bluuebunny/crossref_metadata_2025 huggingface dataset:
Presentation of Gastrointestinal Stromal Tumor, Pancreatic Adenocarcinoma, and Gastric Adenocarcinoma in a Woman With No Identifiable Genetic Abnormalities
Authors: Read Catherine , Hughes Marybeth , Itani Omar
Published: September 2023

This report details the first known case of co-occurrence of gastrointestinal stromal tumor (GIST), pancreatic adenocarcinoma, and gastric adenocarcinoma in an individual with no identifiable genetic abnormalities. The patient is a 57-year-old female who presented with abdominal pain. CT scan demonstrated a pancreatic mass, and endoscopic ultrasound demonstrated an additional gastric mass. Biopsy of both masses demonstrated adenocarcinoma; however, the masses were found to have different origins. The patient underwent neoadjuvant chemotherapy with excellent response. She then underwent surgical intervention, which demonstrated no ongoing adenocarcinoma in either location, and demonstrated a small focus of GIST. Genetic testing demonstrated no identifiable abnormalities. The presence of 3 primary neoplasms in an individual with no known genetic mutations represents a novel case study. These findings may suggest that screening for additional primary neoplasms may be indicated, even in patients for whom metastatic disease is initially suspected.
Comparison of artery diameters in the Aachen minipig serving as a human intracranial in vivo model
Authors: Dorn Christoph , Bender Lara , Sichtermann Thorsten , Minkenberg Jan , Franko Maximilian , Yousefian Ehsan , Wiesmann Martin , Stockero Andrea , May Rebecca , Ridwan Hani , Nikoubashman Omid , Franz Christiane
Published: September 2023

Minipigs are used as in vivo endovascular models, particularly in stroke and aneurysm research. However, detailed knowledge of the diameters of forelimb arteries that are commonly used as surrogates for human brain–supplying arteries are lacking. This study aimed to determine the diameters of forelimb and neck arteries in Aachen minipigs and to compare those to the diameters of human cerebral brain–supplying arteries in order to assess the validity of the Aachen minipig as a human intracranial in vivo model. We measured the diameters in the external carotid artery and eight different branches of the subclavian artery in 12 Aachen minipigs using angiographic imaging. Analysed arteries comprised the external carotid artery, axillary artery, brachial artery, subscapular artery first segment, subscapular artery second segment, external thoracic artery, caudal circumflex humeral artery, suprascapular artery and thoracodorsal artery. We compared these diameters to diameters of the following human brain–supplying arteries: terminal internal carotid artery (carotid-T and petrous segment), M1 segment of the middle cerebral artery, M2 segments of the middle cerebral artery, anterior cerebral artery, vertebral artery and basilar artery. Median diameters of porcine forelimb arteries ranged from 1.8 to 4.9 mm, and human brain supplying arteries ranged in diameter from 1.4 to 4.3 mm. Depending on the intended use, this allows porcine forelimb arteries to be selected which are statistically comparable to human brain–supplying vessels. In conclusion, we identified several equivalent arteries of the porcine subclavian branches that are comparable to human brain–supplying arteries. This may help to validate the minipig as a suitable in vivo model for neurovascular experiments.
Scale and modularity in thermal governance: The replication of India’s heat action plans
Authors: Khandekar Aalok , Cross Jamie , Maringanti Anant
Published: September 2023

Since 2013, when the first urban Heat Action Plan in India was developed in and for the western city of Ahmedabad, Gujarat, there are now more than 30 such plans focused on different cities, regions, and entire states in the country, many following the original template developed in Ahmedabad. This article investigates the temporal and spatial politics of such heat action planning, asking: what is the nature of thermal governance that Heat Action Plans posit? Based on our analysis, we suggest that two key attributes characterise Indian Heat Action Plans: first, they frame heat waves as disasters; second, as the Ahmedabad template has travelled to other locations, Heat Action Plans have ceased to engage with their local contexts in any meaningful way. We further argue that such a conceptualisation of Heat Action Plans has produced important obfuscations, shaping official knowledge about and responses to extreme heat in ways that are unable to grapple with the messy, uneven, and contested nature of the socio-political terrains in which they are supposed to intervene.
A Novel Method for Prediction of Raised Intracranial Pressure Through Automated ONSD and ETD Ratio Measurement From Ocular Ultrasound
Authors: Singh Maninder , Gupta Vishal , Gupta Rajeev , Kumar Basant , Agrawal Deepak
Published: September 2023

The paper presents a novel framework for the prediction of the raised Intracranial Pressure (ICP) from ocular ultrasound images of traumatic patients through automated measurement of Optic Nerve Sheath Diameter (ONSD) and Eyeball Transverse Diameter (ETD). The measurement of ONSD using an ocular ultrasound scan is non-invasive and correlates with the raised ICP. However, the existing studies suggested that the ONSD value alone is insufficient to indicate the ICP condition. Since the ONSD and ETD values may vary among patients belonging to different ethnicity/origins, there is a need for developing an independent global biomarker for predicting raised ICP condition. The proposed work develops an automated framework for the prediction of raised ICP by developing algorithms for the automated measurement of ONSD and ETD values. It is established that the ONSD and ETD ratio (OER) is a potential biomarker for ICP prediction independent of ethnicity and origin. The OER threshold value is determined by performing statistical analysis on the data of 57 trauma patients obtained from the AIIMS, New Delhi. The automated OER is computed and compared with the conventionally measured ICP by determining suitable correlation coefficients. It is found that there is a significant correlation of OER with ICP ( r = .81, p ≤ .01), whereas the correlation of ONSD alone with ICP is relatively less ( r = .69, p = .004). These correlation values indicate that OER is a better parameter for the prediction of ICP. Further, the threshold value of OER is found to be 0.21 for predicting raised ICP conditions in this study. Scatter plot and Heat map analysis of OER and corresponding ICP reveal that patients with OER ≥ 0.21, have ICP in the range of 17 to 35 mm Hg. In the data available for this research work, OER ranges from 0.17 to 0.35.
Advance care planning for patients with chronic obstructive pulmonary disease on home non-invasive ventilation: A qualitative study exploring barriers, facilitators and patients’ and healthcare professionals’ recommendations
Authors: Kavanagh Emily , Rowley Grace , Simkiss Lauri , Woods Elizabeth , Gouldthorpe Craig , Howorth Kate , Charles Max , Kiltie Rachel , Billett Hannah , Mastaglio Francesca , Dewhurst Felicity
Published: September 2023

Background:

Although home non-invasive ventilation for patients with chronic obstructive pulmonary disease and persisting hypercapnia prolongs time to hospital readmission and prognosis, they retain a poor long-term prognosis. Requiring non-invasive ventilation in this population should trigger advance care planning, yet only 50% of patients are engaged in such discussions.

Aim:

This study aimed to explore the barriers and facilitators to advance care planning for patients with chronic obstructive pulmonary disease on home non-invasive ventilation and generate recommendations for improving practice.

Study design:

A cross-sectional interview study took place with 10 patients with chronic obstructive pulmonary disease on home non-invasive ventilation and 12 North East Assisted Ventilation Service healthcare professionals from the North East of England.

Results:

Three themes (‘overlooked’, ‘disjointed care’ and ‘awareness and expertise’) were identified. Patients with chronic obstructive pulmonary disease are a ‘forgotten about’ population, exacerbated by prejudice and unpredictable disease trajectories. Recognition as a distinct and underserved population may improve care and advance care planning. All participants recognised a lack of care continuity, including limited collaboration and communication between services, as a significant barrier to advanced care planning. Additionally, lacking understanding of the rationale and positive impacts of advance care planning, exacerbated by a lack of expertise in difficult conversations, was a barrier to advance care planning.

Conclusions:

Patients and healthcare professionals highlighted the need for individualised and ongoing advance care planning, particularly around prognosis and care preferences. Discussions should be initiated by familiar clinicians. Effective communication between services, clear agreements and protocols and upskilling healthcare professionals may ensure continuity of care.
Swedish sailor songs, popular culture and maritime national identities, 1918–1960
Authors: Arnstad Henrik
Published: September 2023

In twentieth-century Sweden, conventional inland nationalism was challenged by strong currents of maritime national identities. The reason was a national frenzy regarding maritime popular music – primarily, songs about Swedish sailors and their adventures in exotic faraway lands. Throughout the 1920s, 1930s and 1940s, and continuing into the 1950s, numerous Swedish composers, singers and musicians produced hundreds of sailor songs. Their commercial success was staggering, to the delight of Sweden's developing music industry, but the identitarian consequences were even more astonishing. Maritime national identities flourished as Swedishness itself changed drastically via this huge exposure to sailor songs.
Association Between Child Maltreatment and Aggression in Chinese Early Adolescents: The Mediating Role of Irritability
Authors: Xu Baoyu , Li Yonghan , Li Yuan , Xie Jinyu , Ding Han , Wang Jun , Su Puyu , Wang Gengfu
Published: September 2023

Child maltreatment (CM) is a major global public health issue, and a strong association exists between CM and aggression. However, the underlying mechanism of this association has not been understood to date. The objective of this study was to explore the mediating role of irritability in the association between CM and aggression in Chinese early adolescents. A cross-sectional study was conducted using a self-report questionnaire to evaluate the levels of CM, aggression, and irritability in 5,724 middle school students from the Anhui Province, China. Structural equation modeling was used to test the hypothesis of the mediating effect of irritability on the relationship between CM and aggression. We further investigated gender differences in this association using multiple group analyses. CM was positively related to both irritability and aggression, and irritability was positively associated with aggression ( p < .01). The mediating effects of irritability between CM and aggression were significant (β = .107, 95% confidence intervals [CI]: 0.077–0.133, p < .05). Males had a higher indirect effect size of the pathway from CM to aggression via irritability compared with females. Overall, irritability was a crucial mediator in the relationship between CM and aggression in Chinese adolescents, and males were more prone to engage in aggression compared with females through the pathway of irritability. Therefore, early irritability characteristics should be carefully monitored in adolescents, and they should be provided adequate support to acquire critical emotion regulation skills.
Rates and Correlates of Intimate Partner Abuse Among Indigenous Women Caregivers
Authors: Edwards Katie M. , Waterman Emily A. , Mullet Natira , Herrington Ramona , Hopfauf Skyler , Trujllo Preciouse , Even-Aberle Naomi , Wheeler Lorey A. , Cornelius Sloane , Deutsch Arielle R.
Published: September 2023

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one’s partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants’ engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful.
Retirement Pathways’ Effect on Physical and Mental Health: Evidence from Japan
Authors: Mizuochi Masaaki
Published: September 2023

Objectives: Few studies have used rigorous causal analysis to examine the difference in health effects between abrupt and gradual transitions from full-time employment to full retirement. Methods: Data were obtained from 10,253 individuals aged 50 years and older from the 2005–2019 Longitudinal Survey of Middle-aged and Older Adults conducted in Japan. An instrumental variable approach was used to determine the causal relationship between retirement pathways and health by exploiting the public pension eligibility age as the instrument. Results: Abruptly retired individuals were more likely to have physical limitation and less likely to have depression than those not yet retired. In contrast, those who fully retired through a gradual transition were less likely to have physical limitation and more likely to have depression than those not yet retired. Discussion: Retirement pathways have different effects on physical and mental health, providing important implication for labor and health policies in aging societies.
Fragility fractures in lupus patients: Associated factors and comparison of four fracture risk assessment tools
Authors: Ceccarelli Fulvia , Olivieri Giulio , Orefice Valeria , Picciariello Licia , Natalucci Francesco , Conti Fabrizio
Published: September 2023

Objective

Osteoporosis (OP) and fragility fractures (FF) are common comorbidities in patients with systemic lupus erythematosus (SLE). This study aimed to (1) assess the prevalence of these conditions in a cohort of SLE patients (2) evaluate the risk factors associated with FF, and (3) compare the accuracy of four different FF risk assessment algorithms to determine which performs better in this specific rheumatologic population.

Materials and Methods

We conducted a cross-sectional study with SLE women who underwent bone mineral density assessment by dual-energy X-ray absorptiometry (DEXA) within 3 months of their last visit. Conventional radiology methods were used to evaluate the presence of FF. The 10-year risk of osteoporotic fractures was estimated using four tools: DeFRA, FRAX (adjusted for GC dosage), GARVAN, and QFracture. The comparison of these computational tools was analyzed by the area under the receiver operating characteristic (ROC) curves.

Results

We analyzed 86 SLE patients with a median age of 56 years (IQR 12.1) and a median age at diagnosis of 34 years (IQR 17.2). The median T-score values at the femoral neck and lumbar spine were −1.6 (IQR 0.9) and −1.7 (IQR 1.1), respectively. Of the patients, 33 (38.4%) had OP, with 13 patients (15.1%) experiencing FF. Univariate analysis showed that the presence of FF was associated with thrombocytopenia ( p = .01), hemolytic anemia ( p = .0001), and the intake of cyclosporine A ( p = .002), cyclophosphamide ( p = .006), and rituximab ( p = .001). The median 10-year risk of major FF for the four calculation tools were as follows: DeFRA 9.85 (IQR 8.6); FRAX GC 8.8 (IQR11.7); GARVAN 12 (IQR 8.2); QFracture 4.1 (IQR 5.8). We observed a significant correlation among all instruments evaluated ( p < .0001); in particular, the best correlation was recorded between the FRAX GC and the DeFRA (r = 0.85). DeFRA was the best tool for this population with an AUC of 0.94 ( p < .0001, CI 0.88–1).

Conclusions

OP is a common comorbidity in SLE patients, even in younger patients. FF appears to be more frequent in patients with hematologic involvement. The comparison of the four algorithms shows that DeFRA is the most accurate tool and should be applied to SLE patients.
Strategies for success of Indigenous businesses on customary land: case studies of three Itaukei (Indigenous Fijian) enterprises
Authors: Vunibola Suliasi , Scheyvens Regina
Published: September 2023

This article aims to examine crucial elements that provide a platform for the success of Indigenous businesses based on customary land, drawing on case studies from Fiji. A qualitative, ethnographic, three case study approach was conducted, and talanoa (discussion or talking together in groups or between two people) method was used to collect data guided by the Vanua Research Framework. Four significant themes unfolded from the study in terms of essential strategies for the success of the businesses on customary land: following protocols for safe cultural affiliation of the business; practices of people working collectively; making socio-cultural contributions to the community and contributing to employee well-being. The research implies that Indigenous businesses on customary land tend to define success from a cultural viewpoint that differs from how business success is conventionally defined.
Identification of Suitable Rainwater Harvesting Sites Using Geospatial Techniques With AHP in Chacha Watershed, Jemma Sub-Basin Upper Blue Nile, Ethiopia
Authors: Gebremedhn Abrha Ybeyn , Getahun Yitea Seneshaw , Moges Alebachew Shumye , Tesfay Fikrey
Published: September 2023

Rainfed agriculture in Ethiopia has failed to produce enough food, to achieve the increasing demand for food. Pinpointing the appropriate site for rainwater harvesting (RWH) have a substantial contribution to increasing the available water and enhancing agricultural productivity. The current study related to the identification of the potential RWH sites was conducted at the Chacha watershed central highlands of Ethiopia which is endowed with rugged topography. The Geographic Information System with Analytical Hierarchy Process was used to generate the different maps for identifying appropriate sites for RWH. In this study, 11 factors that determine the RWH locations including slope, soil texture, runoff depth, land cover type, annual average rainfall, drainage density, lineament intensity, hydrologic soil group, antecedent moisture content, and distance to the roads were considered. The overall analyzed result shows that 10.50%, 71.10%, 17.90%, and 0.50% of the areas were found under highly, moderately, marginally suitable, and unsuitable areas for RWH, respectively. The RWH site selection was found highly dependent on a slope, soil texture, and runoff depth; moderately dependent on drainage density, annual average rainfall, and land use land cover; but less dependent on the other factors. The highly suitable areas for rainwater harvesting expansion are lands having a flat topography with a soil textural class of high-water holding capacity that can produce high runoff depth. The application of this study could be a baseline for planners and decision-makers and support any strategy adoption for appropriate RWH site selection.
Clinical and radiologic characteristics associated with multiple sclerosis misdiagnosis at a tertiary referral center in the United States
Authors: Wang Yujie , Bou Rjeily Nicole , Koshorek Jacqueline , Grkovski Risto , Aulakh Manek , Lin Doris , Solomon Andrew J , Mowry Ellen M
Published: September 2023

Background:

Misdiagnosis of multiple sclerosis (MS) is common and can have harmful effects on patients and healthcare systems. Identification of factors associated with misdiagnosis may aid development of prevention strategies.

Objective:

To identify clinical and radiological predictors of MS misdiagnosis.

Methods:

We retrospectively reviewed medical records of all patients who were referred to Johns Hopkins MS Center from January 2018 to June 2019. Patients who carried a diagnosis of MS were classified as correctly diagnosed or misdiagnosed with MS by the Johns Hopkins clinician. Demographics, clinical, laboratory, and radiologic data were collected. Differences between the two groups were evaluated, and a regression model was constructed to identify predictors of misdiagnosis.

Results:

Out of 338 patients who were previously diagnosed with MS, 41 (12%) had been misdiagnosed. An alternative diagnosis was confirmed in 28 (68%) of the misdiagnosed patients; cerebrovascular disease was the most common alternate diagnosis. Characteristics associated with misdiagnosis were female sex (odds ratio (OR): 5.81 (95% confidence interval (CI): 1.60, 21.05)) and non-specific brain magnetic resonance imaging (MRI) lesions (OR: 7.66 (3.42, 17.16)).

Conclusion:

Misdiagnosis is a frequent problem in MS care. Non-specific brain lesions were the most significant predictor of misdiagnosis. Interventions aimed to reduce over-reliance on imaging findings and misapplication of the McDonald criteria may prevent MS misdiagnosis.
Reduced expression of transmembrane protein 43 during cardiac hypertrophy leads to worsening heart failure in mice
Authors: Gu Yang , Yao Yi-Ren , Ding Ying , Zhang Xi-Wen
Published: September 2023

Transmembrane protein 43 (TMEM43), a member of the transmembrane protein subfamily, was found to be associated with arrhythmogenic right ventricular cardiomyopathy. However, its role in cardiac hypertrophy has not been elucidated. Here, we used a pressure overload–induced cardiac hypertrophy model to explore the role of TMEM43 in heart failure. Mice were subjected to aortic banding (AB) to induce cardiac hypertrophy. The mice were also randomly selected to receive injection of adeno-associated virus 9 (AAV9)-shTMEM43 to knockdown TMEM43 in cardiomyocytes or control AAV9 (ScRNA). Four weeks after AB, the mice were subjected to echocardiography to evaluate cardiac function. Neonatal rat cardiomyocytes (NRCMs) were stimulated with angiotensin II (AngII, 1 μM) and transfected with an adenovirus to over-express TMEM43. We found that TMEM43 was downregulated in mouse hearts and cardiomyocytes poststimulation. Mice with TMEM43 knockdown showed worsening heart failure accompanied by deteriorating cardiac function and exacerbated cardiac hypertrophy and fibrosis at 4 weeks post-AB. NRCMs over-expressing TMEM43 exhibited an ameliorated hypertrophic response. Moreover, we found that TMEM43 deficiency increased nuclear factor kappa B (NF-κB) activation in mouse hearts post-AB, while TMEM43 over-expression reduced NF-κB activation in cardiomyocytes upon AngII stimulation. Thus, we conclude that reduced expression of TMEM43 during cardiac hypertrophy leads to worsening heart failure in mice.
The Application of Constructivist Grounded Theory Methodology in an Urban Planning Doctoral Thesis
Authors: Dunn Mischka , Nel Verna , van den Berg Henriëtte S. , Huyssteen Elsona
Published: September 2023

The aim of this paper is to show the potential value of using the constructivist grounded theory (CGT) methodology in the Urban and Regional Planning discipline. This is done by reflecting on the application of the CGT fundamentals defined by Kathy Charmaz, applied in a doctoral thesis in Urban and Regional Planning. The substantive area of research in which the thesis took place was the practical training experience of planners in becoming professionally registered. The thesis collected primary data through interviews with 14 planners who have undergone the process of practical training to record, document, and analyse their experiences as a prerequisite and requirement of professional registration. The use of the CGT methodology provides valuable insight into the registration process of planners in South Africa and encourages doctoral candidates to use CGT methodology with the aim of generating new knowledge and theory in the built environment. This paper recommends that CGT methodology should be encouraged, particularly when contributing to fields that are under-researched, limited, or non-existent.
Not about religion: A reinterpretation of the Chinese rites controversy
Authors: Gao Zhe
Published: September 2023

As one of the most significant events in the history of Sino-Western interaction and that of Chinese Christianity, the “Chinese Rites Controversy” has been the subject of numerous studies from both Western and Chinese scholars since the 1980s. When interpreting the rites issue of the Controversy, most studies see the crux of it as the “religious” nature of the Confucian rites. In contrast to this dominant understanding, this article argues that both the uncritical repetition of “religious” in the modern interpretations of the Controversy and its tacitly approved validity presuppose a universal and timeless conception of “religion.” Through a method of historicisation, i.e., examining carefully in what sense “religious” and related terms such as “civil,” “political,” “superstitious,” and “yinsi,” etc. were used in the original texts of the Controversy, this article intends to show that the use of “religious” by modern authors constitutes, though to a great extent unconsciously, a hermeneutical anachronism. The root of this anachronism lies in that the use “religious” as a generic adjective defining a distinct sphere of human enterprise that can be differentiated from those “non-religious” ones is a modern invention, and could find its place in neither encompassing Christian truth nor the tianxia order, nor even the fusion of these two horizons manifested in the awareness of literati Catholics, all of which defined the context in which the rites issue was debated during the Controversy.
Mindfulness improves the mental health of infertile women: A systematic review
Authors: Kundarti Finta Isti , Titisari Ira , Rahayu Dwi Estuning , Kiswati  , Jamhariyah
Published: September 2023

Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study’s purpose was to analyze mindfulness’s effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.
Taking a Rhetorical Perspective on Emerging Communication Practice: Pedagogy as Theory-Building Scholarship
Authors: Cyphert Dale
Published: September 2023

Despite management theorists’ decades-long attention to the robust sustainability of complex organizations, adaptive management practices remain undertheorized. Management is evolving from a hierarchically organized effort in pursuit of strategically determined goals into a facilitation of layered, distributed, autonomous agents able to learn from their errors and ensure the entire system’s long-term survivability. A rhetorical perspective on pedagogy allows us to better prepare our students for success in the 21st century’s adaptive organization as well as contribute to theoretical scholarship of effective organizations.
Development of the Musi-CI Training, A Musical Listening Training for Cochlear Implant Users: A Participatory Action Research Approach
Authors: Veltman Joke , Maas Marjo J.M. , Beijk Cilia , Groenhuis Adinda Y.M. , Versnel Huib , Vissers Constance , Huinck Wendy J. , Hoetink Alexander E.
Published: September 2023

A cochlear implant (CI) is a prosthesis that allows people with severe to profound hearing loss to understand speech in quiet settings. However, listening to music presents a challenge to most CI users; they often do not enjoy music or avoid it altogether. The Musi-CI training course was developed for CI users with the goal of reducing music aversion and improving music enjoyment. A consortium was established consisting of a professional musician with CI, CI rehabilitation professionals and researchers. Participatory action research (PAR) was applied to develop and evaluate the training experiences, collaborating with 37 CI users during three cycles of eight training sessions, each held over a period of 3 months. Input and feedback were collected after each training session using questionnaires, observations and focus group interviews. Almost all participants (86%) completed the training. After completing the training a large majority of participants reported increased music appreciation, increased social participation in musical settings and a positive impact on general auditory perception. The resulting Musi-CI training programme focuses on music listening skills, self-efficacy, and self-motivation. It consists of exercises intended to strengthen attention and working memory, to improve beat and rhythm perception (with online rhythm exercises) and exercises to distinguish timbre of instruments and emotion in music. A Melody Game was developed to improve pitch and melodic contour discrimination.
Unlocking value: The impact of traditional valuation practices on the number of vacant retail units in the built environment
Authors: Johnson Lynn , Muldoon-Smith Kevin , Greenhalgh Paul
Published: September 2023

Across the social science and humanities disciplines, there has been an increased interest in questions of value and valuation. This article responds to the new emphasis by scrutinising the evolution of real estate valuation techniques over time, their embedded nature, and the implication of this for the (re)production of the built environment. This is achieved through the lens of two conceptual positions which are rarely used in the realm of real estate valuation. These are (a) path dependency which in this case charts the evolution of the discipline of valuation as it relates to retail related real estate assets; and (b) lock – in, which seeks to understand how valuation techniques and attitudes have become embedded during this evolution. This position sits alongside a series of investigatory interviews with professional valuers in international real estate organisations specialising in the commercial real estate market. This is often a missing voice in recent research into real estate and the wider subject of valuation. Findings suggest that valuation practice is reliant on confirmatory market practices that do not necessarily capture the contemporary affordability-based requirements of tenants. Instead, practice is locked into reinforcing the nature of zone-based market values for landlords and investors. The geographical implications of this situation at the micro-level can be vacant or poorly performing properties that undermine local areas in the interest of maintaining the headline value of properties in macro-level global capital markets. This new conceptual analysis provides understanding of how the physical built environment is developed and reproduced over time through notions of value, helps to connect often hidden practices of real estate valuation into existing academic debates in urban studies and geography, and in conclusion sheds some light on how practices of real estate valuation can be improved in the disrupted world of retail.
Brand equity and its Influence on Customer Satisfaction in Midscale and Budget Hotels of Jaipur
Authors: Pokhriyal Deepak , Sarabhai Samar
Published: September 2023

The main purpose of this paper is to utilise the customer-based brand equity (CBBE) model of David Aaker (Aaker, 1991) to examine the influence of brand equity on customer satisfaction in midscale and budget hotels in Jaipur. This study recruited 250 respondents who regularly visit the identified branded midscale hotels of Jaipur. In this paper, managerial implication of CBBE is proposed to provide a reference tool for the management of the brand equity of these midscale hotels and to enhance their brand value. The negative impression, which existed in the minds of consumers of midscale and budget hotels, is being replaced by a perception of affordability, efficiency, and good experience. The fast-changing market equation has positively impacted the midscale hotels segment. It can be seen from the competition among domestic as well as international hospitality operators in this segment. Midscale hotels are being redefined with new concepts, innovations, and strategies. Now they are mini full-service hotels being recognised as business class and installed with the basic facilities, targeting a specific market and mid-rank business executives and price sensitive corporate customers. Budget hotels reasonably priced with good service, style, and better ambience demonstrate professionalism. With heavy demand and less supply of midscale and budget hotels in Jaipur, hotel management has to stick to brand equity in order to maintain customer satisfaction, which in turn leads to profit.
Exploring the Implications of Digital Marketing for Higher Education using Intuitionistic Fuzzy Group Decision Making Approach
Authors: Biswas Sanjib
Published: September 2023

This paper endeavours to identify the critical implications of digital marketing (DM) for the higher education sector (HES). Inbound marketing is a growing concern for the strategic decision-makers these days. Unlike the traditional ‘push’-oriented outbound marketing, DM enables the organisation to understand customers better, build a long-term relationship, to design order-winning value propositions and customised products and services, and effective positioning of the brands through the creation of ‘pull’ factors. Hence, it stands as a source of a competitive advantage for the HES. In this paper, an expert opinion-based intuitionistic fuzzy multi-criteria group decision-making framework is used for examining the key implications of DM for the HES. It is revealed that identification of the needs, building of long-term relationships and engagement, and transparent communication have critical implications for DM in the context of higher education.
Consumer Attitude towards Green Products: An outlook from India’s Green State
Authors: N Dr. Joji Alex
Published: September 2023

This study ascertained the importance of factors like product quality, level of awareness and the role of advertisement in consumer attitude to green products in Kerala. The key question is, how do consumers perceive, when they see green practices and products around them. The is a descriptive study and the sample unit consists of frequent & non-frequent users of two green product categories and/or who were aware of them. The consumer attitude (CA) towards green products reveals, seventy-five percent were willing to pay a price premium of one to ten percent, and ten percent agreed to pay a price premium of eleven to thirty percent. Forty percent consumers will not buy green products immediately. For consumers, the environment is not an actionable priority, and has to be imposed by the state and businesses, through heightened community awareness and experiences. The originality of this paper lies in assessing consumer Attitude towards green products from India’s Green state, in the context of local climatic pressures and the various green production and branding initiatives.
When should we involve interventional radiology in the management of acute pulmonary embolism?
Authors: Barca-Hernando María , Jara-Palomares Luis
Published: September 2023

Pulmonary embolism (PE) is a common disease associated with high morbidity and mortality. Currently, guidelines recommend systemic thrombolysis in patients with haemodynamic instability (high-risk PE) or patients with intermediate–high-risk PE with haemodynamic deterioration. Nevertheless, more than half of high-risk PE patients do not receive systemic thrombolysis due to a perceived increased risk of bleeding. In these cases, percutaneous catheter-directed therapy (CDT) or surgical embolectomy should be considered. CDT has emerged and appears to be an effective alternative in treating PE, with a hypothetical lower risk of bleeding than systemic thrombolysis, acting directly in the thrombus with a much lower dose of thrombolytic drug or even without thrombolytic therapy. CDT techniques include catheter-directed clot aspiration or fragmentation, mechanical embolectomy, local thrombolysis, and combined pharmaco-mechanical approaches. A few observational prospective studies have demonstrated that CDT improves right ventricular function with a low rate of haemorrhage. Nevertheless, the evidence from randomised controlled trials is scarce. Here we review different scenarios where CDT may be useful and trials ongoing in this field. These results may change the upcoming guidelines for management and treatment of PE, establishing CDT as a recommended treatment in patients with acute intermediate–high-risk PE.
Building bridges: multidisciplinary teams in tuberculosis prevention and care
Authors: Ramos João Pedro , Vieira Mariana , Pimentel Cátia , Argel Mariana , Barbosa Pedro , Duarte Raquel
Published: September 2023

People with or affected by tuberculosis (TB) experience complex social and cultural constraints that may affect treatment outcomes by impeding access to proper care or by hindering treatment adherence. Low levels of health literacy which leads to inadequate disease information; stigma, discrimination and other forms of prejudice that may result in marginalisation and ostracisation; and socioeconomic vulnerabilities that hamper one's capacity to access essential goods or increase the risk of exposure to the disease are some of the barriers highlighted. These complex hurdles are also disproportionately felt by people with or affected by TB due to gender-related inequalities that need to be properly addressed. Additionally, TB prevention and care should encompass interventions aimed at improving and promoting mental health, given that mental unhealth may further thwart treatment adherence and success. A multifaceted and multidisciplinary approach to TB is required to answer these complex barriers.
Configuration Synthesis and Lightweight Networking of Deployable Mechanism Based on a Novel Pyramid Module
Authors: Guo Jinwei , He Jianliang , Zhang Guoxing , Zhao Yongsheng , Xu Yundou
Published: September 2023

Deployable mechanism with preferable deployable performance, strong expansibility, and lightweight has attracted much attention because of their potential in aerospace. A basic deployable pyramid unit with good deployability and expandability is proposed to construct a sizeable deployable mechanism. Firstly, the basic unit folding principle and expansion method is proposed. The configuration synthesis method of adding constraint chains of spatial closed-loop mechanism is used to synthesize the basic unit. Then, the degree of freedom of the basic unit is analyzed using the screw theory and the link dismantling method. Next, the three-dimensional models of the pyramid unit, expansion unit, and array unit are established, and the folding motion simulation analysis is carried out. Based on the number of components, weight reduction rate, and deployable rate, the performance characteristics of the three types of mechanisms are described in detail. Finally, prototypes of the pyramid unit, combination unit, and expansion unit are developed to verify further the correctness of the configuration synthesis based on the pyramid. The proposed deployable mechanism provides aference for the design and application of antennas with a large aperture, high deployable rate, and lightweight. It has a good application prospect in the aerospace field.
Prediction of diabetes disease using an ensemble of machine learning multi-classifier models
Authors: Abnoosian Karlo , Farnoosh Rahman , Behzadi Mohammad Hassan
Published: September 2023

Background and objective

Diabetes is a life-threatening chronic disease with a growing global prevalence, necessitating early diagnosis and treatment to prevent severe complications. Machine learning has emerged as a promising approach for diabetes diagnosis, but challenges such as limited labeled data, frequent missing values, and dataset imbalance hinder the development of accurate prediction models. Therefore, a novel framework is required to address these challenges and improve performance.

Methods

In this study, we propose an innovative pipeline-based multi-classification framework to predict diabetes in three classes: diabetic, non-diabetic, and prediabetes, using the imbalanced Iraqi Patient Dataset of Diabetes. Our framework incorporates various pre-processing techniques, including duplicate sample removal, attribute conversion, missing value imputation, data normalization and standardization, feature selection, and k-fold cross-validation. Furthermore, we implement multiple machine learning models, such as k-NN, SVM, DT, RF, AdaBoost, and GNB, and introduce a weighted ensemble approach based on the Area Under the Receiver Operating Characteristic Curve (AUC) to address dataset imbalance. Performance optimization is achieved through grid search and Bayesian optimization for hyper-parameter tuning.

Results

Our proposed model outperforms other machine learning models, including k-NN, SVM, DT, RF, AdaBoost, and GNB, in predicting diabetes. The model achieves high average accuracy, precision, recall, F1-score, and AUC values of 0.9887, 0.9861, 0.9792, 0.9851, and 0.999, respectively.

Conclusion

Our pipeline-based multi-classification framework demonstrates promising results in accurately predicting diabetes using an imbalanced dataset of Iraqi diabetic patients. The proposed framework addresses the challenges associated with limited labeled data, missing values, and dataset imbalance, leading to improved prediction performance. This study highlights the potential of machine learning techniques in diabetes diagnosis and management, and the proposed framework can serve as a valuable tool for accurate prediction and improved patient care. Further research can build upon our work to refine and optimize the framework and explore its applicability in diverse datasets and populations.
Detecting natural selection in trait-trait coevolution
Authors: Jiang Daohan , Zhang Jianzhi
Published: September 2023

No phenotypic trait evolves independently of all other traits, but the cause of trait-trait coevolution is poorly understood. While the coevolution could arise simply from pleiotropic mutations that simultaneously affect the traits concerned, it could also result from multivariate natural selection favoring certain trait relationships. To gain a general mechanistic understanding of trait-trait coevolution, we examine the evolution of 220 cell morphology traits across 16 natural strains of the yeastSaccharomyces cerevisiaeand the evolution of 24 wing morphology traits across 110 fly species of the family Drosophilidae, along with the variations of these traits among gene deletion or mutation accumulation lines (a.k.a. mutants). For numerous trait pairs, the phenotypic correlation among evolutionary lineages differs significantly from that among mutants. Specifically, we find hundreds of cases where the evolutionary correlation between traits is strengthened or reversed relative to the mutational correlation, which, according to our population genetic simulation, is likely caused by multivariate selection. Furthermore, we detect selection for enhanced modularity of the yeast traits analyzed. Together, these results demonstrate that trait-trait coevolution is shaped by natural selection and suggest that the pleiotropic structure of mutation is not optimal. Because the morphological traits analyzed here are chosen largely because of their measurability and thereby are not expected to be biased with regard to natural selection, our conclusion is likely general.
Combination of bioaffinity ultrafiltration-UFLC-ESI-Q/TOF-MS/MS, in silico docking and multiple complex networks to explore antitumor mechanism of topoisomerase I inhibitors from Artemisiae Scopariae Herba
Authors: Chen Tong , Hu Jingbo , Wang Huan , Tan Nana , Qi Jianzhao , Wang Xiaoling , Wang Le
Published: September 2023

Background

Artemisiae Scopariae Herba (ASH) has been widely used as plant medicine in East Asia with remarkable antitumor activity. However, the underlying mechanisms have not been fully elucidated.

Methods

This study aimed to construct a multi-disciplinary approach to screen topoisomerase I (topo I) inhibitors from ASH extract, and explore the antitumor mechanisms. Bioaffinity ultrafiltration-UFLC-ESI-Q/TOF-MS/MS was used to identify chemical constitution of ASH extract as well as the topo I inhibitors, and in silico docking coupled with multiple complex networks was applied to interpret the molecular mechanisms.

Results

Crude ASH extract exhibited toxicogenetic and antiproliferative activities on A549 cells. A series of 34 ingredients were identified from the extract, and 6 compounds were screened as potential topo I inhibitors. Docking results showed that the formation of hydrogen bond and π-π stacking contributed most to their binding with topo I. Interrelationships among the 6 compounds, related targets and pathways were analyzed by multiple complex networks model. These networks displayed power-law degree distribution and small-world property. Statistical analysis indicated that isorhamnetin and quercetin were main active ingredients, and that chemical carcinogenesis-reactive oxygen species was the critical pathway. Electrophoretic results showed a therapeutic effect of ASH extract on the conversion of supercoiled DNA to relaxed forms, as well as potential synergistic effect of isorhamnetin and quercetin.

Conclusions

The results improved current understanding of Artemisiae Scopariae Herba on the treatment of tumor. Moreover, the combination of multi-disciplinary methods provided a new strategy for the study of bioactive constituents in medicinal plants.