bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambivalence in Gramsci’s historiography of the Risorgimento
Authors: Wayne Michael
Published: December 2022

Although Gramsci developed his conceptual methodology out of concrete historical analysis, there is a significant tension between his account of the Risorgimento, which plays into a narrative of Italian exceptionalism, and concepts such as historical bloc, hegemony and passive revolution, which point towards European wide convergence in capitalist state dynamics after 1848. This article shows a de-alignment between Gramsci’s account of the Risorgimento and Marx’s analysis of the meaning of 1848 in The Eighteenth Brumaire of Napoleon Bonaparte. At the same time, Gramsci’s conceptual methodology both re-aligns his argument with Marx and significantly develops Marxist analysis of politics. However, Gramsci’s conceptualisation of the role of intellectuals, especially the problematic distinction between traditional and organic intellectuals, does provide support for the kind of exceptionalist argument he offers of the Risorgimento. Therefore, this article reconstructs Gramsci’s account of the intellectuals in order to integrate it better into his analysis of a historical bloc composed of both conservatism and liberalism.
Developing a Conceptual Model with Policy Implications to Better Support Healthcare Providers Working with Older Adults during a Pandemic: An Interpretive Descriptive Qualitative Study
Authors: Weil Joyce , Karlin Nancy J. , Monroe Kimberly
Published: December 2022

Although many studies cover the experiences of older adults during the COVID-19 pandemic, few address the daily impact upon health care workers’ lives. We used an adapted interpretive description approach to analyze narrative data from 54 practitioners working with older adults, June–October 2021. Stemming from research with those working in the health field, this approach applies knowledge directly back to policy and practice. Analysis of narrative data from open-ended survey questions produced themes and conceptual mapping of practitioners’ experiences. Findings illustrate: Advantages and disadvantages of going virtual; challenges of quickly changing policies; concerns about personal and patient safety during the pandemic; needs of the organization and staff; and work-life balance issues. Clearly defining policy-based solutions for delivering services during emergencies offers ways to improve practitioners’ and older adults’ quality of life.
“Friend-ish”: Home Care Workers, “Social Labor” and Managing the Boundaries of the Carer Relationship
Authors: Lam Jack , Baxter Janeen
Published: December 2022

We examine how changes in home care work, with greater emphasis on social support, have led to corresponding changes in the forms of labor performed by home care workers. Drawing on interviews with fifty older adults, we find in addition to physical and emotional labor, workers may be increasingly expected to engage in a form of labor we term “social labor,” in which they actively manage the boundary between the professional services they provide and the personal relationships that may develop. We find examples of such expectations include (1) following the lead of clients who set out terms of the relationship and degree of sociality, (2) managing the potential dual role of “support worker” and “friend,” and (3) meeting social needs of clients vulnerable to isolation. As Government acknowledges the value of social support and companionship, greater attention is needed to this aspect of care work, with implications for workers and clients.
Reduced-Dose Apixaban in the Treatment of Left Ventricular Thrombus: A Report of 2 Cases
Authors: Bundrick Adrienne E. , Bowers Riley D. , Perkins Scott L. , Baker Carrie N.
Published: December 2022

According to the American College of Cardiology and the American Heart Association, warfarin has historically been the standard of care anticoagulant for the treatment of left ventricular thrombus. The use of direct oral anticoagulants (DOACs) has become more prevalent, as they require less frequent laboratory monitoring, offer fixed-dose regimens, are associated with fewer drug-drug and drug-food interactions, and provide more favorable safety profiles when compared to warfarin. However, DOACs are not currently FDA-indicated in the treatment of left ventricular (LV) thrombus. Numerous recent studies have reported and evaluated the use of DOACs for treatment of LV thrombus. Recently, a prospective, open-label, multicenter study evaluated warfarin compared to DOACs for LV thrombus treatment. The AHA recently published a scientific statement regarding the management of patients at risk for and with left ventricular thrombus, which included DOACs as a reasonable alternative to warfarin. This report describes two patients treated with DOACs following LV thrombus diagnosis. The first case is a 71-year-old male admitted for cerebrovascular accident and non-ST-elevation myocardial infarction complicated by a LV thrombus. The second case is an 83-year-old female admitted for acute myocardial infarction complicated with an LV thrombus. Both patients were prescribed apixaban 2.5 mg twice daily. Neither patient has experienced LV thrombus or DOAC treatment related complications. This case series serves as evidence for reduced-dose DOACs as an alternative to warfarin in the treatment of LV thrombus.
Pride-and-Prejudice Perspectives of Marginalization Can Advance Science and Society
Authors: Brannon Tiffany N.
Published: December 2022

Research that conceptualizes marginalization as tied to both pride and prejudice—or as simultaneously a source of strengths and stigma—is especially well positioned to address social problems in ways that can fuel progress for science and society. This review integrates insights from current research to highlight that leveraging pride-and-prejudice perspectives of marginalization can spark meaningful advancement toward mitigating social inequalities. Specifically, focusing on marginalization associated with race-ethnicity, social class, refugee status, and gender identity and sexual orientation, it highlights burgeoning research that harnesses pride-and-prejudice perspectives to advance psychological theory and application linked to (a) inclusion among marginalized groups and (b) intergroup attitudes among more dominant or privileged groups. The review concludes with a discussion of implications for future research and policy directions that can foster inclusion and facilitate positive intergroup attitudes amidst challenges tied to a racial reckoning (e.g., resource or economic scarcity, backlash to diversity and multiculturalism).
Neonatal Transport Facilities and Its Effect on Outcome: An Experience from Tertiary Care Hospital of Central Gujarat
Authors: Rasania Manish , Patel Pooja , Bothra Avinash , Pathak Sunil , Lodaria Binal N , Ranawat Nishi L
Published: December 2022

Background:

This study regarding the transport facilities prevailing in areas surrounding our hospital and the immediate outcome of such transported neonates in terms of morbidity and mortality will provide us an insight into the scope for improvement in the facilities and thus will help in the reduction of mortality of the extramural neonates.

Material and method:

In this prospective observational study, details of all transported extramural sick neonates were obtained regarding the transport facility availed by the patient. The physiology on arrival and immediate outcome were compared between survived and expired neonates.

Results:

Out of 82 neonates enrolled in the study, the majority (38 [48.7%]) had sepsis. The majority of neonates were low birth weight (49 [59.8%]) and preterm (47 [57.3%]). In all, 80.5% of the transported neonates were referred from private pediatric hospitals. Free Government ambulance facility (108) was utilized by only 6 (7.3%). Significantly a greater number of moderately hypothermic neonates were there in the expired group versus the survived group (66.7% vs 20%, p =0.013). Capillary refill time of ≥3 seconds on arrival was significantly associated with poor outcomes (66.7% vs 20%, p =0.013). Saturation levels of <70% on arrival are significantly associated with poor outcome (66.7% vs 6%, p <.0001).

Conclusion:

This study emphasizes the need for appropriate care and management to be provided to critical neonates during transport to maintain hemodynamic stability and improved vitals on arrival to the referred center for a better final outcome.
Palliative Sedation Therapy Practice Comparison – A Survey of Pediatric Palliative Care and Pain Management Specialists
Authors: Cuviello Andrea , Ang Nicholas , Morgan Kyle , Baker Justin N. , Anghelescu Doralina L.
Published: December 2022

Context: Palliative sedation therapy (PST) can relieve suffering at end-of-life (EOL) in children with intolerable and refractory symptoms. However, updated and consistent guidance on PST practices are imperative. Objectives: We investigate current variations in clinical practice and PST implementation among pediatric palliative care (PPC) and pain management (PM) specialists. Methods: We distributed an IRB-exempt electronic anonymous survey via email through the Society of Pediatric Pain Medicine, and the American Academy of Hospice and Palliative Medicine. Survey responses were collated and descriptively reported. Results: Of 83 survey responses, the majority (75%) represented large academic children’s hospitals. The distribution between PPC and pediatric pain management specialists’ responses was 60% and 40%, respectively. Most respondents reported having designated pain management and/or palliative care teams (70% and 90%, respectively). Approximately half (48%) reported following an institutional PST protocol, most not requiring formal ethics consult (69%). Only 54% of respondents noted that the Do Not Resuscitate (DNR) order was required prior to PST initiation. PST was primarily utilized for children with oncologic diagnoses (76%). The primary and secondary medications of choice for PST implementation were reported to be opioids (39%) and benzodiazepines (36%) by pain management specialists, and benzodiazepines (52%) and barbiturates (28%) by palliative care specialists. Conclusions: Our study highlights the variability in the practice and implementation of PST. Further educational efforts are key for establishing PST practices and efficient protocol development.
Heart Rate Response and Flexibility Following Single Bout of Training Using a Seated Elliptical Trainer Among Younger and Older Adults
Authors: Topp Robert , Etnoyer-Slaski Jena , Greenstein Jay
Published: December 2022

The purpose of this study was to compare the effect of a 30-minute activity session using a seated elliptical trainer on heart rate response, knee and ankle range of motion and satisfaction among older and younger adults. Prior to and following completing a 30-minute bout of activity using a seated elliptical trainer, each participant’s leg flexibility was assessed. During every minute of the activity, the participant’s heart rate was recorded. Following the activity, the participants reported their satisfaction with the trainer. Older participants exhibited a greater heart rate response relative to their estimated maximum heart rate during and reported greater satisfaction with the elliptical trainer compared with younger participants. Both groups increased their leg flexibility following use of the trainer. Nurses could prescribe 30 minutes of activity using a seated elliptical trainer to employees in sedentary occupations to improve cardiovascular health and leg flexibility particularly among older adults.
Efficacy and Safety of Vancomycin Bayesian-Estimated Area Under the Curve Versus Trough-Based Dosing
Authors: Cerenzio John , Truong James
Published: December 2022

Background:

Vancomycin guidelines by the Infectious Diseases Society of America and American Society of Health-System Pharmacists endorse Bayesian-software-assisted area under the curve (AUC24h) in their 2020 update. At this time, there are limited clinical data that support its use.

Objectives:

The purpose of this study is to evaluate the safety benefits and efficacy outcomes of using Bayesian-assisted AUC24hdosing compared to trough dosing.

Methods:

Hospitalized patients from before February 1, 2020, (preimplementation of AUC24hdosing) and after August 1, 2020, (postimplementation) were reviewed. Patients with confirmed or suspected methicillin-resistant Staphylococcus aureus (MRSA) infection of the lungs, heart, bones, prosthetic joint, or blood receiving vancomycin for at least 72 hours were included. The primary endpoint was the percentage of patients experiencing an acute kidney injury (AKI) in the trough-based group versus those experiencing AKI in the AUC24hgroup. The composite of all-cause mortality, 30-day readmission, or change in antibiotic therapy due to clinical worsening in patients with confirmed MRSA infections was included as a secondary endpoint. Data were analyzed with statistical testing methods as appropriate.

Results:

There was a significant reduction in AKI between the AUC24hdosing and trough dosing groups (3% vs 12%; P < 0.01). The efficacy for MRSA infections was also similar between groups (11% vs 14%; P = 0.72).

Conclusion and Relevance:

Bayesian-assisted AUC24hdosing was associated with a significant reduction in incidence of AKI when compared to trough-based dosing. There was no difference in the composite efficacy endpoint for patients with confirmed MRSA infection, although the study was not powered for this analysis. These data may provide evidence for more institutions to adopt the Bayesian software to assist in dosing of vancomycin.
Likely Electromagnetic Foundations of Gender Inequality
Authors: León Federico R.
Published: December 2022

Cross-country variation of gender inequality is attributed to cultural, evolutionary, epidemiological, social, and psychological variables, but recent research has shown decreased inequality with proximity to the poles, suggesting that such variables may convey effects of electromagnetics and climate. This study evaluated two mediation models across 98 countries. In the successful model, ultraviolet radiation impaired cognitive performance with the final result of increasing gender inequality; cross-cultural research should pay attention to this three-part connection and specify the process in greater detail. Additionally, gender inequality emerged directly related to ultraviolet radiation with positive sign, suggesting actions of testosterone; field and laboratory studies that address the specific mediating roles of sex hormones are needed. Pathogen prevalence and the ACP1*B allele played complementary roles that are consistent with the literature. The model was robust to post-1500 European ancestry and the radiation – cognitive performance – gender inequality nexus, but not other paths, were reliable across continents.
Do Conservation Films Generate Support for Conservation? A Case Study Using Transportation Theory and Hidden Rivers
Authors: Bozeman Bryan B. , Condit Celeste M. , Grossman Gary D.
Published: December 2022

We conducted an experiment to determine whether a conservation film increased support for conservation and whether transportation and emotion were correlated with shifts in conservation support. Viewers of short and feature-length versions of the conservation film exhibited greater alignment with story-centric beliefs and conservation behavior interest than individuals who viewed a control film. Transportation was correlated with conservation belief alignment and behavior interest; emotion was correlated with behavior interest. This study indicates that even short conservation films can be engaging and persuasive and are potentially powerful tools for generating conservation support among audiences not previously aligned with this topic.
Real-world effectiveness of ribociclib in metastatic breast cancer patients: Does dose affect survival?
Authors: Fernández-Cuerva Cristina , Chinchilla-Alarcón Teresa , Alcaraz-Sánchez Juan José
Published: December 2022

Introduction: Real-world data are critical to demonstrate the reproducibility of evidence and external generalizability of randomized clinical trials. The purpose of this study was to assess real-world security profile and management of adverse events (AEs) presented with ribociclib for the treatment of HR + /HER2− metastatic breast cancer (MBC). Our secondary objective was to provide real-world effectiveness of this treatment (measured with progression-free survival (PFS)) and to confirm the hypothesis that dose reductions are not related with disease progression. Material and methods: Observational retrospective study evaluating all females with MBC treated with ribociclib. Study period: January 2017 to September 2019. Follow-up was done until November 2021. Response was assessed through the PFS according to RECIST1.1 and National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) was used to classify AEs. Results: The most common AE was any grade neutropenia, documented in 37 of 53 patients (69.8%) during the course of treatment. By the end of the follow-up period, overall median PFS with ribociclib therapy was 27.3 months (95% confidence interval (CI) 20.8–71.8 months). In total, 50 patients (94.4%) initiated ribociclib at 600 mg dose, 28 patients (58%) required dose reductions. PFS of patients receiving ribociclib as first-line treatment was 28 (95% CI 15–41 months). Conclusions: Our results from patients treated in real-world clinical settings indicate that ribociclib is safe and their AEs are manageable with active monitoring, temporal suspension of treatment and dose reduction. Furthermore, our results indicate that dose reduction of ribociclib is not associated with a loss of efficacy.
Incidence of acute haemolysis in cats receiving canine packed red blood cells (xenotransfusions)
Authors: Tinson Erica , Talbot Charles T , Humm Karen
Published: December 2022

Objectives

The aim of this study was to report the incidence of transfusion reactions in cats, including acute haemolysis (AH), occurring within 24 h of receiving a xenotransfusion. An additional aim was to determine whether cases with AH could be classified as having an acute haemolytic transfusion reaction (AHTR) as per the definition provided by the Association of Veterinary Haematology and Transfusion Medicine’s Transfusion Reaction Small Animal Consensus Statement.

Methods

Medical records of cats that received canine packed red blood cells (PRBCs) between July 2018 and September 2020 at a veterinary hospital were reviewed. The incidence of AH, AHTRs, febrile non-haemolytic transfusion reactions (FNHTRs), transfusion-associated circulatory overload and septic transfusion reactions were recorded.

Results

The medical records of 53 cats were retrospectively evaluated. Twenty-three (43%) cats had transfusion reactions. Thirteen (25%) cats had AH; however, only four (8%) met the definition of an AHTR. Ten (19%) cats were determined to have FNHTRs. Survival to discharge of cats affected by AH was 50% (25% for cases that met the definition of an AHTR). Survival to discharge of cats not suffering from AHTR was 40%.

Conclusions and relevance

This report indicates that a higher proportion of cats undergo AH (25%) when administered canine PRBCs than previously reported, although many could not be classed as having an AHTR due to an apparently adequate packed cell volume rise. Challenges with sourcing feline blood in emergency situations occasionally necessitates the use of xenotransfusion in transfusion medicine. Clinicians should be aware that haemolysis after xenotransfusion can occur within 24 h and that a repeat feline transfusion may be required sooner than anticipated in some cases.
Subfoveal choroidal thickness following pars plana vitrectomy in tractional diabetic macular edema
Authors: Dourandeesh Maryam , Moeini Mahdieh , Shaye Zahra Abbasi , Shoeibi Nasser , Hosseini Seyedeh Maryam , Banaee Touka
Published: December 2022

Purpose

To evaluate changes in subfoveal choroidal thickness (SCT) in cases of tractional diabetic macular edema (DME) after pars plana vitrectomy (PPV).

Methods

This prospective study included 31 eyes of 31 patients who underwent PPV for the management of tractional DME. Best-corrected visual acuity (BCVA), SCT, and central macular thickness (CMT) were measured before the operation, as well as one, three, and six months following the surgery in the operated eyes and at baseline, as well as six months in the fellow eyes.

Results

The SCT decline in eyes with tractional DME was statistically significant six months postoperatively (P = 0.009). A statistically significant decline was observed in the CMT values one, three, and six months postoperatively in eyes with tractional DME (P = 0.02, P < 0.001, and P < 0.001, respectively). There was a statistically significant improvement in the visual acuity of the affected eyes three (P = 0.047) and six months (P = 0.017) postoperatively.

Conclusion

After PPV for the treatment of tractional DME, a statistically significant decrease in the CMT values is detectable from the first month after surgery, followed by the improvement of BCVA from the third month. It is worth mentioning that a decrease was found in the SCT six months postoperatively.
Wear prediction considering dynamic load for spur gear in mixed elastohydrodynamic lubrication
Authors: Xing Mingcai , Zhou Changjiang , Li Yunzhe , Zheng Ming
Published: December 2022

In this work, a wear prediction model considering the dynamic load is proposed for spur gears in mixed elastohydrodynamic lubrication (EHL). The dynamic load is calculated by gear dynamic model. Combining gear wear model and dynamic model, the wear depth under the dynamic load is determined and compared with that under quasi-static load. The comparative results show that the maximum wear depth under dynamic load is significantly larger than that under quasi-static load near engaging-in point. The effects of fractional film defect coefficient on wear depth are considerable under dynamic load, which is closely related to gear contact temperature. Furthermore, the effects of surface roughness and gear geometrical parameters on wear depth are studied. The investigation reveals that the wear depth decreases with the increased tooth width, module and pressure angle, but increases with the surface roughness. It illustrates that gear wear depth under the dynamic load can be reduced by optimizing gear geometrical parameters.
Populist radical-right junior coalition partners and liberal democracy in Europe
Authors: Bichay Nicolas
Published: December 2022

While many argue populist radical-right parties to be the largest contemporary threat to democracy, much of the evidence either focuses on the rare case of a populist radical-right prime minister, or conflates right-populist prime ministers with right-populist government participation, with some asserting that it would be difficult for these parties to have any real effect without holding the prime ministership. In this paper I conduct a large-scale analysis of European nations to quantify the effect right-populist junior coalition partners have on liberal democracy. I argue that as junior coalition partners, they will indeed affect democratic quality, albeit in ways that differ from that of a right-populist prime minister. While previous literature has demonstrated that populist radical-right parties bring with them decreases in the level of democratic quality pertaining to institutional constraints on power and mass civil liberties, junior coalition partners are only able to effect the latter.
Family environment of youth with first episode Mania
Authors: Klein Christina C , Bruns Kaitlyn M , McLaughlin Laura E , Blom Thomas J , Patino Duran Luis Rodrigo , DelBello Melissa P
Published: December 2022

Background

The purpose is to compare youth- and caregiver-reported characteristics of family environment, within and between families with a child experiencing a first manic episode of bipolar disorder (BPD), and families without a child with BPD or familial history of psychiatric disorders (HF).

Methods

Family environment of 61 families with a child with BPD and 44 HF were assessed with Family Environment Scale (FES). We compared FES subscale scores between families with BPD and HF, and caregiver- and youth-rated scores.

Results

Families with BPD differed significantly from HF on 8/10 FES subscales scores. Youth differed significantly from their caregivers on 7/10 subscales. An interaction effect was observed such that youth with BPD reported lower cohesion and organization, and higher conflict than their caregivers; however, HF did not differ significantly on these domains.

Conclusions

Our results suggest that families with BPD have higher conflict and lower cohesion and organization compared to HF. Results also indicate differences between youth and caregiver perspectives in both groups, which may contribute to family discord. Interventions targeting areas of cohesion, organization, and conflict may be beneficial for youth with BPD and their families, specifically those that identify and bridge perceptual divides.
Sleep and psychiatric symptoms in young child psychiatric outpatients – a Follow-up study
Authors: Kuha Tiia , Saarelainen Taru , Huhdanpää Hanna , Maasalo Katri , Paavonen E Juulia , Aronen Eeva T
Published: December 2022

Background

Knowledge of the continuity of sleep problems and the associations between sleep and psychiatric symptoms in child psychiatric patients is scarce.

Objectives

To investigate the persistency of sleep problems and how sleep at preschool age predicts sleep problems and psychiatric symptoms at school age in child psychiatric patients.

Methods

Participants ( n = 68) were child psychiatry outpatients at Helsinki University Hospital in 2015–2017. Caregivers evaluated sleep with the Sleep Disturbance Scale for Children (SDSC) and psychiatric symptoms with the Child Behavior Checklist (CBCL) at baseline (age 4–7 years) and again at follow-up (age 8–13 years). Family background information was collected at both time points.

Results

Sleep problems at preschool age predicted sleep problems at school age (R2Adjusted = .48, p < .001). Persistent sleep problems associated strongly with the intensity of psychiatric symptoms ( p = .001). Internalizing symptoms were predicted by sleep problems ( p = .038) even after controlling for age, sex, and psychiatric symptoms at preschool age.

Conclusion

Sleep problems are prevalent and persistent and relate to psychiatric symptoms in children treated at child psychiatry clinics. These results emphasize the need for identification and treatment of sleep problems in these children.
In-plane shear strengthening of reinforced concrete diaphragms using fiber reinforced polymer composites
Authors: Aryan Hadi , Gencturk Bora , Alkhrdaji Tarek
Published: December 2022

Reinforced concrete (RC) diaphragms play a fundamental role in seismic resistance of RC buildings. In addition to transferring the gravity loads to the beams and columns, diaphragms need to be sufficiently rigid with high shear capacity to resist and distribute the earthquake loads to the lateral force resisting system. Despite the large building inventory with under designed diaphragms to resist the shear loads from earthquakes, the number of studies investigating possible approaches to increase the in-plane shear capacity of diaphragms is limited. External equally distributed narrow strips of fiber-reinforced polymers (FRP) providing additional shear strength for RC diaphragms is proposed in this study. Five full scale RC diaphragms with overall dimensions of 4.5 m long by 1.5 m wide by 0.1 m thick were built and tested under cyclic shear loading. One out of the five specimens was tested as a reference with no strengthening, while the remaining four were strengthened with external glass or carbon fiber-reinforced polymer (GFRP or CFRP) composites. The test results showed that the FRP strengthening system effectively enhances the in-plane shear capacity of the RC diaphragms. Compared to the reference specimen, the FRP layout used for testing increased the shear capacity by up to 40%. This paper presents the test specimens, strengthening systems, and in-plane shear response of tested diaphragms in terms of failure modes, strength, and deformation. The experimental results were also compared to theoretical values determined according to the evaluation criteria in the International Code Council (ICC)-Evaluation Services (ES), Acceptance Criteria (AC) 125.
Control of a group of uncertain wheeled robots with global inputs in the presence of obstacles
Authors: Mehrabani MohammadBagher Maghsoudi , Khalaji Ali Keymasi , Ghane Mahdi
Published: December 2022

Ensemble control of robots has attracted much attention in engineering, and this is due to the need to control the arrangement and group movement of multi-robot systems in land, air, and sea applications. Multi-robot systems are growing in the industry today, such as security work, factory transportation, and construction. Multi-robot systems are used to collaborate with robots and perform joint missions. Also, in practice, many of the control methods proposed for dynamic systems may not be feasible because the intended model may be inaccurate or the system may be subject to model uncertainties. In this paper, a group of wheeled robots is controlled with a novel global input algorithm in the presence of uncertainties and environmental obstacles. In the following, the ensemble control of robots in the presence of obstacles is discussed using virtual potential functions. These potentials are defined in such a way that in equilibrium, the goal can be achieved. In this article, an algorithm for leading a group of robots among the obstacles is presented.
Influence of abrasive water jet and conventional drilling on the fatigue performance of hybrid carbon/flax laminates
Authors: Hoekstra Braedon , Kolasangiani Kamal , Shekarian Atefeh , Oguamanam Donatus CD , Zitoune Redouane , Bougherara Habiba
Published: December 2022

Most of the research on hybrid natural fiber composites has been focused on non-structural applications. The aim of this research is to improve the understanding of how to use hybrid natural fiber composites for structural applications, such as in the aerospace and automotive industries. The joining of subassemblies with rivets, bolts, or screws is a prominent feature in these industries, which implies that the presence of holes in the structural members is unavoidable. The study of the effect of holes on the mechanical behavior of these members is therefore imperative, especially given that holes are stress risers. An important factor in the design of open-hole hybrid flax composites is their fatigue behavior under cyclic loading because it accounts for most failures in composite structures. The investigation of this behavior is reported in this study where three types of 16-ply symmetric hybrid composites that were manufactured using woven carbon (C) and unidirectional flax (F), namely, unidirectional (CF[0]), cross-ply (CF[0/90]) and angle-ply (CF[[Formula: see text] 45]) are employed. A circular hole was made in the center of each specimen using either an abrasive water jet or conventional drilling methods. The observed machining-induced critical defect was delamination, which manifested in three forms: peel-up, push-out, and secondary. Stepwise fatigue tests were conducted to determine the damage evolution and high-cycle fatigue strength of each layup. The damage evolution of the material was assessed via stiffness damage, thermographic methods, and dissipated energy per cycle. It was observed that CF[0] layups are unaffected by the machining process and they have an identical high-cycle fatigue strength. For the CF[0/90] and CF[[Formula: see text] 45] layups, conventional drilling specimens have a higher high-cycle fatigue strength than their abrasive water jet counterparts.
Role of NRF2 in Colorectal Cancer Prevention and Treatment
Authors: Li Jiaxiang , Wang Dan , Liu Yifei , Zhou Yanhong
Published: December 2022

Nuclear factor erythroid 2-related factor 2 (NRF2) is a basic leucine zipper protein that participates in a complex regulatory network in the body. The activation of NRF2 can prevent and treat colorectal cancer (CRC). A variety of natural compounds can activate NRF2 to inhibit oxidative stress and inflammation to prevent the occurrence and development of CRC, inhibit the proliferation of CRC cells and induce their apoptosis. However, some studies have also shown that it also has negative effects on CRC, such as overexpression of NRF2 can promote the growth of colorectal tumors and increase the drug resistance of chemotherapeutic drugs such as 5-fluorouracil and oxaliplatin. Therefore, inhibition of NRF2 can also be helpful in the treatment of CRC. In this study, we analyze the current research progress of NRF2 in CRC from various aspects to provide new ideas for prevention and treatment based on the NRF2 signaling pathway in CRC.
Combined Radiomics–Clinical Model to Predict Radiotherapy Response in Inoperable Stage III and IV Non-Small-Cell Lung Cancer
Authors: Chen Wenrui , Wang Li , Hou Yu , Li Lan , Chang Li , Li Yunfen , Xie Kun , Qiu Linbo , Mao Dan , Li Wenhui , Xia Yaoxiong
Published: December 2022

Purpose: Radiotherapy is a promising treatment option for lung cancer, but patients’ responses vary. The purpose of the study was to investigate the potential of radiomics and clinical signature for predicting the radiotherapy sensitivity and overall survival of inoperable stage III and IV non-small-cell lung cancer (NSCLC) patients. Materials: This retrospective study collected 104 inoperable stage III and IV NSCLC patients at the Yunnan Cancer Hospital from October 2016 to September 2020. They were divided into radiation-sensitive and non-sensitive groups. We used analysis of variance (ANOVA) to select features and support vector machine (SVM) to build the radiomic model. Furthermore, the logistic regression method was used to screen out clinically relevant predictive factors and construct the combined model of radiomics–clinical features. Finally, survival was estimated using the Kaplan–Meier method. Results: There were 40 patients in the radiation-sensitive group and 64 in the non-sensitive group. These patients were divided into training set (73 cases) and testing set (31 cases) according to the ratio of 7:3. Nine radiomics features and one clinical feature were significantly associated with radiotherapy sensitivity. Both the radiomics model and combined model have good predictive performance (the areas under the curve (AUC) values of the testing set were 0.864 (95% confidence interval [CI]: 0.683-0.996) and 0.868 (95% CI: 0.689-1.000), respectively). Only platelet level status was associated with overall survival. Conclusion: The combined model constructed based on radiomics and clinical features can effectively identify the radiation-sensitive population and provide valuable clinical information. Patients with higher platelet levels may have a poor prognosis.
Weakly Supervised Learning for Poorly Differentiated Adenocarcinoma Classification in GastricEndoscopic Submucosal Dissection Whole Slide Images
Authors: Tsuneki Masayuki , Kanavati Fahdi
Published: December 2022

Objective: Endoscopic submucosal dissection (ESD) is the preferred technique for treating early gastric cancers including poorly differentiated adenocarcinoma without ulcerative findings. The histopathological classification of poorly differentiated adenocarcinoma including signet ring cell carcinoma is of pivotal importance for determining further optimum cancer treatment(s) and clinical outcomes. Because conventional diagnosis by pathologists using microscopes is time-consuming and limited in terms of human resources, it is very important to develop computer-aided techniques that can rapidly and accurately inspect large number of histopathological specimen whole-slide images (WSIs). Computational pathology applications which can assist pathologists in detecting and classifying gastric poorly differentiated adenocarcinoma from ESD WSIs would be of great benefit for routine histopathological diagnostic workflow. Methods: In this study, we trained the deep learning model to classify poorly differentiated adenocarcinoma in ESD WSIs by transfer and weakly supervised learning approaches. Results: We evaluated the model on ESD, endoscopic biopsy, and surgical specimen WSI test sets, achieving and ROC-AUC up to 0.975 in gastric ESD test sets for poorly differentiated adenocarcinoma. Conclusion: The deep learning model developed in this study demonstrates the high promising potential of deployment in a routine practical gastric ESD histopathological diagnostic workflow as a computer-aided diagnosis system.
High Thoracic Tortuosity Is Associated With CT-Markers of Degeneration of the Descending Thoracic Aortic Wall
Authors: Gross Benjamin D. , Cho Logan D. , Taubenfeld Ella , Tadros Rami O. , Faries Peter L. , Marin Michael L. , Miner Grace H.
Published: December 2022

Objective/Introduction

Increased vascular tortuosity may be an independent marker of generalized aortic pathology. This study investigates the association between descending thoracic aortic tortuosity, aneurysm pathophysiology, and outcomes following EVAR in AAA patients.

Methods

Patients who underwent elective EVAR between 2004 and 2018 were reviewed. Thoracic tortuosity index (TTI) was measured using 3D reconstruction software. Patients were dichotomized across the median TTI into high tortuosity [HT] (TTI >1.27, Figure1(a) ) and low tortuosity [LT] (TTI ≤1.27, Figure 1(b) ) groups. Perioperative complications, postoperative outcomes, and CT-based features of thoracic aortic wall degeneration ( Figure 1(c)-(e) ) were collected and analyzed.

Results

136 patients underwent treatment: 70 HT patients, including 54 males and 16 females (mean age: 77 years), and 66 LT patients, including 62 males and 4 females (mean age: 70 years) (age; P < .001). LT patients exhibited greater prevalence of hypercholesterolemia and diabetes (P = .045, P = .01). Presence of degenerative aortic wall markers was greater in HT patients (P = .045). HT patients had higher incidence of multiple aneurysms concurrently present in their aorta compared to LT (32.8% vs 11.3%; P = .002). Frequency of AAA rupture/dissection was 4.3% for HT and 1.5% for LT (P = .339). A trend was observed in all cause 30-day mortality in the HT group (P = .061). Other perioperative complications and postoperative outcomes were similar between groups.

Conclusion

High TTI was associated with older age at time of EVAR, greater prevalence of degenerative markers in the descending thoracic aortic wall, and widespread aorto-iliac dilation. While not predictive of EVAR outcomes, TTI can provide valuable information regarding aneurysm pathophysiology.
Multilevel analysis of teacher professional well-being and its influential factors based on TALIS data
Authors: Kouhsari Masoumeh , Chen Junjun , Baniasad Shahin
Published: December 2022

The current study examines how teachers’ professional wellbeing is affected by teacher-level and school-level factors using the TALIS 2018 data. Teacher-level factors consist of teachers’ instructional practices and teachers’ professional practices and school-level factors include school climate, school leadership styles and workload. The Hierarchical Linear Modeling (HLM) was used to examine whether the principals’ leadership, school climate and workload and teachers’ instructional practices and teachers’ professional practices explain the variation in teacher self-efficacy, teacher job satisfaction, and motivation and perceptions net of several important teacher-level and school-level control variables. The results revealed that both the teacher- and school-level factors were significantly related to teachers’ professional wellbeing. These findings were discussed concerning five countries of Canada, China, Finland, Japan and Singapore. The implications of the findings for improving teachers’ professional wellbeing are discussed.
Postpartum contraceptive initiation and use: Evidence from Accra, Ghana
Authors: Agula Caesar , Henry Elizabeth G , Asuming Patrick O , Obeng-Dwamena Akua , Toprah Theophilus , Agyekum Martin Wiredu , Shah Iqbal , Bawah Ayaga A
Published: December 2022

Background:

Postpartum contraceptive use reduces unintended pregnancies and results in better health outcomes for children and women. However, there is a dearth of knowledge on postpartum contraceptive use in Ghana, particularly among women in low-income urban settings. To shed light on strategies that might enhance access to postpartum family planning services in low-income urban settings, we examined contraceptive use among postpartum women in Accra, Ghana, at 1, 3, 6, and 12 months following the birth and the methods used. The predictors of modern contraceptive use in the 12-month postpartum period were also examined.

Methods:

Data come from a cross-sectional survey conducted in 2018 among 624 women aged 16–44 years who reported giving birth in the past 13–31 months prior to the interview. We generated descriptive statistics to examine the prevalence of contraceptive use among postpartum women at 1, 3, 6, and 12 months after birth. We further estimated a binary logistic regression to examine the predictors of modern contraceptive use at 12 months postpartum.

Results:

Forty percent of postpartum women never used any contraceptive method during 1 year after birth and of those who used a method, 40% relied on traditional methods. Moreover, 29% of women started using a method the immediate 1 month post-birth. Results further show that postpartum modern contraceptive uptake was positively associated with higher education, having more live births, and being currently in a union.

Conclusions:

Findings highlight that there may be opportunities to improve the quality of counseling during antenatal and postnatal care visits by clients to ensure fully informed choices regarding postpartum contraception. Community outreach by health providers/promoters or similar models should be promoted in low-income population settings to educate postpartum women on modern contraceptive use. Women who plan to use traditional methods should be provided with information on the consistent and correct use of these methods.
Instant habits versus flexible tenacity: Do implementation intentions accelerate habit formation?
Authors: van Timmeren Tim , de Wit Sanne
Published: December 2022

Implementation intentions (strategic “if-then” plans) have been shown to support behaviour change. This may be achieved by mentally forming stimulus-response associations, thereby promoting habit formation. Does this deliberate attempt to instal “strategic automaticity” only offer advantages, or does it also come at the cost of reduced flexibility that characterises learnt habits? To investigate this, we tested healthy, young participants on a computerised instrumental learning task. Critically, we introduced implementation intentions (“if I see stimulus X, then I will respond”) versus goal intentions (“for outcome Z, I will respond)” during instrumental acquisition, and subsequently assessed behavioural flexibility in an outcome-revaluation test. In Experiment 1, we conducted a between-subjects manipulation of strategic planning, and in Experiment 2, a within-subject manipulation. We hypothesised that implementation intentions would lead to strong stimulus-response associations and consequently impair performance when the signalled outcome value changed and therefore required a different response, while benefitting performance when the outcome value (and required response) remained the same. We found that implementation intentions supported instrumental learning, but impaired test performance overall (most robustly in Experiment 2), irrespective of whether the signalled outcome value had changed. We argue that this general detrimental effect of implementation intentions on test performance is likely a consequence of their negative effect on stimulus-outcome learning. Our findings warrant caution when applying if-then plans to situations where the agent does not already possess perfect knowledge of behavioural contingencies.While implementation intentions may support efficient and fast behavioural execution, this may come at the expense of behavioural flexibility.
Safety of User-Initiated Intensification of Insulin Delivery Using Cambridge Hybrid Closed-Loop Algorithm
Authors: Ware Julia , Wilinska Malgorzata E. , Ruan Yue , Allen Janet M. , Boughton Charlotte K. , Hartnell Sara , Bally Lia , de Beaufort Carine , Besser Rachel E. J. , Campbell Fiona M. , Draxlbauer Katharine , Elleri Daniela , Evans Mark L. , Fröhlich-Reiterer Elke , Ghatak Atrayee , Hofer Sabine E. , Kapellen Thomas M. , Leelarathna Lalantha , Mader Julia K. , Mubita Womba M. , Narendran Parth , Poettler Tina , Rami-Merhar Birgit , Tauschmann Martin , Randell Tabitha , Thabit Hood , Thankamony Ajay , Trevelyan Nicola , Hovorka Roman
Published: December 2022

Objective:

Many hybrid closed-loop (HCL) systems struggle to manage unusually high glucose levels as experienced with intercurrent illness or pre-menstrually. Manual correction boluses may be needed, increasing hypoglycemia risk with overcorrection. The Cambridge HCL system includes a user-initiated algorithm intensification mode (“Boost”), activation of which increases automated insulin delivery by approximately 35%, while remaining glucose-responsive. In this analysis, we assessed the safety of “Boost” mode.

Methods:

We retrospectively analyzed data from closed-loop studies involving young children (1-7 years, n = 24), children and adolescents (10-17 years, n = 19), adults (≥24 years, n = 13), and older adults (≥60 years, n = 20) with type 1 diabetes. Outcomes were calculated per participant for days with ≥30 minutes of “Boost” use versus days with no “Boost” use. Participants with <10 “Boost” days were excluded. The main outcome was time spent in hypoglycemia <70 and <54 mg/dL.

Results:

Eight weeks of data for 76 participants were analyzed. There was no difference in time spent <70 and <54 mg/dL between “Boost” days and “non-Boost” days; mean difference: –0.10% (95% confidence interval [CI] –0.28 to 0.07; P = .249) time <70 mg/dL, and 0.03 (–0.04 to 0.09; P = .416) time < 54 mg/dL. Time in significant hyperglycemia >300 mg/dL was 1.39 percentage points (1.01 to 1.77; P < .001) higher on “Boost” days, with higher mean glucose and lower time in target range ( P < .001).

Conclusions:

Use of an algorithm intensification mode in HCL therapy is safe across all age groups with type 1 diabetes. The higher time in hyperglycemia observed on “Boost” days suggests that users are more likely to use algorithm intensification on days with extreme hyperglycemic excursions.
Bench-Side Dose Accuracy of an Open-Source Ultra-Low-Cost Insulin-Pump, With Testing Conducted to IEC 60601-2-24
Authors: Payne Matthew , Pooke Francis , Holder-Pearson Lui , Chase J. Geoffrey , de Bock Martin , Campbell Jake , Knopp Jennifer
Published: December 2022

With the prevalence of diabetes higher than ever, governments and people with diabetes are facing significant treatment and indirect costs associated with managing their condition. An ultra-low-cost insulin pump is a possible solution to improving health disparities. This article presents test results for an insulin-pump built from low-cost components (bill of materials < $US100). All testing was completed in accordance with IEC60601-2-24, and results were benchmarked against a commercial pump. Results showed the ultra-low-cost pump has comparable accuracy to the commercially available insulin pump with testing displaying an overall accuracy of 0.089% and −0.392%, respectively. These results show that an ultra-low-cost pump can accurately deliver insulin in limited bench testing. Testing in other environments and scenarios is required to fully meet IEC60601-2-24 standards.