bluuebunny/crossref_metadata_2025 huggingface dataset:
Rivaroxaban for 18 Months Versus 6 Months in Patients With Cancer and Acute Low-Risk Pulmonary Embolism: An Open-Label, Multicenter, Randomized Clinical Trial (ONCO PE Trial)
Authors: Yamashita Yugo , Morimoto Takeshi , Muraoka Nao , Shioyama Wataru , Chatani Ryuki , Shibata Tatsuhiro , Nishimoto Yuji , Ogihara Yoshito , Doi Kosuke , Oi Maki , Shiga Taro , Sueta Daisuke , Kim Kitae , Tanabe Yasuhiro , Koitabashi Norimichi , Takada Takuma , Ikeda Satoshi , Nakagawa Hitoshi , Tsukahara Kengo , Shoji Masaaki , Sakamoto Jiro , Hisatake Shinji , Ogino Yutaka , Fujita Masashi , Nakanishi Naohiko , Dohke Tomohiro , Hiramori Seiichi , Nawada Ryuzo , Kaneda Kazuhisa , Ono Koh , Kimura Takeshi
Published: November 2024

Background: The optimal duration of anticoagulation therapy for patients with cancer and acute low-risk pulmonary embolism (PE) is clinically relevant, but evidence is lacking. Prolonged anticoagulation therapy could have a potential benefit for prevention of thrombotic events; however, it could also increase the risk of bleeding.

Methods: In a multicenter, open-label, adjudicator-blinded, randomized clinical trial at 32 institutions in Japan, we randomly assigned patients with cancer and acute low-risk PE of the simplified version of the Pulmonary Embolism Severity Index score of 1, in a 1:1 ratio, to receive either an 18-month or a 6-month rivaroxaban treatment. The primary end point was recurrent venous thromboembolism (VTE) at 18 months. The major secondary end point was major bleeding at 18 months according to the criteria of the International Society on Thrombosis and Hemostasis. The primary hypothesis was that an 18-month treatment was superior to a 6-month treatment in terms of the primary end point.

Results: From February 2021 to March 2023, 179 patients were randomized, and after the exclusion of one patient who withdrew consent, 178 were included in the intention-to-treat population: 89 patients in the 18-month rivaroxaban group and 89 in the 6-month rivaroxaban group. The mean age was 65.7 years; 47% of the patients were men, and 12% had symptoms of PE at baseline. The primary end point of recurrent VTE occurred in 5 of the 89 patients (5.6%) in the 18-month rivaroxaban group and in 17 of the 89 (19.1%) in the 6-month rivaroxaban group (odds ratio, 0.25 [95% CI, 0.09–0.72];
P
=0.01). Among 22 recurrent VTE, 5 patients presented with a symptomatic recurrent VTE; recurrent PE occurred in 11 patients, including 2 with main and 4 with lobar PEs; and recurrent deep vein thrombosis was seen in 11 patients, including 3 with proximal deep vein thromboses. The major secondary end point of major bleeding occurred in 7 of the 89 patients
(7.8 %) in the 18-month rivaroxaban group and in 5 of the 89 patients (5.6%) in the 6-month rivaroxaban group (odds ratio, 1.43 [95% CI, 0.44–4.70];
P
=0.55).

Conclusions: In patients with cancer and acute low-risk PE of the simplified version of the Pulmonary Embolism Severity Index score of 1, the 18-month rivaroxaban treatment was superior to the 6-month rivaroxaban treatment with respect to recurrent VTE events.
Selective Inference for Change Point Detection by Recurrent Neural Network
Authors: Shiraishi Tomohiro , Miwa Daiki , Le Duy Vo Nguyen , Takeuchi Ichiro
Published: November 2024

In this study, we investigate the quantification of the statistical reliability of detected change points (CPs) in time series using a recurrent neural network (RNN). Thanks to its flexibility, RNN holds the potential to effectively identify CPs in time series characterized by complex dynamics. However, there is an increased risk of erroneously detecting random noise fluctuations as CPs. The primary goal of this study is to rigorously control the risk of false detections by providing theoretically valid p-values to the CPs detected by RNN. To achieve this, we introduce a novel method based on the framework of selective inference (SI). SI enables valid inferences by conditioning on the event of hypothesis selection, thus mitigating bias from generating and testing hypotheses on the same data. In this study, we apply an SI framework to RNN-based CP detection, where characterizing the complex process of RNN selecting CPs is our main technical challenge. We demonstrate the validity and effectiveness of the proposed method through artificial and real data experiments.
A taxonomic monograph of the Eurasian holoparasitic plant genus Lathraea L. (Orobanchaceae)
Authors: HATT SEBASTIAN A. , TSIFTSIS SPYROS , THOROGOOD CHRIS J.
Published: November 2024

A taxonomic monograph is presented for Lathraea L. (Orobanchaceae), a genus of holoparasitic plants distributed across Europe and Asia. Plants in this genus are characterised by their underground stems, achlorophyllous scales with internal gland-lined cavities, and, in some species, explosive seed dehiscence. Despite their conspicuousness, no taxonomic treatment of the genus has been written since 1930. Our work draws upon extensive international field data and a comprehensive survey of herbarium specimens. Detailed descriptions are provided for each species, along with full synonymy, distribution maps, and notes on habitat, host specificity, phenology, ecology, ethnobotany and threat risk. We present evidence to consolidate Lathraea into five species, resolving taxonomic confusion. The infrageneric classification is reviewed and a key to species is provided. Species are illustrated with photographs of living and dried material.
Molecular phylogeny, morphology and distribution of Amphitetras antediluviana Ehrenberg from the Black Sea and the Sea of Azov
Authors: NEVROVA ELENA , MALTSEV YEVHEN , KEZLYA ELENA , MIRONOV ANDREI , KULIKOVSKIY MAXIM
Published: November 2024

The intriguing large-celled species of Amphitetras antediluviana Ehrenberg was originally described as a fossil species (Ehrenberg, 1840), but later noted in a living state in various regions of the World ocean. Our recent studies revealed that the species has been found for the last decade in significant numbers in many habitats along the coast of the Azov-Black Sea basin. Two strains—the large valves from Laspi Bay, the Black Sea (BL-5_12092019) and the small valves from the Sea of Azov (AZ-12_24122019)—were isolated and analyzed using light and scanning electron microscopy along with molecular-genetic investigation. Specimens of the two populations differ in valve sizes and structure, however, their belonging to the same species was confirmed with the help of molecular analysis. Taxonomic positions of the strains of A. antediluviana isolated from two marine waterbodies were clarified. In addition, we provided a detailed morphological diagnosis of the species with a description of the valve ultrastructure and its elements, as well as geographical distribution and taxonomic history.
Morphometric analyses as a tool for the delimitation of a species complex of rupicolous Cattleya orchids from the Brazilian campos rupestres of Minas Gerais and Bahia
Authors: LIMA ANDRÉ P. , SILVA JOÃO RODRIGO S. , SIQUEIRA GABRIELA B. , BERG CÁSSIO VAN DEN
Published: November 2024

In the present study we perform a linear morphometric analysis to assess species delimitation in Cattleya caulescens, C. pabstii, and C. pfisteri, which constitute a species complex in Brazilian campos rupestres. For this purpose, we collected 18 linear measurement variables from flowers of 153 individuals in 11 populations from the three species in the Brazilian States of Minas Gerais and Bahia. We applied Principal Component Analysis (PCA), Canonical Variate Analysis (CVA) and cluster analysis to assess the morphological variation between populations. The analyses indicated a clear difference and cohese clusters of populations for each species, but one of the populations of C. pfisteri was divergent from the other populations. This difference is putatively explained by genetic data from other studies that suggest introgression from a species from a different series, C. sincorana, in this location. The differences between C. caulescens and C. pabstii reinforce the floristic differentiation of the orchid flora from the quartzitic mountains of Southern Minas Gerais in relation to the Espinhaço range to the north, as well as the development of a specialized orchid flora in the iron ore outcrops in Central Minas Gerais.
Infundibulicybe swatica (Basidiomycota, Agaricales), a new species from Pakistan
Authors: KIRAN MUNAZZA , AMJAD ATIKA , NASEER AROOJ , ULLAH ZIA , RAZZAQ ANNUM , HUSSAIN SHAH , KHALID ABDUL NASIR
Published: November 2024

A new species, Infundibulicybe swatica is described and illustrated from District Swat, Khyber Pakhtunkhwa, Pakistan. The new taxon is characterized by pale yellow to pale yellow brown to brown pileus with a dark brown center; a bicolorous stipe, white at the apex and pale yellow brown hues at the base; hyaline, lacrymoid to sub-lacrymoid, small, inamyloid basidiospores (6.5 × 4.2 µm); and the absence of hymenial cystidia. Molecular phylogenetic analyses based on nuclear ribosomal Internal Transcribed Spacer (ITS) and nuclear ribosomal Large Subunit (LSU) regions confirm the novelty of the taxon.
Prestauroneis dayaensis—a new diatom species (Bacillariophyceae: Stauroneidaceae) from Guangdong Province, China
Authors: JIANG YUFEI , LIU TONG , ZHANG JUNYI , KOCIOLEK JOHN PATRICK , ZHANG WEI
Published: November 2024

In this study, we describe a new diatom, Prestauroneis dayaensis sp. nov., found in a coastal river, Danao River, at Daya Bay, Huizhou City, Guangdong Province, China. A detailed morphological description of the new species is provided based on light and scanning electron microscopy. P. dayaensis sp. nov, has an elliptical to lanceolate-elliptical valve outline with distinctive rostrate to subcapitate apices, the raphe straight, and the proximal raphe ends slightly enlarged toward to the same side. Its areolar structure is variable in shape, circular at the central area, linear to elliptic at the ends, and distinct pseudosepta present at both apices. Length 25.5–32.0 μm, width 8.0–11.5 μm. This axial area is narrow and linear. The central area is nearly rectangular, some with one short stria at one side of the valve. Striae are relatively widely spaced and radiate at the center, becoming nearly parallel at both apices. The new species is compared with species from the genus Prestauroneis and Dorofeyukea.
Youngia muliensis (Asteraceae, Crepidinae), a new species from Sichuan, China
Authors: LIAO SHU-YUAN , CHEN YOU-SHENG
Published: November 2024

Youngia muliensis, a new species from Muli county, Sichuan province, China, is described and illustrated. This species is morphologically similar to Y. pilifera, sharing features such as rosulate basal leaves, a stem lacking cauline leaves, strigose leaf surfaces and inner phyllaries that are glabrous abaxially and appressed-hairy adaxially. However, it differs in the size of the lamina of basal leaves (1.5–7 × 1.5–2.5 cm vs. 2–5 × 0.6–1.5 cm), a deeply cordate and revolute base of lamina (vs. attenuate into a winged portion), purplish red (vs. green) petioles, and the inner phyllaries having a subapically plane midvein (vs. crested or corniculate).
Aspidistra leipingensis (Asparagaceae), a new species from Guangxi, China
Authors: DING ZHONG-BIAO , LI SHUANG-LONG , LI REN-KUN , ZENG YONG , DUN CHUN-YAO , LIN CHUN-RUI
Published: November 2024

Aspidistra leipingensis, a new species of Asparagaceae from Guangxi, southern China, is described and illustrated. The new species is morphologically similar to A. punctatoides, but can be distinguished by its shorter leaf blade and petiole, longer perianth tube, stamens inserted in the lower part of the perianth tube, stigma hemispherical shape, upper surface convex and glabrous. Colour plate and line drawing of the new species are provided.
Overlooked coastal habitats expose a new species: Ochthebius vilanovensis sp. nov. (Coleoptera, Hydraenidae)
Authors: VILLASTRIGO ADRIÁN , GARCÍA-ESQUIVEL EVA
Published: November 2024

We describe a new water beetle species, Ochthebius vilanovensis sp. nov., from supralittoral coastal crevices on the northern Mediterranean coast of Spain. Detailed morphological and molecular analyses reveal significant divergence from closely related species, highlighting its taxonomic status. This discovery emphasises the ecological importance of supralittoral habitats and suggests the potential for uncovering additional, cryptic species in these environments.
Macropterous species of genus Melanabropsis Wang & Liu, 2020 (Orthoptera: Anostostomatidae: Anabropsini) from the localities predicted in a previous study
Authors: CHEN PO-WEI
Published: November 2024

The genus Melanabropsis currently consists of four micropterous species and one macropterous species from continental Asia and west Pacific islands. Yin (2024) predicted several potential habitats suitable for Melanabropsis species including Taiwan and Guizhou. In this study two additional new species from Taiwan and Guizhou are described, confirming the distribution prediction proposed by Yin. The distribution pattern of seven Melanabropsis species is discussed.
Notes on Scaphium Kirby (Coleoptera: Staphylinidae: Scaphidiinae) with establishment of a new synonymy
Authors: LÖBL IVAN , JAŁOSZYŃSKI PAWEŁ
Published: November 2024

The diagnostic characters of Scaphium Kirby and its members are discussed and illustrated, and data on their distribution and natural history are summarized. Scaphium ferrugineum Reitter, 1880 is placed as a junior synonym of S. castanipes Kirby, 1837.
A new genus and two new species of Cossidae (Lepidoptera: Cossoidea) from India and Pakistan
Authors: AHMAD JALIL , YAKOVLEV ROMAN V. , JOSHI RAHUL , MÜLLER GÜNTER C. , SINGH NAVNEET
Published: November 2024

Aroriella gen. nov., which includes two new species, A. gobardhani sp. nov. (type species) and A. grimaldii sp. nov., is described from India (Bihar) and Pakistan (Sindh Province). The new genus has a particularly complicated structure of the valva: the specific mid costal process on the inner surface of the valva is bifurcated into a proximal, smaller process and a distal larger process, the latter is in the form of a semicircular transverse plate and is almost attached to the valva. We compared the new genus with its closely related genera, Pygmeocossus Yakovlev, 2005 and Neurocossus Yakovlev, 2011.
Exploring the Cross-Over Effect of Employees’ Compulsory Citizenship Behavior on Spousal Family Satisfaction: A Moderated Mediation Model of Complaints and Mindfulness
Authors: Liang Huai-Liang , Wang Chia-Hsuan
Published: November 2024

Compulsory citizenship behavior (CCB), the “dark” facet of organizational citizenship behavior, typically embodies good citizenship behavior within an organization. This study aimed to examine how employees’ compelled engagement in extraneous role behaviors diminishes their spouses’ well-being through complaints. Specifically, this study developed and evaluated a moderated mediation model in which employee mindfulness moderates the pathway from complaints to spousal well-being. This moderation is achieved by suppressing employees’ behavioral responses and spousal reactions. To validate the proposed model, the author conducted a two-time-point time-lag design to explore the relationships among 386 employee-spouse dyads. The findings confirmed the critical moderating role of mindfulness in these relationships, as elucidated by the time-lag research design. Additionally, this study presents relevant theoretical and practical implications for future studies.
Investigating Verbal Learners' Perspectives on Silence in English as a Foreign Language Classrooms in Myanmar
Authors: Thein Win Khaing Mar , Pruyn Marc , Huynh Huy-Hoang
Published: November 2024

Recognising the value of silence in English as a Foreign Language classes, this study aims to extend critical discussion to similar issues in Myanmar classrooms. We explored how verbally active Myanmar EFL students interpreted classroom silence. A qualitative case study was used to interview three self-perceived EFL ‘verbal learners’. Data analysed thematically using Jaworski's (1993) silence categories and Kurzon's (1995) model of intentionality revealed that participants acknowledged the benefits of silence, yet complained about unintended and pointless silences. The study highlights the usefulness of silence in in-class group learning and the need to explore silence holistically for diverse learning styles.
Dementia Caregiving and Dialectical Tensions During the Early Days of the COVID-19 Pandemic
Authors: Faw Meara H. , Johnson Kylie J.
Published: November 2024

Caregiving for a loved one with Alzheimer's disease or related dementia presents significant challenges which were amplified throughout the COVID-19 pandemic. During this time, care partners were forced to navigate uncertain terrain as well as new and challenging relational tensions. This study investigated the experiences of dementia care partners and the relational tensions present as they managed the early days of the COVID-19 pandemic using Relational Dialectics Theory framework. By analyzing recorded support groups from the early days of the pandemic (April through June, 2020), we identified two chief tensions expressed by participants throughout their support groups: connection—independence and gratitude—frustration. Participants experienced these tensions in different ways, and they engaged in four tension management strategies ( selection, minimization, reframing, and venting and comradery) through the support group. As the pandemic progressed, participants’ tension management evolved, highlighting the complexity inherent in caring for a person with dementia during the COVID-19 pandemic.
Weight Restriction Approach in a Two-stage Network Structure: A DEA-based Approach
Authors: Yekta Azam Pourhabib , Maghbouli Mahnaz
Published: November 2024

The standard data envelopment analysis model aimed to maximize the efficiency scores using the most favourable input/output weights. In two-stage network structures, the presence of intermediate undesirable measures leads to a distinct domain of weight restriction study. In the presence of undesirable intermediate measures and equipped with non-cooperative game theory, this study developes a joint weight restriction approach to derive a common set of weights. Concurrently, the overall efficiency of the system can be evaluated. Numerical instances of 34 OECD countries in 2012 have been presented to elucidate the details and applicability of the proposed method.
The family policing industrial complex: The shadow carceral state in sites intended for the support of families
Authors: Battle Brittany Pearl , Ubel Marleina , Nepomnyaschy Lenna
Published: November 2024

The US criminal punishment system, undergirded by carceral logics that center retributive punishment for all measure of offenses, has extended far beyond the walls of formal institutions of incarceration as a shadow carceral state, including into the institution of the family. Families, particularly those of color and who are low-income, face these carceral logics in systems expected to provide support and services, but that often reinforce and reproduce the criminal punishment system's structural violence and retributive responses. We contribute to the understanding of the carceral state's impact on families by conceptualizing the family policing industrial complex through a synthesis of the carcerality experienced by families in two sites—the immigration system and the child support enforcement system. We conclude by calling for the abolition of this complex, exploring transformative justice-oriented remediations of its harm found in various alternative responses to policing families.
Exploring the utilization of postabortion care services and related factors among women at a tertiary health facility in Gulu, Northern Uganda
Authors: Jackline Ayikoru , Opee Jimmyy , Bongomin Felix , Akello Harriet , Atim Sandra Fiona , Pebolo Pebalo Francis
Published: November 2024

Background:

Abortion-related complications are the third leading cause of maternal mortality in Uganda, accounting for approximately one-fourth of all maternal deaths. Most are preventable through adequate use of the full package of postabortion care (PAC) services.

Objective:

We aimed to assess the level of utilization of PAC services and the associated sociodemographic, obstetric, gynecological, and system-related factors at a high-volume tertiary health facility in Northern Uganda.

Design:

A cross-sectional survey was conducted among women receiving PAC at the Gulu Regional Referral Hospital from March 2023 to June 2023. Participants were recruited consecutively and exit interviews were conducted using structured questionnaires.

Methods:

Utilization of PAC was defined as the use of four or more of the following: counseling, emergency treatment, family planning services, linkage to other sexual and reproductive health services, and community health service provider cooperation. Modified Poisson regression analysis was used to determine the independent predictors of PAC utilization.

Results:

A total of 364 participants were enrolled in the study. Overall, 21.1% ( n = 77) of the participants had used four or more PAC services. Having a supportive partner (adjusted prevalence ratio (aPR): 1.9, 95% confidence interval (CI): 1.19–2.88, p = 0.006), knowledge on PAC services (aPR: 1.7, 95% CI: 1.19–2.48, p = 0.004), low parity (aPR: 2.2, 95% CI: 1.16–4.35, p = 0.016), nulliparity (aPR: 2.4 95% CI: 1.19–4.73, p = 0.014), and provision of privacy(physical privacy during prescription, counseling, procedures) (aPR: 2.3 95% CI: 1.14–4.47, p = 0.02), were significantly associated with utilization of PAC. Overall, only one in five participants utilized four or more PAC services. Use of four or more PAC services was significantly associated with women having a supportive partner, knowledge of PAC services, low parity, nulliparity, and provision of privacy while receiving PAC services.

Conclusion:

Approaches such as advocating male partner involvement, bridging the knowledge gap through health education, and promoting respectful care may improve the utilization of PAC services.
Prevalence of Respiratory Syncytial Virus Among Children Under 5 Years of Age in Sub-Saharan Africa
Authors: Mitiku Habtamu , Tesfa Tewodros , Edae Mekuria , Assefa Nega
Published: November 2024

Background. Pneumonia and bronchiolitis are common childhood illnesses caused by the respiratory syncytial virus. A systematic analysis of published epidemiological data in sub-Saharan African children under the age of 5 was conducted. Methods. To retrieve literature, electronic databases, indexing services, and directories such as PubMed/MEDLINE, Scopus, EMBASE (Elsevier), Google Scholar, and Worldcat were utilized. Data from the included studies were extracted after screening and eligibility evaluation. Results. The pooled prevalence rate of respiratory syncytial virus was 21% (95% CI: 17, 25). Subgroup analysis based on participants’ ages showed that, prevalence was highest in children <6 months (32%). High prevalence was also found in children who were hospitalized (27%), children co-infected with HIV (28%), and children co-infected with bacteria respiratory pathogens (22%). Conclusion. The prevalence of respiratory syncytial virus infection was high in children in sub-Saharan African countries. Therefore, it should be prioritized as a major health problem.
You say de-globalization, I say post-globalization; but don’t call the whole thing off (with apologies to Ira Gershwin)
Authors: Axford Barrie
Published: November 2024

Victor Roudometof's thought-provoking article revisits questions the academy has asked of itself ever since globalization became a must-have concept in the late 1980s: What are we talking about? Have we got it and to what degree? Where is it headed? And finally, what does all this mean for the social-scientific prospectus? Answers to the first two questions are superficially easy but how we respond to them still has a profound bearing on the demeanour of social-scientific inquiry into the human condition. So, willy-nilly, our attention is drawn to the status of global studies as a callow branch of knowledge. If globalization is the matrix of processes that extend social relations and consciousness across world space and world time, what is de-globalization? More to the point, what is post-globalization, the elusive subject of Roudometof's essay? Much abroad these days the latter still gets rather short-shrift as a usable concept despite the fact that it is being asked to carry a considerable analytical burden when describing and predicting the demeanour of the world. De-globalization does not signify an inevitable end to globalization, only a change in its density, extensiveness and velocity. On the other hand post-globalization has about it an aura of transformation. It implies radical, not to say systemic, change. Today we are witnessing renewed attention to globalization because of the changing nature of 21st century global dynamics; though whether these actually sum to a ‘new’ globalization is rightly contested. Is a more agonistic multipolarity the defining feature of this changing (dis)order?
Impact of multicomponent exercise and nutritional supplement interventions for improving physical frailty in community-dwelling older adults: a systematic review and meta-analysis
Authors: Sirikul Wachiranun , Buawangpong Nida , Pinyopornpanish Kanokporn , Siviroj Penprapa
Published: November 2024

Objective

To investigate the efficacy of both multicomponent exercise and nutritional interventions on frailty by conducting a systematic review and meta-analysis to examine changes in frailty incidence.

Design

A systematic review and meta-analysis.

Eligible criteria

The included studies were limited to original controlled trials focused on frailty interventions in older adults aged 65 years and over. The studies involved only participants with specific diseases, and those recovering from surgery or being hospitalized were excluded.

Information sources

A systematic search was performed on three databases: PUBMED, EMBASE, and Cumulative Index to Nursing and Allied Health, with the latest search in October 2024. Three authors independently extracted the data using a standardized data collection form. Relative risks were used as a summary measure. Pooled-effect estimates of each outcome were calculated by the random-effects meta-analysis.

Results

After searching three databases, 5327 records were identified. After removing duplicates and screening the titles and abstracts, 19 multicomponent exercise studies and 7 nutritional intervention studies were eligible. In a pooled analysis of 18 multicomponent exercise RCTs, including a total of 3457 older adults, the multicomponent exercises showed a clinically significant reduction in frailty risk by relative change 55% times (95% CI 45% to 67%, p value < 0.001). The subgroup analysis of combinations of macronutrients and micronutrients also demonstrated statistically significant decrease in frailty risk by relative change 28% times (95% CI 11% to 72%, p value = 0.008).

Conclusion

Multicomponent exercises can effectively improve physical frailty, regardless of the duration and types of the activities, whereas the efficacy of nutritional supplements remains unclear. Personalized multicomponent approaches that incorporate both exercises and nutritional supplements have promised to enhance effectiveness in reducing frailty, thus warranting further investigation.

Trial registration

The study was registered on 12 September 2022, under PROSPERO registration number CRD42022357357.
Lower trapezius transfer to infraspinatus in cases of sequelae of obstetric brachial plexus injury
Authors: Hasan Mohammed A. , El-Sayed Amr , Ezzat Mostafa , Safoury Yasser
Published: November 2024

Background

Deficient shoulder function is a common and exhausting issue in children with obstetric brachial plexus injuries. Even with functioning elbow, wrist, and fingers, upper limb function is markedly disabled by limited shoulder abduction external rotation. Lower trapezius transfer carries many advantages; simple and safe technique, same line of pull as donor; reliable nerve supply (extraplexal from spinal accessory nerve), and not acting on rotation of the shoulder, mostly it will not adversely affect internal rotation range after the transfer. This study aims to evaluate the role of isolated lower trapezius transfer in reconstructing shoulder external rotation.

Materials and methods

This prospective case series study included 20 patients with sequelae of obstetric brachial plexus injury lacking shoulder external rotation who underwent lower trapezius transfer to infraspinatus. In all cases, the lower trapezius muscle was the donor, and the recipient tendon was the Infraspinatus muscle. Shoulder range of motion, Modified Gilbert grading, and Mallet Classification were used to evaluate results.

Results

The mean age at the time of surgery was 4.5 years. The average increase in shoulder external rotation and abduction was 40⁰ and 42.5⁰ respectively, the modified Gilbert grading improved from a mean of 3.85 to 4.85 postoperative. Mallet classification improved from a mean of 3.5 preoperative to 4.8 postoperative. Improvement (Mallet classification of ≥ 4) was obtained in 18 cases (90%).

Conclusion

Isolated lower trapezius transfer is considered an effective option with promising results in cases of sequelae of obstetric brachial plexus injury for restoration of shoulder external rotation as well as abduction.
Cross-cultural adaptation and validation of the Spanish version of the Cardiopulmonary Resuscitation Motivation Scale (s-CPRMS): a cross sectional study
Authors: Rodríguez-García Mª Carmen , Montoya-Giménez Esteban , Martínez-Puertas Helena , Garrido-Molina José Miguel , García-Viola Alba , Márquez-Hernández Verónica V.
Published: November 2024

Background

Cardiac arrest remains a serious global health issue worldwide which claims for review and improvement. High motivation among resuscitators could lead to high-quality resuscitation and better outcomes. This study aimed to translate and cross-culturally adapt the Cardiopulmonary Resuscitation Motivation Scale into Spanish and assess the psychometric properties of the Spanish version (s-CPRMS).

Methods

A sample of critical care and acuity-emergency physicians and nurses (N = 352) participated in an observational cross-sectional study structured in 3 phases.

Results

Face and content validity was confirmed for the s-CPRMS (s-CVI = 0.88). The ordinal alpha was 0.847, ranging from 0.796 to 0.92 for the factors, indicating good reliability and temporal stability (mean ICC = 0.701; p < 0.001). The Exploratory Factor Analysis (EFA) results showed the s-CPRMS was distributed into four factors that explained 58% of the variance with values of the goodness of fit indices indicating an adequate fit for the model extracted in the Confirmatory Factor Analysis (CFA): χ2 (246) = 402.240; p < 0.001, SRMR = 0.086, RMSEA = 0.059, TLI = 0.965, CFI = 0.969, GFI = 0.990.

Conclusions

The s-CPRMS is a valid and reliable instrument to assess the motivation of resuscitation teams, which might lead to potential effective strategies to resuscitation quality improvement and outcomes.
Amplifying youth voices: young people’s recommendations for policy and practice to enhance vaccine acceptability
Authors: Somefun Oluwaseyi Dolapo , Casale Marisa , Ronnie Genevieve Haupt , Sumankuuro Joshua , Akintola Olagoke , Desmond Chris , Cluver Lucie
Published: November 2024

Background

The COVID-19 pandemic has underscored the need for increased vaccine availability and uptake, with vaccine hesitancy posing a significant barrier, particularly among young adults. Evidence from various countries highlight high levels of hesitancy among young people, necessitating targeted interventions. Engaging young adults as key stakeholders in shaping public health strategies is crucial, as their perspectives can enhance vaccine acceptance. This study aimed to assess the overall acceptability of the COVID-19 vaccine among young people and to explore the factors influencing their willingness or reluctance to be vaccinated now and in the future.

Methods

This study used qualitative data from 165 young adults in Nigeria, South Africa, and Zambia, to explore their suggestions for policies and strategies aimed at enhancing the acceptance of the Covid-19 vaccination among their age group. Data collection involved focus groups and interviews that explored participants’ perceptions and recommendations regarding COVID-19 vaccination acceptability. Thematic analysis was used to analyse the data.

Results

Thematic analysis identified several factors influencing vaccine acceptability among young people and suggested recommendations to improve it. The themes included developing targeted communication strategies for accurate vaccine information, offering alternative vaccination methods, promoting vaccine education in schools, and using trusted public figures to share accurate information.

Conclusions

Persistent dissatisfaction with vaccine information dissemination underscores the need for more targeted communication strategies among young adults. Recommendations include developing non-injection vaccine options, incorporating vaccine education into school curricula and community programs, and leveraging influential public figures to build credibility. These insights are valuable for designing future programs to enhance vaccine acceptance among adolescents.
Hospital nurses and physicians’ experiences practicing patient safety work to recognize deteriorating patients: a qualitative study
Authors: Berg Astrid Marie Nysted , Werner Anne , Knutsen Ingrid Ruud , Johannessen Anne-Kari
Published: November 2024

Background

Measures to increase patient safety work aim to prevent patient harm and injuries in hospitals and are a priority worldwide. Several hospitals have implemented various rapid response systems to strengthen patient safety. Knowledge is limited concerning how health professionals interact and how they experience competence development and master emergency situations. The aim of the study was to explore and describe hospital nurses’ and physicians’ experiences with patient safety work, and the implications of this work for collaboration and competence in a hospital.

Methods

We used a qualitative descriptive design and interviewed 21 nurses and physicians from a hospital in Norway. Data were analysed with systematic text condensation, a four-step thematic cross-case analysis. The study adheres to the COREQ guidelines for conducting qualitative research.

Results

Through analysis, three categories were identified: strengthening a common clinical language for patient deterioration; sharing and transferring competencies across hospital wards and amongst professionals; and balancing time pressure and limited resources. The results showed that the patient safety work contributed to building bridges between health professionals and across hospital levels regarding deteriorating patients. It also provided structure and systematization to the hospital professionals’ work with deteriorating patients. However, the results also demonstrated the complexity of maintaining patient safety, pointing to the need to balance limited time and resources in hospital.

Conclusions

The patient safety work presumably provides better emergency care, which may enhance patient safety in hospital. The complexity of hospital work, however, can influence the patient safety performance negatively, requiring health professionals to adopt robust, up-to-date skills and competencies in observing and assessing patient deterioration. In a busy hospital setting, the ability of health professionals to collaborate and communicate is important as they are faced with the challenges of balancing time-pressure and limited resources, which can potentially compromise patient safety work.
A hill tribe community advisory board in Northern Thailand: lessons learned one year on
Authors: Perrone Carlo , Kanthawang Nipaphan , Cheah Phaik Yeong
Published: November 2024

Northern Thailand and its neighbouring regions are home to several minority ethnic groups known as hill tribes, each with their own language and customs. Hill tribe communities live mostly in remote agricultural communities, face barriers in accessing health, and have a lower socio-economic status compared to the main Thai ethnic group. Due to their increased risk of infectious diseases, they are often participants in our research projects.

To make sure our work is in line with the interests of hill tribe communities and respects their beliefs and customs, we set up a hill tribe community advisory board. We consult the members before, during, and after our projects are carried out. This manuscript recounts how we set up the community advisory board and our reflections following one year of activities. Our experience strongly supports engaging with community advisory boards when working with minority ethnic groups in lower and middle-income settings. In particular, we found that over time, as researchers and members familiarise with one another and their respective environments, exchanges gain meaning and benefits increase, stressing the advantages of long-term collaborations over short or project-based ones.
Quantifying the association between PM2.5 air pollution and IQ loss in children: a systematic review and meta-analysis
Authors: Alter Naomi C. , Whitman Ella M. , Bellinger David C. , Landrigan Philip J.
Published: November 2024

Background

A growing body of epidemiologic and toxicologic literature indicates that fine airborne particulate matter (PM2.5) pollution is neurotoxic and threatens children’s neurobehavioral development, resulting in reduced cognitive function. Understanding the magnitude of this effect is critical for establishing public health policies that will protect children’s health, preserve human capital, and support societal progress.

Objective

To quantify the association between ambient PM2.5 air pollution and loss of cognitive function in children, as measured by Intelligence Quotient (IQ) scores, through a systematic literature review and meta-analysis.

Methods

Following PRISMA guidelines, we conducted a systematic literature search across seven databases: Agricultural and Environmental Science, BIOSIS Citation Index, Embase, GreenFILE, PubMed, Scopus, and Web of Science to identify original scientific studies that investigated the impact of PM2.5 exposure during pre-and postnatal periods on IQ loss during childhood. Using data from studies included for final review, we conducted a meta-analysis, using a random effects model to compute a beta coefficient that quantifies the overall effect of PM2.5 exposure on Full-Scale IQ (FSIQ), Performance IQ (PIQ), and Verbal IQ (VIQ).

Findings

Of the 1,107 unique publications identified, six studies met the inclusion criteria for final review, representing 4,860 children across three continents (North America, Europe, and Asia). The mean PM2.5 concentration across all studies was 30.4 ± 24.4 µg/m3. Exposure timing ranged from the prenatal period to mid-childhood. Children were an average of 8.9 years old at the time of cognitive testing. We found that each 1 µg/m3 increase in PM2.5 concentration is associated with a -0.27 point change in FSIQ (p < 0.001), 0.39 point change in PIQ (p = 0.003), and -0.24 point change in VIQ (p = 0.021).

Conclusion

Through a systematic review and meta-analysis, we identified a statistically significant relationship between increased exposure to PM2.5 air pollution and reduced cognitive function in children, with the most pronounced impact on PIQ. This analysis will enable estimation of the burden of adverse neurobehavioral development attributable to PM2.5 in pediatric populations and will inform local and global strategies for exposure prevention.
Some generalized inequalities involving extended beta and gamma functions for several variables
Authors: Mubeen S. , Aslam I. , Khammash Ghazi S. , Nadarajah Saralees , Shehata Ayman
Published: November 2024

Recently, extensions of the gamma and beta functions have been studied due to their appealing properties and wide range of applications in various scientific fields. This note aims to investigate generalized inequalities associated with the extended beta and gamma functions.
Identifying signals of memory from observations of animal movements
Authors: Kim Dongmin , Thompson Peter R. , Wolfson David W. , Merkle Jerod A. , Oliveira-Santos L. G. R. , Forester James D. , Avgar Tal , Lewis Mark A. , Fieberg John
Published: November 2024

Incorporating memory (i.e., some notion of familiarity or experience with the landscape) into models of animal movement is a rising challenge in the field of movement ecology. The recent proliferation of new methods offers new opportunities to understand how memory influences movement. However, there are no clear guidelines for practitioners wishing to parameterize the effects of memory on moving animals. We review approaches for incorporating memory into step-selection analyses (SSAs), a frequently used movement modeling framework. Memory-informed SSAs can be constructed by including spatial-temporal covariates (or maps) that define some aspect of familiarity (e.g., whether, how often, or how long ago the animal visited different spatial locations) derived from long-term telemetry data. We demonstrate how various familiarity covariates can be included in SSAs using a series of coded examples in which we fit models to wildlife tracking data from a wide range of taxa. We discuss how these different approaches can be used to address questions related to whether and how animals use information from past experiences to inform their future movements. We also highlight challenges and decisions that the user must make when applying these methods to their tracking data. By reviewing different approaches and providing code templates for their implementation, we hope to inspire practitioners to investigate further the importance of memory in animal movements using wildlife tracking data.
Nuclear medicine imaging in non-seminomatous germ cell tumors: lessons learned from the past failures
Authors: Ayati Narjess , Askari Emran , Fotouhi Maryam , Soltanabadi Masume , Aghaee Atena , Roustaei Hesamoddin , Scott Andrew M.
Published: November 2024

There is an unmet need for a more accurate molecular imaging radiotracer in the field of non-seminomatous germ cell tumors (NSGCT). The clinical problem is that no single imaging modality is able to differentiate teratoma from necrotic tissue in NSGCTs, which the nuclear medicine techniques are no exception. The exponential growth in the list of potentially promising radiotracers may hold promise in the future for imaging of NSGCTs. Here, we have reviewed the past efforts and potential future advances in this field.
Early sexual debut and pregnancy termination: uncovering the link among sexually active young women in 23 sub-Saharan African countries
Authors: Bolarinwa Obasanjo Afolabi
Published: November 2024

Background

Unplanned pregnancy could be a socio-economic burden for many young women in sub-Saharan Africa (SSA) which often leads to pregnancy termination. The role of age at sexual debut in pregnancy termination in countries with lower income remains unknown. Hence, this study examines the association between age at sexual debut and pregnancy termination among sexually active young women between the ages of 15 -24 in 23 SSA countries.

Methods

Cross-sectional secondary datasets from the most recent Demographic and Health Survey conducted in 23 countries in SSA conducted between 2010 and 2018 among 34,343 sexually active young women were analysed using bivariate and multivariable logistic regression to examine the association between age at sexual debut and pregnancy termination with statistical significance of p < 0.05.

Results

The pooled prevalence of pregnancy termination among sexually active young women in SSA was 11.00%. Higher odds of pregnancy termination were found among those who had early sexual debut (below 16 years) [(aOR = 1.34, 95% CI = (1.22–1.48)] compared to those who had late sexual debut. Furthermore, those who were exposed to mass media [(aOR = 1.29, 95% CI = (1.16–1.43)] were more likely to report pregnancy termination compared to those who were not exposed. On the other hand, those residing in rural areas and those within the richest wealth index were associated with lower odds of pregnancy termination.

Conclusion

The study concluded that early sexual debut of sexually active young women in SSA was significantly associated with pregnancy termination. Mass media exposure was found to be a risk factor for pregnancy termination whilst residing in rural areas, and those within the richest wealth index were protective factors. Interventions should be designed to target young women with early sexual debut to provide comprehensive sexual and reproductive health education to enable them to make informed decisions on pregnancy termination.
Impact of Bone Metastasis in Stage IV Non–Small Cell Lung Cancer Treated With Durvalumab and Tremelimumab With or Without Chemotherapy: A Retrospective Analysis of the CCTG BR.34 Trial
Authors: Annageldiyev Charyguly , Gaudreau Pierre-Olivier , Leitzel Kim , Ali Suhail M. , Ding Keyue , Leighl Natasha B. , Vera Badillo Francisco Emilio , Bradbury Penelope Ann , Goss Glenwood D. , Shepherd Lois E. , Costa Luis , Suva Larry J. , Hughes Brett G.M. , Stockler Martin R. , Drabick Joseph J. , Ma Patrick C. , Joshi Monika , Moku Prashanth , Polimera Hyma V. , Louis Patricia , Ramachandrula Priya , Lipton Allan
Published: November 2024

PURPOSE

This retrospective analysis examines the impact of bone metastasis on outcomes in patients with non–small cell lung cancer (NSCLC) from the CCTG BR.34 trial, which investigated the combined immune checkpoint blockade.

MATERIALS AND METHODS

The CCTG BR.34 trial was a randomized phase II study assessing durvalumab plus tremelimumab, with or without platinum-doublet chemotherapy, in 301 patients with metastatic NSCLC. Patients were categorized into two cohorts on the basis of bone metastasis: cohort A (n = 129) and cohort B (n = 172). The primary end point was overall survival (OS), analyzed using Cox regression and multivariable models.

RESULTS

Patients with bone metastasis had notably poorer outcomes. The median OS was 10.9 months for those with bone metastasis versus 18.7 months for those without (hazard ratio [HR] 1.68,
P
= .001). The median progression-free survival (PFS) was 3.4 months with bone metastasis compared with 7.2 months without (HR, 1.82,
P
< .0001). The overall response rate (ORR) was lower in patients with bone metastasis (29.5%) compared with those without (45.9%; odds ratio [OR], 0.52,
P
= .01). Adding chemotherapy to durvalumab plus tremelimumab did not significantly affect OS (
P
= .23), PFS (
P
= .84), or ORR (
P
= .25) in relation to bone metastasis. Multivariable analysis reaffirmed that bone metastasis was linked to decreased OS (HR, 1.42,
P
= .036), PFS (HR, 1.69,
P
< .0001), and ORR (OR, 0.52,
P
= .01).

CONCLUSION

Bone metastasis was associated with worse outcomes in this dual immune checkpoint blockade trial, with or without chemotherapy. Future trials should consider bone metastasis as a stratification factor and explore combining immune checkpoint inhibitors with targeted therapies addressing bone microenvironment factors (eg, interleukin-8, PTHrP, and transforming growth factor-β).