bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic Folding Envelope Design
Authors: Haji Zamri Mohammad Hazim , Nor Aiman Sukindar  , Fethma M. Nor  , Haji Ismail Muhammad Aqil Aizuddin , Lim Beng Lei  , Ab Aziz Ahmad Azlan
Published: February 2025

This study focuses on the development of the Dynamic Folding Envelope Design (DFED), a portable shading device created in response to global warming challenges. Addressing the need for environmentally conscious yet comfortable shading solutions in outdoor recreational spaces, particularly glamping, the research aims to create a user-focused, versatile, and customizable device. Utilizing research tools, user testing, interviews, and prototyping, the study culminates in an Arduino-powered prototype. Survey results and in-depth interviews highlight the demand for features such as replaceable canopies and autonomous functionality, while also identifying practical hurdles like hardware limitations and coding complexities. The study reviews the DFED's practicality and efficacy, emphasizing the importance of addressing technical challenges and refining design aspects. Overall, the DFED represents a significant step towards sustainable and user-friendly shading solutions in outdoor recreational spaces.
Network Indicators of Public Bus Transportation Network in Klang Valley and their Correlations
Authors: Rashid Nur Umaisara , Chan Kar Tim , Abdul Halim Umair
Published: February 2025

Complex network-based analysis of the real-world system has frequently assisted researchers in providing a crucial and extensive understanding of a variety of interconnected useful data especially on public transportation services. In this paper, we construct a public bus transportation network of eight zones in Klang Valley before evaluating their characteristics based on some network measurements such as average degree and clustering coefficient followed by calculation on five network indicators namely accessibility, centralization, robustness, directness, and service connectivity. These network indicators are helpful in providing extensive analysis of the network performance. Other than that, we also analyse the correlation between the network indicators. It is found that the different network indicator is beneficial in describing the network performance based on different network components and characteristics such as how betweenness centrality and closeness centrality are applied as part of the centralization and accessibility measurement respectively.
Exploring Learning Gaps in the Functions Subtopic: A Study of Form 4 KSSM Additional Mathematics Pretest Results of Secondary School Students
Authors: Iskandar Shah Muhammad Haziq , Anuar Muhammad Faiz , Mohd Siti Munirah , Mohamad Jan Nurhidaya , Masrul Hisham Muhammad Riefdy , Mohd Idris Fadzidah , Kaco Hatika , Nakhma'Ussolikhah Nakhma'Ussolikhah
Published: February 2025

Understanding functions is a crucial aspect of the Form 4 Additional Mathematics curriculum under the KSSM syllabus. However, many students struggle to grasp its core concepts, highlighting potential gaps in instructional effectiveness. This study aims to assess students' proficiency in the Functions subtopic through a diagnostic pretest administered to a group of talented students in secondary school. Methods included the analysis of pretest results to identify common misconceptions and knowledge gaps, using statistical tools to interpret student performance. The results revealed significant areas where students lacked understanding, particularly in inverse functions and composite functions. These findings underscore the need for targeted interventions in teaching methods. In conclusion, this study provides insights into students' challenges with functions and suggests strategies for improving learning outcomes. Future research may extend this approach to other mathematical topics to enhance overall student competency.
Secondary Prevention of Osteoporotic Fracture with IV Zoledronate
Authors: Ng James , Ong Tze Ying
Published: February 2025

Osteoporotic fractures are a significant global public health concern, particularly in aging populations. They contribute to substantial morbidity, mortality, and healthcare costs, with over 300,000 fragility fractures annually in the UK, costing approximately £4.4 billion. Hip fractures are the most severe, with a one-year mortality rate of 20–30%. Effective secondary prevention strategies are essential to reduce the burden on healthcare systems. 
Zoledronate, a third-generation bisphosphonate, effectively reduces recurrent fracture risk, improves bone mineral density, and lowers mortality, with the advantage of annual dosing for better adherence. 
This quality improvement initiative was aimed to enhance secondary prevention through a local protocol promoting intravenous (IV) zoledronate post-hip fracture, in line with the National Osteoporosis Guideline Group (NOGG). Retrospective analysis of 64 patients (mean age 73 years) revealed a significant increase in IV zoledronate prescriptions from 14% to 61% after protocol implementation.
This study demonstrates that local protocols, supported by multidisciplinary team (MDT) education and tools such as Fracture Liaison Services (FLS) and the National Hip Fracture Database (NHFD), have improved osteoporosis management across NHS hospitals. However, challenges persist, including limited FLS coverage, suboptimal treatment adherence, and resource constraints. Addressing these barriers is critical to optimising care for elderly patients at risk of recurrent fractures.
AI in NHS and Social Care
Authors: Aravind Shetty Amrit Raj , Kolli Sreedhar , Pasupuleti Sree Siddi Tilak , Singh Anurag
Published: February 2025

This commentary explores the potential of AI in transforming the NHS and social care in the UK to address challenges like health disparities and chronic diseases. It outlines various applications of AI in different healthcare domains, including pre-hospital health monitoring, elective care waiting lists, triaging, online treatment, diagnosis, imaging, electronic prescribing, and customizing treatment. Leveraging AI can identify vulnerable populations and reduce health disparities. However, it also emphasises the need for further research and careful consideration of ethical and privacy concerns to maximise the benefits of AI integration in healthcare. Overall, AI offers innovative solutions to enhance healthcare delivery and improve public health outcomes.
Light Streak Photometry and Streaktools
Authors: Goodeve Joshua L.
Published: February 2025

The accuracy of photometric calibration has gradually become a limiting factor in various fields of astronomy, limiting the scientific output of a host of research. Calibration using artificial light sources in low Earth orbit remains largely unexplored. Here, we demonstrate that photometric calibration using light sources in low Earth orbit is a viable and competitive alternative/complement to current calibration techniques, and explore the associated ideas and basic theory. We present the publicly available Python code Streaktools as a means to simulate and perform photometric calibration using real and simulated light streaks. Using Streaktools, we perform “pill” aperture photometry on 131 simulated streaks, and Markov chain Monte Carlo based point-spread-function (PSF) model-fitting photometry on 425 simulated streaks in an attempt to recover the magnitude zeropoint of a real exposure of the Dark Energy Camera instrument on the Blanco 4 m telescope. Our results show that calibration using pill photometry is too inaccurate to be useful, but that PSF photometry is able to produce unbiased and accurate (1σ error = 3.4 mmag) estimates of the zeropoint of a real image in a realistic scenario, with a reasonable light source. This demonstrates that light-streak photometry is a promising alternative and complement to established techniques, which should be explored and tested further.
Alfvén Wave Conversion to Low Frequency Fast Magnetosonic Waves in Magnetar Magnetospheres
Authors: Bernardi Dominic , Yuan Yajie , Chen Alexander Y.
Published: February 2025

Rapid shear motion of magnetar crust can launch Alfvén waves into the magnetosphere. The dissipation of the Alfvén waves has been theorized to power the X-ray bursts characteristic of magnetars. However, the process by which Alfvén waves convert their energy to X-rays is unclear. Recent work has suggested that energetic fast magnetosonic (fast) waves can be produced as a byproduct of Alfvén waves propagating on curved magnetic field lines; their subsequent dissipation may power X-ray bursts. In this work, we investigate the production of fast waves by performing axisymmetric force-free simulations of Alfvén waves propagating in a dipolar magnetosphere. For Alfvén wave trains that do not completely fill the flux tube confining them, we find a fast wave dominated by a low frequency component with a wavelength defined by the bouncing time of the Alfvén waves. In contrast, when the wave train is long enough to completely fill the flux tube, and the Alfvén waves overlap significantly, the energy is quickly converted into a fast wave with a higher frequency that corresponds to twice the Alfvén wave frequency. We investigate how the energy, duration, and wavelength of the initial Alfvén wave train affect the conversion efficiency to fast waves. For modestly energetic star quakes, we see that the fast waves that are produced will become nonlinear well within the magnetosphere, and we comment on the X-ray emission that one may expect from such events.
Impacts of UV Radiation from an AGN on Planetary Atmospheres and Consequences for Galactic Habitability
Authors: Sippy Kendall I. , Eager-Nash Jake K. , Hickox Ryan C. , Mayne Nathan J. , Brumback McKinley C.
Published: February 2025

We present a study of the effects of ultraviolet (UV) emission from active galactic nuclei (AGN) on the atmospheric composition of planets and potential impact on life. It is expected that all supermassive black holes, which reside at galactic centers, have gone through periods of high AGN activity in order to reach their current masses. We examine potential damaging effects on lifeforms on planets with different atmosphere types and receiving different levels of AGN flux, using data on the sensitivity of various species’ cells to UV radiation to determine when radiation becomes “dangerous.” We also consider potential chemical changes to planetary atmospheres as a result of UV radiation from AGN, using the Platform for Atmosphere, Land, Earth, and Ocean photochemical model. We find that the presence of sufficient initial oxygen (surface mixing ratio ≥10−3 mol mol−1) in the planet’s atmosphere allows a thicker ozone layer to form in response to AGN radiation, which reduces the level of dangerous UV radiation incident on the planetary surface from what it was in absence of an AGN. We estimate the fraction of solar systems in galaxies that would be affected by substantial AGN UV radiation, and find that the impact is most pronounced in compact galaxies such as “red nugget relics,” as compared to typical present-day ellipticals and spirals (using M87 and the Milky Way as examples).
Interférence des médicaments anticoagulants avec la recherche d’un anticoagulant lupique : attention aux faux positifs !
Authors: Delrue Maxime , Auditeau Claire , Hadj Ali A. , Stepanian Alain , Siguret Virginie
Published: February 2025

La recherche d’un anticoagulant lupique fait partie du bilan biologique réalisé lors d’une suspicion du syndrome des anti-phospholipides ou d’autres maladies auto-immunes. Cet examen est fréquemment prescrit chez des patients traités par un anticoagulant : dérivé de l’héparine, anti-vitamine K (AVK) ou encore anticoagulants oraux directs (AOD). Ces traitements interfèrent avec les tests fonctionnels d’hémostase permettant la détection d’anticoagulant lupique (LA) : temps de céphaline avec activateur sensibilisé et temps de venin de vipère Russell dilué. L’objectif de cet article est d’illustrer, à l’aide de trois cas cliniques, le risque de fausse positivité des tests réalisés en présence d’anticoagulant, et d’aborder les solutions permettant de lever ou de limiter ces interférences analytiques.
Les agents pathogènes transmis par la tique Ixodes ricinus : quoi de neuf ?
Authors: Lejal E. , Vayssier-Taussat Muriel , Thépault Aude
Published: February 2025

En Europe, les tiques sont les premiers vecteurs d’agents pathogènes pour l’Homme et l’animal. De fait, elles représentent un enjeu important en termes de santé publique et vétérinaire. D’autant plus que les maladies à tiques connaissent actuellement une recrudescence, pouvant être due à plusieurs facteurs (gestion des espaces agricoles et forestiers, changements globaux, meilleures connaissances dans le domaine médical, augmentation des pratiques à risques, etc.). Ixodes ricinus est l’espèce de tiques la plus répandue en Europe occidentale et capable de transmettre la plus grande diversité d’agents pathogènes, aussi bien des bactéries que des virus ou des parasites. Elle constitue donc un problème de santé publique et vétérinaire important. Ainsi, les nouvelles connaissances quant à sa distribution, aux agents pathogènes qu’elle véhicule ou au risque de piqûre à un endroit donné, sont autant d’informations cruciales pour améliorer les systèmes de lutte contre les maladies à tiques qui passent en premier lieu par la prévention du risque lié à la piqûre de tique.
Management of safety and health at work: Emotional intelligence in university personnel
Authors: Guimerà Gallent Marta , March Amengual Jaume Miquel , Arimany Serrat Núria
Published: February 2025

Purpose: The aim of this research is to evaluate the effectiveness of an emotional education program in a sample comprising university personnel. The study also seeks to examine the relationships between work engagement and emotional intelligence.Design/methodology/ approach: First, this study includes an exploratory study. Second, it comprises a pre-post quasi-experimental design with random assignment of participants into an experimental group and a control group. For data collection, a mixed methodology has been used.Findings: This study revealed positive correlations between emotional intelligence, engagement and stress. For this reason, for university personnel, it is advisable to promote emotional education programs to increase their emotional intelligence and influence the well-being of staff, with perceptions of stress under control and greater commitment to the institution.Research limitations/implications: A limitation of the study is that it is carried out at a single university in a certain period and cannot be compared with other universities. In future research, the methodology will be extrapolated to other universities to evaluate the results in different university institutions to draw conclusions in this regard in university higher education.Practical implications: The findings of this research have practical implications for organizations aiming to enhance workplace well-being and productivity by implementing emotional education programs among workers.Originality/value: This study contributes to the existing literature by exploring the impact of an emotional education program on university workers, shedding light on the intersection between emotional intelligence, work engagement and perceived stress.
The effectiveness of using the flipped classroom in science education for ninth-grade students
Authors: Anjass Eman , Hamed Claire , Aguaded Ramírez Eva María
Published: February 2025

This study aims to investigate the impact of using the flipped classroom strategy on motivation and academic achievement in learning science among 9th-grade students Proved as an innovative technique, flipped learning improves academic performance, enhances students’ motivation, supports independent learning, triggers higher thinking skills, and establishes lifelong learning. In disadvantaged places at war like Palestine, there are no studies exploring students' engagement with flipped learning in sciences using empirical evidence including a large population of 2489 females and 2366 males with a representative sample of 333 students Pre and post-test assessment, observation, and two semi-structured interviews with teachers and students are utilized in addition to providing multimedia resources related to the Floral Plant unit in the 9th-grade curriculum has been tailored to the content and needs of teachers and students and distributed through social media platforms. A significant difference in the achievement scores, motivation, and overall positive shift in attitudes regarding homework, students' and teachers' roles, and time management between the experimental group and the control group indicates the positive impact of the flipped classroom method on teachers and students both female and male students.
Il “Dugento” a Firenze: un secolo di grandi cambiamenti nella pittura. La Maestà di Cimabue e il suo restauro
Authors: Ciatti Marco
Published: February 2025

In questo corposo saggio, l’autore riassume la storia della transizione artistica dal XII secolo alla fine del XIII-inizio del XIV secolo in area toscana. Particolare attenzione è rivolta ai centri maggiori di Lucca, Pisa, Siena e Firenze; questi ultimi due emersi sugli altri grazie alle loro specifiche situazioni politiche e alla loro economia mercantile e grazie alla presenza degli ordini mendicanti che furono importanti committenti di opere d’arte.Il saggio affronta l’analisi approfondita delle peculiarità tecniche degli esempi superstiti delle diverse tradizioni artistiche, sottolineando le differenze tra l’influenza bizantina e lo stile romanico che diventa predominante a Firenze, grazie all’eccezionale figura di Cimabue.
L’invisibilité sociale comme métaphore et comme expérience
Authors: Renault Emmanuel
Published: February 2025

Le concept d’invisibilité est aujourd’hui d’usage courant pour désigner une forme d’ignorance sociale. Il est généralement entendu en un sens métaphorique, et on lui préfère parfois les métaphores auditives de l’ignorance sociale (comme celle de la réduction au silence et de l’inaudibilité). On peut cependant se demander si les métaphores visuelles ou auditives de l’ignorance ne pourraient pas être avantageusement remplacées par des concepts non métaphoriques. Cet article défend la pertinence du concept d’invisibilité dans un usage non métaphorique permettant de rendre compte d’expériences du déni de reconnaissance consistant à subir une relégation du mauvais côté de la frontière du visible et de l’invisible. La première section décrit la variété des métaphores visuelles de l’ignorance sociale, de Marx à la sociologie contemporaine du travail. La deuxième section souligne des limites des conceptions seulement métaphoriques de l’invisibilité sociale. La troisième section propose une typologie de l’invisibilité sociale entendue en un sens non métaphorique. La quatrième section analyse les différentes formes de l’expérience de l’invisibilité au travail.
Indigenous Knowledge Epistemologies as Futuristic Imperatives
Authors: Ndwandwe Joy
Published: February 2025

This chapter originates from the author's research thesis, which investigated Indigenous dignity from prehistoric epochs through the concept of time, space and knowledge, Moreover, Indigenous constitutive rules, that is, peace, ecology, inclusive development and Indigenous leadership, transforming Indigenous dignity through triangulating rethinking thinking, transdisciplinarity, and cognitive justice into Indigenous people's dignity. Meta-synthesis and genealogy analysis guided by these constitutive rules when applied to qualitative studies data from prehistoric this is prior to the historic advent of and contemporary epochs during systemic negation of Indigenous knowledge. Thus, leading discussions through restorative action by integrating UNSDGs and AU Agenda 2063 into transforming Indigenous people's dignity into Indigenous knowledge epistemologies. Towards futuristic imperatives for integrating within modernity in research and public policy for implementation in the Indigenous Knowledge Hub.
Indigenous Theories and Theorisation in African Scholarship in the Quest for Epistemic Freedom
Authors: Ngulube Patrick
Published: February 2025

This systematic literature review focuses on using Indigenous theories and theorising in African scholarship. African scholars have tended to use Western and other theories without critically evaluating them for their relevance and ability to give a full explanation of the dynamics of their Indigenous phenomena. A clear conceptualisation of these terms can assist African scholars in theorising and using theories that explain their knowledge claims appropriately and contextually. This systematic review aimed to track the use of Indigenous theories in African scholarship and to understand the extent to which Indigenous theories have been employed. A thematic synthesis of the studies showed limited use of Indigenous theories and theorisation in African scholarship. The chapter mapped and provided insights into the use of theory in African scholarship and provided strategies on how African scholars can theorise and use Indigenous theories in their research in the quest for epistemic freedom.
Integrating CARE and FAIR Principles in the Digital Preservation of Indigenous Knowledge to Achieve the Sustainable Development Goals
Authors: Chigwada Josiline , Ngulube Patrick
Published: February 2025

Preserving and disseminating indigenous knowledge in the digital age presents unique ethical challenges. There is a need to use frameworks such as the CARE and FAIR principles in the digital preservation of Indigenous knowledge. A literature review was conducted to unpack how the principles can be integrated into the digital preservation of Indigenous knowledge. The databases searched were Scopus, Web of Science, and Google Scholar. The findings show that integrating both principles require community-led governance models, culturally appropriate metadata systems, and collaborative partnerships between indigenous communities, researchers, and technologists. These approaches ensure that indigenous groups retain authority over sharing knowledge while benefiting from digital advancements. This, emphasising that there is a need for a paradigm shift that respects Indigenous epistemologies and the development of technology that prioritises Indigenous communities by all stakeholders.
Harnessing Language, Adult Education, and Indigenous Knowledge for Sustainable Urban Agriculture in Lagos
Authors: Ayeni Amidu Owolabi , Afonja Adeola Funmilola , Faloju John Olubunmi
Published: February 2025

Language, adult education, and Indigenous knowledge are key pillars in shaping how urban communities engage with agriculture. On this note, this chapter aims to examine the importance of language, adult education, and Indigenous language among adult farmers for sustainable urban agriculture in Lagos. A structured interview was conducted with 114 adult urban farmers of 50 years and above from the six selected urban farms' clusters across Lagos urban areas. The findings of this research reveal that language, adult education, and Indigenous knowledge are sine qua non for sustainable urban agriculture that will alter antiquated methods in agriculture in Lagos and promote effective transmission and usage of improved agro-technologies by farmers and farm labourers. This chapter holds that for sustainable urban agriculture in Lagos to be achieved, language, adult education, and Indigenous knowledge should be integrated and employed in the usage of relevant science and technological innovations.
Transforming Research in Postgraduate Education
Authors: Gumbo Mishack Thiza
Published: February 2025

This literature study aims to interrogate the Western approach to postgraduate education and research from an Indigenous perspective to advance a postcolonial Indigenous paradigm with its transformation goal. Postgraduate education heavily depends on Western paradigms and theories to the detriment of indigenous alternatives. There is a need to transform research at this level to add to the Africanisation of the curriculum project. In this chapter, three critical aspects are up for discussion: the need to transform the institutional culture, supervisors who should supervise as change agents, and understanding of the worldview of indigenous students in the supervision. The discussions in the chapter offer insights into the transformation of the academic project at this level, which culminates in the contribution of an Indigenisation of the Postgraduate Research Framework.
Exploring Risks and Challenges in Crowdfunding Performance Using Text Analytics and Deep Learning
Authors: Xie Chengran , Hou Chenyang , Sun Yanhong , Sugumaran Vijayan
Published: February 2025

The inherent delivery risks of crowdfunding campaigns force crowdfunding platforms to take risk disclosure measures to alleviate information asymmetry between creators and crowdfunders. However, creators might perceive such risk disclosures as a threat to crowdfunding success. Based on the language expectancy theory, this study aims to examine how the contextual characteristics of risk disclosure affect crowdfunding performance. By separating the project description and R&C sections of 21,287 projects on Kickstarter from 2009 to March 2022, we find that the two-sided persuasion topics extracted by LDA model from the R&C section have positive impacts on the funding success. This result indicates that providing two-sided persuasion content in the R&C section can increase the credibility of crowdfunding project narratives and thus the crowdfunding performance. Furthermore, by incorporating the R&C text into the prediction models, the prediction accuracy of funding support is improved by 0.9% from 83.9%, and the results have been proven to be robust through cross-validation experiments.
Assessing strategy to improve dairy production and milk quality under smallholder dairying: Evidence from Ethiopia
Authors: Mengesha Eyob , Didanna Habtamu Lemma , Ayza Asrat
Published: February 2025

Little information exists on effectiveness of the approach in the intervention programme delivered to smallholder dairy farmers. A comparative study was conducted to assess milk production and composition in two districts (Doyogena project area and Angacha as a control) and the associated dairy intervention. Data were collected through household survey and milk testing. The average daily milk yield of crossbred dairy cows was 6.91±1.14 litres, which was significantly (p < 0.05) different across districts. The overall mean fat, solids-not-fat, lactose, salts, protein, and total solids (TS) contents of crossbred cows’ milk were 4.71±0.83, 8.85±0.36, 4.87±0.19, 0.72±0.03, 3.23±0.13 and 13.55±0.19 percent, respectively. The milk composition was significantly (p < 0.05) different across the study areas. Milk fat content is higher than the Ethiopian standard (ES); protein is also comparable. The major constraints for dairy production in the study areas were, in descending order, feed shortage in the dry season, land scarcity, lack of improved breeds, market access, and disease prevalence. To make livestock programs more impactful, strong extension and an integrated approach that encompasses improved feeds, breeding, marketing, and better health management are crucial to alleviate the diverse constraints of smallholder dairying while enhancing productivity and the associated food and nutrition security and livelihoods.
A review of river flood models: Methods and applications for forecasting and simulation
Authors: Anuruddhika M. L. P. , Perera K. K. K. R. , Premarathna L. P. N. D. , Hansameenu W. P. T. , Weerasinghe V. P. A.
Published: February 2025

Flood modeling plays a pivotal role in mitigating flood impacts and ensuring public safety, water management, and environmental preservation. This paper presents a comprehensive review of sixty-two research papers available on “Google Scholar”, analyzing and categorizing various flood models into five types: Time series models, Physical-based models, ANN models, Fuzzy logic models, and Other models. Time series and fuzzy logic models can be applied to forecast floods by predicting key flood-causing factors such as water levels, discharges, and rainfall. Detailed flood extent information can then be simulated using physically based models. Notably, the 1D-2D coupled model stands out as the most effective physical-based model, providing detailed flood information for both rivers and floodplains. The paper identifies user-friendly software packages like HEC-HMS, HEC-RAS, MIKE FLOOD, and LISFLOOD-FP that make physical-based flood models popular despite requiring more input data. Existing flood models exhibit an accuracy level of over 80%, and further improvements can be achieved by incorporating additional flood-dependent factors such as rainfall, slope, topography, and land use. Moreover, combining ANN hydrological model with 2D hydrodynamic model shows promise in obtaining detailed results for future flood events. Commonly used statistics such as RMSE, NSE, R2, and flood area-related metrics are employed for evaluating flood model accuracy.
Evaluation of the BronchiolitisMAD protocol in the out-of-hospital emergency services of the Community of Madrid
Authors: Jiménez-Sánchez Carpio Beatriz , Sánchez-García Laura , Marsinyach-Ros Itziar , Rendo-Murillo Joaquín Antonio , Quesada-Cubo Víctor , Gómez-Morán Quintana Marina , Lorente-Romero Jorge , Sánchez-Sáenz María Isabel , Cintora-Sanz Ana María , Horrillo-García Cristina
Published: February 2025

The objective of this study was to evaluate the BronchiolitisMAD protocol after its implementation in the out-of-hospital emergency services (OHES) of the Autonomous Community of Madrid (ACM), assessing the clinical improvement during the transfer, application of adequate respiratory therapy, and reduction of response times. This is a descriptive, cross-sectional, and retrospective study in the OHES of the ACM, comparing the season prior to the establishment of the BronchiolitisMAD protocol (October 1, 2019, to March 31, 2020) and the subsequent season (October 1, 2022, to March 31, 2023), excluding the epidemic period of the COVID-19 pandemic. The protocol's key point is a stepwise approach based on the severity of the child's bronchiolitis. It provides detailed algorithms and checklists for treatment and transfer decisions. Specific instructions are provided for using an incubator during the transport of critically ill infants. Seventy-nine patients were included. In the post-protocol season, the use of non-invasive mechanical ventilation increased (from 7.5% to 51.3%) in a statistically significant manner. When comparing the initial and final assessment of the patient pre- and post-protocol, in the post-protocol season, there was a reduction in tachycardia (from 71.8% to 42.3%) and tachypnea (from 69.2% to 46.2%), with an increase in the SaFi ratio (p<0.05). A reduction in T1-activation and T2-stabilization times was observed. The BronchiolitisMAD protocol allowed the implementation and generalization of up-to-date care for infants with acute bronchiolitis.
Work policies and mental health: social welfare integration As a tool to foster pathways to recovery
Authors: Venturi Giulia , Mattei Giorgio , Pistoresi Barbara , Nora Arturo , Addabbo Tindara , Galeazzi Gian Maria
Published: February 2025

Work and mental health have always been in a complex and dynamic relationship. The working activity can act, depending on its characteristics, as a possible risk or protective factor against the onset of mental illness. At the same time, labour is used in mental health services as a rehabilitation tool, representing a real hallmark of recovery. Both aspects will be addressed in this paper. First, we will focus on the employment / unemployment status of patients affected by severe psychiatric disorders, and we will outline the relationship between suicide, unemployment, and social spending. Then, the legislative innovations (Regional Law 14/2015) introduced by the Emilia-Romagna Region will be illustrated. This law has redesigned the work integration programmes of “fragile and vulnerable” people, in order to reach a full integration of social and health interventions. The aim of this work is to raise awareness and promote a multidisciplinary dialogue between different agencies active in the field of public policies, work and mental health, to reconcile the intrinsic complexities of the relationship between work and mental health. To this end, some experiences of job placement will be described, based on a fruitful collaboration between different professionals (mental health professionals, social services and charities) and institutions in the Province of Modena.
A proposal for the management of health surveillance and monitoring procedures in relation to the risks posed by SARS-COV-2 to hospital and nursing home workers, based on strategies implemented in the facilities of the Fondazione Opera San Camillo
Authors: Saretto Gianni , Bozzi Carla
Published: February 2025

This paper describes how the health surveillance protocols adopted in hospitals and nursing homes have changed in response to the spread of SARS-CoV-2 and its risks. These changes concern assessments that must be performed with urgency, to detect potential cases and symptoms that may indicate contagion and to protect vulnerable and hypersensitive workers. Besides, these changes have been implemented in order to regulate how the appointed occupational physician should perform everyday tasks, particularly in regard to preventive visits, periodic visits, office visits, and visits meant to authorize one’s return to the workplace. This paper recommends that both preventive visits and periodic visits should include rapid antigen swab tests to screen for SARS-CoV-2 (which, if positive, should be confirmed by molecular tests) and serologic tests to detect IgG SARS-CoV-2 antibodies. Since this phase involves great risks for healthcare facilities, this paper proposes that swab testing should be performed every month and that serologic testing should be performed every three months (depending on whether the first test detects the presence of IgG antibodies). By combining antigen and molecular swab tests, healthcare professionals can diagnose workers with SARS-CoV-2 and identify positive asymptomatic cases. Because of its costs and its long turnaround times for results, molecular swab testing is recommended only when one needs to confirm a positive antigen swab test result. Serologic testing should be used alongside swab testing, to acquire data concerning the immunity of workers.
"ALTERNANZA SCUOLA LAVORO”: AN OBSERVATIONAL STUDY OF THE EXPERIENCE IN ITALY IN UPPER SECONDARY SCHOOL IN THE YEARS 2016-2018
Authors: Salerno Carla , Grassucci Daniele , Ardizzone Carlo , Gelardini Marcello , La Torre Giuseppe
Published: February 2025

Objectives. To assess the results of the national survey published by skuola.net addressed to students involved in the "Alternanza Scuola-Lavoro" (ASL) project in the years 2016-2018.Methods. An anonymous online survey was employed to gather information on students' experiences during the ASL project. Chi-squared test was performed for the univariate analysis.Results. A total of 8695 questionnaires were included in the analysis. The results of the descriptive and univariate analysis showed that a large number of students, especially those living in Northern Italy, performed more than 15 days of ASL during the year. In addition, students belonging to technical and professional institutes spent more hours compared to classical and scientific high schools ones. Employment in private companies was greater in the North than in the Center and South (54.9% vs 47.7% vs 47.7%, p <0.001). In classical and scientific institutes, on the other hand, there were more students who replied that they had received a theoretical training at work (23% vs. 19.7 p <0.001) or that they had carried out "outline tasks such as making photocopies, cleaning etc.". (19.6 vs 11.5, p <0.001). Another aspect investigated what kind of training they had had about safety at the workplace before starting the experience in the company: among the students resident in the South and in the Islands there was the highest number of negative responses, in fact 30.8% answered "No, by no one", compared to 15.2% in the North and 17.6% in the Center (p <0.001).Conclusions. The ASL represented a concrete attempt to overcome the distinction between the world of education and the world of work within the Italian educational system. There were also some critical issues in its implementation, such as the lower involvement of classical and scientific high school students in projects consistent with their studies and their future prospects, compared to those of technical and commercial institutes. There was also a lack of homogeneity in the quality of the experiences lived between geographical macro areas, which reflects the diversity of employment opportunities present on the national territory.
Allostatic Load as a mediator of the association between psychosocial risk factors and cardiovascular diseases. Recent evidence and indications for prevention
Authors: Veronesi Giovanni , Cavicchiolo Narco , Ferrario Marco M.
Published: February 2025

Obiettivi. Alcune categorie di lavoratori sono maggiormente vulnerabili agli effetti negativi dello stress lavoro-correlato sul rischio cardiovascolare. Vogliamo indagare l'accumulo di carico allostatico come possibile meccanismo d'azione.Metodi. Lo studio comprende lavoratori salariati di età 25-64 anni reclutati in 3 coorti di popolazione. Abbiamo definito il carico allostatico (CA) come somma di z-score di 9 biomarcatori; le classi occupazionali (CO) secondo lo schema Erikson-Goldthorpe-Portocarero; ed il job strain (JS) con modello di Karasek. Tramite decomposizione di OaxacaBlinder, il gradiente occupazionale in CA è stato decomposto nella somma di due componenti: differential exposure (dovuta a diversa prevalenza di JS nelle CO) e differential vulnerability (diverso effetto di JS sul CA nelle diverse classi). Risultati. Tra i 2010 lavoratori (62% uomini, 34% manuali), le classi occupazionali, ma non le categorie di JS, risultano 334 associate con il CA, indipendentemente da età e sesso (p-value: 0.02). Nel campione complessivo, JS non ha alcun effetto sul gradiente occupazionale nel CA. Tuttavia, nel sotto-gruppo di lavoratori con disturbi del sonno, disturbi depressivi e che non praticano attività fisica, la componente di differential vulnerability legata al JS è positiva (0.63; C195%: 0.05-1.21).Conclusioni. I lavoratori manuali con ridotta capacità di risposta sono più vulnerabili ad accumulo di carico allostatico legato a job strain.
[Suitability for work in the heart patient: assessing physical and psycho-social risks]
Authors: Borchini Rosanna , Ferrario Marco M.
Published: February 2025

Cardiovascular diseases are the main cause of death and disability in all industrialized countries, including Italy. Advances in acute phase treatment and increasingly effective rehabilitation programs have determined higher survival rates and a subsequent rise in disease prevalence in working age population. Hence the need for implementing social reintegration programs, including interventions aimed specifically at aiding the process of returning to work, in which the occupational physician plays a crucial role by means of assessing the compatibility between the workers residual clinical and functional capabilities and the characteristics of their job profile. On the basis of recent literature data, particular attention must be paid to occupational risks towards which cardiopathic patients are particularly susceptible, i.e. environmental risks (physical effort), organizational and psycho-social risks (workload and time pressure, shifts, job demand and control). A close collaboration between the occupation physician and the cardiologist to ensure an effective return to work process is highly recommended, as well as periodic re-evaluations of job placement adequacy that can also include clinical examinations, performed during working hours, of the degree of cardiovascular adaptation to working conditions.
IoT medical device risks: Data security, privacy, confidentiality and compliance with HIPAA and COBIT 2019
Authors: Khan Na-ella , Rudman Riaan J.
Published: February 2025

Purpose: This study aimed to develop a comprehensive framework to enable the identification of risks pertaining to data security, privacy and confidentiality when using medical Internet of Things (IoT) devices.Design/methodology/approach: A qualitative, non-empirical study was undertaken to identify data-related risks when using medical IoT devices using a systematic literature review and two governance frameworks.Findings/results: Within the medical field, risks of using IoT are concentrated around data security, privacy and confidentiality throughout the data lifecycle prevalent within each layer of the IoT architecture. A comprehensive framework was developed to identify these risks at each layer within the architecture in order to facilitate sound information technology (IT) and data governance.Practical implications: This research documents evidence of the risks posed by IoT devices within the medical field particularly pertaining to IoT data. It provides those charged with governance with a tool to identify all significant risks in this field that is compliant with Health Insurance Portability and Accountability Act and Control Objectives for Information and related Technology 2019.Originality/value: This research provides a comprehensive framework that can be used by those in charge of governance including IT specialist for risk identification during implementation for sound IT and data governance of medical IoT devices using recognised benchmarks. The use of the benchmarks ensures that all significant risks are identified, compared to previous research that identified risks in an ad hoc manner.
Prevalence and Distribution of Refractive Errors among School-going Adolescents: A Retrospective Analysis from Madhya Pradesh, India
Authors: Kawache Kavita A. , Zode Mrunali Y. , Basu Saurav
Published: February 2025

The present study aimed to ascertain the prevalence of refractive errors in school going adolescents in the Dewas district of Madhya Pradesh, India. This secondary data analysis utilized data from school based vision screenings conducted in 2021–2022 in 33 schools in rural and urban regions of Dewas district under the National Program for Control of Blindness and Visual Impairment (NPCBVI). Refractive error was considered as unaided distant visual acuity of 6/9 or less which improved with a pinhole. Screening data of adolescents aged 10–19 years were analyzed using the STATA software, version 15.1. Among the 8071 adolescents studied, 601 (7.44%, 95% CI: 6.88%–8.04%) had refractive errors. Myopia was the most prevalent refractive error seen in adolescents (5.87%, 95% CI: 5.36%–6.40%). The prevalence of refractive errors was higher in females (8.76%) than in male adolescents (5.27%). No significant difference in the prevalence of refractive error was noted between rural and urban regions. In conclusion, a significant burden of refractive errors was observed among school going adolescents in a district of a central Indian state, with 7.44% affected, predominantly by myopia (5.87%), indicative of the need to strengthen cost effective vision screening programs. Future research should focus on identifying barriers and exploring strategies to enhance program delivery, ensure enhanced coverage, monitor adherence to wearing of spectacles, and evaluate outcomes for adolescent eye health.
Incidence and outcome of transient and permanent atrioventricular heart block after pediatric heart surgery: A retrospective study from Saudi Arabia
Authors: Shahzad Muhammad , Alheraish Yasser Abdulrhman , Beheri Reem , Alarwan Khaled , Shahani Majid , Waheed Sarosh , Rizvi Kashif
Published: February 2025

Background:

Atrioventricular heart block (AVHB) following pediatric cardiac surgery has a remarkable concern in postoperative days, sometimes manifesting a transient event resolving in 14 days. The prevalence of this issue has been evidenced to range from 1% to 4% across multiple studies. This study was conducted to find the incidence and outcome of transient and permanent AVHB after heart surgery in children.

Subjects and Methods:

A collection of data was made on patients ranging in age from 0 to 15 years old who had heart block. Twelve-lead electrocardiograms were performed every other day following cardiac surgical intensive care unit policy postoperatively. Patient data were originally analyzed by comparing two cohorts: those with permanent AV block and those with transitory AV block.

Results:

Out of the total of 4920 open heart surgeries, a subset of 146 individuals experienced third-degree AV block for a duration of at least 12 h, representing a prevalence of 2.9%. Within this group, 116 patients exhibited transient AV block, accounting for 2.3% of the total surgeries, while the remaining 30 patients suffered from a permanent form of third-degree AV block, constituting 0.6% of the surgeries. The average duration for the recovery of AV conduction was found to be 6.65 ± 2.8 days. While, weight at time of operation, cardiopulmonary bypass time, and re-intervention at same admission are related with high risk of AVHB.

Conclusions:

AVHB is a notable complication of pediatric heart surgery. It is associated with low weight, longer bypass times, and redo surgery in the same admission.
Physical activity of patients with rheumatoid arthritis in Singapore: a pilot study
Authors: Loh Andre Jin Wei , Ting Ee Lynn , Kwan Yu Heng , Woon Ting Hui , Phang Jie Kie , Ng Chin Teck , Fong Warren
Published: February 2025

Introduction:

Studies have shown that patients with rheumatoid arthritis (RA) have lower levels of physical activity (PA) than healthy controls, despite the benefits of PA in reducing pain and stiffness. We aimed to compare the levels of PA in patients with RA with that of the general population and identify factors associated with meeting the World Health Organization (WHO) recommendations for PA.

Methods:

Consecutive patients with RA were recruited from an outpatient rheumatology clinic in a tertiary hospital in Singapore. Data for the general population were obtained from the Singapore Health 2012 study. To obtain comparable controls from the general population, we performed propensity score matching based on age and gender.

Results:

Sixty patients with RA were recruited. The proportions of patients with RA and controls who met WHO recommendations for PA were similar (78.3% vs. 80.0%, P = 0.82). After propensity matching, patients with RA spent significantly less time on work-related PA compared to controls (54.3 ± 147.4 min vs. 73.0 ± 132.6 min, P < 0.01). Disease activity was insignificant in determining whether WHO recommendations for PA were met in patients with RA. In the multivariable logistic regression, being employed (odds ratio 4.72, 95% confidence interval 1.20–18.59) was associated with meeting WHO recommendations.

Conclusions:

In this study, the proportion of patients with RA who met the recommendations for PA was similar to that of controls after propensity score matching. Among patients with RA, being employed was associated with meeting WHO recommendations for PA.