bluuebunny/crossref_metadata_2025 huggingface dataset:
How service users envision their engagement in processes of collaborative innovation: A Q-methodological study on user involvement in eHealth collaborations
Authors: Callens Chesney , Verhoest Koen , Klijn Erik Hans , Nõmmik Steven , Pina Vicente , Brogaard Lena
Published: April 2023

Involving users in innovating public services is an increasingly common, but challenging practice, as users often have different viewpoints on their own role in the process. Particularly in complex innovation arrangements such as public-private collaborations, governments and service innovators need to be aware of users’ perceptions of their involvement to maximally exploit the advantages of including them. This article theorizes and tests four different roles of user-provider interaction on co-innovation processes: users as (1) legitimators, (2) customers, (3) partners, and (4) self-organizers. These theoretical roles are tested through Q-methodology on service users in 19 public-private eHealth collaborations from five European countries. Our findings suggest the existence of three hybrid empirical profiles of user involvement: (1) users as ‘service consultants’, (2) users as ‘co-designers’, and (3) users as ‘hands-off supporters’. The discovery of these profiles suggests the existence of different viewpoints on user involvement, which can influence the expectations and behavior of the users in innovation processes.
Systematic and axiological capacities in artificial intelligence applied in the public sector
Authors: Ruvalcaba-Gomez Edgar A.
Published: April 2023

Artificial Intelligence (AI) as a technological development is being implemented in the public sector with the intention of improving service delivery, as well as to help solve complex problems. However, there is a wide range of capabilities that AI can perform and that public officials perceive and implement in different ways. This paper aims to describe and analyze some categories into which AI capabilities in the public sector are divided. Using an Exploratory Factor Analysis (EFA), our results show that the capabilities of AI from the perspective of public officials can be classified into two aspects: systematic factors and axiological factors. Systematic factors are related to the analysis and behavior of data, including monitoring, analyzing, interacting, remembering, and anticipation. Axiological factors refer to the impacts of values, ethics, and decisions, including acting, feeling, moralizing, creating, and deciding capacities. This categorization of AI capabilities in the public sector sheds light on the perception of public officials about the implementation of this technological development.
Adaptive diagnosis and non-fragile predictive control for HFV engine with non-Gaussian uncertain output
Authors: Hu Kai-Yu , Cheng Zian , Gong Jingxiu
Published: April 2023

This study presents an adaptive fault estimation and model predictive fault-tolerant control (FTC) for the hypersonic vehicle engine with non-Gaussian uncertain output jet plume. The non-Gaussian probability density function (PDF) describing the plume velocity in a stochastic system is approximated by Type II fuzzy radial basis functions. In the fault observer, the novel prey adaptive estimation method is designed for the valve faults with different amplitudes. Ultimately, this fuzzy-prey fusion adaptive observer shields perturbation and accurately estimates complex faults including incipient and intermittent faults. A predictive tolerant controller compensates for all the faults effects and non-fragile compensation factors of FTC eliminate the perturbation interference, thence the output PDF matches with the expected value. Finally, the more refined internal structure of plume output distribution replaces the local and rough valve position variables, helping this study realizes the hypersonic vehicle engine integrated refine control. Simulation result verifies the effectiveness of the proposed approaches and the superiority compared with the existing method.
Biomechanical evaluation of two internal fixation systems for the treatment of mandibular symphyseal fracture
Authors: Wongwaithongdee Udom , Inglam Samroeng , Chantarapanich Nattapon
Published: April 2023

Due to the disadvantage of maxillomandibular fixation, the semi-rigid and rigid internal fixations have been employed to provide early mouth motion. To find the proper fixation and adequate stability, the biomechanical performance of these systems was assessed using Finite Element (FE) method. The 3D mandible model with a symphyseal fracture, teeth, periodontal ligament, and fixation devices were created for the FE analyzes. The bone structure was determined as a transverse isotropic whereas the fixation devices were titanium. The load includes Masseter, Medial Pterygoid, and Temporalis muscular forces as well as the occlusal forces acting on first molars, canines, and incisors. The maximum stress occurs at the center of fixation devices at symphyseal fracture. The maximum stress values were 877.4 MPa for the reconstruction plate and 646.8 MPa for the mini-plates. The plates maintained the fracture width at mid-region better than superior and inferior. The maximum fracture gap were 1.10 and 0.78 mm for reconstruction plate and mini-plates, respectively. The fracture site’s elastic strain stabilized with the reconstruction plate was 1089.0 microstrains and with the mini-plates was 399.6 microstrains. The treatment of a mandibular symphyseal fracture using a mini-plates provides more adequate fracture stability for new bone formation and mechanically safer than locking reconstruction plate. Mini-plates fixation was able to control the fracture gap better than the reconstruction plate. Mini-plates technique was considered as the first choice of internal fixation, however, a reconstruction plate can also be used in case of unavailability and complication related to mini-plating.
Thinking About God Encourages Prosociality Toward Religious Outgroups: A Cross-Cultural Investigation
Authors: Pasek Michael H. , Kelly John Michael , Shackleford Crystal , White Cindel J. M. , Vishkin Allon , Smith Julia M. , Norenzayan Ara , Shariff Azim , Ginges Jeremy
Published: April 2023

Most humans believe in a god or gods, a belief that may promote prosociality toward coreligionists. A critical question is whether such enhanced prosociality is primarily parochial and confined to the religious ingroup or whether it extends to members of religious outgroups. To address this question, we conducted field and online experiments with Christian, Muslim, Hindu, and Jewish adults in the Middle East, Fiji, and the United States ( N = 4,753). Participants were given the opportunity to share money with anonymous strangers from different ethno-religious groups. We manipulated whether they were asked to think about their god before making their choice. Thinking about God increased giving by 11% (4.17% of the total stake), an increase that was extended equally to ingroup and outgroup members. This suggests that belief in a god or gods may facilitate intergroup cooperation, particularly in economic transactions, even in contexts with heightened intergroup tension.
Late-Holocene hydrological variability from the NW Himalaya and southwestern Tibetan Plateau: Paleo-salinity records from Pangong Tso
Authors: Sagwal Sumit , Kumar Anil , Sharma Choudhurimayum Pankaj , Srivastava Pradeep , Agarwal Shravi , Bhushan Ravi
Published: April 2023

Variations in lake-levels and hydrology are connected to climatic dynamics over the Trans-Himalaya and Tibetan Plateau (TP). Pangong Tso, a ~140 km long hypersaline lake, is sensitive to changes in air temperature, precipitation and snow-glacier melt over the southwestern TP. The incised tributaries entering the lake expose deltaic sequences constituting topset, foreset and bottomset. Sedimentology, chronology and diatom analysis of delta sediments; and stable isotopic and sclerochronological analysis of gastropods helped delineate the Late-Holocene variation in lake levels, surface temperature and salinity. The elevation of the topsets is considered as representing past lake high-stands from where molluscs were also recovered. Three phased lake level changes are observed during the past 3 ka. The first high-stand (+1.4–3.0 m) was at ~2.8–2.0 ka when lake surface salinity and temperature were 4.67–6.01 ppt (parts per thousand) and 5°C–7°C, respectively, against the modern average values of 7.7 ± 0.09 ppt and 16.1°C ± 2.0°C. Followed by a brief decline, another high-stand (+3.0–3.6 m) is observed at 1.1 ka when the salinity is reduced to 4.03–5.72 ppt and lake surface temperature to 5°C–8°C. A corresponding increase in freshwater diatom concentration is also observed here. The third phase over the past 1 ka witnessed a fall of ~3.6–6 m in lake level that is attributed to an abrupt rise in aridity over the TP. We demonstrate that lake level variation in the region is a function of the variability of the Indian Summer Monsoon (ISM) and the westerlies, however during the high-stand, the hydrology of the lake was dominated by ISM precipitation.
Late-Holocene paleoceanographic and climatic changes and their impact on Indian socio-economic conditions: Benthic foraminiferal evidence from the Bay of Bengal
Authors: Mohanty Satabdi , Chaudhuri Swagata , Bhaumik Ajoy K , Kumar Pankaj
Published: April 2023

The present work is pursued on the benthic foraminiferal groups obtained from NGHP core samples of the western Bay of Bengal to understand the variations of paleoceanography and Indian Summer Monsoon (ISM), as well as socio-economic changes in ancient India. Benthic foraminiferal AMS 14C dating reveals that the studied interval spans between 335 BC and 1355 AD, covering the history of the last 1690 years. We compared foraminifera group counts with published isotopes, sunspot number, summer monsoon index, hematite-stained grain, Al/Ca, 14C data sets. Angular Asymmetrical Benthic Foraminifera, infaunal, and dysoxic groups exhibit declining trends with warm, humid intervals with intensified ISM signature from 335 BC to 406 AD (Roman Warm Period) and from 787 to 1202 AD (Medieval Warm Period). The Increasing trend of the above foraminiferal groups captures the signature of weak ISM from 406 to 787 AD (Dark Age Cold Period) and from 1202 to 1355 AD (Medieval Warm Period and Little Ice Age Transition). Whereas rounded symmetrical benthic foraminifera, epifaunal, and oxic groups show a reverse relation with the abovementioned groups. Spectral analysis of foraminiferal groups shows significant periodicities of 563/561, 450, 321, 281/250, 22/27, and 17/16/15 years, corresponding to various solar cycles. This research uncovers the relationship between solar activity and monsoonal changes, which influenced India’s economic growth and played a crucial role in the establishment and demise of successive dynasties throughout the Indian subcontinent during the late-Holocene.
A novel Bayesian multilevel regression approach to the reconstruction of an eastern Mediterranean temperature record for the last 10,000 years
Authors: Ön Z Bora , Macdonald Neil , Akçer-Ön Sena , Greaves Alan M
Published: April 2023

Climate reconstructions derived from proxy records for individual sites often fail to incorporate existing regional information, which may help to determine uncertainties and express variability within specific reconstructions or commonalities between datasets. Such an understanding is crucial when examining past human-environment interactions. Taking the eastern Mediterranean as our case study, we present here a new air temperature model for the last 10,000 years that utilises data from 33 previously published proxy-based independent reconstructions, using a novel fully Bayesian approach that applies multilevel regression models of individual temperature datasets grouped together into 300 year long consecutive sub-intervals. A Bayesian multilevel approach allows the model to share information between each regression model from the individual datasets and the 300 year grouped regression models. The results demonstrate commonalities between individual datasets derived from different sources, and embed the uncertainties within the model. Our results establish that the eastern Mediterranean region was consistently warmer than the 20th century, except for two short intervals at the end of the Early Holocene (between 8400 and 8250 yrs BP) and the start of the mid-Holocene (between 7800 and 7650 yrs BP). We also identify changes within temperature associated with both the 8.2 ka and 4.2 ka BP events, however our findings identify regional warming in the eastern Mediterranean, rather than cooling often associated with the 4.2 ka BP event. Our results are comparable with previous large scale hemispheric reconstructions, demonstrating that our model is a robust candidate for temperature reconstructions within a confined region, which can range from mesoscale up to macroscale.
Chemical Composition, in vitro, and in vivo Antiparasitic Effects of Curcuma zedoaria Rhizome Essential Oil Against Giardia lamblia
Authors: Albalawi Aishah E , Alanazi Abdullah D
Published: April 2023

Background

The present experimental work aimed to evaluate the chemical composition and in vitro and in vivo effects of Curcuma zedoaria essential oil (CZEO) compared with metronidazole (MTZ) for Giardia lamblia infection treatment. The constituents of CZEO were recognized by gas chromatography/mass spectrometry (GC/MS) examination.

Materials and Methods

To assess the in vitro anti- Giardia effects of CZEO, clinical isolates of G. lamblia (cysts and trophozoites) were treated with various concentrations of CZEO (25–100 µg/mL) for 10–360 min. Infected BALB/c mice orally received the CZEO at 200–600 µg/kg/day doses for 7 days. The mean number and viability of excretory cysts were assessed using vital 0.1% eosin staining. Giardia parasite antigen in the stool of the tested mice was also detected on days 5, 10, 15, and 20 post-infection through ELISA using the monoclonal antibodies.

Results

Based on GC/MS, the major components were curzerenone (28.6%), 1,8-cineole (21.3%), and delta-3-carene (10.6%), respectively. CZEO significantly ( p < 0.0001) reduced the viability of G. lamblia cysts and trophozoites as a dose-dependent response. CZEO at the tested doses reduced the mean number and viability of the excreted G. lamblia cysts. The highest reduction of Giardia antigen was detected in mice cured with CZEO at the 600 µg/kg dose; on days 5, 10, 15, and 20, the rate of reduction was 85.97%, 77.86%, 97.09%, and 98.75%, respectively. Biochemical examinations confirmed no significant alteration between the liver and kidney enzymes of the mice cured with CZEO and the control group.

Conclusion

The C. zedoaria essential oil showed potent in vitro and in vivo anti- Giardia effects and can thus have Giardia infection therapeutic potentials. Still, more studies on the exact mechanisms of action of this plant and its toxicity are warranted.
Household Food Insecurity Negatively Impacts Diet Diversity in the Vietnamese Mekong Delta: A Cross-Sectional Study
Authors: Vuong Thuy Ngoc , Dang Chinh Van , Jagals Paul , Toze Simon , Gallegos Danielle , Gatton Michelle
Published: April 2023

Healthy, diverse diets are vital for life. In low/middle-income countries, however, the focus is more on food quantity rather than diet quality. This study assessed household diet diversity (HDD) in the Vietnamese Mekong Delta and its associations with household food insecurity (HFI) and household food availability (HFA) controlling for socioeconomic factors. Primary food-preparers in 552 randomly selected households in two rural provinces were interviewed about socioeconomic factors, HDD, HFI, and HFA. More than 80% of households predominantly consumed energy-dense foods, whereas less than 20% consumed nutrient-dense foods. Lower HDD was associated with HFI, lower HFA, for the Khmer ethnic minority, and low livelihood capitals (landlessness, low expenditure, debt) and low utensil scores. The study highlighted the need to provide improved food and nutrition policies that increase availability and access to diverse and healthy foods as well as reduce poverty and increase incomes for at-risk rural and ethnic minority groups.
Balancing risk-taking and self-care: The ecology of athlete health behaviour during the Olympic qualification phase
Authors: Schubring Astrid , Halltén Mathias , Barker-Ruchti Natalie , Post Anna
Published: April 2023

Athletes who aim to qualify for the Olympic Games need to stay healthy. Research demonstrates, however, that many elite athletes take health risks to achieve sporting success. Drawing on social ecological thinking, the purpose of this study is to understand change in athlete health behaviour during the Olympic Games qualification phase. We draw on data from a six-month-long case study on four athletes who aimed to qualify for the 2016 Olympic Games in Rio. We used semi-structured interviews and weekly-online surveys to collect data. Olympic hopefuls engaged in both risky health behaviour, such as ‘competing while injured’, and in self-caring health behaviour, such as ‘balanced dietary management’. Risk-taking was encouraged by a habit of taking pain medication, insufficient medical support, and time pressure to qualify. Awareness for self-care, a trusting coach-athlete relationship, and a well-rounded athlete support programme were factors that promoted self-care. Conceptually, we found that athlete health behaviour is dynamic and ecological, that is, it is relational to personal, contextual, and temporal factors. Based on the findings, we advise Olympic hopefuls to surround themselves with people who support caring health behaviour, and that sport organisations and stakeholders adopt long-term planning and implement policies of care.
Self-Interest, prosociality, and the moral cognition of markets: A comparative analysis of the Theory of Moral Sentiments and the Wealth of Nations
Authors: Acerbi Alberto , Sacco Pier Luigi
Published: April 2023

In this paper, we perform a text analysis of Adam Smith’s two books, the Theory of Moral Sentiments and the Wealth of Nations, to better characterize their highly disputed differences in terms of moral cognition. In particular, given that Smith’s ideas are still very cited and influential in the current scholarly debate on moral cognition, we are interested in understanding whether a text analysis would unveil a semantic structure that is in line with a dual process theory interpretation or, alternatively, with a neuro-emergent cognition one. We find that, despite that the intellectual koine in which Smith’s thought was originally embedded would be more in line with a dual process theory approach, the analysis reveals a better consonance with the neuro-emergent cognition approach. This opens new and interesting perspectives in future research on the moral cognition of market interactions in a Smithian tradition of thought.
Working Through Stigma: A Constructivist Grounded Theory of Delivering Health Services to Diverse 2SLGBTQ Populations
Authors: Lane Jennifer
Published: April 2023

Previous research inadequately explores processes and factors influencing the delivery of health services to sexual and gender minorities in ways that equitably attend to the infinite diversity held by these groups. This study employed Intersectionality and Critical Theories to inform Constructivist Grounded Theory methods and methodology; social categories of identity were strategically adopted to explore domains of power operating across multiple forms of oppression, think through subjective realities, and generate a nuanced rendering of power relations influencing health service delivery to diverse 2SLGBTQ populations in a Canadian province. Semi-structured interviews were conducted and the co-constructed theory of Working Through Stigma, with three interrelated concepts, depending on context, resolving histories, and surviving the situation, was generated . The theory depicts the concerns of participants and what they do about power relations influencing health service delivery and broader social contexts. While the negative impacts of stigma were widely and diversely experienced by patients and providers, ways of working within power relations emerged that would be impossible if stigma was not present, highlighting opportunities to positively impact those from stigmatized groups. As such, Working Through Stigma is a theory that flouts the tradition of stigma research; it offers theoretical knowledge that can be used to work within power relations upholding stigma in ways that increase access to quality health services for those whose historical underservicing can be attributed to stigma. In doing so, the stigma script is flipped and strategies for working against practices and behaviours that uphold cultural supremacies may be realized.
Parents’ Experiences Navigating Early Intervention and Early Childhood Special Education Services: A Qualitative Metasynthesis
Authors: Batz Ruby , Yadav Asha
Published: April 2023

Existing literature documents the importance and difficulty of serving families under a family-centered approach in Early Intervention/Early Childhood Special Education (EI/ECSE). However, less is known about the collective systematic experiences of those families. Through a qualitative metasynthesis of 15 empirical studies, we unveiled how EI/ECSE systems reproduced and/or reduced inequitable practices and that the promise of a family-centered approach is not experienced by all families and children. At a macro-level, a series of structural (e.g., racism, ableism) and social (e.g., access to various capital) factors shaped access to and the quality of services. At a micro-level, a series of facilitators (e.g., parents as experts) and barriers (e.g., disrespectful interactions) shaped everyday access to services and opportunities for meaningful collaboration between parents and service providers. Current gaps in the literature, implications for policy and practice, and recommendations for future research are addressed.
Exploring Wellness Through Concept Analysis
Authors: Skarbek A. , Endsley P. , Chrisman M.S. , Hastert M. , Stellwagen C.
Published: April 2023

Modern wellness is a concept that has been discussed in the literature since the 1960's. To better understand wellness complexities in a school setting, a concept analysis was conducted using a modified version of Walker and Avant's method incorporating the nursing paradigm in the implications. A literature review was conducted and except for background information, the publication dates were limited to 2017–2022. Key search terms included “wellness,” “school wellness,” “wellness concept.” Additional literature reviews were conducted based on data related to the definitions, attributes, antecedents, and consequences of wellness that were collected from the reviewed studies. Defining attributes of wellness included healthy habits, conscientiousness, and optimum state of health. The antecedents, consequences, and empirical referents of wellness were identified with examples from the literature and case exemplars. Wellness is a dynamic process that has unique implications for school health and school nurses. This concept analysis lays the foundation for future research incorporating nursing domains.
Over-Expression of ARID3B Suppresses Tumor Progression and Predicts Better Prognosis in Patients With Gastric Cancer
Authors: Zhang Xunlei , Qiu Xinyue , Zhao Wenjing , Song Li , Zhang Xingsong , Yang Lei , Tao Min
Published: April 2023

Background

ARID3B (AT-rich interaction domain 3B) has been demonstrated to be associated with the progression and patient prognosis of several human tumors. We conducted the present study to investigate the biological behavior and clinical relevance of ARID3B in gastric cancer (GC).

Methods

Detection of the expression level in GC tissues and cell lines were performed by Western blot and immunohistochemistry. We also retrospectively analyzed the correlation of ARID3B with clinicopathological characteristics and patient prognosis in gastric cancer. The biological functions of ARID3B in GC cells were further explored by transwell migration assays, wound healing assays and cell proliferation assay.

Results

The present study suggested that the expression of ARID3B was significantly lower in GC tissues than in adjacent normal tissues. IHC staining in tissues of 406 GC patients from training and validation sets verified that ARID3B over-expression correlated with clinicopathological features, such as degree of differentiation and clinical stage. Meanwhile, ARID3B was proved to be an independent prognostic factor for GC prognosis. Furthermore, over-expression of ARID3B suppressed proliferation in GC cells according CCK8 assay. We found that over-expression of ARID3B inhibited GC cell migration by transwell assay and wound healing assay. Furthermore, EMT markers were detected in ARID3B over-expression GC cells, which showed that ARID3B may inhibit metastasis of GC cells.

Conclusion

Our results firstly revealed that the expression level of ARID3B was closely correlated with clinicopathological features and may serve as an independent prognostic factor for GC patients. More importantly, ARID3B could suppress GC progression, including cell proliferation, migration and metastasis.
Lung Cancer and Risk Factors in Lebanon: Epidemiology, Temporal Trends, and Comparison to Countries From Different Regions in the World
Authors: Lakkis Najla A. , Musharafieh Umayya M. , Issa Hanane G. , Osman Mona H.
Published: April 2023

Background

Lung cancer (Lca) is the leading cause of cancer morbidity and mortality worldwide. This study examines the Lca incidence and trends in Lebanon and compares them to regional and global ones. It also discusses Lca risk factors in Lebanon.

Methods

Lung cancer data from the Lebanese National Cancer Registry for 2005 to 2016 was obtained. The age-standardized incidence rates (ASRw) and age-specific rates per 100 000 population were calculated.

Results

Lung cancer ranked second for cancer incidence in Lebanon from 2005-2016. Lung cancer ASRw ranged from 25.3 to 37.1 per 100 000 males and 9.8 to 16.7 per 100 000 females. Males 70-74 and females 75+ had the highest incidence. Lung cancer ASRw in males increased significantly at 3.94% per year from 2005 to 2014 ( P > .05), then decreased non-significantly from 2014 to 2016 ( P < .05). Lung cancer ASRw in females increased significantly at 11.98% per year from 2005 to 2009 ( P > .05), then increased non-significantly from 2009 to 2016 ( P < .05). Males' Lca ASRw in Lebanon was lower than the global average in 2008 and became similar in 2012 (34.1 vs 34.2 per 100 000); However, females' Lca ASRw was almost comparable to the global average in 2008 and exceeded it in 2012 (16.5 vs 13.6, respectively, per 100 000). Males’ and Females’ Lca ASRw in Lebanon were among the highest in the Middle East and North Africa (MENA) region but lower than those estimated for North America, China and Japan, and several European countries. The proportion of Lca cases attributed to smoking among Lebanese males and females was estimated at 75.7% and 66.3% for all age groups, respectively. The proportion of Lca cases attributed to air pollution with PM10 and PM2.5 in Lebanon was estimated at 13.5% for all age groups.

Conclusion

Lung cancer incidence in Lebanon is among the highest in the MENA region. The leading known modifiable risk factors are tobacco smoking and air pollution.
Time of Clinic Appointment and Serious Illness Communication in Oncology
Authors: Kolla Likhitha , Chen Jinbo , Parikh Ravi B.
Published: April 2023

Introduction

Serious illness communication in oncology increases goal concordant care. Factors associated with the frequency of serious illness conversations are not well understood. Given prior evidence of the association between suboptimal decision-making and clinic time, we aimed to investigate the relationship between appointment time and the likelihood of serious illness conversations in oncology.

Methods

We conducted a retrospective study of electronic health record data from 55 367 patient encounters between June 2019 to April 2020, using generalized estimating equations to model the likelihood of a serious illness conversation across clinic time.

Results

Documentation rate decreased from 2.1 to 1.5% in the morning clinic session (8am-12pm) and from 1.2% to .9% in the afternoon clinic session (1pm-4pm). Adjusted odds ratios for Serious illness conversations documentation rates were significantly lower for all hours of each session after the earliest hour (adjusted odds ratios .91 [95% CI, .84-.97], P = .006 for overall linear trend).

Conclusions

Serious illness conversations between oncologists and patients decrease considerably through the clinic day, and proactive strategies to avoid missed conversations should be investigated.
Evaluation of Latex Immunoturbidimetric Assay Thresholds and HIT in Cardiothoracic Surgery
Authors: Hernandez Jessica , Patel Hetal , Biddlecome Phil , Kildea Megan , Dwivedi Ruti , Sridhara Shashank , Silvestry Scott , Cavarocchi Nicholas , Francis John L. , Ventura Davide
Published: April 2023

Background

Heparin-induced thrombocytopenia (HIT) is a common differential diagnosis in cardiothoracic surgery. The latex immunoturbidimetric assay (LIA) is an enhanced immunoassay that has recently been introduced for the detection of total HIT immunoglobulin and retains a higher specificity of 95% compared to the enzyme-linked immunosorbent assay.

Objectives

To investigate if a semiquantitative relationship exists between increasing LIA levels beyond the current positivity threshold and its correlation to positive serotonin release assay results in cardiothoracic surgery.

Methods

This was a multicenter, observational cohort of cardiothoracic surgery patients initiated on anticoagulation with heparin-based products. To conduct sensitivity and specificity analysis of LIA values, HIT positive was defined as a LIA value ≥1 unit/mL and HIT negative was defined as a LIA level <1 unit/mL. A receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive performance of the LIA.

Results

At the manufacturer cutoff of ≥1 unit/ml, LIA sensitivity and specificity was 93.8% and 24%, respectively, yielding a false positive rate of 76%. At a higher cutoff of 4.5 units/mL, LIA sensitivity and specificity was 75% and 71%, respectively, yielding a false positive rate of 29% and an area under the ROC curve of 0.75 ( P = .01; 95% confidence interval: 0.615 - 0.88). Bivalirudin was initiated in 84.6% of false positive LIA results.

Conclusion

This study suggests that the diagnostic accuracy of the LIA can be optimized by increasing the LIA positivity threshold. Proposing a higher LIA cutoff, may mitigate unwarranted anticoagulation and bleeding outcomes.
Parent Behavior Management Training for Child ADHD Enhanced to Address Health Behaviors: Comparison of Telemedicine “Telegroup” Versus In-Person Delivery
Authors: Gonzalez Erin Schoenfelder , Tran Nguyen , Wholly Deirdre , Kuhn Michelle , Stein Mark A. , Mendoza Jason , Ola Cindy , Sasser Tyler , Tandon Pooja S.
Published: April 2023

Objective:

ADHD is associated with suboptimal health behaviors including physical activity (PA). LEAP is a parent BMT group program enhanced to focus on health behaviors, integrated with mHealth technology. Little is known about implementing BMT via telemedicine “telegroups.”

Methods:

Children ages 5 to 10 with ADHD and their caregiver wore activity trackers and participated in an 8 to 9 week parent BMT and social media group emphasizing PA, sleep, and screen use. A 7-day child accelerometer-wear and parent and teacher measures were completed pre- and post-group. Groups were in-person prior to the COVID-19 pandemic and in telegroup format during the pandemic.

Results:

Thirty-three families participated in person and 23 participated via virtual telegroup. Group attendance was superior for telegroup with equivalent satisfaction and skill use. Changes in health behavior and clinical outcomes were equivalent.

Conclusions:

LEAP is a feasible and novel BMT intervention that can be delivered in an accessible telegroup format with high participation and acceptability.
Effect of Physiotherapy Interventions on Motor Symptoms in People With Parkinson’s Disease: A Systematic Review and Meta-Analysis
Authors: Yang Yajie , Wang Yang , Gao Tianzi , Reyila Abudurousuli , Liu Jiaxin , Liu Jiajia , Han Hongbin
Published: April 2023

Objective

To evaluate the effectiveness of different types of physiotherapy interventions in people with Parkinson’s disease (PD).

Design

Systematic review and meta-analysis of randomized controlled trials (RCTs).

Methods

Five databases (PubMed, Embase, Cochrane Library, CINAHL and Web of Science Core Collection) were searched for relevant RCTs published from database inception to July 14, 2022. Reviewers independently screened the literature, extracted data, and assessed the literature quality according to the Cochrane Collaboration Risk of Bias Tool and PEDro Scale. This meta-analysis was conducted using RevMan 5.4.1 and reported in compliance with the PRISMA statement.

Results

Forty-two RCTs with 2,530 participants were included. Across all types of physiotherapy, strength training, mind-body exercise, aerobic exercise, and non-invasive brain stimulation (NiBS) were effective in improving motor symptoms as measured by the (Movement Disorders Society-) Unified PD Scale, whereas balance and gait training (BGT) and acupuncture were not. The pooled results showed that the change in mind-body exercise (MD = −5.36, 95% CI [−7.97 to −2.74], p < .01, I2 = 68%) and NiBS (MD = −4.59, 95% CI [−8.59 to −0.59], p = .02, I2 = 78%) reached clinical threshold, indicating clinically meaningful improvements. Considering the effectiveness of the interventions on motor symptoms, balance, gait and functional mobility, mind-body exercise was recommended the most.

Conclusions

Exercise appears to be a better form of physiotherapy than NiBS and acupuncture for improving motor function. Mind-body exercise showed beneficial effects on motor symptoms, balance, gait and functional mobility in people with PD, and is worthy of being promoted.
Cationic nanoemulsion vs. 0.15% sodium hyaluronate artificial tears in the healing process following modern surface keratorefractive surgery
Authors: Jaworski Damian , Cieślińska-Rypolc Agata , Jadczyk-Sorek Katarzyna , Jaworowska-Cieślińska Iwona , Bubała-Stachowicz Beata , Mrukwa-Kominek Ewa , Kałużny Bartłomiej J
Published: April 2023

Purpose

The aim of this study was to investigate the influence of artificial tears containing either cationic nanoemulsion (CCN) or sodium hyaluronate artificial tears (SH) on early postoperative healing after modern surface refractive surgery.

Materials and Methods

In this multicenter, prospective, double-masked, parallel-group (1:1), comparative study, 129 patients (n = 255 eyes) were randomized to receive CCN (n = 128) or SH (n = 127) as an adjuvant treatment after either transepithelial photorefractive keratectomy (transPRK) or Epi-Bowman keratectomy (EBK). The patients’ perspectives were gathered using the Ocular Surface Disease Index (OSDI) questionnaire, and uncorrected (UCVA), and corrected (BCVA) visual acuity were assessed before and one week and one month after the procedure. In addition, corneal epithelization and subjective assessment of visual blur and eye irritation on drop instillation were assessed at one week postoperatively.

Results

No statistically significant differences were found between two groups in age, spherical equivalent refractive error, UCVA, BCVA or OSDI scores before the procedure. There was also no difference between groups in UCVA one week and one month after the procedure. However, statistically significantly lower OSDI scores were found one week and one month after the procedure in the CCN group. Moreover, blurred vision after use of the eye drops was observed less frequently in the CCN group than in the SH group.

Conclusions

The CCN and SH groups had similar postoperative UCVA. However the significantly lower OSDI scores and less frequently blurred vision after application of the eye drops in the CCN group suggest better subjective outcomes in this group.
Vascular dialysis access created in a paretic arm of a patient with a history of cerebral stroke: A case report
Authors: Maloney Sharon-Rose , Beckmann Marianne , Wenger Ursula , Widmer Matthias , Odermatt Urs
Published: April 2023

A patent vascular access is of crucial importance for patients on dialysis. There is no literature describing the success rate and complications of creating dialysis fistulae in a paretic arm. In addition, the risk for non-maturation of dialysis fistula is thought to be high due to the inactivity, muscle atrophy, vascular changes, and higher risk of thrombosis in paretic limbs. Here we describe a case of a successful creation and maturation of a native dialysis fistula.
Efficacy of fresh-frozen cadaveric surgical training for arteriovenous fistula in vascular access
Authors: Hori Katsuhito , Sasaki Yutaro , Shiozaki Keito , Kadoriku Fumiya , Daizumoto Kei , Tomida Ryotaro , Ueno Yoshiteru , Tsuda Megumi , Kusuhara Yoshito , Fukawa Tomoya , Yamaguchi Kunihisa , Yamamoto Yasuyo , Takahashi Masayuki , Tsuruo Yoshihiro , Kanayama Hiroomi
Published: April 2023

Background:

Creation of an arteriovenous fistula (AVF) as vascular access is a basic operation that should be learned by all surgeons involved in renal failure treatment. AVF creation is often challenging for inexperienced young surgeons because it requires comprehensive surgical techniques. For such young surgeons, we introduced cadaveric surgical training (CST) for AVF creation using fresh-frozen cadavers (FFCs). This study was performed to identify the differences in AVF surgical techniques between FFCs and living bodies and to examine the impact of CST on young surgeons.

Methods:

Twelve CST sessions were performed for AVF creation at the Clinical Anatomy Education and Research Center of Tokushima University Hospital from March 2021 to June 2022. Seven young surgeons (1st- and 2nd-year) performed the operation, and two surgeons (10th- and 11th-year) supervised it. We conducted an anonymous questionnaire survey using a 5-point Likert scale to examine the impact of CST on young surgeons.

Results:

Twelve CST sessions were performed on nine FFCs. All training sessions allowed completion of AVF creation with a median operative time of 78.5 min. Although veins and arteries were more difficult to identify than in a living body, other surgical operations could be performed in the same way as in a living body. All the respondents stated that it was good for them to experience CST. In addition, 86% of surgeons responded that CST improved their surgical techniques, and 71% of surgeons responded that they were less anxious about AVF creation.

Conclusions:

CST for AVF creation is useful for surgical education because it enables learning of surgical techniques that are almost equivalent to those in living bodies. In addition, this study suggested that CST not only contributes to the improvement of surgical skills of young surgeons but also promotes the reduction of anxiety and stress about AVF creation.
The safety of peripherally inserted central venous catheters in critically ill patients: A retrospective observational study
Authors: Maezawa Toshinori , Sakuraya Masaaki , Yoshida Kenichi
Published: April 2023

Background:

Centrally inserted central venous catheters (CICCs) are commonly placed in critically ill patients who require a central venous catheter (CVC). Recently, peripherally inserted central venous catheters (PICCs) have been widely used on general wards. However, the safety of PICCs in critically ill patients remains unclear.

Method:

We conducted a retrospective observational study at a mixed intensive care unit (ICU). Adult patients (⩾18 years) who were emergently admitted to the ICU and underwent CVC insertion between April 2019 and March 2021 were enrolled. We compared the safety of PICCs and CICCs. The primary outcome was the overall rate of catheter-related complications, including bloodstream infections, thrombosis, insertional trauma, catheter malfunction, and accidental removal. We used a stabilized inverse probability weighting (sIPW) model to estimate the effects of PICC use.

Results:

A total of 239 CVCs (PICCs, 53; CICCs, 186) were inserted into 229 patients. Although the severity of illness did not differ significantly between the groups, the length of hospital stay and mean indwelling catheter duration were significantly longer in the PICC group. There was no significant intergroup difference in the overall rate of catheter-related complications (PICC: 9.4% vs CICC: 3.8%; odds ratio [OR]: 2.65; 95% confidence interval [CI]: 0.63–10.2, p = 0.145), and there were 7.7 and 9.0 complications per 1000 catheter days in the PICC and CICC groups, respectively (hazard ratio [HR]: 0.61; 95% CI: 0.14–2.65, p = 0.513). After adjustment using the sIPW model, PICC use was not found to be associated with a reduction in catheter-related complications (adjusted OR: 3.10; 95% CI: 0.90–10.7; adjusted HR: 0.53; 95% CI: 0.14–1.97).

Conclusion:

We found no significant differences in catheter-related complications between patients treated using CICCs and those treated using PICCs after emergency ICU admission. Our findings imply that PICCs may be an alternative to CICCs in critically ill patients.
Worldwide Correlations Support COVID-19 Seasonal Behavior and Impact of Global Change
Authors: Hernandez Nicolas , Caetano-Anollés Gustavo
Published: April 2023

Many viral diseases exhibit seasonal behavior and can be affected by environmental stressors. Using time-series correlation charts extrapolated from worldwide data, we provide strong support for the seasonal development of COVID-19 regardless of the immunity of the population, behavioral changes, and the periodic appearance of new variants with higher rates of infectivity and transmissibility. Statistically significant latitudinal gradients were also observed with indicators of global change. Using the Environmental Protection Index (EPI) and State of Global Air (SoGA) metrics, a bilateral analysis of environmental health and ecosystem vitality effects showed associations with COVID-19 transmission. Air quality, pollution emissions, and other indicators showed strong correlations with COVID-19 incidence and mortality. Remarkably, EPI category and performance indicators also correlated with latitude, suggesting cultural and psychological diversity in human populations not only impact wealth and happiness but also planetary health at latitudinal level. Looking forward, we conclude there will be a need to disentangle the seasonal and global change effects of COVID-19 noting that countries that go against the health of the planet affect health in general.
Quantitative Survey on Prevalence of Prescription Pain Medications and Stimulants Use in Young Adults
Authors: Prakash Sreelekha , Gu Yulong , Previti Michele
Published: April 2023

Background:

Prescription drug use including pain relievers and stimulants has been a growing problem in young adults and the issue has been a public health concern for years.

Methods:

This Quantitative Cross-sectional study aimed to collect preliminary data regarding prescription opioid use, prescription stimulant drug use and overdose treatment knowledge in young adults between 18 and 24 years old in a southern New Jersey university through administering an online survey.

Results:

Of the 1663 students who completed the survey, 33% reported using prescription pain relievers and 15% reported using prescription stimulant drugs. Stimulant drug users were found to be more likely to use prescription pain relievers (49%) as compared to non-stimulant users (30%). Furthermore, students with overdose treatment knowledge of opioids were more likely to report misuse of prescription drugs (15%) than students with less knowledge (8%).

Conclusions:

This study reiterates the increasing usage of prescription drugs and stimulant use among college students. There is a need for effective education strategies to inform students about the prescription medication uses and misuse to reduce nonmedical use of prescription medications.
War widows in Serbia: Losses, coping and overcoming
Authors: Bobić Mirjana
Published: April 2023

Unlike the other countries of Central and Eastern Europe, the former Yugoslavia underwent sanguinary disintegration and a socio-economic transformation to the market economy as a result of the wars in the 1990s, and the creation of new national states, with the aim of achieving ethnic homogenisation in the territories of the former republics. The main focus of this article is how war widows – refugees from Croatia and internally displaced persons from Kosovo who settled in Serbia in that period – narrate their experiences of loss, living with and overcoming obstacles in new surroundings. Using conceptualisations of victimhood/survivorship and agency, the article examines how war widows – who were interviewed during field work in several Serbian towns – employed agency and utilised inner and external resources to overcome precarity. War widows and their children are victims of wars, economic and political crisis, nationalism and marginalisation in new places of residence. Nevertheless, many persevered in resolving numerous existential challenges, employing various mechanisms and coping strategies combined with varying degrees of support. In so doing, they gradually regained control over their lives, rebuilt homes and supported their children in the process of moving on from their experiences of war and crisis. The women’s identification with widowhood is a persistent aspect of their lived experiences, and both victimhood and agency are confounded and reflected in their stories, indicating the need to further rethink these concepts, and build policies aimed at both assistance and empowerment.
Feminist futures? Gender and nation in the pro-independence left in Catalonia
Authors: Enguix Grau Begonya
Published: April 2023

This article explores how a feminist approach to politics can resonate within a nation-building project in Catalonia against the backdrop of rising transnational anti-feminist right-wing populism in Europe. Feminism and nationalism have often been presented as oppositional, and nationalist struggles have been considered to further patriarchal regimes. However, nation-building can also be an opportunity to think of feminist alternative futures. The article explores the role of feminism in the political project of the pro-independence Catalan left (Esquerra Independentista), and exposes internal tensions and difficulties in aiming to achieve both independence and feminism in an emancipated Catalonia. Esquerra Independentista adopt two distinctive strategies of feminist politics: the promotion of the indivisibility of social, gender and national struggles (independence, socialism, feminism), and an embodied politics that centralises women’s political agency as a political tool. However, Esquerra Independentista’s proposals for a socialist and feminist future are fragile and limited by internal tensions between the prevalence of masculinist models of doing politics on one hand, and on the other hand, alternative ideas about the strategic importance of class, gender and national oppressions.