bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seasonality in mortality and its impact on life expectancy levels and trends across Europe
Authors: Marinetti Isabella , Jdanov Dmitri A. , Jasilionis Domantas , Nepomuceno Marília , Islam Nazrul , Janssen Fanny 
Published: December 2024

BackgroundSeasonal fluctuations in mortality affect annual life expectancy at birth (e0). Nevertheless, evidence on the impact of seasonal mortality on longevity is very limited and mainly restricted to assessing season-specific mortality levels due to shocks (e.g., heatwaves and influenza epidemics). We investigated the influence of seasonality in mortality on life expectancy levels and temporal trends across 20 European countries during 2000–2019.Data and methodsWe used harmonised weekly population-level mortality data from the Human Mortality Database. Seasonal contributions to life expectancy at birth and age 65, by sex, were estimated using the excess mortality approach and decomposition analysis. Time-series analysis was used to evaluate the impact on long-term mortality trends.ResultsSeasonal mortality had a substantial but stable impact on e0between 2000 and 2019. On average, we found an annual reduction in life expectancy due to seasonal excess mortality of 1.14 years for males and 0.80 years for females. Deaths in the elderly population (65+) were the main driver of this impact: around 70% and 90% of these reductions in life expectancy were attributable to older ages. Excess mortality in winter had the strongest impact on annual life expectancy, especially in Portugal and Bulgaria (around 0.8-year loss on e0).ConclusionsThe study revealed significant cross-country variations in contributions of seasonal mortality. The most pronounced effects were observed in winter months and at older ages. These findings underscore the need for timely and targeted public health interventions to mitigate excess seasonal mortality.
Risk profiles of common brachial plexus block sites: results from the net-ra registry
Authors: Kubulus Christine , Saadati Maral , Müller-Wirtz Lukas M , Patterson William M , Gottschalk Andre , Schmidt Rene , Volk Thomas 
Published: December 2024

IntroductionRegional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia.Methods26,947 qualifying adult brachial plexus blocks (2007–2022) from the Network for Safety in Regional Anesthesia and Acute Pain Therapy registry were included in a retrospective cohort analysis. Interscalene, supraclavicular, infraclavicular, and axillary approaches were compared for block failure and bloody punctures using generalized estimating equations. For continuous procedures, we analyzed the influence of the approach on catheter failure, neurological disorders, and infections.ResultsThe axillary plexus block had the highest risk of block failure (adjusted OR, 2.3; 95% CI 1.02 to 5.1; p=0.04), catheter failure (adjusted OR, 1.4; 95% CI 1.1 to 2.0; p=0.02), and neurological dysfunction (adjusted OR, 3.0; 95% CI 1.5 to 5.9; p=0.002). There was no statistically significant difference among block sites for bloody punctures, while infraclavicular blocks had the highest odds for catheter-related infections.DiscussionThe axillary approach to the brachial plexus had the highest odds for block failure and neurological dysfunction after catheter placement, as well as a significant risk for catheter failure. However, considering that the axillary approach precludes other complications such as pneumothorax, none of the four common approaches to the brachial plexus has a fundamentally superior risk profile.
Mapping axillary sensory cutaneous nerves for enhanced analgesic approaches in axillary surgery: a cadaveric study
Authors: Zurkan Brittany , Wilson Timothy D , Biswas Abhijit 
Published: December 2024

BackgroundInnervation of the breast includes branches of thoracic intercostal nerves, the superficial cervical plexus, the brachial plexus, and the intercostobrachial nerve (ICBN). Commonly used blocks for breast surgery provide incomplete analgesia of the axillary region. This cadaveric study aims to identify and map the axillary sensory cutaneous nerves.MethodsWe conducted nine axillary dissections on cadavers of both sexes with cadavers in supine position and upper limbs abducted. Incisions along the anterolateral thorax and superior clavicle created laterally reflecting skin flaps, allowing visualization of the ICBN and brachial plexus. Photographs were taken during dissections to enabled three-dimensional reconstruction using imaging software 3D Slicer.ResultsIn all dissections, an ICBN and a branch of the posterior cord were identified entering axillary subcutaneous tissue. A branch of the medial cord was identified entering axillary tissue in 5/9 (56%) cadavers. The ICBN remained localized to the anterior axillary base but demonstrated various extrathoracic branching patterns. The posterior cord branch arose from the proximal posterior cord before penetrating the axillary base at its posterior margin in all cadavers. When present, the medial cord branch arose from the proximal medial cord before penetrating the axillary base along the midaxillary line.ConclusionIn addition to the ICBN, two branches of the brachial plexus were identified entering axillary subcutaneous tissue. These branches are not currently considered when providing analgesia for breast surgery and may contribute to pain following surgery that involves axillary dissection.
Induction of interleukin 21 receptor expression via enhanced intracellular metabolism in B cells and its relevance to the disease activity in systemic lupus erythematosus
Authors: Ueno Masanobu , Iwata Shigeru , Yamagata Kaoru , Todoroki Yasuyuki , Sonomoto Koshiro , Nagayasu Atsushi , Miyagawa Ippei , Kubo Satoshi , Miyazaki Yusuke , Miyata Hiroko , Kanda Ryuichiro , Aritomi Takafumi , Nakayamada Shingo , Tanaka Yoshiya 
Published: December 2024

ObjectiveTo elucidate the association between the changes in intracellular metabolism in the early stage of B cell activation and systemic lupus erythematosus (SLE) pathogenesis.MethodsCD19+or CD19+CD27-(naïve) cells from the peripheral blood of healthy controls and lupus patients were cultured under different stimuli. The changes in intracellular metabolism and signalling pathways in these cells were evaluated.ResultsStimulation with CpG (Toll-like receptor 9 (TLR9) ligand) in vitro induced enhanced interleukin 21 (IL-21) receptor expression in CD19+CD27-cells after 24 hours. The addition of IL-21 to the CpG stimulation enhanced the extracellular acidification rate, which indicates glycolysis, within 30 min. IL-21 receptor (IL-21R) expression induced by CpG stimulation was selectively inhibited by 2-deoxy-D-glucose (hexokinase 2 (HK2) inhibitor) and heptelidic acid (glyceraldehyde 3-phosphate dehydrogenase (GAPDH) inhibitor). RNA immunoprecipitation with anti-GAPDH antibody revealed that CpG stimulation dissociated the binding between IL-21R messenger RNA (mRNA) and GAPDH under no stimulation. HK2 and GAPDH expression were higher in CD19+CD27-cells of lupus patients than in those of healthy controls, and GAPDH expression was correlated with the plasmocyte count and disease activity score.ConclusionIL-21R mRNA-GAPDH binding dissociation associated with rapid glycolytic enhancement by the TLR9 ligand in B cells may induce plasmocyte differentiation through IL-21 signals and be involved in exacerbating SLE.
Active–Passive Hybrid Effects of Nonlinear Damping on Chatter Suppression of a Piezoelectric Composite Bar in Boring Operation
Authors: Zhang Jinfeng , Jia Junlei , Feng Chao , Ren Yongsheng , Zhong Peisi , Cao Xiaolong 
Published: December 2024

An active and passive control method is presented to suppress chatter vibrations of the spinning and cylindrical composite boring bar by combining the cutting process damping derived from indentation effect with piezoelectric damping stemmed from Macro Fiber Composite (MFC). The kinetic, potential and electrical energies of the composite boring bar based on the continuous distributed function are established by taking the constitutive relations of piezoelectric materials and the derivative feedback algorithm into account. Introducing the viscoelastic, the hysteretic, the process damping forces, the electrical field as well as cutting forces subjected to the boring process system and forming the virtual work of the non-conservative forces, a final nonlinear equation of motion is derived by utilizing extended Hamilton’s principle and Galerkin procedure. Afterward, the dynamic responses of composite boring bar are derived by using the method of multiple time scales. The proposed approach is validated by comparing the present results with those related papers. A combined model considering process damping effect and feedback gain is also confirmed. The influences of machining, internal and external damping and control parameters on vibration response and process stability of the novel composite boring bar are investigated and discussed. The nonlinear model proposed in this paper can assist in achieving optimal design for composite boring bar and improve the machinability of boring process.
Characteristic and Prognostic Value of Serum Bone Turnover Markers in Pregnant Women With Pre‐Eclampsia: A Prospective Cohort Study
Authors: Yu Fan , Huang Xiaocui , Tang Yuanting , Zhang Yiduo , Li Qing , Jiang Yongmei 
Published: December 2024

Background: Pre‐eclampsia is a severe pregnancy complication affecting about 4%–5% of pregnancies, but the causes and clinical management were full of controversial. Bone turnover markers (BTMs) were sensitive indicators for estimating bone metabolism and were found to be changed in many pregnancy‐related diseases. However, the characteristic and prognostic value of serum BTMs with pre‐eclampsia was uncovered.Methods: A multicenter prospective cohort study was performed in three different hospitals in West China. Pre‐eclampsia patients and healthy pregnant women were recruited from January 2023 to January 2024. Clinical information of included participants was collected, and serum BTM levels were detected by electrochemiluminescence immunoassay. Clinical outcomes including disease aggravation (severe pre‐eclampsia, eclampsia, and HELLP syndrome), low live birth weight (LBW), and premature delivery were followed up.Results: A total of 69 pre‐eclampsia patients and 75 healthy pregnant women were recruited finally, and 48 pre‐eclampsia patients and 48 healthy controls who matched for age and gestational weeks were selected among them. The pre‐eclampsia patients had elevated BTM levels compared with healthy controls. ß‐CTX was an independent risk factor for disease aggravation, LBW, and premature delivery among pre‐eclampsia patients. ß‐CTX was a valuable predictive factor for disease aggravation, LBW, and premature delivery among pre‐eclampsia patients (AUC were 0.772, 0.768, and 0.930, respectively, and p values were 0.001, 0.002, and < 0.001, respectively).Conclusion: Pre‐eclampsia patients may have an activated bone metabolism status compared with healthy controls. Pre‐eclampsia patients with elevated bone resorptive marker ß‐CTX should pay more attention to the risk of disease aggravation and adverse pregnancy outcomes.
Nurse Leaders’ Motivational Forces in Developing a Health‐Promoting Work Environment: A Hermeneutic Study
Authors: Morvati Diako , Solbakken Rita , Vaag Jonas Rennemo , Hilli Yvonne 
Published: December 2024

Background: The literature review highlights that a motivated leader plays a key role in motivating employees and fostering a health‐promoting work environment. Despite its importance, there is limited knowledge about the motivational forces, from a caring science perspective, that drive nurse leaders to develop a health‐promoting work environment.Aim: This study aims to gain a deeper understanding of the motivational forces driving nurse leaders toward developing a health‐promoting work environment.Method: A qualitative design with a hermeneutic approach inspired by Gadamer was chosen. Data were collected through semistructured interviews with 13 nurse leaders in northern Norway between December 2023 and February 2024. The Standards for Reporting Qualitative Research (SRQR) were followed in reporting the results.Findings: The nurse leader’s motivational forces in developing a health‐promoting work environment imbued with an ethos of (1) sense of inner responsibility for promoting the wellbeing of others, (2) sense of trusting relationships in the workplace, (3) sense of mastery through learning and development, and (4) sense of recognition from superiors through being seen, supported, and involved.Conclusion: This study highlights the importance of raising awareness and articulating nurse leaders’ underlying motives and values. Doing so transforms abstract concepts into tangible factors that stakeholders can grasp. In particular, this insight provides valuable guidance to politicians and decision‐makers on how to facilitate improved working conditions for nurse leaders, thereby maintaining and enhancing their motivation.Implications for Nursing Leadership: The findings of this study recommend that superior leaders and policymakers should prioritize involving nurse leaders in decision‐making and promoting their autonomy and room for action. In addition, it suggests facilitating further education and training programs for leaders, as well as maintaining leadership networks where nurse leaders can reflect, exchange experiences, and address challenges.
Development and Healing Process of Severe Radiodermatitis in Patients With Head and Neck Cancer Undergoing Radiotherapy: A Scoping Review
Authors: Miyamae Nao , Imakata Yuko , Kunimitsu Mao , Oe Makoto 
Published: December 2024

Aims: To summarize the morphological characteristics and development and healing processes of severe radiodermatitis for examining the factors contributing to the development of severe radiodermatitis in patients with head and neck cancer.Methods: This scoping review was conducted in accordance with PRISMA extension for Scoping Reviews. Data were extracted from selected references describing detailed conditions of severe radiodermatitis in patients with head and neck cancer. The data were organized separately for radiotherapy, chemoradiotherapy, and bioradiotherapy.Data Sources: Medline, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials databases were used to search for papers from 2000 to December 2023.Results: 11 out of 658 references met the criteria for this review. The morphological characteristics of severe radiodermatitis were categorized by symptoms, site, and shape, and a condition in which moist desquamations and associated crusts spreading to the anterior and lateral neck areas were extracted. In bioradiotherapy, the process of keratinocyte degeneration and formation of blisters under the epidermis leading to moist desquamations was extracted. In chemoradiotherapy, the process of epithelization was extracted 1 week following the occurrence of moist desquamations.Conclusions: Moist desquamations are more likely to occur in severe radiodermatitis in patients with head and neck cancer. Since they can fuse and spread, preventative measures to mitigate spreading are important. However, there is insufficient information to examine the causes of widespread moist desquamations. For preventing moist desquamations and establishing care methods to heal moist desquamations, it may be necessary to identify the symptoms, site, and shape, including the color tone and depth, and healing process during their occurrence.
A Rough Road from Transformation to Innovation
Authors: Karpińska Agnieszka 
Published: December 2024

Abstract
This article addresses the question of which specific features of European postcommunist transition societies determine their low innovation capacity. It suggests that such factors as social organisation, institutional set-up and public trust must be considered alongside economic analyses of innovation. The author draws the conclusion that the dominant pattern of social collaboration in postcommunist countries is close and informal group ties. Though homogenous and tightly knit groups create a safe environment for its participants, they scarcely boost innovative attitudes. The empirical results revised in the text suggest that, in postcommunist countries, the high level of human capital does not translate into social capital and innovation policy in these countries imitates pitfalls of developed countries such as overestimation of the influence of R&D activity on innovation activity.
Discrimination against Darker-Skinned Africans in Tunisia
Authors: Olomojobi Yinka , Abiodun-Oni Taiwo , Lalude Olalekan Moyosore 
Published: December 2024

Abstract
In the diverse and multifaceted social landscape of North Africa, particularly in Tunisia, racial and ethnic tensions have long been part of the region’s history. However, a more insidious form of discrimination has emerged, one that has received far less attention: intra-racial discrimination against darker-skinned Africans. This paper critically investigates the impact of unrestrained remarks and cultural relativism on intra-racial discrimination against darker-skinned Africans in Tunisia. The paper provides an in-depth understanding of the underlying factors that perpetuate colorism within Tunisia’s African community. The paper finds that cultural relativism has led to the normalisation of discriminatory practices, resulting in the marginalisation of darker-skinned Africans within their own communities, and that these practices are further exacerbated by the widespread acceptance of unrestrained remarks that reinforce harmful stereotypes and perpetuate internalised racism. Ultimately, the paper calls for a re-evaluation of the role of cultural relativism in perpetuating intra-racial discrimination and urges the implementation of policies and programmes that promote inclusivity and challenge discriminatory attitudes. By addressing the root causes of colorism and advocating for systemic change, the research contributes to the ongoing discourse surrounding race, identity, colorism and discrimination in Tunisia and beyond. This paper will delve into the historical background of colourism and the contemporary manifestations of this form of discrimination in Tunisia. It will explore the role of language, media, and education in perpetuating harmful stereotypes and discuss the implications of cultural relativism on the persistence of intra-racial discrimination against darker-skinned Africans. Furthermore, it will examine the legal and policy frameworks in place to combat discrimination and identify areas for improvement. By shedding light on this complex and under-researched issue, this study aims to contribute to the ongoing discourse on race, ethnicity, and identity in North Africa and beyond.
The Angolan System of Cities in Late Portuguese Colonialism: Demography, Economy, and Policy
Authors: Tjarks Daniel 
Published: December 2024

Abstract
Late Portuguese colonialism (1945–1975) was a formative period for Angola’s urban system. Viewing Angola’s cities from the bird’s-eye perspective of urbanisation history, an underexplored angle in Angolan historiography, reveals how the colony’s integration in the global economy, belated Portuguese development efforts, and the colonial war shaped not only individual places but also their interrelationships and functional differentiation within Angola’s system of cities.
Cape Verdean Construction Workers in Lisbon (1961–1974): Politics of Ambiguity in the Last Phase of Estado Novo
Authors: Sampaio Catarina 
Published: December 2024

Abstract
In the 1960s and 1970s, Portugal experienced a significant expansion in the field of construction, particularly in public buildings and infrastructures such as the bridge over the River Tagus, the Lisbon underground, and the Olivais housing complex. However, mass recruitment for the colonial war (1961–1974) and emigration to Europe led to a shortage of manpower in Portugal. To complete its infrastructure projects, the government encouraged the migration of Cape Verdean men to work in the construction industry. To manage this migratory movement of workers, the government established the Núcleo de Apoio aos Trabalhadores Migrantes Cabo-verdianos (Nucleus of Support for Migrant Workers from Cape Verde) in January of 1971, to ensure adequate living conditions for those arriving from Cape Verde for this purpose. This article explores the ambiguous nature of that governmental tool. The Government appeared to adopt strategies that both supported and discouraged this flow of migrant workers. Thus, this paper examines: (a) how this mediation tool was used to obscure the Portuguese government’s ambivalence towards Cape Verdeans immigration to Lisbon; (b) how its operational methods contributed to the invisibility of the Cape Verdean workers and to the perpetuation of the precariousness of their living conditions.
Islamists and the Religious Field: (Non-)Transformations of the Religious Institutions in Post-Revolutionary Tunisia
Authors: Mutlu Bedirhan Erdem 
Published: December 2024

Abstract
This article questions the impact of an Islamist party’s ascent to power on the state-run religious institutions through a case study of Tunisia. Literature highlights that pre-existing institutional entanglements between religion and modern states in the mena region provide the Islamists with a chance to launch a state-led project of religious revival. However, Tunisia after the 2011 Revolution presents a “negative case” where Ennahda Movement was unable to capitalize on their position in government to control, empower, or transform religious institutions due to both the democratic power balance in the country and the movement’s strategic choices. Only one major institution, Zitouna University, experienced restructuring and expansion, allying itself with Ennahda thanks to increased institutional autonomy and Bourdieusian field dynamics. These findings suggest that government by Islamists doesn’t necessarily lead to top-down restrengthening of religious authorities, but certain institutions can still form strategic alliances with the Islamists at the bottom.
Wonder and Environment in al-Jazarī’s Technology
Authors: de Miranda Adriana 
Published: December 2024

Abstract
A medieval water-raising device is located in the courtyard of a family house in an ancient area of Damascus. The design of this machine is based upon a project for a hydraulic ḥīla (automata) described in the book of engineering that Ismail ibn al-Razzāz al-Jazarī completed in 602/1206, known to the architect of the device through the copying of al-Jazarī’s manuscript. The machine was built for raising water, from the Yazīd river up to the al-Qaymarī hospital. Previous research has addressed its functional qualities and produced literature that is comprehensive and diverse. However, the present study deals with the analysis of this hydraulic structure to highlight the distinctive feature with respect to al-Jazarī’s description and to its intrinsic resilience in adapting a small-scale project of a playful instrument to an innovative water-raising machine for utilitarian purposes.