bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilience Aware Development-Exploration: An Exercise for Improving Attention to Work Systems Resilience During Technology Design
Authors: Barrett Emily , Neville Kelly J. , Fersch Theresa , de los Santos Erika , Lematta Glenn , Sanders Tracy , Dorton Stephen L. , Langone Andrew , Patterson Emily S.
Published: September 2024

Efficiency, optimization, and improved capability are frequent goals of work system modernization initiatives. Resilience, defined as the ability of a system to adapt in response to diverse conditions and demands, including those that are rare or challenging, is also important. However, resilience is an abstract characteristic of systems. Whereas ways to improve efficiency tend to be easily recognized, ways to improve resilience are less obvious. Our goal was to make resilience visible and thereby enable developers of new technologies, concepts of operations, and policy to address and benefit the resilience of work system operations. To this end, we developed the Resilience-Aware Development—Exploration (RAD-E) that helps development teams think about how their new technology, concept of operations, or policy could impact work system resilience while educating development teams about the significance of work systems resilience and potential opportunities to strengthen the resilience of a work system.
Implementation and Evaluations of Visual Scaffolding to Support Attentional Management Training
Authors: Sebok Angelia , Kreischer Noah , Wickens Christopher , Clegg Benjamin
Published: September 2024

One approach to training is using scaffolding to assist the novice trainee in performing tasks while they develop fundamental skills. This paper describes the implementation and testing of visual scaffolding to support training of attentional management skills. The training tool was developed specifically for sensor operators of unmanned aerial systems (UAS) to learn attentional skills associated with managing the competing demands of UAS operational tasks. A key part of the training included attentional scaffolding—visual highlighting that was used to guide the trainee’s attention. Three different evaluations were conducted to assess performance while leveraging scaffolding: Two were performed with U.S. Navy and U.S. Coast Guard (USCG) sensor operators, and one was performed in a human-in-the-loop (HITL) study. In this paper, we detail the Navy and USCG studies, summarize the HITL study, and synthesize findings across the evaluations.
Uncertainty Differences in Computing Hierarchical Pedestrian Behaviors
Authors: Zhang Zhengming , Tian Renran
Published: September 2024

The development of autonomous vehicles presents significant challenges, particularly in predicting pedestrian behaviors. This study addresses the critical issue of uncertainty in such predictions by distinguishing between aleatoric (intrinsic randomness) and epistemic (knowledge limitations) uncertainties. Using evidential deep learning (EDL) techniques, we analyze these uncertainties in two key pedestrian behaviors: road crossing and short-term movement prediction. Our findings indicate that epistemic uncertainty is consistently higher than aleatoric uncertainty, highlighting the greater difficulty in predicting pedestrian actions due to limited information. Additionally, both types of uncertainties are more pronounced in crossing predictions compared to destination predictions, underscoring the complexity of future-oriented behaviors. These insights emphasize the necessity for AV algorithms to account for different levels of behavior-related uncertainties, ultimately enhancing the safety and efficiency of autonomous driving systems. This research contributes to a deeper understanding of pedestrian behavior prediction and lays the groundwork for future studies to explore scenario-specific uncertainty factors.
Exploring the Intersection of Sex and Race Within Transcranial Doppler Sonography: Implications for Future Neuroergonomic Research and Application
Authors: Azubike Chidera O. , Greenlee Eric T.
Published: September 2024

Transcranial Doppler Sonography (TCD) employs ultrasound to measure cerebral blood flow velocity for medical diagnostics and research. Unfortunately, certain groups experience disproportionately higher TCD failure rates than others, impacting their representation in healthcare and research. To delve into the factors influencing successful TCD application, particularly across different sexes and racial populations, a literature review was conducted. It emerged that factors such as bone density and headset design contribute to these disparities. For example, minority women, on average had comparatively denser temporal windows, consequently facing elevated failure rates in comparison to other groups. Moreover, TCD headset designs often overlook accommodating diverse hairstyles, especially those prevalent in Black communities. While addressing bone density of the transtemporal window is a deeper biomedical engineering issue of the TCD, designers should build upon the insights highlighted in this paper to create a more inclusive TCD that can safely adapt to varying bone density.
Can Proficiency in Chess Predict Situation Awareness in a Novel Task?
Authors: Maroju Rajan , Jamanzi Haroon , Viqer Mohammed , Dattel Andrew R.
Published: September 2024

This study explored the correlation between situation awareness (SA) and proficiency in chess. Eighteen participants were tested, performing a letter factory (LF) task and providing their ELO scores. Each participant received $10 for 30 min of participation. The results showed a negative correlation between the number of games played and the SA score, suggesting that increased gameplay was associated with lower SA in the letter factory task. Additionally, the ELO score was negatively correlated with the number of double attempts to place a designated letter in the loading boxes, indicating that more skilled players made fewer errors.
How Teaching Air Traffic Control College Students About Stress Improves Stress Management
Authors: Dattel Andrew R. , McCormick Michael J. , Maroju Rajan , Jamanzi Haroon , Lee Jae Beum , Bowden Maaliyah , Viqer Mohammed , Belluccio Alexander J. , Yu Dongguang , Barrett Jamie
Published: September 2024

The modern, fast-paced lifestyle intertwined with intricate technological advancements can significantly contribute to stress levels, which can impede decision making and adversely affect action tasks. For Air Traffic Control (ATC) professionals, stress management (SM) skills are increasingly recognized as essential for success. The intent of this study was to evaluate the effectiveness of SM technique training to enhance knowledge about stress and to promote the use of SM techniques. Thirty-one participants from an aeronautical university were assigned to either an experimental group receiving SM training or a control group. A questionnaire assessing SM knowledge and use of SM techniques was administered pre-training, immediately after training, and several weeks after training. Participants in the experimental group showed an increase in SM knowledge and a willingness to use SM techniques, particularly rational self-talk, even weeks after the training. Thus, SM training can improve stress awareness for ATC students, potentially enhancing aviation safety.
Adapting Trauma-Informed Kickboxing for the Salvadoran Context: A Practitioner Essay
Authors: Verry Georgia , McKay Penny
Published: September 2024

This practitioner essay will discuss the evidence base for an Australian trauma-informed kickboxing program, The Fight Back Project. We share key differences and adjustments while delivering this program in the Salvadoran context. We consider practitioner assumptions and limitations when transferring trauma-informed practice principles from the Global North to the Central American setting, and the criticality of gender-responsive adaptations. Drawing from existing research on the benefits of trauma-informed martial arts as a form of physical exercise, we describe the collaborative development and implementation of a trauma-informed kickboxing program alongside a local, community-led organization.
Allyship with Psychiatric Patients for Health Care Practice Reform: A Case Study of a Narrative Approach Using Patient-Authored Medical Records
Authors: Tsubonouchi Chizuru , Asano Midori
Published: September 2024

Introduction: To facilitate partnerships between nurses and their patients with psychiatric illness, it is important to provide a safe narrative space for both parties where patients can voice their opinions. Purpose: A case study shows how the Patient-Authored Medical Record (PAMR) can contribute to health practice reform. Methods: A patient who visited an outpatient psychiatric clinic was asked to describe his life events. The researchers created the patient's PAMR, a first-person account of how he thought his illness could be cured, which was used when conducting follow-up meetings. The contents of the PAMR and that of subsequent meetings were used to evaluate the tool's usefulness. Results: The narrative content of the PAMR and the follow-up meetings reflected a reduction in the patient's symptoms and a change in his perception of his illness. Conclusions: Patient-authored medical records could be a step toward health-care reform. Allyships created with patients can form new cooperative two-way relationships that are more equal than authoritative one-way relationships.
Selecting Informative Patients for Phase 2 Progressive Trials in MS: Design Considerations for Phase 2 Clinical Trials in Progressive MS
Authors: Koch Marcus W. , Camara-Lemarroy Carlos , Strijbis Eva , Mostert Jop , Leavitt Victoria M. , Repovic Pavle , Bowen James D. , Comtois Jacynthe , Uitdehaag Bernard , Cutter Gary
Published: September 2024

While relapsing-remitting multiple sclerosis (MS) has many therapeutic options, progressive forms of MS remain largely untreatable. Phase 2 clinical trials are our main tool to advance new treatments for progressive MS. Given the complexities of progressive MS, it will likely require many phase 2 trials to improve its treatment. To conduct informative and efficient phase 2 trials, it is important that such trials are designed in a way that they can identify a successful treatment as quickly and with as few participants as possible. In this topical review, we discuss cohort selection, outcome selection, cohort enrichment, and dosing selection as strategies to optimize the efficiency of phase 2 clinical trials in progressive MS.
Evaluation of collateral circulation in patients with internal carotid artery occlusion: A clinical and ultrasonographic multicenter study
Authors: Liu Ran , Gao Mingjie , Zhao Xinyu
Published: September 2024

Background:

Internal carotid artery (ICA) occlusion is the major cause of ischemic stroke. The effect of collateral vessels on cerebral hemodynamics in ICA occlusion remains unclear. This study investigated the correlation between collateral vessels and the peak systolic velocity of the middle cerebral artery (MCA) in patients with ICA occlusion.

Methods:

The relevant collateral vessels included the anterior communicating (ACoA), posterior communicating (PCoA), and internal-external carotid (IECCA) arteries, respectively. Patients with unilateral ICA occlusion ( n = 251) underwent transcranial Doppler imaging to detect the peak systolic velocity (PSV) of the MCA and other intracranial arteries. The clinical symptoms were assessed using the National Institutes of Health Stroke Scale (NIHSS).

Results:

Patients with ACoA collaterals had significantly higher PSVMCA scores and significantly lower NIHSS scores than those without ACoA collaterals ( p < 0.001). Patients without any notable collaterals and those with only IECCA had the lowest PSVMCA and highest NIHSS scores. The PSVMCA and NIHSS scores were negatively correlated ( r = −0.566, p < 0.001).

Conclusion:

Collateral circulation patency in unilateral ICA occlusion was closely associated with clinical symptoms, and patients with ACoA collaterals may have favorable outcomes. (ClinicalTrials.gov Identifier: NCT02397655)
Strategies of sexual refusal in effervescent nightlife settings: A study of Spanish university students
Authors: Recalde-Esnoz Irantzu , Tutenges Sébastien , Del Castillo Héctor
Published: September 2024

A growing body of studies focuses on sexual harassment and violence in nightlife venues, primarily as it affects adolescent and adult women. In these settings, the boundary between flirtation and unwanted sexual attention easily blurs. This study examines how young women reject such attention. It draws on in-depth interviews with 53 Spanish undergraduates aged 18 to 25 from a Madrid public university. The findings unveil both individual strategies for sexual refusal (e.g., ignoring, distancing, lying) as well as collective strategies (e.g., using friends as mediators or protectors). The interviewed women perceived these actions as emotionally and practically challenging. These results advance the understanding of interactions in situations of collective effervescence, which may be conducive of transgression and sexual violence.
Experimental study on fatigue damage mitigation in welded beam-to-column connections with passive vibration control
Authors: Yang Fan , Fang Zhao , Zhang Jianshao , Li Aiqun
Published: September 2024

To investigate the effectiveness of a viscous fluid damper (VFD) in mitigating fatigue damage in welded beam-to-column connections, six specimens were manufactured with the full penetration groove weld process. These specimens were divided into three groups: S1, S2, and S3, each containing two specimens. One specimen in each group was equipped with VFD, while the other was not. All specimens underwent the same elastic cyclic loading stage, but a different plastic cyclic loading stage for each group. The study results indicate that the presence of VFD can significantly enhance the load-bearing capacity of the welded beam-to-column connection by 10%–15% when subjected to the same displacement amplitude at the beam end. The primary cause of failure in the welded beam-to-column connection is the fatigue damage of the weld toe on the beam flange, which requires more attention during the welding process. Additionally, the VFD can effectively reduce stress concentration at the weld seam area, leading to a maximum of 50% decrease in the maximum stress near the weld toe of the beam flange center, as observed in our study.
Bearing fault detection system based on a deep diffusion model
Authors: Yau Her-Terng , Kuo Ping-Huan , Yu Shang-Yi
Published: September 2024

Bearings are crucial components of modern high-precision machinery and rotating machines. Excellent bearing failure detection systems are vital for ensuring that machines operate precisely. Advances in artificial neural networks (ANNs) and increases in computer processing speed have led to the application of many ANN models in various fields, including bearing failure detection, with excellent outcomes being achieved. However, to construct an ANN model that can precisely detect bearing failures, large quantities of data must be collected on various types of bearing failures. Thus, considerable time must be spent in data collection before rotating machines are operated on the production line, which increases costs for manufacturers. To overcome this problem, the present study used a diffusion model for data augmentation to improve the accuracy of an ANN model trained on a small quantity of bearing sound data. This study performed time-delay mapping to preprocess the data and convert them into a two-dimensional time-delay mapping diagram to reduce the dimensionality of the data features, a novel approach in the field of bearing failure detection. Finally, this study used a convolutional neural network model, which exhibited the optimal classification performance for time-delay mapping diagrams, for bearing failure detection. By comparing the results obtained from augmented and raw data, this study confirmed that using a diffusion model to augment data can improve the generalization ability of bearing failure detection models trained on a small quantity of data.
Research on the influence of acoustic short circuit fault of air spring isolator on ship floating raft isolation system
Authors: Wang Shuai , Lu Minyue , Tan Haitao , Jiang Shiliang , Zhang Miao , Liu Wei , Yao Jiachi
Published: September 2024

Air spring isolator is the crucial component of ship floating raft isolation system. However, due to various factors such as manufacturing errors and installation conditions of air spring isolators, abnormal contacts cannot be avoided in the internal limiters of air spring isolator, resulting in the acoustic short circuit fault. This leads to a significant decrease in isolation effectiveness. To address this issue, experiments on the acoustic short circuit fault of air spring isolators are conducted, and the experimental results are analysed. Then the causes behind the phenomena and results of the acoustic short circuit experiments are further elucidated through finite element simulations and mathematical theory analysis. The research results indicate that the acoustic short circuit of air spring isolators affects the isolation effectiveness. The more severe the acoustic short circuit fault, the greater its impact on the isolation effectiveness, particularly in the low-frequency isolation component. This is because, during the acoustic short circuit of air spring isolators, the rubber part of the internal limiter comes into contact, causing an increase in the stiffness of the air spring support, thereby resulting in an increase in the modal frequency of the isolation device and consequently severely impacting the low-frequency isolation effectiveness.
Beyond the battle: A cross-sectional study on cancer-related fatigue and predictors of quality of life in female adolescent and young adult survivors
Authors: Naittee George Prema , MP Ganesh
Published: September 2024

Objectives

The study delves into the intricacies of cancer-related fatigue (CRF), the quality of life (QoL), and other demographic variables of female adolescent and young adult cancer survivors (AYACS) in the landscape of Kerala, India.

Methods

The cross-sectional study included 288 female AYACS who were selected through purposive sampling and completed self-reported questionnaires on CRF, QoL, and demographic and clinical data. Statistical analyses were applied, including correlation, one-way ANOVA, and regression.

Results

and discussion: The temporal dimension is particularly interesting, as individuals three to five years post-treatment report heightened CRF and QoL scores. Furthermore, the research unveils the pivotal role played by predictors such as marital status, educational attainment, and employment status in shaping QoL. Marital status and education emerge as positive predictors of well-being. The study unveils compelling insights into AYA cancer survivorship, revealing a profound impact of CRF on the quality of life dimensions. The role of spirituality, sometimes affecting social connectedness, adds intrigue.

Conclusion

The findings provide insights into the complex world of female AYACS, compelling researchers to ponder the significance of addressing CRF and tailoring rehabilitation systems during the critical post-treatment phase, with recognition of gender-specific challenges.
Law: Language, Symbol, Rhetoric
Authors: Mootz Francis J.
Published: September 2024

Legal positivists regard law as written texts enacted and disseminated to be followed as rules. But this project rests on deeply mistaken conceptions about how language works. No written text stands alone and conveys a “plain meaning.” Law is expressed through language, but language does not exhaust the meaning of the law. Legal language always already draws on the ordinary language of the community, which, in turn, draws on a deeply symbolic realm, which it can never fully subordinate or explain. Rhetoric brings the symbolic substrate to life. Legal actors constantly search for the right words to deliberate with others. There is a resonant world to embrace and experience, but it can never be fully captured, understood, or expressed in our legal texts, which hover precariously above our shared ordinary language, which, in turn, is rooted in constitutive symbols that are sustained through an endless spiral of mediation, translation, and application. Nevertheless, we may reason together in a manner that generates rhetorical knowledge even if legal positivism is a failure.
The adoption of dual Vocational Education and Training in Spain: Analysis of descentralised decision-making in educational policy transfer
Authors: Martínez-Izquierdo Luis , Torres Sánchez Mónica
Published: September 2024

This paper examines the adoption of dual VET in Spain as a process of educational policy transfer. Using Phillips and Ochs’ (2003, 2004) policy transfer spectrum and decision-making classification and Perry and Tor’s (2008) model of transfer forms, the study relies on semi-structured interviews with key decision-makers in the Spanish central government and the Autonomous Communities of the Basque Country and Andalusia. Findings indicate that EU diffusion activities facilitated adoption, involving first-order learning. Initially, adoption at the central level was uninformed, driven by quick-fix decisions, but later shifted to informed transfer through second- and third-order learning, enhancing realism. In Andalusia and the Basque Country, decision-making consistently adapted to the real context, progressing from second- to third-order learning. Ultimately, this analysis concludes that dual VET adoption at the central, Andalusian, and Basque levels falls between ‘negotiated under constraint’ and ‘borrowed purposefully’, though not at the same point.
The Study on the Chinese Environmental Audit Tool (C-EAT) for Long-Term Care Facilities
Authors: Lian Fei , Huang Yanan , Fleming Richard
Published: September 2024

Objective: The aim of this study was to translate the Australian Environmental Assessment Tool (EAT) into Chinese and identify culturally specific characteristics in the Chinese context for adaptation. Background: In the context of dementia-specific care, the design of the environment is considered an influential factor in supporting and maintaining skills. However, despite the increasing number of individuals with dementia in China, there is currently no valid instrument available to systematically assess the quality of the physical environment in long-term care facilities (LTCFs). Methods: This study utilized a mixed-method procedure consisting of seven steps, including translation and adaptation. The study involved focus groups comprising an expert panel ( n = 17) and potential users ( n = 64) of the newly developed tool. Cross-cultural adaptation was performed through Chinese literature review and literature quality appraisal, field study, and expert committee review. Results: The final version of the China Environmental Assessment Tool (C-EAT) consisted of 10 key design principles and 64 items. The C-EAT was tested in four LTCFs in China and underwent two rounds of review by an expert panel. Conclusions: The C-EAT was deemed a suitable tool for assessing the environment and enhancing the living environments for individuals with dementia in LTCFs in China. In future research, field tests will be conducted to validate the C-EAT scale and modify the EAT-HC to enhance its applicability in China.
Intrathecal drug delivery for the management of pain and spasticity in adults: British Pain Society’s recommendations for best clinical practice
Authors: Eldabe Sam , Duarte Rui , Thomson Simon , Bojanic Stana , Farquhar-Smith Paul , Bagchi Somnath , Farquhar Lis , Wetherill Bill , Copley Sue
Published: September 2024

The British Pain Society updated their recommendations on intrathecal drug delivery (ITDD) for the management of pain and spasticity in adults. The recommendations are primarily evidence based but where necessary comprise the consensus opinion of the working group. The recommendations are accompanied by information for patients and their carers, intended to inform and support patients in their decision making. The updated guidance includes recent evidence base of ITDD use in pain and spasticity, address the issues of drug pump compatibility following the latest manufacturer and Medicines and Healthcare products Regulatory Agency (MHRA) recommendations as well as provide an update on the indications and complication management particularly endocrine complications and intrathecal granuloma formation.
Effect of methylprednisolone in reducing severe COVID-19 and mortality in high-risk patients: A retrospective study
Authors: Xiao Yan , Wang Jinwei , Yang Kai , Jiang Meiling , Luo Jialin , Chen Kun , Zhang Bo
Published: September 2024

Introduction:

The treatment of COVID-19 patients, especially high-risk patients, remains a large challenge. Glucocorticoids have been accepted as effective medicines for severe COVID-19. However, the glucocorticoid usage guidelines do not cover all the indications for high-risk patients.

Objective:

To identify more effective treatments for high-risk patients with COVID-19, this retrospective study analyzed routine epidemiological, clinical, and laboratory data from 33 high-risk patients with COVID-19 in Beijing Gobroad Boren Hospital, Beijing, China, most of whom responded well to treatment.

Methods:

Severe acute respiratory syndrome coronavirus-2 infection was confirmed via real-time reverse transcriptase polymerase chain reaction assays. Outcome measures such as duration of mechanical ventilation, intensive care unit length of stay, and 28-day mortality were analyzed. Patients were divided into two groups: mild to moderate COVID-19 ( n = 26) and severe COVID-19 ( n = 7). Chest computed tomography images were used to guide methylprednisolone administration or withdrawal.

Results:

Upon intensive care unit admission, 12.1% of patients were mechanically ventilated with an average partial pressure of oxygen/fraction of inspired oxygen(PaO2/FiO2) ratio of 279 ± 146. No coinfections with other endemic viruses were observed. The duration of mechanical ventilation was 16 days (interquartile range: 8–28); the intensive care unit length of stay was 11 (interquartile range: 2–33) days; and the 28-day total mortality was 3.0%.

Conclusion:

Multivariate regression analysis revealed that low-dose, timely methylprednisolone administration was associated with a lower severe COVID-19 rate and mortality in high-risk patients. For high-risk patients, once there are ground-glass opacities (GGO) in the computed tomography image, continuous and low-dose methylprednisolone administration promotes inflammation remission and protects them from severe COVID-19 or mortality.
Vein of Galen aneurysmal malformation diagnosed prenatally: A case report
Authors: Kolsi Nadia , Regaieg Chiraz , Chaabene Maha , Ben Hamad Amel , Charfi Manel , Mnif Zeineb , Ben thabet Afef , Bouraoui Amira , Hmida Nedia
Published: September 2024

The vein of Galen aneurysmal malformation is a rare congenital malformation of the cerebral blood vessels. It is a result of the persistence of an embryonic vessel that drains multiple arteriovenous shunts. This malformation can cause a multitude of symptoms ranging from cardiac failure to headaches depending on the age of presentation. In the fetus, cardiac manifestations are rare and are linked to a very poor prognosis. That’s why prenatal diagnosis is crucial in early detection and management. We present a case of a vein of Galen aneurysmal malformation, diagnosed prenatally with ultrasonography. The newborn developed widely a high-output cardiac failure. Prenatal diagnosis facilitates the early detection of this malformation as well as predicting the prognosis.
An unusual case of early onset opsoclonus-myoclonus syndrome: Case report and literature review
Authors: Chávez-Nomberto Ruth Elizabeth , Díaz-Gambini Mariano David A , Ramos Diaz Katherine Joyce
Published: September 2024

Opsoclonus-myoclonus syndrome is a rare neurological condition characterized by opsoclonus, myoclonus, ataxia, irritability, and sleep disturbances. In pediatric patients, symptoms usually start between 16 and 18 months of age; opsoclonus-myoclonus syndrome presentation in children under 6 months is rare. Approximately 50% of cases are associated with neuroblastoma. We report an early onset presentation of opsoclonus-myoclonus syndrome in a previously healthy, 3-month-old female infant. The diagnostic workup revealed no abnormalities. The patient underwent monthly cycles of dexamethasone pulses and intravenous immunoglobulin with a favorable response. After a few months, the patient presented intermittent opsoclonus before the next scheduled pulse so from the 9th cycle onwards, the intravenous immunoglobulin dose was increased to 2 g/kg. After 9 months of treatment, she was diagnosed with a latent Mycobacterium tuberculosis infection. Due to this infection, dexamethasone pulses were discontinued, and intravenous immunoglobulin treatment was maintained with clinical improvement The patient received 18 intravenous immunoglobulin cycles, leaving her with a score of one on the Mitchell-Pike scale. Developmental milestones have been attained according to age. Despite the range of therapeutic options for managing opsoclonus-myoclonus syndrome described in the literature, the efficacy of these available therapies needs to be better established. A modified upfront approach with dexamethasone and intravenous immunoglobulin could be an option in settings where rituximab is unavailable.
Pseudotumoral pelviperitoneal tuberculosis mimicking ovarian cancer: A case report
Authors: Mejda Zakhama , Rihab Limam , Raoua Baklouti , Ahlem Bellalah , Arwa Guediche , Sofiene Gaied , Imen Jemni , Nabil Ben Chaabene , Ahmed Zrig , Mohamed Hichem Loghmari , Leila Safer
Published: September 2024

Tuberculosis is a rare but treatable infectious disease that continues to pose a significant health issue in regions with high prevalence. Its abdominopelvic localization can mimic advanced ovarian cancer, leading to diagnostic challenges. This report describes the case of a 33-year-old woman who was admitted to the gastroenterology unit with ascites, peritoneal thickening, and an ovarian mass on imaging. The diagnosis of abdominopelvic and peritoneal tuberculosis was confirmed after laparoscopy. The patient underwent antitubercular chemotherapy and showed clinical improvement.
The Process of Personal Social Media for Work: Unveiling the “Work” Behind Social Media
Authors: Dailey Stephanie L. , Martinson Madeline
Published: September 2024

Many employees are engaging in personal social media for work (PSMW), which involves posting work-related content from a user’s individual social-media account. Despite quantitative studies demonstrating the presence and outcomes of talking about work on social media, scholars know little about the process of using PSMW. To fill this gap, the current study uses social identity theory and boundary theory as conceptual frames to learn why and how people engage in PSMW. Through analyzing interview and observational data from employees’ social media across a variety of industries and work arrangements, we present a model of PSMW. Our findings contribute to scholarship in at least three ways. First, this study exposes the “work” behind PSMW through a pattern of Labored Worklife: a paradox of communicating both authentically and strategically. Second, our findings show PSMW as a distinctive, flexible way through which workers can traverse complicated work and non-work borders and communicate multiple (even conflicting) identities on social media. Third, this project suggests connections between PSMW and scholarship surrounding emotion at work.
Legalizing Support for Patients with Rare Diseases in the Social Policy System: The Case of Using Legitimation Strategies in Hong Kong
Authors: Yu Yating , Chan Tayden Fung
Published: September 2024

There is a paucity of research pertaining to the discourse-based construction of legitimation within the realms of law and healthcare. To fill this gap, the present study examines the deliberations within the Legislative Council of Hong Kong pertaining to the enactment of legislation recognizing rare diseases (RDs) as eligible for governmental support. Employing van Leeuwen’s sociosemantic approach, we analyzed the debates, revealing four distinct discursive strategies, namely rationalization, morality, authorization, and mythopoesis, employed by the legislators to advocate for RD legislation. Among these strategies, rationalization emerged as the most frequently employed. The legislators’ discourse carries ideological implications concerning humanitarianism. This study not only sheds light on the utilization of legitimation strategies to advocate for the enactment of social policies within a legal context but also provides valuable insights for other regions seeking to advance RD legislation from a linguistic perspective.
Early Neonatal Shock: Case Report and Lessons Learned in Management
Authors: Salih Aso Faeq , Jawad Ali M. , Jawad Majeed H.
Published: September 2024

We report a case of a neonate, delivered by C-section, that rapidly developed respiratory compromise and hemodynamic instability prompting admission to critical care. Urgent cardiology assessment with echocardiography revealed severe systolic dysfunction from localized myocardial ischemia and pulmonary hypertension. Their management progressively escalated, eventually requiring inotropic support. Despite intensive treatment and meticulous nursing with demonstrable improvement of cardiac function, they deteriorated suddenly and died on Day 2 post-partum. This case emphasizes the challenge in early recognition of neonatal shock due to often nonspecific presentations, with hemodynamic compromise arising later. We recommend close vigilance for deterioration, awareness of indolent etiology including viral myocarditis, titration of appropriate inotropes and synergistic adjunctive vasodilators, and consideration of immune modulators such as corticosteroids that addresses biochemical deficiencies and support cardiac function. Ultimately, aggressive, targeted, and multi-focal treatment, especially in resource-limited environments, maximizes the chances of survival in challenging clinical situations such as progressive neonatal shock.
Risk Factors, Clinical Profile, and Outcomes of Coronary Artery Disease in the Elderly
Authors: Garikapati Vrandha , Mondal Sudipta , P Abhilash Sreevilasam , Sivadasanpillai Harikrishnan , Kumaran Ajit Kumar Valaparambil
Published: September 2024

Objectives

This study aimed to identify risk factors in patients diagnosed with angiographically significant coronary artery disease (CAD) after 65 years of age (elderly) with a subset analysis of more than 75 years, analyze their clinical, angiographic profile and assess their major acute cardiovascular and cerebrovascular events (MACCE).

Methods

This was an observational retrospective and prospective study conducted from January 2022 to June 2023 among consecutive elderly who underwent CAG for suspected or diagnosed CAD between 2010 and 2018 at a tertiary center in South India.

Results

A total of 1,511 patients satisfied eligibility criteria with mean age of 69.38 years and male preponderance (69%). Male gender, dyslipidemia and current tobacco use contributed to angiographically significant CAD by multiple logistic regression analysis but none of the risk factors contributed in the more than 75-year age group. Female patients had higher incidence of atypical presentation, less revascularizations and higher MACCE. Fourteen percent of patients with significant CAD developed MACCE over a median 3.5-year hospital follow-up. Survival analysis of 1,027 patients with significant CAD showed one, three, 5-year mortality rate of 4.3%, 6.9% and 10.8%, respectively, with left ventricular dysfunction and triple vessel disease being associated with worse survival. MACCE and 5-year survival was significantly better among those who underwent revascularization including those with significant left main or triple vessel disease.

Conclusion

This study showed a high prevalence of traditional risk factors in elderly patients among which male gender, dyslipidemia, current tobacco use were found to predict angiographically significant CAD. Triple vessel disease and left ventricular dysfunction were associated with worse survival. Mortality was significantly lower among elderly who underwent revascularization compared to medical management.
Effect of population density in aging societies and severity of motor vehicle crash injuries: the case of Spain
Authors: Cespedes Luis , Ayuso Mercedes , Santolino Miguel
Published: September 2024

The concentration of population in cities and processes of rural depopulation coupled with the generational shift to older societies represent new challenges in road safety. Here, we examine the severity of injuries suffered by the occupants of motor vehicles involved in a crash based on the population density of the area in which the crash occurs, the driver’s age and the density of their place of residence. We conduct the study in Spain, a country with one of the highest levels of elderly population concentrated in rural areas in Europe. Relational methods are used to match Eurostat’s urbanization classifications with the accident database of Spain’s Directorate General of Traffic so as to correlate each crash with the population density of the place where it occurred. A set of generalized linear models with random effects is fitted to analyze the relationship between population density and the bodily injury severity of the occupants of the vehicle(s) involved in a crash, measuring the effect of drivers’ relocation and aging by geographical area. Independence of injury severity and the degree of urbanization was rejected at the 5% significance level. While 53.8% of the Spanish population is living in densely populated areas and only 13.5% in rural areas, the latter concentrates most crashes with fatalities: 2.3 times more than in urban areas (43.5 and 18.6%, respectively). Drivers living in rural areas are more likely to be associated with serious or fatal injuries when involved in a crash in urban and intermediate areas. Moreover, drivers aged over 75 are significantly more likely to be associated with serious and fatal injuries, especially when the crash occurred in urban areas. Recent research alerts on the implications for rural (often elderly) residents of concentrating public services, particularly healthcare, in densely populated areas. Our study shows that motor crashes in more densely populated areas are also a rural health concern. Policy decision-makers need to address this issue to reduce the number of victims and their bodily injury severity.
The frail-LESS (LEss sitting and sarcopenia in frail older adults) remote intervention to improve sarcopenia and maintain independent living via reductions in sedentary behaviour: findings from a randomised controlled feasibility trial
Authors: Bailey Daniel P. , Harper Jamie H. , Kilbride Cherry , McGowan Laura J. , Victor Christina , Brierley Marsha L. , Chater Angel M.
Published: September 2024

Background

Sarcopenia leads to functional disability, dependence in activities of daily living (ADL), and is a key contributor to frailty. Reducing and breaking up sedentary time is associated with improved sarcopenia and frailty-related outcomes. The aim of this study was to determine the feasibility of delivering and evaluating a remote sedentary behaviour intervention to improve sarcopenia and independent living in older adults with frailty.

Methods

A two-arm randomised controlled feasibility trial was conducted with a target of 60 older adults (mean age 74 ± 6 years) with very mild or mild frailty. Participants were randomised to the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or usual care control group for six months. The intervention included tailored feedback on sitting, standing and stepping; an education workbook that included goal setting and action planning; one-to-one health coaching; peer support; and a wearable device to self-monitor sedentary behaviour. Participant recruitment (percentage of eligible individuals recruited), retention and data completion rates were used to assess trial feasibility. Acceptability of the trial was explored through interviews and safety was evaluated via unplanned healthcare utilisation and number of falls. Sitting, standing, stepping and sarcopenia were measured to evaluate potential intervention effects.

Results

Sixty participants were recruited. Recruitment and retention rates were 72% and 83%, respectively. Completion rates for outcome measures ranged from 70 to 100%. The trial was safe (< 1 fall per participant on average at each timepoint) and trial procedures were acceptable. Descriptive analysis (mean ± SD) showed that daily sitting was 25.1 ± 82.1 min/day lower in the intervention group, and 6.4 ± 60.5 min/day higher in the control group, at 6 months compared with baseline. Hand grip strength and sit-to-stand score were improved by 1.3 ± 2.4 kg and 0.7 ± 1.0, respectively, in the intervention group.

Conclusions

This study demonstrates the feasibility and safety of delivering and evaluating a remote intervention to reduce and break up sitting in older adults with frailty. The intervention showed evidence towards reducing daily sitting and improving sarcopenia, supporting its evaluation in a definitive randomised controlled trial.

Trial registration

ISRCTN registry (registration number: ISRCTN17158017). Registered 6th August 2021.
Genomic approach to determine sources of neonatal Staphylococcus aureus infection from carriage in the Gambia
Authors: Bojang Abdoulie , Chung Matthew , Camara Bully , Jagne Isatou , Guérillot Romain , Ndure Ebrahim , Howden Benjamin P , Roca Anna , Ghedin Elodie
Published: September 2024

Staphylococcus aureus is a major cause of neonatal infections in various anatomical sites, resulting in high morbidity and mortality in The Gambia. These clinical infections are often preceded by nasal carriage of S. aureus, a known risk factor. To determine whether potential sources of newborn S. aureus infections were from carriage, and to characterize S. aureus present in different anatomical sites (blood, ear, eye, umbilical cord, skin, pus, oropharynx, breast milk and vagina), we performed whole-genome sequencing of 172 isolates from clinical sites as well as from healthy and unhealthy carriage. A random selection of mothers (n = 90) and newborns (n = 42) participating in a clinical trial and testing positive for S. aureus were considered for this study. Sequence data were analyzed to determine S. aureus multilocus sequence types and selected antimicrobial and virulence gene profiles. Our findings revealed that in The Gambia, ST15 is the dominant sequence type associated with both carriage and clinical infection. In addition, S. aureus isolates causing clinical infection among neonates were genetically similar to those colonizing their oropharynx, and the different anatomical sites were not found to be uniquely colonized by S. aureus of a single genomic profile. Furthermore, while S. aureus associated with clinical infection had similar antimicrobial resistance gene profiles to carriage isolates, only hemolysin and adhesive factor virulence genes were significantly higher among clinical isolates. In conclusion, this study confirmed S. aureus oropharyngeal colonization among neonates as a potential source of clinical infection in The Gambia. Hence, interventions aiming to reduce neonatal clinical infections in The Gambia should consider decreasing oropharyngeal S. aureus carriage.

Trial registration The trial was registered at ClinicalTrials.gov NCT03199547.
Revealing the crosstalk between LOX+ fibroblast and M2 macrophage in gastric cancer by single-cell sequencing
Authors: Chen Dapeng , Tong Wen , Ang Bing , Bai Yi , Dong Wenhui , Deng Xiyue , Wang Chunjiong , Zhang Yamin
Published: September 2024

Background/Aims

Gastric cancer (GC) ranks among the prevalent types of cancer, and its progression is influenced by the tumor microenvironment (TME). A comprehensive comprehension of the TME associated with GC has the potential to unveil therapeutic targets of significance.

Methods

The complexity and heterogeneity of TME interactions were revealed through our investigation using an integrated analysis of single-cell and bulk-tissue sequencing data.

Results

We constructed a single-cell transcriptomic atlas of 150,913 cells isolated from GC patients. Our analysis revealed the intricate nature and heterogeneity of the GC TME and the metabolic properties of major cell types. Furthermore, two cell subtypes, LOX+ Fibroblasts and M2 Macrophages, were enriched in tumor tissue and related to the outcome of GC patients. In addition, LOX+ Fibroblasts were significantly associated with M2 macrophages. immunofluorescence double labeling indicated LOX+ Fibroblasts and M2 Macrophages were tightly localized in GC tissue. The two cell subpopulations strongly interacted in a hypoxic microenvironment, yielding an immunosuppressive phenotype. Our findings further suggest that LOX+ Fibroblasts may act as a trigger for inducing the differentiation of monocytes into M2 Macrophages via the IL6-IL6R signaling pathway.

Conclusions

Our study revealed the intricate and interdependent communication network between the fibroblast and macrophage subpopulations, which could offer valuable insights for targeted manipulation of the tumor microenvironment.
Development of the humeral head offset index for control of humeral torsion
Authors: Razaeian Sam , Husarek Julius , Wangler Sebastian , Dewald Cornelia L. A. , Al-Mousllie Ibrahim , Zhang Dafang
Published: September 2024

Background

Control of humeral torsion can present a challenge, especially intraoperatively during closed reduction and fixation of humeral shaft fractures or 2-part surgical neck fractures of the proximal humerus. The objective of this study is to develop and validate an indirect method for the assessment of humeral torsion using an index that is linearly correlated with rotational arm position and can be derived from only a single plain radiographic image of the proximal humerus.

Methods

The Humeral Head Offset Index (HHOI) is calculated as the ratio of the medial and lateral offset of the humeral head measured from the outer cortices of the shaft on a plain radiographic or fluoroscopic image. The relationship of HHOI with humeral torsion was first verified on a sawbone model with radiopaque characteristics under fluoroscopic control. Different degrees of retroversion were simulated through manual rotation of the humerus with a digital protractor in 5° increments until 40° internally rotated and then in 5° increments until 40° externally rotated from the neutral position. The same procedure was subsequently performed digitally on Digitally Reconstructed Radiographs (DRRs) from computed tomography (CT) dataset of the sawbone. Next, the HHOI index was applied to eight randomly selected patients with total humerus CT using the same method. Spearman’s rho was calculated for the bivariate analysis of correlation between the simulated degree of retroversion and the HHOI. Strength of correlation was classified according to Koo and Li. Interrater and intrarater reliability of three blinded observers with repetition of measurement after three months were analyzed by assessing the intraclass correlation coefficient (ICC).

Results

Both in the sawbone model and in DRRs, we demonstrated a high to very high significant linear correlation between simulated retroversion and the HHOI. ICC values demonstrated excellent interrater reliability and excellent intrarater reliability for measurement of the HHOI.

Conclusions

The HHOI is a new, simple, reliable index that has a linear relationship to the rotation of the humerus and can therefore allow an indirect control of humeral torsion in comparison to the contralateral side.