bluuebunny/crossref_metadata_2025 huggingface dataset:
Myriocin Treatment Reverses Alcohol-Induced Alterations in Polyunsaturated Fatty Acid-Containing Phospholipid Expression in the Liver
Authors: Yalcin Emine B , Tong Ming , Homans Camilla , de la Monte Suzanne M
Published: February 2022

Chronic heavy alcohol exposure causes steatohepatitis manifested by abnormal intra-hepatocyte accumulation of lipid and parenchymal inflammation. Attendant alterations in polyunsaturated fatty acid (PUFA)-containing phospholipids could cause alcoholic liver disease (ALD) to progress by promoting oxidative stress, inflammation, and fibrogenesis. Previously we showed that myriocin, a serine palmitoyltransferase inhibitor, ameliorates experimental alcohol-induced steatohepatitis. However, the surprising overall therapeutic responses suggested that myriocin’s targets may go beyond sphingolipids. To this end, the present study examines the effects of myriocin on hepatic composition of docosahexaenoic acid (DHA)- and arachidonic acid (AA)-containing phospholipids in an experimental model of ALD. A chronic+binge ethanol exposure model was generated by feeding Long Evans rats with ethanol-containing diets (24% caloric content) for 8 weeks and simultaneously binge gavage administering 2 g/kg ethanol on Tuesdays, Thursdays and Saturdays during Weeks 6-8. Myriocin was administered by i.p. injection on Mondays, Wednesdays, and Fridays of Weeks 3-8. Control rats were studied in parallel. Upon euthanasia, the livers were harvested to examine ethanol- and/or myriocin-modulation of hepatic lipids using matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS). Results were analyzed statistically by two-way analysis of variance and depicted with data bar plots and heatmaps. Chronic+binge ethanol exposures significantly increased hepatic expression of AA-containing phospholipids including PE(36:4) ( P = .005), PE(38:4) ( P = .03), and PI(38:4) ( P = .04) and reduced DHA-containing phospholipids including PS(40:6) ( P = .03) and PE(40:6) ( P = .04) relative to control. Myriocin partially reversed ethanol’s effects on hepatic PUFA expression by decreasing PE(36:4) ( P = .004) and increasing PS(40:6) ( P = .04) and PI(40:6) ( P = .0003) relative to ethanol-exposed rats. Ethanol-mediated alterations in hepatic PUFA-containing phospholipids may contribute to hepatic oxidative and inflammatory injury by increasing AA and fibrogenesis by inhibiting DHA. The results suggest that Myriocin may help reduce or prevent long-term and progressive liver injury stemming from excessive chronic+binge ethanol consumption.
Introducing the party-interest group relationships in contemporary democracies datasets
Authors: Allern Elin Haugsgjerd , Hansen Vibeke Wøien , Rødland Lise , Røed Maiken , Klüver Heike , Le Gall Cal , Marshall David , Otjes Simon , Poguntke Thomas , Rasmussen Anne , Saurugger Sabine , Witko Christopher
Published: February 2022

Few existing datasets on parties and interest groups include data from both sides and a wide variety of interest groups and parties. We contribute to filling this gap by making several interconnected new datasets publicly available. The Party-Interest Group Relationships in Contemporary Democracies (PAIRDEM) datasets include cross-national data from three different surveys of (1) central party organizations, (2) legislative party groups, and (3) interest groups. A fourth dataset based on coding of party statutes and party finance data was established together with the Political Party Database. The datasets contain novel indicators on party-group relationships in up to 21 mature democracies. In this research note, we first present the main content of the datasets and the research design. Second, we present descriptive statistics documenting the extent of organizational ties between parties and groups in contemporary democracies. Third, we illustrate more advanced usage through a simple application.
Three-dimensional surface fatigue crack growth life assessment model of steel welded joints and structures
Authors: Fang Zhao , Li Aiqun , Ding Youliang , Shen Sheng
Published: February 2022

To investigate the fatigue crack growth of surface cracks in steel welded joints, a three-dimensional surface fatigue crack growth life assessment model considering both the surface crack growth period and the following through crack growth period is proposed. The fatigue crack growth life of a standard steel butt joint specimen is predicted considering the effect of welding residual stress and it is compared with fatigue test results. An example of a welded beam-to-column connection in a steel high-rise building under wind is selected to demonstrate the improvement of the model to make it applicable to stochastic loading and real engineering structures. The life results are compared with those obtained by other fatigue assessment approaches. The mesh sensitivity analysis is made and the effect of extreme welding imperfections and corrosion environment are both discussed. Guidance to select the fatigue life assessment approaches is also proposed. The results show that the growth shape of the edge crack remains a quarter of a circle while that of the center crack remains a quarter of an ellipse during the growth; When the surface crack grows through the plate thickness and becomes a through crack, the remaining fatigue crack growth life is unneglectable for real engineering components especially for the ones with a large plate width; The effect of welding residual stress on the fatigue crack growth life of real engineering component is complex and it depends on the distribution of the residual stress itself; The proposed three-dimensional surface crack engineering model can acquire accurate life results and is applicable to stochastic loading and engineering structures.
Response of centrifugal pendulum vibration absorber considering gravity at low engine speed
Authors: Zhang Yi , Wu Guangqiang , Zhao Guoqiang , Chen Daguan
Published: February 2022

This study examined the performance of the centrifugal pendulum vibration absorber’s (CPVA) under the influence of centrifugal force and gravity fields. The focus was on identifying the factor that influenced noise, vibration, and harshness (NVH) problems that originate owing to the centrifugal pendulum absorber being at low engine speed such as engine start-stop or idle. Consequently, mathematical models were established employing Lagrange equation of the second kind, analytical solutions were obtained using the method of multiple scales, and several simple elementary mathematical equations describing the movement of the absorber were derived. Further, the analytical solutions were compared with the numerical simulation results of the complete non-linear equation of motion, which indicated that the former were suitable for studying the performance of CPVA.

The theoretical analysis of the application with four absorbers and two absorbers under gravity field was conducted. The absorbers were found to be not always synchronized in the gravity field in certain special conditions such as lower engine speed range or small viscous damping. It was concluded that larger viscous damping coefficient can result in an improvement in the synchronization or reduce the range of nonlinear jumps caused by changes in excitation torque.

Further, super-harmonic resonance of CPVA under the gravity field was determined and exact response was calculated, wherein the term “2nd order response gravity impact factor” was defined. In addition, the effects of CPVA installation angle relative to engine ignition angle were analyzed, and a set of tautochronic epicycloid CPVA was tested to verify the findings. The analytical solutions were consistent with the test results, thereby proving the applicability of the research method and results in a vehicle.
Dissimilar joining of Titanium alloy to Aluminium using Al-Si based filler alloy by vacuum brazing technique
Authors: Basude Ambadas , Kumar Adepu , Rajasingh George , Mugada Krishna Kishore
Published: February 2022

In the present investigation, a dissimilar metal joint between Titanium alloy (Ti6Al4V, ELI) and pure Aluminium (Al) was achieved using an Al-Si based filler alloy by vacuum brazing technique. A sound dissimilar joint of Ti to Al was achieved after a series of pilot experiments with overlap configuration. A thin foil of 0.2 mm thick Al-Si was used as filler alloy. With an overlap of 7.5 mm, the average joint strength achieved was 64 MPa. Mechanical properties were evaluated by varying the overlaps of the vacuum brazed joints and then compared. The average joint strength achieved for an overlap distance of 3, 6 and 9 mm were 57 ± 0.5, 53 ± 0.5 and 59 ± 0.5 MPa, respectively. The brazed joints were investigated for macrostructure, microstructure, scanning electron microscope and electron probe micro analyser analysis for characterization studies.
A comparison of stakeholder perspectives of tourism development in Sapa, Vietnam
Authors: Nguyen Huy Van , Lee Diane , Warren Carol
Published: February 2022

Weber’s theory of formal and substantive rationality (WFSR) explains the range of people’s motivations when engaging in different forms of economic activity. Human rationality is driven by formal rationality, which focuses on economic gains, and substantive rationality which considers non-economic factors such as power, trust, and cultural values that could offset the shortcomings of social exchange theory (SET). The study used the exploratory sequential mixed method including semi-structured interviews with key tourism stakeholders and follow-up survey. Most stakeholders from both groups agreed that tourism brings about economic benefits and employment opportunities; however, tourism results in adverse environmental and cultural impacts. Sapa stakeholders generally support tourism development for both economic and non-economic reasons. The findings of this study do support that the SET and Weber’s theory explain the contradictory perspectives of multiple ethnic groups in the community. Specifically, in this study, the perspectives of Kinh respondents regarding impacts of tourism development were found to be quite contradictory compared to those of the ethnic minority groups. Such contradictions could present a challenge to the application of participatory approaches in tourism development and the development of a “shared vision” among tourism stakeholders. Implications for tourism planners and suggestions for future research are also discussed.
Non-parametric empirical machine learning for short-term and long-term structural health monitoring
Authors: Entezami Alireza , Shariatmadar Hashem , De Michele Carlo
Published: February 2022

Early damage detection is an initial step of structural health monitoring. Thanks to recent advances in sensing technology, the application of data-driven methods based on the concept of machine learning has significantly increased among civil engineers and researchers. On this basis, this article proposes a novel non-parametric anomaly detection method in an unsupervised learning manner via the theory of empirical machine learning. The main objective of this method is to define a new damage index by using some empirical measure and the concept of minimum distance value. For this reason, an empirical local density is initially computed for each feature and then multiplied by the minimum distance of that feature to derive a new damage index for decision-making. The minimum distance is obtained by calculating the distances between each feature and training samples and finding the minimum quantity. The major contributions of this research contain developing a novel non-parametric algorithm for decision-making under high-dimensional and low-dimensional features and proposing a new damage index. To detect early damage, a threshold boundary is computed by using the extreme value theory, generalized Pareto distribution, and peak-over-threshold approach. Dynamic and statistical features of two full-scale bridges are used to verify the effectiveness and reliability of the proposed non-parametric anomaly detection. In order to further demonstrate its accuracy and proper performance, it is compared with some classical and recently published anomaly detection techniques. Results show that the proposed non-parametric method can effectively discriminate a damaged state from its undamaged condition with high damage detectability and inconsiderable false positive and false negative errors. This method also outperforms the anomaly detection techniques considered in the comparative studies.
Links of Adversity in Childhood With Mental and Physical Health Outcomes: A Systematic Review of Longitudinal Mediating and Moderating Mechanisms
Authors: Hales George K. , Saribaz Zeliha E. , Debowska Agata , Rowe Richard
Published: February 2022

Adverse childhood experiences (ACEs) have been associated with causes of early death, addiction, mental illness, and poor health. However, studies investigating underlying mechanisms often rely on cross-sectional data or inappropriate study designs. To prevent the negative sequelae associated with ACEs, it is imperative to understand the mechanisms underlying the prospective relationship. The aim of this present review was to provide a synthesis and critical evaluation of the literature regarding the mechanisms underlying this relationship. A search in SCOPUS, MedLine via Ovid, PsycINFO via Ovid, and Web of Science was performed. Studies that utilised a prospective design assessing ACEs in childhood or adolescence, outcomes in adulthood, and analysed either a mediating or moderating relationship were included, unless the study relied on informant report or official records to assess childhood maltreatment types of ACEs. Twenty-two studies examining a longitudinal mediation or moderation were included in a systematic review. A review of the studies found links to psychopathology, delinquent and problem behaviours, poor physical health, and poor socioeconomic outcomes. A clear image of underlying mechanisms is not forthcoming due to (a) poor study design in relation to assessing longitudinal mechanisms, and (b) heterogeneity in the adversities, mechanisms, and outcomes assessed. Based on the review, several gaps and limitations are highlighted and discussed.
Evaluation Results From the Healthy Work Collaborative: A Cross-Sectoral Capacity Building Partnership to Address Precarious Employment
Authors: Welter Christina , Jarpe-Ratner Elizabeth , Bonney Tessa , Pinsker Eve , Fisher Elizabeth , Deb Nandini , Yankelev Anna , Kapadia Devangna , Love Marsha , Zanoni Joseph
Published: February 2022

Background

The COVID-19 pandemic has illuminated the profound health and safety risks of precariously employed workers, many of whom are disproportionately Latinx and Black. Precarious employment (PE) is a social determinant of health (SDOH) characterized by low wages, hazardous conditions, unstable work schedules, no termination protection, and few benefits. Even before COVID-19, calls for more effective health promotion efforts to address SDOH like PE existed.

Purpose

The University of Illinois at Chicago Center for Healthy Work, Healthy Communities Through Healthy Work developed the Healthy Work Collaborative (HWC) as an evidence-informed capacity building policy, systems, and environmental change (PSE) initiative. The HWC aimed to facilitate cross-sectoral partnerships between health and labor sector partners. The labor sector provided technical assistance (TA) to participants to improve their ability to address PE through PSE.

Methods

This article reports findings from a mixed-methods evaluation using the Kirkpatrick training model including participants’ reactions, learning, behavior, and outcomes. A pre–post survey was administered to participants ( N = 21) and analyzed descriptively; 3-month post HWC interviews were conducted ( N = 13) and thematically analyzed.

Conclusion

Findings included positive results at all Kirkpatrick levels. Participants’ reported that the HWC curriculum and delivery was valuable and well received; they demonstrated gains toward addressing PE through PSE knowledge and skills and increased or strengthened health/labor partnerships. In addition, HWC influenced participants’ application of HWC concepts, and in a few cases, participants’ made changes in policies and plans in their organizational settings. The HWC may serve as a model to address other SDOH through cross-sectoral PSE change.
Effects of an Interdisciplinary Integrative Oncology Group-Based Program to Strengthen Resilience and Improve Quality of Life in Cancer Patients: Results of a Prospective Longitudinal Single-Center Study
Authors: Savaş Burcu Babadağ , Märtens Bettina , Cramer Holger , Voiss Petra , Longolius Julia , Weiser Axel , Ziert Yvonne , Christiansen Hans , Steinmann Diana
Published: February 2022

Background:

Patients with cancer receiving oncological treatment often suffer from a reduced quality of life (QoL) and resilience.

Objectives:

The aim of this study was to evaluate the effect of an interdisciplinary integrative oncology group-based program on resilience and quality of life in patients with cancer during or after conventional oncological therapy.

Methods:

This prospective longitudinal single-center study evaluated the resilience (Resilience Scale), quality of life (EORTC-QLQ C30), anxiety, depression (Hospital Anxiety and Depression Scale), and distress levels (Distress Thermometer) of 60 patients with cancer who participated in a 10-week interdisciplinary integrative oncology group-based program during or after cancer treatment in outpatient clinics. An average of 12 (range 11-13) patients participated in each 10-week group. The program included recommendations for diet, stress management, relaxation, and exercise, as well as naturopathic self-help strategies and psychosocial support.

Results:

There were slight increases in global quality of life scores (week 0: 58.05 ± 20.05 vs week 10: 63.13 ± 18.51, n = 59, P = .063, d = −.25) and resilience scores (week 0: 63.50 ± 13.14 vs week 10: 66.15 ± 10.17, n = 52, P = .222, d = −.17) after the group program compared to before; however, these changes were not statistically significant and had small effect sizes. Patients with at least moderate anxiety symptoms ( P = .022, d = .42) and low resilience ( P = .006, d = −.54) benefited most from the program. The patients reported no relevant side effects or adverse events from the program.

Conclusions:

No significant effects on global quality of life or resilience were found in the general sample; notably, patients with anxiety and low initial resilience benefited the most from the program.
The Place of Greening: Comparing Civic Engagement Scenes of Urban Natures across Danish Cities
Authors: Blok Anders , Juvik Amanda K. , Kvist Møller Anna Helene , Raaschou-Pedersen Jonas Skjold , Laage-Thomsen Jakob
Published: February 2022

As elsewhere in Europe, cities in Denmark have witnessed a surge in civic urban nature engagement, such as place- and practice-based initiatives (e.g., public-access community gardens, organic food collectives, and grazing associations that enhance biodiversity). While this expansion of urban green communities, as we call them, is widely noted in the literature, less attention has been paid to the comparative variability of their local civic expression. In this article, we use digital methods to map out the group styles, the spatial intergroup networks, and the cultural-political value landscapes of 130 urban green communities across the four largest cities in Denmark. To compare results, we develop the concept of “civic engagement scenes” as a way of responding to recent developments in cultural and political sociology. Overall, we show how this notion allows for interpreting civic greening groups: they are neither neighborhood-based endeavors nor hubs of social movement mobilization, but rather geographies of co-engagement that span cities while also forge new senses and practices of place.
Drug-Coated Balloon Versus Drug-Eluting Stent in Patients With Femoropopliteal Artery Disease: A Systematic Review and Meta-Analysis
Authors: Nugraha Harry G. , Hilman Syawaluddin , Santiana Leni , Dewi Dian K. , Raffaelo Wilson M. , Wibowo Arief , Pranata Raymond , Aristiady Eppy B.
Published: February 2022

Objective

In this systematic review and meta-analysis, we aimed to compare drug-coated balloon (DCB) to drug-eluting stent (DES) in patients with femoropopliteal lesions in terms of restenosis, target lesion revascularization (TLR), and mortality.

Methods

A comprehensive literature search was performed through PubMed, Scopus, and Embase databases. The intervention group was patients receiving percutaneous balloon angioplasty using the DCB. The control group was patients receiving percutaneous intervention using the DES. The primary outcome was restenosis, and the secondary outcomes were TLR and mortality.

Results

There were 4 studies comprising 812 patients (906 lesions) included in this systematic review and meta-analysis. The rate of restenosis was .19 [.13, .26] in DCB and .24 [.20, .28] in DES. There was a trend toward lower rate of restenosis (OR .73 [.52, 1.03], P = .074; I2: 46.3%) for DCB use compared to DES use. The rate of TLR was .11 [.08, .14] in DCB and .17 [.14, .21] in DES. TLR was lower (OR .61 [.41, .92], P = .017; I2: 1.2%) in the DCB group compared to the DES group. There were no significant differences in mortality (OR 1.38 [.78, 2.44], P = .268; I2: 0%) among the two groups. Meta-regression analysis showed that the rate of restenosis in DCB in this pooled analysis was affected by sex (reference: male, coefficient −.004, P = .009), smoking (coefficient: .003, P = .010), and total occlusion (coefficient: .008, P = .004).

Conclusion

DCB use in patients with femoropopliteal lesion was associated with similar rate of restenosis, lower TLR, and similar mortality rate compared to DES use.
A Description of Outcomes Experienced by Patients Whose Orders for Peripheral Artery Revascularization Were Reviewed by a Nondenial Prior Authorization Program
Authors: Powell Adam C , Lugo Christopher T. , Dietrich Craig L. , Lucas Elizabeth R. , Long James W. , DeFrance Anthony , Simmons Jeffrey D.
Published: February 2022

Objective

After a nondenial prior authorization program evaluates orders for peripheral artery revascularization (PAR), ordering physicians sometimes withdraw their orders based upon program recommendations. Some patients with withdrawn orders receive PAR if claudication does not resolve. To characterize patient outcomes under this program, we evaluated whether associations existed between the withdrawal of patients’ initial PAR orders and the presence of claims for PAR and claims mentioning intermittent claudication (IC) in the following 16 weeks.

Methods

Orders for PAR placed from 1/1/19 to 9/30/19 for patients with Medicare Advantage health plans were extracted from a national healthcare organization’s database. Claims data from 0 to 16 weeks following the order were reviewed to determine if patients had downstream PAR claims, or if they had emergency department or hospital claims mentioning IC. Chi-square tests were used to assess the association between order withdrawal and downstream PAR, as well as claims mentioning IC. Multivariate logistic regressions were run to assess the same, controlling for patient age, sex, urbanicity, local median income, state obesity rate, type of PAR, ordering physician specialty, and whether PAR was ordered in a hospital setting.

Results

Of 1588 orders meeting inclusion criteria, 71.9% (1038/1444) of authorized orders and 61.1% (88/144) of withdrawn orders were followed by PAR within 16 weeks, a significant difference ( P < .01). Relatedly, 69.8% (1008/1444) of authorized orders and 70.8% (102/144) of withdrawn orders were followed by IC claims, an insignificant difference. Multivariate logistic regressions showed patients with withdrawn PAR orders had significantly lower adjusted odds of PAR (OR: 0.63; 95% CI: 0.44–0.91), but an insignificant difference in their adjusted odds of IC (OR: 1.10; CI: 0.76–1.64).

Conclusions

Although patients with withdrawn PAR orders were significantly less likely to receive PAR in the subsequent 16 weeks, no association was found between withdrawn PAR orders and subsequent claims mentioning IC.
Tribal Deliberations about Precision Medicine Research: Addressing Diversity and Inequity in Democratic Deliberation Design and Evaluation
Authors: Blacksher Erika , Trinidad Susan Brown , Woodbury R. Brian , Hopkins Scarlett E. , Woodahl Erica L. , Boyer Bert B. , Burke Wylie , Hiratsuka Vanessa
Published: February 2022

Deliberative democratic engagement is used around the globe to gather informed public input on contentious collective questions. Yet, rarely has it been used to convene individuals exclusively from Indigenous communities. The relative novelty of using this approach to engage tribal communities and concerns about diversity and inequities raise important methodological questions. We describe the design and quality outcomes for a 2.5-day deliberation that elicited views of American Indian and Alaska Native (AIAN) leaders about the potential value and ethical conduct of precision medicine research (PMR), an emerging approach to research that investigates the health effects of individual genetic variation in tandem with variation in health-relevant practices, social determinants, and environmental exposures. The event met key goals, such as relationship and rapport formation, cross-site learning, equality of opportunity to participate, and respect among participants in the context of disagreement.
The Practical Utility of Mixed Methods: An Empirical Study
Authors: Dahler-Larsen Peter
Published: February 2022

While methodologists often assert that a mixed methods approach has greater practical utility than a monomethod approach used in a similar setting, empirical data have been lacking. To examine this assertion, we studied the practical utility of workplace assessments in 1801 public organizations in Denmark, of which 540 chose mixed methods. We measure utility in terms of action taken as well as perceived utility.

We contribute to mixed methods research by documenting higher practical utility in mixed methods. Mixed methods share with qualitative methods an association with influence from local stakeholders and employee engagement, but not the weaknesses of qualitative methods (such as lack of documentation and incompatibility with management preferences). Mixed methods may serve diverse stakeholders as a successful hybrid rather than as a unique paradigm.
Gabapentinoid Prescribing for Carpal Tunnel Syndrome
Authors: Billig Jessica I. , Gunaseelan Vidhya , Yazdanfar Maryam , Sears Erika D. , Iwashyna Theodore J. , Chang Tammy , Waljee Jennifer F.
Published: February 2022

Background:

Gabapentinoids, including gabapentin and pregabalin, are commonly prescribed for neuropathic pain, but robust evidence recommends against using gabapentinoids for the treatment of carpal tunnel syndrome (CTS). We aimed to quantify national prescribing patterns of gabapentinoids for CTS.

Methods:

We performed a retrospective population-based cohort study using claims data of gabapentinoid-naïve patients with a new diagnosis of CTS (2009-2016). Our primary outcome was a new gabapentinoid fill for CTS. We assessed temporal trends and characteristics associated with a gabapentinoid fill. Multivariable logistic regression was used to evaluate the association between patient-level factors and a new gabapentinoid fill for CTS.

Results:

Of the 248 324 previously gabapentinoid-naïve patients with CTS, 9589 patients (4%) filled a gabapentinoid prescription. Sixty-one percent were prescribed by primary care providers or medical subspecialists. Patients with a history of neck pain (odds ratio [OR]: 1.31, 95% confidence interval [CI], 1.25-1.38), back pain (OR: 1.25, 95% CI, 1.20-1.31), arthritis (OR: 1.25, 95% CI, 1.18-1.31), and other pain conditions (OR: 1.26, 95% CI, 1.20-1.31) were associated with an increased odds of a new gabapentinoid fill. In addition, patients with a history of alcohol or substance use disorder were significantly associated with a new gabapentinoid prescription fill (OR: 1.33, 95% CI, 1.20-1.47).

Conclusions:

Despite evidence recommending against the use of gabapentinoids for CTS, gabapentinoids were frequently initiated among those with higher risk for misuse, including substance use disorders. Given the effectiveness of bracing or surgery for CTS and the risks associated with gabapentinoids, efforts aimed at disseminating evidence-based treatment for CTS are critical to minimize the harms of gabapentinoid misuse.
Multi-objective optimization of automobile body frame considering weight, rigidity, and frequency for conceptual design
Authors: Wang Xiaoguang , Sun Pengfei , Zuo Wenjie , Bai Jiantao
Published: February 2022

At the conceptual stage of product design, simplified automobile body frame constituted by thin-walled beams can effectively be used to predict global performances, including weight, rigidity, and frequency. These performances can be improved by optimizing their cross-sectional shapes (CSS) of thin-walled beams. However, it is difficult to optimize the CSS while satisfying multiple performances, because this is a multiple objectives and design variables optimization problem. The gradient-based optimization algorithms are difficult to obtain the global optimal solutions for the automobile structures. Therefore, this paper proposes an innovative multi-objective optimization method to design the CSS of automobile body by using the non-dominated sorting genetic algorithm (NSGA-II) combining with the artificial neural network. Firstly, the mechanical properties of the CSS are summarized, including open-cell, single-cell, and double-cells. These mechanical properties determine the performances of the automobile structure. Then, the multi-objective optimization model is created by using the NSGA-II while considering the weight, stiffness, and frequency, which is implemented in the self-developed CarFrame software. Finally, the proposed method is verified by optimizing the CSS for the A-pillar of automobile frame.
Alexander’s Thesis of Value Generalization Reconsidered: Focusing on the 2008 Candlelight Vigils in South Korea
Authors: Choi Jongryul
Published: February 2022

This article aims to reconsider Jeffrey C. Alexander’s thesis of ‘value generalization.’ I first review Alexander’s thesis of value generalization by tracking its origin to Weber’s value analysis, and then point out that norms occupy an ‘ambiguous’ status in Alexander’s model of value generalization. Further, I present an alternative that provides inner structures of not only values but also norms and goals, and places semantic and moral tension between values, norms, and goals at the center of cultural-sociological analysis. Specifically, I propose to define values, norms, and goals as a system of ‘axiological-existential symbols,’ a system of ‘moral-aesthetic symbols,’ and a system of ‘instrumental-strategic symbols’ as well as to bring back the generalization-specification scheme to the hierarchy of values, norms, and goals. I develop my own thesis of norm generalization, apply it to the 2008 candlelight vigils in South Korea, demonstrate the vigils as an analytic illustration of norm generalization, and then analyze why norm generalization occurred instead of value generalization. Lastly, I present two contributions, analytic as well as normative, of my study to Alexander’s thesis of value generalization.
Psychotherapy: A tool to prevent postoperative delirium?
Authors: Zangl Quirin , Kaiser Andreas , Iglseder Bernhard
Published: February 2022

The value of psychotherapy in surgical patients suffering from postoperative delirium is unclear. Options for the treatment of established postoperative delirium are few; therapy largely relies on the avoidance of postoperative delirium facilitating factors, like specific drugs and environmental factors in the perioperative setting. Established medical therapies’ efficacy in terms of decreasing incidence of postoperative delirium is very low. The aim of this project is to suggest new therapeutic options in the form of cognitive behavioural therapy as a possible preventive and psychotherapeutic treatment of postoperative delirium. Life expectancy in developed countries increases worldwide and both the need for surgical treatment and the probability of postoperative delirium occurrence increase with age. Due to the necessity of addressing the individual’s negative consequences of postoperative delirium and to optimise socioeconomical needs, new therapeutic options for the treatment of postoperative delirium are desperately needed.
Head and neck positioning for out-of-theatre intubation during the COVID-19 pandemic
Authors: Malin Alexander , Cassidy James
Published: February 2022

The COVID-19 pandemic has brought with it a large number of challenges for healthcare professionals including intubation safety in out-of-theatre environments. An important aspect of this topic is the optimisation of a patient’s head and neck position prior to laryngoscopy which can be challenging when a pillow cannot be located. As a result, the authors compared how well the sniffing position (35o neck flexion and 15o head extension) could be reached using pillows or other novel head supports. The resulting data demonstrated that a 1-litre pressure bag and two 1-litre saline bags achieved the most accurate position.
The innervation of the biceps brachii and brachialis muscles in specimens with a high incidence of an accessory biceps head
Authors: Quintero Iván Darío , Buitrago Edna Rocío , Ballesteros Luis Ernesto
Published: February 2022

We describe the patterns of motor branches to the elbow flexors in 106 fresh-frozen cadaveric upper extremities from 53 donors of the Latin American mestizo race. We identified a 20% incidence of an accessory biceps head. The innervation patterns to this accessory head were specifically described and added to the Yang classification as Type IV for the biceps and Type III for the brachialis. The patterns arising from the musculocutaneous nerve to the biceps brachii were of Type I in 69%, Type II in 9%, Type III in 7% and Type IV in 11%, and to the brachialis of Type I in 77%, Type II in 11% and Type III in 9%. In 4%, the branches did not originate from the musculocutaneous nerve. We hypothesize that the branch to the accessory biceps head might be considered as a donor for nerve transfer in selected brachial plexus injuries.
A comparative analysis of multidimensional computerized adaptive testing for the DASH and QuickDASH scores in Dupuytren’s disease
Authors: Harrison Conrad , Clelland Andrew D. , Davis Tim R. C. , Scammell Brigitte E. , Zhang Weiya , Russell Peter , Fullilove Sue , Chakrabarti Indranil , Davidson Dominique , Rodrigues Jeremy
Published: February 2022

The QuickDASH is a short-form version of the DASH questionnaire, the most widely used patient-reported outcome measure in hand surgery. Multidimensional computerized adaptive testing (MCAT) can produce shorter and more precise testing than static short forms, like QuickDASH. We used DASH responses from 507 patients with Dupuytren’s disease to develop a MCAT. The algorithm was evaluated in a Monte Carlo simulation, where the standard error of measurement (SEm) of scores obtained from the 11-item QuickDASH was compared with scores obtained from an MCAT that could administer up to 11 items from the full 30-item DASH. The MCAT asked a mean of 8.51 items (SD 2.93) and 265/1000 simulated respondents needed to complete ≤five items. Median SEms were better for DASH MCAT: 0.299 (hand function) and 0.256 (sensory symptoms) versus 0.320 and 0.290, respectively, for QuickDASH. Our study showed that the DASH MCAT can produce more precise DASH measurement than the QuickDASH, from fewer items.
First-line everolimus and cisplatin in patients with advanced extrapulmonary neuroendocrine carcinoma: a nationwide phase 2 single-arm clinical trial
Authors: Levy Sonja , Verbeek Wieke H.M. , Eskens Ferry A.L.M. , van den Berg José G. , de Groot Derk Jan A. , van Leerdam Monique E. , Tesselaar Margot E.T.
Published: February 2022

Background:

Extrapulmonary neuroendocrine carcinoma (EP-NEC) are an aggressive subgroup of neuroendocrine neoplasms (NEN). Advanced EP-NEC is generally treated with platinum-based cytotoxic regimens, but progressive disease occurs rapidly, resulting in a poor prognosis. Genetic alterations in the mammalian target for rapamycin (mTOR) pathway have been identified in NEN, providing a rationale for treatment with the mTOR-inhibitor everolimus.

Methods:

A prospective phase 2 single-arm study included patients with advanced EP-NEC from three Dutch NEN expertise centres between March 2016 and January 2020. Treatment consisted of cisplatin 75 mg/m2 every 3 weeks in combination with daily everolimus 7.5 mg for a maximum of six cycles, followed by maintenance everolimus until disease progression. Primary endpoint was disease control rate (DCR), defined as the sum of overall response rate (ORR) plus the rate of stable disease according to RECIST 1.1, assessed at 9-week intervals. Toxicity was evaluated according to CTCAE version 5.0.

Results:

Thirty-nine patients, with a median age of 64 years (range: 28–74), of whom 20 (51%) were male, were enrolled. DCR was 82.1% (95% confidence interval (CI): 66.4–92.4), with an ORR of 58.9% (CI: 42.1–74.4). Median duration of response was 6.4 (CI: 5.8–7.0) months and median progression-free survival was 6.0 (CI: 4.3–7.8) months. Three patients (8%) had durable responses lasting  > 12 months. Median overall survival was 8.7 (CI: 7.8–9.6) months. Most common grade 3/4 toxicities were haematological (36%) and renal (21%).

Conclusion:

Everolimus in combination with cisplatin is an effective first-line treatment option for advanced EP-NEC, especially in highly selected patients.

Trial registration:

Clinicaltrials.gov, NCT02695459, https://clinicaltrials.gov/ct2/show/NCT02695459 .
Cognitively Complex Leaders: How Principals Influence Organizational Learning Through Climate for Innovation
Authors: Da’as Rima’a , Schechter Chen , Qadach Mowafaq
Published: February 2022

Using an information-processing approach, the current innovative study examines a model for the prediction of organizational learning mechanisms (OLMs), linking school principals’ cognitive complexity and OLMs through the mediating effect of an innovative climate. The model was examined for three levels of principals’ cognitive complexity (high, intermediate, and low). Study participants were 131 principals and 1,279 teachers from 131 elementary schools in Israel. Results indicated that principals’ cognitive complexity promotes organizational learning mechanisms through a climate for innovation. The model with a high level of cognitive complexity showed a better fit to the data than those with intermediate (average) and low levels of cognitive complexity.
Color Affects Recognition of Emoticon Expressions
Authors: Liao Songyang , Sakata Katsuaki , Paramei Galina V.
Published: February 2022

In computer-mediated communication, emoticons are conventionally rendered in yellow. Previous studies demonstrated that colors evoke certain affective meanings, and face color modulates perceived emotion. We investigated whether color variation affects the recognition of emoticon expressions. Japanese participants were presented with emoticons depicting four basic emotions (Happy, Sad, Angry, Surprised) and a Neutral expression, each rendered in eight colors. Four conditions (E1–E4) were employed in the lab-based experiment; E5, with an additional participant sample, was an online replication of the critical E4. In E1, colored emoticons were categorized in a 5AFC task. In E2–E5, stimulus affective meaning was assessed using visual scales with anchors corresponding to each emotion. The conditions varied in stimulus arrays: E2: light gray emoticons; E3: colored circles; E4 and E5: colored emoticons. The affective meaning of Angry and Sad emoticons was found to be stronger when conferred in warm and cool colors, respectively, the pattern highly consistent between E4 and E5. The affective meaning of colored emoticons is regressed to that of achromatic expression counterparts and decontextualized color. The findings provide evidence that affective congruency of the emoticon expression and the color it is rendered in facilitates recognition of the depicted emotion, augmenting the conveyed emotional message.
Severe Acute Malnutrition (SAM) associated mortality rate of children attending HIV/AIDS care in North West Ethiopia, 2009–2019
Authors: Kebede Fassikaw
Published: February 2022

Objective:

This study aimed to assess Severe Acute Malnutrition (SAM) associated mortality rate of children attending HIV/AIDS care in North West Ethiopia 2009–2019.

Methods:

Institutional-based retrospective cohort study was employed among 721 on antiretroviral therapy care seropositive children since 2009–2019. Data were entered using EpiData version 4.2 and exported to STATA (SE) R-14 version statistical software for further analysis. Beside, Besides, WHO (World Health Organization) Anthro Plus software was used to assess the nutritional status of the children. Bivariable and multivariable Cox regression analyses were conducted to identify the predictors of mortality. Finally, variables with p-value less than 0.05 were considered significant predictors of mortality.

Result:

Overall, 721 (N = 721) seropositive children were included with a mean (±SD) age of 118.4 ± 38.24 months. A median time of death was reported at 19.5 months (interquartile range = ±8.5). The overall mortality rate in this study was determined as 5.4 per 100 child-years (95% confidence interval: 3.6–5.8). Severe stunting (height for age Z-score <−3) (hazard ratio = 2.9, 95% confidence interval: 1.8–6.4), admission with septic shock (hazard ratio = 2.3, 95% confidence interval: 1.2–4.3, p < 0.008), CD4+ count below threshold (hazard ratio = 1.6, 95% confidence interval: 1.19–7.9), and World Health Organization Stages III and IV (hazard ratio = 2.9, 95% confidence interval: 1.8–6.4) were at high risk of mortality.

Conclusion:

A high rate of SAM associated mortality rate within short median (±SD) time to death was reported as compared with previous finding in Ethiopia. Seropositive children presenting with CD4 counts being below a threshold, World Health Organization Stages III and IV, and being nutritionally stunted during antiretroviral therapy initiation were at high risk of early mortality.
A post-COVID-19 Aspergillus fumigatus posterior mediastinitis: Case report
Authors: Hoyek Nadine El , Ghorayeb Jacques , Daou Iskandar , Jamal Dany , Mahfoud Nathalie , Nawfal Georges
Published: February 2022

Invasive aspergillosis is a life-threatening condition of the immunocompromised, with a low occurrence reported in the immunocompetent. Although usually made by invasive methods, its early diagnosis is the cornerstone of a better prognosis as it yields a timely management and thus a lower mortality risk. Mediastinal invasion by Aspergillus is, like any fungal mediastinitis, uncommon and usually results from a hematogeneous or a contiguous spread, a postoperative fungal infection, a complication of a descending necrotizing fasciitis, or from an esophageal perforation. We report a case of a diabetic patient with a previous history of hospitalization 2 months earlier for a COVID-19 infection, otherwise healthy, presenting with an unresolving dorsal pain. A malignancy was expected but further work-up showed in fine a posterior mediastinitis due to Aspergillus fumigatus. Thus, fungal etiologies are to be included as a differential while diagnosing a posterior mediastinitis even in a relatively immunocompetent patient and with no evident route of entry.
A Unique Multi- and Interdisciplinary Cardiology-Renal-Endocrine Clinic: A Description and Assessment of Outcomes
Authors: Dubrofsky Lisa , Lee Jason F. , Hajimirzarahimshirazi Parisa , Liu Hongyan , Weisman Alanna , Lawler Patrick R. , Farkouh Michael E. , Udell Jacob A. , Cherney David Z.
Published: February 2022

Background:

Patients with diabetes and co-existing chronic kidney disease and/or cardiovascular disease have complex medical needs with multiple indications for different guideline-directed medical therapies and require high health care resource utilization. The Cardiac and Renal Endocrine Clinic (C.a.R.E. Clinic) is a multi- and interdisciplinary clinic offering a unique care model to this population to overcome barriers to optimal care.

Objective:

To describe the patient characteristics and clinical data of consecutive patients seen in the C.a.R.E. Clinic between 2014 and 2020, with a focus on the feasibility, strengths, and challenges of this outpatient care model.

Design:

Single-center retrospective cohort study.

Setting:

The C.a.R.E. Clinic is a multi- and interdisciplinary clinic at Toronto General Hospital in Toronto, Canada.

Patients:

We reviewed the charts of all 118 patients who had been referred to the C.a.R.E. Clinic with type 2 diabetes mellitus, co-existing renal disease, and/or cardiovascular disease.

Measurements:

Demographic data, medication data, clinic blood pressure measurements, and laboratory data were assessed at the first and last available clinic visit.

Methods:

Data were extracted via manual chart review of paper and electronic medical records.

Results:

First and last attended clinic visit data were available for descriptive analysis in 74 patients. There was a significant improvement in low-density lipoprotein (LDL) cholesterol (1.9 mmol/L vs 1.5 mmol/L, P < .01), hemoglobin A1C (7.5% vs 7.1%, P = .02), and the proportion of patients with blood pressure at target (52.7% vs 36.5%, P = .04), but not body mass index (29.7 kg/m² vs 29.6 kg/m², P = .15) between the last and first available clinic visits. There was higher uptake in evidence-based medication use including statins (93.2% vs 81.1%, P = .01), SGLT-2i (35.1% vs 4.1%, P < .01), and GLP-1 receptor agonists (13.5% vs 4.1%, P = .02), while RAAS inhibitor use was already high at baseline (81.8% vs 78.4%, P = .56). There remains a significant opportunity for therapy with sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists.

Limitations:

This is a retrospective chart review lacking a control group, therefore clinical improvements cannot be causally attributed to the clinic alone. New evidence and changes to guideline-recommended therapies also contributed to practice changes during this time period.

Conclusions:

A multi- and interdisciplinary clinic is a feasible and potentially effective way to improve evidence-based and patient-centered care for patients with diabetes, kidney, and cardiovascular disease.
Indocyanine-based near-infrared lymphography for real-time detection of lymphatics in a cat with multiple mast cell tumours
Authors: Arz Raphael , Seehusen Frauke , Meier Valeria S , Nolff Mirja C
Published: February 2022

Case summary

An 11-year-old female domestic shorthair cat was presented with cutaneous mast cell tumours (MCTs) localised at the right temporal region, the left buccal region and on the third digit of the right thoracic limb. Staging was negative and locoregional lymph nodes appeared normal, based on clinical findings. During surgery, real-time indocyanine green (ICG)-based lymphography was performed to detect the cutaneous draining pattern of all the primary MCTs. ICG was injected intracutaneously in four quadrants around each tumour, and a clear lymphogram was visible shortly after injection. Using near-infrared lymphography (NIR-L) for guidance, all lymphadenectomies were performed in 12 mins or less, with a maximal incision length of 3.5 cm. The smallest resected node was 0.9 cm in diameter. All MCTs were classified as low-grade cutaneous MCT. All four ICG-positive lymph nodes were considered premetastatic or metastatic. The only ICG-negative resected node was also negative for tumour cells. No complications related to NIR-L were recorded.

Relevance and novel information

This is the first description of NIR-L in a cat with MCT. Application was straightforward and ICG enrichment only occurred in the metastatic nodes, suggesting correct identification of lymphatic draining patterns. Of note, as previously described in dogs, we did detect nodal metastasis, despite low-grade primary tumours. The clinical relevance should be evaluated in future studies.