bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpersonal Problem Profiles of Personality and Psychopathology Constructs in Chinese Undergraduates and Offenders
Authors: Liu Yuping , Hopwood Christopher J. , Pincus Aaron L. , Zhou Bingtao , Yang Jiali , Bai Shuliang , Yang Bo
Published: April 2024

The interpersonal problem circumplex is extensively used in the field as an assessment framework for understanding the interpersonal implications of a range of personality and psychopathology constructs. The vast majority of this large literature has been conducted in Western convenience and clinical samples. We computed interpersonal problem structural summary parameters for a range of personality and psychopathology variables in two Chinese offender samples ( N = 424 and N = 555) and one undergraduate sample ( N = 511) to test how well findings from Western samples generalize to Chinese undergraduates and offenders. The results showed that findings in Western samples generalized reasonably well to Chinese young adult and forensic contexts, although the interpersonal profiles of external variables were less specific in Chinese samples. Compared with undergraduates, interpersonal distress has stronger associations with the mental health of offenders. This study further elaborates the interpersonal correlates of individual differences in personality and psychopathology across cultures and assessment contexts, and it also extends the literature examining interpersonal problems in forensic settings.
Measurement Invariance of the Children’s Social Desirability Scale–Short Version (CSD-S) Across Gender, Grade Level, and Race/Ethnicity
Authors: Ng Zi Jia , Lin Shengjie , Niu Luping , Cipriano Christina
Published: April 2024

Social desirability bias is a methodological challenge with participant self-reports. Social desirability measures are often used to control the potential effects of social desirability bias on participant self-reports, but whether these measures are interpreted similarly across different demographic groups remains unclear. This study examines the factor structure and measurement invariance of the Children’s Social Desirability Scale–Short version (CSD-S) across gender, grade level, and race/ethnicity with a large sample of children and adolescents in the United States. Results indicate a close fit to a one-factor model. Tests of measurement invariance show partial strong invariance across gender (male vs. female) and grade level (elementary vs. middle vs. high schoolers) as well as strong invariance across race/ethnicity (Asian vs. Black/African American vs. Hispanic/Latine vs. White vs. Bi/Multiracial). Latent mean differences were found across grade level and race/ethnicity but not gender, with lower grades reporting higher social desirability than upper grades and Bi/Multiracials reporting lower social desirability than Asians and Hispanics/Latines. Findings provide preliminary evidence for the use of CSD-S in detecting social desirability bias and assessing meaningful social desirability differences in diverse children and adolescents.
Troponin Elevation in Patients Undergoing Percutaneous Hepatic Perfusion for Metastatic Uveal Melanoma
Authors: Chandrasekhar Sanjay , Perez Matthew , Niaz Zurain , Ekram Jahanzaib , Lal Neelam , Koly Sarah , Cao Biwei , Zager Jonathan S. , Alomar Mohammed
Published: April 2024

Background

Percutaneous Hepatic Perfusion (PHP) is a liver directed regional therapy recently FDA approved for metastatic uveal melanoma to the liver involving percutaneous isolation of liver, saturation of the entire liver with high-dose chemotherapy and filtration extracorporeally though in line filters and veno-venous bypass. The procedure is associated with hemodynamic shifts requiring hemodynamic support and blood product resuscitation due to coagulopathy.

Objective

To assess the cardiac safety and subsequent clinically significant sequalae of this therapy.

Methods

Consecutive PHP procedures done at our center between 2010-2022 were assessed retrospectively. Cardiac risk factors, post procedural cardiac enzymes, electrocardiograms, and transthoracic echocardiograms along with 90-day cardiac outcomes were reviewed. All data were reviewed by cardio-oncologists at our institution.

Results

Of 37 patients reviewed, mean age was 63 years and 57% were women. 132 procedures were performed with an average of 3.57 procedures per patient. 68.6% of patients had elevated troponin during at least 1 procedure. No patients were found to have acute coronary syndrome, heart failure, unstable arrhythmias, or cardiac death. No patients had notable echocardiographic changes. 10.8% of patients with positive troponin had asymptomatic transient electrocardiographic changes not meeting criteria for myocardial infarction. One patient had non-sustained ventricular tachycardiac intra-operatively which did not recur subsequently. Three patients died from non-cardiac causes within 90-days. There was no oncology treatment interruption, even in those with troponin elevation. In multivariable analysis, a history of hyperlipidemia was a predictor of postoperative troponin elevation. ( P = .042).

Conclusion

Percutaneous Hepatic Perfusion is safe and associated with a transient, asymptomatic troponin elevation peri-operatively without major adverse cardiac events at 90 days. The observed troponin elevation is likely secondary to coronary demand-supply mismatch related to procedural hemodynamic shifts, hypotension, and anemia.
Study of the kurtoses transmission of linear structures under stationary non-Gaussian random loadings
Authors: Cui Song , Hong Lei
Published: April 2024

Recent research has discovered that the kurtoses of non-Gaussian stress loadings can significantly impact the fatigue life of in-service structures. To predict potential damage, a fatigue life estimation method based on Gaussian damage and a kurtosis-related corrective coefficient has been developed. However, the transmission of kurtoses from excitations to responses has not been well studied, particularly in multi-input cases. This hinders efforts to accelerate fatigue damage by controlling input kurtoses. Therefore, this paper aims to establish a kurtoses transmission model for a linear structure under multiple uncorrelated stationary non-Gaussian excitations generated by zero-memory non-linear method. Firstly, a single-input kurtosis transmission equation is proposed to establish the relationship between excitation kurtosis and response kurtosis. Using this equation, the response kurtosis is formulated with input kurtosis and the system parameters of a linear structure. Secondly, the response kurtosis of multi-input cases is deduced, and the study shows that the response kurtosis is the weighted sum of the kurtosis induced by each excitation. Finally, numerical validation and experimental studies are conducted to verify the accuracy of both the single-input and multi-input kurtoses transmission models. The validations demonstrate that the proposed models can predict the response kurtoses with satisfactory precision, regardless of the input spectral shape and the number of uncorrelated input forces.
Propelling precision of longitudinal vibration mitigation in ship propeller shafts through advanced nonlinear intelligent semi-active control leveraging adaptive neuro-fuzzy inference system with linear quadratic regulator
Authors: Sharma Sunil Kumar , Sharma Rakesh Chandmal , Lee Jaesun
Published: April 2024

This study presents a pioneering method to address longitudinal vibrations in ship propeller shafts by integrating an intelligent semi-active control system. By leveraging Adaptive Neuro-Fuzzy Inference System (ANFIS) and Linear Quadratic Regulator (LQR) techniques, the proposed system offers a novel solution to a longstanding challenge in maritime engineering. The efficacy of the semi-active control system is assessed through two complementary analyses: frequency domain analyses and Percentage Reduction Index (PRI) values. The investigation reveals substantial PRI values, ranging from 24.68% to 46.87%, indicating notable enhancements in vibration control with the adoption of semi-active technology. Furthermore, frequency domain analyses demonstrate significant advantages, with a peak reduction of 68.21% observed at 750 r/min. To rigorously evaluate the statistical significance of these improvements, paired t-tests were conducted between the semi-active control system and passive strategies. The results confirm a statistically significant difference in vibration reduction ( p < .05) between the two systems. Specifically, for Percentage Reduction Index Values, the t test yielded a p-value of .023, while for Frequency Domain Analyses, the t-statistic significantly exceeded the critical value (t ≈ 8.09, tcritical ≈ 2.571). Both data sets provide compelling evidence to reject the null hypothesis, indicating a significant difference in vibration reduction between the semi-active control system and passive strategies. The PRI values consistently demonstrate superior performance for the semi-active control system, highlighting its effectiveness in mitigating vibrations. These findings validate the effective ness of the system. These results show the practical implications of implementing semi-active control systems in maritime engineering, offering enhanced safety, fuel efficiency, and operational reliability in ship propeller shaft applications.
Multi-motor average deviation coupling control strategy based on hyperbolic convergence law high-order sliding mode control using extended state sliding mode observer
Authors: Zhao Fengshuo , Zhong Yuguang , Wang Shuyang , Song Dening
Published: April 2024

This paper aims to develop a multi-motor synchronous drive control system for the direction of the width of the lifting arm of a catamaran. Firstly, we establish a mathematical model of permanent magnet synchronous motor and introduce the composition of AC servo control systems. We then analyze the sources of control interference in multi-motor drive systems. Based on the mean deviation coupling control strategy of multi-motor synchronous control, we design a speed tracking controller and a speed synchronization controller using hyperbolic convergence law high-order sliding mode control. Then, we design an extended state sliding mode observer to estimate the unmodeled dynamics of the system in real time. We prove the global stability of the controller using Lyapunov stability theory. Finally, the control model is simulated, and the results confirm the effectiveness of the multi-motor synchronization control method based on the hyperbolic convergence law of higher-order sliding mode control. The control method effectively mitigates the jitter associated with traditional sliding mode control and demonstrates improved synchronization and tracking performance.
Design and verification of diesel generator exhaust muffler
Authors: He WenQiang , Gong Xuan , Zhang QiaoXin , Yu JinGui
Published: April 2024

The exhaust muffler is one of the most effective methods to control the exhaust noise of diesel generator. In this paper, a new type of impedance composite muffler is designed for the spectral characteristics of diesel engines and the shortcomings of existing mufflers. The main idea of the design is to reasonably design the key structures such as the length-diameter ratio, the insert-pipe, and the sound-absorbing material of the muffler under the condition of keeping the shape unchanged and low cost, so as to achieve the broadband noise reduction performance and improve the working efficiency of the diesel engine. The basic structure of the designed muffler is introduced. The transmission loss and pressure loss are numerically simulated and analyzed by finite element method, and the experimental verification is carried out. The results show that the structural parameters of the muffler have little effect on the transmission loss in the low frequency range, and the influence is more obvious in the middle- and high-frequency range. Compared with the existing muffler, the designed muffler significantly improves the noise reduction performance and reduces the exhaust back pressure.
Driving simulator: Analysing the impact of mechanical latency on the perception of lateral dynamics
Authors: Melzi Stefano , Previati Giorgio
Published: April 2024

Mechanical latency is the time elapsed between the driver’s input and the subsequent movement of a driving simulator. Large latencies may overlap with the time constants of a vehicle, thus altering its dynamics. As latency introduces inconsistencies between the driver’s input and the vehicle’s response, it may also result in motion sickness. The paper describes the design and the results of a test campaign conceived to understand how mechanical latency impacts the perception of lateral dynamics. In particular, the research aimed at identifying the minimal variation of latency perceived by ordinary drivers. Tests were performed with an innovative cable-driven simulator moving over a 6 × 6 metre platform. A rigorous test procedure was designed while several volunteers of different ages and driving experiences were required to perform a specific manoeuvre with different latencies. The results showed that 20% of the population can perceive latency variations below 40 ms.
Effectiveness of a Telephone Counseling Intervention in Reducing Passive Smoking Among Children
Authors: Anuntaseree Wanaporn , Kongkanin Uthaiwan , Ruangnapa Kanokpan , Saelim Kantara , Prasertsan Pharsai
Published: April 2024

Legislative smoking bans that prohibit smoking in public places have successfully reduced passive smoking in public areas. However, smokers only partially adhere to smoking restrictions in their homes. Young children are particularly vulnerable to exposure to tobacco smoke because they spend more time at home. In this study, we designed an intervention program based on an empowerment theory to reduce passive smoking among children. The priority participants were nonsmoking mothers living with smokers who smoke in the presence of children. The aim of this randomized control trial study was to examine the effectiveness of this intervention in reducing children’s exposure to tobacco smoke at home. The intervention group received tailored educational brochures and two follow-up counseling telephone calls at 2 and 8 weeks, which provided resources to support the mothers to increase their knowledge, skill, and self-confidence in promoting behavior shaping of smokers. The control group received only tailored educational brochures. We found the intervention group demonstrated a higher rate of maternal actions to reduce their children’s exposure to smoke and a higher rate than the control group of attempts to avoid smoking in the presence of children at the 16-week follow-up. These results suggest that the intervention helped reduce passive smoking among children. These findings highlight the need to empower and train mothers to help them develop rules for smoking at home. These interventions could be applied in the home of children who live with smokers who are unable or unwilling to quit smoking.
The impact of the Affordable Care Act Medicaid Expansion in Medicare beneficiaries with peripheral artery disease
Authors: Henkin Stanislav , Kearing Stephen A , Martinez-Camblor Pablo , Zacharias Nikolaos , Creager Mark A , Young Michael N , Goodney Philip P , Columbo Jesse A
Published: April 2024

Background: In 2014, the Affordable Care Act Medicaid Expansion (ME) increased Medicaid eligibility for adults with an income level up to 138% of the federal poverty level. In this study, we examined the impact of ME on mortality and amputation in patients with peripheral artery disease (PAD). Methods: The 100% MedPAR and Part-B Carrier files from 2011 to 2018 were queried to identify all fee-for-service Medicare beneficiaries with PAD using International Classification of Diseases codes. Our primary exposure was whether a state had adopted the ME on January 1, 2014. Our primary outcomes were the change in all-cause 1-year mortality and leg amputation. We used a state-level difference-in-differences (DID) analysis to compare the rates of the primary outcomes among patients who were in states (including the District of Columbia) who adopted ME ( n = 25) versus those who were in states that did not ( n = 26). We performed a subanalysis stratifying by sex, race, region, and dual-eligibility status. Results: Over the 8-year period, we studied 37,743,929 patients. The average unadjusted 1-year mortality decreased from 2011 to 2018 in both non-ME (9.5% to 8.7%, p < 0.001) and ME (9.1% to 8.3%, p < 0.001) states. The average unadjusted 1-year amputation rate did not improve in either the non-ME (0.86% to 0.87%, p = 0.17) or ME (0.69% to 0.69%, p = 0.65) states. Across the entire cohort, the DID model revealed that ME did not lead to a significant change in mortality ( p = 0.15) or amputation ( p = 0.34). Conclusion: Medicaid Expansion was not associated with reduced mortality or leg amputation in Medicare beneficiaries with PAD.
Urinary vanin-1 as a novel biomarker for survival in peripheral artery disease
Authors: Zierfuss Bernhard , Karlinger Anna , Bojic Marija , Koppensteiner Renate , Schernthaner Gerit-Holger , Höbaus Clemens
Published: April 2024

Background:

Chronic kidney disease is associated with increased rates of incidence, morbidity, and mortality in lower-extremity peripheral artery disease (PAD). No specific marker for a functional risk assessment of kidney disease in PAD is known, especially at the early stages. Thus, we speculated that urinary vanin-1 (uVNN1), a marker of oxidative stress even in early kidney injury, could further stratify outcome assessment in patients with PAD.

Methods:

Patients with stable PAD ( n = 304) of the Vienna medical cohort were followed up for up to 10 years and the outcome was assessed by central death database queries. uVNN1 was measured by enzyme-linked immunosorbent assay (ELISA) at study inclusion and normalized to urinary creatinine (uVNN1/Cr). During the observation time (9.3, 7.0–9.8 years), 104 patients died, 54.8% of which were due to cardiovascular causes.

Results:

uVNN1/Cr was associated with a urine albumin–creatinine ratio (UACR) ( R = 0.166, p = 0.004) but not with an estimated glomerular filtration rate ( R = 0.102, p = 0.077). Levels of uVNN1/Cr did not differ between asymptomatic and symptomatic PAD ( p = 0.406). Kaplan–Meier curves showed a clear-cut association with higher all-cause (log-rank p = 0.034) and cardiovascular mortality (log-rank p = 0.032) with higher uVNN1/Cr levels. Similarly, significant associations for all-cause (hazard ratio [HR] 1.34, 95% CI [1.08–1.67], p = 0.009) and cardiovascular mortality (HR 1.45, 95% CI [1.06–1.99], p = 0.020) could be seen in multivariable Cox regression models.

Conclusions:

uVNN1/Cr showed an independent association with both all-cause and cardiovascular mortality in patients with PAD and was associated with early kidney disease. Thus, uVNN1 could be a useful marker for risk stratification of kidney disease in PAD.
Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study
Authors: Gómez-Gómez Irene , Rodero-Cosano María Luisa , Bellón Juan Á , Zabaleta-del-Olmo Edurne , Maderuelo-Fernandez José A , Moreno-Peral Patricia , Magallón-Botaya Rosa , Oliván-Blázquez Bárbara , Casajuana-Closas Marc , López-Jiménez Tomàs , Bolíbar Bonaventura , Llobera Joan , Clavería Ana , Sanchez-Perez Alvaro , Motrico Emma
Published: April 2024

This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression ([Formula: see text]). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.
Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury
Authors: Levy Adam S , Berger Connor , Kumar Vignessh , Badami Abbasali , Côté Ian
Published: April 2024

Introduction

Penetrating spinal cord injuries present unique clinical scenarios with high variability in presentation and management. These injuries are rare, accounting for 0.8% of annual penetrating spine injuries in the United States, with knives being the most common penetrating object. Retention of the knife blade further complicates management, with greater risk of infection and progressive neurologic injury. Given the rarity and variability of such injuries, preferred management for penetrating-knife spinal cord injuries (PKSCI), especially those with retained knife blades, remains contested. Furthermore, the management of PKSCI with concurrent lung injury is poorly described within the literature.

Case Report

Here we discuss a unique case of a neurologically intact adult male who suffered a large lower thoracic PKSCI with complete dural transection and lung involvement. The patient arrived with the blade in situ while maintaining full neurologic function. Emergent imaging revealed the blade trajectory passing through the T8 lamina exiting the spinal canal at the costovertebral junction with involvement of the lung parenchyma and associated pneumorrhachis and pneumothorax. The patient was brought to the operating room where the blade was removed under direct visualization, the dura was repaired, and pneumothorax was stabilized.

Conclusion

We describe in this case the choice of imaging, method of blade removal, cerebrospinal fluid leak management, dural repair, and concurrent lung injury management that afforded a favorable, ASIA class E outcome with complete preservation of neurologic function.
“Hot, dumpster fire, mess”: Police personnel perceptions of the current state of mental health in law enforcement
Authors: Padilla Kathleen E. , Fine Adam D.
Published: April 2024

An abundance of research has focused on police personnel stress and interventions that may reduce the consequences of that stress. What have received less attention, however, are police personnel's perceptions of stress and mental health generally, as well as their perceptions of social norms and departmental views of mental health. Leveraging brief one-on-one interviews conducted with 75 sworn and civilian police personnel of a Southwestern police department, the current study examined police personnel's perceptions about the current state of mental health in law enforcement. In addition, respondents provided insights into injunctive social norms, specifically what they believe their peers think about mental health. Results indicate negative overall perceptions of mental health in policing, from both personal and peer perspectives. Further, respondents highlighted a generational gap in their peers that likely impacted their views on the topic. Implications for policing practice, research, and policy are discussed.
Spray formation and spray-wall-flow interaction in a gasoline direct-injection (GDI) engine under early-injection conditions: A flow bench study
Authors: Lien Hao-Pin , Welch Cooper , Li Yongxiang , Pati Andrea , Hasenzahl Max , Sadiki Amsini , Böhm Benjamin , Hasse Christian
Published: April 2024

The work presented in this study aims to understand the spray-wall-flow interaction within a gasoline direct-injection (GDI) engine flow bench under simulated early-injection conditions. The Engine Combustion Network (ECN) Spray G injector is installed in the Darmstadt optically accessible engine flow bench. Under simulated early-injection conditions, the formation of a multi-hole spray and the interaction with characteristic intake flows, such as the intake jet and central tumble flow, are extensively discussed. By reducing the complexity in the number of variables inherent in engine flow and whole-engine simulation, an engine flow bench operating under various mass flow rates is applied in this study. The numerical simulation is carried out using Large Eddy Simulation (LES) under the Eulerian-Lagrangian framework for spray simulation. Experimental data, acquired through particle image velocimetry (PIV) measurements, provides 2-D flow fields on both the central tumble and valve planes, facilitating the validation of in-cylinder flow fields. Furthermore, experimental data obtained through Mie scattering is utilized to investigate spray formation and evolution within the GDI engine, providing the liquid penetration length and liquid spray angle. Comparison between the numerical and experimental data demonstrates several agreements. Moreover, the variation of different spray plumes under different mass flow rates is observed in the case of both experimental and numerical data. Increasing the mass flow rate distorts the overall plume shape and shifts it away from the intake port. This phenomenon is examined by extracting the liquid volume fraction and vapor fields of each plume. Spray plumes encounter different convective disturbances and evaporation due to their local characteristic in-cylinder flow. Furthermore, spray-wall-flow interaction and wall film deposits are observed during the injection. Lastly, the influence of the spray-induced turbulence is analyzed under different mass flow rates.
‘The toys you sleep with’: Embracing otherwise literacies in early childhood wor(l)ds
Authors: Caetano-Silva Giovanna , Guzmán-Simón Fernando , García-Jiménez Eduardo
Published: April 2024

Early childhood literacy is pervaded by dominant discourses telling children both what to say, how to say it, and what is worthy of adults' attention. These discourses are affected by the need to constantly see language through solely representational accounts, and children as still progressing, developing and becoming literate while excluding the strong presence of more-than-humans and the diverse ways of being child. However, the field of posthuman studies has introduced other perspectives on literacy that are neither solely exclusive to humans nor solely representational or intentional. They trouble the dominant frames of literacy that can serve to diminish children, especially those from minority groups. Building on this framework, we propose to address how otherwise literacies are created among children and objects, such as toys. Our data come from a current research project being developed in a school in Seville (Spain). The children in our research are 4 to 5 years old and come from different socio-cultural backgrounds. In our research, our data are written as a vignette which describes different affective encounters in a classroom. These encounters are part of an action that required children to bring from home a treasure box with cherished elements inside. We diffract these data through theories of affect to consider what otherwise synergies emerge between children and toys and what we can learn about literacy through them. We claim that the toys you sleep with bring otherwise (political) ways of being and becoming through literacies embedded in more-than-wor(l)ds. They recall how literacy practices involve objects that affect (with) us in unpredictable and not easy to describe ways, but that are essential to consider more justice-oriented practices.
Prolonged arthralgias in Whipple’s disease – A common but often overlooked symptom of a rare disease
Authors: Canhão Bernardo Tourais , Trigo André , Madeira Joana Inês , Simão Adélia , Madaleno João
Published: April 2024

Whipple’s disease is a multisystemic chronic infectious condition caused by Tropheryma whipplei ( T. whipplei). Though characterised often by insidious weight loss, diarrhoea, and arthralgia, three other distinct manifestations can be observed, namely localised disease, acute infection and asymptomatic carriage. The diagnosis relies on histopathological examination of duodenal biopsies and polymerase chain reaction analysis of the 16S rRNA gene for T. whipplei. We report the case of a middle-aged man admitted for etiologic investigation of prolonged, migrating, and inflammatory arthralgias and subsequent development of gastrointestinal symptoms. Despite its reputation as a great mimicker of many different illnesses, the difficulty in diagnosis probably lies with its rarity rather than its masking.
Cost and Activity Analysis of Patient Navigation for Persons With HIV: Comparing Health Department and Health Clinic Delivered Interventions
Authors: Lightner Joseph S. , Moore Erik , Barnhart Travis , Rajabiun Serena
Published: April 2024

Background

Housing and employment are key factors in the health and well-being of people with HIV (PWH). Patient navigation programs to improve housing and employment show success in achieving viral suppression. Replicating patient navigation interventions to improve population health is needed. Understanding costs associated with patient navigation is a key next step. Therefore, the purpose of this study is to describe the costs associated with delivering patient navigator interventions in two different organizations to improve housing and employment for PWH.

Methods

We conducted a cost analysis of two models of patient navigation. Costs were collected from two sites’ payroll, invoices, contracts, and receipts. Pre-implementation and implementation costs and utilization of service costs are presented. Potential reimbursement costs were calculated based on salaries from the Department of Labor.

Results

The health clinic’s pre-implementation costs were higher ($169,133) than the health department’s ($22,018). However, costs of patient navigation during the 2-year intervention were similar between health clinic and health department ($264,985 and $232,923, respectively). The health clinic reported more total time spent with clients (16,013.7 hours) than the health department (1,883.8 hours). The costs per additional person suppressed were $20,632 versus $37,810 for the health department and health clinic, respectively, which are lower than the average lifetime cost of HIV treatment.

Discussion

Replicability and scalability of a patient navigation intervention are possible in both health clinic and health department settings. Each site had specific costs, client needs, and other factors that required adaptations to successfully implement the intervention. Future programs should consider tailoring costs to site-specific factors to improve outcomes. Policymakers and public health officials should consider using these results to improve planning and investment in HIV treatment and prevention interventions.
Long-term Outcomes of Endovascular Repair for Blunt Thoracic Aortic Injury: A 10 Year Multi-center Experience
Authors: Wu Mingwei , Zeng Zhaoxiang , Bao Xianhao , Ren Luxia , Feng Jiaxuan , Feng Rui , Xiong Jiang
Published: April 2024

Objective:

This study aimed to assess the long-term outcomes in patients treated by thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injuries (BTAI).

Materials and methods:

From January 2010 to December 2019, this retrospective observational study was conducted at 3 centers, involving 62 consecutive BTAI patients who underwent TEVAR. Computed tomography angiography scans were planned to be conducted at 6 months post-procedure, and annually thereafter.

Results:

Technical success was achieved in all 62 procedures (100%), which included cases of dissection (n=35, 56.45%), pseudoaneurysm (n=20, 32.26%), and rupture (n=7, 11.29%). Mean injury severity score was 31.66±8.30. A total of 21 supra-arch branches were revascularized by chimney technique, with 12 cases involving the left subclavian artery (LSA) and 9 cases involving the left common carotid artery. In addition, 11 LSAs were covered during the procedure. The in-hospital mortality rate was 1.61% (n=1). The mean follow-up time was 86.82±30.58 months. The all-cause follow-up mortality rate was 3.28% (n=2). Stenosis or occlusion of 3 supra-arch branches (4.92%) was identified at follow-up, with 2 cases (3.28%) requiring re-intervention. No spinal cord ischemia, endoleak, or migration was observed.

Conclusions:

Despite only including patients with long-term follow-up, this study confirms the long-term safety and effectiveness of TEVAR for BTAI. For young BTAI patients, as the thoracic aorta increases with age, longer follow-up is needed to observe the potential mismatch between the endograft and the aorta.

Clinical Impact

This study confirms the long-term safety and effectiveness of endovascular treatment for blunt thoracic aortic injury (BTAI). For young BTAI patients, as the thoracic aorta increases with age, longer follow-up is needed to observe the potential mismatch between the endograft and the aorta. Through a remarkably extended follow-up period (86.82±30.58 months) conducted at multiple centers in China, this study confirms the long-term safety and effectiveness of endovascular treatment for BTAI.
Analysis of Aortic Arch Hemodynamics With Simulated Bird’s Beak Effects
Authors: Gonzalez-Urquijo Mauricio , Fumagal González Gerardo Alejandro , Cárdenas Castro Héctor Manuel , Morales Guzman Arnulfo Alejandro , Guzman Valladares Alan Alejandro , MacDonald Danielle Catherine , Moya Bencomo Marcos David , Botello Arredondo Israel , Fabiani Mario Alejandro
Published: April 2024

Objective

The objective of this study was to investigate the flow effects in different degrees of thoracic aortic stent graft protrusion extension by creating bird beak effect simulations using accurate 3D geometry and a realistic, nonlinear, elastic biomechanical model using computer-aided software SolidWorks.

Methods

Segmentation in 3D of an aortic arch from a computed tomography (CT) scan of a real-life patient was performed using SolidWorks. A parametric analysis of three models was performed: (A) Aortic arch with no stent, (B) 3 mm bird-beak configuration, and (C) 6.5 mm bird-beak configuration. Flow velocity, pressure, vorticity, wall shear stress (WSS), and time average WSS were assessed.

Results

The flow velocity in Model A remained relatively constant and low in the area of the ostium of the brachiocephalic artery and doubled in the left subclavian artery. On the contrary, Models B and C showed a decrease in velocity of 52.3 % in the left subclavian artery. Furthermore, Model B showed a drop in velocity of 82.7% below the bird-beak area, whereas Model C showed a decline of 80.9% in this area. The pressure inside the supra-aortic branches was higher in Model B and C compared with Model A. In Model A, vorticity only appeared at the level of the descending aorta, with low to non-vorticity in the aortic arch. In contrast, Models B and C had an average vorticity of 241.4 Hz within the bird beak area. Regarding WSS, Model A, and Model B shared similar WSS in the peak systolic phase, in the aortic arch, and the bird beak area, whereas Model C had an increased WSS by 5 Pa on average at these zones.

Conclusion

In the present simulations’ lower velocities, higher pressures, vortices, and WSS were observed around the bird beak zone, the aortic arch, and the supra-aortic vessels.
Routine External Iliac Artery Cannulation in Robotic Cardiac Surgery: Role of the Corona “Vitae” in Distal Limb Perfusion
Authors: AlJamal Yazan N. , Kitahara Hiroto , Johnson Blaine , Grady Kaitlin , Balkhy Husam H.
Published: April 2024

Objective:

Femoral artery cannulation is the most commonly used approach for cardiopulmonary bypass (CPB) in robotic cardiac procedures. However, without adding a distal perfusion cannula, leg ischemia can occur in up to 11.5% of patients. There is a well-described 2 to 4 mm size arterial branch that originates from the medial side of the external iliac artery or inferior epigastric artery, immediately above the inguinal ligament, and connects to the obturator artery. Therefore, it was historically named the corona mortis, which means “crown of death” in Latin. When peripheral cannulation is performed above this branch in the external iliac artery, we consider it a corona “vitae” because of its role as a limb-saving collateral. We report herein our standard technique of peripheral cannulation without the need of a distal perfusion cannula and preventing limb ischemia.

Methods:

We included all patients who underwent robotic cardiac surgery with peripheral cannulation over a 16-month period at our institution. We cannulated just above the level of the inguinal ligament through a 2 to 3 cm transverse skin incision. The incidence of limb ischemia and vascular complications was recorded and analyzed.

Results:

During the study period, 133 patients underwent robotic cardiac procedures with peripheral “external iliac” CPB. The size of the cannula was 21F or larger in 73% and 23F in 54% of the patients. No leg ischemia or femoral artery complications requiring additional intervention occurred.

Conclusions:

External iliac cannulation can be successfully performed in robot-assisted cardiac surgery using relatively large cannulas without the need of a distal limb perfusion catheter, with good results. In our view, given the importance of the corona mortis (“crown of death” in Latin) in perfusing the limb during CPB, we propose a new name for this artery in robotic cardiac surgery, namely, the corona vitae (“crown of life” in Latin).
‘A Safe Place to be Happy and Content’: Housing and ‘Home’ in Women’s Desistance
Authors: Low Grace , Mills Alice
Published: April 2024

Through narrative interviews with 15 women with histories of imprisonment in Aotearoa New Zealand, this article explores the role of housing and ‘home’ in women’s desistance. The article argues that safety and control are key psycho-social benefits of ‘home’ that support women’s ontological security. The women’s ‘homes’ – as sites of safety and control – could provide a space for them to construct drug and crime free identities and ultimately ‘do’ desistance. Moreover, their ‘homes’ became a physical manifestation or ‘expression’ of their changing identities which served to motivate and further reinforce their desistance.
The Clinical Investigation on Varicocele and Sperm Quality in the Tibet an Plateau of China: A Prospectively Planned Retrospective Cohort Study
Authors: Wang Bo , Liu Xiaoxing , Xu Huan , Shang Shu , Yan Danfeng , Deng Jie , Li Yanfeng , Lan Weihua , Tong Dali
Published: April 2024

Varicoceles are a common cause of male infertility, affecting up to 35% of men undergoing fertility evaluations. This study aims to investigate the potential influence of altitude and residence time on the occurrence of varicoceles, as well as on sperm quality and sterility in plateau areas. A total of 168 patients with varicocele were enrolled in the study, and the study population was divided into groups based on their direct exposure to different high altitudes due to their living locations. The internal diameter in Quiet breath (Dr), internal diameter in Valsalva maneuver (Dv), reflux peak value, and reflux time are gradually increased accompanied with altitude elevation and residence time extension. The number of cases above 4,500 m also increased with the severity of varicocele, and the altitude of clinical types was higher than that of subclinical types of varicocele. Especially above 4,500 m, the Dv, Dr, reflux peak value, and reflux time all increased with the severity of varicocele. The severity of varicocele was positively correlated with the residence time in plateau area. Patients with residence time of more than 1 year had higher values of Dr, Dv, differentiation time, reflux peak value, and reflux time than those with residence time of less than 1 year. Compared to 3,650 m, patients with varicocele in 4,500 m also have worse semen quality. Both altitude and residence time are strongly positively related to the severity and incidence rate of varicocele in plateau areas.
Evaluation of Patient Expectations and Outcomes after Distal Radius Fractures
Authors: Green Anna H. , Alter Todd H. , Varghese Bobby B. , Ferrera Fernando , Doss Thomas , Hawes Joseph , Frias Giulia C. , Guerrero Kevin D. , Tawfik Amr M. , Katt Brian M. , Monica James T.
Published: April 2024

Background:

Patient expectations influence patient-reported outcomes after musculoskeletal injuries. The goal of this study is to determine how pretreatment expectations correlate with outcomes in patients with distal radius fractures.

Methods:

Seventy-five patients with an isolated distal radius fracture were prospectively enrolled into nonoperative and operative cohorts. The Trauma Expectation Factor–Trauma Outcome Measure (TEF-TOM) score was the primary outcome measure. Trauma Expectation Factor scores were recorded at the time of enrollment, and TOM scores were recorded at 3, 6, and 12 months. Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) and Patient-Rated Wrist Evaluation (PRWE) scores were also recorded.

Results:

Trauma Outcome Measure scores at all time points were worse than expected ( P < .01). Expectations were higher for patients younger than 65 years than for the 65+ group ( P = .02). In patients aged 65+ years, mean TOM at 3 months was not significantly different than expected ( P = .11) but decreased by 6 ( P = .04) and 12 months ( P < .01). Baseline TEF and TEF-TOM scores were not significantly different between operative and nonoperative groups ( P = .37). Quick Disabilities of the Arm, Shoulder, and Hand and PRWE scores were not significantly different between age or treatment groups at the final follow-up.

Conclusions:

The overall treatment of distal radial injuries in our study did not meet patient expectations. Patients aged 65 years or older had lower expectations but were not able to predict their outcomes better than patients aged <65 years. There were no differences in TEF or TOM by treatment method. Patients demonstrated improved functional outcomes (qDASH/PRWE) at all time points regardless of age and treatment method.
In Pursuit of Ethical and Inclusive Research: What Ethics Committees and Disability Researchers Can Learn From Each Other
Authors: Walsh Megan , Stead Victoria , Sawyer Susan M. , O’Shea Amie , Watson Joanne M. , Anderson Kate L. M.
Published: April 2024

Across disciplines, qualitative researchers have documented epistemological and practical tensions in the ethical review of community-based and participatory research, with many arguing that ethics committees’ decisions perpetuate the exclusion of marginalised communities from research engagement. In the existing literature, the research team and the ethics committee are often characterised as staunch opponents. Conversely, in our recent qualitative research addressing communication about sexuality with young people with cerebral palsy who use communication methods other than speech (augmentative and alternative communication), we found that constructive collaboration between researchers and committee members yielded novel insights. Co-authored by a multi-disciplinary research team and the former chair of a Human Research Ethics Committee, this reflexive case study identified three key tensions which arose in the ethical review of research involving this purportedly marginalised population, which reflected the wider importance of trust. We propose a series of practical recommendations to support productive collaboration in the pursuit of safe, inclusive and community-driven research.
The Utility of I-Poems to Explore Subjective Well-Being in Children and Adolescents with ADHD
Authors: Nicolaou Andrea Marisa , Eloff Irma
Published: April 2024

This study explores the utility of the I-poem methodology to investigate subjective well-being in children and adolescents with ADHD in South Africa during the COVID-19 pandemic. Subjective well-being in this population has been studied extensively via quantitative methodologies. In addition, narrative studies, discourse and theme analysis, participatory and visual method studies have also contributed to deeper understandings in the field. The current study seeks to contribute to knowledge creation within this field of non-numerical studies in an attempt to decentralise the voice of researchers and highlight the voices of participants. In the I-poem methodology, self-report ratings of children and adolescents with ADHD between the ages of 10 and 18 years old ( n = 376) during the COVID-19 pandemic in South Africa was captured in an open-ended question. Data was analysed through the researcher’s creation of themed I-poems. The findings delineate broad categories of positive, negative and neutral feelings of subjective well-being during the pandemic. Notions of subjective well-being are related to themes of home, school, social life, self-growth and reflection, experiences of change, rules, extra-curricular activities, concerns, loss, finances, the new normal, and emotions. The study illustrates the utility of the I-poem methodology to illuminate dimensions of well-being that may otherwise remain invisible. The study also amplifies the potential of the I-poem methodology to be used in conjunction with, and complementary to, other research methodologies.
Can HALP score predict post-contrast acute kidney injury and 6-year mortality in patients undergoing endovascular abdominal aneurysm repair?
Authors: Özderya Ahmet , Şahin Sinan , Koşmaz Tolga , Maz Mehmet Ali , Yerlikaya Murat Gökhan , Akyüz Ali Rıza , Sayın Muhammet Raşit , Erkan Hakan
Published: April 2024

Background

The aim of this study is to investigate the relationship between HALP score and post-contrast acute kidney injury (PC-AKI) and average 6-year mortality in patients undergoing endovascular abdominal aortic aneurysm repair (EVAR).

Methods

125 patients who underwent EVAR between January 2015 and December 2020 were included in our study. HALP score was calculated with the formula “hemoglobin × albumin × lymphocyte count/platelet count.” In the first phase of the study, two groups were developed: those who developed PC-AKI and those who did not. In the second stage, statistical analysis was performed by creating two groups: average 6-year mortality and survivors group.

Results

HALP score was found to be lower in the PC-AKI group [26.12 (14–61.54) versus 40.53 (7.22–103.61); p < .001]. Low HALP score was found to be both a dependent and independent predictor of the development of PC-AKI ( p = .019). HALP score was also found to be lower in the mortality group compared to the survivors [28.97 (12.6–103.61) versus 40.81 (7.22-99) p = .004]. Low HALP score was found to be only a dependent predictor of mortality. The development of PC-AKI was found to be an independent predictor of mortality ( p = .042).

Conclusions

The HALP score, which can be calculated with a simple formula, can be used to predict PC-AKI and medium-long-term mortality in EVAR patients.