bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of body mass index on immune checkpoint inhibitor efficacy in patients with advanced cancer
Authors: Alkan Şen Gülin , Şentürk Öztaş Nihan , Değerli Ezgi , Guliyev Murad , Turna Hande , Özgüroğlu Mustafa
Published: November 2024

Background:

The need for predictive factors regarding the response to immune checkpoint inhibitors (ICIs) is increasing. Recent research indicates that an enhanced response to ICIs is associated with a higher body mass index (BMI). This study aims to evaluate the relationship between response to ICIs and BMI in solid tumors.

Methods:

We retrospectively analyzed patients with advanced cancer treated with ICIs at one academic center. We compared the treatment responses of patients classified as underweight/normal weight (BMI <25) and overweight/obese (BMI ⩾ 25) according to their BMI at the initiation of ICI treatment. After excluding underweight patients, we also compared the progression-free survival (PFS) and overall survival (OS) of normal-weight, overweight, and obese patients.

Results:

Overall, 113 patients were evaluated. Forty-seven (41.6%) patients had BMI <25 and 66 (58.4%) patients had a BMI ⩾ 25. In underweight/normal patients, median PFS was 7.7 months (95% CI: 4.7-10.6) while it was 8.0 months (95% CI: 4.1–11.9) in overweight/obese patients (HR 1.16, 95% CI: (0.76-1.75), p=0.477). In underweight/normal patients, the median OS was 21.7 months (95% CI: 11.6-31.7) compared to 18.7 months (95% CI: 12.7-24.6) in overweight/obese patients (HR 1.06, 95% CI: (0.69-1.64), p=0.774). The objective response rate (ORR) was 38.3% in underweight/normal patients and 34.8% in overweight/obese patients (p = 0.707). After excluding underweight patients, there were also no significant differences in PFS (p = 0.914), OS (p = 0.642), and ORR (p = 0.909) between patients of normal weight, overweight, and obesity.

Conclusion:

Our research found no correlation between BMI and response to ICIs. Additional prospective studies are necessary to assess the effect of BMI on the response to ICIs.
New masculinities in uro-oncology: A social theory that contributes to the mental health of patients with penile cancer
Authors: Barbosa Daza Natalia , Nieva-Posso Daniel Andrés , García-Perdomo Herney Andrés
Published: November 2024

Sociocultural, the penis has represented an essential element in the identity and masculinity of Western men. Therefore, its injury, damage, or loss leads to psychosocial problems affecting these people’s health and well-being. Penile cancer is a rare malignancy (it represents 1.44% of the cases of genitourinary cancers) that has direct effects on the genitals, and its treatment consists of penectomy (removal of the penis). The loss of the penis due to this disease has a profound impact on the survivors. It is associated with higher rates of depression, anxiety, and loss of male identity, some even feeling like “castrated animals” or fewer men, having not only biological but also social and psychological problems, leading to the loss or decrease of sexual activity, self-esteem, and ability to relate to others. The new masculinities (a social theory much discussed these days) is offered as an alternative to understanding the behavior of men concerning what represents the penis, and the construction of their identity, focusing on the need to reconstruct the idea of masculinity and unlink the identity of men outside their genitals, the discussion of such social elements can be offered alternatives to help improve the psychological condition of patients who have survived the penectomy and contribute significantly to their health and quality of life, especially in improving your mental health.
Priorities to Support Care Partners of People Living With Dementia: Results of a Modified Delphi Process
Authors: Gelmon Sherril B. , Reed Jenn , Dawson Walter D.
Published: November 2024

Objective: To determine priorities for services and policies that better support care partners of people living with dementia. Methods: A modified Delphi process engaged participants from organizations serving people living with dementia and care partners, focusing on historically and currently underserved communities. Eight thematic areas were identified. Participants ( N = 40) responded to three surveys, generating ideas, rating each, and ranking priorities. Results: Each survey received 13–17 responses. Top ranked ideas were arrayed across six thematic areas: care partner supports; programs; funding; information; care coordination; and workforce development. Discussion: The Delphi process empowered participants to share knowledge, and respected their opinions. Anonymity removed power imbalances. The survey iterations blended qualitative and quantitative approaches, and built consensus. The Delphi invited the voices of diverse participants; all voices were weighed equally. This process could be extended to efforts to further engage dementia care partners, helping to value their voices in decision-making for services and policies.
Degradation reliability modeling for ball screws subject to fatigue elastic failure mode
Authors: Zhou Hua-Xi , Wang Xiao-Yi , Zhou Chang-Guang , Zhu Xin-Yu , Sun Liang-Bo
Published: November 2024

Ball screws have been receiving increasing attention in the aerospace and military industry for their high reliability and high positioning accuracy. Under such extreme working conditions, ball screws are required to bear heavy loads in a short time, where they are mainly subject to fatigue elastic failure mode. Traditional reliability modeling methods based on the fatigue pitting failure mode are not suitable any more. However, reliability based on fatigue elastic failure in ball screws has not been investigated yet. To this end, we first established a degradation mechanism model for the fatigue elastic of ball screws. Subsequently, we proposed the degradation reliability model for ball screws, along with a novel Expectation Maximization method for parameter estimation. Additionally, we proposed a novel test method for the fatigue elastic life for ball screws utilizing a designed test bench. The mean curve for the degradation model almost exhibited a relative error less than 5%, confirming the validity of the proposed model. Lastly, we conducted a sensitivity analysis of structural parameters on fatigue elasticity, finding that the helix angle significantly influences the rated elastic life, while the ball diameter has a minimal effect. These findings contribute valuable insights for reliability evaluation and reliability design for ball screws under extreme working conditions.
Towards a Clinically Relevant Appreciation of the Cost of Caring: A Study of Palliative Care Physicians in Malaysia
Authors: Ong Yun Ting , Sinnathamby Annushkha , Tan Jun Hao , Ravindran Nila , Lim Shu Xian , Hiew Aaron Wi Han , Ng Sing Yee , Ong Simon Yew Kuang , Krishna Lalit Kumar Radha
Published: November 2024

Background: The cost of caring for patients and their families in the midst of interconnected resource, ethical, moral, legal and practical considerations compromises a physician’s emotional and physical well-being and therefore patient care. Whilst the cost of caring is historically best associated with compassion fatigue, data has suggested that this may extend to other related concepts, such as vicarious trauma, secondary traumatic stress and burnout. In particular, palliative care physicians are especially vulnerable as they witness and encounter more cases of death and dying. Methods: This study aims to provide a more clinically relevant notion of the cost of caring amongst palliative care physicians in Malaysia. 11 physicians underwent semi-structured interviews as part of the Systematic Evidence-Based Approach (SEBA) for prospective studies. Results: Analysis of the interview transcripts revealed the following domains: (1) conceiving the costs of caring; (2) risk factors; and (3) support mechanisms. Conclusion: This SEBA-guided study into the cost of caring amongst Malaysian palliative care physicians suggests that the costs of caring extend beyond encapsulating moral distress, compassion fatigue, vicarious trauma, secondary traumatic stress and burnout. Rather, the data suggests a personalized notion that varies with individual and contextual factors which are in flux and change over time. A longitudinal, personalized and holistic mentoring program is therefore proposed to counter this cost.
Encapsulated Papillary Carcinoma of the Breast: A Review of Clinicopathologic Characteristics, Molecular Mechanisms, and Patient Management
Authors: Changrong Wang , Zhibo Zuo , Jufeng Guo , Hongju Yan , Feng You , Jingjing Xiang
Published: November 2024

Encapsulated papillary carcinoma (EPC) represents a distinct entity within the spectrum of breast papillary tumors, typically manifesting as a retroareolar mass. This rare subtype can be effectively visualized using ultrasound and magnetic resonance imaging, which reveal characteristic cystic-solid nodules. Histopathologically, EPC is defined by a papillary tumor structure with a well-defined fibrous capsule, devoid of myoepithelial cells both within and around the capsule. Immunohistochemical staining for myoepithelial markers is essential to confirm the absence of these cells, thereby validating the diagnosis of EPC. At the molecular level, EPC exhibits feature similar to estrogen receptor-positive invasive ductal carcinoma (IDC), with a biological behavior that lies between ductal carcinoma in situ (DCIS) and IDC. Generally, EPC has a favorable prognosis, associated with minimal recurrence and metastatic potential. Therapeutic strategies for EPC may parallel those for DCIS, including surgical excision. Adjuvant radiotherapy is recommended following surgery for patients with concurrent DCIS or those who have undergone breast-conserving therapy. In cases with associated IDC, management prioritizes the treatment of the invasive component. High-grade EPC often requires systemic therapies due to its poorer prognosis and increased risk of lymph node involvement.
Editor’s Good-Bye
Authors: Fullerton Jami
Published: November 2024

Final Thoughts from the outgoing editor.
Bladder Cancer Treatments in the Age of Personalized Medicine: A Comprehensive Review of Potential Radiosensitivity Biomarkers
Authors: Feghaly Charbel , Challita Rafka , Hadir Hanine Bou , Mobayed Tala , Bitar Tarek Al , Harbi Mohammad , Ghorayeb Hala , El-Hassan Rana , Bodgi Larry
Published: November 2024

Bladder cancer is one of the most frequently diagnosed cancers in men. While cystectomy remains the primary treatment, advances in radiotherapy and chemotherapy have highlighted the value of bladder-preserving strategies, which can also enhance patients’ quality of life. Despise these advances, around 20% of patients may still require salvage cystectomy due to tumor radioresistance. This underscores the need to develop radiosensitivity predictive assays. Radiotherapy acts by inducing DNA damage, primarily through DNA double-strand breaks, which can significantly affect treatment outcomes if left unrepaired. In addition to activating DNA repair pathways, the response to radiation also involves the tumor microenvironment, cell death pathways, immune responses and different types of cell death and proliferation receptors. In recent years, personalized medicine, which tailors treatments to individual patients, has gained increasing attention in cancer care. The development of chemo- and radiosensitivity predictive assays has become a key focus of cancer research. Despite the potential impact of such assays on bladder cancer treatment, there is still no reliable test that can help clinicians and informs patients in choosing the best treatment. This review aims to highlight studies that attempted to characterize bladder cancer radiosensitivity and to discuss the potential biomarkers that could be used to develop bladder cancer radiosensitivity predictive assays.
Drug Repositioning for Scorpion Envenomation Treatment Through Dual Inhibition of Chlorotoxin and Leiurotoxin
Authors: Zainab Gaouzi , Hanane Abbou , Razana Zegrari , Rachid Eljaoudi , Idrissa Diawara , Mohammed Hakmi , Mouad Mkamel
Published: November 2024

Scorpion envenomation, a grave public health concern, is primarily driven by the potent neurotoxins chlorotoxin and leiurotoxin present in Leiurus species venom. Developing effective treatments is crucial to mitigate its impact. Utilizing a drug-repositioning bioinformatics-based approach, potential inhibitors of these neurotoxins were identified from Food and Drug Administration (FDA)-approved drugs. Through virtual screening and subsequent molecular dynamics simulations, their ability to stabilize the peptides over time was evaluated. Among the compounds scrutinized, bolazine emerged as a promising candidate, demonstrating significant affinity for both neurotoxins, indicating potential dual inhibitory activity. Molecular dynamics simulations further corroborated the enhanced stability of bolazine complexes compared to neurotoxins alone. These findings suggest the feasibility of repurposing existing drugs to develop new therapeutic strategies to treat scorpion envenomation. Such interventions hold promise in alleviating the severe health repercussions of scorpion stings and meeting the urgent demand for effective remedies in affected communities.
Innocence and experience in Barbie
Authors: Connolly Ruth
Published: November 2024

The paradisical garden of archetypal myth is an image both of the world as it once was and of how it should ideally be. This Arcadian or Edenic space, the ‘Happy Garden’, is verdant, safe and sunny. Its inhabitants do not have to labour to live; rather, their environment spontaneously provides all that they need, and more. Barbie alters the terms of the expulsion from Eden that lies at the heart of Jewish and Christian accounts of the origin of patriarchy. Barbie leaves voluntarily, unable to remain in a matriarchy that persists in its investment in the forever young, whereas Ken remains in Barbie Land, uneasily reconciled with its restored gender hierarchy. The film is another instance of the power struggle over the meanings, purpose and agency of the female reproductive body, which is to say it is a film about motherhood, non-motherhood and about the female body as it changes over time. In Jewish and Christian myth, pain in childbirth was a punishment for Eve's transgression and the body's reminder of women's subjugation. In Barbie, by contrast, knowledge of those changes and the experience of coping with them is the mark of Barbie's liberation from the space of innocence.
The effect of employee based brand equity on customer experience in multinational chain hotels
Authors: Zhang Jinlan , Filimonau Viachaslau , Tlemissov Ulan
Published: November 2024

Employees in branded hotels can be more satisfied and better perform at work if they appreciate brand value, thus showcasing employee based brand equity. By interacting with hotel guests, employees can transfer some of this brand value onto customers and affect their experience. The interlinkages between employee based brand equity and customer experience are however under-explored. By surveying employees ( n = 335) and customers ( n = 332) of a renowned multinational hotel chain, this study demonstrates that employee based brand equity exerts significant effect on customer experience. The results suggest that hotel managers should better recognise the key role of employees as brand ambassadors.
Defending against out-migration: Rural precarity, tourism, and hope in Quilotoa, Ecuador
Authors: Quick Joe R
Published: November 2024

This article explores themes of precarity and hope through histories of tourism in Quilotoa, Ecuador. The initial embrace of tourism among Quilotoans in the late 1980s responded to prevailing conditions of precarity in the livelihoods of young migrant laborers from Quilotoa and other rural indigenous communities of the Ecuadorian highlands. The sense of hope that prevailed among Quilotoans by the mid 2010s was rooted in their collective management of tourism as a shared resource, and their shared feeling that tourism provided a bulwark against the intense pressure to migrate that was still felt by young people in neighboring communities. Yet the collapse of tourism in the wake of the COVID-19 pandemic demonstrated the precarity of tourism itself, and many young Quilotoans have once again been forced to leave home in search of precarious wage labor opportunities. This article identifies how the ebbs and flows of hope, precarity, tourism, and labor migration are linked in Quilotoa, and how they are managed collectively by the Center for Community Tourism that oversees tourism there.
Cross-cultural perspectives on ethical consumption: A study of Swedish and Iranian citizens
Authors: Karimzadeh Sara , Boström Magnus
Published: November 2024

Ethical consumption can take different forms, each with its own justifications and underlying rationales. While countries in north-western Europe have well-established mechanisms for promoting ethically labelled products, the situation is different in many other regions across the world. This paper examines ethical consumption in Sweden and Iran to identify the societal factors that influence the phenomenon. Employing social practice theory and a multilevel perspective, the empirical study explores the assumption that ethical consumption develops in an interplay between different levels and between different social actors, which can both challenge and rely on existing capacities. Data was generated from 34 semi-structured interviews with citizens in both countries. Expanding beyond micro-level factors, this study makes a dual contribution to the field of ethical consumption. First, it offers insights into the diverse ethical perceptions related to consumption across societies, broadening the understanding of various aspects of the phenomenon. Secondly, it sheds light on the role of societal regimes in the emergence and adoption of ethical consumption.
Cross-Sectional, Longitudinal, and Dynamic Associations Among Big Five Personality Traits and Resilience in Primarily Female, Upper-Middle Class, Ethnically Diverse U.S. Adolescents
Authors: Metts Allison , Puhlmann Lara M. C. , Zerban Matthias , Kalisch Raffael , Zinbarg Richard E. , Mineka Susan , Craske Michelle G.
Published: November 2024

In this study, we examined how Big Five personality traits relate to outcome-based resilience in primarily female, upper-middle class, ethnically diverse U.S. adolescents (baseline N = 535; age range = 15–17) oversampled on elevated neuroticism. Cross-sectional, prospective-longitudinal, and dynamic analyses were performed with 8-year longitudinal data. Using a residualization approach, we approximated resilience as low stressor reactivity, calculated by regressing depression and anxiety diagnosis severity onto chronic stressor exposure over 1-year periods. Cross-sectional associations with stressor reactivity were observed for neuroticism (positive), extraversion (negative), openness (positive), and conscientiousness (negative). A positive prospective-longitudinal association with stressor reactivity was observed for neuroticism. In contemporaneous and lagged dynamic analyses, within-persons dynamics and mean levels of neuroticism (positive) and extraversion (negative) were associated with stressor reactivity. There were also unique associations with stressor reactivity for neuroticism (positive), extraversion (negative), and agreeableness (positive). Results indicate relevance of mean levels and intraindividual dynamics of personality, particularly neuroticism, for resilience in adolescents.
Efficiency and Heat Production of Ultrasonic Osteotome Strategy in Robot-Assisted Laminectomy
Authors: Wang Chengxia , Li Zhuofu , Jiang Shuai , Zhong Woquan , Li Weishi
Published: November 2024

Study Design

A biomechanical study.

Objective

We aimed to assess temperature fluctuations when applying the ultrasonic osteotome during laminectomy and identify the most appropriate cutting method for robot-assisted laminectomy to mitigate the risk of heat-related injuries.

Methods

Utilizing a robotic system for laminectomy, the study implemented the ultrasonic bone scalpel to cut both artificial polyurethane bones and animal spinal bones. The research focused on comparing and analyzing the maximum temperature of the inner surface of four types of artificial bones through three different cutting techniques: vertical constant cutting at speeds of .5 mm/s and 1 mm/s, as well as robot-assisted vertical reciprocating cutting. After the initial results, two optimal vertical cutting approaches were selected for subsequent trials, evaluating the effectiveness and temperature impact of various ultrasonic osteotome modes on 10 isolated spinal bones from pigs.

Results

When cutting polyurethane bones, reciprocating cutting demonstrated the lowest maximum temperature in contrast to constant speed cutting at .5 mm/s and 1 mm/s. In the animal bone trial, direct cutting registered an average maximum temperature of 43.25°C with an average cutting duration of 688.3 s, while reciprocating cutting recorded an average maximum temperature of 34.20°C with an average cutting time of 713.0 s.

Conclusions

The reciprocating cutting strategy utilized in robot-assisted ultrasonic osteotome is effective in reducing heat generation and maintaining high cutting efficiency.
Defining Clinically Significant Outcome Thresholds for the Patient-Reported Outcomes Measurement Information System (PROMIS) at 2 Years After Gluteus Medius and/or Minimus Repair
Authors: Gilat Ron , Vogel Michael J. , Kazi Omair , Nho Shane J.
Published: November 2024

Background:

Clinically significant outcome (CSO) thresholds are invaluable to the interpretation of patient-reported outcomes (PROs). The Patient-Reported Outcomes Measurement Information System (PROMIS) is gaining popularity among the orthopaedic community; however, CSO thresholds for PROMIS are yet to be defined for outcomes after gluteus medius and/or minimus (GM) repair.

Purpose:

To (1) define CSO thresholds for PROMIS–Pain Interference (PROMIS-PI) and PROMIS–Physical Function (PROMIS-PF) after GM repair, (2) correlate these PROMIS scores with legacy hip-specific PROs, and (3) quantify their floor and ceiling effects.

Study Design:

Case series; Level of evidence, 4.

Methods:

Consecutive patients who underwent primary GM repair between September 2017 and June 2021 with completed PROMIS at minimum 2-year follow-up were evaluated. The minimal clinically important difference, Patient Acceptable Symptom State, and substantial clinical benefit thresholds were defined for the PROMIS-PI and PROMIS-PF as well as for legacy PROs: Hip Outcome Score–Activities of Daily Living (HOS-ADL) and Hip Outcome Score–Sports Subscale (HOS-SS); modified Harris Hip Score (mHHS); 12-item International Hip Outcome Tool (iHOT-12); and the visual analog scale (VAS) for pain and satisfaction. Pearson correlations were performed between PROMIS scores and legacy PROs. Rates of floor and ceiling effects were quantified.

Results:

Overall, 107 patients (81.7% follow-up compliance; mean age, 59.8 ± 8.8 years; 92.5% female; mean body mass index, 28.6 ± 6.3 kg/m2) were included in the analysis. GM tears were partial thickness in 56.1% of cases and treated endoscopically in 64.5% of cases. The minimal clinically important difference, Patient Acceptable Symptom State, and substantial clinical benefit thresholds, respectively, were as follows: PROMIS-PI (–4.6, 56.0, 52.6), PROMIS-PF (3.5, 42.7, 43.7), HOS-ADL (10.7, 68.2, 78.6), HOS-SS (16.5, 58.6, 60.6), mHHS (9.0, 64.3, 71.5), iHOT-12 (14.2, 63.6, 69.4), VAS pain (–16.1, 34.9, 28.1), and VAS satisfaction (not applicable, 70.9, 93.6). Moderate to strong correlations were observed between the PROMIS and legacy PROs. The PROMIS-PI showed a significant postoperative floor effect of 18.7%.

Conclusion:

Study findings indicated that the PROMIS is effective for use in GM repair patients, given the moderate-to-strong correlations between the PROMIS and legacy hip-specific PROs, the mostly limited floor and ceiling effects, and large effect sizes. Use of PROMIS instead of legacy PROs may aid in limiting survey burden.
Debate: The Ideal Approach to Esophageal Subepithelial Tumors—Endoscopic Approach
Authors: Sharma Prabin , Stavropoulos Stavros N.
Published: November 2024

The focus of this review is endoscopic resection (ER) of esophageal subepithelial tumors (SETs) as an alternative to surgical resection. We briefly review relevant background information on the epidemiology and current guidelines for the management of esophageal SETs and then proceed to discuss in detail ER for these tumors. Submucosal Tunnel Endoscopic Resection (STER) has emerged as the dominant ER technique for esophageal SETs. We review this technique and its outcomes and summarize comparative data versus other endoscopic techniques and, importantly, versus surgical approaches. The latter comparison represents the main focus of this review as part of the endoscopy versus surgery debate format of this issue. We conclude that, with proper case selection, STER offers an equally efficacious but less invasive alternative to surgery for resection of esophageal SETs.
The possibilities for thinking beyond proceduralism: A post-phenomenological account of walking as a diffractive practice
Authors: Yan Dave
Published: November 2024

Turning to the possibilities of a posthumanist phenomenology, this autoethnography explores the “wandering” of the immigrant self, navigating between performance and concepts. Shifting away from proceduralism toward performative alternatives to analysis, I consider walking as a diffractive practice that encourages critical awareness and deep engagement with one’s surroundings. Toward the affectivity of post-phenomenological life worlds, the concept of “becoming possible” emerges as a central theme in my daily encounters, moving from imagining alternative ways of being to performing them. In the context of research, this performative event creates a line of flight, in a Deleuzian sense, escaping the established territory of knowing. In doing so, the immigrant self is actualized within a dynamic in-between space of what might be possible. Situated knowledges that are tied with specific contexts are, as a result, produced and reproduced, entangled in non-linear ways that remain resistant to representation, meaning, and understanding. While possibility thinking foregrounds hope, imagination, agency, and creativity, the practice of diffraction provokes an ethics that is accountable to both the social and material world, thereby enabling the envisioning of various possible futures.
Human rights, human wrongs: Don’t look away
Authors: Wyly Elvin
Published: November 2024

Somaiyeh Falahat, Libby Porter, Justin Tse, and Ryan Walker have offered eloquent and powerful critiques of an attempt to interpret images and representations of the Vancouver global city-region in the spirit of crime-scene photographs. This response seeks to engage these valuable critiques in relation to Cindi Katz's work on social reproduction and Gayatri Spivak's conceptualisation of planetarity.
Analytical investigation on the rotational behavior of dovetail mortise–tenon joints between beams and columns in traditional Chinese timber frames
Authors: Li Zherui , Kitamori Akihisa , Zhang Xicheng , Wu Yajie , Zhang Lipeng , Xue Jianyang
Published: November 2024

We theoretically analyzed the rotational behavior of beam–column dovetail joints in traditional Chinese timber frames in this study. An analytical model of dovetail joints at both the column head and body was designed by clarifying the moment generation mechanism and effect of rotational embedment yielding in timber perpendicular to the grain on the rotational behavior of joints. An asynchronous manifestation of rotational embedment deformation across the column surface, tenon cheeks, and upper and lower surfaces of the tenon head was analyzed, and the corresponding characteristic yield points and consequent reduction in rotational stiffness were derived in the model. The Inayama embedment theory was used to clarify the effect of rotational embedment with varying end lengths on the movement of the joint rotation center and asymmetric moment generated in different rotation directions of the column head joint. The precision of the analytical model was validated through a comparative analysis by involving nine sets of experimental data, for estimating the initial stiffness, post-yield stiffness, and identified yield points. The implications of the parameters, including the initial gap between the tenon and mortise, geometric dimensions of the dovetail tenon, and friction coefficient, were also discussed. Controlling the ratio of the initial gap and tenon height within 0.01 to ensure a certain rotational resistance of dovetail beam–column joints within the collapse limits of traditional timber frames is recommended considering the significant effect of the initial gap on the initial sliding angle and moment reduction.
Exploring hybrid models for identifying locations for active mobility pathways using real-time spatial Delphi and GANs
Authors: Calleo Yuri , Giuffrida Nadia , Pilla Francesco
Published: November 2024

The spatial planning process is considered an extremely complex system, as it comprises different variables that interrelate and interact with each other. Effectively addressing this spatial complexity necessitates a multidisciplinary approach, as unified methodologies may prove insufficient. Specifically, in urban planning, it is increasingly crucial to prioritize bike lanes, bike stations, and pedestrian zones, for functional transportation infrastructures. This approach can enhance cities by improving air quality, reducing emissions, and boosting public health and safety through physical activity and accident prevention. However, implementing these changes requires careful planning, community engagement, and stakeholder collaboration. This paper proposes a hybrid model for identifying optimal locations for bike lanes, bike stations, and pedestrian zones adopting Real-Time Spatial Delphi and Generative Adversarial Networks (GANs). The Real-Time Spatial Delphi is a modified version of the traditional Delphi method that incorporates real-time feedback and visualization of group response in real-time, aiming to achieve a convergence of opinions among experts on the territory. Nevertheless, these judgments are a spatial representation not visible in reality, and with the spread of artificial intelligence models, different implementations can support the planning process, such as the use of GANs. In this case, GANs can be exploited by adopting pre-existing location images resulting from experts’ judgments to illustrate the proposed intervention’s visual impact. To demonstrate the effectiveness of our hybrid model, we apply it to the city of Dublin. The results showcased how the method helps stakeholders, policymakers, and citizens in visualizing the proposed changes and gauging their potential impact with greater precision.
Older patients affected by COVID-19: investigating the existence of biological phenotypes
Authors: Zucchelli Alberto , Parigi Marta , Giliani Silvia , Vetrano Davide Liborio , Lucente Daniela , Marzetti Emanuele , Calvani Riccardo , Bellelli Giuseppe , Marengoni Alessandra
Published: November 2024

Introduction

COVID-19 provides an opportunity to examine biological phenotypes (observable morphological, functional and biological characteristics) in individuals who experience the same acute condition, potentially revealing differences in response to acute external stressors. The aim our study was to investigate biological phenotypes in older patients hospitalized for COVID-19, exploiting a panel of aging biomarkers.

Methods

Data were gathered from the FRACOVID Project, an observational multicenter study, aimed to evaluate the impact of frailty on health-related outcomes in patients 60 + with COVID-19 in Northern Italy. A hierarchical cluster analysis was run using log-transformed and scaled values of TNF-a, IL-1 beta, IL-6, PAI-1, GDF-15, NT-proBNP, and Cystatin C evaluated at admission.

Results

Eighty-one participants (mean age 75.3 years; 60.5% male) were evaluated. Frailty was identified in 42% of the sample and 27.2% were unable to ambulate outdoors. The mean hospital stay was 24.7 days, with an in-hospital mortality rate of 18.5%. Three biological phenotypes were found: (1) ‘inflammatory’, with high inflammatory biomarkers; (2) ‘organ dysfunction’, characterized by elevated cystatin C and NT-proBNP, and lower inflammatory markers; and (3) ‘unspecific’, with lower NT-proBNP and GDF-15 levels, and intermediate concentrations of other biomarkers. The ’organ dysfunction’ phenotype showed the highest mean age and prevalence of frailty, disability, and chronic diseases. The ‘inflammatory‘ phenotype showed the highest burden of respiratory and systemic signs and symptoms of infection.

Conclusion

Biological phenotypes might be used to identify different clinical and functional phenotypes in individuals affected by COVID-19.
Retention rate of giomer S-PRG filler containing pit and fissure sealant applied with or without etching: a randomized clinical trial
Authors: Elmokanen Manar Abdelmageed , Gad Hadier Mahmoud Ahmed
Published: November 2024

Background

Pit and fissure sealant is a micro-invasive modality for treating deep and retentive pits and fissures to prevent and/or stop occlusal caries. Every effort needs to be done to enhance sealant retention and survival. The aim of this research is to assess the retention rate of giomer S-PRG filler containing pit and fissure sealant applied with or without etching.

Methods

Overall, 52 patients were included in this trial and they were allocated randomly in 2 groups (n = 26). Group 1 (control group) received giomer sealant (Beautisealant, Shofu, Kyoto, Japan) without an etching step, and group 2 (intervention group) received the same but with a separate preparatory etching step before the sealant application. The retention rate of the sealant was assessed over one year at 3 months, 6 months, and 12 months. Intergroup comparison between categorical variables was done using the chi square test, while intragroup comparison was done using Cochran’s q test followed by multiple comparisons. Relative risk was used to evaluate the clinical significance. Survival rate was analyzed using Kaplan-meier and Log-rank test.

Results

Intergroup comparison between both techniques revealed statistically significant difference within different follow up periods (P < 0.05). Intragroup comparison within both giomer sealant with etching group and giomer sealant without etching group revealed statistically significant difference between different follow-up periods (P < 0.001). There was 69% less risk for total loss or partial loss of giomer sealant with etching when compared to giomer sealant without etching after 12 months.

Conclusion

An initial preparatory step of etching to the enamel surface is crucial before giomer sealant application to enhance its bonding, increase its retention and promote its survival.

Trial registration

Trial registration ClinicalTrials.gov, NCT04929782. Registered 14 July 2024 - Retrospectively registered, https://clinicaltrials.gov/study/NCT06509451
Harmonizing measurements: establishing a common metric via shared items across instruments
Authors: Eekhout Iris , Weber Ann M. , van Buuren Stef
Published: November 2024

Background

The proliferation of instruments that define instrument-specific metrics impedes progress in comparative assessment across populations. This paper explores a method to extract a common metric from related but different instruments and transform the original measurements into scores with a standard unit of measurement.

Methods

Existing data from four assessment instruments of child development, collected from three different samples of children, were used to create “equate clusters” of items that measure the same behaviour in (slightly) different ways. A probability model was formulated to identify best items and groups to serve as anchors linking the instruments, assuming that items in an anchoring or “active” equate cluster are psychometrically equivalent. Quantification and inspection of item characteristic curves were used to resolve which equate clusters should be active. We simulated the impact of various analytic choices.

Results

Simulation confirmed the feasibility of creating a common metric from data collected with different instruments from respondent samples with different abilities. The method performed as expected in an application in early childhood development.

Conclusions

The use of equate clusters is an intuitive and flexible way to establish a common metric across instruments and facilitates the transformation of measurements obtained to a standardized scale. Standardizing instrument scores to a common metric allows for population-level comparisons on a global scale.
Validity and reliability of the short-form adolescent health promotion scale among adolescents and young adults in Ghana: methodological study
Authors: Senu Ebenezer , Afari-Gyan Festus Nana , Effah Alfred , Akpobi Solomon , Oppong Success Acheampomaa , Yeboah Kingsley Takyi , Kwarteng Samuel , Abutiate Solomon , Lamptey Augustina , Arafat Mohammed , Boakye David , Anto Enoch Odame , Opoku Stephen , Amoani Benjamin , Sakyi Samuel Asamoah
Published: November 2024

Background and aim

Assessing health promotion among adolescents and young adults is vital to identify healthy and unhealthy behaviours as well as to evaluate health promotion interventions. However, there is no valid and reliable scale to assess health promotion among Ghanaians. For the first time, this study determined the validity and reliability of the original version of the Short‐Form Adolescent Health Promotion (AHP) scale among adolescents and young adults in Ghana.

Method

This cross-sectional methodological study included 617 adolescents and young adults within Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana. A well-structured questionnaire was used to collect sociodemographic data from study participants. The AHP-Scale was also used to collect data on participants health promoting behaviors. The scale’s validity was evaluated using Kaiser-Meyer-Olkin (KMO), Bartlett’s test of sphericity and Exploratory Factor Analysis (EFA), whilst the reliability was assessed using the Cronbach’s ɑ coefficient. Statistical analysis was performed using SPSS software version 26.

Results

The KMO and the Bartlett’s test of sphericity were reported to be 0.899 and χ2 (276) = 6682.338 respectively, allowing for EFA with orthogonal rotation. The EFA revealed five factors covering 54.62% of the total variance. The factor loading order of the items did not exactly correspond to the order obtained in the original version of the scale’s validity analysis as the original scale had six factors. This six-factor loading scale was valid in regards to construct validity. The obtained factors included: life appreciation, exercise, stress management, nutrition, and social support. In this current study, Cronbach’s ɑ was calculated at 0.87 for the whole scale and between 0.71 and 0.92 for its subscales. Thus, indicating the current scale reliable.

Conclusion

The six-factor loading scale of the Adolescent Health Promotion scale developed in the present study is acceptable for the validity and reliability assessment. However, the construct validity of this scale should be checked in other samples as it did not cover a large variance of the population. Large population wide studies are also needed to augment the current study findings with additional modifications for the adopted AHP scale.
Reach, uptake, and psychological outcomes of two publicly funded internet-based cognitive behavioural therapy programs in Ontario, Canada: an observational study
Authors: Khan Bilal Noreen , Liu Rebecca H. , Chu Cherry , Bolea-Alamañac Blanca , Nguyen Megan , Thapar Serena , Fanaieyan Roz , Leon-Carlyle Marisa , Tadrous Mina , Kurdyak Paul , O’Riordan Anne , Keresteci Maggie , Bhattacharyya Onil
Published: November 2024

Background

Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues.

Methods

An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program.

Results

Between May 2020 and September 2021, 56,769 individuals enrolled in LifeWorks AbilitiCBT, and 73,356 in MindBeacon TAiCBT. However, substantial exclusions were made: 56% of LifeWorks participants and 68% of MindBeacon participants were ineligible or failed to initiate treatment. Consequently, 25,154 LifeWorks participants and 23,795 MindBeacon participants were included in the analysis. Of these, 22% of LifeWorks and 26% of MindBeacon participants completed over 75% of iCBT treatment. On average, LifeWorks participants received 13 ± SD 7.1 therapist messages and sent 5 ± SD 10.3 messages, while MindBeacon participants received 25 ± SD 20.7 therapist messages and sent 13 ± SD 16.4 messages. LifeWorks included synchronous therapist contact averaging 1.4 ± SD 1.9 h per participant, while MindBeacon was purely asynchronous. Baseline severity of anxiety (37%) and depression symptoms (22%) was higher for LifeWorks participants compared to MindBeacon participants (24% and 10%, respectively). Clinically significant changes in anxiety and depression scores were observed: 22% of LifeWorks and 31% of MindBeacon participants exhibited reliable recovery in PHQ-9 scores, while 26% of LifeWorks and 25% of MindBeacon participants demonstrated reliable recovery in GAD-7 scores.

Conclusion

In conclusion, iCBT programs show promise for engaged participants with varying levels of severity in anxiety and depression symptoms. Future iterations of iCBT should consider adopting a broad entry criterion to iCBT programming to increase accessibility, especially for those with severe symptoms, alongside integrated intake care pathways, and potential payment structure adjustments for iCBT service providers. Taken all together, these factors could temper high dropout rates post-intake assessment. This evaluation underscores the potential and value of digital mental health interventions for individuals with mild to severe anxiety or depression symptoms, emphasizing the importance of addressing participant dropout.
Characterization and prediction of hydraulic properties of traffic-compacted forest soils based on soil information and traffic treatments
Authors: Martin Manon , Chanzy André , Lassabatere Laurent , Legout Arnaud , Pousse Noémie , Ruy Stéphane
Published: November 2024

Key message

The hydraulic properties of compacted and rutted soils were evaluated through in-situ infiltration experiments and predicted based on soil texture class and traffic treatments. A significant decrease in saturated soil water content and soil hydraulic conductivity at saturation was observed. The resulting soil hydraulic parameters, when integrated into a soil water transfer model, effectively simulated water dynamics in these impacted forest soils, providing a crucial first step toward developing decision support tools for real-time trafficability. This approach can assist forest managers in minimizing the extent of soil compaction.

Context

To overcome trafficability issues of forest soils induced by heavy logging machinery, planning support tools are needed to determine suitable soil moisture conditions for traffic.

Aims

This study aimed to identify the soil properties that differ significantly between undisturbed and compacted soils and to provide several estimation tools to predict the hydraulic properties of compacted soils beneath the skid trails.

Methods

Four hundred seventeen water infiltration tests were conducted on 19 forest sites, mostly in North-eastern France, and analysed with the BEST method to estimate the hydraulic properties of the skid trails and undisturbed soils. The hydraulic properties of the skid trails were predicted thanks to linear mixed effect models using a bulk treatment effect, a site effect, or a skid trail degradation score. The predicted hydraulic properties were tested using a water flow model to assess their relevance regarding the prediction of water dynamics in skid trails.

Results

The compaction effect was only significant for the logarithm of the hydraulic conductivity at saturation (log10(Ksat)) and the soil water content at saturation (θsat). For the skid trails, θsat was reduced by - 0.02 and − 0.11 m3m−3 in the 0 − 10 cm and 15 − 25 cm layers respectively, compared to undisturbed topsoil (0 − 10 cm). log10(Ksat) was reduced by − 0.38 and − 0.85 for skid trails in the 0 − 10 and 15 − 25 cm soil layers respectively, compared to undisturbed topsoil. The use of a pedotransfer function, in replacement of water infiltration tests, and their combination with the same correction coefficients proved to efficiently simulate the difference in water dynamics between skid trails and undisturbed forest soils.

Conclusion

Estimation of soil hydraulic properties based on in situ water infiltration experiments proved efficient to simulate water dynamics in compacted and rutted forest soils. Yet, further studies are needed to identify the most adapted pedotransfer function to forest soils and to test the generalisation of our findings in different conditions, especially deeply rutted soils (rut depths > 12 cm).
Bending Behavior of RC Beams with Regular Web Openings and Non-corroding GFRP Reinforcement
Authors: Kartal Saruhan , Kısıklı Emin
Published: November 2024

The present study pertains to the flexural behavior of RC beams with openings and non-metallic (GFRP) reinforcement. The main goal of preferring GFRP reinforcement over the conventional steel reinforcement was to safeguard the beams against the reinforcement corrosion. The presence of multiple regular transverse openings throughout the beam length increases the susceptibility of reinforcing bars to corrosion as the larger contact area in these beams with the outside environment increases the ingress of corrosive agents. Within the scope of the study, a total of 8 RC beams, including two reference beams without web openings, were tested under four-point bending. The test parameters were the flexural reinforcement ratio, the presence of short stirrups in the chords, and the presence of diagonal reinforcement spiraling around the openings. Since GFRP stirrups are difficult to bend, each stirrups was formed by connecting four individual FRP bars around the longitudinal bars. The opening circular geometry was adopted to avoid stress concentrations around the sharp corners of opening and to facilitate the placement and fixing of different schemes of reinforcement in the beams. The present tests depicted that the diagonal reinforcement around the openings have considerable contribution to the flexural behavior of RC beams with GFRP reinforcement and with multiple regular transverse openings. The RC beams with openings were able to approach their analytical flexural capacities in the presence of diagonal reinforcement for both moderately and heavily reinforced beam groups. The analytical deflection predictions of GFRP-RC beams with openings showed a good agreement with experimental data.