bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on forming process of equal wall thickness metal spiral pipe by single screw pump
Authors: Shi Changshuai , Zeng Haoyang , Zhu Xiaohua , Wang Ao
Published: November 2023

To solve the problems of poor high temperature resistance of conventional screw pump stator and difficult machining of screw pump stator with equal wall thickness, this paper created a finite element model of equal wall thickness metal spiral pipe for single screw sump with 42CrMo based on tube hydroforming (THF). In this paper, the forming effects of different processes were evaluated by analysing the average pitch, wall thickness thinning rate and inner contour accuracy. Due to the particularity of design section and irregular plastic flow of material, the wall thickness of internal high pressure forming decreases seriously; on the other hand, because the diameter of the designed section is relatively large, the minimum ratio of D2 to Dmin is 1.12, which shows that wrinkles appear in external high pressure forming. As a result, based on the problems of internal and external high pressure forming, a coupling forming process was proposed. The results show that different parameters of coupling forming have little effect on the average pitch of metal spiral tube, and its maximum deviation is 1.08%; while thickness reduction ratio is proportional to initial diameter and thickness. Besides, when the liquid pressure is 350 MPa, the diameter is 60 mm and the wall thickness is 7.5 mm, the contour matching degree is higher; but the material accumulation and wrinkling will happen when the pipe diameter greater than 60 mm.
Rolling bearing fault diagnosis method by using feature extraction of convolutional time-frequency image
Authors: Hou Junjian , Lu Xikang , Zhong Yudong , He Wenbin , Zhao Dengfeng , Zhou Fang
Published: November 2023

The vibration signal of the bearing is mostly used in the fault diagnosis research of rolling bearings, and the vibration signal has the characteristics of strong non-smoothness and is easy to be disturbed by noise. This characteristic of the vibration signal has a strong adverse effect on the fault diagnosis of bearings. To improve the accuracy of bearing fault diagnosis, a rolling bearing fault diagnosis method based on the combination of a short-time Fourier transform and a convolutional neural network is proposed. Firstly, a short-time Fourier transform is performed on the original vibration signal of the bearing to obtain the time-frequency image of the vibration signal. Then, the dual model of 2D convolutional neural network which can obtain abundant fault information is built. Secondly, the obtained time-frequency image is image compressed to fit the proposed model. Finally, the images are input into the network for fault diagnosis, and the fault classification accuracy reaches 100%. The proposed model is tested by two methods: adding Gaussian noise to the time-frequency image and testing the model using bearing data from other working conditions, and the results show that the proposed method has good noise immunity and generalization, which can provide an effective diagnostic scheme for bearing fault diagnosis.
Effect of tightening process parameters on the T-F curve of bolts in composite structures
Authors: Xuande Yue , Xiaogang Dang , Tao Geng , Honghao Zhang , Ying Xie
Published: November 2023

Aircraft composite structures are widely joined using bolts. Differences in the tightening process parameters for tightening bolts can significantly affect the tightening torque (T)-preload (F) relationship. Some of the more significant process parameters include lubrication conditions, tightening speed, tightening area, sealant and washer. The experimental study compared the differences in T-F curves, friction coefficients, torque coefficients and yield preload during the tightening process for different values of the process parameters. The focus was on the state of the thread surface, the state of the bearing surface, the diffusion of the lubricating medium and sealant with preload, etc. The distribution of the T-F curve was obtained for all possible values of the process parameters. As the tightening speed increases, both the inter-thread friction coefficient and the macroscopic increase in the coefficient of friction on the bearing surface are observed when tightening the bolt head. The presence of sealant reduces the inter-thread friction coefficient. The size of the T-F curve area reflects the sensitivity of the bolt tightening process to the various process parameters. The size of the T-F curve area reflects the sensitivity of the bolt tightening process to the various process parameters.
Analytical method to extract tool workpiece engagement from CAM data for five-axis machining stability prediction
Authors: Xu Yangyang , Zhang Liqiang , Wang Nana , Liu Gang
Published: November 2023

Ball end milling cutters are commonly used for precision machining of complex curved parts in five axis CNC systems. To solve the problem of difficulty in adjusting the spindle speed to achieve stable milling during the five axis milling process of ball end cutters, this paper presents an analytical method for extracting the tool-workpiece engagement (TWE) from computer-aided manufacturing (CAM) data. This method extracts the TWE between the end portion of the ball-end mill and the surface of the workpiece during the processing of free-form surfaces, including slotting, first cutting, and following cutting. Further, the TWE extracted by this method is applied for constructing the cutting force model. The entry and exit angles for each of the micro-element cutting edges under different tool postures are obtained through the conversion matrix, and an efficient full discretization method is used for predicting the stability of the five-axis machining in the slotting mode. Finally, the accuracy and efficiency of the analytical method are verified through simulation and experimentation. The experimental results show that the efficiency of the proposed method increases by about 69% when compared to the arc-surface intersection method and that the predicted value of the five-axis machining stability shows good agreement with the experimental results.
Prototypes of People With Depression
Authors: Ziano Ignazio , Koc Yasin
Published: November 2023

This article investigates the content and the consequences of the prototypes of people with depression in a multimethod fashion. Fourteen preregistered studies (total N = 5,023, with U.S. American, British, and French adult participants) show that laypeople consider people with depression as having specific psychological, social, and physical features (e.g., unattractive, overweight, unsuccessful, introverted). Target prototypicality influences how much laypeople believe others have depression, how much observers believe that depression-like symptoms cause someone to experience psychological pain, and how much professional mental health care is appropriate for others. This effect was not reduced by instructing people to focus on the symptoms and ignore the target features yet was weakly reduced by informing them of the effect. We discuss theoretical implications for the understanding of prototypes of people with depression and practical implications for alleviating the impact of prototypes.
The Revolving Door of Im/Migration: Canadian Refugee Protection and the Production of Migrant Workers
Authors: Masoumi Azar
Published: November 2023

This paper places the seemingly distinct projects of refugee protection and temporary foreign worker programs alongside one another to reveal their interlinked relationship. I argue that despite its seeming humanitarian exceptionality, refugee protection is deeply implicated in the production of both the category and supply of temporary foreign workers for the Canadian economy. I demonstrate that the defining limitations of refugee law in relation to questions of class and economic deprivation are integral to the conceptualization of the category of the migrant worker. I then engage with statistical data to show that patterns of refugee adjudications in Canada have contributed to maintaining the supply of temporary foreign workers. In particular, I show that Canada has consistently rejected refugee claims from key source countries of migrant workers, namely Jamaica and Mexico. By refusing these claims, Canadian refugee protection has constituted Jamaican and Mexican nationals as inappropriate subjects of permanent protection and, subsequently, primed them for incorporation as temporary foreign workers. In effect, Canadian im/migration has operated like a revolving door: pushing some nationalities out of the permanent protection of refugee status while pulling them into the precarious opening of temporary labour migration.
Influence of rail side lubrication and slip rate dependent effects upon the corrugation on the metro small curve track
Authors: Wang Zhiqiang , Lei Zhenyu
Published: November 2023

For investigating the rail corrugation characteristics of metro small curve track under the combined effect of rail side lubrication and slip rate dependence, by developing a three-dimensional vehicle-track coupling numerical model, the wheel-rail (WR) contact stick-slip (SS) characteristics under different transition areas of rail side lubrication in the presence of corrugation were analyzed. Meantime, on the basis of considering the friction slip rate dependence, the SS vibration characteristics under different rail side lubrication conditions were further analyzed to understand the effect mechanism of rail surface friction characteristics on corrugation. The results show that, when there is rail side lubrication, both inner and outer WR systems have the possibility for SS vibration, and the longitudinal SS vibration intensity is greater than the transverse SS vibration intensity; the SS vibration intensity of the inner WR system is greater than that of the outer WR system, indicating that the inner rail is more susceptible to corrugation and the corrugation is more acute. With the expansion of the rail side lubrication range, the standard deviations of longitudinal and transverse adhesion coefficients decrease, illustrating that the expansion of the lubrication range can reduce the SS vibration intensity of WR system. When the co-effects of rail side lubrication and slip rate dependence are considered, the increase of the rail side lubrication range leads to the increase of standard deviations of adhesion coefficients, which may be related to the enhancement of slip effect induced by the increase of the lubrication range. The introduction of slip rate dependent effect can reduce the standard deviation of the WR adhesion coefficient, which demonstrates that the slip rate dependent effect can ease the degree of SS vibration of WR system, thus reducing the probability of corrugation occurrence caused by the SS vibration.
Effect of guar gum and egg addition on characteristics of noodle analog made from rice flour
Authors: Halim Yuniwaty , Kusuma Diandra Tirta , Hardoko Hardoko , Handayani Ratna
Published: November 2023

Noodle analog is a non-gluten-based noodle. Noodle analog made from rice flour is known to have less desirable physical characteristics, such as a harder and less chewy texture. The addition of guar gum as a hydrocolloid and egg in this research was done to improve the rice-flour-based noodle analog characteristics. The aim of this research was to determine the best guar gum and egg concentration to enhance the noodle analog characteristics. The guar gum was added in several concentrations (1.5%, 2%, 2.5%, and 3% w/w), and raw fresh chicken egg was also added in different concentrations (3%, 5%, and 7% w/w). The best noodle analog was obtained with the addition of 3% guar gum and 5% raw fresh chicken egg. This formulation has the lowest adhesiveness value, high elongation, cohesiveness and springiness, with better cooking quality, such as low cooking loss and moderate water absorption. The best noodle analog was then compared to the commercial noodle. The noodle analog had a lower cooking loss, but the wheat flour-based commercial noodle still had better textural properties, such as softer, less adhesive, and springier texture. However, the noodle analog had better cohesiveness and higher tensile strength with a similar elongation compared to wheat flour-based commercial noodle.
When “Old” Meets “New”: Unlocking the Future of Innovative Technology Implementation in Heritage Tourism
Authors: Jia Shizhen (Jasper) , Chi Oscar Hengxuan , Martinez Stephanie Daniela , Lu Lu
Published: November 2023

This paper aims to gain insights into how heritage destinations have adopted innovative technologies (e.g., AI, immersive technology, 3D technology, big data) into their daily operations, and to reveal future research directions that can guide technology studies in the heritage tourism domain. Innovative technologies are crucial for heritage tourism management and marketing as they provide interactive experiences for visitors, improve efficient management of resources, and enhance effective communication among all stakeholders, resulting in increased engagement and sustainability for the heritage tourism industry. To achieve this objective, we propose a conceptual framework for Technology-Destination Interaction. A comprehensive literature search was conducted, resulting in the selection of 111 articles being analyzed and discussed, drawing on the framework. Based on the results, this study proposes seven future research directions that include, but are not limited to, the latest technologies (e.g., ChatGPT, Metaverse, Geo AI) and potential challenges in technology adoption (e.g., tourism leakage, technology waste, or ethnical concerns). Thirty research questions were developed for future studies. The paper contributes to both researchers and practitioners who are interested in investigating the impact of innovative technologies on heritage tourism.
Viewing place: Australian queer screen audiences born in the 1970s and 1980s
Authors: Pym Tinonee , Cover Rob
Published: November 2023

This article investigates how viewers born in the 1970s and 1980s recall Australian film and television LGBTQ+ themes, characters and narratives they viewed while they were growing up. Aspects of place and space were centred in these accounts, from memories of watching a shared television in the domestic family setting to the physical artefact of the video tape. Participants emphasised the theme of mobility toward the city and a rural/urban distinction in the film and television they discussed, and the role of city contexts in providing better access to screen media that represented LGBTQ+ lives – for example, through access to independent cinemas. These memorial accounts were considered formative and often provided the framework by which participants perceive and navigate everyday life as members of minority communities. At the same time, these place-bound accounts of encounters with LGBTQ+ screen texts expressed a complex attachment to domestic spaces, tangible objects and narratives of mobility.
Dynamical analysis of a fractional-order nonlinear two-degree-of-freedom vehicle system by incremental harmonic balance method
Authors: Chang Yujian , Zhu Yuxiao , Li Yongkuan , Wang Meiqi
Published: November 2023

At present, there are few studies considering both nonlinear and fractional characteristics of suspension in vehicle systems. In this paper, a fractional nonlinear model of a quarter vehicle with two-degree-of-freedom (2-DOF) is innovatively proposed to describe the suspension system containing the viscoelastic material metal rubber. Given the lack of a general calculation scheme for the multi-degree-of-freedom fractional-order incremental harmonic balance method (IHBM), a general calculation scheme for the 2-DOF incremental harmonic balance method for nonlinear systems with fractional order is derived. The nonlinear dynamical properties of the presented model are acquired using this method. The accuracy of the proposed method is verified through a comparison with the power series expansion method. Afterward, the effects of the various parameters on the dynamic performance are analyzed. The vibration peak value of the fractional-order model is significantly higher than that of the integer-order model (IOM). Therefore, the suspension parameters should be designed with a margin when using IOM.
Comparative Analysis of Mortality and Amputation Rates in Patients Undergoing Atherectomy for Infra-Popliteal Peripheral Arterial Disease: Insight From the VQI
Authors: Jamil Yasser , Nanna Michael G. , Chaar Cassius Iyad Ochoa , Mena-Hurtado Carlos , Attaran Robert Ramak
Published: November 2023

Introduction:

Infra-popliteal peripheral arterial disease (IPPAD) poses challenges due to high restenosis and occlusion rates. The BASIL-2 trial demonstrated the superiority of endovascular treatment compared with surgical bypass in patients with IPPAD. However, the association between different endovascular modalities and clinical outcomes has not been conclusive.

Hypothesis:

Combining plain old balloon angioplasty (POBA) with atherectomy is associated with improved clinical outcomes compared with POBA alone.

Methods:

Patients who underwent POBA vs POBA+atherectomy for IPPAD from the Vascular Quality Initiative database were identified. To mitigate potential selection bias, we employed propensity score matching (PSM) to balance the distribution of confounding variables for mortality identified on multivariable logistic regression. Subsequently, we compared patient characteristics and long-term outcomes between the 2 treatment groups.

Results:

Among patients who underwent endovascular intervention for IPPAD, 19 979 individuals (80.8%) were treated with POBA alone, while 4747 (19.2%) were treated with both POBA+atherectomy after PSM. Propensity score matching ensured minimal differences in baseline characteristics, such as indication for lower extremity revascularization (LER) and history of LER. After PSM, patients receiving POBA+atherectomy experienced higher rates of technical success and lower perioperative complications, such as renal complications and hematoma, compared with POBA alone. During long-term follow-up, patients who underwent atherectomy had lower rates of major amputation and major adverse limb events (MALE) but slightly lower freedom from reintervention. Nonetheless, there were no differences in mortality.

Conclusion:

Combining POBA with atherectomy appears to be a safe approach in patients with IPPAD, with lower rates of long-term amputation and MALE at the cost of a higher risk of reintervention.

Clinical Impact

The use of adjunctive atherectomy is associated with improved long-term outcomes in patients with infra-popliteal disease.
Impact of Accessory Renal Artery Embolization on Renal Deterioration Under Endovascular Aortic Repair
Authors: Tatsuishi Wataru , Shibuya Kei , Konishi Yasunobu , Konno Naoki , Oi Atsushi , Tamura Kazuki , Kato Yusuke , Abe Tomonobu
Published: November 2023

Objective

The optimal management strategy for patients with accessory renal arteries undergoing endovascular aortic repair is unclear. This study aimed to investigate the impact of accessory renal artery (aRA) embolization on postoperative renal deterioration and to identify the predictors of postoperative renal deterioration in patients who underwent endovascular aortic repair (EVAR).

Methods

A retrospective single-centre observational study was conducted at our hospital. Of 331 consecutive patients who underwent endovascular aortic repair between April 2011 and February 2021, 29 patients with an aRA were included in this study. Spearman’s rank correlation coefficients of decrease in estimated glomerular filtration rate (eGFR), renal volume reduction rate, infarcted renal volume, and quantity of contrast use for postoperative renal deterioration were analyzed. The correlation coefficients of the correlations between infarcted renal volume, renal volume reduction rate, and decrease in eGFR and the rate of aRA diameter were also analyzed. Multivariable nominal logistic regression analyses were conducted to evaluate the odds of postoperative renal deterioration.

Results

The renal volume reduction rate and infarcted renal volume had a significant positive correlation with the decrease in eGFR. Body surface area and preoperative renal volume were significantly but negatively correlated with the decrease in eGFR. The infarcted renal volume, renal volume reduction rate, and decrease in eGFR were significantly and positively correlated with the aRA diameter. The odds ratio for decreased eGFR rate in preoperative renal volume was .96 (95% CI 0.930‒.996, P = .009).

Conclusions

EVAR with aRA embolization impacts postoperative renal deterioration in patients with preoperative low renal volume, and the diameter of the embolized aRA might be a predictor of postoperative renal deterioration.
Gendered constructions of good management by men school leaders: Between hegemonic and caring masculinity
Authors: Kabesa Roy , Berkovich Izhak
Published: November 2023

This qualitative study explored the gendered constructions of good management by men school leaders. The research participants were 30 men school leaders in Israel, selected through purposive sampling. The study aimed to identify the dominant discourses of masculinity and how they shaped ideal school leadership practices. The authors conducted semi-structured interviews with the participants and used thematic analysis to explore the data. The findings suggest that the participants constructed good management using two prototypes of masculinity: hegemonic and caring. Hegemonic masculinity was associated with traditional managerial styles, such as being focused on the task and achieving excellence, using charismatic-visionary behaviours and a focus on resources and organizational structure. By contrast, caring masculinity involves more empowering behaviour styles, concern for others, and the distribution of power. To be regarded as good managers, some participants adopted an androgynous management style, indicating the ongoing struggles associated with the gender experiences of current men leaders.
Conversational artificial intelligence interventions to support smoking cessation: A systematic review and meta-analysis
Authors: Bendotti Hollie , Lawler Sheleigh , Chan Gary C K , Gartner Coral , Ireland David , Marshall Henry M
Published: November 2023

Background

Conversational artificial intelligence (chatbots and dialogue systems) is an emerging tool for tobacco cessation that has the potential to emulate personalised human support and increase engagement. We aimed to determine the effect of conversational artificial intelligence interventions with or without standard tobacco cessation interventions on tobacco cessation outcomes among adults who smoke, compared to no intervention, placebo intervention or an active comparator.

Methods

A comprehensive search of six databases was completed in June 2022. Eligible studies included randomised controlled trials published since 2005. The primary outcome was sustained tobacco abstinence, self-reported and/or biochemically validated, for at least 6 months. Secondary outcomes included point-prevalence abstinence and sustained abstinence of less than 6 months. Two authors independently extracted data on cessation outcomes and completed the risk of bias assessment. Random effects meta-analysis was conducted.

Results

From 819 studies, five randomised controlled trials met inclusion criteria (combined sample size n = 58,796). All studies differed in setting, methodology, intervention, participants and end-points. Interventions included chatbots embedded in multi- and single-component smartphone apps ( n = 3), a social media-based ( n = 1) chatbot, and an internet-based avatar ( n = 1). Random effects meta-analysis of three studies found participants in the conversational artificial intelligence enhanced intervention were significantly more likely to quit smoking at 6-month follow-up compared to control group participants (RR = 1.29, 95% CI (1.13, 1.46), p < 0.001). Loss to follow up was generally high. Risk of bias was high overall.

Conclusion

We found limited but promising evidence on the effectiveness of conversational artificial intelligence interventions for tobacco cessation. Although all studies found benefits from conversational artificial intelligence interventions, results should be interpreted with caution due to high heterogeneity. Given the rapid evolution and potential of artificial intelligence interventions, further well-designed randomised controlled trials following standardised reporting guidelines are warranted in this emerging area.
Health Inequities in the Epidemiology, Diagnosis, Treatment, and Outcomes of Plastic Surgery: A Scoping Review
Authors: Moore Ty , Nees Danya , Jacobsen Samuel , Peña Andriana , Anderson Reece , Garrett Elizabeth , Staggs Jordan , Waters Philo , Love Mitchell , Dunford Bryan , Bacani Rigel , Batioja Kelsi , Vassar Matt
Published: November 2023

Background: Plastic surgery is routinely sought after for the treatment of breast cancer, cleft lip and palate, and gender-affirming care. Inequities exist in plastic surgery in regard to the epidemiology, diagnosis, treatment, and outcomes experienced by patients. The purpose of our scoping review was to (1) outline current literature addressing health inequities in plastic surgery and (2) draw attention to the gaps in this literature. Methods: This scoping review was developed following guidelines from the Joanna Briggs Institute and PRISMA extension for scoping reviews. An initial search of MEDLINE (via PubMed), Ovid Embase, Cochrane Database of Systematic Reviews, and Scopus databases was performed to locate published articles on health inequities in plastic surgery. Articles had to address at least one of the National Institutes of Health's inequity groups we examined. Results: After reviewing full text, 153 studies were included in our final sample. We found race/ethnicity (94/153) and age (90/153) to be the 2 most commonly evaluated inequities in the scoping review. We discovered that patient populations that were older had public or no insurance and/or were in historically marginalized racial/ethnic groups were often less likely to be offered plastic surgery treatments. Conclusion: This scoping review describes the current literature on health inequities in plastic surgery and highlights gaps in the literature that warrant further research. We found significant findings regarding how vulnerable patient populations are affected by health inequities. Research should be conducted to investigate these inequities more thoroughly and discover the best solutions to bridge the gaps in providing equitable care.
Dealing With Discrimination in Physical Health Care Services: Strategies of People With Mental Health and Substance Use Conditions
Authors: Cunningham Ruth , Imlach Fiona , Every-Palmer Susanna , Haitana Tracy , Peterson Debbie
Published: November 2023

Discrimination against people with mental health and substance use conditions (MHSUC) by health professionals contributes to the poor physical health outcomes this group experiences. We surveyed people with MHSUC in Aotearoa New Zealand to explore how they experienced and responded to discrimination from physical health services. Participants identified 6 strategies used to avoid or minimize the impact of discrimination. Avoidance strategies included not seeking help, not disclosing MHSUC diagnoses and changing or seeking out health professionals who did not behave in discriminatory ways. Minimizing strategies were being a “model patient,” taking a support person to consultations or advocating for what they needed, even in the face of discrimination. Physical health services must focus on providing non-discriminatory care to reduce the need for compensatory strategies and improve care of physical illness for people with MHSUC.
Patient Experience With Primary Care Physician Assistants in Ontario, Canada: Impact of Trust, Knowledge, and Access to Care
Authors: Moschella Alexa , Burrows Kristen
Published: November 2023

Physician assistants (PAs) have been integrated into primary care settings to reduce wait times and to optimize continuity of care. Though previous studies suggest that PA utilization leads to improved healthcare access, few studies have investigated patient experience with primary care PAs in Canada. The objective of this study is to explore patient perspectives on primary care PAs in Ontario. A patient survey was developed and distributed to patients seen by PAs in 4 family medicine practices across Ontario, Canada. Results demonstrate that many patients are highly satisfied with their experience including the PA's ability to address their medical needs, establish rapport, and provide fast access to care (including same-day and after-hours appointments). Despite preferring to see a physician for more complex concerns, participants felt that PAs demonstrate similar medical knowledge, competencies, and scope of practice as family physicians. Patients demonstrated a solid understanding of the PA role and recognized the collaborative PA–physician relationship. These findings describe successful patient awareness and acceptance of the PA profession, largely due to positive PA–patient interactions in family medicine settings.
Implementation of Supportive Care Program to Decrease CLABSI in a Middle East Pediatric Hematology and Oncology Inpatient Unit
Authors: Thompson Kurt , Shaheen Mahdi
Published: November 2023

Background: Central venous catheters (CVCs) support the administration of chemotherapy and other medications, blood products, fluids, and nutrient infusions, and reduce the need for peripheral blood sampling in children with cancer. CVC use is also associated with the risk of central-line-associated bloodstream infection (CLABSI). Despite the implementation of CLABSI care bundles, CLABSI prevention remains challenging. Method: This project implemented supportive preventive care interventions to decrease CLABSI in pediatric hematology/oncology patients in a tertiary hospital in the Middle East region. Interventions included bathing or skin care once daily, oral care twice daily, and ambulating patients three times daily. Parent and staff education materials were developed. The project moniker was Step 1-2-3, inspired by successful implementations of such measures in a U.S. cohort showing reduced CLABSI rates. The project used a mixed methods approach. We report outcomes through August 2022. Results: Pre-project (12/2019–05/2020) five CLABSIs occurred in the inpatient unit. Following the implementation of Step 1-2-3, Pediatric Oncology achieved 492 CLABSI-free days. Six CLABSIs then occurred over a short period of time between October 2021 and January 2022, which was associated with high levels of patient acuity and staff sick leave. The inpatient ward remained CLABSI-free from January 9, 2022, through August 2022. Discussion: Extended periods of CLABSI-free care in a pediatric hematology/oncology unit are achievable. A variety of factors contribute to the sustainability of being CLABSI-free. Data collection and analysis are important factors which aided in our understanding of our own CLABSI events.
Effects of Introvision, a self-regulation method with a mindfulness-based perception technique in migraine prevention: a monocentric randomized waiting-list controlled study (IntroMig Study)
Authors: Empl Monika , Löser Sonja , Spille Petra , Rozwadowska Agnieszka , Ruscheweyh Ruth , Straube Andreas
Published: November 2023

Background

Migraine is a brain disorder with recurrent headache attacks and altered sensory processing. Introvision is a self-regulation method based on mindfulness-like perception techniques, developed at the University of Hamburg. Here, we examined the effect of Introvision in migraine prevention.

Methods

Migraineurs with at least five headache days per month were block-randomized to the experimental group (EG) or waiting list group (WL), the latter starting Introvision training six weeks after the EG. Participants learned Introvision in six weekly on-site group sessions with video-conference support followed by three individual video-conference sessions. Headache diaries and questionnaires were obtained before Introvision training and three months after the last individual Introvision session.

Results

Fifty-one patients completed the study. The primary outcome, headache days of the EG after Introvision training compared to those of the WL before the training, showed no significant effect (10.6 ± 7.7, n = 22; vs. 10.9 ± 6.3, n = 29, p = 0.63; Mann–Whitney-U-Test). The secondary outcome, comparing pooled EG and WL data before and after Introvision training, revealed a significant reduction of headache days (from 11.7 ± 6.5 to 9.8 ± 7.0; p = 0.003; Wilcoxon-paired-Test) as well as of acute medication intake and Headache-Impact-Test 6 (HIT-6) scores and increased self-efficacy as quantified by increased FKMS-scores (FKMS: german short form of the Headache Management Self-Efficacy Scale (HMSE)).

Conclusion

Although the study did not reach its primary endpoint, several secondary outcome parameters in the pooled (non-controlled) pre-post analysis showed an improvement with a decrease in monthly headache days by 1.9 days/ month. A larger randomized controlled trial has to corroborate these preliminary findings.

Trial registration

NCT03507400, Registration date 09.03.2018.
Postoperative outcomes, predictors and trends of mortality and morbidity in patients undergoing hip fracture surgery with underlying aortic stenosis: a nationwide inpatient sample analysis
Authors: Hassan Shahzad , Anwar Waqas , Mehta Shivani , Hanif Muhammad Iftikhar , Kamouh Abdallah , Blood Alexander J.
Published: November 2023

Background

Hip fractures frequently necessitate hospitalization, especially among patients aged 75 and above who might concurrently suffer from aortic stenosis (AS). This study focuses on postoperative outcomes, potential determinants of morbidity and mortality, as well as evolving trends in patients with AS undergoing surgical repair of hip fractures.

Methods

A retrospective analysis of the Nationwide Inpatient Sample from 2008 to 2019 was conducted. Hip fracture cases were identified, and a subgroup with AS was isolated using the ICD-9 and ICD-10 diagnostic codes. We compared baseline characteristics, postoperative in-hospital outcomes and trends in mortality and morbidity between patients with and without AS.

Results

From the dataset, 2,834,919 patients with hip fracture were identified on weighted analysis. Of these, 94,270 (3.3%) were found to have concurrent AS. The AS cohort was characterized by higher mean age and elevated burden of cardiovascular comorbidities, such as coronary artery disease, peripheral vascular disease, pulmonary hypertension, congestive heart failure and cardiac arrhythmias. Postoperative mortality following hip fracture surgery was greater in the AS groups compared to non-AS group (3.3% vs 1.57%, p < 0.001). Risk factors such as congestive heart failure (OR, 2.3[CI, 2.1–2.6]), age above 85 years (OR, 3.2[CI, 2.2–4.7]), cardiac arrhythmias (OR, 2.4[CI, 2.2–2.6]), end-stage renal disease (OR, 3.4[CI, 2.7–4.1]), malnutrition (OR, 2.3[CI, 2.1–2.7]) and AS (OR, 1.2[CI, 1.08–1.5] were associated with increased adjusted odds of postoperative mortality. AS was linked to higher adjusted odds of postoperative mortality (OR, 1.2 [CI, 1.1–1.5]) and complications such as acute myocardial infarction (OR, 1.2 [CI, 1.01–1.4]), cardiogenic shock (OR, 2.0[CI, 1.4–2.9]) and acute renal failure (OR, 1.1[CI, 1.02–1.2]). While hospital stay duration was comparable in both groups (average 5 days), the AS group incurred higher costs (mean $50,673 vs $44,607). The presence of acute heart failure in patients with AS and hip fracture significantly increased mortality, hospital stay, and cost. A notable decline in postoperative in-hospital mortality was observed in both groups from 2008–2019 though the rate of major in-hospital complications rose.

Conclusion

AS significantly influences postoperative in-hospital mortality and complication rates in hip fracture patients. While a reduction in postoperative mortality was observed in both AS and non-AS cohorts, the incidence of major in-hospital complications increased across both groups.
Condom use and HIV testing among adults in Switzerland: repeated national cross-sectional surveys 2007, 2012, and 2017
Authors: Buitrago-Garcia Diana , Salanti Georgia , Low Nicola
Published: November 2023

Background

Monitoring of HIV and sexually transmitted infection (STI) prevention is important for guiding national sexual health programmes for both the general population and key populations. The objectives of this study were to examine trends and patterns of condom use at last intercourse and lifetime HIV testing in 2007, 2012 and 2017 in Switzerland, and to explore factors associated with these behaviours in men and women with opposite-sex partners and with same sex partners.

Methods

We analysed data from the 2007, 2012 and 2017 Swiss Health Survey. For each time point, outcome and population group, we conducted a descriptive analysis of weighted data and conducted multivariable logistic regression to obtain adjusted odds ratios (aOR) with 95% confidence intervals (CI) and compared outcomes between the timepoints.

Results

In total, 46,320 people were interviewed: 21,847 men and 23,141 women, who reported having sex only with partners of the opposite sex, 633 men who reported sex with a male partner and 699 women who reported sex with a female partner. Among the three surveys the prevalence of condom did not change but varied from 22 to 26% of men and 15 to 21% in women with only opposite-sex partners (aOR men, 0.93, 95% CI 0.82, 1.06; women 0.98, 95% CI 0.86 to 1.11). In men with any same sex partner the prevalence of condom use was 40% in 2007, 33% in 2012 and 54% in 2017 (aOR 1.80, 95% CI 0.97, 3.34). In multivariable analysis, the factor most strongly associated with condom use was sex with an occasional partner at last intercourse. HIV testing ever increased across all three survey years in people with opposite sex partners: 2017 vs. 2007, aOR men with only opposite-sex partners 1.64 (95% CI 1.49, 1.82), women with only opposite-sex partners 1.67 (1.51, 1.85), men with any same sex partner 0.98 (0.49, 1.96), women with any same sex partner 1.31 (0.74, 2.30).

Conclusions

Monitoring of condom use, and HIV testing should continue and contribute to the development of the national sexual health programme. Stronger promotion of condoms for people with opposite-sex partners might be needed, since overall condom use at last intercourse has not changed since 2007.
Use of traditional and complementary medicine by ethnic Indian women living with polycystic ovary syndrome: a global survey
Authors: Rao Vibhuti Samarth , Armour Mike , Cheema Birinder S , Smith Caroline A , Moran Lisa , Perera Romain S , Lim Siew , Gupta Sabrina , De Manincor Michael , Vaidya Rama , Ee Carolyn
Published: November 2023

Background

Traditional, complementary, and integrative medicine (TCIM) is commonly used by those living with Polycystic Ovary Syndrome (PCOS) but little is known about the use of TCIM such as yoga and Ayurveda in ethnic Indian women with PCOS living worldwide. This survey aimed to explore the prevalence and types of TCIM used and in particular the pattern of use of yoga and Ayurveda including reasons for not using and future interest in using them among non-users.

Method

An online, international cross-sectional survey was conducted using a pre-designed survey tool. Participants were ethnic Indian women of reproductive age who reported that they were medically diagnosed with PCOS. Descriptive analysis was used to identify the proportion of TCIM users, while a multivariable binary logistic regression was used to analyze their characteristics.

Results

Data from 3130 respondents were analysed. The prevalence of TCIM use was 80% (2515/3130). Yoga and Ayurveda were the most frequently practised TCIM modalities with a prevalence of 57% and 37% respectively. We found a high future interest in using yoga (81%) and Ayurveda (70%) among the non-users. The motivation for most Ayurveda use was a recommendation from family/friends (66%), rather than personal choice (38%) or the internet (19%). Most women used Ayurveda because it has natural ingredients (64%) and it is safe (60%) and cited its use to be safe and somewhat helpful. The majority of women were currently practising yoga (73%) up to four times a week (54%) at home (93%). Yoga was primarily used to improve overall health (67%), manage weight (64%), stress (54%) hormonal imbalance (49%) and emotional well-being (48%). Barriers to practising yoga were common among the current users and non-users and included lack of motivation (59% and 59%), time constraints (48% and 39%), and non-availability of yoga teachers specialised in PCOS (31% and 23%). Most women found yoga to be helpful and preferred individual one-on-one (52%) yoga sessions specifically tailored for PCOS (58%).

Conclusion

This is the first international study that discovered the prevalence and pattern of TCIM use among ethnic Indian women with PCOS living worldwide. We support the urgent need for more research, education, and regulation of different TCIM modalities to promote safe and effective practices globally.
The “new normal” of hygiene measures at the end of the COVID-19 epidemic: a survey among French dentists
Authors: Broyer Charles , Fernandez de Grado Gabriel , Offner Damien
Published: November 2023

Objectives

The COVID-19 epidemic upset the standards in terms of hygiene and protection in the dental office, bringing additional precautions for dentists. The objective of our study was to draw the “new normal” of hygiene measures at the end of the COVID-19 epidemic.

Materials and methods

A self-administered questionnaire about transitional recommendations for oral care in the context of the COVID-19 epidemic was published online in private groups dedicated to French dentists.

Results

The 246 respondents understood the reasons behind those recommendations, since 10 out of 11 measures reached a mean score greater than 2.5 on a 0 (not at all) to 4 (absolutely) scale when it came to determining whether the measure made the practitioner feel safe and ensured patient safety. Besides, more of the respondents intended to maintain the measures than they were to apply them before the epidemic.

Conclusions

The COVID-19 epidemic reshaped the relationship to hygiene and protection measures in the context of dental practices. The “new normal” of hygiene measures at the end of the COVID-19 epidemic will probably involve more protective measures than before.

Clinical relevance

These results constitute interesting avenues for public health deliberation, which would make it possible to best adapt future health recommendations in order to define the “new normal” of hygiene measures in dental practices at the end of the COVID-19 epidemic. Therefore, it could have an impact on all practitioners in their clinical activities.
Molecular epidemiology and phylodynamic analysis of enterovirus 71 in Beijing, China, 2009–2019
Authors: Li Jie , Liang Zhichao , Huo Da , Yang Yang , Li Renqing , Jia Lei , Wang Xiaoli , Huang Chun , Wang Quanyi
Published: November 2023

Background

Enterovirus 71(EV71)-associated hand, foot and mouth disease (HFMD) decreased dramatically in Beijing from 2009 to 2019. This study was to investigate the epidemiological characteristics, evolutionary dynamics, geographic diffusion pathway, and other features of EV71 in Beijing, China.

Methods

We conducted a retrospective study of EV71-associated HFMD and its causative agent in Beijing, China, from 2009 to 2019. Phylogenetic and phylogeographic methods based on the EV71 genome were used to determine the evolution features, origin, and spatiotemporal dynamics. Positive selection sites in the VP1 gene were identified and exhibited in the tertiary structure. Bayesian birth-death skyline model was used to estimate the effective reproductive number (Re).

Results

EV71-associated HFMD decreased greatly in Beijing. From 2009 to 2019, EV71 strains prevalent in Beijing shared high homology in each gene segment and evolved with a rate of 4.99*10− 3 substitutions per site per year. The genetic diversity of EV71 first increased and peaked in 2012 and then decreased with fluctuations. The time to the most recent common ancestor (TMRCA) of EV71 in Beijing was estimated around 2003 when the EV71 strains were transmitted to Beijing from east China. Beijing played a crucial role in seeding EV71 to central China as well. Two residues (E145Q/G, A293S) under positive selection were detected from both the VP1 dataset and the P1 dataset. They were embedded within the loop of the VP1 capsid and were exposed externally. Mean Re estimate of EV71 in Beijing was about 1.007.

Conclusion

In recent years, EV71 was not the primary causative agent of HFMD in Beijing. The low Re estimate of EV71 in Beijing implied that strategies for preventing and controlling HFMD were performed effectively. Beijing and east China played a crucial role in disseminating EV71 to other regions in China.
DNA damage response and repair gene mutations are associated with tumor mutational burden and outcomes to platinum-based chemotherapy/immunotherapy in advanced NSCLC patients
Authors: Gu Weiguang , Zhuang Wenya , Zhuang Mengxia , He Minhong , Li Zhihua
Published: November 2023

Background

DNA damage response and repair (DDR) genes are crucial for maintaining the integrity of the genome. This study aims to explore the correlation of DDR gene mutations with TMB, clinical characteristics, and outcomes to platinum-based chemotherapy and platinum-based chemotherapy/immunotherapy in non-small cell lung cancer (NSCLC) without EGFR and ALK alterations.

Methods

Tumor tissue from 49 patients with stage III or IV NSCLC who were without EGFR and ALK alterations were analyzed using targeted next-generation sequencing (NGS). Among them, 13 patients received first-line platinum-based chemotherapy, 32 patients received first-line platinum-based chemotherapy/immunotherapy.

Results

In these NSCLC patients without EGFR and ALK alterations, the frequently mutated genes included TP53, KMT2D and KRAS, the most frequently mutated DDR gene was FANCG, DDR gene mutations were detected in 20 patients. The mutation frequency of homologous recombination (HR) pathway was significantly higher in lung squamous cell carcinoma (LUSC) than that in lung adenocarcinoma (LUAD) (30.8% vs. 5.7%). Among DDR positive patients, a lower percentage exhibited metastasis. Patients with DDR gene mutations, cell-cycle checkpoint pathway mutations, and BER pathway mutations had significantly higher TMB compared to those without corresponding mutations. In the patients receiving platinum-based chemotherapy/immunotherapy, the disease control rate was significantly lower in the DDR-positive group compared with that in the DDR-negative group (55.6% vs. 100.0%). Among LUAD patients receiving platinum-based chemotherapy/immunotherapy, we observed a worse overall survival (OS) in DDR-positive group, as well as poorer progression-free survival(PFS)and OS in BER-positive and FANCG mutated group.

Conclusions

DDR gene mutations are associated with tumor metastasis, TMB, and outcomes to platinum-based chemotherapy/immunotherapy in advanced NSCLC patients.