bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loneliness Gets Under the Skin: A Scoping Review Exploring the Link Between Loneliness and Biological Measures of Inflammation
Authors: Kim Bohyun , Weibel Maria , McDaniel Jodi 
Published: October 2024

Background: Research suggests that systemic inflammation may link loneliness to adverse health outcomes, yet there is a gap in comprehensively reviewing recent evidence on the relationship between loneliness and biological measures of inflammation in adults. This scoping review synthesizes current research to address the question: Is there a definitive link between loneliness and biological markers of inflammation in adults? Methods: Following the methods outlined by Arksey and O’Malley, we developed a protocol, defined our research question, and systematically searched PubMed, CINAHL, Embase, and Scopus for English-language studies conducted from 2018 to 2023 exploring the relationship between loneliness and biomarkers of inflammation in adults. Results: Twelve studies meeting the inclusion criteria displayed heterogeneity in terms of sample characteristics, loneliness scales, and inflammatory biomarkers. The UCLA Loneliness Scale, in various forms, emerged as the predominant tool for measuring loneliness, while C-reactive protein and interleukin-6 were the most frequently evaluated inflammatory biomarkers. Notably, all 12 studies reported an association between loneliness and at least 1 biological marker of inflammation. Conclusion: Research consistently associates loneliness with poor health outcomes in aging adults, but the underlying mechanisms remain unclear. This scoping review suggests that inflammation may serve as a pathway linking loneliness to adverse health outcomes. However, the variability across studies highlights the need for standardized measurement methods and a consideration of both the duration and extent of loneliness. Enhancing our understanding of how loneliness affects systemic inflammation may help clarify why loneliness is associated with negative health outcomes.
Buildings as Batteries
Authors: Lopez Alejandro , Bunn Derek 
Published: October 2024

Aggregators are increasingly using portfolios of various end-user resources such as local renewable generation, batteries, EVs, and demand-side management to participate in the electricity markets as virtual power plants. Whilst the smart control of energy within buildings is well established for cost optimization, the prospect of an aggregator collaborating with the energy managers of buildings to trade electricity in the wholesale markets is under researched. This paper uses a state-of-the-art architectural simulator to model the thermal inertia of a typical high-rise building in London and represent the thermodynamics of its hourly occupancy and weather responses. The building is simulated as a virtual battery by manipulating the HVAC settings. Price arbitrage on the electricity wholesale market and contracting with the local distribution network for flexible reserve services are both feasible and profitable. It is concluded that aggregators can apparently use buildings as additional assets within their trading portfolios. JEL Classification: L85 and L94.
Rooftop Solar PV, Coal Plant Inflexibility and the Minimum Load Problem
Authors: Simshauser Paul , Wild Phillip 
Published: October 2024

Australia’s National Electricity Market (NEM) has amongst the highest take-up rates of rooftop solar PV in the world. As with California, this has produced a distinctive load shape termed the “duck curve.” The Queensland version is being principally driven by non-scheduled (i.e., uncontrolled) rooftop solar PV. When combined with inflexible coal plant, it leads to a “minimum load problem.” In this article, we examine the feasibility of dispatch with ever-expanding rooftop solar PV resources in the NEM’s Queensland region and minimal demand elasticity. We find episodes of intractable dispatch throughout the year with rising intensity in the winter and spring months. Furthermore, we find no ability to “export your way out of the problem” via larger interstate interconnectors because the same problem is emerging in the adjacent region at the same time. Resolution ultimately requires inflexible coal plant exit, and entry of flexible plant. JEL Classification: D25, D80, G32, L51, Q41
Exploring Perceptions of Communication among Culturally Diverse Nurses in Saudi Arabia
Authors: Theron Liesel , Shopo Khumoetsile Daphney , Ngami Olivia 
Published: October 2024

Introduction: Cultural diversity among nurses in the Kingdom of Saudi Arabia poses problems in communication management to ensure optimal patient care. This study explored and described the perceptions of communication among nurses in a culturally diverse workforce. Methodology: A qualitative approach was used; a sample of seventeen (n=17) nurses was purposively selected. Data obtained from semi-structured interviews were analyzed using Braun and Clarke’s six steps of thematic qualitative analysis. Results: Key themes were (1) nurses’ perceptions of communication in a culturally diverse workforce, (2) barriers to communication in a culturally diverse workforce, and (3) facilitators of effective communication in a culturally diverse workforce. Discussion: Nurses have recognized the importance of communicating in a culturally diverse environment to provide optimal care. Strategies such as cultural competence training, open communication forums, and mentorship programs are recommended to improve cross-cultural understanding and collaboration in care teams.
Influence of cork-rubber gasket on the circular propagation of train-induced vibration waves in high-speed railway shield tunnels
Authors: Liu Yifan , Jin Hao , Tang Shilong , Jiang Bolong 
Published: October 2024

Shield tunnels are constructed by assembling segment, and this construction method will produce a large number of joints. As the component with the largest contact area in the joints of the shield tunnel, the cork-rubber gasket has a significant effect on the transmission of train-induced vibration waves between the segments. In order to study the influence of cork-rubber gasket on the transmission of train-induced vibration waves in the circumferential direction, based on the hammering test of high-speed railway shield tunnel, a dynamic calculation model for high-speed railway shield tunnel was constructed, and the influence of elasticity modulus of cork-rubber gasket on the propagation of train-induced vibration waves was investigated. The results show that: (1) the longitudinal joints of high-speed railway shield tunnels can weaken high-frequency vibration waves more than low-frequency vibration waves; (2) the lower the modulus of elasticity of cork-rubber gasket is, the greater the attenuation of the peak of the temporal range of vibration acceleration of train-induced vibration waves after they pass through the longitudinal joints; (3) compared with the cork-rubber gasket of high elasticity, the cork-rubber gasket with low elasticity can improve the damping effect of the longitudinal joints on low-frequency bands (0–500 Hz) effectively. This research offers new methodologies for optimising vibration isolation in shield tunnels and contributes to the advancement of tunnel design for high-speed rail systems.
Static Stability of Elbow Interposition Arthroplasty Stabilized With Novel Ligament Reconstruction
Authors: Chen Jeffrey S. , Beckwitt Colin H. , Robertson Emerald D. , Bosetti Alexandria A. , Baratz Mark E. , Kaufmann Robert A. 
Published: October 2024

Background: Outcomes of interposition arthroplasty for treatment of elbow arthritis are highly dependent on elbow stability. The purpose of this study was to determine whether interposition arthroplasty with a novel bidirectional ligament reconstruction technique could adequately restore the static stability of the native elbow. Methods: Static varus and valgus elbow stability was tested in 7 cadaver elbows with intact ligaments and capsule at 5 flexion angles (0°, 30°, 60°, 90°, and 120°). At each angle, the distance between fixed reference points across the elbow was measured both medially and laterally. The elbows were then destabilized and an interposition arthroplasty with ligament reconstruction was performed. Static elbow stability was reassessed by comparing postoperative deflection measurements with those of the native state. Graft slippage or loosening was visually assessed following testing. Results: Interposition arthroplasty was performed in 7 cadaver specimens. Following ligament reconstruction, specimens reproduced the flexion angle-dependent static stability of native elbows to both varus and valgus stress. The greatest deflection changes between native elbows and elbows after interposition arthroplasty were 2.7% ( P = .13) medially and 2.3% ( P = .42) laterally, which were not significant. There was no loosening or slippage of either the interposition graft or the ligament reconstruction grafts. Conclusions: Cadaveric elbow specimens underwent interposition arthroplasty with a novel technique for bidirectional ligament reconstruction. Static stability was maintained at varying degrees of elbow flexion, comparable to that of the native elbow. Interposition and ligament reconstruction grafts maintained secure fixation following static biomechanical testing.
Concussion Assessment and Management Self-efficacy Among Irish Clinicians
Authors: Postawa Anna P. , O’Connor Siobhán , Whyte Enda F. 
Published: October 2024

Background: This study explored concussion assessment and management self-efficacy and practices of allied healthcare professionals in Ireland. Hypotheses: (1) Self-efficacy levels and practices vary across different concussion assessment and management skills, (2) the ability to practice skills impacts self-efficacy most. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Survey of allied healthcare professionals (285 responders), investigating (1) demographics, (2) concussion assessment (immediate and office) and management (postconcussion advice and management/rehabilitation) self-efficacy levels and practices, and (3) factors affecting self-efficacy. Results: Levels of self-efficacy among clinicians were 64.5 ± 26.6 (immediate assessment) and 56.6 ± 25.4 (postconcussion advice) (highest scores: concussion symptom checklist [80 ± 28.4], physical rest advice [80.1 ± 27.8]; lowest: Child Sport Concussion Assessment Tool [44.6 ± 41.2] and nutrition advice [34.1 ± 33.7]). Overall levels of self-efficacy among Certified Athletic Therapists and Chartered Physiotherapists were 51.5 ± 20.1 (assessment) and 62.1 ± 20.9 (management) (highest scores: history/clinical evaluation nonspecific to concussion [86.6 ± 16.2], physical rest advice [86.3 ± 20]; lowest: paper/pencil neuropsychological test [16.7 ± 28.6], advice on medication use [39.2 ± 35]). A strong positive correlation was observed between clinician self-efficacy and frequency of use of overall ( r = 0.795; P < 0.01) and immediate ( r = 0.728; P < 0.01) assessment, advice ( r = 0.805; P < 0.01), and management ( r = 0.812; P < 0.01) skills. Factors with greatest positive impact on clinician self-efficacy were the ability to practice skills during clinical placement (3.3 ± 0.9) and remaining emotionally (3.3 ± 0.8) and physically (3.3 ± 0.8) calm while practicing. Conclusion: Clinicians in Ireland had moderate self-efficacy in concussion care. Those who used concussion-relevant skills frequently in practice displayed higher self-efficacy for those skills. Clinical Relevance: Concussion-related self-efficacy can be enhanced through practice in a clinical environment and through experiencing composure while practicing.
Factors associated with delayed diagnosis of endometriosis: A systematic review
Authors: Harzif Achmad Kemal , Nurbaeti Putri , Sayogo Putri Atikah , Silvana Vita , Andyra Azizah Fitriayu , Wiweko Budi 
Published: October 2024

Background: Endometriosis affects approximately 4%–10% of women of reproductive age. The most common symptom is dysmenorrhea, which can impact patients’ physical, mental, and social lives. Early diagnosis is imperative, despite the fact that it is indeed challenging that diagnostic delay occurs frequently. Both physician and patient factors contribute to the diagnostic delay of endometriosis. Methods: We conducted a literature search published from March 2015 to March 2023 in PubMed, Cochrane, PMC, CINAHL, and SCOPUS databases reporting about factors associated with delayed diagnosis of endometriosis. Results: Six studies were included in the analysis. Patient aspects, including age at first symptom ( p < 0.001) and first consultation ( p < 0.001), were associated with delayed diagnosis of endometriosis. Physician aspects, which include the number of doctors’ visits to get a diagnosis ( p < 0.001), time to referral to a gynecologist ( p = 0.028), and false diagnosis by a general practitioner ( p = 0.021), are also associated with delayed diagnosis and treatment of endometriosis. From patient’s perspectives, their symptoms are often normalized by general practitioners, and general practitioners lack knowledge regarding endometriosis. From a health professional’s perspective, time-consuming consultation correlates with delayed diagnosis. Conclusion: Factors associated with delayed diagnosis of endometriosis were patient—and physician-related, including age at first symptom and first consultation, normalization of symptoms, and lack of knowledge among general practitioners. Increasing awareness and knowledge about endometriosis will likely reduce the diagnostic delay.
Contribution of Ethnomedical Use Data to the Marketing Authorization of Traditional Herbal Medicines in Mali
Authors: Sangho Aboubacar , Ouoba Kampadilemba , Semdé Rasmané , Sanogo Rokia 
Published: October 2024

Background To improve the supply of health care and health care products, traditional herbal medicines that are safe, effective, and of good quality need marketing authorizations. This study aims to determine the contribution of ethnomedical evidence to the marketing of traditional herbal medicines in Mali. Methods This was a descriptive cross-sectional study conducted from December 2023 to March 2024 supplemented by a literature review of the legislative and regulatory provisions relating to traditional medicine and the requirements for marketing authorization of traditional herbal medicines in Mali and the West African sub-region. Results The regulatory framework for marketing authorization is governed by decree no. 04-557/P-RM of 01 December 2004 and interministerial order no. 05-2203/MS-MEP-SG of 20 September 2005 in Mali. These texts set out the specific requirements for the marketing authorization of traditional plant-based medicines, depending on the category. They consider ethnomedical evidence drawn from long experience of traditional use as proof of efficacy and tolerance for category 2 traditional medicines. As a result, marketing authorizations were issued for 15 products derived from traditional medicine and pharmacopeia, 5 of which are included in the National List of Essential Medicines and the National Therapeutic Formulary of Mali. Conclusion The use of ethnomedical evidence provides a good opportunity to obtain marketing authorization for phytomedicines derived from traditional medicine without having to go through long and costly non-clinical and clinical studies.
Recombinant Erwinia asparaginase (JZP458) in ALL/LBL: complete follow-up of the Children’s Oncology Group AALL1931 study
Authors: Maese Luke , Loh Mignon L. , Choi Mi Rim , Agarwal Shirali , Aoki Etsuko , Liang Yali , Lin Tong , Girgis Suzette , Chen Cuiping , Roller Shane , Chandrasekaran Vijayalakshmi , Iannone Robert , Silverman Lewis B. , Raetz Elizabeth A. , Rau Rachel E. 
Published: October 2024

Abstract
Children’s Oncology Group study AALL1931 investigated the efﬁcacy and safety of recombinant Erwinia asparaginase (JZP458) in patients with acute lymphoblastic leukemia/lymphoblastic lymphoma and hypersensitivity reactions/silent inactivation to Escherichia coli–derived asparaginases. Each pegylated Escherichia coli asparaginase dose remaining in a patient’s treatment plan was replaced by intramuscular (IM) or IV JZP458 (6 doses) administered Monday/Wednesday/Friday (MWF). Three IM cohorts (1a [25 mg/m2 MWF], n = 33; 1b [37.5 mg/m2 MWF], n = 83; 1c [25/25/50 mg/m2 MWF], n = 51) and 1 IV cohort (25/25/50 mg/m2 MWF, n = 62) were evaluated. The proportion (95% confidence interval [CI]) of patients maintaining nadir serum asparaginase activity (NSAA) levels of ≥0.1 IU/mL at the last 72 (primary end point) and 48 hours during course 1 was 90% (95% CI, 81-98) and 96% (95% CI, 90-100) in IM cohort 1c, respectively, and 40% (95% CI, 26-54) and 90% (95% CI, 82-98) in the IV cohort. Population pharmacokinetic modeling results were comparable with observed data, predicting the vast majority of patients would maintain therapeutic NSAA levels when JZP458 is administered IM or IV 25 mg/m2 every 48 hours, or IM 25/25/50 mg/m2 MWF, or with mixed IM and IV administration (IV/IV/IM 25/25/50 mg/m2 MWF). Drug discontinuation occurred in 23% and 56% of patients in the IM and IV cohorts, respectively; 13% and 33% because of treatment-related adverse events (mainly allergic reactions and pancreatitis). JZP458 achieves therapeutic NSAA levels via multiple IM and IV dosing schedules based on combined observed and modeled data with a safety profile consistent with other asparaginases. This trial was registered at www.ClinicalTrials.gov as #NCT04145531.
Assessment of nursing managers’ awareness and hospital preparedness for disasters: a cross-sectional study
Authors: Rahimi Borhan , Yari Arezoo , Rafiei Fatemeh , Mahmoudi Mokhtar 
Published: October 2024

Abstract
Introduction
Preparedness, focused on planning, training, and research, is one of the primary stages of the disaster management cycle. Accordingly, this study was conducted to determine the level of awareness in nursing managers and the preparedness of hospitals for disasters in the hospitals of Sanandaj, the capital of Kurdistan Province.

Methods
This cross-sectional study was conducted in 2023, with a total of 167 Nursing Managers in Sanandaj selected as the research sample using a census approach. Data were collected using a demographic information form, WHO Hospital Emergency Response Checklist, and managers’ emergency awareness questionnaire. Data were analyzed using Chi-square tests, Fisher’s exact test, independent t-tests, analysis of variance (ANOVA), and Pearson correlation. Data analysis was performed using SPSS v26 (P < 0.05).

Findings
The results indicated that the overall mean score of managers’ awareness was 77.89%, categorized as good. The assessment of hospital preparedness showed that the overall emergency preparedness level of hospitals in Sanandaj was 69.23%, considered strong. Among the dimensions of hospital preparedness, the highest score was in the command-and-control dimension at 83.33%, while the lowest was in the human resources dimension at 56.66%.

Conclusion
The findings indicated a high level of awareness among nursing managers and a strong level of hospital preparedness in Sanandaj. However, improving and enhancing specific dimensions may require targeted educational and organizational approaches.
Longitudinal mediation analysis with multilevel and latent growth models: a separable effects causal approach
Authors: Di Maria Chiara , Didelez Vanessa 
Published: October 2024

Abstract
Background
Causal mediation analysis is widespread in applied medical research, especially in longitudinal settings. However, estimating natural mediational effects in such contexts is often difficult because of the presence of post-treatment confounding. Moreover, many models frequently used in applied research, like multilevel and latent growth models, present an additional difficulty, i.e. the presence of latent variables. In this paper, we propose a causal interpretation of these two classes of models based on a novel type of causal effects called separable, which overcome some of the issues of natural effects.

Methods
We formally derive conditions for the identifiability of separable mediational effects and their analytical expressions based on the g-formula. We carry out a simulation study to investigate how moderate and severe model misspecification, as well as violation of the identfiability assumptions, affect estimates. We also present an application to real data.

Results
The results show how model misspecification impacts the estimates of mediational effects, particularly in the case of severe misspecification, and that the bias worsens over time. The violation of assumptions affects separable effect estimates in a very different way for the mixed effect and the latent growth models.

Conclusion
Our approach allows us to give multilevel and latent growth models an appealing causal interpretation based on separable effects. The simulation study shows that model misspecification can heavily impact effect estimates, highlighting the importance of careful model choice.
Changes in BMI prior to and during the COVID-19 pandemic among children: a retrospective cohort study in San Francisco, CA
Authors: Maxwell Sarah L. , McCulloch Charles E. , Fernandez Alicia , Beck Amy L. 
Published: October 2024

Abstract
Background
The COVID-19 pandemic led to dramatic changes in the lives of children that impact cardiometabolic health. Cities and counties had varying policies with respect to school closure, recreational programs, and efforts to mitigate food insecurity and economic distress. Our objective was to evaluate changes in BMI-z score and prevalence of overweight/obesity prior to and during the pandemic among children in San Francisco, CA, where public schools were closed for 18-months.

Methods
This was an electronic medical record-based retrospective cohort study. We included 15,401 children, 4–17 years of age at study onset. Our exposure was time into each of three time periods: (1) March 2018-February 2019; (2) March 2019-February 2020; (3) March 2020-August 2021 (the pandemic period of school closure). Generalized estimating equations (GEE) were used to assess changes in BMI-z score and overweight/obesity across the three time periods. We assessed for effect modification by age-category, insurance status, and race/ethnicity.

Results
Mean BMI-z score increased by 0.06 per year in time period 2, the year prior to the pandemic (p < 0.001, 95% CI: 0.04, 0.09), and by 0.12 per year during time period 3, the first 18 months of the pandemic (p < 0.001, 95% CI 0.10, 0.13). The proportion of children with overweight/obesity increased by 1.4% points per year during time period 2 (p = 0.012, 95% CI: 0.03, 2.46) and by 4.9% points per year during the first 18 months of the pandemic (p < 0.001, 95% CI: 4.11, 5.67). The effect modification analysis demonstrated that the youngest age group, publicly insured children (versus privately insured), and Black, Latino, and Asian children (versus White children) experienced greater increases in BMI-z score during the pandemic (p < 0.01 for all comparisons). The youngest age group (p = 0.022) and publicly insured children (versus privately insured children) (p < 0.001) also experienced greater increases in the proportion of children with overweight/obesity during the pandemic.

Conclusions
Among children in San Francisco, increases in BMI-z score and overweight/obesity were greater during the pandemic compared to prior changes, with the most pronounced increases among younger and publicly insured children. These findings support the need for more targeted and effective policies for addressing childhood overweight/obesity, especially among these high-risk populations.