bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing interprofessional collaboration for unattached patients in primary care
Authors: Boulanger Élise , Dumas-Pilon Maxine , Wicks Victoria , Gaboury Isabelle , Breton Mylaine , Smithman Mélanie-Ann
Published: August 2024

This project explored an interprofessional collaboration initiative at Clinique Indigo which aimed to improve comprehensive care for unattached patients in Quebec’s primary care system. Throughout the project, physicians and non-physician health professionals alike became more actively engaged in the care of patients lacking a regular primary care provider. The project successfully demonstrated that defining a common vision for “well care” within the clinic and integrating diverse professionals could significantly improve quality of care for unattached patients, evidenced by an increase from 13% to 43% in comprehensive care provision. However, the initiative also faced challenges, including professional turnover and gaps in primary care training, suggesting critical areas for future improvement in healthcare policy and practice. These results support expanded interprofessional approaches in primary care to address systemic care disparities in universal healthcare settings such as this one caused by the differential or absence of attachment to a primary care provider.
Strengthening collaboration for interprofessional primary care teams: Insights and key learnings from six disciplinary perspectives
Authors: Ashcroft Rachelle , Bobbette Nicole , Moodie Sheila , Miller Jordan , Adamson Keith , Smith Mary Anne , Donnelly Catherine
Published: August 2024

We provide a case example of the collaborative process required to plan and implement initiatives to enhance team-based primary care, drawing on experiences of six disciplines working together to create new curricula as part of Team Primary Care. Recommendations to strengthen collaboration from our team include building capacity requires an understanding of unique disciplinary roles and understanding of unique elements of primary care; competencies have to be specifically articulated and demonstrated within a primary care context; interprofessional education within and across disciplines is needed; establishing primary care competencies would provide a common set of skills, knowledge, values, and attitudes to form a foundation in which to build the capacity of the interprofessional primary care workforce; and interprofessional collaboration is needed in implementing team-based primary care in practice and in preparing an interprofessional workforce prepared to leverage the expertise of the entire team.
Rehabilitation Intervention Is Associated With Improved Neurodevelopment and Modulation of Inflammatory Molecules in Children With Cerebral Palsy
Authors: Magalhães Rafael Coelho , Filha Roberta da Silva , Vieira Érica Leandro Marciano , Teixeira Antônio Lúcio , Moreira Janaina Matos , Simões e Silva Ana Cristina
Published: August 2024

Aim

To evaluate the effects of systematic rehabilitation on both the neuropsychomotor development, and on the peripheral response from immunological and neuroplastic mediators in children with cerebral palsy.

Methods

This is a prospective cohort study with 90 children with cerebral palsy at 18 months of age. Sixty children received rehabilitation for 6 months, and they were compared to 30 children that were placed in the waiting list. Peripheral biomarkers and neuropsychomotor parameters were compared between the Rehab vs the Nonrehab groups at baseline and at 6 months.

Results

Results showed higher Bayley III scores in the Rehab group, with significant differences in inflammatory and neurotrophic biomarkers between groups. Rehabilitation was associated to decreased levels of IL-12p70, IL-6, IL-1β, CXCL8 IL-8, and CXCL9/MIG and increased levels of BDNF and GDNF. Nonrehab children had stable immune molecule levels but decreased BDNF levels over time.

Conclusion

Rehabilitation improved neurodevelopment parameters and modulated levels of inflammatory (↓) and neurotrophic (↑) biomarkers.
Dexmedetomidine Improves Microcirculatory Alterations in Patients With Initial Resuscitated Septic Shock
Authors: Xu Jingyuan , Wang Yeming , Shu Chang , Chang Wei , Guo Fengmei
Published: August 2024

Background: The study was to investigate the effects of dexmedetomidine on microcirculation in patients with early septic shock despite initial resuscitation. Methods: This was a single-center prospective study. Patients with early septic shock despite initial fluid resuscitation who still required norepinephrine to maintain target arterial pressure were enrolled. Hemodynamic and gas analysis variables, sublingual microcirculatory parameters were measured at baseline, and during the infusion of dexmedetomidine for 1 h (0.7mcg/kg/h). To elucidate the possible mechanisms of the effect of dexmedetomidine on microcirculation, after interim analysis, the dose-effect relationship of dexmedetomidine on microcirculation and catecholamine level were investigated at baseline, 1h after stabilization at different doses of dexmedetomidine (0.7 and 0.3 mcg/kg/h), and 2h after dexmedetomidine cessation. Results: Forty-four patients with septic shock were enrolled after initial resuscitation. Compared with baseline, total and perfused vascular densities were statistically increased after infusion of dexmedetomidine, which was correlated with the dose of dexmedetomidine. During dexmedetomidine infusion, plasma norepinephrine, and dopamine level were significantly decreased. Changes in plasma norepinephrine level contributed to dexmedetomidine infusion were well correlated with changes in total and perfused vascular densities. Conclusions: In adult patients with resuscitated septic shock, dexmedetomidine improved microcirculation, which might be associated with plasma catecholamine level. However, double-blinded large sample studies should be performed to verify the results.

Trial registration: Clinicaltrials.gov NCT02270281. Registered October 16, 2014.
Antibacterial activity of a silver-incorporated vancomycin-modified mesoporous silica against methicillin-resistant Staphylococcus aureus
Authors: Chamani Mehdi , Asgari Shadi , Najmeddin Ali , Pourjavadi Ali , Amin Mohsen , Gholami Mahdi , Dorkoosh Farid Abedin
Published: August 2024

Since conventional antibiotics are almost ineffective on methicillin-resistant Staphylococcus aureus (MRSA) strains, designing their antibacterial alternatives is necessary. Besides, the use of vancomycin is applied for specific detection of the bacteria. Silver-incorporated vancomycin-modified mesoporous silica nanoparticles (MSNs@Van@Ag NPs) were designed for detection and treatment of MRSA bacteria. Mesoporous silica nanoparticles (MSNs) were synthesized through the template method, modified with vancomycin, and finally incorporated with silver nanoparticles (Ag NPs). The MSNs@Van@Ag NPs with a homogenously spherical shape, average size of 50-100 nm, surface area of 955.8 m2/g, and thermal stability up to 200°C were successfully characterized. The amount of Ag incorporated into the MSNs@Van@Ag was calculated at 3.9 ppm and the release amount of Ag was received at 2.92 ppm (75%) after 100 h. The in vitro antibacterial susceptibility test showed the MIC of 100 μg mL−1 for MSNs@Van and 50 μg mL−1 for MSNs@Van@Ag, showing in vitro enhanced effect of Ag and vancomycin in the bactericidal process. An in vivo acute pneumonia model was performed and biochemical assays and pathological studies confirmed the nanomedicine’s short-term safety for in vivo application. Cytokine assay using ELISA showed that MSN@Van@Ag causes a reduction of pro-inflammatory cytokines and bacterial proliferation leading to alleviation of inflammatory response.
Evaluating 3D Apparel Simulation Technology's Performance of Creative Pattern-Cutting Techniques with the Assist of ASVT
Authors: Hakeem Fatimah , Xia Sibei , Stannard Casey
Published: August 2024

Three-dimensional (3D) simulation technologies have experienced a significant rise in popularity in the fashion industry. Analyzing the efficacy of such technologies aids in pinpointing areas that require enhancement. While previous studies mostly focused on evaluating the fit and appearance of 3D simulation technologies with simple clothing styles, this research aims to assess the effectiveness of 3D fashion simulation software in producing digital designs that include creative pattern-cutting techniques known for their intricate structures and design complexities. Four designs were chosen to exemplify different design characteristics, and 95 people were recruited to assess the effectiveness of two cuttingedge 3D fashion simulation programs. Furthermore, the researchers utilized the apparel spatial visualization tests (ASVT) to examine whether the participants’ spatial visualizing aptitude would impact their assessment outcomes. The findings offer suggestions for enhancing the existing 3D simulation technology and provide instructions for the assessment procedure.
Impact of deposition pressure on the structural, nanomechanical, and tribological properties of δ-TaN coatings deposited via magnetron sputtering on Ti6Al7Nb alloy
Authors: Singh Vivek , Sharma Rajesh Kumar , Sehgal Rakesh
Published: August 2024

In the present study, δ-TaN thin films were deposited by reactive magnetron sputtering (physical vapour deposition) on Ti6Al7Nb alloy by varying the deposition pressure (0.8–0.2 Pa). Their crystalline structure, chemical composition, surface roughness, and surface morphology were investigated by using grazing incidence X-ray diffraction, energy dispersive spectroscopy, scanning probe microscope, and field emission scanning electron microscopy (FESEM), respectively. Structural analysis results confirmed the deposition of cubic δ-TaN thin films along the (111) basal plane; moreover, spherical dome-like surface morphology was observed by FESEM. Further, to analyze the nanomechanical properties of the deposited δ-TaN coatings, such as hardness (H) and modulus (E), scratch tests were performed utilizing the nanomechanical system. Moreover, friction and wear properties of the coating and bare sample (substrate) were investigated on nano-tribometer equipment using a rotary ball-on-disk type configuration. The stainless steel (SS-316) and silicon nitride (Si3N4) balls were used as the counter materials for the tribological tests. The observations of nanomechanical tests revealed that H (GPa), E (GPa), and H/E ratio values increased from 11.83 to 28.30 GPa, 176.02 to 248.45 GPa, and 0.06 to 0.11, respectively, with the decrease of the deposition pressure. In the scratch test, the highest critical load (cohesion failure) was found for δ-TaN coating deposited at the lowest deposition pressure (0.2 Pa). Tribological results of δ-TaN coatings demonstrated average coefficient of friction (COF) value ranges between 0.066–0.092 and 0.072–0.029 against steel and Si3N4 balls, respectively. The wear rate values were observed to vary from 8.15 × 10−5 to 7.56 × 10−6 and from 1.77 × 10−3 to 8.99 × 10−6 against steel and Si3N4 balls, respectively. Generally, the average COF and wear rate decreased against 316 SS and Si3N4 balls as the deposition pressure of coatings decreased. However, the coating deposited at 0.8 and 0.6 Pa against Si3N4 ball showed early delamination of the coating, resulting in the sudden fluctuation in COF plots and higher wear rate in the range of 10−3 mm3/N.m.
A new strategy for manufacturing, modeling, and optimization of 3D printed polylactide based on multiple nonlinear neuro regression analysis and stochastic optimization methods
Authors: Savran Melih , Aydin Levent , Ayaz Asil , Uslu Tuğrul
Published: August 2024

Although there are many studies related to design, modeling, and optimization of fused deposition modeling (FDM) process parameters in the literature, the absence of a systematic approach to increase the reliability of model selection and optimization results is an important shortcoming that must be addressed. To make up for this deficiency, a new strategy was proposed to obtain desired quality on mechanical properties by adjusting FDM process parameters. This attempt involves manufacturing, modeling, and optimization point of view. The D-optimal method was employed to form experiment set, including process parameters. A hybrid approach neuro regression combining artificial neural network (ANN) and regression analysis together was used for modeling of FDM process. The most significant advantage of the neuro-regression approach compared to ANN is that the mathematical models can be used directly without needing any transformation. This is not possible in neural networks and, therefore, significantly limits and complicates the use of models obtained using ANN. The present study aims at optimization of the FDM process parameters, including infill density, infill pattern, layer thickness, and print speed on ultimate strength, fracture strength, and fracture strain for polylactide (PLA). In this regard, modified versions of the optimization algorithms Differential Evolution, Nelder Mead, and Simulated Annealing were used to find the best or elite designs. Linear or nonlinear models consisting of polynomial, trigonometric, and logarithmic expressions and their hybrid forms were employed to define the strength and strain behavior of PLA. It is concluded that (a) implementations of the optimization algorithms provide a 19% improving the minimum strain value if it is compared with the experimental results, (b) infill pattern types ( x2) were found as honeycomb, triangle, and cubic for the designs in terms of maximum fracture strength, minimum strain, and maximum ultimate tensile strength respectively, (c) many alternatives near optimum local designs could be obtained based on Nelder Mead algorithm for fracture strength and ultimate strength parameters. Thus, this allows work in a wide range of applications without depending on a single result for production.
Prediction models for seal performance of a space seal considering atomic oxygen effects
Authors: Liao Chuanjun , Xu Mingzhao , Da Wei , Sun Hailiang
Published: August 2024

A low impact docking system with advanced capabilities has been developing for future spacecrafts, and its main interface docking seal (MIDS) is both a critical component and a research topic of interest. It is a typical design for the MIDS that adopts the elastomer seal-on-seal structure made of silicone rubbers, and the atomic oxygen (AO) in space had been found to take great effects on the sealing performance by previous experimental studies, especially for the seal leak, seal adhesion, and compression set. Exposure to AO may cause obvious changes on the sealing surface of the MIDS, and some characteristic parameters of morphology are proposed to characterize the changes in this study, including of the porosity, roughness and radius of curvature. Both the leakage model and the adhesion model of the MIDS are further developed to predict the sealing performance considering AO effects, which had been confirmed by the application experiments. The experimental data are in good agreement with the calculation data. The effects of AO on the sealing performance are simulated and analyzed by the proposed prediction models. The results are beneficial to the developments of the MIDS and other space seals.
Exploring the machining characteristics of aluminum 6061 using nanosecond pulse fiber laser machine
Authors: Chandan Guddakesh Kumar , Aslam Mohd , Saha Subhankar , Kanchan Brajesh Kumar
Published: August 2024

The present study aims to probe the influence of nanosecond laser parameters on the surface quality of aluminum material (Al 6061) using a full factorial design approach. Additionally, the study utilizes the Harris Hawks optimization (HHO) algorithm to determine the optimized laser parameters for achieving desirable surface features on straight-cut aluminum samples. Subsequently, the machined samples are analyzed through optical microscopy, scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS). The evaluation criteria for the present study are taper, surface roughness, and heat-affected zone (HAZ) thickness. The results revealed that average laser power significantly impacted the taper (17.01%), and scanning speed contributed significantly to the taper (26.62%). The average power and scanning speed combined showed the most substantial influence on taper (47.76%). Furthermore, the average power had the most significant effect on the heat-affected zone (77.76%) and surface roughness (SR) (72.22%). The optimal conditions determined by the HHO were a pulse frequency of 100 Hz, a scanning speed of 10 mm/s, and an average power of 40 W, resulting in heat-affected zone = 36.047, surface roughness = 5.496, and taper angle = 23.188. These findings hold significant implications for enhancing the surface characteristics of aluminum in laser machining processes, thereby benefiting industries such as aerospace, automotive, and electronics.
Unsupervised Liu-type shrinkage estimators for mixture of regression models
Authors: Ghanem Elsayed , Hatefi Armin , Usefi Hamid
Published: August 2024

The mixture of probabilistic regression models is one of the most common techniques to incorporate the information of covariates into learning of the population heterogeneity. Despite its flexibility, unreliable estimates can occur due to multicollinearity among covariates. In this paper, we develop Liu-type shrinkage methods through an unsupervised learning approach to estimate the model coefficients in the presence of multicollinearity. We evaluate the performance of our proposed methods via classification and stochastic versions of the expectation-maximization algorithm. We show using numerical simulations that the proposed methods outperform their Ridge and maximum likelihood counterparts. Finally, we apply our methods to analyze the bone mineral data of women aged 50 and older.
Expansion of Smoke-Free Laws in Public Places and Support for Smoke-Free in Malaysia: Findings from the 2020 ITC Malaysia Survey
Authors: Gan Shiz Yee , Hairi Farizah Mohd , Danaee Mahmoud , Amer Nordin Amer Siddiq , Quah Anne C. K. , Kaai Susan C. , Yan Mi , Fong Geoffrey T
Published: August 2024

Smoke-free laws (SFL) are more effective with public support. This study investigated the smoking prevalence, public perceptions of smoking rules, and support for comprehensive SFL among 1047 people who smoke (PWS) and 206 people who do not smoke (PNS) aged ≥18 in the 2020 International Tobacco Control Malaysia Survey. Smoking prevalence was highest in nighttime entertainment venues (85.7%), non-air-conditioned eateries (49.7%), and indoor workplaces (34.6%). Respondents reported that smoking was banned in most indoor workplaces (81.7% PNS, 69.2% PWS), air-conditioned eateries (84.7% PNS, 75.7% PWS), and non-air-conditioned eateries (81.2% PNS, 78.7% PWS), but much less so in nighttime entertainment venues (30.1% PNS, 24.6% PWS). Support for comprehensive SFL in public venues was highest among PNS (≥84.9%) but still substantial among PWS (≥49.9%). PWS under 40, Malay, married, and aware of smoking rules supported SFL more. Robust SFL enforcement is essential in Malaysia to reduce secondhand smoke exposure in public places.
‘Seeing it as a whole’: A research agenda for the sociology of sport and climate change
Authors: McMillan Chris
Published: August 2024

Climate change poses an existential, if varied, threat to sport. Equally, sporting activity is having a substantial impact on the natural environment, an impact to which sporting bodies have been slow to quantify and mitigate. Despite this bidirectional threat, social science research on the relationship between sport and climate change is underdeveloped. Much of the existing research is generated by scholars within sport management and the nascent sub-discipline of sport ecology, both of which tend to focus on organisations’ and managerial responses to climate change. By contrast, climate change and the natural environment have been understudied within the sociology of sport. In this paper, I argue that the limited contribution of sociological perspectives to the debate has restricted the ability to critically examine the social context within which sport and climate change intersect. In response, I advocate for the value of a sociological approach and propose a research agenda for examining climate change within the sociology of sport.
Publication Trends and Surgeon Perceptions: A Comprehensive Analysis of Gender Disparities in Craniofacial Surgery
Authors: MacIsaac Molly F. , Khan Iman F. , Tiongco Rafael Felix P. , Wright Joshua M. , Qamar Fatima , Cooney Carisa M. , Redett Richard J. , Halsey Jordan N.
Published: August 2024

In academic craniofacial surgery, gender disparities exist across various metrics including faculty positions, leadership roles, and conference representation. This study benchmarks the academic productivity of craniofacial surgeons in 2022 and surveys their perspectives regarding diversity, equity, and inclusion (DEI).

Total, first author, and senior author PubMed publications in 2022 were recorded for 193 craniofacial attendings and fellows. Craniofacial surgeons were also surveyed regarding academic experience, leadership roles, and DEI perceptions.

Electronic

26 craniofacial attendings

Total, first author, and senior author publication counts in 2022

Women comprised 27% (n = 53) of the craniofacial surgeon cohort. Men led total publications (81% vs 19%, p < 0.001), senior-author publications (84% vs 16%, p < 0.001), average total publications (6.6 vs 4.0, p = 0.043), and average senior-author publications (3.1 vs 1.5, p = 0.02). Sub-analysis of craniofacial fellows showed a higher proportion of women (65%) with no statistical difference in total or average publication counts. Survey responses (n = 26) included a perceived lack of female representation in academic and leadership roles. Barriers included inadequate support from current leadership, systemic issues, and biases. Recommendations for improvement included mentorship programs, targeted recruitment, and equitable conference speaker selection.

Ongoing gender disparities are evident in craniofacial surgery, particularly in academic metrics. However, trends in younger cohorts exhibit more balanced gender representation, publication records, and leadership positions, indicating potential improvements. Further studies are needed to examine these cohorts more comprehensively and longitudinally. Sustained commitment, including mentorship programs and enhanced DEI efforts, is needed to continue this progress.
Moral Education in Tanzania: Analysis of Indigenous and Formal Education Systems
Authors: Seleman Amina Jumanne , Mgonda Nkanileka Loti
Published: August 2024

This paper analyzes moral education in Tanzania between indigenous and formal schooling. Through a critical comparison approach, the paper analyzes the aspects of goals, teachers, content, language, methodology, and certification. Thereafter, the paper draws up some lessons from indigenous moral education such as fear of God, education for life, adult moral models, and using local languages. Others are conformity to perennial moral values, ethical background of teachers, and moral maturity as an addition to other recruitment criteria. Finally, the paper recommends to policymakers and curriculum developers to consider the excellent deeds of indigenous moral education throughout formal education system and cooperate with different stakeholders to build and maintain moral values. There should be an equilibrium in taking good aspects of indigenous moral education and integrating them into formal schooling to ensure the continuity of morality and on the other hand preparing children for the contemporary world.
Victims of Corrupt Practices: Does Crime Seriousness Affect Bribe Payers’ Decision to Report?
Authors: Shahbazov Ingilab , Rahimli Javid , Balayeva Ayshem , Afandiyev Zaur
Published: August 2024

Despite the considerable amount of literature on self-reported corruption and the salience of anti-corruption narratives among international organizations, little is known about bribe payers’ reporting decisions. Relying on the analysis of a self-report survey among a specific subsample of the victimized population—the university students who were forced to pay a bribe in their interaction with state agencies after extortion in Azerbaijan ( n = 152), this paper attempts to ascertain whether the previously employed crime seriousness construct is relevant in the context of bribery. Results suggest that only 25.7% of bribe payments have been reported to the authorities. As the first study exploring the role of crime seriousness in the context of bribery reporting, we found that neither financial impact nor emotional distress caused by a bribe payment affects reporting behavior. Instead, previous contact with the criminal justice system was the sole predictor of decision-making, indicating for the first time in the literature the applicability of the contact thesis in the context of corruption. The study contributes to victimology as it provides insights into the correlates of decision-making among victims of bribery requests and tests the applicability of crime seriousness in a previously unstudied offence.
Co-workers’ reactions to (Mis)Alignment between supervisors’ intentions and Co-workers’ perceptions of I-deal secrecy: An uncertainty management perspective
Authors: De Winne Sophie , Marescaux Elise , Raets Emma , Dries Nicky
Published: August 2024

This study employs Uncertainty Management Theory (UMT) to explore how co-workers respond to supervisors’ communication about idiosyncratic deals (i-deals), specifically comparing secrecy and transparency. We suggest that co-workers’ perceptions of i-deal secrecy, as opposed to transparency, lead to uncertainty. Moreover, misalignment between co-workers’ perceptions and supervisors’ intentions regarding i-deal communication may create a second source of uncertainty. We propose that co-workers cope with this uncertainty by forming moral judgments about the i-deal communication, which subsequently relate to their trust in their supervisor and their turnover intentions. Data were collected from 27 supervisors and 224 co-workers across 27 teams, resulting in 224 matched co-worker-supervisor responses. Polynomial regressions reveal varying outcomes depending on the (mis)alignment between co-workers’ perceptions and supervisors’ intentions. Co-workers’ moral judgments, trust in their supervisor and turnover intentions are optimal when they perceive i-deal transparency, regardless of the supervisor’s intentions. These factors are suboptimal when co-workers’ perceptions of i-deal secrecy align with supervisors’ intentions, and detrimental when co-workers perceive i-deal secrecy while supervisors intend transparency. Our findings highlight the potential consequences of supervisors’ intentions for i-deal transparency, showing they can be positive or negative depending on co-workers’ perceptions. Moreover, supervisors’ intentions for i-deal secrecy are not necessarily problematic as long as co-workers perceive transparency. Yet, once secrecy intentions are revealed, suboptimal co-worker reactions occur.
Sensitivity study of process parameters of wire arc additive manufacturing using probabilistic deep learning and uncertainty quantification
Authors: Pham Thinh Quy-Duc , Tran Van-Xuan
Published: August 2024

This study employs a deep learning (DL) based stochastic approach to comprehensively interpret the effects of current intensity and velocity variations on temperature evolutions and cooling rates in the wire arc additive manufacturing (WAAM) process of a thin wall. Uncertainty raised from process parameters, material properties, and environmental conditions significantly impacts the final product quality. Furthermore, understanding the relationship between the process and temperature evolution within the WAAM process is complex. This study contributes to quantifying the uncertainty to the final product quality, such as temperature evolutions and cooling rates via a fast and accurate DL-based surrogate model. This contribution helps to precise adjustments and optimizations to enhance the overall WAAM process. Initially, a DL-based surrogate model is constructed using data obtained from a high-fidelity validated finite element (FE) model, ensuring an impressive 99% accuracy compared to the FE model while reducing computational costs. Subsequently, probabilistic methods are used to characterize uncertainties in current intensity and velocity, and the Monte-Carlo method is applied for uncertainty propagation. The findings illustrate that small variations in the input parameters can lead to significant fluctuations in temperature evolutions. Additionally, a sensitivity analysis is conducted to precisely quantify the influence of each input parameter. Finally, an uncertainty reduction is performed to enhance the variation of cooling rate. In general, this study is expected to make precise adjustments and optimizations to enhance the overall WAAM process for better quality of printed piece.
“Being Able to Think Outside the Box”: Exploring Counselors' Competency Development Working with Children Diagnosed with Autism Spectrum Disorder and Their Families
Authors: Feather Katherine A. , Dahl-Jacinto Heather , Kaur Gurjot
Published: August 2024

Professional counselors can play a critical role in treating symptoms of autism spectrum disorder (ASD) among children and working alongside their families. While ethical mandates and best practices for treatment center on holding clinical competencies and working within one's scope, the exploration of counselors in the field who specialize in the treatment of children diagnosed with ASD has not been previously explored in counseling research. Through a focus group format, we utilized interpretative phenomenological inquiry to investigate how six professional counselors who specialize in treating ASD diagnosis made sense in building clinical expertise. Implications for professional counselors were presented to better serve this ever-increasing client population.
Postoperative Calcaneocuboid Joint Subluxation and Midtarsal Joint Changes in Pediatric Idiopathic Flexible Flatfoot Treated With Calcaneal Lengthening Osteotomy: A Midterm Follow-up Study
Authors: Bae Kunhyung , Kwak Yoon Hae , Kang Michael Seungcheol , Huser Aaron J. , Kim Dohun , Kim Gisu , Kim Min-Ju , Park Soo-Sung
Published: August 2024

Background:

Calcaneal lengthening osteotomy (CLO) is one of the main surgical options for treatment of pediatric idiopathic flexible flatfoot (FFF). Reportedly, calcaneocuboid (CC) joint subluxation occurs after CLO; however, its effect on the midfoot remains unclear. This study aimed to investigate the radiologic midterm results after CLO treatment in pediatric idiopathic FFF.

Methods:

We evaluated 23 pediatric patients with idiopathic FFF aged ≥8 years, who underwent CLO from 1999 to 2017 owing to moderate to severe flatfoot deformity (assessed by visual inspection). Patients aged between 8 and 14 years were included (mean follow-up: 6.3 years; range, 3.1-11.4 years). Anteroposterior and lateral weightbearing foot radiographs were assessed for radiologic parameters preoperatively and at the 3-month, 1-year, and final follow-ups postoperatively.

Results:

All patients had immediate postoperative radiologic correction of the flatfoot deformity, and these improvements were maintained until the final follow-up. The mean allograft length inserted was 9 (range, 8-10) mm. There was increased CC joint subluxation after CLO, but it improved continuously until the final follow-up. A CC joint spur was newly noted in 1 case. There were 24 cases (24/39, 61.5%) of talonavicular (TN) joint spurs at the final follow-up, but 19 of these were already present on the preoperative radiographs (19/24, 79.2%). Further, the new-onset TN joint spurs were not associated with preoperative clinicoradiologic factors.

Conclusion:

In pediatric patients with idiopathic FFF receiving CLO treatment, preoperative radiologic angles improved. CC joint subluxation increased after surgery; however, it gradually reduced without evidence of CC joint arthritic changes over the time period studied in this cohort.
The Insider’s Journey: Two Investments for Epistemic Justice in Educational Research
Authors: Hill-Jackson Valerie
Published: August 2024

The extent to which any social scientist is authentically an insider continues to be a spirited debate within qualitative circles. Amid this weighty dispute, “insider” researchers, or me-searchers, maintain that we have certain advantages in conducting qualitative inquiry in marginalized communities that mimic our personal histories and life experiences. This article reports my first professional study as a publicly engaged scholar who directed an ethnographic childhood lead poisoning study among my cultural group, and the ways in which that initial investigation formed the trajectory of my identity as an educational researcher. Two investments needed by African American me-searchers, regarding personal and professional contributions for qualitative inquiry among marginalized people, are explored. Upon reflection, disclosure of the insider’s personal history and the inclusion of the researched as affirmed collaborators in studies that impact their lives are determined to be prerequisites to epistemic justice.
Cellular therapy site-preparedness: Inpatient pharmacy implementation at a large academic medical center
Authors: Martino Janine G. , McConnell Kim , Greathouse Lorraine , Rosario Brent Del , Jaskowiak Jaclyn M.
Published: August 2024

Background

With the recent Food & Drug Administration (FDA) approval of cellular therapy that requires product manipulation prior to administration in combination with a short stability window, the need was identified for local dose preparation within the pharmacy rather than the off-site stem cell processing laboratory. This approval gave rise to assessment of regulatory standards surrounding cellular therapy, evaluation and revision of current standard operating procedures and policies with formal process validation, assessment of occupational exposure mitigation and safety considerations, and development of staff training and education.

Objective

To describe and provide insight into the stepwise process of FACT validation and onboarding of commercially available cellular therapy products that require sterile compounding manipulation within a pharmacy prior to administration.

Discussion

A multidisciplinary effort is required to attain FACT certification and implement pharmacist compounding of cellular therapy products. 1 Local preparation within a pharmacy facilitates a sound operational workflow and provides a pathway to perform aseptic manipulations of cellular therapy products safely and efficiently.

Conclusion

Safe and successful administration of cellular therapies handled and compounded by pharmacy department staff along with program validation requires a preemptive review utilizing a multidisciplinary approach for process development. This manuscript will provide a foundation based on consistency and transparency in effective cellular therapy sterile compounding and aseptic manipulation, proper handling and disposal procedures, increased communication through creation and optimization of treatment plans and order-sets, standardized medical center staff education, and development of policies and standard operating procedures for the entire health care team.
Unethical Consumer Behavior Following Artificial Intelligence Agent Encounters: The Differential Effect of AI Agent Roles and its Boundary Conditions
Authors: Lei Shaohui , Xie Lishan , Peng Jiamin
Published: August 2024

Recent research has shown that consumers tend to behave more unethically when encountering artificial intelligence (AI) agents than with human agents. Nevertheless, few studies have explored the differential impact of AI agents on unethical consumer behavior. From the perspective of the power relationship between AI and consumers, we classify the role of an AI agent as that of a “servant” or “partner.” Across one field study and four scenario-based experiments (offline and online), we reveal that consumers are more likely to engage in unethical behavior when encountering servant AI agents than partner AI agents due to increased anticipatory moral disengagement. We also identify the boundary conditions for the moral disengagement effect of AI agents, finding that this effect is attenuated (a) among consumers with high moral identity, (b) with human-like AI agents, and (c) in the context of high behavioral visibility. This research provides new insight into the AI morality literature and has practical implications for service agencies using AI agents.
Pachychoroid neovascular membrane in a patient with sickle cell disease trait
Authors: Córdoba-Ortega Carlos Miguel , Arias Aristizabal Juan D , Suta Figueroa María , Pérez-Vergara Valentina , Pulgarin Dayron Martínez
Published: August 2024

Purpose

To describe a rare presentation of pachychoroid neovascular membrane in a patient with sickle cell trait and the accuracy of ruling out hemoglobinopathies in the presentation of pachychoroid spectrum.

Methods

The patient was subjected to physical examinations, multimodal images (fluorescein angiography, optical coherence tomography), hemoglobin electrophoresis, and peripheral blood smear, documenting sickle cell trait. The management included laser treatment to target non-perfusion areas, along with a single dose of anti-VEGF.

Results

A 45-year-old male patient with diagnosis of pachychoroid neovascularization treated for 6 years with multiple anti VEGF injections in the left eye. A detailed clinical evaluation included hypochromic conjunctiva, peripheral vascular occlusion with non-perfusion areas led us to suspect sickle cell disease retinopathy. The images of fluorescein angiography showed peripheral arteriovenous anastomosis with non-perfusion areas; the optical coherence tomography revealed a thinner neuroepithelium with a thicker choroid; also, hemoglobin electrophoresis and peripheral blood smear documenting sickle cell trait. The chosen management was photocoagulation of the peripheral retina on the non-perfusion areas and anti VEGF without neovascular activity recurrence in the follow up period.

Conclusion

Although sickle cell trait is considered a mild form of this pathology without serious retinal manifestations, it has to be noted that in the context of pachychoroid spectrum diseases is a trigger that could perpetuate retinal ischemia and neovascular activity.
Primary Healthcare Marketing: A Bibliometric Study and Research Agenda
Authors: Rościszewski Piotr , Stępień Mariusz , Berniak-Woźny Justyna
Published: August 2024

The evolution of our lives has forced changes to the healthcare system and consequently established healthcare marketing as an essential element of health services, including primary health care (PHC). This article aims to analyze the size, structure, and dynamics of research on primary healthcare marketing to identify the main topics and research trends in this area. The authors conducted a bibliographic analysis based on the methods of performance analysis and scientific mapping. The bibliographical analysis covered 1981 publications selected from the Scopus database and was carried out with the use of the MS Excel and VOSviewer applications. The results were supplemented with an in-depth analysis of 34 publications selected based on bibliographic coupling analysis to determine key research trends and results, which increased the understanding of the research area. The conducted research proves that the issue of marketing in primary health care is rarely addressed by researchers, which translates into very limited research results and little impact on the decision-making process in this area. This research field requires much greater commitment, especially in the areas indicated in the future research agenda recommendations.
A Systematic Review of Clinical Features and Treatment Outcomes of Xanthoma Disseminatum
Authors: Mija Lorena Alexandra , Zhu Catherine Keying , Mukovozov Ilya
Published: August 2024

Xanthoma disseminatum (XD) is a rare normolipidemic mucocutaneous xanthomatosis within the spectrum of cutaneous non-Langerhans histiocytosis. Managing XD poses substantial challenges, with limited available data. This study aims to comprehensively evaluate existing literature on clinical features of XD and treatment outcomes. A systematic search of MEDLINE, Embase, and PubMed was performed, using “xanthoma disseminatum” and “Montgomery syndrome” as search terms, without restrictions. Screening was performed in duplicate by 2 reviewers. One hundred fifty-one studies met the inclusion criteria, yielding 166 cases of XD (106 females, 60 males), mean age at diagnosis 35.3 years (range: 9 months-87 years). XD typically presented as yellow-to-brown coalescing papules/plaques and nodules. Distribution affects mainly the face (n = 116/166), flexures (n = 45/166), trunk (n = 65/166), and genitalia/inguinal areas (n = 63/166). Most cases (99.4%; n = 165/166) exhibited extracutaneous manifestations, including the pituitary gland and the oropharynx. Treatment options rendered low complete response rates (CRRs). Treatments with reported outcomes included surgical resection (n = 17/99), systemic steroids (n = 40/99), immunosuppressants/immunomodulators (n = 73/99), energy-based devices (n = 7/99), lipid-lowering agents (n = 24/99), cryotherapy (n = 6/99), lasers (n = 10/99), topical steroids (n = 6/99), oral retinoids (n = 2/99), and radiotherapy (n = 5/99), with CCRs of 23.5% (n = 4/17), 5.0% (n = 2/40), 9.6% (n = 7/73), 14.3% (n = 1/7), 4.2% (n = 1/24), 16.7% (n = 1/6), 10.0% (n = 1/10), 0% (n = 0/6), 0% (n = 0/2), and 0% (n = 0/5), respectively. The most promising therapy is cladribine, with the highest CRR of 27.1% (n = 6/22) and the lowest no response rate (9.1%; n = 2/22) of all reported treatments. This review confirms the high prevalence of systemic manifestations in XD. Treatment options vary widely; thus, further research is needed to establish management strategies for this challenging condition.
Research on the supporting mechanism of internal feedback hydrostatic hybrid bearing considering flow rate correction
Authors: Ma Honglie , Zhang Tao , Yang Congbin , Liu Zhifeng , Zhao Yongsheng
Published: August 2024

The internal feedback hydrostatic bearing features a distinctive structural design, playing a pivotal role in high-precision machine tools. Its performance significantly influences the improvement of machining accuracy and stiffness. In this study, the working principle of the internal feedback closed hydrostatic bearing is described, the equivalent liquid resistance model of oil circuit considering internal flow effect is established, an analysis method for evaluating the support performance of the internal feedback hydrostatic bearing is proposed, flow rate correction methods are proposed, and the influence of load-carrying capacity and flow rate due to inlet pressure, oil film thickness, and the size of the restrictor is discussed. The accuracy of the method is verified by simulation, and insights for the future development of hydrostatic bearings are provided.
Tooth friction in spur gear transmission. From local to mean tooth friction loss
Authors: Diab Yasser , Touret Thomas , Ville Fabrice , Changenet Christophe
Published: August 2024

In a gear transmission, power losses come from a variety of sources, classified as load-dependent and no-load-dependent losses. No-load-dependent losses are the ones that remain constant regardless of the applied load, such as losses due to drag in rolling element bearings, seals, churning and/or windage for gears. Load-dependent losses include friction losses due to sliding and rolling between gear teeth. These losses are particularly important in some gear transmissions because of their direct impact on overall efficiency and thermal behaviour. Consequently, knowledge of the friction coefficient associated to this loss is of major interest for optimising gears (geometry, surface finish, lubrication, etc.). In this article, a new method is proposed for predicting the mechanical efficiency losses associated with the mean coefficient of friction for pairs of cylindrical gears. It is based on a model developed previously to estimate the instantaneous tooth friction along the plane of action in gears. This model takes into account the lubricant shear and the friction on contacting asperities. The proposed mean friction coefficient is deduced from the instantaneous friction coefficient using specific calculations, particularly at the pitch point. To verify the method, the estimated results are compared with those in the literature calculated for gears and operating conditions common on FZG test rigs.
Cognitive progression independent of relapse in multiple sclerosis
Authors: Fuchs Tom A , Schoonheim Menno M , Zivadinov Robert , Dwyer Michael G , Colato Elisa , Weinstock Zachary , Weinstock-Guttman Bianca , Strijbis Eva MM , Benedict Ralph HB
Published: August 2024

Background:

Substantial physical-disability worsening in relapsing-remitting multiple sclerosis (RRMS) occurs outside of clinically recorded relapse. This phenomenon, termed progression independent of relapse activity (PIRA), is yet to be established for cognitive decline.

Methods:

Retrospective analysis of RRMS patients. Cognitive decline was defined using reliable-change-index cut-offs for each test (Symbol Digit Modalities Test, Brief Visuospatial Memory Test–Revised, California Verbal Learning Test–II). Decline was classified as PIRA if the following conditions were met: no relapse observed between assessments nor within 9 months of cognitive decline.

Results:

The study sample ( n = 336) was 80.7% female with a mean (standard deviation (SD)) age, disease duration, and observation period of 43.1 (9.5), 10.8 (8.4), and 8.1 (3.1) years, respectively. A total of 169 (50.3%) subjects were cognitively impaired at baseline relative to age-, sex-, and education-matched HCs. Within subjects who experienced cognitive decline ( n = 167), 89% experienced cognitive PIRA. A total of 141 (68.1%) cognitive decline events were observed independent of EDSS worsening. Cognitive PIRA was more likely to be observed with increased assessments ( p < 0.001) and lower assessment density ( p < 0.001), accounting for baseline clinical factors.

Conclusion:

These results establish the concept of cognitive PIRA and further our understanding of progressive cognitive decline in RRMS.
The (in)visibility of diversity on streaming platforms in France and Norway: A quantitative and qualitative visual analysis of thumbnails
Authors: Ceuterick Maud , Malet Marine
Published: August 2024

In the film and television industry, many social movements as #MeToo, #BuryYourGay or #BlackLivesMatter have highlighted the necessity of better representations of marginalised communities on and off screen. As diversity and inclusion have become major issues in contemporary societies, video-on-demand (VOD) platforms have publicly committed to diversify representation in the films and series they produce and distribute. This article investigates how streaming platforms with different commercial or public interests and in different national contexts understand and promote diversity and inclusion through the analysis of paratext. Focussing on the visual analysis of thumbnails, we compare the French and Norwegian national public platforms (France TV and NRK TV) with the most popular commercial national platforms in each country (Canal + Series in France and Viaplay in Norway). The visibility and invisibility of gender, race, sexuality and (dis)ability on TV series’ thumbnails reveal certain national and platforms’ social, cultural and political values. By using mixed quantitative and qualitative methods including interviews conducted with industry professionals, we aim to highlight the impact of streaming platforms’ promotional practices on the (in)visibility of diversity.