bluuebunny/crossref_metadata_2025 huggingface dataset:
The Regional Diagnosis of Onset and Demise of the Rainy Season over Tropical and Subtropical Australia
Authors: Misra Vasubandhu , Dixit Shubham , Jayasankar C. B.
Published: March 2023

In this paper, we introduce a novel strategy to robustly diagnose the onset and demise of the rainy season using daily observed rainfall over seven specific regions across Australia, as demarcated by the Natural Resource Management (NRM) agency of Australia. The methodology lies in developing an ensemble spread of the diagnosed onset and demise from randomly perturbing the observed daily time series of rainfall at synoptic scales to obtain a measure of the uncertainty of the diagnosis. Our results indicate that the spread of the ensemble in the diagnosis of the onset and demise dates of the rainy season is higher in the subtropical region than the tropical region. Secular change of earlier onset, later demise, longer length, and wetter season are also identified in many of these regions. The influence of the PDO at decadal scale, ENSO and Indian Ocean dipole at interannual scale, and MJO at intraseasonal scale also reveals significant influence on the evolution of the rainy season over these regions in Australia. Most important, the covariability of the onset date with the length of the season and seasonal rainfall anomaly of the season is highlighted as a valuable relationship that can be exploited for real-time monitoring and providing an outlook of the forthcoming rainy season, which could serve some of the NRM regions.

Significance Statement

We document the rainfall variability during the rainy season over tropical, subtropical, and semiarid regions of Australia and relate them to modes of climate variability spanning from intraseasonal to secular time scales. The study highlights the varied influence of the modes of climate variability on various aspects of the evolution of the rainy season, such as its onset and demise dates and the seasonal rainfall anomaly over these Australian regions. The study uses 114 years of data and shows that the variations in the length of the rainy season and its seasonal rainfall anomaly are strongly dictated by variations of rainy-season onset date. This provides a quick seasonal outlook of the forthcoming rainy season by just monitoring the onset-date evolution in these regions.
User Experiences of Well-Being Chatbots
Authors: Kettle Liam , Lee Yi-Ching
Published: March 2023

Objective

The current paper conducted two parallel studies to explore user experiences of well-being conversational agents (CAs) and identify important features for engagement.

Background

Students transitioning into university life take on greater responsibility, yet tend to sacrifice healthy behaviors to strive for academic and financial gain. Additionally, students faced an unprecedented pandemic, leading to remote courses and reduced access to healthcare services. One tool designed to improve healthcare accessibility is well-being CAs. CAs have addressed mental health support in the general population but have yet to address physical well-being support and accessibility to those in disadvantaged socio-economic backgrounds where healthcare access is further limited.

Method

Study One comprised a thematic analysis of mental health applications featuring CAs from the public forum, Reddit. Study Two explored emerging usability themes of an SMS-based CA designed to improve accessibility to well-being services alongside a commercially available CA, Woebot.

Results

Study One identified several themes, including accessibility and availability, communication style, and anthropomorphism as important features. Study Two identified themes such as user response modality, perceived CA role, question specificity, and conversation flow control as critical for user engagement.

Conclusion

Various themes emerged from individuals’ experiences regarding CA features, functionality, and responses. The mixed experiences relevant to the communication and conversational styles between the CA and the user suggest varied motivations for using CAs for mental and physical well-being.

Application

Practical recommendations to encourage continued use include providing dynamic response modalities, anthropomorphizing the chatbot, and calibrating expectations early.
Foreign Capital Inflow, Exportability and the Indian Economy
Authors: Maiti Dibyendu , Singh Prakash
Published: March 2023

The article investigated the effect of foreign direct investment (FDI) on Indian exports using aggregate and disaggregate data to capture macro- and micro-channels. India registers a steady rise in FDI during 1980–2018 in absolute terms but not in terms of GDP share. At the aggregate level, FDI is found to have significantly influenced Indian exports (both manufacturing and services) during 1980–2018 by suppressing its adverse effect on currency appreciation. Even at the firm-level analysis using the World Bank Enterprise Survey database, it is evident that higher participation of foreign ownership, a proxy of FDI measure, seems to have encouraged their export decisions. However, more than 50% of the capital inflows are received from two three countries which is also on limited service-related activities. The lower FDI share on manufacturing has limited the export rise.

JEL Codes: F16, L11
Profound Simplicity: Lessons Learned from Ed Schein on Rituals That Sustain and Nurture Relationships
Authors: Wasserman Ilene C.
Published: March 2023

As I attempt to digest Ed Schein's recent passing, I am present to the friendship I was honored to develop with him over the past 12 years and the voluminous lessons I learned. Like so many, my career was shaped by Ed Schein's scholarship. And yet, it was in our personal, unstructured conversations that I was most impacted by who he was, and the values and principles by which he lived. Our conversations centered on what creates, sustains and nurtures relationships all while we were doing so.
Tactile perception of textile fabrics using event-related potentials and nonlinear methods
Authors: Tang Chaoquan , Zhuang Tengfei , Fang Xingxing , Yu Chuang , Tang Wei
Published: March 2023

Tactile perception is processed in the somatosensory cortices of the brain. To study the electrical activity of the brain evoked by the tactile perceptions of fabric textures, electroencephalograph signals during tactile perception were evaluated using event-related potentials and recurrence quantification analysis methods. A support vector machine was used to realize the identification of electroencephalograph signals. The results showed that fabric surface with large surface roughness, critical buckling force, and fiber diameter, and low warp-weft density was preferentially perceived, need large attentional resources, and evoke strong nonstationary state of the electroencephalographic system during the tactile perception. The δ rhythm was the main rhythm of event-related potential signals evoked by tactile perception of fabrics and the main energy of the electroencephalograph rhythm was concentrated in the low frequency band. The electroencephalographic system was in a strong nonstationary and fluctuating state during the production stage of P200 and P300 components of the event-related potential wave. The combination of P200, P300, mean diagonal line length L, and trapping time TT can significantly improve the classification accuracy of the electroencephalograph signal of tactile perception to about 72%.
A review of approaches and applications in building stock energy and indoor environment modelling
Authors: Dong J , Schwartz Y , Mavrogianni A , Korolija I , Mumovic D
Published: March 2023

Current energy and climate policies are formulated and implemented to mitigate and adapt to climate change. To inform relevant building policies, two bottom-up building stock modelling approach: 1) archetype-based and 2) Building-by-building have been developed. This paper presents the main characteristics and applications of these two approaches and evaluates and compares their ability to support policy making. Because of lower data requirements and computational cost, archetype-based modelling approaches are still the mainstream approach to stock-level energy modelling, life cycle assessment, and indoor environmental quality assessment. Building-by-building approaches can better capture the heterogeneous characteristics of each building and are emerging due to the development of data acquisition and computational techniques. The model uncertainties exist in both models which may affect the reliability of outputs, while stochastic archetype models and timeless digital twin model have the potential to address the issue. System dynamics modelling approach can describe and address the dynamics and complexity of often-conflicting policies and achieve co-benefit of multiple policy objectives.

This paper aims to provide comprehensive knowledge on building stock modelling for modellers and policymakers, so they could use a building stock model with an appropriate user interface without having to fully understand the underlying algorithms or complexities.
Endoscopic total thyroidectomy using a unilateral transaxillary approach: A case report
Authors: Liu Yang , Wang Jiazhong , Chen Shuo , Cao Gang
Published: March 2023

Endoscopic transaxillary thyroidectomy is a common method for remote-access thyroidectomy. The approach typically uses a gasless method, and a long incision to insert a special retractor. In addition, it is considered only suitable for unilateral lobectomy because of problems accessing contralateral parts of the thyroid gland. We describe here, a case of a young woman who had a total thyroidectomy performed using an endoscopic approach. We reduced the non-inflated 4–6 cm incision that is usually required, into three holes, and performed unilateral transaxillary thyroidectomy; this was verified by radioactive iodine uptake and thyroglobulin levels during follow-up. The approach was clinically successful and resulted in minimal scarring. More studies are required to optimize this promising technique.
How Has Anticipated Post-Pandemic Ride-Sourcing Use Changed During the COVID-19 Pandemic? Evidence from a Two-Cycle Survey of the Greater Toronto Area
Authors: Loa Patrick , Ong Felita , Nurul Habib Khandker
Published: March 2023

The COVID-19 pandemic has significantly affected activity-travel behavior in cities across the world, and in particular, travel mode choices. Studies on the topic have attributed shifts in modal preferences to the changes in attitudes toward different modes of travel that resulted from the pandemic. A common theme is that attitudes toward so-called individual modes of travel, such as private vehicles and active modes, have become more positive. In contrast, attitudes toward shared modes have become more negative. Ride-sourcing represents a relatively unique middle ground, as it combines the attributes of individual and shared modes. Given the potential for the availability of these services to influence activity-travel behavior and the operations of transportation networks before the pandemic, the potential nature of post-pandemic ride-sourcing use has important implications for transportation planning. This study uses data from a web-based, two-cycle survey to examine anticipated post-pandemic ride-sourcing usage among pre-pandemic ride-sourcing users in the Greater Toronto Area. The results highlight how anticipated post-pandemic ride-sourcing usage has changed as the pandemic has progressed, including the extent to which the determinants of anticipated usage have shifted. Notably, it was observed that changes in perceptions of risk during the pandemic influence anticipated post-pandemic ride-sourcing use. Furthermore, changes in ride-sourcing use in response to the pandemic and the utilization of ride-sourcing during the pandemic were also found to influence anticipated post-pandemic usage. Overall, the results of this study underscore the potential for post-pandemic ride-sourcing usage to differ from that of pre-pandemic usage.
Capacity at All-Way Stop Control Intersections: Case Study
Authors: Al-Kaisy Ahmed , Doruk Dorukhan
Published: March 2023

This paper presents an empirical investigation into the capacity of all-way stop-controlled (AWSC) intersections. Video data was collected over four days at an AWSC intersection site in Bozeman, Montana. The site is characterized by single-lane approaches and high level of vehicular and pedestrian traffic. Using strict protocols, video records were processed at the individual vehicle level and several information metrics were extracted for each vehicle in the data set on all approaches. Study results indicate that the total intersection capacity at the study site varied between 400 and 1,400 vehicles per hour. The study suggests that the wide range of capacity observations is largely associated with the pedestrian crossing activity at the study site. Statistical tests confirmed that both pedestrian crossing activity and the level of conflict have significant effects on intersection capacity at the 95% confidence level. For movement type, the right-turn movement was not found to have a significant effect on intersection capacity while left-turn movement was found to negatively affect the intersection capacity. The results presented in this paper offer valuable information on AWSC intersection capacity, given the limited amount of information in the literature and the dated nature of those empirical observations.
Layered Viscoelastic Analysis with Moving Loads of Low-Volume Roadway Pavement Response
Authors: Stache Jeremiah M. , Doyle Jesse D.
Published: March 2023

Low-volume roads (LVRs) are typically not expected to withstand large amounts of traffic, consequently they have relatively thin pavement structures. However situations can occur when traffic loading rapidly increases, resulting in rapid structural deterioration of the pavement. Examples include resource exploration and production, new industrial facilities, and military operations. Improved evaluation procedures, including computation of pavement structural responses, are needed to accommodate these scenarios. This paper reports recent advances in methods for computing the structural response of LVRs that incorporate viscoelastic asphalt material behavior and accommodate moving loads. Application of layered elastic analysis, using a Hankel transform with numerical integration methods, is popular in several mechanistic-empirical pavement design procedures. This paper describes an application of the collocation method for approximating the creep compliance and viscoelastic solution, which removes the necessity for approximating the Laplace transform inversion. This was coupled with Boltzmann’s superposition principle for moving loads. Comparisons showed that the proposed approximate method matched well with the viscoelastic solution, and with the full-scale instrumented test data of highway pavements. The measured near surface response of a thin LVR test pavement subjected to military truck loads was then modeled to determine the suitability of the approach for LVR. The modeled results for asphalt strain and vertical pressure in the granular layers showed generally good agreement with the measured instrumentation data. The developed structural response model provided a more realistic simulation of flexible pavement viscoelastic material behavior and accommodation of moving loads with similar computational speed to a conventional layered elastic approach.
Biomechanical Comparison of Anterior Cruciate Ligament Reconstruction Using a Single-Bundle Round or Ribbon-like Hamstring Tendon Graft
Authors: Delaloye Jean-Romain , Hartog Christoph , Blatter Samuel , Schläppi Michel , Müller Dominic , Schwenke Thorsten , Murar Jozef , Koch Peter P.
Published: March 2023

Background:

Persistent instability of the knee is reported in up to 30% of patients after anterior cruciate ligament (ACL) reconstruction. Based on anatomic findings showing that ACL is a flat ribbon-like structure that twists during knee flexion, a new surgical ACL reconstruction technique using a ribbon-like graft has been developed. However the effect of this surgical technique on knee kinematics has not yet been evaluated.

Purpose:

To compare the anteroposterior and rotational stability of the knee after ACL reconstruction using single-bundle (SB) round and ribbon-like grafts in anterolateral-intact/deficient knees.

Study Design:

Controlled laboratory study.

Methods:

Twelve human fresh-frozen cadaveric knees were tested with a 6 degrees of freedom robotic system. Internal rotation and anterior translation of the knee were recorded from 0° to 90° of flexion. A full kinematic assessment was performed in each of the following conditions: (1) intact knee, (2) after sectioning of the ACL, (3) after ACL reconstruction using a SB hamstring tendon graft in a round configuration and a ribbon-like configuration, and (4) after sectioning of the anterolateral structures. One-way analysis of variance and post hoc Tukey tests were used for statistical analyses.

Results:

When compared with the intact knee, the ACL-deficient knee demonstrated a mean ± SD increase in anterior translation and internal rotation of 6.3 ± 2.5 mm ( P < .01) and 5.8°± 2.3° ( P < .01), respectively. After ACL reconstruction using a SB ribbon-like graft, the mean difference in anterior translation and internal rotation as compared with the intact knee was −0.1 ± 1.5 mm ( P = .842) and 0.0°± 1.1° ( P = .999). These differences from the intact knee were also not significant after ACL reconstruction using a round graft (−0.1 ± 1.3 mm, P = .999; −0.5°± 1.5°, P = .401). In the ACL-reconstructed knee using either a ribbon-like or round graft, sectioning of the anterolateral structures did not induce a significant increase of anterior translation and internal rotation of the knee.

Conclusion:

ACL reconstruction using a SB ribbon-like or round graft restored the kinematics of the intact knee at time zero. Secondary sectioning of the anterolateral structures in the ACL-reconstructed knee using both types of graft did not significantly affect the anterior translation and internal rotation of the knee.

Clinical Relevance:

This is the first biomechanical study on the new ACL reconstruction technique using a ribbon-like graft.
What Can Unions Do? An Impact Estimate for an Increase in the US Private-Sector Unionization Rate on Workers’ Earnings
Authors: Kristal Tali
Published: March 2023

Unions are known to increase earnings and wage equality. Therefore, indications for recent union revitalization provoke the question of what unions would do today were they to restore their union density and hence power to the level of the early 1980s (about 20%). This article presents wage estimates for 1983 to 2020, assuming a 20% union density from 1983 onward, revealing higher earnings and lower wage inequality. However, since union membership today typifies low-wage workers with weaker bargaining power than formerly, the benefits from restoring union density and power will likely be lower today than in the past.
Encapsulation and antibacterial studies of goji berry and garlic extract in the biodegradable chitosan
Authors: Baysal Gülay , Olcay Hatice Sena , Günneç Çağatay
Published: March 2023

As known, the chitosan is a biodegradable biopolymer with antibacterial properties, therefore it is used in the fields of pharmacy, medical, wastewater treatment, biotechnology, cosmetics, textiles, and agriculture. Apart from these, the chitosan has an important place in the food industry with its widespread use. In this research article, the chitosan were encapsulated with the taurine and garlic extracts by the spray dryer. The CSA and CSB compounds synthesized as final products were analyzed by Fourier transformed infrared spectroscopy (FTIR) and High Performance Liquid Chromatography (HPLC). The effect of the encapsulation process on the molecular weight of the polymer structure was investigated using the cryoscopy method. The compound CSA represents 1/2 encapsulation of chitosan with taurine and increased garlic extracts, respectively, while CSB represents 1/1 encapsulation of chitosan with increased taurine and fixed garlic extracts. The % antioxidant activity of the final products was determined by DDPH method. The inhibition zone and surface activity proporties of the CSA and CSB were carried out against Listeria monocytogenes, Staphylococcus aureus, E. coli, and Salmonella bacteria. The results obtained as a result of the analyzes were evaluated, and optimum values were determined for use in food packaging.
Noise Complaints and Land Rezoning as a Predictor of Hate Crimes in a New York City Borough
Authors: Lettieri Jess , Logie Kenji , Paccione-Frometa Jill
Published: March 2023

Hate crimes generally have severe victim outcomes compared to other crimes, and therefore warrant further investigation. These types of crimes can often happen in neighborhoods where people from various cultures, socioeconomic backgrounds, religions, etc. meet. Understanding how neighborhood tensions impact the level of hate crimes is important in reducing hate crimes and building community. The current study investigates neighborhood level predictors of hate crimes in a borough of New York City (NYC). Using symbolic threat and defended neighborhoods frameworks, we consider how 311 noise complaints and land use rezoning data can be predictors of hate crimes. We use data from the New York City Police Department (NYPD) and NYC Land Use Tax Output. We find that hate crimes are more likely in the neighborhoods where the noise complaints and land use rezoning are higher than the median. The theoretical implications of these findings are discussed below.
Preparation and electrochemical properties of thieno-[3,4-b] pyrazine conjugated polymer composite supercapacitor carbon powder electrode materials for Li-organic battery
Authors: Yue Xin , Zhao Jinsheng
Published: March 2023

In this work, two D-A monomers 2,3-di(5-methylfuran-2-yl)-5,7-di(thiophene-2-yl) thiopheno[3,4-b] pyrazine (MFTTP) and 2,3-di(5-methylfuran-2-yl)-5,7-di(4-methoxythiophen-2-yl) thiopheno [3,4-b] pyrazine (MFMOTTP) were first obtained by Stille Coupling reaction, and then the corresponding composites were obtained by in-situ oxidative polymerization method with supercapacitor carbon. The surface morphology, chemical structure, and the element valence states of two materials were characterized by scanning electron microscopy, infrared and XPS, respectively. The specific surface areas of PMFTTP@SC and PMFMOTTP@SC are measured as 756.5 and 954.9 m2/g, respectively. The CV curves were used to determine the initial oxidative and initial reduction potentials, both polymers have a narrow band gap with Eg values below 1.5 eV, electron clouds in the HOMO and LUMO orbits of the polymer are mainly distributed on the aromatic rings of the polymer backbone. Polymer composite materials were used as the anode materials and the lithium sheets were used as counter electrode, and then lithium ion batteries are assembled. The first discharge specific capacities of PMFTTP@SC and PMFMOTTP@SC are 741.9 and 951.3 mAh/g at a current density of 100 mA/g, and as the electrodes are activated in the subsequent cycles, their coulomb efficiencies can reach more than 92% from the third cycle. In contrast, PMFMOTTP with methoxy-thiophene as the donor unit has higher conductivity and lower corresponding impedance due to its stronger electron donating ability and abundant pore structure, which is also more conducive to the lithiation/delithiation redox process.
Influence of vortex interactions on the exergy transfer and performance of OWC wells turbine
Authors: Geng Kaihe , Yang Ce , Zhang Hanzhi , Zhao Ben , Hu Chenxing , Gao Jianbing , Li Yanzhao
Published: March 2023

To provide deep dives about aerodynamic loss mechanisms in Wells turbines for wave energy conversion, a loss audit analysis was performed by numerical experiments in a monoplane Wells turbine with guide vanes. The interactions between the tip-leakage and leading-edge vortices during the stall process were captured by an improved vortex identification method, which revealed the relationship between vortex interactions and stall mechanisms by identifying coherent structures and tracking the vortex core trajectory. Finally, the influence of vortex interactions on exergy transfer was quantified. The results indicate that the lost kinetic energy and mixing losses dominate the loss generation in the Wells turbine stage under stall conditions. Under the beneficial effect of tip leakage flow, leading-edge separation first begins at the equilibrium region between the tip-leakage and leading-edge vortices. As the leading-edge vortices expand toward the blade tip, the intensified leading-edge vortex interacts with the casing suction-side corner vortex and accelerates the dissipation of the tip-leakage vortices. Consequently, the contributions of viscous irreversibilities outweigh those of shaft work, being the dominant factor in the decrease in flow exergy, leading to a decrease in exergy utilization by 38.46% from the pre-stall condition to the stall condition.
Pilot study: External surface contamination of gemcitabine and 5-fluorouracil on drug packaging
Authors: Kåredal Monica , Özdemir Jennie , Tinnert Andreas , Wetterling Maria , Hedmer Maria
Published: March 2023

Introduction

Antineoplastic drugs (ADs) are commonly used pharmaceuticals for anticancer treatments. It has previously been shown that the external surface of drug vials frequently is contaminated with ADs. More than a decade ago methods to prevent occupational exposure were introduced by using plastic coverage of the glass vials or packing vials in a secondary plastic container. The aim of the pilot study was to determine contamination levels of ADs on different parts of AD packaging of two different commercially available drug vials on the Swedish market and to investigate the occurrence of cross contamination of ADs.

Methods

Packagings of gemcitabine (GEM) and 5-fluorouracil (5-FU) were tested by wipe sampling. Five ADs; GEM, 5-FU, cyclophosphamide (CP), ifosfamide and etoposide were quantified using liquid chromatography mass spectrometry.

Results

AD contaminations were detected in 69% and 60% of the GEM and 5-FU packaging samples. Highest levels, up to approximately 5  µg/sample, were observed on the glass vials. The protective shrink-wrap of 5-FU vials and the plastic container of GEM were contaminated with low levels of 5-FU and GEM, respectively, and furthermore the 5-FU vials with shrink-wrap were cross-contaminated with GEM. Cross-contamination of CP and GEM was detected on 5-FU vials with plastic shrink-wrap removed.

Conclusions

External contamination of ADs are still present at primary drug packagings on the Swedish market. Protection of AD vials by plastic shrink-wrap or a secondary plastic container does not remove the external contamination levels completely. The presence of cross contamination of ADs on drug packagings was also observed.
Emergency Nurses’ Care of Psychiatric Patients
Authors: Hennen Rebecca , Phillips Kathryn E.
Published: March 2023

Objective:

The volume of patients with mental illness presenting to the emergency department (ED) has been increasing in recent years, yet many ED nurses hold stigmatized attitudes and behaviors about patients with mental illness, creating barriers to therapeutic care. At the same time, there has been an increase in workplace violence (WPV) against nurses. Fortunately, resilience helps nurses manage their response to WPV and continue to provide therapeutic care. Although research has considered many barriers to the therapeutic care of patients with mental illness in the ED, the variables of stigma, resilience, and the experience of WPV have not been considered in relation to behavioral care competence and work performance, which is the purpose of this study.

Methods:

A survey consisting of the Brief Resilience Scale, the Individual Work Performance Questionnaire, the Behavioral Healthcare Competency (BHCC) survey, the Opening Minds Scale for Healthcare Providers, and open-ended questions about WPV were used to collect data. Independent t-tests were run between scale scores and categorical descriptive data. Correlations were run between scale scores and continuous descriptive data.

Results:

Over half (60%) had experienced a personal injury from WPV. Higher behavioral competence scores were associated with lower stigma and higher contextual work performance. Nurses who experienced a WPV injury had higher mean BHCC and higher contextual work performance scores.

Conclusions:

WPV may be an impetus for nurses to improve their practice in behavioral health and working as part of a team.
The Complex Genetics of Common Variable Immunodeficiency
Authors: Schroeder Harry W. , Schroeder Harry W. , Sheikh Sofia M.
Published: March 2023

Immunoglobulin (lg)A deficiency and common variable immunodeficiency (CVID) are the most common primary immunodeficiency disorders in North America and Europe. These diseases appear to comprise a familial spectrum of immunodeficiency that ranges from partial IgA deficiency to a complete absence of serum immunoglobulin. The CVID phenotype is typically acquired and can spontaneously revert to IgG and IgM sufficiency. Family studies suggest the presence of at least two susceptibility loci within the major histocompatibility complex on the short arm of chromosome 6: one located near the class II region and the other located near the junction between the class III and class I regions. Inheritance of these susceptibility genes may yield an additive risk for the development of immunodeficiency. First-degree family members of patients with CVID are at risk throughout their lives for the development of these diseases and should be monitored with a high index of suspicion.
Forming Your Phase III Trial's Data and Safety Monitoring Board: A Perspective on Safety
Authors: Wittes Janet
Published: March 2023

A data safety monitoring board (DSMB) established in a phase III trial to monitor the safety of participants in a clinical trial views itself as protecting participants and ensuring the integrity of the study. The DSMB should operate under a clear charter, with expectations understood by all members of the Board, the sponsor, and the investigators. Sponsors must trust their DSMBs. The sponsor must give the DSMB the tools and the data that it needs to operate effectively in protecting the safety of the participants.
Diagnostic accuracy and management concordance of otorhinolaryngological diseases through telehealth or remote visits: A systematic review & meta-analysis
Authors: Shah Sunny R , Munhall Christopher C , Nguyen Shaun A , O’Rourke Ashli K , Miccichi Kate , Meyer Ted A
Published: March 2023

Introduction

COVID-19 has led to delays in providing healthcare in both emergency and non-emergency settings, especially in surgical subspecialties which rely heavily on referrals and in-person visits. Without an established telehealth infrastructure, many otorhinolaryngological departments experienced decreases in consultations. Telemedicine has attempted to bridge the gap between pre- and post-pandemic periods by creating a safe avenue of communication between otorhinolaryngologists and patients. This review hopes to address the accuracy of telemedicine in patient diagnosis and management.

Methods

Searches were conducted since study conception until June 30, 2022, on multiple databases including PubMed, SCOPUS, and CINAHL for this systematic review and meta-analysis. Diagnostic accuracy, management accuracy, kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were meta-analyzed by comparing virtual visits to in-person visits (gold standard).

Results

Nineteen studies were included in this review. A total of 1518 patients were included across all studies. When comparing virtual visits against in-person visits, accurate diagnosis was made in 86.2% [82.1,89.9, I2 = 73.5%, P < 0.0001] of patients and management accuracy was 91.5% [86.1,95.7, I2 = 81.8%, P < 0.0001] when treating patients. Kappa value determining interrater reliability was 0.8 [0.7,0.9, I2 = 81.8%, P < 0.0001].

Conclusion

Our data suggest that diagnostic and management concordance is above 80% when comparing diagnosis and management strategies in patients who underwent both telehealth and in-person visits with an otorhinolaryngologist. In uncomplicated patients, telehealth might be a reliable source for diagnosis and management however, in-person consultation is likely still required for pathologies in which physical exam, imaging or procedural elements represent a vital component of the work-up.
Rethinking frame analysis ‘from the margins’: A decolonial-intersectional epistemology to studying immigrants’ rights claims
Authors: Cappiali Teresa M
Published: March 2023

In this article, I explain how I use frame analysis in my research on immigrants’ rights claims in receiving society. My theoretical approach relies on two core aspects. First, I use a decolonial-intersectional epistemology to conceptualize my methodology and conduct my empirical research. This approach allows to bring into focus the analysis of ideology and power dynamics to understand how immigrants are constructed by different political actors and how immigrant activists respond. Second, I adopt an actor-oriented approach and combine ethnographic research with frame analysis to make sense of how pro-immigrant actors and immigrants themselves frame their approach to migration and the ways in which they translate their framing into specific strategies to integrate immigrants in society and promote their rights. As an example, I discuss how I have applied the theoretical approach to my research on immigrant activism in Italy. Beyond my work, this article emphasizes that a decolonial-intersectional approach can improve current research on frame analysis of rights claims of marginalized groups, by addressing how these groups expose and challenge structures of oppression in their own terms.
Back lane geography: in praise of worlds behind
Authors: Nieuwenhuis Marijn
Published: March 2023

‘Gateshead’, the Tory playwright Samuel Johnson said, is ‘the dirty back lane leading to Newcastle’. What his derogatory dialectic misses is the significance of the back lane as a place in and of itself. Although not written about much, at least not in geography, I believe that these streets are important places to understand neighbourhoods and communities in the Northeast of England. Without the lives and places of the back lane a Northern town is only nominally northern. Sticking to the limitations imposed by the COVID lockdown restrictions at the time of writing, which asked people to remain indoors whenever possible, I chose to travel and explore the significance of these streets digitally. Using both autoethnographic reflections from memories of walking in these streets and Google Street View, I explore the hidden geographies of back lanes in Bensham, a neighbourhood of Gateshead, Tyne and Wear, England, where I live.
Ablative Therapies for Breast Cancer: State of Art
Authors: Carriero Serena , Lanza Carolina , Pellegrino Giuseppe , Ascenti Velio , Sattin Caterina , Pizzi Caterina , Angileri Salvatore Alessio , Biondetti Pierpaolo , Ianniello Andrea Antonio , Piacentino Filippo , Lavorato Roberto , Ierardi Anna Maria , Carrafiello Gianpaolo
Published: March 2023

Breast cancer (BC) is the most frequently diagnosed malignancy among women. In the past two decades, new technologies and BC screening have led to the diagnosis of smaller and earlier-stage BC (ESBC). Therefore, percutaneous minimally invasive techniques (PMIT) were adopted to treat patients unfit for surgery, women who refuse it, or elderly patients with comorbidities that could make surgery a difficult and life-threatening treatment. The target of PMIT is small-size ESBC with the scope of obtaining similar efficacy as surgery. Minimally invasive treatments are convenient alternatives with promising effectiveness, lower morbidity, less cost, less scarring and pain, and more satisfying cosmetic results. Ablative techniques used in BC are cryoablation, radiofrequency ablation, microwave ablation, high-intensity focused ultrasound (US), and laser ablation. The aim of our study is to discuss the current status of percutaneous management of BC, evaluate the clinical outcomes of PMIT in BC, and analyze future perspectives regarding ablation therapy in BC.
A survey of fatigue measures and models
Authors: Laverghetta Antonio , Tran Minh , Braynen Alec , Steinle Stephen , Moydinboyev Bekhzodbek , Daas Heba , Licato John
Published: March 2023

In long, stressful operational periods, military personnel face numerous challenges that may compromise their performance, an especially important one being fatigue. Current literature supports the view that behavioral, physiological, and cognitive factors are all predictive of the level of fatigue in individuals. However, much of the work on modeling fatigue has taken a narrow approach, relying only on a handful of modalities to measure fatigue. This paper aims to fill the void by providing an extensive overview of the current literature on both computationally measuring and modeling fatigue. We provide up-to-date and practical advice on which models are best suited for different situations and highlight directions for future work.
Using modified intention-to-treat as a principal stratum estimator for failure to initiate treatment
Authors: Kahan Brennan C , White Ian R , Edwards Mark , Harhay Michael O
Published: March 2023

Background:

A common intercurrent event affecting many trials is when some participants do not begin their assigned treatment. For example, in a double-blind drug trial, some participants may not receive any dose of study medication. Many trials use a ‘modified intention-to-treat’ approach, whereby participants who do not initiate treatment are excluded from the analysis. However, it is not clear (a) the estimand being targeted by such an approach and (b) the assumptions necessary for such an approach to be unbiased.

Methods:

Using potential outcome notation, we demonstrate that a modified intention-to-treat analysis which excludes participants who do not begin treatment is estimating a principal stratum estimand (i.e. the treatment effect in the subpopulation of participants who would begin treatment, regardless of which arm they were assigned to). The modified intention-to-treat estimator is unbiased for the principal stratum estimand under the assumption that the intercurrent event is not affected by the assigned treatment arm, that is, participants who initiate treatment in one arm would also do so in the other arm (i.e. if someone began the intervention, they would also have begun the control, and vice versa).

Results:

We identify two key criteria in determining whether the modified intention-to-treat estimator is likely to be unbiased: first, we must be able to measure the participants in each treatment arm who experience the intercurrent event, and second, the assumption that treatment allocation will not affect whether the participant begins treatment must be reasonable. Most double-blind trials will satisfy these criteria, as the decision to start treatment cannot be influenced by the allocation, and we provide an example of an open-label trial where these criteria are likely to be satisfied as well, implying that a modified intention-to-treat analysis which excludes participants who do not begin treatment is an unbiased estimator for the principal stratum effect in these settings. We also give two examples where these criteria will not be satisfied (one comparing an active intervention vs usual care, where we cannot identify which usual care participants would have initiated the active intervention, and another comparing two active interventions in an unblinded manner, where knowledge of the assigned treatment arm may affect the participant’s choice to begin or not), implying that a modified intention-to-treat estimator will be biased in these settings.

Conclusion:

A modified intention-to-treat analysis which excludes participants who do not begin treatment can be an unbiased estimator for the principal stratum estimand. Our framework can help identify when the assumptions for unbiasedness are likely to hold, and thus whether modified intention-to-treat is appropriate or not.
Circulating tumour DNA in the evolving treatment landscape of locally advanced rectal cancer: where does it fit in?
Authors: Piercey Oliver , Tie Jeanne
Published: March 2023

The management of locally advanced rectal cancer (LARC) requires multimodality treatment, typically with neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision. However, the treatment landscape is rapidly evolving with total neoadjuvant therapy and non-operative management for selected patients emerging as other novel treatment approaches. With so many treatment options, there is a need for biomarkers to direct a more personalised treatment strategy for patients with LARC. In this review, we summarise the available data regarding the use of circulating tumour DNA (ctDNA) in patients with LARC, as both a marker of treatment response to neoadjuvant therapy and as a marker of minimal residual disease (MRD) after patients have completed definitive local treatment. To date, the ability of ctDNA status to predict for pathologic complete response at any timepoint during multimodality treatment has been variably reported. The most consistent finding across available studies is the ability of ctDNA to detect MRD after CRT and surgery, the presence of which confers a significantly poor prognosis, with increased risk of cancer recurrence and worse overall survival. It is yet to be determined if providing additional therapies to patients with MRD improves outcomes. The available studies assessing the potential utility of ctDNA in LARC are limited by significant heterogeneity in the choice of ctDNA assay, timepoint at which ctDNA was collected, treatment that patients received and length of follow-up, leading to uncertainties about how to implement it into daily clinical practice. As the treatment landscape evolves, larger randomised trials assessing the role of ctDNA in LARC are needed.
The application of machine learning in early diagnosis of osteoarthritis: a narrative review
Authors: Xuan Anran , Chen Haowei , Chen Tianyu , Li Jia , Lu Shilong , Fan Tianxiang , Zeng Dong , Wen Zhibo , Ma Jianhua , Hunter David , Ding Changhai , Zhu Zhaohua
Published: March 2023

Osteoarthritis (OA) is the commonest musculoskeletal disease worldwide, with an increasing prevalence due to aging. It causes joint pain and disability, decreased quality of life, and a huge burden on healthcare services for society. However, the current main diagnostic methods are not suitable for early diagnosing patients of OA. The use of machine learning (ML) in OA diagnosis has increased dramatically in the past few years. Hence, in this review article, we describe the research progress in the application of ML in the early diagnosis of OA, discuss the current trends and limitations of ML approaches, and propose future research priorities to apply the tools in the field of OA. Accurate ML-based predictive models with imaging techniques that are sensitive to early changes in OA ahead of the emergence of clinical features are expected to address the current dilemma. The diagnostic ability of the fusion model that combines multidimensional information makes patient-specific early diagnosis and prognosis estimation of OA possible in the future.
Outcomes of percutaneous femoral derotational osteotomy in pediatric patients
Authors: Geffner Adam D , Ellsworth Bridget K , Greenstein Michael , Fragomen Austin T , Rozbruch S Robert
Published: March 2023

Background:

Percutaneous femoral derotational osteotomies are performed in both adult and pediatric patients. There is little published on the outcomes after femoral derotational osteotomy in pediatric patients.

Methods:

A retrospective cohort study of pediatric patients treated with percutaneous femoral derotational osteotomy by one of two surgeons between 2016 and 2022 was performed. Data collected included patient demographics; surgical indications; femoral version; tibial torsion; magnitude of rotational correction; complications; time to hardware removal; pre-operative and post-operative patient-reported outcome scores, including Limb Deformity–Scoliosis Research Society and Patient-Reported Outcomes Measurement Information System; and time to consolidation. Descriptive statistics were used to summarize the data and t tests used to compare means.

Results:

Thirty-one femoral derotational osteotomies in 19 patients were included with an average age of 14.7 (9–17) years. The average rotational correction was 21.5° ± 6.4° (10°–40°). The average length of follow-up was 17.9 ± 6.7 months. There were no instances of nonunion, joint stiffness, or nerve injury. No patients returned to the operating room for additional surgeries other than routine hardware removal. There were no cases of avascular necrosis of the femoral head. Of the 19 patients, 8 completed both a pre-operative and post-operative survey set. There were significant improvements in the Limb Deformity–Scoliosis Research Society Self-Image/Appearance sub-category and the Patient-Reported Outcomes Measurement Information System Physical Function sub-category.

Conclusion:

Femoral derotational osteotomy using a percutaneous drill hole technique with antegrade trochanteric entry femoral nail is safe in the pediatric population and improves self-image in patients with symptomatic femoral version abnormalities.
Restoration longevity: Q: “How long will my crown last?” A: “78 years, Madame” – A case report
Authors: Maidment Yann
Published: March 2023

This case report describes a post-retained crown placed on an anterior tooth that survived 78 years, with restoration repairs at 40 years and 58 years following placement. The history of the patient’s other dental restorations and care showed a similar longevity.
Evaluation of marginal and internal fit of lithium disilicate and zirconia all-ceramic CAD-CAM crowns using digital impressions: A systematic review
Authors: Turkyilmaz Ilser , Benli Merve , Yun Sarah
Published: March 2023

Purpose:

A range of materials for single-tooth computer-aided design and computer-aided manufacturing (CAD-CAM) restorations have been introduced that may affect CAM accuracy. This study aimed to review articles evaluating marginal and internal fit of lithium disilicate (LD) and zirconia (Z) crowns fabricated by CAD-CAM systems using intraoral optical scanners (IOS).

Materials and methods:

Under the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA), a systematic review was performed along with an electronic article search in the Medline/Pubmed database. The articles were limited to those in the English language that were published within the past ten years.

Results:

The initial search resulted in 50 articles and of those, a total of 18 articles were selected for full-text review following abstract evaluation. Eight articles that did not meet the inclusion criteria were excluded and the remaining ten articles, which provided internal and marginal gap values, were used in this review. For LD crowns, marginal gap values ranged between 45µm and 190.2µm. For Z crowns, the values varied between 39µm and 126.4µm. For LD crowns, the internal gap values were between 57.8µm and 475.4µm, and for Z crowns, the values were between 79µm and 205.8µm.

Conclusion:

The outcome of this review suggests that clinically acceptable marginal and internal fit can be attained with LD and Z all-ceramic CAD-CAM crowns using digital impressions. Additionally, it has been found that LD and Z ceramics provide similar marginal gap values, but LD material provides better internal fit than Z.