BACKGROUND: Establishing causal relationships is essential in biology and medicine. However, various notions of causality have been operationalized at different times in various fields of the life and health sciences. While this is expected from a history or sociology of science point of view, as different accounts may correspond to what is valued in terms of establishing causal relationships at different times as well as in different fields of biology and medicine, this may come as a surprise for a present-day actor in those fields. If, over time, causal accounts have not been fully dismissed, then they are likely to invite some form of, potentially salutary, explanatory pluralism.
CONCLUSIONS: In the decades following WWII, psychosomatic medicine could propose that psychological factors cause somatic diseases. But today, most medicine has to meet the standard of a randomized clinical trial before any causal relationship can be proposed. Instead, in biology, mechanisms seem to be the most-valued causal discourse to explain how phenomena of interest are brought about. Here, the focus will be on how psychoneuroimmunology, an interdisciplinary research field addressing interactions between the nervous system and immune system, and between behavior and health, has considered causal relationships between psychological factors and cancer.
CONCLUSIONS: When it comes to causal explanations of links between psychological factors and cancer, psychoneuroimmunology is invited to consider the question of the directionality of these links as well as what and how factors causally contribute to cancer.

UNASSIGNED: Globally, 75% of neonatal deaths occur during the first weeks of life and more than 43% of deaths are covered by sub-Saharan Africa. Health-related policymakers and decision-makers need to use evidence-based treatments to reduce the time to early neonatal death and associated predictors. However, there are limited studies on median survival time, cause, incidence, and predictors in the study area as well as the country. Therefore, the aim of the present study was to assess time, the cause of early neonatal death, and its predictors among neonates admitted to neonatal intensive care units at Bahir Dar City public hospitals in northwest Ethiopia.
UNASSIGNED: An institution-based prospective follow-up study design was conducted among 387 early neonates selected by systematic sampling between 22 February and 22 April 2023. Statistical software, Epi Data version 4.6 and Stata version 14, was used for entry and analysis, respectively. Proportional hazard assumption and model fitness were checked by the Schoenfeld residual test and the Cox-Snell residual test, respectively. Descriptive statistics, the Kaplan-Meier curve, and the life table were used to describe variables. The Cox regression analysis model was fitted to identify the predictors of early neonatal death.
UNASSIGNED: During the follow-up time, 59 (15.25%) early neonates died, with an incidence of 31.79 per 1,000 early neonate days [95% confidence interval (CI): 0.024-0.041]. The leading causes of early neonatal death were prematurity complications, asphyxia, sepsis, meconium aspiration syndrome, and necrotizing enterocolitis. The mean survival time was 2.72 days. Being born from a multigravida mother [adjusted hazard ratio (AHR) 4.34; 95% CI: 1.63-11.55], a grand multigravida mother (AHR 3.50; 95% CI: 1.12-10.95), respiratory distress syndrome (AHR 2.60; 95% CI: 1.03-6.58), birth asphyxia (AHR 7.51; 95% CI: 2.30-24.51), a small gestational age (AHR 2.05; 95% CI: 1.08-4.92), and being unable to exclusively breastfeed (AHR 3.46; 95% CI: 1.52-7.88) were significantly associated predictors for time to early neonatal death.
UNASSIGNED: The incidence of early neonatal death was high, and the mean survival time was 2.72 days. Gravidity, respiratory distress syndrome, birth asphyxia, and being unable to exclusively breastfeed were identified as predictors of early neonatal death. Therefore, future research will consist of long-term prospective follow-up studies at a multicenter, nationwide level.

OBJECTIVE: To explore the risk factors for maternal near-miss (MNM) using the WHO near-miss approach.
METHODS: Data were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012-2022. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for MNM.
RESULTS: Our study included 780,359 women with 731,185 live births, a total of 2461 (0.32%) MNMs, 777,846 (99.68%) non-MNMs, and 52 (0.006%) maternal deaths were identified. The MNM ratio was 3.37‰ (95%CI: 3.23-3.50). Coagulation/hematological dysfunction was the most common cause of MNM (75.66%). Results of multivariate logistic regression analysis showed risk factors for MNM: maternal age > = 30 years old (aOR > 1, P < 0.05), unmarried women (aOR = 2.21, 95%CI: 1.71-2.85), number of pregnancies > = 2 (aOR > 1, P < 0.05), nulliparity (aOR = 1.51, 95%CI: 1.32-1.72) or parity > = 3 (aOR = 1.95, 95%CI: 1.50-2.55), prenatal examinations < 5 times (aOR = 1.13, 95%CI: 1.01-1.27), and number of cesarean sections was 1 (aOR = 1.83, 95%CI: 1.64-2.04) or > = 2 (aOR = 2.48, 95%CI: 1.99-3.09).
CONCLUSIONS: The MNM ratio was relatively low in Hunan Province. Advanced maternal age, unmarried status, a high number of pregnancies, nulliparity or high parity, a low number of prenatal examinations, and cesarean sections were risk factors for MNM. Our study is essential for improving the quality of maternal health care and preventing MNM.

BACKGROUND: Splenic infarction is a rare event in clinical practice, diagnosed by CT scan. There are many causes. They often determine the treatment given. However, there is no consensus on etiological investigations.
METHODS: We present here an almost systematic review of the literature, based on data available on Pubmed from 1991 to 2022. Using the keywords \"splenic infarct\", from 1893 references, 11 cohort studies and 867 clinical cases were included in this review. Articles written in languages using alphabets other than Latin were excluded.
CONCLUSIONS: Analysis of these various studies has enabled us to draw up a list that is intended to be as exhaustive as possible of the causes of splenic infarction. The most frequent are emboligenic heart disease, hematological malignancies, solid neoplasia and certain infections. The descriptions available in the literature were mainly based on isolated clinical cases, not always making it possible to establish a causal link with the disease described, especially as around 20% of reported cases of splenic infarction were asymptomatic and potentially of incidental discovery. Based on the findings of this literature review, we propose a protocol for the etiological assessment of splenic infarcts.

In recent years, there has been renewed interest in diversifying the understanding and discussion about the causes of depression to move beyond biomedical determinism-a view that biomedical factors are the ultimate cause of an individual\'s depression. There is increasing emphasis on diversity in how people seek to articulate the causes of depression to incorporate non-biomedical dimensions. Furthermore, the biomedical understanding of depression has been increasingly questioned due especially to emerging limitations in pharmacotherapy. These shifts encourage social analyses that explore what narratives as to the causes of depression are constructed and presented with relative plausibility in different contexts and why and how. By analysing published memoirs of individuals diagnosed with depression in Japan, this study aims to provide fresh insights into narratives around the causes of depression. It illustrates how memoirs portray depression and its perceived causes in characteristic ways in a nation that adopts Western diagnostic systems, biomedical therapeutics and other relevant technologies. I will show that \'burnout\' is the dominant theme in the Japanese data, diverging from the predominantly biomedical narrative in Western societies. This burnout narrative depicts depression as the somewhat unfortunate but unsurprising result of overwork arising from individual active adaptations to structural features of the Japanese work culture. I argue that reasons, rather than causes, articulate the making of the burnout narrative by revealing the interplay between the structural and individual and ultimately enrich the understanding of depression. The paper concludes with a call for exploring the shifting relationship between illness and normalcy that the burnout narrative implies. I suggest that further studies could explore how the boundaries between normalcy and illness are enacted and re-enacted and to what avail through public discourse and through shifting diagnostic schemata in the context of different national norms and practices.

The question of whether a fall directly onto the shoulder can cause a rotator cuff tear has occupied doctors (and courts) for many years. Experts who rely on the medical insurance literature usually reject the causality of the incident. There are no scientific studies on this. The report below describes a typical case in which a fall directly onto the shoulder caused a massive rotator cuff tear.
UNASSIGNED: Die Frage, ob ein Sturz direkt auf die Schulter eine Rotatorenmanschettenruptur verursachen kann, beschäftigt Ärzte (und Gerichte) seit vielen Jahren. Gutachter, welche sich auf die versicherungsmedizinische Literatur stützen, lehnen die Unfallkausalität in der Regel ab. Wissenschaftliche Untersuchungen dazu gibt es nicht. Der untenstehende Bericht beschreibt einen typischen Fall, bei dem ein Sturz direkt auf die Schulter eine massive Rotatorenmanschettenruptur verursacht hat.

The unreasonable diet is threatening not only by development of hypodynamia but also by loosing job on board of sea vessel. Such diseases of seamen as gastric ulcer, duodenal ulcer, gastritis, pancreatitis are a basis of non-making or non-extending employment contract. The significant causes of occurrence and development of this category of occupational illness are lacking of proper diet on shipboard that considers conditions of voyages, inadequate qualification training of ship cooks, as well as insufficient funding by particular shipowners daily food allowance of crew members. The article reveals requirements of international and national normative documents regarding organization of proper diet and table service, determines daily diet of crew members of sea and river vessels. The results of survey of active sailors and cadets of higher maritime school regarding the satisfaction of organized diet are discussed. The recommendations to ensure balanced rations on board the ship are proposed.

The negative effect of oil vapors and oil products on health of crew of tanker fleet is a large-scale problem of shipping since safety of life and health of seamen is declared as essential value in implementation of production activity. The inert gases emitted during handling and transportation of oil products, in view of their toxicity, may result not only in acute intoxication but also in development of chronic diseases when inhaling harmful substances in moderate concentrations. The article considers main professional industrial factors that affect crew members of bulk-oil fleet, symptomatology of intoxication and initial care of crew members, application of personal cover when working with this type of cargo. The special attention is paid to chronic diseases developing against the background of negative effect of oil products on health of seamen. The recommendations of prevention and timely detection of their development are proposed.

The causes of accidents are studied in the belief that by finding causes, accidents can be prevented by removing or controlling their causes. It follows that the risk factors that have traditionally been regarded as contributing to accidents can only be regarded as causes if it is possible to alter them by means of one or more road safety measures. Risk factors are causes if their relationship to accidents can be changed by implementing one or more road safety measures influencing the risk factors. Hence, road safety measures that could have been implemented to change risk factors identified as contributing to an accident, but have not, are also causes of accidents. Many of the human factors that have traditionally been identified as risk factors for accidents, like age, gender, driving experience, expectations or involuntary inattention are not causes of accidents, because they cannot be changed by means of any realistic road safety measure. What cannot be changed (could not have been different) is not a cause. It is possible, both in case studies and in statistical analyses, to determine when a set of factors precipitating or contributing to accidents is complete. A list of road safety measures that could have been implemented is only limited by our creativity and imagination and will therefore never be complete.

OBJECTIVE: To investigate the prevalence, characteristics, causes, consequences, and predictors of and responses to disruptive behavior toward nurses in the perioperative arena.
METHODS: A cross-sectional design using a network questionnaire platform.
METHODS: Nurses in the perioperative arena were recruited online in March 2020. Data on disruptive behavior toward nurses in the past 6 months and nurses\' sociodemographic and environmental factors were collected.
RESULTS: Nurses (N = 496) responded validly to the survey. In total, 82.1% of participants experienced disruptive behavior. Assignment of overwhelming workloads and verbal aggression were the most common behaviors, and surgeons were the major perpetrators. Perpetrators\' intrapersonal issues were the most commonly perceived causes. A positive strategy was the most common strategy adopted by participants. Further, 80.8% of participants recounted their negative experiences, and more than half of respondents (59.9%) talked with their nursing colleagues. Nearly half of respondents (45.9%) did not report disruptive behavior. Negative emotions as an immediate effect were reported by 53.1% of the participants, and the most common long-term impact was decreased passion for work. Middle age, job position, practice environment, and system help were risk factors for experiencing disruptive behavior.
CONCLUSIONS: The prevalence of disruptive behavior toward nurses in the perioperative arena is high, and its ramifications should not be ignored. Health care institutions should urgently implement intervention strategies to reduce disruptive behavior toward nurses.