bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining meaningful thresholds for evaluating treatment efficacy in patients with alopecia areata
Authors: Law Ernest H. , Williams Nicole J. , Korver Dane , Bender Randall H. , Mitra Debanjali , Schaefer Gregor , Nelson Lauren M.
Published: May 2024

Background

The Severity of Alopecia Tool (SALT) is a clinician‐reported outcome measure of scalp hair loss in alopecia areata (AA).

Objectives

To characterise the magnitudes of change in SALT scores corresponding to meaningful treatment benefits from the patient's perspective.

Methods

Anchor‐based methods for the estimation of meaningful within‐patient change thresholds were applied to pooled data from a randomised, double‐blind trial of ritlecitinib. Anchors included a patient‐reported measure of change in AA severity, the Patient Global Impression of Change (PGI‐C) and three items comprising the Patient Satisfaction with Hair Growth (P‐Sat) questionnaire. After reviewing Pearson correlations between change‐from‐baseline SALT scores and each anchor to confirm adequate association, potential thresholds were computed as mean change‐from‐baseline SALT scores among patients who reported moderate improvement on the PGI‐C and/or moderate satisfaction on each of three P‐Sat items at week 24.

Results

Six hundred and fifty participants (86% adults, 14% adolescents) had mean (standard deviation) SALT scores of 90.6 (14.3) at baseline, suggesting a sample with primarily severe AA. Correlations between SALT change‐from‐baseline scores and the patient‐reported items supported their use as anchors. Estimates based on patients reporting moderate improvement in AA (n = 102) on the PGI‐C and those reporting moderate satisfaction on the P‐Sat item related to the amount of hair growth at week 24 (n = 122) were −42.2 (26.1) and −43.1 (26.8), respectively. Supportive estimates based on the remaining P‐Sat items were similar in magnitude.

Conclusions

Among patients with severe AA, SALT change‐from‐baseline scores of 42 or 43 represent meaningful improvements. While the achievement of low SALT scores of ≤10–≤20 have been used to characterise efficacy in clinical trials, the amount of change required to meet this endpoint far exceeds the estimates in this study. The treatment goals of individual patients must be considered when evaluating benefit in both clinical trials and clinical practice.
Improvement in clinical outcomes following arthroscopic all‐inside medial lateral ligament reconstruction for rotational ankle instability
Authors: Lewis T. L. , Ayathamattam J. , Vignaraja V. , Dalmau‐Pastor M. , Ferreira G. F. , Nunes G. A. , Ray R.
Published: May 2024

Purpose

Rotational ankle instability can be diagnosed in up to 18% of cases of chronic lateral ankle instability. It is characterised by an abnormal increase of talar rotation within the tibiofibular mortise, due to an injury in the most anterior component of the deltoid ligament secondary to a chronic deficiency of the lateral collateral ligament. The aim of this prospective observational study was to investigate the clinical outcomes following arthroscopic all‐inside medial and lateral ligament reconstruction for rotational ankle instability.

Methods

A prospective observational study of consecutive patients undergoing arthroscopic all‐inside medial and lateral ligament reconstruction for rotational ankle instability with minimum 6‐month follow‐up. The primary outcome was a validated patient‐reported outcome measure (PROM), the Manchester‐Oxford Foot Questionnaire. Secondary outcomes included the EQ‐5D, European Foot and Ankle Society score and complications.

Results

Between 2020 and 2023, 12 patients underwent primary arthroscopic all‐inside medial and lateral ligament reconstruction for rotational ankle instability with pre‐ and post‐operative PROMs available for all 12 patients. The mean ± standard deviation age was 33.9 ± 7.2 years and the mean follow‐up was 1.9 ± 1.2 (range: 0.5–3.8, interquartile range: 0.9–3.0) years. There was a significant improvement in all Manchester‐Oxford Foot Questionnaire domain scores (p < 0.05): Index 53.1 ± 19.1 to 26.4 ± 27.6, Pain 46.7 ± 20.3 to 26.2 ± 26.8, Walking/Standing 58.7 ± 26.0 to 27.0 ± 30.0 and Social Interaction 51.2 ± 19.5 to 25.6 ± 30.1. There were improvements in EQ‐5D‐5L Index, VAS and VAS Pain; however, these were not statistically significant. There was one complication—a superficial peroneal nerve injury which resolved with a corticosteroid injection.

Conclusion

The arthroscopic all‐inside medial and lateral ligament reconstruction technique is a reliable and safe method for treating rotational ankle instability, demonstrating significant improvement in PROMs at a mean 1.9‐year follow‐up.

Level of Evidence

Level IV.
The ISAKOS subclassification of Rockwood type III AC joint dislocations in a stable type A and an unstable type B is not clinically relevant
Authors: Haugaard Kristine B. , Bak K. , Ryberg D. , Muharemovic O. , Hölmich P. , Barfod K. W.
Published: May 2024

Purpose

The treatment of Rockwood type III AC joint dislocations has been debated for decades. In 2014, the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee suggested a subclassification of the injury into type A, considered stable and best treated nonsurgically, and type B, considered unstable and best treated surgically. Type B is defined by the presence of scapular dyskinesis and overriding of the clavicle to the acromion on a modified lateral radiograph. The objective of the study was to investigate if this subclassification is clinically relevant.

Methods

This was a prospective cohort study. Inclusion criteria were patients aged 18–60 years with acute AC joint dislocation and a baseline Zanca radiograph with an increase in the CC distance of >25% compared to the uninjured side. All patients were treated nonsurgically with 3 months of home‐based training and with the option of delayed surgical intervention. Patients were assessed at baseline and at follow‐ups 6 weeks, 3 months, 6 months and 1 year after the injury. At the 6‐week follow‐up, patients were graded as stable and unstable according to the ISAKOS criteria. Outcomes were the Western Ontario Shoulder Instability Index (WOSI) and referral for surgery.

Results

At 6 weeks of follow‐up, 20 patients were classified as stable type A and 69 were classified as unstable type B. The ISAKOS subclassification was not clinically relevant, but patients graded as stable had statistically significantly better WOSI scores at 6 months compared to the unstable group (p = 0.03) but not at 3 months or 1 year. Nine patients (9.5%), all from the unstable group, were referred for surgery. No patients from the stable group underwent surgery (n.s).

Conclusion

The ISAKOS subclassification of Rockwood type III in a stable type A and an unstable type B is not clinically applicable.

Level of Evidence

Level II.
Adolescents with prior patellar dislocation report affected quality of life and function, as measured using the Banff Patella Instability Instrument, Kujala and EQ‐5D‐5L index scores
Authors: Eysturoy Niclas H. , Husum Hans‐Christen , Ingelsrud Lina H. , Danielsen Oddrún , Blønd Lars , Mortensen Elinborg , Hölmich Per , Barfod Kristoffer W.
Published: May 2024

Purpose

We aimed to establish patient‐reported outcome measure (PROM) reference data for a cohort of patients with prior patellar dislocation without previous knee surgery.

Methods

All inhabitants of the Faroe Islands aged 15–19 years were sent an online survey via secure email to establish a national cohort. They were asked to answer questions regarding demographics, whether they had prior patellar dislocation and to complete the PROMs: the Banff Patella Instability Instrument (BPII), Kujala, Marx activity and EQ‐5D‐5L questionnaires. Participants who had undergone knee surgery were excluded. Participants who had prior patellar dislocation underwent radiographic examinations to diagnose trochlear dysplasia. The study included three cohorts: the general population, prior patellar dislocation and prior patellar dislocation and trochlear dysplasia cohorts.

Results

Of the 3749 individuals contacted, 1119 completed the survey and responded to at least one PROM. Of these, 102 reported a history of patellar dislocation and 57 of them had trochlear dysplasia. All PROMs, except the Marx score, reflected a worse quality of life and function after patellar dislocation than in the general population cohort; this was most pronounced in the BPII. The percentage of people experiencing problems in EQ‐5D‐5L dimensions was higher in the patellar dislocation and trochlear dysplasia cohorts than in the general population cohort in all EQ‐5D‐5L domains, except anxiety/depression.

Conclusion

Adolescents who had patellar dislocation reported reduced quality of life and function according to the BPII, Kujala and EQ‐5D‐5L index values, as well as all EQ‐5D‐5L domains, except for anxiety/depression. However, their activity levels remained high.

Level of Evidence

Level III.
High in‐vivo accuracy of a novel robotic‐arm‐assisted system for total knee arthroplasty
Authors: Zaidi Faseeh , Goplen Craig M. , Fitz‐Gerald Connor , Bolam Scott M. , Hanlon Michael , Munro Jacob T. , Monk Andrew P.
Published: May 2024

Purpose

Robotic‐assisted total knee arthroplasty (TKA) has been shown to improve the accuracy and precision of bony resections and implant position. However, the in vivo accuracy of the full surgical workflow has not been widely reported. The primary objective of this study is to determine the accuracy and precision of a robotic‐arm‐assisted system throughout the intraoperative workflow.

Methods

This was a retrospective cohort study of adult patients who underwent primary TKA with various workflows and alignment targets by three arthroplasty‐trained surgeons with previous experience using the ROSA® Knee System (Zimmer Biomet) over a 3‐month follow‐up period. Accuracy and precision were determined by measuring the difference between various workflow time points, including the final preoperative plan (PP), robot‐validated (RV) resection angle and postoperative radiographs (PR). The absolute mean difference between the measurements determined accuracy, and the standard deviation represented precision. The lateral distal femoral angle, medial proximal tibial angle, femoral flexion angle and tibial slope were measured on postoperative coronal long‐leg radiographs and true short‐leg lateral radiographs.

Results

A total of 77 patients were included in the final analyses. The accuracy for the coronal femoral angle was 1.62 ± 1.11°, 0.75 ± 0.79° and 1.96 ± 1.29° for the differences between PP and PR, PP and RV and RV and PR. The tibial coronal accuracy was 1.44 ± 1.03°, 0.81 ± 0.67° and 1.57 ± 1.14° for PP/PR, PP/RV and RV/PR, respectively. Femoral flexion accuracy was 1.39 ± 1.05°, 0.83 ± 0.59° and 1.81 ± 1.21° for PP/PR, PP/RV and RV/PR, respectively. Tibial slope accuracy was 0.99 ± 0.72°, 1.19 ± 0.87° and 1.63 ± 1.11°, respectively. The proportion of patients within 3° was 93.2%, 95.3%, 97.3% and 94.6% for the distal femur, proximal tibia, femoral flexion and tibial slope angles when the final intraoperative plan was compared to PRs. No patients had a postoperative complication at the final follow‐up.

Conclusions

The ROSA Knee System has acceptable accuracy and precision of coronal and sagittal plane resections with few outliers at various steps throughout the platform's entire workflow in vivo.

Level of Evidence

Level III.
Efficiency and greenness evaluation of urban land use change in the Yangtze River Economic Belt, China
Authors: Guo Changqing , Kuang Wenhui , Dou Yinyin , Dong Yulin
Published: May 2024

Improving urban land use efficiency and greenness is essential for achieving sustainable urban development and improving the well‐being of urban settlements. Using satellite‐based land use data, socioeconomic data, and sustainable development goal (SDG) indicators, we quantified the changes in the urban land use efficiency and greenness under rapid urban expansion in provincial cities in the Yangtze River Economic Belt (YREB) from 1990 to 2020. Over this period, urban area increased significantly, by 254.57%, at a rate of 191.41 km2 per year in the YREB, as national macro‐policies shifted the center of urban expansion westward. Nevertheless, the urban land use efficiency and greenness have both increased. The ratio of land consumption rate to population growth rate increased from 0.55 in 1990–2000 to 0.83 in 2010–2020 in the YREB, accompanied by an increase in the investment output ratio of fixed assets. In addition, the population‐weighted greenspace exposure increased by 5.31%, due to an 8.16% increase in the urban greenspace coverage, which improved the urban living environment amidst substantial urban population growth. We emphasize the importance of fostering coordinated development between central and western cities in the YREB. The results provide an important reference for the rational allocation of land resources, improving land use efficiency, and building resilient cities within global urbanization hotspots under the SDG framework.
The effect of vorticity on the feeding of a freshwater grazer
Authors: Goulet Luc , Currie Warren Joseph Sproule , Ackerman Josef Daniel
Published: May 2024

The transfer of energy through zooplankton grazing on phytoplankton is one of the most important interactions in aquatic ecosystems, yet the role of hydrodynamic forces is not fully understood. Factors that influence these interactions include algal size and shape and the interactions between grazer and alga dictated by hydrodynamic forces. Hydrodynamic forcing lead to unimodal relationships in grazer clearance rates (CR) because water motion and turbulence increases encounters but interferes with feeding at high levels. We expect higher CR on small algae due to increased encounter rates caused by vorticity generated in a horizontally oriented rotating cylinder to model increasing turbulence, whereas longer cells, tumbling in the flow, may be more difficult to handle. Ultimately, we expect that increased vorticity will interfere with zooplankton swimming. The CR of Daphnia magna followed the unimodal trend, with higher CR on the small, spherical Chlorella vulgaris than on larger, elongated, and colonial Scenedesmus quadricauda. This was likely due to lower handling time and higher concentration of the smaller cells in the feeding radius around D. magna. The normal hop‐sink swimming behavior of the Daphnia was affected by increasing vorticity; hop frequency decreased, displacement increased, and there was a loss of vertical orientation. This pattern in feeding and swimming were predicted by vorticity. These results for Daphnia differ from those obtained for copepods, which do not respond to vorticity. Given the importance of vorticity in nature, it is relevant to examine grazer feeding interactions under ecologically relevant hydrodynamic conditions.
Operando Battery Monitoring: Lab‐on‐Fiber Electrochemical Sensing Technologies
Authors: Xue Xiaobin , Han Xile , Li Wanjun , Li Kaiwei , Liu Fu , Guo Tuan
Published: May 2024

Success in the development of next‐generation rechargeable batteries is attained by achieving low cost, high energy density, and long cycling life. Battery optimization is challenging due to the complicated processes involving material selection and optimal utilization of cell components. Battery performance and status during the charging/discharging cycle depend on the complicated interdependence of battery design and operational parameters. Monitoring techniques must be able to detangle the hidden high‐value information, including states of charge, health estimations, and operational guidance, as well as provide non‐electrochemical early failure indicators. Fiber–optic battery monitoring methods, which are advantageous because of their low cost, compactness, remote sensing capabilities, and simple integration without interfering with internal chemistry, are recently reported. The convergence of fiber optic technology and smart battery platforms promises to revolutionize the industry. The introduction of electrochemical lab‐on‐fiber sensing technology to continuously operando monitor the performance, health, and safety status of batteries will promote more reliable energy storage systems. This review highlights recent advancements in, and associated benefits of, electrochemical fiber grating battery sensing. This powerful sensing technology's potential to make possible the next generation of sustainable energy storage, and discuss future directions for improving battery sustainability is showcased.
Design and Fabrication of Fibrous Spindle‐Like Constructs Using a Melt Electrohydrodynamic Writing Process
Authors: Zaeri Ahmadreza , Cao Kai , Zhang Fucheng , Zgeib Ralf , Chang Robert C.
Published: May 2024

Advanced manufacturing of 3D‐structured materials enables the production of biomimetic muscle tissues. While models of muscle tissue exist, current approaches possess a limited ability to capture essential elements of the muscle tissue microarchitecture. Therefore, this paper aims to engineer the intrinsically complex muscle spindle‐like ellipsoid geometry using a polymer melt‐based electrohydrodynamic (EHD) printing system. EHD systems have conventionally reported fiber deposition in a layerwise fashion. However, without mitigation, the observed fiber sagging and residual charge phenomena for the melt electrowriting (MEW) process limit the ability to produce layered fibrous 3D constructs with in‐plane fiber alignment. However, in this work, fiber sagging and residual charge phenomena are leveraged as part of the design intent to deposit nonoverlapping suspended fibers between two stationary walls toward spindle‐like construct fabrication. Specifically, herein the structural and mechanical properties of the MEW‐enabled spindle‐like constructs are analyzed as a function of the process and design parameters that govern control over fiber sagging and residual charge. The results indicate that the collector speed and wall‐to‐wall distance are the key parameters for tuning the spindle morphology. Moreover, cycle number and fiber diameter are identified as effective parameters for tuning the spindle mechanical properties.
The hyperellipsoidal system
Authors: Dassios George
Published: May 2024

One hundred ninety years ago, Lamé introduced the celebrated ellipsoidal system, which is an orthogonal curvilinear system that incorporates any anisotropic characteristics of three‐dimensional space. Since then, the theory of ellipsoidal harmonics has been successfully developed, but almost nothing has been achieved for ellipsoidal waves. This is due to the fact that, in order to deal with the ellipsoidal harmonics, Lamé introduced some ingenious arguments that led to a complete spectral theory for the Kernel space of the Laplacian, but no such arguments have been proposed for the Kernel space of the d'Alembert operator. So, one possible approach to develop a method that will give us ellipsoidal wave functions is to try to generalize the Lamé arguments (to the extent that this is possible) to four‐dimensional ellipsoidal harmonics. This procedure will give us the hyperellipsoidal harmonics. Then we can replace the fourth coordinate by
in order for the four‐dimensional Laplace operator to become the three‐dimensional wave operator of d'Alembert and the four‐dimensional harmonics to become three dimensional waves. The present work is the first stage of this project. It develops the geometry of a four‐dimensional ellipsoidal system and calculates the Laplace operator in this hyperellipsoidal system.
Deep Learning Method for Rapid Simultaneous Multistructure Temporal Bone Segmentation
Authors: Neves Caio A. , Chemaly Trishia El. , Fu Fanrui , Blevins Nikolas H.
Published: May 2024

Objective

To develop and validate a deep learning algorithm for the automated segmentation of key temporal bone structures from clinical computed tomography (CT) data sets.

Study Design

Cross‐sectional study.

Setting

A total of 325 CT scans from a clinical database.

Method

A state‐of‐the‐art deep learning (DL) algorithm (SwinUNETR) was used to train a prediction model for rapid segmentation of 9 key temporal bone structures in a data set of 325 clinical CTs. The data set was manually annotated by a specialist to serve as the ground truth. The data set was randomly split into training (n = 260) and testing (n = 65) sets. The model's performance was objectively assessed through external validation on the test set using metrics including Dice, Balanced accuracy, Hausdorff distances, and processing time.

Results

The model achieved an average Dice coefficient of 0.87 for all structures, an average balanced accuracy of 0.94, an average Hausdorff distance of 0.79 mm, and an average processing time of 9.1 seconds per CT.

Conclusion

The present DL model for the automated simultaneous segmentation of multiple structures within the temporal bone from CTs achieved high accuracy according to currently commonly employed objective analysis. The results demonstrate the potential of the method to improve preoperative evaluation and intraoperative guidance in otologic surgery.
Health‐Related Quality of Life in Patients With a Stable or Growing Vestibular Schwannoma Managed by Wait and Scan or Stereotactic Radiosurgery
Authors: Pruijn Ineke M.J. , Parmaksiz Merve , Verheul Jeroen B. , Mulder Jef J.S. , Kievit Wietske , Kunst Henricus P.M.
Published: May 2024

Objective

To assess the effect of wait and scan (W&S) and stereotactic radiosurgery (SRS) on health‐related quality of life (HRQoL) over time in patients with a stable vestibular schwannoma (VS) and growing VS.

Study Design

Longitudinal, multicenter, observational study.

Setting

Tertiary expert center for VS (Radboudumc Nijmegen) and Gamma‐Knife center ETZ Hospital Tilburg.

Methods

Changes in HRQoL, measured with the Penn Acoustic Neuroma Quality‐of‐Life (PANQOL), and the physical and mental component summary scores (PCS and MCS, respectively) derived from the 36‐Item Short Form Health Survey (SF‐36), were compared among patients managed by W&S and SRS between 2017 and 2022. Second, HRQoL over time in patients with a growing VS was compared between W&S and SRS.

Results

Differences in PANQOL total and subdomain scores, PCS and MCS scores over time in the W&S (n = 73) and SRS (n = 170) groups were nonsignificant and on average did not exceed the minimal clinically important differences (mean difference of −2.56 [PANQOL total], 1.22 [PCS], and −1.76 [MCS]; all P > .05). In growing VS, comparison of W&S (n = 29) and SRS (n = 154) also revealed no significant difference (mean difference of 1.19 (PANQOL total), 1.83 (PCS) and −0.12 (MCS); all P > .05).

Conclusion

Differences in HRQoL in patients with VS are minor and not significantly different or clinically relevant between patients managed with W&S or SRS. Similarly, patients with a growing VS managed with W&S or SRS exhibit no significant or clinical relevant difference in HRQoL during follow‐up. This can aid clinicians in the counseling of patients regarding HRQoL when deciding on a management strategy after diagnosis or documented growth.
Over‐The‐Counter Hearing Aids: Are They Safe and Effective?
Authors: Shah Rema , Wilkins Sarah G. , Panth Neelima , Tyagi Sidharth , Dunn Hannah , Bell Moira D. , Norgaard Sophie , Guyer Elizabeth , Schwartz Nofrat
Published: May 2024

Objective

In 2022, the Food and Drug Administration established a new regulatory category for over‐the‐counter (OTC) hearing aids for mild to moderate hearing loss. Herein, we aim to better compare the safety and efficacy of these devices to that of prescription hearing aids.

Study Design

Comparative‐effectiveness model.

Setting

Academic Audiology Center.

Methods

The safety and efficacy of prescription and OTC hearing aids was compared using the AudioScan Verifit 2 Testbox software. Three types of hearing loss (downsloping, sharp downsloping, and reverse sloping) were analyzed. Efficacy was tested at 3 volume inputs and was measured by calculating the average difference in test points (produced by the devices) and target points (estimated by the software). Safety was assessed by calculating the average difference in test points and the maximally safe hearing level (produced by the software).

Results

Prescription hearing aids were found to have a better safety profile by being further from the safety threshold compared to OTC devices at the 8000 Hz frequency for the 2 types of downsloping hearing loss patterns studied (48 vs 30.5 dB, P = .04; 51 vs 32.5 dB, P = .03). Prescription hearing aids also carried a statistically significant advantage at 3 test points. OTC hearing aids generally had a greater difference between test and target points.

Conclusion

OTC and prescription hearing aids are comparably safe, though OTC hearing aids are slightly less efficacious. Further evaluation of the OTC hearing aid efficacy is warranted to ensure it provides the gain of benefit needed for different types of hearing loss.
The Use of Chatbots in Head and Neck Mucosal Malignancy Treatment Recommendations
Authors: Washington Caretia J. , Abouyared Marianne , Karanth Shama , Braithwaite Dejana , Birkeland Andrew , Silverman Dustin A. , Chen Si
Published: May 2024

Objective

As cancer patients increasingly use chatbots, it is crucial to recognize ChatGPT's potential in enhancing health literacy while ensuring validation to prevent misinformation. This study aims to assess ChatGPT‐3.5's capability to provide appropriate staging and treatment recommendations for head and neck mucosal malignancies for vulnerable populations.

Study Design and Setting

Forty distinct clinical vignettes were introduced into ChatGPT to inquire about staging and treatment recommendations for head and neck mucosal malignancies.

Methods

Prompts were created based on head and neck cancer (HNC) disease descriptions (cancer location, tumor size, lymph node involvement, and symptoms). Staging and treatment recommendations according to the 2021 National Comprehensive Cancer Network (NCCN) guidelines were scored by three fellowship‐trained HNC surgeons from two separate tertiary care institutions. HNC surgeons assessed the accuracy of staging and treatment recommendations, such as the completeness of surgery and the appropriateness of treatment modality.

Results

Whereas ChatGPT's responses were 95% accurate at recommending the correct first‐line treatment based on the 2021 NCCN guidelines, 55% of the responses contained inaccurate staging. Neck dissection was incorrectly omitted from treatment recommendations in 50% of the cases. Moreover, 40% of ChatGPT's treatment recommendations were deemed unnecessary.

Conclusion

This study emphasizes ChatGPT's potential in HNC patient education, aligning with NCCN guidelines for mucosal malignancies, but highlights the importance of ongoing refinement and scrutiny due to observed inaccuracies in tumor, nodal, metastasis staging, incomplete surgery options, and inappropriate treatment recommendations. Otolaryngologists can use this information to caution patients, families, and trainees regarding the use of ChatGPT for HNC education without expert guidance.
Evaluation of Cochlear Implantation in Children With Cochlear Nerve Absence or Deficiency
Authors: Shakhtour Leyn B. , Song Sophia , Orobello Nicklas C. , Garrett Samuel , Ambrose Tracey , Behzadpour Hengameh K. , Vezina Gilbert , Preciado Diego A. , Reilly Brian K.
Published: May 2024

Objective

To identify associations between cochleovestibular anatomy findings and hearing outcomes found in children with imaging evidence of an absent or hypoplastic cochlear nerve treated with cochlear implantation (CI).

Study Design

retrospective review.

Setting

Cochlear implant program at tertiary care center.

Methods

A retrospective review was performed to identify children with imaging evidence of cochlear nerve absence or deficiency who underwent CI evaluation. High‐resolution 3‐dimensional T2‐weighted magnetic resonance imaging in the oblique sagittal and axial planes were reviewed by a neuroradiologist to identify cochleovestibular anatomy. Hearing was assessed pre and postoperatively with Speech Perception Category scores.

Results

Seven CI recipients were identified (n = 10 ears) who had bilateral severe to profound sensorineural hearing loss with lack of auditory development with binaural hearing aid trial and imaging evidence of cochlear nerve aplasia/hypoplasia. All ears had 2 nerves in the cerebellopontine angle (100%, n = 10), half of the ears had evidence of 2 or less nerves in the internal auditory canal (IAC). All children showed large improvement in speech perception after CI.

Conclusion

Our experience with CIs for children with absent or hypoplastic cochlear nerves demonstrates that CI can be a viable option in select patients who satisfy preoperative audiological criteria. Radiological identification of a hypoplastic or aplastic cochlear nerve does not preclude auditory innervation of the cochlea. CI recipients in this subgroup must be counseled on difficulty in predicting postimplantation language and speech outcomes, and cautioned about facial nerve stimulation.
Theoretical prediction model for the compressive behavior of the hybrid tube considering compression angle
Authors: Liu Baichuan , Liang Hongyu , Pu Yongfeng , Wang Dengfeng , Chen Jing , Ma Wenting , Hu Qinchao
Published: May 2024

The oblique collision happening in vehicle accidents poses a huge threat to passive safety, which causes great difficulties in the design of energy absorption (EA) structures and the prediction of EA capacity due to its highly nonlinear deformation characteristics. This study aims to establish a theoretical prediction model for the compression performance of Carbon Fiber Reinforced Polymer (CFRP)/Al hybrid tube considering the loading angle. First, a high‐precision FE model was established to obtain the influence laws of tube diameter, Al thickness, and CFRP thickness on the crashworthiness of CFRP/Al hybrid tubes, laying the foundation for subsequent theoretical model validation. Second, by summarizing the deformation modes of hybrid tubes generated by various parameter combinations, a modified global origami deformation assumption was proposed under multi‐angle compression conditions, and the key terms in energy composition are extracted based on the initial and final states of folding elements. Third, a theoretical model for predicting the mean crushing forces (MCFs) of hybrid tubes was established by revealing the correlation mechanism between energy composition terms and loading angle. Finally, the theoretical prediction model was validated by experiment and simulation results and the application premise was given. Results showed that the theoretical prediction model was proved to be of high accuracy, as the average absolute prediction errors of MCF under axial, 10°, 20°, and 30° compression conditions were 6.54%, 4.63%, 3.72%, and 3.93%, respectively. This study provides valuable guidance for the forward design and development of multi‐material hybrid structures facing complex crushing conditions.

Highlights

An analytical model of the hybrid circular tubes considering compression angle is newly proposed.

Deformation mode and axial crushing response are analyzed by experiments.

The major energy dissipation mechanism for hybrid circular tubes is explicitly derived.

The Al thickness has the most significant impact on energy absorption.

The recommendations for the design and development of hybrid tube are provided.
Phase behavior of rubber and supercritical CO2: Operating parameters and swelling characteristics
Authors: Li Xiang , Deng Xiaoqing , Liu Jianxin , Zhang Xiaolei
Published: May 2024

This study aims to compare the difference in the swelling process between styrene butadiene rubber (SBR) and natural rubber (NR) in ScCO2. A high‐pressure visual stainless‐steel autoclave was used to carry out swelling measurements based on the sample dimensions. The swelling rates for both rubbers followed a first‐order kinetic model. The diffusion coefficient for CO2 was determined from the change in the swelling degree with time. The shrinking process for the expanded rubber obeyed a second‐order kinetic model. A 2‐level full factorial experimental design was employed to discuss the influence of variables on rubber swelling and CO2 diffusion. Temperature and pressure were found to have a great influence on the equilibrium swelling degree, swelling rate and diffusion coefficient. For both SBR and NR, the maximum equilibrium swelling degrees were observed at 120°C and 20 MPa, yielding values of 1.18 and 1.16, respectively. The maximum diffusion coefficient reached approximately 3 × 10−9 m2 s−1 for both types of rubber at 120°C and 8 MPa. The crosslink density failed to affect these three responses, but the volume of expansion and the shrinkage rate were found to significantly decrease and increase, respectively, with increasing crosslink density. The motion of polymer segments forced by ScCO2 led to rearrangement of the material structure, which governed the nature of swelling, expansion, and shrinkage. Due to a lower number of entanglements and a weak electrostatic interaction exists between CO2 and the π‐system, SBR can absorb more CO2 and easily restructure than NR under the same conditions, resulting in higher equilibrium swelling degree, larger expansion and faster shrinkage than NR.

Highlights

Swelling of nature rubber and styrene‐butadiene rubber in ScCO2 is compared.

Swelling degree is positively correlated with temperature and pressure.

Diffusion coefficient increases with temperature but decreases with pressure.

Swelling degree varies with rubber type, while CO2 diffusion dose not.

Crosslink density significantly affects expansion and shrinkage of rubber.
School psychologists' perceptions, roles, and training regarding sexual health education for students with intellectual and developmental disabilities
Authors: Stair Anne C. , Roach Andrew T. , Graybill Emily C. , Perkins Catherine A. , Barger Brian , Mason Erin C.
Published: May 2024

Despite research indicating evidence‐based sexual health education results improved student outcomes, students with intellectual and developmental disabilities (I/DD) do not typically receive sexual health education. While school psychologists possess skills that could contribute to sexual health education for students with I/DD, there is no existing research on this topic. To address this, we conducted a survey of school psychologists in a state in the Southeastern United States regarding their attitudes, perceptions of social norm and self‐efficacy, and training and familiarity in regard to sexual health education for students with I/DD. The survey's focus and design were guided by the Reasoned Action Approach. Data collection and analyzes addressed (a) the underlying structure and internal consistency of our survey's scales; (b) school psychologists' level of training, knowledge, and beliefs about implementing sexual health education programs with students with I/DD; and (c) the relationship between school psychologists' previous training, knowledge, and beliefs and their implementation of and advocacy for sexual health education for students with I/DD. Descriptive statistics, principal component analyzes, and multiple regression were used to summarize the data and address the research questions. Data from the multiple regression analysis indicated that a significant amount of the variance in participants' implementation/advocacy scores was explained by attitude, social norms, behavioral control/self‐efficacy, and training/familiarity. Our findings suggest that school psychologists' engagement in implementation of and advocacy for sexual health education for students with I/DD can be influenced by level of training and knowledge and perceived capability and behavioral control.
Effects of rapid maxillary expansion on upper airway parameters in OSA children with maxillary restriction: A CBCT study
Authors: Zreaqat Maen , Hassan Rozita , Alforaidi Sahal , Kassim Nur Karyatee
Published: May 2024

Background

Rapid maxillary expansion (RME) has been proposed as an effective treatment for pediatric obstructive sleep apnea (OSA) and maxillary restriction in children. This study aimed to evaluate the effect of RME appliances on the nasomaxillary complex dimensions in children with OSA and maxillary constriction.

Methods

This prospective longitudinal study included 34 children aged 8–12 years with maxillary restriction and OSA confirmed by polysomnography who had completed RME therapy. The nasomaxillary complex is segmented into the nasal cavity, maxillary sinuses, and nasopharynx. The effect of RME on nasomaxillary complex dimensions was assessed pre and posttreatment using cone‐beam computed tomography, analysis, while a second standard overnight polysomnography (PSG) was performed to assess changes in respiratory parameters.

Results

Significant improvements were observed, including inferior maxillary dislocation (S‐S1 distance and N‐ANS), increased anterior and posterior facial height, and a 5.43 events/h reduction in Apnea‐Hypopnea Index (p < .001). The nasal cavity volume increased by 2439 (±584) mm3 (p < .001), nasopharynx size increased by 883 (±479) mm3 (p = .008), mid cross‐sectional area increased by 31.74 (±14.50) mm2 (p < .001), and the distance between the right and left maxillary sinuses increased by 8.37 (±3.67) mm (p < .001) all exhibited positive changes, with some insignificant variations in volume change (p = .254).

Conclusion

RME treatment was found to be effective in improving nasal cavity and nasopharyngeal dimensions, leading to improved respiratory parameters in children with OSA and maxillary constriction. While these results are promising, considerations about the potential long‐term benefits of RME on future growth are important. The study provides valuable insights into the efficacy of RME as a treatment option for this pediatric population.
Comparison of clinical features of cystic fibrosis patients eligible but not on CFTR modulators to ineligible for CFTR modulators
Authors: Nayır Büyükşahin Halime , Emiralioğlu Nagehan , Yalçın Ebru , Şen Velat , Selimoğlu Şen Hadice , Arslan Hüseyin , Başkan Azer Kılıç , Çakır Fatma Betül , Koray Cem Fırat , Yılmaz Aslı İmran , Ercan Fatih , Altıntaş Derya Ufuk , Serbes Mahir , Keskin Özlem , Arık Elif , Gülen Figen , Barlık Meral , Karcıoğlu Oğuz , Damadoğlu Ebru , Köse Mehmet , Ersoy Ali , Bingöl Ayşen , Başaran Erdem , Çakır Eylül Pınar , Aslan Ayşe Tana , Canıtez Yakup , Korkmaz Merve , Özdemir Ali , Harmancı Koray , Soydaş Şule Selin , Hangül Melih , Yüksel Hasan , Özcan Gizem , Korkmaz Pervin , Kılıç Mehmet , Gayretli Aydın Zeynep Gökçe , Çaltepe Gönül , Can Demet , Doğru Sibel , Kartal Öztürk Gökçen , Süleyman Ayşe , Topal Erdem , Özsezen Beste , Hızal Mina , Demirdöğen Ezgi , Ogun Hamza , Börekçi Şermin , Yazan Hakan , Çakır Erkan , Şişmanlar Eyüboğlu Tuğba , Çobanoğlu Nazan , Cinel Güzin , Pekcan Sevgi , Özçelik Uğur , Doğru Deniz
Published: May 2024

Introduction

Cystic fibrosis transmembrane conductance regulator (CFTR) modulator drugs target the underlying defect and improve CFTR function. They are a part of standard care in many countries, but not all patients are eligible for these drugs due to age and genotype. Here, we aimed to determine the characteristics of non‐eligible patients for CFTR modulators in the CF registry of Turkey (CFRT) to highlight their clinical needs.

Methods

This retrospective cohort study included CF patient data from the CFRT in 2021. The decision of eligibility for the CFTR modulator was determined according to the ‘Vertex treatment‐Finder' on the Vertex® website. Demographic and clinical characteristics of patients were compared between eligible (group 1) and ineligible (group 2) groups for CFTR modulators.

Results

Among the study population (N = 1527), 873 (57.2%) were in group 1 and 654 (42.8%) were in group 2. There was no statistical difference between groups regarding sex, meconium ileus history, diagnoses via newborn screening, FEV1 z‐score, CF‐associated complications, organ transplant history, and death. Patients in group 2 had a higher incidence of pancreatic insufficiency (87.7% vs. 83.2%, p = .010), lower median height z‐scores (−0.87 vs. −0.55, p < .001), lower median body mass index z‐scores (−0.65 vs. −0.50, p < .001), longer days receiving antibiotics due to pulmonary exacerbation (0 [interquartile range, IQR: 0–2] vs. 0 [IQR: 0–7], p = 0.001), and more non‐invasive ventilation support (2.6% vs. 0.9%, p = 0.008) than patients in group 1.

Conclusion

The ineligible group had worse clinical outcomes than the eligible group. This highlights their need for life‐changing drugs to improve clinical outcomes.
Generating synthetic rainfall fields by R‐vine copulas applied to seamless probabilistic predictions
Authors: Schaumann Peter , Rempel Martin , Blahak Ulrich , Schmidt Volker
Published: May 2024

Many post‐processing methods improve forecasts at individual locations but remove their correlation structure. However, this information is essential for forecasting larger‐scale events, such as the total precipitation amount over areas like river catchments, which are relevant for weather warnings and flood predictions. We propose a method to reintroduce spatial correlation into a post‐processed forecast using an R‐vine copula fitted to historical observations. The method rearranges predictions at individual locations and ensures that they still exhibit the post‐processed marginal distributions. It works similarly to well‐known approaches, like the “Schaake shuffle” and “ensemble copula coupling.” However, compared to these methods, which rely on a ranking with no ties at each considered location in their source for spatial correlation, the copula serves as a measure of how well a given arrangement compares with the observed historical distribution. Therefore, no close relationship is required between the post‐processed marginal distributions and the spatial correlation source. This is advantageous for post‐processed seamless forecasts in two ways. First, meteorological parameters such as the precipitation amount, whose distribution has an atom at zero, have rankings with ties. Second, seamless forecasts represent an optimal combination of their input forecasts and may spatially shifted from them at scales larger than the areas considered herein, leading to non‐reasonable spatial correlation sources for the well‐known methods. Our results indicate that the calibration of the combination model carries over to the output of the proposed model, that is, the evaluation of area predictions shows a similar improvement in forecast quality as the predictions for individual locations. Additionally, the spatial correlation of the forecast is evaluated with the help of object‐based metrics, for which the proposed model also shows an improvement compared to both input forecasts.
Synergizing social sustainability and technological innovation for carbon neutrality in OECD economies
Authors: Wang Yiwen , Hanif Nadia , Arshed Noman , Hussain Muzzammil , Arshad Zeeshan , Usman Muhammad
Published: May 2024

Economies around the globe are pushing toward a society's sustainability perspectives and upgradation in technology to protect the environment from global warming and the depletion of energy supplies. This shift in perception is primarily intended to alter people's attitudes toward posterity. By integrating the theories of interactions between social and ecological systems and the environment Kuznets curve (EKC) framework, this study explores the impact of nonrenewable energy consumption, social sustainability, and technological innovation on CO₂ emissions across the Organization for Economic Co‐operation and Development (OECD) countries from 2001 through 2020. Based on the estimates of FMOLS, PARDL, and QARDL, the 10‐year CO2 emissions and gross domestic product projections are traced using the average growth rate for each country and an average value of independent variables. The findings of this study highlight the detrimental effect of nonrenewable energy consumption on CO₂ emissions, underscoring the urgency for sustainable energy alternatives. However, the positive role of social sustainability and technological innovation in curbing CO₂ emissions within OECD countries is equally significant. Accentuating the importance of social sustainability within this context, the study sheds light on the integral role that societal factors, such as education, public awareness, and social well‐being, play a substantial role in shaping sustainable practices. It is found that Brazil, China, Malaysia, Russia, South Africa, and Thailand need to focus on higher economic growth to experience decarbonizing economic growth.
Exploring student teachers' latent coping profiles and their relations to perceived stress and stressors
Authors: Schlesier J. , Westphal A.
Published: May 2024

As coping profiles can offer concrete intervention opportunities, the goal of the present study is to explore latent coping profiles in a sample of 316 student teachers at a German university, using the Brief COPE inventory (Carver, 1997). Furthermore, we aim to test the extent to which students with specific coping profiles differ in the levels of stress (PSS; Schneider et al., 2020) and stressors they perceive. Latent profile analysis (LPA) reveals that a six‐profile solution shows the optimal fit, with high entropy. The six profiles include two more support‐seeking coping profiles (networking and disengaged copers), withdrawn, cognitive restructuring, avoidant and repertoire‐oriented copers. Both more support‐seeking coping profiles used in particular strategies concerning seeking social and emotional support, and are associated with less stress. Avoidant and withdrawn copers show unfavourable perceptions of stress levels and stressors. Thus, programs to promote social‐emotional support should be implemented in teacher training courses.
Computational Hyperspectral Microflow Cytometry
Authors: Yun Hyo Geun , Cadierno Yoel Alonso , Kim Tae Won , Muñoz‐Barrutia Arrate , Garica‐Gonzalez Daniel , Choi Sungyoung
Published: May 2024

Miniaturized flow cytometry has significant potential for portable applications, such as cell‐based diagnostics and the monitoring of therapeutic cell manufacturing, however, the performance of current techniques is often limited by the inability to resolve spectrally‐overlapping fluorescence labels. Here, the study presents a computational hyperspectral microflow cytometer (CHC) that enables accurate discrimination of spectrally‐overlapping fluorophores labeling single cells. CHC employs a dispersive optical element and an optimization algorithm to detect the full fluorescence emission spectrum from flowing cells, with a high spectral resolution of ≈3 nm in the range from 450 to 650 nm. CHC also includes a dedicated microfluidic device that ensures in‐focus imaging through viscoelastic sheathless focusing, thereby enhancing the accuracy and reliability of microflow cytometry analysis. The potential of CHC for analyzing T lymphocyte subpopulations and monitoring changes in cell composition during T cell expansion is demonstrated. Overall, CHC represents a major breakthrough in microflow cytometry and can facilitate its use for immune cell monitoring.