bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing the mediatory role of kinesiophobia in the association between perceived greenspace and physical activity among individuals with chronic low back pain
Authors: Li Hansen , Browning Matthew H.E.M. , Tian Haodong , Huang Li , Zhang Xing , Yin Mingyue , Liu Haowei
Published: March 2024

To test the mediatory role of kinesiophobia between greenspace and physical activity, we conducted a cross-sectional survey and recruited 801 participants with chronic low back pain. The level of greenspace was assessed using both perceived greenspace and the Normalized Difference Vegetation Index (NDVI). The frequency of walking and moderate and vigorous physical activities was measured using a brief assessment, while kinesiophobia was evaluated using the 11-item Tampa Scale for Kinesiophobia (TSK-11). The results revealed that perceived greenspace was positively associated with all measured physical activities, and was negatively associated with kinesiophobia. Meanwhile, NDVI was only positively associated with moderate and vigorous physical activity. Kinesiophobia played a marginal but significant mediating role in the association of perceived greenspace with walking, moderate physical activity, and vigorous physical activity. In conclusion, our findings offer early evidence of associations and pathways between greenspace and physical activity among individuals with chronic low back pain.
Social Constructivist Meta-Ethnography - – A Framework Construction
Authors: Soundy Andrew
Published: March 2024

Objective: The objective of this review was to establish a modified meta-ethnography framework by integrating the traditional phases with methods from social constructivist grounded theory. The modified version was required to identify methods which can ensure analytic generalisability and honour critical inquiry. Method: A narrative synthesis review was undertaken using 4 electronic databases. Articles were located that described the methods and methodologies of meta-ethnography and social constructivist grounded theory. A synthesis was undertaken which integrated the methods of social constructivist grounded theory. Results: The meta-ethnography was undertaken in 5 phases: (1) The positionality of the researcher and the area of interest identified. (2) Identifying what is relevant. (3) Reading the included studies and determining how studies are related. (4) The iterative process of idea generation required for theory generation. And (5) Expression of the theory, model, or process. Conclusion: The current review has been able to create a social constructivist meta-ethnographic framework for reviewing empirical qualitative research. This framework will support the development of a substantive theory (a theory in one area) which can be used then to consider its application in other areas. This approach will help create new lines of research and aid the explanation of problems in other areas.
Negotiating for influence and resources: A study of Swedish teachers’ and principals’ experiences of aggressive emails from parents
Authors: Cowen Forssell Rebecka , Berthelsen Hanne , Jönsson Sandra
Published: March 2024

This article focuses on teachers’ and principals’ experiences of aggressive emails in home–school collaborations with parents. Semi-structured interviews with 31 teachers and principals from primary, lower and upper secondary schools in Sweden were conducted. Three categories were identified in the material which illuminate the phenomenon of cyberaggression towards principals and teachers from parents: ‘aggressive emails as reactions to principals and teachers’ performances’, ‘aggressive emails as a way of imposing power’ and ‘aggressive emails as a source of anxiety, loss of joy, and decreased focus on core tasks’. The study concludes that cyberaggression in emails from parents is centred around the act of negotiating and that email communication opens up spaces for negotiation to take place. The study also concludes that email cyberaggression tends to be instrumental in character, intended to result in a specific outcome rather than to cause harm. However, cyberaggression influences professional practice and can create a vicious circle of administrative obligation.
Clinical Experience With a Less Invasive Surgical Transparotid Approach and Trapezoidal Plate for Neck and Base Condylar Fractures: A Retrospective Study
Authors: Cortez Fuentes Carlos , Astorga Mori Felipe , Valladares Pérez Salvador , Gahona Gutiérrez Osvaldo , Sepúlveda Troncoso Gerson , Dallaserra Albertini Matias , Vargas Buratovic Juan Pablo
Published: March 2024

Study Design

This is a retrospective observational study.

Objective

To evaluate the clinical outcomes after an open reduction and internal fixation (ORIF) of condylar neck and base fractures (CNBFs) with a trapezoidal shape plate in patients using a less invasive transparotid approach.

Methods

Fifteen patients with condylar fractures were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen Craniomaxillofacial (AOCMF) classification system, treated by ORIF with a trapezoidal plate. All patients were evaluated by clinical examination (pain, occlusion, and mandibular dynamics) and imaging through computed axial tomography. Postoperative evaluations considered a favourable clinical outcome of fragment stability, stable occlusion, absence of pain, and regular mouth opening ranges. In addition, any signs of local infection, malocclusion, facial nerve damage, or failure of the fixation system were recorded.

Results

According to the AOCMF classification for condylar fractures, eight fractures affected the condylar base and seven involved the condylar neck. No patients presented pain or joint sounds in the TMJ. All patients obtained a buccal opening greater than or equal to 35 mm. Two patients showed postoperative malocclusion which was corrected by intermaxillary elastics therapy. In addition, two patients had transient paresis during the postoperative period. One of them had paresis of the frontal and buccal branches of the facial nerve while the second patient had paresis of the zygomatic and buccal branches.

Conclusions

Using trapezoidal miniplates provides functionally stable fixation for neck and base condylar fractures and allows for a less invasive surgical transparotid approach (2 cm extension). They also reduce the amount of osteosynthesis material and are easier to adapt and fix in the author’s opinion.
Brain functional and structural changes in diabetic children. How can intellectual development be optimized in type 1 diabetes?
Authors: Stanisławska-Kubiak Maia , Majewska Katarzyna Anna , Krasińska Agata , Wais Paulina , Majewski Dominik , Mojs Ewa , Kȩdzia Andrzej
Published: March 2024

The neuropsychological functioning of people with type 1 diabetes (T1D) is of key importance to the effectiveness of the therapy, which, in its complexity, requires a great deal of knowledge, attention, and commitment. Intellectual limitations make it difficult to achieve the optimal metabolic balance, and a lack of this alignment can contribute to the further deterioration of cognitive functions. The aim of this study was to provide a narrative review of the current state of knowledge regarding the influence of diabetes on brain structure and functions during childhood and also to present possible actions to optimize intellectual development in children with T1D. Scopus, PubMed, and Web of Science databases were searched for relevant literature using selected keywords. The results were summarized using a narrative synthesis. Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with diabetes, it is essential to prevent disorders of the central nervous system by maintaining peri-normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of any cognitive dysfunctions, followed by the development of individual management strategies and the training of appropriate skills, together with complex, multidirectional environmental support.
Tau and delirium superimposed on dementia: A case report
Authors: Yu Po-Chung , Kuo Ching-Min , Chen I-Chun
Published: March 2024

We present a case involving a 60-year-old man with subacute delirium characterized by challenging attention shifts and obstinate behavior, contrasting with his usual mild-mannered personality. The patient developed pneumonia and a urinary tract infection following the onset of subacute delirium. Despite exhaustive investigations, the cause remained elusive until cerebrospinal fluid analysis revealed Tau positivity. Our overview suggests neurodegenerative diseases as the primary cause, rather than infectious or autoimmune factors. The case underscores a significant association between Tau and delirium superimposed on dementia, offering guidance to clinicians managing such patients.
Working as a “Token”: Different Perspectives on the Role of International Faculty in Korean Universities
Authors: Song Inyoung , Kim Yangson
Published: March 2024

Purpose

This study examined the factors influencing the tokenization of international faculty in Korean universities. It also explored how domestic faculty and staff perceive the role of international faculty and the process by which they adapt to the Korean education system.

Design/Approach/Methods

The study used a qualitative design. Universities were arranged by region and objectives (research-oriented, teaching-oriented, or combined teaching and research) for sampling, and in-depth interviews were conducted with three groups: international faculty, Korean faculty, and Korean staff.

Findings

First, Korean faculty and staff expressed low expectations of international faculty based on their different definitions of internationalization. Second, these low expectations resulted in role encapsulation, limiting the functions of international faculty. In addition, although Korean universities compete to hire international faculty, they do not provide them with adequate support post-hire. The burden of this lack of support is often passed on to Korean faculty, instilling a negative perception of international faculty.

Originality/Value

Using the framework of tokenism, this study analyzed Korean universities’ efforts to hire international faculty as part of university internationalization; it determined whether the latter ultimately became major actors in the internationalization strategy.
Group Counseling for Black Male Students: A Strengths-Based Approach
Authors: Gibson Eva M. , Sandifer Mariama I. Cook , Rollins Kimberly , Osagie-Ekhovbiye Felix
Published: March 2024

The American School Counselor Association calls for counselors to utilize multitiered systems of support to minimize gaps. Specifically, Tier 2 interventions provide a method to address equity issues and foster growth. Black male students experience the greatest disparities in schools; therefore, school counselors should consider culturally affirming, strengths-based groups to meet these students’ needs. This practitioner research outlines an intervention resulting in participants’ decreased discipline referrals and enhanced social/emotional skills.
Reimagining Groups: A Phenomenological Investigation of Affinity Groups in Schools
Authors: Beasley Jordon J. , Ieva Kara P. , Steen Sam
Published: March 2024

This study provides insight into the role of affinity groups within educational environments focusing on the perspectives of school counseling practitioners who facilitate these groups. Affinity groups, designed to bring together students with shared identities or interests, serve as spaces for supportive dialogue, learning, and empowerment. The research study utilizes a qualitative, descriptive phenomenological approach to capture the subjective realities shaped by participants’ unique intersecting identities and social contexts. Through in-depth narratives gathered from consenting school counseling practitioners, the study addresses key questions about the definition, operationalization, and implementation of affinity groups in educational settings. The analysis identifies six consistent themes: affinity groups at the Tier 1 level, evaluation, connection, agency, stigma, and safety. Participants’ individual stories enrich the exploration of these themes, shedding light on the varied experiences within affinity spaces in educational environments.
Unified Theory of Acceptance and Use of Technology (UTAUT) Model: Factors Influencing Mobile Banking Services’ Adoption in China
Authors: Mensah Isaac Kofi , Khan Muhammad Khalil
Published: March 2024

This study uses a modified UTAUT model to examine behavioral factors influencing mobile banking services’ (MBS) adoption in China. Despite the abundance of smart mobile phones, the uptake of mobile banking among the population remains low. To address this issue, this study integrates four variables—perceived financial cost, awareness, technology infrastructure support, and government regulations—into the UTAUT framework to explore their impact on driving the adoption of MBS. Based on convenient sampling techniques, it uses 567 valid responses collected through a self-administered questionnaire and applies multiple regression analysis methods for data analysis using SPSS-26 software. Results indicate that performance expectancy, effort expectancy, perceived financial cost, and awareness are significant drivers of behavioral intention to use MBS in China. Technological infrastructure support positively influences performance expectancy, and individuals’ intent to use and adopt MBS in China. Government support significantly drives the individual’s behavioral intention to use and adopt MBS. Furthermore, behavioral intention to use MBS significantly predicts its adoption in China. The practical and academic ramifications of MBS on the growth and development of sustainable mobile banking systems are presented.
Contemporary ‘Pasmanda’ Leadership and the Hindutva Politics in Uttar Pradesh
Authors: Ali Manjur , Singh Shilp Shikha
Published: March 2024

The article explores the positioning of the political elite of a marginalized minority community in the state of Uttar Pradesh. The co-option of Pasmanda elites within the BJP has seemingly transformed the nature of Pasmanda politics. The article argues that the non-ideological assertion of the Pasmanda elites leaves little room for politics of autonomy. These elites are drawn from the newly-educated, self-interested, middle class amongst the Pasmanda. They draw a distinction between the political, social and cultural needs of the community. They attempt to invoke politics for developmental gains, keeping aside the cultural and social predicaments of the Muslim community within the hegemonic Hindutva politics of the BJP. The old agenda of democratizing Muslim politics has been replaced by promoting the individual interest of the new Pasmanda elite. For the BJP, Pasmanda is a tool that enables inclusive political posturing.
The Collision of Global Scripts with Local Constraints: Education as a Risk Factor for Unintended Pregnancy
Authors: Smith-Greenaway Emily , Lin Yingyi , Yeatman Sara
Published: March 2024

Extensive sociological research concludes that education informs people’s desires for their lives and plays an instrumental role in facilitating the fulfillment of those desires. In this article, we ask if societal barriers can leave the most educated to desire outcomes that are unattainable and thus paradoxically place them at highest risk of unwanted outcomes. We answer this question by analyzing societal variation in the potential for education to facilitate women achieving their lower fertility desires: Are there fertility contexts wherein educated women’s lower fertility desires are distinctly unattainable? Multilevel models analyzing Demographic and Health Survey Program data on women from 50 low- and middle-income countries emphasize the collision of global scripts with local constraints: In low contraceptive contexts, education is associated with higher risk of unintended pregnancy. The results clarify that the potential for education to facilitate the achievement of desires is fraught with contingencies.
Pharmacokinetics, pharmacodynamics, efficacy, and safety of ravulizumab in pediatric paroxysmal nocturnal hemoglobinuria
Authors: Chonat Satheesh , Kulagin Alexander , Maschan Alexey , Bartels Marije , Buechner Jochen , Punzalan Rowena , Richards Michael , Ogawa Masayo , Hicks Eden , Yu Ji , Baruchel André , Kulasekararaj Austin G.
Published: March 2024

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disease of uncontrolled terminal complement activation leading to intravascular hemolysis, thrombotic events and increased morbidity and mortality. This phase 3, open-label, single-arm, multicenter study evaluated ravulizumab treatment in eculizumab-naive or -experienced pediatric patients (aged <18 years) with PNH over a 26-week primary evaluation period (PEP) and 4-year extension period (EP). Patients included in the study received weight–based intravenous ravulizumab dosing. Primary end points were pharmacokinetic and pharmacodynamic parameters to confirm complement component 5 (C5) inhibition by ravulizumab; secondary end points assessed the efficacy (including percentage change in lactate dehydrogenase levels over time) and safety of ravulizumab. Thirteen patients, 5 (38.5%) eculizumab-naive and 8 (61.5%) eculizumab-experienced, were enrolled. Ravulizumab Ctrough levels were above the pharmacokinetic threshold of 175 μg/mL in the PEP and EP except in 1 patient. At the end of the study, pre- and post-infusion mean ± standard deviation serum ravulizumab concentrations were 610.50 ± 201.53 μg/mL and 518.29 ± 109.67 μg/mL for eculizumab-naive and eculizumab-experienced patients, respectively. After the first ravulizumab infusion, serum-free C5 concentrations were <0.5 μg/mL in both cohorts until the end of the study (0.061 ± 0.021 μg/mL and 0.061 ± 0.018 μg/mL for eculizumab-naive and eculizumab-experienced patients, respectively). Compared with baseline, ravulizumab improved and maintained efficacy outcomes in both groups. Ravulizumab had an acceptable safety profile with no new safety signals identified, and provided immediate, complete, and sustained terminal complement inhibition, translating to clinical benefit for pediatric patients with PNH. This trial was registered at www.ClinicalTrials.gov as #NCT03406507.
Sirtuins in intervertebral disc degeneration: current understanding
Authors: Shen Jianlin , Lan Yujian , Ji Ziyu , Liu Huan
Published: March 2024

Background

Intervertebral disc degeneration (IVDD) is one of the etiologic factors of degenerative spinal diseases, which can lead to a variety of pathological spinal conditions such as disc herniation, spinal stenosis, and scoliosis. IVDD is a leading cause of lower back pain, the prevalence of which increases with age. Recently, Sirtuins/SIRTs and their related activators have received attention for their activity in the treatment of IVDD. In this paper, a comprehensive systematic review of the literature on the role of SIRTs and their activators on IVDD in recent years is presented. The molecular pathways involved in the regulation of IVDD by SIRTs are summarized, and the effects of SIRTs on senescence, inflammatory responses, oxidative stress, and mitochondrial dysfunction in myeloid cells are discussed with a view to suggesting possible solutions for the current treatment of IVDD.

Purpose

This paper focuses on the molecular mechanisms by which SIRTs and their activators act on IVDD.

Methods

A literature search was conducted in Pubmed and Web of Science databases over a 13-year period from 2011 to 2024 for the terms “SIRT”, “Sirtuin”, “IVDD”, “IDD”, “IVD”, “NP”, “Intervertebral disc degeneration”, “Intervertebral disc” and “Nucleus pulposus”.

Results

According to the results, SIRTs and a large number of activators showed positive effects against IVDD.SIRTs modulate autophagy, myeloid apoptosis, oxidative stress and extracellular matrix degradation. In addition, they attenuate inflammatory factor-induced disc damage and maintain homeostasis during disc degeneration. Several clinical studies have reported the protective effects of some SIRTs activators (e.g., resveratrol, melatonin, honokiol, and 1,4-dihydropyridine) against IVDD.

Conclusion

The fact that SIRTs and their activators play a hundred different roles in IVDD helps to better understand their potential to develop further treatments for IVDD.

Novelty

This review summarizes current information on the mechanisms of action of SIRTs in IVDD and the challenges and limitations of translating their basic research into therapy.
Adulterants present in the San Diego county fentanyl supply: a laboratory analysis of seized law enforcement samples
Authors: Galust Henrik , Seltzer Justin A. , Hardin Jeremy R. , Friedman Nathan A. , Salamat Jeff , Clark Richard F. , Harmon Jennifer
Published: March 2024

Background

The opioid overdose crisis is one of the worst public health crises ever to face the US and emerging evidence suggests its effects are compounded by the presence of drug adulterants. Here we report our efforts to characterize the adulterants present within the local fentanyl supply of San Diego County, obtained from undifferentiated drug samples seized by local law enforcement over the calendar year 2021.

Methods

Thirty-two participating local law enforcement agencies across San Diego submitted 4838 unknown individual illicit drug samples (total of 312 kg) to the San Diego County Sheriff’s Department Regional Crime Laboratory for identification.

Results

Qualitative analysis of these samples via FTIR and GC-MS identified methamphetamine (38.7%), fentanyl (20.8%), diacetylmorphine (heroin) (10.2%), codeine (5.8%) and alprazolam (4.3%) as the most common illicit substances and the presence of 52 unique adulterants. The most common adulterants included 4-methylaminoantipyrine (4-MAAP) (10.9%), mannitol (9%), acetaminophen (8.5%), methamphetamine (4.2%), diacetylmorphine (heroin) (3.6%), tramadol (1.9%), and xylazine (1.7%). Several additional pharmacologically active adulterants and contaminants of interest were also identified.

Conclusion

This analysis is vital for public health use and harm reduction efforts at the level of the individual consumer. Continued direct surveillance of the drug supply is necessary for the detection of potentially harmful adulterants that may pose serious threats to the public.
Impact of simulation-based training on bougie-assisted cricothyrotomy technique: a quasi-experimental study
Authors: Zhou Ying , Gao Huibin , Wang Qianyu , Zhi Juan , Liu Quanle , Xia Weipeng , Duan Qirui , Yang Dong
Published: March 2024

Background

Cricothyrotomy is a lifesaving surgical technique in critical airway events. However, a large proportion of anesthesiologists have little experience with cricothyrotomy due to its low incidence. This study aimed to develop a multisensory, readily available training curriculum for learning cricothyrotomy and evaluate its training effectiveness.

Methods

Seventy board-certificated anesthesiologists were recruited into the study. Participants first viewed an instructional video and observed an expert performing the bougie-assisted cricothyrotomy on a self-made simulator. They were tested before and after a one-hour practice on their cricothyrotomy skills and evaluated by a checklist and a global rating scale (GRS). Additionally, a questionnaire survey regarding participants’ confidence in performing cricothyrotomy was conducted during the training session.

Results

The duration to complete cricothyrotomy was decreased from the pretest (median = 85.0 s, IQR = 72.5–103.0 s) to the posttest (median = 59.0 s, IQR = 49.0–69.0 s). Furthermore, the median checklist score was increased significantly from the pretest (median = 30.0, IQR = 27.0-33.5) to the posttest (median = 37.0, IQR = 35.5–39.0), as well as the GRS score (pretest median = 22.5, IQR = 18.0–25.0, posttest median = 32.0, IQR = 31.0-33.5). Participants’ confidence levels in performing cricothyrotomy also improved after the curriculum.

Conclusion

The simulation-based training with a self-made simulator is effective for teaching anesthesiologists to perform cricothyrotomy.
Access to continuous professional development for capacity building among nurses and midwives providing emergency obstetric and neonatal care in Rwanda
Authors: Gakwerere Mathias , Ndayisenga Jean Pierre , Ngabonzima Anaclet , Uhawenimana Thiery Claudien , Yamuragiye Assumpta , Harindimana Florien , Rwabufigiri Bernard Ngabo
Published: March 2024

Background

Nurses and midwives are at the forefront of the provision of Emergency Obstetric and Neonatal Care (EmONC) and Continuous Professional Development (CPD) is crucial to provide them with competencies they need to provide quality services. This research aimed to assess uptake and accessibility of midwives and nurses to CPD and determine their knowledge and skills gaps in key competencies of EmONC to inform the CPD programming.

Methods

The study applied a quantitative, cross-sectional, and descriptive research methodology. Using a random selection, forty (40) health facilities (HFs) were selected out of 445 HFs that performed at least 20 deliveries per month from July 1st, 2020 to June 30th, 2021 in Rwanda. Questionnaires were used to collect data on updates of CPD, knowledge on EmONC and delivery methods to accessCPD. Data was analyzed using IBM SPSS statistics 27 software.

Results

Nurses and midwives are required by the Rwandan midwifery regulatory body to complete at least 60 CPD credits before license renewal. However, the study findings revealed that most health care providers (HCPs) have not been trained on EmONC after graduation from their formal education. Results indicated that HCPs who had acquired less than 60 CPD credits related to EmONC training were 79.9% overall, 56.3% in hospitals, 82.2% at health centres and 100% at the health post levels. This resulted in skills and knowledge gaps in management of Pre/Eclampsia, Postpartum Hemorrhage and essential newborn care. The most common method to access CPD credits included workshops (43.6%) and online training (34.5%). Majority of HCPs noted that it was difficult to achieve the required CPD credits (57.0%).

Conclusion

The findings from this study revealed a low uptake of critical EmONC training by nurses and midwives in the form of CPD. The study suggests a need to integrate EmONC into the health workforce capacity building plan at all levels and to make such training systematic and available in multiple and easily accessible formats.

Implication on nursing and midwifery policy

Findings will inform the revision of policies and strategies to improve CPD towards accelerating capacity for the reduction of preventable maternal and perinatal deaths as well as reducing maternal disabilities in Rwanda.
Barriers and facilitators to implementing a multilevel, multicomponent intervention promoting colorectal cancer screening in health centers: a qualitative study of key informant perspectives
Authors: Telles V. M. , Rodriguez S. , Torres M. , Schneider J. , Haughton J. , Maldonado M. , Arredondo E.
Published: March 2024

Background

Colorectal cancer (CRC) continues to be a major cause of death in the U.S. despite the availability of effective screening tools. U.S. Latinos have lower rates of CRC screening and higher rates of death due to colorectal disease compared to non-Hispanic whites. Federally Qualified Health Centers (FQHCs) serve medically underserved populations, including many Latino patients. Given the low CRC screening rates, identifying culturally sensitive and cost-effective methods of promoting screening is a priority for many FQHCs.

Methods

We interviewed FQHC leaders and providers using the Consolidated Framework for Implementation Research (CFIR) to identify barriers and facilitators to implementation of a multilevel, multicomponent (ML-MC) CRC screening intervention (i.e., promotor navigation and group-based education) in FQHCs. A rapid qualitative analysis approach was used to identify themes organized according to the following CFIR constructs: intervention characteristics, outer and inner settings, and characteristics of the individual.

Results

We completed interviews with 13 healthcare professionals in leadership positions at six FQHCs. The participating FQHCs perceived the ML-MC screening CRC program as feasible and expressed interest in implementing the program at their sites. Facilitators included financial incentives for increasing screening rates, the need for patient education programming, and involving promotores to support the work of clinical teams. Barriers included concerns about available resources to implement new programs, lack of federal reimbursement for health education, competing priorities of other health concerns, and the need for more resources for confirmatory screening and treatment following a positive screen.

Conclusions

FQHCs provide essential primary care to millions of underserved patients in the U.S. and have the ability and motivation to provide screenings for colorectal cancer. Partnering with an academic institution to deliver a group-based, promotor-led CRC screening intervention for patients not up to date with screening could help increase screening rates. By identifying the specific barriers and facilitators to implementing CRC intervention, findings suggest that group-based, promotor-led interventions are a promising approach.
Factors influencing the length of stay in forensic psychiatric settings: a systematic review
Authors: Dima Aikaterini , Wazir Adonis , Clark-Castillo Raquel , Zakopoulos Iordanis , Smith Shubulade , Gaughran Fiona
Published: March 2024

Background

Forensic psychiatry is often associated with long admissions and has a high cost of care. There is little known about factors influencing length of stay (LOS), and no previous systematic review has synthesised the available data. This paper aims to identify factors influencing the LOS in forensic psychiatry hospitals to inform care and interventions that may reduce the length of admissions.

Methodology

A systematic review was conducted by searching major databases, including PubMed, EMBASE and PsycInfo, from inception until May 2022. Observational studies conducted in forensic hospitals that examined associations between variables of interest and LOS were included. Following data extraction, the Newcastle‒Ottawa Scale was used for quality appraisal. No meta-analysis was conducted due to heterogeneity of information; a quantitative measure to assess the strength of evidence was developed and reported.

Results

A total of 28 studies met the inclusion criteria out of 1606 citations. A detailed quantitative synthesis was performed using robust criteria. Having committed homicide/attempted homicide, a criminal legal status with restrictions, and a diagnosis of schizophrenia-spectrum disorders were all associated with longer LOS. Higher Global Assessment of Functioning (GAF) scores were associated with a shorter LOS.

Conclusion

High-quality research examining factors associated with LOS in forensic psychiatry is lacking, and studies are heterogeneous. No modifiable characteristics were identified, and thus, practice recommendations were not made. There is an increasing necessity to understand the factors associated with longer admissions to inform care and increase success in reintegration and rehabilitation. This paper provides recommendations for future research.
Association between the ROX index and mortality in patients with acute hypoxemic respiratory failure: a retrospective cohort study
Authors: Liu Kai , Ma Xin-Yi , Xiao Hua , Gu Wan-Jie , Lyu Jun , Yin Hai-Yan
Published: March 2024

Background

Although ROX index is frequently used to assess the efficacy of high-flow nasal cannula treatment in acute hypoxemic respiratory failure (AHRF) patients, the relationship between the ROX index and the mortality remains unclear. Therefore, a retrospective cohort study was conducted to evaluate the ability of the ROX index to predict mortality risk in patients with AHRF.

Method

Patients diagnosed with AHRF were extracted from the MIMIC-IV database and divided into four groups based on the ROX index quartiles. The primary outcome was 28-day mortality, while in-hospital mortality and follow-up mortality were secondary outcomes. To investigate the association between ROX index and mortality in AHRF patients, restricted cubic spline curve and COX proportional risk regression were utilized.

Result

A non-linear association (L-shaped) has been observed between the ROX index and mortality rate. When the ROX index is below 8.28, there is a notable decline in the 28-day mortality risk of patients as the ROX index increases (HR per SD, 0.858 [95%CI 0.794–0.928] P < 0.001). When the ROX index is above 8.28, no significant association was found between the ROX index and 28-day mortality. In contrast to the Q1 group, the mortality rates in the Q2, Q3, and Q4 groups had a substantial reduction (Q1 vs. Q2: HR, 0.749 [0.590–0.950] P = 0.017; Q3: HR, 0.711 [0.558–0.906] P = 0.006; Q4: HR, 0.641 [0.495–0.830] P < 0.001).

Conclusion

The ROX index serves as a valuable predictor of mortality risk in adult patients with AHRF, and that a lower ROX index is substantially associated with an increase in mortality.
Efficacy of artesunate-amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in mainland Tanzania
Authors: Ngasala Billy , Bushukatale Samwel , Chiduo Mercy , Makene Twilumba , Mkony Lilian , Mohamed Ally , Molteni Fablizio , Chacky Frank , Njau Ritha J. A. , Mwaiswelo Richard
Published: March 2024

Background

Diversification of artemisinin-based combination therapy (ACT) is suggested as one of the strategies that can be used to contain artemisinin resistance. Artesunate-amodiaquine (ASAQ) is one of the artemisinin-based combinations that can be used in the diversification strategy as an alternative first-line treatment for uncomplicated malaria in mainland Tanzania. There is however limited data on the efficacy of ASAQ in mainland Tanzania. This study assessed the efficacy of ASAQ for treatment of uncomplicated Plasmodium falciparum malaria in selected sentinel sites for therapeutic efficacy studies in mainland Tanzania.

Methods

Between December 2018 and March 2020, children aged between 6 months and 10 years, attending at Nagaga, Mkuzi, and Mlimba primary health facilities, and with suspected uncomplicated malaria infection were screened for eligibility to participate in the study. Malaria infection was screened using microscopy. Children with uncomplicated P. falciparum monoinfection and who fulfilled all other inclusion criteria, and had none of the exclusion criteria, according to the World Health Organization (WHO) guidelines, were treated with ASAQ. Follow-up visits were scheduled on days 0, 1, 2, 3, 7, 14, 21, and 28 or on any day of recurrent infection for clinical and laboratory assessment. Polymerase chain reaction (PCR)-corrected cure rate on day 28 was the primary outcome.

Results

A total of 264 children, 88 in each of the three study sites (Mlimba, Mkuzi and Nagaga health facilities) were enrolled and treated with ASAQ. The ASAQ PCR-corrected cure rate was 100% at all the three study sites. None of the participants had early treatment failure or late clinical failure. Furthermore, none of the participants had a serious adverse event.

Conclusion

ASAQ was highly efficacious for the treatment of uncomplicated P. falciparum malaria in mainland Tanzania, therefore, it can be deployed as an alternative first-line treatment for uncomplicated malaria as part of diversification strategy to contain the spread of partial artemisinin resistance in the country.
Association between dietary antioxidant capacity and type 2 diabetes mellitus in Chinese adults: a population-based cross-sectional study
Authors: Li Xiaoxia , Xue Yixuan , Zhang Yadi , Wang Qingan , Qiu Jiangwei , Zhang Jiaxing , Yang Chan , Zhao Yi , Zhang Yuhong
Published: March 2024

Background

Higher intakes of dietary antioxidants have been linked to a lower type 2 diabetes mellitus (T2DM) risk. However, few studies have comprehensively examined the overall dietary antioxidant capacity, assessed by dietary antioxidant quality scores (DAQS) and dietary total antioxidant capacity (DTAC), related to T2DM risk, especially in populations consuming relatively monotonous diets. This study aimed to evaluate the associations of DAQS, DTAC, and T2DM among rural Chinese adults.

Methods

Data from 12,467 participants from the Natural Population Cohort of Northwest China: Ningxia Project was analyzed. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. DAQS were calculated based on vitamins A, C, and E, zinc (Zn), and selenium (Se) intake. DTAC was estimated using the ferric-reducing ability of plasma assay. Logistic regression models were used to evaluate the associations of DAQS and DTAC with T2DM risk. Restricted cubic splines were used to assess potential non-linear relationships between DTAC and T2DM.

Results

T2DM was observed in 1,238 (9.9%) participants. After adjusting for confounders, compared to the lowest tertiles (T1) of DAQS, the odds ratios (ORs) for T2DM were 1.03 (95% CI 0.82–1.30) in T2 and 0.85 (95% CI 0.68–1.06) in T3 (P = 0.010). Compared to T1, the ORs for T2DM in the highest T3 were 0.78 (95% CI 0.67–0.91, P-trend = 0.008) for vitamin A, 1.34 (95% CI 1.15–1.56, P-trend < 0.001) for vitamin E, 0.83 (95% CI 0.71–0.97, P-trend = 0.007) for Se, and 0.86 (95% CI 0.74–1.01, P-trend = 0.033) for Zn. Compared to the lowest quartile(Q1) of DTAC, the OR in the highest Q4 was 0.96 (95% CI 0.80–1.17, P-trend = 0.024) for T2DM. A non-linear relationship was observed between DATC and T2DM.

Conclusion

Higher DAQS and DATC were associated with a lower T2DM risk, suggesting that consuming antioxidant-rich foods may reduce the T2DM risk.
Parental conscription and cumulative adverse experiences in war-affected children and adolescents and their impact on mental health: a comment following Russia’s invasion of Ukraine in 2022
Authors: Erlewein Katrin , Gossmann Emily , Fegert Jörg M.
Published: March 2024

Background

With Russia’s invasion of the Ukraine on February 2022, Ukrainian children and adolescents have been exposed to several stressful life events. In addition to the confrontation with war, flight and parent-child separation due to flight and forced displacement, the majority underwent another challenge at the initial phase of the war: the fatherly separation due to conscription.

Main body

In the literature, the negative effects of exposure to war and flight/refuge, parent-child separation due to flight or forced displacement and parental deployment are well established. In the context of self-experienced war, the effects of parent-child separation caused by compulsory military service have not yet been sufficiently taken into account. However, the findings of the literature on the impact of these events on the mental health of children and adolescents show that they are at high risk for developing numerous psychological and behavioral problems.

Conclusion

As children’s and adolescents’ mental health might be severely affected by war and its consequences, interventional programs that address the special needs of those children and adolescents are crucial.
Pancreaticopleural fistula causing pleural effusion: a case report and review of the literature
Authors: Khadka Milan , Bhusal Suzit , Pantha Binod , Gautam Rabin , Gautam Kapil , Chaudhary Ashlesha
Published: March 2024

Background

Pancreaticopleural fistula is a rare complication of pancreatitis and poses diagnostic and therapeutic challenges. This case report sheds light on the unique challenges posed by pancreaticopleural fistula as a rare complication of pancreatitis. The aim is to contribute valuable insights to the scientific literature by presenting a case involving a middle-aged man with acute necrotizing pancreatitis and associated pleural effusion.

Case presentation

A 41-year-old Asian male with a history of pancreatitis and chronic alcohol use presented with severe dyspnea, chest pain, and left-sided pleural effusion. Elevated serum amylase lipase levels and imaging confirmed acute necrotizing pancreatitis with a computed tomography severity index of 8/10. Magnetic resonance cholangiopancreatography revealed pancreatic necrosis and pseudocyst formation and findings suggestive of pancreaticopleural fistula. The patient was then treated with octreotide therapy.

Conclusion

The management of pancreaticopleural fistula demands a comprehensive and individualized approach. Recognition guided by high clinical suspicion coupled with appropriate investigations and a careful balance between medical, endoscopic, and surgical interventions is crucial for achieving favorable outcomes. This case report adds to the scientific literature by providing insights into the complexities of pancreaticopleural fistula and emphasizing the importance of personalized strategies in its management.
Matrix representation of Toeplitz operators on Newton spaces
Authors: Ko Eungil , Lee Ji Eun , Lee Jongrak
Published: March 2024

In this paper, we study several properties of an orthonormal basis $\{N_{n}(z)\}$
{

N
n

(
z
)
}
for the Newton space $N^{2}({\mathbb{P}})$

N
2

(
P
)
. In particular, we investigate the product of $N_{m}$

N
m

and $N_{m}$

N
m

and the orthogonal projection P of $\overline{N_{n}}N_{m}$

N
n

‾

N
m

that maps from $L^{2}(\mathbb{P})$

L
2

(
P
)
onto $N^{2}(\mathbb{P})$

N
2

(
P
)
. Moreover, we find the matrix representation of Toeplitz operators with respect to such an orthonormal basis on the Newton space $N^{2}({\mathbb{P}})$

N
2

(
P
)
.
Nutrient recycling of source-separated human faeces using biochar immobilized indigenous psychrotrophic bacteria for sustaining the agroecosystems of north-western Himalaya
Authors: Borker Shruti Sinai , Thakur Aman , Pandey Krishna Kanta , Sharma Pallavi , Manyapu Vivek , Khatri Abhishek , Kumar Rakshak
Published: March 2024

The Himalayan composting toilets (CTs) offer a sustainable solution for converting human faeces (HF) into compost, supplementing the low-fertile land of the region. However, CTs face challenges such as delayed composting processes (6–8 months), increased heavy metal content, and foul odour. Therefore, the current study evaluated biochar-amended psychrotrophic bacteria for HF degradation under low-temperature conditions (10 ± 2 °C). Out of 153 psychrotrophic bacteria isolated from HF compost, 17 bacterial strains were selected based on highest and two or more hydrolytic activities. Furthermore, considering the isolation source, bacterial strains were examined for haemolytic activity, biofilm formation, cytotoxicity and seed germination assay. In total, 14 potential strains belonging to Pseudomonas, Microbacterium, Arthrobacter, Streptomyces, Glutamicibacter, Rhodococcus, Serratia, Exiguobacterium, and Jeotgalicoccus genera were considered safe for both human handling and plants. The composting process was conducted in modified plastic drums at 10 ± 2 °C for 90 days through two treatments: Treatment 1 (T1) involving HF, non-immobilized biochar and cocopeat, and Treatment 2 (T2) involving HF, consortium-immobilized biochar and cocopeat. The consortium-immobilized biochar (T2) degraded HF within 90 days with hemicellulose and cellulose degradation ratios of 73.9% and 62.4%, respectively (p ≤ 0.05). The compost maturation indices like C/N ratio (16.5 ± 1.85), total nitrogen (2.66 ± 0.07), total phosphate (0.4 ± 0.005), total potassium (1.8 ± 0.05) also improved in T2 treatment (p ≤ 0.05). Additionally, T2 was more effective in achieving safe levels of faecal coliforms (< 1000 MPN g−1) and reducing heavy metal content compared to T1. 16S rRNA amplicon-based analysis demonstrated an enhancement of bacterial community diversity in T2, with the presence of Rhodococcus, Pseudomonas, Arthrobacter, and Streptomyces at the end of the composting period promoting HF degradation. Furthermore, T2-fertilized soil showed a germination index (121 ± 0.4, p ≤ 0.05) and stimulated root, shoot and yield by 110%, 45.2%, and 288%, respectively, in pea (Pisum sativum var. AS-10) compared to T1 (49.6%, 19%, and 5.8%, respectively) (p ≤ 0.05). In conclusion, the developed biochar-based formulation proved effective in degrading HF at low temperatures, mitigating foul odours, reducing heavy metals, and enhancing the agronomic value of the final compost. This study presents a promising approach for the sustainable management of HF that can supplement the non-nutritive soil of high-altitude regions.
Insomnia and creativity in Chinese adolescents: mediation through need for cognition
Authors: Ren Xiaoyang , Shi Min , Si Si
Published: March 2024

Background

Creativity is an essential cognitive ability that plays a crucial role in advanced thinking. While previous research has demonstrated the impact of insomnia on cognitive function, its effects on creativity in Chinese adolescents remain unclear. This study explored the relationship between insomnia (specifically, daytime and nighttime disturbances) and creativity in adolescents. Additionally, it examined the potential mediating effect of the need for cognition on this relationship.

Methods

Questionnaires were administered to 302 adolescents to measure their creativity, need for cognition, and insomnia levels using the Williams Creative Tendencies Scale, Need for Cognition Scale, and Bergen Insomnia Scale, respectively. Regression analysis was conducted to examine the direct impact of insomnia on creativity. Furthermore, a mediation model was constructed to investigate the role of the need for cognition in mediating the relationship between insomnia and creativity.

Results

The findings of the present study indicated that insomnia had a direct impact on the creativity of adolescents, demonstrating a time-of-day effect. Daytime disturbances were found to have a positive correlation with overall creativity and imagination, whereas no significant direct effect was found between nighttime disturbances and creativity. Further analysis revealed that insomnia, specifically daytime disturbances, might influence creativity by affecting the individual’s need for cognition. However, no similar indirect effects were observed for the relationship between nighttime disturbances and creativity.

Conclusions

Our findings indicate that adolescents might experience improved creativity as a result of daytime disruptions, and the level of need for cognition could play a crucial role in understanding the link between insomnia and creativity in adolescents.