bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on the impact of leadership on improving urban water efficiency and water conservation policies
Authors: Meng Meng 
Published: August 2024

AbstractThe increasing urbanization and growing urban population present significant challenges for urban water resources. Inadequate management has led to a decline in water quality and a mismatch between the availability and usage of city water resources. In this period of significant growth, improving urban water efficiency and reinforcing water resource protection are especially important. Leadership is essential in developing and carrying out urban water resource policies. This research investigates how leadership influences the operational efficiency of water resources protection policies. The study seeks to fill the gap in understanding the relationship between leadership, member trust, and policy effectiveness in water resource management by constructing a theoretical model and conducting empirical analysis through questionnaire surveys. The findings of this study are expected to provide valuable insights into the significance of leadership in driving improvements in water conservation policies. By establishing a link between leadership, member trust, and operational efficiency, the research contributes to both theoretical knowledge and practical implications for enhancing water resource management strategies.
The Consequences of HLA Screening in the Prevention of Graft‐Versus‐Host Disease in Living Donor Liver Transplantation
Authors: Ercan Leman Damla , Durmaz Özlem , Kaymakoğlu Sabahattin , Önal Zerrin , Büyükbabani Nesimi , Güllüoğlu Mine , Alper Aydın , İbiş Cem , Cantez Serdar , Yavru Hacer Ayşen , Oğuz Fatma Savran , Özden İlgin 
Published: August 2024

ABSTRACTAimsTo study the effects of routine HLA screening and the policy of avoiding donor‐dominant one‐way HLA match to prevent graft‐versus‐host disease (GVHD) after living donor liver transplantation (LDLT).Patients and MethodsThe records of potential living liver donors and recipients who attended our center between 2007 and 2018 were reviewed retrospectively.ResultsOf the 149 patients who underwent LDLT and survived longer than 3 months, two developed GVHD despite our strict policy. The first patient presented with grade II GVHD limited to the skin. She was treated successfully by briefly discontinuing immunosuppression and switching to everolimus. In the second case, the policy had been relaxed due to the availability of a single donor for ABO‐incompatible transplantation without any intervention to decrease anti‐A antibody levels (special case: A2 to O). Nevertheless, the patient presented with grade I GVHD limited to skin and was treated successfully by adding oral methylprednisolone to tacrolimus and mycophenolate mofetil. To the best of our information, this is the second reported case who recovered from GVHD after LDLT from a donor, homozygous at HLA A, B and DR and a recipient, heterozygous for all. Sixteen potential donors (1.2% of all candidates) of 14 recipients were disqualified solely on the basis of the HLA results; five of these patients died due to unavailability of another donor.ConclusionThe results support the policy of avoiding HLA combinations that preclude immune recognition of graft lymphocytes as foreign to decrease the risk of GVHD after LDLT.
Exploring adolescent‐facing US clinicians' perceptions of their contraceptive counseling and use of shared decision‐making: A qualitative study
Authors: Thornton Madeline , Mann Emily S. , Bullington Brooke W. , Hartheimer Joline , Arora Kavita Shah , Allison Bianca A. 
Published: August 2024

AbstractBackgroundAdolescent contraceptive decision‐making is influenced by a number of patient and clinician‐driven factors. Although the AAP continues to endorse an efficacy‐based model of contraceptive counseling, many professional organizations are shifting to a shared decision‐making model as the optimal approach for providing unbiased and patient‐driven contraceptive counseling. While SDM is intended to reduce the influence of clinician bias, it can exacerbate inequity if a clinician tailors a conversation based on their assumptions of a patient's goals or preferences. In this qualitative study, we explored self‐reported contraceptive counseling practices among US‐based clinicians who see adolescent patients to assess how these practices create barriers or facilitators to SDM and person‐centered contraceptive care.MethodsWe interviewed 16 clinicians at the 2022 AAP Annual Meeting who counsel adolescent patients about contraception. We used thematic content analysis to analyze interview transcripts using Dedoose.ResultsWe identified six aspects of contraceptive counseling that clinicians commonly employed with adolescent patients. These were: (1) sociodemographic characteristics driving counseling, (2) reliance on tiered effectiveness counseling, (3) initiating counseling conversations using “ask then explain” or “explain then ask” approaches, (4) emphasis on teen pregnancy prevention, (5) the influence of method accessibility on counseling, and (6) parental involvement in decision‐making and patient confidentiality. We describe how these themes align with or diverge from each component of the SDM framework.ConclusionClinicians in this study frequently engaged in non‐patient‐centered techniques during contraceptive counseling with adolescents. These findings can inform practice recommendations to support clinicians in providing high‐quality contraceptive counseling using shared decision‐making.
Resting vagally‐mediated heart rate variability in the laboratory is associated with momentary negative affect and emotion regulation in daily life
Authors: Bylsma Lauren M. , DeMarree Kenneth G. , McMahon Tierney P. , Park Juhyun , Biehler Kaitlyn M. , Naragon‐Gainey Kristin 
Published: August 2024

AbstractVagally‐mediated heart rate variability (vmHRV) is a physiological index reflecting parasympathetic activity that has been linked to emotion regulation (ER) capacity. However, very limited research has examined associations of physiological indices of regulation such as vmHRV with emotional functioning in daily life. The few studies that exist have small samples sizes and typically focus on only a narrow aspect of ER or emotional functioning. In this study, we examined associations between vmHRV assessed in the laboratory and emotional/mental health functioning in daily life using a 7‐day ecological momentary assessment design in 303 adult community participants. We hypothesized that higher resting vmHRV would be associated with higher positive affect (PA), lower negative affect (NA), less affective variability, greater well‐being, fewer dysphoria symptoms, greater use of engagement ER strategies, and less use of avoidance ER strategies, as assessed in daily life. Results revealed that higher resting vmHRV in the laboratory (as indexed by both high frequency heart rate variability, HF‐HRV, and the root mean of successive square deviations between heart beats, RMSSD) was significantly associated with less frequent use of avoidance ER strategies in daily life. Theoretical and clinical implications are discussed, including the association of vmHRV with negatively valenced, rather than positively valenced, daily life experiences.
Augmenting patient monitoring during intravenous moderate sedation with artificial intelligence: A pilot study
Authors: Mincer Melanie N. , Mincer Reeva C. , Sung Eric C. 
Published: August 2024

AbstractPurpose/objectivesA precordial stethoscope (PS) is essential for ensuring clear breath sounds during open airway sedations. However, a traditional PS limits the ability of new users to simultaneously listen to heart and lung sounds alongside experienced practitioners, hindering their learning and development. Bluetooth speaker systems allow for multiple providers but amplify all noise. An artificial intelligence (AI) PS has the potential to selectively reduce ambient noise, allowing multiple providers to monitor concurrently and provides a visual representation of the sound waves. The study looks at the benefits of AI PS in teaching in the dental setting.MethodsA questionnaire was created to compare the new AI PS to a conventional PS during intravenous moderate sedation in a dental clinic setting.ResultsSixteen individuals involved in sedations (four dental attendings, seven dental residents, and five dental assistants), were polled with a 100% response rate. 75% of participants agreed that clarity was improved using the AI PS and 81.25% of participants agreed that breath sounds and loudness were improved using the AI PS. 93.75% reported the AI PS was beneficial in allowing attendees to concurrently monitor a sedation case alongside dental residents. 100% of assistants reported that the AI PS benefited from their participation in sedation cases.ConclusionAs technology advances, it is important that we as providers continue to evolve and consider implementing AI to improve our ability to monitor patients and enhance educational experiences for dental resident trainees.
Understanding Residual Stress Evolution in Directed Energy Deposition With Interlayer Deformation
Authors: Mithal Abeer , Maharjan Niroj , Tan Nicholas Yew Jin , Chew Youxiang , Idapalapati Sridhar 
Published: August 2024

Abstract
Control of residual stresses (RS), inherent to fusion-based additive manufacturing (AM), process is important for the satisfactory mechanical performance of components. Recent work has attempted to control the RS profiles in AM components by applying mechanical peening between built layers. During laser powder bed fusion (LPBF), it has been shown that subsequent layer building does not relieve all the peening-induced compressive stresses. In this work, a similar study has been performed on a directed energy deposition (DED) process. It is shown that owing to the vastly different thermal profile in DED compared to LPBF, the compressive RS induced by peening, is completely alleviated during subsequent layer deposition for 316L stainless steel. Irrespective of the magnitude and depth, the peening-induced compressive stresses were not present in the final part. Experimental and numerical analyses revealed that stress relief due to intrinsic heating was insufficient to explain stress relaxation. Rather, the localized heating and constrained expansion from surrounding cold material was the mechanism responsible for strain redistribution and hence stress relaxation.
Ultrasonic Levitation as a Handling Tool for In-Space Manufacturing Processes
Authors: Raffel Jan , Böhm Torben , Düsing Jan , Röhl Marvin , Schilde Carsten , Malshe Ajay P. , Overmeyer Ludger , Lotz Christoph 
Published: August 2024

Abstract
3D printing is one of the key technologies in space exploration. The disparity in gravitational forces between Earth and space presents both challenges and opportunities with regard to material handling. This article examines the potential of employing ultrasonic levitation as a handling tool for substrate-free additive manufacturing processes in microgravity environments. Through preliminary experiments, we demonstrate the feasibility of manipulating polymer powders using acoustic fields while concurrently melting the levitated material. Subsequent experiments conducted in our drop tower facility confirm our ability to manipulate particles with acoustic traps under microgravity conditions. Building upon these findings, we outline plans to further advance our research using an expanded acoustic levitation system capable of three-dimensional object manipulation. Our objectives include moving and orienting large components beyond the wavelength limit in microgravity, manipulating granular raw material while melting it in proximity to the print part, and achieving a semi-continuous fusion of print material with the print part. Therefore, we present an intelligent control strategy based on the results of a digital twin simulation. Furthermore, we utilize a stereo camera combined with computer vision as feedback for the control system to ensure precise handling of the manipulated objects and particles. This study represents a significant advance toward the realization of efficient substrate-free additive manufacturing processes in microgravity environments, with potential applications for in-space manufacturing. Ultimately, this could result in long-term space missions becoming less reliant on supply deliveries, thus reducing cost and additionally enabling faster response to unforeseen issues.
Physical Conditioning and Functional Injury-Screening Profile of Elite Female Soccer Players: A Systematic Review
Authors: Ruiz-Rios Maitane , Setuain Igor , Cadore Eduardo L. , Izquierdo Mikel , Garcia-Tabar Ibai 
Published: August 2024

Purpose: To identify the physical conditioning and functional injury-screening characteristics of elite female soccer players. Methods: This review was prospectively registered (PROSPERO CRD4202346765). Searches were conducted in PubMed/MEDLINE, Cochrane Library, Scopus, and Web of Science (from inception in March 2023 to July 2023). Updated searches were conducted in October 2023 and April 2024. Included studies were quantitative studies conducted on female soccer players. Main outcomes were functional and physical profiles. Screening, data extraction, and quality assessment (Quality Assessment Tool for Quantitative Studies and the Oxford Levels of Evidence scales) were performed. Mean differences between preseason and in-season testing periods were estimated by Hedges g effect size. Methods and results were reported according to PRISMA guidelines. Results: The search yielded 1727 articles, of which 10 were included. Overall methodological quality of the studies was strong, with a moderate level of evidence. Players exhibited mean maximal oxygen uptake of 52.6 (4.5) mL·min−1·kg−1, 20-m linear-sprint performance of 3.58 (0.18) seconds, countermovement jump of 31.0 (2.9) cm, unilateral countermovement jump of 14.4 (2.1) cm, and quadriceps and hamstring peak torque at 60°·s−1 of 133 (23) and 87 (17) N·m, respectively. Mean scores recorded during in-season were 2% to 22% better than in preseason (effect size: small to very large). Conclusions: This review provides valuable normative physical conditioning and functional injury-risk assessment data for elite female soccer players. Coaches and conditioning staff can use these insights to interpret their own records and optimize their training processes. Furthermore, this study identifies methodological limitations to address in future research.
Instrument-Assisted Soft Tissue Mobilization 2-Handed Grip Force Production Consistency During Simulated Treatment: A Technical Report
Authors: Baker Russell T. , Martonick Nickolai J.P. , Smitley Matthew C. , Ludwig Christopher M. , Reeves Ashley J. 
Published: August 2024

Context: Instrument-assisted soft tissue mobilization (IASTM) continues to increase in popularity and utilization among manual therapists. Despite its popularity, little is known about the consistency in peak or average forces that clinicians apply when performing IASTM treatments with a 2-handed grip. The purpose of this study was to examine intraclinician consistency in peak and average forces when applying a 2-handed IASTM grip. Design: Randomized crossover study conducted in a university biomechanics laboratory. Methods: Five (5) licensed athletic trainers with prior IASTM training used 5 different IASTM instruments to apply simulated treatment. Average peak forces (Fpeak) and average mean forces (Fmean) were collected via force plate for all 5 IASTM instruments with a skin simulant attached. Descriptive statistics, coefficients of variation (CVs), box and density plots, and Bland–Altman plots were assessed. Results: The clinicians’ average Fpeak ranged from 3.0 N to 11.6 N and average Fmean from 1.9 N to 8.1 N. Fpeak CVs for all instruments ranged from 14% to 31%, and Fmean CVs ranged from 15% to 35%. Bland–Altman plots indicated that for both Fpeak and Fmean, 97% of the data points fell within the limits of agreement across instruments and clinicians. Mean differences across instruments ranged from 0.9 N (91.8 g) to 4.1 N (418.1 g) for Fpeak and from 1.0 N (102.0 g) to 2.8 N (285.5 g) for Fmean. Thus, CVs, box and density plots, and Bland–Altman plots supported general force application consistency. Conclusion: Trained IASTM clinicians produced consistent treatment application forces (ie, Fpeak and Fmean) within treatment sessions during 2-handed simulated application.
Investigating sustainability in work after participating in a welfare-to-work initiative using a 2-year cohort study of Work Programme participants in Scotland
Authors: Brown Judith , Walker Simon Harold , McQuaid Ronald W , Katikireddi Srinivasa Vittal , Leyland Alastair H , Frank John , Mackay Daniel , Macdonald Ewan 
Published: August 2024

ObjectivesThis study investigated sustainability and multimorbidity alongside barriers to employment including health and policy to demonstrate intersectional impact on return-to-work success within a UK welfare-to-work programme.DesignCohort study design: The study calculated the proportion of time spent employed after experiencing a job start and the proportion retaining work over 6 months. Employment/unemployment periods were calculated, sequence-index plots were produced and visualisations were explored by benefit type and age.SettingThis study used confidential access to deidentified data from unemployed Work Programme clients operated by Ingeus on behalf of the UK Government in Scotland between 1 April 2013 and 31 July 2014.Participants13 318 unemployed clients aged 18–64 years were randomly allocated to a Work Programme provider and monitored over 2 years.ResultsThis study has two distinct groupings. ‘Employment and Support Allowance (ESA)’ corresponding to those with work-limiting disability in receipt of related state financial support, and ‘Jobseeker’s Allowance (JSA)’ corresponding to unemployment claimants. Despite fewer and later job starts for ESA clients, those that gained employment spend relatively more subsequent time in employment when compared with individuals without work-limiting conditions (ESA clients under 50, 0.73; ESA clients over 50, 0.79; JSA clients under 50, 0.67 and JSA clients over 50, 0.68). Proportion in permanent jobs was higher among ESA than JSA clients (JSA under 50, 92%; JSA over 50, 92%; ESA under 50, 95% and ESA over 50, 97%).ConclusionThe research demonstrated that returning to paid employment after a reliance on welfare benefits is challenging for people aged over 50 and those with disability. The study found that although fewer older ESA claimants entered employment, they typically remained in employment more than JSA clients who did not leave the Work Programme early. This indicates the importance of identifying risk factors for job loss in ageing workers and the development of interventions for extension of working lives.
The spectrum of acute illness and mortality of children and adolescents presenting to emergency services in Sanghar district hospital, Pakistan: a prospective cohort study
Authors: Muttalib Fiona , Memon Zahid Ali , Muhammad Shah , Soomro Asif , Khan Samia , Bano Shazia , Jawwad Muhammad , Soofi Sajid , Hansen Bettina , Adhikari Neill KJ , Bhutta Zulfiqar 
Published: August 2024

ObjectiveTo describe presenting diagnoses and rates and causes of death by age category and sex among children with acute illness brought to a district headquarter hospital in Pakistan.DesignProspective cohort study.SettingSanghar district headquarter hospital, Sindh, Pakistan between December 2019 and April 2020 and August 2020 and December 2020.Participants3850 children 0–14 years presenting with acute illness to the emergency and outpatient departments and 1286 children admitted to the inpatient department.Outcome measuresThe primary outcome was Global Burden of Disease diagnosis category. Secondary outcomes were 28-day mortality rate, cause of death and healthcare delays, defined as delay in care-seeking, delay in reaching the healthcare facility and delay in appropriate treatment.ResultsCommunicable diseases were the most common presenting diagnoses among outpatients and among inpatients aged 1 month to 9 years. Non-communicable diseases and nutritional disorders were more common with increasing age. Few children presented with injuries. Newborn period (age <28 days) was associated with increased odds of death (OR 4.34 [95% CI 2.38 to 8.18], p<0.001, reference age 28 days–14 years) and there was no significant difference in odds of death between female vs male children (OR 1.12, 95% CI 0.6 to 2.04, p=0.72). 47 children died in the hospital (3.6%) and three (0.2%) died within 28 days of admission. Most children who died were <28 days old (n=32/50, 64%); leading diagnoses included neonatal sepsis/meningitis (n=13/50, 26%), neonatal encephalopathy (n=7/50, 14%) and lower respiratory tract infections (n=6/50, 12%). Delays in care-seeking (n=15) and in receiving appropriate treatment (n=12) were common.ConclusionThis study adds to sparse literature surrounding the epidemiology of disease and hospital outcomes for children with acute illness seeking healthcare in rural Pakistan and, in particular, among children aged 5–14 years. Further studies should include public and private hospitals within a single region to comprehensively describe patterns of care-seeking and interfacility transfer in district health systems.
Cohort profile: The Aboriginal Families Study – a prospective cohort of Aboriginal children and their mothers and caregivers in South Australia
Authors: Glover Karen , Leane Cathy , Nikolof Arwen , Gartland Deirdre , Cahir Petrea , Mensah Fiona K , Giallo Rebecca , Reilly Sheena , Middleton Philippa , Makrides Maria , Francis Theresa , Collins-Clinch Amanda , Clark Yvonne , Gee Graham , Brown Stephanie Janne 
Published: August 2024

PurposeThe Aboriginal Families Study is a prospective, intergenerational cohort study with well-established Aboriginal governance arrangements and community partnerships to support all research processes including data collection, interpretation and knowledge translation.Participants344 Aboriginal and Torres Strait Islander children born in South Australia between July 2011 and June 2013 and their mothers and other primary caregivers. Two waves of survey data collection have been undertaken: early in the first year postpartum and when the study children were aged 5–8 years. Children participated in direct developmental assessments of their cognitive, speech and language development at 5–8 years of age. Social and cultural determinants of health and well-being have been assessed at each wave of data collection.Findings to datePublications and policy briefs to date focus on social determinants of women’s and children’s physical and mental health; identifying gaps in access to pregnancy, postnatal, primary, specialist and allied healthcare; and evidence that Aboriginal-led services in South Australia have improved women’s experiences and access to antenatal care.Future plansWave 3 follow-up is planned as the study children reach 14–16 years of age. Longitudinal follow-up of women and children in the cohort will generate new knowledge about factors promoting children and young people’s social and emotional well-being. Our goal is to build a stronger understanding of the potential for key domains of social and emotional well-being (eg, connection to community, family and kin, country and spirituality) to buffer the impacts of social determinants of health, including intergenerational trauma and social inequity.