bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding of Autonomy in Russian Youth: An Interview Study
Authors: Mikhaylova Oxana
Published: December 2023

This study aimed to explore Russian young people’s perceptions of autonomy and the sources of these perceptions. It included thirty participants (16 female and 14 male) aged 11 to 24. Thirteen were Muscovites and 17 were from other Russian cities. Semi-structured interviews were conducted online in summer of 2022. Thematic analysis was employed to analyze the data. Findings suggest that the majority of participants perceived autonomous actions in a non-specific way or as being actions independent from others. Other meanings included adult, unruly, disciplined, responsible, successful, creative, and authoritative. The main sources of these perceptions were family, peers, education, and public opinion. Additional sources were the media, university, supplementary education, romantic partners, work, and older people. Overall, it is recommended to use non-interview methods such as observation to determine the influence of different sources on youth perceptions of individual autonomy, as it was difficult to fully capture this in interviews although their presence was detected.
Lower Blepharoplasty With Fat Transposition and Three-Vector Suspension Technique
Authors: Fakih-Gomez Nabil
Published: December 2023

The aging appearance of the lower eyelids is multifactorial, involving changes in the skin, orbital fat, orbicularis muscle, soft tissue of the midface, tear trough, and tear valley. Traditional techniques of lower blepharoplasty are based on transcutaneous or transconjunctival approaches with skin removal, followed by adjunctive procedures, such as canthal suspension, fat resection, or repositioning. However, these approaches can hardly achieve excellent transitions simply because they do not effectively address every age-related issue affecting the lower eyelid. Conversely, the approach presented herein, focuses on blending the lid-cheek junction by means of skin resection, fat transposition, and three periosteal suspension vectors, including canthal, skin-muscle flap, and sub-orbicularis oculi fat (SOOF) suspensions. It provides adequate volume restoration in the tear trough and tear valley, along with enhanced support and stability to the eyelid with canthopexy, double muscle flap, and SOOF suspension. The aim of this article is to provide a detailed step by step description of this technique along with the results of 269 patients who underwent this procedure from 2019 to 2023. This technique offers a safe and effective solution for lower eyelid aging, yielding long-lasting aesthetic results with excellent transitions.
Melatonin: A Paradigm Shift in the Management of Melasma
Authors: Malankar Tanvi E. , Thomas Mohan , Gangawane Aishwarya A. , Rajpurohit Ladusingh
Published: December 2023

Aim of the study: Comparative evaluation of the efficacy of oral melatonin in combination with oral tranexamic acid (TXA) versus the use of oral TXA alone in the management of melasma. Materials and methods: An in vivo, prospective, randomized, clinical study was conducted to compare and evaluate the efficacy of oral melatonin with oral tranexamic acid (TXA) as a combination therapy versus the use of Oral TXA alone in the management of melasma. Out of 20 patients selected, 10 patients were treated with a combination of oral melatonin and oral TXA (Group A). The remaining 10 patients were treated with oral TXA alone (Group B). Modified Melasma Area and Severity Index (MMASI) was used to assess the treatment outcomes of both the groups before starting the treatment and after every 15 days for 3 months. Result: The P value of <.05 showed that the study results were significant. It indicated a definite statistical difference between the 2 groups. Group A showed a steep unanticipated improvement in the severity score from day 15 to 2 months. Followed by sudden decrease in the severity score from 2 months to day 75 and a gradual decrease up to 3 months. On the contrary, Group B (oral TXA) showed not much improvement till day 15, followed by a slow improvement in 2 months. After 2 months, Group B showed gradual reduction in the severity score up to 3 months. Conclusion: Oral melatonin has an antioxidative property and its use along with oral TXA in the management of melasma gave better results. There was a substantial difference in the severity scores between the 2 groups, demonstrating that using oral TXA alone did not produce as good results as using it in conjunction with oral melatonin.
Healthcare and successive natural disasters: Lessons still to be learned
Authors: Sauve Michel , Bly Jared , Francescutti Louis H.
Published: December 2023

This article explores the increasing impact of natural disasters on healthcare leadership and disaster preparedness, particularly in Fort McMurray, Alberta. It underscores the importance of building disaster resilience in healthcare, distinguishing between emergencies, disasters, and catastrophes, and advocating for a multi-dimensional resilience approach. The need for robust electronic communication channels and comprehensive family-oriented evacuation plans, considering family and pet safety, is emphasized. The protection of vulnerable patients, the importance of resilient healthcare infrastructure, and dedicated protective equipment for first responders are also discussed. The article highlights the critical role of government support in flood prevention and disaster preparedness. Through the experiences of Fort McMurray, the article demonstrates the necessity of comprehensive disaster planning and the crucial role of healthcare systems in rapid recovery and adaptation in the face of disasters. It aims to contribute to an improved understanding and strategies for managing such critical situations in the future.
The health of Royal Navy sailors in the West Indies during the American War of Independence, 1776–1783
Authors: Convertito Cori
Published: December 2023

The islands of the West Indies are often considered the most dangerous places for eighteenth century British sailors. Contemporary sources maintain that the level of sickness and mortality in the West Indies crippled the Royal Navy's fleet to such an extent as to render it extremely ineffective during the American Revolutionary War. There can be no doubt that disease, accidents and naval action had an effect on the Royal Navy in the West Indies; however the true extent of the impairment has been grossly exaggerated. This paper seeks to examine the precise effects of disease and mortality on British sailors stationed in the West Indies during the American War of Independence.
Aftermath of COVID-19: Exploring the Perception of Violence Against Women in the Middle East and North Africa
Authors: Pourmehdi Mansour
Published: December 2023

This article explores the perception of violence against women (VAW) in the Middle East and North Africa in the aftermath of the COVID-19 pandemic using Arab Barometer VI parts 1 and 3 ( N = 12,548). Results showed that men and social conservatism were less likely to perceive that the VAW in the community had increased. For religious people, the odds of perceiving violence in the community were higher. Individuals whose jobs were interrupted because of the COVID-19 outbreak were more likely to perceive VAW in the community has increased compared to individuals whose jobs were not interrupted. The strongest predictor of the perception of increased VAW in the community because of COVID-19 was the current economic situation of the country. Those who perceived the economic situation of the country as bad were 1.6 times more likely to believe that VAW has increased. Government handling of the crisis and overall government performance increased the odds of perceiving that VAW has increased. Investigating correlates of VAW as the consequence of the COVID-19 pandemic is crucial because it helps governments, emergency services, and community leaders develop strategies of prevention for future disasters and improve community and institutional reactions.
Anti-lock braking control using an interval type-2 fuzzy neural network scheme for electric vehicles
Authors: Wang Jun-cheng , Wang Fa-hui , He Ren , Lv Lin-feng
Published: December 2023

Control precision and robustness can be regarded as essential challenges of slip ratio control because of the external uncertainties of road conditions and the internal delay response of braking actuators. In addition, it is difficult to obtain a trade-off between braking energy recovery efficiency and braking safety under some extreme braking conditions. To synchronously improve both slip ratio control and braking energy recovery efficiency for different road conditions, an anti-lock braking system (ABS) using a novel interval type-2 fuzzy neural network (IT2FNN) control scheme is proposed for electrohydraulic braking systems. The novel IT2FNN control scheme with five layers is designed to calculate the commanded braking torque. The membership function layer utilizes type-2 fuzzy sets to describe the slip ratio error degree, which enhances the scheme’s anti-interference ability, and the enhanced Karnik-Mendel (EKM) algorithm is used in the type-reduction layer to accelerate computation. Additionally, the network adjusts the parameters of the membership function and rules by decreasing the performance function value corresponding to the braking torque error to improve slip ratio control and enhance the self-adaptation capacity. Simulations showed that IT2FNN control can not only improve slip ratio control performance and decrease the braking torque error but also enhance the energy recovery efficiency of regenerative braking on different road surfaces.
Distributed MPC-based posture control for knee-wheeled wheel-legged robots with multi-actuation
Authors: Pan Zheng , Li Boyuan , Zhou Shiyu , Liu Shaoxun , Niu Zhihua , Wang Rongrong
Published: December 2023

Wheel-legged robots (WLRs) with knee-wheel placement can switch motion mode into wheeled motion and legged motion depending on the road condition. However, in wheeled motion mode, robots are energy-efficiency and high maneuverability but struggle to handle rough terrain. To address this challenge, we propose a quarter-car model predictive controller (MPC) that utilizes both thigh and calf leg actuation to track sprung mass displacement and regulate tire force during unknown road disturbances. To overcome the high computational demands of whole-body MPC-based posture control for the entire robot, we propose a distributed MPC-based framework with inverse kinematics. Simulations, including quarter-car wheel-legged system simulation, posture tracking, braking, and steering with load transfer, were conducted to evaluate the effectiveness of our proposed control framework and the promising performance of multi-actuation involving the calf leg. The results of this paper demonstrate that our proposed approach is effective in improving the posture control and stability of knee-wheeled WLRs, particularly in rough terrain conditions.
A lightweight deep learning-based method for health diagnosis of internal combustion engines on an internet of vehicles platform
Authors: Dou Quanli , Luo Hanbin , Zhang Zhenjing , Song Yedong , Chu Shilong , Mao Zhiwei
Published: December 2023

The health status diagnosis method for internal combustion engines based on deep learning mainly focuses on the research of vibration signals, but the hardware cost required for vibration signal monitoring is expensive, and the model is also complex, which is not suitable for vehicle internal combustion engines. The Internet of Vehicle (IoV) platform provides a lot of thermal parameter data that can reflect the status and performance of internal combustion engines. However, there is currently insufficient study on thermal parameters, and the in-depth fusion analysis of multiple parameter associations has not been realized. At the same time, considering the numerous thermal parameters of internal combustion engines and the complex relationship between them. This article proposes a deep learning lightweight diagnosis method based on thermal parameters to explore the important value of thermal parameters in the health diagnosis of internal combustion engines. Firstly, a parameter grouping model based on Mutual information is proposed to realize the automatic grouping of parameters, reduce the complexity of the model, and realize lightweight processing. Then, based on grouping, a deep learning health status diagnosis model based on denoising autoencoder-attention mechanism-bidirectional gated recurrent unit (DAE-AM-BiGRU) is proposed to achieve the purpose of data dimensionality reduction, noise reduction, and obtaining key features and timing relations. Finally, a simulation model of an internal combustion engine was constructed using GT-POWER simulation software to obtain simulation data of thermal parameters, verifying the effectiveness of the proposed method.
Adaptive fault-tolerant control based on linear matrix inequalities for actuator failures in steer-by-wire system
Authors: Liu Wenguang , Jiang Zhuan
Published: December 2023

Aiming at the vehicle stability and safety problems caused by the actuator failure of Steer-By-Wire (SBW) system, a two-layer control strategy combining the Performance-Preserving Robust Control (PPRC) and Adaptive Fault-Tolerant Control (AFTC) using the Linear Matrix Inequality (LMI) processing is proposed. The PPRC of the SBW system by tracking the ideal reference model is the first layer of control, the vehicle is robust to speed and low failure rate defects of the SBW system actuator within the performance range of the SBW system, and the side slip angle ([Formula: see text]) and yaw rate ([Formula: see text]) of the vehicle can approach optimal values; The second layer of control: AFTC is added to the above PPRC based on the online estimation of the final failure, when a high failure rate failure in the actuator of the SBW system occurs and the performance limit of the PPRC is exceeded, this allows the vehicle state in the high failure rate failure mode of the actuator to still track the specified ideal reference state. Compared with the traditional Fault-Tolerant Control (FTC) that requires Fault Detection and Isolation (FDI), the control method used in this paper does not require accurate fault information, but only uses the system state change generated by the fault as the information to automatically adjust the control input, which can still achieve the purpose of stabilizing the whole SBW system when the actuator fails.
Prediction of electric power performance of the exhaust waste heat recovery system of an automobile with thermoelectrical generator under real driving conditions by means of machine learning algorithms
Authors: Çelik Ahmet , Kunt M Akif , Güneş Haluk
Published: December 2023

In internal combustion engines, approximately 40% of the thermal power obtained from fuel burning is thrown out to the environment from the exhaust system. Implementations of waste heat recovery systems with thermoelectrical generator over exhaust system have become widespread as it is the waste heat resource with the highest temperature in a vehicle. During literature research, experiments related to waste heat recovery under real road conditions are very few and no study on estimation of system performance by machine learning algorithms has been found; therefore, Toyota Corolla has designed an air-cooled waste heat recovery system using 3 thermoelectrical generators for the exhaust system of the automobile. During the road tests, temperature and electric power generation values obtained as per gear, vehicle speed and engine speed have been recorded. In the study, a dataset consisting of 10 attributes was created with each record as a result of the path test. Using this dataset, Random Forest, Support Vector Machine (SVM) and Naive Bayes machine learning algorithms estimated the electrical power to be generated from the thermoelectric generator recovery system. In the study, 7 electric power classification estimates were made. In the estimation process, 76% of the dataset was used for training and 24% was used for testing. In terms of estimation success; an estimation success of 96.6% has been achieved by Random Forest method; 94.6% by Support Vector Machine (SVM) method; and 76.7% by Naive Bayes method. The results show that prospective electricity generation estimation can be achieved with high level of accuracy.
Improvement in tribological and hydrophobic properties of thrust plate of gear pump through oxyacetylene flame spraying in diverse cooling Medium
Authors: Sharma Anubhav K , Kumar Niranjan , Das Alok K
Published: December 2023

In the present research, a flame spraying technique with diverse cooling mediums has been used to enhance the surface properties of the thrust plate of a gear pump made of aluminium alloy. The influence of flame spraying on the surface of the thrust plate with reference to the coefficient of friction, wear volume, micro-hardness, change in microstructure, surface roughness, and formation of hard phases have been highlighted in this research. The field emission scanning electron microscopy micrograph indicates the formation of fine-grain microstructure in the flame-hardened surfaces due to the formation of the hard phases. Dry sliding wear test results indicate the improvement in friction coefficient in the hardened sample with olive oil cooling as compared to the parent surface. Optical profile analysis of the wear track shows the lower wear volume for the hardened samples with oil cooling as compared to the parent material. Micro-hardness of the flame-hardened surface increased from 80 HV0.5 (parent surface) to a maximum value of 132 HV0.5 (flame-hardened with oil-cooled). A significant improvement in water contact angle (from 740 to 970) also has been observed, indicating the enhancement in the hydrophobic nature of flame-hardened surfaces.
Application of Ni-based superalloy in aero turbine blade: A review
Authors: Behera Asit , Sahoo Ashok K , Mahapatra S S
Published: December 2023

A superalloy is a high-performance alloy used for achieving stability and strength at elevated temperatures. Generally, a temperature of about 800°C is developed at the first stage of the aero turbine blade. So it is a challenge to choose a material that can withstand such high temperatures. Nowadays advanced generation single crystal Ni-based superalloys are being used for the fulfillment of high-temperature requirements in aero turbine components. But the continuous effort is being carried out to manufacture new materials that can withstand more and more temperatures generated at aero turbine because the high-temperature operation of the turbine is directly proportional to the efficiency of a turbine engine. The requirement of high-temperature application upgraded the Ni-based superalloy and different generations of alloys were prepared from time to time those were discussed in the paper. Recent developments of superalloys in the paper mainly include fifth and sixth generations of superalloys those incorporate Hf, Re, and Ru-like elements in significant amounts. A brief extension discussion has been placed on the types, processing, and hot deformation characteristics of Ni-based superalloys. VIM melting, single crystal growth, directional solidification, and powder metallurgy techniques for manufacturing Ni-based superalloys are discussed in detail. The strengthening mechanism and machinability behavior depict the characteristics of superalloys in a mechanical direction. Heat treatment and hot deformation behavior of Ni-based superalloy was precisely discussed in the context so as to correlate the strength of the material with the temperature change. Overall, the paper describes the origin, processing and characteristics of Nickel based superalloy in detail.
Supply chain performance, information and communication technology capital formation, and green growth in top carbon emitter economies
Authors: Ren Huang , Qifeng Xu , Yongjun Guan , Yunbao Xu , Gaole Hu
Published: December 2023

The emergence of green growth has proved vital for achieving sustainable development goals, and a supply chain can expedite the nation's journey toward green growth. This analysis aims to investigate the impact of supply chain performance and information and communication technology on green growth in top polluted economies by controlling the impact of education, financial development, renewable energy consumption, and foreign direct investment. For empirical analysis, we have employed the ordinary least squares, two-stage least squares, and generalized methods of moments. The main findings of the study confirm that logistics performance, infrastructure, and services are vital in promoting green growth. The diffusion of information and communication technology, education, the use of renewable energy, and financial development all help to achieve green growth. We suggest that firms should invest in green manufacturing practices, intelligent distribution networks, and better and energy-efficient logistics infrastructure, which can help the economies keep the environmental impact of economic growth at bay. Thus, our results emphasize the priorities of supply chain performance and information and communication technology diffusion in top carbon emitter economies.
Awareness to Action: Strengthening RCCE, Combating Future Pandemics in Bangladesh
Authors: Gupta Deepak , Hassan Badrul , Narain Jai P.
Published: December 2023

During the COVID-19 pandemic in Bangladesh, the risk communication and community engagement (RCCE) platform aimed to provide accurate information and encourage community engagement to minimise risks. The RCCE partners utilised behaviour change approaches to motivate people to take appropriate action and collaborated with communities to develop plans based on their unique circumstances. Throughout the pandemic, the RCCE platform worked tirelessly to disseminate real-time information and facilitate communication among frontline health providers, community outreach workers and community members in partnership with various stakeholders. This article addresses several possible questions regarding the effectiveness and efficiency of the RCCE response to the COVID-19 pandemic in Bangladesh. Was the RCCE platform able to swiftly and efficiently orchestrate a campaign that yielded results for the country? Was there a concrete platform in place, which could address the challenges posed by the pandemic? Lastly, what revisions could be envisioned for the next pandemic response?
Pattern of Public Healthcare Expenditure and Preparedness for COVID-19 in India: An Interstate Analysis
Authors: Das Tiken , Guha Pradyut
Published: December 2023

The present study made an attempt to examine the changing pattern of public healthcare expenditure across Indian states for the period 1979–1980 to 2019–2020 and tried to relate this with the spread and mortality of COVID-19 infected cases. An attempt was also made to analyse the responsiveness of per capita public healthcare expenditure (PCPHE) with the change in per capita GSDP (PCGSDP) to a much-disaggregated level. The supply side composite index (SSCI), panel regression and panel generalised method of moments (GMM) was used for analytical purpose. The study found that the greater variation in PCPHE across Indian states start exhibiting since the early years of initiation of NRHM policy and continued till recent years. Unlike the PCPHE, the public healthcare expenditure to GSDP ratio declined for all states in the subsequent time periods. The value of SSCI for both revenue and capital expenditure was low in states having larger populations and geographical areas. The study argued that the average PCPHE across Indian states exhibited irregular pattern of association with the COVID-19 confirmed cases, positivity and death rate. The panel GMM estimate of PCPHE exhibited an inelastic relationship with PCGSDP implying public healthcare is a ‘necessity’ across the Indian states.
An Economic Approach to Human Resource Planning: Application of WISN for a Dialysis Centre Staffing
Authors: Gupta Ashish , Mittal Prerak , Kalita Bhaskar J. , Patnaik Saroj Kumar
Published: December 2023

Background: By 2019, the estimated CKD prevalence in India was 7%–9%, and around 174,000 patients were on renal replacement therapy. India is likely to witness a rise in the number of patients with chronic kidney disease (CKD). Studies have identified that millions of people die of end-stage renal disease (ESRD) every year in the world, while poor infrastructure and deprived staffing are affecting dialysis access for patients. Inadequate staffing has proven to cause burnout and therapeutic errors which affect the quality of care and increase the financial burden of the illness. Optimal human resources planning is, hence, inescapable for healthcare quality, low attrition and economic viability to patients. With that premise, this study was carried out to ascertain the staffing of a dialysis centre.

Methods: We have applied the workload indicator of staffing needs (WISN) method to estimate staffing for a six-bedded dialysis centre of a public sector hospital in Pune, India, with the aim to improve healthcare delivery.

Results: The staffing requirement was conclusively calculated to be more than the current employment of two dialysis technicians.

Conclusion: Additional employment would prevent staff fatigue and improve hospital operations, reducing the cost burden, enhancing patient safety and improving healthcare indices. The WISN method can be used to assess accurate healthcare staffing and is recommended for all healthcare facilities.
Precarious Implications of Functional Flexibilisation in Labour Management: A Qualitative Analysis of Nurses' Ward Transitions
Authors: SarıtaŞ Canet Tuba
Published: December 2023

This article examines functional flexibilisation in nursing labour management, considering Turkey’s healthcare restructuring since 2003. It provides a qualitative analysis of nurses’ ward transition experiences through in-depth interviews with 38 female nurses in hospital wards. Along with functional insecurity, the findings suggest that ward transitions lead to insecurity and uncertainty in nurses’ career prospects, skill reproduction and specialisation in a particular clinical area. Moreover, the intersection of healthcare restructuring principles and occupational power relations underlines that applying ward transitions as a functional flexibilisation strategy triggers non-professionalisation and/or degradation of nursing as an occupation.
Decider in Chief? Why and How the Public Exaggerates the Power of the Presidency
Authors: Clifford Scott , Flynn D. J. , Nyhan Brendan , Rhee Kasey
Published: December 2023

Democratic accountability requires that citizens accurately attribute credit and blame to leaders and institutions. However, citizens tend to simplify politics by personifying the state as its leader and directing credit and blame accordingly. Using an expert survey and a five-wave public panel survey spanning two administrations, we contrast public and expert perceptions of presidential power. We demonstrate that the public exaggerates the president’s powers relative to scholarly experts and that people who exaggerate presidential powers most are more likely to attribute blame to the president. However, a change in partisan control of the presidency shifts perceptions of power among partisans. Finally, we find suggestive evidence of similar shifts in belief after salient policy failures. These results provide the most direct evidence to date that citizens generally exaggerate the president’s influence and control but that these beliefs change over time in response to events.
Deregulated Long Non-Coding RNA HCG11 in Cerebral Atherosclerosis Serves as a Biomarker to Predict the Risk of Cerebrovascular Events
Authors: Du Juan , Wang Lingling , Lv Cunling
Published: December 2023

Carotid artery stenosis (CAS) is one of the main risk factors of ischemic stroke (IS), which needs a screening and monitoring biomarker. The study focused on the clinical significance of long non-coding RNA (lncRNA) HCG11 in CAS patients aiming to identify a potential therapeutic target for CAS. Serum samples were collected from 70 CAS patients and 80 age- and gender-matched healthy people. HCG11 levels were measured via quantitative real-time PCR (qRT-PCR), and its significance in CAS identification and development prediction was also assessed. HCG11 was enriched in the serum of CAS patients, and serves as a possible biomarker for disease diagnosis with the area under the curve (AUC) of 0.930. Elevated expression of HCG11 was significantly correlated with hypertension, dyslipidemia, and degree of carotid stenosis. HCG11 was highly expressed in severe CAS cases compared to moderate ones, which was positively related to the disease severity. Cox regression analysis determined the close relationship of serum HCG11 with the occurrence of cerebral ischemia events. CAS patients with high HCG11 expression showed a high occurrence rate of cerebral ischemia events. The upregulation of HCG11 could serve as a potential diagnostic biomarker for CAS and is positively related to the disease severity. Serum HCG11 can independently predict the occurrence of following cerebral ischemia events.
Usefulness of the Quick-Sepsis Organ Failure Assessment Score in Cardiovascular Intensive Care Unit to Predict Prognosis in Acute Coronary Syndrome
Authors: Bouchlarhem Amine , Bazid Zakaria , Ismaili Nabila , Noha El Ouafi
Published: December 2023

Triage of patients with acute coronary syndrome (ACS) at high risk of in-hospital complications is essential. In this study, we evaluated the quick sepsis organ failure assessment (qSOFA) score as a tool for predicting the prognosis of 964 patients admitted to the cardiovascular intensive care unit (CICU) with ACS over a 4-year period. In total, out of 964 patients included, with a percentage of 4.6% for 30-day mortality. The risk of 30-day mortality was independently associated with qSOFA ≥ 2 at admission (hazard ratio = 2.76, 95% CI 1.32-5.74, p = 0.007). For MACEs, qSOFA ≥ 2 at admission was a predictive factor with (odds ratio = 2.42, 95% CI 1.37–4.36, p = .002). A qSOFA ≥ 2 on admission had an AUC of 0.729 (95% CI [0.694, 0.762]), with a good specificity of 91.6%. For 30-day mortality, an AUC of 0.759 (95%CI [0.726, 0.792]) for cardiogenic shock with specificity of 92.5%. For MACEs, an AUC of 0.702 (95% CI [0.64, 0.700] with a specificity of 95%. Concerning the different scores tested, we found no significant difference between the Zwolle score and the qSOFA score for predicting prognosis, whereas the CADILLAC score was better than qSOFA for predicting 30-day mortality (AUC = 0.829 and De long test = 0.03). However, there was no difference between qSOFA and CADILLAC scores for predicting cardiogenic shock (De Long test at 0.08). This is the first study to evaluate qSOFA as a predictive score for 30-day mortality and MACEs, and the results are very encouraging, particularly for cardiogenic shock.
Efficacy of Cognitive Behavioral Therapy Combined with Pharmacotherapy Versus Pharmacotherapy Alone in Adult ADHD: A Systematic Review and Meta-Analysis
Authors: Li Yanxi , Zhang Lina
Published: December 2023

Background:

ADHD diagnosis rates are rising; however, currently, no effective treatment method that has been identified. This study compared the efficacy of CBT + M with M for adult ADHD.

Methods:

PubMed, Embase, WOS, and Cochrane Library databases were searched up to July 29, 2023. Literature screening and data analysis were conducted.

Results:

The six randomized controlled studies included. Meta-analysis showed that CBT + M was more effective than M in improving ADHD symptoms. Subgroup analysis showed developed countries significant in ADHD symptoms improvement. At the 3-month, CBT + M was superior to M, but at the 6 and 9 months, no statistically significant differences were observed.

Conclusion:

CBT + M is more effective than M in improving adult ADHD symptoms and maintains an advantage for at least 3 months. It is recommended to intensifying CBT treatment after 3 months. Country and economy may influence results. Combined therapy for ADHD should be prioritized in developed countries.
Simulator Driving Abilities, Executive Functions, and Adaptive Behavior Among Adolescents With Complex Attention Deficit Hyperactivity Disorder
Authors: Nissim Michal , Shfir Or , Ratzon Navah Z.
Published: December 2023

Objective:

To examines the driving skills, executive functions, and adaptive behavior of adolescents diagnosed with Attention-deficit/hyperactivity disorder (ADHD) combined with emotional difficulties and/or learning disabilities (complex ADHD), compared to adolescents without ADHD.

Method:

A cross-sectional study including 30 adolescents with complex ADHD and 33 adolescents without ADHD aged 15 to 18 years. Driving skills on a simulator, executive functions, and adaptive behavior were evaluated.

Results:

Adolescents without ADHD demonstrated significantly higher total scores on the driving simulator, indicating better driving performance compared to adolescents with complex ADHD. In the complex ADHD group, after controlling for different Conners Comprehensive Behavior Rating Scale-Self Report scales, driving simulator scores were partially correlated with executive functions.

Conclusion:

These findings emphasize the unique needs of adolescents with complex ADHD. Given the significance of driving in today’s society, it is crucial to consider the development of intervention programs to support this population’s driving skills.
The ADHD Phenotype in Black and White Girls From Childhood to Adolescence: Results From the Community-Based Pittsburgh Girls Study
Authors: Gross Israel Moses , Gao Yangfeifei , Lee Mary J. , Hipwell Alison E. , Keenan Kate
Published: December 2023

Objective:

The goal of the present study is to describe the ADHD phenotype from childhood to adolescence in Black and White girls in a community sample.

Method:

Primary caregivers enrolled in the population-based, longitudinal Pittsburgh Girls Study reported on girls’ ADHD symptoms and impairment from ages 7 to 17; diagnostic subtypes were estimated based on meeting symptom criteria.

Results:

The prevalence of any subtype of ADHD ranged from 6.4 to 9.2% and from 2.3 to 6.4% for Black and White girls respectively; the inattentive subtype was most endorsed. A relatively equal number of new diagnoses at each age was observed. Persistence of ADHD diagnoses was typically 1 to 2 years.

Conclusions:

ADHD in the community is relatively common, with the inattentive subtype as the most common phenotype for Black and White girls. Research on developmentally sensitive periods for symptom exacerbation or new onset of ADHD in girls is needed.
Preclinical Models of Attention Deficit Hyperactivity Disorder: Neurobiology, Drug Discovery, and Beyond
Authors: McCarthy Deirdre M. , Spencer Thomas J. , Bhide Pradeep G.
Published: December 2023

Objective:

We offer an overview of ADHD research using mouse models of nicotine exposure.

Method:

Nicotine exposure of C57BL/6 or Swiss Webster mice occurred during prenatal period only or during the prenatal and the pre-weaning periods. Behavioral, neuroanatomical and neurotransmitter assays were used to investigate neurobiological mechanisms of ADHD and discover candidate ADHD medications.

Results:

Our studies show that norbinaltorphimine, a selective kappa opioid receptor antagonist is a candidate novel non-stimulant ADHD treatment and that a combination of methylphenidate and naltrexone has abuse deterrent potential with therapeutic benefits for ADHD. Other studies showed transgenerational transmission of ADHD-associated behavioral traits and demonstrated that interactions between untreated ADHD and repeated mild traumatic brain injury produced behavioral traits not associated with either condition alone.

Conclusion:

Preclinical models contribute to novel insights into ADHD neurobiology and are valuable tools for drug discovery and translation to benefit humans with ADHD.
Anxiety and Disruptive Behavior Symptoms and Disorders in Preschool-Age Offspring of Parents With and Without Bipolar Disorder: Associations With Parental Comorbidity
Authors: Abel Madelaine R. , Henin Aude , Holmén Jordan , Kagan Elana , Hamilton Antonia , Noyola Nestor , Hirshfeld-Becker Dina R.
Published: December 2023

Objective:

We examined the relative contribution of parental bipolar disorder (BPD) and psychiatric comorbidities (disruptive behavior disorders [DBD] and anxiety disorders) in predicting psychiatric symptoms and disorders in 2-5-year-old offspring.

Methods:

Participants were 60 families with a parent with BPD and 78 offspring and 70 comparison families in which neither parent had a mood disorder and 91 offspring. Parent and offspring diagnoses and symptoms were assessed using standardized diagnostic interviews and measures, with offspring assessors masked to parental diagnoses.

Results:

Offspring of parents with BPD had significant elevations in behavioral, mood and anxiety disorders and symptoms. Both parental BPD and DBD contributed to elevations in child disruptive behavioral symptoms, whereas child anxiety symptoms were more strongly predicted by comorbid parental anxiety. Parental BPD was a stronger predictor than comorbid DBD of child DBDs.

Conclusion:

Some of the elevated risk for disorders in preschoolers is accounted for by parental comorbidity.
Exploring Diagnostic Performance of a Screening Instrument for ADHD and DSM-5 Number of Symptoms Criterion in Primary School Students From Mozambique
Authors: Daniel Helena Mutede Cutótua , Duarte Igor , Caye Arthur , Rohde Luis Augusto
Published: December 2023

Objective:

To explore the ADHD diagnostic performance of a screening instrument, and which DSM-5 ADHD number of symptoms (criterion A) was best associated with impairment in a sample of students from 106 primary schools in Nampula, Mozambique.

Methods:

A random sample of 748 students were assessed using SNAP-IV and 152 youths (76 positive and 76 negative screeners) were invited for psychiatric diagnostic confirmation.

Results:

The performance of the screening instrument for predicting ADHD diagnosis was poor (all AUCs < 0.53). No other cut-off worked best in predicting impairment than the six symptoms cutoff suggested by DSM-5 for both inattention (AUC = 0.78; 95% CI [0.69, 0.86]) and hyperactivity/impulsivity (AUC = 0.75; 95% CI [0.67, 0.84]).

Conclusion:

Our findings highlight the adequacy of the DSM-5 ADHD criterion A in an African culture but indicate low diagnostic performance of a screening instruments only based in parent or teacher reports on symptoms to predict ADHD diagnosis.
Validation of the Measurement Approaches to Partnership Success (MAPS) Questionnaire
Authors: Lachance Laurie , Brush Barbara L. , Mentz Graciela , Lee Shoou-Yih D. , Chandanabhumma P. Paul , Coombe Chris M. , DeMajo Ricardo , Gabrysiak Adena , Jensen Megan , Reyes Angela G. , Rowe Zachary , Schulz Amy J. , Wilson-Powers Eliza , Israel Barbara A.
Published: December 2023

Conceptualizing and testing factors that contribute to the success of community–academic partnerships are critical to understanding their contributions to the health and well-being of communities. Most measures to date focus on factors that contribute to the development of new partnerships, and only a few have been adequately tested and validated. Methods. The Measurement Approaches to Partnership Success (MAPS) study followed a community-based participatory research (CBPR) approach and a multiphase process that included the construction and pilot testing of a questionnaire, and a national survey to validate the psychometric properties of the questionnaire in long-standing CBPR partnerships (existing ≥ six years). All members within partnerships were recruited to complete the survey (55 partnerships with 563 partners). We used confirmatory factor analysis (CFA), Cronbach’s alpha statistics, and a pairwise correlations approach to assess discriminant and convergent validity, and assessed internal consistency, and test–retest reliability. Results. All MAPS Questionnaire dimensions demonstrated strong validity and reliability and demonstrated agreement over time. Conclusion. The MAPS Questionnaire includes seven dimensions and 81 items related to the MAPS conceptual model and provides a scientific, in-depth measurement tool that allows long-standing CBPR partnerships to evaluate their work toward achieving health equity.
Bacterial Contamination and Antimicrobial Resistance in Drinking Water From Food and Drinking Establishments in Shashemane Town, Ethiopia
Authors: Bonso Musa , Bedada Dinaol , Dires Simachew
Published: December 2023

We investigated the bacteriological quality of drinking water and antimicrobial resistance of bacterial isolates in food and drinking establishments in Shashemane town, Ethiopia. A cross-sectional study was conducted from July to August 2022. One hundred water samples were collected from the tap water and storage containers of 50 selected establishments. All the collected samples were analyzed for bacteriological and antimicrobial susceptibility tests using standard procedures. The study found approximately 80% of water samples from the tap and all water samples (100%) from storage containers were contaminated with total coliforms. E. coli was detected in 20% and 26% of water samples from the tap and storage containers, respectively. A total of 68 bacterial isolates were identified, including E. coli (33.8%), Staphylococcus (25%), Salmonella (17.64%), Klebsiella (11.76%), Shigella (10.29%), and Pseudomonas (1.4%). The highest resistance by the isolates was observed against ampicillin (96%), followed by amoxicillin (94%), cotrimoxazole (76.8%), chloramphenicol (36%), gentamycin (23%), ciprofloxacin (23%), and ceftriaxone (12%). The study concluded that drinking water in food and drinking establishments was found vulnerable to microbiological contamination and it is a health risk to consumers. The level of contamination in stored water was found higher than tap water. In addition, antimicrobial-resistant bacteria such as E. coli, Salmonella, Shigella, Klebsiella, and Staphylococcus aureus were detected in both tap water and stored water. Therefore, awareness should be given to food handlers and owners of the establishments on hygienic water handling practices by the regulatory bodies of Shashemane town and stakeholders.
Influence of Smoking Habits on the Efficacy of EGFR-TKI Therapy in Patients with Advanced NSCLC: A Systematic Review and Meta-Analysis
Authors: Mo Zexun , Ye Meifeng , He Hua , Huang Xiaomei , Guo Weihong , Zhao Ziwen , Li Yujun , Wei Shuquan
Published: December 2023

Background:

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are considered as the first-line treatment for advanced EGFR mutation-positive non-small cell lung cancer (NSCLC). We aimed to analyze the efficacy of EGFR-TKIs treatment in patients with advanced NSCLC of different smoking habits.

Methods:

We conducted a search for meta-analyses and systematic reviews on the PubMed, MEDLINE, Embase, and the Cochrane Library to address this knowledge gap. Patients were divided into 2 groups: (1) experimental group: treated with EGFR-TKIs or EGFR-TKIs combined with chemotherapy, immunotherapy, antiangiogenesis, radiotherapy and (2) control group: treated with chemotherapy. Progressive-free survival (PFS) and total survival (OS) were adopted for evaluating the efficacy of EGFR-TKIs between experimental group and control group.

Results:

Eleven studies including 6760 patients were included in the meta-analysis. The results showed that smoking (including previous and current smoking) significantly reduces the PFS and OS in comparison to non-smoking group in the treatment of NSCLC with EGFR-TKIs. In addition, EGFR-TKIs combined with anti-vascular endothelial growth factor therapy can reduce the risk of disease progression in smokers.

Conclusions:

Our study indicated that smoking significantly reduced the PFS and OS in comparison to non-smoking group in the treatment of NSCLC with EGFR-TKIs.
Design as Playground: Exploring Spatial Design Through Playful Practices
Authors: Paez Roger
Published: December 2023

This article explores how incorporating game-based formats and playful practices into the design process can inform urban and architectural design. In response to the question “How can we think of design as a playground?,” the article presents an expanded notion of play and delves into its implications when incorporated into the design process. The role of play in design is examined according to three aspects: constraints (facilitating an explorative use of factual or self-imposed constraints), engagement (prompting new types of engagement and authorship through dialogism), and chance (creatively embracing chance). Through a series of case studies, this article investigates a range of possibilities for introducing play into spatial design practice and reflects on how it can serve as a foundation for rethinking authorship in design.
Trends and outcomes of lytic-based therapies for high-risk pulmonary embolism: A nationwide analysis
Authors: Abumoawad Abdelrhman , ElBallat Ahmed , Mkhaimer Yaman , Ghanem Fares , Obaed Nadia , Bunte Matthew C
Published: December 2023

Background:

Systemic thrombolysis (ST) is the guideline-recommended treatment for high-risk pulmonary embolism (PE), although catheter-directed thrombolysis (CDT) may provide a treatment alternative associated with lower rates of bleeding. Furthermore, the treatment trends and outcomes among those with high-risk PE according to treatment assignments of no lytic therapy (NLT), ST, and CDT are underreported.

Methods:

Patients hospitalized for high-risk PE between 2016 and 2019 were identified by administrative claims codes from the National Readmission Database. Therapy assignment was similarly defined by administrative codes, then stratified into NLT, ST, and CDT cohorts to report patient characteristics, care settings, and clinical outcomes. The primary outcome was in-hospital mortality with rates adjusted for patient and hospital characteristics using multivariable logistic regression. Secondary outcomes included intracranial hemorrhage (ICH), gastrointestinal bleeding (GIB), and 90-day readmission. Over the years of interest, trends in lytic treatment along with concomitant use of mechanical or surgical thrombectomy were reported.

Results:

Among 74,516 patients with high-risk PE, 61,569 (82.6%) received NLT, 8445 (11.3%) received ST, and 4502 (6.04%) received CDT. The NLT subgroup, relative to ST and CDT, tended to be older (66.1 ± 15.4, 62.8 ± 15.3, and 63.4 ± 14.4; p < 0.001) and more frequently women (56.0%, 54.4%, and 51.3%; p < 0.001), respectively. The unadjusted in-hospital mortality rate was highest for ST (18.8%, 34.1%, and 18.3% for NLT, ST, and CDT, respectively; p < 0.001) and persisted after multivariable adjustment (adjusted odds ratio (aOR) 0.43; 95% CI 0.38–0.49; p < 0.0001) of in-hospital mortality for CDT relative to ST. The unadjusted rate of ICH or GIB was lowest for NLT (1.0%, 2.0%, and 0.6% for NLT, ST, and CDT, respectively; p < 0.001). CDT, relative to ST, was associated with reduced odds of ICH (aOR 0.32; 95% CI 0.18–0.55; p < 0.0001) and GIB (aOR 0.78; 95% CI 0.62–0.98; p < 0.0001). Readmissions were highest for NLT (21.7%, 9.6%, and 12.1% for NLT, ST, and CDT, respectively; p < 0.001). CDT was associated with a higher incidence of 90-day readmission relative to ST (aOR 1.32; 95% CI 1.10–1.57; p < 0.001). From 2016 to 2019, individual treatment trends were not significantly different, although NLT tended to be offered among smaller and rural hospitals. Rates of concomitant thrombectomy were low in all three treatment groups.

Conclusions:

Among a large, contemporary, US cohort with high-risk PE, over 80% of patients did not receive any form of thrombolysis. High-risk PE that did receive systemic thrombolysis was associated with the highest rates of in-hospital mortality, suggesting opportunities to study the implementation of lytic and nonlytic-based treatments to improve outcomes for those presenting with high-risk PE.