bluuebunny/crossref_metadata_2025 huggingface dataset:
How an unprecedented wildfire shaped tree hollow occurrence and abundance—implications for arboreal fauna
Authors: Wagner Benjamin , Baker Patrick J. , Nitschke Craig R.
Published: May 2024

Background

Tree hollows are an important habitat resource used by arboreal fauna for nesting and denning. Hollows form when trees mature and are exposed to decay and physical damage. In the absence of excavating fauna, hollow formation can take up to 200 years in Australian temperate Eucalyptus forests, making tree hollows a critical but slow forming habitat feature. The increasing frequency and severity of wildfires due to climate change has led to increased concern about the landscape-scale loss of nesting space for arboreal fauna, including endangered species such as the folivorous southern greater glider (Petauroides volans). To understand patterns of nesting resource availability, we assessed drivers of hollow occurrence in southeastern Australian mixed-species Eucalyptus forests and quantified the effects of an unprecedented large-scale wildfire, the 2019/2020 Black Summer bushfires, on hollow occurrence and abundance.

Results

Tree size and shape, as well as site productivity and topography, were important predictors for hollow occurrence both before and after the fires. The occurrence of the southern greater glider was strongly dependent on high proportions of hollow-bearing trees. While high fire severities had a negative impact on southern greater glider occurrence, the number of hollow-dependent arboreal species was not affected. While the wildfires significantly reduced hollow abundance, we did not find significant effects on hollow occurrence. Fires altered the relationship between tree size and hollow occurrence expressed as a change in the probability of hollow occurrence, with a higher likelihood at smaller tree sizes after the fires.

Conclusions

Our findings suggest that post-fire nesting space may be reduced at the tree-scale, while at the stand-scale, hollow-bearing trees persist as biological legacies. These persisting trees can support the recovery of hollow-dependent arboreal fauna, such as the endangered southern greater glider by providing denning and nesting space. Hollow-bearing trees that survived the fires have the potential to form new hollows faster compared to undisturbed mature trees.
Post-COVID-19 syndrome and its sequelae: a cross-sectional study
Authors: Allam Hemat , Elsheikh Mai S. , Elwahidy Ahmad , Monir Rasha , Medhat Amira , Ziada Yasmin M. , Gharib Ahmed , Hamdy Gehan
Published: May 2024

Background

The long-term post-COVID is a very complex pandemic phenotype disease. The persistence of manifestations had resulted in classifying COVID-19 infection into bipolar phase which is a post-COVID-19 subacute phase by which the ongoing symptoms extended for 4–12 weeks and chronic or long COVID-19 phase by which the associated symptoms and abnormalities were extending for more than 12 weeks even after the pandemic.

Aim

Determining the percentage of patients who continued to suffer from different symptoms beyond 12 weeks of COVID-19 exposure and the use of different complementary modalities among patients with post-COVID.

Patients and methods

The present study is a cross-sectional analytical observational study which was conducted through an online questionnaire using Google Forms with a total sample of 123 Egyptian patients older than 30 years old diagnosed with symptomatic and/or laboratory-confirmed COVID-19 infection with persistent health problems over 12 weeks prior to December 2021.

Result

The findings revealed elevated percentages of persistent symptoms and unfavorable long-term consequences extending beyond 12 weeks post-infection, irrespective of vaccination status or hospitalization. These outcomes significantly affected individuals’ health, finances, family dynamics, and lifestyle. Additionally, a notable proportion of cases sought relief through complementary medicine, particularly probiotics and herbal remedies.

Conclusion

The questionnaire is an addition for a comprehensive long-term evaluation that might aid the clinician for follow-up of patient infected with COVID-19 and broaden the use of various complementary medical disciplines.
Surgical management of pseudoaneurysm after subclavian artery-to-descending aorta bypass in an adult patient with aortic coarctation
Authors: Hatori Kyohei , Mohara Jun , Murata Miyuki , Koyano Tetsuya
Published: May 2024

Background

Coarctation of the aorta is a relatively common congenital heart defect. Various operative techniques have been proposed for aortic coarctation repair, which are tailored to individual patient circumstances. However, regardless of the chosen surgical approach, some patients may develop late thoracic pseudoaneurysms. Repeated surgery with a left thoracotomy increases the risk of lung injury and bleeding due to adhesions and rich collateral blood circulation.

Case presentation

The patient underwent subclavian artery descending aortic bypass surgery for coarctation of the aorta at the age of 22 years and developed a pseudoaneurysm 30 years after bypass surgery. From the available surgical options for this condition, we selected total arch replacement using a frozen elephant trunk. The outcomes were excellent.

Conclusions

Depending on each patient’s circumstances, revision surgery using the frozen elephant trunk technique can be a viable option.
Reviews
Authors: Aitken Julie
Published: May 2024

Computing the Climate: How We Know What We Know About Climate Change, by Steve M. Easterbrook, 2023
Risk Assessment of Diabetes Mellitus During and After Pregnancy in Women With Prolactinomas
Authors: Scairati Roberta , Auriemma Renata S , Di Meglio Sara , Del Vecchio Guendalina , Pirchio Rosa , Graziadio Chiara , Pivonello Claudia , Pivonello Rosario , Colao Annamaria
Published: May 2024

Context

Prolactin (PRL) is a crucial mediator of glucoinsulinemic metabolism.

Objective

This work aims to dissect glucose metabolism during and after pregnancy in patients with prolactinomas.

Methods

A total of 52 patients treated with cabergoline (CAB) were evaluated before conception, during pregnancy, and up to 10 years after delivery. During pregnancy, CAB was discontinued, while it was restarted in 57.7% of patients after delivery, due to recurrent hyperprolactinemia (RH). Hormonal (serum PRL) and metabolic (glycated hemoglobin A1c [HbA1c], fasting glucose [FG], glucose tolerance) parameters were assessed.

Results

During pregnancy, PRL gradually increased, while FG remained stable. An inverse correlation between PRL and FG was found in the first (P = .032) and third (P = .048) trimester. PRL percentage increase across pregnancy was inversely correlated with third-trimester FG. Serum PRL before conception emerged as a predictive biomarker of third-trimester FG (t = 2.603; P = .048). Older patients with lower HbA1c in the first trimester and lower FG at 3 years post partum delivered infants with reduced birth weight. Breastfeeding up to 6 months correlated with lower FG at 4 and 10 years post partum. A positive correlation between BMI and FG at 10 years after delivery (P = .03) was observed, particularly in overweight/obese patients requiring higher CAB doses. Patients with RH who had to restart CAB showed shorter breastfeeding duration and higher FG at 2 years post partum.

Conclusion

Low PRL levels before pregnancy may be detrimental to FG during pregnancy. CAB duration and dose may influence long-term glucose tolerance, besides family history and BMI. Preconception metabolic management should be recommended to reduce the risk of gestational and type 2 diabetes mellitus.
At the Intersection of Adverse Life Course Pathways: The Effects on Health by Migration Status
Authors: Loi Silvia , Li Peng , Myrskylä Mikko
Published: May 2024

Adverse life events are major causes of declining health and well-being, but the effects vary across subpopulations. We analyze how the intersection of migration status and sex relates to two main adverse life events—job loss and divorce—thereby affecting individual health and well-being trajectories. Using data from the German Socio-Economic Panel (1984–2017), we apply descriptive techniques and individual fixed-effects regressions to analyze how job loss and divorce influence the health of immigrants and nonimmigrants. Our results support the hypothesis that immigrants suffer more from adverse life events than nonimmigrants in both the short and the long run. Relative to nonimmigrants, immigrants have a health advantage at younger ages, which becomes a disadvantage at older ages, and this faster decline at older ages is particularly steep among immigrants who experience adverse life events. These results help explain the vanishing health advantage of immigrants by showing that they are exposed to a double disadvantage over the life course: immigrants are more likely than nonimmigrants to suffer from adverse life events, such as job loss, and these events typically have a larger impact on their health. Our findings are the first to provide evidence regarding the consequences of different adverse life events and how they relate to the intersection of migration status and sex. Moreover, our results highlight the importance of intersectional analyses in research on immigrant health.
Συγκριτική μελέτη της εφαρμογής του αναλυτικού προγράμματος στα νηπιαγωγεία γενικής και ειδικής εκπαίδευσης και οι επιπτώσεις της στην ποιότητα της εκπαίδευσης των νηπίων
Authors: Παππά Αλεξάνδρα
Published: May 2024

Τα Αναλυτικά Προγράμματα Σπουδών αποτελούν πυξίδα της διδασκαλίας των εκπαιδευτικών όλων των βαθμίδων εδώ και δεκαετίες. Η εφαρμογή τους ήδη από την ευαίσθητη ηλικία του Νηπιαγωγείου στοχεύει στην ολόπλευρη ανάπτυξη της προσωπικότητας του παιδιού, ειδικότερα μέσω καινοτόμων μεθόδων και εμπλουτισμένων μαθησιακών προγραμμάτων. Σκοπός αυτής της προσπάθειας είναι η παροχή ποιοτικής εκπαίδευσης στα νήπια, προκειμένου να καταφέρουν να δομήσουν μια ισχυρή προσωπικότητα και να αποκτήσουν γνώσεις που θα τα βοηθήσουν να ανταποκριθούν στις ολοένα αυξανόμενες ανάγκες και προκλήσεις της σύγχρονης κοινωνίας. Σκοπός της παρούσας έρευνας ήταν να διερευνηθούν οι απόψεις των Νηπιαγωγών που εργάζονται στη Γενική και σε δομές της Ειδικής Εκπαίδευσης (Ειδικά Νηπιαγωγεία, Τμήματα Ένταξης και Παράλληλη Στήριξη) αναφορικά με την εφαρμογή των Αναλυτικών Προγραμμάτων Σπουδών που προτείνονται για τη βαθμίδα του Νηπιαγωγείου, όπως επίσης και οι επιπτώσεις της στην ποιότητα της εκπαίδευσης των νηπίων. Η έρευνα διακρίνεται σε ποιοτική, όπου Νηπιαγωγοί και των δύο ειδικοτήτων από την Περιφέρεια Ηπείρου κλήθηκαν να απαντήσουν σε ερωτήσεις σχετικά με την εφαρμογή του Αναλυτικού Προγράμματος Σπουδών και σε ποσοτική, όπου Νηπιαγωγοί Γενικής και Ειδικής Εκπαίδευσης από όλη τη χώρα κλήθηκαν να αξιολογήσουν προτάσεις που αφορούσαν την ποιότητα της εκπαίδευσης που παρέχεται στην προσχολική εκπαίδευση. Τα ευρήματα της έρευνας φανέρωσαν τους προβληματισμούς και τις δυσκολίες που αντιμετωπίζουν καθημερινά οι εκπαιδευτικοί της Γενικής και Ειδικής Εκπαίδευσης κατά την εφαρμογή των Αναλυτικών Προγραμμάτων Σπουδών και ειδικότερα του νέου Προγράμματος (2023), για το οποίο δήλωσαν απροετοίμαστοι να προχωρήσουν στην εφαρμογή του και να ανταποκριθούν στις απαιτήσεις του. Έπειτα, οι απόψεις των εκπαιδευτικών για την ποιότητα της εκπαίδευσης σε γενικές γραμμές είχαν θετικό πρόσημο, ενώ οι συσχετίσεις που προέκυψαν από τις απαντήσεις των συμμετεχόντων/ουσών προβάλλουν νέες προοπτικές για την έρευνα, καθώς υπάρχουν σημεία που αξίζουν περαιτέρω διερεύνηση.
Comparison of two-dimensional Grummons’ analysis and three-dimensional asymmetry index measurement in diagnosis of dentocraniofacial asymmetry
Authors: Siswoyo Stefanus , Purbiati Maria , Krisnawati Krisnawati
Published: May 2024

Background Dentocraniofacial asymmetry is a common condition that affects many individuals. Accurate diagnosis of this condition is essential for effective treatment planning. Aim This study aimed to compare the diagnosis of dentocraniofacial asymmetry using two-dimensional and three-dimensional methods. Methods A cross-sectional, observational study was conducted at the Orthodontic Specialist Clinic of the Dental Hospital Faculty of Dentistry, University of Indonesia from March to April 2023. The study included 15 patients who had not undergone orthodontic treatment and were diagnosed with dentocraniofacial asymmetry. The study compared the results of diagnosing asymmetry in 15 different facial features, including the anterior nasal spine, upper and lower first incisors, pterygomaxillary fissure, orbita, menton, porion, upper and lower first molars, coronoid process, gonion, zygoma, latero nasale, and jugulare. Results The study found that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two- and three-dimensional methods across all 15 parameters measured. The researchers used Fisher's Exact Test to compare the proportion between dependent variables and found that the p-value was greater than 0.05, indicating that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two methods. The study also used Kappa Cohen analysis to measure the strength of agreement between the diagnosis of dentocraniofacial symmetry of the two-dimensional and three-dimensional methods on each parameter. Conclusion The findings of this study suggest that both two-dimensional and three-dimensional methods are equally effective in diagnosing dentocraniofacial asymmetry. This information may be useful for orthodontists in deciding which method to use when diagnosing dentocraniofacial asymmetry.
There is no easy fix to peer review but paying referees and regulating the number of submissions might help
Authors: L. Seghier Mohamed
Published: May 2024

The exponential increase in the number of submissions, further accelerated by generative AI, and the decline in the availability of experts are burdening the peer review process. This has led to high unethical desk rejection rates, a growing appeal for the publication of unreviewed preprints, and a worrying proliferation of predatory journals. The idea of monetarily compensating peer reviewers has been around for many years; maybe, it is time to take it seriously as one way to save the peer review process. Here, I argue that paying reviewers, when done in a fair and transparent way, is a viable solution. Like the case of professional language editors, part-time or full-time professional reviewers, managed by universities or for-profit companies, can be an integral part of modern peer review. Being a professional reviewer could be financially attractive to retired senior researchers and to researchers who enjoy evaluating papers but are not motivated to do so for free. Moreover, not all produced research needs to go through peer review, and thus persuading researchers to limit submissions to their most novel and useful research could also help bring submission volumes to manageable levels. Overall, this paper reckons that the problem is not the peer review process per se but rather its function within an academic ecosystem dominated by an unhealthy culture of ‘publish or perish’. Instead of reforming the peer review process, academia has to look for better science dissemination schemes that promote collaboration over competition, engagement over judgement, and research quality and sustainability over quantity.
Case Report: A rare renal manifestation of Acute intermittent porphyria
Authors: C Shetty Bhushan , S Arun , R Madi Deepak , M Raj Sheetal
Published: May 2024

Acute porphyria is a group of metabolic disorders characterized by a deficiency in enzymes involved in heme biosynthesis. A 21-year-old female with abdominal pain and an altered sensorium, eventually leading to a diagnosis of acute porphyria. Glucose treatment and other supportive measures were given and her general condition improved. Renal biopsy was done in view of persistent renal dysfunction, which revealed acute tubulointerstitial nephritis with 5-10% interstitial fibrosis and tubular atrophy. This Case highlights a unique manifestation of acute porphyria involving the kidney and emphasizes the importance of considering acute tubulointerstitial nephritis as a cause of renal dysfunction in acute porphyria.
THE PEDAGOGICAL INFLUENCE OF RELIGIOUS EDUCATION ON THE LEGAL CONSCIOUSNESS OF A STUDENT
Authors: Slanov Oleg T.
Published: May 2024

Purpose. The article is devoted to the problem of the influence of religious consciousness on the legal students’ consciousness. The purpose of this work is to study the influence of religious education on the formation of legal consciousness of schoolchildren and students in the modern Russian sociocultural situation.
The work is aimed at identifying the role of religiosity and traditional values in maintaining high moral principles, the unity of society, as well as determining the effectiveness of the pedagogical impact of religious education on the legal consciousness of young people.
Methodology. The work analyzes domestic and foreign research on the influence of religious education on legal consciousness. At the same time, attention is focused on research that is related to the pedagogical impact of religious education on legal consciousness.
Results. The author comes to the conclusion that it will be effective to introduce into teaching activities a block of subjects related to religious education of a supra-confessional nature, promoting unity and education of citizens based on common values.
The effectiveness of modern education is associated not only with knowledge, but also with internal comprehension, which requires independent decisions of students. Religious education and its pedagogical method, based on love and care, taking into account the priority of spirituality, is capable of shaping civic identity. The role of dialogue, creativity and project work is important for deep understanding and value development, promoting the creation of a society based on mutual understanding and respect.
Religious education in such a context acts as a basis for dialogue and mutual understanding, which provides the basis for mutual respect and peaceful coexistence between different religious traditions.
Practical implications. Research can be used to update the educational system, introducing new approaches to learning based on mutual understanding, respect and dialogue. This includes the development and implementation of modules related to religious education, of a supra-confessional nature, which can promote unity and the education of citizens on the basis of common values.
The results of this work can be applied both in the training of teachers and directly within the framework of the organization of legal education in educational organizations.
ORGANIZATION OF EXPERIMENTAL WORK IN A SPECIALIZED GYMNASIUM FOR MANAGING ITS INNOVATIVE DEVELOPMENT
Authors: Kiseleva Galina N.
Published: May 2024

Purpose. The article addresses the current problem of modern education related to the management of innovative development in the educational process at school. The study is dedicated to the theoretical and practical exploration of ways and techniques aimed at effective management of the innovative development of the educational process in schools. The content of the experimental work reveals three directions of innovative development in the educational institution, i.e., specialized education (socio-economic profile), creation of an inclusive environment, and the implementation of innovative pedagogical technologies at each level of education (the technology of developmental learning at the primary education level; the technology of critical thinking at the level of basic general education; the technologies of problem-based and project-based learning at the level of secondary general education).
Method and methodology of the study. The foundation of the research consists of theoretical methods such as analysis and synthesis, as well as empirical methods.
Results. The novelty of the study lies in the development of an organizational-functional model for managing the innovative development of the school's educational process, which consists of five blocks, i.e., conceptual-target, analytical, organizational-managerial, procedural, and analytical-generalizing ones. The practical significance includes the outlined stages and activities in the study at each stage, which will enhance the effectiveness of the educational process.
Practical implications of the results: The obtained results are advisable to be applied in educational institutions of the LPR (Luhansk People's Republic) as well as the Russian Federation.
INFLUENCE OF VISUALIZATION TECHNOLOGIES ON THE DEVELOPMENT OF MEDICAL STUDENTS’ AUTONOMY IN THE PROCESS OF THEIR PROFESSIONAL TRAINING
Authors: Ushakova Olga M. , Strelnikov Sergey S. , Katkova Alla L. , Turov Rostislav S.
Published: May 2024

The autonomy of medical trainees is a critical dimension in their professional maturation. The deployment of visual technologies within the educational frameworks of medical institutions can potentially enhance the autonomy of nascent physicians. However, the discourse on this subject appears to be underexplored. This manuscript endeavors to bridge this lacuna by delineating prospective avenues for inquiry into the interplay between imaging technologies and autonomy.
Materials and Methods. In pursuit of the outlined objective, the investigation employed a multifaceted research paradigm: a systematic approach underpins the study's foundational structure; a methodological perspective, considering visualization not merely as an instructional resource but also as a cognitive tool; and a competency-based approach, positing that the accrual of professional competencies transcends mere knowledge, skills, and abilities, embodying a nuanced professional ethos towards the executed job function.
Research results. The investigation elucidates a dialectical nexus between the utilization of visualization technologies and the burgeoning autonomy of medical students. Primacy in mastering visualization methodologies during decision-making processes cultivates reflective capacities, heralding the development of metacognitive elements conducive to the appraisal of personal knowledge. Such introspection potentially steers students towards deliberate choices regarding their developmental trajectories, fostering accountability for these decisions and, by extension, the attributes of an autonomous individual.
Discussions and Conclusions. A review of extant literature substantiates that the integration of visualization technologies within educational paradigms necessitates a profound methodological familiarity with visualization instruments. The acquisition of visualization technologies mandates the engagement of abstract reasoning, the imperative to conceptualize personal knowledge, and the proficient execution of analytical, synthetic, and modeling techniques to articulate the resultant insights visually. These competencies, while facilitative of autonomy, presuppose an existing degree of individual autonomy, thus illustrating the dialectical interrelation between these constructs.
RESPONSIVENESS OF THE NUR CORN HYBRID TO FOLIAR TOP DRESSING WITH CARBAMIDE AND GROWTH STIMULANT IZAGRI VITA IN THE SOIL AND CLIMATIC CONDITIONS OF THE REPUBLIC OF TATARSTAN
Authors: Mikhaylova Marina
Published: May 2024

The feed potential of the universal early-maturing hybrid corn Nur was studied in the conditions of the Ancestral region of the Republic of Tatarstan on gray forest heavy loamy soils. The content of humus in the arable layer was characterized as increased by 4.4 %, mobile phosphorus as very high - more than 377 mg/kg, exchangeable potassium increased – 124 mg/kg. The soil had a medium reaction close to neutral (pH 6.3). Meteorological conditions in 2023 were characterized as arid with a lack of precipitation during the growing season of corn. To obtain high-quality feed from corn, different corn nutrition systems were studied: without fertilizers, background N16P16K16, background N16P16K16 + urea leaf dressing in the 5-7 leaf phase, background N16P16K16 + Izagri Vita leaf dressing in the 5-7 leaf phase, background N16P16K16 + Izagri Vita leaf dressing in the 5-7 leaf phase and cob formation. Izagri Vita is a growth stimulant with trace elements. Improving the nutritional conditions of corn extends the growing season by 2-3 days. Corn responds positively to the application of mineral fertilizers and carrying out leaf fertilization with carbamide. This technique ensures the formation of the highest plant height (159.7 cm) and leaf area (42.19 thousand m2/ha). The largest aboveground mass was formed on the von NPK+ variant Izagri Vita 44.50 t/ha. Biometric indicators of corn also improved on fertilized food backgrounds. The highest yield of green mass was obtained on the variants background NPK and background NPK + Izagri Vita (2 phases) (45.81 and 41.88 t/ha). The increase in yield from the applied mineral fertilizers amounted to 16.25 and 12.31 t/ha. Better nutrition of corn provides a more nutritious feed from corn. The NPK background variant had the highest mass fraction of dry matter (86.3 %), crude fiber (35.0 %), and NPK background + From graphite, where the mass fraction of nitrogen was 20.5 g/kg, crude protein 128.2 g/kg, phosphorus 1.0%.
The Appreciative Language of the Appreciative Paradigm
Authors: Varona Federico
Published: May 2024

In the realm of Appreciative Paradigm and Inquiry, the mantra ‘words create worlds’ resonates deeply, emphasizing the transformative potential of language. Through oral and written expressions, our linguistic choices shape our perceptions and aspirations. This essay explores Appreciative Language’s essence, tracing its roots, unique traits, and its role in social sciences. By examining its distinct ontology, research methods, intervention approaches, axiology and defining characteristics, we unravel its potential impact on fostering positive change and shaping a better world.
Using Appreciative Inquiry to Understand Workload Reasonability
Authors: Buttram Maria , Stadtmiller Shane
Published: May 2024

This article describes an organizational continuous process improvement project using Appreciative Inquiry to evaluate staff members’ perception of their unreasonable workload, as indicated in the Federal Employee Viewpoint Survey. The goal for approaching the management-directed study was to use AI to frame the conversation around the lifegiving forces aspects AI brings to the organization rather than a traditional continuous process improvement approach in which we would investigate a problem, identify issues, and propose solutions to correct it.
Measuring important activities for patients with knee osteoarthritis: a cross-sectional study
Authors: Dannecker Erin A , Krug Giulianne , Stephens Kelly , Clark Mary J , Aggarwal Ajay
Published: May 2024

Background/Aims

Some patient-reported outcome measures ask questions about fixed (ie standardised) activities. Other patient-reported outcome measures ask questions about activities that patients choose or generate. However, patients' appraisals of the importance of fixed and generated activities have not been directly compared and little is known about the construct of activity importance. The aim of this study was to compare patients' importance ratings for fixed and generated activities. It also examined relationships among patients' ratings of activity importance, pain and physical function.

Methods

Within a prospective cross-sectional design, 60 participants with knee osteoarthritis completed the Brief Pain Inventory, Western Ontario and McMaster Universities Osteoarthritis Index, as well as the McMaster Toronto Arthritis Patient Preference Questionnaire and a Patient-Reported Outcomes Measurement Information System physical function short form, which were modified to measure the importance of generated or fixed activities respectively.

Results

Participants rated generated activities as more important than fixed activities (P<0.01). They also gave higher importance ratings for fixed activities that they performed than fixed activities that they did not perform (P<0.01). The importance of the generated activities correlated with the Brief Pain Inventory (P<0.05) and Western Ontario and McMaster Universities Osteoarthritis Index (P<0.01), but the fixed activities' importance did not. Participants preferred to rate generated activities more than fixed activities (63.8%) and believed that their ratings of generated activities would better inform physicians than fixed activities (55.0%).

Conclusions

The results from this study identified benefits of including generated activities within patient-reported outcome measures and clarified the construct of activity importance for patients with musculoskeletal pain.

Implications for practice

Allied health professionals may maximise activity importance for their patients by focusing on patient-generated activities. However, the best instructions for collecting patient-generated activities are unknown.
Clinical decision making within occupational therapy: a critical reflection of providing palliative care for a patient in the community
Authors: Newson Abigail L
Published: May 2024

Clinical decision-making within occupational therapy is a complex and dynamic process shaped by numerous scientific, narrative, professional, ethical, legal and personal factors. By reflecting on these factors and by developing metacognition of one's own reasoning pathways, biases, and heuristics, patient-centred and balanced clinical decisions can be made. This reflective case study examines the factors underpinning an occupational therapist's clinical decision making for a man with terminal cancer. A critical reflective model is used in this article to provide structure and to ensure critical consideration of the case. Implications for practice aim to serve as inspiration for others to reflect on their own journey, and personal action points are detailed to develop the author's own clinical decision-making.
Developing Students' Critical Thinking: Examining the Influence of Learning Management Approaches Through Meta-Analysis and Propensity Score Matching
Authors: Surin Supansa , Damrongpanit Suntonrapot
Published: May 2024

Critical thinking is a skill that enables individuals to keep pace with changes and enhances crucial competencies for contemporary competitiveness. Many researchers have studied learning management approaches to develop students' critical thinking, resulting in a substantial body of knowledge but lacking clear systematic summaries. The researchers aimed to (a) examine the effect sizes and research characteristics influencing students' critical thinking, and (b) compare the effect sizes of learning management approaches after adjusting with propensity score matching from 108 graduate research published between 2002 and 2021. Data were collected using research characteristics recording forms and research quality assessment questionnaires. Effect sizes were calculated using Glass's method and analyzed through random effect, fixed effect, and regression meta-analysis. Findings revealed that (a) research on developing learning management approaches influences students' critical thinking at a high level (d ̅ = 1.669), with nine research characteristics, including the field of publication, courses, total duration, teacher learning process, learning media, measurement and evaluation, research design, research statistics, and research quality, statistically significantly influencing students' critical thinking, and (b) after adjustment, inquiry-based learning significantly influences students' critical thinking. Recommendations for developing students' critical thinking include learning activities that encourage problem exploration, expanding thinking through collaborative analysis, and applying diverse media and activity sheets tailored to context suitability.
Novel Tricyclic Functionalized Azetidinone Molecules: Synthesis, Characterization and Evaluation of Antidepressant Action
Authors: Bhadre Dipak , Parulben D Mehta
Published: May 2024

In order to assess the depression decreasing effect of the molecules, a forced swim protocol in rats was used to manufacture azetidinone compounds with a tricyclic nucleus. Three different procedures were used in order to synthesize the necessary compounds. Step one involved reacting anthracene-9,10-dione with hydrazine hydrate in the presence of methanol under refluxing conditions to produce 2. Next, several substituted aromatic aldehydes were refluxed with 2 under the influence glacial acetic acid as catalyst to create Schiff bases. Chloracetyl chloride was used under alkaline circumstances to accomplish cyclization in the last stage. The produced compounds 4a-e had a yield range from 61-70% and shown solubility or mild solubility in DMSO, methanol, and chloroform. Using methanol:ethyl acetate (4:6) as the solvent solution, TLC was used to evaluate the purity of the produced compounds. The compounds' Rf values ranged from 0.59 to 0.73. The compounds have a melting temperature range of 172-214°C and were produced as a white to yellow solid. The compounds demonstrated antidepressant activity that was dosage dependent. Compounds 4a, 4b, and 4d had significantly shorter immobility times (p<0.01) than the control group. It became clear that each test chemical may exhibit antidepressant activity when the dosage was increased.
Exertion of Modified Mineral and Plant – based Powders in the Sorption of Pb(II) Ions
Authors: P Indhumathy , Andal N Muthulakshmi
Published: May 2024

Heavy metal rich industrial discharges solemnly threaten the condition of ecosystem and human haleness. Lead pollution as a result of various anthropogenic activities is a major concern due to its high toxic nature. Chelating capacities of treated Magnolia champaca Barks (TMCB) and treated Attapulgite Clay Powder (TACP) are investigated in the process of sequestration under lab scale conditions. The sorbent matrices are subjected to microscopic, SEM / EDAX and FTIR analyses to study the variations in the adsorbents surfaces, alterations in the surface morphological characteristics, specific involvement of metal ions and functional group peaks, with respect to the sorption process. Dimensions and masses of sorbents, metal ion concentration, agitating periods, pH and temperature of the analyzed systems are optimized under Batch Equilibration studies. The experimentally verified samples are analyzed using Atomic Absorption Spectrophotometer to determine the Pb(II) ions concentrations. The derived Freundlich and Langmuir isothermal plots based on the experimental results obtained for TMCB – Pb(II) / TACP – Pb(II) exhibited a better linearity for Freundlich model, thereby, supporting multilayer sorption. A judicious comparison made between TACP and TMCB reveals a marginal sorption performance by the former.
Ganz femoral head reduction associated with coverage and containment procedures improve radiological and functional outcomes in Perthes’ disease
Authors: Massè Alessandro , Giachino Matteo , Audisio Andrea , Donis Andrea , Giai Via Riccardo , Secco Davide C. , Limone Beatrice , Turchetto Luigino , Aprato Alessandro
Published: May 2024

Aims

Ganz’s studies made it possible to address joint deformities on both the femoral and acetabular side brought about by Perthes’ disease. Femoral head reduction osteotomy (FHRO) was developed to improve joint congruency, along with periacetabular osteotomy (PAO), which may enhance coverage and containment. The purpose of this study is to show the clinical and morphological outcomes of the technique and the use of an implemented planning approach.

Methods

From September 2015 to December 2021, 13 FHROs were performed on 11 patients for Perthes’ disease in two centres. Of these, 11 hips had an associated PAO. A specific CT- and MRI-based protocol for virtual simulation of the corrections was developed. Outcomes were assessed with radiological parameters (sphericity index, extrusion index, integrity of the Shenton’s line, lateral centre-edge angle (LCEA), Tönnis angle), and clinical parameters (range of motion, visual analogue scale (VAS) for pain, Merle d'Aubigné-Postel score, modified Harris Hip Score (mHHS), and EuroQol five-dimension five-level health questionnaire (EQ-5D-5L)). Early and late complications were reported.

Results

The mean follow-up was 39.7 months (standard deviation (SD) 26.4). The mean age at surgery was 11.4 years (SD 1.6). No major complications were recorded. One patient required a total hip arthroplasty. Mean femoral head sphericity increased from 46.8% (SD 9.34%) to 70.2% (SD 15.44; p < 0.001); mean LCEA from 19.2° (SD 9.03°) to 44° (SD 10.27°; p < 0.001); mean extrusion index from 37.8 (SD 8.70) to 7.5 (SD 9.28; p < 0.001); and mean Tönnis angle from 16.5° (SD 12.35°) to 4.8° (SD 4.05°; p = 0.100). The mean VAS improved from 3.55 (SD 3.05) to 1.22 (1.72; p = 0.06); mean Merle d’Aubigné-Postel score from 14.55 (SD 1.74) to 16 (SD 1.6; p = 0.01); and mean mHHS from 60.6 (SD 18.06) to 81 (SD 6.63; p = 0.021). The EQ-5D-5L also showed significant improvements.

Conclusion

FHRO associated with periacetabular procedures is a safe technique that showed improved functional, clinical, and morphological outcomes in Perthes’ disease. The newly introduced simulation and planning algorithm may help to further refine the technique.

Cite this article: Bone Joint J 2024;106-B(5 Supple B):40–46.
Preoperative phenotype has no significant impact on the clinical outcomes and long-term survival of mechanically aligned total knee arthroplasty in Asian patients with osteoarthritis
Authors: Bae Kinam , Lee Bum-Sik , Kim Jong-Min , Bin Seong-Il , Lee Jongjin , Kim Donghyok , Jeon Taehyeon
Published: May 2024

Aims

The aim of this study was to investigate the distribution of phenotypes in Asian patients with end-stage osteoarthritis (OA) and assess whether the phenotype affected the clinical outcome and survival of mechanically aligned total knee arthroplasty (TKA). We also compared the survival of the group in which the phenotype unintentionally remained unchanged with those in which it was corrected to neutral.

Methods

The study involved 945 TKAs, which were performed in 641 patients with primary OA, between January 2000 and January 2009. These were classified into 12 phenotypes based on the combined assessment of four categories of the arithmetic hip-knee-ankle angle and three categories of actual joint line obliquity. The rates of survival were analyzed using Kaplan-Meier methods and the log-rank test. The Hospital for Special Surgery score and survival of each phenotype were compared with those of the reference phenotype with neutral alignment and a parallel joint line. We also compared long-term survival between the unchanged phenotype group and the corrected to neutral alignment-parallel joint line group in patients with Type IV-b (mild to moderate varus alignment-parallel joint line) phenotype.

Results

The most common phenotype was Type I-b (mild to moderate varus alignment-medial joint line; 27.1% (n = 256)), followed by Type IV-b (23.2%; n = 219). There was no significant difference in the clinical outcomes and long-term survival between the groups. In Type IV-b phenotypes, the neutrally corrected group showed higher 15-year survival compared with the unchanged-phenotype group (94.9% (95% confidence interval (CI) 92.0 to 97.8) vs 74.2% (95% CI 98.0 to 100); p = 0.020).

Conclusion

Constitutional varus was confirmed in more than half of these patients. Mechanically aligned TKA can achieve consistent clinical outcomes and long-term survival, regardless of the patient’s phenotype. The neutrally corrected group had better long-term survival compared with the unchanged phenotype group.

Cite this article: Bone Joint J 2024;106-B(5):460–467.
PREDICTING MINIMAL CLINICALLY IMPORTANT DIFFERENCE USING IHOT-12 AT ONE YEAR FOLLOWING ARTHROSCOPIC TREATMENT FOR FEMOROACETABULAR IMPINGEMENT USING MACHINE LEARNING
Authors: Green Justin , Khanduja Vikas , Malviya Ajay
Published: May 2024

Femoroacetabular Impingement (FAI) syndrome, characterised by abnormal hip contact causing symptoms and osteoarthritis, is measured using the International Hip Outcome Tool (iHOT). This study uses machine learning to predict patient outcomes post-treatment for FAI, focusing on achieving a minimally clinically important difference (MCID) at 52 weeks.

A retrospective analysis of 6133 patients from the NAHR who underwent hip arthroscopic treatment for FAI between November 2013 and March 2022 was conducted. MCID was defined as half a standard deviation (13.61) from the mean change in iHOT score at 12 months. SKLearn Maximum Absolute Scaler and Logistic Regression were applied to predict achieving MCID, using baseline and 6-month follow-up data. The model's performance was evaluated by accuracy, area under the curve, and recall, using pre-operative and up to 6-month postoperative variables.

A total of 23.1% (1422) of patients completed both baseline and 1-year follow-up iHOT surveys. The best results were obtained using both pre and postoperative variables. The machine learning model achieved 88.1% balanced accuracy, 89.6% recall, and 92.3% AUC. Sensitivity was 83.7% and specificity 93.5%. Key variables determining outcomes included MCID achievement at 6 months, baseline iHOT score, 6-month iHOT scores for pain, and difficulty in walking or using stairs.

The study confirmed the utility of machine learning in predicting long-term outcomes following arthroscopic treatment for FAI. MCID, based on the iHOT 12 tools, indicates meaningful clinical changes. Machine learning demonstrated high accuracy and recall in distinguishing between patients achieving MCID and those who did not. This approach could help early identification of patients at risk of not meeting the MCID threshold one year after treatment.
ACETABULAR FRACTURES IN OLDER PATIENTS INTERVENTION TRIAL (ACEFIT): A FEASIBILITY TRIPLE-ARM RANDOMIZED CONTROLLED STUDY
Authors: Martin Alexander , Alsousou Joe , Chou Daud , Costa Matt , Carrothers Andrew
Published: May 2024

Current treatment options for displaced acetabular fractures in elderly patients include non-surgical management, surgical fixation and surgical fixation with simultaneous hip replacement, the so-called “fix-and-replace”™. There remains a paucity of evidence to guide surgeons in decision making for these difficult injuries. The aim of this study was to assess the feasibility of performing an appropriately powered RCT between treatment options for acetabular fractures in older patients.

This was an NIHR funded feasibility triple-arm RCT with participation from 7 NHS MTCs. Patients older than 60 were recruited if they had an acetabular fracture deemed sufficiently displaced for the treating surgeon to consider surgical fixation. Randomisation was performed on a 1:1:1 basis. The three treatment arms were non-surgical management, surgical fixation and fix-and-replace. Feasibility was assessed by willingness of patients to participate and clinicians to recruit, drop out rate, estimates of standard deviation to inform the sample size calculation for the full trial and completion rates to inform design of a future definitive trial. EQ-5D was the primary outcome measure at 6 months, OHS and Disability Rating Index were secondary outcome measures.

Of 117 eligible patients, 60 were randomised whilst 50 declined study participation. Nine patients did not receive their allocated intervention. Analysis was performed on an intention to treat basis. During the study period 4 patients withdrew before final review, 4 patients died and 1 was lost to follow-up. The estimated sample size for a full scale study was calculated to be 1474 participants for an EQ-5D MCID of 0.06 with a power of 0.8.

This feasibility study suggests a full scale trial would require international collaboration. This study also has provided observed safety data regarding mortality and morbidity for the fix-and-replace procedure to aid surgeons in the decision-making process when considering treatment options.
PREDICTING LENGTH OF STAY OF JOINT REPLACEMENT PATIENTS AT ASHFORD AND ST. PETER'S HOSPITAL USING ARTIFICIAL INTELLIGENCE AND MACHINE LEARNING
Authors: Adla Sreekanteshwar Reddy , Ameer Ashna , Silva Mitul D , Unnithan Ashwin
Published: May 2024

Arthroplasties are widely performed to improve mobility and quality of life for symptomatic knee/hip osteoarthritis patients. With increasing rates of Total Joint Replacements in the United Kingdom, predicting length of stay is vital for hospitals to control costs, manage resources, and prevent postoperative complications. A longer Length of stay has been shown to negatively affect the quality of care, outcomes and patient satisfaction.Â Thus, predicting LOS enables us to make full use of medical resources.

Clinical characteristics were retrospectively collected from 1,303 patients who received TKA and THR. A total of 21 variables were included, to develop predictive models for LOS by multiple machine learning (ML) algorithms, including Random Forest Classifier (RFC), K-Nearest Neighbour (KNN), Extreme Gradient Boost (XgBoost), and Na¯ve Bayes (NB). These models were evaluated by the receiver operating characteristic (ROC) curve for predictive performance. A feature selection approach was used to identify optimal predictive factors. Based on the ROC of Training result, XgBoost algorithm was selected to be applied to the Test set.

The areas under the ROC curve (AUCs) of the 4 models ranged from 0.730 to 0.966, where higher AUC values generally indicate better predictive performance. All the ML-based models performed better than conventional statistical methods in ROC curves. The XgBoost algorithm with 21 variables was identified as the best predictive model. The feature selection indicated the top six predictors: Age, Operation Duration, Primary Procedure, BMI, creatinine and Month of Surgery.

By analysing clinical characteristics, it is feasible to develop ML-based models for the preoperative prediction of LOS for patients who received TKA and THR, and the XgBoost algorithm performed the best, in terms of accuracy of predictive performance. As this model was originally crafted at Ashford and St. Peters Hospital, we have naturally named it as THE ASHFORD OUTCOME.
Development of Ozone Generator Mini with DDBD (Double Dielectric Barrier Discharge) Technology at Atmospheric Air Pressure
Authors: Sudarmanto Agus , Yulianto Eko , Nur Muhammad
Published: May 2024

Pesticide residues in fruits and vegetables pose a danger to human health if consumed for a certain period. This requires appropriate technology for household scale and is environmentally friendly. Ozone is a strong oxidizing agent capable of degrading pesticide residues in fruits and vegetables. Ozone is a green chemical compound because it does not produce harmful derivative compounds, and is even friendly to the environment. The development of a mini ozone generator with DBD technology has been successfully carried out. The DDBD reactor is made of Pyrex glass with a length of 10 cm and an outer diameter of 4 cm. The reactor uses electrodes made of copper plates. The outer electrode is 13 cm long and 5 cm wide, while the inner electrode is 10 cm long and 5 cm wide. Optimization of the mini ozone generator is carried out using high voltage AC pulses whose pulse frequency can be varied from 30 to 60 Hz with 10 Hz intervals. The free air flow rate was varied at 0.2 – 0.8 lpm with an interval of 0.2 lpm. The optimum ozone production of 480 mg/l was obtained at a voltage setting of 2.8 kV and a frequency of 50 Hz and a flow rate of 0.2 lpm. In this setting, the DDBD reactor consumes 9.32 watts of power. The development of mini ozone generator technology has the potential to be applied on a household scale because of the small reactor size and low power consumption.  