bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual reality training to enhance clinical competence and student engagement in Ghana
Authors: Baidoo Kodjo , Adu Chioma 
Published: December 2024

Background/Aims Virtual reality simulates real-world scenarios, allowing midwifery students to hone their skills without the risks of live clinical settings. This study's aims were to evaluate the educational impact of virtual reality, including its potential benefits and challenges, in a laboratory at a health education institution in Ghana. Methods This mixed-methods study examined the implementation of virtual reality in midwifery education. The quantitative arm involved pre- and post-tests administered to two cohorts of first-year midwifery students in consecutive years. The first cohort (n=42 students) was taught using conventional task trainers. The second (n=46 students) was trained using immersive virtual reality simulations. Results Post-test and practical scores for the virtual reality trained cohort were significantly higher than their traditionally trained counterparts (P<0.0001). These students also reported significantly higher satisfaction (P<0.0001), perceived effectiveness of the course (P<0.0001) and confidence in clinical application (P<0.0001). Conclusions Virtual reality can substantially enrich the learning environment and enhance the acquisition of practical skills in midwifery education. This investigation into the use of advanced simulation technologies in healthcare education paves the way for future studies on sustainable pedagogical practices. Implications for practice Virtual reality should be integrated into midwifery curricula, and further research into its long-term educational outcomes and integration strategies is vital.
Exploring the relationship between trunk flexibility and arterial stiffness measured by pulse wave velocity: A systematic review and meta-analysis
Authors: Cavero-Redondo Iván , Fonseca Helder , Otero-Luis Iris , Bohn Lucimere , Lever-Megina Carla Geovanna , Moreno-Herraiz Nerea , Saz-Lara Alicia 
Published: December 2024

Background
As individuals age, the risk of cardiovascular disease (CVD) increases, largely due to progressive stiffening of the arteries. This relationship underscores the critical need to monitor arterial stiffness as a predictor of CVD outcomes. While aerobic exercise has demonstrated benefits for vascular health, the influence of flexibility, particularly trunk flexibility, on arterial stiffness remains underexplored. Thus, this study aimed to analyse the overall relationship between trunk flexibility and arterial stiffness across different age groups (young, middle-aged, and older adults) and according to sex.

Methods
A systematic review and meta-analysis were conducted following the MOOSE and JBI Manual for Evidence Synthesis on systematic reviews of etiology and risk guidelines. Searches in PubMed, Scopus, and Web of Science identified studies investigating the association between trunk flexibility and arterial stiffness measured by pulse wave velocity. Data extraction, quality assessment, and statistical analyses were performed following predefined criteria.

Results
Five studies involving 2797 participants were included. Poor trunk flexibility was associated with increased arterial stiffness compared to high flexibility (pooled standardized mean difference = -0.27, 95% CI: -0.39, -0.14), with substantial heterogeneity observed. Subgroup analyses by sex and age revealed significant associations predominantly in men and older individuals. Sensitivity analyses confirmed the robustness of the findings, and meta-regression models showed no significant differences according to age, BMI, or blood pressure. No evidence of publication bias was found.

Conclusion
Poor trunk flexibility is linked to elevated arterial stiffness across diverse demographic groups, highlighting its potential as a surrogate marker for cardiovascular health. Physiological mechanisms involving connective tissue integrity and neural regulation may underpin this relationship. Understanding the role of flexibility in arterial health could inform targeted interventions to mitigate age-related increases in arterial stiffness and reduce cardiovascular disease risk. However, further research is needed to validate these findings and explore potential sex-specific differences.
Acceptance-based process variables on postpartum well-being and distress: The mediating role of psychological flexibility
Authors: Bonacquisti Alexa , Woodworth Emily C. , Diaz Maria , Grunberg Victoria A. 
Published: December 2024

Objective
Although up to 20% of women experience postpartum depression and/or anxiety, current interventions are limited. Identifying the processes that impact outcomes can inform and enhance interventions. Our study aims to examine: (1) whether acceptance-based process variables (awareness, acceptance, cognitive defusion, psychological flexibility) were associated with postpartum outcomes; and (2) whether psychological flexibility mediated the relationship between treatment engagement and postpartum outcomes.

Method
Postpartum women (N = 266) were recruited online using snowball sampling via social media (i.e., Facebook). They completed a cross-sectional survey of validated and reliable quantitative measures assessing their well-being, emotional distress, and acceptance-based processes.

Results
Hierarchical regressions revealed that women with more awareness (β = .13; p = .023), acceptance (β = .17; p = .036), and cognitive defusion (β = -.46; p < .001) reported better well-being. When adding in psychological flexibility, cognitive defusion (β = -.24; p = .031) and psychological flexibility (β = -.33; p = .003) explained variance in well-being. Women with more acceptance (β = -.32; p < .001) and cognitive defusion (β = .52; p < .001) endorsed less emotional distress. When adding in psychological flexibility, acceptance (β = -.28; p < .001), cognitive defusion (β = .40; p < .001), and psychological flexibility (β = .18; p = .047) explained variance in emotional distress. Mediation models revealed that psychological flexibility explained the relationship between mental health treatment and well-being (b = 3.91, SE = 0.66, CI = [2.69, 5.30]) and emotional distress (b = -5.74, SE = 1.08, CI = [-1.26, 3.00]).

Conclusions
Targeting these acceptance-based processes in interventions may help to improve maternal, child, and family outcomes.
Right ventricle free wall longitudinal strain screening of lung transplant candidates
Authors: Scaravilli Vittorio , Scansani Silvia , Meani Paolo , Turconi Gloria , Guzzardella Amedeo , Bosone Marco , Bonetti Claudia , Vicenzi Marco , Morlacchi Letizia Corinna , Rossetti Valeria , Rosso Lorenzo , Blasi Francesco , Nosotti Mario , Grasselli Giacomo 
Published: December 2024

Background
Lung transplant (LUTX) candidates have subclinical right ventricular (RV) dysfunction, which has not yet been assessed by speckle-tracking echocardiography (STE)-derived RV free-wall longitudinal strain (RVFWLS). To evaluate the prevalence of RV dysfunction by RVFWLS and its relationship with conventional RV echocardiographic indexes in LUTX candidates.

Methods
In a single-center prospective observational cohort study, from January 2021 to March 2023 consecutive LUTX candidates underwent cardiac catheterization, radionuclide ventriculography, standard and STE. The diagnostic accuracy of RV ejection fraction by ventriculography (RVEF), tricuspid annular plane excursion (TAPSE), fractional area change (FAC), tricuspid peak annulus systolic velocity (S’) versus RVFWS were computed.

Results
Thirty-four patients (female, 41%) with a mean age of 48 [36–59] years old enlisted for pulmonary fibrosis (35%) and cystic fibrosis (30%) were included. At cardiac catheterization, only 7 (23%) had pulmonary hypertension. Around 15–25% presented right heart enlargement. Tricuspid regurgitation was present in 20 (60%) of the patients. Median RVFWLS was -20.1% [-22.5%–-17%], being impaired (> -20%) in 16 (47%) of the patients. RVFWLS identified the highest percentage (47%) of RV dysfunction, compared to TAPSE (32%), S’ (27%), FAC (26%), and ventriculography (15%), which had very low sensitivity for detecting RV dysfunction compared to RVFWLS.

Conclusions
In patients enlisted for LUTX, RV dysfunction assessed by STE-derived RVFWLS is highly prevalent. STE can detect RV dysfunction better than standard two-dimensional echocardiography and ventriculography. Further studies are urgently needed to define the clinical implications and the prognostic value of RV dysfunction measured with RVFWLS.
Cardiovascular complications in vascular connective tissue disorders after COVID-19 infection and vaccination
Authors: Guerrerio Anthony L. , Mateja Allyson , MacCarrick Gretchen , Fintzi Jonathan , Brittain Erica , Frischmeyer-Guerrerio Pamela A. , Dietz Harry C. 
Published: December 2024

Background
COVID-19 infection and vaccination have been reported to confer an elevated risk for cardiovascular events (CVE). We sought to determine whether individuals with an underlying vascular connective tissue disorder including Marfan syndrome (MFS), Loeys-Dietz syndrome (LDS), or vascular Ehlers Danlos syndrome (vEDS) are at increased risk for cardiac events after COVID-19 infection or vaccination.

Methods
325 respondents self-reported data through a cross-sectional, web-based survey available from 22 November 2021, through 15 March 2022 regarding COVID-19 illness and vaccinations, the occurrence of any CVE, and adverse events following vaccination. The data were analyzed using a Cox proportional hazards model with time varying indicators for COVID-19 illness/vaccination in the preceding 30 days.

Results
COVID-19 illness was significantly associated with an increased rate of a new abnormal heart rhythm 30 days following infection. No other CVEs were reported in the 90 days after COVID-19 illness. We did not find evidence of an increased rate of any CVE in the 30 days following any COVID-19 vaccination dose.

Conclusion
In respondents with MFS, LDS, or vEDS, we uncovered no evidence of an increase in CVEs in the 30 days following COVID-19 illness, with the possible exception of dysrhythmia. In light of the absence of a substantial increase in self-reported CVEs in the 30 days following COVID-19 vaccination, these data are in keeping with the recommendation from the Marfan Foundation Professional Advisory Board that all eligible persons be vaccinated for COVID-19.
Pattern, causes and functional outcome of peripheral neuropathies in the Amazon region
Authors: Deschamps Nathalie , Nacher Mathieu , Preux Pierre-Marie , Takam Valérie , Blaizot Romain , Cenciu Beatrice , Sabbah Nadia , De Toffol Bertrand 
Published: December 2024

Background
Peripheral neuropathies have a wide variety of causes and pathophysiologies. Assuming that there are local particularities in the Amazon region, the aim of this study was to describe the characteristics of patients by determining the factors associated with functional severity.

Methods
This was a retrospective observational study at Cayenne Hospital between January 2015 and May 2023. We included patients from the French hospital activity monitoring database “Programme de médicalisation des systèmes d’information” by searching for the keywords "neuropathy" "Guillain-Barre syndrome"(GBS) "multineuritis" "polyneuritis". The Peripheral Neuropathy Disability (PND) score was determined to quantify the functional severity of patients.

Results
A total of 754 patients were included, with a mean age of 60 years (SD = 14.6) and a predominance of women (53.6%). Gait disorders were present in 16.3% of patients (PND between 2 and 4). Mortality was 14.3% at 3 years. The most common causes of neuropathy were diabetes (58.2%), chemotherapy induced polyneuropathy toxicity (21.5%), Guillain-Barre syndrome (6.0%), unlabeled (3.2%), and infectious causes (2.0%). Infectious causes mainly included HIV in 13 patients (43.3%) and leprosy in 8 patients (26.7%). Only GBS was significantly associated with functional severity but all patients with a deficiency had a severe score. But, after excluding GBS, infectious causes were significantly associated with a severe PND score (aOR = 3.69 [1.18–11.58]).

Discussion
The characteristics of French Guiana combine those found in developed and developing countries, with an over-representation of infections (notably HIV and leprosy), and diabetes. The causes often result from social inequalities in health.

Conclusion
This is the first comprehensive study of the diverse causes of neuropathy in a territory undergoing epidemiologic transition in the Amazon region.
Evaluating the accuracy of a nutritional screening tool for patients with digestive system tumors: A hierarchical Bayesian latent class meta-analysis
Authors: Yang Menghao , Xiao Na , Tang Le , Zhang Yang , Wen Yuexiu , Yang Xiuqin 
Published: December 2024

Background
Cancer, particularly tumors of the digestive system, presents a major global health challenge. The incidence and mortality rates of these cancers are increasing, and many patients face significant nutritional risks, which are often overlooked in clinical practice. This oversight can lead to serious health consequences, underscoring the need for effective nutritional assessment tools to improve clinical outcomes. Although several nutritional risk screening tools exist, their specific utility for patients with gastrointestinal tumors remains unclear. This study aimed to address this gap by systematically evaluating the performance of various nutritional screening tools in this patient population.

Methods
A systematic search of six databases was conducted to identify studies that met predefined inclusion and exclusion criteria. Diagnostic test metrics such as sensitivity, specificity, and likelihood ratios (positive and negative) were estimated using a hierarchical summary receiver operating characteristic model. This approach was used to compare the accuracy of different nutritional screening scales.

Results
A total of 33 eligible studies were included in this meta-analysis, assessing six nutritional screening tools: the Malnutrition Universal Screening Tool, Malnutrition Screening Tool, Nutritional Risk Screening 2002, Mini Nutritional Assessment-Short Form, Nutritional Risk Index, and Patient-Generated Subjective Global Assessment. Among these, the Patient-Generated Subjective Global Assessment demonstrated the highest performance, with a sensitivity of 0.911 (95% confidence interval: 0.866–0.942) and a specificity of 0.805 (95% confidence interval: 0.674–0.891), outperforming the other screening tools.

Conclusions
This study confirms the effectiveness of the Patient-Generated Subjective Global Assessment in identifying malnutrition risk among patients with digestive system tumors. However, as this research focused on a Chinese population, future studies should encompass a broader geographic scope and work toward standardized assessment criteria to enhance the global validation and refinement of nutritional screening tools.
Loving Fanfiction: Exploring the Role of Emotion in Online Fandoms, Brit Kelley (2023)
Authors: Randazzo Katherine 
Published: December 2024

Review of: Loving Fanfiction: Exploring the Role of Emotion in Online Fandoms, Brit Kelley (2023)
New York: Routledge, 244 pp.,
ISBN 978-0-36776-754-9, p/bk, $52.95
ISBN 978-1-00302-054-7, e-book, $37.91
Fanvids: Television, Women, and Home Media Re-Use, E. Charlotte Stevens* (2020)
Authors: Barkin Lena 
Published: December 2024

Review of: Fanvids: Television, Women, and Home Media Re-Use, E. Charlotte Stevens (2020)
Amsterdam: Amsterdam University Press, 277 pp.,
ISBN 978-9-46298-586-5, h/bk, £117.00
Legal instruments for strengthening the position of agricultural producers in the agri-food supply chain
Authors: Lipińska Izabela 
Published: December 2024

The article deals with issues regarding the protection of the position of an agricultural producer in the agri-food supply chain vis a vis significant differences that frequently occur in the bargaining power between suppliers and buyers of agricultural and food produce. These issues are analysed against the background of unfair trade practices. The aim of the article is to answer the question of whether the normative solutions adopted at the EU and at national levels serve to adequately strengthen the position of agricultural producers in the food supply chain. It ends with a conclusion that despite the existence of certain legal mechanisms supporting agricultural producers, the protection they provide is still insufficient.
Speech Acts in the Digital Sphere: A Corpus-Based Exploration of Interactional Dynamics on Social Media Platforms
Authors: Jegede Olusegun Oladele 
Published: December 2024

Abstract
This study was motivated by the need to understand the ways users perform speech acts on social media platforms, specifically Twitter, Facebook, and Instagram, and how these acts differ between public and private contexts. The purpose was to analyse the frequencies and types of speech acts (requests, apologies, and compliments) and identify the linguistic and pragmatic strategies employed. Using a mixed-methods research design, a corpus of 3 million posts was collected and analysed. Stratified random sampling ensured a balanced representation of speech acts, and both manual annotation and machine learning techniques were used for classification. Three major findings emerged: first, requests were significantly more frequent and direct in private messages than in public posts across all platforms; second, public apologies were more formal and detailed, while private apologies were concise and personal; third, Instagram had the highest frequency of compliments, with public posts being more explicit and enthusiastic compared to private messages. The study concluded that context and platform-specific features heavily influence communication strategies. These insights advance theoretical understanding and offer practical applications for optimizing social media communication.
Investigation of the compaction density of electromagnetic moulding of poly(ether-ketone-ketone) polymer powder
Authors: Xu Fan , Liu Hong , Yao Quantong , Wang Huixiong 
Published: December 2024

Abstract
During the moulding process of polymer composite powders, carbonisation often occurs owing to the insufficient ability to control temperature, thereby affecting the service performance of parts. This research studies the electromagnetic moulding (EM) of polymer powders at room temperature and demonstrated the deformation behaviour of poly(ether-ketone-ketone) (PEKK) powder particles for aviation under high-speed impact during EM. The orthogonal analysis method showed that the PEKK powder with a mass of 0.4 g had the highest compaction density of 1.242 when the discharge voltage was 8 kV. Discharge voltage was the most important parameter affecting compaction density, as discharge voltage increases, compaction density increases, but the mass is the opposite. The microstructure and hardness distribution in the specimens further demonstrate that discharge voltage is an important parameter affecting compaction density and provide process guidance for obtaining the high relative density of polymer products.
Bioprospecting hydroxylated chalcones in in vitro model of ischemia-reoxygenation and probing NOX4 interactions via molecular docking
Authors: Ali Arif , de Almeida Igor Moreira , Magalhães Emanuel Paula , Guedes Jesyka Macedo , Cajazeiras Francisco Ferdinando Mesquita , Marinho Marcia Machado , Marinho Emmanuel Silva , de Menezes Ramon Róseo Paula Pessoa Bezerra , Sampaio Tiago Lima , Santos Hélcio Silva dos , da Silva Júnior Geraldo Bezerra , Martins Alice Maria Costa 
Published: December 2024

Abstract
Ischemia/reperfusion injury (I/R) is a leading cause of acute kidney injury (AKI) in conditions like kidney transplants, cardiac surgeries, and nephrectomy, contributing to high global mortality and morbidity. This study aimed to analyze the protective effects of 2′-hydroxychalcones in treating I/R-induced AKI by targeting key pathological pathways. Considering strong antioxidant action along with other pharmacological roles of chalcone derivatives, six 2′-hydroxychalcones were synthesized via Claisen-Schmidt condensation and analyzed for their protective effects in an I/R induced AKI model using HK-2 cells. Among six 2′-hydroxychalcones, chalcone A4 significantly increased the HK-2 cells viability compared to I/R group. Chalcone A4 reduced the cell death events by reducing generation of cytoplasmic ROS and mitochondrial transmembrane potential. It also increased GSH and SOD activity while reducing TBARS levels, indicating strong antioxidant action. Scanning electron microscope images showed that chalcone A4 reversed I/R-induced morphological changes in HK-2 cells, including apoptotic blebbing and cytoplasmic fragmentation. Furthermore, in silico studies revealed interactions with NADPH oxidase 4, further supporting its protective role in I/R-induced AKI. These results showed that chalcone A4 possess potential protective action against I/R induced cellular damage possibly due to its strong antioxidant action and potential interaction with NOX4 subunit of NADPH oxidase.
E-commerce big data processing based on an improved RBF model
Authors: Lu Qiuping 
Published: December 2024

Abstract
In the dynamic landscape of China’s booming economy, the surge in e-commerce customer volume presents both opportunities and challenges, notably in managing customer churn (CC). Addressing this critical issue, this study introduces an innovative approach employing a radial basis function neural network for predicting CC within the e-commerce sector. To enhance the model’s performance in handling the vast and complex data inherent to e-commerce, the least absolute shrinkage and selection operator regression algorithm is employed, optimizing the model’s predictive accuracy. By meticulously analyzing the customer lifecycle, this refined model adeptly predicts churn at various stages, enabling the identification of features most correlated with churn. Empirical results underscore the model’s exceptional capability, achieving a prediction accuracy of 95% and a remarkably low loss rate of 3%. Furthermore, during the excavation, advanced, stable, and decline stages of the customer lifecycle, accuracy levels of 97.6, 93.1, 92.7, and 91.8% are attained, respectively, facilitating the precise selection of highly correlated customer features. Thus, the advanced churn prediction model proposed herein significantly contributes to the e-commerce domain, offering a robust tool for strategizing customer retention and mitigating churn.