bluuebunny/crossref_metadata_2025 huggingface dataset:
Representation and Analysis of Kinship, Based on the Naming Pattern
Authors: Joram Arun , Singh Karam Ratan
Published: August 2024

In this study, we develop a graph-theoretic network model for genealogical data. It is based on the naming system used by the Galo tribe in the Indian state of Arunachal Pradesh. P-graphs are used to visually represent the genealogy. According to the analysis of the network on social network metrics, the genealogical network is a sparsely connected, scale-free network with an average path length of 11.615 and a graph density of 0.002. Only a small portion of its nodes have high centrality values. The network has three communities, twenty authority nodes, two hub nodes, and observed no relinking marriages.
Does Valuing Happiness Lead to Well-Being?
Authors: Huang Kuan-Ju
Published: August 2024

Happiness has become one of the most important life goals worldwide. However, does valuing happiness lead to better well-being? This study investigates the effect of valuing happiness on well-being using a population-based longitudinal survey of Dutch adults ( N = 8,331) from 2019 to 2023. Random-intercept cross-lagged panel models indicated that those who valued happiness generally exhibited higher well-being as manifested by life satisfaction, more positive affect, and less negative affect. However, increases in valuing happiness did not result in changes in life satisfaction 1 year later and had mixed emotional consequences (i.e., increasing both positive and negative affect). Additional analyses using fixed-effects models indicated that valuing happiness had contemporaneous positive effects on well-being. These findings indicate that endorsing happiness goals may have immediate psychological benefits but may not necessarily translate into long-term positive outcomes.
Parent capability: A factorial survey experiment on the duration of parental leave
Authors: Fernández-Cornejo José Andrés , Castellanos-Serrano Cristina , Del Pozo-García Eva , Escot Lorenzo
Published: August 2024

We use Sen’s capability approach to identify factors able to increase the effective freedom of working parents when deciding the length of their parental leave. We conducted a factorial survey experiment (FSE) with a Spanish sample of employees aged between 25 and 45. Respondents were asked to imagine that they were first-time parents and several descriptions of hypothetical situations or vignettes (where aspects of the leave system, workplace and family environment were randomly varied) were presented to them. Our goal was to identify the causal effect of a number of dimensions on their hypothetical decisions about the total number of weeks they would be on parental leave. A longer statutory duration and a higher replacement rate (of the paid part of the leave), having job security, and a workplace with friendly practices and cultures, were found to have a significant positive impact on the duration of parental leave.
Narrow-band and broadband vibration control of double-layer vibration isolation system based on a Youla parameterized adaptive controller
Authors: Pu Huayan , Li Zhentan , Zhu Jiahao , Zhang Chunlin , Bai Ruqing , Li Xueping , Luo Jun , Yuan Shujin
Published: August 2024

Periodic motion equipment such as motors and pistons will generate broadband and narrow-band vibrations that vary with working conditions, thus reducing the process and measurement accuracy. The traditional control algorithm suppresses the vibration by increasing the broadband open-loop gain, but its effect on narrow-band vibration is limited. The Youla parameterized adaptive controller based on the internal model principle (IMP) is an effective method that can be used to suppress unknown time-varying narrow-band vibrations. However, the existing studies are insufficient for the control of broadband random vibrations. In this paper, a Youla parameterized adaptive controller with an improved central controller is designed to suppress broadband random and unknown narrow-band vibrations in a double-layer vibration isolation system. An optimal linear quadratic Gaussian (LQG) central controller is designed to first suppress the broadband random vibrations. Then, the global stable controllers with the Q parameter are obtained with the Youla parameterization method, and the Q parameter is adjusted online by the adaptive recursive least squares (RLS) algorithm to make the controller converge to the desired controller to suppress the unknown narrow-band vibrations. The results of experiments performed with a double-layer isolator show that the designed adaptive controller not only suppresses the broadband random vibrations to a certain extent but also almost completely eliminates the three unknown time-varying narrow-band vibrations. In practical applications, the controller can suppress the vibrations generated by a motor with varying rotational speeds, achieving an average peak attenuation of 95 dB with a tracking response time within 0.3 s.
Finite-element-based cross-section analysis method for functionally graded sandwich members with arbitrary shapes and gradients
Authors: Li Guanhua , Gu Zi-Zhang , Ouyang Weihang , Liu Si-Wei , Abdelrahman A. H. A.
Published: August 2024

Recent advancements in manufacturing technologies have facilitated the efficient and cost-effective production of functionally graded (FG) sandwich members, offering exceptional structural performances. However, designing these members is challenging due to the difficulties in accurately determining their cross-sectional properties, especially within routine designs that rely on beam-column elements. To this end, this paper introduces a robust finite-element-based cross-section analysis method for FG sandwich sections considering arbitrary shapes and material gradients. A novel nonhomogeneous plane triangle (NPT) element is formulated to enhance the computational efficiency of the developed cross-section analysis approach. A new structural analysis software with a graphic user interface, namely MSASect2, is developed based on the proposed cross-section analysis approach for its convenient implementation in practice. Four examples are displayed to verify the correctness of the present study and MSASect2, indicating their potential to promote the broader application of FG sandwich sections.
Identification of Lupus-Associated Genes in the Pathogenesis of Pre-eclampsia Via Bioinformatic Analysis
Authors: Dai Qianwen , Li Mengtao , Tian Xinping , Song Yijun , Zhao Jiuliang
Published: August 2024

Pre-eclampsia (PE) is a severe pregnancy complication that is more common in patients with systemic lupus erythematosus (SLE). Although the exact causes of these conditions are not fully understood, the immune system plays a key role. To investigate the connection between SLE and PE, we analyzed genes associated with SLE that may contribute to the development of PE. We collected 9 microarray data sets from the NCBI GEO database and used Limma to identify the differentially expressed genes (DEGs). In addition, we employed weighted gene co-expression network analysis (WGCNA) to pinpoint the hub genes of SLE and examined immune infiltration using Cibersort. By constructing a protein-protein interaction (PPI) network and using CytoHubba, we identified the top 20 PE hub genes. Subsequently, we created a nomogram and conducted a receiver operating characteristic (ROC) analysis to predict the risk of PE. Our analysis, including gene set enrichment analysis (GSEA) and PE DEGs enrichment analysis, revealed significant involvement in placenta development and immune response. Two pivotal genes, BCL6 and MME, were identified, and their validity was confirmed using 5 data sets. The nomogram demonstrated good diagnostic performance (AUC: 0.82-0.96). Furthermore, we found elevated expression levels of both genes in SLE peripheral blood mononuclear cells (PBMCs) and PE placental specimens within the case group. Analysis of immune infiltration in the SLE data set showed a strong positive correlation between the expression of both genes and neutrophil infiltration. BCL6 and MME emerged as crucial genes in lupus-related pregnancies associated with the development of PE, for which we devised a nomogram. These findings provide potential candidate genes for further research in the diagnosis and understanding of the pathophysiology of PE.
Prediction of wear of short glass fiber reinforced polyamide 66 composite sprocket
Authors: Sivakumar K , Venkata Timmaraju Mallina , Gnanamoorthy R
Published: August 2024

The wear of a polymer composite sprocket primarily depends on contact pressure and sliding velocity that vary significantly during service. The sliding distance and contact pressure at the sprocket/roller interface were estimated for a pristine polymer composite sprocket engaged with a standard and a 3% extended steel chain by employing the explicit finite element method. A set of experiments was executed to find the friction and wear coefficients of sprocket material using polyamide 66 composite pins and standard steel disc at sliding speeds of 1, 2, and 3 m/s and normal loads of 10, 20, 30, and 40 N. The wear depth is estimated after getting friction and wear coefficients experimentally, and contact pressure and sliding distance numerically. Archard wear model was executed using the UMESHMOTION subroutine with the Arbitrary Lagrangian-Eulerian technique in ABAQUS. The peak contact pressure on the sprocket is increased approximately by 1.5 times as the chain elongates from 0% to 3%. A pristine sprocket engaging a 3% extended chain after one lakh cycles experienced an approximate wear depth of 90 µm.
Fostering healthy outcomes in hotels: The effects of healthy organizational resources on employees’ stress reduction, resilience, and task performance
Authors: El-Said Osman Ahmed , Kattara Hanan , Smith Michael , Youssif Marwa
Published: August 2024

This study aims to learn from past global health crises, encouraging industry leaders worldwide to take proactive steps in implementing extra health and safety measures for future potential crises. The research employs a quantitative approach to investigate a proposed model suggesting that hotel employees’ adherence to health and safety regulations is contingent on the availability of supportive organizational resources. An electronic questionnaire was administered to hotel employees in Egypt, resulting in 213 valid responses. The data was analyzed using SPSS 25 and AMOS 24. The findings indicate a strong connection between health and safety training, health and safety resources, and health and safety compliance. Additionally, the results reveal direct and significant links between health and safety compliance, stress reduction, improved employee resilience, and enhanced task performance. Moreover, significant indirect effects were found between health and safety training, health and safety resources, and healthy organizational outcomes, with health and safety compliance serving as a mediator. The current study provides a valuable theoretical and practical contribution on employee motivation to comply with health standards, employee-organization interactions, resilience, and crisis management to better prepare for future health crises.
Construction of a Prognostic Nomogram for Major Amputation Within 30 Days Postrevascularization in Patients With Acute Lower Limb Ischemia Based on 2D Perfusion Parameters
Authors: Guo Jiandong , Lin Yinsheng , Li Chengzhi , Zhang Yan , Li Wanghai
Published: August 2024

Purpose:

The purpose of the study is to develop a prediction model for major amputation (MA) within 30 days after arterial revascularization in patients with acute lower limb ischemia (ALLI) using 2-dimensional (2D) perfusion imaging parameters.

Materials and Methods:

A retrospective study was performed in ALLI patients undergoing arterial revascularization between October 2015 and May 2022. Patients were randomly assigned into training and validation cohorts in a ratio of 7:3. Variables were selected using univariate and multivariate logistic regression. A nomogram for the MA risk within 30 days after arterial revascularization in ALLI patients was created. Its discrimination, calibration, and clinical effectiveness were reported.

Results:

A total of 310 ALLI patients (326 limbs) were included. The MA rate within 30 days after arterial revascularization was 11.6%. Skin speckle, myoglobin, and time-to-peak were independent risk factors, while atrial fibrillation was a protective factor (all p <0.05). The nomogram predicted 30-day MA with satisfactory discriminative ability. The integrated discrimination improvement was 0.279 and 0.379 for the training and validation cohorts, respectively (both p<0.001). Calibration curves were close to the standard curve. The decision curve analysis demonstrated net benefits.

Conclusion:

This 2D perfusion imaging parameter–based nomogram could accurately predict the risk of MA within 30 days postrevascularization in ALLI patients.

Clinical Impact

This study introduces a novel nomogram based on 2-dimensional (2D) perfusion imaging that can significantly advance the prognosis prediction in ALLI patients. By calculating the risk of major amputation within 30 days postrevascularization, this nomogram offers an accurate predictive tool and can lead to more informed decision-making on patient management. The innovative aspect of this research lies in its utilization of 2D perfusion parameters, a novel approach that enhances risk assessment accuracy in ALLI patients. This nomogram represents a significant step toward risk stratification and can guide future research for appropriate management on ALLI patients with different risk profiles.
Prediction of Upper Limb Motor Recovery by the PREP2 Algorithm in a Nonselected Population: External Validation and Influence of Cognitive Syndromes
Authors: Millot Sarah , Daghsen Lina , Checkouri Thomas , Wittwer Aymeric , Valabregue Romain , Galanaud Damien , Lamy Jean Charles , Rosso Charlotte
Published: August 2024

Background

Early prediction of poststroke motor recovery is challenging in clinical settings. The Prediction recovery potential (PREP2) algorithm is the most accurate approach for prediction of Upper Limb function available to date but lacks external validation.

Objectives

(i) To externally validate the PREP2 algorithm in a prospective cohort, (ii) to study the characteristics of patients misclassified by the algorithm, and (iii) to compare the performance according to the presence of cognitive syndromes (aphasia, neglect, cognitive disorders).

Methods

We enrolled 143 patients with stroke and upper extremity weakness persistent at Day 3. Evaluation to predict the recovery status according to the PREP2 algorithm included age, SAFE and NIHSS scores at Day 3 and transcranial magnetic stimulation to determine the presence of the motor-evoked potential before day seven. Actual recovery (excellent, good, limited, or poor) was defined based on the Action Research Arm test score at 3 months. Accuracy was computed by comparing the predictions of the PREP2 and the actual category of the patient. Additionally, to investigate misclassifications and the impact of cognitive syndromes, we recorded SAFE and NIHSS scores at Day 7, the Montreal Cognitive Assessment (MoCA) score, the presence of aphasia and neglect and Magnetic Resonance Imaging was used to evaluate the corticospinal tract lesion load.

Results

The PREP2 algorithm showed a very good predictive value with 78% accuracy [95% CI: 71.2%-86.1%], especially for the extreme categories of recovery (EXCELLENT 87.5% [95% CI: 78.9%-96.2%] and POOR 94.9% [95% CI: 87.9%-100%]), and only 46.5% [95% CI: 19.05%-73.25%] for the GOOD category and even worse than chance for the LIMITED category 0%. Pessimistic predictions (false-negative cases) had a drastic improvement in the SAFE score acutely compared to that of well-predicted patients with unfavorable recovery ( P < 001). The predictive value of PREP2 decreased significantly when patients had cognitive disorders (MoCA score <24) versus not (69.4% [95% CI: 52.8%-86.1%] vs 93.1% [95% CI: 83.9%-100%], P = .01).

Conclusion

Our study provides an external validation of the PREP2 algorithm in a prospective population and underlines the importance of taking into account cognitive syndromes in motor recovery prediction.
Effects of Balance Exercise Interventions on Balance-Related Performance in People With Multiple Sclerosis: A Systematic Review and a Meta-Analysis of Randomized Controlled Trials
Authors: Wallin Andreas , Johansson Sverker , Brincks John , Dalgas Ulrik , Franzén Erika , Callesen Jacob
Published: August 2024

Background

Balance training covers a range of different modalities and complexity levels for people with multiple sclerosis (MS). When evaluating the effects of balance training across different kinds of interventions, determination of the specific intervention content that predict effects are needed.

Objective

To investigate the effects of balance training on gait and dynamic balance outcomes.

Methods

Four databases were systematically searched. Randomized controlled trials involving people with MS (Expanded Disability Status Scale [EDSS] score ≤7.5) where at least 50% of the intervention targeted balance control were included. Interventions were categorized based on training types. Risk-of-bias was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX).

Results

A total of 18 included studies involved 902 people with MS (EDSS range from 0 to 7.5). Interventions evaluated with a balance composite score or a mobility test showed a moderate effect size (ES = 0.46 [95% confidence interval (CI) = 0.18 to 0.74]; p < .01) and a small overall ES (ES = 0.19 [95% CI = 0.01–0.36]; p = .04), respectively, across different training types. Stepping and gait speed outcomes showed no effect. Cognitive dual-task training showed a significant effect (ES = 0.81 [95% CI = 0.24 to 1.37]) on subgroup level, when evaluated with a mobility outcome measure. The median TESTEX score on study quality and reporting was 11 (maximum score = 15).

Conclusions

Improvements of balance were found across interventions when measured by balance composite scores and mobility tests, but not when measured by stepping or gait speed outcomes. Large training volume was positively associated with effect on balance. A definition of intensity in balance training is needed for evaluation of its impact on the effect of balance interventions.
Research report: Management of dysphagia using pharyngeal electrical stimulation in the general intensive care population – A service development
Authors: Williams Thomas , Walkden Elizabeth , Patel Karishma , Cochrane Naomi E , McGrath Brendan A , Wallace Sarah
Published: August 2024

Background:

Dysphagia places a substantial burden on the critically ill, affecting 12%–84% of this cohort, and is independently associated with worse outcomes. Pharyngeal electrical stimulation (PES-treatment) is a novel dysphagia therapy with an emerging evidence base. This retrospective observational study describes our dysphagia service and reports the use of PES-treatment as a standard of care in recovering critically ill patients at a single-site tertiary UK hospital.

Methods:

Patients admitted to Acute or Cardio-Thoracic adult intensive care units between 1st July 2017 and 30th June 2022 were routinely referred to Speech and Language Therapy (SLT) following tracheostomy, or suspected dysphonia/dysphagia. Clinical assessments and direct laryngeal visualisation using Fibreoptic Evaluation of Swallowing (FEES) were performed. Severe dysphagia was defined as Penetration-Aspiration Score of ⩾6 and patients were offered PES-treatment when staffing allowed.

Results:

Of 289 patients with severe dysphagia, 19 underwent a course of PES-treatment with the remaining patients receiving standard care. PES-treatment patients were significantly less likely to remain nil-by-mouth (11.1% vs 62.5%, Chi2 p < 0.001) or to have an enteral feeding tube in situ at discharge from critical care (27.8% vs 62.5%, p = 0.006) than those receiving standard dysphagia care. Both groups demonstrated an improvement in Penetration-Aspiration Score at repeat FEES: PES-treatment mean difference −2.0 ( p = 0.003); non-PES-treatment −1.68 ( p < 0.001); (61% PES-treatment improved vs 40% non-PES-treatment, p = 0.09).

Conclusion:

Our observations suggest that PES may be effective in the general critical care population. PES may offer new treatment options for patients and healthcare staff managing severe dysphagia and its significant consequences.
Moort dandjoo kaadadjiny: Growing up aboriginal kids strong in their culture and identity
Authors: Whyman Theoni , Jones Larissa , Farrant Brad , Michie Carol , Ilich Nicole , Shapcott Jason , Hill Doris , McNamara Albert , Bowie Muriel , Penny Millie , Pell Charmaine , Green Oriel
Published: August 2024

Community Elders in Boorloo (Perth) identified early childhood education (ECE) as a priority area for Aboriginal children’s research. This is due to a lower number of Aboriginal children attending ECE programs compared to non-Aboriginal children. Attending ECE programs sets children up for school success and is an indicator for positive life outcomes in later life. Therefore, we sought to co-design and implement a program that encourages Aboriginal children and families to attend ECE programs, known as Moort Dandjoo Kaadadjiny. Since 2021, 57 children have attended, and 27 participants yarned about their experience with the program. These yarns revealed the importance of building trust, being Aboriginal led, and holistic engagement in Aboriginal culture as essential in co-designing culturally safe ECE programs. This program serves as a foundation for developing culturally appropriate ECE programs for Aboriginal children and families to ensure Aboriginal kids grow up strong in their culture and identity.
Exploring Environmental Considerations for Terminally Ill Pediatric Patients in Palliative Care Inpatient Units: A Narrative Review
Authors: Nourmusavi Nasab Sara , McLaughlan Rebecca , Smith Chris L.
Published: August 2024

Background: The end-of-life experience is significantly influenced by the surrounding environment, emphasizing the importance of exploring built environmental factors in palliative care, especially for pediatric patients. As the majority of end-of-life individuals are elderly or adults, most studies have focused on the environment for this demographic. However, it is essential to recognize that children and adolescents may have distinct needs in this regard. Aim: This narrative review aims to explore the impact of the built environment on pediatric end-of-life patients in inpatient units within palliative care settings. Method: A comprehensive search was conducted across four key databases (PubMed, MEDLINE, PsycINFO, and CINAHL) to identify relevant articles. The screening process commenced with an initial assessment of article titles and abstracts, followed by a thorough examination of full-text studies that met the inclusion criteria. Data synthesis involved thematic analysis facilitated by NVIVO software and informed by the findings extracted from selected literature. Results: The review identified 22 studies meeting inclusion criteria, revealing key insights into environmental considerations in pediatric palliative care. Four themes emerged, highlighting the significance of activities and play environments, accommodation spaces for patients, supportive spaces for families, and outdoor and green spaces. Conclusions: Acknowledging limited research on architectural aspects and reliance on family and staff perspectives, future studies should prioritize understanding pediatric patients’ perspectives, particularly adolescents. The study underscores the importance of enhancing environmental design in pediatric palliative care to meet the unique needs of patients and their families.
Persistent post-discharge opioid use and opioid stewardship: A single-centre retrospective cohort study
Authors: Hapca Sandra , Peet Louise , Gibson Christine , Harvey Andrea , Forget Patrice
Published: August 2024

Persistent post-operative opioid use is a public health concern contributing to population morbidity and mortality. Opioid stewardship is a strategy adopted to rationalise opioid prescribing and limit harmful use. We describe persistent post-discharge opioid use rates and risk factors in a single-centre cohort and describe the opioid stewardship role of our Acute Pain Service (APS). We conducted a retrospective 4-year cohort study of inpatients referred to the APS and discharged with new strong opioids prescribed. We investigated persistent post-discharge opioid use rates, risk factors and patterns of opioid use after community follow-up by APS. We found that 24% of patients discharged with new strong opioids developed persistent opioid use. Risk factors associated with persistent post-discharge opioid use in our cohort included female sex (Odds Ratios [95% confidence interval], p value, OR: 1.89 [1.11–3.22], p = 0.019), pre-admission mental health history (OR: 2.85 [1.64–4.95], p < 0.001) and pre-admission opioid use (OR: 1.79 [1.03–3.11], p = 0.004). A smaller proportion of patients with APS follow-up in community developed persistent opioid use (22%) compared to those without (32%). We conclude that having opioids prescribed at time of discharge can result in persistent opioid use in up to a quarter of patients. The APS has an important protective role in rationalising opioid use in hospital but also following discharge. Development of further opioid stewardship policies is needed including improvement of patient and staff awareness and pre-operative assessment of patients with recognised risk factors.
Enhancing health care through medical cognitive virtual agents
Authors: Mishra Sushruta , Chaudhury Pamela , Tripathy Hrudaya Kumar , Sahoo Kshira Sagar , Jhanjhi NZ , Hassan Elnour Asma Abbas , Abdelmaboud Abdelzahir
Published: August 2024

Objective

The modern era of cognitive intelligence in clinical space has led to the rise of ‘Medical Cognitive Virtual Agents’ (MCVAs) which are labeled as intelligent virtual assistants interacting with users in a context-sensitive and ambient manner. They aim to augment users' cognitive capabilities thereby helping both patients and medical experts in providing personalized healthcare like remote health tracking, emergency healthcare and robotic diagnosis of critical illness, among others. The objective of this study is to explore the technical aspects of MCVA and their relevance in modern healthcare.

Methods

In this study, a comprehensive and interpretable analysis of MCVAs are presented and their impacts are discussed. A novel system framework prototype based on artificial intelligence for MCVA is presented. Architectural workflow of potential applications of functionalities of MCVAs are detailed. A novel MCVA relevance survey analysis was undertaken during March-April 2023 at Bhubaneswar, Odisha, India to understand the current position of MCVA in society.

Results

Outcome of the survey delivered constructive results. Majority of people associated with healthcare showed their inclination towards MCVA. The curiosity for MCVA in Urban zone was more than in rural areas. Also, elderly citizens preferred using MCVA more as compared to youths. Medical decision support emerged as the most preferred application of MCVA.

Conclusion

The article established and validated the relevance of MCVA in modern healthcare. The study showed that MCVA is likely to grow in future and can prove to be an effective assistance to medical experts in coming days.
Association of Smaller Intercondylar Notch Size With Graft Failure After Anterior Cruciate Ligament Reconstruction
Authors: Hughes Jonathan D. , Boden Stephanie A. , Belayneh Rebekah , Dvorsky Jenna , Mirvish Asher , Godshaw Brian , Sansone Mikael , Karlsson Jon , Musahl Volker
Published: August 2024

Background:

Smaller intercondylar notch sizes have been consistently associated with a predisposition for primary anterior cruciate ligament tears.

Purpose:

To evaluate the association between intercondylar notch size, graft size, and postoperative complications, including knee stiffness and return to the operating room, after primary anatomic anterior cruciate ligament reconstruction (ACLR).

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This was a retrospective analysis of prospectively collected data from consecutive patients who underwent anatomic single-bundle primary ACLR using a bone-patellar tendon-bone or quadriceps tendon autograft performed by fellowship-trained orthopaedic sports medicine surgeons between April 2009 and August 2019. Graft failure was defined as patient report of instability, pathologic laxity on clinical examination, or graft rerupture confirmed by magnetic resonance imaging and/or subsequent arthroscopy. To ensure the purposeful selection of covariates, univariate analyses were conducted on the list of potential confounders selected a priori, and those with a significance value of P < .10 were considered for the multivariate regression model. Covariates found to be statistically significant with univariate analysis were patient age, notch size, and graft type. After validating all potential covariates, they were added to the regression model and then eliminated in a stepwise fashion.

Results:

In total, 252 patients were included for analysis (99 bone-patellar tendon-bone and 153 quadriceps tendon autograft; age, 22.2 ± 7.0 years; graft size, 9.8 ± 1.0 mm; time to follow-up, 50.4 ± 28.9 months). Knee stiffness developed in 23 patients (9.1%), and 15 grafts failed (6.0%). Smaller notch size on magnetic resonance imaging was significantly associated with graft failure ( P = .005). There was a significantly higher risk of graft failure with notch size <16 versus ≥16 mm (17.6% vs 2.3%; P = .005) with an odds ratio (OR) of 5.0 (95% CI, 1.7-15.1; P = .004). Notch size <15 mm was associated with the highest risk of graft failure (22.2%; OR, 5.8; 95% CI, 1.6-20.6; P = .006). There was no significant association between notch size or graft–notch size ratio and knee stiffness, meniscal injury, or cartilage damage at the time of ACLR, regardless of graft type.

Conclusion:

Intercondylar notch size <16 mm was associated with a 5-fold increased risk of graft failure after primary anatomic ACLR.
Monkeypox Emergence Post-COVID: Insight into Egyptian Older Adult’s Awareness, Concern, and Mental Health
Authors: Ibrahim Fatma Magdi , Abd Elmawla Doaa Abd Elhameed , Elgarhy Safaa Mabrouk Abdel Aziz , Ibrahim Ateya Megahed , Fadila DoaaE
Published: August 2024

Aim: To identify Egyptian older adults’ awareness, concerns, and mental health about the monkeypox outbreak. Background: In light of the ongoing COVID-19 pandemic, monkeypox disease is receiving more attention. The monkeypox virus outbreak has posed a global concern, especially to older adults with comorbidities. Natural disasters, and endemic affect older persons’ mental health. Design: A cross-sectional descriptive design was followed. Methods: 254 older adults were recruited from three outpatient clinics using consecutive sampling using four tools. Results: 74.0% of older study participants were unaware of monkeypox. Gender, level of education, residence, worry about contracting monkeypox infection, and mental distress are predictors of awareness about monkeypox ( p < .001). Worry of contracting monkeypox infection was common among female participants ( p = .038), highly educated ( p = .001), who had a low level of awareness and high level of mental distress ( p = .001 for both). Conclusion: Awareness of monkeypox was associated with worry and mental distress. Gerontological nurses have a vital role in contacting older adults and providing care and education that decreases worry and preserves minds and feelings, improving their quality of life. Establishing a national strategic planning and crisis prevention framework to alleviate psychological distress and prevent mental health issues from deteriorating in this group is crucial.
Beyond the Books: COVID-19's Influence on Future Life Behaviors of Aspiring Medical and Health Professionals
Authors: Gong Zheng , Adu-Amankwaah Joseph , Fu Lu , Qiao Weili , Li Wen , Hou Hongjian , Ma Tongtong , He Mingyu , Cubelo Teodora A. , Sun Hong
Published: August 2024

BACKGROUND

The lifestyle of most people was forced to change due to the COVID-19 pandemic. Perhaps after the pandemic, we will find that these subtle changes in life and from the depths of our hearts are thorough and profound. They may form our conceptual consensus and behavioral habits, becoming part of our long-term personal consciousness. This study explored the impacts of the COVID-19 pandemic on the future life behavior intentions of medical and health-related students studying at universities in China.

METHODS

Electronic questionnaires were distributed to students studying at 3 universities in China. A total of 251 valid questionnaires were obtained, and the chi-squared test was used to compare the corresponding groups.

RESULTS

In the future, students plan to pay more attention to wearing masks and maintaining social distance in public places, do more online shopping, have more meals at home or in the canteen, engage in less international travel, and have fewer gatherings with friends. However, compared with Chinese students, more non-Chinese students plan to increase domestic and international travel and reduce online learning. Furthermore, only among non-Chinese students did gender, urban or rural origin, and family economic conditions influence how the COVID-19 pandemic affected their future life behaviors.

CONCLUSION

The COVID-19 pandemic changed the future life behavior intentions of medical and health-related students. The future behaviors of these students will impact the entire society. This study will help the government and policymakers predict and prepare for general lifestyle changes in our society.
Living on the Margins, Working in the Planned: Domestic Workers Traversing to/Between Squatter Settlements and Planned Colonies in South and South-West Delhi
Authors: Balu Gayatri
Published: August 2024

This article explores the lives and labour dynamics of domestic workers in Delhi, focusing on their work in planned colonies and residence in jhuggi jhopri (JJ) clusters, or squatter settlements. Through narratives and in-depth interviews, it explores the complex interplay between these women’s employment and the broader urban landscape. The study investigates the intergenerational journey of domestic workers, tracing their migration from rural areas to urban centres in search of better opportunities. Further, it unpacks the realities of exclusion faced by domestic workers, residing in JJ clusters, which often lack legally secured tenure rights and access to basic amenities. The article examines the systematic flow of labour from JJ clusters to nearby planned colonies, where domestic workers play a crucial role in the functioning of households. Despite contributing significantly to the urban workforce, domestic workers remain in the shadows of planned development, enduring informality and inadequate legal protections. Through an interdisciplinary approach, this research highlights the socio-spatial dynamics that confine domestic workers to their settlements and restrict their mobility options. By understanding the intricate relationships between gendered work and urbanisation, this study aims to contribute to the creation of more inclusive and equitable urban spaces, shelter and employment in Delhi and beyond.
Sea Voyage Interview as a conversational method for strengthening the sense of psychological safety and security
Authors: Chrząstowski Szymon
Published: August 2024

The Sea Voyage Interview is a new and original method grounded in attachment narrative therapy, which serves as a therapeutic metaphorical framework to enhance clients’ narratives relating to safety and security, and to cope with the latter’s loss. It encourages clients to introspect and enrich their narratives by integrating cognitive and affective information, thereby improving threat identification and response strategies. This interview process acknowledges the distortions people create in their stories to feel secure, without judging the veracity of these narratives. The method employs a systemic approach, emphasizing context in shaping a sense of security and incorporates a playful element with kinetic sand and figurines to facilitate expression. It is non-diagnostic, designed for adult therapy, and does not explore childhood safety experiences, leaving this to established instruments. The Sea Voyage Interview prioritizes flexible conversational guidance, focussing on perceived threats, coping mechanisms, and psychological resources to foster a strengthened sense of security.
Exploring Symptom Management Experiences Among College Students With Type 1 Diabetes Mellitus Using a Theoretical Framework: A Qualitative Study
Authors: McFadden Ny’Nika T. , Wilkerson Amanda H. , Chaney Beth H. , Carmack Heather J. , Jaiswal Jessica , Stellefson Michael L. , Lovett Kylie
Published: August 2024

Purpose

The purpose of this study was to explore symptom management experiences among college students with type 1 diabetes mellitus (T1DM). Limited qualitative data using a theoretical framework exist that explore the self-care behavior processes for symptom management.

Methods

A qualitative approach was used for this study. The middle-range theory of self care of chronic illness served as a framework for data collection and analysis procedures. Data collection included distributing a survey to collect participants’ demographic and sociodemographic data and utilizing a semi-structured interview guide to conduct one-on-one interviews with 31 participants. Interviews occurred via Zoom (n = 28) and in person (n = 3). Interview transcripts were uploaded in NVivo for data management. The research team created a codebook using theoretical constructs to assist with thematic analysis. Data are representative of a sample whose characteristics include undergraduate students ages 18 to 23 living with T1DM for 2 years or more who attended large, public, 4-year universities located in the southeastern United States.

Results

Three main themes were created using theoretical constructs: symptom detection experiences, symptom interpretation experiences, and symptom response experiences. Two subthemes were identified for each theme. Participants engaged in symptom management for blood glucose regulation through detecting changes in their blood glucose physiologically and via technology. Additionally, symptom interpretation involved analyzing blood glucose trends and determining common causes of blood glucose changes. Symptom response included immediately addressing hypoglycemia but delayed responses addressing hyperglycemia.

Conclusions

Challenges were present responding to hypoglycemia; therefore, additional research is warranted to improve symptom response skills.
Adherence to integrated management of childhood illness (IMCI) guidelines by community health workers in Kano State, Nigeria through use of a clinical decision support (CDS) platform
Authors: McLaughlin Megan , Metiboba Loveth , Giwa Aisha , Femi-Ojo Olufunke , Ravi Nirmal , Mahmoud Nasir Mamoud , Mount-Finette Ezra , Langle-Chimal Ollin , Abbas Dina , Finette Barry
Published: August 2024

Background

The World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) guidelines established in 1992 to decrease preventable under-five child morbidity and mortality, was adopted by Nigeria in 1997. Over 20 years later, while under-five child mortality remains high, less than 25% of first level facilities have trained 60% of community health workers (CHW) who care for sick children with IMCI. This study investigated the impact in CHWs overall adherence to IMCI guidelines, particularly for critical danger signs, as well as usability and feasible following the implementation of THINKMD’s IMCI-based digital clinical decision support (CDS) platform.

Methods

Adherence to IMCI guidelines was assessed by observational and digital data acquisition of key IMCI clinical data points by 28 CHWs, prior, during, and post CDS platform implementation. Change in IMCI adherence was determined for individual CHW and for the cohort by analyzing the number of IMCI data points acquired by each CHW per clinical evaluation. Consistency of adherence was also calculated by averaging the percentage of total evaluations each data point was observed. Usability and acceptability surveys were administered following use of the CDS platform.

Results

THINKMD CDS platform implementation notably enhanced the CHWs’ ability to capture key IMCI clinical data elements. We observed a significant increase in the mean percentage of data points captured between the baseline period and during the CDS technology implementation (T-test, t = -31.399, p < 0.016, Holm-Bonferroni correction, two-sided), with the mean values going from 30.7% to 72.4%. Notably, even after the completion of the technology implementation phase, the mean percentage of IMCI elements captured by CHWs remained significantly elevated compared to the baseline, with a 26.72 percentage point increase (from 30.7% to 57.4%, T-test, t = -15.779, p < 0.05, Holm-Bonferroni correction, two-sided). Usability and feasibility of the platform was high. CHWs reported that the CDS platform was easy to learn and use (93%) and enabled them to identify sick children (100%).

Conclusion

These results demonstrate that utilization of a digital clinical decision support tool such as THINKMD’s IMCI based CDS platform can significantly increase CHW adherence to IMCI guidelines over paper-based utilization, increase clinical quality and capacity, and improve identification of key danger signs for under-five children while being highly accepted and adopted.
EpCAM-targeted betulinic acid analogue nanotherapy improves therapeutic efficacy and induces anti-tumorigenic immune response in colorectal cancer tumor microenvironment
Authors: Dutta Debasmita , Al Hoque Ashique , Paul Brahamacharry , Park Jun Hyoung , Chowdhury Chinmay , Quadir Mohiuddin , Banerjee Soumyabrata , Choudhury Arghadip , Laha Soumik , Sepay Nayim , Boro Priyanka , Kaipparettu Benny Abraham , Mukherjee Biswajit
Published: August 2024

Background

Betulinic acid (BA) has been well investigated for its antiproliferative and mitochondrial pathway-mediated apoptosis-inducing effects on various cancers. However, its poor solubility and off-target activity have limited its utility in clinical trials. Additionally, the immune modulatory role of betulinic acid analogue in the tumor microenvironment (TME) is largely unknown. Here, we designed a potential nanotherapy for colorectal cancer (CRC) with a lead betulinic acid analogue, named as 2c, carrying a 1,2,3-triazole-moiety attached to BA through a linker, found more effective than BA for inhibiting CRC cell lines, and was chosen here for this investigation. Epithelial cell adhesion molecule (EpCAM) is highly overexpressed on the CRC cell membrane. A single-stranded short oligonucleotide sequence, aptamer (Apt), that folds into a 3D-defined architecture can be used as a targeting ligand for its specific binding to a target protein. EpCAM targeting aptamer was designed for site-specific homing of aptamer-conjugated-2c-loaded nanoparticles (Apt-2cNP) at the CRC tumor site to enhance therapeutic potential and reduce off-target toxicity in normal cells. We investigated the in vitro and in vivo therapeutic efficacy and anti-tumorigenic immune response of aptamer conjugated nanotherapy in CRC-TME.

Methods

After the characterization of nanoengineered aptamer conjugated betulinic acid nanotherapy, we evaluated therapeutic efficacy, tumor targeting efficiency, and anti-tumorigenic immune response using cell-based assays and mouse and rat models.

Results

We found that Apt-2cNP improved drug bioavailability, enhanced its biological half-life, improved antiproliferative activity, and minimized off-target cytotoxicity. Importantly, in an in vivo TME, Apt-2cNP showed promising signs of anti-tumorigenic immune response (increased mDC/pDC ratio, enhanced M1 macrophage population, and CD8 T-cells). Furthermore, in vivo upregulation of pro-apoptotic while downregulation of anti-apoptotic genes and significant healing efficacy on cancer tissue histopathology suggest that Apt-2cNP had predominantly greater therapeutic potential than the non-aptamer-conjugated nanoparticles and free drug. Moreover, we observed greater tumor accumulation of the radiolabeled Apt-2cNP by live imaging in the CRC rat model.

Conclusions

Enhanced therapeutic efficacy and robust anti-tumorigenic immune response of Apt-2cNP in the CRC-TME are promising indicators of its potential as a prospective therapeutic agent for managing CRC. However, further studies are warranted.

Graphical abstract
Socioeconomic benefits associated with bats
Authors: Aggrey Siya , Rwego Innocent B. , Sande Eric , Khayiyi Joyce D. , Kityo Robert M. , Masembe Charles , Kading Rebekah C.
Published: August 2024

Background

While bats are tremendously important to global ecosystems, they have been and continue to be threatened by loss of habitat, food, or roosts, pollution, bat diseases, hunting and killing. Some bat species have also been implicated in the transmission of infectious disease agents to humans. While One Health efforts have been ramped up recently to educate and protect human and bat health, such initiatives have been limited by lack of adequate data on the pathways to ensure their support. For instance, data on the role of bats in supporting different components of human welfare assets would be utilized as a stepping stone to champion conservation campaigns. Unfortunately, these data are limited and efforts to synthesize existing literature have majorly focused on few components human welfare leaving other important aspects.

Methods

Here, we analyze benefits associated with bats in the context of welfare economics considering all the asset components. We surveyed scientific and gray literature platforms utilizing particular keywords. We then classified these values using integrated approaches to understand different values across human welfare assets of “health,” “material and immaterial assets,” “security or safety” and “social or cultural or spiritual relations”.

Results

We found 235 papers from different countries indicating that bats play fundamental roles in supporting human welfare. These benefits were more prevalent in Asia and Africa. In terms of the use of bats to support welfare assets, bats were majorly utilized to derive material and immaterial benefits (n = 115), e.g., food and income. This was followed by their use in addressing health challenges (n = 99), e.g., treatment of ailments. There was a similarity in the benefits across different regions and countries.

Conclusion

These results indicate potential opportunities for strengthening bat conservation programs. We recommend more primary studies to enhance understanding of these benefits as well as their effectiveness in deriving the perceived outcomes.