bluuebunny/crossref_metadata_2025 huggingface dataset:
Probabilistic State Estimation Under Varying Loading States via the Integration of Time-Varying Autoregressive and Gaussian Process Models
Authors: Amer Ahmad , Ahmed Shabbir , Kopsaftopoulos Fotis
Published: February 2024

In this work, probabilistic damage quantification under varying loading conditions in a non-stationary, guided-wave environment is being tackled via the synergistic integration between Time-varying Autoregressive (TAR) models and Gaussian Process regression models (GPRMs). Applying these TAR-GPRMs onto an aluminum coupon with simulated damage under different loading conditions fitted with piezoelectric sensors/actuators, the TAR models show the capability of capturing the non-stationarity in the ultrasonic guided-wave signals generated by the actuators under varying plate-loading conditions. They also provide insights to the maintainer by showing when in time the guided-wave time series deviate the most. In order to take advantage of that, a time instant selection algorithm was developed to allow flexibility in choosing the time instant(s) at which probabilistic damage quantification should be done. Finally, this quantification task is tackled by GPRMs, in which multiple GPRMs are trained using the TAR model parameters under varying conditions, and then used to predict damage size and/or loading state. While this framework is much more powerful in terms of tapping into the dynamics of how guided-waves change with varying conditions compared to simpler forms of GPRMs (such as damage index-trained GPRMs), training of TAR-GPRMs is far more complex. The advantages and challenges associated with the proposed TAR-GPRM approach is presented herein along with potential open areas for research in this regard.
An adaptable rotated bounding box method for automatic detection of arbitrary-oriented cracks
Authors: An Yonghui , Kong Lingxue , Hou Chuanchuan , Ou Jinping
Published: February 2024

Concrete crack detection is a crucial task for the safety and durability of engineering structures. Extensive research has been conducted on deep-learning methods employing horizontal bounding boxes (HBBs) for crack detection. However, due to the inherently random distribution of concrete cracks, HBB-based methods often produce excessive overlaps and encompass extensive background regions, obstructing the effective interpretation and adaptation of the detection results. To address this issue and achieve efficient utilization of bounding box space for detecting cracks at any orientation, a rotated bounding box (RBB)-based method, that is, Rotated Faster R-CNN with a post processing strategy (RFR-P), was proposed. To realize this method, an RBB-based crack annotation strategy was introduced to standardize the annotation baseline for the evolutionarily established RBB-based crack detection dataset. Then, an RBB-based post-processing strategy was inventively developed to quantify the patterns of cracks with their corresponding rotation angles encompassing longitudinal cracks, transverse cracks, and diagonal cracks. Subsequently, experimental results showed that the RFR-P method provides more reasonable and elaborate detection results in terms of crack distribution patterns when compared to HBB-based methods. Based on the comprehensive consideration of evaluation metrics and detected results, it can be concluded that the RFR-P is aptly designed for detecting cracks at any rotation angle with relatively high accuracy. Finally, an RBB-based concrete crack detection platform was established to automatically detect in situ concrete bridge cracks for real-world applications. The proposed RFR-P model introduces a new perspective on crack detection methods and offers practical references for structural condition evaluation.
Enhanced adaptive high-frequency resonance technology for bearing fault detection
Authors: Li Hua , Wang Tianyang , Zhang Feibin , Chu Fulei
Published: February 2024

The traditional high-frequency resonance technology has two disadvantages: (1) The resonance frequency (RF) is obtained by using Fourier spectrum (FS) and the bandwidth is obtained based on experience, and the effect is often poor due to severe noise interference; (2) the separation of compound faults is not considered. After systematic research, a feasible fault detection methodology named enhanced adaptive high-frequency resonance technology is summarized and introduced, which is on the basis of power spectrum (PS) analysis, abbreviated as enhanced adaptive high-frequency resonance technique based on power spectrum (PS-EAHFRT), to realize the single fault detection and compound fault separation of bearing. Firstly, the theoretical values of various bearing fault modes are calculated to establish a database. Then, a series of spectral peaks are obtained by performing PS analysis, and each prominent spectral peak is considered as an alternative RF, that is, an alternative central frequency. Then, the bandwidth calculation formula of the bandpass filter is given, and the optimal bandwidth parameter is calculated by using the signal envelope kurtosis as a sparse measure. Finally, the original signal is denoised by the optimized band-pass filter, and then the filtered signal is demodulated by envelope PS analysis, and compared with the theoretical value in the library, and then the fault category is obtained. Simulated and real-world bearing cases are used to demonstrate the effectiveness and advantages of PS-EAHFRT. It is demonstrated that the PS-EAHFRT can effectively realize the bearing single fault detection and the compound fault separation. Moreover, the lower bound of the frequency interval in which this method can achieve bearing composite fault separation is explored.
A novel feature extraction method: iterative Ramanujan Fourier mixture spectrum
Authors: Cheng Jian , Pan Haiyang , Zheng Jinde
Published: February 2024

As a classical demodulation method, envelope spectrum (ES) has been used in rotating machinery fault diagnosis. However, for strong noise or multiple faults, the feature extraction ability of ES is not outstanding, even if it is unable to extract obvious fault features. Fourier transform (FT) in ES analysis is also not suitable for analyzing non-stationary signals. Considering the shortcomings of FT, this paper defines the Ramanujan Fourier mixture transform (RFMT). The RFMT has outstanding period feature extraction ability and can accurately extract the periodic features in the envelope signal. Based on this, this paper proposes the iterative Ramanujan Fourier mixture spectrum (IRFMS) method. The IRFMS enhances the fault features in the signal by iterative envelope and selects the envelope signals with obvious fault features by cyclic kurtosis. The results of signal analysis verify that IRFMS has excellent fault feature extraction ability, which is suitable for various fields of rotating machinery fault diagnosis.
Quantitative blade damage detection based on multisource domain and multistage joint transfer
Authors: Shen Junxian , Ma Tianchi , Song Di , Xu Feiyun
Published: February 2024

For blade damage detection under variable rotational speeds of centrifugal fans, transfer learning under working conditions appears to be more effective than deep learning. However, damage detection models with small samples and single-source domain transfer are still characterized by insufficiencies, such as negative transfer and poor accuracy. Therefore, in this paper, a quantitative blade damage detection method based on multisource domain and multistage joint transfer is proposed. First, an anchor adapter is constructed using linear discriminant analysis projection combined with a feature similarity index metric to acquire the weight matrix of multisource domain-target domain data. Second, a multisource domain feature extractor based on the fusion of vibroacoustic information is established, obtaining the feature set of the target domain data. Then, the feature set is filtered through information gain and max-relevance and min-redundancy to remove the negative transfer features and is combined with an improved supervised locally linear embedding to build a subspace structure preservation model for the alignment between the source and target domain feature distributions. Finally, the classifier is fine-tuned with small sample data for quantitative damage detection of blades with variable rotational speeds. The proposed method is verified using experimental data from two centrifugal fans. The results show that the detection accuracy of the proposed model is significantly higher than that of any comparison model with a single source domain or single stage. Compared with other transfer models, the proposed method is characterized by higher detection accuracy and generalization performance.
Non-contact impact load identification based on intelligent visual sensing technology
Authors: Zhang Shengfei , Ni Pinghe , Wen Jianian , Han Qiang , Du Xiuli , Xu Kun
Published: February 2024

Accurate identification of impact loads is vital for structural assessment and design. Traditional methods rely on complex equipment, such as accelerometers or strain gauge, which can be expensive and prone to failure. This study introduces a non-contact intelligent identification approach incorporating visual sensing technology, providing a convenient means to identify impact loads. Numerical simulations explore the differences in identifying impact forces through acceleration and displacement responses, particularly by considering such variables as measurement noise and number of measurement points. A meticulously designed experiment verified the feasibility of the proposed method for measuring the displacement and velocity of rapidly moving targets, and evaluated its performance in terms of accuracy. A series of impact loading experiments were conducted on a simply supported girder bridge model to validate the effectiveness of the proposed impact force identification method. Results indicate strong agreement between displacement response measurements and percentile meters. The proposed non-contact method accurately identifies single or continuous impact loads, with a minimum peak relative error of 0.2%. This study represents a pioneering application of intelligent visual sensing technology in the field of impact load identification. Moreover, the current research introduces a novel approach to address the challenges faced by conventional methods in identifying impact loads. Future research can leverage the groundwork laid by this study to further optimize and expand the proposed method, enhancing its capabilities and fully harnessing its potential to offer advanced solutions in structural health monitoring.
Enhanced antimicrobial performance of textiles coated with TiO2 nanoparticles
Authors: Salama Khaled F , AlJindan Reem , Alfadhel Ahmed , Akhtar Sultan , Al-Suhaimi Ebtesam A
Published: February 2024

Modifying cotton fabrics to obtain significant new properties is of relevance to creating multifunctional textiles that could address challenges across different sectors. One of the critical challenges associated with textiles is hospital-acquired infections, which could be prevented through the utilization of antimicrobial fabrics. Titanium dioxide (TiO2) nanoparticles (NPs) have been introduced in literature for their photocatalytic antibacterial applications against prevalent microorganisms, such as Escherichia coli and Staphylococcus aureus. A newly developed coating process was utilized that includes chemical modification and nanocoating of cotton fabrics to achieve safe to use products that demonstrate durable and highly effective antibacterial properties. Thorough characterization was conducted to analyze the properties of the utilized materials and investigate the quality of the NPs coating on the cotton fabrics. Bacterial cultures and colony counts were performed using standard microbiological techniques. Bacterial studies revealed that the TiO2 NPs coated textile exhibited a significant antibacterial property with 99.99% bacteria growth reduction for S. aureus and E coli, in comparison to the control cotton fabrics. Coating durability analysis was also conducted by washing the coated fabrics using a standard protocol and repeating the qualitative and antibacterial characterization. The durability study revealed the outstanding performance of the coating technology to withstand at least 40x intensive washing cycles with >98% bacteria growth reduction for S. aureus and E coli. These results demonstrate the effectiveness and commercial suitability of the presented process to produce cotton textiles with outstanding antimicrobial properties that can reduce hospital-obtained infections.
Novel Journal Metrics in Cardiothoracic Surgery: How Different Are Contemporary Metrics From the Impact Factor?
Authors: Martins Russell Seth , Ahmed Warda , Barolia Mehak , Poulikidis Kostantinos , Weber Joanna , Latif M. Jawad , Razi Syed Shahzad , Bhora Faiz Y.
Published: February 2024

Objective:

Despite shortcomings, impact factor (IF) remains the “gold standard” metric for journal quality. However, novel metrics including the h-index, g-index, and Altmetric Attention Score (AAS; mentions in mainstream/social media) are gaining traction. We assessed correlations between these metrics among cardiothoracic surgery journals.

Methods:

For all cardiothoracic surgery journals with a 2021 Clarivate IF ( N = 20), the 2-year IF (2019 to 2020) and 5-year IF (2016 to 2020), h-index, and g-index were obtained. Two-year journal-level AAS (2019 to 2020) was also calculated. Journal Twitter presence and activity was sourced from Twitter and the Twitter application programming interface. Correlations were assessed using Spearman correlation, and coefficients of determination were calculated.

Results:

IF demonstrated a moderate–strong positive correlation with the h-index ( rs = 0.48 to 0.77) and g-index ( rs = 0.49 to 0.79) and a moderate correlation with AAS ( rs = 0.53 to 0.58). The 2-year IF accounted for 25% to 49% of variability in the h-index, 27% to 55% of variability in the g-index, and 32% of variability in the AAS. Among journals with a Twitter account ( N = 10), IF was strongly correlated with Twitter following ( rs = 0.81 to 0.86), which was in turn strongly correlated with journal AAS ( rs = 0.79). Article-level AAS was moderately correlated with citation count ( rs = 0.47).

Conclusions:

IF accounted for only between 25% and 55% of variability in the h-index and g-index, indicating that these newer metrics measure unique dimensions of citation-based impact. Thus, the academic community must familiarize itself with these newer journal metrics. Social media attention may be associated with scholarly impact, although further work is needed to understand these relationships.
Robot-Assisted Thoracoscopic Resection of Ectopic Parathyroid Tissue in Mediastinum: A Scoping Review
Authors: Anemoulis Marios , Kachtsidis Vasileios , Geropoulos Georgios , Panagiotopoulos Nikolaos
Published: February 2024

Ectopic parathyroid tissue in the mediastinum represents a rare and potentially serious clinical entity with challenging diagnostic and surgical management. The main surgical approach for this issue is open thoracotomy, which is a safe technique but carries risks and complications associated with such as extensive surgery. The purpose of this study is to demonstrate robotic thoracic surgery as an alternative and potentially advantageous method to treat patients with ectopic parathyroid adenomas compared with open and video-assisted thoracoscopic surgery approaches. A total of 13 reports in the literature were identified that provided details in terms of complications, surgical approach, and results of minimally invasive surgical resection of mediastinal ectopic parathyroid tissue.
Outcomes for children with autism spectrum disorder and their families after two years of school based early intensive behavioural intervention
Authors: Grey Ian , Brennan Deirdre , Cody Brettjet
Published: February 2024

The effectiveness of a school based Early Intensive Behavioural Intervention (EIBI) program was assessed over a two-year period for a cohort of 16 pre-school children with autism spectrum disorder (ASD) and their families. Children with a mean age of 40 months, were assessed prior to intervention, after 1 year of intervention, and again after 2 years. Significant improvements were observed on measures of adaptive behaviour, communication ability and challenging behaviour. Parents of children attending the program also reported increased familial quality of life, specifically improved emotional and physical well-being and increased parenting capacity over the duration of the program. The current study suggests that EIBI for young children with ASD can be effective in facilitating improvements in communication ability, reducing challenging behaviours and improving quality of life for families. Children’s pre-intervention adaptive skills appeared to be the strongest predictor of post intervention gains as initial level of adaptive ability was positively related to improved post-intervention outcomes.
An audit of postoperative haemodynamic stability after intraoperative labetalol administration in non-cardiac surgery patients
Authors: Cairns Benjamin B , McNeil Megan V , Milne Andrew D
Published: February 2024

Anaesthesiologists commonly use intravenous labetalol to adjust patient haemodynamics during surgical procedures. Cases of profound hypotension after continuous labetalol infusions have been reported; however, there is limited evidence regarding the safety of intraoperative labetalol boluses. This audit examined the frequency of postoperative hypotension and bradycardia in 292 adult non-cardiac surgery patients treated with intraoperative labetalol boluses. Blood pressure and heart rate data were collected from the post-anaesthesia care unit and on the floor units for 24 hours after surgery. The median total intraoperative labetalol dose was 10mg. A total of 30/292 patients had all-cause postoperative hypotension within 24 hours of surgery, 26 of which had other medical or surgical precipitants. Fifteen patients developed bradycardia. There were no deaths or intensive care unit admissions attributed to labetalol. This audit demonstrates a low risk of all-cause postoperative hypotension (10%) and bradycardia (5%) after the use of small IV doses of intraoperative labetalol.
Cytokines (IL1β, IL6, TNFα) and serum cortisol levels may not constitute reliable biomarkers to identify individuals with post-acute sequelae of COVID-19
Authors: Fleischer Michael , Szepanowski Fabian , Mausberg Anne K , Asan Livia , Uslar Ellen , Zwanziger Denise , Volbracht Lothar , Stettner Mark , Kleinschnitz Christoph
Published: February 2024

Background:

Post-acute sequelae of COVID-19 (PASC) comprise a broad spectrum of symptoms such as fatigue, general weakness, compromised attention and sleep or anxiety disorders. PASC represents a medical and socio-economic challenge.

Objectives:

Our study evaluated cytokines (IL-1β, IL-6 and TNFα) and cortisol levels in a cohort of typical patients with PASC, suffering concentration problems, fatigue and difficulties finding words.

Design:

This was a prospective cohort study. Four groups were analysed and compared: those who had never contracted SARS-CoV-2 ( n = 13), infected but had no PASC ( n = 34), infected with former PASC that resolved ( n = 40) and patients with ongoing PASC after infection ( n = 91).

Methods:

Cytokine and cortisol serum levels were determined in patients’ blood samples.

Results:

Cytokine levels of IL-1β, IL-6, TNFα and cortisol levels did not differ between groups analysed.

Conclusion:

This may indicate a non-organic/psychosomatic genesis of PASC; further studies are needed to elucidate the underlying causes of PACS, and non-organic causes should not be overlooked.
Charcot Neuroarthropathy Is Associated With Higher Rates of Phantom Limb After Lower Extremity Amputation
Authors: Nam Hannah H. , Martinazzi Brandon J. , Lorenz F. Jeffrey , Kirchner Gregory J. , Bonaddio Vincenzo , Adeyemo Adeshina , Walley Kempland C. , Aynardi Michael C.
Published: February 2024

Background

The incidence of phantom limb pain in patients with Charcot neuroarthropathy who undergo major amputation is not well described. The purpose of this study was to determine whether patients with Charcot neuroarthropathy and diabetes who underwent either a below-knee amputation (BKA) or above-knee amputation (AKA) had an increased rate of phantom limb pain compared with those with a diagnosis of diabetes alone.

Methods

Using international classification of disease (ICD) and common procedural terminology (CPT) codes, the TriNetX research database identified 10 239 patients who underwent BKA and 6122 who underwent AKA between 2012 and 2022. Diabetic patients with and without Charcot neuroarthropathy were compared in terms of demographics and relative risk of developing phantom limb pain after AKA or BKA.

Results

Age, sex, ethnicity, and race did not significantly differ between groups. Charcot neuroarthropathy was associated with significantly increased risk of phantom limb pain following both BKA (risk ratio [RR]: 1.2, 95% confidence interval [CI]: 1.1-1.3, P < .01) and AKA (RR: 1.6, 95% CI: 1.2-2.3, P < .0068).

Conclusion

Our results indicate that patients with a coexisting diagnosis of Charcot neuroarthropathy who require BKA or AKA may have an increased risk of developing phantom limb pain.

Levels of Evidence:

Level III
A National Survey on the Relationship of Youth Sport Specialization Behaviors to Self-Reported Anxiety and Depression in Youth Softball Players
Authors: Zeller Anne Marie , Lear Aaron , Post Eric , McNulty Suzanne , Bentley Brett
Published: February 2024

Background:

There are little to no data on whether any associations exist between sport specialization and mental health in youth softball athletes.

Hypothesis:

Highly specialized youth softball athletes will have worse self-reported depression and anxiety symptom scores compared with low and moderate specialized athletes.

Study Design:

Cross-sectional survey.

Level of Evidence:

Level 4.

Methods:

An online cross-sectional survey was distributed in the fall of 2021 to a national sample of female youth softball athletes between the ages of 12 and 18 years. Sport specialization status was determined using a 3-point specialization scale that classifies either low, moderate, or high. The patient health questionnaire-9 (PHQ-9) and the 7-item general anxiety disorder scale (GAD-7) were used to assess self-reported symptoms of depression and anxiety. Comparison also included sports participation and specialization behaviors between specialization groups.

Results:

A total of 1283 subjects (mean age, 15.1 ± 1.7 years) fully completed the survey. After adjusting for covariates, lower scores were reported on both the PHQ-9 and GAD-7 by highly specialized athletes compared with moderate or low specialization athletes (PHQ-9, high = 8.6 ± 0.4; moderate = 11.2 ± 0.3; low = 10.9 ± 0.5; P < 0.01; GAD-7, high = 6.5 ± 0.4; moderate = 8.6 ± 0.3; low = 8.4 ± 0.4, P < 0.01). Conversely, higher scores were reported on both scales for athletes who received private softball coaching compared with those who did not (PHQ-9, 11.5 ± 0.3 vs 9.0 ± 0.3; P < 0.01; GAD-7, 8.8 ± 0.3 vs 6.9 ± 0.3, P < 0.01). Finally, athletes who reported an arm overuse injury in the previous year reported higher PHQ-9 scores (10.8 ± 0.3 vs 9.8 ± 0.3; P < 0.01).

Conclusion:

While sport specialization, as measured by the validated 3-point scale, was not associated with increased anxiety and depression symptom scores, other aspects of specialization behavior such as private coaching or overuse injury history were associated with worse scores on these scales, indicating potential concern for anxiety and depression. However, although the differences we observed were statistically significant, they did not exceed the minimal clinically important difference values that have been established for the PHQ-9 (5 points) or GAD-7 (4 points).

Clinical Relevance:

This project is a first step toward understanding the sport specialization behaviors and their influence on the mental health of youth softball athletes. Focusing on investigating specialization behaviors further may reveal to be a better indicator of risk of developing anxiety and depression symptoms compared with utilizing the 3-point specialization scale.
Application of near-infrared spectroscopy for predicting the wood density of teakwood stands by increment cores and thin wood surface sampling
Authors: Arra’d Sofianto Imran , Dwianto Wahyu , Sudarmanto  , Narto  , Adi Danang Sudarwoko , Triwibowo Dimas , Darmawan Teguh , Amin Yusup , Bahanawan Adik , Sejati Prabu Satria , Damayanti Ratih , Djarwanto  , Rahmanto Raden Gunawan Hadi , Agustiningrum Dyah Ayu , Pari Rohmah , Dewi Listya Mustika , Kusumah Sukma Surya , Augustina Sarah , Marbun Sari Delviana
Published: February 2024

Density, as the most critical information for wood materials could be predicted by near-infrared (NIR) spectroscopy. Increment cores and thin wood samples of teakwood ( Tectona grandis) served as research materials for this new approach to sampling for NIR spectroscopy, explained in detail. Density data were combined with their NIR spectra data for analysis using cross-validation partial least squares regression as chemometrics to produce a density prediction model. A new approach of increment cores from teakwood stands for NIR spectroscopy measurements for density predictions resulting in a 0.34 coefficient of determination for cross-validation (R2CV) and 0.40 of R2CV for thin wood samples as the best result from the first derivative with 25 smoothing points of NIR spectra. The improvement from the previous research for density prediction accuracy resulted in an R2CV value of 0.55. The smaller diameter of the increment core sample than the NIR light beam's diameter and illuminated mixed surface (transversal and radial) are supposed to give weaker prediction accuracy by this new approach.
Healthcare workers’ perceptions about the use of mobile health technologies in public health facilities in Lagos, Nigeria
Authors: Shekoni Oluwatobi , Iversen Synne , Diaz Gabriela J , Aune Anders , Ubuane Peter Odion , Imam Zainab , André Beate
Published: February 2024

Background:

Mobile health has enormous potential in healthcare due to the increasing use of mobile phones in low- and middle-income countries; its effective deployment, uptake, and utilization may result in improved health outcomes, including a reduction in neonatal deaths. However, there is a suboptimal uptake of mobile health technologies among healthcare workers in low-resource settings like Nigeria, which are often context-specific.

Objective:

To investigate healthcare workers’ perceptions of mobile health technologies in public health facilities in Lagos, Nigeria.

Method:

A qualitative study was conducted, and data were collected through six focus group discussions with 26 healthcare workers (doctors, nurses, and community health extension workers) from three public health facilities in Lagos, Nigeria. The collected data were analyzed using a thematic approach, where themes and subthemes were created.

Results:

Although the participants acknowledged that mobile health enhances patient–provider communication and saves time, they identified altering of healthcare workers’ routine practices, information overload, power and network failure, skepticism, lack of trust, and concerns over diagnostic accuracy as potential barriers to its uptake.

Conclusion:

Addressing healthcare workers’ perceptions of mobile health technologies may enhance the deployment and uptake of such solutions in Nigeria and similar low-resource settings. Developers and implementers of such can use them to create new or enhance existing mobile health solutions to better meet the needs and requirements of healthcare workers in low- to middle-income health settings, such as Lagos, Nigeria.
Prevalence of goiter and associated factors among adolescent girls in the highland area of Northwest Ethiopia
Authors: Teshome Assefa Agegnehu , Ashagrie Berhanu Kindu , Agmas Atalo Ayenew , Mengstie Misganaw Asmamaw , Molla Yalew Melkamu , Baye Nega Dagnaw , Abate Agmas Wassie , Gebeyehu Asaye Alamneh , Yazie Taklo Simeneh , Chanie Ermias Sisaye , Kassaw Amare Wolie , Admasu Fitalew Tadele , Walle Gashaw Ayehu
Published: February 2024

Background:

Goiter is a common public health issue in Ethiopia; however, there is not much evidence of it among adolescent girls, especially in Northwest Ethiopia.

Objective:

This study aimed to determine the prevalence and associated factors of goiter in adolescent girls living in the highlands of Northwest Ethiopia.

Methods:

From 5 January to 15 February 2022, 560 adolescent girls participated in this study. A multistage sampling method was used. Participants were checked for goiter using World Health Organization guidelines. Using a quick test kit, the amount of iodine in samples of table salt was determined. After being entered into Epi Info version 7, the data were exported to the SPSS version 22 for statistical analysis. Binary logistic regression was applied. It was decided to set the statistically significant level at p < 0.05.

Results:

In this study, the total prevalence of goiter among adolescent girls was 33.4% (95% CI: 26.3%–39.4%). The odds of goiter were 5.3 times higher among adolescents whose families had a history of goiter (AOR = 5.34, 95% CI: 3.65–9.74). The likelihood of developing goiter was 3.7 times greater among adolescent girls who consumed cabbage at least once per week (AOR = 3.74, 95% CI: 2.46–8.31). In addition, adolescent girls who did not consume meat at all were 3.3 times more likely to develop goiter (AOR = 3.32, 95% CI: 1.95–6.78). Similarly, the odds of getting goiter among adolescent girls from families who use salt with inadequate levels of iodine (0–14) were 9.84 times greater compared to their counterparts (AOR = 9.84, 95% CI: 5.61–26.24).

Conclusion:

In the study area, goiter was very common. Therefore, the district’s health sector should make an effort to raise community knowledge by spreading important messages regarding the proper use of iodized salt and food sources.
Beliefs, experiences and concerns of using artificial intelligence in healthcare: A qualitative synthesis
Authors: Fazakarley Carol-Ann , Breen Maria , Thompson Ben , Leeson Paul , Williamson Victoria
Published: February 2024

Objective

Artificial intelligence (AI) is a developing field in the context of healthcare. As this technology continues to be implemented in patient care, there is a growing need to understand the thoughts and experiences of stakeholders in this area to ensure that future AI development and implementation is successful. The aim of this study was to conduct a literature search of qualitative studies exploring the opinions of stakeholders such as clinicians, patients, and technology experts in order to establish the most common themes and ideas that have been presented in this research.

Methods

A literature search was conducted of existing qualitative research on stakeholder beliefs about the use of AI use in healthcare. Twenty-one papers were selected and analysed resulting in the development of four key themes relating to patient care, patient–doctor relationships, lack of education and resources, and the need for regulations.

Results

Overall, patients and healthcare workers are open to the use of AI in care and appear positive about potential benefits. However, concerns were raised relating to the lack of empathy in interactions of AI tools, and potential risks that may arise from the data collection needed for AI use and development. Stakeholders in the healthcare, technology, and business sectors all stressed that there was a lack of appropriate education, funding, and guidelines surrounding AI, and these concerns needed to be addressed to ensure future implementation is safe and suitable for patient care.

Conclusion

Ultimately, the results found in this study highlighted that there was a need for communication between stakeholder in order for these concerns to be addressed, mitigate potential risks, and maximise benefits for patients and clinicians alike. The results also identified a need for further qualitative research in this area to further understand stakeholder experiences as AI use continues to develop.
The shackles of gender still exist: Chinese women authors’ consciousness in boys’ love fiction
Authors: Ma Wen , Chen Zhuo , Li Ying , Ju Guodong , Chen Yunsong
Published: February 2024

Boys’ love (BL) fiction has flourished in China since the beginning of the twenty-first century. It primarily focuses on the romance between men, while most authors and readers of BL fiction are heterosexual women; thus it is paradoxically patriarchal and feminist. This study aims to explore two main questions: (1) What topics do Chinese BL fiction authors prefer? (2) How do the gender concepts of Chinese culture affect the topics and contents of BL fiction? Adopting machine learning methods––the Latent Dirichlet Allocation (LDA) topic model and word vector technology—this study presents the typical topics and specific contents of 72,548 original BL fiction pieces from synchronic and diachronic dimensions. The findings reveal that Chinese BL fiction extensively uses Chinese myths and history to create heterosexually structured fantasies. Furthermore, under the Chinese patriarchal culture, primarily the clan concept, BL authors attach great importance to marriage and reproduction issues. Such discourses eventually limit Chinese BL women authors’ awakening of a feminist consciousness.
Ultrasound imaging in spinal cord injury patients with shoulder pain
Authors: Saengsuwan Jittima , Sirasaporn Patpiya
Published: February 2024

Objective

To examine shoulder ultrasound imaging in both tetraplegic and paraplegic spinal cord injury (SCI) patients with shoulder pain.

Methods

All 28 individuals with SCI with shoulder pain were enrolled in this study. Fifty-six shoulders were evaluated by ultrasound (US) imaging.

Results

Fourteen tetraplegics and 14 paraplegics were enrolled (age 45.4 ± 13.8 years [mean ± SD]). Median time post-SCI was 8.6 years. Twenty-three individuals (82.1%) were independent in transfer and four individuals (14.3%) were partially independent in transfer. The prevalence of shoulder pain was 78.6% in manual wheelchair ambulators, 10.7% in gait aids users, 7.1% in wheelchair sitters, and 3.6% in no assistive device individuals. Abnormal US imaging was found in 24/28 (85.7%) individuals. Total shoulder US abnormalities were 38 units. Most common abnormal US imaging was supraspinatous tendinosis (42.1%), biceps tendon effusion (23.7%), positive dynamic supraspinatus impingement (21.1%), and subdeltoid bursitis (18.4%).

Conclusions

Shoulder ultrasonographic abnormalities were common in the patients with SCI with shoulder pain. The supraspinatus tendinosis is the most common abnormal US imaging in patients with SCI with shoulder pain.
Contexts and Prevalence of Classroom Discussion in Nordic Social Science Teaching: A Large N Observational Study
Authors: Teglbjærg Jonas Henau
Published: February 2024

Classroom discussion constitutes a unique opportunity for student deliberation and is often believed to be a desirable attribute of Social Science teaching. Yet, despite its potential, large scale observational research on discussion in Nordic classrooms is scarce. To address this shortcoming, the present study investigated the prevalence and contexts of classroom discussion in a Nordic sample of 375 teaching segments (each lasting 15 min). The sample was gathered through video observations, and discussion was measured by an element from the Protocol for Language Arts Teaching Observations. Discussion was present in 39.2% of the investigated segments but was very unequally distributed across classes. While this study found classroom discussion to be most likely during small group work, in the middle of a 45-min lesson, and in schools with high achieving students, more research is needed to determine the sources of inequality in social science students’ opportunities for classroom deliberation.
Evaluating the impact of attachment and trauma training for children’s social care teams
Authors: Fflur Siana , Pepper Rebecca , Donnelly Katherine , Halstead Samantha , Campbell Kirsty , McDonnell Lynn
Published: February 2024

Embedding attachment- and trauma-informed knowledge and skills throughout the services that support children and families who have experienced developmental trauma is vital to meeting the needs of this population. The current pilot study provides provisional data regarding the impact of training delivered by the Gwent Attachment Service to increase awareness and use of attachment- and trauma-informed working across social care teams within Gwent. The training package comprised two-days’ training plus six skill development sessions (SDS) delivered to 274 staff within 21 social care teams within Gwent. Staff self-rated their knowledge of, confidence in, and worries about working in an attachment- and trauma-informed way at three time points; pre-training, post-training and post-skill sessions. Statistical analyses revealed significant increases in staff knowledge and confidence pre-post training, plus a significant decrease in worries pre-post training. Whilst a significant decrease in knowledge and confidence, and significant increase in worries was seen between post-training to post-SDS, the final post-SDS ratings remained significantly improved compared to pre-training. Whilst preliminary given the current study limitations, such findings suggest that the current training and SDS programme successfully improved and maintained knowledge, confidence and level of worry regarding attachment- and trauma-informed working. They also demonstrate the feasibility of National Health Service-based teams delivering such training to improve the service offered to children and families affected by developmental trauma, in keeping with the values of prudent healthcare and taking a whole-systems approach to addressing the needs of this population.
Using the Carers’ Alert Thermometer tool to identify needs and support family caregivers of people with motor neurone disease: moving beyond needs assessments
Authors: Aoun Samar M. , O’Brien Mary R. , Knighting Katherine
Published: February 2024

Background:

Family caregivers of people with motor neurone disease (MND) experience adverse health outcomes as a result of their caregiving experience. This may be alleviated if their support needs are identified and addressed in a systematic and timely manner. The objective of this pilot study was to assess the feasibility and relevance of the Carers’ Alert Thermometer (CAT) in home-based care, from the perspective of MND family caregivers. The tool provides a formal structure to facilitate discussions with caregivers to enable needs to be addressed.

Methods:

This mixed-method study was conducted in Western Australia (2020–2021). Forty-one caregivers and five MND Advisors participated in trialling the CAT intervention which consisted of two encounters with Advisors (6–8 weeks apart) to identify and address support needs through action plans. Caregivers’ feedback was obtained via telephone interviews and a thematic analysis was undertaken.

Results:

Thirty caregivers completed two CAT assessments. Caregivers identified support priorities of managing their feelings and worries, providing emotional or spiritual care, information about the person’s condition and how their care needs might change. Seventeen caregivers were interviewed and found that this assessment process adequately addressed their needs and it should be continued, it brought the focus onto them to clarify problems and work through solutions. The improvements that were suggested by them, including better information/education in palliative care, led to the development of an online support/information toolkit, which served to empower caregivers and staff by accessing relevant information and resources.

Conclusions:

The CAT demonstrated utility for triaging caregivers most in need of additional support and those whom signposting to additional information and self-directed access to support was most appropriate. For any tool to become an integrated part of care, service provider support is key for implementation, allowing for the time resource required and an appropriate education and support structure. MND Associations have an important role in building stronger partnerships with supportive community networks, through compassionate communities models of care, to address the identified needs of MND families in a more sustainable and wholistic manner. Needs assessment is a means towards building this capacity between formal and informal networks.
Does the American Foregut Society Endoscopic Classification of Esophago-gastric Junction Integrity Predict Acid Reflux and Esophago-gastric Junction Disruption?
Authors: Siboni Stefano , Sozzi Marco , Kersik Alessia , Lovece Andrea , Milito Pamela , Menikou Fedra , Bonavina Luigi , Froiio Caterina , Bernardi Daniele , Asti Emanuele
Published: February 2024

Background:

Gastroesophageal reflux disease (GERD) is usually associated with disruption of the esophagogastric junction (EGJ). The endoscopic Hill classification has proven to be inadequate to assess EGJ integrity. Recently, the American Foregut Society (AFS) developed an endoscopic classification focused on hiatal hernia (L), hiatal opening (D), and the flap valve (F). While pH-monitoring remains the gold standard for the diagnosis of GERD, high-resolution manometry (HRM) can assess EGJ anatomy and competency. Aim of this study is to validate the AFS classification in patients with suspected GERD assessing its accuracy in predicting EGJ disruption and pathologic reflux.

Methods:

We prospectively enrolled patients with suspected GERD who underwent upper endoscopy, HRM and pH-study between November 2022 and March 2023. Demographic and clinical data were analyzed. The efficacy of the AFS classification in predicting GERD (acid exposure time, AET > 6%) was assessed. Each component of the classification was compared with the corresponding HRM variable.

Results:

Among 56 patients (48% men, BMI 23.5 kg/m2, age 43 years), an AET > 6% was found in 22 (39%), and in 0% of patients with AFS grade I, 5.9% with grade II, 52% with grade III and 77.8% with grade IV ( P < .001). The L component effectively predicted the EGJ type, the D the EGJ-Contractile Integral, while the absence of the flap valve was related to a positive Straight Leg Raise maneuver.

Conclusions:

The new grading system is able to stratify patients with pathologic GERD. Moreover, the single components of the AFS classification are associated with manometric markers of EGJ disruption.
Speculative and anticipatory urban futures
Authors: Boudreau Julie-Anne
Published: February 2024

In this short comment on Beveridge and Koch's intervention on radical democracy and urbanization, I wish to take their idea of democratic engagement and push it towards epistemological reflections. Democratic engagement is a form of anticipation of urban futures – futures characterized by caring democracy. Adjusting our analytical lens to better see these everyday practices requires rebalancing critical versus generative epistemologies.
Influence of metabolic state and body composition on the action of pharmacological treatment of migraine
Authors: Bruijn Noor , van Lohuizen Romy , Boron Malgorzata , Fitzek Mira , Gabriele Francesca , Giuliani Giada , Melgarejo Laura , Řehulka Pavel , Sebastianelli Gabriele , Triller Paul , Vigneri Simone , Özcan Behiye , van den Brink Antoinette Maassen ,   the European Headache Federation School of Advanced Studies (EHF‐SAS)
Published: February 2024

Migraine is a disabling neurovascular disorder among people of all ages, with the highest prevalence in the fertile years, and in women. Migraine impacts the quality of life of affected individuals tremendously and, in addition, it is associated with highly prevalent metabolic diseases, such as obesity, diabetes mellitus and thyroid dysfunction. Also, the clinical response to drugs might be affected in patients with metabolic disease due to body composition and metabolic change. Therefore, the efficacy of antimigraine drugs could be altered in patients with both migraine and metabolic disease. However, knowledge of the pharmacology and the related clinical effects of antimigraine drugs in patients with metabolic disease are limited. Therefore, and given the clinical relevance, this article provides a comprehensive overview of the current research and hypotheses related to the influence of metabolic state and body composition on the action of antimigraine drugs. In addition, the influence of antimigraine drugs on metabolic functioning and, vice versa, the influence of metabolic diseases and its hormonal modulating medication on migraine activity is outlined. Future exploration on personalizing migraine treatment to individual characteristics is necessary to enhance therapeutic strategies, especially given its increasing significance in recent decades.
Risk factors for early septic failure after two-stage exchange total knee arthroplasty for treatment of periprosthetic joint infection
Authors: Lee Woo-Suk , Park Kwan Kyu , Cho Byung-Woo , Park Jun Young , Kim Inuk , Kwon Hyuck Min
Published: February 2024

Background

The cause of early septic failure after two-stage exchange revision total knee arthroplasty (TKA) for chronic periprosthetic joint infection (PJI) and the factors affecting it are not well known. The purpose of this study was to determine the surgical outcomes and the risk factors for early septic failure after two-stage revision TKA for chronic PJI.

Methods

We identified a total of 246 adult patients who met the Musculoskeletal Infection Society (MSIS) diagnostic criteria for chronic PJI at two academic tertiary hospitals from March 2012 to December 2018. Finally, 151 patients who consecutively received two-stage exchange revision TKA for chronic PJI and who had a minimum 3-year follow-up were enrolled and retrospectively reviewed. Successful surgical treatment was evaluated for two-stage revision TKA and risk factors for early septic failure were identified.

Results

Early septic failures occurred within 3 years after reimplantation in 48 patients (31.8%). After accounting for potentially confounding variables, we found that male patient [odds ratio (OR): 2.753, 95% confidence interval (CI) 1.099–6.893, p = 0.031], fungus or mycobacterial infection (OR: 5.224, 95% CI 1.481–18.433, p = 0.01), and positive culture at reimplantation (OR: 4.407, 95% CI 1.255–15.480, p = 0.021) were independently associated with early septic failure after two-stage exchange revision TKA.

Conclusion

Male patients, fungus or mycobacterial infection, and positive culture at reimplantation were independently associated with an increased risk of early septic failure after two-stage exchange revision TKA despite normal C-reactive protein values prior to reimplantation. Further prospective and high-quality studies are needed to determine the risk factors of two-stage exchange revision TKA for chronic PJI.

Level of evidence: level IV; retrospective comparison; treatment study.