bluuebunny/crossref_metadata_2025 huggingface dataset:
Fractional picosecond laser treatment of non‐acne atrophic scars and scar erythema in Chinese patients
Authors: Li Jing , Duan Fangfang , Kuang Jie , Liu Xiao , Pan Jing , Wei Jia , Zhao Jinghui
Published: July 2024

Background

Fractional picosecond lasers (FPL) are reported to be effective and safe for atrophic acne scars and post‐acne erythema. However, there is no evidence regarding the effectiveness and safety of FPL treatment for non‐acne atrophic scars and scar erythema among Chinese patients.

Methods

In this retrospective study, 12 Chinese patients with non‐acne atrophic scars, including nine with scar erythema, were treated with one to three sessions of 1064 nm FPL treatment. Clinical improvement was objectively assessed through blinded evaluations by external physicians. A modified Manchester Scar Scale (mMSS) and the Clinician Erythema Assessment Scale (CEAS) were individually used to evaluate atrophic scars and scar erythema based on photographs. Physician‐assessed and subject‐assessed Global Aesthetic Improvement Scale (GAIS) were used to assess changes before and after FPL treatment. Patient satisfaction and adverse events were also documented.

Results

Total mMSS scores, as well as three parameters (color, distortion, and texture), were significantly decreased after FPL treatment, with a mean reduction of 3.18 ± 1.60 in total scores (p < 0.05). The CEAS scores were significantly reduced from 2.41 ± 0.98 before treatment to 0.41 ± 0.40 at the final visit (p < 0.05). Based on physician‐assessed and subject‐assessed GAIS scores, 11 (91.7%) patients were improved after FPL treatment. 33.3% of patients were very satisfied, and 41.7% were satisfied. No serious, prolonged (> 3 weeks) adverse events were observed.

Conclusion

Our study suggests that 1064 nm FPL treatment may be a promising option for non‐acne atrophic scars, especially with scar erythema. Further studies are needed to confirm our results.
Continuous negative‐pressure wound therapy improves the survival rate of skin grafts and shortens the time required for skin graft survival
Authors: Tsuchiya Masato , Kushibiki Toshihiro , Yamashiro Toshifumi , Mayumi Yoshine , Ishihara Miya , Azuma Ryuichi
Published: July 2024

Background

The effectiveness of negative‐pressure wound therapy (NPWT) in skin graft fixation has been demonstrated in several clinical studies. However, in vitro and in vivo studies on skin graft fixation with NPWT have been scarce. In this in vivo study, we aimed to determine whether NPWT fixation enhances skin graft survival and how it contributes to improving skin graft survival biologically.

Materials and methods

We harvested skin from the bilateral abdominal wall of 88 mice after anesthetizing them. Full‐thickness skin grafts (FTSGs) were performed on contralateral harvest sites, and grafts were fixed using NPWT (continuous and intermittent modes), conventional compression methods, and wrapping with polyurethane foam as a control group. On days 5 and 10 of grafting, the survival rates of the FTSGs were evaluated. Immunohistopathological analysis and measurement of the expression levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF‐2), and epidermal growth factor (EGF) were performed.

Results

The survival rates of FTSG in the continuous NPWT group were significantly higher than those in the other groups. The number of capillaries in the dermis was significantly higher in the continuous NPWT group than in the other groups. In the wound bed, VEGF levels were significantly higher in both NPWT groups than in the other groups.

Conclusion

Continuous NPWT increases the survival rate of FTSGs and shortens the duration of skin graft survival.
Incorporating Tensile Stress Into Electromigration Life Prediction for Cu/SAC305/Cu Solder Joints
Authors: Vinson Whit , Huitink David
Published: July 2024

Accelerated testing has been executed to examine the combined influence of electromigration (EM) stressors (elevated current density and elevated ambient temperature) and tensile stress on the lifetime of SAC305 solder joints (300 μm diameter) at two current densities (8500 and 9100 A/cm2), two ambient temperatures (100 and 150 °C), and five tensile stresses (0, 0.5, 1, 2.5, and 5 MPa). 60 total samples were tested, four of which survived the 500-h test duration limit. As tensile stress was increased, a significant reduction in lifetime was observed for each of the four EM conditions (current density–temperature pairs). Voltage drop across the solder samples was measured in situ, capturing the time to failure (TTF) for all samples and allowing for the development of life prediction models based on the multistress experimental scenario. Post failure analysis of the samples tested under combined electromigration and tensile stress showed necking or breakage at the Cu/SAC305 interface on the upstream side of electron flux. The cross-sectional analysis of tested samples is consistent with the findings from other studies regarding electromigration failure in Cu/SAC305/Cu solder joint assemblies, where the intermetallic regions at Cu/SAC305 interfaces grow asymmetrically. Inherent process voids in the experimental samples are discussed as a source of error and a brief computational examination of the impact of process-related voiding on stress as well as current density and self-heating within solder samples is provided.
Transient Liquid Phase Bond Acceleration Using Copper Nanowires
Authors: Harris John , Huitink David
Published: July 2024

Increasing heat flux in power electronics modules is taxing the limits of thermal management technologies. This is the result of wide bandgap semiconductor devices with superior voltage blocking capabilities. These same devices have the capability of operating at elevated junction temperatures when properly packaged. Transient liquid phase (TLP) bonding forms intermetallic compounds (IMC) with high melting temperatures at more conventional processing temperatures. Copper and tin transient liquid phase intermetallic formation in SAC305 solder bonds can be accelerated using copper nanowires. This work explores the feasibility of accelerated transient liquid phase bonding using solder and nanowires. This includes electroforming of nanowires, contact angle analysis of solder on nanowires, void analysis using scanning acoustic microscopy (SAM), and cross-sectional scanning electron microscopy (SEM). SAC305 solder is deposited on substrates with 0.4 μm diameter copper nanowires using a 75 μm stencil and subjected to solder reflow. It is found that atmospheric storage at 260 °C results in regions of complete intermetallic bonding after 2 h. Shear strength of bonds completed with this nanowire transient liquid phase bonding method averages 11.99 kg or 13 MPa.
The viscosity re-assessment of the Cu–X (X = Ag, Al, Sn, Mg) and Ag–X (X = Sn, Sb, In, Au) liquid alloys
Authors: Li Xi , Deng Jiyuan , Zuo Xing , Chen Zhenjie , Chen Zetong , Xiong Tao , Wu Liang
Published: July 2024

The viscosity of the eight binary systems (Cu–X ([Formula: see text], Al, Sn, Mg) system and Ag–X ([Formula: see text], Sb, In, Au)) was re-assessed, employing a new CALPHAD-type equation model proposed in our previous work. The calculated viscosities of the binary alloys were compared with the experimental data. It was found that this CALPHAD-type equation is very effective in fitting with the experimental data. Therefore, this work proves the validity of our new CALPHAD-type equation model for accurate viscosity predictions in alloys with varying component compositions.
Large-Scale K-Clustering
Authors: Voevodski Konstantin
Published: July 2024

Large-scale learning algorithms are essential for modern data collections that may have billions of data points. Here, we study the design of parallel

\(k\)

-clustering algorithms, which include the

\(k\)

-median,

\(k\)

-medoids, and

\(k\)

-means clustering problems. We design efficient parallel algorithms for these problems and prove that they still compute constant-factor approximations to the optimal solution for stable clustering instances. In addition to our theoretic results, we present computational experiments that show that our

\(k\)

-median and

\(k\)

-means algorithms work well in practice—we are able to find better clusterings than state-of-the-art coreset constructions using samples of the same size.
Nanomaterials-Integrated Electrochemical Biosensors as Pioneering Solutions for Zoonotic Disease Diagnosis
Authors: Saklani Shivani , Barsola Bindiya , Pathania Diksha , Sonu Sonu , Kumari Priyanka , Singh Pardeep , Taha Bakr Ahmed , Rustagi Sarvesh , Thakur Pankaj , Narayan Mahesh , Chaudhary Vishal
Published: July 2024

Zoonotic diseases are a pressing challenge to global health, arising from their interspecies transmission and potential for pandemics. Conventional diagnostic methodologies often suffer from limitations in speed, sensitivity, and accuracy, underscoring the imperative for innovative solutions. Nanomaterial-integrated biosensors, especially in electrochemical modules, have gained increasing attention as promising tools for the rapid, sensitive, point-of-care and targeted detection of zoonotic pathogens. Despite considerable progress, pervasive challenges, including market fragmentation and research disparities, impede widespread adoption. This review explores the essential role of electrochemical biosensors in combating zoonotic diseases, underscoring the urgency for accessible, cost-effective, and high-throughput diagnostic platforms. It details the principles of electrochemical biosensing and highlights the role of diversified nanomaterials in enhancing the performance of biosensors. Furthermore, it examines the integration of nanomaterials with different electrodes and signal amplification strategies to improve its sensing performance. It details the current challenges, alternate solutions and perspectives in developing and translating these biosensors for point-of-care diagnosis/surveillance of zoonotic diseases. This review provides valuable insights into the potential of nanomaterial-based electrochemical biosensors to revolutionize the diagnosis and management of zoonotic diseases, ultimately contributing to global efforts to mitigate the impact of these contagious threats on human and animal health.
Predictive Validity of Motor Assessment Scale on Poststroke Discharge Destination
Authors: Conradsen Irene , Henriksen Marius , Rytter Hana Malá
Published: July 2024

Background: Stroke frequently leads to hospital admission and subsequent rehabilitation in order to overcome poststroke sequelae, such as motor impairments. Efficient planning of the steps following hospital admission includes early prediction of whether the patient can be discharged home or not. Early assessment of motor performance in patients with stroke‐induced motor deficits may be able to function as a predictor of discharge destination but is less explored.

Objective: The primary objective was to assess the predictive validity of the Motor Assessment Scale (MAS) on discharge destination both regarding total score and regarding subscores (transfer‐mobility items and upper extremity items).

Design: The study was designed as a prospective cohort study.

Subjects: Thirty‐seven consecutively recruited patients with stroke are the subjects of the study.

Methods: Logistic regression model was used to calculate the odds of being discharged to own home upon hospital admittance. The predictive ability was examined with a receiving operator characteristic (ROC) curve, and cut‐points from the curve were employed in Cox regression.

Results: A one‐unit higher score on the total MAS significantly increased the odds of being discharged home upon hospital admittance (odds ratio (OR) 1.14, 95% CI 1.04–1.25). The same pattern was observed with the summed items of 1–5 and 6–8. The total MAS showed sensitivity of 91.7% and specificity of 68.0%. Patients having a total MAS score ≥ 24 were 17 times more likely to be discharged home (HR 17.64, 95% CI 2.23–139.57) compared to patients with a lower score.

Conclusion: Motor function measured by the MAS can be applied as a predictor of discharge destination upon hospital admission after stroke in Danish setting.
Genomic Insights of a Methicillin‐Resistant Biofilm‐Producing Staphylococcus aureus Strain Isolated From Food Handlers
Authors: Ballah Fatimah Muhammad , Hoque M. Nazmul , Islam Md. Saiful , Faisal Golam Mahbub , Rahman Al-Muksit Mohammad Taufiquer , Khatun Mst. Minara , Rahman Marzia , Hassan Jayedul , Rahman Md. Tanvir
Published: July 2024

Methicillin‐resistant Staphylococcus aureus (MRSA) is an important zoonotic pathogen associated with a wide range of infections in humans and animals. Thus, the emergence of MRSA clones poses an important threat to human and animal health. This study is aimed at elucidating the genomics insights of a strong biofilm‐producing and multidrug‐resistant (MDR) S. aureus MTR_BAU_H1 strain through whole‐genome sequencing (WGS). The S. aureus MTR_BAU_H1 strain was isolated from food handlers’ hand swabs in Bangladesh and phenotypically assessed for antimicrobial susceptibility and biofilm production assays. The isolate was further undergone to high throughput WGS and analysed using different bioinformatics tools to elucidate the genetic diversity, molecular epidemiology, sequence type (ST), antimicrobial resistance, and virulence gene distribution. Phenotypic analyses revealed that the S. aureus MTR_BAU_H1 strain is a strong biofilm‐former and carries both antimicrobial resistance (e.g., methicillin resistance; mecA, beta‐lactam resistance; blaZ and tetracycline resistance; tetC) and virulence (e.g., sea, tsst, and PVL) genes. The genome of the S. aureus MTR_BAU_H1 belonged to ST1930 that possessed three plasmid replicons (e.g., rep16, rep7c, and rep19), seven prophages, and two clustered regularly interspaced short palindromic repeat (CRISPR) arrays of varying sizes. Phylogenetic analysis showed a close evolutionary relationship between the MTR_BAU_H1 genome and other MRSA clones of diverse hosts and demographics. The MTR_BAU_H1 genome harbours 42 antimicrobial resistance genes (ARGs), 128 virulence genes, and 273 SEED subsystems coding for the metabolism of amino acids, carbohydrates, proteins, cofactors, vitamins, minerals, and lipids. This is the first‐ever WGS‐based study of a strong biofilm‐producing and MDR S. aureus strain isolated from human hand swabs in Bangladesh that unveils new information on the resistomes (ARGs and correlated mechanisms) and virulence potentials that might be linked to staphylococcal pathogenesis in both humans and animals.
On the Use of Taguchi Method in the Analysis of the Dynamic Response of Variable Bearing Design under Impact Load
Authors: Jamali Hazim U. , Mohammed M. N. , Jweeg Muhsin Jaber , Mahdi E. , Aljibori H. S. S. , Abdullah Oday I. , Ruggiero Alessandro , Alfiras M. , Schlattmann Josef
Published: July 2024

Optimizing the bearing design is an essential step to maintain safe operation and extend the bearing life. Taguchi method is one of the powerful methods in this direction, which can be used to assess the geometrical design parameters under shaft deviation. Shaft deviation is unavoidable in the industrial applications of journal bearing. It results from installation and manufacturing errors, bearing deformation, asymmetric loading, and many other sources. This work investigates the use of three bearing profiles with a wide range of geometrical characteristics to minimize the deviation negative effects. These designs modified the inner bearing surface in a linear, parabolic, or cubic shape. A general 3D deviation representation is considered in the analysis where the deviations in the horizontal and vertical directions are taken into consideration. The analysis is performed for a finite‐length journal bearing using the Taguchi method to determine the optimal design characteristics. This analysis is achieved in terms of the rotor critical speed and the film thickness of the lubricant. Furthermore, the system response to an impact load is analyzed. The finite difference method is used in the analysis to solve the governing equations of the hydrodynamic problem, and the 4th‐order Range Kutta solution is considered to solve the motion equations of the rotor under the impact load. Results show that using the suggested designs enhances the system’s critical speed, elevates the thickness of the lubricant layer, and extends the safe operation limits under impact load. The parabolic profile gives the most effective outcome where the shaft trajectory under impact excitation is very close to the ideal journal‐bearing case. The suggested design reduces the maximum pressure by 17.07%, increases the minimum film thickness by 175.04%, and increases the critical speed by 23.42%.
Comparison of GLP‐1 Receptor Agonists, SGLT‐2 Inhibitors, and DPP‐4 Inhibitors as an Add‐On Drug to Insulin Combined With Oral Hypoglycemic Drugs: Umbrella Review
Authors: Chai Sanbao , Niu Yapin , Liu Fengqi , Wu Shanshan , Yang Zhirong , Sun Feng
Published: July 2024

Background: The objective was to evaluate the efficacy of the combination of Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), dipeptidyl peptidase‐4 inhibitors (DPP‐4i), and sodium‐glucose cotransporter 2 inhibitor (SGLT‐2i) in the treatment of Type 2 diabetes with poor efficacy of basic insulin and metformin/sulfonylurea by umbrella review.

Materials and Methods: Forming the data of publication of each database through 13 September 2022, PubMed, EMBASE, and Cochrane Library were surveyed.

Results: A total of seven meta‐analyses were included in the umbrella review. The combination of GLP‐1 RA (WMD −3.41 [−5.61, −1.21], p = 0.002), SGLT‐2i (WMD −5.34 [−9.56, −1.13], p = 0.013), and DPP‐4i (WMD −5.56 [−7.39, −3.73], p ≤ 0.001) can significantly reduce HbA1c levels, respectively. The combination of GLP‐1 RA (WMD −1.55 [−2.92, −0.18], p = 0.027), SGLT‐2i (WMD −2.96 [−6.68, 0.77], p = 0.12), and DPP‐4i (WMD −2.05 [−2.82, −1.28], p ≤ 0.001) can significantly reduce fasting plasma glucose (FPG) levels, respectively. The combination of GLP‐1 RA (WMD −3.24 [−5.14, −1.34], p < 0.001) can significantly reduce body weight of Type 2 diabetes mellitus (T2DM). The dose of basic insulin in diabetes patients after combined use of GLP‐1 RA (WMD −2.74 [−4.26, −1.22], p ≤ 0.001) was significantly reduced. The combination use of GLP‐1 RAs (OR 1.28 [1.05, 1.56], p = 0.017) increases the risk of hypoglycemia.

Conclusions: The combination of GLP‐1 RAs, DPP‐4i, and SGLT‐2i can effectively lower HbA1c and FPG in T2DM patients who have poor therapeutic effects on basic insulin combined with metformin/sulfonylureas, respectively. Compared to placebo, GLP‐1 RAs can significantly reduce body weight and basic insulin dosage, while DPP‐4i and SGLT‐2i have a lower risk of hypoglycemia.

Trial Registration:CRD42023410345.
Mortality and Morbidity After Open Surgical Lower Extremity Revascularization in Patients With Peripheral Artery Disease and Concurrent Abdominal Stoma
Authors: Leverich Matthew , Afifi Ahmed M. , Ren Gang , Nazzal Munier , Osman Mohamed
Published: July 2024

Objectives

Patients with peripheral artery disease (PAD) often require treatment with open lower extremity revascularization (LER). Patients with PAD often have other comorbidities and associated conditions that affect procedural outcomes, including abdominal stomas. The aim of this work is to investigate the impact that stomas may have on postoperative outcomes and complications.

Methods

We performed a 5-year (2016-2020) analysis of the Nationwide Readmission Database. We identified all adult patients undergoing open LER. These patients were categorized into 2 groups: stoma and no-stoma. Propensity score matching (1:1) was used to control for demographics and comorbidities. Index admission outcomes and readmission rate were examined.

Results

212,275 open LER patients were identified. A matched cohort of 3088 patients (1:1 stoma vs no-stoma) was obtained. Patients with stomas had higher rates of several postoperative complications: acute posthemorrhagic anemia (29.1%, P < 0.01), acute kidney injury (21.4%, P < 0.001), index sepsis (10.3%, P < 0.001), and index SSI (2.8%, P < 0.001). There were no significant statistical differences between the 2 groups for acute myocardial infarction. Those with stomas had worse outcomes: greater in-hospital mortality (4.7%, P < 0.05), length of stays (median 7 days, P < 0.001), total charges (median 108,037 dollars, P < 0.001), discharges to long-term care facilities (30.8%, P < 0.001), discharges to their own homes needing home health care (30.1%, P < 0.001), 30-day readmission rates (23.2%, P < 0.01), and 30-day readmission mortality (6.1%, P < 0.01).

Conclusions

Concurrent abdominal stoma is associated with increased postoperative morbidity and mortality after open LER. Further prospective studies are needed to validate these results.
Toward a Practice of Critical Recognition: Life Narrative in the Sociology Classroom and Beyond
Authors: Carruyo Light
Published: July 2024

The centrality of the self (including in published life narratives, social media confessionals, social movements and even our own classroom rituals), and the attendant conflation of experience, analysis, and truth, revive longstanding questions about our investment in the individual. The self and its narration continue to be messy and evolve in tandem with intense societal, technological, and economic shifts. This article grows from an interest in the tension between affirming the diverse set of experiences that gather in our classrooms, and challenging students to think systemically about the social world and our place in it. Published life-narratives—here I discuss the work of Virginia Grise and Valeria Luiselli—provide pedagogical opportunities to fortify agentic knowers by cultivating a practice of critical recognition. A practice of critical recognition in the classroom and beyond may help us all better face both what we know and what we don’t know, together.
Gifted Students’ Academic Motivation During the COVID-19 Pandemic: A Qualitative Study in Croatia, Serbia, and Slovenia
Authors: Juriševič Mojca , Krnjaić Zora , Šimon Jana
Published: July 2024

Research suggests that the effect of emergency remote education on the motivation of gifted students during the COVID-19 pandemic differs from that observed in traditional students. The main aim of the present study was to explore the lived experience of academic motivation among gifted high school students in Croatia, Serbia, and Slovenia. Semistructured interviews were conducted with 47 gifted students aged 15 to 18, using the same methodological procedure in the three countries with similar educational backgrounds. Grounded in gifted students’ narratives about their academic motivation, we detected three groups of students who experienced decreased, no change in, or increased academic motivation. Furthermore, we identified group-specific patterns based on the most common activities and salient features of students’ school context, learning, and leisure time during the pandemic.
The Effects of Concrete and Virtual Manipulatives on Solving Algebraic Equations in Students With Disabilities
Authors: Thomas Jessica , Bicard Sara , Simmons Kate D.
Published: July 2024

An alternating treatments design was used to analyze the effects of concrete and virtual manipulatives on the duration and number of correctly solved linear equations by three middle school students with cognitive disabilities. Participants physically manipulated algebra tiles to solve an equation during the concrete manipulative condition. During the virtual manipulative condition, participants used a Chromebook to manipulate the virtual algebra tiles presented on the BrainingCamp website. All participants exceeded their average baseline accuracy scores using both forms of manipulatives to solve one and two-step algebraic equations. Comparing the two treatment conditions, two of the three participants had higher average scores for accuracy using the concrete manipulatives than the virtual manipulatives. One of the three participants solved algebraic equations in a shorter duration of time with concrete manipulatives. The data suggest both concrete and virtual manipulatives can successfully support students with disabilities to solve algebraic equations.
Cultivating purpose and internalized motivation through workplace learning
Authors: Kenny Maureen Emily , Medvide Mary Beth , Gordon Pamela
Published: July 2024

Building on prior research documenting associations between youth purpose and academic, psychological and physical well-being, this study examined the contributions of workplace learning (WPL) to youth purpose and internal motivation among 281 youth of diverse racial and ethnic identities and economic status enrolled in two high school networks offering innovatively designed WPL. Sequential regression analyses revealed that the quality of WPL, defined by mentor support for training, learning opportunities, and youth autonomy, contributed positively to youth purpose and internal motivation, beyond the negative effects of perceived social and economic barriers. Findings are discussed through the perspectives of psychology of working, decent education, self-determination theory and career construction and suggest that WPL is a promising intervention for overcoming inequities in fostering youth talent and purpose, including personal goals, meaning and intentions for social contribution.
Three perspectives for assessing and monitoring talent development: A holistic theoretical approach with empirical applications
Authors: Merello Paloma
Published: July 2024

The study of giftedness and evolution toward talent development models have been approached mostly from an educational perspective. Talent potential development cannot be understood without comprehensively looking at all individuals’ facets. This work proposes a theory by which talent potential, considered by the conjunction of cognitive and non cognitive individual traits, is evolutionary and dynamical, and can be manifested into three different talent dimensions that represent contributions to social development, knowledge and individuals' psychological balance. The holistic approach allows for cross-cultural conceptions of talent, and more flexible and dynamic organizations of education, which entail the recovery of individuals' potential and provides opportunities in any development stage. The paper provides a framework with quasimathematical notation for its empirical application in research and talent management.
Examine the influence of collaborative business culture and data-driven analytic capability on business innovation: Moderation role of managerial capability
Authors: Kissi Philip Siaw
Published: July 2024

The literature has predominantly overlooked the significant combined influence of data-driven analytic capability (DDAC) alongside managerial capability and a collaborative business culture (CBC) on business innovation, despite advancements in DDAC within certain organisations. Therefore, this study examines the relationship between DDAC, CBC, and business innovation while exploring the moderating effect of managerial capability. Data from 577 managers were collected via a survey questionnaire. Research hypotheses were tested using a consistent Partial Least Squares Structural Equation Modeling (PLS-SEM) algorithm alongside bootstrapping methodology. Findings indicate that DDAC positively influences CBC, business innovation, and collaborative business culture. Additionally, a collaborative business culture has a positive impact on business innovation and partially mediates the relationship between DDAC and business innovation. Most importantly, the study reveals that combining managerial capability and DDAC has a less notable impact on CBC than on DDAC alone. However, the joint effect of managerial capability and CBC is stronger than CBC alone on business innovation. Theoretical and managerial implications are extensively discussed.
Laughing Matters in Courts: Humor’s Role in Normalizing Hate Speech
Authors: Zinigrad Roman
Published: July 2024

Humor is a form of speech capable of boosting the political value of a speech’s content or even reversing its meaning. Courts acknowledge these qualities by considering that an expression may enjoy an elevated level of free speech protection against government sanctions or private suits if it is formulated in a humorous way. This article spotlights another key attribute of humor, that is perhaps more consequential for the socio-political impact of an expression but that nonetheless does not seem to be invoked in free speech litigation: its power to increase the exposure of the speech. A humorous presentation of an idea offers its audience an entertaining form that is desirable to consume independently of the message it conveys. It lowers the costs of processing irrelevant or objectionable content and so bears the potential of catching the attention of those who would not otherwise be exposed to it. I argue that the capacity of humor to “raise the volume” of speech must be accounted for in the balancing formulas of constitutional and international free speech litigation. To underline the importance of this factor, I focus on cases of hate speech, a category where humor plays a decisive role in the outreach to audiences that do not always share the prejudice or intolerance of the speaker. This article analyzes the case law of the European Court of Human Rights (ECtHR) and of French courts as an example of the general disregard of courts for humor’s amplification of hate speech. The far-reaching damage potential of this disregard is demonstrated on the case of Dieudonné, a notorious French antisemitic comic who has masterfully exploited humor to expose large audiences to hateful content.
Family Involvement in the Care of Nursing Home Residents With Dementia: A Scoping Review
Authors: Wei Andrea , Bell Jessica , Locke Jenna , Roach Ashley , Rogers Anita , Plys Evan , Zaguri-Greener Dalit , Zisberg Anna , Lopez Ruth P.
Published: July 2024

Family members are involved in the lives of older adults with dementia in complex ways. This scoping review synthesizes existing research on family involvement in the care of nursing home residents with advanced dementia. Using the Arksey and O’Malley scoping review framework, electronic searches of PubMed, EBSCO’s CINAHL Complete, and APA PsychInfo on the Ovid platform were conducted. Twenty-eight studies met inclusion criteria. Emergent themes and definitions of involvement were obtained through thematic analysis, including: (1) contact (through visitation, calling, or writing letters); (2) engagement in care activities (instrumental/activities of daily living); (3) planning and monitoring care (being aware of health and treatment changes, partnership with care staff, ensuring adequate care, and decision-making); and (4) supporting the resident (advocacy, socioemotional support, and financial support). Moreover, limited psychometrically sound instruments exist to measure family involvement. These limitations stall the progression of research targeting family involvement.
Understanding Polarized Reactions to Sport CSR and Sustainability Communication on Social Media Through Dialogic Openness
Authors: Harrison Virginia S. , Seaton William , White Carla
Published: July 2024

Dialogic openness suggests that organizations should employ an agonistic approach to conversation, discussion, and listening when communicating with activist groups. This study applies this theoretical premise to corporate social responsibility communication in motorsport, specifically Formula 1, which has been increasingly communicating about sustainable initiatives on social media. Through quantitative content analysis, we analyzed 820 responses to 10 CSR-related tweets during the 2021 season. We found that reactions to the messages were mostly critical, from both the left and right political perspectives. More liberal viewpoints indicated that Formula 1 should do more to address sustainability, while more conservative viewpoints complained that Formula 1 should “stick to sports” and stop engaging in social issues. Both sides showed high levels of skepticism for the intentions behind the messages. Based on our findings, we suggest that sport organizations should use principles of dialogic openness foster deliberative communication around sustainability in sport.
Development of a Medication-Use Evaluation Template for Andexanet Alfa in the Reversal of Anticoagulation With Factor Xa Inhibitors
Authors: Fera Toni , Burnett Allison , Grandoni Jessica , Moore Mary R. , Nussbaum Barbara B. , Pollack Charles V. , Rose Anne E. , Spinler Sarah A. , Streiff Michael B. , Turck Charles J , Fanikos John
Published: July 2024

Medication-use evaluations are meant to ensure that medication-use processes are consistent with prevailing standards of care, assure optimal use of therapy, and reduce the risk of medication-related problems. Reversal agents for direct oral anticoagulants are a worthy focus for medication-use evaluations for reasons of efficacy, safety, and cost. A multidisciplinary team of experts developed 2 medication-use evaluation templates illustrating the application of professional society guidelines to the appropriate use of andexanet alfa.
Psychosocial Well-Being Differences Between the Young Old, Old-Old, and Oldest Old: A Global Comparison
Authors: Burns Shane D. , Crimmins Eileen M. , Zhang Mutian , Ailshire Jennifer A.
Published: July 2024

Objectives

We investigate global differences in psychosocial well-being between older adult age groups.

Methods

Using multinomial logistic regression, we analyzed 2018 data ( n = 93,663) from 9 countries/regions in the Health and Retirement Study international family of studies to compare age group differences in depression, loneliness, and happiness.

Results

Compared to the young old, the old-old reported more depression in Southern Europe, while the oldest old had higher risk in India and Southern Europe but lower risk in the United States. The old-old reported less loneliness in the United States but more in Southern Europe, while the oldest old had greater risk in Southern Europe. The old-old reported less happiness in Korea, while the oldest old had lower reports in Korea but higher reports in the United States.

Discussion

The psychosocial well-being of the oldest old is exceptionally good in the United States but exceptionally poor in Southern Europe.
Bilateral outer foveal microdefect in a patient with systemic lupus erythematosus using hydroxychloroquine - A case report
Authors: Alves Eneida Machado , Fonseca Vanessa , Moura Carlos Antonio , Oliveira Isabela S. , Santiago Mittermayer B.
Published: July 2024

Introduction

The association of outer foveal microdefect and LES or hydroxychloroquine use has not been established in current literature.

Case report

We present the first reported case of bilateral outer foveal microdefect ina a patient with systemic lúpus erythematosus using hydroxycloroquine.

Discussion/conclusion

While it is not possible to definitively attribute the described findings in our patient to HCQ use, it is important to be aware of the possibility that the outer foveal microdefect may be caused by this medication. Therefore, patients on chronic HCQ therapy should be informed about the risk of potential visual adverse effects, so that appropriate interventions can be implemented if necessary.
The relationship between nurses’ professional values and ethical attitudes to pain
Authors: Korkut Sevda , Saatçi Gamze
Published: July 2024

Background

Pain management is a fundamental human right for everyone who experiences it. The management of pain is an ethical obligation for all health professionals. Professional values have an important place in appropriate clinical decision-making.

Research aim

This study was conducted to determine the relationship between nurses' ethical attitudes in pain management and their compliance with professional values.

Research design

The study was conducted as a descriptive and correlational research. The study data were collected by online survey method using the Introductory Characteristics Form, Ethical Attitude Scale for Pain Management in Nursing, and Nurses Professional Values Scale – Revised.

Participants and research context

The population of the study consisted of nurses working in tertiary treatment centers in a country. A total of 388 nurses participated in the study.

Ethical considerations

Ethical approval was obtained from the University Ethics Committee. Consent was obtained from the nurses.

Results

The mean total score of the Ethical Attitude Scale for Pain Management in Nursing was 98.96 ± 9.37, and the mean total score of the Nurses Professional Values Scale was 101.51 ± 15.20. The scores of the Ethical Attitude Scale for Pain Management in Nursing were positively and moderately correlated with the total scores of the Professional Values Scale. Compliance with professional values explained 41% of the total variance of ethical attitude for pain management.

Conclusions

In this study, it was found that nurses' ethical attitudes for pain management and compliance with professional values were at a high level, compliance with professional values was associated with ethical attitudes for pain management, and ethical attitudes for pain management decreased with increasing working years. A nurse with high ethical sensitivity and compliance with professional values can easily recognize ethical problems, effectively manage the ethical decision-making process, and provide appropriate patient care.
The invisible leverage of the rich. Absentee debtors and their hedge funds
Authors: Sgambati Stefano
Published: July 2024

The existing literature on finance, debt, and inequality depicts economic elites as a creditor class. According to a popular thesis, over the past four decades, the rich and ultra-rich households have experienced a saving glut (excess income), which they have invested in the debts of the poor and their governments. While it is undeniable that the rich have expanded their income share at the expenses of the poor, to refer to them as ‘creditors’ or ‘lenders’ is a misrepresentation of how they actually expand their wealth and income shares by financial means. For it conceals the fact that a great deal of their investments is leveraged, that is, carried out with borrowed money. This article shows that the debts generated for the sake of affluent households easily surpass those of all other households. However, these debts are not accounted for in statistics on household debt. This is because affluent households, particularly multi-millionaires and billionaires inside the top 1%, do not simply borrow from banks, like normal households do, but they are instead absentee debtors who borrow through corporate structures of which they are dominant shareholders and ultimate beneficiaries. To gain an insight into their invisible leverage, the article looks at how much hedge funds borrow and why their leverage matters.
Substance use by homeless clinic attenders in Sydney
Authors: Solterbeck Kirra , Staples Lauren , Woodman Logan , Burns Nicholas , Mitchell Rebecca , Nielssen Olav
Published: July 2024

Objective

Describe patterns of substance use and comorbid conditions among clinic attenders in homeless shelters in Sydney.

Method

Retrospective cohort study of 2498 people who attended a psychiatric clinic at one of three homeless hostels between February 2008 and May 2020. Multivariable logistic regression was used to identify factors associated with self-reported substance use, psychiatric diagnosis and measures of social function.

Results

A total of 2041 of the 2498 (81.7%) reported the harmful use of at least one substance, with alcohol (61.8%), cannabis (50.9%) and stimulant drugs (34.9%) the three most common. Those reporting the regular use of two or more substances (1466, 58.7%) were more likely to have a history of early life and adult trauma, a diagnosis of personality disorder, a criminal conviction, receive the Disability Support Pension, be chronically homeless and sleep in the open.

Conclusions

The study found a high rate of polysubstance use among homeless clinic attenders in Sydney, and an increase in the prevalence of substance use compared to previous studies. Substance use is both a cause and a consequence of homelessness, and services to address substance use have to be part of any program to reduce homelessness and sleeping in the open.
Antibiotic Use at the End of Life: Current Practice and Ways to Optimize
Authors: Kang Minji , Wang Winnie S. , Chang Zieanna
Published: July 2024

Infections are common complications in end of life (EOL). However, clinicians have minimal guidance regarding antibiotic decision-making in EOL care, leading to the overuse of antibiotics. While symptom relief is frequently cited as a major reason for antibiotic use in EOL, antibiotics have not been shown to provide significant improvement in symptoms outside of urinary tract infections. In addition, when prognosis is expected to be in the range of days to weeks, antibiotics have not been shown to provide significant survival benefit. Antibiotics can be beneficial in EOL care in appropriate scenarios, but the current widespread use of antibiotics in EOL requires reevaluation. There needs to be broader efforts to think about antibiotics like other invasive medical procedures in which benefits and risks are weighed, recognizing that not all patients in EOL who receive antibiotics will benefit. In addition, during care planning process, discussing and documenting antibiotic preferences will be beneficial. Non-antibiotic symptom management should be incorporated to plan of care when infection is suspected. Ultimately, the use of antibiotics at EOL should be for the clear benefit for the recipient and should be guided by the type of infection and its clinical course, patients’ primary disease and its prognosis, and the preferences of patients or surrogate decision makers.
Evaluation of Radiotherapy Efficacy and Prognostic Analysis for Solid and Cystic Brain Metastases
Authors: Sun Lu , Lin Shouyu , Bi Jianping , Yuan Zilong , Li Ying , Wei Wei , Peng Yi , Hu Desheng , Han Guang
Published: July 2024

Objectives

Brain metastases (BMs) are commonly categorized into cystic and solid. However, the difference in the prognosis of patients with either cystic or solid BMs following radiotherapy remains poorly understood. We used a retrospective design to elucidate the disparities in survival between these two patient groups undergoing radiotherapy and to identify factors influencing the overall survival (OS) of patients with BMs.

Methods

This retrospective study encompasses 212 patients diagnosed with BMs. We meticulously analyzed the clinical characteristics, radiation therapy modalities, and risk factors influencing the OS among these patients, categorized by BMs type, post-brain radiation therapy.

Results

A statistically significant difference in mOS was observed between the two cohorts (Solid vs Cystic: 23.1 vs 14.6 months). Subgroup analysis unveiled distinctions in mOS, particularly in patients with EGFR-mutant lung adenocarcinoma (Solid vs Cystic: 23.1 vs 6.43 months). The volume of BMs and the biological effective dose (BED) emerged as significantly prognostic factors for patients with cystic BMs. For patients with solid BMs, fraction dose, BED, and the number of BMs were identified as independent prognostic factors for survival.

Conclusion

Brain radiotherapy shows superior survival benefits for lung cancer patients with solid BMs compared to those with cystic BMs, particularly in EGFR-mutant lung cancer. In particular, patients receiving BED ≥60 Gy have a more favorable prognosis than those receiving BED <60 Gy, regardless of the type of BM (solid or cystic) in lung cancer.
Amplification effect and influencing factors of rebound-collision impact amplifier
Authors: Shi Ye , Lei Lei , Yan Ming , Gu Xiping
Published: July 2024

In strong impact environment, traditional impact test platform cannot obtain high peak acceleration, resulting in products being hindered in the testing process. The objective of this paper is to build the rebound-collision impact amplifier that can be used in a strong impact environment and to investigate its mechanism, influencing factors, and amplification effect. The kinematic model of the rebound-collision impact amplifier was established by combining dynamic contact theory with classical collision theory, considering energy loss, and introducing collision recovery coefficient. A theoretical formula for calculating acceleration and acceleration magnification was derived. The effects of the collision duration ratio, the mass ratio of the amplification platform to the falling platform, and the reserved clearance on the acceleration magnification were investigated, respectively. Finally, the feasibility test was verified. The test results show that the rebound-collision impact amplifier motion model is in good agreement with the theoretical model. Acceleration magnification decreases with increasing mass ratio and increases with increasing collision duration ratio. The ideal reserved clearance can be found to make the acceleration of the amplification platform obtain the maximum value. Selecting the ideal reserved clearance is more conducive to impact amplification.
Observation vector reconstruction-based nonparametric nonlinear restoring force identification for granules-structures coupled vibrating system
Authors: Dong Jinlu , Li Jian , Hong Guangyang , Li Hang , Ning Yang
Published: July 2024

The nonlinear restoring force (NRF) generated by the collision and friction between particles and structures is the leading cause of the complex dynamic response of the granules-structures coupled vibrating system (GSCVS). Identification of NRF can provide critical information for post-event damage diagnosis and structural design of immersed structures. However, the spatial distribution and dynamic response of the particles near the structures are diverse and complex, making it difficult to describe the NRF with an accurate mathematical model. This paper proposed a data-based nonparametric method to estimate the NRF in the GSCVS. A nonparametric model of NRF that considered the additional effects of particles on both sides of the structures and consisted of system response and undetermined coefficients was developed. The observation vector of the conventional Extended Kalman Filter (EKF) was reconstructed by the sparse measurement of the strain response. The reconstructed observation vector contains three response components: translational displacement, translational acceleration, and rotational acceleration, in which the rotational acceleration response is difficult to measure in engineering applications. The proposed EKF based on observation vector reconstruction (EKF-OVR) can identify the undetermined coefficients in the nonparametric model, and then the NRF can be calculated. Numerical studies showed that EKF-OVR achieved higher accuracy and noise robustness than the conventional EKF and the data fusion based EKF. A dynamic experimental study on granules-beam coupled vibrating system (GBCVS) was conducted, and the proposed algorithm was employed to identify the NRF of the GBCVS. The effects of excitation amplitude, particle size, and immersed depth on NRF are analyzed, and it is found that higher harmonic components in the NRF led to period doubling and chaos of the beam response.
Determinants of women legislators’ media coverage in a male-dominated Kenya political landscape
Authors: Ireri Kioko , Ochieng Jimmy
Published: July 2024

This research explores visibility of Kenyan women Members of Parliament (MPs) in newspapers news between 2013 and 2017 – a non-election period. Within the backdrop of coverage based on news values, the study examines whether non-institutional characteristics (ethnic group size and seniority), and institutional attributes (party size and political leadership) predicted the coverage of 68 female legislators. And under the context of media as a mirror of political reality, it investigates if criticizing national government, commenting on corruption and devolution determined their appearance in national newspapers’ news. Findings indicate that commenting on corruption, criticizing national government, and seniority were the main predictors of the MPs’ newspapers reportage.