bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suitability of paediatric legislation beyond the USA and Europe: a qualitative study on access to paediatric medicines
Authors: Volodina Anna , Jahn Albrecht , Jahn Rosa 
Published: February 2024

BackgroundPaediatric legislation has contributed to better access to appropriate treatments in the European Union and the USA by requiring paediatric research in return for financial incentives. This study explored whether similar policies could improve access to medicines in other countries.MethodsWe conducted 46 interviews with representatives from healthcare practice, patient organisations and health authorities from six countries (Australia, Brazil, Canada, Kenya, Russia and South Africa) as well as multinational pharmaceutical companies exploring their views regarding access barriers to paediatric medicines. Emphasis was placed on regulation-related barriers and the effect of the COVID-19 pandemic. Where participants were familiar with paediatric legislation, views regarding its relevance for domestic context were explored in depth.ResultsInsufficient paediatric research and development, regulatory hurdles and reimbursement constraints were reported to be relevant access barriers in all studied settings. In the absence of marketing registration or reimbursement, access to paediatric medicines was associated with increased legal, financial and informational barriers. Brazil, Kenya, Russia and South Africa additionally described overarching deficiencies in medicines provision systems, particularly in procurement and supply. The COVID-19 pandemic was said to have reduced regulatory hurdles while further heightening global access inequalities.Views regarding paediatric legislation were mixed. Concerns regarding the implementation of such policies focused on regulatory resource constraints, enforceability and potential reduction of industry activity.ConclusionsThe study findings suggest that paediatric legislation may be most impactful in mature health systems and should be accompanied by measures addressing access barriers beyond marketing registration. This could include strengthening domestic manufacturing capacities and technology transfer for medicines with high public health relevance. Ideally, legislative changes would build on global harmonisation of paediatric legislation, which could be achieved through existing WHO structures.
Coping strategies of fathers and siblings of children with cancer: a literature review
Authors: Rea Teresa , Sansone Vincenza , Zibaldo Andrea , Bellingrath Anna , Guillari Assunta 
Published: February 2024

IntroductionsThe impact of paediatric cancer diagnosis on the family system is universally recognised, as well as the need for the family to find a new balance. Paediatric nurses, being promoters of the care of family and children diagnosed with cancer, need to deepen the experiences of siblings, fathers and mothers to offer better holistic child and family centred care. Although other literature reviews on this topic are present, none of these take into consideration the coping strategies of fathers and siblings in an aggregative way, as we do in this paper. The aim of this study is to look into the coping strategies of healthy siblings and fathers during the therapeutic process of a child with cancer.MethodsAn aggregative literature review was conducted through the consultation of some of the main electronic databases. Studies satisfying the following criteria were included: (a) primary studies conducted in the last 10 years, (b) published in English or Italian, (c) focusing on coping strategies adopted at diagnosis and during therapy by fathers and siblings of children with cancer.ResultsThe results were collected in three main categories looking at the problem from the parents’, the siblings’ and eventually the whole family’s points of view. The three categories have in common the expression of contrasting feelings by each member of the family that generates changes in roles and responsibilities.ConclusionsFurther studies are needed to better understand how nurses can lead a family centred care approach to improve the general familiar management and coping strategies.
Trajectories of antidepressant use before and after union dissolution and re-partnering in later life: a prospective total population register-based cohort study
Authors: Hu Yaoyue , Metsä-Simola Niina , Malmberg Satu , Martikainen Pekka 
Published: February 2024

BackgroundGrey divorce and later remarriage have become increasingly common in high-income countries, but previous evidence on their impacts on mental health is scarce. Even less is known about the effects of non-marital separation and re-partnering in later life.MethodsUsing Finnish registry data from 1996 to 2018 on 228 644 individuals aged 50–70 in 2000–2014, trajectories of antidepressant (AD) use 4 years before and 4 years after divorce, non-marital separation, bereavement and subsequent re-partnering were examined using individual fixed-effects (FE) linear probability models.ResultsIn adjusted FE models, for both genders AD use increased during the 4 years before divorce (men: 5.00 percentage points (95% CI 4.50 to 5.50); women: 6.96 (95% CI 6.34 to 7.59)), non-marital separation (men: 3.20 (95% CI 2.72 to 3.69); women: 5.98 (95% CI 5.30 to 6.66)) and bereavement (men: 4.53 (95% CI 3.97 to 5.09); women: 5.64 (95% CI 5.25 to 6.04)), with the increase accelerating immediately before the event. AD use gradually declined after union dissolution, after which it stabilised on a persistently higher level compared with pre-dissolution. Re-partnering was only associated with a small and transitory reduction in AD use (0.1–1.5 percentage points). The increases in AD use associated with union dissolution were larger in women than in men, whereas the small reductions in AD use associated with re-partnering were particularly short-lived among women.ConclusionsOur results suggest that union dissolution in later life is associated with large and persistent increases in AD use, whereas the reductions associated with re-partnering are limited both in magnitude and duration.
Prognostic value of right ventricular free-wall longitudinal strain in patients with pulmonary hypertension: systematic review and meta-analyses
Authors: Nabeshima Yosuke , Kitano Tetsuji , Node Koichi , Takeuchi Masaaki 
Published: February 2024

BackgroundRight ventricular (RV) dysfunction is associated with adverse outcomes in patients with pulmonary hypertension (PH). This systematic review and meta-analysis evaluated the prognostic value of RV free-wall longitudinal strain (RVfwLS), compared with other RV parameters in PH.MethodsWe searched for articles presenting the HR of two-dimensional RVfwLS in PH. HRs were standardised using the within-study SD. The ratio of HRs of a 1 SD change in RVfwLS versus systolic pulmonary arterial pressure (SPAP), systolic tricuspid annular velocities (s’-TV), RV fractional area change (FAC) or tricuspid annular plane systolic excursion (TAPSE) was calculated for each study, after which we conducted a random model meta-analysis. Subgroup analysis regarding the type of outcome, aetiology of PH and software vendor was also performed.ResultsTwenty articles totalling 2790 subjects were included. The pooled HR of a 1 SD decrease of RVfwLS was 1.80 (95% CI: 1.62 to 2.00, p<0.001), and there was a significant association with all-cause death (ACD) and composite endpoints (CEs). The ratio of HR analysis revealed that RVfwLS has a significant, strong association with ACD and CE per 1 SD change, compared with corresponding values of SPAP, s’-TV, RVFAC or TAPSE. RVfwLS was a significant prognostic factor regardless of the aetiology of PH. However, significant superiority of RVfwLS versus other parameters was not observed in group 1 PH.ConclusionsThe prognostic value of RVfwLS in patients with PH was confirmed, and RVfwLS is better than other RV parameters and SPAP. Further accumulation of evidence is needed to perform a detailed subgroup analysis for each type of PH.Trial registration numberUMIN Clinical Trials Registry (UMIN000052679).
Axion-polaritons in quark stars: a possible solution to the missing pulsar problem
Authors: Ferrer E. J. , Incera V. de la 
Published: February 2024

AbstractThis paper proposes an alternative mechanism to solve the so-called missing pulsar problem, a standing paradox between the theoretical expectations about the number of pulsars that should exist in the galaxy center of the Milky Way and their absence in the observations. The mechanism is based on the transformation of incident $$\gamma $$
γ
rays into hybridized modes, known as axion-polaritons, which can exist inside highly magnetized quark stars with a quark matter phase known as the magnetic dual chiral density wave phase. This phase, which is favored over several other dense matter phases candidates at densities a few times nuclear saturation density, has already passed several important astrophysical tests. In the proposed mechanism, the absence of young magnetars occurs because as electromagnetic waves inside the star can only propagate through the hybridized modes, incident photons coming from a $$\gamma $$
γ
-ray burst get transformed into massless and massive axion polaritons by the Primakoff effect. Once thermalized, the massive axion-polaritons can self-gravitate up to a situation where their total mass overpasses the Chandrasekhar limit for these bosons, producing a mini blackhole that collapses the star.
How long do neutrinos live and how much do they weigh?
Authors: Pompa Federica , Mena Olga 
Published: February 2024

AbstractThe next-generation water Cherenkov Hyper-Kamiokande detector will be able to detect thousands of neutrino events from a galactic Supernova explosion via Inverse Beta Decay processes followed by neutron capture on Gadolinium. This superb statistics provides a unique window to set bounds on neutrino properties, as its mass and lifetime. We shall explore the capabilities of such a future detector, constraining the former two properties via the time delay and the flux suppression induced in the Supernovae neutrino time and energy spectra. Special attention will be devoted to the statistically sub-dominant elastic scattering induced events, normally neglected, which can substantially improve the neutrino mass bound via time delays. When allowing for a invisible decaying scenario, the 95% CL lower bound on $$\tau /m$$

τ
/
m

is almost one order of magnitude better than the one found with SN1987A neutrino events. Simultaneous limits can be set on both $$m_\nu $$

m
ν

and $$\tau _{\nu }$$

τ
ν

, combining the neutrino flux suppression with the time-delay signature: the best constrained lifetime is that of $$\nu _1$$

ν
1

, which has the richest electronic component. We find $$\tau _{\nu _1}\gtrsim 4\times 10^5$$

τ

ν
1

≳
4
×

10
5

s at 95% CL. The tightest 95% CL bound on the neutrino mass we find is 0.34 eV, which is not only competitive with the tightest neutrino mass limits nowadays, but also comparable to future laboratory direct mass searches. Both mass and lifetime limits are independent on the mass ordering, which makes our results very robust and relevant.
A Gibiteca Stan Lee: Uma articulação entre quadrinhos, leitura e temas transversais
Authors: Simões Alex Caldas , Clementino Jehíza Kiister , Rocha João Vitor do Vale da , Bertazo Kedson de Oliveira 
Published: February 2024

Uma Gibiteca é um espaço de socialização de leituras de quadrinhos, bem como de organização, seleção e aquisição de HQs (NOGUEIRA, 2015). É um estímulo à leitura multimodal, à crítica e à reflexão à indústria cultural. Relatamos aqui a experiência de implementação da Gibiteca itinerante Stan Lee na cidade de Venda Nova do Imigrante (ES). O projeto articulou os quadrinhos aos temas transversais propostos pelos PCN, às datas comemorativas do ano letivo escolar e às temáticas escolares relevantes. Aqui a HQ é um objeto interdisciplinar (JAPIASSÚ, 1976) e integrador das disciplinas. Como resultados parciais do projeto temos: (a) a constituição de um acervo representativo de HQs, cujo critério foi abordar os temas transversais; e (b) a realização de oficinas de leitura sobre o mês da mulher, tendo como base a alfabetização dos quadrinhos (VERGUEIRO, 2009), onde sua linguagem (RAMOS, 2009) foi apresentada. Tivemos como objeto de estudo as HQs Mulher-Maravilha: Deuses e Mortas e Mafalda: feminino singular. A proposta se desenvolveu na biblioteca da escola parceira e revelou ser um instrumento relevante para discussão dos temas transversais e do currículo oculto. A leitura da HQs mobilizou conhecimentos de leitura, sociedade e texto.
Lipid‐Lowering Therapy and Risk of Hemorrhagic Stroke: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Bétrisey Sylvain , Haller Moa Lina , Efthimiou Orestis , Speierer Alexandre , Del Giovane Cinzia , Moutzouri Elisavet , Blum Manuel R. , Aujesky Drahomir , Rodondi Nicolas , Gencer Baris 
Published: February 2024

Background
There is debate over whether statins increase risk of hemorrhagic stroke, so we assessed current evidence, including data from new statin trials and trials of nonstatin low‐density lipoprotein‐cholesterol (LDL‐C)– and triglyceride‐lowering therapies.

Methods and Results

We performed a systematic review of large randomized clinical trials (≥1000 patients with ≥2 years follow‐up) of LDL‐C–lowering therapy (statin, ezetimibe, and PCSK‐9 [proprotein convertase subtilisin/kexin type 9] inhibitor) and triglyceride‐lowering therapy (omega‐3 supplements and fibrate) that reported hemorrhagic stroke as an outcome. We searched MEDLINE, Embase, and Cochrane Library up to July 2, 2021 and updated a meta‐analysis of cardiovascular statin trials published in 2012. Among our several subgroup analyses, we looked at difference depending on stroke status and also depending on age. We identified 37 trials for LDL‐C lowering (284 301 participants) and 11 for triglyceride lowering (120 984 participants). Overall, we found a higher risk of hemorrhagic stroke for LDL‐C lowering, risk ratio (RR) 1.16 (95% CI, 1.01–1.32,
P
=0.03). For statins (33 trials, 216 258 participants), RR=1.17 (95% CI, 1.01–1.36); for PCSK‐9 inhibitors (2 trials, 46 488 participants), RR=0.86 (95% CI, 0.43–1.74); and for ezetimibe (2 trials, 21 555 participants), RR=1.14 (95% CI, 0.64–2.03). In statin trials of patients with previous stroke/transient ischemic attack, RR was 1.46 (95% CI, 1.05–2.04), and in trials with mean age ≥65 years old, RR=1.34 (95% CI, 1.04–1.73) (
P
int
=0.14 and
P
int
=0.23 respectively); for triglyceride lowering (11 trials, 120 984 participants), RR=1.05 (95% CI, 0.86–1.30).

Conclusions
We found evidence for a small increased risk of hemorrhagic stroke events with LDL‐C–lowering therapies but no clear evidence for triglyceride‐lowering therapies.

Registration

URL:
https://www.crd.york.ac.uk/prospero
; Unique identifier: CRD42021275363.
The pragmatics of communicating threat and constructing the future in the discourse of the Iranian Supreme Leader
Authors: Basarati Ali , Zohrabi Fateme 
Published: February 2024

Abstract
The paper aims at studying how the discourse of the Iranian Supreme Leader communicates threat and how it presents the reality of Iran’s future in light of policy options. Our data comes from 50 speeches of the Iranian Supreme Leader, delivered between 2005–2020. Adopting the Proximisation Theory, we indicate that spatial and axiological threats are conceptualised in the SL’s discourse as encroaching upon the present and future to impact the Islamic Republic of Iran. But, at the same time, the SL’s discourse depicts the impact consequences as relatively remote from Iran’s present and possible to materialise in the future space provided that certain preliminary circumstances are fulfilled. In this regard, aiming to neutralise the construed threats, the SL’s discourse depicts the privileged vision of the future space involving hortatory preemptive policies. We indicate that the SL’s discourse employs the construal of threats to necessitate and justify taking up future-building preemptive policies.
Process-Based Attribution of Summer Upper-Tropospheric Temperature Related to the South Asian Summer Monsoon
Authors: Wu Qingyuan , Li Qingquan , Hu Xiaoming , Sun Xiaoting 
Published: February 2024

Abstract
Using the ERA5 reanalysis data and the Climate Feedback Response Analysis Method (CFRAM), we attribute the mechanism of summer upper-tropospheric temperature (UTT) variations in the South Asian summer monsoon (SASM) region to several external forcing and internal feedback processes. The summer UTT in the SASM region is dominated by two modes. The first empirical orthogonal function (EOF) mode (EOF1) is a monopolar warming pattern, and the second EOF mode (EOF2) shows a meridional dipole pattern. CFRAM results show that summer UTT anomalies are mainly attributed to cloud feedback and nonradiative processes of atmospheric dynamics (ATD) and surface-related processes. For EOF1, ocean heat storage and partial cloud feedback processes contribute most UTT anomalies over the Indian Ocean. The ATD increases the UTT over East Asia through the adiabatic warming caused by anomalous anticyclone in the upper troposphere. The formation of EOF2 is closely linked to the ATD, while the cloud process partially compensates for the excessive changes in UTT caused by the ATD. The South Asian high and its circulation in the midlatitude region are significantly enhanced. The anomalous anticyclone over northern East Asia along with the anomalous easterly wind on the south side of the South Asian high favors increased warm advection and adiabatic heating, contributing to the warming of UTT. Meanwhile, adiabatic cooling resulting from the atmospheric ascent in the middle and upper troposphere leads to UTT cooling over the Indian Ocean. The quantitative attribution of UTT has great implications for better understanding future SASM variation.

Significance Statement
The purpose of this study is to understand the physical mechanisms of upper-tropospheric temperature (UTT) changes in the South Asian summer monsoon (SASM). Although previous studies have examined temperature variation from the perspective of atmospheric circulation, there has been limited investigation into the influence of various feedback processes. Our study reveals that the summer UTT in the SASM region is dominated by monopolar and meridional dipole modes. Utilizing a climate feedback–response analysis method, we attribute the UTT anomalies in the SASM region to the cloud feedback, oceanic heat storage, and atmospheric dynamics processes, and explore the physical mechanisms of their effects. These results have important implications for the better prediction of monsoon variability.
Pharmaceutical Care in Mental Health: Pharmacists’ Barriers, Collaborations, Attitudes, and Perceptions
Authors: Iheanacho Chinonyerem O. , Tugbobo Adepeju Oluwaseyi , Eze Uchenna I. H. 
Published: February 2024

Background: Pharmaceutical care is an essential component of mental healthcare. Objectives: The study assessed pharmacists’ collaborations, barriers, perceptions on therapeutic relationships and attitudes toward pharmaceutical care to persons with mental illness. Methods: A questionnaire-based descriptive cross-sectional survey was conducted among 175 pharmacists in a Nigerian state via purposive sampling. Average mean score of >3 (±SD) was considered positive attitude toward pharmaceutical care, and positive for respondents’ perception of pharmacists-patient relationship during consultations. Data were analyzed using SPSS version 25.0 for descriptive statistics. Results: A total of 140 (80.0%) respondents participated in the study. Access to patients’ medical records 90 (64.3%) was the major barrier to the provision of pharmaceutical care to persons with mental illness. Almost half of the study participants 69 (49.3%) desired collaboration with only general practitioners and psychiatrists. Only 44 (31.4%) had full co-operation from their desired collaborators. Average score for respondents’ attitude toward provision of pharmaceutical care to the patients, and perception of pharmacist-patient relationship were 4.5 (±0.7) and 3.8 (±0.9) respectively. Conclusions: Study participants’ attitude toward pharmaceutical care, and perception on therapeutic relationship in persons with mental disorder were positive. Lack of access to patients’ records mostly hindered provision of pharmaceutical care, and full collaboration with other mental health experts was mostly lacking. Appropriate policies are required to improve these vital components of mental healthcare for desired outcomes.
COVID-19, Economic Package and Indian Stock Market: An Event Analysis
Authors: Dahal Mahesh , Das Joy , Sangma Amit 
Published: February 2024

The present study is an attempt to analyse the behaviour of securities around the outbreak of the COVID-19 pandemic and the declaration of an economic package by the government of India. In this study, daily prices of securities constituting the BSE 100 index are considered as these securities are highly traded and their trading impact would immediately reflect on the index. To present a sector-specific analysis, the securities are further classified based on sectors and are analysed using the event study methodology. Average abnormal returns (AARs) and cumulative average abnormal returns (CAARs) for overall market and for each sector have been calculated and their significance have been tested using parametric T-statistics, standardised cross-sectional test and non-parametric sign test. Based on the analysis, the study concluded that it was not the pandemic but the actions towards controlling the pandemic that caused a negative impact on the Indian stock market. The economic package declared by the government of India to boost the economy also turned out to be futile and failed in achieving its objectives. Among the sectors, only the technology sector has been positively impacted by the pandemic. The outcome of the study would be beneficial to the trading community in identifying the sectors/securities that would act as hedging in the pandemic situations. JEL Codes: E44, G1, G14, G18
Growing Concern About Unsheltered Homelessness Among Veterans: Clinical Characteristics and Engagement in Health Care Services
Authors: Kinney Rebecca L. , Szymkowiak Dorota , Tsai Jack 
Published: February 2024

Objectives: Veteran homelessness has declined in the past decade, but the proportion of unsheltered homeless veterans has increased. We identified characteristics of unsheltered homelessness in a large contemporary veteran cohort and examined outpatient and inpatient encounters before and after intake to US Department of Veterans Affairs (VA) homeless programs. Methods: National data from the Homeless Operations Management Evaluation System (HOMES) database and the Corporate Data Warehouse were analyzed on 191 204 veterans experiencing housing instability from January 2018 through December 2021. We used hierarchical multivariate logistic regressions to model associations between sheltered status and veteran correlates. Repeated-measures analysis of variance assessed changes in care utilization after intake in homeless programs. Results: Age <50 years (odds ratio [OR] = 1.3; 95% CI, 1.2-1.4), Hispanic ethnicity (OR = 1.2; 95% CI, 1.1-1.3), some college education (OR = 1.1; 95% CI, 1.0-1.1), and a bachelor’s degree (OR = 1.2; 95% CI, 1.1-1.2) were associated with veteran unsheltered homelessness. Unsheltered veterans were more likely to have a VA service-connected disability (OR = 1.4; 95% CI, 1.4-1.5), military sexual trauma (OR = 1.1; 95% CI, 1.0-1.1), and/or combat exposure (OR = 1.1; 95% CI, 1.0-1.1). Unsheltered and sheltered homeless veterans had an increase in outpatient encounters and a decrease in inpatient care after intake to the VA homeless program. Conclusions: Contemporary unsheltered homeless veterans are younger and Hispanic with some college education. Innovative public health approaches that better engage and reduce barriers to entry need to be tested for a diverse unsheltered homeless population.