bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproductive coercion and abuse in intimate relationships: Women’s perceptions of perpetrator motivations
Authors: Tarzia Laura , McKenzie Mandy
Published: April 2024

Reproductive coercion and abuse is a hidden and poorly recognised form of violence against women. It refers broadly to behaviours that interfere with or undermine a person’s reproductive autonomy, specifically to promote or prevent pregnancy. Reproductive coercion and abuse can involve physical, sexual, financial or psychological abuse in order to achieve these aims, and is overwhelmingly perpetrated by men against women. As an emerging field of scholarship, conceptual understanding of reproductive coercion and abuse is still in its infancy; however, it is often described as being linked to coercive control. In this article, we seek to highlight the complexity of this relationship through qualitative analysis of in-depth interviews with 30 victim/survivors in Australia recruited from the community, focusing on their perceptions of the perpetrator’s motivations. We developed four themes from our analysis: 1) His needs came first; 2) The illusion of a perfect father; 3) Creating a weapon of control; and 4) My body was his. Perceived perpetrator motivations ranged from entitlement and self-interest to a deep desire for domination and entrapment. Pregnancy preventing behaviour was more likely to be linked with entitlement and self-interest, whereas pregnancy promoting behaviour tended to be described by participants in relationships where there was a broader pattern of ongoing control and entrapment. Thus, we suggest that coercive control is a motivating factor for some, but not all men who perpetrate reproductive coercion and abuse. A greater understanding perpetrator motivations may be important for practitioners, particularly those working in sexual and reproductive health services, since it could be relevant to women’s level of risk for coercive controlling behaviour or more extreme forms of physical or sexual violence.
Is self-screening for 'at risk of malnutrition' feasible in a home setting?
Authors: Tangvik Randi J. , Skeie Eli , Haugen Arvid Steinar , Harthug Stig , Harris Kristin
Published: April 2024

Introduction

Despite malnutrition being established as a well-known risk for postoperative complications, the lack of screening for nutritional risk remains a challenge. The aim of this study was to investigate whether self-screening for nutritional risk prior to surgery is feasible in a home setting and if it will increase number of patients screened for nutritional risk, and secondly, to compare their screening results with the “in-hospital assessments” conducted by healthcare professionals.

Materials and methods

This was a prospective study involving patients from six randomly selected surgical wards at two Norwegian hospitals as a part of the “Feasibility study of implementing the surgical Patient Safety Checklist the (PASC)”. This checklist included a self-reported screening tool based on the Nutritional Risk Screening tool (NRS 2002) to identify “at risk of malnutrition” in patients that will undergo surgery the next 3 months or less. The original screening tool (NRS 2002) was used as a standard routine to identify “at risk of malnutrition” by healthcare professionals at hospital. The interrater reliability between these results was investigated using Fleiss multi rater Kappa with overall agreement and reported with Landis and Koch’s grading system (poor, slight, fair, moderate, substantial, and almost perfect).

Results

Out of 215 surgical patients in the home setting, 164 (76.7%) patients completed the self-reported screening tool. A total of 123 (57.2%) patients were screened in-hospital, of whom 96 (44.7%) prior to surgery and 96 (44.7%) were screened both at hospital (pre- and post-surgery) and at home. Self-screening at home improved malnutrition screening participation by 71.9% compared to hospital screening prior to surgery (165 (76.7%) and 96 (44.7%), respectively) and by 34.1% compared to pre- and postoperative in-hospital screening, 165 (76.7%) and 123 (57.2%), respectively). The degree of agreement between patients identified to be “at risk of malnutrition” by the self-reported screening tool and healthcare professionals was poor (κ = - 0.04 (95% CI: -0.24, 0.16), however, the degrees of agreement between the patients and healthcare professionals answers to the initial NRS 2002 questions “low BMI”, “weight loss”, and “reduced food intake” were almost perfect (κ = 1.00 (95% CI: 0,82, 1.18)), moderate (κ = 0.55 (95% CI: 0.34, 0.75)), and slight (κ = 0.08 (95% CI: - 0.10, 0.25) respectively.

Conclusions

Three out of four patients completed the self-screening form and the preoperative screening rate improved with 70%. Preoperatively self-screening in a home setting may be a feasible method to increase the number of elective surgical patients screened for risk of malnutrition.

Trial registration

The trial is registered in ClinicalTrials.gov ID NCT03105713. https://classic.clinicaltrials.gov/ct2/show/NCT03105713.
Decision analysis of PPP project’s parties based on deep consumer participation
Authors: Liu Wei , Wang Xiaoli , Jiang Sheng
Published: April 2024

Although PPP(Public-private partnership) mode has been applied for a long time in infrastructural project, the success rate is not very high. The sustainability of PPP projects is still influenced by many factors. In order to examine the evolutionary stable strategies (ESSs) of social capital, government, and paying consumers, a tripartite evolutionary game model is established in this work. In order to further promote consumer participation, it is necessary to make the assumption that customer oversight and review can have an impact on service prices. The results show: i)The strategy choice of consumer depends on the comparison between supervision cost of consumer and price coefficient for consumer to social capital. ii)Consumer supervision can promote the provision of high-quality services by social capital. iii)The difference between high-quality cost and low-quality cost, subsidy coefficient, price coefficient and supervision cost of consumer are critical factors influencing both evolutionary results and trajectories. This paper also puts forward policy implications for the three stakeholders to promote social capital’s high-quality strategy so as to maintain the sustainability of PPP projects.
Impact of brining and drying processes on the nutritive value of tambaqui fish (Colossoma macropomum)
Authors: Mebratu Awot Teklu , Asfaw Yohannes Tekle , Merckx Wouter , Hendriks Wouter H. , Janssens Geert P. J.
Published: April 2024

Preservation of fish as diet ingredient is challenging in many tropical regions due to poor socioeconomic conditions and lack of freezing facilities. So, alternative preservation techniques could be viable to address the issue. The present study evaluated the effect of brine salting (15% w/v) prior to drying at different temperatures on the nutrient profiles of tambaqui fish (Colossoma macropomum). Whole fish samples (n = 48; 792 ± 16 g; 8 months old) were grouped into two as brine-salted and non-salted, and treated at seven different drying temperatures of 30, 35, 40, 45, 50, 55 and 60°C for a period of 23 h each. To evaluate the impact of Maillard reaction, reactive lysine was also quantified. Drying temperature had no effect on the evaluated macro- and micro-nutrients of tambaqui fish (P > 0.05) while brining reduced the overall protein concentration by 6% (58.8 to 55.4 g/100 g DM; P = 0.004). Brining significantly reduced many amino acids: taurine by 56% (7.1 to 3.1 g/kg; P < 0.001), methionine 17% (14.7 to 12.1 g/kg; P < 0.001), cysteine 11% (5.1 to 4.4 g/kg, P = 0.016), and reactive lysine 11% (52.0 to 46.4 g/kg; P = 0.004). However, alanine, arginine, and serine were not affected by brining (P > 0.05). Brining also reduced the concentrations of Se by 14% (149 to 128 μg/kg DM; P = 0.020), iodine 38% (604 to 373 μg/kg DM; P = 0.020), K 42% (9.71 to 5.61 g/kg DM; P < 0.001) and Mg 18% (1.32 to 1.10 g/kg DM; P = < 0.001) versus an anticipated vast increase in Na by 744% (2.70 to 22.90 g/kg DM; P < 0.001) and ash 28% (12.4 to 16.0 g/100g DM; P < 0.001) concentration. Neither brining nor drying temperature induced changes in % lysine reactivity and fat content of tambaqui fish (P > 0.05). Agreeably, results of multivariate analysis showed a negative association between brining, Na, and ash on one side of the component and most other nutrients on the other component. In conclusion, drying without brining may better preserve the nutritive value of tambaqui fish. However, as a practical remark to the industry sector, it is recommended that the final product may further evaluated for any pathogen of economic or public health importance.
Numerical investigation of LDL nanoparticle collision in coronary artery grafts with porous wall and different implantation angles and two state of inlet velocity
Authors: Karimian Reza , Saghafian Mohsen , Shirani Ebrahim
Published: April 2024

This study aimed to reduce the risk of graft occlusion by evaluating the two-phase flow of blood and LDL nanoparticles in coronary artery grafts. The study considered blood as an incompressible Newtonian fluid, with the addition of LDL nanoparticles, and the artery wall as a porous medium. Two scenarios were compared, with constant inlet velocity (CIV) and other with pulsatile inlet velocity (PIV), with LDL nanoparticles experiencing drag, wall-induced lift, and induced Saffman lift forces, or drag force only. The study also evaluated the concentration polarization of LDLs (CP of LDLs) near the walls, by considering the artery wall with and without permeation. To model LDL nanoparticles, the study randomly injected 100, 500, and 1000 nanoparticles in three release states at each time step, using different geometries. Numerical simulations were performed using COMSOL software, and the results were presented as relative collision of nanoparticles to the walls in tables, diagrams, and shear stress contours. The study found that a graft implantation angle of 15° had the most desirable conditions compared to larger angles, in terms of nanoparticle collision with surfaces and occlusion. The nanoparticle release modes behaved similarly in terms of collision with the surfaces. A difference was observed between CIV and PIV. Saffman lift and wall-induced lift forces having no effect, possibly due to the assumption of a porous artery wall and perpendicular outlet flow. In case of permeable artery walls, relative collision of particles with the graft wall was larger, suggesting the effect of CP of LDLs.
Associations between EEG power and coherence with cognition and early precursors of speech and language development across the first months of life
Authors: Bradley Holly , Smith Beth A. , Xiao Ran
Published: April 2024

The neural processes underpinning cognition and language development in infancy are of great interest. We investigated EEG power and coherence in infancy, as a reflection of underlying cortical function of single brain region and cross-region connectivity, and their relations to cognition and early precursors of speech and language development. EEG recordings were longitudinally collected from 21 infants with typical development between approximately 1 and 7 months. We investigated relative band power at 3-6Hz and 6-9Hz and EEG coherence of these frequency ranges at 25 electrode pairs that cover key brain regions. A correlation analysis was performed to assess the relationship between EEG measurements across frequency bands and brain regions and raw Bayley cognitive and language developmental scores. In the first months of life, relative band power is not correlated with cognitive and language scales. However, 3-6Hz coherence is negatively correlated with receptive language scores between frontoparietal regions, and 6-9Hz coherence is negatively correlated with expressive language scores between frontoparietal regions. The results from this preliminary study contribute to the existing literature on the relationship between electrophysiological development, cognition, and early speech precursors in this age group. Future work should create norm references of early development in these domains that can be compared with infants at risk for neurodevelopmental disabilities.
Age at natural menopause and its determinants in female population of Kharameh cohort study: Comparison of regression, conditional tree and forests
Authors: Pasokh Zahra , Seif Mozhgan , Ghaem Haleh , Rezaianzadeh Abbas , Ghoddusi Johari Masoumeh
Published: April 2024

Background

Natural menopause is defined as the permanent cessation of menstruation that occurs after 12 consecutive months of amenorrhea without any obvious pathological or physiological cause. The age of this phenomenon has been reported to be associated with several health outcomes.

Objectives

This study aimed to estimate the Age at Natural Menopause (ANM) and to identify reproductive and demographic factors affecting ANM.

Methods

This cross-sectional, population-based study was conducted on 2517 post-menopausal women aged 40–70 years participating in the first phase of the PERSIAN cohort study of Kharameh, Iran, during 2014–2017. To more accurately detect the determinants of ANM, we applied multiple linear regression beside some machine learning algorithms including conditional tree, conditional forest, and random forest. Then, the fitness of these methods was compared using Mean Squared Error (MSE) and Pearson correlation coefficient.

Results

The mean±SD of ANM was 48.95±6.13. Both applied forests provided more accurate results and identified more predictors. However, according to the final comparison, the conditional forest was the most accurate method which recognized that more pregnancies, longer breastfeeding, Fars ethnicity, and urbanization have the greatest impact on later ANM.

Conclusions

This study found a wide range of reproductive and demographic factors affecting ANM. Considering our findings in decision-making can reduce the complications related to this phenomenon and, consequently, improve the quality of life of post-menopausal women.
Chorematic modeling to represent dynamics in the quinoa agroecosystems in Peru
Authors: Fagandini Ruiz Francesca , Villanueva Antonio , Bazile Didier
Published: April 2024

Our research occurred in the Andean region, one of the eight global centers of domestication of plant species grown for agriculture. The shores of Lake Titicaca (located between Peru and Bolivia), at 3800 meters above sea level, are recognized as the center of origin of quinoa (Chenopodium quinoa Willd.). In this region, complex societies have emerged, thanks to the development of water and soil management technologies. They have managed to overcome high mountain territories’ extreme and variable climatic conditions. These societies have traditionally protected and preserved quinoa as food for present and future generations through their long-standing knowledge and cultivation practices. The fieldwork occurred in the context of Andean family farming, and our study analyzes nature-society dynamics with a chorematic approach and interviews with local communities. The interest of this work is the transformation of the landscape at the scale of the mountain agroecosystem to understand better the impacts of rural development policies. Chorematic modeling was applied to two periods, before and after 1970, a pivotal year in Peru for agriculture, to show how socio-spatial dynamics in the Andean environment are changing, particularly concerning the evolution of quinoa cultivation. The results show that wild quinoa relatives’ distribution is strongly linked to the socio-spatial organization of the agroecosystem. Different species of wild quinoa relatives are maintained by villagers for their multiple foods, medicinal and cultural uses in natural areas, grazed areas, on edge, and also within cultivated fields. However, this management is changing under the pressure of global issues related to the international quinoa market, whose requirements imply reducing the presence of wild relatives in cultivated fields.
Immunotherapy utilization patterns in patients with advanced cancer and autoimmune disease
Authors: Li Huaqi , Huntington Scott , Gross Cary , Wang Shi-Yi
Published: April 2024

Purpose

Immunotherapy has been shown to improve cancer survival, but there are no consensus guidelines to inform use in patients with both cancer and autoimmune disease (AD). We sought to examine immunotherapy utilization patterns between cancer patients with and without AD.

Patients and methods

This retrospective cohort study utilized data from a de-identified nationwide oncology database. Patients diagnosed with advanced melanoma, non-small cell lung cancer, and renal cell carcinoma were included. Outcomes of interest included first-line immunotherapy, overall immunotherapy, and number of immunotherapy cycles. We used logistic and Poisson regression models to examine associations between AD and immunotherapy utilization patterns.

Results

A total of 25,076 patients were included (796 with AD). Patients with AD were more likely to be female, White, receive care at academic centers, and have ECOG ≥ 3. Controlling for demographic and clinical variables, AD was associated with lower odds of receiving first-line (odds ratio [OR] = 0.68, 95% confidence interval [CI] 0.56–0.82) and overall (OR = 0.80, 95% CI 0.67–0.94) immunotherapy. Among patients who received at least one cycle of immunotherapy, there was no difference in mean number of cycles received between patients with and without AD (11.3 and 10.5 cycles respectively). The incident rate of immunotherapy cycles received for patients with AD was 1.03 times that of patients without AD (95% CI 1.01–1.06).

Discussion

Patients with AD were less likely to receive immunotherapy as first-line and overall therapy for treatment of their advanced cancer. However, among those who did receive at least one cycle of immunotherapy, patients with AD received a similar number of cycles compared to patients without AD. This not only indicates that AD is not an absolute contraindication for immunotherapy in clinical practice but may also demonstrate overall treatment tolerability and net benefit in patients with AD.
Linguistic correlates of societal variation: A quantitative analysis
Authors: Chen Sihan , Gil David , Gaponov Sergey , Reifegerste Jana , Yuditha Tessa , Tatarinova Tatiana , Progovac Ljiljana , Benítez-Burraco Antonio
Published: April 2024

Traditionally, many researchers have supported a uniformitarian view whereby all languages are of roughly equal complexity, facilitated by internal trade-offs between complexity at different levels, such as morphology and syntax. The extent to which the speakers’ societies influence the trade-offs has not been well studied. In this paper, we focus on morphology and syntax, and report significant correlations between specific linguistic and societal features, in particular those relating to exoteric (open) vs. esoteric (close-knit) society types, characterizable in terms of population size, mobility, communication across distances, etc. We conduct an exhaustive quantitative analysis drawing upon WALS, D-Place, Ethnologue and Glottolog, finding some support for our hypothesis that languages spoken by exoteric societies tend towards more complex syntaxes, while languages spoken by esoteric societies tend towards more complex morphologies.
Protective effect and pharmacokinetics of dihydromyricetin nanoparticles on oxidative damage of myocardium
Authors: Du Lixin , Lu Huiling , Xiao Yifei , Guo Zhihua , Li Ya
Published: April 2024

Purpose

This study aims to investigate the protective mechanism of dihydromyricetin PLGA nanoparticles (DMY-PLGA NPs) against myocardial ischemia-reperfusion injury (MIRI) in vitro and the improvement of oral bioavailability in vivo.

Methods

DMY-PLGA NPs was prepared and characterized by emulsifying solvent volatilization, and the oxidative stress model of rat H9c2 cardiomyocyte induced by H2O2 was established. After administration, cell survival rate, lactate dehydrogenase (LDH), malondialdehyde (MDA) and superoxide dismutase (SOD) were detected, and the expressions of PGC1α and PPARα were detected by western blot (WB). At the same time, the pharmacokinetics in rats were studied to explore the improvement of bioavailability.

Results

DMY-PLGA NPs can significantly increase cell survival rate, decrease LDH and MDA content, increase SOD content and PGC1α、PPARα protein expression. Compared with DMY, the peak time of DMY-PLGA NPs was extended (P<0.1), and the bioavailability was increased by 2.04 times.

Conclusion

DMY-PLGA NPs has a significant protective effect on H9c2 cardiomyocytes, which promotes the absorption of DMY and effectively improves bioavailability.
Maternal occupational noise exposure during pregnancy and children’s early language acquisition
Authors: Jungewelter Soile , Taskinen Helena , Sallmén Markku , Lindbohm Marja-Liisa , Airo Erkko , Remes Jouko , Huotilainen Minna , Jansson-Verkasalo Eira
Published: April 2024

Introduction

Noise exposure during pregnancy may affect a child’s auditory system, which may disturb fetal learning and language development. We examined the impact of occupational noise exposure during pregnancy on children’s language acquisition at the age of one.

Methods

A cohort study was conducted among women working in the food industry, as kindergarten teachers, musicians, dental nurses, or pharmacists who had a child aged <1 year. The analyses covered 408 mother-child pairs. Language acquisition was measured using the Infant-Toddler Checklist. An occupational hygienist assessed noise exposure individually as no (N = 180), low (70–78 dB; N = 108) or moderate/high exposure (>79 dB; N = 120).

Results

Among the boys, the adjusted mean differences in language acquisition scores were -0.4 (95% CI -2.5, 1.8) for low, and -0.7 (95% CI -2.9, 1.4) for moderate/high exposure compared to no exposure. Among the girls the respective scores were +0.1 (95% CI -2.2, 2.5) and -0.1 (95% CI -2.3, 2.2). Among the children of kindergarten teachers, who were mainly exposed to human noise, low or moderate exposure was associated with lower language acquisition scores. The adjusted mean differences were -3.8 (95% CI -7.2, -0.4) for low and -4.9 (95% CI -8.6, -1.2) for moderate exposure.

Conclusions

In general, we did not detect an association between maternal noise exposure and children’s language acquisition among one-year-old children. However, the children of kindergarten teachers exposed to human noise had lower language acquisition scores than the children of the non-exposed participants. These suggestive findings merit further investigation by level and type of exposure.
The correlation of obesity status with serum 25-hydroxyvitamin D in US Asian adults: NHANES 2011–2018
Authors: Qiu Linjie , Ren Yan , Li Jixin , Li Meijie , Li Wenjie , Qin Lingli , Zhang Jin , Gao Feng
Published: April 2024

Background

There is a correlation between obesity and 25-hydroxyvitamin D (25OHD) that tends to be negative. However, this relationship varies among different races. In this study, Asian adults with and without obesity were compared in terms of their levels of 25OHD.

Methods

We carried out a cross-sectional analysis on 2664 non-Hispanic Asian adults who participated in the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. To examine the connection between obese status, body mass index (BMI), waist circumference (WC) and weight, and 25OHD, we ran multivariate linear regression models and multivariate logistic regression models.

Results

After adjusting for all confounding factors, obesity status shows a significant positive correlation with vitamin D deficiency (model 3: OR = 2.318, 95% CI:1.317, 4.082). This positive correlation remains significant in males (males: OR = 2.713, 95% CI: -13.398, 5.217). In all three models, a negative association was observed between obesity status and 25OHD (model 1: β = -4.535, 95% CI: -6.987, -2.083; model 2 β = -4.249, 95% CI: -6.549, -2.039; model 3 β = -1.734, 95% CI: -7.285, 3.816). After controlling for covariates, there was a significant negative correlation between WC and 25OHD when stratified by gender and obesity status in both males with and without obesity (males with obesity: β = -1.461, 95% CI: -2.485, -0.436; males without obesity: β = -0.855. 95% CI: -1.499, -0.210). In males with obesity, there was a very strong positive connection between body weight and 25OHD (β = 0.912, 95% CI: 0.227, 1.597). In addition, neither gender’s obese individuals showed a significant link between BMI and 25OHD.

Conclusion

This study demonstrated a positive correlation between obesity and vitamin D deficiency and a negative correlation between obesity and 25OHD in Asian American adults. Additionally, among male obese individuals, there was a significant negative correlation between WC and 25OHD, an observation that needs to be validated in further prospective studies.
Moderating role of political stability and economic policy uncertainty between country governance practice and stock market performance. A comparative analysis of Pakistan and Kurdistan Region of Iraq
Authors: Maghdid Rekurd S. , Kareem Saeed Mohammed , Salih Hama Yaseen , Waris Muhammad , Naveed Rana Tahir
Published: April 2024

The objective of the study is to explore the relationship between country governance practices along with political stability and Economic policy uncertainty, and stock market performance of two different economies, Pakistan and Kurdistan region of Iraq. To meet our objectives, we used the 25 years past data from 1996 to 2021. Data is collected from the DataStream database. The regression analysis is used as the method of estimation for linear and moderation effect. Our results show that regulatory quality, rules of law and political stability has significant positive relationship with stock market performance of Pakistan, but all the governance indicators have significant positive relationship with stock market performance of the Kurdistan Region of Iraq. Moreover, political stability has significant moderating impact between the governance practices and the performance of the stock markets of both economies indicating that the governance practices perform well with the political stability that leads to rise in the stock market indices of selected countries. Economic policy uncertainty has significant negative moderation impact due to creating the risk in both economies that decrease the performance of the stock markets of the selected economies. Finally, our study advocated some implications for the investors to increase their confidence on the stock of high political stability and low economic policy uncertainty economies. Government can take significant measures to control the uncertainty of the policy and portfolio managers can adjust their risk on the ground of the political stability and efficient governance practices countries.
Molecular epidemiological study of Scrub Typhus in residence, farm and forest habitats from Yunnan Province, China
Authors: Tian Jia-Wei , Kong Yi-Chen , Han Pei-Yu , Xu Fen-Hui , Yang Wei-Hong , Zhang Yun-Zhi
Published: April 2024

The number of people suffering from scrub typhus, which is not of concern, is increasing year by year, especially in Yunnan Province, China. From June 1, 2021 to August 15, 2022, a total of 505 mammalian samples were collected from farm, forest, and residential habitats with high incidence of scrub typhus in Yunnan, China, for nPCR (nested PCR) and qPCR (quantitative real-time PCR) detection of Orientia tsutsugamushi. A total of 4 orders of murine-like animals, Rodentia (87.52%, n = 442), Insectivora (10.29%, n = 52), Lagomorpha (1.79%, n = 9) and Scandentia (0.40%, n = 2) were trapped. Comparing the qPCR infection rates in the three habitats, it was no significant difference that the infection rate of residential habitat (44.44%) and that of the farm habitat (45.05%, P>0.05), which is much larger than that of the forest habitat (3.08%) (P<0.001). Three genotypes (Karp-like, Kato-like and TA763-like) of O. tsutsugamushi were found from Yunnan, China in this study.
Intra-abdominal hematomas and identifiable risk factors in patients receiving subcutaneous enoxaparin
Authors: Lager Stephanie , Balakrishnan Gautam , Eiberger Riley
Published: April 2024

Background

Low molecular weight heparin has proven to be safe and effective but is not without potential risks such as spontaneous bleeding in the abdominal cavity. There is limited evidence evaluating the true incidence of this potential risk and the available literature is primarily via case reports.

Case summary

The purpose of this study was to identify the incidence and risk factors associated with enoxaparin use (prophylaxis or treatment) abdominal hematomas in a 350-bed community hospital during an 8-month time period. A total of 44 patients were identified as clinically significant bleeds receiving enoxaparin treatment or prophylactic therapy. Ultimately, 25 patients were excluded from the analysis due to an external cause of the abdominal hematoma or a temporal mismatch in enoxaparin administration and hematoma formation. After exclusion, there were a total of 19 patients that were assessed for the risk factors such as age, gender, renal function, and weight. After evaluation of risks, over half of the patients developing a clinically significant bleed were considered elderly (>65 years of age) and impaired renal function with a creatinine clearance of 60ml/min or less.

Conclusion

Patients at risk for an enoxaparin associated hematoma include female patients with a CrCl <60ml/min and/or BMI >30 kg/m2 receiving enoxaparin treatment dosing.
An agent-based model on antimicrobial de-escalation in intensive care units: Implications on clinical trial design
Authors: Huo Xi , Liu Ping
Published: April 2024

Antimicrobial de-escalation refers to reducing the spectrum of antibiotics used in treating bacterial infections. This strategy is widely recommended in many antimicrobial stewardship programs and is believed to reduce patients’ exposure to broad-spectrum antibiotics and prevent resistance. However, the ecological benefits of de-escalation have not been universally observed in clinical studies. This paper conducts computer simulations to assess the ecological effects of de-escalation on the resistance prevalence of Pseudomonas aeruginosa—a frequent pathogen causing nosocomial infections. Synthetic data produced by the models are then used to estimate the sample size and study period needed to observe the predicted effects in clinical trials. Our results show that de-escalation can reduce colonization and infections caused by bacterial strains resistant to the empiric antibiotic, limit the use of broad-spectrum antibiotics, and avoid inappropriate empiric therapies. Further, we show that de-escalation could reduce the overall super-infection incidence, and this benefit becomes more evident under good compliance with hand hygiene protocols among health care workers. Finally, we find that any clinical study aiming to observe the essential effects of de-escalation should involve at least ten arms and last for four years—a size never attained in prior studies. This study explains the controversial findings of de-escalation in previous clinical studies and illustrates how mathematical models can inform outcome expectations and guide the design of clinical studies.
Exploring coagulation parameters as predictive biomarkers of Plasmodium infection: A comprehensive analysis of coagulation parameters
Authors: Tesfaye Zelalem , Derso Adane , Zeleke Ayalew Jejaw , Addisu Ayenew , Woldu Berhanu , Deress Teshiwal , Mekonnen Gebeyaw Getnet , Tegegne Yalewayker
Published: April 2024

Background

Malaria affects the intravascular environment, leading to abnormal coagulation activation, prolonged prothrombin time, and activated partial thromboplastin time. Despite the high prevalence of malaria in the study area, there has been little published research on the effects of Plasmodium infection on coagulation parameters.

Objective

The aim was to assess the effect of malaria on basic coagulation parameters among patients attending Dembia Primary Hospital and Makisegnit Health Center.

Methods

A cross-sectional study was carried out from January to March 2020. The study involved 120 participants. Blood specimens were collected, which were analyzed using a Huma Clot Due Plus analyzer. The collected data were entered into EpiData and exported to SPSS version 21 for analysis. Non-parametric statistical methods were employed to analyze the data. The results were considered statistically significant if the p-value was less than 0.05.

Results

Individuals infected with Plasmodium exhibit coagulation disorders with elevated levels of PT (Prothrombin Time), APTT (Activated Partial Thromboplastin Time), and INR (International Normalization Ratio) in comparison to healthy controls. The median PT, APTT, and INR values for infected cases were measured at 20.5 [8.6], 39.5 [17.9], and 1.8 [0.9], respectively, while healthy controls had measurements of 15.1 [2.5], 28.8 [8.3], and 1.3 [0.2] (p ≤ 0.001). The severity of coagulation disorders increased with an increase in parasitemia levels. The type of Plasmodium species present had a significant impact on PT and INR values (p ≤ 0.001), whereas APTT did not show any significant impact across the Plasmodium species (p > 0.05).

Conclusion

The results of this study found that malaria has a substantial impact on various blood clotting parameters, including PT, APTT, and INR. Parasitemia severity is significantly associated with extended PT and INR, implying that the higher the parasitemia, the longer it takes for blood to clot. Furthermore, the study discovered that the PT and INR levels differed based on the type of Plasmodium species responsible for the infection.
Adsorption of phosphate over a novel magnesium-loaded sludge-based biochar
Authors: Wang Chu-Ya , Wang Qi , Zhou Heng-Deng , Fang Xin , Zeng Qi , Zhu Guangcan
Published: April 2024

The production of sludge-based biochar to recover phosphorus (P) from wastewater and reuse the recovered phosphorus as agricultural fertilizer is a preferred process. This article mainly studied the removal of phosphate (PO4-P) from aqueous solution by synthesizing sludge-based biochar (MgSBC-0.1) from anaerobic fermentation sludge treated with magnesium (Mg)-loading-modification, and compared it with unmodified sludge-based biochar (SBC). The physicochemical properties, adsorption efficiency, and adsorption mechanism of MgSBC-0.1 were studied. The results showed that the surface area of MgSBC-0.1 synthesized increased by 5.57 times. The material surface contained MgO, Mg(OH)2, and CaO nanoparticles. MgSBC-0.1 can effectively remove phosphate in the initial solution pH range of 3.00–7.00, with a fitted maximum phosphorus adsorption capacity of 379.52 mg·g-1. The adsorption conforms to the pseudo second-order kinetics model and Langmuir isotherm adsorption curve. The characterization of the adsorbed composite material revealed the contribution of phosphorus crystal deposition and electrostatic attraction to phosphorus absorption.
Trends, patterns and relationship of antimicrobial use and resistance in bacterial isolates tested between 2015–2020 in a national referral hospital of Zambia
Authors: Shawa Misheck , Paudel Atmika , Chambaro Herman , Kamboyi Harvey , Nakazwe Ruth , Alutuli Luke , Zorigt Tuvshinzaya , Sinyawa Taona , Samutela Mulemba , Chizimu Joseph , Simbotwe Manyando , Hayashida Kyoko , Nao Naganori , Kajihara Masahiro , Furuta Yoshikazu , Suzuki Yasuhiko , Sawa Hirofumi , Hang’ombe Bernard , Higashi Hideaki
Published: April 2024

Increased antimicrobial resistance (AMR) among bacteria underscores the need to strengthen AMR surveillance and promote data-based prescribing. To evaluate trends and associations between antimicrobial usage (AMU) and AMR, we explored a dataset of 34,672 bacterial isolates collected between 2015 and 2020 from clinical samples at the University Teaching Hospital (UTH) in Lusaka, Zambia. The most frequently isolated species were Escherichia coli (4,986/34,672; 14.4%), Staphylococcus aureus (3,941/34,672; 11.4%), and Klebsiella pneumoniae (3,796/34,672; 10.9%). Of the 16 drugs (eight classes) tested, only amikacin and imipenem showed good (> 50%) antimicrobial activity against both E. coli and K. pneumoniae, while nitrofurantoin was effective only in E. coli. Furthermore, 38.8% (1,934/4,980) of E. coli and 52.4% (2,079/3,791) of K. pneumoniae isolates displayed multidrug resistance (MDR) patterns on antimicrobial susceptibility tests. Among S. aureus isolates, 44.6% (973/2,181) were classified as methicillin-resistant (MRSA). Notably, all the MRSA exhibited MDR patterns. The annual hospital AMR rates varied over time, while there was a weak positive relationship (r = 0.38, 95% CI = 0.11–0.60) between the monthly use of third-generation cephalosporins (3GCs) and 3GC resistance among Enterobacterales. Overall, the results revealed high AMR rates that fluctuated over time, with a weak positive relationship between 3GC use and resistance. To our knowledge, this is the first report to evaluate the association between AMU and AMR in Zambia. Our results highlight the need to strengthen antimicrobial stewardship programs and optimize AMU in hospital settings.
The power of digital story in early mathematics education: Innovative approaches for children with intellectual disabilities
Authors: Altindağ Kumaş Özlem
Published: April 2024

This study explored the effectiveness of digital story interventions in improving early math skills in kindergarten children with mild intellectual disabilities. Digital stories are multimedia narratives that combine text, images, and audio to enhance learning experience. This experimental study used a pretest-posttest control group design. The intervention group consisted of 15 children who participated in an 8-week digital story intervention targeting early math skills. A matched control group was used to control for sex differences. Data were collected through the TEMA-3 test scores and teacher and child feedback. Post-intervention, the experimental group showed significant improvements in TEMA-3 test scores compared to the control group. Teachers and children reported a positive perception of the intervention’s social validity, highlighting enhanced engagement and understanding of math concepts. This study demonstrated that digital story-based education is a promising approach for improving early math skills in children with mild intellectual disabilities. These findings suggest potential implications for integrating digital storytelling into special education curricula and highlight avenues for future research in this field.
Developing community music in Italy: The journey
Authors: Coppi Antonella
Published: April 2024

This article deals with the relationship between community music and scholarly research within the context of Italian community life, cultural politics, conditions and history. Community music theory and practice activities provide participants with opportunities for growth, development and collaboration, ranging from specific musical skills to social and cultural outreach and the positive challenge of increasing self-awareness and empowerment. After discussing the links between community music projects and social work, music therapy or arts education, the article locates community music in the landscape of Italian music research and, especially, musicology. It summarizes the current state of community music and the efforts to create an Italian network of community music scholars as well as establish a dialogue with similar international networks. The aim is to create the conditions for the establishment of an academic and theoretical framework for community music in Italy that can work as a pathway between music for social change, musicology and music education.
Music and community in South Tyrol: Perspectives, projects and research
Authors: Coppi Antonella , Somigli Paolo
Published: April 2024

This article deals with the importance of music-making within both instrumental and vocal ensembles in South Tyrol based on the results of two different research projects: ‘Cultura musicale e funzione sociale della musica in Alto Adige’ (‘Music culture and the social function of music in South Tyrol’), by Paolo Somigli and Ilaria Riccioni, and ‘Going to the Source’, carried out by Antonella Coppi. Through a reflection on the two research projects, this article aims to provide an image of the role of music in the South Tyrolean community; although the two research projects were carried out between 2011 and 2019 overall, they are still relevant, as they represent ground-breaking research in this region. The two research projects complement each other in a reciprocal contextualization of issues about the role of non-formal musical ensembles in developing the social and cultural fabric in South Tyrol. The different perspectives and objects of the two studies offer a broader view of music-making, not only from a musicological but also from a sociological and pedagogical perspective.
The impact of community music therapy intervention in older adults’ care home communities: Assessing community music therapists’ views
Authors: Mangiacotti Anthony M. A. , Masotti Arianna , Biasutti Michele
Published: April 2024

Community music-therapy (CMT) service evaluation in older adults’ care home communities is an important process to enhance the quality of therapists’ outputs and the development of client-centred approaches to meet the needs of residents and community. However, administrative limitations that could affect therapists’ contact time with clients may lead to the underestimation of service evaluation within the system. This study aims to explore community music therapists’ perceptions of the impact of their services in older adults’ care home communities using a qualitative approach based on semi-structured interviews. The therapists were asked to reflect on specific aspects of their community music therapy service, potential cognitive-behavioural and physiological effects of therapy, best-practices for assessment in MT and challenges experienced in this particular setting. Participants highlighted the unique value of CMT in care home communities. They demonstrated the ability to detect and assess impacts of CMT using clinical analysis methods, which can improve care plans for the residents. However, certain limitations, such as reduced hours, inadequate funding and a lack of recognition of CMT’s benefits by care home staff, were identified. Moreover, the analysis shed light on how COVID-19 impacted the CMT service in this context, emphasizing the need for adaptability and resilience in providing care. The implications of the results in an Italian community context are further analysed and discussed, stressing the importance of supporting CMT as a fundamental service in care home communities for older adults. By addressing the highlighted limitation and embracing the perspectives of community music therapists, care homes can optimize their services and enhance the well-being of their residents.
La Agencia Europea de la Guardia de Fronteras y Costas
Authors: Velasco Miranda Iván
Published: April 2024

Dos de los grandes problemas que reflejan invariablemente los eurobarómetros de este continente son la inmigración irregular y la delincuencia. Y en ambas temáticas, la Agencia Europea de la Guardia de Fronteras y Costas, a la que habitualmente nos referimos como Frontex, tiene un papel clave. Muchos son los cambios que ha experimentado Frontex en su travesía. Siendo criticada abiertamente, tanto por aquellos que esperan dotarla de una mayor capacidad de respuesta, como por parte de los que afirman que es necesario controlar más firmemente sus actuaciones; lo que ha provocado que su regulación se haya revisado hasta en cuatro ocasiones en su corta existencia. En este escenario que vivimos, la pregunta que se suscita es insoslayable: ¿Está la Agencia Europea de la Guardia de Fronteras y Costas preparada para asumir su mandato actual, así como para gestionar las futuras crisis migratorias y fronterizas que tenga que afrontar este continente? Para dar respuesta a esta pregunta, esta monografía se centra en el nacimiento, evolución y situación actual de la Agencia Europea de la Guardia de Fronteras y Costas, indudablemente marcada por el Reglamento (UE) 1896/2019, de reciente creación. Se analiza la crucial ampliación de sus capacidades, así como la férrea fiscalización a la que se ve sometida tras los repetidos reveses políticos y judiciales sufridos en los últimos años, principalmente en el ámbito de la protección de los derechos fundamentales. Este es un contexto plagado de riesgos, vulnerabilidades y oportunidades donde ve la luz el Cuerpo Permanente, el primer cuerpo uniformado europeo con competencias ejecutivas que, sin duda, representa un paso de gigante en el proceso de integración y convergencia de este continente.
Predicting the Spatial Distribution of Groundwater Using a Numerical Approach
Authors:   Crisis and Emergency Management: Theory and Praxis, Kim Beobkyun , Seo Youngmin , Lim Yuseong , Lee Byungjoon , Choi Yunyoung
Published: April 2024

This study applied the MODFLOW model using finite difference method and the NNRK model combining neural network and residual kriging for spatial groundwater level prediction in Jeju Island, South Korea. For the MODFLOW model, the differences between observed and predicted groundwater levels were 0.014-4.327 m and the relative errors were 0.50-50.82 %. For the NNRK model, the differences between observed and predicted groundwater levels were 0.022-6.185 m and the relative errors were 0.66-49.35 %. Based on MSRE, IDW model, which is a non-spatial statistical model, showed better spatial prediction results than SK and OK models, whereas RK and NNRK models outperformed the IDW model. The MODFLOW model showed relatively better results than the NNRK model in dense areas considering recharge and geological structure although the MODFLOW and NNRK models produced similar results. Furthermore, the MODFLOW model was found to effectively reflect groundwater flow by strata and temporal groundwater head fluctuations due to pumping compared to the NNRK model.
Simulation of Mobilization and Support of Disaster Management Resources Using System Dynamics: Focusing on Deicing Agents
Authors:   Crisis and Emergency Management: Theory and Praxis, Jang Ha Young , Kim Yon Soo , Jang Dae Won
Published: April 2024

In this study, a disaster management resource simulation model between local governments was suggested using the system dynamics methodology. At this time, the subject of analysis was selected as the stockpile of deicing agents for each district in Seoul. Based on statistical data, a scenario was set in which the expected amount of heavy snowfall reached level 3, and the response to heavy snowfall reached level 4 for 5 days in the 11 districts of Seoul. The simulation shows that in areas with heavy snow, the deicing agent stock falls below the minimum by the 4.5th day, and in areas without heavy snow, it happens by the 14.5th day. Additionally, it was estimated that the Seoul Disaster Resource Integrated Management Center required about 2,155 tons of deicing agents. This study is meaningful because it can be used to set the RTO(Recovery Time Objective) for the mobilization and support of deicing agents. Furthermore, it can be used to interconnect disaster management resources by suggesting an appropriate stockpile of deicing agents for the Seoul Disaster Resource Integrated Management Center.