bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomised controlled trial of a psychoeducational group intervention for family and friends of young people with borderline personality disorder features
Authors: Betts Jennifer K , Seigerman Mirra R , Hulbert Carol , McKechnie Ben , Rayner Victoria K , Jovev Martina , Cotton Sue M , McCutcheon Louise K , McNab Catharine , Burke Emma , Chanen Andrew M
Published: May 2023

Objective:

Preliminary evidence indicates that interventions designed to support family and friends (‘carers’) of young people with early-stage borderline personality disorder effectively improve carer outcomes. None of these interventions have been tested in a randomised controlled trial.

Method:

This clustered, partially nested, randomised controlled trial was conducted at Orygen, Melbourne, Australia. Carers of young people (aged 15–25 years) with borderline personality disorder features were randomly assigned as a unit in a 1:1 ratio, balanced for young person’s sex and age, to receive a 15-day intervention comprising: (1) the three-session, in-person, Making Sense of BPD (MS-BPD) multi-family group programme, plus two self-directed online psychoeducational modules (MS-BPD + Online, n = 38), or (2) the two self-directed online psychoeducational modules alone (Online, n = 41). The primary outcome was ‘negative experiences of care’, measured with the Experience of Caregiving Inventory, at the 7-week endpoint.

Results:

A total of 79 carers were randomised (pool of 281, 197 excluded, 94 declined) and 73 carers (51 females [69.9%], Mage = 43.8 years [standard deviation, SD = 12.9], MS-BPD + Online n = 35 [47.9%], Online n = 38 [52.1%]) provided follow-up data and were included in the intent-to-treat analysis. The intent-to-treat (and per protocol) analyses did not find any significant differences between the groups on the primary ( d = −0.32; 95% confidence interval = [−17.05, 3.97]) or secondary outcomes. Regardless of treatment group, caregivers improved significantly in their personality disorder knowledge.

Conclusion:

Delivering MS-BPD in conjunction with an online psychoeducational intervention was not found to provide additional benefit over and above access to an online intervention alone. In accordance with national guidelines, carer interventions should be routinely offered by youth mental health services as part of early intervention programmes for borderline personality disorder. Further research is warranted into which interventions work for whom, carers’ preferences for support and barriers to care.
Understanding the Legacy of the Gulf Cooperation Council and Turkey on Bangladesh Politics
Authors: Sanyal Paulami
Published: May 2023

This commentary discusses Bangladesh’s interactions with Middle East countries, particularly focusing on the Gulf Cooperation Council (GCC) and Turkey. Although Bangladesh’s relations with the GCC are seemingly and dominantly economic, there is a significant level of cultural interconnectedness as well, especially with Saudi Arabia. In Bangladesh–Turkey relations, there is also a similar type of cultural attachment operating via each country’s religious identities. This attachment, especially in the last decade, was bolstered by deepening cooperation in counterterrorism activities and further economic interactions. The interactions with these Middle Eastern countries are not only important to Bangladesh’s foreign policy and economy but also to assuage some domestic tensions.
Modelling the residual strength degradation in composite materials without using residual strength tests
Authors: Vanhari Afrooz Kazemi , Fagan Edward , Goggins Jamie
Published: May 2023

Residual strength models are widely used to predict the fatigue life of composite laminates under highly variable loads. However, they often require considerable experimental effort to accurately determine model parameters. This paper introduces a new approach for predicting the residual strength of composite materials with less experimental data. The method is based on two common strength-based wearout models, the Sendeckyj model and Schaff and Davidson model. The Sendeckyj model consists of an equation with two model parameters, which describes the shape of the S-N curve by fitting fatigue test data. The Schaff and Davidson model is a single-parameter function which calculates the residual strength based on the number of fatigue cycles. Using a novel mathematical algorithm, the residual strength model parameter in the Schaff and Davidson model is estimated directly from the S–N curve without running any residual strength tests. Five data sets from the literature are used to validate the new methodology. The results show that the residual strength model parameter is dependent on both the stress level and the number of loading cycles experienced at this stress level, both of which are considered in the new strategy. In addition, if the fatigue data are well distributed, the residual strength model parameter estimated by the new strategy is close to the experimental data.
Effects of graphene oxide concentration and frequency on morphology, mechanical and rheological studies of fluoroelastomer nanocomposites
Authors: Kumar Pushpendra , Penta Santhosh , Mahapatra Shyama Prasad
Published: May 2023

Fluoroelastomer nanocomposites have been prepared using different concentrations (1-5 wt%) of graphene oxide (GO) nanoparticles through mechanical mixing and compression molding. The surface morphology of prepared fluoroelastomer/GO nanocomposites has been studied by scanning electron microscopy (SEM). The mechanical properties of fluoroelastomer nanocomposites show increase in hardness, tensile strength, modulus, toughness and decrease in elongation at break with the increasing of GO’s concentration. This can be attributed towards excellent distribution of GO nanoparticles in the fluoroelastomer matrix. The effect of GO nanoparticle concentration on rheological properties of fluoroelastomer nanocomposites like: loss factor, storage modulus, loss modulus and complex viscosity have been studied as a function of temperature (5-100°C) and at different frequency 1, 10, and 100 Hz. The non-linear relationship between storage and loss moduli have been observed through Cole-Cole plots of fluoroelastomer/GO nanocomposites. The linear relationship of loss factor and storage modulus plots was explained on the basis of fluoroelastomer/GO interactions. The visco-elastic properties show increase in loss modulus, storage modulus, complex viscosity and decrease in loss factor with GO concentration, which can be attributed towards better fluoroelastomer-nanoparticle interactions.
“Mom Calling the Commanding Officer”: The Changing Relationship Between Mothers and Their Sons Serving in Israel Defense Forces
Authors: Bershtling Orit
Published: May 2023

Anchored in feminist theory, this article examines the relationship between mothers and their sons serving in Israel Defense Forces. A review of the feminist literature reveals that the military is one of the main sources of gender inequality and reproduction of traditional gender roles. The military plays a pivotal role in male socialization and encourages soldiers to distance themselves both physically and psychologically from their mothers and deny any feminine traits that may be attributed to them. Yet this qualitative study, which is based on 28 interviews with mothers and sons, reveals a more complex picture. Although the military does serve as a gatekeeper that distances mothers and reinforces hypermasculinized culture, the participants depict the mothers’ active involvement in the daily life of their soldier sons without any sense of inferiority in confronting the military apparatus. The mothers assume the role of psychologists, save the sons from entanglement with their direct commanders, and even organize their sons’ service route. The extension of maternal practices into the military realm blurs the binary conceptualization of “men in arms and women at home” and sheds more light on contemporary changes that have taken place in military–family relations in Israel.
“In Other News”: China’s International Media Strategy on Xinjiang—CGTN and New China TV on YouTube
Authors: Alpermann Björn , Malzer Michael
Published: May 2023

In the Western world China stands accused of severe human rights violations regarding its treatment of the Uyghurs and other predominantly Muslim minorities in its northwestern Xinjiang Uyghur Autonomous Region. This is the first article to systematically analyze the response of China’s international state media to these allegations. By studying the YouTube channels of two leading Chinese state media, China Global Television Network (CGTN) and New China TV (operated by Xinhua News Agency), it presents an in-depth understanding of how China’s foreign-facing propaganda works in a crucial case. The quantitative content analysis highlights how China reacted to increasing international (mostly United States) pressure regarding its Xinjiang policies by producing higher volumes of videos and putting out new counternarratives. The qualitative analysis that follows provides in-depth treatment of the most important discourses that Chinese media engage in to salvage the nation’s international image, namely those on development, culture, nature, and terrorism. It finds several ways of countering criticism, ranging from presenting a positive image of China, in line with traditional propaganda guidelines and President Xi Jinping’s assignment to state media to “tell the China story well,” to more innovative approaches. Thus the development narrative becomes more personalized, the discourse on culture supports the “heritagization process” to incorporate minority cultures into a harmonized “Chinese civilization,” representations of nature firmly tie Xinjiang into the discourse of “beautiful China,” the “terror narrative” strategically employs shocking footage in an attempt to gain international “discourse power,” etc. The article provides an up-to-date picture of China’s state media strategy on a highly contentious international issue.
Adaptive neural control for non-strict feedback stochastic nonlinear systems with input delay
Authors: Zheng Xiao-Yi
Published: May 2023

In this paper, the problem of adaptive control is investigated for a class of non-strict feedback stochastic nonlinear systems with input delay. First, the effect of the input delay is eliminated by constructing an appropriate auxiliary system with the same order as the considered system. Then, with the help of the backstepping technique and the structural characteristics of the radial basis function (RBF) neural network (NN), an adaptive neural control scheme is extended to non-strict feedback stochastic nonlinear systems with input delay, in which uncertain nonlinear functions are approximated by RBF NN. Furthermore, the proposed adaptive controller ensures that all the closed-loop signals remain bounded in probability. Finally, two examples are provided to confirm the effectiveness of the designed strategy.
Deceased Donor Kidney Transplantation for Older Transplant Candidates: A New Microsimulation Model for Determining Risks and Benefits
Authors: Kaufmann Matthew B. , Tan Jane C. , Chertow Glenn M. , Goldhaber-Fiebert Jeremy D.
Published: May 2023

Background

Under the current US kidney allocation system, older candidates receive a disproportionately small share of deceased donor kidneys despite a reserve of potentially usable kidneys that could shorten their wait times. To consider potential health gains from increasing access to kidneys for these candidates, we developed and calibrated a microsimulation model of the transplantation process and long-term outcomes for older deceased donor kidney transplant candidates.

Methods

We estimated risk equations for transplant outcomes using the Scientific Registry of Transplant Recipients (SRTR), which contains data on all US transplants (2010–2019). A microsimulation model combined these equations to account for competing events. We calibrated the model to key transplant outcomes and used acceptance sampling, retaining the best-fitting 100 parameter sets. We then examined life expectancy gains from allocating kidneys even of lower quality across patient subgroups defined by age and designated race/ethnicity.

Results

The best-fitting 100 parameter sets (among 4,000,000 sampled) enabled our model to closely match key transplant outcomes. The model demonstrated clear survival benefits for those who receive a deceased donor kidney, even a lower quality one, compared with remaining on the waitlist where there is a risk of removal. The expected gain in survival from receiving a lower quality donor kidney was consistent gains across age and race/ethnic subgroups.

Limitations

Limited available data on socioeconomic factors.

Conclusions

Our microsimulation model accurately replicates a range of key kidney transplant outcomes among older candidates and demonstrates that older candidates may derive substantial benefits from transplantation with lower quality kidneys. This model can be used to evaluate policies that have been proposed to address concerns that the current system disincentivizes deceased donor transplants for older patients.

Highlights

The microsimulation model was consistent with the data after calibration and accurately simulated the transplantation process for older deceased donor kidney transplant candidates. There are clear survival benefits for older transplant candidates who receive deceased donor kidneys, even lower quality ones, compared with remaining on the waitlist. This model can be used to evaluate policies aimed at increasing transplantation among older candidates.
Radiomic analysis of preoperative magnetic resonance imaging for the prediction of pituitary adenoma consistency
Authors: Mendi Bökebatur Ahmet Raşit , Batur Halitcan , Çay Nurdan , Çakır Banu Topçu
Published: May 2023

Background

The consistency of pituitary adenomas affects the course of surgical treatment.

Purpose

To evaluate the diagnostic capabilities of radiomics based on T1-weighted (T1W) and T2-weighted (T2W) magnetic resonance imaging (MRI) in conjunction with two machine-learning (ML) techniques (support vector machine [SVM] and random forest classifier [RFC]) for assessing the consistency of pituitary adenomas.

Material and Methods

The institutional database was retrospectively scanned for patients who underwent surgical excision of pituitary adenomas. Surgical notes were accepted as a reference for the adenoma consistency. Radiomics analysis was performed on preoperative coronal 3.0T T1W and T2W images. First- and second-order parameters were calculated. Inter-observer reproducibility was assessed with Spearman's Correlation (ρ) and intra-observer reproducibility was evaluated with the intraclass correlation coefficient (ICC). Least absolute shrinkage and selection operator (LASSO) was used for dimensionality reduction. SVM and RFC were used as ML methods.

Results

A total of 52 patients who produced 206 regions of interest (ROIs) were included. Twenty adenomas that produced 88 ROIs had firm consistency. There was both inter-observer and intra-observer reproducibility. Ten parameters that were based on T2W images with high discriminative power and without correlation were chosen by LASSO. The diagnostic performance of SVM and RFC was as follows: sensitivity = 95.580% and 92.950%, specificity = 83.670% and 88.420%, area under the curve = 0.956 and 0.904, respectively.

Conclusion

Radiomics analysis based on T2W MRI combined with various ML techniques, such as SVM and RFC, can provide preoperative information regarding pituitary adenoma consistency with high diagnostic accuracy.
Geography and ethics II: Justification and the ethics of anti-oppression
Authors: Schmidt Jeremy J
Published: May 2023

This report on geography and ethics focusses on the justification of normative evaluations. Justifying why actions are right or wrong often relies on appeals to high-order principles, such as the common good. But this is not always the case, as this report shows by identifying an ethics of anti-oppression that relies instead on struggles against individual and social harms and the conditions that generate them. Through resistance, ethics of anti-oppression also shift the terms of normative justification across a range of considerations within geography and beyond it, from refugees and asylum seekers to food production and blockades against extractive infrastructure.
Identity Formation and Post-Traumatic Growth Among Central American Immigrant Youth
Authors: Muñoz Bohorquez Juliana , Yumiseva-L. Martha , Dudamel Ana , Roy Kevin , Lewin Amy
Published: May 2023

To examine how Central American immigrant youth move from experiences of trauma to psychological growth as they transition into adulthood. The sample consisted of 20 (10 males and 10 females) adolescent and young adult immigrants (ages 18–26) from Honduras (20%), Guatemala (35%), and El Salvador (45%). Most participants migrated unaccompanied when they were 13 to 20, and their average time in the United States was 4.4 years. Data were collected with Identity, Inc., a community-based organization that supports Latino youth (ages 8–25) and their families living in poverty in Maryland. Semi-structured life history interviews were conducted in Spanish by a bilingual, bicultural staff member in person and on zoom. A diverse research team used a grounded theory approach to code transcripts in pairs, and then synthesize this coding within a post traumatic growth framework. A grounded theory approach was used to conduct open, axial, and selective coding of translated and de-identified transcripts. Findings from this study revealed the potential for post-traumatic growth, including a sense of one’s strength and enhanced meaning and purpose, and the importance of positive interpersonal connections in fostering growth. This study demonstrates a capacity for growth in Central American immigrant youth that goes beyond acculturation or coping with trauma and supports the value of trauma-informed services for this population.
Heat transfer enhancement in channels with roughened and elastic walls
Authors: Akbarpour Ghazani Mehran , Razavi Seyed Esmail , Ranjbar Faramarz
Published: May 2023

In this research, a combination of passive and active heat transfer enhancements are used synergistically to assist in the increase of absorbed heat from a channel by roughened and fluctuating walls. To this end, the upper wall is artificially roughened and a fluctuating segment is added to the lower wall. Flow regime is considered to be laminar and Reynolds number is 1000 at the entrance of the channel. Combinations of various roughness geometries and fluctuations are studied. It was found that due the increase of the fluid kinetic energy and its interaction with roughened surface and elastic segment, heat transfer rate is amplified. To investigate the overall efficiency of the system, Nusselt number and friction factor are calculated and a maximum value of 37.5% increase in average Nusselt number of the midsection where elastic wall is placed has been reached by flexible plate displacement. A maximum Nusselt number increase of 167% has been observed when the elastic plate reaches its peak value.
Asymmetric linkages between pandemic uncertainty and environmental quality: Evidence from emerging economies
Authors: Wentao Chang , Xinjian Zhou , Nazar Raima
Published: May 2023

The current COVID-19 pandemic was a huge shock, influencing a wide range of socioeconomic measures, including the environment. The issue of how the uncertainty caused by pandemics will influence environmental quality is critical. This research examines the nonlinear relationship between pandemic uncertainty and environmental quality across leading polluted emerging economies (China, India, Russia, Indonesia, Brazil, Mexico, Iran, Saudi Arabia, South Africa, and Turkey). Using data ranging from 1996 to 2020, a distinctive approach, ‘Quantile-on-Quantile’, is used. Greenhouse gas emissions (GHG) are adopted as a proxy for environmental quality. The outcomes analyze how pandemic uncertainty's quantiles influence the quantiles of GHG asymmetrically, giving an efficient paradigm for grasping the entire dependence structure. The findings show that pandemic uncertainty improves environmental quality by decreasing GHG in our sample economies at diverse quantiles. Higher levels of GHG (75th–90th quantiles) suggest a strong negative association between pandemic uncertainty and GHG in the majority of nations. The magnitude of the coefficients helps to explain why pandemic uncertainty has a significantly greater impact on GHG in Mexico and Turkey (with a coefficient size of −2) compared to Russia, India, and South Africa, where the effect is considerably smaller (with a coefficient size of −0.05). Furthermore, the rank of asymmetry in our chosen variables fluctuates by nation, underscoring the prominence of governments exercising caution and prudence while implementing pandemic-based uncertainty and environmental quality measures.
Designing practical fuzzy gain scheduling controllers for micromobility applications of permanent magnet synchronous machines
Authors: Gul Kursad Metehan , Kacar Berk , Aziziaghdam Mohammad , Kumbasar Tufan
Published: May 2023

In micromobility applications, maintaining satisfactory motor drive performance in the full torque-speed envelope of an outer rotor non-salient permanent magnet synchronous machine is a challenge due to the drastic performance degradation with the increasing non-linearity above the nominal ratings of the motor. In this article, we tackle this challenge via fuzzy gain scheduling proportional–integral speed controllers that have been designed by taking into account practical considerations. On the basis of experimental voltage ripple analyses conducted on the speed control loop with different system characteristics, we develop a single-input fuzzy gain scheduling proportional–integral speed controller and a double-input fuzzy gain scheduling proportional–integral speed controller to reduce the voltage ripples while providing satisfactory dynamical performance. The proposed structures continuously adjust the characteristics of the speed control loop within a specified region to exhibit different dynamical system characteristics against varying conditions. It is verified by the experimental test results that the proposed structures successfully reduced the increasing voltage ripples as the disturbances increase while providing satisfactory dynamical performance. Finally, we provided a discussion on the trade-off between the proposed structures and suggested deploying single-input fuzzy gain scheduling proportional–integral controller for micromobility speed control applications as it is agnostic to noise to a certain degree hence offering better reliability.
Unmet Needs and Burden of Caregivers of Patients Being Evaluated for a Liver Transplant Are Similar to Those of Cancer Caregivers
Authors: Verma Manisha , Horrow Jay , Carmody Stacey , Navarro Victor
Published: May 2023

Background

The caregivers (CG) of patients with serious illnesses often experience stress and psycho-social issues. High burden is expected for CG of patients for whom liver transplant (LT) is the only curative option. This study aims to measure the burden, unmet needs, and quality of life (QoL) of CG of patients being evaluated for LT.

Methods

This cross-sectional study enrolled CG of patients being evaluated for LT. CaTCoN (Caregiving Tasks, Consequences and Needs Questionnaire) was used to assess caregiving consequences and needs related to interactions with healthcare professionals (HCPs). ZBI-12 (Zarit Burden Interview) was used to assess CG burden, and PROMIS-29 (Patient Reported Outcomes Measurement Information System) to assess QoL. Caregivers completed the study instruments in person, while they were in the clinic. CaTCoN scores from our study were compared with cancer caregivers’ historical data.

Results

18 CG were enrolled, mean age 54 [14] years; 72% were white and 77% were women. 61% worked full time; 45% provided >20 hours of care per week. Two-thirds cared for patients with alcoholic liver disease. All CaTCoN scores were no different from CGs of cancer patients (all P > .05). The total ZBI score (mean SD 12.4 [8.3]) did not differ from published scores for CG of cancer patients (12.0 [8.5]). 44% had high (≥12) ZBI scores reflecting “high burden.” Their PROMIS-29 T scores, compared to those with low burden, showed more anxiety ( P = .01), depression ( P = .04), fatigue ( P = .02) and deteriorated social function ( P = .009). Physical function and social function were diminished among these CGs compared to the general population ( P < .0001).

Conclusion

CGs of patients being evaluated for LT suffer from high burden similar to cancer CGs and have reduced physical and social function. Despite the small sample size, the data completion rate was almost 100%.
A non-ordinary state decomposition method for three-body potential peridynamics model
Authors: Li Xiaolong , Hao Zhiming
Published: May 2023

A non-ordinary state decomposition method is proposed for the bond shear form of three-body potential peridynamics (PD) model. To accomplish this formulation, the effective relative displacement between two points is first decomposed into the volumetric and deviatoric parts based on the definition of dilatation. Starting from this, we give decomposition forms of the elementary deformations and strain energy density of this PD model and finally express the PD force function in the form of the sum of dilatational and distortional parts, which enable the PD model to clearly reflect material response dependence on volume changes and shape distorsion. Combined with the computational scheme of strain and stress tensors presented in the paper, the proposed method is validated numerically. The study permits the possibility of introducing plastic incompressibility for the three-body potential PD model.
Relationships and responsibilities between Anishinaabek and Nokomis Giizis (Grandmother Moon) inform N’bi (Water) governance
Authors: Chiblow Susan
Published: May 2023

Efforts continue to evolve for sustainable and inclusive water governance in Canada. All humanity relies on N’bi (Water) for life, yet contrasting views and knowledge on N’bi still elude water governance. Far too often, Indigenous women are left out of water governance regardless of their relationships and responsibilities to and for N’bi. Indigenous women, more specifically Anishinaabek (Indigenous Peoples of Turtle Island also known as Canada and the USA) kweok (women) understand the relationships and responsibilities Nokomis Giizis (Grandmother Moon) has to N’bi through the cycles of kweok and Nokomis Giizis and how this is guided through natural law. This article explores the relationships and responsibilities between Anishinaabek kweok and Nokomis Giizis and how it can inform water governance based on Anishinaabek naaknigewin (law).
“Pepe the frog, the greedy merchant and #stopthesteal”: A comparative study of discursive and memetic communication on Twitter and 4chan/pol during the insurrection on the US Capitol
Authors: Kasimov Andrey , Johnston Regan , Heer Tej
Published: May 2023

Following the January 6 insurrection on the US Capitol, we sought to explore how two social media platforms were being used concurrently to disseminate far-right memes and discourse. Our study employs a mixed-methods approach to collect a large data set of images from 4chan/pol/ and using the “#stopthesteal” hashtag on Twitter between 1 January 2021 and 13 January 2021. Our findings reveal how each platform influenced the usage of memes toward identity building and far-right activism in the days leading up to and immediately after the insurrection. Our findings reveal that Twitter was used to mobilize users leading up to January 6 but led to in-fighting among the pro-Trump crowd in the days after. Meanwhile 4chan/pol users took advantage of the Overton window of the Insurrection to disseminate far-right ideology and attempt to recruit and radicalize disgruntled Trump supporters after the insurrection was deemed a failure.
Hierarchies of bias in artificial intelligence architecture: Collective, computational, and cognitive
Authors: Kudless Andrew
Published: May 2023

This paper examines the prevalence of bias in artificial intelligence text-to-image models utilized in the architecture and design disciplines. The rapid pace of advancements in machine learning technologies, particularly in text-to-image generators, has significantly increased over the past year, making these tools more accessible to the design community. Accordingly, this paper aims to critically document and analyze the collective, computational, and cognitive biases that designers may encounter when working with these tools at this time. The paper delves into three hierarchical levels of operation and investigates the possible biases present at each level. Starting with the training data for large language models (LLM), the paper explores how these models may create biases privileging English-language users and perspectives. The paper subsequently investigates the digital materiality of models and how their weights generate specific aesthetic results. Finally, the report concludes by examining user biases through their prompt and image selections and the potential for platforms to perpetuate these biases through the application of user data during training.
Brain Stimulation and Constraint Induced Movement Therapy in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial
Authors: Gupta Juhi , Gulati Sheffali , Singh Upinder Pal , Kumar Atin , Jauhari Prashant , Chakrabarty Biswaroop , Pandey Ravindra Mohan , Bhatia Renu , Jain Suman , Srivastava Achal
Published: May 2023

Background

There is a crucial need to devise optimum rehabilitation programs for children with cerebral palsy (CP).

Objective

This study aimed to assess the feasibility, safety, and efficacy of combining 6-Hz primed, low-frequency, repetitive transcranial magnetic stimulation (rTMS) with modified constraint-induced movement therapy (mCIMT) in improving upper limb function in children with unilateral CP.

Methods

Children aged 5 to 18 years with unilateral CP were randomized (23 in each arm) to receive 10 sessions of mCIMT with real rTMS (intervention arm) or mCIMT with sham rTMS (control arm), on alternate weekdays over 4 weeks. The primary outcome was the difference in mean change in Quality of Upper Extremity Skills Test (QUEST) scores. Secondary outcomes were changes in QUEST domain scores, speed and strength measures, CP quality of life (CP-QOL) scale scores, and safety of rTMS.

Results

All 46 children completed the trial except one. At 4 weeks, the mean change in total QUEST scores was significantly higher in the intervention arm as compared to the control arm (11.66 ± 6.97 vs 6.56 ± 4.3, d = 5.1, 95% CI 1.7-8.5, P = .004). Change in “weight bearing” and “protective extension” domain score was significantly higher for children in the intervention arm. These improvements were sustained at 12 weeks ( P = .028). CP-QOL scores improved at 12 weeks. No serious adverse events were seen.

Conclusion

A 6-Hz primed rTMS combined with mCIMT is safe, feasible, and superior to mCIMT alone in improving the upper limb function of children with unilateral CP.

Trial Registration:

ClinicalTrials.gov Identifier: NCT03792789.
Changes in deadlift six repetition maximum, countermovement jump performance, barbell velocity, and perceived exertion over the duration of a microcycle
Authors: Guppy Stuart N. , Nagatani Tsuyoshi , Poon Wayne C. K. , Kendall Kristina L. , Lake Jason P. , Gregory Haff G.
Published: May 2023

The primary aim of this study was to investigate the stability of the six-repetition maximum (6RM) deadlift over the length of a five-day microcycle and whether the fatigue induced by maximal effort testing detrimentally impacted preparedness. Twelve participants performed four testing sessions, comprising a one-repetition maximum test and three 6RM tests separated by 48 hours. Countermovement jumps were performed before each testing session, and barbell velocity was measured during each warm-up set to assess changes in preparedness. The 6RM deadlift was not statistically different between any of the testing sessions ( p  =  .056; ηp2  =  0.251). Similarly, there were no significant differences in jump height or other CMJ variables between sessions ( p > .05). There were small to moderate differences in mean barbell velocity between the first and second 6RM test ( g  =  0.24–0.88), while there were only small differences in mean velocity (MV) between the second and third 6RM test at some of the warm-up loads (40% 6RM: g  =  0.20; 80% 6RM: g  =  −0.47). Taken collectively, these data indicate that 6RM deadlift strength is stable over five days and does not appear to induce sufficient fatigue to impact vertical jump performance or rating of perceived exertion despite some changes in barbell velocity.
The FIFA 11 + : Why is adherence so challenging? Insights from a cross-sectional study of stakeholders in Australian amateur football (soccer)
Authors: Ross Andrew G. , McKay Marnee J. , Pappas Evangelos , Whalan Matthew , Parsanejad Elia , Peek Kerry
Published: May 2023

Objectives

To explore the usage and awareness of the FIFA 11 + (11 + ) across multiple stakeholders involved with amateur football.

Methods

Coaches, players, non-coaching staff and medical personnel in New South Wales (NSW), Australia, were invited to complete a cross-sectional online survey, which was disseminated using a targeted email to two Football NSW member organisations and a social media campaign. Categorical data (including age-groups and sex) are presented as counts and percentages and analysed using a Chi-square or Fisher's exact test. A significance level of 0.05 was used for all analyses.

Results

In total 328 players, 55 coaches, 37 non-coaching staff and 16 medical personnel completed the survey (n  =  436). Awareness of the 11  +  was lowest among non-coaching staff (16.2%) and players (32.6%) but higher among coaches (52.7%) and medical personnel (93.8%). Once aware of the 11 + , 75.8% of all respondents used the program although 89.5% of them did so with modifications. In addition, only 40.0% of players reported completing all three parts of the 11  +  program. Veteran players were less likely to complete any type of warm-up compared with junior players (63.7% vs. 96.3%, respectively).

Conclusions

Although awareness of the 11  +  varied amongst survey respondents, 3 out of 4 respondents who were aware of the 11  +  adopted the program. However, respondents reported modifying the 11  +  and not completing the program as intended, which suggests modification guidance is required to maintain the efficacy of the 11  +  .
Reliability analysis of complex multi-state system based on universal generating function and Bayesian Network
Authors: Liu Xu , Yao Wen , Zheng Xiaohu , Xu Yingchun , Chen Xiaoqian
Published: May 2023

In the complex multi-state system (MSS), reliability analysis is an important research content, both for equipment design, manufacturing, operation and maintenance. Universal Generating Function (UGF) is an essential method in reliability analysis, which efficiently obtains system reliability by a fast algebraic procedure. However, when structural relationships between subsystems or components are unclear or without explicit expressions, the UGF method is difficult to use or not applicable at all. Bayesian Network (BN) has a natural advantage in terms of reliability inference for the relationship without explicit expressions. When the number of components is extremely large, though, it has the defects of low efficiency. To overcome the respective shortcomings of UGF and BN, a novel reliability analysis method called UGF-BN is proposed for the complex MSS. In the UGF-BN framework, the UGF method is first used to analyze the bottom components with a large number. Then probability distributions obtained are taken as the input of BN. Finally, the reliability of the complex MSS is modeled by the BN method. This proposed method improves the computational efficiency, especially for the MSS with a large number of bottom components. Besides, the aircraft reliability-based design optimization based on the UGF-BN method is further studied with budget constraints on mass, power, and cost. Finally, two cases are used to demonstrate and verify the proposed method.
Multimodal intertextuality and persuasion in advertising discourse
Authors: Xing Chunyan , Feng Dezheng (William)
Published: May 2023

This paper provides an integrated social semiotic framework for analyzing intertextuality in multimodal advertising discourse. Following the distinction between manifest intertextuality and interdiscursivity, our model entails the three interrelated components of explicating what the intertextual sources are, how they are constructed with multimodal resources, and how they interact with the promotional discourse. Analysis of 30 popular video advertisements shows the fundamental role of character voices and different social semiotic activities in achieving the purpose of promoting products and services. Through intertextual devices, the advertisements construct multiple identities, including authoritative and peer ones, to evoke different reading positions. In particular, the identity of middle-class urbanites sharing their experiences and values with the audience is dominant. The intertextual devices achieve promotional, relational, and entertainment functions, and the promotional function is realized through sharing, recreating, expounding, and reporting activities, while the recommending activities only occupy a very small portion of the screen time of the advertisements. The framework of multimodal intertextuality provides a useful lens for explicating the complex meaning-making resources, their communicative functions, and hidden ideologies in advertising discourse, which can further provide new insight into the social reality.
Pulse oximetry in children
Authors: Silverston Paul , Ferrari Marco , Quaresima Valentina
Published: May 2023

Pulse oximeters detect and quantify the degree of hypoxaemia in a way that is non-invasive, relatively inexpensive, and simple to perform. This makes pulse oximeters ideal for use in children in the primary care setting. However, although many GPs now have access to a pulse oximeter, few have received formal training in pulse oximetry and many are unaware of the potential for pulse oximeters to produce inaccurate readings in some patients and in some circumstances. This article discusses the use of pulse oximetry in children and highlights the need for GPs to be aware of the factors that can cause oxygen saturation readings to be inaccurate or misinterpreted.
The role of molecular testing in pancreatic cancer
Authors: Zhen David B. , Safyan Rachael A. , Konick Eric Q. , Nguyen Ryan , Prichard Colin C. , Chiorean E. Gabriela
Published: May 2023

Pancreatic ductal adenocarcinoma (PDA) is highly aggressive and has few treatment options. To personalize therapy, it is critical to delineate molecular subtypes and understand inter- and intra-tumoral heterogeneity. Germline testing for hereditary genetic abnormalities is recommended for all patients with PDA and somatic molecular testing is recommended for all patients with locally advanced or metastatic disease. KRAS mutations are present in 90% of PDA, while 10% are KRAS wild type and are potentially targetable with epidermal growth factor receptor blockade. KRASG12C inhibitors have shown activity in G12C-mutated cancers, and novel G12D and pan-RAS inhibitors are in clinical trials. DNA damage repair abnormalities, germline or somatic, occur in 5–10% of patients and are likely to benefit from DNA damaging agents and maintenance therapy with poly-ADP ribose polymerase inhibitors. Fewer than 1% of PDA harbor microsatellite instability high status and are susceptible to immune checkpoint blockade. Albeit very rare, occurring in <1% of patients with KRAS wild-type PDAs, BRAF V600E mutations, RET and NTRK fusions are targetable with cancer agnostic Food and Drug Administration-approved therapies. Genetic, epigenetic, and tumor microenvironment targets continue to be identified at an unprecedented pace, enabling PDA patients to be matched to targeted and immune therapeutics, including antibody–drug conjugates, and genetically engineered chimeric antigen receptor or T-cell receptor – T-cell therapies. In this review, we highlight clinically relevant molecular alterations and focus on targeted strategies that can improve patient outcomes through precision medicine.
The Compassionate Communities Connectors programme: experiences of supported families and referring healthcare providers
Authors: Aoun Samar M , Rosenberg John , Richmond Robyn , Rumbold Bruce
Published: May 2023

Background and Aim:

Comprehensive evaluations that include the experience of patients and service providers are vital if interventions are to be translated into the standard practice of health services and allow formal networks to work as partners with informal community networks. However, published evaluations are limited in the palliative care volunteering literature. The objective of the study is to explore the experiences and views of both patients and their family carers who received support and their referring healthcare providers concerning their participation in the Compassionate Communities Connectors programme, in the south-west region of Western Australia. Connectors identified and addressed gaps in community and healthcare provision by accessing resources and mobilising social networks of people with life-limiting illnesses. The perspectives of patients, carers and service providers concerning the feasibility and acceptability of the intervention were sought.

Methods:

Semistructured interviews were undertaken with 28 patients/families and 12 healthcare providers, resulting in 47 interviews in total (March 2021-April 2022). An inductive content analysis was used in analysing interview transcripts to identify key themes.

Results:

Families greatly appreciated the support and enablement received from the Connectors. Healthcare providers were impressed with the high level of resourcefulness exhibited by the Connectors and perceived a great need for the programme, particularly for those socially isolated. Three themes captured the patients’/families’ perspectives: connector as an advocate, increasing social connectedness and taking the pressure off families. Healthcare providers’ perspectives were captured in three themes: reducing social isolation, filling a gap in service provision and building the capacity of the service.

Conclusions:

Perspectives of patients/families and healthcare providers demonstrated the mediating role of Connectors. Each group saw the Connectors’ contribution through the lens of their particular interests or needs. However, there were indications that the connection was shifting the way each group understood and practised care, encouraging or restoring agency to families and reminding healthcare providers that collaborating beyond the boundaries of their roles actually enhances the whole ecology of care. Using a Compassionate Communities approach to mobilise health and community sectors has the potential to develop a more holistic approach that addresses the social, practical and emotional domains of care.
Assessing the relationship between gut microbiota and irritable bowel syndrome: a two-sample Mendelian randomization analysis
Authors: Liu Bin , Ye Ding , Yang Hong , Song Jie , Sun Xiaohui , He Zhixing , Mao Yingying , Hao Guifeng
Published: May 2023

Background

Growing evidence has suggested that gut microbiota is closely related to the risk of irritable bowel syndrome (IBS), but whether there is a causal effect remains unknown. We adopted a Mendelian randomization (MR) approach to evaluate the potential causal relationships between gut microbiota and the risk of IBS.

Methods

Genetic instrumental variables for gut microbiota were identified from a genome-wide association study (GWAS) of 18,340 participants. Summary statistics of IBS were drawn from a GWAS including 53,400 cases and 433,201 controls. We used the inverse-variance weighted (IVW) method as the primary analysis. To test the robustness of our results, we further performed the weighted-median method, MR-Egger regression, and MR pleiotropy residual sum and outlier test. Finally, reverse MR analysis was performed to evaluate the possibility of reverse causation.

Results

We identified suggestive associations between three bacterial traits and the risk of IBS (odds ratio (OR): 1.08; 95% confidence interval (CI): 1.02, 1.15; p = 0.011 for phylum Actinobacteria; OR: 0.95; 95% CI: 0.91, 1.00; p = 0.030 for genus Eisenbergiella and OR: 1.10; 95% CI: 1.03, 1.18; p = 0.005 for genus Flavonifractor). The results of sensitivity analyses for these bacterial traits were consistent. We did not find statistically significant associations between IBS and these three bacterial traits in the reverse MR analysis.

Conclusions

Our systematic analyses provide evidence to support a potential causal relationship between several gut microbiota taxa and the risk of IBS. More studies are required to show how the gut microbiota affects the development of IBS.
Pediatric hypereosinophilic syndrome associated with liver damage, portal vein, splenic vein and superior mesenteric vein thromboses: a case report
Authors: Zheng Hai-Tao , Xu Yan , Yan Xiao-Yu , Yan Yong-Bin , Ma Shu-Xia , Liu Ling-Ling , Zhao Qian-Yi
Published: May 2023

Background

The hypereosinophilic syndrome (HES) is a group of rare blood disorders characterized by persistent eosinophilia and damage to multiple organs. HES can be either primary, secondary or idiopathic. Secondary HES are commonly caused by parasitic infections, allergic reactions or cancer. We described a pediatric case of HES associated with liver damage and multiple thrombi.

Case summary

A 12-year-old boy with eosinophilia was complicated with severe thrombocytopenia, liver damage, portal vein, splenic vein, and superior mesenteric vein thromboses. The thrombi recanalized after treatment with methylprednisolone succinate and low molecular weight heparin. No side effects appeared after 1-month.

Conclusions

Corticosteroids should be used at an early stage of HES to prevent further damage to vital organs. Anticoagulants should be recommended only in cases with thrombosis which should be actively screened as a part of evaluation of end organ damage.