bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Medicaid expansion and stage at diagnosis and treatment rates of non-small cell lung cancer.
Authors: Gaddipati Greeshma Nihitha , Mensah Boniface , Bilalaga Mariah Malak , Akhiwu Ted , Vasireddy Ramya , Atarere Joseph , Erasani Greeshma , Agrawal Simran , Kancharla Pragnan
Published: September 2024

87

Background:
Lung cancer is a leading cause of cancer mortality in the United States, with Non-small cell lung cancer (NSCLC) being the most common subtype. Under the Affordable Care Act, 39 states adopted Medicaid Expansion (ME) in 2014, while 12 did not. ME improved insurance coverage and lung cancer screening rates. This study examined the association between ME and NSCLC stage at diagnosis and treatment rates.
Methods:
We performed a retrospective observational study using Surveillance, Epidemiology, and End Results (SEER) database including patients aged 55-64 diagnosed with NSCLC from 2007 to 2021. Multivariate logistic regression analysis was performed to compare the odds of Early NSCLC diagnosis (Stages 1 and 2) and odds of treatment for early NSCLC between ME states and non-ME states before and after 2014.
Results:
During the study period, 191,785 patients were diagnosed with NSCLC, of which 42,338 were early NSCLC. The odds of early NSCLC diagnosis and treatment in early NSCLC were similar in ME and non-ME states before 2014. After 2014, the odds of early NSCLC diagnosis were significantly higher in ME states [AOR-1.53 (1.45-1.63)] compared to non-ME states [AOR-1.34 (1.25-1.44)]. However, there was no significant difference in odds of treatment for early NSCLC in ME states [1.36 (1.01 -1.81) and non-ME states 1.25 (0.93-1.68) after 2014.
Conclusions:
We conclude that ME is associated with increased odds of early-stage diagnosis of NSCLC. However, the odds of receipt of treatment were not affected. These findings highlight the benefits of ME as an effective strategy to improve access to care, but also underscore that other barriers to receiving treatment exist despite early diagnosis. Further studies are warranted to identify the barriers and potential limitations of policy change to improve outcomes.

Logistic analysis for odds of early-stage NSCLC diagnosis and odds of treatment in early NSCLC.

Early NSCLC Diagnosis
Odds Ratio
p-value
95% Confidence Interval

Non – ME States (Pre- Expansion)
1.00 (Reference)

Non – ME States (Post- Expansion)
1.34
0.00
1.25 - 1.44

ME States (Pre- Expansion)
1.04
0.16
0.98 - 1.11

ME States (Post- Expansion)
1.53
0.00
1.45 - 1.63

Treatment of Early NSCLC

Non - ME States (Pre- Expansion)
1.00 (Reference)

Non-ME States (Post- Expansion)
1.25
0.13
0.93-1.68

ME States (Pre- Expansion)
1.40
0.05
1.00 - 1.95

ME States (Post- Expansion)
1.36
0.04
1.01- 1.81

NSCLC- Non-Small Cell Lung Cancer, ME- Medicaid Expansion.
Race/ethnicity and human epidermal growth hormone receptor 2–targeted therapy for breast cancer.
Authors: Krishnamurthy Sudarshan , Jazowski Shelley A. , Roberson Mya L. , Reeder-Hayes Katherine Elizabeth , Dusetzina Stacie B. , Essien Utibe R.
Published: September 2024

91

Background:
Breast cancer is the most common cancer in the US. Up to 25% of breast cancers are classified as human epidermal growth factor receptor 2 (HER2)-positive and associated with an aggressive tumor burden. HER2-targeting monoclonal antibodies improves survival in patients with HER2-positive breast cancer. Prior work has demonstrated disparities in access to oncologic therapies among older women. Our study seeks to examine racial/ethnic disparities in receiving HER2-targeted therapies for patients with HER2-positive breast cancer and trends in use over time.
Methods:
In the Surveillance, Epidemiology and End Results (SEER) Medicare-linked database we identified women diagnosed with breast cancer from 2010 to 2019. We included those >66 years old who survived 12 months after diagnosis, were enrolled in Medicare Parts A/B for 12 months pre and post-diagnosis, and had local or regional stage HER2-positive cancer. Our primary outcome was receipt of HER2-targeted therapies in the 12 months after diagnosis. Our independent variable was race/ethnicity as measured by the validated Research Triangle Institute race/ethnicity codes in Medicare. Due to small sample sizes, we focus our analysis on White, Black, or Hispanic women. We used multivariable Modified Poisson regression to evaluate changes in the probability of HER2-targeted therapy receipt by race/ethnicity over time, adjusted for sociodemographics, cancer factors, and medical comorbidities.
Results:
Our cohort comprised 13,887 patients including 8.7% Black, 7.5% Hispanic, and 83.8% White (mean age 74.9). Overall, 7,351 (52.9%) received HER2-targeted therapies in the 12 months post-diagnosis, with use increasing over time in all racial/ethnic groups (Table). Compared with White patients, Black and Hispanic patients had a 19% (adjusted risk ratio [aRR] 0.81, 95% CI:0.69-0.96) and 27% (aRR 0.73, 95% CI 0.61-0.89) lower likelihood, respectively, of receiving HER2-targeted therapies from 2010-2011 (Table). By 2018-2019, no significant differences in receiving HER2-targeted therapies were observed across racial/ethnic groups.
Conclusions:
In a national cohort of Medicare enrollees with HER2-positive breast cancer, we observed significant racial/ethnic disparities which narrowed over time. Overall utilization rates were low. Future work is needed to understand how improved access to breast cancer treatments impact downstream outcomes.

Use of human epidermal growth hormone receptor 2–targeted therapy from 2010-2011 and 2018-2019 by race/ethnicity.

Race and Ethnicity
Unadjusted Rates
Adjusted Risk Ratios (95% CI)*

2010-2011
2018-2019
2010-2011
2018-2019

Black
36%
62%
0.81 (0.69-0.96)
0.97 (0.87-1.08)

Hispanic
31%
68%
0.73 (0.61-0.89)
1.01 (0.92-1.12)

White
42%
64%
Reference
Reference

*Adjusted for age, marital status, region, breast cancer stage and year of diagnosis, and medical comorbidities.
The Black (W)hole of Dysphoria
Authors: Chaudhry V Varun
Published: September 2024

This essay returns to Evelynn Hammonds’s field-changing essay “Black (W)holes and the Geometry of Black Female Sexuality,” with a focus on the labor of knowledge production under fraught institutional conditions, characterized in this essay as languaging. The simultaneous desire for and impossibility of accurate language to describe racialized, gendered, and sexual subjectivity drive Hammonds’s essay as well as a number of other key texts in Black feminist sexuality studies. This essay (re)introduces the diagnostic category of dysphoria to speak to this paradox: here, dysphoria describes the affective and psychic condition of institutional illegibility and fungibility for racialized and gendered people. Using the analytic of dysphoria to characterize and connect the political economy of Black feminist knowledge production and the life narrative of A. Dionne Stallworth, a Black trans woman activist, this essay directs urgent attention to the simultaneously material, spiritual, psychic, and affective dimensions of self-, knowledge-, and world-making.
Incidence and Risk Factors of Proximal Junctional Complications and Rod Fractures After Long-Segment Fusion Surgery With Anterior Column Realignment for Adult Spinal Deformity: A Minimum 2-Year Follow-Up
Authors: Kang Dong-Ho , Park Jin-Sung , Park Se-Jun , Lee Chong-Suh
Published: September 2024

BACKGROUND AND OBJECTIVES:

To investigate the incidence and risk factors of proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and rod fractures in patients undergoing long-segment (≥4 levels) fusion surgery with anterior column realignment (ACR) for adult spinal deformity.

METHODS:

Patients aged ≥60 years with at least a 2-year follow-up were grouped based on PJK, PJF, and rod fracture occurrence. Patient, surgical, and radiographic factors were compared to identify risk factors for these complications. Independent risk factors were identified using univariate and multivariate logistic regression.

RESULTS:

Among 106 patients, the incidence rates of PJK, PJF, and rod fractures were 15.1%, 28.3%, and 17.9%, respectively. PJK was significantly associated with fewer fusion levels (odds ratio [95% CI], 0.30 [0.13-0.69]), a cranially directed uppermost instrumented vertebra (UIV) screw angle (1.40 [1.13-1.72]), postoperative overcorrection of age-adjusted pelvic incidence-lumbar lordosis (LL) (7.22 [1.13-45.93]), and a large increase in thoracic kyphosis (1.09 [1.01-1.17]). PJF risks were associated with a cranial UIV screw orientation (1.23 [1.09-1.39]), overcorrection of age-adjusted pelvic incidence-LL (10.80 [2.55-45.73]), and a smaller change in sacral slope (0.87 [0.80-0.94]). For rod fractures, prominent factors included a greater number of fusion levels (1.70 [1.17-2.46]), a larger postoperative LL (1.07 [1.01-1.15]), a smaller postoperative thoracic kyphosis (0.92 [0.86-0.98]), and smaller changes in sacral slope (0.73 [0.58-0.92]) and pelvic tilt (0.72 [0.56-0.91]).

CONCLUSION:

The incidence and risk factors of PJK, PJF, and rod fractures were similar to those observed in previous studies on long-segment fusion surgery without ACR. The number of ACR levels was not a significant risk factor for PJK, PJF, or rod fractures. When performing deformity correction using ACR, surgeons should carefully consider the direction of the UIV screw and ensure that overcorrection is avoided.
The Elasticity of Aggregate Output with Respect to Capital and Labor
Authors: Vollrath Dietrich
Published: September 2024

It is often assumed that the elasticity of GDP with respect to capital is one-third, but this assumes zero markups and an aggregate production function. I estimate the elasticity allowing markups to vary by industry and with a rich input-output structure. Assumptions about capital costs provide bounds on elasticity. In the United States from 1948–1995, the capital elasticity ranged from 0.19–0.32 and shifted to 0. 24–0.37  by 1996–2018. Excluding housing or decapitalizing intellectual property lowers bounds to as low as 0. 11–0.26. Based on these elasticities, common estimates of total factor productivity growth represent a lower bound. (JEL E13, E22, E23, E25, N12)
A quem pertencem os clientes?
Authors: Fabiani Emerson Ribeiro , Tormin Mateus Matos
Published: September 2024

Contextualização: A relação cliente-advogado suscita debates de ética profissional, sendo relevante contemporaneamente a discussão a respeito de a quem os clientes pertencem: se aos profissionais ou às sociedades de advocacia.
Objetivo: Este artigo visa a analisar a aplicação da Resolução nº 16/98, que disciplinou a matéria no Estado de São Paulo e que, após muita controvérsia, foi recentemente revogada.
Método: Utiliza-se o método de análise de casos; mais especificamente, mapeiam-se, sistematizam-se e analisam-se os casos envolvendo a resolução que foram julgados no Tribunal de Ética e Disciplina da OAB/SP, a fim de lançar luz sobre questões, como: pode o advogado que se desliga de uma sociedade de advocacia atender clientes ou ex-clientes desta? A quem pertencem, afinal, os clientes? Como disciplinar a mobilidade profissional na advocacia?
Resultados: Por meio da sistematização de uma amostra de 36 casos, propôs-se revisitar a história de aplicação da resolução em três etapas: a primeira década, em que a resolução foi aplicada de modo inconteste; o período pós-2008, momento a partir do qual ela passou a ser questionada e flexibilizada; e, por fim, um momento em que o dissenso se mostrou suficientemente forte a ponto de indicar a necessidade de sua revisão.
Conclusões: Atualmente, prevalece a liberdade do cliente de escolher seu representante em casos de mobilidade profissional, ressalvadas as hipóteses em que o advogado retirante age com deslealdade. Do ponto de vista político-regulatório, sugere-se que é mais adequado que as próprias partes disponham a respeito contratualmente, em oposição à solução regulamentar via órgão de classe.
Computational modelling of visual fear conditioning
Authors: Παύλου Αθανάσιος
Published: September 2024

Η ανίχνευση ενός δυνητικά απειλητικού ερεθίσματος είναι μια κρίσιμη λειτουργία για την επιβίωση κάθε οργανισμού και συχνά συνδέεται με την έκφραση του φόβου. Ο φόβος είναι ένα καλά μελετημένο συναίσθημα, διότι εκτός από την έμφυτη αντίδραση μπορεί επίσης να μαθευτεί μέσω της διαδικασίας της εξάρτησης, μέσω της οποίας ένα κατά τα άλλα ουδέτερο ερέθισμα αποκτά συναισθηματικές ιδιότητες. Παρά την αυξανόμενη κατανόηση της επεξεργασίας των οπτικών ερεθισμάτων από αυτόν τον μηχανισμό, δεν έχουν παραχθεί ακόμη επαρκείς τεχνικές για την οπτική εξάρτηση φόβου. Επιπλέον, παρόλο που αυτό είναι ένα ιδιαίτερα εξελιγμένο και αποδοτικό σύστημα, δεν έχει ποτέ εξερευνηθεί ως εναλλακτική αρχιτεκτονική για σύνθετες εργασίες ανίχνευσης απειλών. Το σύστημα αυτό αποτελείται από μια φλοιική και μια υποφλοιική οδό που μεταδίδει ερεθίσματα στην αμυγδαλή, τη νευρική δομή που είναι υπεύθυνη για την αξιολόγηση των απειλών. Στη εργασία μας, παρέχουμε μια αφηρημένη αλλά βιολογικά εύλογη αναπαράσταση των συμμετεχόντων νευρικών δομών σε αυτή τη διαδικασία, η οποία αξιολογείται έναντι αφηρημένων και πραγματικών δισδιάστατων οπτικών εισροών.Το μοντέλο μας παρείχε υπολογιστικά στοιχεία για την επίδραση της υποφλοιικής οδού στην αμυγδαλή υπό προσομοιώσεις πειραμάτων οπτικής μάσκας. Επιπλέον, η χρήση του για την ταξινόμηση συναισθηματικών εκφράσεων προσώπου επιβεβαίωσε την ικανότητά του να διαχειρίζεται σύνθετες εισροές, επιτυγχάνοντας ακρίβεια ταξινόμησης 77% για τα έξι βασικά συναισθήματα. Για να ενισχύσουμε περαιτέρω τη βιολογική ευλογοφάνεια του μοντέλου μας, δείξαμε ότι οι μηχανισμοί του είναι επαρκείς για την ανάπτυξη συναπτικών σχηματισμών που προσεγγίζουν κεντρικά-περιφερειακά και επιλεκτικά ως προς τον προσανατολισμό οπτικά πεδία υποδοχής. Τέλος, δείξαμε ότι η αρχιτεκτονική μας μπορεί να επεκταθεί σε βιολογικές προσομοιώσεις νευρικών δομών όπως ο άνω διδύμιο (ΑΔ). Αναπαράξαμε συμπεριφορές που παρατηρούνται στο ΑΔ, όπως η ευθυγράμμιση συντεταγμένων, η πολυαισθητηριακή ενσωμάτωση αφηρημένων ακουστικών και οπτικών ερεθισμάτων και η επίδραση της φλοιικής ανάδρασης στις πολυαισθητηριακές αποκρίσεις.
Digital twin and its applications in the construction industry: A state-of-art systematic review
Authors: Su Shuaiming , Zhong Ray Y. , Jiang Yishuo
Published: September 2024

The construction industry has a great impact on social and economic development because of its wide coverage and a large number of stakeholders involved. It is precisely owing to its large volume that technological innovation of the construction industry is relatively slow. The birth and rapid development of digital twins brings more hope to the construction industry. This paper summarizes the current development of digital twin and its applications in construction industry. First, the concepts and applications of digital twin are analyzed. Then, the research on digital twins in the construction industry in the past five years is reviewed. The main research directions and key technologies are pointed out in the end. This paper could guide related practitioners to clearly grasp the research application status of digital twin in the construction industry. It could also help to find suitable research directions.
Code and Data Repository for Fraud Detection by Integrating Multisource Heterogeneous Presence-Only Data
Authors: Qiu Yongqin , Chen Yuanxing , Fang Kan , Yu Lean , Fang Kuangnan
Published: September 2024

This repository provides data for the problem and code for the method. The main folders are data and code.
Exploring influential factors in selecting halal pharmaceuticals among students (study case IAI Tazkia & University Ibnu Khaldun in Bogor)
Authors: Suriedi Muhammad Ridho Al Fathan , Priantina Anita
Published: September 2024

Users of halal-certified medicines involve individuals, groups, and organizations; individual actors cannot be separated from students. Several factors influence students who use halal-certified medicines, including attitudes, subjective norms, and purchase intentions. These factors are motivated by the desires and needs of students. This study investigates the impact of knowledge, attitudes, and subjective norms on the purchase intention of halal-certified medicines. The research explores the factors influencing the intention to purchase halal-certified over-the-counter medicines among students at IAI Tazkia and Ibn Khaldun University in Bogor. Data collection primarily comprises primary data. The primary data utilized in this study were gathered by distributing questionnaires to 215 student respondents. This research uses a qualitative methodology and is analyzed using Structural Equation Modeling (SEM) with the help of SmartPLS 3 software with 215 respondents. The results showed that the attitude variables and subjective norms were significantly affected. On the other hand, the knowledge variable was found to have a low influence on the purchase intention of halal medicines among Muslim students, indicating that other factors may play a more significant role in their purchase decisions.
 
Keywords: Attitude, Halal medicine, Purchase intention, Subjective norms
Appraisal of Characterization and Adsorption Isotherm in the Bioremediation of Cu and Zn Ions from Aqueous Solutions Exploiting Unmodified Corn and Coconut Husk
Authors: Praveen B. M. , Guruprashanth N
Published: September 2024

Environment is contaminated by heavymetals has emerged as a substantial globaly. Conventional remediation methods have proven inadequate and costly in addressing this issue. Hence, there is a pressing need to discover bio-remediation as a cost effective, effectual, and environmentally, a substitute for heavymetal removal. This work investigates the adsorption behaviour of Corn Husk (CH) and Coconut Husk (CCH), an inexpensive adsorbent, towards Cu and Zn ions for potential application in wastewater treatment. The physico-chemical variables of unmodified CH and CCH were appraised, and batch experimental methods were employed to study variables like pH, contact time, size of particle, and preliminary content of metals. The impact of solution pH on metals uptake by the adsorbent was investigated on the pH range of 3 to 8, revealing optimal removal efficiencies at pH 6 for Cu and pH 5 for Zn. Equilibrium adsorption times were determined to be 80 minutes for Cu and 60 minutes for Zn ions onto CH and CCH. adsorption volumes is conforming to mono-layer coverage, attained from the Langmuir plots were 4.792 mg/g and 4.594 mg/g respectively for Cu and Zn metals onto the CH and 4.771 mg/g and 4.400 mg/g for their adsorption onto CCH. Experimental values were confirmed to the Langmuir model and Freundlich model, with the Langmuir model providing the best fit. The CH based adsorbent was generally found to have an increased capacity of adsorption of the metal contents than Coconut husk (CCH). These findings underscore the strength of Corn husk as an active adsorbent to extract cationic heavymetal contents from industrial effluents.
Assessing Urbanization Dynamics Through Land Use/Land Cover Change Detection in Zunheboto Sadar, Nagaland, India
Authors: Kiho Khekuto , K.G Asha Manjari , Haokip Paolenmang
Published: September 2024

Providing a systematic overview of the environment is crucial for identifying environmental changes and understanding human-related factors and feedback in research on land use and land cover (LULC) changes and the incorporation of LULC data facilitates pinpointing particular areas undergoing changes, discerning the character of these changes, and gaining insights into the evolving nature of the land. Utilizing Remote Sensing & Geographic Information System (GIS) and methodologies, this study aims to examine variation LULC patterns between 2014 and 2023 in Zunheboto Sadar, the highest populated region in the Zunheboto district of Nagaland with area covering about 123 Km2 and altitude encompassing from 642 m to 1989 m above mean sea level. Landsat-8 OLI data was employed to produce a map depicting LULC in the study region. The application of Supervised classification method, specifically the Maximum Likelihood Classifier (MLC), were utilised in producing LULC maps. Through this comprehensive analysis, the research aims to identify specific areas undergoing alterations, discern the nature and extent of these changes, and explore the underlying causes and human responses. Eight classes were delineated namely Jhum cultivation, Moderately Dense Forest, Open Forest, Settlements, Shrub, Terrace Cultivation, Very Dense Forest, and Water Bodies. In the year 2023, Jhum cultivation has decreased by 68.36%, Very Dense Forest by 16.96%, Water Bodies by 6.53%, Shrub by 52.36%, and Terrace Cultivation by 32.83%. Conversely, there is an increase in Moderately Dense Forest by 21.39%, Open Forest by 111.25%, and Settlements by 38.41%. The Kappa accuracy assessment technique was chosen for evaluating the accuracy of the categorized map. The categorized map of 2023 exhibits an Overall Classification Accuracy of 86.50%, coupled with a Kappa Coefficient of 0.84, indicating an almost perfect classification. Similarly, for 2014, the Overall Classification Accuracy stands at 78.50%, with a Kappa Coefficient of 0.75, also falling into the Substantial classification category.
Environment Planning Approach for Mining Wastelands: A Review of Case Studies
Authors: Vikram Lavanya
Published: September 2024

The case of mining land use typology post-independence planning has to be done with the consideration of ecological or landscape factors which could be the foundation for their approved post-mining closure plans. This paper reviews two such case studies on the mining activity carried out for more than 25 years. Kudremukh Iron Ore Corporation Limited (KIOCL) and Neyveli Lignite Corporation Ltd. (NLC) are the two companies in South India, led by the Central Government for the identified mineral extraction. KIOCL had to come to a complete halt in the year 2005 whereas NLC is an ongoing mining site. This review paper studies the environment planning approaches at global, national, and state levels in both cases. The paper tries to identify the gap in the planning approach considering landscape factors that can be imperative for achieving sustainable development goals from the critical review of case studies in India.
Gestão e planejamento contingencial para tomada de decisão em uma organização hospitalar na Covid-19
Authors: Stigger Klaus Nobre , Longaray André Andrade , Barlem Edison Luiz Devos , Silveira Rosemary Silva da , Dalmolin Graziele de Lima , Muñoz Paulo Roberto da Silva , Stigger Danubia Andressa da Silva
Published: September 2024

Objetivo: descrever o processo de tomada de decisão da gestão estratégica de uma organização de saúde ao implantar um serviço de atendimento para Covid-19. Método: estudo de abordagem qualitativa, aprovado pelo comitê de ética e pesquisa, desenvolvido em um hospital brasileiro que, na pandemia, foi referência para pacientes com Covid-19. Realizou-se entrevista com 27 gestores que atuaram nesse contexto. Utilizou-se a análise Textual Discursiva, com uso do software Iramuteq. Resultados: foram descritas seis classes semânticas que elucidaram a dinâmica de trabalho dos gestores e os desafios enfrentados, relacionados à estrutura da performance gerencial, ao processo de tomada de decisão multiprofissional, aos aspectos psicológicos, laborais, humanos, psicossociais, técnicos, de logística de suprimentos e de dinâmica da estrutura organizacional. Conclusão: a árdua jornada laboral instigou as forças de trabalho a cooperar e fortalecer as relações interpessoais formando uma frente de combate engajada e coesa, através do processo de tomada de decisão.
Women's experiences of vaginal examinations in labour: a literature review
Authors: Searle Harriet , White Helen
Published: September 2024

Background/Aims

Evidence for vaginal examinations to assess labour progress is inconclusive and indicates some negative psychological impacts for women. Understanding women's perceptions of vaginal examinations is essential to guide future clinical practice. This literature review aimed to explore women's experiences of vaginal examinations in labour.

Methods

A comprehensive review of four databases was carried out, searching for publications made between 2012 and 2023. Findings were synthesised using thematic analysis.

Results

Eight relevant papers were included. Four themes emerged: frequency of vaginal examinations, true, informed consent, emotional reactions and rapport building and humanisation.

Conclusions

Negative experiences were associated with overuse and lack of properly informed consent. Positive experiences linked to continuity in carer. Further research into alternative ways of assessing labour progression to minimise non-clinically indicated vaginal examinations may improve women's labour experience.

Implications for practice

There is a need for further education for healthcare professionals on ongoing informed consent, appropriate communication, the necessary frequency of vaginal examinations and avoiding desensitisation. Additional training should be well-established in hospitals to minimise exams when not clinically indicated.
The respiratory system and associated disorders
Authors: Anderson Alison , McEwan Tom , Leader Claire , Peate Ian
Published: September 2024

This series of three articles will explore the fundamentals related to anatomy, physiology and pathophysiology in relation to three important topics: the cardiac system, the respiratory system and the endocrine system. This series is intended to provide an informative and evidence-based summary of each topic for both students and clinicians. This second article explores the maternal respiratory system, outlining the key physiological adaptations in pregnancy and summarises the key pathophysiological conditions that may occur.
The Systemic Inflammatory Response Index as a Novel Diagnostic Indicator for Bell’s Palsy
Authors: Liu Jianhui , Li Guangyu , Wu Rui , Qin Xuan , Pan Shuixiang , Liang Ping , Sun Jingbo
Published: September 2024

Aims/Background The systemic inflammatory response index (SIRI), an emerging hematological marker of inflammation, has shown promise as a promising biomarker for a variety of inflammatory conditions. This study aims to explore the diagnostic role of SIRI in Bell’s palsy (BP).

Methods For this retrospective study, 73 people diagnosed with BP between January 2021 and December 2023 were recruited, along with 73 healthy controls who were age- and sex-matched. The SIRI and other blood inflammatory markers, including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were determined for all participants, by enumerating their peripheral blood cell counts. Facial nerve function was assessed upon admission and after one month of treatment using the House-Brackmann Facial Nerve Grading System (H-B). According to this system, patients with an H-B grade of 1–2 are considered recovered, while those with an H-B grade of 3–6 are regarded as not recovered.

Results The SIRI (0.94 vs 0.48, p < 0.001), SII (480.3 vs 329.12, p < 0.001), NLR (2.42 vs 1.41, p < 0.001), and PLR (141.05 vs 117.28, p = 0.001) showed a significant increase in the BP group compared to the control group. The receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) for SIRI was higher than those for SII, NLR, and PLR, respectively. Upon one-month follow-up, significant differences in the values of SIRI, SII, and NLR were observed between the favorable prognosis group and the poor prognosis group (SIRI: 1.07 vs 0.87, p = 0.011; SII: 647.85 vs 422.11, p = 0.005; NLR: 3.31 vs 2.11, p = 0.013). The AUC of ROC curve for SIRI was found to be lower than that of SII but higher than that of NLR.

Conclusion The SIRI has the potential to be an important BP diagnostic and prognostic marker.
Fragility fractures in older people: how to reduce the risk and increase strength and resilience
Authors: Palmer Sarah Jane
Published: September 2024

Sarah Jane Palmer discusses the risks of fragility fractures to which older people are susceptible, and how to decrease the possibility of sustaining them.
Tax-free benefits for staff: what nursing and residential care home managers can provide
Authors: Thornley Helen , Bernstein Adam
Published: September 2024

In this article, Helen Thornley and Adam Bernstein discuss how managers of nursing or residential care homes can provide tax-free benefits for their staff.
Analyzing the Educational Needs of Dental Hygiene Students Using the Borich Needs Assessment and Locus for Focus Models
Authors: Yeo An-Na , Lee Jin-Hee , Oh Eun-Sol , Lee Da-Geon , Han Se-Jung
Published: September 2024

Objective: This study aimed to develop a standard for a practice-based curriculum that reflects the needs of dental hygiene students’ clinical practice education and to provide basic data that can contribute to improving dental hygienists’ competence in clinical practice. Methods: A survey of 132 dental hygiene students from selected universities was conducted. The Borich Needs Assessment model and The Locus for Focus models were used to evaluate the students’ educational needs for clinical practice content. Results: The highest level of present educational needs was for ‘fluoride application,’ while the greatest requirement was for ‘preparing surgical dental treatment’. Using The Locus for Focus model, 33 items in the first quadrant were identified as common to the Borich Needs Assessment priorities. These items include ‘dental insurance claims’, ‘patient reception’, ‘dental materials counseling’, ‘making a temporary crown’, ‘setting a temporary crown’, ‘document management’ and ‘prepare of dental emergencies’. Conclusions: The analysis of the clinical practice needs of dental hygiene students identified the needs for practice-oriented education. These findings suggest that future curriculum revisions should reflect not only the needs of students, but also the perspectives of educators and clinical dental hygienists.
Principal and Secondary Diagnoses Related to Eye Injury: Characteristics from a tertiary center in Northern Thailand
Authors:   Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand, Anujaree Pongpawat , Choovuthayakorn Janejit ,   Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand, Chokesuwattanaskul Susama ,   Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand, Paspisanu Chantawan ,   Nursing Division, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Thailand
Published: September 2024

OBJECTIVE This study aimed to explore the epidemiological characteris-tics of primary and secondary diagnoses of eye injuries requiring hospitali-zation in a tertiary referral center. METHODS The medical records of 726 patients with diagnoses of eye injury who were admitted between January 2016 and December 2019 were reviewed. RESULTS Four hundred and thirty-six of the patients (60.1%) were hospitalized with a principal diagnosis related to eye injury, while 290 patients (39.9%) were admitted with secondary diagnoses. Over the four-year period of study, the proportion of admissions with a principal diagnosis stayed consistently in the range of 54.0% to 63.9%. Most of the patients in the principal diagnosis group were age between 41 and 60 years. Patients in the secondary diagnosis group, however, were mostly between the age of 21 and 40 years. The majority of patients in the principal diagnosis group (267 patients, 61.2%) had eye injuries which had occurred at work, whereas in the secondary diagnosis group most (230 patients, 79.3%) had eye injuries resulting from traffic accidents. CONCLUSIONS Work-related accidents and traffic accidents were the two main types of at-risk behaviors in both the primary and secondary diagnosis categories. Initiatives for public health education related to eye injuries should pay more special attention to these two primary causes of severe eye injuries. KEYWORDS principal diagnosis, secondary diagnosis, eye injury, hos- pitalization
Improving safe pedestrian behavior through virtual reality: an empirical study
Authors: López-Álvarez Alicia , Piovano Luca , Luque Francisco , De Aldama Carlos
Published: September 2024

INTRODUCTION. Over the last few years, the number of pedestrian fatalities on urban roads has increased, largely due to infractions associated with their behaviors (e.g., crossing when traffic lights are red). It is argued that these behaviors reflect a lack of risk perception. Road safety programs have tried to raise awareness through various methods, using quite often emotionally powerful experiences (e.g. testimonies of people who have experienced an accident themselves). Recently, Virtual Reality (VR) has been deployed with the aim of increasing the efficacy of these safety programs. Previous studies have demonstrated the potential of VR to improve pedestrian safety, especially when it is accompanied bydebriefing and critical reflection. METHOD. A total of 43 participants (M = 24.5 years old; SD = 5.14; 65.12% female) were involved in an experimental study with a 2x2 factorial design and pre-post measures. They were randomly assigned to one of four groups (Experience a VR accident /Experience VR without an accident; having a debriefing after the VR experience/not having a debriefing after the VR experience). Pre-post measures were of two kinds, (a) self-report measures and (b)VR behavioral measures. Multivariate Analysis of Variance (MANOVA) and general linear mixed models (GLMM) were used to analyze the data. RESULTS AND DISCUSSION. The main results revealed that (a) participants reported a general reduction in the number of rules violations, regardless of condition, and (b) there was a significant reduction in the number of violations committed in VR (i.e., crossing when the traffic light is red) in the condition where participants had previously experienced an accident. These results support the potential of using VR environments to improve pedestrian safety-related behavior. Implications for future research are delineated.
El desarrollo de competencias emprendedoras desde la acción profesional orientadora en la universidad
Authors: Romero-García Carolina , Suárez-Ortega Magdalena
Published: September 2024

INTRODUCCIÓN. En este artículo se analiza la situación del emprendimiento en la universidad, conociendo y comprendiendo las acciones orientadoras que se ponen en marcha para estimular el espíritu emprendedor, así como el desarrollo de proyectos emprendedores en el alumnado universitario. MÉTODO. Se aplica una metodología cualitativa, con un enfoque fenomenológico, mediante la realización de 17 entrevistas semiestructuradas a profesionales técnicos expertos en orientación profesional y emprendimiento, entre los que se encuentran 2 profesores de másteres que trabajan la creación de ideas emprendedoras; todos ellos pertenecientes a 12 universidades públicas y españolas donde se imparte el Grado en Pedagogía. Los datos obtenidos han sido analizados a partir de un sistema de categorías (deductivo e inductivo) y con el apoyo del software informático Nvivo, en su versión 12. RESULTADOS. Los hallazgos encontrados permiten obtener una visión a nivel global de la situación emprendedora en la universidad, identificando los métodos orientadores que los/as profesionales emplean en las sesiones de orientación y guía, y poniendo de manifiesto las posibles necesidades y mejoras del alumnado universitario en materia de emprendimiento desde la perspectiva de estos profesionales. DISCUSIÓN. Los resultados obtenidos permiten establecer conclusiones y propuestas de mejora que ayudan a promover el desarrollo de proyectos emprendedores nacientes en la universidad. En consonancia, este estudio plantea acciones e implicaciones importantes a nivel de política y gestión universitaria, mejorando la formación y orientación de proyectos profesionales emprendedores que incrementen el impacto estudiantil en el mercado laboral, y que den respuesta a las necesidades que se detectan en los estudiantes universitarios.
La inquietud ante la observación en el aula en el docente de lenguas extranjeras
Authors: Martínez Vargas Ana Elena , Redondo Duarte Sara
Published: September 2024

INTRODUCCIÓN. La inquietud y preocupación que la observación en el aula despierta entre el profesorado es un tema recurrente y bien conocido en la literatura. La observación durante el ejercicio de su desempeño despierta miedos y recelos entre los docentes, incluso entre aquellos con más años de experiencia. El presente trabajo indaga en los sentimientos que despierta en el docente la observación en el aula. MÉTODO. Se llevó a cabo un estudio de caso único con entrevistas en profundidad a catorce docentes del Departamento de Idiomas de la Universidad. El objetivo de las entrevistas era comprender y estudiar en profundidad el impacto de las observaciones en el docente y en su práctica en el aula, así como valorar el impacto del feedback en su desarrollo profesional. Se llevó a cabo un análisis cualitativo mediante el software Atlas.ti 6.2. Se realizó una primera fase de codificación inicial o codificación “abierta” para identificar los temas o dimensiones más relevantes, seguida de una segunda fase de análisis de los datos de manera deductiva, donde se recurrió a la teoría y a la literatura sobre observación docente. RESULTADOS. Se confirman los sentimientos de temor y rechazo del profesorado al hecho de ser observados, así como una inquietud por la falta de estándares y criterios de observación claros. No obstante, los docentes sienten una paulatina reducción de esta inquietud ante la continua exposición a las observaciones. DISCUSIÓN. En línea con los resultados de investigaciones anteriores, los profesores entrevistados reconocen que han alterado su conducta normal al sentirse observados. Asimismo, al igual que en otros estudios, se advierte un cambio de conducta positivo en el estudiante al sentirse observado, tendiendo esta a naturalizarse a medida que transcurre la observación.
Involving children and young people in supportive cancer care research: the value of FDS grant funding and charitable partnerships
Authors: Heggie Claudia , Kisby Natalie , Day Peter , Phillips Bob
Published: September 2024

INTRODUCTION

Involvement of children and young people in research has a multitude of benefits for children, researchers and the quality of the research itself. Despite the benefits of involvement, this is not always completed or reported in practice.

METHODS

This paper looks at the involvement of children and young people during a research study exploring the acceptability of photobiomodulation for mucositis management. It considers the importance of costing involvement into grant funding, and the value of charitable partnerships in conducting research with patient and public involvement.

RESULTS

Children and young people with experience of cancer, and their parents, were involved at the stages of grant application, research design, data analysis and dissemination. Involvement of families resulted in changes to inclusion criteria, plain language summaries and participant information documents. They provided insight into data analysis, and designed and filmed co-created video outputs to support acceptability of the treatment, dissemination of the research and research involvement of other children. Involvement was supported both practically and financially by charitable partnership with the Candlelighters children’s cancer charity as well as research grant funding from the Royal College of Surgeons of England’s Faculty of Dental Surgery.

CONCLUSIONS

Child and parent contributors shaped the research project, resulting in changes to the study design, data analysis and co-creation of video resources. Charitable partnership and flexibility of involvement supported diversity in the context of paediatric cancer research. Researchers should consider what they can contribute in return to child contributors and charities who provide support.
The impact of technology on Brazilian social work: potentials and challenges in ethical and socio-educational intervention
Authors: Santos Eduardo Henrique Moraes , Mendes Raquel de Oliveira , Oliveira Alan Farley Prates , Lopes Flávia Augusta Santos de Melo
Published: September 2024

The integration of technology into Brazilian social work has presented both potentials and challenges. Social workers, historically engaged in socio-educational interventions from various perspectives, have experienced changes in their working conditions and tools due to technological innovations, especially following the COVID-19 pandemic. The analysis presented reveals that while technology provides greater access to information and connections, it can also be used to amplify neoliberal influences, prioritising low-cost intervention methods at the expense of service quality and distancing professionals from the population they serve. Social work must adopt a critical and proactive approach, guided by its ethical-political project, to identify the challenges and possibilities of this process. Ignoring technological advances can lead to a detachment from social reality or submission to institutional and neoliberal demands. Methodologically, a systematic literature review and qualitative analysis of secondary data were employed, guided by contemporary critical perspectives within social work.
Delays to accessing healthcare for older adults with disabilities in Bengaluru, India: views of healthcare providers and older adults
Authors: Patil Divya Sussana , Bailey Ajay , George Sobin , Ashok Lena
Published: September 2024

Introduction:

A person’s ability to live independently may be limited by physical and cognitive declines associated with ageing, including disabilities that affect mobility and self-care. This study examines the delays to accessing healthcare facilities among older adults who are frail or have disabilities, using the three-delays model.

Methods:

A qualitative study was conducted during March and April 2022 among 21 older adults (aged 60 or above) who were frail or disabled (using assistive devices) in Bengaluru and nine key informants, consisting of geriatricians, physiotherapists, psychologists and NGO workers. Data were analysed using NVivo 12.

Results:

Delays in accessing healthcare for older adults were attributed to multidimensional factors related to the individual (disability; lack of trust in healthcare workers; low/no income), the community and household (neglect/lack of awareness by the family; limited, inaccessible and unaffordable transport modes) and the health system (poor staffing; under-supplied healthcare facilities; waiting times at the hospital). Delays led to complications, hospitalisations and financial burdens for the older adults. The key informant interviews supported these findings.

Conclusion:

This research highlights that it is important to overcome delays in accessing healthcare for older adults to ensure better health and wellbeing among this group. A holistic approach is needed to reach out to individuals, communities and households, and the healthcare system. Providing adequate transport services to hospitals should be planned in conjunction with the health department for timely delivery of care. Providing health insurance for older adults and improving geriatric care would be highly beneficial to improving health outcomes.
Modeling and application of a bidirectional Mach–Zehnder electro-optic modulator with enhanced high-frequency modulation efficiency
Authors: Ma Xuepei , Ou Yiwen , Qian Li , Guo Huiyong , Cheng Chunfu , Zhou Ciming , Lv Hui
Published: September 2024

We present a simple way to enhance bidirectional broadband modulation in a traveling wave Mach–Zehnder electro-optic modulator (EOM) by removing matched impedance and effecting a reflection of the microwave signal. A model was devised for determining the modulation efficiency (ME) in the presence of microwave reflection, without access to the physical parameters of the EOM. By using the model, the simulated MEs matched well with the measured ones, which verified the correctness of the model and demonstrated that the internal parameters of the modulator could be inferred from the model. Compared with the traditional unidirectional EOM, the measured ME of the bidirectional modulator for the optical signal that counter-propagates with the incident microwave signal was improved by 10 times at least. When the velocities of microwave and optical signals were matched, the MEs at the frequency higher than 3.3 GHz were further improved. Our model was also used to derive the optical interference signal utilizing bidirectional modulation. It was found that the signal intensity was enhanced significantly, and further improved after introducing the velocity match. This work can be expected to open up many microwave photonics applications where bidirectional optical modulation is utilized in novel sensing and metrology.
AI-based 3D analysis of retinal vasculature associated with retinal diseases using OCT angiography
Authors: Liu Yu , Tang Zhenfei , Li Chao , Zhang Zhengwei , Zhang Yaqin , Wang Xiaogang , Wang Zhao
Published: September 2024

Retinal vasculature is the only vascular system in the human body that can be observed in a non-invasive manner, with a phenotype associated with a wide range of ocular, cerebral, and cardiovascular diseases. OCT and OCT angiography (OCTA) provide powerful imaging methods to visualize the three-dimensional morphological and functional information of the retina. In this study, based on OCT and OCTA multimodal inputs, a multitask convolutional neural network model was built to realize 3D segmentation of retinal blood vessels and disease classification for different retinal diseases, overcoming the limitations of existing methods that can only perform 2D analysis of OCTA. Two hundred thirty sets of OCT and OCTA data from 109 patients, including 138,000 cross-sectional images in normal and diseased eyes (age-related macular degeneration, retinal vein occlusion, and central serous chorioretinopathy), were collected from four commercial OCT systems for model training, validation, and testing. Experimental results verified that the proposed method was able to achieve a DICE coefficient of 0.956 for 3D segmentation of blood vessels and an accuracy of 91.49% for disease classification, and further enabled us to evaluate the 3D reconstruction of retinal vessels, explore the interlayer connections of superficial and deep vasculatures, and reveal the 3D quantitative vessel characteristics in different retinal diseases.
Optical circuit switched three-stage twisted-folded Clos-network design model guaranteeing admissible blocking probability
Authors: Taniguchi Ryotaro , Inoue Takeru , Anazawa Kazuya , Oki Eiji
Published: September 2024

Some data center networks have already started to use optical circuit switching (OCS) with potential performance benefits, including high capacity, low latency, and energy efficiency. This paper addresses a switching network design to maximize the network radix, i.e., the number of terminals connected to the network under the condition that a specified number of identical switches with the size N×N and the maximum admissible blocking probability are given. Previous work presented a two-stage twisted and folded Clos network (TF-Clos) with a blocking probability guarantee for OCS, which has a larger network radix than TF-Clos with a strict-sense non-blocking condition. Expanding the number of stages allows for enhancing the network radix. This paper proposes a model designing an OCS three-stage TF-Clos structure with a blocking probability guarantee to increase the network radix compared to the two-stage TF-Clos. We formulate the problem of obtaining the network configuration that maximizes the network radix as an optimization problem. We conduct an algorithm based on an exhaustive search to obtain a feasible solution satisfying the constraints of the optimization problem. This algorithm identifies the structure with the largest network radix in non-increasing order to avoid unnecessary searches. Numerical results show that the proposed model achieves a larger network radix than the two-stage model.