bluuebunny/crossref_metadata_2025 huggingface dataset:
Vertical Motions in Orographic Cloud Systems over the Payette River Basin. Part IV: Controls on Supercooled Liquid Water Content and Cloud Droplet Number Concentrations
Authors: Zaremba Troy J. , Rauber Robert M. , Geerts Bart , French Jeffrey R. , Tessendorf Sarah A. , Xue Lulin , Friedrich Katja , Weeks Courtney , Rasmussen Roy M. , Kunkel Melvin L. , Blestrud Derek R.
Published: August 2023

This paper examines the controls on supercooled liquid water content (SLWC) and drop number concentrations (Nt,CDP) over the Payette River basin during the Seeded and Natural Orographic Wintertime Clouds: The Idaho Experiment (SNOWIE) campaign. During SNOWIE, 27.4% of 1-Hz in situ cloud droplet probe samples were in an environment containing supercooled liquid water (SLW). The interquartile range of SLWC, when present, was found to be 0.02–0.18 g m−3 and 13.3–37.2 cm−3 for Nt,CDP, with the most extreme values reaching 0.40–1.75 g m−3 and 150–320 cm−3 in isolated regions of convection and strong shear-induced turbulence. SLWC and Nt,CDP distributions are shown to be directly related to cloud-top temperature and ice particle concentrations, consistent with past research over other mountain ranges. Two classes of vertical motions were analyzed as potential controls on SLWC and Nt,CDP, the first forced by the orography and fixed in space relative to the topography (stationary waves) and the second transient, triggered by vertical shear and instability within passing synoptic-scale cyclones. SLWC occurrence and magnitudes, and Nt,CDP associated with fixed updrafts were found to be normally distributed about ridgelines when SLW was present. SLW was more likely to form at low altitudes near the terrain slope associated with fixed waves due to higher mixing ratios and larger vertical air parcel displacements at low altitudes. When considering transient updrafts, SLWC and Nt,CDP appear more uniformly distributed over the flight track with little discernable terrain dependence as a result of time and spatially varying updrafts associated with passing weather systems. The implications for cloud seeding over the basin are discussed.
Comparison of Caregiver and Provider Food Insecurity Screening Preferences Within a Health System
Authors: Alvis Courtney E. , Mosha Maua , Amankwah Ernest K. , Hernandez Raquel G. , Morrison John M.
Published: August 2023

Food insecurity is a public health concern associated with poor health. Evidence guiding how to best implement screening for food insecurity across a pediatric health care system is lacking. We performed a single-center, multi-department, cross-sectional study of caregivers and health care providers in outpatient and inpatient settings to describe the beliefs, barriers, preferences, and preferred food insecurity screening location. Most providers and caregivers underestimated the pervasiveness of food insecurity while acknowledging the benefit of screening. Caregivers are overall receptive to food insecurity screening and disagree with feelings of discomfort or shame when disclosing food insecurity status. Providers acknowledged perceived caregiver discomfort, lack of community food resources, and lack of a validated screening tool as barriers to screening. Both caregivers and providers identified the primary care setting as the preferred screening setting.
Role of Stigma for Health Care Professionals With Nonmedical Substance Use
Authors: McNeely Heidi L. , Nelson-Brantley Heather , Teel Cynthia , Peterson Moya
Published: August 2023

Background:

Stigma toward those with non-medical substance use may present as anticipated, perceived, enacted, or internalized stigma.

Objective:

The purpose of the study was to describe the role of stigma on health care professionals with non-medical substance use, from the perspective of treatment providers. Soliciting information about stigma from treatment providers is a unique perspective lacking in current literature.

Methods:

A qualitative descriptive design was used with semi-structured interviews of treatment providers (N = 16) in Colorado. Inductive content analysis was used to identify concepts and themes across interviews.

Results:

Findings showed that stigma is a major concern and a barrier for health care professionals seeking substance use treatment. Nurses and physicians demonstrate shame and guilt (internalized stigma) around their substance use. These professionals also experience fear around their reputation (perceived stigma) and challenges around re-entry to the workforce after treatment (anticipated stigma).

Conclusions:

The awareness of existing stigma as well as internalized stigma impacts how health care professionals approach treatment, recovery, and returning to work.
LIWC Indicators of Cross-Country Income Inequality at the United Nations General Debate (1987-2020): An Elastic Net Analysis
Authors: Shen Lin
Published: August 2023

Can a set of Linguistic Inquiry and Word Count (LIWC) indicators differentiate between the UN speeches from higher-income and lower-income countries? Based on 34 years of 6,095 speeches (14,300,539 words) and dynamic income grouping, an elastic net analysis selects 18 such categories. The hypothetical explanations are discussed with four theoretical perspectives: gender-neutral language, politeness, scarcity mindset, and expectation states theory. The findings on cross-group LIWC variation provide UN-setting linguistic evidence for the theories and insights into the language of global income inequality between countries.
Congenital pelvic kidney perfusion during infrarenal aortic aneurysm repair
Authors: García Pérez Yuki-ko , Lozano-Corona Rodrigo , Campos-Rentería Sandra , Pérez Delgado Maria Fernanda , Torres-Machorro Adriana
Published: August 2023

Purpose: This case report describes a patient with a pelvic kidney associated with an aortoiliac aneurysm amenable to open repair.

Methods: We chose the selective cold renal perfusion to preserve renal function.

Results: Other techniques such as transient or permanent extra-anatomic bypass, extracorporeal circulation and proximal aortic double clamping are also described in this report.

Conclusions: Choosing the renal perfusion technique depended on the anatomical evaluations of the kidney and the renal artery location during the preoperative period.
Identifying Plants as a Process of Cultural Cognition: Comparing Knowledge Production and Communities of Practice in Modern Botanical Science and Nuaulu Ethnobotany
Authors: Ellen Roy
Published: August 2023

We all seek to identify plants in our ordinary lives, or as professionals, yet what we mean by ‘identifications’ and our intentions in seeking them are not always the same. Moreover, the ‘identifications’ we achieve are often subject to disagreement. This paper compares the practices of contemporary professional taxonomists in producing herbarium reference collections, and plant naming among Nuaulu subsistence cultivators in eastern Indonesia. I examine how these communities of practice differ as groups and among themselves in the identifications they make of plants. I argue that the differences between them arise from the way material presents itself in radically different socio-cultural contexts, and the purposes for which the identifications are made. Differences between the groups arise from the ways individuals prioritise different kinds of information as it becomes available. Ethnobotanists often seek to translate between different worlds of identification by seeking one-to-one correspondences between scientific and local categories that we describe as taxa, but sometimes fail because the material used to identify plants, and the purposes of identification, are so different. I conclude by asking how intra-cultural and cross-cultural translation might operate in in-between hybrid spaces, such as para-taxonomy, where different assumptions and practices overlap or collide.
Italian oncologists and vaccinations against infectious diseases: Results of a survey of the Italian Association of Medical Oncology
Authors: Lasagna Angioletta , Brunello Antonella , Silvestris Nicola , Pedrazzoli Paolo , Di Maio Massimo , Cinieri Saverio
Published: August 2023

Background:

Patients with cancer present a higher risk of vaccine-preventable diseases. Recommended vaccinations are the most cost-effective measure to reduce the risk of transmission and related complications. Nevertheless, vaccination rates are inadequate. Oncologists have a central role in tailored vaccine communication to their patients. We present the results of a survey conducted by AIOM in 2022, focusing on the perception of the problem by oncologists.

Materials and Methods:

An anonymous 31-item online questionnaire was shared on 15 September 2022 on the AIOM website. The objectives of this survey were to examine the perception of Italian oncologists on vaccine-preventable diseases and the main available vaccines, their attitude towards recommending vaccines and the COVID-19 pandemic impact on their habits regarding vaccine-preventable diseases.

Results:

Between September 2022 and January 2023, 114 medical oncologists (5% of the members) completed the anonymous questionnaire. At the first oncological visit, only 30% of respondents usually propose a vaccination schedule to all their patient, 41% do not usually discuss vaccinations at the first visit and 29% recommend vaccines exclusively to specific categories of patients. For 56% of respondents, patients are more aware of the benefits of vaccines, whereas 36% reported that patients are worried of receiving too many vaccines.

Conclusion:

This is the first survey conducted among Italian oncologists to better understand the perception and attitudes towards the vaccination. It highlights the urgent issues of educating and training oncologists in vaccine-preventable diseases and vaccine awareness and the need to build (or implement) a network of multidisciplinary collaborations.
Long Commutes, Work-Life Balance, and Well-Being: A Mixed-Methods Study of Hong Kong’s New-Town Residents
Authors: He Sylvia Y. , Chen Xueying , Tao Sui
Published: August 2023

This study examines the cascading effects of long commutes on the work-life balance and subjective well-being of commuters from Hong Kong’s new towns. We collected questionnaire surveys and developed a structural equation model. Our results show that new-town commuters experienced lower levels of travel satisfaction, work-life balance, and subjective well-being. Meanwhile, our qualitative analysis of interview transcripts reveals that new-town residents endure longer commutes for various reasons but primarily to enjoy the better natural environment and living conditions available in suburban areas. However, the inadequate supply of public amenities and social and cultural venues in the suburbs can undermine well-being.
Impact of variable exhaust valve timing on diesel engine characteristics fueled with waste cooking oil biofuel blends: A numerical analysis
Authors: Patel Santosh , Torgal Suwarna , Purohit Tanmay , Kumar Ravinder , Singh Dheerendra Vikram , Kanchan Sumit , Soudagar Manzoore Elahi M. , Ahamad Tansir , Kalam MA , Patel Mahaboob
Published: August 2023

The quantity of the conventional sources of energy such as petroleum, coal, and the deposits of hydrocarbon are limited in nature. The rapid growth is observed in the industrial and transportation section due to increase in population that has compelled the mankind to look for an alternative to conventional fuels. Biodiesel can be a potential substitute due to its ease of availability, accessibility, lower cost, and nontoxic characteristics. In this study, waste cooking oil (WCO) as the feedstock for biodiesel due to its abundance and low prices is chosen. It has been observed that the high prices of cooking oil have compelled people to reuse it multiple times, which can have negative health consequences such as inflammation, cholesterol issues, diabetes, and cancer. However, if people can obtain WCO at a reasonable cost, they will refrain from reusing it repeatedly. This article presents a numerical method that investigates the effects of variable exhaust valve timing on the performance, emissions, and combustion parameters of WCO and its different blends in a conventional mechanical fuel injection system diesel. The study was conducted using a single-cylinder, water-cooled, in-line diesel engine running at a constant speed. As, it is not possible to determine the values of engine performance, emissions, and combustion parameters for different valve timings experimentally, a numerical method has been adopted. The valve timing range was taken as 46–66° before bottom dead center (BDC) for exhaust valve opening and 6–20° after top dead center (TDC) for exhaust valve closing and the inlet valve opening and closing are constant at 16° b TDC and 33° a BDC, respectively.
Effect of alkali-treated Moringa oleifera fruit husk fibre/SiC nanoparticle reinforced polymer composites
Authors: Saravanakumar Palanisamy , Karuppuswamy Palanisamy , Binoj Joseph Selvi
Published: August 2023

Composite industries use natural fibre as a sustainable resource to improve the sustainability and eco-friendliness of polymer composites. The characterization of alkali-treated Moringa oleifera fruit husk fibres (AMOFHFs) reinforced in unsaturated polyester resin matrix with varying weight percent of nano-sized silicon carbide (SiC) particles as filler material is presented in this paper. The AMOFHFs reinforced composite (AMOFHFC) specimens contain 20 wt.% AMOFHFs and nano-sized SiC particles ranging from 1 to 5 wt.% in 1 wt.% steps. The effect of wt.% variation in nano-sized SiC particles on the mechanical, morphological, tribological and water absorption behaviour of AMOFHFC specimens was thoroughly investigated. According to the findings, the AMOFHFC specimen with 4 wt.% nano-sized SiC particles as filler material has the best mechanical, tribological and water absorption properties. The hardness, tensile, flexural and impact strength of the AMOFHFC specimen with 4 wt.% nano-sized SiC particles improved by 14.86%, 23.11%, 9.6% and 23.22% respectively compared to the composite specimen without SiC nanoparticles as filler material. Similarly, the AMOFHFC specimen with 4 wt.% nano-sized SiC particles exhibited a lesser weight loss of 96.7% compared to the composite specimen without SiC nanoparticles as filler material during the Pin-on-disk experimentation which showcases its superior tribological characteristics. Furthermore, SEM images of fractured tensile AMOFHFC specimens aided in understanding the bonding nature of the AMOFHFs, SiC nanoparticles and unsaturated polyester resin matrix in the composite specimens. The findings above led us to the conclusion that AMOFHFCs with acceptable hydrophobic nature are best suited for light weight automotive and structural applications.
Numerical simulation of liquid–solid two-phase flow and erosion of Y-type slurry valve with different openings
Authors: Zhang Guang , Xin Jialin , Chen Desheng , Lin Zhe
Published: August 2023

Most conveyed industrial slurries contain hard particles, and the Y-type slurry valve is eroded after the long-term operation, causing economic losses. In this study, the liquid–solid two-phase flow and erosion characteristics of the Y-type slurry valve were studied. The distribution positions of particles with different sizes were determined, and large particles showed a deposition phenomenon. The particle distributions were more dispersed. At smaller valve opening degrees and the average velocity of solid particles decreased with the increase in valve opening degree. The main erosion area of the valve was concentrated on the ring area around the valve body connecting the downstream pipeline, and the valve disc. The relationship between the particle size and the erosion rate was analyzed, and the distribution of the main erosion area was obtained.
Robust adaptive control for hybrid electric vehicles using sliding mode control
Authors: Ding Jingang , Jiao Xiaohong , Zhang Jingyi
Published: August 2023

The complicated transient coupling driving performance of the electromechanical coupling driving system for hybrid electric vehicles can be guaranteed by reasonably distributing the power between the engine and the electric machine. However, the disturbances resulting from system parameter perturbation, model uncertainty, unknown road condition, and uncertain preceding vehicle acceleration would degrade the control performance. To this issue, this article investigates a robust adaptive control scheme based on sliding mode control techniques to handle the complicated transient coupling driving problem for the electromechanical coupling driving process. In the robust adaptive control method, the coordinated control mechanism is designed using the electric machine to compensate for the response deviation of engine torque. Meanwhile, the double-loop adaptive terminal sliding mode speed-tracking control scheme and the adaptive dynamic sliding mode torque tracking control method are designed for the engine and the electric machine, respectively. The proposed control scheme ensures accurate tracking of the desired trajectories of the engine and electric machine in the presence of parameter perturbation and the unknown driving condition. Both simulation and actual vehicle experimental results demonstrate the effectiveness and practicality of the proposed control strategy.
Entrepreneurial CEO’s Intended Public Language Clarity as a Strategic Tool for Corporate Communication: Linguistic Analysis of Automotive Industry Leaders
Authors: Kim Sehoon
Published: August 2023

Despite various efforts in management studies, the literature has neglected to explore the strategic use of public language, defined as the external communication by the CEO, in entrepreneurial settings. This study hypothesizes that entrepreneurial strategic intent leads to the intended clarity to achieve the desired business goals on a theoretical basis of upper echelons theory, sense-making and active audience theory. The analytical procedure included linguistic analysis for readability and simplicity of the public language of Tesla and four other incumbents based on the corpus spoken by CEOs under official settings. The findings reveal that Tesla’s CEO delivered intended clarity, delivering the most comprehensible information to the stakeholders, as hypothesized in the research design. This article contributes to the literature by suggesting a novel S-P-I model that investigates the ‘Strategic intent– Public language–Intended clarity’ flow. Managerial implications advise organizations adequately manage their public language to have desired results.
Correlation Between Cancer Pain and Quality of Life in Patients With Advanced Cancer Admitted to a Palliative Care Unit
Authors: Costa Maria Fernanda Fernandes Duarte , Bilobran Marcela Amitrano , de Oliveira Livia Costa , Muniz Andrezza Helena Regadas , Chelles Patricia Almeida , Sampaio Simone Garruth dos Santos Machado
Published: August 2023

Introduction

Cancer pain is one of the most prevalent manageable symptoms in patients with advanced cancer, and it has a negative impact on quality of life (QoL).

Objective

The aim of this study is to examine the correlation between cancer pain and QoL in patients with advanced cancer who are hospitalized in a palliative care unit.

Methods

This study is a cross-sectional analysis of patients with advanced cancer who were hospitalized with cancer pain at a specialized palliative care unit between June 2021 and February 2022. Pain intensity and its impact on daily activities were assessed using the Brief Pain Inventory (BPI), while the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 PAL (QLQ-C15-PAL) was used to evaluate QoL.

Results

A total of 104 patients with cancer pain were included, with a mean age of 53.6 years (±14.1). Most of the patients were female (65.38%), and the most common primary tumor site was in the gastrointestinal tract (22.11%). The most frequently reported site of cancer pain was the abdomen (32.69%). The mean duration of cancer pain was 52.3 days (±6.2). The domains of QoL most strongly correlated with cancer pain were weakness (coefficient = .52, P < .001), nausea (coefficient = .36, P < .001), and the physical domain (coefficient = -.30, P < .001).

Conclusion

Cancer pain is strongly correlated with a deterioration in QoL in patients with advanced cancer, and its management should be pursued as a strategy for optimizing QoL.
‘I’m Not Victim-Blaming, But . . .’: Young People’s Discourses in Understanding Sexual Violence Against Women
Authors: Bolton Robert , Edwards Claire , Leane Máire , Ó Súilleabháin Fiachra
Published: August 2023

This article explores the discourses that young people (aged 18–24) in Ireland use in understanding men’s sexual violence against women (SVAW). Drawing on a two-part vignette used in interviews with young people to elicit a corpus of data, we deploy critical discourse analysis to unpack the nuanced argumentative structures, interpretive repertoires, and subject positions used in apportioning blame for SVAW. We find that when blame is placed solely on men as perpetrators, young people draw on critical discourses that recognise the socially constructed basis of SVAW. In contrast, those who in some way blame women for their victimisation draw on disclaimers and essentialist repertoires that discursively normalise SVAW. We also identify a ‘rights discourse’ that young people use in their attributions of blame and responsibility for SVAW.
Go big or go home: Examining the longitudinal relations between exposure to successful portrayals on social media and adolescents’ feelings of discrepancy
Authors: Devos Sarah , Schreurs Lara , Eggermont Steven , Vandenbosch Laura
Published: August 2023

Social media abound with successful portrayals in nearly every life domain (e.g. appearance, social life). Many researchers have expressed concerns about such portrayals, claiming that they might be detrimental to adolescents’ self-development. More specifically, continuous exposure to successful portrayals on social media may encourage adolescents to perceive these portrayals as standards to meet, which might evoke feelings of discrepancy (i.e. the feeling of falling short of important standards). The results of a three-wave longitudinal study ( N = 1032, Mage = 14.55, SD = 1.65) revealed that exposure to different types of successful portrayals on social media (i.e. attractive appearance and a perfect life) does not relate to feelings of discrepancy over time, and vice versa at a within-person level. Yet, between-person associations were present for both types of successful portrayals with feelings of discrepancy. Hence, our findings stress the importance of taking into account both between- and within-person relations when examining social media effects.
Dual-input anomaly detection method based on deep reinforcement learning
Authors: Kang Yuxiang , Chen Guo , Wang Hao , Pan Wenping , Wei Xunkai
Published: August 2023

Aiming at the problem of low accuracy of unsupervised learning anomaly detection algorithm, a dual-input anomaly detection method based on deep reinforcement learning was proposed. The proposed model mainly consists of a feature extractor and anomaly detector. Based on the deep reinforcement learning framework, the feature extractor uses a dual-input deep neural network to form the current value network and the target value network, which are used to extract the low-dimensional feature vectors. Based on the 3 σ principle, the reward function of reinforcement learning is designed to reward and punish the output results of the model during training. The model was trained only with the normal data, and the extracted feature vector of the normal class was used as the input of the anomaly detector to complete the learning of the detector. During the test, the input anomaly detection was realized based on the dual-input convolutional neural network, and the anomaly detector was completed by learning. To illustrate the generality and generalization performance of the proposed method, four sets of image data and two sets of rolling bearing fault data in different fields were verified respectively. At the same time, the proposed method is applied to the fault detection of a real aero-engine rolling bearing.The results show that the proposed model has high anomaly detection accuracy, which is superior to the current optimal method.
What Predicts Willingness to Participate in a Follow-up Panel Study among Respondents to a National Web/Mail Survey?
Authors: Saw Htay-Wah , West Brady T. , Couper Mick P. , Axinn William G.
Published: August 2023

The American Family Health Study (AFHS) collected family health and fertility data from a national probability sample of persons aged 18–49 between September 2021 and May 2022, using web and mail exclusively. In July 2022, we surveyed AFHS respondents and gauged their willingness to become part of a national web panel that would create novel longitudinal data on these topics. We focus on predictors of willingness to participate, identifying the potential selection bias that this type of approach may introduce. We found that efforts of this type to create a national web panel may introduce potential selection bias in estimates based on the panel respondents, with individuals having higher socioeconomic status being more cooperative. Thus, alternative recruitment strategies and re-weighting of the subsample may be needed to further reduce selection bias. We present methodological implications of our results, limitations of our approach, and suggestions for further research on this topic.
Mannose binding lectin deficiency and COVID-19 rates of thrombosis and mortality: Partial protection by immunodeficiency
Authors: Hayes Breanne , Peppers Brian P
Published: August 2023

Objective: The purpose of this study is to determine the effects of COVID-19 infection on individuals with mannose binding lectin deficiency.

Methods: An electronic medical records search was conducted for MBL deficiency and COVID-19 positive tests from March 2020-August 2022. Individualized chart analysis was conducted and statistical analysis was performed.

Results: Thirty-three people in WVU medicine health system carry a diagnosis of mannose binding lectin deficiency and were diagnosed with COVID-19. The mean age of this cohort was 41 years. Seven individuals had severe enough symptoms to lead to an emergency department visit. One person was hospitalized. MBL deficient individuals had 7 times the odds of hospitalization ( p = .1506, OR 7.06 (CI 1.117-44.52)) compared to the general public. There was zero mortality among the MBL deficient population. None of the patients reported thrombosis or blood clots.

Conclusion: This retrospective cross-sectional analysis of those with known MBL deficiency and COVID-19 infection suggest a lower risk of fatalities and thrombotic events in this cohort. There was however a higher odds ratio of hospitalization compared to the general public, although this was not statistically significant.
Use of Continuous Glucose Monitors in the Hospital: The Diabetes Technology Society Hospital Meeting Report 2023
Authors: Tian Tiffany , Aaron Rachel E. , Yeung Andrea M. , Huang Jingtong , Drincic Andjela , Seley Jane Jeffrie , Wallia Amisha , Gilbert Gregory , Spanakis Elias K. , Masharani Umesh , Faulds Eileen , Hirsch Irl B. , Dawood Gigi E. , Espinoza Juan C. , Mendez Carlos E. , Kerr David , Klonoff David C.
Published: August 2023

The annual Virtual Hospital Diabetes Meeting was hosted by the Diabetes Technology Society on April 14 and 15, 2023, with the goal of reviewing the progress made in the hospital use of continuous glucose monitors (CGMs). Meeting topics included (1) Nursing Issues, Protocols, Order Sets, and Staff Education for Using CGMs, (2) Implementing CGM Programs for Use in the Wards, (3) Quality Metrics and Financial Implications of CGMs in the Hospital, (4) CGMs in the Critical Care Setting, (5) Special Situations: Labor/Delivery and Hemodialysis, (6) Research Session on CGMs in the Hospital, (7) Starting a CGM on Hospitalized Patients, (8) Automated Insulin Delivery Systems in the Hospital, (9) CGMs in Children, (10) Data Integration of CGMs for Inpatient Use and Telemetry, (11) Accuracy of CGMs/Comparison with Point-of-care Blood Glucose Testing, and (12) Discharge Planning with CGMs. Outcome data as well as shared collective real-life experiences were reviewed, and expert recommendations for CGM implementation were formulated.
Novel Robust Needle Tip Design Enables Needle Reuse and Reduced Skin Trauma in Combination With Autoinjector Needle Shields
Authors: Staples Anne-Sofie Madsen , Schwartz Julie , Præstmark Kezia Ann Friis , Traberg Marie Sand
Published: August 2023

Background:

Pen needles and autoinjectors are necessary for millions of patients needing injectable drug treatment but pose economic and environmental burdens. A durable device with a multiuse needle could reduce cost and improve user experience. This study explores a novel robust needle tip (EXP) designed for multiple uses and durability against hooking.

Method:

Needle robustness was investigated through a structural analysis. Furthermore, EXP and control needles (NF30, NF28) were evaluated in an in-vivo porcine model as pen needles or embedded in autoinjectors to study the resulting increase in skin blood perfusion (SBP). The SBP was assessed by laser speckle contrast analysis (LASCA) of 192 randomized and blinded needle insertions.

Results:

Forming a 33 µm hook against a hard surface requires 0.92 N for the NF30 control needle and 5.38 N for EXP. The EXP did not induce more tissue trauma than the NF30. There was a positive relation between needle diameter and SBP ( P < .05). Furthermore, the presence of an autoinjector shield and applied force of 10 N was found to significantly reduce SBP for worn EXP needles ( P < .05) compared to insertions without autoinjector shield.

Conclusions:

The investigated robust needle EXP is on par with the single-use needle NF30 in terms of tissue trauma, which is further reduced by combining the needle with a needle shield. These results should encourage the innovation and development of durable, reusable injection systems with pharmacoeconomic and environmental value and a simplified and enhanced user experience for patients.
Student Versus Expert Outlines in Reading Comprehension: The Effect of Collaborative Construction
Authors: Abdelshaheed Bothina S. M.
Published: August 2023

Reading comprehension is a basic skill that influences the outcomes of language learning. The role played by using different cognitive organizers and collaboration as well in the improvement of reading comprehension of academic texts has been a subject of recent literature. Hence, this study employed the experimental 2 × 2 factorial design to identify the difference in effect of two types of outlines, student-constructed versus expert-constructed, on EFL learners’ reading comprehension across two modes of learning, collaborative and individual. Participants were 161 English majors from a reading intact English course at a Saudi university. They were randomly assigned into four treatment groups, two student-constructed and two expert-constructed outlines groups. After ensuring a homogenous level of the four groups in reading comprehension, the groups had the reading comprehension test on one mode of application; collaborative student-constructed, collaborative expert-constructed, individual student-constructed, and individual expert-constructed outlines. The findings revealed that there was a significant main effect among the four groups in reading comprehension scores favoring the student-constructed outlines groups. Besides that, the findings indicated that the collaborative student-constructed outlining is the most effective mode. The implications are discussed in terms of the efficacy of student-construction of outlines in a collaborative context and recommend its significance in supporting EFL learners’ reading comprehension of academic texts.
ChatGPT and its Role in the Decision-Making for the Diagnosis and Treatment of Lumbar Spinal Stenosis: A Comparative Analysis and Narrative Review
Authors: Rajjoub Rami , Arroyave Juan Sebastian , Zaidat Bashar , Ahmed Wasil , Mejia Mateo Restrepo , Tang Justin , Kim Jun S. , Cho Samuel K.
Published: August 2023

Study Design

Comparative Analysis and Narrative Review.

Objective

To assess and compare ChatGPT’s responses to the clinical questions and recommendations proposed by The 2011 North American Spine Society (NASS) Clinical Guideline for the Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis (LSS). We explore the advantages and disadvantages of ChatGPT’s responses through an updated literature review on spinal stenosis.

Methods

We prompted ChatGPT with questions from the NASS Evidence-based Clinical Guidelines for LSS and compared its generated responses with the recommendations provided by the guidelines. A review of the literature was performed via PubMed, OVID, and Cochrane on the diagnosis and treatment of lumbar spinal stenosis between January 2012 and April 2023.

Results

14 questions proposed by the NASS guidelines for LSS were uploaded into ChatGPT and directly compared to the responses offered by NASS. Three questions were on the definition and history of LSS, one on diagnostic tests, seven on non-surgical interventions and three on surgical interventions. The review process found 40 articles that were selected for inclusion that helped corroborate or contradict the responses that were generated by ChatGPT.

Conclusions

ChatGPT’s responses were similar to findings in the current literature on LSS. These results demonstrate the potential for implementing ChatGPT into the spine surgeon’s workplace as a means of supporting the decision-making process for LSS diagnosis and treatment. However, our narrative summary only provides a limited literature review and additional research is needed to standardize our findings as means of validating ChatGPT’s use in the clinical space.
Aorta to Right Ventricular Fistula Status Post-TAVR
Authors: Abaya Ghazaleh Jonathan , Cacdac Robert , Lim Anthony , Oudah Bashar , Naderi Mohabadi Ali
Published: August 2023

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that involves replacing a damaged aortic valve using a catheter, typically inserted through a small incision in the leg, leading to faster recovery and reduced risks compared with traditional open-heart surgery. It is a common procedure; however, it is not without adverse events. We report a case of an 83-year-old man who underwent TAVR for the indication of severe symptomatic aortic stenosis. Shortly thereafter, he complained of progressive shortness of breath and was hospitalized for acute on chronic heart failure. Transesophageal echocardiography (TEE) was the first indication of a potential aorta to right ventricular fistula, and this was confirmed by a cardiac computed tomography angiography (CTA). He underwent a period of medical observation but did not do well, requiring re-admission to the hospital for acute on chronic heart failure. He was ultimately treated by percutaneous low-profile shunt closure using a septal occluder device. Percutaneous shunt closure in symptomatic patients using percutaneous low-profile shunt closure devices seems to be the best treatment option in high surgical risk patients.
Culture-Negative Endocarditis in an Immunocompromised Patient: A Case of Suspected Bartonella and Coxiella Co-Infection
Authors: Swarath Steven , Maharaj Nicole , Kawall Tiffany , Seecheran Rajeev , Seecheran Valmiki , Giddings Stanley , Seecheran Naveen Anand
Published: August 2023

We present the case of a 23-year-old man with a previous deceased-donor renal transplant maintained on tacrolimus and prednisone who developed culture-negative endocarditis (CNE) of the mitral and aortic valves. He was suspected of being co-infected with Bartonella henselae and Coxiella burnetii, confirmed with serology testing. He was successfully managed with appropriate antibiotics and dual valve replacement.
Chicken Bone Ingestion Leads to Aortoesophageal Fistula With Catastrophic Bleeding
Authors: Nana Sede Mbakop Raissa , Shah Jamil , Forlemu Arnold , Gayam Vijay , Bandaru Praneeth , Kumar Vikash , Reddy Madhavi
Published: August 2023

Aortoesophageal fistula (AEF) is an uncommon, but potentially fatal cause of upper gastrointestinal bleeding. Aortoesophageal fistulas caused by foreign body ingestion are rare but devastating. The classic clinical triad of AEF consists of mid-thoracic pain or dysphagia, a herald episode of hematemesis, followed by fatal exsanguination after a symptom-free period (Chiari’s triad). Computed tomography angiography (CTA) is the preferred diagnostic tool for identifying AEF and is substantially more sensitive than upper endoscopy for detecting AEF. Endoscopy can detect AEF as it might show pulsatile blood, pulsatile mass, hematoma, or adherent blood clot in the esophagus, or a deep esophageal tear. However, endoscopy has a low sensitivity and may delay definitive treatment. Several management options for AEF have been suggested; however, the definitive treatment is surgery performed on the thoracic aorta and esophagus, including esophagectomy, surgical replacement of the thoracic aorta, thoracic endovascular aortic repair, or omental flap. We report a case of a 63-year-old man who presented with hematemesis 2 weeks after chicken bone ingestion.
The association of vitamin K status with lung function and disease in a general population
Authors: Jespersen Torkil , Kampmann Freja Bach , Dantoft Thomas Meinertz , Jørgensen Niklas Rye , Kårhus Line Lund , Madsen Flemming , Linneberg Allan , Thysen Sanne Marie
Published: August 2023

Introduction

Matrix Gla protein (MGP) is an inhibitor of lung tissue calcification. The plasma level of dephosphorylated-uncarboxylated MGP (dp-ucMGP) is a biomarker of vitamin K status. The present study assessed whether lower vitamin K status (reflected by higher dp-ucMGP) was associated with lung function and lung disease/symptoms.

Methods

A general population sample of 4092 individuals, aged 24 to 77 years, underwent a health examination including questionnaires, spirometry and measurements of plasma dp-ucMGP. Associations of dp-ucMGP with lung function and self-reported disease/symptoms were estimated using regression models adjusted for age, sex and height. Associations were expressed as β-estimates or odds ratios (ORs) per doubling in dp-ucMGP.

Results

Lower vitamin K status (higher dp-ucMGP) was associated with lower forced expiratory volume in 1 s (FEV1) (98 mL; 95% CI: 54–141 mL) and lower forced vital capacity (FVC) (136 mL; 95% CI: 85–187 mL). Dp-ucMGP was not associated with the FEV1/FVC ratio (0.0 percentage points higher than the expected value; 95% CI: −1.0–1.0). Furthermore, lower vitamin K status was associated with COPD (OR 2.24, 95% CI: 1.53–3.27), wheezing (OR 1.81, 95% CI: 1.44–2.28) and asthma (OR 1.44, 95% CI: 1.12–1.83).

Conclusion

Lower vitamin K status was associated with lower ventilatory capacity (lower FEV1and FVC), and with higher risk of self-reported asthma, COPD and wheezing. Vitamin K status was not associated with airflow obstruction (FEV1/FVC ratio).
A randomised phase 2a study to investigate the effects of blocking interleukin-33 with tozorakimab in patients hospitalised with COVID-19: ACCORD-2
Authors: Wilkinson Tom , De Soyza Anthony , Carroll Miles , Chalmers James D. , Crooks Michael G. , Griffiths Gareth , Shankar-Hari Manu , Ho Ling-Pei , Horsley Alex , Kell Chris , Lara Beatriz , Mishra Biswa , Moate Rachel , Page Clive , Pandya Hitesh , Raw Jason , Reid Fred , Saralaya Dinesh , Scott Ian C. , Siddiqui Salman , Ustianowski Andy , van Zuydam Natalie , Woodcock Ashley , Singh Dave
Published: August 2023

Background

Increased serum interleukin (IL)-33 predicts poor outcomes in patients hospitalised with coronavirus disease 2019 (COVID-19). We examined the efficacy and safety of tozorakimab, a monoclonal antibody that neutralises IL-33, in improving outcomes in ACCORD-2 (EudraCT: 2020-001736-95).

Methods

ACCORD-2 was an open-label, phase 2a study in adults hospitalised with COVID-19. Patients were randomised 1:1 to tozorakimab 300 mg plus standard of care (SoC) or SoC alone. The primary end-point was time to clinical response (sustained clinical improvement of ≥2 points on the World Health Organization ordinal scale, discharge from hospital or fit for discharge) by day 29. Other end-points included death or respiratory failure, mortality and intensive care unit admission by day 29, and safety. Serum IL-33/soluble stimulated-2 (sST2) complex levels were measured by high-sensitivity immunoassay.

Results

Efficacy analyses included 97 patients (tozorakimab+SoC, n=53; SoC, n=44). Median time to clinical response did not differ between the tozorakimab and SoC arms (8.0 and 9.5 days, respectively; HR 0.96, 80% CI 0.70–1.31; one-sided p=0.33). Tozorakimab was well tolerated and the OR for risk of death or respiratory failure with treatmentversusSoC was 0.55 (80% CI 0.27–1.12; p=0.26), while the OR was 0.31 (80% CI 0.09–1.06) in patents with high baseline serum IL-33/sST2 complex levels.

Conclusions

Overall, ACCORD-2 results suggest that tozorakimab could be a novel therapy for patients hospitalised with COVID-19, warranting further investigation in confirmatory phase 3 studies.
Neuroimaging in the pre-ictal or premonitory phase of migraine: a narrative review
Authors: Karsan Nazia , Goadsby Peter J.
Published: August 2023

Background

The premonitory phase, or prodrome, of migraine, provides valuable opportunities to study attack initiation and for treating the attack before headache starts. Much that has been learned about this phase in recent times has come from the outcomes of functional imaging studies. This review will summarise these studies to date and use their results to provide some feasible insights into migraine neurobiology.

Main body

The ability to scan repeatedly a patient without radiation and with non-invasive imaging modalities, as well as the recognition that human experimental migraine provocation compounds, such as nitroglycerin (NTG) and pituitary adenylate cyclase activating polypeptide (PACAP), can trigger typical premonitory symptoms (PS) and migraine-like headache in patients with migraine, have allowed feasible and reproducible imaging of the premonitory phase using NTG. Some studies have used serial scanning of patients with migraine to image the migraine cycle, including the ‘pre-ictal’ phase, defined by timing to headache onset rather than symptom phenotype. Direct observation and functional neuroimaging of triggered PS have also revealed compatible neural substrates for PS in the absence of headache. Various imaging methods including resting state functional MRI (rsfMRI), arterial spin labelling (ASL), positron emission tomography (PET) and diffusion tensor imaging (DTI) have been used. The results of imaging the spontaneous and triggered premonitory phase have been largely consistent and support a theory of central migraine attack initiation involving brain areas such as the hypothalamus, midbrain and limbic system. Early dysfunctional pain, sensory, limbic and homeostatic processing via monoaminergic and peptidergic neurotransmission likely manifests in the heterogeneous PS phenotype.

Conclusion

Advances in human migraine research, including the use of functional imaging techniques lacking radiation or radio-isotope exposure, have led to an exciting opportunity to study the premonitory phase using repeated measures imaging designs. These studies have provided novel insights into attack initiation, migraine neurochemistry and therapeutic targets. Emerging migraine-specific therapies, such as those targeting calcitonin gene-related peptide (CGRP), are showing promise acutely when taken during premonitory phase to reduce symptoms and prevent subsequent headache. Therapeutic research in this area using PS for headache onset prediction and early treatment is likely to grow in the future.
Comparative evaluation of RBPT, I-ELISA, and CFT for the diagnosis of brucellosis and PCR detection of Brucella species from Ethiopian sheep, goats, and cattle sera
Authors: Legesse Abinet , Mekuriaw Aregitu , Gelaye Esayas , Abayneh Takele , Getachew Belayneh , Weldemedhin Wubet , Tesgera Takele , Deresse Getaw , Birhanu Kenaw
Published: August 2023

Background

Brucellosis is an economically devastating animal disease and has public health concern. Serological methods such as Rose Bengal Plate Test (RBPT), Complement Fixation Test (CFT), and Indirect-Enzyme-Linked Immunosorbent Assay (I-ELISA) have been used to detect brucellosis. However, there is limited comparative evaluation studies and lack of molecular confirmation of the causative agents in the study areas. The study was aimed to compare RBPT, I-ELISA, CFT, and confirmation using Polymerase Chain Reaction (PCR). A total of 2317 sera samples were collected from brucellosis-affected areas of Ethiopia with no vaccination history. All sera were subjected to comparative serological assays. Post-cross tabulation, sensitivity, and specificity were determined using Receiver Operating Characteristics (ROC) curve analysis software. PCR was performed on 54 seropositive samples using genus- and species-specific primers.

Results

Among the 2317 sera tested for comparative serological assays, 189 (8.16%) were positive for RBPT, 191 (8.24%) for I-ELISA, and 48 (2.07%) for CFT. Sensitivity to RBPT was 100% (95%) in shoats and 74% (95%) in cattle. Specificity on RBPT was 98.69% (95%), 99.28% (95%), 100% (95%) in sheep, goats, and cattle, respectively. CFT sensitivity was 4 (95%) in sheep, 9.65 (95%) goats, and 72 (95%) cattle. Specificity on CFT was 100% (95%) for sheep, goats, and cattle. A 223bp Brucella genus-specific and 156bp B. abortus species-specific detected. However, B. melitensis not detected.

Conclusion

In this study, I-ELISA was the most sensitive and specific test. RBPT detected all Brucellosis-infected sheep and goats; nevertheless, it showed false positive in sheep and goats and false negative in cattle. The presence of B. abortus in small and large ruminants was confirmed by PCR. This is the first report of B. abortus detection in small ruminant in Ethiopia. B.abortus detected in non-preferred hosts. The findings suggest further study on molecular epidemiology of Brucella species.