bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the moderating role of travel motivation in the process of negotiating travel constraints to travel alone of Indonesian muslim female travelers
Authors: Nguyen Dang Thuan An , Luong The-Bao
Published: September 2024

The number of Asian female solo travelers, especially in the Muslim women travel market, has increased significantly due to the changes in social structures and women empowerment. However, Muslim women face unique travel constraints related to gender, social responsibilities, cultural norms, and religious practices, which need to be negotiated when attempting to travel alone. This constraint negotiation process of Muslim women should gain more attention in tourism literature. Thus, the study aims to examine the relationships between travel constraints, negotiation strategies, motivation, and intention to travel alone among Indonesian Muslim women. The structured survey was distributed, and 484 valid responses were collected. The data were then analyzed to test the proposed hypotheses. The results confirm the significant effects of travel constraints on negotiation and travel intention. The moderating roles of travel motivation in the constraint negotiation model are partly supported. The finding of this paper provides insights into the perspectives and travel behavior of Indonesian Muslim women. The results may lack generalizability but offer an opportunity for future studies to further explore the relationships between the proposed constructs. Practically, providers of tourism services should create suitable offerings to meet the distinct requirements of female Muslim travelers.
Development of a glue bonded shear connections aimed for mass timber composites
Authors: Hull T. , Ackerman P. , Lacroix D.
Published: September 2024

Mass timber composites (MTCs) generally require stiff glued connections to meet serviceability design criteria; however, achieving stiff glued connections without conventional pressing infrastructure can necessitate alternative gap filling adhesives. A readily available construction adhesive with potential for use with alternative pressing methods is investigated to develop the needed information for its commercial application in MTCs. The glue line thickness, surface coverage, three contact pressures, and how these parameters influence the load-slip curve of the connection when loaded in pure shear are investigated. The average glue line thickness ranged from 0.76 to 0.33 mm, with lower pressures having thicker glue lines and higher pressures having thinner glue lines. The planning precision was found to be more critical than clamping pressure for glue line thickness. Based on glue bond thickness testing and fabrication experience it is recommended to use 1.2–1.4 mm2 of adhesive per mm width to create full coverage glue bonds without excessive adhesive squeeze out. When tested under pure shear, specimens were observed to fail with a mixture of wood and glue, with more glue failure present as the pressure was increased. The initial stiffness of the connection tended to increase with clamping pressure, while the strength tended to decrease. Two bi-linear data fit models are applied to determine the yield point and simplify the load-slip behaviour for use in design analysis. Overall, the 75% max load method better fit the behaviour and was simpler to apply. The shear strength and stiffness achieved experimentally across all pressures were comparable to other glue connection literature results, and when applied in the design of a 10 m long MTC ribbed panel all pressures achieved near fully composite action. Overall, the adhesive has shown to be an easy to apply and structurally viable connection alternative for MTCs.
Therapeutic advances in neuroinfectious diseases
Authors: Ardakani Rumyar , Jia Lucy , Matthews Elizabeth , Thakur Kiran T.
Published: September 2024

There have been several major advances in therapeutic options for the treatment of neurological infections over the past two decades. These advances encompass both the development of new antimicrobial therapies and the repurposing of existing agents for new indications. In addition, advances in our understanding of the host immune response have allowed for the development of new immunomodulatory strategies in the treatment of neurological infections. This review focuses on the key advances in the treatment of neurological infections, including viral, bacterial, fungal, and prion diseases, with a particular focus on immunomodulatory treatment options. This review also highlights the process by which clinicians can request access to therapeutic agents on a compassionate or emergency basis when they may not be commercially available. While many therapeutic advances have been achieved in the past several years, there remains a pressing need for the continued development of additional therapeutic agents in the treatment of neurological infections.
Status of quality indicators in a mycobacteriology culture laboratory, Hawassa, Sidama, Ethiopia
Authors: Geda Wolde Abreham , Anticho Tariku Lambiyo , Ormago Moges Desta
Published: September 2024

Objective:

We aimed to assess performance parameters in a Hawassa Tuberculosis Culture Laboratory, in the Sidama Regional Public Health Institute.

Methods:

A cross-sectional survey was conducted between 27 October 2020 and 31 May 2021, on 439 clinical specimens. The specimens were processed using standard procedures, and the final suspension was inoculated into a Microbial Growth Indicator Tube and Lowenstein–Jensen media slant. Ziehl–Neelsen staining and the Bioline test kit were used to identify and confirm Mycobacterium tuberculosis. The data were analyzed using the IBM Statistical Package for Social Sciences (SPSS, version 26).

Results:

Out of a total of 439 specimens that were processed, the recovery rates for smear-positive specimens were 61% (25 out of 41) and 58.5% (24 out of 41) for the Mycobacterial Growth Indicator Tube, and the Lowenstein–Jensen methods, respectively. For smear-negative samples, the recovery rates were 4.5% (18 out of 398) for both methods. Only 4 (0.9%) specimens were rejected. The mean turnaround times to detect mycobacteria from smear-positive samples were 14 and 32 days for the Mycobacterial Growth Indicator Tube and Lowenstein–Jensen methods, respectively. The standard deviations were ±6.3 days and ±9.7 days, respectively. For smear-negative samples, the mean turnaround times were 17.7 and 31 days for the Mycobacterial Growth Indicator Tube and Lowenstein–Jensen methods, respectively. The standard deviations were ±9.2 days and ±9.6 days, respectively. The contamination rates for the Mycobacterial Growth Indicator Tube and Lowenstein–Jensen methods were 9.8% (43 out of 439) and 9.6% (42 out of 439), respectively. The detection rate of nontuberculosis mycobacteria was 1.4% (6 out of 439).

Conclusion:

It demands attention to improve the low recovery rate among smear-negative cultures and culture contamination rates.
Post-varicella Secondary Disseminated Staphylococcus aureus Infection in a Child Complicated by Ventricular Pseudoaneurysm and Constrictive Pericarditis: Its Management and Review of Literature
Authors: Sahoo Biswajit , Mohanty Satyapriya , Gulla Krishna Mohan , Nayak Manoj Kumar , Pitchaimuthu Arunprakash
Published: September 2024

Postinfective left ventricular pseudoaneurysm is extremely rare, and very few case reports are available in the literature. Ventricular pseudoaneurysm secondary to staphylococcal infection is usually managed through surgical intervention. We are presenting here a rare case of post-varicella disseminated Staphylococcus aureus infection with ventricular pseudoaneurysm and constrictive pericarditis, which was managed successfully through surgical intervention.
Implementing an early-life nutrition intervention through primary healthcare: staff perspectives
Authors: Osorio Natalie Garzon , Vik Frøydis Nordgård , Helle Christine , Hillesund Elisabet Rudjord , Øverby Nina Cecilie , Helland Sissel H. , Love Penelope , Barker Mary Elizabeth , van Daele Wim , Abel Marianne Hope , Rutter Harry , Bjørkkjær Tormod , Gebremariam Mekdes Kebede , Lian Henrik , Medin Anine Christine
Published: September 2024

Background

Nutrition interventions targeting early childhood can be cost-effective and may provide lifelong, intergenerational benefits. From October 2022 to April 2023 the Nutrition Now (NN) e-learning resource was implemented within Early Childhood Education and Care centres and the Maternal and Child Healthcare Centre (MCHC) in a southern Norwegian municipality. As part of the NN project, the present study aims to explore the MCHC staff’s experiences with implementing the NN resource, to gain insights into measures important to scale up digital early-life nutrition interventions.

Methods

Three group interviews were conducted among public health nurses and midwives alongside one individual interview with the department leader of a MCHC in May 2023. An inductive thematic analysis, as described by Braun and Clarke, was conducted to generate the key themes and subthemes regarding the implementation process of NN within the MCHC.

Results

Three main themes were generated: [1] Important resource but not always utilized; [2] Parents are interested but had issues with access; and [3] Staff and stakeholder buy-in and commitment needed from the start. Overall, the staff viewed the NN resource as a potential tool for promoting diet-related topics and believed it could support the guidance they were already providing parents. However, few staff members fully familiarized themselves with the resource. While staff perceived parents as positive when informed about NN, they believed issues such as access challenges, competing platforms, and time constraints reduced parental engagement. Lastly, staff suggested improvements for NN’s implementation, including enhanced training, better planning, assigning champions, and lowering the threshold for access.

Conclusion

The findings of this study suggest that the real-world implementation of digital evidence-based health behaviour interventions is feasible but would be enhanced by employing strategies focusing on engagement and utilization.

Trial registration

The main study is registered in the ISRCTN registry with ID ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967. (Registration date: 19-06-2022).
Anatomy, digital radiography and cone-beam computed tomography of Western European hedgehog (Erinaceus europaeus) skull
Authors: Ruszkowski Jakub Jędrzej , Zdun Maciej , Arciszewski Marcin Bartłomiej
Published: September 2024

Background

European hedgehogs (Erinaceus europaeus) are small insectivorous mammals common in Europe. With increased urbanization, the species become more frequent in the cities and near other human dwellings. The anatomy of the species with the use of diagnostic imaging techniques along with the classical anatomical methodology has not been researched before. In addition to the description of this species' skull, the data may contribute to progress in hedgehog medicine, delivering a basis for diagnosing and treating head trauma in this species.

Results

Cadavers of 30 European hedgehogs have been used to study the anatomy of the head of the species. Along with classical anatomical techniques – latex and corrosion cast specimens, x-ray, and cone-bean computed tomography scans were performed. The methods were then compared, and the detailed anatomy of the head was described. The skull of the Western European hedgehog was elongated and oval in shape, and could be divided into two distinct regions: one formed of neurocranial bones and the other of facial bones. The neurocranium was composed of the following bones: the occipital, interparietal, parietal, frontal, temporal, sphenoid, ethmoid, and pterygoid bones. The following facial bones were identified: the incisive, nasal, maxilla, zygomatic, palatine, vomer, and the mandible. The most important findings include the primitive tympanic bullae, the absence of a supraorbital foramen, and the lacrimal bones, which were indistinguishably fused with the maxillae.

Conclusions

The results of the study may be used in future research on the comparative anatomy of the other members of the Eulipotyphla order. With the increase of hedgehogs in the cities, it is important to establish new diagnostic and treatment protocols for wildlife rehabilitation centers. Anatomical and radiological descriptions may be used as a base for such work. The anatomical features of the hedgehog skull described in the study may prove useful for further studies from a comparative anatomical perspective. Additionally, the data may serve as a basis for developing identification guidelines for archaeological studies and forensic research.
Why are healthcare professionals leaving NHS roles? A secondary analysis of routinely collected data
Authors: Leary Alison , Maxwell Elaine , Myers Rebecca , Punshon Geoffrey
Published: September 2024

Background

Much policy attention focuses on increasing the supply of workers in the English NHS but there has been less attention paid to the rise in leavers. This paper seeks to explore how existing data sets can illuminate the decision-making of leavers and inform actions that could mitigate this.

Method

Secondary analysis of routinely collected data from 79 workforce projects in the UK (n = 46 339 participants) over a 4-year (2019–2023) period was undertaken. Free text data we extracted and analysed using content analysis, sentiment analysis and text mining. Inclusion criteria were those who stated they had resigned, had confirmed retirement date, and had secured employment elsewhere either within or without the sector but had not yet resigned. Exclusion criteria were those who had not indicated they were leaving or indicated intention to leave. These findings were then compared with themes from Herzberg’s work hygiene theory and Hoffat and Woods’s professional practice environment theory.

Results

Multiple reasons were given for leaving. Findings were congruent with Herzberg’s two factor work hygiene theory and demonstrate that leavers are driven by the inability to meet their intrinsic motivation to practice according to their professional standards as much as by terms and conditions. Leavers describe suboptimal professional practice environments which produce obstacles to achieving their work objectives and leaving their intrinsic motivation frustrated.

Conclusion

Whilst reasons for leaving differ between people, there is a relationship between intrinsic motivation (why they want to do the job) and the conditions in which they try to do the job. This study suggests that looking beyond the primary reason for leaving given in the national dataset could identify how the practice environment influences the decision.
Miniaturized protein profiling permits targeted signaling pathway analysis in individual circulating tumor cells to improve personalized treatment
Authors: Rivandi Mahdi , Franken André , Yang Liwen , Abramova Anna , Stamm Nadia , Eberhardt Jens , Gierke Berthold , Beer Meike , Fehm Tanja , Niederacher Dieter , Pawlak Michael , Neubauer Hans
Published: September 2024

Background

Traditional genomic profiling and mutation analysis of single cells like Circulating Tumor Cells (CTCs) fails to capture post-translational and functional alterations of proteins, often leading to limited treatment efficacy. To overcome this gap, we developed a miniaturized ‘protein analysis on the single cell level’ workflow—baptized ZeptoCTC. It integrates established technologies for single-cell isolation with sensitive Reverse Phase Protein Array (RPPA) analysis, thus enabling the comprehensive assessment of multiple protein expression and activation in individual CTCs.

Methods

The ZeptoCTC workflow involves several critical steps. Firstly, individual cells are labeled and isolated. This is followed by cell lysis and the printing of true single cell lysate preparations onto a ZeptoChip using a modified micromanipulator, CellCelector™. The printed lysates then undergo fluorescence immunoassay RPPA protein detection using a ZeptoReader. Finally, signal quantification is carried out with Image J software, ensuring precise measurement of multiple protein levels.

Results

The efficacy of ZeptoCTC was demonstrated through various applications. Initially, it was used for measuring EpCAM protein expression, a standard marker for CTC detection, revealing higher levels in single MCF-7 over MDA-MB-231 tumor cells. Furthermore, in Capivasertib (Akt-inhibitor)-treated MCF-7 single cells, ZeptoCTC detected a 2-fold increase in the pAkt/Akt ratio compared to control cells, and confirmed co-performed bulk-cell western blot analysis results. Notably, when applied to individual CTCs from metastasized breast cancer patients, ZeptoCTC revealed significant differences in protein activation levels, particularly in measured pAkt and pErk levels, compared to patient-matched WBCs. Moreover, it successfully differentiated between CTCs from patients with different Akt1 genotypes, highlighting its potential to determine the activation status of druggable cancer driving proteins for individual and targeted treatment decision making.

Conclusions

The ZeptoCTC workflow represents a valuable tool in single cell cancer research, crucial for personalized medicine. It permits detailed analysis of key proteins and their activation status of targeted, cancer-driven signaling pathways in single cell samples, aiding in understanding tumor response, progression, and treatment efficacy beyond bulk analysis. The method significantly advances clinical investigations in cancer, improving treatment precision and effectiveness. The workflow will be applicable to protein analysis on other types of single cells like relevant in stem cell, neuropathology and hemopoietic cell research.
High prevalence of HPV-56 and HPV-39 in Sari, Iran: an analysis of genotype distribution
Authors: Letafati Arash , Farahani Ali Vasheghani , Nasiri Mohammad Mostafa Baradaran , Pourmoein Hossein , Ardekani Omid Salahi , Ahoodashty Haniyeh , Hashemi-Soteh Mohammad Bagher , Dadgar Aniseh , Behshood Parisa , Azhar Iman Rezaee , Parsania Masoud
Published: September 2024

Background

Human papillomavirus (HPV) is responsible for the most common sexually transmitted infection, particularly among sexually active individuals. Understanding the geographical distribution and epidemiology of the most prevalent HPV genotypes is essential for developing effective prevention strategies. Consequently, this study aimed to examine the distribution of HPV genotypes among HPV-positive women and men in Sari, the capital city of Mazandaran province in northern Iran.

Materials and methods

HPV DNA was extracted (PZP Company, Molecular IVD, Iran) from genital and cervical samples of the study participants. Genotyping was conducted for 90 cases utilizing the High + Low Papilloma Strip test (Operon Company, Spain). Demographic data were statistically analyzed in correlation with the virological data (STATA version 17).

Results

Overall, 67.7% (61 out of 90) of the cases tested positive for HPV, with 75% of those being classified as high-risk. The participant group consisted of 92% females (83) and 8% males (7). The highest HPV prevalence, 75% (36), was observed in females and males aged under 31, with the majority of positive cases belonging to high-risk genotypes. The most frequently identified genotypes were HPV-11 (23%), HPV-6 (21%), HPV-56 (18%), HPV-39 (16%), HPV-16, HPV-91, and HPV-66 each comprising (14%). HPV-56 was the most common high-risk genotype, accounting for 11 cases (18%), followed by HPV-39, which was present in 10 cases (16%).

Conclusion

The prevalence of HPV infection was particularly high among individuals under the age of 31 for both genders, with men exhibiting a 100% infection rate. These findings emphasize the urgent need for targeted education aimed at the younger population and the implementation of infection control measures. Specifically, widespread HPV vaccination targeting HPV-6, HPV-11, HPV-39, and HPV-56 should be prioritized for the general population.
Defending the right to health in Gaza: a call to action by health workers
Authors: Mohammed Fatima , Elgailani Umniha Siddig Ahmed , Ibrahim Ali Sondos Yassir , Mohamed Razan Faisal Abdullah , Su Yin Elaine Tan , Bravo-Vasquez Martha L.
Published: September 2024

The ongoing conflict in Gaza has led to severe destruction of the health system and eventually its collapse. Moreover, multiple attacks on health workers were reported which led to obstacles in service delivery. The conflict has led to further humanitarian crises including shortage of food, water sanitation, and hygiene, and outbreaks of infectious diseases. About 2 million of Gaza’s population are internally displaced with the majority in Rafah. Rafah’s population has increased by 500% in less than four months. This has led to acute food severity in Gaza for the whole of the population. Moreover, the cut of UNRWA aid is expected to further expand the humanitarian crisis as over 2 million of the population depends on the aid.
The impact of body composition on functional recovery, mortality, and survival: a systematic review of research conducted in a cohort of stroke survivors
Authors: Ewah Patrick Ayi , Badaru Umaru Muhammad , Abba Muhammad Aliyu , Womboh Idoo
Published: September 2024

Background

The phrase obesity paradox after stroke appears to be a recent phenomenon and was first coined in the early 2000s; thereafter, there has been a growing controversy about the phenomenon, with many studies in favor and a few others against it. Notably, obesity a major risk factor for stroke is now regarded as global pandemic. The purpose of this study was to carry out a systematic review on the impact of body weight on functional recovery, mortality, and survival among stroke survivors.

Methods

We searched PubMed and Google scholar from January 2011 to 2022. Studies were recruited if they reported the impact of body weight on functional recovery, mortality, and survival among stroke survivors.

Results

A total of 284,699 subjects (30-studies) were included, and 2 were RCTs and a nested case–control study. Seventeen (n = 197,833, two on intravenous thrombolysis-IVT), and two studies (n = 2565) on body weight and outcome among stroke patients receiving insulin were in support of the obesity paradox. Nine studies (n = 79,451, four on IVT) were against the obesity paradox. For body weight and outcome of ischemic stroke patients treated with IVT, a total of six studies (n = 2940) four against and two in support of the obesity paradox. In addition, two studies (n = 4124) reported on WHR, WC, and BMI on mortality and outcome.

Conclusions

Overall, the odds were in favor of the obesity paradox among stroke patients with their first-time stroke with no report on second-time stroke. The underweight patients showed the worst unfavorable outcome and mortality. Insulin resistance is a major factor underpinning the presence of a paradox among stroke patients with diabetes receiving treatment with insulin therapy. We recommend that the nutritional status of stroke patients be taken into consideration during management. More studies especially on RCT should be conducted to determine the impact of body weight other that BMI on mortality and functional recovery among stroke survivor of African descent.
Feasibility of an antegrade-retrograde single-sheath inverse technique via vertical puncture in dysfunctional hemodialysis arteriovenous fistula angioplasty
Authors: Hasegawa Tetsuya , Tsuboi Masahiro , Takahashi Yuki , Endo Akira , Gotoh Yasuo
Published: September 2024

Background

Stenosis resulting in dysfunctional dialysis access may occur simultaneously on the anastomotic and central venous side. The purpose of this study was to retrospectively evaluate the feasibility of a single sheath inverse technique using the vertical puncture approach to perform bidirectional transvenous percutaneous transluminal angioplasty (PTA) from a single sheath for such dialysis access stenoses.

Materials and Methods

Twenty patients (26 cases; 13 males; median age, 74 [range: 50–89] years) who underwent PTA using the sheath inverse technique for dysfunctional arteriovenous fistula stenoses between April 2019 and June 2023 were included. All procedures were performed in an outpatient setting. A 4-cm sheath (4Fr, four cases; 5Fr, 19 cases; 6Fr, three cases) was inserted by vertical puncture through a cutaneous vein in the forearm (20 cases) or upper arm (six cases). After treating one side of the lesion, the sheath was reversed to treat the lesion on the opposite side. The vessel diameter at the sheath insertion site, the success rate of sheath inversion, the number of PTA balloon catheters used, the PTA success rate, adverse events, and primary and secondary patency rates up to one year after PTA were evaluated.

Results

The median diameter at the sheath indwelling site was 5.2 (range: 3.6–9.5) mm, and sheath inversion was successful in all cases, eliminating the need to place an additional sheath at another site for contralateral stricture treatment. The number of balloon catheters used was one and two in 17 (65%) and eight cases (31%), respectively, and three in one case wherein a drug-coated balloon was used. PTA was successful in all cases and major complications were not observed. However, in one case wherein a sheath had to be placed at the arterial needle puncture site, the skin was hard, leading to difficulty in inversion, and transient venous spasm occurred post-inversion. The primary patency rates at 3, 6 and 12 months after the PTA were 87.5%, 41.7%, and 20.8%, respectively. The secondary patency rates at 6 and 12 months were 100% and 75%, respectively.

Conclusion

The single-sheath inverse technique for arteriovenous fistulas was feasible without sheath withdrawal.

Graphical Abstract
Development and content validation of coordinate response measure (CRM) corpus in Kannada for informational masking measurement
Authors: Rachana Dhananjay , Neelamegarajan Devi
Published: September 2024

Background

Assessing informational masking (IM) involves various methods, broadly categorized as electrophysiological and behavioral approaches. In behavioral methods, researchers often use a range of stimulus types such as tone-in-noise masking, speech masking, music masking, gap detection, modulation masking, and spatial masking. The evaluation of speech perception in noisy conditions often utilizes the coordinate response measure (CRM), a publicly available test developed by Moore (AGARD conference proceedings 311, 1981). The objective of the study is to develop and content validate the Kannada coordinate response measure (CRM) sentences corpus for the information masking measurement.

Results

Stage 1: A total of thirty-eight call signs, eight colors, and eight numbers in the Kannada language were compiled and were given to 15 experts to select the appropriate stimuli. Those stimuli that satisfied the criteria of CVI ≥ 0.90 and CVR ≥ .90 were selected, which consisted of eight call signs, seven numbers, and five colors. Stage 2: By incorporating the chosen call signs, numbers, and colors, seven sentence structures were formulated and were subjected to content validation (criteria of CVI ≥ 0.90 and CVR ≥ .90). The sentence structure “(Call sign) iga (Color) bannada (Number) torsu” was finalized.

Stage 3: Eight speakers (four males and four females) recorded Kannada sentences of about 3.5 s each, which were evaluated by five audiologists for voice quality, rate, and speech clarity using a 4-point scale. The evaluation identified two male and two female speakers with the best recordings.

Stage 4: The final stage involved recording 235 sentences by the selected speakers, which were then assessed by two Kannada-speaking audiologists for face validity on various parameters, ensuring linguistic appropriateness and cultural relevance for inclusion in the final CRM corpus.

Conclusion

The resulting corpus, meticulously curated and content-validated, presents significant potential for advancing research and clinical assessment of informational masking within the Kannada-speaking community. Overall, the CRM’s exceptional performance in challenging listening environments, inherent adaptability across languages, versatility for different age and literacy levels, and effectiveness in speech-intelligibility testing with multiple simultaneous talkers due to its use of call signs underscores its value as a superior measurement tool, which can be used in IM measurement in Kannada-speaking population.
Exploring the associations between momentary cortisol levels and psychotic-like experiences in young adults: Results from a temporal network analysis of daily-life data
Authors: Grąźlewski Tomasz , Samochowiec Jerzy , Gelner Hanna , Gawęda Łukasz , Bogudzińska Bogna , Kowalski Krzysztof , Piotrowski Patryk , Misiak Błażej
Published: September 2024

Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis has been implicated in the development of psychosis and subthreshold psychotic symptoms commonly referred to as psychotic-like experiences (PLEs). The exact mechanisms linking the HPA axis responses with the emergence of PLEs remain unknown. The present study aimed to explore real-life associations between stress, negative affect, salivary cortisol levels (a proxy of the HPA axis activity) as well as PLEs together with their underlying cognitive biases (i.e., threat anticipation and aberrant salience). The study was based on the experience sampling method scheduled over 7 consecutive days in the sample of 77 drug-naïve, young adults (18–35 years). The saliva samples were collected with each prompt to measure cortisol levels. A temporal network analysis was used to explore the directed associations of tested variables. Altogether, 3234 data entries were analyzed. Data analysis revealed that salivary cortisol levels did not directly predict next-moment fluctuations of PLEs. However, higher salivary cortisol levels were associated with higher next-moment levels of PLEs through the effects on threat anticipation and negative affect. In turn, PLEs appeared to predict cortisol levels through the effects on negative affect and event-related stress. Negative affect and threat anticipation were the most central nodes in the network. There might be bidirectional associations between the HPA axis responses and PLEs. Threat anticipation and negative affect might be the most important mediators of these associations. Interventions targeting these mediators might hold promise for disrupting the connection between the HPA axis dysregulation and PLEs.
Reply to S. Najem et al
Authors: El Bairi Khalid , Trapani Dario
Published: September 2024

The emergence of predatory oncology journals represents a significant threat to research integrity. Distance-education approaches to inform oncologists about this risk is promising and effective, particularly for LMICs, as it offers flexibility and affordability.
Determining Clinicopathologic Factors That Influence Treatment in Advanced Breast Cancer in Argentina After CDK4/6 Inhibitors
Authors: Waisberg Federico , Mandó Pablo , Almada Carolina , Kassis Naima , Mainella Andrea , Cermignani Luciano , Riggi María Cecilia , Winocur Melina , González Ramiro , Guercovich Andres , Ayala Natalia , Micheri Cristian , Ituarte Ana Carolina , González Mattos Lucía , Llugdar Pamela , Casalnuovo Mónica , Lutteral Maribel , Cinquini Sebastián , Mazzotta Alejandro , Lara Alcantara Janeth , Penayo Rosa , Gomez-Abuin Gonzalo
Published: September 2024

PURPOSE

The optimal treatment sequence for hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2–) advanced breast cancer (ABC) after progression on first-line cyclin-dependent kinase 4/6 inhibitor (CDKi) and endocrine therapy is unclear. Clinical and biological factors influencing treatment choices and outcomes in the second-line setting need to be elucidated.

MATERIALS AND METHODS

This is a retrospective analysis of a real-world cohort including patients with HR+/HER2– ABC who received CDKi and endocrine therapy in the first-line setting and progressed, requiring second-line treatment. Clinical and biological factors were analyzed to evaluate their association with daily treatment decisions and the prognostic role of progression-free survival (PFS) in the second-line setting.

RESULTS

Two hundred thirty-five patients were included. Second-line treatments were hormone therapy (HT) based in 60% and chemotherapy based in 40% of patients. The second-line median PFS was 6.6 months, with no difference between treatment types. In multivariable analysis, postmenopausal status, lower Ki-67 expression, and non–de novo stage IV disease were associated with improved second-line (2L) PFS. Menopausal status significantly interacted with treatment type, with reduced PFS in premenopausal patients receiving HT-based treatments (4.7 v 8.7 months, P = .00045).

CONCLUSION

In our study, treatment decisions reflected the current algorithm incorporated in our clinical guidelines, and prior treatment response was the most relevant factor to determine 2L treatment decision. Menopausal status interacted with the subsequent therapy efficacy in this setting. Hence, we consider that menopausal status should be routinely evaluated in the subgroup analysis of clinical trials.
Real-World Outcomes of First-Line Treatment With Anti–PD(L)1-Based Combination Therapy for Nonsquamous Metastatic Non–Small Cell Lung Cancer: A Multiregional Chart Review in Europe, Japan, and the United States
Authors: Liu Stephen V. , Dasgupta Anandaroop , Latremouille-Viau Dominick , Rossi Carmine , Rai Pragya , Barlesi Fabrice , Leal Ticiana A.
Published: September 2024

PURPOSE

Anti–PD-1/PD(L)1-based combination therapy is the standard of care in first line (1L) for metastatic nonsquamous non–small cell lung cancer (mnsqNSCLC) without driver alterations. This study aimed to evaluate real-world clinical outcomes in this population.

METHODS

Eligible physicians in the United States, Europe, and Japan abstracted information from medical charts of eligible adult patients with mnsqNSCLC (without EGFR/ ALK, no known ROS1 alterations) who initiated 1L anti–PD(L)1-based combination therapy for mnsqNSCLC between 2017 and 2021. Kaplan-Meier analyses were used to assess overall survival (OS), time-to-treatment discontinuation (TTD), and real-world progression-free survival (rwPFS) after 1L initiation.

RESULTS

Overall, 142 physicians contributed deidentified data from 430 patients' medical charts. The distribution of PD-L1 expression levels was 31.2% with tumor proportion score (TPS) <1%, 42.3% with TPS 1%-49%, and 26.5% with TPS ≥50%. In 1L, patients received anti-PD(L)1 + chemotherapy (84.6%), anti-PD(L)1 + anti-CTLA4 with or without chemotherapy (11.9%), and anti-PD(L)1 + chemotherapy + anti-vascular endothelial growth factor receptor (3.5%). The median OS was 21.7 months (TPS <1%: 18.3 months; TPS 1%-49%: 21.6 months; TPS ≥50%: 24.0 months). The median TTD was 11.0 months (TPS <1%: 9.1 months; TPS 1%-49%: 10.9 months; TPS ≥50%: 12.2 months). The median rwPFS was 11.2 months (TPS <1%: 9.3 months; TPS 1%-49%: 11.1 months; TPS ≥50%: 13.2 months).

CONCLUSION

This study assessed the real-world clinical effectiveness of 1L anti–PD(L)1-based combination therapy for mnsqNSCLC. Results from this study were generally consistent with previous clinical trials and published real-world evidence in 1L mnsqNSCLC.
Ευρωπαϊκή ολοκλήρωση και νεολειτουργισμός
Authors: Φραγκούλη Χρυσούλα
Published: September 2024

Στις μέρες μας, υπάρχει ιδιαίτερο ενδιαφέρον για το μέλλον του προγράμματος ERASMUS. Το ερώτημα που τίθεται στο πλαίσιο της παρούσας μελέτης είναι η εξέταση της ευρωπαϊκής πολιτικής στον τομέα της εκπαίδευσης με έμφαση στη μελέτη των ευρωπαϊκών εκπαιδευτικών προγραμμάτων και ιδιαίτερα του προγράμματος Erasmus. Ειδικότερα, διερευνάται ο βαθμός στον οποίο οι θεωρητικές παραδοχές της νεολειτουργικής προσέγγισης μπορούν να ερμηνεύσουν την εξέλιξη της ευρωπαϊκής πολιτικής στον τομέα της εκπαίδευσης. Η επιλογή του προγράμματος ERASMUS έγινε με βάση ότι είναι το πιο σημαντικό, δημοφιλέστερο και μαζικότερο πρόγραμμα στο πλαίσιο της ευρωπαϊκής εκπαιδευτικής πολιτικής. Η έρευνα αφορά μια μακροχρόνια περίοδο (1971-2007) για την ανάδειξη των αλλαγών που συντελούνται στους άξονες δράσης, τους θεσμούς και τις πολιτικές επιλογές, καθώς και για τον εντοπισμό των επαναλήψεων των φαινομένων που μαρτυρούν τη λειτουργία της Ε.Κ. /ΕΕ.
Key Guidelines for Responding to Reviewers
Authors: Hidouri Saida , Kamoun Hela , Salah Sana , Jellad Anis , Ben Saad Helmi
Published: September 2024

Background The process of preparing a scientific manuscript is intricate, encompassing several critical stages, including pre-writing, research development, drafting, peer review, editing, publication, dissemination, and access. Among these, the peer review process (PRP) stands out as a pivotal component requiring seamless collaboration among editors, reviewers, and authors. Reviewers play a crucial role in assessing the manuscript’s quality and providing constructive feedback, which authors must adeptly navigate to enhance their work and meet journal standards. This process can often appear daunting and time-consuming, as authors are required to address numerous comments and requested changes. Authors are encouraged to perceive reviewers as consultants rather than adversaries, viewing their critiques as opportunities for improvement rather than personal attacks. Methods Opinion article. Aim To equip authors with practical strategies for engaging effectively in the PRP and improving their publication acceptance rates. Results Key guidelines include thoroughly understanding and prioritizing feedback, maintaining professionalism, and systematically addressing each comment. In cases of significant disagreement or misunderstanding, authors have the option to refer the issue to the editor. Crafting a well-organized and scientific “response to reviews” along with the revised manuscript can substantially increase the likelihood of acceptance. Best practices for writing an effective response to reviews include expressing gratitude, addressing major revisions first, seeking opinions from co-authors and colleagues, and adhering strictly to journal guidelines. Emphasizing the importance of planning responses, highlighting changes in the revised manuscript, and conducting a final review ensures all corrections are properly documented. Conclusion By following these guidelines, authors can enhance their manuscripts’ quality, foster positive relationships with reviewers, and ultimately contribute to scholarly advancement.
A Strategic Approach to Succeed on Clinical Case-Based Multiple-Choice Exams
Authors: Jain Animesh , Patel Kunal P. , Fleischman Gita , Howard Neva , Lacy Smith Kelly , Niess Meredith , Bakal Erin , Shenvi Christina L.
Published: September 2024

Despite the importance of case-based multiple-choice question (CBMCQ) exams, medical educators rarely discuss strategies to systematically approach these questions, and literature on the topic is limited. Through trial-and-error, many students discover or develop more refined and efficient approaches to answering CBMCQs that help them maximize the application of their knowledge base. In this article we present a structured approach to answering CBMCQs, including meta-cognitive strategies to understand the reasons for errors. We provide strategies for success on CBMCQ-based exams and approaches to challenging question types. We also present tips for helping neurodiverse students and an approach for medical educators to teach these skills to their learners.
Building resilient infrastructure, supporting sustainable industrialization, and fostering innovation (SDG 9) in selected European countries: spatial and taxonomic analysis
Authors: Grodzicki Tomasz , Jankiewicz Mateusz
Published: September 2024

Sustainable Development Goals (SDGs) consist of 17 goals and 169 targets to be met by the end of 2030. Since the European Union (EU) members are also included in the 2030 Agenda for Sustainable Development set by the United Nations (UN) countries, it is vital to analyze the Sustainable Development performance of the EU economies. This paper focuses on SDG 9, which aims to build resilient infrastructure, support inclusive and sustainable industrialization, and foster innovation. This research analyzes the industry, innovation and infrastructure indicators in selected European economies. The main aim of this paper is to assess the performance of the European economies in SDG 9 and to verify whether there are any spatial dependencies among countries. Applying the taxonomic measure of development and its spatial version to the group of 29 countries from Europe shows that Sweden and Denmark were the leading countries in SDG 9 in 2013 and 2019. Eastern and South-Western Europe was characterized by the lowest level of SDG 9 in 2013 and 2019. The level of SDG 9 increased over the period 2013–2019.
Atividade física e comportamento sedentário de adolescentes da rede pública: uma análise de redes
Authors: Porto Bruno  de Albuquerque , Nascimento José Ywgne Vieira do Nascimento , Giudicelli Bruno Barbosa , Pinheiro Ingrid Kelly Alves dos Santos , Assis Vannina Oliveira , Bandeira Paulo Felipe Ribeiro , Silva Danilo Rodrigues Pereira da , Luz Leonardo Gomes de Oliveira
Published: September 2024

O Programa Saúde na Escola (PSE) e a Pesquisa Nacional de Saúde do Escolar (PeNSE) merecem destaque entre as ações de promoção e monitoramento da saúde de estudantes brasileiros. Nesse contexto, a promoção da atividade física em escolas integra as ações do PSE, além de ser monitorada pela PeNSE. O presente estudo verificou a associação entre características do indivíduo, socioeconômicas, de ações de promoção da atividade física e da saúde na escola, incluindo a adesão escolar ao PSE, com os comportamentos ativo e sedentário de estudantes brasileiros matriculados em escolas públicas, participantes da PeNSE – 2019. Trata-se de estudo com dados secundários. A amostra contou com 48.204 adolescentes, com idades entre 13 e 18 anos. As variáveis foram coletadas através de questionário. A adesão da escola ao PSE é uma das variáveis de maior centralidade da rede, com destaque para a sua medida de força (1,433); entretanto, apresentou-se pouco conectada aos indicadores de atividade física e ao comportamento sedentário dos jovens. A análise de redes mostrou que o gênero feminino participa menos das atividades físicas em aulas de Educação Física (-0,176) e em tempo livre (-0,283), assim como ter internet em casa foi a principal variável associada com o maior tempo de exposição aos comportamentos sedentários (0,225). Os resultados apontam para a importância da adesão escolar ao PSE e para a necessidade do desenvolvimento de ações efetivas de promoção da atividade física como estratégia de promoção da saúde no âmbito do PSE.
A Review of the Physio-Biochemical and Molecular Mechanisms of Salt Tolerance in Crop
Authors: Shelar Pramod Vilas , Mankar Ganesh Deepak , Sontakke Om Prafull , Bhosale Kishor Suresh , Nikalje Ganesh Chandrakant , Ahire Mahendra Laxman , Nikam ukaram Dayaram , Barmukh Rajkumar Baban
Published: September 2024

Soil salinity is a major abiotic stressor that hampers agricultural productivity worldwide, with both natural and anthropogenic factors contributing to its rise. Salinity disrupts osmotic and ionic balance, impairs seed germination, hinders photosynthesis, and exacerbates oxidative stress, leading to significant membrane damage. In response, plants have evolved various biochemical and physiological and molecular mechanisms to tolerate high salinity. Recent research has greatly advanced our understanding of salt tolerance by identifying key genes associated with this trait. These studies have highlighted essential genes involved in ion transport, stress signaling, and maintaining osmotic balance. By integrating genetic insights with practical approaches like breeding and genetic engineering, researchers are developing crops better suited to saline environments, which is crucial for addressing global food security challenges. This paper aims to review recent findings on the impact of salt stress on plants and explore the physiological, biochemical, and molecular mechanisms underlying salt tolerance.
Exploring the Use of Cropping Indices Over the Growth and Yield Performance for Selecting Okra–cowpea Intercropping Systems
Authors: Arumugasamy Kirisha , Karthigesu Jeyavanan , Sinnamani Sritharan
Published: September 2024

Intercropping of crops has several advantages over monocropping systems, offering efficient utilization of farm resources. While growth and yield remain primary determinants of intercropping success, factors such as crop selection, farm resources, cropping period, and competition also influence outcomes. The choice of appropriate evaluation methods becomes significant for sustainable crop management. Therefore, employing suitable evaluation methods is crucial in the choice of an intercropping system. To address this, three intercropping systems were established in a randomized complete block design (RCBD): single row of okra with single row of cowpea (T1), single row of okra with double–row of cowpea (T2), and double–row of okra with single row of cowpea (T3). Additionally, monocropping systems of each crop were established for evaluation of cropping indices. Cropping indices such as land equivalent ratio (LER), relative yield total (RYT), area time equivalent ratio (ATER), competition index (CI), aggressivity index (Ai) and multiple cropping index (MCI) were applied to assess the intercropping systems. We found that the most favourable combination was T3 based on cropping indices, contrasting with outcomes from growth and yield analysis (T1 and T2). T3 exhibited a yield advantage of 4.2%, with no observed crop competition and maximal land utilization (>95%), establishing cowpea as the dominant crop in these systems. In conclusion, while growth and yield analysis have been practiced in evaluating intercropping systems, this study emphasizes the importance of incorporating cropping indices to comprehensively assess efficiency and sustainability in intercropping practices.
Design and Implementation of a Cloud-Based Smart Agriculture System for Crop Yield Prediction using a Hybrid Deep Learning Algorithm
Authors: Sharma Avdesh Kumar , Rathore Abhishek Singh
Published: September 2024

This article proposes a cloud-based smart agriculture system for crop yield prediction using hybrid deep learning techniques. The study aims to improve crop yield prediction accuracy and facilitate decision-making for farmers. The system utilizes a hybrid deep learning approach that combines convolutional neural networks (CNNs) and recurrent neural networks (RNNs) to process multi-sensor data, including weather data, soil moisture data, and crop growth data. The CNNs are used to extract spatial features from the input data, while the RNNs are used to capture temporal dependencies. The proposed model is employed on a cloud platform, allowing farmers to access the system from anywhere using a web-based interface. Experimental results show that the proposed hybrid deep learning approach outperforms traditional machine learning methods for crop yield prediction, achieving a prediction accuracy of over 90%. Its ability to predict crop yields properly was demonstrated by its decreased MAE and RMSE to 2.17% and 2.94% respectively. It also showed a better fit between the expected and actual data, with a higher R-squared value. The proposed system has the potential to improve the efficiency and profitability of farming operations and contribute to sustainable agriculture practices.