bluuebunny/crossref_metadata_2025 huggingface dataset:
O direito da sociedade digital: tecnologia, inovação jurídica e aprendizagem regulatória
Authors:   Universidade de São Paulo. Faculdade de Direito, Amato Lucas Fucci
Published: April 2024

Na última década do século XX, enquanto a internet se generalizava para usos domésticos e comerciais, Niklas Luhmann (1927-1998) concluía uma das mais abrangentes e originais teorias da sociedade, calcada em homologias entre os sistemas sociais e os sistemas cibernéticos. Direito, política, economia, ciência, arte, educação – cada setor da sociedade seria uma rede autorreferencial de comunicações distinguidas por certo código binário: lícito/ ilícito, governo/ oposição, ter/ não ter, verdade/falsidade, beleza/ feiura, aprovado/ reprovado. O direito da sociedade (1993), A realidade dos meios de comunicação (1994), A sociedade da sociedade (1997) mal testemunharam a massificação da internet. O que dizer então do amplo e intensivo processo de digitalização de tratamentos e pagamentos, processos de ensino-aprendizagem, solução de conflitos e tomada de decisão, operações de produção, comércio e consumo? Inteligência artificial, fake news, big data, privacidade de dados pessoais nas redes e plataformas digitais – em que medida este novo horizonte tecnológico pode se valer das formulações disruptivas da teoria dos sistemas sociais para atualizá-las e assim mobilizá-las para descrever a complexidade dos desafios impostos ao sistema jurídico? Como vem se construindo o direito, em sua função de imunizar a sociedade digital contra os vírus da incerteza radical, da desinformação massiva, da perda de referências de sentido, da desintegração de razões e padrões de avaliação, justificação e crítica? Eis o horizonte teórico e problemático deste livro.
Contemporary Valvular Mechanisms of Aortic Regurgitation in Tricuspid Aortic Valves: Importance in Repair Versus Replacement Strategy
Authors: Almaghrabi Saifalislam , Michelena Hector , Jelenc Matija , Abeln Karen B. , Ehrlich Tristan , Schäfers Hans‐Joachim
Published: April 2024

Background

This study was performed to determine cusp causes of aortic regurgitation in patients with tricuspid aortic valves without significant aortic dilatation and define cusp pathologies amenable to surgical repair (aortic valve repair [AVr]) versus aortic valve replacement.

Methods and Results

We retrospectively reviewed surgical reports of consecutive adults with tricuspid aortic valves undergoing surgery for clinically significant aortic regurgitation within a prospective registry from January 2005 to September 2019. Valvular mechanisms were determined by systematic in vivo intraoperative quantification methods. Of 516 patients, 287 (56%) underwent repair (AVr; mean±SD age, 59.9±12.4 years; 81% men) and 229 (44%) underwent replacement (aortic valve replacement; mean±SD age, 62.8±13.8 years [
P
=0.01 compared to AVr]; 67% men). A single valvular mechanism was present in 454 patients (88%), with cusp prolapse (46%), retraction (24%), and perforation (18%) being the most common. Prolapse involved the right cusp in 86% of cases and was more frequent in men (
P
<0.001). Two‐dimensional transesophageal echocardiography accuracy for predicting mechanisms was 73% to 82% for the right cusp, 55% to 61% for the noncoronary cusp, and 0% for the left‐coronary cusp. Cusp prolapse, younger age, and larger patient size were associated with successful AVr (all
P
<0.03), whereas retraction, perforation, older age, and concomitant mitral repair were associated with aortic valve replacement (all
P
<0.03).

Conclusions

Right cusp prolapse is the most frequent single valvular mechanism in patients with tricuspid aortic valve aortic regurgitation, followed by cusp retraction and perforation. The accuracy of 2‐dimensional transesophageal echocardiography is limited for left and noncoronary cusp mechanistic assessment. Prolapse is associated with successful AVr, whereas retraction and perforation are associated with aortic valve replacement. With systematic intraoperative quantification methods and current surgical techniques, more than half of tricuspid aortic valve aortic regurgitation cases may be successfully repaired.
Prognostic Value of Depressive Symptoms for Cardiovascular Events in Female Patients With Heart Failure With Reduced Ejection Fraction and Heart Failure With Preserved Ejection Fraction
Authors: Zhao Hengli , Jiang Jiaxue , Zhong Guoheng , Peng You , Wen Yihong , Liang Yu , Shan Zhixin
Published: April 2024

Background

Among those with heart failure (HF), women are more likely to develop depression than men. Few studies have focused on the outcomes of female patients with HF with depressive symptoms.

Methods and Results

A total of 506 female patients with HF with preserved ejection fraction were included in this secondary analysis from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) cohort, and 439 female patients with HF with reduced ejection fraction were included from the HF‐ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) cohort. Depressive symptoms were measured using the Patient Health Questionnaire‐9 and Beck Depression Inventory‐II. The depression class was categorized by severity, and the change in clinical depression class was defined as aggravated (1‐grade increase) or improved (1‐grade decrease). The prognostic value of depressive symptoms was determined by using multivariable Cox proportional hazards models. Female patients with improved depressive symptoms had worse depressive status at baseline and lower baseline Kansas City Cardiomyopathy Questionnaire scores. Depression class at the 12‐month visit and depression class change were the dominant prognostic factors for cardiovascular death in female patients with HF with preserved ejection fraction (hazard ratio [HR], 1.43 [95% CI, 1.02–2.01],
P
=0.036; HR, 1.71 [95% CI, 1.14–2.55],
P
=0.009). Among the patients with HF with reduced ejection fraction, both the depression class at baseline and depression class change had significant prognostic effects on cardiovascular death (HR, 3.30 [95% CI, 1.70–6.39],
P
<0.001; HR, 2.21 [95% CI, 1.28–3.80],
P
=0.004). However, the prognostic value of depressive assessments for hospitalization in patients with HF is unclear.

Conclusions

In female patients with HF with reduced ejection fraction, the depression class at baseline was most strongly associated with cardiovascular death, whereas in female patients with HF with preserved ejection fraction, the change in depression class exhibited a more significant prognostic trend.
Hypertension Trends and Disparities Over 12 Years in a Large Health System: Leveraging the Electronic Health Records
Authors: Brush John E. , Lu Yuan , Liu Yuntian , Asher Jordan R. , Li Shu‐Xia , Sawano Mitsuaki , Young Patrick , Schulz Wade L. , Anderson Mark , Burrows John S. , Krumholz Harlan M.
Published: April 2024

Background

The digital transformation of medical data enables health systems to leverage real‐world data from electronic health records to gain actionable insights for improving hypertension care.

Methods and Results

We performed a serial cross‐sectional analysis of outpatients of a large regional health system from 2010 to 2021. Hypertension was defined by systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or recorded treatment with antihypertension medications. We evaluated 4 methods of using blood pressure measurements in the electronic health record to define hypertension. The primary outcomes were age‐adjusted prevalence rates and age‐adjusted control rates. Hypertension prevalence varied depending on the definition used, ranging from 36.5% to 50.9% initially and increasing over time by ≈5%, regardless of the definition used. Control rates ranged from 61.2% to 71.3% initially, increased during 2018 to 2019, and decreased during 2020 to 2021. The proportion of patients with a hypertension diagnosis ranged from 45.5% to 60.2% initially and improved during the study period. Non‐Hispanic Black patients represented 25% of our regional population and consistently had higher prevalence rates, higher mean systolic and diastolic blood pressure, and lower control rates compared with other racial and ethnic groups.

Conclusions

In a large regional health system, we leveraged the electronic health record to provide real‐world insights. The findings largely reflected national trends but showed distinctive regional demographics and findings, with prevalence increasing, one‐quarter of the patients not controlled, and marked disparities. This approach could be emulated by regional health systems seeking to improve hypertension care.
Clinical Benefit of Fixed‐Dose Combination of Amlodipine and Potent Atorvastatin in Patients With Concomitant Hypertension and Hypercholesterolemia
Authors: Lin Chia‐Pin , Hsu Tzyy‐Jer , Tung Ying‐Chang , Hsiao Fu‐Chih , Chou Shing‐Hsien , Lin Yu‐Sheng , Chen Shao‐Wei , Chu Pao‐Hsien
Published: April 2024

Background

Hypertension and hypercholesterolemia are important risk factors for cardiovascular disease, and treatment with fixed‐dose combination (FDC) regimens is recommended by current guidelines. However, the clinical outcomes of different FDC dosages remain unknown. This study aimed to examine the clinical outcomes of FDC regimens and the free combination of amlodipine and atorvastatin at different dosages.

Methods and Results

Patients with concurrent hypertension and hypercholesterolemia treated daily with an FDC of 5 mg amlodipine and 10 mg atorvastatin (5/10 fixed group), and FDC of 5 mg amlodipine and 20 mg atorvastatin (5/20 fixed group), or free combination of 5 mg amlodipine and 20 mg atorvastatin (5/20 free group) were identified from the National Health Insurance Research Database of Taiwan. The primary outcome was the composite cardiovascular outcomes, including cardiovascular death, acute myocardial infarction, stroke, and coronary intervention. A total of 9095 patients were eligible for inclusion. The incidence of primary outcome per 1000 person‐years was 16.6 in the 5/10 fixed group, 12.6 in the 5/20 fixed group, and 16.5 in the 5/20 free group (5/20 fixed versus 5/20 free: hazard ratio [HR], 0.76 [95% CI, 0.64–0.91]; 5/20 fixed versus 5/10 fixed: HR, 0.76 [95% CI, 0.63–0.90]).

Conclusions

Among patients with concomitant hypertension and hypercholesterolemia, treatment with an FDC of amlodipine and high‐dose atorvastatin led to a lower risk of a composite of cardiovascular outcomes than treatment with the free combination or a similar FDC with a lower dose of atorvastatin.
Heart Failure–Related Death in Subjects With Atrial Fibrillation in the United States, 1999 to 2020
Authors: Zuin Marco , Bertini Matteo , Vitali Francesco , Turakhia Mintu , Boriani Giuseppe
Published: April 2024

Background

Population‐based data on heart failure (HF)‐related death in patients with atrial fibrillation (AF) are lacking. We assessed HF‐related death in people with AF in the United States over the past 21 years and examined differences by age, sex, race, ethnicity, urbanization, and census region.

Methods and Results

Data were extracted from the Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research to determine trends in age‐adjusted mortality rates per 100 000 people, due to HF‐related death among subjects with AF aged ≥15 years. To calculate nationwide annual trends, we assessed the average annual percent change (AAPC) and annual percent change with relative 95% CIs using joinpoint regression. Between 1999 and 2020, 916 685 HF‐related deaths (396 205 men and 520 480 women) occurred among US adults having a concomitant AF. The overall age‐adjusted mortality rates increased (AAPC: +4.1% [95% CI, 3.8–4.4];
P
<0.001), especially after 2011 (annual percent change, +6.8% [95% CI, 6.2–7.4];
P
<0.001) in men (AAPC, +4.8% [95% CI, 4.4–5.1];
P
<0.001), in White subjects (AAPC: +4.2% [95% CI, 3.9 to 4.6];
P
<0.001) and in subjects aged <65 years (AAPC: +7.5% [95% CI, 6.7–8.4];
P
<0.001). The higher percentage of deaths were registered in the South (32.8%). During the first year of the COVID‐19 pandemic, a significant excess in HF‐related deaths among patients with AF aged >65 years was observed.

Conclusions

A worrying increase in the HF‐related mortality rate among patients with AF has been observed in the United States over the past 2 decades.
Determinants of Market Participation of Artisanal Gold Miners: Evidence from Kumuruk District, Northwest Ethiopia
Authors: Benti Teha , Yeneneh Mihret , Aman Hassen , Sale Abdurazak , Dawd Sadik
Published: April 2024

In Ethiopia as well as most other regions of the world, the artisanal mining industry was mostly ignored, because of there are a number of factors limiting the performance of Ethiopia's artisanal mining market participation. So the purpose of this study was to determine the extent of market participation of artisanal gold miners in the Kumuruk District, Northwest Ethiopia. The respondents were chosen using a two stage sampling procedure in order to accomplish this. The initial phase involves the deliberate selection of Seven Assosa District gives rise to Kumuruk District. Five kebeles were chosen at random from the sixteen kebeles in the second stage. From the provided sampling frame, 200 respondents were chosen using a systematic random sampling technique. Tools used to analyze the data included Stata14 version and SPSS version 21 statistical software. The results of descriptive statics show that gold producers and brokers were found to be important gold market mediators at mining gate and that eight market catchments were present in the study area. Additionally, the Heckman two stage econometric estimation procedure was used to identify factors that limit gold market participation decision and gold sale weight of the artisan gold miners’ households in the study area. Informational resources, age, proximity to the market, prior mining experience, years of schooling, and household size all have a favorable and significant impact on gold market involvement. The amount of gold that each responder provided served as the depend ant changeable. Age, years of schooling, ownership of mining equipment, availability of non-mining income, cost of transportation, and informational resources were all significantly and favorably correlated with the amount of gold supplied for sales. This implies that a rise in any of these factors will result in a rise in the amount of gold offered for sale. According to the survey, efforts should be taken to open more places of sale. In order to increase market participation, mining areas should establish a direct market channel with the National Bank of Ethiopia. Additionally, youth participation in mining operations should be encouraged in order to minimize transportation expenses. Encourage the government to set up a revolving and collateral fund, and encourage microfinance institutions to open branches close to artisanal miners.
Construction of Training Curriculum System for Venous Thromboembolism (VTE) Liaison Nurses
Authors: Guo Ge , Yun Du , Lan Li , Cuiqing Liu , Baoxiang Wang
Published: April 2024

Objective To construct a training curriculum system for venous thromboembolism (VTE) liaison nurses and provide a basis for corresponding clinical training, evaluation and certification. Methods Analyzed the training needs of VTE liaison nurses. Conducted two rounds of Delphi surveys with 27 experts from Hubei, Sichuan, Guizhou, Guangxi and Guangdong provinces in China. Determined the weights of indicators at all levels using the Analytic Hierarchy Process (AHP) and equal weighting method. Results The age of the participants ranged from 38~59 (46.63±5.343), and the years of working ranged from 12~42 (25.48±7.439). 27 and 26 valid questionnaires were collected respectively from the first and second rounds of the surveys. The effective response rates of the two-round Delphi survey were 90.0% and 96.3%, respectively, and the experts’ authoritative coefficients were 0.884 and 0.906, respectively, and Kendall’s coefficient of concordance of experts’ opinions were 0.261 and 0.276, respectively (P <0.01). A training system with 5 first-level indicators and 26 second-level indicators was finally formed after two rounds of Delphi surveys. Conclusions The training system for VTE liaison nurses constructed in this study is highly scientific and practical, which can provide a basis for the training assessment and ability evaluation of VTE liaison nurses, and also provide a reference for VTE prophylaxis, treatment and nursing.
Metabolic Equivalent Distance Across Game Quarters and Athlete Position in Female Collegiate Lacrosse Players
Authors: Symons Brock , Bunn Jennifer
Published: April 2024

As a sport, field lacrosse requires seamless transitions between acceleration and deceleration. Unfortunately, linear displacement variables at a constant speed underestimate the energy demand in team sports, as they fail to account for the additional energy expended during acceleration and deceleration. In order to address these additional energy costs and offer a more precise measure of an athlete's workload, the metric called metabolic equivalent distance (MED) was developed. The purpose of the study was to assess the differences in MED across game quarters and athlete positions among female collegiate lacrosse players and determine potential relationships between MED and other workload variables. Seventeen female collegiate lacrosse players wore global positioning systems units, and data were collected over the course of 17 games. Performance variables were analyzed per minute played (min PT) and included: MED (m), total distance (m), accelerations (count), decelerations (count), total sprints (count), metabolic peak power (J), metabolic energy cost (J/kg/m), and equivalent distance index (%). No difference was found between athlete position. Performance variables did not differ between game quarters, except for playing time (p < .001). Athlete playing time was reduced in the 3rd and 4th quarters compared to quarter 1 (p < .001). MED showed a perfect correlation with total distance and metabolic energy cost (r = 1; p < .001) and a near-perfect correlation with accelerations and total sprints (r = .93; p < .001). Decelerations exhibited a strong correlation with MED (r = .86; p < .001). MED was moderately correlated with metabolic peak power (r = .34; p < .001); whereas equivalent distance index displayed a small correlation (r = .15; p = .02). Athletes exhibited a consistent output in metabolic workload variables across position and game per minute of play. MED could serve as a surrogate workload variable to better understand the athlete’s energy expenditure during high-intensity training and game play.
Classification and Prediction Method for Dolomite Reservoirs in the Permian Maokou Formation in the Sichuan Basin
Authors: Yao Lu , Shize Wang , Haiyin Li , Xiaojie Cui , Jing Zhao , Li Li , Wen Zou , Qun Yan
Published: April 2024

The Lower Permian Maokou Formation in the Hechuan area is one of the key horizons for natural gas exploration in the Sichuan Basin, showing a low degree of exploration and great exploration potential. The Lower Permian gas reservoir is mainly controlled by the reservoir, therefore it is subject to the development of the Maokou Formation reservoir. However, due to the strong heterogeneity and significant variations in physical properties of the Maokou Formation dolomite reservoir in the Hechuan area, there are significant differences in seismic response characteristics of reservoirs with different porosities. Through comprehensive analysis of gas testing wells in the Maokou Formation, criteria for reservoir classification were established based on lithology, average porosity, plane porosity, and thickness of dolomite reservoirs. The effective reservoirs in the Maokou Formation were divided into two types: high-porosity reservoirs and medium-porosity reservoirs. On the basis of establishing a physical quantity model for the Lower Permian carbonate rock in the research area, the rock physical characteristics and seismic response characteristics of reservoirs with different pores are determined through model forward modeling, and appropriate methods are selected for prediction. By using the optimization processing method of gathers and wavelet decomposition to remove sidelobes, the issue of seismic abnormal response caused by lateral velocity changes in the underlying Maokou Formation has been solved. The relative strength relationship of seismic response amplitude can effectively characterize the true situation of reservoir development. Then, by using post-stack inversion and pre-stack simultaneous inversion methods, the high-porosity and medium-porosity dolomite reservoirs in the Maokou Formation are classified and predicted, thereby to effectively improve the prediction accuracy of reservoirs, ultimately providing a reliable basis for the exploration and development of the Maokou Formation in the Hechuan area in the later stage.
Intraoperative Hypoxemia in the Right Lateral Decubitus Position: A Case Report
Authors: Wu Guowei , Xu Hongwei
Published: April 2024

Platypnea-Orthodeoxia syndrome (POS), an exceptionally uncommon condition, is characterized by decreased oxygen saturation in an upright posture with corresponding improvement in the supine position. Recently, an 85-year-old female patient presented for surgery due to a left femoral neck fracture. Following successful tracheal intubation and anesthesia induction, the ventilator indicated an airway pressure of 15mmHg. While in the right lateral decubitus position, the patient developed hypoxia despite normal arterial blood pressure and symmetrical breath sounds. Attempts to alleviate the hypoxia through pure oxygen ventilation, tympanic lung ventilation, and high-frequency ventilation were unsuccessful. Subsequently, there was a notable decrease in both blood pressure and heart rate, prompting an immediate halt to the surgery and repositioning the patient to the supine position. This resulted in the normalization of the patient's heart rate, oxygen saturation, and blood pressure. To investigate the etiology, a TEE probe was inserted, revealing the presence of a patent foramen ovale (PFO) and a significant right-to-left shunt while the patient was in the lateral position. The procedure was performed in a specific right lateral decubitus position. This case may represent a unique manifestation of POS syndrome, expanding the differential diagnosis for intraoperative position-related hypoxemia. Given the severe hypoxemia observed with intraoperative positional changes, a strong suspicion of POS syndrome is warranted.
Investigating the Relationship Between Brand Equity and Customer Loyalty the Moderating Effect of Customer Satisfaction in the Telecom Industry
Authors: Desta Endalkachew , Amantie Chalchissa
Published: April 2024

The study explores the connection between brand equity and customer loyalty in the telecom industry. It specifically examines how customer satisfaction plays a moderating role in this relationship. The research employed structural equation modeling and involved 386 Ethio telecom customers. Several aspects were evaluated, including reliability, convergent validity, and sample adequacy. The study's findings highlight a strong positive correlation between brand equity and customer loyalty within the telecom industry. Factors such as positive brand image, perceived quality, brand awareness, and brand associations were found to have significant influences on customer loyalty. Furthermore, customer satisfaction was identified as a moderator, enhancing the positive impact of brand equity on loyalty. Based on the results, the study emphasizes the importance of brand equity and customer satisfaction in fostering loyalty in the telecom industry. It suggests that telecom companies should invest in building a strong brand image, improving perceived quality, increasing brand awareness, and cultivating favorable brand associations. Policymakers and regulators are also encouraged to create a competitive telecom market that promotes innovation, high-quality service delivery, and reasonable pricing. The practical implications of these findings are significant for the industry. They underscore the need for strong brand equity strategies and the delivery of exceptional customer experiences. By prioritizing these aspects, telecom companies can enhance customer loyalty and gain a competitive advantage in the market.
A Secondary Urothelial Carcinoma of the Penis Diagnosed
Authors: Thiapato Faye , Amadou Diallo , Talib Thiam , Désiré Niang , Hamidou Kikalulu , Mamadou Dembele , Mohamed Jalloh , Racine Kane , Lamine Niang
Published: April 2024

Aim: Penile cancer is one of the rarest urogenital cancers. Penile metastases after cystectomy are possible and seem to be associated with the existence of an extensive tumor on the surgical specimen. Case Presentation: We report here the case of old man 78 years old, with a history of Radical Cysto-Prostatectomy with Bricker type urinary diversion, indicated for a pT3N0M0R0 infiltrating urothelial carcinoma of the bladder. He had consulted 7 years post surgery for an indurated lesion of the penis with urethrorrhagia. On examination, he presented an ulcerative-necrotic lesion under the left lateral coronal area of the penis, a diffuse induration of corporal bodies from the glans to the bulb, bilateral inguinal macro lymphadenopathies. Magnetic Resonance Imaging of the penis suggested a tumor extending over the entire penis, infiltrating the corpora cavernosa and spongiosa, with invasion of the albuginea, adjacent fat and skin. In view of this picture, a total penectomy with emasculation was performed. The histology of the surgical specimen showed a poorly differentiated urothelial carcinoma with an immunohistochemical study in favor of a primary urothelial origin (GATA3+). The tumor infiltrated both corpora cavernosa and the urethra with positive margins of resection. The right inguinal lymph node dissection showed one metastatic node out of two. The left inguinal lymph node dissection showed one metastatic lymph node out of six with capsular rupture. Thoracic-abdominopelvic CT Scan showed a right inguinal adenopathy with no other lesions suggestive of secondary localization. The diagnosis of secondary urothelial carcinoma of the penis classified as pT4N2M0R1 was made and the patient underwent chemotherapy on tumor board meeting. Conclusion: Secondary cancers of the penis, although rare, can occur years after radical treatment of the primary tumor. Immuno-histochemestry was esential to differentiate from primary squamous cell carcinoma in our case.
Meta-Analysis of Randomized Controlled Trials: High-Intensity Electroacupuncture Outperforms Low-Intensity Electroacupuncture for Knee Osteoarthritis
Authors: Zihang Chen , Xingsen Liang , Huajun Wang , Xiaofei Zheng , Jing Zhao , Peng Qing , Mingmin Zhu , Chang Ji , Kejie He , Hai Zeng , Cheang Lek , Tam Man , Jian Guan , Li Jia , Gao Yanping , Li Ling
Published: April 2024

Background: Electroacupuncture (EA) has been proven to be efficacious and safe in patients with knee osteoarthritis (KOA), yet the superior intensity current for pain control in KOA remains unspecified. The present meta-analysis aimed to assess the efficiency of high-intensity and low-intensity EA in pain relief and functional improvement in KOA. Methods: A thorough and comprehensive literature search for randomized controlled trials (RCTs), all looking at the intensity of EA for KOA, was carried out in PubMed, EMBASE, Cochrane Library, clinicaltrials.gov, China National Knowledge Infrastructure (CNKI), China Science Journal Citation Report (VIP) and Wanfang database. All databases were searched from the available date of inception until the latest issue (Apr 2022). The study quality was evaluated via the Jadad five-point scale. Ultimately, a meta-analysis of all eligible RCTs was conducted utilizing Review Manager 5.3. Results: Three studies with 472 individuals were included in the Meta-analysis. The pain intensity reductions are significantly different between the high-intensity EA group and low-intensity EA group (MD=-0.22, 95%CI=-0.26 to -0.18, P< 0.00001). There is no significant difference between the two groups in the WOMAC index (MD=-3.62, 95%CI=-12.22 to 4.98, P= 0.41). High-intensity EA group significantly improve the emotional scale (ES) in comparison to the low-intensity EA group (MD=-0.72, 95%CI=-0.76 to -0.67, P< 0.00001). Conclusion: The findings of this work indicated that high-intensity EA provides superior pain relief and emotional scale in KOA patients. Moreover, both high-intensity and low-intensity EA exert a significant functional improvement effect in KOA.
Assesment of Quality Management Practice on High-Rise Building, the Case of Banking and Insurance Companies in Addis Ababa
Authors: Menberu Michael
Published: April 2024

This research focuses on the assessment of quality management practices within the context of constructing high-rise buildings, with a particular emphasis on buildings designated as headquarters for banking and insurance companies in Addis Ababa. The objective of this study is to gain a comprehensive understanding of the various factors that contribute to the successful execution of complex construction projects in this domain. Employing a hybrid research approach that combines both qualitative and quantitative methods, the investigation explores a range of aspects related to quality assurance, monitoring, evaluation, and regulatory oversight. The study explores the impact of inadequate quality management on the overall quality, structural integrity, and safety of high-rise buildings. It also identifies barriers and challenges in implementing quality management practices, as well as performance indicators and metrics for assessing the effectiveness of quality control measures. Additionally, the research delves into monitoring construction activities for compliance with quality control measures and ensuring quality standards for materials used in high-rise construction. Furthermore, it discusses quality benchmarks, standards, and the monitoring and evaluation of quality assurance measures implementation within organizations, including policies and procedures specific to high-rise building projects. Through interviews with various stakeholders, this study aims to provide valuable insights into enhancing the quality management processes in high-rise construction projects, ultimately contributing to the advancement of building safety and integrity in urban environments. Building upon these insights, the research concludes by presenting a series of strategic recommendations designed to enhance quality management practices in high-rise building construction projects. These recommendations span multiple dimensions, including strengthening regulatory oversight, implementing integrated quality assurance policies, establishing comprehensive monitoring and evaluation frameworks, defining quality benchmarks and performance metrics, ensuring robust materials quality control.
Determination of Sulphur Dioxide (SO2) Air Emission of Refined Petroleum Products by Emission Factor Approach for Air Pollution Control
Authors: Oni Olufemi , Sonibare Jacob , Fakinle Bamidele , Oke Daniel , Odofin Odunola , Oladele Motunrayo , Ikeh Michael
Published: April 2024

Air pollution control is a safe method for achieving a sustainable environment and can be accomplished by adequately monitoring pollutants that pose significant environmental risks. The combustion of sulfur-containing petroleum products has been a major concern for several decades. Therefore, this study was aimed at determining sulfur levels in refined petroleum products such as Premium Motor Spirit (PMS), Automotive Gas Oil (AGO), and Dual-Purpose Kerosene (DPK). It also investigated the air quality implications of sulfur levels and estimated the contribution of the refinery’s products to sulfur dioxide air emission. Fuel samples were collected from the Warri Refining and Petrochemical Company (WRPC) in Nigeria and analyzed using Ultraviolet-visible spectrophotometer (UV-Vis) and Energy-Dispersive X-ray Fluorescence (EDXRF). Sulfur levels were determined at 425 nm wavelength, and sulfur dioxide air emission were estimated for seven consecutive years from 2010 to 2016 using the emission factor approach. The densities of PMS, AGO, and DPK were 0.77 kg/l, 0.832 kg/l, and 0.82 kg/l respectively. The levels of sulfur in PMS, AGO, and DPK were 2.007 x 10-4 %, 6.970 x 10-5 wt%, and 4.233 x 10-5 wt% respectively from UV-Vis technique and 0.016, 0.087 and 0.029% respectively for EDXRF technique were found below the sulfur limit of 0.015 %, 0.005 % and 0.015 % for PMS, AGO and DPK respectively specified by Standard Organization of Nigeria (SON) specifications of 0.1, 0.5 and 0.15wt% for PMS, AGO and DPK respectively. The annual sulfur dioxide emissions were obtained for seven consecutive years from 2010 to 2016. The results from UV-VIS were observed to have the highest SO2 emission of 0.1718 tons for PMS in 2011, 0.2593 tons in 2010 for AGO, and 0.0974 tons for DPK in 2010, while the lowest emission was observed to be 0.029 tons for PMS in 2015, 0.0362 tons in 2015 for AGO and 0.0181 tons for DPK also in 2015. The results from EDXRF technique were observed to have the highest SO2 emission of 13.6939 tons for PMS in 2012, 323.6881 tons for AGO in 2010, and 66.7147 tons for DPK also in 2010, while the lowest emissions for PMS, AGO and DPK were all observed in 2015 to be 2.3122, 45.1872, and 12.4182 tons respectively. The study concluded that the refinery complied with the set requirements.
Analysis of Campus Recruitment in Contemporary AI Companies
Authors: Xinghang Yuwen
Published: April 2024

With the continuous evolution of AI technology, the demand for talents is constantly increasing, and the demand for high-quality talents is becoming increasingly urgent. Campus recruitment, as an important way of talent introduction, provides AI companies with rich talent selection space. However, people from different eras have completely different cognitive and behavioral preferences towards campus recruitment. The generation that grew up before and after the reform may not have established a sense of independent career choice when they first entered society at a young age; Some of the post-90s generation, who were initially labeled as "rebellious," have now entered their thirties and are increasingly learning to seek their professional value under the premise of seeking stability in reality. In the post-95s and post-00s generation who have been "rectifying the workplace", they have learned to make two-way choices and can even use various information channels to conduct "reverse interviews" with enterprises to ensure suitable employment opportunities. At present, the campus recruitment group has gradually entered the "post-2000" era. While AI companies need to face fierce market competition, how to attract and retain excellent young talents has become an important challenge. The article analyzes and summarizes the current situation of campus recruitment in contemporary AI enterprises, and provides suggestions for optimization solutions. It is hoped that this can solve the practical problems that contemporary AI companies face in campus recruitment and provide reference for the implementation of campus recruitment plans in related AI enterprises in the future.
An Acid-Responsive Iron-Based Nanocomposite for OSCC Treatment
Authors: Zhao X. , Leng D. , Wang H. , Jin H. , Wu Y. , Qin Z. , Wu D. , Wei X.
Published: April 2024

Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer, characterized by invasiveness, local lymph node metastasis, and poor prognosis. Traditional treatment and medications have limitations, making the specific inhibition of OSCC growth, invasion, and metastasis a challenge. The tumor microenvironment exhibits mildly acidity and high concentrations of H2O2, and its exploitation for cancer treatment has been widely researched across various cancers, but research in the oral cancer field is relatively limited. In this study, by loading ultra-small Prussian blue nanoparticles (USPBNPs) into mesoporous calcium–silicate nanoparticles (MCSNs), we developed an acid-responsive iron-based nanocomposite, USPBNPs@MCSNs (UPM), for the OSCC treatment. UPM demonstrated excellent dual enzyme activities, generating toxic ·OH in a mildly acidic environment, effectively killing OSCC cells and producing O2 in a neutral environment to alleviate tissue hypoxia. The results showed that UPM could effectively inhibit the proliferation, migration, and invasion of OSCC cells, as well as the growth of mice solid tumors, without obvious systemic toxicity. The mechanisms may involve UPM inducing ferroptosis of OSCC cells by downregulating the xCT/GPX4/glutathione (GSH) axis, characterized by intracellular iron accumulation, reactive oxygen species accumulation, GSH depletion, lipid peroxidation, and abnormal changes in mitochondrial morphology. Therefore, this study provides empirical support for ferroptosis as an emerging therapeutic target for OSCC and offers a valuable insight for future OSCC treatment.
Toward an Integrated Framework of Knowledge Transfer: When Non-Profit Organizations Become International
Authors: Hsu Shih-Lung , Lin Hsin-Mei
Published: April 2024

Existing literature lacks an in-depth exploration of Non-Profit Organizations (NPOs) studying transnational religious rituals and scripture dissemination, leaving a notable research gap. The study integrated the SECI model with an institutional distance framework to create a new path analysis, this research aims to reveal interorganizational knowledge transfer dynamics within such religious groups, focusing on Tiandi Teachings (TT) in Taiwan and its Branches of the Japan Diocese (BJD). Employing extended case methodology with participant observation and semi-structured interviews, the study analyzed data using grounded theory and NVivo 12 software. It identified insights into knowledge transfer processes within international religious organizations, elucidating mechanisms for establishing local legitimacy and transferring religious knowledge across borders. This research contributes to understanding how religious organizations globalize, enriches institutional theory, and underscores the importance of integrating institutional concepts with knowledge transfer models. Its findings offer practical benefits to religious leaders, policymakers, and academics.
The Rhythm of Hidden Religious Heritage: Dhol Puja of India’s Hijra Community
Authors: Mal Sibsankar , Mundu Grace Bahalen
Published: April 2024

This Context of Religious Research commentary describes why scholars should attend to the Hijras of India. The Hijras are a marginalized transgender community in India. Although having a long historical presence with sociocultural importance, this community was often stigmatized and discriminated against due to their ambiguous gender identity and expression. The commentary identifies the Dhol Puja as a traditional clandestine ritual of the Hijra community that reflects their unique identity and cultural, religious heritage. Based on prior ethnographic research and community study throughout various locales of India, this commentary provides insights into the symbolic meaning and significance of the Dhol Puja for the Hijra community. It asserts that their spiritual performance serves as a form of sacred ritual that is resisting adaptation to modern times, and which could be a revival or adaptation of an ancient tradition. Additionally, the spiritual performance continues to serve as a celebration of the unique identity and religious tradition of the Hijra community. Offering this context can cultivate greater recognition and understanding of the religious practices in promoting social inclusion of Hijra community in India.
Malaria Prevalence and Macroeconomic Output in Ghana, 1990 to 2019
Authors: Immurana Mustapha , Klu Desmond , Aberese-Ako Matilda , Abdullahi Ibrahim
Published: April 2024

In Ghana, malaria remains the number 1 reason for outpatient department visits, making it a major public health problem. Thus, there could be significant lost productivity days as a result of malaria morbidity and mortality, which could negatively affect economic output at the macrolevel. Nonetheless, there is a dearth of empirical evidence of the effect of malaria on macroeconomic output in Ghana. This study therefore aims to provide the foremost empirical evidence regarding the effect of malaria prevalence on macroeconomic output in Ghana using a time series design with data spanning the period 1990 to 2019. Gross Domestic Product (GDP), serving as a proxy for macroeconomic output, is the dependent variable, while the prevalence of malaria (overall, among only males and among only females) serves as the main independent variable. The Ordinary Least Square (OLS) regression is used as the baseline estimation technique and the Instrumental Variable Two-Stage Least Square (IV2SLS) regression is employed as the robustness check estimator due to its ability to deal with endogeneity. The IV2SLS regression results show that a percentage increase in the overall prevalence of malaria is associated with a 1.16% decrease in macroeconomic output at 1% significance level. We also find that the effect of malaria in males on macroeconomic output is slightly higher relative to females. The findings from the OLS regression are not qualitatively different from the IV2SLS regression estimates. There is therefore the need to strengthen efforts such as quality case management, larval source management, mass distribution of long-lasting insecticide-treated bed nets, social behavior change, surveillance (both epidemiological and entomological), intermittent preventive treatment of malaria in pregnancy, research among others, which are important toward eliminating malaria.
Experimental Study on Compression Failure of Type II Ballastless Track Slab Based on Optical Fiber Sensing
Authors: Xuebing Zhang , Yang Quan , Zhizhou Zheng , Li Wang , Hongtian Cui , Xiaonan Xie , Han Wu , Xiaochun Liu , Delei Yang , Huaping Wang , Ping Xiang
Published: April 2024

Ballastless track structures are widely employed in high-speed rail networks because of their superior safety and durability. Among the various types of ballastless track, the Type II slab is currently one of the most extensively used and mature technologies in practice. Over the course of its service life, the damage within the ballastless track structure gradually accumulates in response to increased external loads. Therefore, it is crucial to continuously monitor the health condition of the track structure. In this study, a quasi-distributed fiber optic sensing system is adopted to monitor the deformation capacity and force performance of a Type II ballastless track slab under vertical load. The investigation aims to analyze the damage mechanism of the track structure under vertical pressure by assessing the deformation differences among its different components. The findings reveal that the incorporation of vertical reinforcement can enhance the pressure bearing capacity of the cement asphalt mortar layer to a certain extent, subsequently affecting the stress dilation. The stress performance of the ballastless track slab can be effectively monitored using the quasi-distributed fiber optic sensing technology under pressure. The outcomes of this research offer valuable insights for controlling displacement and analyzing damage in ballastless railway systems subjected to compression.
Comparison of Windup and Stretch Pitching Biomechanics in Baseball With Implications for Safety and Performance
Authors: Fleisig Glenn S. , Slowik Jonathan S. , Kutz Charles B. , Escamilla Rafael F.
Published: April 2024

Background:

Historically, it was assumed by some that high leg lift with windup pitching generated more ball velocity whereas pitching from the stretch was quicker to reduce the risk of base stealing but also more stressful on the arm. However, many now believe that velocity and stress do not differ between windup and stretch and always pitching from the stretch is simpler than mastering 2 techniques.

Purpose/Hypothesis:

The purpose of this study was to compare windup and stretch fastball pitching biomechanics. It was hypothesized that there would be statistically significant and clinically important differences in ball velocity, timing of angular velocities, joint kinetics, and pitching kinematics.

Study Design:

Controlled laboratory study.

Methods:

Fastball pitching biomechanics previously captured for 221 healthy baseball pitchers (105 professional, 52 collegiate, and 64 high school level) were analyzed. For each pitcher, data for 3 to 10 windup trials and 3 to 10 stretch trials were available. Ball velocity was recorded using a radar gun. A 12-camera, 240-Hz automated motion capture system was used to track 39 reflective markers attached to the pitcher. A total of 24 kinematic parameters, 4 temporal parameters, and 5 kinetic parameters were calculated. Data for each parameter were compared across the 2 techniques and 3 competition levels using 2-way repeated-measures analysis of variance ( P < .01). Based on previous studies and the expertise of the investigators, the minimal clinically important difference (MCID) was set as 2° for angle measurements, 20 deg/s for angular velocities, 0.5 m/s for fastball velocity, and 0.3% body height × weight for normalized joint torque.

Results:

Fastball velocity was statistically greater from the windup than stretch for the collegiate subgroup but not for the other 2 levels. The collegiate level difference was below the MCID. Pitching from the windup generated greater front knee height and required more time from initiation of leg lift to front foot contact. From foot contact to ball release, there were 11 additional small, statistically significant differences between windup and stretch; however, each of these was well below the MCID.

Conclusion:

Pitching from the stretch was quicker and should be used with runners on base to prevent stealing. Pitching from the windup and stretch produced similar ball velocity, joint kinetics, and kinematics. Thus, pitchers may choose to use both techniques or stretch only based on comfort and personal preference.

Clinical Relevance:

The decision to pitch from both the windup and stretch or only from the stretch should not affect a pitcher's performance or joint stress (and injury risk).
Increasing Naloxone Access and Prescribing for Patients on High-Dose Opioids From a Managed Care Pharmacy Health Plan Perspective
Authors: Hansgen Jodi P. , Robertson Megan L. , Verzino Ellen M. , Manning Lindsay M.
Published: April 2024

Background: Opioid overdoses decrease when communities have access to naloxone. Clinicians play a key role in offering naloxone to high-risk chronic opioid patients. Managed care pharmacists within our health plan noted disproportionate processing for claims of opioid utilizers compared to claims of naloxone prescriptions. Objective: To increase naloxone access and prescribing to members who classify at a dosage with a higher risk for opioid overdose, defined as over 90 morphine milligram equivalents (MME). Methods: Multiple system-wide initiatives were implemented to improve naloxone access. A claims file was pulled monthly to identify members on opioids meeting MME criteria >90 MME per day excluding members with cancer, sickle cell disease, or on hospice. A separate report was then matched to naloxone claims and prescribing percentages calculated. Results: 12 444 utilizing members on opioids were identified from June 2019 prescription claims data. Of these, 131 were on opioids exceeding 90 MME per day, or 1.05% of utilizers, and the percentage of members exceeding 90 MME per day prescribed naloxone was 6.87%. By May 2023, the percentage of opioid utilizers exceeding 90 MME per day decreased to 0.58%. Naloxone prescribing increased to 41.18%. Conclusion: A multi-pronged approach to improve access to naloxone and continued educational efforts by our health plan increased naloxone prescribing in members on opioids exceeding 90 MME per day.