bluuebunny/crossref_metadata_2025 huggingface dataset:
Behaviour of T-shaped stiffened concrete-filled steel tubular stub columns after uniform and non-uniform fire exposure
Authors: Lyu Xuetao , Li Ying , Wang Weiwei , Liu Faqi , Xu Yang
Published: November 2023

The post-fire behaviour of T-shaped stiffened concrete-filled steel tubular stub columns was investigated by the heating and residual mechanical performance tests. Key parameters, such as heating duration, number of surfaces exposed to fire and the influence of the stiffening steel bars, were studied. Temperature distribution, failure modes, mid-height strain curves, and load-displacement curves were obtained and discussed. The study reveals that the number of fire-exposure surfaces significantly affects the temperature distribution of the specimen section. Both the bearing capacity and compressive stiffness decrease with the increase of fire exposure surfaces and heating time, whereas the ductility follows an inverse pattern. The transverse stiffeners can enhance the mechanical performance of these stub columns, especially for ductility.
Online connections: Designing virtual seminars for academic knowledge transfer
Authors: Hardy Anne , Young Tamara
Published: November 2023

Research seminars are a crucial aspect of academic careers and professional development, especially in the field of tourism and hospitality scholarship. The COVID-19 pandemic forced researchers into isolation and resulted in the cancellation of face-to-face academic seminars, conferences, and events. To continue academic knowledge transfer and research collaborations, an online seminar series called Iso-CHATS was created. The design of Iso-CHATS was theoretically informed by the Elaboration Likelihood Model (ELM), a framework focusing on maximising the uptake of messages through communication. The series became very popular and extended to a 2-year period throughout 2020 and 2021, attracting over 400 participants from 15 countries. This paper reports on the design of Iso-CHATS through the application of the ELM for academic knowledge transfer. The leaders of Iso-CHATS prioritised four factors for enhancing the uptake of messages: information quality, source credibility, interaction, and accessibility. This research challenges existing conceptions of the ELM, showing how messages are received and understood by participants in an online seminar environment. This study is important because it highlights how to design research events to enhance knowledge transfer outcomes and support wellbeing through collegial online connections.
Animated movements, animating methods: An interaction geography approach to space and affect in early childhood education
Authors: Shapiro Ben Rydal , Silvis Deborah
Published: November 2023

This article uses a comparative case study to examine how a methodological approach called interaction geography provides alternative ways to animate space, movement, and affect within the context of early childhood education. We take animation to incorporate the methods for representing space, movement, and affect; the social-material environment which animates the people and things we study; and the lively, energetic talk-in-interaction that takes place as people and things move. Our first case uses interaction geography to animate what we call gestural energies and choreographies between a teacher, students, and materials in a bilingual kindergarten classroom activity. Our second case uses interaction geography to animate a young child’s excitement for learning and teaching through movement in a cultural heritage museum. Together, our analysis demonstrates how interaction geography provides alternative ways to conceptualize the multimodal nature of literacy practices and contributes to a recent turn to affect in literacy research. We discuss how this work has implications not only for literacy researchers, teachers, and teacher educators, but also for architects, administrators, and researchers concerned with the physical design of literacy spaces.
Factors Associated with Non-Fatal Strangulation Victimization in Intimate Relationships: A Meta-Analysis
Authors: Spencer Chelsea M. , Keilholtz Brooke M. , Palmer Megan , Vail Summer L.
Published: November 2023

Intimate partner violence (IPV) is a public health crisis across the globe, and one particular act of IPV, non-fatal strangulation, warrants serious attention. Non-fatal strangulation is a risk factor for intimate partner homicide (IPH) and can create long-term negative mental and physical health consequences. In this meta-analysis, we sought to examine factors associated with non-fatal strangulation victimization among women to help inform education and assessment efforts. Using database searches and Boolean search terms, a total of 16 studies met the inclusion criteria. A total of 16 factors that were found in at least two unique studies were examined. The strongest associated factors included physical IPV victimization, physical injury, IPH, and sexual IPV victimization. Other significant associated factors included lower education, anxiety symptoms, perceived risk of harm, post-traumatic stress symptoms, depressive symptoms, stalking victimization, and identifying as a Black woman. Experiencing childhood trauma, the length of the relationship, age, substance use, and identifying as Hispanic were not significantly related to strangulation victimization by an intimate partner. Education and assessment implications are discussed.
Deceased Organ Donor Management and Organ Distribution From Organ Procurement Organization-Based Recovery Facilities Versus Acute-Care Hospitals
Authors: Vail Emily A. , Schaubel Douglas E. , Potluri Vishnu S. , Abt Peter L. , Martin Niels D. , Reese Peter P. , Neuman Mark D.
Published: November 2023

Introduction: Organ recovery facilities address the logistical challenges of hospital-based deceased organ donor management. While more organs are transplanted from donors in facilities, differences in donor management and donation processes are not fully characterized. Research Question: Does deceased donor management and organ transport distance differ between organ procurement organization (OPO)-based recovery facilities versus hospitals? Design: Retrospective analysis of Organ Procurement and Transplant Network data, including adults after brain death in 10 procurement regions (April 2017-June 2021). The primary outcomes were ischemic times of transplanted hearts, kidneys, livers, and lungs. Secondary outcomes included transport distances (between the facility or hospital and the transplant program) for each transplanted organ. Results: Among 5010 deceased donors, 51.7% underwent recovery in an OPO-based recovery facility. After adjustment for recipient and system factors, mean differences in ischemic times of any transplanted organ were not significantly different between donors in facilities and hospitals. Transplanted hearts recovered from donors in facilities were transported further than hearts from hospital donors (median 255 mi [IQR 27, 475] versus 174 [IQR 42, 365], P = .002); transport distances for livers and kidneys were significantly shorter ( P < .001 for both). Conclusion: Organ recovery procedures performed in OPO-based recovery facilities were not associated with differences in ischemic times in transplanted organs from organs recovered in hospitals, but differences in organ transport distances exist. Further work is needed to determine whether other observed differences in donor management and organ distribution meaningfully impact donation and transplantation outcomes.
Performance Arts in Zimbabwe: Setting the Agenda for Peace and Development
Authors: Mutanda Darlington
Published: November 2023

Using purposively selected works of Zimbabwean artists posted on YouTube, and the public comments on this content, this article demonstrates the agenda-setting capabilities of performance artists, particularly those anchored on theatre, music and poetry. It does this by analysing how the artists set the agenda for peace, economic equity, political justice, social harmony and development in Zimbabwe. The paper notes that performance arts have been vital cogs in supporting and strengthening interventions aimed at achieving peace and development in the country. On the other hand, the comments section on social media sites was viewed as a ‘public space’ where people ‘converge’ to share their thoughts on various issues affecting them as raised by artists. Using document analysis and social media for observational data, this article argues that artists are critical in contributing to the peacebuilding discourse in Zimbabwe through putting important governance issues on the public agenda. The onus is on the authorities and other development partners to use this information to address the needs and the plight of the masses as a prerequisite for conflict transformation.
Age-related difference in acute type B aortic dissection
Authors: Zhang Zhigong , Lin Feng , Huang Xiaoci , He Zhipeng , Wang Haoran , Cheng Tingting
Published: November 2023

Objective

The objective is to compare the characteristics of clinical data, imaging data, and treatment methods of young and old patients with acute type B aortic dissection (ABAD).

Methods

ABAD patients admitted to the Department of Vascular Surgery of the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2018 were retrospectively reviewed. Patient demographics, such as gender, age, diabetes, hypertension, presenting symptoms, imaging characteristics, laboratory data on admission, hemodynamics on admission and in-hospital management, and mortality of different age groups were compared and analyzed. Categorical variables were compared using χ2 tests or Fisher’s exact test. Continuous variables were compared using Student’s t-test or Mann–Whitney U-test.

Results

A total of 141 ABAD patients were included in this study. Old ABAD patients were more likely to have a prior history of hypertension (88.6% vs 70.4%, p = 0.037) and atherosclerosis (29.8% vs 7.4%, p = 0.016). In the young group, Marfan syndrome was significantly higher (14.8% vs 0.9%; p = 0.005). Compared with the old group, the number of distal tears in the young group was significantly higher (62.3% vs 39.5%, p = 0.027). The proportion of patients with malperfusion of lower limbs in the young group was significantly higher than that in the old group (22.2% vs 6.1%, p = 0.026). There was no significant difference in the treatment methods and in-hospital mortality between the two groups.

Conclusion

Compared with old ABAD patients, young ABAD patients had more distal tears and a higher proportion of lower limbs malperfusion.
Hygrothermal performance of natural building materials: Simulations and field monitoring of a case study home made of wood fiber insulation and clay
Authors: Bastien Diane , Winther-Gaasvig Martin , Zhang Andersson Jeppe , Xiao Zhe , Ge Hua
Published: November 2023

This contribution presents temperature and relative humidity data monitored over nearly two years for a case study building made of natural building materials. The case study building is a single-family house located in Denmark made of wood fiber insulation, wood fiber boards and indoor clay plaster without any membranes. Three different types of cladding systems have been tested: 1) mineral plaster rendering; 2) wood cladding applied directly over wood fiberboards; 3) wood cladding with a ventilated cavity. Monitored data is provided and compared with simulations performed with a commercial hygrothermal software. The moisture content and mold growth index are calculated from monitored data. The data indicates that the hygrothermal performance of the roof is excellent (RH < 70%); the hygrothermal performance of the walls with the three different cladding systems is good; one out of two sensor groups in the floor exhibits a moisture content up to 18% at the cold side of the insulation during summer and fall. Securing sufficient and evenly distributed crawlspace ventilation is recommended for eliminating concerns of eventual mold growth. Measurements show that materials employed in this house respond quickly to moisture changes, more quickly that simulated data. This work highlights the need for validating and adjusting WUFI simulation results with measured data to provide reliable results for building envelopes composed of highly hygroscopic plant-based materials. For these assemblies in these conditions, including a vapor retarder is not needed for achieving a satisfactory hygrothermal behavior.
Decolonizing western science education and knowledge in early childhood: Rethinking natural hazards and disasters framework through indigenous ‘ecology of knowledges’ in Kenya
Authors: Bertoli Anny , Ng’asike John Teria , Amici Stefania , Madjar Andrew , Tesar Marek
Published: November 2023

This article presents the epistemological complexity inherent in the roll out of an international project on Disaster and Risk Reduction, and consequently about science education in the Indigenous context of Turkana County in Kenya. After an introduction that explains the current state of Disaster and Risk Reduction, the paper focuses on the ‘Paper Volcanoes Laboratory’ program and toolkit for children and teachers, which aims to spread awareness about natural hazards among children. The paper argues that the geographical, social and educational context where the project is carried out is critical to consider, and decolonial studies provide a conceptual and theoretical framework for this project. This allows to recognize reproduction of infantilization of Indigenous people and children through Western knowledge and science if implemented without consideration for local contexts, and demonstrates how Western educational projects have been a tool of discrimination and colonization. However, at the same time, it opens up the possibility for a dialogue and an encounter between the different epistemologies present in a project that was conceptualized within the Western context, but is to be carried out in Turkana County in Kenya.
Endoscopic management of anastomotic leakage after colorectal cancer surgery in a Moroccan center: A case series and literature review
Authors: Aourarh Benayad , Souadka Amine , Majbar Mohamed Anass , Benkabbou Amine , Chakkor Amal , Bakkar Meriem , Mohsine Raouf , Amrani Laila
Published: November 2023

Endoscopic management has become an alternate treatment to a revision surgery for colorectal fistulas. Eight patients who were treated by endoscopy for postoperative anastomotic leakage to colorectal cancer were included. A univariate analysis was carried out to determine the predictive factors of success. All our patients were treated using metallic clips. The primary efficiency of this technique was 50%. In a univariate analysis, the size of the fistula and its distance from the anal margin had an influence on the efficiency of the endoscopic treatment, which was not the case for either the surgical technique or the use of neoadjuvant radiotherapy. This endoscopic treatment is effective and represents a more secure alternative than revision surgery. In our study, the use of metallic clips showed a 50% success rate, going up to 100% for the group of patients with a fistula ostium of a size ⩽1 cm, proving the necessity of using this technique.
Hazardous waste in the Anthropocene: The comparative methods for asbestos roofs detection to assess the environmental risk
Authors: Krówczyńska Małgorzata , Wilk Ewa
Published: November 2023

In the Anthropocene, humanity faces many questions related to the harmful effects of many substances on their health and the environment around them. One such mineral that had many uses, useful in human daily life, but which ultimately turned out to have a detrimental effect on human health and the environment, is asbestos. Due to the progressive urbanization of the world, asbestos has been widely used in the economies of many countries. Its’ unique physical and chemical properties were used, inter alia, for the production of asbestos-cement roofs. The only data available used by researchers and provided by USGS are on asbestos fiber production, which will not enable us to assess the health and environmental risk. It is estimated that over 90% of asbestos-containing products still in use are asbestos roofs. Quantity information is missing so other methods are being sought to estimate the amount and spatial distribution of these roofs to safely eliminate them from use since the environmental pollution with asbestos fibers poses a threat to humans and the natural environment. The purpose of the study is to present methods for estimating the number of asbestos-cement roofs to assess the environmental risk of air pollution on a national scale and to present methods for the recognition of asbestos-cement roofs using various classification algorithms and image data. These algorithms can be successfully used in other countries to determine the amount of asbestos-cement roofs to be safely disposed of and take the necessary actions.
Feasibility of using the Automated Self-Administered 24-hour (ASA-24) dietary assessment tool in older adults
Authors: Spangler Hillary B , Driesse Tiffany , Fowler Michael , Lynch David H , Liang Xiaohui , Gross Danae , Petersen Curtis , Batsis John A
Published: November 2023

Background

Dietary patterns can impact the trajectories of healthy aging. However, dietary assessment tools can be challenging to use. With the increased use of technology in older adults, we aimed to evaluate the feasibility of older adults completing the online, Automated Self-Administered 24-h (ASA-24) dietary assessment tool.

Methods

We conducted a randomized, two-period, two-sequence, crossover design of twenty community-dwelling older adults (≥65 years) comparing their preference for completing the ASA-24 alone versus with a research assistant (RA). Participants were recruited via ResearchMatch.com and randomly allocated 1:1 to a sequence of completing both an ASA-24 alone or with an RA, separated by one week. After each session, participants completed an online 11-item feasibility survey (Likert-scale range of 1–5, strongly disagree to strongly agree). Mean and standard deviations were reported for each question.

Results

Mean age was 69 ± 3.5 years (90% females), with no differences were observed for sex, age, race, ethnicity, education, or income. Neither group felt a need for RA assistance ( p = 0.34). However, both groups felt the system was easier to follow with the help of an RA (RA: 4.4 ± 1.3, vs. SA 4.6 ± 0.5, p = 0.65), particularly when they completed the ASA-24 alone, first ( p = 0.04). When conducting the ASA-24 alone, there was less confidence the system could be learned quickly (SA 4.5 ± 0.5→3.4 ± 1.0 vs RA 3.4 ± 1.0→3.4 ± 0.7, p = 0.001). The ASA-24 was thought to be less cumbersome after repeated exposure in those concluding with the RA.

Conclusion

While older adults were able to complete the ASA-24 independently, the use of an RA led to improved confidence. Enhancing the sample diversity in a larger number of participants could provide helpful data to improve the science of dietary assessment.
Risk Factors for Radiotherapy Failure in the Treatment of Spinal Metastases
Authors: McKibben Natasha S. , MacConnell Ashley E. , Chen Yiyi , Gao Lina , Nguyen Thuy M. , Brown Simon A. , Jaboin Jerry J. , Lin Clifford , Baksh Nikolas H.
Published: November 2023

Study Design

Retrospective cohort study.

Objective

To build a predictive model for risk factors for failure of radiation therapy, hypothesizing a higher SINS would correlate with failure.

Methods

Patients with spinal metastasis being treated with radiation at a tertiary care academic center between September 2014 and October 2018 were identified. The primary outcome measure was radiation therapy failure as defined by persistent pain, need for re-irradiation, or surgical intervention. Risk factors were primary tumor type, Karnofsky and ECOG scores, time to treatment, biologically effective dose (BED) calculations using α/β ratio = 10, and radiation modality. A logistic regression was used to construct a prediction model for radiation therapy failure.

Results

One hundred and seventy patients were included. Median follow up was 91.5 days. Forty-three patients failed radiation therapy. Of those patients, 10 required repeat radiation and 7 underwent surgery. Thirty-six patients reported no pain relief, including some that required re-irradiation and surgery. Total SINS score for those who failed reduction therapy was <7 for 27 patients (62.8%), between 7-12 for 14 patients (32.6%), and >12 for 2 patients (4.6%). In the final prediction model, BED (OR .451 for BED > 43 compared to BED ≤ 43; P = .174), Karnofksy score (OR .736 for every 10 unit increase in Karnofksy score; P = .008), and gender (OR 2.147 for male compared to female; P = .053) are associated with risk of radiation failure (AUC .695). A statistically significant association between SINS score and radiation therapy failure was not found.

Conclusions

In the multivariable model, BED ≤ 43, lower Karnofksy score, and male gender are predictive for radiotherapy failure. SINS score was among the candidate risk factors included in multivariable model building procedure, but it was not selected in the final model.

Level of Evidence:

Prognostic level III
Performance and Efficiency of Public Sector in Independent Namibia
Authors: Kumar De Utpal , Shafuda Christopher P. P.
Published: November 2023

An analysis of the performance and efficiency of the Namibian government’s interventions after the end of the colonial era has been made in this study for the period 1990 to 2015. Using the Afonso et al. public sector performance (PSP) and public sector efficiency (PSE) method and the Stochastic frontier analysis (SFA), the findings reveal a sluggishly improving efficiency in the public sector in Namibia. However, some performance indicators showed significant improvement, while others did not record any substantial improvement. Progress is recorded in government efforts and programmes to reduce inequality and poverty, but the outputs moved at a plodding pace. Programmes and policies to reduce unemployment failed to produce the expected outcomes. Additionally, technical progress has been very slow since independence, as reflected by the technical efficiency parameter. The findings suggest a need to improve the public sector’s performance and efficiency to ensure stability and accelerate growth in the previously colonized economies with the same features as Namibia.

JEL Classification: H00, H11, H89, L38
The Panopticon reloaded: A critical analysis of performance management systems in the trans-European transport network policy
Authors: Esposito Giovanni , Terlizzi Andrea , Pichault François
Published: November 2023

This article examines Performance Management Systems (PMSs) as socio-technical policy instruments for shaping power relations in megaprojects. Employing an abductive approach, it innovatively applies Foucault's Panopticon theory to the case of the Lyon-Turin railway, a megaproject funded by the European Union's Trans-European Transport Network policy. Our research reveals that PMSs operate as intellectual technologies that enable megaproject promoters to establish control over participants and align their collective behavior with planned policy objectives. We find that this process follows three Foucauldian panoptic principles: hierarchical observation, where participants are organized under nested managerial tiers, establishing vertical lines of command; examination, which uncovers performance flaws; and normalization, which standardizes behavior across the megaproject field. We argue that: PMSs can be employed by policy-makers as instruments to instil governability and shape the collective behavior of megaproject participants consistently with planned policy goals; no matter how effective the panoptic scheme is, there are always avenues of resistance available among those perceiving the megaproject as a threat; and, the configuration and constitution of power relations in megaprojects involve a complex interplay of discipline, sovereignty, and security mechanisms.
A Postmodern Psychoanalytic Critique of Narrative Disruptions and Subversions in Dalit and Post-apocalyptic Narratives: A Comparative Study
Authors: Paul David , Alan G.
Published: November 2023

This research study investigates narrative disruptions and subversions in Dalit and post-apocalyptic literature using a postmodern psychoanalytic methodology. Drawing on the concepts of Jacques Lacan and Homi K. Bhabha, the research argues that these literary genres use language and plot to subvert and disrupt dominant power structures, social hierarchies and hegemonic discourses. The study examines a few works of Dalit and post-apocalyptic fiction to show how both genres use narrative methods such as fragmentation, irony, parody and subversion to question established standards of representation and disclose the traumas and disjunctions of the oppressed. The voice of the oppressed is explicit through the analysis of the selected texts.
Introduction to a review series on RNA therapeutics in hematology
Authors: Gotlib Jason
Published: November 2023

Small molecule inhibitors and antibody therapies have led the way for targeted therapy of a range of hematologic disorders; however, the number of amenable targets is limited. RNA-directed therapies can be a solution for targets deemed “undruggable,” with modulation of RNA expression through a variety of methods, expanding the therapeutic possibilities. In this Review Series edited by Associate Editor Jason Gotlib, 3 articles highlight areas in which RNA therapeutics are most advanced: acute hepatic porphyria, transthyretin amyloidosis, and hemophilia. This series offers insight into the promise of these new therapies.
Treatment patterns for patients initiating novel acute migraine specific medications (nAMSMs) in the context of monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway
Authors: Zhou Zifan , Urman Robert , Gill Karminder , Park Andrew S. , Vuvu Fiston , Patel Leah B. , Lu Jingsong , Wade Rolin L. , Frerichs Lindsay , Bensink Mark E.
Published: November 2023

Background

New acute and preventive migraine medications are available, but data on current treatment patterns are limited. This study describes migraine treatment patterns among patients initiating novel acute migraine specific medications (nAMSMs), overall and by prior use of anti-calcitonin gene-related peptide (CGRP) pathway monoclonal antibodies (mAbs).

Methods

In this retrospective cohort study using IQVIA open-source pharmacy and medical claims data, we identified patients with ≥ 1 claim for a nAMSM (ubrogepant, rimegepant, lasmiditan) between 01/01/2020 and 09/30/2020 (index period). Patients were indexed on their first nAMSM claim and stratified into 2 cohorts: patients with prior mAb use (≥ 1 claim for erenumab, fremanezumab, galcanezumab in the 6-month pre-index period) or patients without prior mAb use. Treatment patterns were assessed during the 6-month post-index period.

Results

Overall, 78,574 patients were identified (63% indexed on ubrogepant, 34% on rimegepant, and 3% on lasmiditan) with 26,656 patients (34%) having had prior mAb use. In the pre-index period, 79% of patients used non-mAb preventive medications and 75% of patients used acute medications. Following the index nAMSM claim, 65% of patients had ≥ 1 refill and 21% had ≥ 4 refills of their index nAMSM; 10% of patients switched to another nAMSM. Post-index mAb use was observed in 82% of patients with a prior mAb and 15% of patients without. Among patients with pre- and post-index use of acute medications, 38% discontinued ≥ 1 acute medication class in the post-index period. Among patients with concomitant use of traditional preventive medications at index, 30% discontinued ≥ 1 concomitant preventive anti-migraine medication in the post-index period.

Conclusions

Most patients initiating nAMSMs had prior treatment with acute and preventive medications. Approximately one-third of patients had prior treatment with anti-CGRP pathway mAbs. After starting nAMSMs, more than one-third of patients discontinued at least one traditional acute medication and one-third of patients discontinued at least one traditional preventive medication.

Despite nAMSM initiation, most patients with prior anti-CGRP pathway mAb use continued mAb use. Around 15% of patients without a prior mAb newly started a mAb. These results provide insight into how nAMSMs and mAbs have been integrated into clinical management of migraine in the real-world.
Extracellular Vesicles for Drug Delivery in Cancer Treatment
Authors: Wang Li , Yu Xin , Zhou Juan , Su Chunxia
Published: November 2023

Extracellular vesicles (EVs) are nanoscale vesicles derived from cells that mediate intercellular communication by transporting bioactive molecules. They play significant roles in various physiological and pathological conditions. EVs hold great potential as novel biomarkers of diseases, therapeutic agents, and drug delivery vehicles. Furthermore, EVs as novel drug delivery vehicles have demonstrated significant advantages in preclinical settings. In this review, we discussed the biogenesis and characteristics of EVs and their functions in cancer. We summarize the therapeutic applications of EVs as a natural delivery vehicles in cancer therapy. We highlight the existing challenges, illuminate vital questions, and propose recommendations to effectively address them effectively.
Male contraception: narrative review of ongoing research
Authors: Louwagie Eli J. , Quinn Garrett F.L. , Pond Kristi L. , Hansen Keith A.
Published: November 2023

Background

Since the release of the combined oral contraceptive pill in 1960, women have shouldered the burden of contraception and family planning. Over 60 years later, this is still the case as the only practical, effective contraceptive options available to men are condoms and vasectomy. However, there are now a variety of promising hormonal and non-hormonal male contraceptive options being studied. The purpose of this narrative review is to provide clinicians and laypeople with focused, up-to-date descriptions of novel strategies and targets for male contraception. We include a cautiously optimistic discussion of benefits and potential drawbacks, highlighting several methods in preclinical and clinical stages of development.

Results

As of June 2023, two hormonal male contraceptive methods are undergoing phase II clinical trials for safety and efficacy. A large-scale, international phase IIb trial investigating efficacy of transdermal segesterone acetate (Nestorone) plus testosterone gel has enrolled over 460 couples with completion estimated for late 2024. A second hormonal method, dimethandrolone undecanoate, is in two clinical trials focusing on safety, pharmacodynamics, suppression of spermatogenesis and hormones; the first of these two is estimated for completion in December 2024. There are also several non-hormonal methods with strong potential in preclinical stages of development.

Conclusions

There exist several hurdles to novel male contraception. Therapeutic development takes decades of time, meticulous work, and financial investment, but with so many strong candidates it is our hope that there will soon be several safe, effective, and reversible contraceptive options available to male patients.
Effects of xenon anesthesia on postoperative neurocognitive disorders: a systematic review and meta-analysis
Authors: Yang Yu-Shen , Wu Shan-Hu , Chen Wei-Can , Pei Meng-Qin , Liu Yi-Bin , Liu Chu-Yun , Lin Shu , He He-Fan
Published: November 2023

The latest clinical trials have reported conflicting outcomes regarding the effectiveness of xenon anesthesia in preventing postoperative neurocognitive dysfunction; thus, this study assessed the existing evidence. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to April 9, 2023, for randomized controlled trials of xenon anesthesia in postoperative patients. We included English-language randomized controlled studies of adult patients undergoing surgery with xenon anesthesia that compared its effects to those of other anesthetics. Duplicate studies, pediatric studies, and ongoing clinical trials were excluded. Nine studies with 754 participants were identified. A forest plot revealed that the incidence of postoperative neurocognitive dysfunction did not differ between the xenon anesthesia and control groups (P = 0.43). Additionally, xenon anesthesia significantly shortened the emergence time for time to opening eyes (P < 0.001), time to extubation (P < 0.001), time to react on demand (P = 0.01), and time to time and spatial orientation (P = 0.04). However, the Aldrete score significantly increased with xenon anesthesia (P = 0.005). Postoperative complications did not differ between the anesthesia groups. Egger’s test for bias showed no small-study effect, and a trim-and-fill analysis showed no apparent publication bias. In conclusion, xenon anesthesia probably did not affect the occurrence of postoperative neurocognitive dysfunction. However, xenon anesthesia may effectively shorten the emergence time of certain parameters without adverse effects.
Identifying and managing apathy in people with dementia living in nursing homes: a qualitative study
Authors: Nijsten Johanna M. H. , Smalbrugge Martin , Plouvier Annette O. A. , Koopmans Raymond T. C. M. , Leontjevas Ruslan , Gerritsen Debby L.
Published: November 2023

Background

Although apathy is common in people with dementia and has profound negative effects, it is rarely diagnosed nor specifically treated in nursing homes. The aim of this study is to explore experiences in identifying and managing apathy from the perspectives of people with dementia and apathy (PwA), family caregivers (FCs) and professional caregivers (PCs).

Methods

Descriptive qualitative study with purposive sampling, comprising eleven semi-structured in-depth interviews with PwA, FCs or PCs and focus groups with twelve PCs in Dutch nursing homes. Seventeen additional in-depth interviews with caregivers were held, after signals of increasing apathy during the first Covid-19 lockdown. Using an inductive approach, data was analysed thematically to explore the experiences in identifying and managing apathy from the perspective of different stakeholders.

Results

Three themes were identified: 1) the challenge to appraise signals, 2) the perceived impact on well-being, 3) applied strategies to manage apathy. Although participants described apathy in line with diagnostic criteria, they were unfamiliar with the term apathy and had difficulties in appraising signals of apathy. Also, the perceived impact of apathy varied per stakeholder. PwA had difficulties reflecting on their internal state. FCs and PCs experienced apathy as challenging when it reduced the well-being of PwA or when they themselves experienced ambiguity, frustration, insecurity, disappointment or turning away. Dealing with apathy required applying specific strategies that included stimulating meaningful contact, adjusting one’s expectations, and appreciating little successes.

Conclusions

When addressing apathy in nursing homes, it is important to consider that a) all stakeholders experience that appraising signals of apathy is challenging; b) apathy negatively influences the well-being of people with dementia and especially their FCs and PCs; and c) FCs and PCs can successfully, albeit temporarily, manage apathy by using specific strategies.
Age-dependent gender differences in the diagnosis and treatment of osteoporosis during hospitalization in patients with fragility fractures
Authors: Li Qingmei , Yang Jiancheng , Tang Qinghua , Feng Yan , Pan Mingming , Che Maohong , Shi Jie , Zeng Yuhong
Published: November 2023

Background

There is a gender difference in the acceptance of osteoporosis diagnosis and treatment in patients after fragility fractures, but this difference is rarely assessed during hospitalization, and it is unclear whether these differences are age-dependent. This study aimed to evaluate the differences between male and female fragility fracture patients of different age groups who received the diagnosis and treatment of osteoporosis during hospitalization.

Methods

31,265 fragility fracture patients aged ≥ 50 years from the Fragility Fracture Management Database in a high-volume orthopedic hospital from December 2019 to February 2023 were included in this study. We compared the differences in the rates of men and women with fragility fracture who received the measurement of bone mineral density (BMD) and bone metabolism biochemical markers (BMBMs) and treatment with anti-osteoporosis medications (AOMs), and follow-up to the internal medicine clinic within 3 months after discharge, across all age groups and across different age stages (50–59, 60–69, 70–79, and ≥ 80 years).

Results

The detection rates of female patients receiving BMD and BMBMs during hospitalization were 31.88% and 5.30%, respectively, compared with 22.23% and 2.69% for men. The rate of receiving any AOMs treatment was 44.63% for women and 31.60% for men. The follow-up rate of returning to the internal medicine clinic within 3 months after discharge was 9.79% for women compared to 3.00% for men. There was a significant difference between males compared to females (P < 0.0001). Analysis of patients by different age group revealed that differences in the diagnosis and treatment of osteoporosis were found only in patients under 80 years of age, while gender differences in the return to the internal medicine clinic for follow-up after discharge were present in all age groups.

Conclusions

Gender differences present in osteoporosis management in patients with fragility fracture during hospitalization, especially for patients under 80 years of age. This finding suggests that orthopedic surgeons neglect to manage osteoporosis in male patients with fragility fracture during hospitalization.
Abnormal expression of miR-3653-3p, caspase 1, IL-1β in peripheral blood of schizophrenia
Authors: Zhao Xin-ling , Liu Yi-lin , Long Qing , Zhang Yun-qiao , You Xu , Guo Ze-yi , Cao Xiang , Yu Lei , Qin Fu-yi , Teng Zhao-wei , Zeng Yong
Published: November 2023

Schizophrenia (SCZ) is a chronic, highly relapsing, severe mental disorder with an unclear etiology. Cytokine-mediated neuroimmune abnormalities have been repeatedly revealed. IL-1β was reported to play a vital role in expanding the inflammatory response. However, the underlying molecular mechanism is poorly understood. In this study, we found that miR-3653-3p with the NLRP3 binding site in Targetscan was differentially expressed in miRNA high-throughput sequencing in schizophrenia (SCZ), and indeed, its downregulation in SCZ peripheral blood was also verified by RT-qPCR (P-value = 0.015). Furthermore, we found that the mRNAs of caspase 1 and IL-1β are elevated in people who suffer from SCZ (P = 0.044 and P = 0.001, respectively). Moreover, the interaction of NLRP3, Caspase1, and IL-1β was found in the peripheral blood of patients with SCZ. The expression level of miR-3653-3p was negatively correlated with NLRP3 and IL-1β mRNA contents (r = 0.487, P = 0.04 and r = 0.508, P = 0.037, respectively). NLRP3 mRNA was positively correlated with caspase1 mRNA. Meanwhile, the expression of miR-3653-3p was also negatively correlated with negative symptom subscores of PANSS (r = 0.450, P = 0.046). IL-1β mRNA is positively correlated with the total scores of PANSS (r = 0.690, P = 0.002) and the sub-scores of general psychopathology of PANSS (r = 0.583, P = 0.014). Additionally, a significant positive relationship exists between IL-1β and the total duration (r = 0.638, P = 0.006). We found that the combination of miR-3653-3p, caspase 1, and IL-1β have better diagnostic values. The results indicate that miR-3653-3p, caspase 1, and IL-1β can potentially be biomarkers of SCZ, identifying negative symptoms or a chronic course. A further understanding of the involvement of IL-1β in SCZ may be a crucial molecular effector for the chronic course to intervene.
Risk factors of positive depression screening during the third trimester of pregnancy in a Chinese tertiary hospital: a cross-sectional study
Authors: Sun Ying , He Xiaobo , Gu Xuejun , Yang Xiuping
Published: November 2023

Objective

Pregnant women experience enormous psychological pressure, particularly during the late trimester. Symptoms of depression in late pregnancy may persist postpartum, increasing the incidence of postpartum depression. This study is aimed to investigate the factors influencing depressive symptoms among pregnant women in their third trimester at a Chinese tertiary hospital and provide information for effective intervention.

Methods

Pregnant women in their third trimester who visited the Ningbo Women and Children’s Hospital between January 1, 2020 and June 30, 2022 participated in this study. A score of ≥ 13 on the Edinburgh Postnatal Depression Scale (EPDS) was considered as positive for depressive symptom. Potential influencing factors were examined by using an online questionnaire and analyzed using multivariate logistic regression.

Results

A total of 1196 participants were recruited. The mean EPDS score was 7.12 ± 4.22. The positive screening rate for depressive symptom was 9.9%. Univariate analysis showed that living with partner, annual family income, planned pregnancy, sleep quality, and partner’s drinking habits were related to positive screening for depression(P < 0.05). Furthermore, multivariate logistic regression analysis showed that living away from the partner (odds ratio [OR]: 2.054, 95% confidence interval [CI]: 1.094–3.696, P = 0.02), annual family income < 150,000 Chinese Yuan (CNY; OR: 1.762, 95% CI: 1.170–2.678, P = 0.007), poor sleep quality (OR: 4.123, 95% CI: 2.764–6.163, P < 0.001), and partner’s frequent drinking habit (OR: 2.227, 95% CI: 1.129–4.323, P = 0.019) were independent influencing factors for positive depression screening (P < 0.05).

Conclusion

Family’s economic condition, sleep quality, living with partner, and partner's drinking habits were related to positive depression screening in late pregnancy. Pregnant women with these risk factors should be given more attention and supported to avoid developing depression.
Gender and sexual identity-based inequalities in adolescent wellbeing: findings from the #BeeWell Study
Authors: Marquez Jose , Humphrey Neil , Black Louise , Cutts Megan , Khanna Devi
Published: November 2023

Background

Gender and sexual minority adolescents experience greater symptoms of psychological distress than their peers, but little is known about broader aspects of their wellbeing. This study examines wellbeing inequalities relating to gender and sexual identity among adolescents from Greater Manchester in the United Kingdom.

Method

37,978 adolescents (aged 12–15, attending 165 secondary schools) completed surveys of life satisfaction, positive and negative affect (hedonic framework); autonomy, self-esteem, optimism, and positive relationships (eudaimonic framework); and, symptoms of distress and mental wellbeing (complete state framework). Structural correlated factors models were used to assess gender and sexual identity wellbeing inequalities.

Results

The magnitude of wellbeing inequalities pertaining to gender and sexual identity were routinely substantially greater than those concerning other characteristics (e.g., socio-economic disadvantage). Gender identity wellbeing inequalities followed a consistent pattern, with the largest disparities evident between gender diverse adolescents and boys. Sexual identity wellbeing inequalities also followed a consistent pattern, with the largest disparities evident between sexual minority youth (both gay/lesbian and bi/pansexual) and their heterosexual peers. Finally, variation was evident across wellbeing domains. For example, observed gender identity (boys vs. girls) and sexual identity (heterosexual vs. sexual minority) disparities were substantially greater for symptoms of distress than for mental wellbeing in the complete state model.

Conclusions

LGBTQ + adolescents experience lower wellbeing than their peers, and this is evident across a range of wellbeing domains. Accordingly, there is an urgent need for the prioritisation of improved prevention and intervention efforts that can better meet the needs of gender diverse and sexual minority youth, and future research should be conducted to improve understanding of the mechanisms underpinning the wellbeing inequalities observed.
Walking against traffic and pedestrian injuries in the United Kingdom: new insights
Authors: Widodo Akhmad Fajri , Chen Chenyi , Chan Cheng-Wei , Saleh Wafaa , Wiratama Bayu Satria , Pai Chih-Wei
Published: November 2023

Background

Studies from Finland and Taiwan have shown that walking against traffic was beneficial for reducing pedestrian crashes and fatalities. This study examined whether such beneficial effects are consistent across various circumstances.

Methods

This study aimed to investigate pedestrian fatalities in walking-against or with-traffic crashes by analysing the UK STATS19 crash data for the period between 1991 and 2020. We firstly employed Chi-square tests to examine risk factors for pedestrian injury severity. These variables were then incorporated into stepwise logistic regression models with multiple variables. We subsequently conducted joint effect analysis to investigate whether the beneficial effects of walking against traffic on injury severity vary across different situations.

Results

Our data contained 44,488 pedestrian crashes, of which 16,889 and 27,599 involved pedestrians walking against and with traffic, respectively. Pedestrians involved in with-traffic crashes were more likely to sustain fatalities (adjusted odds ratio [AOR] = 1.542; confidence interval [CI] = 1.139–1.927) compared with those in walking against-traffic crashes. The detrimental effect of walking with traffic on fatalities appeared to be more pronounced in darkness-unlit conditions (AOR = 1.48; CI = 1.29–1.70), during midnight hours (00:00–06:59 am) (AOR = 1.60; CI = 1.37–1.87), in rural areas (AOR = 2.20; CI = 1.92–2.51), when pedestrians were elderly (≥ 65 years old) (AOR = 2.65, CI = 2.16–3.26), and when heavy goods vehicles were crash partners (AOR = 1.51, CI = 1.28–1.78).

Conclusions

Walking against traffic was beneficial in reducing pedestrian fatalities compared with walking with traffic. Furthermore, such a beneficial effect was more pronounced in darkness-unlit conditions, at midnights (00:00–06:59 am), in rural areas, when pedestrians were elderly, and when heavy goods vehicles struck pedestrians.