bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Contingency and Inflation Practices Within Several Departments of Transportation in the United States
Authors: Alsharef Abdullah , Findley Daniel , Jaselskis Edward , Dudley Thomas , Pyo Kihyun , Yang Guangchuan
Published: March 2024

Transportation projects are notorious, among both the public and transportation professionals, for missing their intended cost and schedule targets as a result of project complexity and uncertainties. The significant discrepancy between cost estimates and final project costs remains a major concern for state Departments of Transportation (DOTs). Several risk factors, including estimation errors and price fluctuations, contribute to these discrepancies and are typically managed by adding a contingency to project estimates. Cost escalation can also result from inadequate adjustment for inflation in estimates, given the current economic environment and the lengthy duration of major transportation projects. This paper summarizes how several state DOTs apply contingencies to mitigate the impact of certain risks and adjust their State Transportation Improvement Program (STIP) revenues and costs to account for inflation. The study surveyed 13 state DOTs to understand how contingencies are applied to the three major components of transportation projects (construction, right of way, and utilities). Additionally, interviews were conducted with 15 state DOTs to understand how they address inflation, particularly as it pertains to the STIP process. The results indicate that most DOTs apply contingency allowances to their project estimates during the early project development and maintain some level of contingency allowance at the plans, specifications, and estimate (PS&E) stage. As for addressing inflation, most state DOTs include inflation of the project cost in the project estimates to the time of bid letting or year of expenditure. The findings of this study can benefit state DOTs that are reassessing their strategies for implementing contingency and inflation within their STIP.
Deformation Responses of a Geosynthetic Reinforced Soil-Integrated Bridge System Under Static Loading and Sensitivity Analysis of Influential Factors Based on the Improved Grey Relational Method
Authors: Peng Tiekun , Zhu Yunsheng , Wang Kaifeng , Huang Hongchao
Published: March 2024

A numerical parametric study is conducted to evaluate the effects of various parameters on the deformation responses of a geosynthetic reinforced soil-integrated bridge system (GRS-IBS) under static load. The investigated parameters include the abutment height, reinforcement spacing, reinforcement length, reinforcement stiffness, bridge load, and backfill internal friction angle. The improved grey relational method is used to investigate the sensitivity of influential factors on the deformation responses of the GRS-IBS. The simulation results indicate that the abutment height, reinforcement spacing, and bridge load have a significant impact on the performance of the GRS-IBS with respect to lateral displacement and settlement, while the effects of reinforcement length, reinforcement stiffness, and backfill internal friction angle on the deformation behavior of the abutment are negligible. Differential settlements between the girder and approach are minimal under all conditions. The potential failure envelope of the GRS-IBS exhibits a “L” shaped configuration where the potential failure surface starts beneath the inner edge of the strip footing, extending vertically downward to half of the wall height and further bifurcating toward the strip footing and the toe of the wall. The results of the improved grey relational analysis show that reinforcement spacing is the most sensitive to the lateral displacement of the GRS-IBS. The abutment height and bridge load are more sensitive to abutment deformation than other influential factors. These three parameters are crucial to the deformation behavior and should be given primary consideration when designing a GRS-IBS.
Vehicle Delay Model for Signalized Midblock Crosswalk Under Mixed Traffic Conditions
Authors: Manthirikul Sandeep , Jain Udit
Published: March 2024

For signalized locations, delay is one of the key parameters in assessing the level of service and redesigning the traffic signals. Around the world, Highway Capacity Manual (HCM) and Webster delay models are commonly used in calculating the vehicle delay at signalized intersections, notwithstanding that these models assume homogeneous traffic conditions and lane discipline. Furthermore, it is worth noting that previous studies have mostly focused on developing delay models for signalized intersections, whereas signalized midblock crosswalks were overlooked by past researchers. In view of this, the current study presents a modified vehicle delay model for signalized midblock crosswalks (SMCs) under mixed traffic conditions. Mixed traffic conditions refers to diverse vehicles, complex interactions, and no lane discipline on the road—conditions which are usually noticed in developing nations. The HCM vehicle delay model is modified in the current study by incorporating factors related to mixed traffic conditions and SMCs. To test the accuracy of the proposed model, it was validated with the field delay using data collected at other SMCs in Hyderabad, India. Field delay was calculated by plotting the measured queue length against the signal cycle length. The performance metrics of root mean square error (RMSE), mean absolute percentage error, Nash–Sutcliffe efficiency, RMSE-observations standard deviation ratio, and percent bias were used to test the accuracy of the proposed model. Results revealed that the proposed model yielded the lowest error rates and the highest correlation coefficients between modeled and actual vehicle delay. The maximum error between the field delay and the modeled delay was found to be less than 5%.
Evaluating the Fatigue-Cracking Resistance of North Dakota’s Asphalt Mixtures
Authors: Oteki Duncan , Yeneneh Andebut , Gedafa Daba S. , Suleiman Nabil
Published: March 2024

Fatigue cracking is a critical pavement distress caused by extreme environmental conditions and heavy repeated cyclic loading. Performance-based design methods that use mechanistic models focus on material performance properties, creating an opportunity to use engineered and recycled materials such as reclaimed asphalt pavement (RAP). The primary goal of this study was to use the simplified viscoelastic continuum damage (S-VECD) model to assess the fatigue behavior of North Dakota’s asphalt mixtures. Eight mixtures typically used in North Dakota were sampled and underwent | E*| testing to determine their linear viscoelastic (LVE) properties. The S-VECD tests were conducted on the same mixtures to determine their damage characteristics. The outputs from the two tests were exported to the FlexMATTM software to obtain their damage characteristic curves, DR failure criterion parameters, and Sapp-index values. CT-index values for the same mixtures were obtained from the North Dakota Department of Transportation (NDDOT). The results revealed that the mixture used for HWY 52, which does not contain RAP, was least susceptible to fatigue cracking. The mixture used for HWY 6, which contains the highest RAP content (25%), had the lowest fatigue resistance, revealing RAP’s stiffening effect on asphalt mixtures. The mixture used for HWY 1, which used the performance grade (PG) 58S-34 binder, had the second-highest fatigue-cracking resistance despite containing 15% RAP, indicating that binder grade affects an asphalt mixture’s fatigue behavior. A relatively low correlation was observed between the CT-index and Sapp-index.
Synthesis and characterization of chitosan for medical applications: A review
Authors: Isa Muhammed Tijani , Abdulkarim Abdulwadud Yusuf , Bello Abdullahi , Bello Tajudeen Kolawole , Adamu Yusuf
Published: March 2024

Chitosan has gained considerable recognition within the field of medical applications due to its exceptional biocompatibility and diverse range of properties. Nevertheless, prior reviews have primarily focused on its applications, offering limited insights into its source materials. Hence, there arises a compelling need for a comprehensive review that encompasses the entire chitin and chitosan life cycle: from the source of chitin and chitosan, extraction methods, and specific medical applications, to the various techniques employed in evaluating chitosan’s properties. This all-encompassing review delves into the critical aspects of chitin and chitosan extraction, with a strong emphasis on the utilization of natural raw materials. It elucidates the various sources of these raw materials, highlighting their abundance and accessibility. Furthermore, a meticulous examination of extraction methods reveals the prevalent use of hydrochloric acid (HCl) in the demineralization process, alongside citric, formic, and phosphoric acids. Based on current review information, these acids constitute a substantial 69.2% of utilization, surpassing other mentioned acids. Of notable importance, the review underscores the essential parameters for medical-grade chitosan. It advocates for a degree of deacetylation (DDA) falling within the range of 85%–95%, minimal protein content <1%, ash content <2%, and moisture content <10%. In conclusion, these crucial factors contribute to the understanding of Chitosan’s production for medical applications, paving the way for advancements in biomedical research and development.
Novice Teachers and Student Attendance in Early Elementary School
Authors: Gottfried Michael , Little Michael , Ansari Arya
Published: March 2024

Student absenteeism in the earliest years of elementary school has been linked to a range of negative outcomes. Though the literature has examined numerous factors that are associated with children missing school, the role of teachers—especially at the early elementary level—has not been well understood. Given that students spend the majority of their time in elementary school with one teacher in a single classroom, a large component of early elementary school is underexplored, and our understanding of absenteeism remains incomplete. In this vein, we looked into whether having novice versus more experienced teachers was linked to the frequency of student absenteeism in the earliest years of school. Using a national dataset including repeated observations of students in grades K-2, we found that novice teachers have students with fewer absences and a lower probability of being chronically absent. There were no differences in the outcomes of novice teachers as a function of child nor classroom characteristics. Implications for policy and practice are discussed.
Beyond Diversity and Homogeneity: Conceptualizing Compatibility in Cognition
Authors: Wang Shirley C. , Cronin Matthew A. , Mannix Elizabeth A.
Published: March 2024

Despite the oft touted benefits of having differences in how people think about a task, teams often are not able to capitalize on their heterogeneity. The problem, we demonstrate, is that representational gaps—fundamental incompatibilities in the way that team members conceptualize the problem and solution space—degrade the knowledge synthesis capabilities of teams. We show that rGaps degrade team processes and thus have a unique effect on performance above and beyond mere differences in cognition. In two laboratory studies, we find that representational gaps hurt verbal and nonverbal communication and increased relationship conflict. Relationship conflict, in turn, mediated the negative relationship between rGaps and performance. We discuss possible interventions when rGaps are present.
Psychometric Evaluation of the Social Phobia Inventory (SPIN) in Algeria: A Comprehensive Approach Utilizing Network Analysis, Confirmatory Factor Analysis, and the Polytomous Rasch Model
Authors: Kerriche Ahmed
Published: March 2024

This study aimed to evaluate the psychometric characteristics of the Social Phobia Inventory (SPIN) by employing network analysis, confirmatory factor analysis, and the Polytomous Rasch Model. A cross-sectional data set was collected comprising 1,530 participants, with 959 being women and 571 being men. The Bootstrap Exploratory Graph Analysis unveiled the presence of two dimensions, with Items 17, 15, 5, 14, 6, and 9 exhibiting the highest strength centrality index. Notably, the Network Comparison Test indicated no differences in Network Invariance and global strength between the networks of women and men. Furthermore, the confirmatory factor analysis results demonstrated that the two extracted dimensions displayed an acceptable goodness of fit. In addition, the reliability coefficient values were acceptable, exceeding the threshold of 0.70. The Rasch analysis results suggested an overall fit, but some items exhibited overlap, suggesting their potential removal. Furthermore, it was recommended to develop new items to address gaps between existing items, particularly for measuring the lower levels of Social Anxiety Disorder. In conclusion, these findings provide robust evidence supporting the reliability and validity of the SPIN as a tool for measuring Social Anxiety Disorder in Algeria.
Constraint-following adaptive robust control for multi-vehicle system formation with collision avoidance
Authors: Xiao Gang , Li Jiawen , Yang Qinwen , Fan Longjie , Liao Qin , Huang Jin
Published: March 2024

For the formation on unstructured road with complex road conditions, the rationality of constraint design and uncertainty compensation seriously affect the connected and autonomous vehicle (CAV) system performance. The system constraints are studied for safe and efficient formation driving, and an adaptive robust formation control scheme is proposed. First, for the desired configuration and global collision avoidance, a series of equality and unilateral inequality constraints are designed for inter-vehicle spacing. Second, a constraint handling scheme is proposed based on the diffeomorphism method, adjustable transformation function, and bounded constraint. Third, (possibly fast) time-varying but bounded multi-source uncertainty is considered, and then a self-adjusting leakage-type adaptive law is proposed to estimate the integrated uncertainty bound online. Fourth, the performance measure β is defined to evaluate the constraint-following error, and an adaptive robust control is proposed. The effectiveness of the proposed control scheme is verified by simulation. The results show that the proposed control renders the error to be uniformly bounded and uniformly ultimately bounded. The CAV system approximately follows the constraints, regardless of the uncertainty.
The effects of two methods of on-line planning on L2 task-based speaking performance and strategy use
Authors: Gu Qianqian , Van den Branden Kris
Published: March 2024

Studies on on-line planning have been based upon the same definition in the past few decades, and they have operationalized on-line planning in similar ways. Drawing upon theories in cognitive psychology, the present study sets out to propose a revised definition of on-line planning that aims at capturing a greater variety of on-line planning behaviors. Two methods of eliciting on-line planning were implemented: providing students with listener’s feedback between two consecutive rounds of task performance, and providing them with criteria for successful task performance. Their effects on second language (L2) narrative task performance and the use of planning strategies were investigated with 90 Chinese learners of English as a foreign language (EFL) who were first-year English majors. To assess the quality of task performance, complexity, accuracy and fluency (CAF) measures and a measure of story completeness were employed. Post-task interviews were conducted to explore planning strategies. Results from the quantitative and the qualitative analyses suggest that utilizing listeners’ feedback successfully elicited an increased number of on-line planning activities. Participants under this on-line planning condition also produced significantly more complex and accurate output than the non-intervention group.
Applications of the partial-order continual reassessment method in the early development of treatment combinations
Authors: Wages Nolan A , Dillon Patrick M , Portell Craig A , Slingluff Craig L , Petroni Gina R
Published: March 2024

Combination therapy is increasingly being explored as a promising approach for improving cancer treatment outcomes. However, identifying effective dose combinations in early oncology drug development is challenging due to limited sample sizes in early-phase clinical trials. This task becomes even more complex when multiple agents are being escalated simultaneously, potentially leading to a loss of monotonic toxicity order with respect to the dose. Traditional single-agent trial designs are insufficient for this multi-dimensional problem, necessitating the development and implementation of dose-finding methods specifically designed for drug combinations. While, in practice, approaches to this problem have focused on preselecting combinations with a known toxicity order and applying single-agent designs, this limits the number of combinations considered and may miss promising dose combinations. In recent years, several novel designs have been proposed for exploring partially ordered drug combination spaces with the goal of identifying a maximum tolerated dose combination, based on safety, or an optimal dose combination, based on toxicity and efficacy. However, their implementation in clinical practice remains limited. In this article, we describe the application of the partial order continual reassessment method and its extensions for combination therapies in early-phase clinical trials. We present completed trials that use safety endpoints to identify maximum tolerated dose combinations and adaptively use both safety and efficacy endpoints to determine optimal treatment strategies. We discuss the effectiveness of the partial-order continual reassessment method and its extensions in identifying optimal treatment strategies and provide our experience with executing these novel adaptive designs in practice. By utilizing innovative dose-finding methods, researchers and clinicians can more effectively navigate the challenges of combination therapy development, ultimately improving patient outcomes in the treatment of cancer.
Decoding paradoxical identities: The discourse construction of left-behind children in news reports
Authors: Liang Linlin , Wang Hongli , Zhang Wenshu
Published: March 2024

This paper presents an empirical corpus-based study on the identity of left-behind children in China, employing the discourse-historical approach (DHA) framework. It is the first study to combine Latent Dirichlet Allocation (LDA) topic modeling and reported speech analysis to examine how China Daily constructs the identity of left-behind children and explore the cultural and rhetorical factors influencing this identity construction. By integrating computational techniques and qualitative analysis methods, this study provides a comprehensive understanding of the intricate nature of identity construction for left-behind children. This interdisciplinary approach strengthens the theoretical foundations of media analysis and offers fresh insights into the dynamics of media discourse. The findings reveal that China Daily portrays left-behind children in a multifaceted and diverse manner, encompassing both positive and negative aspects, while placing emphasis on their vulnerability and passivity. Furthermore, the media employs communication techniques such as identification by sympathy, antithesis, and inaccuracy to establish emotional resonance and foster audience identification, ultimately influencing the audience’s perspectives on these children.
UCL Throwing Injuries in Nonprofessional Baseball Players: A 14-Year Retrospective Study
Authors: Zaremski Jason L. , Pazik Marissa , Hunt Harold , Dodd William S. , Nguyen Binh K. , Farmer Kevin W. , Horodyski MaryBeth
Published: March 2024

Background:

This study evaluated treatment modality (surgical vs nonoperative) of medial ulnar collateral ligament (UCL) injuries in nonprofessional throwing baseball athletes by comparing type, severity, and location of UCL injury.

Hypothesis:

Baseball players with closed medial epicondyle physes and concomitant throwing-related UCL injury will be more likely to undergo surgical intervention than players with open medial epicondyle physes.

Study Design:

Retrospective.

Level of Evidence:

Level 5.

Methods:

A total of 119 baseball players with a mean age of 16.9 ± 2.5 years (range, 11-25 years) were included in the study. Datapoints included sex, age at time of injury, severity, and location of UCL injury, growth plate status, operative versus conservative management, and concomitant flexor forearm injury.

Results:

A total of 75 players were treated conservatively; 43 underwent UCL reconstruction (UCL-R), and 1 had an unknown treatment outcome. No significant difference was found for age related to treatment type, UCL-R (17.2 ± 2.2) versus conservative treatment (16.8 ± 2.6). Athletes with closed medial epicondylar growth plates were more likely to undergo UCL-R than athletes with open medial epicondylar growth plates ( P = 0.02). There were no significant differences between UCL injury location (42 distal, 37 proximal, 18 combined tear locations, 11 complete tears, and 11 intact UCLs with inflammation) by treatment type ( P = 0.09). There was a significant difference for UCL severity (11 complete tears, 96 partial tears) by treatment type ( P = 0.03).

Conclusion:

Nonprofessional athletes with closed medial epicondylar growth plates and throwing-related UCL injuries were more likely to be treated surgically. Baseball athletes with partial tears, if skeletally immature, require further long-term evaluation.

Clinical Relevance:

Continued knowledge gains in this area of throwing medicine will further improve our treatment algorithms in nonprofessional baseball players.
Cortical Laminar Necrosis After Severe Hydrocephalus: Case Report and Review of the Literature
Authors: Peyton Margo A. , Cho Sung-Min , Xia Yuanxuan , Piran Pirouz , Luciano Mark , Rivera-Lara Lucia
Published: March 2024

Objectives

We present a case of cortical laminar necrosis after severe hydrocephalus to highlight considerations for multimodal cerebral autoregulation monitoring to determine mean arterial pressure (MAP) thresholds during neurological emergencies, as well as postoperative head imaging for patients with ventriculoperitoneal shunts (VPS).

Methods

A 40-year-old woman with a history of Chiari II malformation and non-communicating hydrocephalus with VPS presented in septic shock from a sacral wound. One week after colostomy for fecal diversion, the patient became comatose and had progressive slowing to full suppression on electroencephalogram (EEG).

Results

CT imaging revealed hydrocephalus, most likely due to VPS distal obstruction from intraperitoneal surgery. Despite neurosurgical and neurocritical care management, MRI confirmed diffuse cortical hypoxic ischemic injury.

Discussion

The Neurocritical Care Society’s Emergency Neurological Life Support (ENLS) protocol for neurological emergencies focuses on managing increased intracranial pressure (ICP) but does not set MAP goals. As ICP may be very high during brain herniation, our case demonstrates that higher MAP may be required to maintain adequate circulation. To determine the optimal MAP target, bedside multimodality monitoring, including ICP monitors, transcranial doppler, and near infrared spectroscopy, can help establish individualized cerebral autoregulation guided thresholds. Outside of a neurological intensive care unit, EEG can monitor cerebral blood flow and indicate windows for intervention before exam or imaging changes. Additionally, our case demonstrates how a post-operative surveillance CT head should be considered for patients with VPS.
Magneto-dynamic tool for full arch immediate loading in post-traumatic restoration with narrow implants: A case report
Authors: Cervino Gabriele , Fiorillo Luca , Scotti Nicola , Motta Francesco Alessandro , Motta Francesco Maria , Colombo Jacopo , Heboyan Artak , Baldi Domenico
Published: March 2024

New surgical techniques using narrow, tilted implants positioned through a magneto-dynamic tool in guided surgery for a Toronto restoration. A 69-year-old woman wanted fixed rehabilitation to replace her removable complete dentures. A cone-beam computed tomography showed significant bone resorption in both the maxillary and mandibular regions. The plan was to load the entire upper arch with six implants immediately, while removable partial dentures were recommended for the lower jaw. The guided surgery project was aligned with the new dentures, and the laboratory created a printed cast with dental implant analogues in planned positions. A metal-reinforced denture was constructed, and surgery was performed to place six narrow implants using the magneto-dynamic instrument. The denture was directly screwed onto multi-unit abutments. Final rehabilitation was completed after 6 months. Narrow implants can be a good option for fixed, full-arch rehabilitations. Further research is needed to confirm these findings on a larger scale.
Feasibility and Impact Assessment of a Food Insecurity Protocol in a Large Urban Pediatric Primary Care Network
Authors: Kim Noah , Fischer Laura , Gross Sarah Haley , Weissman Mark , Essel Kofi
Published: March 2024

Introduction/Objectives:

In 2022, 1 in 6 households with children experienced food insecurity (FI) in the United States. The negative impact of FI on child health is well documented and pediatric clinicians are encouraged to actively screen and intervene in clinical settings. This study aims to evaluate the feasibility and impact of a FI management protocol implemented in 2017 at a pediatric primary care health network serving patients who are Medicaid-eligible in Washington, DC.

Methods:

In 2019, an 18-item electronic survey was sent to a convenience sample of 42 pediatric clinicians within the health network to understand their knowledge, attitudes, and behaviors surrounding implementation. Both quantitative and qualitative responses were collected and analyzed. We report frequencies of the Likert-type responses, including perceived compliance with protocol components and intervention efficacy. We evaluated the relationship between FI knowledge level and rates of clinician documentation compliance by chi square and Cramer’s V statistic for effect size. Open-ended responses were reviewed, and common themes were identified and used to provide context for quantitative results.

Results and Conclusions:

Out of 42 clinicians invited to complete the survey, 35 completed responses. All respondents reported universal screening for FI (100%) at routine examinations, 80% reported frequently electronically documenting FI in medical records, and 91% of clinicians reported frequently referring families who screened positive for FI to at least one FI resource, with 24% reporting that resources met families’ needs. Open-ended responses revealed increased awareness of FI prevalence and of patient experiences in households experiencing FI, increased satisfaction with clinical management of FI, but also concerns around having limited clinical time to do the protocol and the usefulness and accessibility of referred resources. In conclusion, implementing this pilot FI protocol was feasible, but clinicians perceived limited impact of the protocol on alleviating FI and desired more robust intervention options. Further improvements include shifting the burden of performing the protocol away from the clinician, such as by streamlining the protocol or identifying a resource staff member, and establishing more accessible and effective FI interventions such as “Food as Medicine” offerings in partnership with community organizations.
Cross-Cultural Adaptation and Validation of the Perception of the Doctor-Patient Relationship (PREMEPA) Questionnaire in Chronic Multi-Pathological Patients
Authors: Zarza-Arribas María , Menárguez Puche Juan Francisco , Morales López Rosario , Barber Valles Josep Xavier , Orozco Beltrán Domingo Luis
Published: March 2024

Objective:

To conduct a cross-cultural adaptation and validation in Primary Care of the PREMEPA doctor-patient relationship perception questionnaire.

Design:

Descriptive, cross-sectional study, using self-administered questionnaires. Qualitative validation: an adapted version of the original questionnaire, was adapted to our culture. The process consisted of the evaluation, cross-cultural adaptation and consensus of a group of experts. The questionnaire was piloted on a sample of 32 patients diagnosed with at least 2 chronic pathologies.

Measures:

Cognitive piloting, comprehensibility assessment, content validation and internal consistency analysis using Cronbach’s alpha coefficient. Quantitative validation: the internal consistency, construct validity and validity of the questionnaire were studied by means of a confirmatory factor analysis developed in a multicenter study, randomly selecting 202 patients with at least 2 chronic pathologies.

Results:

Content validity of the new Spanish version was confirmed to be adequate. Comprehensibility and internal consistency (Cronbach’s α coefficient = 0.78) were adequate. The confirmatory factor analysis showed good dimensionality, factor relationship and internal consistency, as well as acceptable construct validity. The final result was a 13-item questionnaire consisting of 2 dimensions, which explain 58.5% of the variance: participation in decision-making (accounting for 45.2% of the variance) and person-centered communication (encompassing courtesy, empathy, humanity, and trust).

Conclusions:

This adapted version of the PREMEPA questionnaire can be considered valid for use in the Spanish population with a history of chronic pathology. This version of PREMEPA provides a new instrument to understand and improve chronic patient care, which can improve the doctor-patient relationship, encouraging adherence to treatment and enhancing health outcomes.
Expatriate Cross-Cultural Adjustment: Role of Social Media
Authors: Hammadeen Hamzeh , Eyoun Khalid , Campbell Allison Glenn
Published: March 2024

Cross-cultural adjustment continues to be among the main challenges’ expatriates encounter in the foreign society. One promising tool which may influence expatriate adjustment is social media. A case study was undergone to highlight the role that social media plays in the journey of expatriates’ adjustment by analyzing the experience of an expatriate manager in the hospitality industry. The case revealed that the use of social media was an effective and helpful tool during the adjustment process in terms of learning the language, building and retaining social connections, easing and reducing culture shock, assimilate quickly, and performing better.
Review Article: Sunita Sharma, Dalit Women: From Exclusion to Integration
Authors: Basu Rajsekhar
Published: March 2024

Sunita Sharma, Dalit Women: From Exclusion to Integration (Jaipur: Rawat Publications), 2022, 254 pp., ₹1,250 (Hb).
Hierarchies of Oppression: Ancient Indian Antecedents of Caste and Gender
Authors: Shah Shalini
Published: March 2024

This article seeks to analyse the evolution of social hierarchies in ancient India. While the primary focus of the article is on gender hierarchy, it also attempts an examination of the intersection of class and caste as well. This article seeks to trace the linkages between women and śūdra in the ancient textual sources. It has also been argued that since hierarchy is never organic but a deliberate act of creation, in this deliberation, alternative possibilities are either marginalised or effaced.
Does pay disclosure in job offers remove gender differences in pay estimations? Evidence from an experiment with students and job seekers in the context of Austria
Authors: Yilmaz Levent , Brandl Julia
Published: March 2024

Pay disclosure aims at closing the gender pay gap by providing employees especially women with better salary knowledge, yet the effectiveness of employers’ practices is little understood. We use a lab-in-the-field experiment where participants estimate the salaries for several common pay statements for job offers which employers use in the context of the legislation in Austria. Our study with management students ( n = 385) shows that employer practices offer no solution to the problem of gender differences, except for the practice of salary range. The replication of the experiment with the real job seekers ( n = 242) demonstrates that gender differences disappear also for some practices, but not for the practice of mentioning excess payment (or overpay) options, which is common in Austria. This means that legislation addresses the gender gap most effectively when it encourages employers to display the salary range.
A Radiologic Triangle Sign for Percutaneous Adductor Tendon Release (PATR): Cadaveric Study and Case Series
Authors: Del Vecchio Jorge Javier , Dealbera Eric Daniel , Chemes Lucas Nicolás , Slullitel Gastón , Calvi Juan Pablo , Dalmau-Pastor Miki
Published: March 2024

Background:

Combining osteotomies and soft tissue procedures is believed to reduce sesamoids in their anatomical position and maintain long-term correction when treating hallux valgus deformity. This study determines if a radiologic association exists between a radiolucent sign and a full percutaneous adductor tendon release (PATR), including a cadaveric study and a consecutive case series. Another aim was to determine the intra- and interobserver reliability of these observations.

Methods:

A prospective observational study was made between 2018 and 2019. First, a PATR was done on cadaveric specimens and, after the procedures, dissected to correlate what was seen fluoroscopically. The clinical group included 39 feet that presented mild-to-moderate HV deformity and were treated with percutaneous osteotomies associated with PATR.

Results:

Observers 1 and 2 saw a radioscopic radiolucent sign in 100% of cadavers and the patient population. They also observed a triangle-shaped image with an incidence of 75%, which we have named the “triangle sign.”

Conclusion:

The triangle sign may be helpful in the intraoperative confirmation of PATR and latero-plantar capsule release using this percutaneous technique.

Level of Evidence:

Level II, development of diagnostic criteria.
An interactive simulator to deepen the understanding of Guyton’s venous return curve﻿
Authors: Mamorita Noritaka , Takeuchi Akihiro , Kamata Hirotoshi
Published: March 2024

Mean circulatory filling pressure, venous return curve, and Guyton’s graphical analysis are basic concepts in cardiovascular physiology. However, some medical students may not know how to view and interpret or understand them adequately. To deepen students’ understanding of the graphical analysis, in place of having to perform live animal experiments, we developed an interactive cardiovascular simulator, as a self-learning tool, as a web application. The minimum closed-loop model consisted of a ventricle, an artery, resistance, and a vein, excluding venous resistance. The simulator consists of three modules: setting (parameters and simulation modes), calculation, and presentation. In the setting module, the user can interactively customize model parameters, compliances, resistance, Emax of the ventricular contractility, total blood volume, and unstressed volume. The hemodynamics are calculated in three phases: filling (late diastole), ejection (systole), and flow (early diastole). In response to the user’s settings, the simulator graphically presents the hemodynamics: the pressure–volume relations of the artery, vein, and ventricle, the venous return curves, and the stroke volume curves. The mean filling pressure is calculated at approximately 7 mmHg at the initial setting. The venous return curves, linear and concave, are dependent on the venous compliance. The hemodynamic equilibrium point is marked on the crossing point of venous return curve and the stroke volume curve. Users can interactively do discovery learning, and try and confirm their interests and get their questions answered about hemodynamic concepts by using the simulator.
Socioeconomic inequalities in type 2 diabetes mellitus: a study based on a population-based survey in Iran
Authors: Darvishi Ali , Nikkhah Adeleh , Mahmudimanesh Marzieh , Balajam Narges Zargar , Shafiee Gita , Heshmat Ramin
Published: March 2024

Background

Type 2 diabetes mellitus (T2DM) is the most prevalent form of Diabetes Mellitus (DM), with social and economic determinants significantly influencing its prevalence. This study aimed to analyze the socioeconomic inequalities associated with T2DM in Iran.

Methods

Data from an observational survey in Iran, titled “Diabetes Care (DiaCare),” were utilized for this study. Socioeconomic inequalities were assessed through variables including Hemoglobin A1C (HbA1c), Fasting Blood Glucose (FBG), and Triple target (HbA1c, blood pressure, LDL-C), using concentration indices (CIs) and a multivariate logistic regression analysis. Individual socioeconomic status (SES) was determined by calculating an asset index using principle component analysis (PCA) based on their properties. Data analysis was conducted using STATA software version 14.

Results

A total of 13,321 participants were included in the study. The CIs were significantly positive for controlled HbA1c (0.0324) and triple target (0.1067), while for controlled FBG, it was 0.0125, although not significant. Among females, the CIs were significantly positive for controlled HbA1c (0.0745), FBG (0.0367), and triple target (0.209). Additionally, in the 45–55 and 65–75 age groups, the CIs were significantly positive for controlled HbA1c (0.0607) and FBG (0.0708), respectively. This index was significant for controlled Triple target in the 35–45 (0.376) and 65–75 (0.124) age groups. The CI for controlled FBG was significant in rural dwellers (-0.044) while the concentration of controlled triple target was significant in urban dwellers (0.0967). Controlled HbA1c showed significant concentration in both urban (0.0306) and rural (-0.0576) dwellers. Furthermore, the CIs were significant for controlled HbA1c in regions with medium prevalence (0.0534) and FBG in regions with low prevalence (-0.0277). This index was significantly positive for controlled triple target in regions with high prevalence (0.124).

Conclusions

Diabetes care is more concentrated among individuals with higher SES. Policymakers should consider this to mitigate the inequality and alleviate the burden of T2DM.
Patients’ recommendations to improve help-seeking for vaginismus: a qualitative study
Authors: Pithavadian Rashmi , Dune Tinashe , Chalmers Jane
Published: March 2024

Background

Research to improve healthcare experiences for women with vaginismus tends to be produced from the perspective of healthcare professionals or health-based researchers. There is lacking research on women’s experiences and recommendations to improve help-seeking for vaginismus from their perspective. To address this research gap, this qualitative study aimed to identify the issues that women face when help-seeking for vaginismus and their recommendations to address it. This sought to support the wellbeing of patients to advocate for their healthcare needs which is often overlooked.

Methods

Using a feminist theoretical approach, semi-structured interviews were conducted with 21 participants who sought help for their vaginismus. Thematic analysis was employed to analyse participants’ recommendations.

Results

Four main themes emerged: Increase awareness of vaginismus, Dismantle myths about sex, Destigmatise vaginismus, and Empower people with vaginismus during medical consultations. Subthemes were identified as actionable strategies that participants recommended to improve help-seeking and healthcare for vaginismus.

Conclusions

The findings from this study can inform healthcare practice and policy to foster better synchronicity between health professionals and their patients’ perceptions and expectations of treating vaginismus. This can promote more acceptance of patients’ advocacy of their needs and goals to improve the therapeutic alliance and treatment outcomes for vaginismus in healthcare practice. The strategies recommended to increase awareness of vaginismus and challenge its stigma should be considered in policy to incite a culture of change in healthcare practice and broader society.
Astaxanthin attenuates cigarette smoke-induced small airway remodeling via the AKT1 signaling pathway
Authors: Ding Haidong , Yan Liming , Wang Yu , Lu Ye , Deng Mingming , Wang Yingxi , Wang Qiuyue , Zhou Xiaoming
Published: March 2024

Background

Astaxanthin (AXT) is a keto-carotenoid with a variety of biological functions, including antioxidant and antifibrotic effects. Small airway remodeling is the main pathology of chronic obstructive pulmonary disease (COPD) and is caused by epithelial-to-mesenchymal transition (EMT) and fibroblast differentiation and proliferation. Effective therapies are still lacking. This study aimed to investigate the role of AXT in small airway remodeling in COPD and its underlying mechanisms.

Methods

First, the model of COPD mice was established by cigarette smoke (CS) exposure combined with intraperitoneal injection of cigarette smoke extract (CSE). The effects of AXT on the morphology of CS combined with CSE -induced emphysema, EMT, and small airway remodeling by using Hematoxylin-eosin (H&E) staining, immunohistochemical staining, and western blot. In addition, in vitro experiments, the effects of AXT on CSE induced-EMT and fibroblast function were further explored. Next, to explore the specific mechanisms underlying the protective effects of AXT in COPD, potential targets of AXT in COPD were analyzed using network pharmacology. Finally, the possible mechanism was verified through molecular docking and in vitro experiments.

Results

AXT alleviated pulmonary emphysema, EMT, and small airway remodeling in a CS combined with CSE -induced mouse model. In addition, AXT inhibited the EMT process in airway cells and the differentiation and proliferation of fibroblasts. Mechanistically, AXT inhibited myofibroblast activation by directly binding to and suppressing the phosphorylation of AKT1. Therefore, our results show that AXT protects against small airway remodeling by inhibiting AKT1.

Conclusions

The present study identified and illustrated a new food function of AXT, indicating that AXT could be used in the therapy of COPD-induced small airway remodeling.
Sex-specific trends in incidence of first myocardial infarction among people with and without diabetes between 1985 and 2016 in a German region
Authors: Claessen Heiner , Narres Maria , Heier Margit , Kvitkina Tatjana , Linkohr Birgit , Wolff Georg , Roden Michael , Icks Andrea , Peters Annette
Published: March 2024

Background

The reduction of myocardial infarction (MI) and narrowing the gap between the populations with and without diabetes are important goals of diabetes care. We analyzed time trends for sex-specific incidence rates (IR) of first MI (both non-fatal MI and fatal MI) as well as separately for first non-fatal MI and fatal MI in the population with and without diabetes.

Methods

Using data from the KORA myocardial infarction registry (Augsburg, Germany), we estimated age-adjusted IR in people with and without diabetes, corresponding relative risks (RR), and time trends from 1985 to 2016 using Poisson regression.

Results

There were 19,683 people with first MI (34% fatal MI, 71% men, 30% with diabetes) between 1985 and 2016. In the entire study population, the IR of first MI decreased from 359 (95% CI: 345–374) to 236 (226–245) per 100,000 person years. In men with diabetes, IR decreased only in 2013–2016. This was due to first non-fatal MI, where IR in men with diabetes increased until 2009–2012, and slightly decreased in 2013–2016. Overall, fatal MI declined stronger than first non-fatal MI corresponding to IRs. The RR of first MI substantially increased among men from 1.40 (1.22–1.61) in 1985–1988 to 2.60 (2.26–2.99) in 1997–2000 and moderately decreased in 2013–2016: RR: 1.75 (1.47–2.09). Among women no consistent time trend for RR was observed. Time trends for RR were similar regarding first non-fatal MI and fatal MI.

Conclusions

Over the study period, we found a decreased incidence of first MI and fatal MI in the entire study population. The initial increase of first non-fatal MI in men with diabetes needs further research. The gap between populations with and without diabetes remained.
The molecular subtyping and precision medicine in triple-negative breast cancer---based on Fudan TNBC classification
Authors: Weng Lijuan , Zhou Jianliang , Guo Shenchao , Xu Nong , Ma Ruishuang
Published: March 2024

Triple-negative breast cancer (TNBC) is widely recognized as the most aggressive form of breast cancer, occurring more frequently in younger patients and characterized by high heterogeneity, early distant metastases and poor prognosis. Multiple treatment options have failed to achieve the expected therapeutic effects due to the lack of clear molecular targets. Based on genomics, transcriptomics and metabolomics, the multi-omics analysis further clarifies TNBC subtyping, which provides a greater understanding of tumour heterogeneity and targeted therapy sensitivity. For instance, the luminal androgen receptor subtype (LAR) exhibits responsiveness to anti-AR therapy, and the basal-like immune-suppressed subtype (BLIS) tends to benefit from poly (ADP-ribose) polymerase inhibitors (PARPis) and anti-angiogenic therapy. The efficacy of multi-dimensional combination therapy holds immense importance in guiding personalized and precision medicine for TNBC. This review offers a systematic overview of recent FuDan TNBC molecular subtyping and its role in the instruction of clinical precision therapy.
Biological roles of SLC16A1-AS1 lncRNA and its clinical impacts in tumors
Authors: Liao Bing , Wang Jialing , Yuan Yalin , Luo Hongliang , Ouyang Xi
Published: March 2024

Recent studies have increasingly highlighted the aberrant expression of SLC16A1-AS1 in a variety of tumor types, where it functions as either an oncogene or a tumor suppressor in the pathogenesis of different cancers. The expression levels of SLC16A1-AS1 have been found to significantly correlate with clinical features and the prognosis of cancer patients. Furthermore, SLC16A1-AS1 modulates a range of cellular functions, including proliferation, migration, and invasion, through its interactions with diverse molecules and signaling pathways. This review examines the latest evidence regarding the role of SLC16A1-AS1 in the progression of various tumors and explores its potential clinical applications as a novel prognostic and diagnostic biomarker. Our comprehensive review aims to deepen the understanding of SLC16A1-AS1’s multifaceted role in oncology, underscoring its potential as a significant biomarker and therapeutic target.