bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental investigation on punch shear strength of poly lactic acid specimens for biomedical applications
Authors: Sharma Shrutika , Gupta Vishal , Mudgal Deepa
Published: April 2024

The designed biomedical implants require excellent shear strength primarily for mechanical stability against forces in human body. However, metallic implants undergo stress shielding with release of toxic ions in the body. Thus, Fused Deposition Modeling (FDM) has made significant progress in the biomedical field through the production of customized implants. The mechanical behavior is highly dependent on printing parameters, however, the effect of these parameters on punch shear strength of ASTM D732-02 standard specimens has not been explored. Thus, in the current study, the effect of infill density (IFD), printing speed (PTS), wall thickness (WLT), and layer thickness (LYT) has been investigated on the punch shear strength using Response Surface Methodology. The Analysis of Variance (ANOVA) has been performed for predicting statistical model with 95% confidence interval. During the statistical analysis, the terms with p-value lower than 0.05 were considered significant and the influence of process parameters has been examined using microscopic images. The surface plots have been used for discussing the effect of interactions between printing parameters. The statistical results revealed IFD as the most significant contributing factor, followed by PTS, LYT, and WLT. The study concluded by optimization of printing parameters for obtaining the highest punch shear strength.
The impact of industry integration on industrial energy efficiency in China
Authors: Wei Haohao , Ding Sheng
Published: April 2024

This study examined the impact of industrial integration on industrial energy efficiency in China. We measured industrial energy efficiency using stochastic frontier analysis with Mundlak auxiliary equations and distinguished between effective and ineffective energy use. We empirically examined the causal relationship between industrial integration and industrial energy efficiency using Chinese provincial industrial sector data for 2004 to 2021. The estimates showed that increasing the industry integration level by 1% reduced industrial inefficient energy use by 1.640%, which demonstrates that industry integration improved industrial energy efficiency significantly. The mechanism test showed that industrial integration improved industrial energy consumption through the scale effect. However, industrial integration can improve production efficiency through the technique effect, promote industrial upgrading through the composition effect, and reduce industrial energy intensity. Additionally, the causal relationship between industrial integration and industrial energy efficiency showed regional heterogeneity. The scale effect caused by industrial integration, rebound effect of technological progress, and transregional industrial transfer weakened the energy-saving effect of industrial integration.
Citizens and conspiratorial anti-science beliefs: Opposition versus support in 38 countries across Europe
Authors: de Boer Joop , Aiking Harry
Published: April 2024

This article aims to clarify citizens’ responses to conspiratorial anti-science beliefs (e.g. “The cure for cancer exists but is hidden from the public by commercial interests”). Based on Eurobarometer 95.2 (Spring 2021, 38 countries), we examine how public opposition or support for conspiratorial anti-science beliefs is related to individual- and country-level variables. There were large differences between the countries in their opposition or support. Controlling for artifacts, the individual-level variables showed associations with science-specific variables, for example, knowledge, preferred communication sources, social evaluations of scientists, attitude toward vaccines, and more general political (dis)satisfaction. At the country level, Affluence and Women’s representation were useful indicators for describing these differences. The conclusion is that the negativity of conspiratorial anti-science beliefs can be avoided by policies that highlight the rationality of science as a source of orientation and legitimation for change processes, and that are responsive to the needs of all citizens.
Motivated Counterfactual Thinking and Moral Inconsistency: How We Use Our Imaginations to Selectively Condemn and Condone
Authors: Effron Daniel A. , Epstude Kai , Roese Neal J.
Published: April 2024

People selectively enforce their moral principles, excusing wrongdoing when it suits them. We identify an underappreciated source of this moral inconsistency: the ability to imagine counterfactuals, or alternatives to reality. Counterfactual thinking offers three sources of flexibility that people exploit to justify preferred moral conclusions: People can (a) generate counterfactuals with different content (e.g., consider how things could have been better or worse), (b) think about this content using different comparison processes (i.e., focus on how it is similar to or different than reality), and (c) give the result of these processes different weights (i.e., allow counterfactuals more or less influence on moral judgments). These sources of flexibility help people license unethical behavior and can fuel political conflict. Motivated reasoning may be less constrained by facts than previously assumed; people’s capacity to condemn and condone whom they wish may be limited only by their imaginations.
Intimate Partner Violence, Femicide, and General Theories: Issues for Research and Policy From the View of Modern Control Theory
Authors: Gottfredson Michael R. , Nielsen Mikaela S.
Published: April 2024

Intimate partner violence (IPV), including intimate partner homicide (IPH) and femicide, raises issues for general theories of crime, such as control and opportunity theories, that see close relationships among friends and family as barriers to interpersonal crimes. Crime-specific studies of both correlates and trends in IPV, including recent interrupted trend studies that examine the effects of COVID restrictions, often test opportunity theories absent considerations of theoretically driven images of actors. Review of empirical research on IPV and IPH reveals strong compatibility between the predictions of modern control theory and consistent findings from trend data. Barriers to understanding of the explanatory power of general theories of crime (including, for example, control theories and feminist perspectives) in contemporary research include use of poor definitions of intimacy, misspecification of age effects, failure to consider the versatility of offending behavior, neglecting the importance of trends in analogous behaviors, neglecting the role of situational factors in violence, and the limitations in the measurement of repetitive victimization. Theories such as routine activity and situational crime prevention that fail to explicitly include characteristics of actors can go only a limited way in providing meaningful policy. Research supports the potential policy effects of investments in early childhood and attention to situational barriers (including limitations on alcohol use and firearm availability) to reduce IPV. Although modern control theory is used to illustrate these issues, other general theories, like feminist theories, can make similar arguments.
Design and performance analysis of a piezoelectric jetting dispensing valve
Authors: Shi Yihong , Huang Annan , Fu Bo
Published: April 2024

In order to meet the requirements of high frequency, high precision, and micro-scale dispensing in the field of microelectronics packaging, a piezoelectric jetting dispensing valve based on two-stage displacement amplifying mechanism was proposed. First, the overall structure and working principle of the proposed piezoelectric jetting valve were described. The displacement amplifying mechanism was designed, and the mathematical relationship between the output displacement and the structural parameters was established. In addition, the performance and the structural size of the displacement amplifying mechanism were analyzed and optimized by using the finite element analysis software. The influences of driving pressure, glue viscosity, needle displacement, and other parameters on droplet diameter and jetting velocity in the process of dispensing were simulated and analyzed. In order to obtain the optimal nozzle structure, the changing curves of glue flowing velocity with different nozzle seal forms, nozzle cone angles, and outlet inner diameters were compared and analyzed. Finally, the prototype of the piezoelectric jetting dispensing valve was machined, and experimental study was performed. The influence laws of driving pressure, glue viscosity, driving voltage, and other parameters on the diameter of droplet were explored. The performance of the prototype was evaluated from three aspects of dispensing frequency, consistency, and minimum dispensing droplet diameter. Results show that the highest dispensing frequency is 230 Hz, the deviation of dispensing consistency is ±8.77%, and the minimum dispensing droplet diameter is 0.54 mm. The experimental results verify the high frequency, consistency, and micro-scale dispensing performance of the piezoelectric jetting dispensing valve based on the displacement amplifying mechanism, which provides a reference for the research of piezoelectric high-frequency jetting dispensing.
Ketamine Use for Palliative Care in the Austere Environment: Is Ketamine the Path Forward for Palliative Care
Authors: Reed John R. , Parks Stephanie K. , Kaniaru Antony , Hefley Justin , Yauger Young , Edwards Jeremy V. , Glymph Derrick C.
Published: April 2024

The goal of palliative care is to focus on the holistic needs of the patient and their family versus the pathology of the patient’s diagnosis to reduce the stress of illness. U.S. servicemembers deployed to austere environments worldwide have significantly less access to palliative care than in military treatment facilities in the U.S. Preparation for future conflicts introduces the concept of prolonged medical management for an environment where urgent casualty evacuation is impossible. Ketamine is currently widely used for analgesia and anesthesia in the care of military service members and its use has increased in combat zones of Iraq and Afghanistan due to the favorable preservation of respiratory function, minimal changes in hemodynamics, and lower pain scores compared to opioids. Ketamine acts as a non-competitive antagonist on N-methyl-D aspartate (NMDA) receptors. Its anesthesia and analgesic effects are complex and include both presynaptic and postsynaptic neurons in brain and spinal cord. The use of palliative care to minimize suffering should not be withheld due to the logistical boundaries of austere military environments or lack of guidelines for recommended use. The use of ketamine for palliative care is a new clinical management strategy to provide both sedation and pain management for an acute pain crisis or comfort measures for the terminally ill. This makes ketamine an attractive consideration for palliative care when managing critically wounded patients for an extended time.
Building Family Interventions for Scalability and Impact
Authors: Danford Cynthia A. , Mooney-Doyle Kim , Deatrick Janet A. , Feetham Suzanne , Gross Deborah , Knafl Kathleen A. , Kobayashi Kyoko , Moriarty Helene , Østergaard Birte , Swallow Veronica
Published: April 2024

Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental work with policy integration. The purpose of this manuscript is to provide pragmatic, evidence-based guidance for advancing family intervention research from foundational work through efficacy testing. Guidance regarding the development of family interventions is presented using the first three of Sidani’s five-stage method: (a) foundational work to understand the problem targeted for change; (b) intervention development and assessment of acceptability and feasibility; and (c) efficacy testing. Each stage of family intervention development is described in terms of process, design considerations, and policy and practice implications. Examples are included to emphasize the family lens. This manuscript provides guidance to family scientists for intervention development and implementation to advance family nursing science and inform policy.
IGFT-MHCNN: An intelligent diagnostic model for motor compound faults based decoupling and denoising of multi-source vibration signals
Authors: Gong Xiaoyun , Zhi Zeheng , Gao Yiyuan , Du Wenliao
Published: April 2024

In view of the insufficient representation of single source signals for multi-point compound fault and the nonlinear strong coupling of vibration signals in motor transmission system, the inverse graph Fourier transform and improved multi-head convolutional neural network (IGFT-MHCNN) diagnostic model–based decoupling and denoising of multi-source vibration signals is proposed. The MHDCNN is constructed by improved multi-head convolution network and multi-label decoupling classifier, in which they extract multi-source signal features and decouple compound fault label information, respectively. Due to strong noise in compound fault and mapping capability of graphic signal processing method for complex data, a signal reconstruction method based on IGFT is established to remove residual noise from multi-source signals and enhance the main feature components. Two experimental cases show that the constructed model can effectively reduce vibration noise and achieve multi-label decoupling and identification of motor compound faults with strong coupling.
Unheard Voices of LGB People in Türkiye on LGB-specific Experiences of Intimate Partner Violence: A Qualitative Analysis
Authors: Ummak Esra , Toplu Demirtaş Ezgi , Özkan Hande
Published: April 2024

Drawing upon in-depth, semistructured interviews with 26 LGB participants, we explored how LGB individuals experience IPV uniquely in Türkiye. Conducting thematic analysis, we generated four themes: (a) invalidation of sexual identity, (b) controlling sexuality and sexual behaviors, (c) disclosure of sexual orientation, and (d) binegativity. The analysis emphasizes LGB-specific power dynamics influencing IPV. A discussion is provided regarding the extent to which these four themes are specific to IPV in LGB relationships. Additionally, recommendations are offered to mental health professionals on tailoring their approaches and promoting advocacy for the needs of LGB IPV survivors.
The COVID-19 Lived Experience Through the Eyes of Nursing and Social Work Students
Authors: Lindsay Judith , Cropley Stacey , Benton Amy , Thompson Morgan , Clary Kelly
Published: April 2024

Purpose: The purpose of this study was to explore the lived experiences of nursing and social work students who were taking courses during the COVID-19 pandemic. Focus group discussions gave students a chance to express the pandemic's effects on their education and life. Methods: A hermeneutic phenomenological approach using Van Manen's Four Lifeworld Existentials guided this study. Using an open-ended format, interviews were conducted in 6 small groups ranging from 2 to 9 individuals, in person or via Zoom. The study was conducted from May to August 2022 in a university setting with 23 participants. Results: Ten existential themes emerged: Being Behind, Groundhog Day, Trying to Keep Up, Loss of Community, Fear of COVID, Being Alone, What is Self-Care?, Is This Career Right for Me?, What is Healthy?, and Access to Counseling. Conclusions: Participants indicated that the COVID-19 pandemic negatively impacted educational delivery, limiting learning opportunities and increasing feelings of isolation, stress, and anxiety. Implications for Education and the Future Workforce: Projected health-care workforce shortages may be exacerbated by students departing from the health-care professions as a result of increased burnout. Resilience training while in school is necessary to help promote coping, self-care strategies, and retention in the health-care professions.
Optimization of tribological performance of TiB2-reinforced Al6063 composite using grey-fuzzy tool
Authors: Bhowmik Abhijit , Bhattacharjee Biplab , Adewale Akinwande Abayomi , Majumder Prasanta , Giri Jayant , Satish Kumar P , Katiyar Jitendra Kumar
Published: April 2024

The utilization of TiB2 particle reinforcement in aluminium matrix composites, particularly with Al6063, has been explored in this study for its resilience to mechanical erosion, low oxidation rate, and excellent heat conductivity. The composite was produced using stir casting with 9 wt% TiB2. The investigation focuses on wear behaviour, examining three key process parameters such as load, sliding speed, and covering sliding distance across four settings to identify the optimal combination for achieving a favourable wear rate. Statistical analysis of variance reveals significant differences among the tested parameters. Conclusively, the study highlights the superiority of the grey-fuzzy approach over a simple grey relational grade in validating decision-making for wear performance attributes. The research identifies the ost significant grey relational grade and grey fuzzy grade values as 0.913 and 0.902, respectively. These values correspond to optimal operating conditions, specifically a 15 N load, a sliding speed of 15 m/s, and a sliding distance of 1200 m. The findings underscore the efficacy of the grey-fuzzy technique in authenticating decision-making processes related to wear performance characteristics, emphasizing its superiority over relying solely on a plain grey relational grade.
Effectiveness of behavior change and self-management theoretically-informed telehealth interventions for stroke secondary prevention: An overview of systematic reviews
Authors: da Cruz Peniche Paula , Faria Christina Danielli Coelho de Morais , Hall Patricia , Lennon Olive
Published: April 2024

Introduction

Despite the increased use of telehealth interventions, low-level evidence supports their use for behavior change and self-management in stroke secondary prevention. Therefore, this overview of systematic reviews (SRs) critically appraises and consolidates the evidence about theoretically-informed telehealth interventions in stroke secondary prevention.

Methods

Two phases were conducted independently by two reviewers. Phase-1 included SRs contemplating randomized controlled trials (RCTs) implementing telehealth interventions with individuals post-stroke, targeting cardiovascular events, risk-reducing health behaviors or physiological risk factors. Phase-2 interrogated RCTs from these SRs that implemented theoretically-informed interventions. Best-evidence synthesis of published meta-analyses and new meta-analyses of theoretically-informed interventions were conducted. GRADE evidence was applied.

Results

In Phase-1 (15 SRs), best-evidence synthesis identified telehealth interventions as effective in reducing recurrent angina and recurrent stroke rates (both with very low GRADE), improving medication adherence (low GRADE), physical activity participation (very low GRADE), and blood pressure targets (very low GRADE), reducing systolic blood pressure (SBP) (moderate GRADE) and low-density lipoprotein levels (very low GRADE). In Phase-2 (14 RCTs), new meta-analyses identified theoretically-informed telehealth interventions as effective in improving medication adherence (SMD: 0.38; 95%CI: 0.13–0.64; I²: 72%, low GRADE) and healthy eating (SMD: 0.38; 95%CI: 0.15–0.60; I²: 38%, low GRADE), and decreasing SBP (MD: −9.19; 95%CI: −5.49 to −12.89; I²: 0%, moderate GRADE).

Discussion

Telehealth demonstrates utility in stroke secondary prevention, notably in SBP reduction. High-quality RCTs are required given the lack of current evidence supporting theoretically-informed telehealth interventions addressing primary outcomes of secondary prevention, and the low certainty evidence identified for health behavior change.
“I have to charge my social battery”: Perspectives from autistic young adults on Quality of Life
Authors: Øverland Elisabeth , Hauge Åshild Lappegard , Orm Stian , Øie Merete Glenne , Skogli Erik Winther , Pellicano Elizabeth , Andersen Per Normann
Published: April 2024

Several studies report on lower quality of life for autistic people when compared to non-autistic people. However, there are ongoing discussions about the conceptualization of quality of life for the autistic population. This qualitative study investigated self-perceived quality of life in the context of autistic young adults’ everyday lives. Participants (age range 21–29 years) were recruited from a 10-year follow-up study, Lillehammer Neurodevelopmental Follow-up Study, all diagnosed in childhood and adolescence. Fourteen individual in-depth interviews were conducted. When asked about what was important for having a good quality of life, our autistic participants described relationships to people and pets as important, as well as having meaningful activities. Specific interests had guided many to their choice of both academic and work career. Many also described obstacles in their environment that had influenced their quality of life negatively, such as being misunderstood by teachers and other professionals, being bullied, and sensory and emotional overload. Our findings indicate that those in supportive roles should provide help with establishing connections to activities and people/animals, as this seems to be essential for creating a good quality of life. Taking advantage of passions and interests can create opportunities for autistic people. Findings suggest that future research should address the communication barriers between autistic people and professionals that can lead to misunderstandings.

Lay abstract

In this study we have asked a group of autistic young adults to describe what is important for their quality of life. The 14 participants (aged 21–29 years) were recruited from a 10-year follow-up study of autistic people. During interviews, our participants described the importance of having relationships with family, friends and pets. Having meaningful activities and being able to immerse themselves in particular interests was also reported to be important for a good quality of life. Interests had also guided their choice of what to study and what to do for work. They also spoke of how communication problems with professionals, bullying and sensory and emotional overload could have a negative impact on quality of life. Future interventions should focus on how professionals can help autistic people to connect to people/animals and meaningful activities, as the participants described this as important for having a good quality of life. These findings may be helpful in enhancing how passions and interests can be seen as opportunities for both academic and work careers for autistic people. Future research and interventions should also look at the communication barriers between autistic people and professionals, and how two-way understanding can be improved.
Bridge temperature prediction method based on long short-term memory neural networks and shared meteorological data
Authors: Zhou Linren , Wang Taojun , Chen Yumeng
Published: April 2024

Temperature is an important load factor affecting the structural performances of bridges. The rapid acquisition of bridge temperature data is significant for bridge temperature effect analysis and assessment. On the bases of ground meteorological shared big data, a bridge temperature prediction method based on long short-term memory (LSTM) neural network is proposed. The proposed method is used to investigate the key issues of data preprocessing, model input feature selection, time-length determination, and hyper-parameter preference. Moreover, the proposed method relies on the maximum information coefficient to quantify the strongly correlated features and uses a two-layer deep LSTM neural network to improve the model’s time series information utilization and prediction capability. The constructed neural grid model is experimentally studied and verified based on the long-term measured data of the scaled bridge model in an outdoor environment. Comparative assessment with other typical time series models, such as NARX, RNN, and GRU, demonstrate that the LSTM neural network model exhibits the best generalization ability and highest temperature prediction accuracy, with a maximum absolute error of approximately 2°C and relative error below 5%. The engineering applicability and effectiveness of LSTM for bridge temperature prediction are verified.
Effect of low dissolved oxygen concentration on the tribocorrosion properties and ion release of Ti-13Nb-13Zr
Authors: Zhang Shuangshuang , Du Xinyu , Shi Wei , Xiang Song
Published: April 2024

The tribocorrosion of titanium implants is the primary cause of their late failure. As the most promising third-generation medical β-type titanium alloy, Ti-13Nb-13Zr (TC26) demonstrates superior corrosion resistance and harmless chemical element composition, making it an excellent alternative to Ti-6Al-4V alloy (TC4). Nonetheless, this study has revealed a significant weakness of TC26 in tribocorrosion properties under low dissolved oxygen concentration conditions, which could pose potential hazards in subsequent medical applications. The effects of low dissolved oxygen concentration on the tribocorrosion properties and ion release were examined using electrochemical methods, laser confocal microscopy, scanning electron microscopy, and inductively coupled plasma emission spectrometer. The findings indicate that TC26 exhibits significantly inferior corrosion resistance compared to TC4 due to the sluggish recovery rate of the passivation film under low dissolved oxygen concentration conditions during wear. Moreover, TC26 experiences greater mechanical wear loss than that of TC4. However, under the synergistic effect of wear and corrosion, TC26 releases a minimal amount of ions, while excessive harmful Al ions are released by TC4.
Any Way You Slice It: Corpus Callosotomy in Pediatric Drug-Resistant Epilepsy
Authors: Fine Anthony
Published: April 2024

[Box: see text]
Mixed Methods in Landscape Archaeology: An Application to Explore Identity Formation in the Romano-British Period, Shropshire Region
Authors: May Daniel E.
Published: April 2024

This article proposes a novel methodology designed to identify past/ancient identities from archaeological information available in rural landscapes. It consists of a quantitative stage based on network analysis followed by a qualitative analysis based on phenomenology. Such methodology contributes to the field of mixed method research in two ways. First, in contrast to existing approaches that use people’s opinions to collect data, the proposed methodology extracts information from archaeological remains and the landscape; second, it extends the scope of topics considered by the field of mixed method research. The methodology was applied to the study of identity evolution in the Romano-British period in Shropshire. The results illustrate the potential of the proposed methodology to understand the formation/evolution of past identities.
Promotion of Muscle-Strengthening Activity Among Latina and Black/African American Women: A Review of Literature
Authors: Benitez Tanya J. , Brown Nashira , Marcus Bess , Sanchez Ashley , Von Ash Tayla , Joseph Rodney P.
Published: April 2024

Latina and Black/African American (AA) women report disproportionately low levels of muscle-strengthening activities (MSA) and high rates of related chronic health conditions. Despite the health benefits of MSA, physical activity intervention research in these populations has focused mostly on increasing aerobic physical activity. The purpose of this review was to describe the current state of scientific literature on MSA interventions among Latina and Black/AA women. Two electronic databases, CINAHL and PubMed, were searched for studies published during the past 10 years. Studies were included in this review if they reported promotion of MSA, included at least 50% Latina and/or Black/AA women in their samples, and used an interventional design. Search procedures identified 8 unique interventions targeting MSA in Latina (n = 3) and Black/AA women (n = 5). Results revealed there is limited published research on MSA promotion among Latina and Black/AA women, especially on theory-based interventions that address psychosocial and behavioral influences of MSA, as well as assessment of MSA outcomes in these populations. This review highlights a critical need for research on culturally tailored behavioral interventions to reduce the low MSA in Latina and Black/AA women and provides future research directions on this topic.
Long-term limb salvage and functional outcomes for patients undergoing partial calcanectomy
Authors: Kostiuk Valentyna , Gazes Michael , Fereydooni Soraya , Chaar Cassius Iyad Ochoa , Guzman Raul J , Tonnessen Britt Hansen
Published: April 2024

Introduction

Partial calcanectomy (PC) can be performed to treat chronic heel ulcers in patients with calcaneal osteomyelitis. Patients undergoing PC often have multiple comorbidities, limited mobility, and face high risk of major limb amputation. This study examined the extent of vascular diagnostic testing and interventions as well as long-term outcomes in patients undergoing PC.

Methods

A retrospective analysis was performed on patients who underwent PC for non-healing calcaneal ulcer over a ten-year period. Demographics, comorbidities, vascular testing, and procedural data were recorded. Additional subgroup analysis was performed according to presence or absence of peripheral arterial disease (PAD). Primary outcomes were major limb amputation (above or below the knee) and mortality. Secondary outcomes included successful wound healing, time to complete wound healing, re-interventions, and change in ambulatory status.

Results

A total of 157 patients underwent partial calcanectomies on 162 limbs. 78.3% of patients had diabetes mellitus and 47.8% were diagnosed with PAD. Ankle brachial index with pulse volume recording (ABI/PVR) was performed for 46.5% (73/157) of patients, arterial duplex in 44.6% (70/157), and 19.7% (31/157) had a computed tomography angiogram. Lower extremity revascularization was performed in 28.4% of limbs (46/162). Independent ambulatory status was reported in 40.1% prior to PC and decreased to 17.9% by the time of last recorded follow-up ( p < .00001). Long-term amputation-free survival was significantly higher in patients without PAD at 7 years (78.4% vs 57.1%, p = .02). Multivariate logistic regression analysis demonstrated that PAD and end-stage renal disease (ESRD) increased the odds of major limb amputation (OR 3.5 and 2.8, respectively), whereas ESRD and adjuvant podiatric procedures were associated with increased mortality (OR 4.8 and 4.8, respectively).

Conclusion

Non-invasive vascular testing should be obtained in all patients undergoing PC, in order to stratify risk of amputation and identify candidates for revascularization. Over the long-term, patients undergoing PC face significant risk of prolonged wound healing, decline in ambulatory status, and major limb amputation.
Non-cirrhotic portal hypertension in pregnancy due to schistosomiasis: A case series
Authors: Carrim Mohammed Farhaan , Mbelle Mzamo , Rabali Zwido , Nyakoe Robert Barasa , Mokgoko Didintle , Zamparini Jarrod
Published: April 2024

The presence of non-cirrhotic portal hypertension in pregnancy poses a challenging clinical scenario as it predisposes women to several life-threatening complications such as variceal haemorrhage, splenic artery aneurysm, pulmonary hypertension and bacterial peritonitis. The haemodynamic changes in pregnancy along with the demands of a growing fetus may worsen the severity of pre-existing non-cirrhotic portal hypertension. In this case series, we discuss four cases of non-cirrhotic portal hypertension in pregnancy in a low to middle income setting and review the literature related to this condition.
Long-term safety and efficacy of zilucoplan in patients with generalized myasthenia gravis: interim analysis of the RAISE-XT open-label extension study
Authors: Howard James F. , Bresch Saskia , Farmakidis Constantine , Freimer Miriam , Genge Angela , Hewamadduma Channa , Hinton John , Hussain Yessar , Juntas-Morales Raul , Kaminski Henry J. , Maniaol Angelina , Mantegazza Renato , Masuda Masayuki , Nowak Richard J. , Sivakumar Kumaraswamy , Śmiłowski Marek , Utsugisawa Kimiaki , Vu Tuan , Weiss Michael D. , Zajda Małgorzata , Bloemers Jos , Boroojerdi Babak , Brock Melissa , de la Borderie Guillemette , Duda Petra W. , Vanderkelen Mark , Leite M. Isabel ,   the RAISE-XT Study Team*
Published: April 2024

Background:

Generalized myasthenia gravis (gMG) is a chronic, unpredictable disease associated with high treatment and disease burdens, with a need for more effective and well-tolerated treatments.

Objectives:

To evaluate the long-term safety, tolerability, and efficacy of zilucoplan in a mild-to-severe, acetylcholine receptor autoantibody-positive (AChR+) gMG population.

Design:

Ongoing, multicenter, phase III open-label extension (OLE) study.

Methods:

Eligible patients had completed a qualifying randomized, placebo-controlled phase II or phase III zilucoplan study and received daily, self-administered subcutaneous 0.3 mg/kg zilucoplan. The primary endpoint was incidence of treatment-emergent adverse events (TEAEs). Secondary efficacy endpoints included change from baseline in Myasthenia Gravis Activities of Daily Living (MG-ADL) score.

Results:

In total, 200 patients enrolled. At the cut-off date (8 September 2022), median (range) exposure to zilucoplan in RAISE-XT was 1.2 (0.11–4.45) years. Mean age at OLE baseline was 53.3 years. A total of 188 (94%) patients experienced a TEAE, with the most common being MG worsening ( n = 52, 26%) and COVID-19 ( n = 49, 25%). In patients who received zilucoplan 0.3 mg/kg in the parent study, further improvements in MG-ADL score continued through to Week 24 (least squares mean change [95% confidence interval] from double-blind baseline −6.06 [−7.09, −5.03]) and were sustained through to Week 60 (−6.04 [−7.21, −4.87]). In patients who switched from placebo in the parent study, rapid improvements in MG-ADL score were observed at the first week after switching to zilucoplan; further improvements were observed at Week 24, 12 weeks after switching (−6.46 [−8.19, −4.72]), and were sustained through to Week 60 (−6.51 [−8.37, −4.65]). Consistent results were observed in other efficacy endpoints.

Conclusion:

Zilucoplan demonstrated a favorable long-term safety profile, good tolerability, and sustained efficacy through to Week 60 with consistent benefits in a broad AChR+ gMG population. Additional long-term data will be available in future analyses.

Trial registration:

ClinicalTrials.gov identifier: NCT04225871 ( https://clinicaltrials.gov/ct2/show/NCT04225871 )
East Meets West: The Rise of Chinese Information and Communication Technology Servicification in European Manufacturing
Authors: Cieślik Ewa
Published: April 2024

The article aims to show the changes in shares of added value coming from Chinese information and communications technology (ICT) services to European manufacturing in total value-added inflows (the servicification of European manufacturing with Chinese ICT services). The study focused on Chinese ICT servicification of European transport equipment and computer, electronic, and electrical equipment. The study tried to answer two questions: (a) whether the servicification of European manufacturing with Chinese ICT services increases, expressed by the growing share of Chinese value-added among partners providing services to European manufacturing and (b) whether an economy's relative position and participation in global value chains (GVCs) has impact on the servicification of European manufacturing with Chinese ICT. The study proved that the shares of inflows of Chinese ICT into European manufacturing have increased. Moreover, both higher relative position and participation in GVCs boost the servicification of European manufacturing.
Reduced Efficacy of Glucagon-Like Peptide-1 Receptor Agonists Therapy in People With Type 1 Diabetes and Genetic Forms of Obesity
Authors: Klein Matthew P. , Akturk Halis Kaan , Snell-Bergeon Janet K. , Shah Viral N.
Published: April 2024

Background:

Once weekly Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA) have been shown to improve glycemic outcomes and cause significant weight loss. However, 9% to 27% of individuals have little or no response to these drugs. In this article, we investigated the efficacy of GLP-1 RA therapy among adults with type 1 diabetes and obesity likely related to genetic mutations compared with obesity likely unrelated to genetic mutations.

Methods:

In this retrospective study, we compared body weight and glycated hemoglobin (HbA1c) change with the use of GLP-1 RA therapy (including a dual agonist, Tirzepatide) over six months among adults with type 1 diabetes and obesity likely (n = 11, median age 39.5 years with a median BMI of 43.0 kg/m2) versus unlikely related to genetic mutation(s) (n = 15, median age 45.8 years with a median BMI of 38.7 kg/m2).

Results:

Six months of GLP-1 RA treatment resulted in a numerically lower reduction of weight (−5.75 ± 9.46 kg vs −8.65 ± 9.36 kg, P = .44) and HbA1c (−0.28 ± 0.96% vs −0.43 ± 0.57%, P = .64) among individuals with obesity likely versus unlikely related to a genetic mutation(s), respectively. Fewer individuals with genetic obesity met goal weight loss ≥5% or HbA1c decrease ≥0.4% than did individuals with obesity unlikely related to a genetic cause (36.4% vs 80.0%, P = .04).

Conclusions:

The weight loss and glycemic lowering effects of GLP-1 RA therapy may be decreased in people with type 1 diabetes and obesity likely related to genetic causes. Further research is needed to understand GLP-1 RA mechanisms via energy regulating genes.
A systematic review of technology in the after-action review (or debrief)
Authors: Keiser Nathanael L.
Published: April 2024

The after-action review (AAR), also termed debrief, is a training approach that commonly encompasses some form of technology, but technology is largely a tangential consideration, which serves as the impetus for this review. Based on a systematic review of 91 empirical studies (113 AARs), a variety of nuances are identified about (1) where in the AAR technology is used, and the (2) users, (3) type, and (4) use of that technology. Technology is indeed common to AARs, but typically relegated to either aid in the task performance episode (92%) or in the provision of task feedback (52%). More broadly, the findings from the present review reflect the inherent complexity of determining how best to use technology in AARs with little extant guidance. These findings are followed by a set of six recommendations that will ideally spur greater use of technology in AARs to address longstanding issues that attenuate its effectiveness.
Pattern and determinants of health-related quality of life of adolescents with congenital heart disease in Cameroon: A single-center cross-sectional study
Authors: Kamdem Félicité , Meyanga Ngoah Jerrold , Nganou Gnindjio Chris Nadège , Mekoulou Ndongo Jerson , Ba Hamadou , Mouliom Sidick , Viché Lade , Ngoté Henri , Kenmegne Caroline , Tsague Kengni Hermann , Ndom Ebongue Marie Solange , Djibrilla Siddikatou , Bika Léle Elysée Claude
Published: April 2024

Background

Health-related quality of life (HRQoL) assessment is necessary for the management of patients with congenital heart diseases (CHD). No study has yet been reported on Cameroonian adolescents. The aim of this study was to evaluate the profile of and look for determinants of HRQoL in adolescents with CHD in Cameroon.

Methods

This was a cross-sectional study with prospective recruitment carried out on 71 adolescents diagnosed with CHD aged 12 to 18 years and recruited at the Douala General Hospital. Sociodemographic and clinical data were collected using a structured questionnaire. HRQoL was assessed using the pediatric quality of life inventory (PedsQL4.0) for child and parent reports. Multivariate linear regression was used to assess the determinants of HRQoL. Differences were considered significant for p < 0.05.

Results

Mean age of participants was 15 ± 2 years with 54.9% women. Mean physical and psychosocial functioning scores were 50.7 ± 13.9 and 60.5 ± 9.6 for parent report and 49.5 ± 13.4 and 59.1 ± 9.1 for child report respectively; with no significant difference according to gender. Distribution of functioning scores according to anatomical complexity showed no significant difference while it was lower in patients with a greater physiological severity and to those with no surgical intervention compared to the others. After multivariate adjustments, physiological stage 3 or 4 was negatively associated while cardiac intervention was positively associated with HRQoL.

Conclusion

CHD adolescents exhibit a low level of quality of life. Cardiac intervention positively affects HRQoL and should be targeted in the reduction of HRQoL burden from CHD in Cameroon.
Returning to and continuing the traditional Chinese family system via WeChat: Digitally mediated families in liquid China
Authors: Xiong Yutian
Published: April 2024

This article rethinks digitally mediated family, contending that WeChat facilitates the integration of digitally mediated Chinese family units and family practices into an entire system within traditional patterns. WeChat can serve as the hub for this kind of family mediation, since it is the dominant mega-platform in the smartphone-based Chinese polymedia environment, possessing superior technological convergence and sociocultural affordances. Based on qualitative data from 48 Chinese internal migrants, this article characterizes the entire system of the traditional Chinese family mediated by WeChat. First, the static Chinese family units converged on WeChat inherit spatial and hierarchical structures from the traditional models. Second, individuals’ WeChat usage for dynamic family practices is guided by Chinese family ethics, particularly those related to intergenerational and gendered ethics. Lastly, intimacy practices within Chinese families are digitally mediated to maintain ethically guided features in the Chinese style. This article emphasizes the role of polymedia-mediated ambient co-presence in activating implicit Chinese-style intimacy practices in the digital family spheres. Overall, when Chinese people log in to WeChat, they experience a return to traditional Chinese families, playing roles that contribute to the continuity of the entire traditional Chinese family system. This article suggests that the digitally mediated traditional family system ensures family stability in a highly modernized society where population mobility has become normalized.
Disseminated tuberculosis presenting as bilateral chylothorax: A case report
Authors: Wickramasinghe WMMHP , Ranaweera RMSN , Yasaratne BMDG
Published: April 2024

Tuberculosis, being an airborne disease with a broad spectrum of symptoms and signs, is a rare cause of chylothorax. Mortality due to tuberculous chylothorax is 6%, and bilateral chylothorax has a higher mortality with a poor prognosis. A previously well 28-year-old male with a household contact history of tuberculosis exposure presented with a 1-month history of shortness of breath, fever, pleuritic chest pain, and constitutional symptoms. He was found to have bilateral chylothorax, generalized lymphadenopathy, hepatosplenomegaly, and miliary nodules in chest x-ray. Sputum acid-fast bacilli, pleural fluid TB PCR (Tuberculosis polymerase chain reaction) and culture became negative. Sputum culture became positive for Mycobacterium tuberculosis at 6 weeks. He had marked clinical and radiological improvement within 2 months of starting anti-tuberculosis treatment. Diagnosis of pleural tuberculosis is difficult as pleural fluid acid-fast bacilli detection has poor sensitivity. It is important to consider tuberculosis in patients with chylothorax and initiate prompt treatment.
A pilot randomised controlled trial exploring the feasibility and efficacy of a human-AI sleep coaching model for improving sleep among university students
Authors: Liu Jintana , Ito Sakura , Ngo Tra My , Lawate Ashwini , Ong Qi Chwen , Fox Tatiana Erlikh , Chang Si Yuan , Phung Duy , Nair Elizabeth , Palaiyan Malar , Joty Shafiq , Abisheganaden John , Lee Chuen Peng , Lwin May Oo , Theng Yin Leng , Ho Moon-Ho Ringo , Chia Michael , Bojic Iva , Car Josip
Published: April 2024

Objective

Sleep quality is a crucial concern, particularly among youth. The integration of health coaching with question-answering (QA) systems presents the potential to foster behavioural changes and enhance health outcomes. This study proposes a novel human-AI sleep coaching model, combining health coaching by peers and a QA system, and assesses its feasibility and efficacy in improving university students’ sleep quality.

Methods

In a four-week unblinded pilot randomised controlled trial, 59 university students (mean age: 21.9; 64% males) were randomly assigned to the intervention (health coaching and QA system; n = 30) or the control conditions (QA system; n = 29). Outcomes included efficacy of the intervention on sleep quality (Pittsburgh Sleep Quality Index; PSQI), objective and self-reported sleep measures (obtained from Fitbit and sleep diaries) and feasibility of the study procedures and the intervention.

Results

Analysis revealed no significant differences in sleep quality (PSQI) between intervention and control groups (adjusted mean difference = −0.51, 95% CI: [−1.55–0.77], p = 0.40). The intervention group demonstrated significant improvements in Fitbit measures of total sleep time (adjusted mean difference = 32.5, 95% CI: [5.9–59.1], p = 0.02) and time in bed (adjusted mean difference = 32.3, 95% CI: [2.7–61.9], p = 0.03) compared to the control group, although other sleep measures were insignificant. Adherence was high, with the majority of the intervention group attending all health coaching sessions. Most participants completed baseline and post-intervention self-report measures, all diary entries, and consistently wore Fitbits during sleep.

Conclusions

The proposed model showed improvements in specific sleep measures for university students and the feasibility of the study procedures and intervention. Future research may extend the intervention period to see substantive sleep quality improvements.
A Harmony-Based Approach to Student Diversity
Authors: Yiu Lisa
Published: April 2024

Purpose

Inspired by Kuan-Hsing Chen's “Asia as method,” this study investigates a multicultural approach to education. Using East Asia as the frame of reference, this study explores multiculturalism in middle school classrooms in Chinese Taiwan.

Design/Approach/Methods

Semistructured interviews were conducted with principals, administrators, and teachers at a middle school known for its diversity work. Data were coded based on the conceptual framework and emergent themes analyzed using NVivo.

Findings

Findings elucidate the harmony-oriented multicultural approach adopted by administrators and teachers to empower the youth to embrace their ethnic heritage. This approach was characterized by three Confucian-influenced features: whole-person development, strengthening of the collective school unit, and a school decision-making approach prioritizing “fairness.”

Originality/Value

This study investigates the multicultural responses of teachers and schools to student diversity through a nondeficit lens in East Asia, revealing the harmony-oriented practices adopted in this respect. In addition to establishing a foundation for East Asian scholars to explore how teachers respond to student diversity in their respective contexts through an asset lens, the findings of this study advance our understanding of how to recognize differences and maintain social cohesion.