bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure and Characteristics of Synoptic-Scale Waves in the Northern Eurasian Storm Track during Summer
Authors: Fukutomi Yoshiki , Hiyama Tetsuya
Published: November 2023

This study examined the dominant structure and characteristics of synoptic-scale (2–8-day periods) waves over northern Eurasia during 40 summer seasons (June–August, 1979–2018). The synoptic-scale wave patterns are isolated using an extended empirical orthogonal function (EEOF) analysis on the 300-hPa geopotential height anomalies, and a composite based on atmospheric circulation fields and gridded precipitation product. The wave patterns are classified into two types from two pairs of EEOF modes. These two different wave types are defined as the polar frontal (PF) mode and Arctic frontal (AF) mode, respectively. The PF-mode waves are initiated in the North Atlantic sector to the west of the British Isles. They propagate eastward across Siberia into the North Pacific, and produce precipitation mainly over the Eurasian polar frontal zone. The AF-mode wave train arcs along the climatological Arctic frontal zone (AFZ). The AF-mode waves originate near the Scandinavian Peninsula. Their eastward passage brings precipitation along the AFZ. The development of the synoptic-scale waves is reflected by unique background conditions over northern Eurasia. The lower-tropospheric baroclinicity in southern Siberia and central Asia favored the baroclinic growth of the PF-mode waves. The AF-mode waves are trapped in the well-organized baroclinic zone along the north coast of the Eurasian continent. The baroclinic zone is coupled with a band of large meridional gradient of potential vorticity in the upper troposphere, suggesting that this band acts as a waveguide for the AF-mode waves.

Significance Statement

This study examines the synoptic-scale waves in the 2–8-day range of time scales over northern Eurasia during summer. The synoptic-scale waves are categorized into two distinct types at different latitude bands by the EEOF analysis on the 300-hPa z anomalies. They are defined as polar frontal (PF) mode and Arctic frontal (AF) mode. Then the EEOF-based composite analysis is conducted to detect the large-scale circulation anomalies associated with the propagation of different types of synoptic-scale waves. The structure and characteristics are examined. The roles of the mean background conditions in the development and propagation of the respective types are discussed. The behavior of these wave disturbances as rain-producing weather systems is also examined.
Cultural trespassers or disruptors? Femininity reinvented and the career advancement strategies of Saudi women senior managers
Authors: Tlaiss Hayfaa A , Khanin Dmitry
Published: November 2023

Does the way in which people do gender influence their career advancement strategies? Based on semi-structured interviews with Saudi women senior managers and drawing from the postcolonial feminist theory, we discover in this study that it does. We show that Saudi women choosing to do gender well, the Sailing Through cohort, achieve career advancement by amplifying their commitment to family responsibilities, enacting respectful femininity, and invoking family associations to build winning alliances. We describe this form of resistance as crafty agency. In contrast, Saudi women choosing to do gender differently, the Trailblazing cohort, achieve their advancement goals by acting in a serious, composed, and competitive manner, investing in their human and professional capital, and effectively using self-promotion and self-advocacy. We describe this form of resistance as determined agency. Overall, our study demonstrates that Saudi women’s agency is not fixed, or definite, or passive but rather it is fluid, multifaceted, and transformational. This article contributes to gender studies by showing how different stances on doing gender drive the reinvention of gender identities and pursuit of alternative career advancement strategies. It also provides a nuanced understanding of how Saudi women attain senior management positions as they navigate the messiness and contradictions of gender roles and gendered contexts, agency, doing gender well and doing gender differently, and career advancement strategies.
Environmental Governance at Crossroads: Civil Society’s Fight Against Industrial Pollution in Kathua Industrial Area, Jammu and Kashmir
Authors: Sharma Manik , Rao G. Durga
Published: November 2023

As a key stakeholder within the domain of environmental governance, the civil society influences the actions and outcomes of regulatory processes, mechanisms and organisations in addition to state, market and communities. The research article attempts to understand the influence the civil society exerts in addressing the environmental concerns of three village panchayats of Kathua district, Jammu and Kashmir, by studying the case of industrial pollution caused by Kathua Industrial Area. Issues like severity and impact of pollution on affected population, awareness, participation and role of the civil society and the ways in which the affected population negotiate with the problem of industrial pollution are analysed. It is found that the civil society is unable to exert bottom-up pressure in influencing the policy actions and outcomes in the study area. The reasons behind such inability and the measures required to make civil society a reckoning force in environmental governance are also discussed in the article.
Drug Legalization and Decriminalization Beliefs Among Individuals with and without a History of Substance Use
Authors: Park Brandon , Hammond Alexis S. , Dunn Kelly E. , Strain Eric C. , Bergeria Cecilia L.
Published: November 2023

Drug legalization and decriminalization policy has changed in recent years. This study examined attitudes regarding drug legalization and decriminalization among persons who use substances, a perspective that can provide a unique view on legalization/decriminalization. A nationwide sample of 515 adults with and without substance use were surveyed online to assess opinions on drug legalization and decriminalization. Legalization/decriminalization beliefs were rated on an 11-point scale (0, “strongly disagree”; 10, “strongly agree”) and compared across demographic and drug use characteristics. Among persons with lived experiences in substance use, direct use of certain substances such as opioids or stimulants appears to be associated with low levels of support for legalization and modest support for decriminalization. Individuals with cannabis use largely supported cannabis legalization and decriminalization. Reasons behind ratings by persons with opioid and cocaine use should be further evaluated. Evolving social acceptance of illicit drug use may shift attitudes over time.
The Structure of Selfhood and Affection in Husserl’s Phenomenology and the Praxis of Mindfulness
Authors: Yang Ying-Chien
Published: November 2023

In this article, I will elaborate what kind of theory of subjectivity is implied in the practice of mindfulness. This article attempts to explain Husserl’s accounts of the constitution of selfhood (as the person) and of affection in our life-stream of consciousness to develop a more complete view of “who we are” in the practice of mindfulness. The practice of mindfulness provides a path to the well-being of the person’s emotional life. What underlies the practice of mindfulness is a particular image of the human mind, which is not just a brain, but a whole person with a psychic life that includes various types of activity, passivity, and embodied emotion. Moreover, the person’s habituality can still be transformed through mental exercise. If we thoroughly understand the relevant relationships between attention, emotions, and affective feelings in our living experience, we can then further confirm, from the Husserlian phenomenological point of view, the benefits of practicing mindfulness for emotional regulation. Emotion is not only a matter of affective feeling, but is also cognitive and is combined with the function of reason.
How Important Is Early Paternal Engagement? Deriving Longitudinal Measures of Fathers’ Childcare Engagement and Exploring Structural Relationships With Prior Engagement and Employment Hours
Authors: Norman Helen , Elliot Mark , Vanchugova Darya
Published: November 2023

Paternal childcare engagement is a focus of work–family policy debates yet there is little consensus about what engagement means and how it might be measured. Drawing on Lamb’s (1986) classification of paternal involvement, we run confirmatory factor analysis on a sample of two-parent households from the UK’s Millennium Cohort Study to derive latent paternal engagement measures at nine months, three, five, seven and eleven years old. Structural Equation Modelling is used to explore the relationship between the engagement measures and parents’ employment hours. Employment hours have a significant association with paternal childcare engagement in the early stages of a child’s life, but it is paternal engagement in the previous time period that has a far stronger effect at every age. Specifically, paternal engagement in the first year of parenthood is important for fostering ongoing engagement until the child is at least age eleven, and this positive effect builds over time.
Factors Associated With Loneliness Among Chinese Patients With Cancer: A Cross-sectional Study
Authors: Lin Jingjing , Zheng Li , Zhang Jun , Zhang Lili , Zeng Yinghua , Liu Yawei , Xiao Lin
Published: November 2023

Background:

Loneliness has a significant impact on the physical and psychological well-being of patients with cancer. However, the specific factors contributing to loneliness among patients with cancer within the context of Chinese culture remain poorly understood.

Objective:

The objective of this study was to identify the factors associated with loneliness among patients with cancer in China.

Methods:

A cross-sectional study was conducted using convenience sampling, involving a sample of 205 patients with cancer from a tertiary hospital in Guangzhou, China. Participants completed several validated questionnaires, including the Cancer Loneliness Scale (CLS), Hospital Anxiety and Depression Scale (HADS), Cancer-Related Negative Social Expectations Scale (C-rNSES), and Social Support Rating Scale (SSRS). Multiple linear stepwise regression analysis was employed to explore the relationships between loneliness and psychosocial factors.

Results:

The median score for loneliness among patients with cancer was 13, with an interquartile range of 8. The multiple linear stepwise regression analysis revealed that negative social expectations, social support, and depression were significantly associated with loneliness in this population. Collectively, these factors accounted for 50.1% ( R2 = .501) of the variance in loneliness.

Conclusions:

The findings of this study highlight the importance of addressing negative social expectations and depression and improving social support to prevent or reduce loneliness among patients with cancer. Health care providers should consider these factors when developing interventions aimed at preventing or alleviating loneliness in this population.
Bidirectional Glenn operation without cardiopulmonary bypass: Single center experience and results
Authors: Nguyen Tran Thuy , Nguyen Duc Hoang , Nguyen Tran-Chung , Luong Long Hoang
Published: November 2023

Background

The bidirectional Glenn (BDG) shunt operation serves as temporary surgery for the treatment of single-ventricle physiology with the eventual Fontan procedure. In some cases, the procedure can be performed without the support of a cardiopulmonary bypass (CPB) machine. In this study, we present the surgical outcomes of off-pump BDG operation with the use of a temporary veno-atrial shunt to decompress the superior vena cava (SVC) during clamping time.

Methods

A cohort of 23 patients underwent off-pump BDG operations at Cardiovascular Center, E Hospital. All patients were operated on using a veno-atrial shunt to decompress the SVC.

Results

Satisfactory results with mean oxygen saturation increased from 79.6 ± 11.2% to 87.2 ± 4.7%. The SVC clamping time was 14 ± 2.4 min (ranging from 12 to 21 min). Among 23 patients, only six patients required blood transfusion, 17 patients had BDG without blood transfusion. No neurological complications or deaths occurred after the surgery, and the post-operative period was uneventful.

Conclusions

The use of veno-atrial shunts to decompress SVC during off-pump BDG operation is safe with good surgical outcomes and can avoid the deleterious effects caused by CPB. It is easily reproducible, at low cost and economically effective.
Relationships between music performance anxiety and impostor phenomenon responses of graduate music performance students
Authors: Sims Wendy L , Ryan Charlene
Published: November 2023

The purpose of this study was to explore potential relationships between music performance anxiety (MPA) and feelings associated with the impostor phenomenon (IP). Participants completed an online questionnaire comprising demographic questions and two instruments: the Kenny Music Performance Anxiety Inventory (KMPAI) and an adapted version of the Clance Impostor Phenomenon Scale (CIPS-P). Although MPA has been found to affect performers of many ages and levels, IP is associated with individuals who are considered successful. Thus, we chose graduate students pursuing music performance degrees at colleges and universities in the United States and Canada to serve as the participants-individuals who have attained success in music performance. Findings from the 171 participants reveal a strong positive correlation between higher levels of MPA and higher frequency of impostor feelings. Responses indicated that over 75% of participants experienced clinically high levels of MPA and frequent to intense impostor feelings. When asked to comment on their experiences related to the pandemic, some of the performers discussed finding little fulfillment performing without an audience present, others described virtual performances as being less stressful than live, and there was concern that the long period without in-person performances may result in a set-back in dealing with performance anxiety.
The investigation on mechanical properties of ultra-high toughness cementitious composite using orthogonal experiment
Authors: Li Hedong , Qiu Xiaoyu , Qiu Yifu , Liu Hanyong , Pan Yunfeng
Published: November 2023

Ultra-high toughness cementitious composite (UHTCC) exhibits excellent deformability and multiple cracking properties under tensile loading, which are subjected to multiple compositional parameters. This paper simultaneously investigated the effects of water to binder ratio (W/B), cement and silica fume to fly ash ratio (CS/F), and amount of expanded perlite powder (EPP) on the mechanical properties of UHTCC using the orthogonal experiment, with compressive strength and tensile properties. The result of range analysis presented that the order of the influence of factors on mechanical indexes was CS/F > W/B > EPP. An increasing CS/F was conducive to the strength. Conversely, a lower CS/F had a beneficial effect on the tensile performance. In addition, the best level (within limited levels in this study) of each factor on indexes was carried out. The consequence of analysis of variance showed that W/B and CS/F had significance on the compressive strength and CS/F was a crucial factor in applications with lower crack width required, such as waterproof engineering. The comprehensive analysis indicated that the combination of W/B = 0.3, CS/F = 4:6, and EPP = 23.3 g/L was recommended for general mechanical properties of UHTCC.
Analysis of fracture state and fatigue life of high modulus carbon fiber wrapped composite barrel
Authors: Yin Rui , Tao Gang
Published: November 2023

High-modulus Carbon Fiber-reinforced Polymer composites are widely used in critical industries due to their exceptional mechanical properties. However, the fatigue and fracture of high modulus carbon fiber materials are currently poorly studied. For this purpose, the NOL ring fatigue tensile testing is referenced and improved to investigate the performance and service life of high-modulus carbon fiber wound barrels. NOL ring specimens, made of M40 carbon fiber material, are subjected to quasi-static tensile and fatigue tests. The fracture state and characteristics of high modulus materials during fatigue are analyzed. Two-parameter Weibull distribution function is used to analysis statistically the fatigue life results of composite samples. Then, the life curve is drawn for different stress amplitudes. Additionally, the fiber fracture surface is observed under a high-power microscope. The fiber fracture model under brittle fracture is established. The results indicate that the fracture characteristics and mechanisms of high-modulus materials differ from those of high-strength materials, necessitating different fatigue life assessment methods. The fatigue failure of high modulus fibers exhibits brittle fracture similar to quasi-static loss, with flat fracture surfaces and minimal cumulative damage. The failure mechanism is accompanied by brittle fractures with a small amount of fiber pulled out.
Risk Factors for Post-Discharge Adverse Outcomes Following Hospitalization Among Older Adults Diagnosed With Elder Mistreatment
Authors: Pappadis Monique R. , Wood Leila , Haas Allen , Westra Jordan , Kuo Yong-Fang , Mouton Charles P.
Published: November 2023

Using 100% Medicare data files, this study explored whether primary elder mistreatment (EM) diagnosis, EM type, and facility type were associated with 3-year mortality and 1-year unplanned hospital readmission among older patients diagnosed with EM with hospital discharge from 10/01/2015 through 12/31/2018 ( n = 11,023). We also examined outcome differences between older patients diagnosed with EM and matched non-EM patient controls. Neglect by others was the most common EM diagnosis. Three-year mortality was 56.7% and one-year readmission rate was 53.8%. Compared to matched non-EM patient controls, older EM patients were at an increased risk of mortality and readmission. Among patients diagnosed with EM, patients with a secondary (vs. primary) diagnosis and those discharged from a skilled nursing facility (vs. acute hospital) were at an increased risk for both mortality and readmission. Compared to other EM types, patients diagnosed with neglect by others had a greater risk for mortality following discharge.
How Do Female Entrepreneurs Differ From Male Entrepreneurs? Distinguishing Personality Traits Throughout the Entrepreneurial Journey
Authors: Gerke Alina , Ianiro-Dahm Patrizia , Muck Peter , Lehmann-Willenbrock Nale , Hell Benedikt
Published: November 2023

This study addresses the underrepresentation of women and the so-far neglected process perspective in empirical entrepreneurial research. It aims to identify the personality traits that differentiate successful female entrepreneurs from their less successful peers and to determine which traits are crucial for pre-launch, launch, and post-launch success. Independent t-tests on 305 female entrepreneurs (and 476 male entrepreneurs) from the DACH region highlight the role of self-efficacy, proactivity, locus of control, and need for achievement for female entrepreneurs. Multiple regression analyses further reveal the importance of self-efficacy for every phase of women’s entrepreneurial journey. While the need for autonomy was critical during pre-launch and launch, locus of control significantly predicted female entrepreneurial success in the pre-launch and post-launch phases. Contrary to previous research, risk-taking was not a crucial trait for female entrepreneurs when compared to their male counterparts, while both showed similar levels of need for autonomy, proactivity, need for achievement, perseverance, self-control, and locus of control. The study offers valuable insights into successful entrepreneurship and highlights the need for female- and phase-specific support programs to enhance self-efficacy among female entrepreneurs.
Crisis Leadership and Moral Rhetoric After a Foreign Attack on the Homeland: Zelenskyy, Bush, and Churchill
Authors: Murray Gregg R. , Sandlin Grantham , Tatalovich Raymond
Published: November 2023

What kind of moral rhetoric do national leaders use after their homelands are attacked by foreign forces? Informed by crisis leadership literature, this study uses Moral Foundations Theory (MFT) to examine the rhetoric of three leaders of nations before and after attacks by foreign forces: Ukrainian President Zelenskyy and the 2022 Russian invasion, U.S. President Bush and the September 11, 2001, terrorist attacks, and British Prime Minister Churchill and the 1940–41 German bombing campaign. The word-based automated content analysis shows that following the attacks the leaders substantially shifted their moral rhetoric. They also employed similar moral rhetoric, mainly by using Harm rhetoric, presumably to condemn the destruction and loss of life suffered by their nations. All three also emphasized Loyalty rhetoric, presumably as a call to nationalism, and Authority rhetoric, presumably to rally followership. Otherwise, they gave little attention to Degradation rhetoric, which presumably would demonize the enemy. This study is one of very few to evaluate political elite rhetoric during crises. It is also one of a small number to assess political elite rhetoric through the lens of MFT. It demonstrates that MFT can be a useful tool for understanding political elite rhetoric and crisis management across heterogeneous contexts.
Dialectical Pluralism for Nursing Knowledge Development
Authors: Inayat Shahzad , McCaffrey Graham
Published: November 2023

The purpose of this paper is to explore the potential of dialectical pluralism (DP) for nursing knowledge development. Nursing scholars have discussed ways of developing nursing knowledge, exploring the fit and relevance of various worldviews for knowledge development and examining the dynamic and perpetual processes of knowledge development. Scholars have argued that knowledge development occurs under a certain worldview to which the researcher adheres. Many nurses employ various worldviews, which can give rise to ontological and epistemological conflicts. DP can help nurses appreciate the diversity of worldviews and recognize the importance of implicit worldviews to generate more practical nursing knowledge. DP as a philosophical approach can enable nurses to communicate between diverse worldviews, become tolerant of conflicting differences, and develop an array of nursing knowledge.
What Factors Contribute to Reading in ADHD: Examining Reading-Related Skills in Children With ADHD Only/Comorbid Developmental Dyslexia
Authors: Liu Wenjuan , Hong Tian , Wang Jiuju , Zhang Linjun , Kang Limei , Wang Changming , Shu Hua , Wang Yufeng
Published: November 2023

Background:

ADHD and developmental dyslexia (DD) frequently co-occur. However, it is unclear why some children with ADHD acquire DD while others do not.

Methods:

A total of 830 children (including typically developing controls, ADHD only, DD only, and ADHD + DD groups) of two ages (younger: first–third grade; older: fourth–sixth grade) were assessed on measures of reading ability and reading-related skills.

Results:

The clinical groups had different degrees of impairment in each reading-related skill. Regression results found that the four groups had different skills in predicting reading ability in younger and older grades. Especially, rapid automatized naming (RAN) was the only predictor of reading ability in children with ADHD only.

Conclusions:

The study highlights that RAN plays an important role in the reading development of children with ADHD only, reflecting the possible protective role of RAN in reading development.
Implementation of the Revised National Malaria Control Guidelines: Compliance and Challenges in Public Health Facilities in a Southern Nigerian State
Authors: Akpan Ubong , Edet Ekpo , Arogundade Kazeem , Akpanika Chinyere , Ekott Mabel , Etuk Saturday
Published: November 2023

Background:

There has been a concerted effort to reduce malaria burden and bring malaria related mortality to zero. The objectives of this survey were to assess the level of adherence to the current revised malaria control guidelines in the public health facilities in Cross River State of Nigeria and to identify the challenges as well as suggest ways for improvement in treatment outcomes.

Methods:

This was a mixed observational and qualitative survey conducted in 32 public health facilities from 21st to 25th June 2022. Treatment records on malaria were assessed for adherence to the National guidelines. In-depth interviews were conducted with 36 key informants and 4 purposefully selected stakeholders to identify the successes and challenges. Quantitative data were summarized and presented in simple proportions and percentages while qualitative information was recorded, the transcripts thematically coded, analyzed and presented using NVivo 11 software.

Results:

The survey revealed that vector control program was poorly implemented across the state. For case management, presumptive treatment was frequently practiced especially at secondary health facilities for uncomplicated malaria. More than 60% of uncomplicated malaria were being treated with parenteral artemether instead of oral artemisinin combination therapy (ACTs) as recommended. Severe malaria were not treated with Intravenous (IV) Artesunate as first line drug in about 40% of the secondary health facilities. Key successes were noted in malaria management in pregnancy. Major challenges identified include: stock out of commodities, shortage of clinical man power, and low trust in parasitological diagnosis.

Conclusion:

The survey showed that adherence to the key recommendations in various categories of malaria control among health care providers in the public health facilities was below expectation. Malaria preventive treatment in pregnancy with SP fared better perhaps because of its inclusion in ANC packages.
Providers’ Competencies and Management Practices for Traditional Palliative Cancer Care Service Delivery in Kenya
Authors: Cheboi Solomon K , Ng’ang’a Wanjiru S , Nyamanga Philamon , Kibet Stanley
Published: November 2023

Background:

Many people in developing countries are struggling with chronic diseases yet traditional health services remain under-utilized in the quest for universal health care. Thousands patronize these outlets for care yet little is known about provider’s competence and how these competencies inform palliative care decisions and practices. The study documented traditional health practitioners (THPs) competencies and practices for traditional palliative cancer care service delivery in Kenya.

Methods:

This study utilized mixed-methods design and was undertaken in major towns across Kenya. A total of 201 Traditional health practitioners were purposely sampled, and interviewed. Five in-depth interviews and 6 focus group discussions were conducted. Quantitative data were analyzed using SPSSv22 while thematic and discourse analysis was carried out for qualitative data.

Results:

Majority (92.7%) of the THPs provided general traditional health services. Nearly half of the respondents (47.7%, n = 92) stated that they had received their knowledge and abilities through divine gifting, 71 (36.8%) lineage, 61 (31.6%) apprenticeship, and 39 (20.2%) formal study. Palliative care was determined by patient state and followed consultation with caregivers for 165 (85.5%) of respondents. For 160 respondents (83%), management practices involved a mix of patient examination, conventional medical tests, herbal medicine administration, follow-up or referral. Positive feedback consisted of symptom reduction and function recovery.

Conclusion:

Core competencies identified include: knowledge acquisition and specialization, assessment, diagnosis and disclosure, decision making, treatment, follow-up, and referral. Traditional palliative care providers share common health-related beliefs, practices and abilities that influence how they approach and make decisions regarding the health management of their patients, despite marked ethnic diversity. The shared pathways offer a chance to develop a cogent traditional palliative care service delivery model and health policy framework to promote its integration within the health workforce. The leading unmet requirements are knowledge of intellectual property rights, disclosure frameworks, and ethical regulation principles.
Deciphering prognostic indicators in AQP4-IgG-seropositive neuromyelitis optica spectrum disorder: An integrative review of demographic and laboratory factors
Authors: Guo Ruo-Yi , Wang Wen-Ya , Huang Jing-Ying , Jia Zhen , Sun Ya-Fei , Li Bin
Published: November 2023

Background:

Neuromyelitis optica spectrum disorder (NMOSD) is a group of inflammatory diseases affecting the central nervous system, characterized by optic neuritis and myelitis. The complex nature of NMOSD and varied patient response necessitates personalized treatment and efficient patient stratification strategies.

Objective:

To provide a comprehensive review of recent advances in clinical and biomarker research related to aquaporin-4 (AQP4)-immunoglobulin G (IgG)-seropositive NMOSD prognosis and identify key areas for future research.

Methods:

A comprehensive review and synthesis of recent literature were conducted, focusing on demographic factors and laboratory investigations.

Results:

Demographic factors, such as age, ethnicity, and sex, influence NMOSD prognosis. Key biomarkers for NMOSD prognosis include homocysteine, antinuclear antibodies, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, thyroid hormone levels, neurofilament light chain levels, and serum glial fibrillary acidic protein might also predict NMOSD attack prognosis.

Conclusion:

Further investigation is required to understand sex-related disparities and biomarker inconsistencies. Identification and understanding of these factors can aid in the development of personalized therapeutic strategies, thereby improving outcomes for NMOSD patients. Future studies should focus on unifying research design for consistent results.
Exploring the relationship between government stringency and preventative social behaviours during the COVID-19 pandemic in the United Kingdom
Authors: Al-Zubaidy Noor , Fernandez Crespo Roberto , Jones Sarah , Drikvandi Reza , Gould Lisa , Leis Melanie , Maheswaran Hendramoorty , Neves Ana Luisa , Darzi Ara
Published: November 2023

We constructed a preventive social behaviours (PSB) Index using survey questions that were aligned with WHO recommendations, and used linear regression to assess the impact of reported COVID-19 deaths (RCD), people’s confidence of government handling of the pandemic (CGH) and government stringency (GS) in the United Kingdom (UK) over time on the PSB index. We used repeated, nationally representative, cross-sectional surveys in the UK over the course of 41 weeks from 1st April 2020 to January 28th, 2021, including a total of 38,092 participants. The PSB index was positively correlated with the logarithm of RCD (R: 0.881, p < .001), CGH (R: 0.592, p < .001) and GS (R: 0.785, p < .001), but was not correlated with time (R: −0.118, p = .485). A multivariate linear regression analysis suggests that the log of RCD (coefficient: 0.125, p < .001), GS (coefficient: 0.010, p = .019), and CGH (coefficient: 0.0.009, p < .001) had a positive and significant impact on the PSB Index, while time did not affect it significantly. These findings suggest that people’s behaviours could have been affected by multiple factors during the pandemic, with the number of COVID-19 deaths being the largest contributor towards an increase in protective behaviours in our model.
Chronic ischemic lesions and presence of patent foramen ovale in young adults with embolic stroke of undetermined source: Results of the young ESUS patient registry
Authors: Meinel Thomas Raphael , Tsiplova Kate , Taylor Amanda , Meseguer Elena , Haeusler Karl Georg , Hart Robert G , Arnold Marcel , Perera Kanjana S
Published: November 2023

Background:

Chronic ischemic lesions (CILs) are frequent findings in patients with acute ischemic stroke, but their phenotypes and relevance in young adults with embolic stroke of undetermined source (Y-ESUS) remains uncertain. We aimed to compare Y-ESUS patients with CIL to those without CIL and assessed the association of CIL and its phenotypes with the presence of patent foramen ovale (PFO).

Methods:

This prospective longitudinal, multicenter cohort study enrolled consecutive patients 50 years and younger with ESUS from October 2017 to October 2019 in 41 stroke research centers in 13 countries. Local investigators adjudicated presence and phenotypes of CIL on routine brain imaging (either magnetic resonance imaging (MRI) or computed tomography (CT)).

Results:

Overall, 535 patients were enrolled (mean age = 40.4 (standard deviation (SD) = 7.3) years, 238 (44%) female). CILs were present in 76/534 (14.2%) patients with a median count CIL count of 1.0 (interquartile range (IQR) = 1–2), 42/76 (55%) had at least one cortical phenotype and 38/76 (50%) at least one non-cortical phenotype. Y-ESUS with CIL were less often female (32% vs 47% in non-CIL Y-ESUS), were older (mean 43 vs 40 years), had more often hypertension (42% vs 19%), diabetes (17% vs 7%), and hyperlipidemia (34% vs 18%). CIL Y-ESUS were independently associated with lower stroke recurrence (relative risk (RR) = 0.17 (0.05–0.61)). In Y-ESUS with PFO, CILs were less frequent in probable pathogenic PFO than with probable non-pathogenic PFO (6.1% vs 30% p< 0.001).

Conclusion:

One in seven Y-ESUS patients has additional CIL. CILs were associated with several vascular risk factors, lower probability of a pathogenic PFO, and lower stroke recurrence.
Mental Health in Emerging Adults With ADHD and/or Specific Learning Disabilities: A Scoping Review
Authors: Wilcox Gabrielle , Gibson Arianna M. , Lindsay Brittany L. , Prasad Sonal , Szeto Andrew C. H.
Published: November 2023

The transition to adulthood, including mental health, has been a focus of research; however, little is known about the mental health outcomes of emerging adults with high incidence diagnoses including ADHD and specific learning disabilities (SLD). This scoping review describes the current state of the research on our understanding of both positive and negative mental health outcomes in these populations. Results of this scoping found an emphasis on emerging adults with ADHD (78%) over those with SLD (12%) or with ADHD and SLD (10%), and over half focused on those who attended postsecondary institutions despite low percentages of these populations going on to postsecondary education. Studies included frequently provided limited information on race or ethnicity, sex or gender, or ADHD or SLD subtypes. Additionally, there was greater focus on negative mental health outcomes (e.g., anxiety, depression) than positive mental health outcomes (e.g., wellbeing, flourishing). We end by discussing implications for future research.0020.
MSMEs: Its Role in Inclusive Growth in India
Authors: Prakash Prem , Verma Pyare Lal , Negi Vinod
Published: November 2023

To foster economic development, generation of jobs, reduction in poverty and promotion of equality, the role of micro-, small- and medium-sized enterprises (MSMEs) becomes crucial in every economy of the world. The MSME sector encourages equitable distribution and inclusive growth as an engine of economic progress. MSMEs have the highest employment growth rate, which has a positive impact on export and industrial growth. The primary objective of this article is to analyse MSMEs’ performance and their contribution to India’s inclusive prosperity. Over the previous two decades, the Indian economy has performed well but the rewards of this expansion have not been distributed fairly. The impact of MSMEs on various socio-economic groups and the engagement of women in India has been studied using a variety of metrics, including employment generation, regional industry distribution and entrepreneurship. The information used in this article was gathered from secondary sources such as Annual MSMEs Reports and the Handbook of Indian Economy Statistics. According to the study’s findings, the MSME sector contributes to inclusive growth in India by offering substantial job possibilities, ensuring that industries are distributed fairly and promoting entrepreneurship among women from underprivileged backgrounds. ‘Make in India’, ‘Digital India’ and other initiatives have created new possibilities for the MSME sector to grow significantly during the coming 10 years.
The promotion of sestrin2/AMPK signaling by HIF-1α overexpression enhances the damage caused by acute myocardial infarction
Authors: Wang Jie , Du Honglei , Sun Qing , Wan Weiping , Zhang Haifeng
Published: November 2023

Objective

Acute myocardial infarction (AMI), is a serious form of coronary heart disease. The present study sought to investigate the impact of HIF-1α on AMI, along with its fundamental mechanism.

Methods

Sprague-Dawley (SD) rats were used to conduct an AMI model. 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) staining was used examine the region of myocardial infract area at various time intervals. Protein expression levels were detected using western blotting. The rats were randomly divided into sham, model, negative control (NC), HIF-1α overexpression (HIF-1α-OE), and HIF-1α-OE+ si-sestrin2 groups. We examined the impact of HIF-1α overexpression on AMI rats using Haematoxylin-Eosin (H&E) staining, TTC staining, enzyme-linked immunosorbent assay (ELISA), TdT-mediated dUTP Nick-End Labeling (TUNEL) assay, and immunohistochemistry (IHC) staining.

Results

According to the TTC findings, the region affected by myocardial infarction reached its peak at day 14. Based on the results from the western blot analysis, the levels of HIF-1α and sestrin2 were found the minimum on day 28. Subsequently, we discovered that the overexpression of HIF-1α rescued the cardiac function parameters, improved the morphology of myocardial tissue, and mitigated inflammation. Furthermore, the overexpression of HIF-1α led to a reduction in the levels of MDA and an increase in the levels of SOD. Moreover, the overexpression of HIF-1α resulted in a decrease in cellular apoptosis. This result was confirmed by the expression levels of Bcl-2 and Bax. Nevertheless, the defensive impact of elevated HIF-1α expression was somewhat counteracted by the suppression of sestrin2. In terms of mechanism, the overexpression of HIF-1α enhanced the levels of sestrin2 and the protein adenosine monophosphate activated kinase (AMPK).

Conclusion

Our research suggests that the overexpression of HIF-1α may rescue the damage to myocardial tissue, and this effect is associated with the sestrin2/AMPK signaling pathway. Our study provides a novel comprehension of the protective effects of HIF-1α overexpression on AMI.
Diabetes mellitus affects the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis
Authors: Xu Guisheng , Hu Xiaojiang , Lian Yanshu , Li Xiuting
Published: November 2023

Background

Both tuberculosis (TB) and diabetes mellitus (DM) are major public health problems threatening global health. TB patients with DM have a higher bacterial burden and affect the absorption and metabolism for anti-TB drugs. Drug-resistant TB (DR-TB) with DM make control TB more difficult.

Methods

This study was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. We searched PubMed, Excerpta Medica Database (EMBASE), Web of Science, ScienceDirect and Cochrance Library for literature published in English until July 2022. Papers were limited to those reporting the association between DM and treatment outcomes among DR-TB and multidrug-resistant TB (MDR-TB) patients. The strength of association was presented as odds ratios (ORs) and their 95% confidence intervals (CIs) using the fixed-effects or random-effects models. This study was registered with PROSPERO, number CRD: 42,022,350,214.

Results

A total of twenty-five studies involving 16,905 DR-TB participants were included in the meta-analysis, of which 10,124 (59.89%) participants were MDR-TB patients, and 1,952 (11.54%) had DM history. In DR-TB patients, the pooled OR was 1.56 (95% CI: 1.24–1.96) for unsuccessful outcomes, 0.64 (95% CI: 0.44–0.94) for cured treatment outcomes, 0.63 (95% CI: 0.46–0.86) for completed treatment outcomes, and 1.28 (95% CI: 1.03–1.58) for treatment failure. Among MDR-TB patients, the pooled OR was 1.57 (95% CI: 1.20–2.04) for unsuccessful treatment outcomes, 0.55 (95% CI: 0.35–0.87) for cured treatment outcomes, 0.66 (95% CI: 0.46–0.93) for treatment completed treatment outcomes and 1.37 (95% CI: 1.08–1.75) for treatment failure.

Conclusion

DM is a risk factor for adverse outcomes of DR-TB or MDR-TB patients. Controlling hyperglycemia may contribute to the favorite prognosis of TB. Our findings support the importance for diagnosing DM in DR-TB /MDR-TB, and it is needed to control glucose and therapeutic monitoring during the treatment of DR-TB /MDR-TB patients.
Associated organs and system with COVID-19 death with information of organ support: a multicenter observational study
Authors: Nakayama Ryuichi , Bunya Naofumi , Tagami Takashi , Hayakawa Mineji , Yamakawa Kazuma , Endo Akira , Ogura Takayuki , Hirayama Atsushi , Yasunaga Hideo , Uemura Shuji , Narimatsu Eichi
Published: November 2023

Background

The organ dysfunction that is associated with death in COVID-19 patients has not been determined in multicenter epidemiologic studies. In this study, we evaluated the major association with death, concomitant organ dysfunction, and proportion of multiple organ failure in deaths in patients with COVID-19, along with information on organ support.

Methods

We performed an observational cohort study using the Japanese multicenter research of COVID-19 by assembling a real-world data (J-RECOVER) study database. This database consists of data on patients discharged between January 1 and September 31, 2020, with positive SARS-CoV-2 test results, regardless of intensive care unit admission status. These data were collected from the Diagnosis Procedure Combination and electronic medical records of 66 hospitals in Japan. The clinician identified and recorded the organ responsible for the death of COVID-19.

Results

During the research period, 4,700 patients with COVID-19 were discharged from 66 hospitals participating in the J-RECOVER study; of which, 272 patients (5.8%) from 47 institutions who died were included in this study. Respiratory system dysfunction (87.1%) was the leading association with death, followed by cardiovascular (4.8%), central nervous (2.9%), gastrointestinal (2.6%), and renal (1.1%) dysfunction. Most patients (96.7%) who died of COVID-19 had respiratory system damage, and about half (48.9%) had multi-organ damage. Of the patients whose main association with death was respiratory dysfunction, 120 (50.6%) received mechanical ventilation.

Conclusion

This study showed that although respiratory dysfunction was the most common association with death in many cases, multi-organ dysfunction was associated with death due to COVID-19.
A novel MRI feature, the cut green pepper sign, can help differentiate a suprasellar pilocytic astrocytoma from an adamantinomatous craniopharyngioma
Authors: Xu Shumin , Yang Wanqun , Luo Yi , Wang Xiaoyu , Li Yaowen , Meng Xianlei , Zhang Yuze , Zeng Hongwu , Huang Biao
Published: November 2023

Objective

There are no specific magnetic resonance imaging (MRI) features that distinguish pilocytic astrocytoma (PA) from adamantinomatous craniopharyngioma (ACP). In this study we compared the frequency of a novel enhancement characteristic on MRI (called the cut green pepper sign) in PA and ACP.

Methods

Consecutive patients with PA (n = 24) and ACP (n = 36) in the suprasellar region were included in the analysis. The cut green pepper sign was evaluated on post-contrast T1WI images independently by 2 neuroradiologists who were unaware of the pathologic diagnosis. The frequency of cut green pepper sign in PA and ACP was compared with Fisher’s exact test.

Results

The cut green pepper sign was identified in 50% (12/24) of patients with PA, and 5.6% (2/36) with ACP. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the cut green pepper sign for diagnosing PA were 50%, 94.4%, 85.7% and 73.9%, respectively. There was a statistically significant difference in the age of patients with PA with and without the cut green pepper sign (12.3 ± 9.2 years vs. 5.5 ± 4.4 years, p = 0.035).

Conclusion

The novel cut green pepper sign can help distinguish suprasellar PA from ACP on MRI.
Machine learning-based approach for predicting low birth weight
Authors: Ranjbar Amene , Montazeri Farideh , Farashah Mohammadsadegh Vahidi , Mehrnoush Vahid , Darsareh Fatemeh , Roozbeh Nasibeh
Published: November 2023

Background

Low birth weight (LBW) has been linked to infant mortality. Predicting LBW is a valuable preventative tool and predictor of newborn health risks. The current study employed a machine learning model to predict LBW.

Methods

This study implemented predictive LBW models based on the data obtained from the “Iranian Maternal and Neonatal Network (IMaN Net)” from January 2020 to January 2022. Women with singleton pregnancies above the gestational age of 24 weeks were included. Exclusion criteria included multiple pregnancies and fetal anomalies. A predictive model was built using eight statistical learning models (logistic regression, decision tree classification, random forest classification, deep learning feedforward, extreme gradient boost model, light gradient boost model, support vector machine, and permutation feature classification with k-nearest neighbors). Expert opinion and prior observational cohorts were used to select candidate LBW predictors for all models. The area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall, and F1 score were measured to evaluate their diagnostic performance.

Results

We found 1280 women with a recorded LBW out of 8853 deliveries, for a frequency of 14.5%. Deep learning (AUROC: 0.86), random forest classification (AUROC: 0.79), and extreme gradient boost classification (AUROC: 0.79) all have higher AUROC and perform better than others. When the other performance parameters of the models mentioned above with higher AUROC were compared, the extreme gradient boost model was the best model to predict LBW with an accuracy of 0.79, precision of 0.87, recall of 0.69, and F1 score of 0.77. According to the feature importance rank, gestational age and prior history of LBW were the top critical predictors.

Conclusions

Although this study found that the extreme gradient boost model performed well in predicting LBW, more research is needed to make a better conclusion on the performance of ML models in predicting LBW.