bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Health Literacy Level of Caregivers of Individuals With Diabetes on Care Activities and Supportive Behaviours
Authors: Semerci Çakmak Vahide , Akeren Zahide , Sönmez Sarı Ebru , Kalyoncuo Servet
Published: January 2025

Background

To determine the effect of the health literacy levels of caregivers of individuals with T2DM on caregiving activities and supportive behaviours.

Methods

Cross sectional study. The sample for the study comprised of people who provided care for 442 individuals who were diagnosed with diabetes. The data were collected using the Personal Information Form, HLS‐14 and D‐CASS. Descriptive statistics, Independent samples t test, One‐Way ANOVA and multiple linear regression analysis were used to analyse the data.

Results

According to the results of the multiple linear regression analysis, the model was found to be statistically significant, and the variables that were incorporated into the model were able to explain 68.1% of the variance. Among the variables included in the model, HLS‐14, educational status, employment status, income status and diabetes‐related education were found to affect the care activities and supportive behaviours of caregivers of individuals with diabetes.

Conclusion

In the research, it was determined that care activities and supportive behaviours were higher in those with higher levels of HL, higher levels of education, those who were not employed, those with higher income levels, and those who received education about diabetes. Nurses should develop training programmes to increase the HL levels of caregivers.
Hedge funds and climate news risk: Evidence from stock holdings in fossil fuel firms
Authors: Lantushenko Viktoriya , Nelling Edward , Schellhorn Carolin
Published: January 2025

We examine the role of hedge funds in facilitating the transition to a low‐carbon economy. As highly informed and relatively unregulated investors, hedge funds are in a unique position to recognize and address climate change risks. We analyze hedge fund ownership of fossil fuel firms in response to climate news risk and the related lobbying activities of their portfolio firms. With the rise of the divestment movement after 2013, the hedge fund sector reduced its portfolio commitment to risk‐exposed lobbyists that are slowing progress towards decarbonization. Our results suggest that hedge funds help facilitate the transition to low‐carbon energy sources.
Investigating the Condition and Flood Effects of Undocumented Levees, A Case Study Within the Waimea Floodplain
Authors: Wallace Thomas , Crawford‐Flett Kaley , Wilson Matthew , Logan Tom
Published: January 2025

Levees play a crucial role in flood protection, but globally, there is a need for more knowledge about levee networks and their flood routing effects. Without complete knowledge, the question arises: ‘What is the flood risk associated with an unknown or partially known levee portfolio?’ Unknown or undocumented levees can be maladaptive and undermine system resilience. However, current literature often does not acknowledge undocumented levees, assuming all assets are known. A greater understanding would provide insight into present vulnerabilities and enable more complete management of our flood protection systems, reducing communities' risk. Our research assessed the physical condition of two undocumented levees in a case study. Computational flood modelling then simulated (1) their present condition, (2) their removal and (3) their reconstruction to a good physical condition. This determined their effect on inundation area and building damages, allowing their classification. The undocumented levees in the case study were significantly degraded, leading to an insignificant impact on flood routing and flood damages in their present state. However, if reconstructed, the levees could be valuable if the surrounding land were developed. More broadly, this study illustrates the importance of identifying and integrating undocumented levees into network modelling and maintenance.
Long‐Term Risk of Inflammatory Bowel Disease With MASLD: A Large‐Scale Prospective Cohort Study in UK Biobank
Authors: Zhang Qian , Xu Fang , Wang Zuyao , Liu Si , Zhu Shengtao , Zhang Shutian , Wu Shanshan
Published: January 2025

Background

Similar worsening epidemics globally have been showed in newly coined metabolic dysfunction‐associated steatotic liver disease (MASLD) and inflammatory bowel disease (IBD). We aimed to investigate the prospective association of MASLD, MASLD types, and cardiometabolic risk factors (CMRFs) with long‐term risk of incident IBD in a large‐scale population cohort.

Methods

Participants free of IBD at enrollment from UK Biobank were included. Baseline MASLD was measured by fatty liver index together with at least one CMRF, based on the latest AASLD/EASL criteria. MASLD type was classified as pure MASLD and MetALD (MASLD with increased alcohol intake). Primary outcome was incident IBD, including ulcerative colitis (UC) and Crohn's disease (CD). Multivariable Cox regression was conducted to examine the related associations.

Results

Overall, 403 520 participants (aged 56.2 ± 8.1 years, 45.6% males) were included. Of whom, 151 578 (37.6%) were considered as MASLD at baseline. During a median of 13.0 years' follow‐up, 2398 IBD cases were identified. Compared with normal population, individuals with MASLD showed significant higher associations of incident IBD (HR = 1.39, 95% CI: 1.21–1.60), UC (HR = 1.34, 95% CI: 1.13–1.58), and CD (HR = 1.51, 95% CI: 1.20–1.89). Meanwhile, results were consistent when assessing pure MASLD (HR = 1.43, 95% CI: 1.23–1.66) and MetALD (HR = 1.46, 95% CI: 1.15–1.86). The excess risk of incident IBD was more evident with the increase of CMRFs numbers (ptrend < 0.001).

Conclusion

MASLD, either pure MASLD or MetALD, and a combination of different CMRFs are all associated with increased risk of IBD, including both UC and CD. Additionally, there is greater risk of incident IBD as the number of CMRFs increase.
Characteristics of nursing homes with high rates of invasive methicillin‐resistant Staphylococcus aureus infections
Authors: See Isaac , Jackson Kelly A. , Hatfield Kelly M. , Paul Prabasaj , Li Rongxia , Nadle Joelle , Petit Susan , Ray Susan M. , Harrison Lee H. , Jeffrey Laura , Lynfield Ruth , Bernu Carmen , Dumyati Ghinwa , Gellert Anita , Schaffner William , Markus Tiffanie , Gokhale Runa H. , Stone Nimalie D. , Jacobs Slifka Kara
Published: January 2025

Background

Nursing home residents experience a large burden of invasive methicillin‐resistant Staphylococcus aureus (MRSA) infections. Data are limited regarding nursing home characteristics associated with differences in facility‐level invasive MRSA rates.

Methods

We analyzed 2011–2015 data from CDC's Emerging Infections Program (EIP) active population‐ and laboratory‐based surveillance for invasive MRSA cases within seven states. A nursing home‐onset case was defined as MRSA cultured from a normally sterile site in a person living in a nursing home 3 days before culture collection. Facility rates were calculated as nursing home‐onset cases per 100,000 resident‐days. Nursing home resident‐day denominators and facility characteristics were obtained from four Centers for Medicare & Medicaid Services (CMS) datasets. A general estimating equations model with a logit link assessed characteristics of the facilities with highest rates comprising 50% of nursing home MRSA cases (“high rates”).

Results

The 626 nursing homes in the surveillance area had 2824 invasive MRSA cases; 82% of facilities had at ≥1 case. The 20% of facilities with highest rates (≥3.84 cases/100,000 resident‐days) had 50% of nursing home‐onset cases. In multivariable regression, facilities with high rates were more likely to have CMS‐derived characteristics of presence of a resident with a multidrug‐resistant organism; or greater proportions of residents who were male, were short stay (in the facility <100 days), had a nasogastric or percutaneous gastrostomy tube, or require extensive assistance with bed repositioning; and more likely to be in an EIP area with higher hospital‐onset MRSA rates. Higher registered nurses staffing levels (hours/resident/day) and higher proportions of White residents were associated with lower rates.

Conclusions

Facilities with higher invasive MRSA rates served residents with more clinical and functional care needs. Increasing registered nurse staffing in high‐risk facilities might assist with reduction of invasive MRSA rates. These findings could help prioritize nursing homes for future MRSA prevention work.
Procuring Medical Devices: The Price Effect of Mergers Among Orthopedic Prostheses Producers
Authors: Atella Vincenzo , Ceschin Nicola , Decarolis Francesco
Published: January 2025

This paper quantifies the price effects of a merger between two major producers of orthopedic prostheses. It shows that, in the public procurement markets where these products are purchased, the effect of the merger hinges on the characteristics of both the procurement design and the organizational structure of the buyers. Using data from all public procurement events in Italy between 2012 and 2019, and exploiting a difference‐in‐differences model where pacemakers play the role of the control group, we find that the merger led to a 7.6% increase in prices and that this effect is concentrated in the first three years post‐merger. Further insights are: (i) a heterogeneous impact among gender and age groups such that most of the burden is on female patients aged 65 and above; (ii) short‐term quality does not change, but patenting activity declines; (iii) there is no evidence of the merger triggering ex‐post coordinated effects in the form of bidding and entry patterns compatible with firm collusion.
Kidney function decline improves after lithium discontinuation
Authors: Fransson Filip , Werneke Ursula , Öhlund Louise , Jonsson P. Andreas , Ott Michael
Published: January 2025

Background

Long‐term lithium treatment decreases kidney function. However, it remains unclear whether stopping lithium improves kidney function.

Objectives

To study kidney function in patients who stopped and subsequently restarted lithium treatment.

Methods

Mirror‐image design using data from the LiSIE retrospective cohort study. The mirror was set to when lithium was stopped with a 5‐year pre‐ and post‐mirror period. Adult patients with bipolar, schizoaffective disorder or unipolar depression, who had lithium ≥4.5 years in the pre‐mirror period, were included. Creatinine measurements were available from 1997 to 2017. The main outcome was the difference in mean annual change of the estimated glomerular filtration rate (eGFR) adjusted for sex, hypertension and diabetes mellitus.

Results

A total of 168 participants (94 women, 74 men) were included. Mean annual eGFR change was −1.58 (−1.87 to −1.28) mL/min/1.73 m2/year before and −0.023 (−0.49 to +0.44) mL/min/1.73 m2/year after lithium discontinuation (p < 0.0001 for difference). The improvement was 0.77 (0.35–1.20) mL/min/173 m2/year in participants with eGFR >60 mL/min/1.73 m2, and 3.03 (2.15–3.92) mL/min/1.73 m2/year for participants with eGFR <30 mL/min/1.73 m2. The effect was persistent over the 5‐year post‐mirror study period. For participants restarting lithium, the mean annual eGFR change was −1.71 (−2.26 to −1.16) mL/min/1.73 m2/year, a setback compared to their lithium‐free post‐mirror period (p < 0.0001). We did not see any difference compared to the pre‐mirror period (p = 0.51).

Conclusions

Stopping lithium slowed down mean eGFR decline. This effect was more pronounced in participants with lower eGFR at the time of lithium discontinuation. In participants who restarted lithium, the annual decline of eGFR reverted to pre‐lithium discontinuation levels.
Voice for ourselves or myself in times of crisis: When and how crisis‐related uncertainty motivates employee voices
Authors: Wang Xiaotian , Duan Jinyun , Xu Yue , Shi Lixiaoyun , Qian Cheng
Published: January 2025

Drawing on fairness heuristic theory, we propose that organizational justice serves as a boundary condition determining how employees respond to perceived uncertainty in times of organizational crisis with different types of proactive voice (i.e. prosocial or self‐interested). We conducted a three‐wave survey study to test our hypotheses with a sample of 401 employee‐supervisor dyads during the COVID‐19 period. Results demonstrated the employee crisis‐related uncertainty perception's positive indirect effect on employee prosocial voice via prosocial motive when organizational justice was higher, and its positive indirect effect on employee self‐interested voice via self‐interested motive when organizational justice was lower. We then discussed our implications for organizational crisis and employee voice literature.
Circumstances Versus Efforts: Dissecting the Drivers of Adolescent Obesity Inequality
Authors: Zhang Kangkang , Fan Jiaxue , Xu Xinpeng , You Hua
Published: January 2025

Background

Previous studies have focused predominantly on socioeconomic disparities in adolescent obesity, but the sources of inequality may be more extensive.

Objectives

We aim to quantify and decompose the inequality of opportunity (IOp) in adolescent obesity caused by circumstances and examine the indirect effects of these circumstances on obesity through key effort factors.

Methods

Based on the IOp framework and previous evidence, we categorised age, gender, socioeconomic status, and family‐school environments of adolescents (N = 9117) as circumstances and obesity‐related behaviours as efforts. The IOp was quantified and decomposed to determine the contribution of each circumstance. We also analysed the association between sleep debt and the circumstances to calculate the magnitude of indirect effects.

Results

Of the obesity‐related behaviours, only sleep debt showed a significant association with obesity (OR = 1.21, p < 0.05). Age and gender contributed 45.97% to the IOp, whereas socioeconomic status contributed 10.43% and family‐school environments contributed 43.59%. Older and female adolescents whose fathers held high‐status occupations tended to suffer from obesity due to sleep debt, while the opposite was true for adolescents whose mothers exercised, only children, boarders, high school students, and those from wealthier families.

Conclusions

Family‐school environments contribute much greater to the IOp in adolescent obesity than socioeconomic status, and sleep debt plays an essential mediating role. The government bears the responsibility to undertake corresponding prioritised actions.
Resource Segmentation: A New Dimension of the Segmentation Hypothesis in Drought Adaptive Strategies and Its Links to Tree Growth Performance
Authors: Yue Chen , Wang Huimin , Meinzer Frederick C. , Dai Xiaoqin , Meng Shengwang , Shao Hui , Kou Liang , Gao Decai , Chen Fusheng , Fu Xiaoli
Published: January 2025

The segmentation hypothesis, a framework for understanding plant drought adaptive strategy, has long been based on hydraulic resistance and vulnerability. Storage of water and carbohydrate resources is another critical function and shapes plant drought adaption and fitness together with hydraulic efficiency and vulnerability. However, patterns and implications of the interdependency of stored water and carbohydrate resources in the context of the segmentation hypothesis are poorly understood. We measured resource pools (relative water content [RWC] soluble sugar [SS] and starch [S]) and anatomical features of leaves and supporting twigs for 36 trees in a subtropical population during the dry season when the Budyko's aridity index was 0.362. For each tree, we rank‐transformed the RWC (RWCrank), SS (SSrank), and S (Srank) and characterised the resource segmentation within organs using Ln(RWCrank/SSrank) and Ln(RWCrank/Srank). We also assessed the resource segmentation between organs using the difference in resource pools between leaves and twigs (RWCleaf‐twig, SSleaf‐twig, and Sleaf‐twig). Resource segmentation was much more effective than the organ‐level resource pool alone in predicting intraspecific variation of tree growth rates. Fast‐growing individuals were mainly characterised by lower leaf Ln(RWCrank/SSrank), higher twig Ln(RWCrank/SSrank), and lower SSleaf‐twig. The resource segmentation strategy of fast‐growing individuals was associated with anatomical attributes that facilitate phloem SS loading and unloading and thus water supply upstream. Our results highlight that resource segmentation is an important dimension of plant drought adaptive strategies and enables better prediction of tree growth vigour than resource pool attributes individually.
Comparative study of inactivation efficacy of far‐UVC (222 nm) and germicidal UVC (254 nm) radiation against virus‐laden aerosols of artificial human saliva
Authors: Monika  , Damle Eeshan Ajay , Kondabagil Kiran , Kunwar Ambarish
Published: January 2025

Virus‐laden aerosols play a substantial role in the spread of numerous infectious diseases, particularly in enclosed indoor settings. Ultraviolet‐C (UVC) disinfection is known to be a highly efficient method for disinfecting pathogenic airborne viruses. Recent recommendations suggest using far‐UVC radiation (222 nm) emitted by KrCl* (krypton‐chloride) excimer lamps to disinfect high‐risk public spaces due to lower exposure risks than low‐pressure (LP) mercury lamps (254 nm). This study experimentally explored the comparative effectiveness of far‐UVC (222 nm) and germicidal UVC (254 nm) in inactivating virus‐laden aerosols of different protective vector media in an air disinfection chamber. The UVC inactivation performances of individual filtered KrCl* excimer lamp and LP mercury lamp were determined for inactivating the bacteriophages, MS2 (icosahedral and non‐enveloped ssRNA virus) and Phi6 (spherical and enveloped dsRNA virus) aerosolized from artificial human saliva or sodium chloride and magnesium sulfate (SM) buffer as a vector media. Disinfection efficacy of filtered KrCl* excimer lamp (222 nm) and LP mercury lamp (254 nm) were evaluated for highly concentrated viral aerosols, which replicate those exhaled from infected individuals and remain suspended in air or deposited on surfaces as fomites. Our results show that using individual filtered KrCl* excimer lamp (222 nm) and LP mercury lamp (254 nm) could greatly accelerate the inactivation of the viral bioaerosols formed from artificial human saliva and SM buffer. In the case of 222 nm exposure, Phi6 exhibited significantly more susceptibility in artificial human saliva than in SM buffer whereas MS2 showed comparable vulnerability in both artificial human saliva and SM buffer. However, in the case of 254 nm exposure, both Phi6 and MS2 demonstrated significantly greater susceptibility in artificial human saliva than in SM buffer. This study offers valuable insights and improves our understanding of the influence of different vector media on UVC disinfection of exhaled virus‐laden aerosols in indoor environments. These findings can guide the deployment of UVC devices which could greatly contribute to mitigating the transmission of exhaled bioaerosols in public settings.
The prevalence of Phytophthora in British plant nurseries; high‐risk hosts and substrates and opportunities to implement best practice
Authors: Green Sarah , Cooke David E. L. , Barwell Louise , Purse Bethan V. , Cock Peter , Frederickson‐Matika Debra , Randall Eva , Keillor Beatrix , Pritchard Leighton , Thorpe Peter , Pettitt Tim , Schlenzig Alexandra , Barbrook Jane
Published: January 2025

Invasive Phytophthora species infect a very broad range of herbaceous and woody hosts globally. The UK alone has experienced a particularly damaging series of outbreaks and epidemics of new, invasive Phytophthora species affecting the nation's trees over the last 30 years. The link between Phytophthora outbreaks and the importation and spread of infected nursery stock is well established across many countries worldwide. To understand better the pathways of spread of Phytophthora in the nursery trade in Britain, we applied a standardized nursery sampling method combined with a refined metabarcoding detection method to capture the diversity of Phytophthora species at 134 British plant nurseries representing a range of biosecurity and trading practices over multiple sampling years between 2016 and 2022. This included root and water samples collected from 17 nurseries sampled seasonally and root samples collected from 117 nurseries sampled once as part of plant health inspections. Based on analyses of 1894 pooled samples, DNA barcodes of 85 Phytophthora species or complexes were detected, with variation in species' relative frequencies across nurseries. We present the top 20 host–Phytophthora associations ranked by relative frequency and report five novel Phytophthora records for the UK. We identified surprisingly high‐risk hosts (such as Douglas fir) with the greatest number of Phytophthora associations and revealed Phytophthora nursery niche preferences for water or roots. We discuss the implications of our findings in terms of pathogen diversity and abundance, high‐risk hosts, our information dissemination approach and resulting advice on nursery practices aimed at reducing risk.
Effects of 8 Weeks of Moderate‐ or High‐Volume Strength Training on Sarcoplasmic Reticulum Ca2+ Handling in Elite Female and Male Rowers
Authors: Mazza Oscar , Nielsen Joachim , Mathiesen Jonas , Højme Daniel , Lundby Carsten , Hostrup Morten , Thomassen Martin , Plomgaard Peter , Gejl Kasper Degn , Ørtenblad Niels
Published: January 2025

While acute exercise affects sarcoplasmic reticulum (SR) function, the impact of resistance training remains unclear. The purpose of the present study was to investigate SR Ca2+ handling plasticity in response to moderate‐ and high‐volume strength training in elite rowers. Twenty elite male (n = 12) and female (n = 8) rowers performed three weekly strength training sessions for 8 weeks and were randomly allocated to either perform 3 sets (3‐SET) or progressive increase from 5 to 10 sets (10‐SET) of 10 repetitions during the training period. Skeletal muscle biopsies were collected before and after the intervention period and analyzed for SR vesicle Ca2+ handling, SR related proteins, and myosin heavy chain (MHC) composition. Muscle strength was determined by isometric midthigh pull (IMTP). Training increased both the overall SR Ca2+ release (19%) and uptake rates (34%), with no differences between groups. SR protein analysis revealed a high variability but suggests an increase of RYR1 and SERCA1, while SERCA2 decreased, corroborating changes in SR function, with no differences between groups. Regardless of training volume, a 9% higher relative MHCIIa proportion and a 7% decrease in the MHCI isoform was observed. There was an overall 8% increase of IMTP. Males exhibited higher SR Ca2+ uptake and release rates compared to females, likely explained by a higher proportion of MHCII. These findings suggest that 8 weeks of moderate‐ or high‐volume strength training enhances SR vesicle Ca2+ uptake and release rates in elite male and female rowers, accompanied by a shift toward a larger proportion of MHCIIa fiber type.
Shattering the Shield: Embracing Complexity in Undergraduate Medical Education
Authors: Bezzina Cara , McQuade Robert , Lowe Wendy , Mair Frances , Pope Lindsey
Published: January 2025

Background

Multimorbidity and patient complexity are increasing, yet undergraduate medical education curricula remain dominated by single disease frameworks, where students are often shielded from exposure to this complexity. Why this shielding continues to occur is understandable; however, this may leave graduates feeling underprepared for real‐world practice. This study aimed to explore medical students' experiences of encountering, managing and dealing with complexity and to provide informed recommendations for integrating complexity into clinical teaching.

Methodology

Situated within a constructivist paradigm, this qualitative study involved focus groups (n = 4) with fourth‐ and fifth‐year medical students (n = 17) from two Scottish Universities. Data were analysed using reflexive thematic analysis.

Findings

Learners in this study recognised multimorbidity, complex communication and emotionally charged interactions in their definitions of complexity. They described varying levels of exposure to complexity and opportunities to engage meaningfully with complex patients. Students felt that supervisors who shield students from learning opportunities with complex patients, together with a failing healthcare system, were critical limiting factors in their development. Learners emphasised the powerful role of supervisors in their learning experiences, which limited their ability to experiment and learn from productive failure but felt that with guided scaffolding and supervision, teaching and learning in this space could be meaningfully enhanced.

Conclusion

Exposure to and engagement with complex patients offer critical learning opportunities that may allow students to explore and better develop skills in managing complexity. With appropriate scaffolding, students can be empowered to embrace complexity in the clinical learning environment, potentially equipping them to care for complex patients.
El retorno del nacionalismo romántico en el discurso sobre los pueblos indígenas
Authors: Gabbert Wolfgang
Published: January 2025

En la llamada era de la globalización, se ha invocado a menudo el fin del Estado-nación como forma predominante de organización sociopolítica. Por el contrario, los conceptos clave del pensamiento nacionalista romántico, surgidos en Europa en el siglo XVIII, están en auge en todo el mundo. Sobre la base de los procesos de diferenciación social en muchos países y mediados a través de las organizaciones internacionales y la política internacional, se han convertido en los fundamentos ampliamente reconocidos para la constitución de unidades políticas. Esto se nota, por ejemplo, en las discusiones sobre la autonomía y el reconocimiento del derecho indígena en América Latina. Frecuentemente se emplean conceptos semejantes al «Volksgeist» (espíritu del pueblo), elaborado por Johann Gottfried Herder y otros, y la idea de que cada «pueblo» se caracteriza por un idioma, una cultura e instituciones sociales comunes. El artículo muestra que existen paralelismos en las condiciones socioestructurales en las que surgieron las ideologías nacionalistas y étnicas en Europa a principios del siglo XIX y en América Latina en la segunda mitad del siglo XX. Sostiene que, en los debates sobre la autonomía, se suele ignorar la poca antigüedad de la etnogénesis de los grupos indígenas y su creciente diferenciación social, que es un factor crucial para explicar el surgimiento de las organizaciones indígenas a nivel local, nacional e internacional. Las reformas constitucionales y legales en América Latina no conservan tradiciones ancestrales, sino que dan lugar a la aparición de nuevas formas de participación política y práctica jurídica.
Desafíos de diálogo intercultural en la consulta previa: El pueblo wayúu y el desvío del arroyo Bruno en la Guajira colombiana
Authors: Silva Cantillo Nurys Esperanza , Calle Alzate Laura
Published: January 2025

Este artículo destaca los desafíos del diálogo intercultural en los procesos de Consulta Previa. Adopta una lente teórica de ontología política y se basa en un análisis antropológico de un caso clave: la Sentencia de la Corte Constitucional de Colombia SU 698 de 2017 (Caso Wayúu). El estudio profundiza en las complejidades de definir impactos, asegurar derechos e implementar medidas que contribuyan al bienestar del pueblo wayúu, particularmente en el contexto de la modificación del arroyo Bruno (La Guajira, Colombia). A través del análisis de este caso, argumentamos la incorporación de una perspectiva biocultural que trascienda la dicotomía naturaleza-cultura al evaluar los impactos de los proyectos en los territorios de las comunidades étnicas. El artículo enfatiza la importancia de considerar los efectos socioambientales y utilizar indicadores bioculturales en el marco de la ontología política.
«A mí déjenme ser libre»: Tres ilusiones en torno al trabajo de mujeres recicladoras en Ecuador
Authors: Egas Loaiza Sebastián , Idrovo Landy Israel , Chiriboga Herrera Gabriela , Aguirre Abad Jacinta , Vásquez Espinoza Tatiana , Gómez Ayora Andrea
Published: January 2025

El presente artículo estudia la experiencia laboral de mujeres recicladoras en Ecuador, explorando sus percepciones e ilusiones en torno a la noción de trabajo. Con ello buscamos comprender cómo negocian su lugar en sistemas más amplios de desigualdad y discriminación. Basados en estudios antropológicos sobre trabajo marginal y a partir de una investigación etnográfica multisituada de cerca de seis meses, identificamos una mirada particular en el significado de la autonomía, en el manejo del tiempo y en la noción del respeto, que deben ser negociados diariamente en un contexto de estigma social y circunstancias de exclusión. Este artículo pretende aportar a debates contemporáneos en la antropología del trabajo al pensar críticamente y desde una experiencia concreta y situada cómo se puede entender y ejercer el trabajo, así como evidenciar una búsqueda de estructuración vital a través del reciclaje, una fluidez entre tareas productivas y reproductivas, y el desarrollo de estrategias creativas de resistencia y afirmación de su agencia.
«La tierra sin mal»: Paisaje e identidades en el delta inferior del río Paraná, Argentina
Authors: Pizarro Cynthia Alejandra
Published: January 2025

En este artículo se analizan las resignificaciones que los integrantes de la Asociación Civil Isleños Unidos II, localizada en el delta del río Paraná, realizan de su identidad. Sus socios se identifican con su paisaje, al que denominan «la isla» y resaltan las especificidades de la «cultura isleña», aludiendo a las sedimentaciones de las actividades desarrolladas por ellos y sus ancestros europeos. En base a un estudio etnográfico se indaga la manera en que incluyeron elementos de sentido del discurso ambientalista en sus narrativas identitarias. En el marco de una histórica confrontación con quienes denominan «ambientalistas» se observa que, si bien algunos de estos elementos de sentido fueron incorporados recientemente, también fueron confrontados. La metáfora: «La tierra sin mal» con que se nominó a una lancha de pasajeros podría llevar a pensar que resignificaron el hito fundante que marca como sus ancestros a los europeos y que reprodujeron una posible ancestralidad de los grupos originarios. Por otro lado, incluyeron elementos de sentido del discurso ambientalista otorgando a los muelles nombres de distintas especies emblemáticas de la «flora y fauna autóctonas». Sin embargo, confrontaron estos elementos al referirse a su ser-en-el mundo. Señalaron la co-construcción del paisaje isleño a través de prácticas productivas y de vida desarrolladas por ellos y sus antepasados. Además, confrontaron con el discurso ambientalista argumentando que estas prácticas no representan un «peligro»” para el ecosistema, sino que se trata de un cuidado recíproco. Estas vivencias se condensan emotivamente en la expresión «nosotros creamos el delta».
Video analysis of neonatal intubations using video laryngoscopy: a prospective comparison of clinical practice with resuscitation guidelines
Authors: Ní Chathasaigh Caitríona M , Dunne Emma A , Geraghty Lucy E , O'Donnell Colm P F , O'Currain Eoin , Curley Anna E
Published: January 2025

Background

The Neonatal Resuscitation Program recommends direct laryngoscopy (DL) as the primary method for neonatal intubation. Video laryngoscopy (VL) is suggested as an option, particularly for training novice operators or for intubating infants with difficult airways. The programme outlines specific steps for intubation, including managing the external environment and techniques for visualising key anatomical landmarks. It is unclear whether the DL method can be effectively applied to VL.

Objectives

To determine the degree of adherence to resuscitation guidelines during intubation using VL, and to examine the relationship between guideline adherence and intubation success.

Methods

In a cohort of newborn infants who were intubated with VL, we simultaneously recorded the view obtained with the video laryngoscope and an external view of the procedure with a GoPro video camera, and synchronised the recordings for analysis. In each set of recordings, we assessed infant and operator positions, interventions during the procedure, and the anatomical landmarks visualised.

Results

We assessed 95 intubation attempts in 57 infants (median corrected gestational age: 28 weeks; median weight: 1160 g). Sixty-six of these attempts (69%) were successful. Operators spent more time attempting to insert the endotracheal tube through a visible glottis than locating it. Sixty-six (69%) attempts were performed with an appropriate lift manoeuvre. The vocal cords were visualised in only 58 (61%) attempts, while the glottis was seen in 85 (89%).

Conclusions

Neonatal intubation using VL differed from the technique recommended in resuscitation guidelines. Revised guidelines considering the use of VL may be warranted.
Mesenteric fibromatosis as an irreducible inguinal hernia
Authors: Siahetiong Samantha Jiselle Go , Onglao Mark Augustine S , Manlubatan Sofia Isabel Tamesa , Lopez Marc Paul Jose
Published: January 2025

We present the case of a man in his 60s with hypertension, who had a 3-year history of an irreducible mass in the left inguinal area. The patient presented at the emergency room with left lower quadrant pain and scrotal pain. The clinical examination was not suggestive of an acute abdomen. A CT scan was done showing an anterior abdominal wall defect at the left inguinal region. The patient underwent exploratory laparotomy, ileal resection and anastomosis, mesh hernioplasty left for the mesenteric fibromatosis mass mimicking as an irreducible inguinal hernia. Histopathology and immunohistochemistry showed desmoid-type fibromatosis.
Stroke thrombolysis in tuberculous meningitis
Authors: Chan Pik Ee , Saha Anamika , Saunders Tim , Yiin Gabriel SC
Published: January 2025

A woman in her 30s presented with sudden onset right-sided weakness, speech difficulties and transient loss of consciousness. She had a medical history of migraine, hypothyroidism and cervical lymphadenopathy. On examination, her National Institutes of Health Stroke Scale (NIHSS) score was 8 due to dense right-sided hemiparesis. CT brain imaging showed no intracranial haemorrhage but revealed incidental findings of left supraclavicular and cervical lymphadenopathy. CT intracranial angiogram did not show large vessel occlusion. She received thrombolytic treatment for ischaemic stroke. NIHSS improved to 3 with no immediate complications. Following admission, she developed swinging fever, seizures and fluctuating right-sided weakness. Repeat MRI of the head showed leptomeningeal enhancement. Biopsy of the cervical lymph nodes showed histiocytic granulomatous lymphadenitis, which was suggestive of tuberculous meningitis (TBM). She was treated with quadruple antimicrobial therapy and steroids for TBM, as well as aspirin for ischaemic stroke, which resulted in good clinical improvement.
Catastrophic iatrogenic abdominal aorta haemorrhage during anterior resection
Authors: Head Marion , Fonseka Ruwan , Lala Anil , Ahmad Suhaib JS
Published: January 2025

A woman in her 70s with hypertension, breast cancer and diverticulosis underwent laparoscopic anterior resection for a tubule-villous adenoma, converted to open Hartmann’s with aorto-bi-iliac bypass due to a vascular injury. Intraoperative complications included haem-o-lok penetration of the calcified aorta, necessitating vascular team intervention. Postoperative issues included bilateral popliteal artery emboli requiring embolectomy and fasciotomy, and a parastomal abscess. Despite significant blood loss and complications, the patient recovered well and remains cancer-free. This case underscores the importance of early conversion to laparotomy in major vascular injuries and preoperative assessment for vascular calcification.
Perianal angiolymphoid hyperplasia with eosinophilia mimicking Kaposi sarcoma in a patient living with HIV
Authors: McKenzie Ning C , Reddy Vidhatha D , De La Sancha Carlo , Leslie Kieron S
Published: January 2025

A woman in her 70s with well-controlled HIV on antiretroviral therapy presented with a several-month history of an asymptomatic perianal lesion. Skin examination showed a 0.5–1 cm red-pink, shiny, exophytic papule with visible telangiectasias near the anal verge. The differential diagnosis was most concerning for Kaposi sarcoma. A shave biopsy with electrodessication was performed for both diagnostic and therapeutic purposes. Histology revealed a dome-shaped lesion with a diffuse inflammatory infiltrate composed of lymphocytes and eosinophils. The vessels in the superficial and mid-dermis showed cuboidal-to-columnar endothelial cells with nuclear enlargement, conspicuous nucleoli, and ample cytoplasm. These findings were consistent with angiolymphoid hyperplasia with eosinophilia (ALHE). Only 2.4% of ALHE occur on the genitals and fewer than 1% on the buttocks. Additionally, few of these are reported in female patients and none in female patients with HIV. At 12 months post-treatment, the patient remains without evidence of recurrence.
Acute upper limb ischaemia secondary to metastatic tumour thromboembolism: a rare clinical phenomenon
Authors: Zhao Yue , Chi Hannah Yee Shuen , Ding Cristine Szu Lyn , Lee Shaun Qingwei
Published: January 2025

Acute upper limb ischaemia is a vascular emergency which requires prompt diagnosis and treatment to optimise outcomes. Tumour embolism is a rare but known cause of this. We hereby report a rare case of acute upper limb ischaemia from a malignant lung embolism, which was subsequently treated successfully with surgical embolectomy.
Perhexiline-induced toxicity in a geriatric patient presenting with peripheral neuropathy, hepatotoxicity and recurrent falls
Authors: Waters Nicholas Joseph , Mouchaileh Nadia , Low Tessa , Ting Celia
Published: January 2025

Perhexiline is an antianginal medication used in refractory disease. Despite being highly efficacious, it is seldom prescribed due to its risk of neurotoxicity and hepatotoxicity. These adverse effects are often linked to high plasma concentration in patients with impaired metabolism, identified through therapeutic drug monitoring. In this report, a man in his 70s developed hepatotoxicity, lower limb weakness, poor coordination and reduced mobility following 6 months of perhexiline use, leading to recurrent falls and multiple hospitalisations. Extensive testing ruled out other causes of the patient’s symptomatology. During his third hospital presentation, elevated serum perhexiline levels confirmed toxicity. Cessation of perhexiline led to a marked improvement in liver function, mobility and function, allowing for the patient to be discharged home. This case underscores the critical role of therapeutic drug monitoring and the need to consider adverse drug reactions in vulnerable older patients.
Alcohol restrictions and suicide rates in South Africa during the COVID-19 pandemic: results of a natural experiment
Authors: Hodgson Anthony Fish , Bantjes Jason , Pirkis Jane , Hawton Keith , Basera Wisdom , Matzopoulos Richard
Published: January 2025

Background

Alcohol use is a well-established potentially modifiable risk factor for suicide, yet few studies have investigated the impact of alcohol restrictions on suicide rates, particularly in low- and middle-income countries.

Methods

We used data from nationally representative annual surveys of postmortem investigations in 2017 (n=6117) and 2020/21 (n=6586) to estimate changes in suicide rates associated with the COVID-19 pandemic and related alcohol restrictions.

Findings

Age standardised suicide mortality rates per 100 000 were 10.91 (10.64, 11.18) in 2017 and 10.82 (10.56, 11.08) in 2020/2021, with approximately 4.4 times more deaths among males than females in both periods. No significant differences were observed between overall suicide rates during the 2020/2021 pandemic period compared with 2017 (risk ratio=1.04 (1.00, 1.07)), but in the 15–24-year age group, suicide rates were 11% higher among males and 31% higher among females than in 2017. Partial alcohol restrictions during the pandemic were not associated with lower suicide risk. However, the shift from partial to full restriction on the sale of alcohol was associated with an 18% (95% CI 10% to 25%) reduction in suicides for both sexes combined and a 22% (95% CI 13% to 30%) reduction in suicides among men, but no significant reduction among women.

Interpretation

Our findings offer some support for the hypothesis that restricting access to alcohol at a population level is associated with a reduction in suicide rates and suggests that restricted access to alcohol may have been one of the reasons global suicide rates did not increase during the pandemic in some countries.
Analysing expression of loneliness and insomnia through social intelligence analysis
Authors: Shah Hurmat Ali , Househ Mowafa
Published: January 2025

Background

Loneliness and insomnia are mutually occurring conditions. This paper investigates whether keywords depicting loneliness and insomnia are expressed together on social media. Understanding loneliness through data fills the gaps or validates the literature on loneliness from sociological and psychological perspectives. Loneliness is associated with various physical and mental health conditions but there are opportunities to understand it from the perspectives and lens of health informatics through social media data. Because loneliness is a subjective phenomenon, therefore, the self-reporting nature of social media data can provide an intimate glimpse into the feelings associated with loneliness.

Methods

This study uses sentiment analysis of collected tweets on loneliness and insomnia to filter out the tweets that have negative connotations. Those tweets are then further analysed to find out categories and themes associated with loneliness and insomnia.

Results

Through the frequency of word occurrence analysis, it was seen that the association between loneliness and insomnia can be found. The association, in the tweets analysed, is mediated by words denoting depressive symptoms. Moreover, the themes and categories which are associated with the expression of both loneliness and insomnia are those of personal feelings and time.
Large language models for data extraction from unstructured and semi-structured electronic health records: a multiple model performance evaluation
Authors: Ntinopoulos Vasileios , Rodriguez Cetina Biefer Hector , Tudorache Igor , Papadopoulos Nestoras , Odavic Dragan , Risteski Petar , Haeussler Achim , Dzemali Omer
Published: January 2025

Objectives

We aimed to evaluate the performance of multiple large language models (LLMs) in data extraction from unstructured and semi-structured electronic health records.

Methods

50 synthetic medical notes in English, containing a structured and an unstructured part, were drafted and evaluated by domain experts, and subsequently used for LLM-prompting. 18 LLMs were evaluated against a baseline transformer-based model. Performance assessment comprised four entity extraction and five binary classification tasks with a total of 450 predictions for each LLM. LLM-response consistency assessment was performed over three same-prompt iterations.

Results

Claude 3.0 Opus, Claude 3.0 Sonnet, Claude 2.0, GPT 4, Claude 2.1, Gemini Advanced, PaLM 2 chat-bison and Llama 3-70b exhibited an excellent overall accuracy >0.98 (0.995, 0.988, 0.988, 0.988, 0.986, 0.982, 0.982, and 0.982, respectively), significantly higher than the baseline RoBERTa model (0.742). Claude 2.0, Claude 2.1, Claude 3.0 Opus, PaLM 2 chat-bison, GPT 4, Claude 3.0 Sonnet and Llama 3-70b showed a marginally higher and Gemini Advanced a marginally lower multiple-run consistency than the baseline model RoBERTa (Krippendorff’s alpha value 1, 0.998, 0.996, 0.996, 0.992, 0.991, 0.989, 0.988, and 0.985, respectively).

Discussion

Claude 3.0 Opus, Claude 3.0 Sonnet, Claude 2.0, GPT 4, Claude 2.1, Gemini Advanced, PaLM 2 chat bison and Llama 3-70b performed the best, exhibiting outstanding performance in both entity extraction and binary classification, with highly consistent responses over multiple same-prompt iterations. Their use could leverage data for research and unburden healthcare professionals. Real-data analyses are warranted to confirm their performance in a real-world setting.

Conclusion

Claude 3.0 Opus, Claude 3.0 Sonnet, Claude 2.0, GPT 4, Claude 2.1, Gemini Advanced, PaLM 2 chat-bison and Llama 3-70b seem to be able to reliably extract data from unstructured and semi-structured electronic health records. Further analyses using real data are warranted to confirm their performance in a real-world setting.
Barcode medication administration system use and safety implications: a data-driven longitudinal study supported by clinical observation
Authors: Williams Rachel , Kantilal Kumud , Man Kenneth K C , Blandford Ann , Jani Yogini
Published: January 2025

Objectives

Barcode medication administration (BCMA) systems may improve patient safety with successful integration and use. This study aimed to explore the barriers and enablers for the successful use of a BCMA system by examining the patterns of medication and patient scanning over time and potential safety implications.

Methods

Retrospective longitudinal study informed by prospective clinical observations using data extracted from five hospital wards over the first 16 months after implementation to determine trends in medication and patient scanning rates, reasons for non-compliance and scanning mismatch alerts. Regression models were applied to explore factors influencing medication scanning rates across wards of different specialties.

Results

Electronic data on 613 868 medication administrations showed overall medication scanning rates per ward ranged from 5.6% to 67% and patient scanning rates from 4.6% to 89%. Reported reasons for not scanning medications were ‘barcode not readable’ and ‘unavailability of scanners’. Scanning rates declined over time and the pattern of reason codes for not scanning also changed. Factors associated with higher scanning rates included a locally led quality improvement (QI) initiative, the medication administration time and the medication formulation, for example, tablets and liquids. Overall, 37% of scanning alerts resulted in a change in user action. Staff tried to comply with the BCMA system workflow, but workarounds were observed.

Discussion

Compliance with BCMA systems varied across wards and changed over time. QI initiatives hold promise to ensure sustained use of BCMA systems.

Conclusions

BCMA systems may help to improve medication safety, but further research is needed to confirm sustained safety benefits.