bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing Surgical Choices of Renal Artery Aneurysm With Sequential Use of “Two-Click AVA” Technique and FlightPlan for Embolization: A Report of Two Cases
Authors: Li Siting , Li Fangda , Zeng Rong , Liu Xiaolong , Liu Zhili , Zheng Yuehong
Published: August 2024

Background

Selecting intervention strategies for renal artery aneurysms (RAAs) is challenging especially for those located at the vessel bifurcation. The relationship between the aneurysm and renal branches could not always be accurately viewed from traditional computed tomography angiography (CTA) images.

Case presentation

This study proposed a new method to investigate the anatomy and affected vessel branches of RAAs using automated software. Two patients with RAAs located at the renal artery bifurcation underwent Cone beam CTA (CBCTA) analysis. We sequentially coupled the “two-click AVA” function of Vessel IQ Xpress (GE Healthcare) with the “vascular tree extraction” function from FlightPlan for Embolization (GE Healthcare) to evaluate the relationship among the main renal artery, vessel branches, and aneurysms. The results showed that one patient had 1 out of 3 branches affected by the aneurysm, whereas the other’s branches were all affected. Endovascular repair and open surgery were performed respectively based on the image analysis. Both patients recovered well at follow-up examination.

Conclusions

Based on CBCTA analysis, the combination use of the “two-click AVA” function of VesselIQ Xpress and FlightPlan for Embolization software could assist in aneurysm assessment and intervention choices for RAAs.
A Comparison of Outcome in Patient With and Without Undergoing Cardiopulmonary Exercise Testing (CPET)
Authors: Veeralakshmanan Pushpa , Juszczak Maciej , Tiwari Alok
Published: August 2024

Background

Cardiopulmonary exercise testing (CPET) is a preoperative risk stratification tool providing an objective measure of fitness and functional capacity. There is however little evidence on the use of this compared to non-physiological test in vascular surgery despite its current use. This study investigates whether CPET perioperatively has value alongside non-physiological testing for patients undergoing elective open abdominal aortic aneurysm (AAA) repair.

Method

Retrospective data was collected at 2 vascular centres between 2015-2019 in a CPET centre vs non-CPET centre in patients undergoing elective AAA repair. Outcomes measured included: length of stay in an intensive care unit (ICU); total length of stay; post-operative complications and acute kidney injury (AKI). Statistical analysis was performed using IBM SPSS software.

Results

There were 38 patients at each centre. The mean duration of stay in ICU for patients in CPET centre was 2.5 ± 2.13 days whilst in non-CPET centre it was 3.68 ± 4.08 days ( P = 0.05). The mean duration of stay in ICU and total length of stay was significantly shorter in CPET centre ( P = 0.05 and P = 0.015 respectively). Mortality in CPET centre was 2.63% and 5.26% in non-CPET centre (not significant). The number of patients developing AKI post-operatively was 13.61% in CPET vs 28.95% in non-CPET centre.

Conclusion

CPET tested patients have statistically significant lower length of total and ICU stay compared to non-CPET patients. CPET is therefore a useful adjunct in selecting patients for open surgery compared to non-physiological testing. This study provides some evidence on the use of this routinely but not validated assessment tool in aortic aneurysm repair.
Streamers as Arts Educators: Exploring Their Streaming Approaches as Pedagogical Practices
Authors: Yolac Ahu , Hetrick Laura J.
Published: August 2024

In this paper, we focus on video game streaming and content creation as educationist or pedagogical practices where viewers can learn through the streamers’ unintentional approaches of constructivism, the Zone of Proximal Development (ZPD), and emergent curriculum. We posit that online gaming streaming services create and support informal learning spaces within virtual communities as communities of practice and that they need to be considered more closely from a scholarly perspective. We begin with a cursory overview of online content creation and streaming in general, then transition to brief backgrounds on two specific sites, before exploring gaming streamers’ various actions and approaches. We then delineate three pedagogical concepts that we as educators immediately recognize when viewing streamers’ actions from an educationist lens. We conclude with suggestions that arts educators can learn from streamers’ unintentional approaches as well as what streamers could learn from arts educators’ intentional and purposeful pedagogical practices.
The impact of delivery technique on Woven EndoBridge deployment and detachment in an in vitro aneurysm model
Authors: Essibayi Muhammed Amir , Altschul David J.
Published: August 2024

Background

The Woven EndoBridge (WEB) device is increasingly used for treatment of wide-neck bifurcation aneurysms. With the newer 17 system, WEB deployment has been associated with a phenomenon known as incomplete or “sticky” detachment from the delivery wire, which may lead to imprecise placement. Optimal techniques for WEB manipulation and delivery to avoid this problem are poorly defined. This study aimed to evaluate standard WEB deployment techniques and determine the impact of delivery techniques and WEB stickiness on procedural success.

Methods

An in vitro study using identical silicone middle cerebral artery aneurysm models ( n = 32) assessed WEB (6 × 2 mm) deployment through a VIA 17 microcatheter via three techniques that involved: “loading,” “neutral,” and “tension” on the pusher wire. Microcatheter position was placed in varied positions from the WEB device. Woven EndoBridge stickiness was graded during detachment attempts. Primary outcomes were detachment stickiness and attempt number, compared between techniques using Fisher's exact test.

Results

The tension technique resulted in significantly fewer sticky detachments and detachment attempts compared to forward load or neutral techniques (p < 0.001). Sticky detachment was lower with tension (0% sticky) versus forward load (42% sticky, 8% very sticky) (p < 0.001). Forward load had a 50% rate of stickiness versus 0% with tension and neutral (p < 0.001). Forward load required multiple attempts in 100%, compared to 57% with neutral and 8% with tension (p < 0.001). Higher stickiness grades increased the need for multiple attempts (p < 0.001).

Conclusion

The tension technique reduces incomplete WEB detachment and enables precise single-attempt detachment, optimizing delivery precision. In vivo confirmation is needed.
Comparing visualization performance of liquid embolic agents using a novel injectable phantom
Authors: Mason J Ryan , Dodge Cristina , Beardsley Adam , Hilsenbeck Susan , Benndorf Goetz
Published: August 2024

Background

Radiographic visualization of liquid embolic agents (LEAs) during embolization procedures in neurovascular territory represents a crucial feature to ensure efficacy and safety for the patients during endovascular treatment of arteriovenous shunting lesions. Radiopacity of available LEAs varies significantly and limited methods are currently available for comparison. The purpose of this study was to compare the contrast resolution (CR) during injection under blank roadmap of various LEAs, as well as standard contrast material.

Methods

An injectable angiographic phantom was designed consisting of parallel tubings between 313 and 1000 micron. Under roadmap, eight radiopaque liquid agents were injected and analyzed: Onyx18®, 34® Squid®12, 18, PHIL®25% (PHIL®25), PHIL®30% (PHIL®30). TrufillTM (NBCA), 30% dilution and Omnipaque®300. CR was evaluated as a contrast to noise ratio (CNR) and calculated as mean peak signal (Sa) minus mean background signal (Sb) divided by the standard deviation of the background signal (Std) [Formula: see text].

Results

Omnipaque 300 and NBCA were found to have the highest CR. PHIL®25 demonstrated the lowest CNR (45% of Omnipaque CNR). Onyx 18 and 34 (Both around 82% of Omnipaque CNR) demonstrated higher CNR compared to Squid®12 and 18 (52–55% of Omnipaque CNR). On average, at 500 micron there is a >70% reduction in CNR, and at 313 micron there is a 90% reduction in CNR compared to 1000 micron.

Conclusions

Significantly different CNR between most LEAs and iodinated contrast media was evident under roadmap conditions and should be considered prior to injection.
Speaker variability, but not bilingualism, influences cross-situational word learning
Authors: Crespo Kimberly , Kaushanskaya Margarita
Published: August 2024

When learning new words, listeners must contend with multiple sources of ambiguity and variability. Research has revealed that learners can resolve referential ambiguity by tracking co-occurrence statistics between words and their referents across multiple exposures over time—a process termed cross-situational word learning (XSWL). However, the degree to which variability in the input, such as input from multiple speakers, and variability in learner experience, such as bilingual language experience, modulate XSWL remains unclear. In this study, we examined the effects of speaker variability in XSWL performance in monolingual adults and bilingual adults with a range of second language backgrounds and language acquisition histories. Results revealed above-chance word learning in both the single and the multiple-speaker conditions across language groups. An advantage for word learning was observed in the single-speaker condition, but the effects of bilingual language experience were null. This research adds to the limited body of work dedicated to extending theories of statistical learning to account for variations in both input and learner characteristics as well as their interactions.
The cross-script cognate effect in spoken and written second language production: A study based on Chinese-English bilinguals
Authors: Zheng Guorui , Yang Tingting , Lin Weihao , Yang Yueran , Wang Ruiming
Published: August 2024

Previous studies using cognates with the same writing system have found cognate facilitation effect in the lexical processes of spoken and typewritten productions and cognate interference effect in the sub-lexical process of typewritten production. This study focused on cross-script cognates, Chinese-English, which have different writing systems, and explored cognate effects based on the input and output modalities by using a Chinese-English translation task. Experiment 1 was under visual input modality and investigated the cross-script cognate effect in all three output modalities: spoken, typewritten and handwritten. Results revealed a cognate facilitation effect in the lexical processes across all three output modalities. However, it showed a cognate facilitation effect rather than a cognate interference effect in the sub-lexical process of typewritten production. Experiment 2 was under auditory input modality and focused on exploring cross-script cognate effect on typewritten and handwritten modalities, finding a consistent result on cognate effects with Experiment 1. Both experiments showed higher accuracy for cognates, and there was no significant difference in cgnate effect between visual and auditory inputs. In summary, these findings indicated that the use of cross-script cognates could effectively mitigate cognate interference. While spoken, handwritten and typewritten production share lexical processes, differences emerge in sub-lexical processes, with spoken production being less influenced by orthography. Furthermore, combining the results of Experiments 1 and 2, typewritten production may lean towards the phonological route while handwritten production may favour the direct lexical-orthographic route in the sub-lexical processes.
Evaluation of indications and efficacy of doxycycline for surgical antibiotic prophylaxis
Authors: Fritz Andrew A , Standen Kevin N , Reinert Justin P
Published: August 2024

Given medical advancements in global healthcare systems over the past decade, it may be reasonable to assume that the incidence of surgical site infections would have decreased; however, surveillance data indicate that these rates have held constant. Surgical prophylaxis guidelines from the United States and United Kingdom recommend cefazolin, vancomycin and clindamycin in most surgeries for no longer than 24 hours. As a result of medication shortages impacting the global supply chain, surgeons have needed to evaluate alternative perioperative antibiotics, such as doxycycline; however, research into using doxycycline for preventing surgical site infections is limited. The goal of this study is to retrospectively assess doxycycline’s efficacy, safety and role in preventing surgical site infections.
Distributed agency in smart homecare interactions: A conversation analytic case study
Authors: Albert Saul , Hall Lauren
Published: August 2024

The agent of action in Human-Computer Interaction is, as the hyphenated name of the field suggests, usually conceptualized as an contrastive binary of either human or computer. This study, informed by ethnomethodology and conversation analysis, instead describes the interactional achievement of distributed agency in a ‘smart homecare’ setting where a homecare worker and a disabled person coordinate shared activities using a virtual assistant. We focus on the tacit criteria, attributions, and discourses of agency embedded in the interactional details of their everyday homecare routine. The analyses reveal how collaboration in everyday care tasks involves the distributed agency of all participants, irrespective of their ostensible ‘humanness’. Our findings (a) provide a critical perspective on the technological imaginary of expensive, high-tech robotic replacements for human care work; (b) advocate low-tech strategies for adapting consumer technology for smart homecare systems; and (c) suggest alternative approaches to agency in assistive technology design, grounded in detailed observation of the interactional infrastructure of real homecare settings.
Single- versus double-artery repair without vein anastomosis in Tamai I fingertip replantations: a retrospective cohort study
Authors: Ozcelik Ismail Bulent , Kabakas Fatih , Mersa Berkan , Purisa Husrev , Sezer Ilker , Jusoh Mohd Hanifah
Published: August 2024

The aim of the study was to report outcomes of fingertip replantations in Tamai zone I without vein anastomosis. The success rate and need for external bleeding between patients who underwent single and double-artery repair were compared. In this retrospective multicentre study, 144 replantations were carried out with a single-artery repair and 35 with a double-artery repair. The difference between the success of replantation in these two groups was not statistically significant: 108 (75%) in the single-artery group and 29 (83%) in the double-artery group. External bleeding was more frequently needed in the single-artery repair group ( n = 135, 94%) than in the double-artery repair group ( n = 6, 17%). Although there was no statistical difference in replantation success, performing double-artery repair may be more beneficial as there was less need for external bleeding and as a result complications associated with external bleeding can be avoided.

Level of evidence:

III
National trends of upper extremity replantation and revascularization operations in Finland
Authors: Pyörny Joonas , Sletten Ida Neergård , Jokihaara Jarkko
Published: August 2024

We studied the national trends of upper extremity replantation and revascularization operations in 2434 patients who had sustained an upper extremity injury from the national database in Finland. The operation rate was higher between the months of April and September, and overall, lower on Sundays and Mondays.
Non-operative management of proximal phalanx spiral fractures: the use of elastic strapping to treat malrotation
Authors: Davies Angharad , Haines Samuel , Giddins Grey
Published: August 2024

This study assessed rotation control elastic strapping as a treatment for proximal phalanx spiral fractures in adults, with good clinical outcomes. This is a cheap, simple and reliable management technique that avoids potential operative complications.
Proximal interphalangeal joint arthroplasty: current trends and evidence-based practice
Authors: Murray Peter M. , Hobby Jonathan , Talwalkar Sumedh , Herren Daniel , Rice Tyler
Published: August 2024

Arthroplasty of the proximal interphalangeal joint (PIPJ) has evolved since its inception over 60 years ago. This review examines the indications for surgery, highlights the differences in current arthroplasty designs, variances in surgical techniques, clinical controversies, current implant outcomes data and salvage options for the failed implant. Overall, PIPJ implant arthroplasty is a good and reliable option for symptomatic PIPJ degenerative, post-traumatic or inflammatory arthritis given the proper clinical setting. If current techniques for implantation and rehabilitation are followed, predictable pain relief and satisfactory function can be anticipated. The purpose of this review article is to examine the current evidence-based indications for PIPJ arthroplasty and examine the reported, implant-specific outcomes of this procedure. Various techniques and rehabilitation strategies will also be outlined.
Treatment utilization for Dupuytren’s contracture in the United States is influenced by socioeconomic factors
Authors: Zhuang Thompson , Berns Ellis M. , Lee Hannah H.
Published: August 2024

We examined whether treatment utilization for Dupuytren’s contracture varied with the presence of adverse socioeconomic determinants of health in the United States. After propensity score matching, the presence of adverse socioeconomic determinants of health was associated with decreased treatment utilization.
The use of ultrasound to predict flexor tendinopathy after anterior locking plating of the distal radius
Authors: Estermann Lea , Donaldson Matthew , Spasojevic Milos , Lurie Brett , Sivakumar Brahman , Ledgard James , Hile Mark
Published: August 2024

This study compares ultrasound to clinical and radiographic measurements for assessing tendon pathology associated with distal radial anterior locking plates. A total of 46 patients undergoing removal of a distal radial plate had a preoperative clinical examination, radiographs and ultrasound evaluation to detect evidence of tendon irritation. Gross changes to the tendon were assessed during plate removal. In total, 32 patients demonstrated clinical abnormality. Soong 2 position was noted in 13 patients. Ultrasound revealed tenosynovitis in nine patients, tendon fibrillation or thickening in four patients and a single case of partial discontinuity. Intraoperative assessment revealed tenosynovitis in 28 patients and tendon fibre discontinuity in eight patients. Ultrasound findings were not predictive of intraoperative tenosynovitis and discontinuity. A relationship was noted between higher Soong grade, especially grade 2, and intraoperative presence of tenosynovitis, as well as Soong grade and amount of soft-tissue coverage. This study negates our hypothesis that ultrasound is useful for identifying tendinopathy after distal radial anterior plate fixation.

Level of evidence: II
The impact on time between injury and semi-acute surgery for hand fractures after virtual fracture clinic implementation
Authors: Salentijn Dorien A. , Willinge Gijs J.A. , Dijkgraaf Marcel G.W. , van Veen Ruben N.
Published: August 2024

The aim of this before-and-after study was to evaluate the implementation of a virtual fracture clinic (VFC) on the time between injury and surgery in patients presenting with a phalangeal or metacarpal fracture and in need of semi-acute surgical treatment. Between 1 January and 30 September 2018 (pre-VFC) and in the same period in 2022 (VFC), 101 and 113 patients were included, respectively. Before VCF implementation, the time between injury and surgery was 8.9 days (95% confidence interval [CI]: 8.1 to 9.6), while after VCF implementation it was 7.6 days (95% CI: 7.0 to 8.3). In 2018, 7% of operations were unacceptably delayed beyond 14 days from injury, which was reduced to 5% in 2022, despite patient-presentation delays of up to 10 days. VFC implementation was associated with a reduction in time until semi-acute surgery for phalangeal or metacarpal fractures and improved the quality of semi-acute surgery planning.

Level of evidence: Level III
A surge in the incidence of invasive Group A Streptococcus hand infections: a single Hand Unit experience
Authors: Parsons Aleksandra , Selby Anna , Johnson Nick
Published: August 2024

We highlight an increase in the number of invasive Group A streptococcal soft tissue infections and present the impact of those on the hand surgery service, based on a single Hand Unit experience at the Pulvertaft Hand Centre.
Is the feeling of ‘weakness’ associated with unhelpful thoughts or distress regarding symptoms?
Authors: Davids Floor A. , Brinkman Niels , Broekman Melle M. , Ring David , Reichel Lee M. , Vagner Gregg A.
Published: August 2024

This cross-sectional study looked for factors associated with feelings of weakness, level of capability and pain intensity in people seeking musculoskeletal speciality care for non-traumatic upper extremity conditions. A survey was conducted in 139 English-speaking adults, with 135 participants completing it. We found that greater intensity of feelings of weakness correlated with higher distress regarding symptoms and with older age. Lower level of capability was associated with greater intensity of feelings of weakness, greater distress regarding symptoms and older age. Higher pain intensity was associated with greater distress regarding symptoms and greater intensity of feelings of weakness. These findings suggest that the symptom of weakness may be a cue to explore potential distress about symptoms in addition to examining for actual weakness. This understanding could be a guide to a more compassionate approach to alleviate distress rather than focusing on neuromuscular pathophysiology alone, with the potential to reduce unnecessary tests and treatments.

Level of evidence: IV
Characterization and Improvement of Sleep Activity of Ziziphi Spinosae Semen Oil Microcapsules Prepared by Complex Coacervation
Authors: Chen Jiaxin , Shi* Xinbo , Tang** Zhishu , Song Zhongxing , Li Guolong , Liu Hongbo
Published: August 2024

Objective: Ziziphi Spinosae Semen oil (ZSSO) is a fatty oil extracted from Ziziphi Spinosae Semen, and its main component is unsaturated fatty acid. It is susceptible to oxidation and deterioration. The aim of this study was to improve the stability of ZSSO and protect its quality. Methods: gelatin-sodium alginate was used as the wall material for the preparation of ZSSO microcapsules by the complex coacervation. The particle size and zeta potential of the microcapsules were determined using a Malvern particle size meter. The microstructure and stability of the microcapsules were determined by SEM, FTIR, TGA and PV. The sleep-improving activity of the microcapsules was also determined by sleep induction assay, Elisa and HE staining. Results: The encapsulation efficiency of microcapsules was 56.08% ± 0.19%, average particle size was 166.17 nm, and zeta potential was 38.2. Morphology of microcapsules was observed by SEM. The FTIR results showed that the fatty oil was successfully embedded, and PV indicated that microcapsules had a slow oxidation rate. A preliminary study on the sleep-improving activity of ZSSO and microcapsules demonstrated that it could shorten sleep latency and prolong sleep time of insomniac mice, and increase the levels of 5-HT and GABA and decrease the level of Glu in the brain of mice. In addition, ZSSO and microcapsules can repair damaged neuronal cells in the hypothalamus of insomniac mice to improve sleep. Conclusion: The quality evaluation of the microcapsules indicates that the prepared ZSSO-MPs have a small particle size and good stability. Moreover, ZSSO and microcapsules can effectively improve the sleep status of insomnia mice.
Kaempferol Protects Pulmonary Vascular Endothelial Function in Rats with High Altitude Pulmonary Hypertension by Regulating RAS System and AMPK/Arg2/eNOS Signaling Pathway
Authors: Xie Xin , Li Huiru , Wang Liangqi , Zhang Xiaonan , Lu Dianxiang , Li Zhanqiang
Published: August 2024

Background

Previous studies have found that kaempferol can relieve pulmonary hypertension (PH).

Objective

Explore the protective impact of kaempferol on pulmonary vascular endothelium in rats with high altitude pulmonary hypertension (HAPH).

Materials and methods

In a simulated altitude of 5000 m environment, rats were induced to develop HAPH after continuous intragastric administration of kaempferol (25, 50 and 100 mg·kg−1) and Sildenafil (30 mg·kg−1) for 28 days. Assessment of isolated pulmonary arterial rings in rats and relevant indicators in lung tissue was performed, with the mechanism of action investigated using Western blotting.

Results

Kaempferol effectively dilates rat pulmonary arterial rings, with an EC50 of 55.75 μmol/L. L-NAME can effectively counteract the vasodilatory effect of kaempferol. Acetylcholine demonstrated better relaxation of pulmonary arterial rings in HAPH rats after kaempferol intervention. Elastic Van Gieson staining (EVG) and immunohistochemistry (CD31) results indicate that kaempferol can partially protect pulmonary vascular endothelial function in HAPH rats. Western blotting reveals that kaempferol has the ability to regulate the Renin-Angiotensin System (RAS). This leads to a compensatory increase in eNOS expression, upregulation of AMPK activity, and downregulation of eNOS monomer/dimer levels.

Conclusions

Kaempferol can improve pulmonary vascular endothelial dysfunction caused by chronic hypoxia by upregulating the phosphorylation level of AMPK, regulating the RAS system, and inhibiting eNOS uncoupling, thereby achieving vasodilation and endothelial protection.
Assessing the Readability, Reliability, and Quality of AI-Modified and Generated Patient Education Materials for Endoscopic Skull Base Surgery
Authors: Warn Michael , Meller Leo L.T. , Chan Daniella , Torabi Sina J. , Bitner Benjamin F. , Tajudeen Bobby A. , Kuan Edward C.
Published: August 2024

Background

Despite National Institutes of Health and American Medical Association recommendations to publish online patient education materials at or below sixth-grade literacy, those pertaining to endoscopic skull base surgery (ESBS) have lacked readability and quality. ChatGPT is an artificial intelligence (AI) system capable of synthesizing vast internet data to generate responses to user queries but its utility in improving patient education materials has not been explored.

Objective

To examine the current state of readability and quality of online patient education materials and determined the utility of ChatGPT for improving articles and generating patient education materials.

Methods

An article search was performed utilizing 10 different search terms related to ESBS. The ten least readable existing patient-facing articles were modified with ChatGPT and iterative queries were used to generate an article de novo. The Flesch Reading Ease (FRE) and related metrics measured overall readability and content literacy level, while DISCERN assessed article reliability and quality.

Results

Sixty-six articles were located. ChatGPT improved FRE readability of the 10 least readable online articles (19.7 ± 4.4 vs. 56.9 ± 5.9, p < 0.001), from university to 10th grade level. The generated article was more readable than 48.5% of articles (38.9 vs. 39.4 ± 12.4) and higher quality than 94% (51.0 vs. 37.6 ± 6.1). 56.7% of the online articles had “poor” quality.

Conclusions

ChatGPT improves the readability of articles, though most still remain above the recommended literacy level for patient education materials. With iterative queries, ChatGPT can generate more reliable and higher quality patient education materials compared to most existing online articles and can be tailored to match readability of average online articles.
Projectile spinning effects undergoing normal impact
Authors: Vaggu Pranay , Panigrahi SK
Published: August 2024

The present research deals with the study of the effects of spinning on a projectile undergoing normal impact using the principle of energy. When the projectile is fired from firearms, some of the energy liberated by the propellant is utilized for engaging the driving band with the rifling of a gun barrel which causes the projectile to spin. The spinning helps the projectile to stabilize in the air. The total energy of the projectile comprises both translational and rotational energies just before the impact of the target. Most of the research studies consider translational energy of the projectile only in impact studies by ignoring other forms of energy such as energy due to spinning velocity of the projectile. In the present study, the effect of spinning is studied considering a 7.62 Armour piercing (AP) projectile, at different impact velocities for a varying target thickness having two different target materials viz. Al 7075-T651 and Mild steel. The residual velocity of the projectile and energy required to penetrate the target has been evaluated by Finite Element Analysis (FEA) using a commercially available FE code known as LS-DYNA. Initially, the model is validated with experimental results available in the literature. Subsequently, the validated model is used for studying the projectile spinning effects. It is observed that at some impact velocities, there is very little variation in residual velocity with spin while considering the variation in energy required to penetrate the target is significant. So, the energy required to penetrate the target with spin and without spin is compared for analysis. Another observation is, that near the ballistic limit velocity, the spin of the projectile made the projectile stuck inside the target with partial perforation. For a particular target with a specific target thickness, there is a velocity range in which the energy required to penetrate the target with spin is less than without spin. Within the considered impact velocities, the velocity ranges for the target of Al 7075-T651 with 12 mm thickness are 818–900 m/s, for 20 mm target thickness these velocities are 818–1000 m/s, and for mild steel target of thickness values of 12 mm and 20 mm it is 640.5 to 900 m/s. For a particular target material with finite thickness, the effect of spin is very less or approximately negligible for a given velocity. For the considered impact velocity condition, in case of mild steel, this velocity is approximately equa to 900 m/s, and for Al 7075-T651, it is between 715.7 and 818 m/s.
Cloud-based STEM learning: Using an online simulation to teach renewable resources management in a remote learning classroom during the COVID-19 pandemic
Authors: Ku Nat , Lin Bonnie , Sun Jonathan , Wang Andrew , Mahmoudinobar Farbod , Montclare Jin Kim
Published: August 2024

During the abrupt and unplanned transition to remote online learning formats due to the COVID-19 outbreak, educators have had to adopt new teaching methods. For instance, online simulations tailored to specific curriculum topics emerged, allowing students to apply their knowledge creatively, with potentially positive effects on engagement and learning efficacy. Here, we examine the implementation of the “Save the World” simulation, created by Wonderville.org, in a high school Advanced Placement Environmental Science classroom in a remote online learning setting. In this module, students determine the most viable renewable energy generation option for given environments. Based on student and teacher feedback, the simulation effectively delivers educational material and promotes student engagement, demonstrating that online simulations can serve as a viable tool to enhance environmental science education and remote learning.
Eco-Warrior: A theory-based mobile app intervention for forming and sustaining pro-environmental habits
Authors: Chuan Ching-Hua , Seelig Michelle , Tsai Wan-Hsiu Sunny , Tao Weiting
Published: August 2024

This study developed and evaluated a theory-driven mobile app to facilitate pro-environmental behavior change and habit formation to address the prevalent attitude-behavior gap in environmental activism. The app first informs users of interconnected environmental problems and offers various pro-environmental behaviors for users to practice daily. The app further nudges users toward achieving their behavioral goals through personalized daily reminders, progress-tracking, empowering messages that celebrate their achievements, and reaffirmation of the beneficial impacts of their actions to facilitate eco-habit formation. To evaluate the app's effectiveness, a sequential mixed-design method combining a pre-and-post-design experiment and focus groups was conducted. Quantitative and qualitative assessments indicated the effectiveness of this mobile app in fostering the development of eco-habits.
Probable idiopathic hypereosinophilic syndrome: A case report of severe multi-organ eosinophilic involvement in a young male presenting with heart failure
Authors: Sullivan Bryanna , Matti Moreen , Cho Gene , Lee Seoyoon , Nobari Matthew
Published: August 2024

Hypereosinophilic syndrome (HES) is a disorder characterized by elevated levels of eosinophils, which may be associated with multi-organ involvement depending on severity. The recent diagnostic criteria for idiopathic HES require an elevated absolute eosinophil count (AEC) above 1500 cells/mcL with evidence of tissue damage. We present a case of a 37-year-old male firefighter with a purported history of eosinophilic bronchitis who was referred to the hospital with syncopal episodes and a persistent productive cough. The patient showed an AEC of 4500 cells/mcL on admission associated with high inflammatory markers. Cardiac imaging demonstrated acute myocarditis with heart failure and a reduced ejection fraction. Chest imaging was initially suggestive of community-acquired pneumonia. Workup was negative for a malignant etiology; infectious causes similarly were excluded. After a multidisciplinary evaluation, a diagnosis of idiopathic HES was made and steroids were instituted with rapid resolution of symptoms. Our case illustrates the importance of considering hypereosinophilia as a precipitating factor for acute heart failure in an otherwise healthy adult. An expeditious diagnosis can lead to early initiation of steroids to avoid progression toward multi-organ failure.
Complete radiographic response after proton radiation therapy in the re-irradiation of a diffuse high-grade glioma: A case report
Authors: Hassan Jacfar , Hyde Christian , Joiner Michael , Miller Steven Raymond
Published: August 2024

High-grade gliomas (HGGs) are the most aggressive of brain tumors and are one of the most common primary intracranial malignancies. The poor prognosis after aggressive treatment of HGGs makes these gliomas a challenge to treat with curative intent. Proton radiation therapy is a recent radiation modality that is being explored for the treatment of HGGs. Proton radiation therapy provides improved sparing of critical normal structures while giving an ablative dose of radiation to the tumor, which can be performed more accurately than photon beam radiation therapy. We report a case of a diffuse HGG treated with proton radiotherapy and chemotherapy after previously being treated with photon irradiation. A complete radiographic response was seen on MRI imaging after proton irradiation.
Use of dupilumab for recalcitrant bullous pemphigoid: A case report
Authors: Lamb Jillian , Purdy Kerri , Sutherland Ashley
Published: August 2024

Bullous pemphigoid is an autoimmune blistering disease affecting the dermo-epidermal junction, most commonly seen in older patients. First-line treatment includes systemic, topical corticosteroids and/or steroid-sparing immunosuppressants. Treatment with these medications may be limited by their safety profile. Dupilumab is a humanized monoclonal antibody targeting interleukin-4 and interleukin-13 cytokines currently indicated for moderate-to-severe atopic dermatitis, severe asthma, chronic rhinosinusitis with nasal polyposis, and moderate-to-severe prurigo nodularis. We report a case of a patient with recalcitrant bullous pemphigoid effectively treated with dupilumab.
Toward reliable diabetes prediction: Innovations in data engineering and machine learning applications
Authors: Talukder Md. Alamin , Islam Md. Manowarul , Uddin Md Ashraf , Kazi Mohsin , Khalid Majdi , Akhter Arnisha , Ali Moni Mohammad
Published: August 2024

Objective

Diabetes is a metabolic disorder that causes the risk of stroke, heart disease, kidney failure, and other long-term complications because diabetes generates excess sugar in the blood. Machine learning (ML) models can aid in diagnosing diabetes at the primary stage. So, we need an efficient ML model to diagnose diabetes accurately.

Methods

In this paper, an effective data preprocessing pipeline has been implemented to process the data and random oversampling to balance the data, handling the imbalance distributions of the observational data more sophisticatedly. We used four different diabetes datasets to conduct our experiments. Several ML algorithms were used to determine the best models to predict diabetes faultlessly.

Results

The performance analysis demonstrates that among all ML algorithms, random forest surpasses the current works with an accuracy rate of 86% and 98.48% for Dataset 1 and Dataset 2; extreme gradient boosting and decision tree surpass with an accuracy rate of 99.27% and 100% for Dataset 3 and Dataset 4, respectively. Our proposal can increase accuracy by 12.15% compared to the model without preprocessing.

Conclusions

This excellent research finding indicates that the proposed models might be employed to produce more accurate diabetes predictions to supplement current preventative interventions to reduce the incidence of diabetes and its associated costs.
Data management plan and REDCap mobile data capture for a multi-country Household Air Pollution Intervention Network (HAPIN) trial
Authors: Jabbarzadeh Shirin , Jaacks Lindsay M , Lovvorn Amy , Chen Yunyun , Wang Jiantong , Elon Lisa , Nizam Azhar , Aravindalochanan Vigneswari , Ntivuguruzwa Jean de Dieu , Willams Kendra N , Ramirez Alexander , Johnson Michael A , Pillarisetti Ajay , Gurusamy Thangavel , Rosa Ghislaine , Diaz-Artiga Anaité , Romero Juan C , Balakrishnan Kalpana , Checkley William , Peel Jennifer L , Clasen Thomas F , Waller Lance A
Published: August 2024

Background

Household air pollution (HAP) is a leading environmental risk factor accounting for about 1.6 million premature deaths mainly in low- and middle-income countries (LMICs). However, no multicounty randomized controlled trials have assessed the effect of liquefied petroleum gas (LPG) stove intervention on HAP and maternal and child health outcomes. The Household Air Pollution Intervention Network (HAPIN) was the first to assess this by implementing a common protocol in four LMICs.

Objective

This manuscript describes the implementation of the HAPIN data management protocol via Research Electronic Data Capture (REDCap) used to collect over 50 million data points in more than 4000 variables from 80 case report forms (CRFs).

Methods

We recruited 800 pregnant women in each study country (Guatemala, India, Peru, and Rwanda) who used biomass fuels in their households. Households were randomly assigned to receive LPG stoves and 18 months of free LPG supply (intervention) or to continue using biomass fuels (control). Households were followed for 18 months and assessed for primary health outcomes: low birth weight, severe pneumonia, and stunting. The HAPIN Data Management Core (DMC) implemented identical REDCap projects for each study site using shared variable names and timelines in local languages. Field staff collected data offline using tablets on the REDCap Mobile Application.

Results

Utilizing the REDCap application allowed the HAPIN DMC to collect and store data securely, access data (near real-time), create reports, perform quality control, update questionnaires, and provide timely feedback to local data management teams. Additional REDCap functionalities (e.g. scheduling, data validation, and barcode scanning) supported the study.

Conclusions

While the HAPIN trial experienced some challenges, REDCap effectively met HAPIN study goals, including quality data collection and timely reporting and analysis on this important global health trial, and supported more than 40 peer-reviewed scientific publications to date.
Educating Cancer on TikTok: Expanding Online Self-Disclosure of Cancer Patients
Authors: Pluta Magdalena , Siuda Piotr
Published: August 2024

The article uses the concept of online self-disclosure and examines whether TikTok videos reveal information similar to what is reported in existing research on social media within this field. In addition, the study aims to identify the creators’ motivations and the meanings they attribute to disclosing cancer and asks whether this disclosure challenges or supports the concept of a positive culture defined within the online self-disclosure framework. While similar research typically focuses on posts and is thus limited, this study combines conventional content analysis of 862 videos with in-depth interviews, offering a more nuanced understanding of the users’ lived experience. The findings highlight that TikTok is a platform for negative (e.g., fears, anxiety) and positive self-disclosure (e.g., joyful life events, self-acceptance). What is crucial, though, is that users feel exceedingly competent in educating others. The research debunks positive culture as an overly general category and undermines the traditional understanding of online self-disclosure. It reveals that seeking support is less important for patients than informing and warning others. By focusing on the educational meanings attributed to self-disclosure, this study enriches the body of research on cancer-related content shared on TikTok, including studies on low-quality cancer-related information.
Safe and serving school in troubled waters: A Christian-holistic approach to the pedagogical mission in times of rapid cultural change
Authors: van Olst Peter
Published: August 2024

Due to rapid cultural change, schools in the Western world are facing a series of new challenges. Especially Christian schools need to find out how to adapt their personhood and character formation to the necessities of ethnical and directional pluralism. Invited or even obliged by governments and other partners, schools have to incorporate efforts for responsible citizenship, social cohesion, and sustainable development into their curricula. Investigating this dynamic empirically, this paper argues that Christian schools, to be both safe and serving, need to combine a strong focus on their pedagogical mission with a holistic approach of pupils and students.
A Workplace Physical Activity Intervention and a Smartphone App for Overweight and Obese Sedentary Women
Authors: Cebrick-Grossman Joan A. , Fetherman Debra L.
Published: August 2024

Background:

The sedentary aspects of many U.S. occupations and the amount of time American workers spend in the workplace make it an ideal location to implement health promotion programs.

Methods:

This study assessed the effectiveness of a free smartphone app with a goal-setting feature to increase physical activity (PA) and impact anthropometric, body mass (BM), and body composition (BC) changes among overweight and obese women within a community health workforce. Eighteen overweight and obese (body mass index [BMI] = 32.18 ± 4.48 kg/m2), adult (50.73 ± 8.76 years), female volunteers, tracked daily steps with a free smartphone app (StridekickTM) over an 8-week period. Pre- and post-program body composition (BC) measurements included: relative (%) body fat (BF), fat mass (FM), fat-free mass (FFM), and lean mass (LM), using dual X-ray absorptiometry (DEXA scan), and five anthropometric measurements (biceps, waist, abdomen, hips, and thigh).

Findings:

Pre- to post-program average daily steps resulted in significant anthropometric changes for biceps, hips, and thigh measures, with encouraging changes in FFM, LM, and relative (%) BF. The goal-setting feature of the app did not result in significant differences between the experimental and control groups. No differences were noted in FM, BMI, waist, and abdomen or step goals compared with steps completed.

Conclusions:

An occupational PA health promotion intervention program that tracked daily steps through the StridekickTM smartphone app resulted in anthropometric, BM, and BC changes.

Application to Practice:

The workplace is an ideal location to affect change in health behaviors via a free smartphone app to increase PA and improve health.
Development of a New Tool to Combine the Promotion of Patient Mobility With Safe Patient Handling Equipment: The Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide
Authors: Kumble Sowmya , McLaughlin Kevin H. , Funk Karli , Dekany Steven , Ludwig Daniel , Farley Holley , Stone Anita M. , Tahara Nozomi , Newkirk Erica , Hoyer Erik , Young Daniel L. ,   JH-AMP Group
Published: August 2024

Background:

Promoting safe patient mobility for providers and patients is a safety priority in the hospital setting. Safe patient handling equipment aids safe mobility but can also deter active movement by the patient if used inappropriately. Nurses need guidance to choose equipment that ensures their safety and that of the patients while promoting active mobility and preventing workplace-related injury.

Methods:

Using a modified Delphi approach with a diverse group of experts, we created the Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide. This diverse group of 10 experts consisted of nurses, nurse leaders, physical and occupational therapists, safe patient handling committee representatives, and a fall prevention committee leader. The application of the tool was then tested in the hospital environment by two physical therapists.

Findings:

Consensus was reached for safe patient handling (SPH) equipment recommendations at each level of the Johns Hopkins Mobility Goal Calculator (JH-Mobility Goal Calculator). Expert SPH equipment recommendations were then added to JH-Mobility Goal Calculator levels to create the JH-Safe Patient Handling Mobility Guide. JH-Safe Patient Handling Mobility Guide equipment suggestions were compared with equipment recommendations from physical therapists revealing strong agreement ( n = 125, 88%).

Conclusion:

The newly created JH-Safe Patient Handling Mobility Guide provides appropriate safe patient-handling equipment recommendations to help accomplish patients’ daily mobility goals.

Applications to Practice:

The Johns Hopkins Safe Patient Handling Mobility Guide simultaneously facilitates patient mobility and optimizes safety for nursing staff through recommendations for safe patient handling equipment for use with hospitalized patients.