad Jahanzaib , Kulkarni Siddhant , D’Angelo Katelyn , Felicio Anthony , Iftikhar Asma
Published: November 2024

Venous obstructions and thrombosis can present diagnostic challenges due to their varied presentations and potential for significant complications if untreated. Pulse wave doppler ultrasound via identification of damping or loss of cardiac pulsatility and/ or respiratory phasicity of venous waveforms serves as a practical, noninvasive, fast, and efficient diagnostic tool for identifying venous obstructions in the presence of compressible veins beyond the point of evaluation.

We present two cases demonstrating the effectiveness of pulse wave doppler ultrasound in identifying significant and life-threatening venous obstructions. The first case involves a 68-year-old male with an incidental finding of a compressible left subclavian vein showing a monophasic waveform. Further investigation revealed significant compression of the left brachiocephalic vein by an aortic arch aneurysm. The second case describes a 65-year-old male with a compressible right femoral vein but a monophasic waveform, leading to the discovery of extensive thrombosis from the iliac veins to the inferior vena cava. This series proposes to always assess cardiac pulsatility and respiratory phasicity during doppler ultrasound procedure such as thyroid ultrasounds, deep vein thrombosis (DVT) evaluations, and pre-central vein catheterizations for identifying any venous obstructions, whether they are intrinsic or extrinsic, and for reducing the risk of thromboembolic complications.
Double the Tasks, Double the Control: An Analysis of Workers’ Practices to Increase Visibility in Cleaning, Care, and Accommodation Platforms in Spain
Authors: Piña Martina , Establés María-José , Guerrero-Pico Mar
Published: November 2024

A vast amount of literature on social media has researched how content creators develop practices to present themselves and play the ‘visibility game’ (Cotter, 2019). Similarly, platformization of work has led to algorithmic control through the logic of ratings and visibility. This article studies how platforms shape the practices of workers who carry out services in domestic spaces. We conducted a qualitative content analysis of 36 profiles in cleaning, care, and accommodation platforms in Spain complemented by 10 in-depth interviews with workers. Similarly to what has been found for social media, we observed how workers manage their profiles following a presentation logic, including disclosing personal information and knowledge, achieving desired results in terms of metrics, and interpreting and surpassing the clients’ expectations. Thus, the work process is geared toward satisfying clients and platforms to access working opportunities, resulting in double the work and showing how visibility permeates and shapes a variety of sectors.
Professionalization from above in domestic work: Accessing work on marketplace platforms
Authors: Ettarfi Khaoula
Published: November 2024

Domestic work has always been a quintessential example of invisible labour. In this article, I explore how workers build individual visibility on marketplace platforms. Drawing on semi-structured interviews with workers who use different marketplace platforms in Geneva and surrounding areas to find domestic work, I show how visibility on marketplace platforms requires invisible work and a different set of skills, competencies, codes of conduct and client management. I argue that visibility on marketplace platforms can be interpreted as a form of professionalization from above. On one hand, visibility becomes a barrier to entry in finding work. The different requirements for building visibility lead to an institutionalization of standardized skills and practices necessary to access work on the platform. On the other hand, marketplace platforms ignore the formality of the employment relationship and decent wages, which are externalized and managed between workers and the platform clients.
Effects of nanodiamonds on the mechanical properties, acoustic properties, vibration damping, and flame retardancy of ramie-fiber epoxy composite panels used for indoor applications
Authors: Kanniyappan Sudhakar , Selvaraj Senthil Kumaran
Published: November 2024

This research aims to systematically analyze the impact of nanodiamonds (NDs) in ramie fiber-reinforced epoxy resin acoustic panels used for indoor applications. The panels (four variants) are fabricated using six layers of ramie fiber with various weight percentages of NDs (0.0, 0.2, 0.4, and 0.6) in epoxy resin by the vacuum resin infusion process (VRIP). Mechanical characterization (tensile and flexural strength) was carried out using Instron 8801 universal testing machine. The impedance tube-based sound absorption coefficient (SAC) test was performed at low frequency and higher frequency, respectively. The void content in the panel is evaluated using a micro-x-ray computed tomography (CT) scanner. The dispersion of nanoparticles is studied using scanning electron microscopy (SEM) images. The vertical flame-retardant test and the horizontal flame-retardant test were conducted according to the UL-94 standard. The 0.4 wt.% NDs sample showed good tensile strength (59.178 MPa) and flexural strength (69.134 MPa) compared with other panels. The panels showed differences in SAC values for different weight percentages of NDs, both at lower and higher frequencies. The 0.6 wt.% NDs sample attained the maximum SAC of 0.906 at 6000 Hz in the high-frequency and 0.34 at 1112 Hz in the low-frequency. The SEM reveals an even distribution of NDs in both the 0.2 and 0.4 wt.% NDs panels, while agglomerates form in the 0.6 wt.% panels. The CT scan result shows void content both internally and externally in the panels. There are no voids in the panels where NDs are uniformly distributed. The synergistic effect of NDs in epoxy resin forms a char over the burnt surfaces of samples, enhancing the flame-retardant properties of the panels. According to this study, adding NDs to ramie fiber epoxy composites has improved the panels’ necessary qualities, making them suitable for use as indoor acoustic conditioning materials.
Formulation in Palliative Care: Elevating Our Potential for Therapeutic Communication
Authors: Chammas Danielle , Moment Amanda , Rosenberg Leah , Shalev Daniel , Brenner Keri O.
Published: November 2024

A fundamental principle of clinical reasoning is that assessment precedes plan; clinicians are taught to base interventions on the presumed etiology of a presentation. A notable exception is in the domain of communication education, where training is focused heavily on tools and interventions, with minimal focus on the assessment that informs which tools or strategies to select with a given patient. The concept of formulation (foundational in psychotherapy education) provides a framework with which to address this gap, enhancing a clinician’s ability to be more therapeutically effective with the communication tools at their disposal. Our formulation serves as the compass that guides our decisions around communication, allowing us to conceptualize communication as a therapeutic intervention and align our approach to communication with the broader philosophy of clinical reasoning. This manuscript explores the concept of formulation, the direct relevance and applicability to palliative care, sample cases to underscore the impact of this framework, and high-yield tips for use of formulation in general palliative care practice. Palliative care clinicians and IDTs can readily apply formulation in synergy with the communication tools they already possess, elevating their ability to address patients’ psychological needs.
Recalcitrant Torticollis: A Formidable Treatment Challenge
Authors: Daly Gwendolyn E. , Otto Madeline , Alturky Sara , Balumuka Darius , Isbester Kelsey , Stefanik Fiona , Sjostrand Gregory , Howell Lori K. , Wolfswinkel Erik M.
Published: November 2024

Introduction

There are few evidence-based practice guidelines for recalcitrant torticollis (RT), defined as torticollis that persists past 1 year of age despite conservative therapy. Available evidence recommends a combination of physical therapy (PT), occupational therapy (OT), botulinum toxin injection (BTI), and in the most severe cases, surgical release.

Methods

This is a single-center, retrospective study conducted with Institutional Review Board approval. Inclusion criteria were diagnosis of congenital muscular torticollis before 1 year old and persistence of symptoms past 1 year despite conservative treatment between January 1, 2005, and January 30, 2023. Patients with incomplete data, acquired torticollis, confounding diagnoses, or who did not receive a diagnosis or conservative therapy before 1 year of age were excluded.

Results

Seventy-seven patients met the inclusion criteria. The average age at diagnosis was 4.5 ± 2.5 months. Initial treatment consisted of PT for 61 patients (79.2%), stretching exercises for 11 patients (14.3%), and OT for 4 patients (5.2%). Regardless of timing, 74 patients in total (96.1%) received PT for an average of 13.3 ± 8.6 months. Conservative treatment modalities led to the resolution of symptoms for 40 patients (51.2%) and improvement of symptoms for 35 patients (45.5%). Two patients received at least 1 BTI which led to further improvement of symptoms. One patient underwent operative intervention which consisted of sternocleidomastoid release.

Conclusions

RT is a challenging clinical entity that requires diligent multidisciplinary care. Patients who present and begin conservative therapy before 1 year of age are likely to have improvement or resolution of symptoms without more advanced therapies.
Malignant Esophageal Glomus Tumor With CARMN::NOTCH2 Fusion: An Additional Tumor Underscoring the Frequent Tendency of Esophageal Glomus Tumors for Aggressive Behavior
Authors: Pancsa Tamás , Martínek Petr , Michal Michael
Published: November 2024

Malignant glomus tumors are rare tumors of pericytic origin with a propensity to develop in the upper gastrointestinal tract. Hereby we demonstrate a tumor of a 20-year-old man, who presented with dysphagia and an exophytic esophageal mass. Histologic examination of the resected mass revealed a multinodular tumor in the esophageal wall composed of epithelioid cells showing nesting and monomorphic atypia, staghorn vessels and scanty stroma. Immunohistochemically, the neoplastic cells were positive for SMA, and H-caldesmon, while desmin was negative. Collagen IV and laminin decorated a dense intercellular basal membrane meshwork. RNA-sequencing using TruSight RNA Pan-Cancer Panel revealed a CARMN::NOTCH2 fusion, that is a recurrent, frequently described and so far specific genetic alteration in glomus tumors. In spite of the adjuvant chemotherapy regimens, the patient died of disseminated metastatic disease 2 years after the diagnosis. Our patient presentation and the previous reports in the literature highlight the frequently aggressive behavior of glomus tumors arising in the esophagus.
Convergent Validity of Experimental Cognitive Tests in a Large Community Sample
Authors: Dean Andy C. , Pochon Jean-Baptiste , Bilder Robert M. , Sabb Fred W. , Congdon Eliza , Ghahremani Dara , Karlsgodt Katherine H. , van Erp Theo G. M. , Schwarzlose Rebecca F. , Cannon Tyrone D. , Freimer Nelson B. , London Edythe D.
Published: November 2024

Experimental cognitive tests are designed to measure particular cognitive domains, although evidence supporting test validity is often limited. The Consortium for Neuropsychiatric Phenomics test battery administered 23 experimental and traditional neuropsychological tests to a large sample of community volunteers ( n = 1,059) and patients with psychiatric diagnoses ( n = 137), providing a unique opportunity to examine convergent validity with factor analysis. Traditional tests included subtests from the Wechsler and Delis–Kaplan batteries, while experimental tests included the Attention Networks Test, Balloon Analogue Risk Task, Delay Discounting Task, Remember–Know, Reversal Learning Task, Scene Recognition, Spatial and Verbal Capacity and Manipulation Tasks, Stop-Signal Task, and Task Switching. Several experimental cognitive measures were insufficiently related to other tests and were excluded from factor analyses. In the remaining 18 tests, exploratory factor analysis and subsequent multigroup confirmatory factor analysis supported a three-factor structure broadly corresponding to domains of verbal/working memory, inhibitory control, and memory. In sum, several experimental measures of inhibitory control had weak relationships with all other tests, while the convergent validity of most tests of working memory and memory was supported.
Plate and beam moment-field formulation
Authors: Wolfgram Zachary , Ostoja-Starzewski Martin
Published: November 2024

Governing equations of the linear elastic Euler–Bernoulli beam and pure bending Kirchhoff–Love plate are developed in a pure stress form with the evolution of the bending moments fields. In the case of elastodynamics, the governing equations are used to find mode restrictions of vibration within both structures. These vibration restrictions are then compared with the solutions found through the displacement formulation finding both forms to give the same solution under the same boundary conditions. The waves are assumed to be harmonic with only spatial contributions being examined, validating the stress approach. More advanced cases involving anisotropic and non-classical boundary conditions are also explored to demonstrate further implications of following the stress evolution. Elastostatic plates are examined under the compatibility conditions to be met for moment fields to possess uniqueness and to show the CLM (Cherkaev–Lurie–Milton) invariance of the inhomogeneous plane-stress problem.
Enhanced Prenatal and Postnatal Development Study in Marmoset Monkeys Following Administration of Felzartamab
Authors: Mangelberger-Eberl Doris , Cosenza Mary Ellen , Härtle Stefan , Luetjens C. Marc , Welsh Brian T. , Steidl Stefan , Flesher Donna L. , Chinn Leslie W.
Published: November 2024

Felzartamab is a recombinant fully human immunoglobulin G1 anti-CD38 monoclonal antibody under clinical investigation for immune-mediated diseases. In support of felzartamab clinical development, toxicology studies were conducted in marmoset monkeys, which was the most relevant species based on CD38 binding affinity, pharmacologic activity, and target expression. The felzartamab toxicology program included an enhanced prenatal and postnatal development (ePPND) study to identify potential reproductive and postnatal development risks. In this ePPND study, pregnant marmoset monkeys were randomized to receive vehicle (0 mg/kg) or felzartamab at two dose levels (15 mg/kg and 75 mg/kg) twice per week until parturition, and maternal animals and infants were evaluated for 6 months thereafter. Felzartamab exposure was confirmed in maternal animals and infants in both dosing groups. Overall, felzartamab was well tolerated by pregnant animals at the evaluated doses, with no effect on body weight or body weight gain during pregnancy. No felzartamab-related effects on pregnancy loss or stillbirth rate were observed, and litter counts and numbers of liveborn infants were similar between the vehicle and felzartamab groups. Among infants, there were no felzartamab-related malformations or variations in external anatomy or skeletal morphology and no felzartamab-related observations in histopathology, hematologic and immune cell development, or humoral immune response to vaccination. In conclusion, among pregnant marmoset monkeys dosed with felzartamab, the lack of reproductive toxicity and felzartamab-related effects on offspring supports the clinical evaluation of felzartamab in women of childbearing potential and further demonstrates the suitability of the marmoset monkey for ePPND studies.
Computer-Aided Discovery of Abrus precatorius Compounds With Anti-Schistosomal Potential
Authors: Shoko Ryman , Mazadza Allen
Published: November 2024

Schistosomiasis, which causes over 200 000 deaths annually, has since the 1970s been controlled by praziquintel. The reliance on a single drug to combat schistosomiasis, and reports of laboratory resistance to the drug, has created an urgent need in the scientific community to develop new chemotherapies to complement or supplement praziquantel. Medicinal plants are a potential reservoir of compounds with schistosomicidal activity. In the current study, we carried out computer-aided screening of Abrus precatorius compounds to discover compounds with potential to inhibit Schistosoma mansoni purine nucleoside phosphorylase ( SmPNP). Thus, 99 compounds retrieved from Lotus Natural Compounds Database were docked into the active site of SmPNP. The top-ranked compounds were subjected to Lipinski’s druglikeness and toxicity risk predictions. Three lead compounds, abrusogenin, cirsimaritin and hispidulin, were identified as having high binding affinities, favourable interactions with SmPNP active site residues and good toxicity risk prediction results. Molecular dynamics (MD) simulations were used to assess the stability of the interactions of these lead compounds with SmPNP. Collectively, analyses of the MD trajectories confirms that the lead compounds bound and interacted stably with active site residues of SmPNP. We conclude that abrusogenin, cirsimaritin and hispidulin could serve as hit compounds for the development of new antischistosomal drugs, based on plant-derived natural products. However, experimental studies are required to further evaluate the potentials of these compounds as possible therapeutics against schistosomiasis.
Assessing the impact of telemedicine interventions on systolic and diastolic blood pressure reduction: A systematic review and meta-analysis
Authors: Moulaei Khadijeh , Parhizkar Roudsari Peyvand , Shahrokhi Sardoo Adel , Hosseini Mobina , Anabestani Mehrdad , Moulaei Reza , Sabet Babak , Afrash Mohammad Reza
Published: November 2024

Background

Hypertension, characterized by high blood pressure, poses a significant risk for cardiovascular diseases, stroke, and heart attack. Managing it is particularly challenging in areas with limited healthcare access and for patients who cannot attend regular in-person visits. Telemedicine interventions offer a promising solution by improving patient adherence and facilitating timely treatment adjustments. This study aims to systematically evaluate the impact of these telemedicine interventions on reducing systolic and diastolic blood pressure.

Methods

A comprehensive search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. Two independent reviewers screened and selected eligible articles, extracting key data using a standardized form. The quality of the included studies was assessed with the Mixed Methods Appraisal Tool (MMAT). A random effects model was used to combine the results, with treatment effects measured using standardized mean differences (Hedges's g). Consistency of findings was evaluated through statistical tests, including the Q test and I² statistic, to assess heterogeneity. Data analysis was conducted using Stata statistical software version 17.0.

Results

Of the 2700 articles retrieved, 35 studies were selected for inclusion in the analysis. Using a random-effects model, the overall effect size was Hedges's g = −0.22 (95% CI: −0.30 to −0.15; p-value < 0.001), indicating a small but meaningful reduction in blood pressure (systolic and diastolic). Telemedicine interventions had a greater impact on systolic blood pressure (Hedges's g = −0.27, 95% CI: −0.39 to −0.15; p-value < 0.001) compared to diastolic blood pressure (Hedges's g = −0.17, 95% CI: −0.26 to −0.07; p-value < 0.001), though both reductions were clinically relevant.

Conclusion

This study demonstrates that telemedicine interventions significantly reduce both systolic and diastolic blood pressure, with a more pronounced effect on systolic pressure. The overall effect size indicates a small but meaningful improvement in hypertension management. These findings highlight the potential of telemedicine as an effective strategy for enhancing patient outcomes in hypertension care.
Lack of diversity in patients undergoing carotid artery stenting: Implications for the Distressed Community Index
Authors: Pajarillo Carmen , Romain Gaëlle , Cleman Jacob , Scierka Lindsey , Grubman Scott , Schenck Christopher , Kluger Jonathan , Smolderen Kim G , Mena-Hurtado Carlos
Published: November 2024

Introduction:

As the role of social determinants in carotid artery stenting (CAS) outcomes remains unclear, we investigated the association between the Distressed Community Index (DCI) (zip-code based) and post-CAS mortality/stroke outcomes.

Methods:

We analyzed patients undergoing CAS from 2015 to 2019 using the Medicare claims-linked Vascular Quality Initiative database. Patients were grouped based on high (DCI ⩾ 60) and low (DCI < 60) community distress. We analyzed 36-month mortality using Kaplan–Meier survival curves and hierarchical Cox regression, and 36-month stroke using cumulative incidence function curves and Fine–Gray models.

Results:

The final cohort included 8717 patients (3032 DCI ⩾ 60), with a mean DCI score of 46.2 (± 28.5) and mean age of 74.7 (± 7.8) years. Most participants were men (64.3%), White (92.7%), and non-Hispanic/Latino (97.7%). There was no significant difference in the 36-month mortality incidence between high and low community distress groups (25.6% vs 23.5%, p = 0.22), and no significant association between high community distress and mortality (unadjusted HR: 1.04; 95% CI 0.90–1.21; adjusted HR: 1.02; 95% CI 0.89–1.17). The high community distress group experienced an elevated 36-month stroke incidence (26.8% vs 22.4%, p = 0.048), but no significant association with stroke was observed (unadjusted sub-HR: 1.12; 95% CI 1.00–1.24; adjusted sub-HR: 1.03; 95% CI 0.92–1.16).

Conclusion:

Our cohort showed underrepresentation in terms of sex, race, and ethnicity, with a skewed DCI distribution towards lower community distress. Contrary to what we know about community distress, no independent association between higher community distress and post-CAS stroke/mortality risk was found. Future work must examine whether accessibility barriers and selective CAS allocation explain our results.
Navigating institutional ethics processes: Insights from higher degree by research students and supervisors doing research in fragile contexts
Authors: Baker Sally , Burke Rachel , Cabiles Bonita , Fox Alison , Molla Tebeje
Published: November 2024

Although gaining ethical approval is a conventional and established requirement for academic scholarship, institutional approaches remain subject to sustained critique. While not questioning the legitimacy of institutional ethical procedures, the dominance of legal frameworks and a focus on entry to ‘the field’ is inflexible and irresponsive to ethical complexities in practice. This is particularly evident in situations where participants experience ongoing trauma, marginalisation, and social and political precarity, or settings that we refer to in this paper as ‘ fragile contexts’. Responding to such ethical dilemmas, this article draws on Guillemin and Gillam’s (2004) notions of ‘ ethics-in-practice’ and ‘ethically important moments’ to examine how doctoral candidates and their supervisors navigate the compliance requirements of institutional ethics vis-à-vis the requirements of ethics-in-practice. Our findings foreground the need to attend to the linguistic and discursive challenges associated with research in fragile contexts, the temporalities of vulnerability, the management of community expectations, and a humbling of researchers and their institutional research ethics committees to avoid compounding injustices and power imbalances.
Hereditary haemochromatosis: A review
Authors: Singh Prabhsimran , Millson Charles , Driver Robert
Published: November 2024

Hereditary haemochromatosis (HH) is the commonest genetic condition among populations of Northern European ancestry. Mutations to the HFE gene leads to uninhibited intestinal iron absorption followed by excess iron deposition in various organs such as the liver, pituitary gland, pancreas and heart. Due to variable biochemical and clinical penetrance, not all individuals with C282Y homozygosity will develop HH. Early diagnosis is crucial to prevent morbidity and mortality but is challenging with most patients not exhibiting any symptoms. Patients with HH should undergo clinical assessment to evaluate their symptoms, presence of organ damage and hepatic fibrosis using transient elastography. Patients who are negative for the HFE mutations but have significant liver iron loading seen on magnetic resonance imaging should be reviewed by a specialist and considered for genetic tests looking for the rarer non- HFE mutations. HH patients are predominantly treated with venesection which can improve symptoms, hepatic fibrosis and mortality.
Endovascular Repair of Primary Aortocaval Fistula at the Caval Confluence in a Ruptured Abdominal Aortic Aneurysm
Authors: Williams Zachary E. , Choudhry Asad , Rahman Naveed A. , Chihade Deena B. , Surowiec Scott M.
Published: November 2024

Background: Primary aortocaval fistulas (ACF) are a rare complication of abdominal aortic aneurysm (AAA), for which treatment options encompass both endovascular and open surgical intervention. Purpose: To report a rare presentation of primary aortocaval fistula. Research Design: Case Report. Study Sample: Single Patient Case. Data Collection and/or Analysis: Single case report. Results: We present a 54-year-old male with a ruptured AAA and associated ACF uniquely located near the caval confluence which was managed through primary endovascular exclusion. Notably, we report significant migration of our graft upon deployment, due to high flow through the ACF. Following a literature review on ACFs, we remark on the anatomic challenges regarding management of an ACF. Conclusions: Awareness of the clinical signs and symptoms remains imperative in proper ACF management given its high mortality.
A growth posture identification method of immature peaches in natural environments
Authors: Lv Jidong , Niu Liangliang , Han Ying , Sun Xiaoqin , Wang Lingyun , Rong Hailong , Zou Ling
Published: November 2024

The precise bagging of immature peaches by the fruit bagging robot requires the identification of the target young fruits as well as the acquisition of their growth angles. The network models employed in single detection algorithms exhibit complexity and pose challenges for deployment on mobile terminals as they heavily rely on the availability of labeled samples. A semi-supervised learning and lightweight strategy based on YOLOv8n-seg was proposed to identify the growth posture of immature peaches in the work. Firstly, the self-training method and data enhancement in semi-supervised learning were used to generate efficient pseudo-label data. A tremendous labeling workload was solved. Secondly, the YOLOv8n-seg backbone network was replaced with an improved MobileNetv3 structure for better real-time detection on MT to reduce network parameters and calculations. The model was easily deployed with improved detection speed. Meanwhile, the original upsampling module was replaced with the CARAFE module to enhance the recognition capability of global features, which considered the impact of immature peaches on the nearby color background. The CIOU loss function was ultimately substituted with the SIOU loss function to further optimize the boundary frame loss and target detection accuracy. The enhanced model could predict the coordinate information of immature peaches and calculate growth angles. The experimental results show that the improved peach seedling growth posture network model has a weight size of only 23.1% of the original model. Additionally, the algorithm achieved a remarkable rate of 87.8% in identifying young peach fruits, with an average error of ±3.3° in estimating the growth angle. It took an average of 31 ms to detect a 3024 × 4032 pixels image in the edge computing device JETSON AGX ORIN CLB development kits. The method could rapidly identify immature peaches and estimate the growth angle, which ensured accurate bagging.
Anti-hypertensives associated with survival in cancer patients receiving immunotherapy: new evidence from a real-world cohort study and meta-analysis
Authors: Ma Ping , Zhang Zhihuan , Qian Mengying , Jiang Hao , Zhao Yu , Shan Qing , Liu Xia , Yao Tianming , Guo Jinmin
Published: November 2024

Background:

The efficacy of immune checkpoint inhibitors (ICIs) in cancer patients taking anti-hypertensive drugs is still not well established.

Objective:

To elucidate the effect of anti-hypertensive drugs on the clinical outcome of cancer patients receiving immunotherapy.

Design:

A retrospective cohort study and meta-analysis.

Method:

We conducted a real-world retrospective study of cancer patients treated with immunotherapy at two tertiary centers between January 2019 and June 2023, with primary outcomes being overall survival (OS) and progression-free survival (PFS). In addition, we performed a meta-analysis to synthesize currently relevant clinical studies.

Results:

A retrospective clinical study of 336 patients from 2 centers suggested that the use of anti-hypertensive drugs was related to a preferable OS (hazard ratio (HR) = 0.55, 95% confidence interval (CI): 0.33–0.90) compared to non-users. For PFS, no significant correlation was detected (HR = 0.71, 95% CI: 0.49–1.03). Further analysis revealed that renin–angiotensin system inhibitor (RASi) and calcium channel blocker (CCB) have a synergistic effect with ICIs. In addition, subgroup analysis found that the benefits of RASi or CCB in combination with ICIs are greater in women or patients ⩾65 years of age. There was better disease control in lung cancer patients using RASi, and a significantly longer OS was observed in patients with gastrointestinal tumors taking CCB. Meta-analysis suggested that anti-hypertensive drugs were associated with improved OS, but only the combination of RASi and immunotherapy showed a synergistic effect. No significant correlation with OS was found for other anti-hypertensive drugs, and there was no overall positive effect on PFS.

Conclusion:

Our study found that use of anti-hypertensive drugs, particularly RASi or CCB, was associated with improved OS in patients undergoing immunotherapy. The synergistic effects of RASi or CCB with ICIs were more pronounced in females or elderly. RASi or CCB exhibited different benefits in various types of tumors. These findings provide valuable insights for treating cancer patients with hypertension.
Sex Estimation Using Heel–Ball Index: A Metric-Based Comparative Study on Foot and Footprint Dimensions
Authors: Shetty Suraj S. , Ananthan M. A. S. , Shetty Varsha A. , Tom Nevin , Verma Aashi , Shetty Mahabalesh , Rani Smitha
Published: November 2024

Background: Sexual dimorphism plays a vital role in individual identification, and body dimensions can contribute to establishing a biological profile for identification purposes. Aims and Objectives: To determine the reliability of the Heel–Ball Index (HBI) in estimating sex from foot dimensions and footprint dimensions and also to investigate the potential of dimensions and indices, using a standardized value, in estimating sex, from foot dimensions and footprint dimensions. Materials and Methods: In this study, a group of 112 young Indian adults aged 18 to 22, consisting of 56 males and 56 females, was examined. The foot breadth at ball (BBAL) and foot breadth at heel (BHEL) of both feet were measured using sliding digital calipers from foot and footprint dimensions. Results: Significant sexual dimorphism was observed in BBAL, BHEL, and HBI (HBI = BHEL/BBAL × 100) measurements in both feet of both sexes. Conclusion: HBI yielded better accuracy for foot dimensions than footprint dimensions. It was also found that utilizing absolute foot dimensions (BBAL and BHEL) yielded more accurate results in estimating sex compared to the HBI, which is calculated as a ratio of absolute measurements.
To live or to stay alive? A thematic and sentiment analysis of public posts on social media during the 2022 Shanghai COVID-19 outbreak
Authors: Chen Lixiong , Xu Nairui
Published: November 2024

Objective

The use of social media during the COVID-19 pandemic has been researched extensively since the outbreak. Sina Weibo, as one of most commonly used social media platforms in China, played an important role in public expression for the duration of COVID-19. We investigated the themes that emerged from the posts and examined the sentiments associated with each theme.

Methods

For this study, we collected 72,084 Weibo posts related to the 2022 Shanghai public health event to present a thematic and sentiment analysis of posts by the public.

Results

The findings showed that the public was more inclined to express concerns about the impact of the outbreak and of outbreak containment measures on their personal lives on social media and exhibited negative attitudes and opinions rather than discussing the impact of COVID-19 on human life and health, suggesting that the impact of the outbreak on people's daily lives was greater than was the impact on their livelihoods and health risks.

Conclusions

This research highlights the importance of understanding the role of social media in times of crisis and the potential insights that can be gained from analyzing online public discourse. Our empirical findings provide insights for future public health communication strategies and crisis management plans in China in the information age.
Effect of a Low Salt Diet on the Progression of Chronic Kidney Disease: A Prospective, Open-Label, Randomized Controlled Trial
Authors: Trakarnvanich Thananda , Chailimpamontree Worawon , Kantachuvesiri Surasak , Anutrakulchai Sirirat , Manomaipiboon Basmon , Ngamvitchukorn Tanun , Suraamornkul Swangjit , Trakarnvanich Thanphisit , Kurathong Sathit
Published: November 2024

Introduction:

A causal relationship exists between salt intake and hypertension, stroke, and kidney disease. However, whether or not reduced salt intake slows progression of renal diseases has been intensely debated.

Methods:

In this prospective, open-label, randomized controlled trial, we examined the impact of a low salt diet on renal function, blood pressure, and other metabolic parameters. Herein, 194 patients with chronic kidney disease (CKD) stages 1 to 3 were randomized in low salt (intervention) and control groups. The intervention group was provided a low salt diet (1.5 g/day) for 3 months. The control group consumed their usual diet, and daily food intake was recorded in the control group. Renal function tests, 24-h urinary sodium excretion, urinary protein, serum calcium, phosphorus, and electrolyte levels were recorded monthly.

Results:

After 3 months, the mean reduction in estimated glomerular filtration rate was significantly higher in the control group (mean reduction in eGFR, −3.011 mL/min/1.73 m2; 95% confidence interval (CI) = −5.367, −0.656, P = .013). Blood pressure (BP) decreased significantly in both groups; systolic and diastolic BP reduction at 3 months was significantly greater in the intervention group (systolic BP mean reduction −6.57/−4.29 mmHg; 95% CI = −10.24, −2.89) and diastolic BP mean reduction −6.95, −1.64 mmHg) compared with the control group (systolic BP mean reduction −0.58/−2.63 mmHg; 95%, CI = −4.33, 3.17 and diastolic BP mean reduction −5.34, −0.08 mmHg). The mean reduction in 24-h urine sodium excretion was greater in the intervention group, reaching a significant level at month 2 (−14.45 mmol/day; 95% CI = −27.63, −1.22).

Conclusion:

Overall, salt restriction can help slow the progression of renal insufficiency and results in statistically significant and clinically important reductions in BP among patients with CKD.

ClinicalTrials.Gov Identifier:

NCT05716386 on 28/01/2023.
Collaboration in Occupational Health Nursing: A Concept Analysis Review
Authors: Kobayashi Kisaki , Honda Hikaru
Published: November 2024

Objectives:

Establishing collaboration with occupational health staff is essential to support workers and organizations in the field of occupational health. Accordingly, occupational health nurses (OHNs) have recognized the need to collaborate with other professionals, including non-health care professionals. This review aimed to examine the components of collaboration in OHNs.

Methods:

This review was conducted using Walker and Avant’s eight-step analysis method on 267 papers (174 in Japanese and 93 in English) identified through an extensive literature review.

Results:

Key attributes, antecedents, consequences, and empirical referents helped shape an operational definition of the concept of collaboration. Collaboration among OHNs is a process that integrates individuals, organizations, and systems. Further, OHNs are responsible for ensuring that employers and workers collaborate to actively promote and facilitate occupational health activities. In addition, OHNs assess the health status of individuals and organizations to determine whether collaboration is needed through the occupational nursing process. The quality and outcomes of collaboration are influenced by social trends and the health culture of each organization. Through collaboration with various stakeholders, OHNs contribute to making the workplace a better environment, improving labor efficiency, increasing worker productivity, and ensuring health and safety.

Conclusions:

This review provides a comprehensive understanding of collaboration in occupational health nursing. Collaboration among OHNs is notably characterized by its “integration.” OHNs can facilitate collaboration between employers and employees in occupational health activities, potentially benefiting both businesses and health care. The clarification of collaboration in this review has the potential to enhance OHN practices and guide future research.
Predictors of Early Mortality After Traumatic Spinal Cord Injury in South Africa
Authors: Jacob Alina , Wirtz Christian R. , Loibl Markus , Kruger Stefan , Blankson Benjamin H. , Dunn Robert N. , Kruger Nicholas A.
Published: November 2024

Study Design

Retrospective cohort study.

Objectives

To identify predictors for early mortality following traumatic spinal cord injury (TSCI), as recognition of factors associated with early mortality is essential for public resource allocation and optimized acute care.

Methods

Retrospective Analysis of SCI patients admitted to the acute SCI ward from 2003 to 2022 was performed. Days elapsing from the date of injury to date of death established the survival time. Early mortality was defined as survival time ≤ 365 days. Multivariable logistic regression was used in modeling of early death following TSCI with age, gender, neurologic deficit, type of neurologic injury, ventilation status, and count of complications as covariates.

Results

Simple logistic regression indicated a significant association of early mortality with the number of complications ( P < .0001), neurological deficit ( P < .0001), complete neurological injury ( P < .0001), ventilation status ( P < .0001), and age group ( P < .0003). After adjusting for other covariates, complete neurological injury (OR: 1.75, P < .0001), ventilation (OR: 2.80, P < .0001), and Age group (over 60 OR: 17.71, P < .0001) were significantly associated with early mortality. The multivariable model showed a good overall fit (Hosmer-Lemeshow P = .315; AUC 0.85).

Conclusions

Predictors of early mortality after TSCI are high complete spinal cord injury, age, number of complications, and the need for ventilation. Identification of high-risk patients is crucial to rationalize and improve acute care to potentially reduce mortality rates.
Impact of a Unilateral High Tibial Osteotomy With a Large Correction on Functional Lateral Acetabular Coverage of the Hip Joint
Authors: Song Sang Jun , Yoon Kyoung Ho , Lee Seung Jae , Park Cheol Hee
Published: November 2024

Background:

Changes in limb length and coronal pelvic tilt, which occur along with changes in limb alignment, may affect the functional lateral acetabular coverage of the hip joint under weightbearing conditions.

Purpose:

To analyze the functional lateral acetabular coverage after unilateral closed-wedge and open-wedge high tibial osteotomies with a large wedge correction of ≥10 mm.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective analysis was conducted for 107 unilateral closed-wedge high tibial osteotomies (CWHTOs) and 100 unilateral open-wedge high tibial osteotomies (OWHTOs) with a wedge correction of ≥10 mm and without correction loss during a 2-year follow-up. Limb length and coronal pelvic tilt were measured. Functional lateral acetabular coverage was evaluated using the lateral center-edge angle (LCEA), acetabular index, sharp angle, and femoral head extrusion index (FHEI) with reference to the ground horizontal line. Appropriate ranges of the LCEA (22° to 40°), acetabular index (−8° to 14°), sharp angle (34° to 43°), and FHEI (11% to 27%) were investigated.

Results:

Limb length significantly decreased after CWHTO (−7.2 mm) and increased after OWHTO (11.5 mm). The pelvis of the operative limb tilted downward after CWHTO (−1.0°) and upward after OWHTO (2.1°). The mean parameters for functional lateral acetabular coverage significantly changed toward more coverage after CWHTO and less coverage after OWHTO (change in LCEA, acetabular index, sharp angle, and FHEI = 1.2°, −1.1°, −1.0°, and −0.7%, respectively, in CWHTO and −1.3°, 1.8°, 1.6°, and 2.7%, respectively, in OWHTO). When evaluating the appropriateness of each parameter for coverage, cases of conversions from undercoverage to appropriate coverage (1.9% to 4.7%) and appropriate to overcoverage (0.9% to 5.6%) after CWHTO and from overcoverage to appropriate coverage (0% to 8%) and appropriate to undercoverage (2% to 7%) after OWHTO were observed.

Conclusion:

The functional lateral acetabular coverage increased after CWHTO and decreased after OWHTO. Surgeons may want to consider the acetabular coverage of the ipsilateral hip joint when performing a unilateral high tibial osteotomy with a large correction.