bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative Risk Factors for Discharge to Facility After Surgery in Geriatric Patients
Authors: Abbitt Danielle , Choy Kevin , Robinson Thomas N. , Jones Edward L. , Horney Carolyn , Sommerville Shala , Jones Teresa S.
Published: May 2024

Background

The Geriatric Surgery Verification Program (GSV) was developed to address perioperative care for patients ≥75 years, with a goal of improving outcomes and functional abilities after surgery. We sought to evaluate preoperative factors that place patients at risk for inability to return home (ie, discharge to a facility).

Methods

Retrospective review of patients ≥75 years old who underwent inpatient surgery from January 2018 to December 2022 at a referral Veterans Administration Medical Center enrolled in the GSV program. Preoperative factors included fall history, mobility aids, housing status, function, cognition, and nutritional status. Postoperative outcomes were discharge designations as home and home with services compared to a facility (skilled nursing facility and acute rehab). Exclusion criteria included preoperative facility residence, cardiac surgery, hospital transfer, postoperative complications, hospice discharge, or in-hospital mortality.

Results

605 patients met inclusion criteria and 173 (29%) excluded as above. Of the remaining 432 patients, mean age was 79 ± 5 and the majority were male, 426 (99%). The majority of patients were discharged home, 388 (90%), compared to a facility, 44 (10%). Patients with a fall history (OR: 2.95, 95% CI: 1.56, 5.57), utilizing a mobility aid (OR: 6.0, 95% CI: 2.8, 12.83), were partial or totally dependent (OR: 4.83, 95% CI: 2.29, 10.17), or who lived alone (OR: 2.57, 95% CI: 1.08, 6.07) had higher rates of discharge to a facility.

Discussion

Preoperative mobility compromise and functional dependence are associated with higher rates of discharge to a facility. These preoperative factors are possibly modifiable with multidisciplinary care teams to decrease risks of facility placement.
A Realist Evaluation of Social Care Practitioners’ Experiences With and Understanding of Applied Healthcare Research
Authors: Birdi Gurkiran K. , Wong Geoffrey , Upthegrove Rachel , Higgs Suzanne , Walsh Annabel , Ahern Amy , Allen Katherine , Howe Jo , Habib Hafsah , Nixon Karen , Oduola Sheri , Maidment Ian
Published: May 2024

Social care practitioners are often under-represented in research activity and output. Evidence-based practice enables social care practitioners to develop/engage the skills to evaluate evidence and be more actively involved in research. REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) is a NIHR-funded study where realist synthesis is used to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions help service users, with severe mental illness, to manage antipsychotic-induced weight gain. Social care practitioners are a key part of the team providing care for people living with severe mental illness and therefore supporting antipsychotic-induced weight gain. The current study, RESOLVE 2, uses realist evaluation and RESOLVE as an illustrative example to help understand why and how social care practitioners engage (or not) with research. Semi-structured, audio-recorded interviews will be undertaken with a purposive sample of approximately 20 social care practitioners working with people who have severe mental illness, are treated with antipsychotics, and have experienced weight gain. Participants will be recruited from NHS Trusts and recruitment avenues such as social media and personal networks. Topics discussed during interviews will include barriers and facilitators to engagement in research, current, and past engagement as well as recommendations for researchers and other practitioners. Interview recordings will be transcribed verbatim and analyzed using realist evaluation which will allow in-depth causal explanations for research engagement. Better understanding of research engagement by social care practitioners will allow for evidence-based practice and better patient outcomes within these settings.
Using active cooling/heating for 1C1R grey-box model parameter identification in an actual environment: A proof-of-concept study
Authors: Takahashi Atsushi , Hokari Hiroaki , Doi Mamoru , Yoshikawa Nobuyuki , Mariyama Toshisada , Ueda Naonori , Hirai Norio
Published: May 2024

A model predictive control (MPC) has been important method for managing both comfort and energy saving in heating, ventilation, and air conditioning (HVAC) problems. However, recent data-driven models for MPC, relying on extensive training data, pose challenges for practical implementation in real-world thermal environments due to their time-consuming nature. The grey-box approach, utilizing a simple RC model as a thermal environment proxy, is well known for its data efficiency. Nevertheless, numerical instability arising from the multi-collinearity of observed data can degrade the model’s time efficiency. To deal with this issue, we propose and implement a rapid and stable parameter identification method that integrates active cooling-heating within the actual thermal environment. Our method requires only a single day of data to estimate basic RC model parameters, allowing for immediate use of the RC model in MPC as soon as an air conditioner is installed.

Practical Application

Using a grey-box model for MPC in HVAC systems is efficient, but the multicollinearity problem of observed data undermines its time efficiency. Our method deals with this challenge by enabling immediate model parameter identification with just 1 day’s data, incorporating active cooling-heating. We demonstrate it in an actual thermal environment. The high level of time and data efficiency afforded by our method is particularly beneficial for IoT applications like malfunction detection and adaptive room reparameterization associated with room rearrangement.
Comparison of 1 Year Nasal Tip Projection Results of Triple Cartilage Combining Suture (Flexible Tongue-in-Groove) and Classical Tongue-in-Groove Techniques
Authors: Bafaqeeh Sameer Ali , Bayar Muluk Nuray , Öztürk Zeynel , Oğuz Oğuzhan , Altiner Halil İbrahim , Cingi Cemal
Published: May 2024

Objectives: In the present study, we compared patient satisfaction with classical tongue-in-groove (TIG) technique and triple cartilage combining suture (TCCS; flexible tongue-in-groove) techniques applied to the nasal tip in rhinoplasty. Methods: In this retrospective study, 80 patients who underwent rhinoplasty operations with TIG or TCCS techniques applied to the tip region were included. There were 40 patients in both groups. All patients in groups 1 and 2 were evaluated by the criteria written below at preoperative, postoperative first month, and postoperative first year: (1) Rhinoplasty Outcomes Evaluation Questionnaire (ROE), (2) tip projection (cm), (3) nasal dorsum length (cm), (4) tip projection ratio (Goode), (5) nasofrontal angle, and (6) nasolabial angle. Results: The patients were followed up at 84.32 ± 19.38 months in the TIG group and 87.47 ± 18.01 months in the TCCS group. Our results showed that preoperative, postoperative first-month, and first-year tip projection ( P = .013, P = .022, and P = .020, respectively), and nasal dorsum length values ( P = .009, P = .020, and P = .020, respectively) of the TCCS group were significantly lower than those in the TIG group. There was a positive correlation between the postoperative first month and postoperative first year ROE scores. Lower preoperative tip projection ratio (Goode) values and higher nasolabial angle values were related to higher ROE scores showing patient satisfaction. Conclusion: For the patient satisfaction after tip rhinoplasty, lower projection ratio (Goode) and higher nasolabial angle values were related to ROE scores. Although there are no significant results, lower tip projection results in the TCCS group may be related to more patient satisfaction due to natural appearance.
Applying the human component model of parenting to other primates: Developmental patterns of mother-child interactions across primate species
Authors: Liebal Katja , Ersson-Lembeck Manuela , Amici Federica , Schultze Martin , Holodynski Manfred
Published: May 2024

The component model of human parenting has been extensively used to study parents’ interactions with their offspring and to examine variation across cultural contexts. The current study applies this model to nonhuman primates to investigate which forms of parenting humans share with other primates and how these interactions change over infants’ first year of life. We repeatedly observed 52 mother-infant pairs, including humans ( N = 11), chimpanzees and bonobos ( N = 21), and several species of small apes ( N = 20), during different daily activities when infants were 1, 6, and 12 months of age. Humans differed from apes in their higher probability of face-to-face contact and the use of object stimulation. Moreover, parenting seemed to be characterized by more variability within humans than within and possibly between ape species. Overall, the component model of parenting appears to be an effective tool to study the functional systems of parenting behavior in a comparative developmental perspective, by allowing direct comparisons between human and non-human primate species across development.
Pyruvate dehydrogenase complex deficiency masked by septic shock-induced lactic acidosis: a case report
Authors: Zhou Hao , Wen Yin , Ding Hongguang
Published: May 2024

Pyruvate dehydrogenase complex (PDHC) deficiency is a common genetic disorder leading to lactic acidosis, which can also result from several nongenetic conditions, such as septic shock. The present study reports a case of PDHC deficiency masked by septic shock-induced lactic acidosis. This case involved a 16-year-old adolescent with poor exercise tolerance compared with his peers, and no underlying diseases. The disease onset was characterized by cough, fever, and dyspnea, with hypotension and elevated lactate levels, which indicated septic shock. However, severe hypoglycemia and lactic acidosis persisted despite resolution of a pulmonary infection and correction of septic shock, requiring continuous intravenous infusion of 50% glucose. Although the patient did not experience acute kidney injury and had normal urine output, continuous renal replacement therapy was used to regulate the internal environment owing to the severity of the acidosis. The diagnosis of PDHC deficiency was considered on the basis of the persistent hypoglycemia and hyperlactatemia, before genetic mutation testing was completed. The clinical thinking process required a rich accumulation of pathophysiological knowledge. This article reports a case of PDHC deficiency masked by septic shock-induced lactic acidosis to raise awareness of the disease and avoid misdiagnosis and missed diagnosis.
Computer-Based Training for Cognitive Behavioural Therapy for Substance Use Disorder: A Randomized Controlled Trial Including Quantitative and Qualitative Health and Economic Outcomes: Formation informatisée pour la thérapie cognitivo-comportementale pour les troubles liés à l'usage de substances : un essai randomisé contrôlé y compris les résultats quantitatifs et qualitatifs en matière de santé et d’économie
Authors: Patel Alina , Corman Michael , de Oliveira Claire , Mason Joyce , Somé Nibene , Downie Danielle , Jain Esha , Patterson Michelle , Cunningham John A. , George Tony P. , Le Foll Bernard , Quilty Lena C.
Published: May 2024

Objectives

Heavy alcohol and drug use is reported by a substantial number of Canadians; yet, only a minority of those experiencing substance use difficulties access specialized services. Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT) offers a low-cost method to deliver accessible and high-quality CBT for substance use difficulties. To date, CBT4CBT has primarily been evaluated in terms of quantitative outcomes within substance use disorder (SUD) samples in the United States. A comparison between CBT4CBT versus standard care for SUDs in a Canadian sample is critical to evaluate its potential for health services in Canada. We conducted a randomized controlled trial of CBT4CBT versus standard care for SUD.

Methods

Adults seeking outpatient treatment for SUD ( N = 50) were randomly assigned to receive either CBT4CBT or treatment-as-usual (TAU) for 8 weeks. Measures of substance use and associated harms and quality of life were completed before and after treatment and at 6-month follow-up. Qualitative interviews were administered after treatment and at follow-up, and healthcare utilization and costs were extracted for the entire study period.

Results

Participants exhibited improvements on the primary outcome as well as several secondary outcomes; however, there were no differences between groups. A cost-effectiveness analysis found lower healthcare costs in CBT4CBT versus TAU in a subsample analysis, but more days of substance use in CBT4CBT. Qualitative analyses highlighted the benefits and challenges of CBT4CBT.

Discussion

Findings supported an overall improvement in clinical outcomes. Further investigation is warranted to identify opportunities for implementation of CBT4CBT in tertiary care settings. Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03767907
Bi-objective optimization for last-mile routing of garbage trucks: Aesthetics and Public exposure
Authors: Das Aathira K. , Chilukuri Bhargava Rama
Published: May 2024

In the area of Solid Waste Management, transportation of the collected waste is a critical aspect considering the substantial time spent by garbage trucks on public roads. Studies have reported that transporting garbage has challenges related to public exposure and aesthetics. This study presents a generalised bi-objective formulation for the optimal routing of garbage trucks from transfer stations to recycling sites/landfills considering the trade-off between public exposure and aesthetic loss and constraining the operating cost. The formulation uses the novel link capacity function to account for the delay at traffic signals and the mix of trucks and cars on link performance. The proposed formulation is solved using the weighted sum and ε-constraint methods and applied to a realistic case study of the City of Chicago, USA. The Pareto Front obtained for the bi-objective formulation offers diverse trade-off solutions catering to distinct performance metrics. The results highlight the disparity across the solutions; the solution (P0.95 on Pareto Front) for minimum operating cost (or travel time or distance travelled) is very different from the solution (P0.4 on Pareto Front) for aesthetic cost and public exposure. The parametric study indicated that a modest operating budget may suffice for achieving aesthetic benefits, but minimising public exposure requires a higher operating budget. Finally, the proposed framework is adaptable to address various challenges pertaining to waste transportation, thereby serving as a valuable tool for evaluating policies and practices geared towards sustainability objectives.
Bond graph realizations of state space linear time-invariant multivariable descriptions
Authors: Galindo Orozco René
Published: May 2024

Given a state space description of a linear time-invariant multivariable system, a similarity transformation is applied to get a controllability canonical form. This transformation assures a Bond Graph (BG) realization and avoids the use of active bonds. Active or signal bonds do not preserve the continuity of power flows and consequently, energy conservation properties are lost. The state matrix of the system in transformed coordinates contains an antisymmetric matrix associated with the storage field and the rest is associated with the dissipative field. Thus, in general, the dissipative field is implemented with a multiport element, and in order to give physical meaning, the storage field is implemented with one-port elements. The resulting BG model does not have zero-order causal paths, that is, algebraic loops between the dissipative elements. The results are applied to the BG realization of a linear robust multivariable controller that is designed for a two mass system modelled in BG.
Employees’ Entrepreneurial Orientation in Manufacturing Firms: An Empirical Study
Authors: Nallaluthan Kesavan , Amin ul Haq Mirza , Ghouri Arsalan Mujahid , Hanafi Norshafizah Binti , Baskaran Shathees
Published: May 2024

This study aims to examine the relationship between organizational characteristics, knowledge management enablers, learning orientation, and employee entrepreneurial orientation (EO) among manufacturing industry employees in Klang Valley, Malaysia. The theoretical model based on the Resource-Based Theory approach to employee EO was developed. To answer the research questions, seven hypotheses were formulated. Self-administered questionnaires were distributed to the manufacturing industry employees. A total of 386 manufacturing employees of all levels were involved in this study, making an overall 25.73% response rate. This study utilized the Partial Least Squares Structural Equation Modelling to establish the validity and reliability of the measurement model and test the relationships. The findings of the study showed that both organizational characteristics and knowledge management enablers have significant influences on employee EO. The results indicated that learning orientation has a mediating role in the relationship between organizational characteristics toward employee EO, and knowledge management enablers toward employee EO. The findings offered several theoretical and practical implications to employees and policymakers. The limitations of the study are addressed and recommendations for future research work are also offered.
Medical Education Technology: Past, Present and Future
Authors: Chowdhury Plaban Nath , Vaish Abhishek , Puri Bipin , Vaishya Raju
Published: May 2024

Background and Aims:

Medical Education Technology has witnessed significant transformation over the years, largely influenced by advancements in technology. From traditional lecture-based teaching to the integration of multimedia tools and virtual simulations, the landscape of medical education has evolved to meet the needs of learners in an ever-changing healthcare environment.

Objectives:

To explore the evolution of Medical Education Technology, highlighting key milestones from the past, assessing the current state of technology integration in medical education, and envisioning future trends and challenges.

Methods:

A comprehensive review of the literature was conducted to examine the historical progression of Medical Education Technology.

Results:

The review revealed a notable evolution in Medical Education Technology, from early implementations of multimedia tools to the widespread adoption of online platforms and virtual simulations.

Conclusions:

Medical Education Technology has evolved significantly from past innovations to the present integration of virtual platforms. Looking ahead, future advancements promise to further revolutionise medical education, ensuring better preparation of healthcare professionals for the challenges of modern practice.
“It’s Not the CEOs, It’s Us”: On the Challenges of CEO Research and a Call for Deeper Engagement
Authors: Bourgoin Alaric , Harms P. D.
Published: May 2024

Much of the upper echelons’ literature presumes that CEOs are unlikely and unwilling to participate in research regarding their roles and decision-making processes. In this opinion piece, we argue that the dearth of research utilizing primary data from the CEO population poses a challenge to the diversity and soundness of scholarship in this field, limiting our own capacity to truly know these crucial informants. Furthermore, we assert that the reluctance of organizational scholars to involve CEOs in their research is rooted in several assumptions that warrant re-evaluation. Drawing from a critical assessment of existing literature and our own experiences, we propose suggestions for effective strategies to engage with CEOs in our research endeavors.
Families as Healing Partners: A Collaborative Approach to Addressing Suicidality in Child Counseling
Authors: Wisolmerski Rachel , Frawley Caitlin
Published: May 2024

Suicide is the second leading cause of death in the United States for youth ages 12 to 17; thus, child counselors are encouraged to gain knowledge and skills to address this public health crisis. A major component of all child counseling practices, and particularly crisis counseling, is family collaboration. Given the dearth of research and scholarship regarding family counseling practices for addressing youth suicidality, we propose a five-week model to support counselors’ systemic healing work: Family Collaboration in Suicide Prevention ( FCSP). In this article, we introduce the model through providing (a) strategies for family rapport building, (b) engaging in means reduction with families, (c) developmental considerations for response and assessment practices, and (d) an overview of the model objectives and weekly curriculum.
The Impact of Climate Change and Natural Disasters on Pakistan's GDP Growth: An ARDL Analysis
Authors: Wu Shengwen , Liu Xuefeng , Ali Asma Muhammad , Awan Abdul Ghafoor
Published: May 2024

The main objective of this study is to determine the impact of climate change and natural disasters on GDP growth rate. In order to examine long run association between climate change, natural disasters and GDP, an Auto Regressive Distributed Lag (ARDL) model and correlation matrix were employed, using 20 years data spanning from 2001 to 2021. The focus of the study was to investigate into how CO2 emission causes climate change and climate change, in turn, causes natural disasters and, in turn, natural disasters cause human and crop losses as well as high inflation. The empirical evidence reveals that climate change, CO2 emissions and natural disasters have negative association with GDP because natural disasters in the shape of earthquakes, heavy rains, and floods cause huge human and crop losses, have negative impact on GDP. The variables, agriculture production and employment, have positive and significant association with GDP growth because increase in agriculture production and employment will definitely have significant and positive impact on GDP growth in the long run. The study suggests to build resilient technologies to cope with climate change, control CO2 emissions and inflation as these three variables have negative impact on GDP growth in the long run. This study significantly contributes by highlighting the link between climate change and natural disasters and their consequential negative impact on GDP growth.
A fast calculation method for internal blast shock wave in confined structures
Authors: Yao Shujian , Wang Yanjing , Hu Yutao , Zhang Duo
Published: May 2024

Internal explosions are more complicated and destructive than external explosions. It is hard to give accurate predictions of the internal blast load by existing simplified models. In the present work, a fast calculation method for the shock wave of internal blast within a confined space was developed. Firstly, the theoretical bases of this method, the reflection addition rules and the image burst theory, were introduced and validated. Then, the concept of the influence region of image burst for internal blast calculation was proposed, and the detailed calculation method for internal blast load was presented. In addition, the internal blast loads inside a typical cubic structure and a tunnel model were calculated using this developed method, respectively. Moreover, comparison studies between the calculated results and experimental data as well as numerical simulation results were conducted. It was found that the results of the fast calculation model are in good agreement with those of the blast experiment and fine numerical simulation, but the fast calculation takes only less than 2 min. Finally, the advantages and defects of the present method were discussed and further study advices were suggested to improve the accuracy.
Towards exascale for wind energy simulations
Authors: Min Misun , Brazell Michael , Tomboulides Ananias , Churchfield Matthew , Fischer Paul , Sprague Michael
Published: May 2024

We examine large-eddy-simulation modeling approaches and computational performance of two open-source computational fluid dynamics codes for the simulation of atmospheric boundary layer flows that are of direct relevance to wind energy production. The first code, NekRS, is a high-order, unstructured-grid, spectral element code. The second code, AMR-Wind, is a second-order, block-structured, finite-volume code with adaptive mesh refinement capabilities. The objective of this study is to co-develop these codes in order to improve model fidelity and performance for each. These features will be critical for running ABL-based applications such as wind farm analysis on advanced computing architectures. To this end, we investigate the performance of NekRS and AMR-Wind on the Oak Ridge Leadership Facility supercomputers Summit, using 4 to 800 nodes (24 to 4,800 NVIDIA V100 GPUs), and Crusher, the testbed for the Frontier exascale system, using 18 to 384 Graphics Compute Dies on AMD MI250X GPUs. We compare strong- and weak-scaling capabilities, linear solver performance, and time to solution. We also identify leading inhibitors to parallel scaling.
Tourists’ willingness to adopt government-led smart tourism platforms: A mixed-methods study
Authors: Lu Jiaxin , Fan Alei , Liu Jia , Qi Ying
Published: May 2024

The diversity of demands in the mass tourism market together with the complexity of innovative technologies makes promoting smart tourism a challenge. In recent years, government-led smart tourism platforms have become a representative product of smart tourism in China, but tourists do not seem ready to embrace innovative products. The current research adopted a mixed-methods approach by employing a decision-making trial and evaluation laboratory method followed by a survey-based study to explore key factors driving Chinese tourists’ adoption of government-led smart tourism platforms. The results revealed that the elements influencing tourists’ willingness to adopt are complex and include tourists’ innovativeness, performance expectancy, perceived cost, perceived risk, and perceived playfulness. Among them, tourists’ innovativeness showed a positive impact on tourists’ willingness to adopt through the mediation effects of performance expectancy. Meanwhile, the positive effect of performance expectancy on their willingness to adopt can be mediated by perceived playfulness. The findings enhance our understanding of which factors impact tourists’ adoption theoretically thereby practically helping the government provide better tourism service experiences in both online and offline contexts.
Identification of bridge influence line and multiple-vehicle loads based on physics-informed neural networks
Authors: Li Xingtian , Zhu Jinsong
Published: May 2024

Influence lines (ILs) and vehicle loads identification are critical in the design, health monitoring, and damage detection of bridges. Traditionally, the approach used in most existing literature has been to solve the system of equations directly. However, these approaches require complex calculations such as matrix decomposition and regularization coefficient optimization, making them difficult to implement. In addition, there are difficulties in obtaining accurate axle information and effectively separating the bridge response due to each vehicle. Thus, the improvement of identification algorithms for ILs and multi-vehicle loads remains of significant importance. To address these issues, this paper presents a novel approach that integrates prior physical equations and neural networks. This is achieved by integrating the equation that reflects the relationship between axle loads and bridge response into the neural network, utilizing existing methods for acquiring axle information of vehicles. To validate the effectiveness of the proposed method, it was first applied to theoretical and simulation data. The study then investigated the impact of noise and dynamic effects on the accuracy of the results, as well as the range of the neural network layers and sampling intervals. Finally, the method was implemented for identifying multiple-vehicle loads. The findings of the study confirm the feasibility and numerical stability of the proposed approach. The proposed method eliminates the need for complex computational processes, including matrix decomposition, diagonalization, regularization coefficient optimization, and solution vector smoothing fitting. As a result, the implementation of the algorithm is significantly less challenging, and identification accuracy is improved. It is important to note, however, that the proposed method is relatively more time-consuming due to the iterative learning and training required by the neural network.
Design and research on multi-sensory comfort data acquiring of tight sportswear in motion
Authors: Cheng Pengpeng , Zeng Xianyi , Bruniaux Pascal , Tao Xuyuan
Published: May 2024

This study aims to achieve intelligent monitoring of clothing comfort in motion, providing data and technical assistance for the research of comfort in motion and an efficient design foundation for sportswear comfort optimization. In view of the present situation of smart wear used in clothing comfort research, this paper primarily presents the construction of an acquisition system in motion, including temperature, humidity, and pressure data acquisition device, data pre-processing, data storage, and so on, which was called the ATHPD system for short. With the help of this acquisition system, tights in motion may now be tested for pressure, heat, and humidity for the first time. It can also transmit data wirelessly. Meanwhile, in order to verify the effectiveness of the acquisition system, by comparing the measurement data of the acquisition system (ATHPD system) with the measurement data of existing acquisition equipment (AMI3037 pressure measurement system, DS1923 button temperature and humidity recorder). The findings demonstrate that there is no significant difference between the data collected by the two methods, which proves the reliability of the acquisition system in this paper. The system guarantees the same quantity of temperature, humidity, and pressure data to be gathered at the same time and the consistency of the corresponding time points and also provides relevant data support for the evaluation and prediction model construction of human comfort in motion.
Language and LGBTQ Politics: The Effect of Changing Group Labels on Public Attitudes
Authors: Jones Philip Edward
Published: May 2024

The labels used to describe sexual and gender minorities in the U.S. have shifted over time and become increasingly inclusive. Movement organizations have changed from describing the “lesbian, gay, and bisexual” (“LGB”) community to adding transgender (“LGBT”) and then also queer (“LGBTQ”) identities. Do these different labels affect public views of the group and support for their rights? I embedded a question wording experiment in a statewide survey, asking respondents about either LGB, LGBT, or LGBTQ people. The labels had no discernible effect on (1) support for requiring businesses to serve the group; nor (2) views of the group’s political leanings. There is no evidence that ideology and partisanship moderated these null effects: liberals and conservatives, Democrats and Republicans, were unaffected by the changing designations. This suggests public attitudes are not contingent on how the LGBTQ community is labelled, a finding with implications both for movement organizations and survey researchers.
Advancing Cross-Cultural Research Through Mixed Methods Inquiry
Authors: Hitchcock John H. , Nastasi Bonnie K.
Published: May 2024

Mixed methods principles can support and advance cross-cultural research. This article provides different ways for researchers to conceptualize culture and summarizes the Synergistic Participatory Mixed Methods Quality Model (SPMMQM): Cycle of Research. The SPMMQM summarizes several mixed methods principles and philosophical foundations that support cross-cultural work, including the application of etic and emic concepts drawn from ethnography. This article also introduces the idea of using joint displays within the SPMMQM and cites several primary resources readers can consult should they wish to learn more about cross-culture mixed methods research.
The effect of anxiety and its interplay with social cues when perceiving aggressive behaviours
Authors: Silva Fábio , Garrido Marta I. , Soares Sandra C.
Published: May 2024

Contextual cues and emotional states carry expectations and biases that are used to attribute meaning to what we see. In addition, emotional states, such as anxiety, shape our visual systems, increasing overall, and particularly threat-related, sensitivity. It remains unclear, however, how anxiety interacts with additional cues when categorising sensory input. This is especially important in social scenarios where ambiguous gestures are commonplace, thus requiring the integration of cues for a proper interpretation. To this end, we decided to assess how states of anxiety might bias the perception of potentially aggressive social interactions, and how external cues are incorporated in this process. Participants ( N = 71) were tasked with signalling the presence of aggression in ambiguous social interactions. Simultaneously, an observer (facial expression) reacted (by showing an emotional expression) to this interaction. Importantly, participants performed this task under safety and threat of shock conditions. Decision measures and eye-tracking data were collected. Our results showed that threat of shock did not affect sensitivity nor criterion when detecting aggressive interactions. The same pattern was observed for response times. Drift diffusion modelling analysis, however, suggested quicker evidence accumulation when under threat. Finally, dwell times over the observer were higher when under threat, indicating a possible association between anxiety states and a bias towards potentially threat-related indicators. Future probing into this topic remains a necessity to better explain the current findings.
Economic evidence of clinical decision support systems in mental health: A systematic literature review
Authors: Stien Line , Clausen Carolyn , Feldman Inna , Leventhal Bennett , Koposov Roman , Koochakpour Kaban , Nytrø Øystein , Westbye Odd Sverre , Pant Dipendra , Røst Thomas Brox , Skokauskas Norbert
Published: May 2024

Mental health conditions are among the highest disease burden on society, affecting approximately 20% of children and adolescents at any point in time, with depression and anxiety being the leading causes of disability globally. To improve treatment outcomes, healthcare organizations turned to clinical decision support systems (CDSSs) that offer patient-specific diagnoses and recommendations. However, the economic impact of CDSS is limited, especially in child and adolescent mental health. This systematic literature review examined the economic impacts of CDSS implemented in mental health services. We planned to follow PRISMA reporting guidelines and found only one paper to describe health and economic outcomes. A randomized, controlled trial of 336 participants found that 60% of the intervention group and 32% of the control group achieved symptom reduction, i.e. a 50% decrease as per the Symptom Checklist-90-Revised (SCL-90-R), a method to evaluate psychological problems and identify symptoms. Analysis of the incremental cost-effectiveness ratio found that for every 1% of patients with a successful treatment result, it added €57 per year. There are not enough studies to draw conclusions about the cost-effectiveness in a mental health context. More studies on economic evaluations of the viability of CDSS within mental healthcare have the potential to contribute to patients and the larger society.
Predicting fracture risk for elderly osteoporosis patients by hybrid machine learning model
Authors: Liu Menghan , Wei Xin , Xing Xiaodong , Cheng Yunlong , Ma Zicheng , Ren Jiwu , Gao Xiaofeng , Xu Ajing
Published: May 2024

Background and Objective

Osteoporotic fractures significantly impact individuals's quality of life and exert substantial pressure on the social pension system. This study aims to develop prediction models for osteoporotic fracture and uncover potential risk factors based on Electronic Health Records (EHR).

Methods

Data of patients with osteoporosis were extracted from the EHR of Xinhua Hospital (July 2012–October 2017). Demographic and clinical features were used to develop prediction models based on 12 independent machine learning (ML) algorithms and 3 hybrid ML models. To facilitate a nuanced interpretation of the results, a comprehensive importance score was conceived, incorporating various perspectives to effectively discern and mine critical features from the data.

Results

A total of 8530 patients with osteoporosis were included for analysis, of which 1090 cases (12.8%) were fracture patients. The hybrid model that synergistically combines the Support Vector Machine (SVM) and XGBoost algorithms demonstrated the best predictive performance in terms of accuracy and precision (above 90%) among all benchmark models. Blood Calcium, Alkaline phosphatase (ALP), C-reactive Protein (CRP), Apolipoprotein A/B ratio and High-density lipoprotein cholesterol (HDL-C) were statistically found to be associated with osteoporotic fracture.

Conclusions

The hybrid machine learning model can be a reliable tool for predicting the risk of fracture in patients with osteoporosis. It is expected to assist clinicians in identifying high-risk fracture patients and implementing early interventions.
Oral health in systemic sclerosis: A scoping review
Authors: Gagarine Maria , Cañedo-Ayala Mara , Cook Vanessa , Discepola Marie-Nicole , Guillot Genevieve , Leader David M , Lim Mathew AWT , Yap Tami , Furst Daniel E , Gietzen Amy , Lapointe McKenzie Jo-Ann , Van Pelt Shelley , Vidiricaire Louise , Carrier Marie-Eve , Krishnan Ankur , Tao Lydia , Kwakkenbos Linda , Thombs Brett D
Published: May 2024

Background:

Limited research on oral health in systematic sclerosis poses a significant challenge for people with systematic sclerosis and health care professionals. We conducted a scoping review to map existing research on oral health–related quality of life in systematic sclerosis across domains including (1) oral manifestations or symptoms, (2) functional consequences, (3) psychosocial aspects, (4) associated patient factors and (5) self-care and management considerations.

Methods:

We searched MEDLINE, EMBASE, SCOPUS and CINAHL databases to 10 March 2023 for studies on oral health in people with systematic sclerosis. Study data were mapped into pre-specified domains of oral health–related quality of life, subtopics and types of research and reported in tabular form.

Results:

Of 1460 unique studies reviewed, 91 were eligible and included in the scoping review; of these, 69 (76%) were published as full-text versions, 72 (79%) were from Europe or North America, and 63 (69%) included ⩽50 participants. Only 1 study had >200 participants (N = 382). By domains, 85 (93%) studies reported aspects of oral manifestations or symptoms, with the most common subtopics being oral opening and mandibular function, sicca, periodontitis and soft tissue changes and pathology; 36 (40%) studies provided information on associated patient factors, 23 (25%) on self-care and management, 19 (21%) on psychosocial aspects and 6 (7%) on functional consequences. No studies related to interventions included >50 participants.

Conclusion:

Most studies on oral health in systematic sclerosis report on manifestations or symptoms, and there are relatively few studies on other important domains. Most studies have been conducted with small samples. Updated systematic reviews should evaluate the quality of existing evidence in domains where enough studies have been done. Large, well-conducted primary studies are needed to address knowledge gaps across domains, including studies that test approaches for supporting oral self-care, improving routine professional care and addressing major disability-causing manifestations.
Factors affecting need and utilization of palliative care services among Ethiopian women in an oncology department: A hospital-based cross-sectional study
Authors: Fetene Deriba , Taylor Lesley , Ferrell Betty , Deribe Bedilu , Abdella Jabir , Aynalem Amdehiwot
Published: May 2024

Background:

Palliative care, which aims to alleviate physical and emotional distress from cancer, is underutilized in many African healthcare systems. Therefore, there is a lack of data on the need and utilization of palliative care services among women with breast cancer in Ethiopia.

Objectives:

The goal of this study was to identify the level of need and utilization of palliative care services and identify associated factors among women in an oncology department of Hawassa comprehensive and specialized hospitals.

Design:

Hospital-based cross-sectional study.

Methods:

A total of 121 women age ⩾18 years old with breast cancer participated from 1 August to 30 October 2021. A hospital-based consecutive sampling technique was used. Data regarding the need and utilization of palliative care services were collected via questionnaire and interview, entered using EpiData 4.6.0.6, and analyzed by SPSS version 25. Variables with p < 0.25 were considered for multivariate analysis, and those with p < 0.05 indicate an association with palliative care utilization.

Result:

Seventy-two (59.5%) had worse utilization of palliative care services, with higher odds in rural areas (adjusted odds ratio = 11.82).

Conclusion:

The study findings indicated that more than half of the study participants had worse utilization of palliative care services, with rural living being a contributing factor.
Relationship between serum apolipoprotein B and risk of all-cause and cardiovascular disease mortality in individuals with hypertension: a prospective cohort study
Authors: Huang Ying , Chen Siwei , Pan Huachun , Yang Shumin , Cheng Wenke
Published: May 2024

Background

Dyslipidemia frequently coexists with hypertension in the population. Apolipoprotein B (ApoB) is increasingly considered a more potent predictor of cardiovascular disease (CVD). Abnormal levels of serum ApoB can potentially impact the mortality risk.

Methods

The prospective cohort study employed data from the National Health and Nutrition Examination Survey (NHANES), which was performed between 2005 and 2016, with follow-ups extended until December 2019. Serum ApoB concentrations were quantified using nephelometry. In line with the NHANES descriptions and recommendations, the reference ranges for ApoB concentrations are 55–140 and 55–125 mg/dL for men and women, respectively. Participants were categorized into low, normal, and high ApoB levels. The low and high groups were combined into the abnormal group. In this study, all-cause mortality (ACM) and CVD mortality (CVM) were the endpoints. Survey-weighted cox hazards models were used for evaluating the correlation between serum ApoB levels and ACM and CVM. A generalized additive model (GAM) was employed to examine the dose-dependent relationship between ApoB levels and mortality risk.

Results

After a median of 95 (interquartile range: 62–135) months of follow-up, 986 all-cause and 286 CVD deaths were recorded. The abnormal ApoB group exhibited a trend toward an elevated risk of ACM in relative to the normal group (HR 1.22, 95% CI: 0.96–1.53). The risk of CVM was elevated by 76% in the ApoB abnormal group (HR 1.76, 95% CI: 1.28–2.42). According to the GAM, there existed a nonlinear association between serum ApoB levels and ACM (P = 0.005) and CVM (P = 0.009).

Conclusions

In the US hypertensive population, serum Apo B levels were U-shaped and correlated with ACM and CVM risk, with the lowest risk at 100 mg/dL. Importantly, abnormal Apo B levels were related to an elevated risk of ACM and CVM. These risks were especially high at lower Apo B levels. The obtained findings emphasize the importance of maintaining appropriate Apo B levels to prevent adverse outcomes in hypertensive individuals.
Regional structural abnormalities in thalamus in idiopathic cervical dystonia
Authors: Luo Yuhan , Liu Huiming , Zhong Linchang , Weng Ai , Yang Zhengkun , Zhang Yue , Zhang Jiana , He Xiuye , Ou Zilin , Yan Zhicong , Cheng Qinxiu , Fan Xinxin , Zhang Xiaodong , Zhang Weixi , Hu Qingmao , Peng Kangqiang , Liu Gang , Xu Jinping
Published: May 2024

Background

The thalamus has a central role in the pathophysiology of idiopathic cervical dystonia (iCD); however, the nature of alterations occurring within this structure remain largely elusive. Using a structural magnetic resonance imaging (MRI) approach, we examined whether abnormalities differ across thalamic subregions/nuclei in patients with iCD.

Methods

Structural MRI data were collected from 37 patients with iCD and 37 healthy controls (HCs). Automatic parcellation of 25 thalamic nuclei in each hemisphere was performed based on the FreeSurfer program. Differences in thalamic nuclei volumes between groups and their relationships with clinical information were analysed in patients with iCD.

Results

Compared to HCs, a significant reduction in thalamic nuclei volume primarily in central medial, centromedian, lateral geniculate, medial geniculate, medial ventral, paracentral, parafascicular, paratenial, and ventromedial nuclei was found in patients with iCD (P < 0.05, false discovery rate corrected). However, no statistically significant correlations were observed between altered thalamic nuclei volumes and clinical characteristics in iCD group.

Conclusion

This study highlights the neurobiological mechanisms of iCD related to thalamic volume changes.
Impact of homocysteine on acute ischemic stroke severity: possible role of aminothiols redox status
Authors: Dong Wei-Chong , Guo Jia-Liang , Xu Lei , Jiang Xin-Hui , Chang Cheng-Hao , Jiang Ye , Zhang Ying-Ze
Published: May 2024

Background

Acute ischemic stroke (AIS) is one of the most common cerebrovascular diseases which accompanied by a disruption of aminothiols homeostasis. To explore the relationship of aminothiols with neurologic impairment severity, we investigated four aminothiols, homocysteine (Hcy), cysteine (Cys), cysteinylglycine (CG) and glutathione (GSH) in plasma and its influence on ischemic stroke severity in AIS patients.

Methods

A total of 150 clinical samples from AIS patients were selected for our study. The concentrations of free reduced Hcy (Hcy), own oxidized Hcy (HHcy), free reduced Cys (Cys), own oxidized Cys (cysteine, Cyss), free reduced CG (CG) and free reduced GSH (GSH) were measured by our previously developed hollow fiber centrifugal ultrafiltration (HFCF-UF) method coupled with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The concentration ratio of Hcy to HHcy (Hcy/HHcy), Cys to Cyss (Cys/Cyss) were also calculated. The neurologic impairment severity of AIS was evaluated using National Institutes of Health Stroke Scale (NIHSS). The Spearman correlation coefficient and logistic regression analysis was used to estimate and perform the correlation between Hcy, HHcy, Cys, Cyss, CG, GSH, Hcy/HHcy, Cys/Cyss and total Hcy with NIHSS score.

Results

The reduced Hcy and Hcy/HHcy was both negatively correlated with NIHSS score in AIS patients with P = 0.008, r=-0.215 and P = 0.002, r=-0.249, respectively. There was no significant correlation of Cys, CG, GSH, HHcy, Cyss, Cys/Cyss and total Hcy with NIHSS score in AIS patients with P value > 0.05.

Conclusions

The reduced Hcy and Hcy/HHcy, not total Hcy concentration should be used to evaluate neurologic impairment severity of AIS patient.