bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the protection of sunscreen products against long wavelength ultraviolet A1 and visible light‐induced biological effects
Authors: Ezekwe Nneamaka , Pourang Aunna , Lyons Alexis B. , Narla Shanthi , Atyam Amruth , Zia Shereen , Friedman Ben J. , Hamzavi Iltefat H. , Lim Henry W. , Kohli Indermeet 
Published: December 2023

AbstractBackgroundLong wavelength ultraviolet‐A1 in combination with visible light induces hyperpigmentation, particularly in dark‐skin phototypes. This study evaluated the efficacy of four sunscreen formulations in protecting against VL + UVA1 (370–700 nm).MethodsThe test products (A–D) were applied to the back of 12 volunteers, then irradiated with 320 J/cm2 VL + UVA1 (3.5% UVA1 [370–400 nm]). Immediately after irradiation, and at Days 1, 7, and 14, erythema and pigmentation were assessed by investigator global assessment (IGA), colorimetry (Δa* and ΔITA) and diffuse reflectance spectroscopy (DRS)‐measured relative dyschromia (area under the curve AUC). Control areas were irradiated without sunscreen.ResultsProduct D, containing titanium dioxide 11%, iron oxides 1%, and antioxidants, provided the highest and most consistent protection. Compared with unprotected irradiated control, it had statistically significantly less erythema on IGA, DRS (Δoxyhemoglobin), and colorimetry (Δa*) at Day 0; less pigmentation on IGA at all time points, on DRS (relative dyschromia) at Days 7 and 14, and on colorimetry (ΔITA) at Day 0. Product B, containing zinc oxide 12% plus organic UV filters, iron oxides 4%, and antioxidants, also showed some efficacy.ConclusionOf the sunscreens tested, the tinted products provided better protection against VL + UVA1 than the non‐tinted products. Since the product with 1% iron oxides was superior to the product with 4% iron oxides, further studies are needed to evaluate whether iron oxide content correlates with better protection.
Inquiry beyond knowledge
Authors: Beddor Bob 
Published: December 2023

AbstractWhy engage in inquiry? According to many philosophers, the goal of inquiring into some question is to come to know its answer. While this view holds considerable appeal, this paper argues that it stands in tension with another highly attractive thesis: knowledge does not require absolute certainty. Forced to choose between these two theses, I argue that we should reject the idea that inquiry aims at knowledge. I go on to develop an alternative view, according to which inquiry aims at maximizing the epistemic value of our credences. This alternative view makes room for knowledge that falls shy of certainty, and it coheres nicely with a rich body of work in epistemic decision theory. I proceed to highlight the implications of this replacement for some important topics in epistemology, including the dogmatism paradox, the nature of interrogative attitudes, and the norm of practical reasoning.
Sensitivity analysis for a participatory approach to enhance the climate resilience of Venice, Italy
Authors: Sambo Beatrice , Sano Marcello , Sperotto Anna , Zanetti Marco , Torresan Silvia , Lambert James H. , Linkov Igor , Critto Andrea 
Published: December 2023

AbstractIncreases in the magnitudes and frequencies of climate‐related extreme events are redistributing risk across coastal systems, including their environmental, economic, and social components. Consequently, stakeholders (SHs) are faced with long‐term challenges and complex information when managing assets, services, and uses of the coast. In this context, SH engagement is a key step for risk management and in the preparation of resilience plans to respond and adapt to climate change. This paper develops a participatory method to identify and prioritize a set of risk measures, combining multi‐criteria analysis with sensitivity analysis. The process involved local and regional authorities of the Veneto region testing the method, including national, regional, and local government, catchment officers, research organizations, natural parks managers and Non‐Governmental Organizations (NGOs). SHs identified and ranked a range of adaptation measures to increase climate resilience, with a focus on coastal risk in the Venice lagoon. Results demonstrate that the sensitivity analysis provides useful information on how different sectors of expertise can influence the ranking of the identified risk management measures, highlighting the value of investigating the preferences or priorities of different SH groups within the definition of adaptation plans.
Risk perception and interpersonal discussion on risk: A systematic literature review
Authors: Perlstein Sara 
Published: December 2023

AbstractRisk perception research has long been attentive to the fact that risk is a social construction. Nevertheless, this fact has not been integrated into empirical research in any systematic manner. Empirical studies that do focus on the social construction of risk often do so from very different positions and with different objectives in mind. Interpersonal discussion, while considered an important medium of social construction, is rarely given consideration. This systematic literature review aims to provide a coherent foundation for empirical studies of interpersonal discussion on risk. Specifically, it summarizes existing research into the reciprocal relationship between interpersonal discussion on risk and individual‐level risk perception. The systematic literature review adheres to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A total of 843 unique articles were identified, of which 60 are included in the review. A majority of the articles in the corpus found a positive association between interpersonal discussion on risk and risk perception. This association, however, lacks robustness, especially in terms of the direction of causality. Three theoretical interpretations of the relationship are found in the corpus: (1) interpersonal discussion as a conduit for risk information, (2) risk perception as shared social schemata, and (3) interpersonal discussion on risk as a facilitator of similarity between network members. Implications for future research are discussed. This literature review concludes with six guiding principles for future research into the interpersonal discussion–risk perception relationship.
The Rubik's cube of doing and being: Factors influencing professional identity transition to the medical registrar
Authors: Kerins Joanne , Phillips Emma C. , Smith Samantha E. , Tallentire Victoria R. 
Published: December 2023

AbstractBackgroundProfessional identity transitions, such as the transition to medical registrar, are challenging. How minoritised identities influence transitions during medical training requires further study. This study aimed to explore the factors influencing the transition to the medical registrar in Scotland to guide support during training.MethodsInterviews exploring this transition with internal medicine trainees were audio recorded, transcribed verbatim and double‐coded using template analysis. We applied an initial coding template informed by multiple and multidimensional transition theory of individual, interpersonal, systemic and macro‐level factors. Using a critical theory lens, a further template analysis specifically sought to understand how trainees' social identities interacted with the various levels.FindingsNineteen IM trainees were interviewed between January 2021 and February 2022. Influential factors reflected a parallel process of competence (doing) and identity (being) development. The interaction of social identities, such as gender (being a woman) and country of origin (being an international medical graduate), occurred across levels. This can be conceptualised as a Rubik's cube with the interplay between doing and being from an individual to a macro level with trainees' social identities interacting at all levels.ConclusionThe transition to the medical registrar is multifaceted; with a challenging balance between support and independence in providing opportunities to perform (doing) whilst identity develops (being). Identity transitions involve multiple Rubik's‐cube‐like rotations between the facets of ‘doing’ and ‘being,’ until these align. Taking heed of influential factors and the interaction of minoritised social identities could guide a trainee‐centred and smoother transition.
Quilts and crossings: A call to wholistic, multi‐modal, and multi‐layered andragogic practices in theological education
Authors: Jaeger‐Sanders Charissa 
Published: December 2023

AbstractWhen you think back to your own experiences as a student, what was meaningful? Memorable? Had a lasting effect? Who are the teachers that stand out? And why? Throughout our lives, we have instructors both in and beyond the classroom, and upon intentional reflection, we can pick up on some qualities that make certain teachers more effective than others. Passionate, kind, humorous, and grace‐filled teachers, who used wholistic, multi‐modal, and multi‐layered pedagogical practices, enabled us to learn in “thick” and lasting ways. This article examines wholistic, multi‐modal, and multi‐layered andragogic practices in theological education that lead to “thick,” collaborative, and lasting learning. I argue that these practices should be embodied in theological education so that students can become not only story receivers but also fellow storytellers in their own journey of lifelong learning.
Fertility desires and sexual behaviours among women recovering from genital fistula repair in Eldoret, Kenya
Authors: Wilson Susan F. , Alway Jessica , Hotchkiss Emily , Aluku Carolyne , Matityahu Debra , Mabeya Hillary , El Ayadi Alison M. 
Published: December 2023

AbstractObjectivesThe reproductive desire of women following genital fistula repair surgery is complex, varied and often not addressed, although it carries significant consequences. The aim of this study was to better understand the fertility desires and sexual behaviours of women who recently underwent surgical repair of a genital fistula.MethodsThis is a secondary analysis of a retrospective cohort study designed to assess the effectiveness of Beyond Fistula, a reintegration programme for women recovering from genital fistula surgery in Eldoret, Kenya. One hundred women who participated in the Beyond Fistula programme between 2013 and 2019 were interviewed in person regarding future fertility desire, current sexual behaviour and contraceptive use.ResultsAmong the 79 reproductive‐aged women included in this study, 63.3% reported no future desire for pregnancy. Those that desired another pregnancy were significantly younger (48.3% were 18–29 years old vs. 66.0% were 35 years old or more, p = 0.004), had fewer living children (70% had 0–2 children vs. 56% had 3 or more children, p < 0.001), and a lower level of food insecurity (27.6% reported no to marginal insecurity vs. 14%, p = 0.014). Current sexual activity was marginally different between women who did and did not desire future pregnancy (82.8% vs. 66.0%, p = 0.053). Of the 50 women in our study who did not desire pregnancy, 62.0% were sexually active and of these, only 38.7% were preventing pregnancy. Lack of knowledge and access to methods were most commonly cited as barriers to use.ConclusionsMany women recovering from genital fistula surgery do not desire pregnancy and are sexually active but are not using a method to prevent pregnancy. The potential for post‐surgical reintegration programmes to address education and access to contraception is a vital and unmet need to promote reproductive empowerment in this population of women as they reestablish their lives.
Fatal hemolytic disease of the newborn due to anti‐B Isohemagglutinin: An unfamiliar presentation of a familiar disease
Authors: Longacre Mckenna , Bendapudi Pavan K. 
Published: December 2023

AbstractBackgroundHemolytic disease of the newborn (HDN) occurs in approximately 1 out of 3000 live births. Severe presentations are atypical but must be recognized and treated rapidly to avoid life‐threatening organ dysfunction.Case PresentationHere we report an unusual case of neonatal ABO HDN that illustrates the enormous inflammatory potential of maternal‐fetal blood group mismatch. Following an uneventful delivery notable only for HDN caused by maternal anti‐B IgG, our patient developed shock, DIC, and renal failure. Despite numerous interventions, she experienced a rapid clinical decline and died 10 days after birth. Treatment with whole blood exchange and a monoclonal antibody directed at complement component 5 (eculizumab) were attempted late in the disease course but were unsuccessful. Importantly, this patient had several known risk factors for severe ABO HDN, including the pentad of a group O mother with a group B neonate, high newborn red blood cell B antigen expression, presence maternal anti‐B isohemagglutinin in high titer, presence of a maternal IgG anti‐B isohemagglutinin, and African ancestry.ConclusionClinicians should be aware of the potential for severe ABO HDN and consider earlier diagnostic workup and more aggressive therapy in patients with high‐risk features.
Efficacy of the topical antihistamine olopatadine in dogs with experimentally induced allergic conjunctivitis
Authors: Mamo Esther T. , Newbold Georgina M. , Moorehead Shelby C. 
Published: December 2023

AbstractObjectiveThe objective of the study was to evaluate the efficacy of a once a day, over the counter antihistamine eye drop, 0.7% olopatadine hydrochloride, in treating or preventing experimentally induced allergic conjunctivitis in dogs.Animals studiedTwelve systemically healthy pet dogs with no known history of allergies or atopic dermatitis, and in the past 12 months had no known ocular abnormalities.ProceduresDogs were randomly assigned to two groups: “Treatment” which received topical 0.7% olopatadine hydrochloride and “Control” which received artificial tears. Dogs received the antihistamine eye drops before (Phase 1) or after (Phase 2) receiving a compounded ophthalmic histamine solution to induce clinical signs of allergic conjunctivitis. Conjunctival hyperemia, chemosis, follicles, ocular discharge, and ocular pruritus were graded, and photographs were used to document changes. Schirmer tear test values, fluorescein staining, and intraocular pressures were monitored throughout.ResultsIn both Phase 1 and Phase 2, conjunctival scores increased 10 min after histamine administration (p < .05). There was no difference between maximum overall conjunctival scores between treatment and control groups in either phase or when comparing treatment groups of Phase 1 to Phase 2 (p > .05). However, treatment groups in Phase 2 did have a higher maximum conjunctival chemosis score and spent more time at their maximum chemosis score when compared to Phase 1 (p < .05).ConclusionOlopatadine may be beneficial as prophylaxis to reduce the degree and duration of clinical signs of allergic conjunctivitis.
Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys
Authors: Singh Lucky , Jain Pankhuri , Kumar Chandan , Singh Ankur , Lal Pranay , Yadav Amit , Singh Prashant Kumar , Singh Shalini 
Published: December 2023

ObjectiveTobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22% of tobacco smokers and 81% of smokeless tobacco (SLT) users reside.MethodsData from the nationally representative Global Adult Tobacco Surveys in India, Bangladesh and Pakistan were analysed to examine patterns of initiation among smokers and smokeless tobacco users.ResultsData on 94 651 individuals were analysed, of which 13 396 reported were ever daily smokers and 17 684 were ever SLT users. The proportion of individuals initiating tobacco use before the age of 15 years has increased over time. The rates of SLT initiation among those aged 15–24 years increased markedly in Bangladesh (by 7.8%) and Pakistan (by 37.7%) between 1983 and 1999–2000. Among males, the increase in SLT initiation was higher in individuals aged below 15 years compared with other age groups in India and Bangladesh. Smoking initiation among females aged below 15 years has also significantly increased in India over time. Compared with the initiation of tobacco smoking before the age of 15 years, a greater increase in the proportion of SLT users was observed in urban areas.ConclusionOur findings indicate that the proportion of youth initiating tobacco (both smoking and smokeless) before the age of 15 years has increased over time in all three countries. Moreover, variations in age at initiation for different types of tobacco products across countries, and by rurality, were noticeable. Younger youths (aged up to 15 years) should therefore be a priority population for tobacco control interventions. Strategies such as raising the legal age of tobacco sale and use to 21 years, and, other measures under WHO Framework Convention on Tobacco Control (FCTC), may prevent underage use and avert lifelong addiction to tobacco products.
Prevalence and risk factors of metabolic syndrome in Ethiopia: describing an emerging outbreak in HIV clinics of the sub-Saharan Africa – a cross-sectional study
Authors: Abdela Abdurezak Ahmed , Yifter Helen , Reja Ahmed , Shewaamare Aster , Ofotokun Ighovwerha , Degu Wondwossen Amogne 
Published: December 2023

ObjectivesHIV-induced chronic inflammation, immune activation and combination antiretroviral therapy (cART) are linked with adverse metabolic changes known to cause cardiovascular adversities. This study evaluates the prevalence of lipodystrophy, and metabolic syndrome (MetS), and analyses risk factors in HIV-infected Ethiopians taking cART.MethodsA multicentre cross-sectional study was conducted at tertiary-level hospitals. Eligible participants attending the HIV clinics were enrolled. Sociodemographic, anthropometric, clinical, HIV treatment variables, lipid profile, fasting blood glucose level, risk factors and components of MetS, also lipodystrophy, were studied. Data were analysed by SPSS statistical package V.25 with descriptive and analytical statistics. For multivariable analysis of risk factors, a logistic regression model was used. Results were presented in frequency and percentages, mean±SD, or median+IQR. Statistical significance was taken as p<0.05.ResultsAmong 518 studied participants, two-thirds were females, and the mean age of the study population was 45 years (SD=11). The mean duration of cART was 10 years (SD=4). Median CD4 count was 460 cells/mm3. The prevalence of MetS according to the Adult Treatment Panel III (2005) criteria was 37.6%. In multivariable analysis, independent risk factors for MetS were age >45 years (aHR 1.8, 95% CI 1.2 to 2.4), female sex (aHR 1.8, 95% CI 1.1 to 2.8), body mass index (BMI)>25 kg/m2(aHR 2.7, 95% CI 1.8 to 4.1), efavirenz-based cART (aHR 2.8, 95% CI 1.6 to 4.8) and lopinavir/ritonavir-based cART (aHR 3.7, 95% CI 1.0 to 13.3). The prevalence of lipodystrophy was 23.6%. Prior exposure to a stavudine-containing regimen was independently associated with lipodystrophy (aHR 3.1, 95% CI 1.6 to 6.1).ConclusionOur study revealed 38% of the participants had MetS indicating considerable cardiovascular disease (CVD) risks. Independent risk factors for MetS were BMI≥25 kg/m2, efavirenz and lopinavir/ritonavir-based cART, female sex and age ≥45 years. In addition to prevention, CVD risk stratification and management will reduce morbidity and mortality in people with HIV infection.
Does atrial fibrillation affect prognosis in hospitalised COVID-19 patients? A multicentre historical cohort study in the Netherlands
Authors: Spruit Jocelyn R , Jansen René W M M , de Groot Joris R , de Vries Tim A C , Hemels Martin E W , Douma Renee A , de Haan Lianne R , Brinkman Kees , Moeniralam Hazra S , de Kruif Martijn , Dormans Tom , Appelman Brent , Reidinga Auke C , Rusch Daisy , Gritters van den Oever Niels C , Schuurman Robert J , Beudel Martijn , Simsek Suat 
Published: December 2023

ObjectivesThe aim of this multicentre COVID-PREDICT study (a nationwide observational cohort study that aims to better understand clinical course of COVID-19 and to predict which COVID-19 patients should receive which treatment and which type of care) was to determine the association between atrial fibrillation (AF) and mortality, intensive care unit (ICU) admission, complications and discharge destination in hospitalised COVID-19 patients.SettingData from a historical cohort study in eight hospitals (both academic and non-academic) in the Netherlands between January 2020 and July 2021 were used in this study.Participants3064 hospitalised COVID-19 patients >18 years old.Primary and secondary outcome measuresThe primary outcome was the incidence of new-onset AF during hospitalisation. Secondary outcomes were the association between new-onset AF (vs prevalent or non-AF) and mortality, ICU admissions, complications and discharge destination, performed by univariable and multivariable logistic regression analyses.ResultsOf the 3064 included patients (60.6% men, median age: 65 years, IQR 55–75 years), 72 (2.3%) patients had prevalent AF and 164 (5.4%) patients developed new-onset AF during hospitalisation. Compared with patients without AF, patients with new-onset AF had a higher incidence of death (adjusted OR (aOR) 1.71, 95% CI 1.17 to 2.59) an ICU admission (aOR 5.45, 95% CI 3.90 to 7.61). Mortality was non-significantly different between patients with prevalent AF and those with new-onset AF (aOR 0.97, 95% CI 0.53 to 1.76). However, new-onset AF was associated with a higher incidence of ICU admission and complications compared with prevalent AF (OR 6.34, 95% CI 2.95 to 13.63, OR 3.04, 95% CI 1.67 to 5.55, respectively).ConclusionNew-onset AF was associated with an increased incidence of death, ICU admission, complications and a lower chance to be discharged home. These effects were far less pronounced in patients with prevalent AF. Therefore, new-onset AF seems to represent a marker of disease severity, rather than a cause of adverse outcomes.