bluuebunny/crossref_metadata_2025 huggingface dataset:
Explicit solution to the nonlinear geometry of double wishbone suspension by decoupling steering and wheel jumping DOF
Authors: Niu Zhihua , Liu Shaoxun , Li Boyuan , Pan Zheng , Wang Rongrong
Published: February 2024

The suspension system is vital to vehicle performance because it undertakes most of the interactions between wheels and the vehicle body. Due to the significant geometric nonlinearity, there is still a gap of suitable suspension models that are both accurate and computationally efficient. To solve the problem, this paper proposes an explicit solution to the nonlinear geometry of double wishbone suspension by decoupling steering and wheel jumping degrees of freedom (DOF). By discarding the small displacement assumption in the derivation process, the new model gets rid of repeated numerical iterations, resulting in substantial enhancement in computational efficiency. Furthermore, it is noticed in the comparative study that the proposed model can achieve the same level of accuracy as Adams. Benefiting from high computational efficiency and accuracy, the decoupling model presented is successfully used in the optimal design of a double wishbone suspension for smaller variation ranges of wheel alignment parameters. It is anticipated that the research will make significant contribution to fast dimension design of suspension geometry and real-time control of active variable geometry suspensions.
Investigation of mechanical and tribological behavior of Al-Ni-Co-MWCNT composites prepared by powder metallurgy technique
Authors: Thirumurugan Rama , Padmanaban M , Ramkumar T , Shanmugam D
Published: February 2024

The intended research is to improve the mechanical and tribological properties of Al-Ni-Co alloy by reinforcing the alloy with multiwall carbon nanotubes (MWCNT) using powder metallurgy. In this work MWCNT content varied from 0.5, 1.0, and 1.5 as wt. % and mixed with the Al-Ni-Co matrix. The composites are fabricated by cold compaction and conventional sintering technique. The presence of homogenous distribution was analyzed by using scanning electron microscope (SEM) with energy dispersive spectroscopy. The hardness of the composites was also explored by using Vickers' indentation and found that porosity plays a vital role and it directly influences the hardness and the mechanical properties. The wear behavior of the composites was measured using the Pin-on-Disc method at room temperature. The results revealed that 84.5Al-10Ni-4Co-1.5MWCNT possessed less volume loss (0.458 mm3) and coefficient of friction (0.45) compared to other samples. After wear analysis, the surface morphology was analyzed using SEM. The outcome of the research is MWCNT plays a vital role to improve the mechanical and tribological properties of Al-Ni-Co composites.
Numerical investigation of corrugated wall configuration on hydrothermal performance and irreversibility characteristics
Authors: Kanchan Brajesh Kumar , Chandan Guddakesh Kumar , Aslam Mohd
Published: February 2024

Improving thermal performance while minimizing pressure differences and irreversibility characteristics remains a persistent challenge in thermo-mechanical systems. This study investigates a corrugated channel with different profiles (triangular, square, and elliptical) for steady, laminar, incompressible, and mixed convective flow through a backward-facing step. The impact of corrugated wall geometrical characteristics, such as height, width, and angle, on hydrothermal performance is explored. Additionally, the study investigates the influence of inline and staggered arrangements for various channel configurations. The finite element method is employed for numerical investigation of thermohydraulic and irreversibility characteristics. Results, presented through streamlines, contours, and line plots, reveal a significant modulation of reattachment length based on corrugate architecture. Notably, the local Nusselt number is highest at the initial interaction with the corrugated channel, regardless of the channel configuration. Hydrothermal measurements highlight elliptical configurations as optimal, exhibiting a 60% improvement in thermal performance compared to a non-corrugated channel. Moreover, increasing corrugate height results in higher Nusselt numbers, pressure drops, and irreversibility. Reduced corrugate width leads to a higher Nusselt number due to the formation of a secondary recirculation zone. An elliptical corrugate with a 0° angle inclination yields the highest Nusselt number by facilitating a stronger recirculation zone. Thus, optimal corrugated wall configuration involves higher height, lower width, and no angle inclination, emphasizing the significant impact of these parameters on hydrothermal performance and their importance as design characteristics.
Effects of composite coatings on pool boiling performance characteristics in demineralized water
Authors: Kumar Nitish , Ghosh Pradyumna , Shukla P. , Tandon Roopchand
Published: February 2024

Nucleate boiling is known for its high heat transfer capacity which occurs at a reasonably low temperature difference between the surface and saturated liquid due to the rapid vaporization process. The vaporization process and boiling heat transfer (BHT) primarily depend on surface morphology and wettability. In this article, surface morphology and wettability of smooth copper surfaces have been altered by coating with binary oxide nanoparticles. Three different combinations of composite coatings: TiO2/SiO2, TiO2/Al2O3 and SiO2/Al2O3 are considered and pool boiling performances have been investigated in demineralized water. Samples have been prepared using electrophoretic deposition techniques in binary oxide nanofluid of 0.1 wt. % concentration. The coating was performed for a fixed duration of 10 min in a medium of hybrid nanofluids of TiO2/SiO2, TiO2/Al2O3 and SiO2/Al2O3 which are referred to as S1, S2 and S3, respectively, in the text. The surface morphology, wettability and coating layer thickness of the sample are varied with the coating duration. The smooth copper surface is hydrophilic while coated samples are hydrophobic by nature. Experiments were carried out on all surfaces, and the results were compared with the smooth copper surface. The maximum enhancements in BHT coefficient for surfaces S1, S2 and S3 are 38%, 43% and 59%, respectively, corresponding to heat flux of ∼275,∼ 200 and ∼220 kW/m2. The reduction in boiling incipient temperature is 0.7, 3.6 and 4.4°C, respectively.
Housing and Social Control: Reassessing the Protection Asymmetries of Article 8 of the European Convention on Human Rights
Authors: Atalay Serde
Published: February 2024

This article explores how the right to respect one's home under Article 8 of the European Convention on Human Rights would apply in the context of housing and social control. After explaining the connections between social control, housing, and human rights, it analyzes the selected case law of the European Court of Human Rights on Article 8 in certain cases concerning housing with a view to understanding the protection asymmetries inherent to the provision, and what that would entail for the employment of social control in the sphere of housing. These protection asymmetries are identified between, first, the homeless/inadequately housed and those with a home, and second, with regard to the latter, between lawful occupiers and unlawful occupiers. The examination is conducted, first, by analyzing the Court's interpretation of the definitional scope of Article 8 and its exclusion, in principle, of the provision of housing therefrom, and second, by looking at the application of Article 8 in public eviction cases.
Reducing inequalities by supporting individuals to make informed decisions about accepting their breast screening invitations
Authors: Nicholson Sarah L , Douglas Heidi , Halcrow Stephen , Whelehan Patsy
Published: February 2024

Objectives

Individuals from deprived areas are less likely to attend breast screening. Inequalities in the coverage of breast screening are associated with poorer cancer outcomes. Individuals who have a positive first experience are more likely to attend subsequent mammograms. This work evaluates the provision of an additional telephone call to individuals who have never attended breast screening, to establish whether this increases attendance.

Setting and Methods

1423 patients from four general practitioner practices within socially deprived areas of National Health Service Tayside (UK) comprised the study population. In addition to their standard appointment letter, individuals were to receive a call at least 24 h prior to their appointment. The call identified barriers to screening, and offered a supportive, problem-solving approach to overcoming these barriers. Data collected included: age, Scottish Index of Multiple Deprivation, first-time invite or previous non-attender, if contactable, duration of call, number of days prior to appointment, and confirmation appointment letter was received. The primary outcome was attendance at the screening.

Results

Contact by phone was made with 678 (47.6%) of the study population. Of those, 483 (71.2%) attended their appointment, 122 (18%) cancelled and 73 (10.8%) did not attend (DNA), versus 344 (46.2%) attending, 34 (4.6%) cancelling and 367 (49.3%) not attending among those who were not able to be contacted. Those who received a call were more likely to attend their appointment and less likely to DNA compared to individuals not receiving the call.

Conclusion

The intervention is simple and low cost; results indicate that the additional call may increase attendance and reduce DNA appointments at breast screening.
The Influence of Sidedness in Unilateral Cleft Lip and Palate on Mid Facial Growth at Five Years of Age
Authors: Fell Matthew , Chong David , Parmar Paras , Su Ting-Li , Enocson Lars , Richard Bruce
Published: February 2024

Objective

To determine whether facial growth at five years is different for children with a left versus right sided cleft lip and palate.

Design

Retrospective cohort study.

Setting

Seven UK regional cleft centres.

Patients

Patients born between 2000-2014 with a complete unilateral cleft lip and palate (UCLP).

Main Outcomes Measure

5-Year-Old's Index scores.

Results

378 children were included. 256 (68%) had a left sided UCLP and 122 (32%) had a right sided UCLP. 5-Year-Old's index scores ranged from 1 (good) to 5 (poor). There was a higher proportion of patients getting good scores (1 and 2) in left UCLP (43%) compared to right UCLP (37%) but there was weak evidence for a difference (Adjusted summary odds ratio 1.27, 95% CI 0.87 to 1.87; P = .22).

Conclusions

Whilst maxillary growth may be different for left versus right sided UCLP, definitive analysis requires older growth indices and arch forms.
Evaluation of Short Versus Long Courses of Antibiotics in Critically Ill Patients With Gram-Negative Bloodstream Infections
Authors: Anderson Daniel T. , Sharma Divisha , Chase Aaron M. , Sulaiman Zoheb Irshad , Anderson August H. , Huggett Ashley L. , Eudy Joshua
Published: February 2024

Background:

Short courses of antibiotics (7-10 days) are effective for uncomplicated gram-negative bloodstream infections (GN-BSI). However, prior studies have been limited to small cohorts of critically ill patients.

Objective:

The objective of this study was to evaluate the safety and efficacy of short courses of therapy compared with longer courses in patients admitted to the intensive care unit (ICU) with GN-BSI.

Methods:

Propensity-matched, retrospective cohort study of critically ill patients with GN-BSI. The primary outcome was a composite of 30-day mortality or 60-day relapse. Secondary endpoints were components of the composite, 30-day relapse, cure with or without adverse drug events (ADE), and ADEs. Regression analysis was performed to identify factors predictive of the composite outcome.

Results:

225 patients were included in the propensity analysis, 145 in the long cohort and 80 in the short cohort. The primary outcome occurred in 3.8% of patients in the short group and 9.0% of patients in the long group ( P = 0.24). There was no difference in 30-day mortality (3.8% vs 5.5%, P = 0.79), 60-day relapse (0% vs 3.4%, P = 0.23), or 30-day readmission (20% vs 22.8%, P = 0.76). ADEs were more common in the long group (47.2% vs 34.1%, OR 1.7, 95% CI 1.04-2.9), primarily attributable to diarrhea.

Conclusion and Relevance:

In critically ill patients with GN-BSI, there were no efficacy outcome differences in patients treated with a short course of antibiotics compared with longer. However, patients in the short group were less likely to experience ADE. These findings suggest that short courses of antibiotics are effective for GN-BSI in critically ill patients.
Social and Economic Indicators of Psychological Symptoms and Life Satisfaction Among Dutch and Hong Kong Adolescents: A Cross-National HBSC Study
Authors: Bogt Tom ter , de Looze Margreet , Lee Annisa , van den Eijnden Regina , Stevens Gonneke , Fung Anthony
Published: February 2024

Adolescent mental health and life satisfaction are grounded in social and economic factors. However, studies investigating these relations across European and Asian contexts, using identical questionnaires, are scarce. The 2017/18 Health Behaviour of School-aged Children (HBSC) study conducted with 4,168 Dutch adolescents ( Mage 13.0 years) and 1,948 Hong Kong adolescents ( Mage 13.1 years) aged 11, 13, and 15 reported on family status and affluence, school experiences, relations with parents and friends, psychological symptoms (irritability/bad temper, feeling low or nervous, difficulty sleeping), and life satisfaction. Dutch boys had the lowest number of psychological symptoms. Dutch girls and Hong Kong girls and boys reported significantly more symptoms. Dutch boys had the highest level of life satisfaction, followed by Dutch girls and, subsequently, Hong Kong girls and boys. In the Netherlands and Hong Kong, communicative and supportive relationships with parents, low school pressure, school liking, and helpful fellow students related to less psychological symptoms and higher life satisfaction. In addition, family affluence further enhanced life satisfaction. It is concluded that cultural and gender differences may permeate the structuring of adolescent relations with parents, teachers, and peers but that an identical set of social and economic determinants affect adolescent girls’ and boys’ symptoms and satisfaction in a highly similar fashion in the Netherlands and Hong Kong.
Longitudinal and Gender Measurement Invariance of the General Health Questionnaire-12 (GHQ-12) From Adolescence to Emerging Adulthood
Authors: Schlechter Pascal , Neufeld Sharon A. S.
Published: February 2024

Psychological distress often onsets during adolescence, necessitating an accurate understanding of its development. Assessing change in distress is based on the seldom examined premise of longitudinal measurement invariance (MI). Thus, we used three waves of data from Next Steps, a representative cohort of young people in the UK ( N = 13,539) to examine MI of the General Health Questionnaire-12 (GHQ-12). We examined MI across time and gender from ages 15 to 25 in four competing latent models: (a) a single-factor model, (b) a three-factor correlated model, (c) a bifactor model of “general distress” and two orthogonal specific factors capturing positive and negative wording, and (d) a single-factor model including error covariances of negatively phrased items. We also tested acceptability of assumptions underlying sum score models. For all factor models, residual MI was confirmed from ages 15 to 25 years and across gender. The bifactor model had the best fit. While sum score model fit was not unequivocally acceptable, most mean differences across time and gender were equivalent across sum scores and latent difference scores. Thus, GHQ-12 sum scores may be used to assess change in psychological distress in young people. However, latent scores appear more accurate, and model fit can be improved by accounting for item wording.
Neural Network Excitation/Inhibition: A Key to Empathy and Empathy Impairment
Authors: Tang Yuanhong , Wang Chunjian , Li Qingquan , Liu Gang , Song Da , Quan Zhenzhen , Yan Yan , Qing Hong
Published: February 2024

Empathy is an ability to fully understand and feel the mental states of others. We emphasize that empathy is elicited by the transmission of pain, fear, and sensory information. In clinical studies, impaired empathy has been observed in most psychiatric conditions. However, the precise impairment mechanism of the network systems on the pathogenesis of empathy impairment in psychiatric disorders is still unclear. Multiple lines of evidence suggest that disturbances in the excitatory/inhibitory balance in neurologic disorders are key to empathetic impairment in psychiatric disorders. Therefore, we here describe the roles played by the anterior cingulate cortex– and medial prefrontal cortex–dependent neural circuits and their impairments in psychiatric disorders, including anxiety, depression, and autism. In addition, we review recent studies on the role of microglia in neural network excitation/inhibition imbalance, which contributes to a better understanding of the neural network excitation/inhibition imbalance and may open up innovative psychiatric therapies.
The Democratic Value of Strategic Game Reporting and Uncivil Talk: A Computational Analysis of Facebook Conversations During U.S. Primary Debates
Authors: Camaj Lindita , Hellmueller Lea , Vallejo Vera Sebastián , Lindner Peggy
Published: February 2024

This study explores discourse features on Facebook pages of news organizations during the 2020 U.S. primary debates using a state-of-the-art machine-learning model. Informing the scholarly debate about the implications of strategic game reporting in online spaces, we find that it is not necessarily linked to uncivil discourse, yet it might deter from relevant conversations. Second, addressing fears about the undesired outcomes of uncivil talk, our data suggest that incivility can coexist with rational discourse in user comments, although this relationship is not pervasive. Implications of these results are discussed in the context of the role of hybrid media for political engagement during electoral campaigns.
Dialysis nurses’ knowledge, attitude, practices, and self-efficacy regarding vascular access care: A multicenter cross-sectional survey in Singapore
Authors: Meng Lingyan , Tan Pauline , Ali Khan Behram , Liao Jun , Lou Lillian , Chen Shune , Teo Boon Wee , Guo Wei , Ho Pei
Published: February 2024

Background:

Dialysis nurses play a pivotal role in the management of vascular access (VA), physician-patient liaison, and patient education for hemodialysis patients. This multicenter study aims to review the dialysis nurses’ knowledge, attitude, practice, and self-efficacy toward providing care for patients’ VA.

Methods:

A multi-centered study was conducted using a self-administered survey. Nurses from 47 Singapore dialysis centers (five hospital-based and 42 community-based) providing hemodialysis were invited to participate on a voluntary and anonymous basis from April to November 2022. The survey consists of nurses’ knowledge on VA (10 items), attitude on VA care (six items), usual practices (seven items), and self-efficacy in VA cannulation and management (six items). The total scores for the knowledge, attitude, and self-efficacy components were 50, 30, and 30 respectively. The instrument has been validated in a pilot study.

Results:

In total, five hundred sixteen dialysis nurses participated the survey. The mean (±SD) knowledge score of the participants toward VA care was 30.0 (±8.1) over a total score of 50. The means (±SD) of their attitude and self-efficacy scores were 24.4 (±4.1) and 24.2 (±3.1) over 30 respectively. The majority of the nurses (84.1% in hospital-based centers and 98.9% in community-based centers) conducted patient education in some aspects of VA care. The percentage of nurses indicated need for referral to access specialists due to various abnormalities varied significantly between the hospital-based and community-based settings. In the multivariable linear regression analysis, longer working experience was a significant factor for higher knowledge score ( B = 0.26; p = 0.001), attitude score ( B = 0.08; p = 0.01), and self-efficacy score ( B = 0.34; p < 0.001).

Conclusion:

Dialysis nurses in Singapore have satisfactory knowledge, practice, and self-efficacy on VA care. The majority of them expressed positive opinions toward the VA-related training they received, new technologies, and communications. The identified knowledge and practice gaps could be incorporated into the future training programs.
Paycheck Protection Program and lending discrimination in the US hospitality industry
Authors: Lelo de Larrea Gabriela , Altin Mehmet , Koçak Emrah , Okumus Fevzi
Published: February 2024

This study aims to assess lending discrimination in the Paycheck Protection Program (PPP) in the hospitality industry. PPP is one of the initiatives of the US government in response to the COVID-19 pandemic to support small businesses. While the US Congress aimed to target minority-owned and other businesses at a disadvantage, early research on the program found lending discrimination. This study contributes to this research stream by being the first to focus on the nationwide hospitality industry and consider all three funding rounds. Specifically, the study analyzed differences in approval amounts based on race and gender and found significant differences between White- and Black or African American-owned businesses and between male- and female-owned businesses, with the latter of these groups at a considerable disadvantage. The results of this study could guide policymakers in creating assistance programs with more stringent clauses to ensure the support gets to those most in need.
Subjective versus objective language proficiency measures in the investigation of bilingual effects on cognitive control
Authors: Zhou Yu , Privitera Adam John
Published: February 2024

Purpose:

Bilingual language experience is thought to confer non-linguistic benefits in general cognition including improved cognitive control. These bilingual effects are most often observed in samples of bilinguals who are highly proficient in both languages. However, across the majority of previous studies, assessments of language proficiency are exclusively subjective. While evidence supports that subjective and objective measures of language proficiency are correlated, no studies have explored whether the use of either measure impacts on model results when investigating bilingual effects on cognitive control.

Methodology:

Mandarin-English bilingual young adults completed both subjective and objective assessments of language proficiency and a Simon task to measure differences in cognitive control.

Data and Analysis:

Data were analyzed using linear mixed-effects models to best account for differences in linguistic and non-linguistic variables as well as the repeated-measures nature of the Simon task.

Findings and Conclusions:

We report no evidence in support of improved cognitive control associated with higher levels of language proficiency. Crucially, results did not differ when either subjective or objective measures were included in our models. Results support that both subjective and objective assessments of language proficiency may be equivalent when modeling bilingual effects on cognitive control.

Originality:

This study is the first direct investigation of the influence of the proficiency assessment method on model results.

Implications:

The findings of this study have implications for the assessment of language proficiency in future investigations of bilingual effects.
Physio-chemical analysis of pollutants in residential micro-environment through continuous monitoring and settled dust characterization
Authors: Bedi Tanya Kaur , Bhattacharya Shankha Pratim
Published: February 2024

The concern about indoor air quality in various micro-environments has been on the rise as buildings are vulnerable to an array of contaminants generated from various sources. The study aims to investigate and highlight the pollutant sources and composition in middle-income residential spaces through a case study approach. With large migration from small towns and saturation of megacities, the middle-income population in tier-2 cities in India is on the rise, raising concern about the well-being of the dense urban population. It involves a careful selection of typical MIG housing to identify major pollution sources from outdoor and indoor environments. The focus lies in the findings stemming from continuous air quality monitoring of PM10, PM2.5, SO2, NO2, HCHO, TVOC, CO and C6H6 and an in-depth physio-chemical analysis facilitated by Fourier transform infrared (FTIR), Analytical Scanning Electron Microscope (A-SEM) and energy-dispersive X-ray (EDX) spectroscopy of settled household dust. Analysis unveiled indoor PM2.5 concentrations of 21.93 µg/m3, exceeding WHO standards, whereas, TVOC concentrations were higher indoors than outdoors. Stark disparities between indoor and outdoor dust compositions and sources were also observed. Despite limitations, it provides a portrait of middle-income housing conditions, offering insights for interventions and future research on indoor air quality challenges.
Research frontiers on the attention-based view of the firm
Authors: Joseph John , Laureiro-Martinez Daniella , Nigam Amit , Ocasio William , Rerup Claus
Published: February 2024

The attention-based view (ABV) offers a foundational perspective on strategy and organizing. Despite its significance, questions persist about the relationship between organizational attention and strategic organization. Inspired by the evolving literature on organizational attention, its determinants, and consequences, this special issue aims to advance theory and research in the ABV realm. It includes eight articles—three empirical and five theoretical—spanning a diverse range of topics. Emerging themes include a shift from viewing attention as individual cognition toward attentional engagement through interactions and social relations within organizations, the temporal and dynamic nature of attention, and an explicit recognition that ABV is not about a fixed quantity of attention but what shapes strategic organizational behavior and adaptation.
The Effect of Peer Victimization During Adolescence on Depression and Gender Differences: A Systematic Review and Meta-analysis
Authors: Song Qianqian , Yuan Tongshuang , Hu Yueyang , Liu Xiaoying , Fei Junsong , Zhao Xixi , Gao Ren , Yue Jingyi , Mei Songli
Published: February 2024

Peer victimization during adolescence has a detrimental impact on the mental health of victims throughout their lives. However, it remains unclear whether these effects are gender-specific. The present study conducted a systematic review to examine the effects of peer victimization on depression status, explore potential sources of heterogeneity, and investigate gender differences in these effects. We systematically searched four electronic databases (Web of Science, PubMed, Embase, and CNKI) for relevant articles that published as far as July 2022. We then extracted odds ratios (OR) and 95% confidence intervals (CI) to assess the association between peer victimization during adolescence and depression, and potential gender differences in the relation. Meta-analysis was performed, using fixed effects models and random effects models, to evaluate the association between each exposure and the outcome. A meta-analysis of 27 studies revealed that peer victimization during adolescence was significantly associated with higher risks of depression (OR = 2.79, 95% CI [2.43, 3.21], p < .001). This finding was consistent across subgroup analyses. In particular, the effect of peer victimization during adolescence on depression was found to be more pronounced in studies conducted in Asia (OR = 3.06, 95% CI [2.38, 3.92], p < .001). Furthermore, five studies focused on gender differences demonstrated that peer victimization has a stronger association with the risk of depression in women (OR = 2.84, 95% CI [2.49, 3.26], p < .001). Peer victimization during adolescence is a significant risk factor for depression, with a greater impact on women and individuals residing in Asia. Further prospective studies are needed to investigate the relationship between peer victimization and depression.
Five-Year Outcomes of the SuperB Trial: A Multicenter Randomized Controlled Trial Comparing Heparin-Bonded Endograft to Surgical Femoropopliteal Bypass
Authors: van Walraven Laurens A. , van Wijck Iris P. S. , Holewijn Suzanne , Fritschy Wilbert M. , Zeebregts Clark J. , Lemson Suzanna M. , Wikkeling Otmar R. M. , Reijnen Michel M. P. J.
Published: February 2024

Objective:

This study aims to compare the 5-year outcomes of endoluminal bypass (EB) using heparin-bonded self-expanding covered stents versus bypass surgery for extensive femoropopliteal disease, including technical and clinical outcomes and health status.

Background:

The surgical femoropopliteal bypass was the gold standard to treat peripheral arterial disease (PAD) for decades; however, endovascular treatment modalities are now recommended for most femoropopliteal lesions. One-year data of a randomized controlled trial comparing EB with surgical bypass (SB) have shown a faster recovery, less morbidity, and comparable patency rates between the two techniques. To date, long-term randomized controlled data regarding both techniques are lacking.

Methods:

Five-year results of a multicenter randomized controlled trial comparing EB with SB in patients with femoropopliteal artery disease were evaluated based on intention-to-treat and per-protocol analyses.

Results:

At 5-year follow-up, primary, primary-assisted, and secondary patency rates were 36.2%, 52.4%, and 68.1% for EB and 49.4%, 72.2%, and 77.8% for SB, respectively (p=0.608). Freedom from target lesion revascularization (fTLR) was 34.1% for EB and 57.6% for SB (p=0.365). In both groups, the ankle-brachial index, Rutherford classification, and walking distance significantly improved compared with baseline without differences between groups at follow-up. Freedom from major amputation rate was 92.6% in the EB group and 96.2% in the SB group (p=0.361). The 36-Item Short-Form Health Survey showed no significant differences between groups.

Conclusion:

Treatment of extensive femoropopliteal disease with self-expanding covered stents provides comparable clinical-related and health-related questionnaire outcomes when compared with SB through 5 years of follow-up. However, the EB is related to a higher number of reinterventions.

Clinical Impact

This present study is the first to report five-year outcomes comparing an endoluminal (EB) using heparin-bonded self-expanding covered stents with surgical bypass (SB) for long and complex femoropopliteal disease. Although the advantages of treatment with EB are mostly seen in the early period after treatment, the outcomes support the use of EB for this indication and seems to be a valid and safe alternative for bypass surgery. Future trials comparing various endovascular strategies may provide further guidance for the development of an evidence-based treatment algorithm.
Optical coherence tomography findings of balloon angioplasty/stenting for in-stent restenosis after carotid artery stenting
Authors: Yamada Shingo , Harada Kei , Baba Daichi , Oshima Takatusugu , Tanaka Koki
Published: February 2024

Objectives

The optimal therapeutic methods for in-stent restenosis (ISR) after carotid artery stenting (CAS) remains controversial. This study aimed to use optical coherence tomography (OCT) to evaluate the in-stent architectures during endovascular angioplasty/stenting for ISR.

Materials and Methods

Six lesions of ISR after CAS were evaluated by OCT during endovascular angioplasty/stenting.

Results

In one lesion, the OCT system could not be crossed because of elongation distal to the ISR lesion. In five lesions, pre-procedural OCT clearly revealed neointimal hyperplasia or neoatherosclerosis. The mean in-stent area stenosis was 84%. After regular balloon angioplasty, tissue compression and dissection of various sizes and layers were detected. After balloon angioplasty (with a mean balloon size of 5.4 mm), the minimum lumen area (from 1.7 ± 0.6 to 11.4 ± 5.3 mm2, p < 0.01) and the minimum in-stent area (12.7 ± 2.6 to 21.8 ± 5.0 mm2, p < 0.01) showed a significant increase. Additional stent was placed in one lesion that developed into a flap by dissection after balloon angioplasty. In another lesion in which sufficient dilatation was not achieved by balloon angioplasty, a major stroke occurred by acute occlusion of the ISR lesion 10 months later.

Conclusions

OCT can detect the in-stent architecture of ISR lesions after balloon angioplasty and additional stent placement. However, which dissection should be treated by additional stent remain problematic.
Hybrid leadership configurations in networked learning communities in Singapore
Authors: Ho Jeanne , de Laat Maarten , Ong Monica , Munir Norhayati Binte
Published: February 2024

Networked learning communities (NLCs) are increasingly advocated for teachers to grow professionally. Leadership of NLCs is essential to effectively unite members with diverse interests and expertise towards collective action. Hybrid leadership is proposed as a theoretical framework to examine leadership in NLCs. The article presents a case study of how leadership of seven institutionally supported NLCs in Singapore was configured, and how such configurations were perceived as contributing to teachers’ professional development. A total of 27 NLC sessions, which were conducted via the Zoom platform, were video recorded and 68 NLC participants were engaged through interviews or focused group discussions. Analysis was grounded in the data with selected leadership functions and hybrid leadership as sensitising concepts to examine leadership enacted by individuals or collectively by pairs/triads/groups, and what enabled these leadership configurations. The findings suggest that individual and collective leadership are both required for the NLC to negotiate a shared agenda as well as to co-ordinate collaborations and build capacity. Leadership is planned or emergent in nature, depending on NLC members’ expertise, relationships and needs. NLC members’ engagement in individual and collective leadership was perceived as contributing to their own learning as well as their peer's learning.
Telemedical stroke care significantly improves patient outcome in rural areas: Long-term analysis of the German NEVAS network
Authors: Masouris Ilias , Kellert Lars , Pradhan Cauchy , Wischmann Johannes , Schniepp Roman , Müller Robert , Fuhry Leonard , Hamann Gerhard F , Pfefferkorn Thomas , Rémi Jan M , Schöberl Florian
Published: February 2024

Background:

Comprehensive stroke centers (CSC) offer state-of-the-art stroke care in metropolitan centers. However, in rural areas, sufficient stroke expertise is much scarcer. Recently, telemedical stroke networks have offered instant consultation by stroke experts, enabling immediate administration of intravenous thrombolysis (IVT) on-site and decision on thrombectomy. While these immediate decisions are made during the consult, the impact of the network structures on stroke care in spoke hospitals is still not well described.

Aims:

This study was performed to determine if on-site performance in rural hospitals and patient outcome improve over time through participation and regular medical staff training within a telemedical stroke network.

Methods:

In this retrospective study, we analyzed data from stroke patients treated in four regional hospitals within the telemedical Neurovascular Network of Southwest Bavaria (NEVAS) between 2014 and 2019. We only included those patients that were treated in the regional hospitals until discharge at home or to neurorehabilitation. Functional outcome (modified Rankin scale) at discharge, mortality rate and periprocedural intracranial hemorrhage served as primary outcome parameters. Door-to-imaging and door-to-needle times were secondary outcome parameters.

Results:

In 2014–2019, 5,379 patients were treated for acute stroke with 477 receiving IVT. Most baseline characteristics were comparable over time. For all stroke patients, door-to-imaging times increased over the years, but significantly improved for potential IVT candidates and those finally treated with IVT. The percentage of patients with door-to-needle time <30 min increased from 10% to 25%. Clinical outcome at discharge improved for all stroke patients treated in the regional hospitals. Particularly for patients treated with IVT, good clinical outcome (modified Rankin scale 0–2) at discharge increased from 2014 to 2019 by 19% and mortality rates dropped from 13% to 5%.

Conclusions:

24-h/7-day telemedical support and regular on-site medical staff training within a structured telemedicine stroke network such as NEVAS significantly improve on-site stroke care in rural areas, leading to a considerable benefit in clinical outcome.

Data access statement:

The data that support the findings of this study are available upon reasonable request and in compliance with the local and international ethical guidelines.
The MAPSTROKE project: A computational strategy to improve access to acute stroke care
Authors: Carbonera Leonardo Augusto , Rivillas Julián Alejandro , Gordon Perue Gillian , da Luz Dorneles Leonardo , Boiani Mateus , de Souza Ana Cláudia , Sampaio Silva Gisele , Dorn Marcio , Martins Sheila Cristina Ouriques
Published: February 2024

Background:

Global access to acute stroke treatment is variable worldwide, with notable gaps in low and middle-income countries (LMIC), especially in rural areas. Ensuring a standardized method for pinpointing the existing regional coverage and proposing potential sites for new stroke centers is essential to change this scenario.

Aims:

To create and apply computational strategies (CSs) to determine optimal locations for new acute stroke centers (ASCs), with a pilot application in nine Latin American regions/countries.

Methods:

Hospitals treating acute ischemic stroke (AIS) with intravenous thrombolysis (IVT) and meeting the minimum infrastructure requirements per structured protocols were categorized as ASCs. Hospitals with emergency departments, noncontrast computed tomography (NCCT) scanners, and 24/7 laboratories were identified as potential acute stroke centers (PASCs). Hospital geolocation data were collected and mapped using the OpenStreetMap data set. A 45-min drive radius was considered the ideal coverage area for each hospital based on the drive speeds from the OpenRouteService database. Population data, including demographic density, were obtained from the Kontur Population data sets. The proposed CS assessed the population covered by ASCs and proposed new ASCs or artificial points (APs) settled in densely populated areas to achieve a target population coverage (TPC) of 95%.

Results:

The observed coverage in the region presented significant disparities, ranging from 0% in the Bahamas to 73.92% in Trinidad and Tobago. No country/region reached the 95% TPC using only its current ASCs or PASCs, leading to the proposal of APs. For example, in Rio Grande do Sul, Brazil, the introduction of 132 new centers was suggested. Furthermore, it was observed that most ASCs were in major urban hubs or university hospitals, leaving rural areas largely underserved.

Conclusions:

The MAPSTROKE project has the potential to provide a systematic approach to identify areas with limited access to stroke centers and propose solutions for increasing access to AIS treatment.

Data access statement:

Data used for this publication are available from the authors upon reasonable request.
The Dynamics of Bioactive Ingredients With Anti-Inflammatory and Anti-Breast Cancer Activity During Prunellae Spica Development
Authors: Zhang Zhimin , Su Qian , Lin Yan , Xia Bohou , Li Yamei , Xie Jingchen , Wu Ping , Liao Duanfang , Lin Limei
Published: February 2024

To investigate the scientific connotation of harvest period for Prunella vulgaris L. ( P vulgaris, known as Prunellae Spica), the triterpenoids and phenols of Prunellae Spica in developmental stages were quantified by high performance liquid chromatography, and the anti-inflammatory and anti-breast cancer properties of which were investigated. Furthermore, Grey correlation and Pearson correlation analysis were used to screen the anti-inflammatory and anti-breast cancer–related effective ingredients, and a multidimensional network of “ingredient-target-pathway” through network pharmacology was constructed. The results showed that the harvest time of Prunellae Spica was closely related to its chemical composition and pharmacological activity. Phenols, such as salvianic acid A, caffeic acid, and salviaflaside, mainly accumulated in late development, while rosmarinic acid showed the opposite. Triterpenes, such as oleanolic acid and ursolic acid, mainly accumulated in early development, while betulinic acid accumulated during ripening. The anti-breast cancer activity of Prunellae Spica in early development was stronger than that in the later, but the anti-inflammatory activity in late development was stronger than that in the early stage. Significantly associated with anti-inflammatory activity in Prunellae Spica was salviaflaside, which may regulate TNF and NOD-like receptor signaling pathways by acting on targets such as CASP7, CASP8, CASP3, NOD2, and CASP1. Significantly associated with anti-breast cancer activity were oleanolic acid and ursolic acid, which may regulate Ovarian steroidogenesis and Prolactin signaling pathways on targets such as PTGS2, CYP19A1, ESR2, CYP17A1, and MAPK3. These results suggest that P vulgaris could be harvested before ripening for its anti-breast cancer use, and after ripening for its anti-inflammatory use.
Dose-Response Effect of Mental Health Diagnoses on Concussion Recovery in Children and Adolescents
Authors: Master Christina L. , Corwin Daniel J. , Fedonni Daniele , Ampah Steven B. , Housel Kaitlyn C. , McDonald Catherine , Arbogast Kristy B. , Grady Matthew F.
Published: February 2024

Background:

Pre-existing mental health diagnoses may contribute to greater emotional symptom burden and prolonged recovery after concussion.

Hypothesis:

Youth with pre-existing mental health diagnoses will have greater emotional symptom burden, greater risk for delayed return to exercise, and more prolonged recovery from concussion than those without those diagnoses.

Study Design:

Prospective cohort.

Level of Evidence:

Level 3.

Methods:

A prospective registry of youth concussion was examined for differences in emotional symptom burden after injury to develop a predictive risk model for prolonged recovery. The impact of individual and total number of pre-existing mental health diagnoses (0, 1, 2, and 3+) was assessed, and multivariable logistic regression was performed to identify factors associated with prolonged recovery.

Results:

Among a cohort of 3105 youth with concussion, those with a history of mental health diagnoses, in a dose-response fashion, had greater postinjury emotional symptom burden (7 emotional symptoms vs 4; P < 0.01), visio-vestibular dysfunction (65% abnormal vs 56% abnormal; P < 0.01), later return to symptom-limited exercise (23 vs 21 days; P < 0.01), and overall longer concussion recovery (38 days, interquartile range [IQR] 18, 80) versus 25 days (IQR 13, 54; P < 0.01). Boys with prolonged recovery after concussion had greater emotional symptom burden than girls (5 emotional symptoms vs 3; P < 0.01).

Conclusion:

Pre-existing mental health diagnoses are associated with greater postinjury emotional symptom burden and longer concussion recovery in a dose-response fashion. Visiovestibular deficits and delayed return to exercise are also associated with pre-existing mental health diagnoses and prolonged recovery. Boys with prolonged recovery from concussion experience greater emotional symptom burden than girls.

Clinical Relevance:

Addressing pre-existing mental health diagnoses is essential to concussion management. Boys with prolonged recovery from concussion may particularly benefit from interventions to address their higher emotional symptom burden. Interventions, including a home visio-vestibular exercise program and symptom-limited exercise, may contribute to improving time to concussion recovery.
Undergraduate public relations education in the United Kingdom: Quo Vadis?
Authors: Chmiel Michal , Moise Raluca
Published: February 2024

In the current context of the undergraduate PR academic education in the United Kingdom degrees being shut down or merged with other communication disciplines, the present essay represents a timely reflection on the results and internal incoherence of PR education provision in the United Kingdom. Starting from the key idea that public relations is a mature occupation and academic social discipline, we developed a thorough analysis of PR fields, where we analysed the intra- and inter-dynamics between these various types of fields, aiming at identifying the main issues that impact the teaching of PR and its academic expressions. Drawn from the field analysis, we then focused on two key trends which currently shape the undergraduate PR education in the UK to recommend changes to the process of curriculum development that reconstructs the social value of Public Relations.
Does Supply Chain Resilience Mediate the Relationship Between CRM Dimensions and Customer Satisfaction?
Authors: Alsmairat Mohammad A. K. , Hussain Sharafat , AlOqool Abdalrazzaq , Ali Wael
Published: February 2024

Supply chain (SC) disruptions are increasingly common in today’s dynamic business environment, and understanding the effectiveness of customer relationship management (CRM) practices in achieving customer satisfaction through supply chain resilience (SCR) can provide valuable insights for businesses. This study aims to empirically examine the impact of CRM dimensions and SCR on customer satisfaction. It also examined the mediation role of SCR between different dimensions of CRM and customer satisfaction. A total of 529 responses were collected from different customers of small and medium-sized enterprises (SMEs) in the Middle Eastern region. For empirical analysis, this study employed structural equation modelling through PLS software. The results clearly show a significant direct influence of SCR, customer orientation and knowledge management on customer satisfaction, while surprisingly technology-based CRM does not influence customer satisfaction. Further, the outcomes of this study indicate that there is a significant mediation role of SCR between CRM practices (knowledge management, technology-based CRM) and customer satisfaction. The findings of this study can have important ramifications for managers, stakeholders and policymakers regarding the significance of CRM dimensions and SCR as factors that increase customer satisfaction in Middle Eastern businesses in particular and in developing nations in general.