bluuebunny/crossref_metadata_2025 huggingface dataset:
A mixed Methods Study of Multilevel Factors Influencing Sexual Risk-Taking Behaviors Among Adolescent Girls in Uganda
Authors: Sensoy Bahar Ozge , Sssewamala Fred M. , Namuwonge Flavia , Abdella Meti , Kizito Samuel , Namuli Florence , Nabunya Proscovia ,   ICHAD Field Team
Published: August 2024

Sub-Saharan Africa is home to two-thirds of people living with HIV globally. Adolescent girls and young women are twice as likely to be living with HIV compared to young men. Sexual risk-taking behaviors put adolescent girls at risk for adverse health outcomes, including HIV/AIDS. In this study, we conducted semi-structured in-depth interviews to explore multi-level factors that influence decisions to engage in sexual risk-taking among 58 school-going adolescent girls in Uganda. Both protective and risk factors cut across personal, proximal, and distal contexts. At the personal level, future goals and fear of negative health outcomes were identified as the most common protective factors. Positive family relations and peers were cited most frequently as protective factors at the proximal level. At the distal level, poverty was the most common risk factor. Relatedly, families’ ability to provide for adolescent girls’ needs was a protective factor. Study results point to the need for multilevel combination interventions to reduce sexual risk-taking among adolescent girls in Uganda.
Problematic Pharmacokinetics: A Case of Recurrent Pancreatitis Post Discontinuation of a Glucagon-Like Peptide 1 Receptor Agonists
Authors: Morehouse Zachary P. , Ledford Jack D.
Published: August 2024

Glucagon-like peptide 1 receptor agonists (GLP-1RA) are guideline recommended agents for the treatment of type 2 diabetes mellitus (T2DM) and select agents (liraglutide and semaglutide) are FDA approved as anti-obesity pharmacotherapy options. These drugs act on the incretin hormone system within the body to revive insulin excretion, delay gastric emptying, and inhibit the production of glucagon from pancreatic alpha cells. Acute pancreatitis is a serious condition that may have a fatal outcome. It has been shown, and is now part of the prescribing information label, that GLP-1RA agents can cause changes in the pancreas that may ultimately lead to pancreatitis. We describe the case of a 53-year-old female patient with uncontrolled type II diabetes mellitus, who experienced multiple episodes of pancreatitis, from what we suspect was due to repeated exposure to the GLP-1 RA agent, semaglutide. After discontinuation of semaglutide, our patient experienced another episode of pancreatitis roughly 15-week later; which we believe may be due to the patient experiencing the effects of a smoldering pancreas brought on by repeated injury and prolonged circulation of semaglutide post-discontinuation.
The environmental repercussions of financial development and green energy in BRICS economies: From the perspective of new composite indices
Authors: Fakher Hossein Ali , Nathaniel Solomon Prince , Ahmed Zahoor , Ahmad Mahmood , Moradhasel Niloofar
Published: August 2024

This study is significant because it fills the gap in future literature by looking at the panel of 5 Brazil, Russia, India, China, and South Africa (BRICS) economies regarding the important role of financial development (FD) in environmental deterioration under the holistic measures of FD and environmental quality, something that has been largely overlooked in preceding studies. Consequently, this study explores the environmental effects of FD, employing a composite environmental quality proxy (CEQP) and a composite FD proxy (CFDP). In pursuit of this objective, the continuously updated fully modified (Cup-FM) and continuously updated bias corrected (Cup-BC) procedures are applied. These procedures enabled us to comprehensively explore the dynamic interactions between the combined index for FD and CEQP controlling agricultural activities, economic growth, renewable energy consumption, and nonrenewable energy consumption (NREC) in the panel of 5-BRICS economies from 2005 to 2019. The empirical results show that CFDP appeases environmental deterioration and thus improves environmental quality. The agricultural activities intensify environmental deterioration. The analysis also reveals a U-shaped relationship between the CEQP and economic growth (inverted U-type environmental Kuznets curve hypothesis) for the BRICS nations. Additionally, renewable energy improves environmental quality, whereas NREC decreases it. As supported by the results of the study, BRICS policymakers should encourage the financial sector to support green energy initiatives and achieve environmental stability.
Public libraries’ role in supporting Ukrainian refugees: A focus on Hungary and Poland
Authors: Johnston Jamie , Mierzecka Anna , Tóth Máté , Paul Magdalena , Kisilowska-Szurmińska Małgorzata , Khosrowjerdi Mahmood , Vårheim Andreas , Rydbeck Kerstin , Jochumsen Henrik , Hvenegaard Rasmussen Casper , Pálsdóttir Ágústa , Olson Anna , Skare Roswitha , Mathiasson Mia Høj
Published: August 2024

The Russian invasion of Ukraine in February 2022 led to Europe’s largest displacement of people since World War II, with significant substantial numbers of Ukrainian refugees seeking shelter in neighbouring countries. International research attests to the crucial roles public libraries can play in the reception and integration of refugees. However, diverse professional and geographical contexts and sociopolitical landscapes in which libraries work to support refugee reception and integration processes, necessitate ongoing and renewed focus on the topic. Therefore, this study examines how public libraries in Hungary and Poland responded to the influx of Ukrainian refugees, investigating their roles, programmes and partnerships. Using mixed methods, the study analyses previously unexamined 2018 questionnaire results and conducts 12 subsequent interviews with library staff. Findings reveal that libraries addressed a spectrum of user needs falling into three broad phases. Initially, they focussed on primary needs during the first phase, transitioning to settlement-related needs in the second phase. Variances between Poland and Hungary emerged during this phase, with Hungary primarily serving transient refugees and those with Hungarian backgrounds, while Poland saw a higher number of refugees of Ukrainian background settling. In the final phase, libraries emphasized literacy, integration and cultural support, aligning with reading and collection-oriented services. Service provision was characterized by nontraditional services in the first phase, non-collection-oriented services in the second phase and collection-oriented services in the third phase, with information provision central to all three phases. The study underscores public libraries’ role in addressing community needs, rooted in their core values of inclusivity and community engagement. However, their effectiveness hinges on inclusion in community-level efforts, awareness among new groups and securing economic and political support. Further research is warranted to explore library services to refugees globally amid increasing global migration and to understand the experiences of refugees using library services.
Knowledge-Related Resourcefulness for Growth in Weak Entrepreneurial Ecosystems
Authors: Rawhouser Hans , Sutter Chris , Holzaepfel Natalie , Conger Michael , Newbert Scott L.
Published: August 2024

Entrepreneurs need to access knowledge to grow, but weak entrepreneurial ecosystems tend to lack the types of knowledge that foster venture growth. To explore how entrepreneurs can act resourcefully as they overcome local ecosystem deficiencies in efforts to grow, we conducted 78 interviews with growth-oriented entrepreneurs in Central America. These entrepreneurs, perceiving that their ecosystem was subordinate to stronger ecosystems, challenged local knowledge, prompting them to engage in knowledge-related resourcefulness, which involves reorienting network targets (resourceful cognition) and assembling network tie proxies (resourceful behavior), to leverage benefits from both local and distant entrepreneurial ecosystems in pursuit of steady organic growth.
Living With Cancer: Child–Parent Dyads’ Perspectives and Experiences From a Private Tertiary Care Hospital in Pakistan
Authors: Sajjad Sehrish , Barolia Rubina , Gul Raisa B.
Published: August 2024

The life experiences of children with cancer and their parents as individuals have been well documented in literature. However, little is known about their experiences as child–parent dyads in Pakistan regarding these children’s quality of life. Thus, the study was conducted in the context of the family-centric society of Pakistan. In-depth interviews were conducted with 28 participants (14 child–parent dyads), comprising 9 female and 5 male children receiving cancer treatment and 8 mothers and 6 fathers (primary caregivers). All the participants were Muslims and hailed from diverse ethnic backgrounds, and most belonged to middle socioeconomic backgrounds. Thematic analysis was performed using Braun and Clarke’s (2006) framework, which revealed four themes: (1) Stress, Fears, and Optimism; (2) Reactions to Restrictions; (3) Adaptation and Coping; and (4) Support Structure and Mechanisms. The findings indicated that children’s and parents’ daily lives were affected in various ways during the children’s cancer journey. They faced several challenges which impacted their well-being. Particularly, the children considered their symptoms as restrictions in the way of carrying out their routine lives. However, children and parents also elaborated on using different coping strategies, such as play, reminiscing the past, incorporating religious practices into their daily routines, and keeping a family-centred approach towards the child’s care. The parents also recommended that cancer-specialised services and support groups should be accessible. Conclusively, these findings are useful for healthcare providers in giving family-centred care to afflicted families and devising innovative interventions that address the needs of children with cancer and improve their quality of life.
Caregiving During COVID and Beyond: The Experience of Workplace Stress and Chaplain Care Among Healthcare Workers
Authors: Colorafi Karen , Sumner Sarah , Rangel Teresa , Powell Lexie , Vaitla Kavya , Leavitt Robert , Gaines Adam
Published: August 2024

Healthcare workers (HCWs) experience occupational stressors that negatively impact emotional well-being and exacerbate turnover intentions. In the wake of the COVID-19 pandemic, the resultant acute care turnover rates have reached an all-time high. In addition, occupational stressors lead to psychological stress, including moral distress, defined as the dissonance between perceiving what the right course of action is and encountering an obstacle to acting accordingly. This qualitative descriptive study explored the perceptions of patient-facing HCWs in acute care hospital settings regarding the workplace stressors they encountered and the role of hospital-based chaplains in addressing emotional well-being and stress with 33 interviews. Findings suggest that HCW frequently experience work-related moral distress and seek relief by interacting with hospital chaplains. Chaplain care, common in American healthcare facilities for the spiritual care of patients, is an easily accessible resource to HCWs. Facilitating chaplain–HCW interactions may be an effective strategy for responding to moral distress and improving healthcare workers’ well-being.
Sibling Sexual Abuse: Youth Counseling Considerations
Authors: Kress Victoria E. , McAllister Christine A. , Hall Alicia K. , Forner Emma H.
Published: August 2024

Sibling sexual abuse (SSA) can have a significant impact on human development and counselors play an important role in identifying, advocating for, and supporting youth who have been sexually abused. In this article, considerations for counselors working with youth who have experienced SSA are discussed. The impacts of SSA on youth development, and challenges that counselors face when working with those affected by SSA are addressed. Counseling interventions that may be useful when counseling those who have experienced SSA are also provided, along with suggestions for future research.
Association of High Body Mass Index in Early Life With the Development of Colorectal Cancer
Authors: Wu Nian , Chen Yangyang , Li Guosheng
Published: August 2024

Colorectal cancer (CRC) is one of the most common malignant tumors of the digestive tract. In recent years, the age at which CRC is diagnosed has been trending younger on a global scale. Obesity, as a worldwide epidemic, is on the rise in most countries due to changes in dietary habits and lifestyles. Concurrently, with increased screening efforts and growing public awareness of health, the incidence of CRC in older adults is gradually declining, while the incidence in younger and middle-aged individuals is steadily increasing. This seems to indicate a strong association between overweight and obesity and a younger age of colorectal cancer diagnosis. Currently, with advancements in research on the relationship between early life (childhood and adolescence) body weight and CRC, new insights have been gained regarding the role of high BMI (overweight and obesity) in the occurrence and development of CRC, as well as its impact at different early life stages. Adolescence appears to be a particularly critical period. Therefore, this review will summarize the relationship between early life high BMI and CRC, aiming to provide a reference for clinical and basic research as well as CRC prevention.

Significance

This study on the relationship between early life high BMI and the development of CRC reveals the role of high BMI during childhood and adolescence in the occurrence and progression of CRC. It suggests the importance of restoring normal weight or reducing weight in individuals with high BMI early in life for the prevention of colorectal cancer.
Attorneys’ Questions About Time in Criminal Cases of Alleged Child Sexual Abuse
Authors: Cameron McKenna N. , Merriwether Ella P. , Katzman Jacqueline , Stolzenberg Stacia N. , Evans Angela D. , McWilliams Kelly
Published: August 2024

In cases of alleged child sexual abuse, information about the timing of events is often needed. However, published developmental laboratory research has demonstrated that children struggle to provide accurate and reliable testimony about time and there is currently a lack of field research examining how attorneys actually question child witnesses about time in court. The current study analyzed 130 trial transcripts from cases of alleged child sexual abuse containing a child witness between the ages of 5–17 years old to determine the frequency, style, and content of attorneys’ questions and child responses about time. We found that attorneys primarily ask closed-ended temporal location questions (i.e., asking when an event took place using a temporal construct such as day, month, and year) to child witnesses. Additionally, children, of all ages, rarely said “I don’t know” or expressed uncertainty in response to temporal questions. These findings are concerning as researchers find that children tend to struggle with temporally locating past events.
Successful treatment of PD1-inhibitor induced psoriasiform dermatitis using IL-17 blockade without compromising immunotherapy efficacy
Authors: Greene Adina , Penner Scott , Edmond Amanda , Camou Monica , Niu Jiaxin , Abbott Jordan
Published: August 2024

Introduction

Pembrolizumab is a monoclonal PD-1 inhibitor used in the treatment of lung cancer in addition to several other malignancies. Psoriasiform dermatitis is a well-documented adverse effect.

Case report

We present a 68 year-old-male with a 50-year smoking history and a 30-year remote history of plaque psoriasis, limited to the knees and elbows, who presented with metastatic non-small cell lung cancer. He was started on a chemotherapy regimen of carboplatin, paclitaxel, and pembrolizumab. One month later, he presented to dermatology with diffuse erythematous scaly papules coalescing into plaques on 80% of body surface area (BSA).

Management & outcome

Pembrolizumab treatment was paused. The patient was prescribed triamcinolone 0.1% twice daily, but still had significant BSA at one-month and was started on an Il-17 inhibitor, ixekizumab, clearing the psoriasiform dermatitis. He was rechallenged with pembrolizumab every 3 weeks and repeat PET/CT demonstrated excellent tumor response.

Discussion

This case prompted a literature review to further characterize the use of IL-17 inhibitors for psoriasiform dermatitis in the setting of ICI therapy. All six cases demonstrated improvement of psoriasiform dermatitis, with two cases showing partial response and four cases showing complete resolution. In three of the six cases, the patients exhibited clinical response to the primary malignancy after rechallenging with ICI, while remaining on an IL-17 inhibitor. Our case, in conjunction with the other reported cases, seems to suggest that IL-17 blockade can maintain a fine balance in this challenging clinical scenario by treating psoriasiform dermatitis without compromising the efficacy of immunotherapy.
The Relation Between Sexual Fantasies and Offense-Supportive Cognitions in People Convicted of Sexual Offenses: A Preliminary Study
Authors: Riberas-Gutiérrez María , Prieto Ursúa María , Martínez-Huertas José Ángel , Bueno-Guerra Nereida
Published: August 2024

The main objective of this research is to study the relationships of offense-supportive cognitions and sexual fantasies with sex crime. The research involved 48 men: 26 convicted of sexual offenses against minors and 22 convicted of sexual offenses against adults from different prisons in the Community of Madrid, Spain. We used the RAPE Scale and the Sex With Children Scale to evaluate offense-supportive cognitions and an ad hoc adaptation of the Multidimensional Developmental, Sex and Aggression Inventory to evaluate sexual fantasies with minors and sadomasochistic fantasies. The results show that both groups present similar offense-supportive cognitions, while each group had significantly more sexual fantasies related to their specific crime. Participants who had sexual fantasies about minors presented significantly more offense-supportive cognitions justifying child sexual abuse than those who did not present these fantasies, while participants with sadomasochistic fantasies did not present more offense-supportive cognitions about rape. After collecting this information, we ran four mediation models to assess potential relationships between fantasies, offense-supportive cognitions, and specific sexual crime. The mediation models showed that both sexual fantasies with minors and sadomasochistic fantasies had direct relationships with sex crimes. Upon further confirmation with studies with larger sample sizes, our findings support the importance of dealing with sexual fantasies in treatment of people convicted of sexual offenses and imply a need for differentiated treatment, since the content of sexual fantasies was different in each group.
Relationship between persistence with topical antiglaucomatous prescription and patient socioeconomic status at a tertiary university hospital in Jerez de la Frontera (Spain)
Authors: Pereira-Gonzalez Ignacio , Sanchez Javier Benitez-del-Castillo , Carmona Soledad Jimenez , Cordoba Doña Juan Antonio
Published: August 2024

Introduction

To study the relationship between socioeconomic status and persistence with topical antiglaucomatous medication.

Methods

A retrospective epidemiological observational cohort study was conducted with a sample of 1563 patients. The main dependent variable was persistence (medication possession ratio), the independent variable was socioeconomic status (deprivation index). Additional independent variables were used for multivariate analysis: individual health card index, sex, age, pharmacological group, number of eye drops, preservatives, diagnosis and concurrent medications. Bivariate statistical analysis was obtained using non-parametric tests. Logistic regression was used for multivariate analysis. The level of statistical significance was set at p < 0.05.

Results

We obtained data showing greater persistence in the groups with a higher socioeconomic level (deprivation index 1 and 2), with medication possession ratio values of 79.97 and 75.30, respectively) as opposed to the groups at lower socioeconomic levels (deprivation index 4 and 5, with medication possession ratio values of 73.75 and 69.85, respectively. Logistic regression corroborated this difference, reaching a significant value (no persistence in deprivation index group 5 versus 1) with OR = 1.62; 95%CI: 1.13–2.31. Additionally, lower persistence was detected in males, under 60 years of age, undergoing treatment with alpha-agonists, and in patients with ocular hypertension.

Discussion

Low socioeconomic status of the patient was significantly associated with decreased persistence with topical antiglaucomatous therapy.
Xen gel stent implant for persistent glaucoma after silicone oil removal
Authors: Boscia Francesco , Ferreri Paolo , Sisto Dario , Niro Alfredo , Boscia Giacomo , Scotti Giacomo , Viggiano Pasquale , Sborgia Alessandra , Sborgia Giancarlo , Giancipoli Ermete , Alessio Giovanni
Published: August 2024

Purpose

To evaluate the effectiveness and safety of the XEN-Stent for managing unresponsive to medical therapy secondary glaucoma after silicone oil (SO) removal.

Methods

This retrospective chart reviewed 12 patients who underwent vitrectomy and SO endotamponade. They experienced intraocular pressure (IOP) elevation after SO removal despite taking the maximum tolerated glaucoma medication. Eleven eyes underwent an XEN-implant, while 1 underwent an XEN-implant with phacoemulsification/IOL implantation. The primary outcome was to achieve success criteria: IOP <18 mmHg and >20% IOP reduction without medication (complete success) or with medication (qualified success) and without a secondary IOP-lowering procedure. IOP, best-corrected visual acuity (BCVA), and the number of glaucoma medications (Glaucoma Medication Score-GMS) were recorded at baseline, 1 day, 1 week, 1 (M1), 3 (M3), 6 (M6), and 12 (M12) months postoperatively.

Results

Baseline characteristics included males percentage 66.6%, mean age of 61.8 ± 5.7 years, BCVA 0.69 ± 0.3 logMAR, IOP 30 ± 4.2 mmHg, and GMS 3.1 ± 0.5. There was a significant reduction in IOP by 14 ± 1.9 mmHg and GMS by 0.27 ± 0.6 at M12 compared to baseline (p < 0.01), but no significant change in BCVA (p = 0.21). Complete success dropped to 50% (M3), rising to 75% (M6, M12) after needling. Two patients achieved qualified success at M12. Needling was performed in 6 eyes, with 3 requiring a second procedure. Ex-PRESS was required in 1 eye. One eye experienced hypotony and hyphema, which resolved within a week.

Conclusion

XEN implant may be an initial treatment for persistent post SO removal glaucoma with minimal complications. Needling procedures can help maintain or restore surgical success.
One-Year comparative analysis between standalone iStent implantation versus combined iStent implantation with phacoemulsification
Authors: Khoo Phong Yue , Tang Seng Fai , Lam Chenshen , Cheng Teck Chee , Din Norshamsiah Md
Published: August 2024

Purpose

To evaluate the real-world efficacy and safety of iStent implanted standalone or combined with phacoemulsification in open-angle glaucoma (OAG) patients.

Methods

This is a retrospective observational study of OAG patients who underwent standalone or combined iStent procedures were reviewed. Inclusion criteria included age over 18 years and open angle on gonioscopy. Exclusion criteria were prior incisional glaucoma surgeries, missing data, or follow-up shorter than 6 months. The primary outcome was surgical success between the two groups after one year. Secondary outcomes included differences in IOP reduction and medication use.

Results

We included 48 eyes with primary (n = 44) and secondary OAG (n = 4). Nineteen eyes had standalone while 29 eyes had combined procedures. Kaplan-Meier analysis revealed overall surgical success in 31.3% of eyes after one year. Qualified success was higher in the combined group than the standalone group [62.5% (10 eyes) vs 27.3% (3 eyes), p = 0.239]. At 24 months, mean IOP reduced by 2.2 ± 2.5 mmHg vs 3.3 ± 2.9 mmHg, p = 0.333), and the number of medications reduced by 1.1 ± 1.2 vs 1.3 ± 0.1, p < 0.001) in the standalone and combined group, respectively. Stent occlusion occurred in two eyes.

Conclusions

While both standalone and combined iStent procedures provide safe IOP reduction throughout 12 months, there was no statistically significant difference in surgical success between them.
Modified viscotrabeculotomy versus modified trabeculotomy in late-onset primary congenital, juvenile, and secondary open-angle glaucoma
Authors: Fakhraie Ghasem , Ansari Shabnam , Tabatabaei Seyed Mehdi , Hamzeh Nikoo , Vahedian Zakieh , Beikmarzehei Alireza
Published: August 2024

Purpose

To compare modified viscotrabeculotomy (VCO-Tbo) to modified trabeculotomy (Tbo) in late-onset primary congenital, juvenile open-angle, steroid-induced, and pigmentary glaucoma.

Methods

Patients were randomly assigned to VCO-Tbo and Tbo groups in this study. Intraocular pressure (IOP), antiglaucoma medications, and success/failure rates were assessed. A linear mixed model was used to compare the change trend at different follow-up times. Survival time was evaluated using the Kaplan-Meier graph and Log-Rank test.

Results

The mean IOP at 1, 3, and 12 months in the VCO-Tbo group was 14.1 ± 3.1, 15.9 ± 3 and 17 ± 3.1 mmHg, respectively. The mean IOP at the same time points in the Tbo group was 15.9 ± 3.3, 17.6 ± 3.5 and 18.4 ± 3.2 mmHg (P = 0.051, 0.058, 0.088, respectively). The VCO-Tbo group had significantly lower IOP after six months (16.5 ± 4.1 mmHg vs. 18.7 ± 3.8 mmHg; p = 0.031) and by the last visit (16.8 ± 2.1 mmHg vs. 18.8 ± 2 mmHg; p = 0.013). The reduction in the number of medications was significant in both groups compared to baseline (P < 0.001), but there was no significant difference between groups (P = 0.450). The complete and qualified success rate was 43.9% and 34.1% in the VCO-Tbo group and 46.8% and 10.6% in the Tbo group at the final follow-up (p = 0.040, and 0.039, respectively).

Conclusion

Both procedures are effective in IOP and medication reduction. The survival time and efficacy of modified trabeculotomy can be augmented by injecting cohesive viscoelastic in the Schlemm's canal.
Return to surfing following hip arthroplasty
Authors: Berger Garrett K , Ta Canhnghi N , Hachadorian Michael , Ehlers Cooper B , O’Leary Ryan , Gurusamy Pradyumna , Ball Scott T
Published: August 2024

Background:

To date, no previous studies have explored return to surfing after hip arthroplasty. The objective of this study is to analyse return to a risky activity following hip arthroplasty.

Methods:

A retrospective chart review was conducted on all primary total hip arthroplasties (THA) and hip resurfacing arthroplasties (HRA) performed by the senior author from 2014 to 2021. Patients identified as surfers were contacted to complete a survey including surfing history and patient-reported outcomes.

Results:

83 hips in 67 patients were contacted. There were 66 THAs and 17 HRAs. 81 hips were performed through a posterior approach and 2 through an anterior approach. At an average of 67 months, there were no dislocations and no patients reported hip pain while surfing. Time to resume surfing was a median of 16 (range 8–144) weeks. Among 13 patients who did not return to surfing, 8 cited new lifestyle restrictions, 4 attributed it to other arthritic joints, and only 1 patient attributed their limitation to the replaced hip. This group had taken significantly more time off from surfing prior to surgery.

Conclusions:

Return to surfing following THA and HRA is common and safe in our study population with no complications and specifically no dislocations. Patients with other sites of arthritis and patients who have more extensive time away from surfing prior to surgery are less likely to return to sport. While surfing is clearly not without risk, patients can generally expect a high rate of successful return to surfing after hip arthroplasty.
A Retrospective Comparison of Diagnostic Tools of Bullous Pemphigoid for Elderly Patients
Authors: Chang Yung-Chun , Chang Yu-Jun , Yang Hui-Ju
Published: August 2024

Background:

Older patients who are predisposed to bullous pemphigoid (BP) may exhibit reluctance to undergo skin biopsy due to potential complications.

Objectives:

This study aimed to conduct a comparative evaluation among histology, direct immunofluorescence (DIF), and indirect immunofluorescence (IIF) to determine the optimal diagnostic tool in elderly patients.

Methods:

A retrospective study was conducted on 841 patients suspected of having BP. All cases were initially classified as BP and non-BP in accordance with the diagnostic criteria. Student’s t-test and chi-squared test examined differences between the 2 groups. We evaluated the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio detected by the 3 tools. We stratified the analysis by age to compare the performance of the diagnostic tools and examined the risk factors associated with BP using logistic regression.

Results:

Overall, histology exhibited the highest sensitivity (89.4%), while DIF demonstrated the highest specificity (67.1%). In the elderly, the IIF test exhibited the highest specificity (57.5%), the highest positive likelihood ratio (2.047), and the lowest negative likelihood ratio (0.226). Among patients taking Dipeptidyl Peptidase-4 (DPP-4) inhibitors, IIF demonstrated the highest positive likelihood ratio (3.194) and the second-lowest negative likelihood ratio (0.235).

Conclusions:

In cases that elderly patients suspected of having BP are reluctant to undergo skin biopsy, IIF demonstrates the optimal diagnostic method due to its highest positive likelihood ratio, the lowest negative likelihood ratio among the 3 diagnostic measures. Moreover, IIF is found to be a more effective tool for detecting BP in patients using DPP-4 inhibitors.
Participatory design in telehealth research: Practical case examples
Authors: Clemensen Jane , Holm Kristina G , Jakobsen Pernille R , Jensen Charlotte M , Nielsen Charlotte , Danbjørg Dorthe B , Smith Anthony C , Rothmann Mette J
Published: August 2024

Participatory design (PD) is a methodology that emphasizes user participation in the design of new technologies to leverage change within organizations and services. PD originated in the computer science field in the 1970s and 1980s when new programs and technologies were developed to empower workers, by involving them in decisions that affected them. PD in health research has been proven to change clinical practice. Genuine user involvement that includes all stakeholders, and robust collaborations across sciences, sectors, and disciplines are basic elements of successful research to change clinical practice and to implement novel technical and organizational approaches. This paper summarizes seven case studies involving the use of PD in telehealth research. All cases presented promoted organizational changes supported by health information and communications technology, and have been implemented at either international, national, regional, or local levels. We describe how PD can be applied in health sciences and used to facilitate organizational changes, new perspectives, and new communications methods. The relevance and suitability of PD as a research design in health science is explained, and recommendations for conducting PD studies in telehealth research are presented. In PD, mutual learning and co-creation is facilitated. Consequently, learning from users, rather than studying them, corroborates our understanding and the emergence of new knowledge.
Local economic inequality and mortality: Too little within-unit variation for fixed effects analysis?
Authors: Elstad Jon Ivar , Heggebø Kristian , Dahl Espen
Published: August 2024

This debate article discusses the use of fixed effects models for causal analysis, with reference to an article recently published in Scandinavian Journal of Public Health.
Nonlinear oscillators dynamics using optimal and modified homotopy perturbation method
Authors: Roy Tapas , Rath Biswanath , Asad Jihad , Maiti Dilip K , Mallick Pravanjan , Jarrar Rabab
Published: August 2024

This study investigates the several strongly nonlinear oscillators (Van der Pol, Duffing and Rayleigh) for which we have applied the most powerful and advanced optimal semi-analytical technique: optimal and modified homotopy perturbation method (OM-HPM) for the convergent semi-analytical series solution. The numerical simulation demonstrates the high accuracy of the OM-HPM, which is straightforward, does not require any domain decomposition, special transformation, or pade approximations to get the convergent series solution. The key features for the high accuracy of the OM-HPM lies on the best optimal auxiliary linear operator. Therefore, OM-HPM offering a valuable tool for engineers and researcher to analyze the complex nonlinear oscillator.
Torsional vibration suppression of cantilever beams system with the PNESI
Authors: Li Hui , Yao Hongliang , Dou Jinxin , Jia Ruyu , Wei Guochong
Published: August 2024

Considering the intricate design of the conventional inerter structures, the compressive-torsional coupling effects of chiral metamaterial are used to achieve the torsional movement alongside linear movement, forming a simplified inerter mechanism. This simplified design is then integrated with the nonlinear energy sink (NES). In this study, a novel NES with the chiral metamaterial inerter structure is suggested to mitigate vibrations in the cantilever beam system. The introduction includes both the piecewise linear beam, providing nonlinear stiffness, and the chiral metamaterial inerter structure. These components are combined to form the piecewise nonlinear NES with inerter (PNESI) structure. Subsequently, the PNESI structure is integrated with the cantilever beam system, and a corresponding dynamic model is formulated to evaluate its vibration mitigation capabilities. The theoretical results are verified through experiments. The findings indicate that under steady-state vibration conditions, PNESI achieves peak vibration reductions of 88.6% in simulations and 62.7% in experiments for the cantilever beam system.
The mixed embeddedness of female entrepreneurship across countries: A configurational approach
Authors: Deng Wei , Liang Qiaozhuan , Wang Wei
Published: August 2024

The study of female entrepreneurship (FE) unfolds as an intricate puzzle woven by a myriad of contextual factors that shape necessity (NBFE) and opportunity-based (OBFE) female entrepreneurship. Motivated by the urgency to decipher this complexity, this research delves into the nuanced dimensions of FE across countries. Utilizing a mixed embeddedness perspective, we aim to gain a comprehensive understanding of the family, market, and institutional contexts that exert influence on FE. Leveraging data from the Global Entrepreneurship Monitor the Gender, Institutions, and Development Database, and the World Development Indicators Database, we employ fuzzy set qualitative comparative analysis to examine the configurational impact of multiple embeddedness on NBFE and OBFE across 50 countries. The results spotlight divergent configurations for enabling and constraining NBFE and OBFE, contributing to the FE literature by emphasizing the need to move beyond a one-size-fits-all approach in policy formulation. Our findings advocate for adopting targeted measures tailored to the unique challenges and opportunities faced by different groups of female entrepreneurs.
Determination of cyclic air-fuel ratio and analysis of low and high-frequency variations in dual-fuel RCCI engine
Authors: Saxena Mohit Raj , Maurya Rakesh Kumar
Published: August 2024

Higher cyclic variations (CVs) in the engine affect the performance, emissions and drivability of the vehicle. Higher CVs are one of the challenges in dual-fuel reactivity-controlled compression ignition (RCCI) engines, mainly at lower loads. Cyclic disparities in the charge preparation, such as air-fuel ratio (AFR), result in CVs in the combustion parameters. The pressure moment method (PMM) is employed in the gasoline/methanol-diesel RCCI engine to estimate cyclic disparities in AFR. The logged cyclic in-cylinder pressure is used to calculate the cyclic AFR. After determining the cyclic AFR, statistical analysis and return maps are applied for the analyses of variations in the AFR, CA10, CA50, pmax and IMEP. For examining the low and high-frequency disparities in cyclic [Formula: see text] and its relationship with CA10, Wavelet transform (WT) is further applied. A good relationship is found between the estimated mean AFR and the experimental mean AFR. Return maps signify that for the earlier start of injection (SOI), the data points of AFR are more scattered correspondingly, the data points for CA10, CA50, pmax and IMEP are more scattered. WT analysis shows that both high-frequency and low-frequency variations are present in dual-fuel RCCI combustion. It is found that high-frequency discrepancies in the AFR are consistent throughout the engine cycles for all the tested injection timings. Wavelet results confirm that high-frequency fluctuations in AFR result in disparities in CA10 and IMEP.
Enhancing airflow dynamics in airjet spinning: A machine learning approach to optimize nozzle design
Authors: Koetzsch Anja , Weide Thomas
Published: August 2024

This research delves into using machine learning techniques to enhance the airflow dynamics in Airjet spinning. It focuses on understanding the factors that affect airflow by examining components of a spinning nozzle including the fiber inlet element, injector nozzle and spinning spindle. A prototype Airjet spinning nozzle was developed to evaluate the Intake Airflow and Airflow Rate, which serve as the basis for a simulation model. A total of 501 data points were empirically gathered, and machine learning methods were applied to uncover patterns and make predictions. The study combines conventional measurement techniques with data analysis tools, like linear regression, decision trees, random forest and support vector regression. After developing a applicable machine learning tool, the hyperparameters are optimized with the goal to improve the model’s reliability. Following this optimization process it was found that the CatBoost model outperformed ML models in terms of all performance metrics. Furthermore insights, into how nozzle features impact airflow dynamics were obtained through sHapley Additive exPlanations (SHAP) analysis. The results indicate that specific nozzle design parameters play a significant role in improving airflow dynamics. Integrating machine learning techniques into the design process marks a departure from conventional empirical methods. This scientific method allows for a more rapid and precise Airjet nozzle design process, fostering innovation in textile manufacturing technology.
Investigator-initiated clinical trial of stabilizer device: A novel intracranial exchange guidewire for neuroendovascular treatments
Authors: Sakai Chiaki , Sakai Nobuyuki , Peterson Catherine , Ohta Tsuyoshi , Oishi Hidenori , Fujinaka Toshiyuki , Matsumaru Yuji , Ishii Akira , Imamura Hirotoshi , Yoshimura Shinichi , Izumi Takashi , Satow Tetsu , Ito Yasushi , Sugiu Kenji , Miyachi Shigeru , Hirano Teruyuki , Kagimura Tatsuo , Kaneko Naoki , Tateshima Satoshi
Published: August 2024

Background

Neuroendovascular procedures, especially those involving significant vessel tortuosity, giant intracranial aneurysms, or distally located lesions, frequently necessitate exchange methods. However, exchange maneuvers pose a risk of inadvertent vessel injury. To address these challenges, a Stabilizer device was developed and evaluated for its efficacy and safety. This clinical trial aimed to assess the efficacy and safety of the Stabilizer device in facilitating the navigation of neuroendovascular devices to target lesions in cases where the exchange technique was necessary.

Methods

This was a single-arm, prospective, open-label, multicenter clinical trial performed at nine different sites. It focused on investigating the use of the Stabilizer device for treating intracranial aneurysms and atherosclerosis.

Results

A total of 31 patients were enrolled across nine centers in Japan from July 21, 2022, to March 10, 2023. The study enrolled 24 (77.4%) patients with intracranial aneurysms and seven (22.6%) patients with intracranial artery stenosis. Majority of the target lesions were in the middle cerebral artery territory (83.9%). The Stabilizer device was used to exchange for 0.027-inch catheters, intermediate catheters, PTA balloons, and Wingspan stent system. The Stabilizer device demonstrated 100% technical success rate. While three complications related to the treatment were noted, there were no complications related to the device, including any vascular damage.

Conclusions

This is the first multicenter clinical trial that investigated and demonstrated technical efficacy as well as overall safety profile of the Stabilizer device in neuroendovascular procedures where the use of an exchange method was necessary.
Part 2: The development and advancement of the detachable balloon catheter; a historical and technical review
Authors: Madapoosi Adrusht , Sanchez-Forteza Anthony , Mrad Tatiana Abou , McGuire Laura Stone , Theiss Peter , Tshibangu Mpuekela , Charbel Fady , Alaraj Ali
Published: August 2024

The detachable balloon catheter (DBC) was a revolutionary technique for the treatment of cerebrovascular pathologies. It was used to treat carotid cavernous fistulas (CCFs), vertebro-jugular fistulas, arteriovenous malformations (AVMs), and aneurysms. The DBC became the foundation for neurointerventional techniques, leading to the development of coil embolization and bioactives. Our team selected relevant articles from PubMed published between 1974 and 2023. Articles were excluded if they did not discuss the use or development of the detachable balloon catheter or subsequent technologies. The DBC was used to occlude vessels, either temporarily or permanently. Dr Gerard Debrun implemented findings from Dr Fedor Serbinenko's research to develop an intravascular detachable balloon technique. He developed many variations using type I and type II balloon catheters that differed in size, length, and material, allowing for the personalization of treatment based on the lesion. This revolutionary thinking showed that every pathology has a different shape and anatomy that require a unique approach. The DBC would offer the first alternative to the conventional practice of carotid occlusion in CCF treatment at the time. The DBC would later be used in aneurysm occlusion and the embolization of AVMs, with additional benefit in traumatic vascular sacrifice. Although the DBC has largely been replaced, it is still useful in a small subset of patients, and has financial incentive as it is more affordable than coils. This technique was a monumental stride in the history of neurointervention and helped propel the specialty to the current era of patient-specific interventions.
Indwelling urinary catheter use and adherence to clinical practice guidelines: A point prevalence study in adult hospital inpatients
Authors: Wickins Jane , Rickard Claire M , Kasper Karen , Morton Leanne , Doellinger Jessica , Thomas-Gabbett Patricia , Marsh Nicole
Published: August 2024

Background

Approximately 25% of hospitalised adults require an indwelling urinary catheter (IDC) during their hospital stay. IDCs expose patients to risks of infectious and non-infectious complications.

Aims

To identify IDC prevalence, assess adherence to clinical practice guidelines and patient-reported involvement in IDC care for adult hospital inpatients.

Methods

This point prevalence study was conducted in 22 wards in a single quaternary hospital. Data was collected by clinical and research nurses working in pairs on a single day. Study outcomes were reported descriptively as frequencies and percentages.

Results

Of 502 patients included, 77 (15.3%) had an IDC (median duration 99.6 h). The median age of patients with an IDC was 64 years (interquartile range 22–88 years), 54 (70%) were male and one-quarter ( n = 19; 25%) of IDCs were inserted at another hospital. More than half ( n = 44; 57%) of the 77 IDCs had no documented removal plan. Three patients were unavailable for review for observed clinical practices, and it was found 43% ( n = 32/74) lacked a securement device. Of 77 people with IDCs, there were 44 patient responses, and 27 (61.4%) patients did not know the reason for their catheter.

Discussion

Areas for improvement included securement device use, timely removal plans and patient education for the reason for the device. Regular point prevalence studies to assess use and adherence to clinical practical guidelines can improve safety outcomes for patients requiring IDCs.
Integrating human factors into the distribution model of goods and fast-moving consumer goods for effective inventory control
Authors: Ogbeyemi Afolabi , Ogbeyemi Akinola , Zhang Wenjun
Published: August 2024

Multiple factors contribute to the occurrences of disruptions in workflow management within the e-commerce system that focuses on the distribution of goods and other fast-moving consumer goods (FMCG). These disruptions have particularly affected and increased lead times and caused frequent shipment delays. The causes of these disruptions, especially in the context of distribution of goods and FMCG towards inventory control, have been widely speculated upon in recent years. Given the recent interruptions, the study presented in this paper used a methodology called statistical model analysis (SMA) to study the impact of human factors (HFs) on the system performance in a warehouse distribution system. A case study was taken on a particular company called ABC and XYZ to model the impact of some specific HF such as job fatigue, and job rotation to name a few and to uncover the underlying reasons behind the ongoing disruptions within the distribution system. Specifically, the result of this study aims to provide a data-driven understanding of these issues and one of the contributions of this study is to enhance our understanding of the significance of these HFs, rather than focusing on the equipment and materials as seen in prior research. Through this data-based approach study, stakeholders in operations management, e-commerce, and the supply chain system would be well-informed in many ways to resolve the challenges faced by humans in the system towards enhancing their overall system performance.
“I Go Where They Go”: Emigration and Jewish Connections with Lithuania from 1918–1940
Authors: Čypaitė-Gilė Dovilė
Published: August 2024

From the second half of the 19th century, emigration was part of the daily life of almost all Eastern Europeans. According to Lithuanian census data from 1923, the Jewish community accounted for 150,000 (7%) of Lithuania’s total population of 2 million people (excluding the Vilnius region). During the period 1928–1938, Jews made up about 34% of all Lithuanian emigrants. The aim of this article is to explore the relationship between Jewish emigrants and the Lithuanian government from 1918 to 1940. The article will attempt to show how those who have already emigrated are connected to Lithuania, both at a governmental and personal level. Correspondence between the Lithuanian Ministry of Foreign Affairs and Lithuanian Jewish communities shows connections related to economic, cultural, and political networks. In addition, the Lithuanian government sought to strengthen ties with the Lithuanian Jewish diaspora, but personal perspective of emigrants does not reflect this tendency. By combining the personal and governmental perspectives, it becomes clear whether these different viewpoints provide similar or different answers to the research questions, and allows us to see the Jewish emigration process in its entirety.