bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of BiZact™ tonsillectomy versus cold steel dissection technique in adults: Analysis of operating time, intraoperative blood loss, postoperative bleeding rate and pain
Authors: Falz Hendrik , von Lücken Hans‐Jürgen , Münscher Adrian , Möckelmann Nikolaus
Published: January 2024

Objectives

To analyse operating time, intraoperative blood loss, postoperative bleeding rate and pain when using the relatively new BiZact™ tonsillectomy device compared to the commonly used cold steel dissection technique with bipolar cautery in adults.

Design

Retrospective case control study. Parameters analysed for significant association with technique were operating time, intraoperative blood loss, wound pain on postoperative days 1–4 and rate of post‐tonsillectomy bleeding (PTB).

Setting

Monocentric study at a department of otolaryngology and head and neck surgery at a tertiary centre in Germany.

Participants

A total of 183 patients who underwent a bilateral tonsillectomy with either the BiZact™ tonsillectomy device or the cold dissection technique with bipolar cautery for haemostasis.

Main Outcome Measures

Operating time, intraoperative blood loss, postoperative pain on the first to fourth postoperative day (numeric rating scale: 0–10) (PTB, primary bleeding ≤24 h, secondary bleeding >24 h postoperative; Stammberger scale).

Results and Conclusion

The BiZact™ tonsillectomy device leads to a significant shorter operating time with less intraoperative blood loss compared to cold steel dissection with bipolar haemostasis. No benefits with regards to PTB or postoperative pain could be observed. The use of the BiZact™ device provides major benefits in clinical routine and stands up to conventional tonsillectomy techniques.
Joint optimization of UAV position and user grouping for UAV‐assisted hybrid NOMA systems
Authors: Sun Yuan , Dong Zhicheng , Yang Liuqing , Cai Donghong , Zhou Weixi , Zhou Yanxia
Published: January 2024

This article investigates the use of unmanned aerial vehicles (UAVs) in assisting hybrid non‐orthogonal multiple access (NOMA) systems to enhance spectrum efficiency and communication connectivity. A joint optimization problem is formulated for UAV positioning and user grouping to maximize the sum rate. The formulated problem exhibits non‐convexity, calling for an effective solution. To address this issue, a two‐stage approach is proposed. In the first stage, a particle swarm optimization algorithm is employed to optimize the UAV positions without considering user grouping. With the UAV positions optimized, a game theory‐based approach is utilized in the second stage to optimize user grouping and improve the sum rate of the hybrid NOMA system. Simulation results demonstrate that the proposed two‐stage method achieves solutions close to the global optimum of the original problem. By optimizing the positions of UAVs and user groups, the sum rate can be effectively improved. Additionally, optimizing the deployment of UAVs ensures better fairness in providing communication services to multiple users.
Introduction: Contributions and reflections on Modern Heritage in the Anthropocene
Authors: Denison Edward , Vawda Shahid
Published: January 2024

Modern Heritage in the Anthropocene draws from a critical selection of the 54 papers presented at the second International MoHoA conference Modern Heritage in the Anthropocene, (October 26–28, 2022), hosted by The Bartlett School of Architecture, University College London, in partnership with the University of Liverpool's School of Architecture. The conference expanded MoHoA's aim of encouraging equitable approaches to modern heritage as an urgent and essential response to an age of planetary crises whose roots are entangled with centuries‐old culture of extraction, exploitation, and domination. Building on the lessons learned from the first MoHoA conference, Modern Heritage of Africa (2021), hosted by the University of Cape Town and the subject of an earlier special edition of Curator (65/July 3, 2022), this second conference emphasized the interconnection between these cultures and the dawn of the Anthropocene. Participants were asked to reflect on reconceptualized formulations of modern heritage and its entangled relationship with the planetary crises experienced, albeit unevenly and unequally, by all living and nonliving things. This paper assembles and reflects on the contributions of 18 peer‐reviewed papers that collectively demonstrate the range and depth of topics presented. In the spirit of equity, diversity, and inclusivity and in line with MoHoA's decentering, decolonizing, and reframing agenda, these have also been chosen to reflect the different contributors' experiences, from senior academics to young and early career professionals.
Patterns of metformin use and glycated haemoglobin trends among patients with newly diagnosed type 2 diabetes in Alberta, Canada
Authors: Kim Tina , Campbell Dennis B. , Au Flora , Ronksley Paul E. , Weaver Robert G. , Campbell David J. T.
Published: January 2024

Aim

Canadian guidelines recommend metformin as first‐line therapy for incident uncomplicated type 2 diabetes and the vast majority of patients are treated accordingly. However, only 54% 65% remain on treatment after 1 year, with the highest discontinuation rates within the first 3 months. The purpose of this study was: (a) to identify individual and clinical factors associated with metformin discontinuation among patients with newly diagnosed uncomplicated type 2 diabetes in Alberta, Canada, and (b) describe glycated haemoglobin (HbA1c) trajectories in the first 12 months after initiation of pharmacotherapy, stratified by metformin usage pattern.

Materials and Methods

We conducted a retrospective cohort study using linked administrative datasets from 2012 to 2017 to define a cohort of individuals with uncomplicated incident type 2 diabetes. Using logistic regression, we determined individual and clinical characteristics associated with metformin discontinuation. We categorized individuals based on patterns of metformin use and then used mean HbA1c measurements over a 12‐month follow‐up period to determine glycaemic trajectories for each pattern.

Results

Characteristics associated with metformin discontinuation were younger age, lower baseline HbA1c and having fewer comorbidities. Sex, income and location (urban/rural) were not significantly associated with metformin discontinuation. Individuals who continued metformin with higher adherence and individuals who discontinued metformin entirely had lowest HbA1c values at 12 months from treatment initiation. Those who changed therapy or had additional therapies added had higher HbA1c values at 12 months.

Conclusion

Identifying characteristics associated with discontinuation of metformin and individuals' medication usage patterns provide an opportunity for targeted interventions to support patients' glycaemic management.
Clinical features of type 1 diabetes in older adults and the impact of intermittently scanned continuous glucose monitoring: An Association of British Clinical Diabetologists (ABCD) study
Authors: Deshmukh Harshal , Adeleke Kazeem , Wilmot Emma G. , Folwell Anna , Barnes Dennis , Walker Neil , Saunders Simon , Ssemmondo Emmanuel , Walton Chris , Patmore Jane , Ryder Robert E. J. , Sathyapalan Thozhukat
Published: January 2024

Aims

To evaluate the clinical features and impact of flash glucose monitoring in older adults with type 1 diabetes (T1D) across age groups defined as young‐old, middle‐old, and old‐old.

Materials and Methods

Clinicians were invited to submit anonymized intermittently scanned continuous glucose monitoring (isCGM) user data to a secure web‐based tool within the National Health Service secure network. We collected baseline data before isCGM initiation, such as demographics, glycated haemoglobin (HbA1c) values from the previous 12 months, Gold scores and Diabetes Distress Scale (DDS2) scores. For analysis, people with diabetes were classified as young‐old (65–75 years), middle‐old (>75–85 years) and old‐old (>85 years). We compared baseline clinical characteristics across the age categories using a t test. All the analyses were performed in R 4.1.2.

Results

The study involved 1171 people with diabetes in the young‐old group, 374 in the middle‐old group, and 47 in the old‐old group. There were no significant differences in baseline HbA1c and DDS2 scores among the young‐old, middle‐old, and old‐old age groups. However, Gold score increased with age (3.20 [±1.91] in the young‐old vs. 3.46 [±1.94] in the middle‐old vs. 4.05 [±2.28] in the old‐old group; p < 0.0001). This study showed reduced uptake of insulin pumps (p = 0.005) and structured education (Dose Adjustment For Normal Eating [DAFNE] course; p = 0.007) in the middle‐old and old‐old populations compared to the young‐old population with T1D. With median isCGM use of 7 months, there was a significant improvement in HbA1c in the young‐old (p < 0.001) and old‐old groups, but not in the middle‐old group. Diabetes‐related distress score (measured by the DDS2) improved in all three age groups (p < 0.001) and Gold score improved (p < 0.001) in the young‐old and old‐old populations but not in the middle‐old population. There was also a significant improvement in resource utilization across the three age categories following the use of is CGM.

Conclusion

This study demonstrated significant differences in hypoglycaemia awareness and insulin pump use across the older age groups of adults with T1D. The implementation of isCGM demonstrated significant improvements in HbA1c, diabetes‐related distress, hypoglycaemia unawareness, and resource utilization in older adults with T1D.
Populist Challenges to Truth and Democracy Met with Pragmatist Alternatives in Citizenship Education
Authors: Stitzlein Sarah M.
Published: January 2024

Populists employ truth as a tool for aligning the people against the elite. Citizenship education rarely takes up critiques of liberal democracy, discussions of populism, or conversations about what truth is. This paper provides an alternative pragmatist vision of truth that builds on the populist call for democracy to better reflect the will of the people, while also pushing back against the harms potentially caused by populism. Students today need to learn how populism works performatively and through discourse. But more importantly, they also need to learn how to engage with populism by taking up some of the real challenges it poses in their communities today. Citizenship education that overtly talks about how truth operates and demonstrates how inquiry can be used to determine “what works” better prepares students for the flawed democracy we see at play today and provides pathways for improving it in the future.
Alarm therapy for nocturnal enuresis in children: A literature review
Authors: Wilson Julie S. , Doddy Gertrude
Published: January 2024

Nocturnal enuresis is a common childhood problem impacting the quality of life of children and families. Treatment with an enuresis alarm is recommended for 8–12 weeks by the International Children's Continence Society as first line management of monosymptomatic nocturnal enuresis. However, the effectiveness of alarm therapy varies between 80% and 45.9%. There is minimal evidence within the literature exploring the factors impacting this varying response to alarm therapy. Therefore, this literature review aims to explore factors that impact the effectiveness of the enuresis alarm as a treatment for nocturnal enuresis, in children aged 5–17 years. Literature searches were conducted on MEDLINE (Ovid), SCOPUS and CINAHL Databases. The PRISMA tool was used to report the data in the search strategy. The inclusion criteria of children aged 5 to 17 years was chosen based on International Children's Continence Society Guidelines. English language, academic journals and studies in the past 10 years were selected as additional inclusion criterion to identify the most recent, robust literature for the review. All 13 primary research articles were critiqued using the Caldwell Framework. Data were extracted and presented in table format highlighting study methodology, sample, duration of treatment, relevance to review topic and key findings. The findings highlight factors influencing the effectiveness of alarm therapy related to the impact on the child and family, heighten arousal to the alarm, the duration of therapy, age of child and the impact of overlearning. This review provides health professionals with an insight into strategies that may help children and their family to respond successfully to enuresis alarm treatment.
NLRP3‐mediated periodontal ligament cell pyroptosis promotes root resorption
Authors: Li Xinyi , Men Xinrui , Ji Ling , Chen Xinyi , He Shushu , Zhang Ping , Chen Song
Published: January 2024

Aim

To investigate the mechanisms by which periodontal ligament cells (PDLCs) convert biomechanical stimulation into inflammatory microenvironment inducing root resorption (RR).

Materials and Methods

RNA sequencing was employed to explore mechanisms in force‐inflammatory signal transduction. Then resorption volume, odontoclastic activity, PDLC pyroptotic ratio and NOD‐like receptor protein 3 (NLRP3)‐mediated pyroptosis pathway activation were analysed under force and pyroptosis inhibition. Further osteoclast formation, macrophage number and transwell polarization demonstrated the effects of PDLC pyroptosis on osteoclastogenesis and M1 polarization.

Results

RNA sequencing revealed that NLRP3‐mediated PDLC pyroptosis induced by Toll‐like receptor 4 (TLR4)/nuclear factor kappa B (NFκB)/NLRP3 pathway may be involved in mechano‐inflammatory signal transduction. PDLC pyroptosis under force and the expression of NLRP3‐mediated pyroptosis pathway in force‐enhanced PDLCs were significantly increased, both in vivo and in vitro. MCC950 administration was sufficient to reduce PDLC pyroptosis and alleviate RR, odontoclast formation and M1 polarization in vivo. Further in vitro exploration showed that MCC950 treatment reduced PDLC force‐promoted pyroptosis and blocked NLRP3‐mediated pyroptosis pathway. Moreover, by treating THP‐1 with force‐pretreated PDLCs or supernatants, NLRP3‐mediated PDLC pyroptotic released products induced osteoclast formation and M1 polarization.

Conclusions

NLRP3‐mediated PDLC pyroptosis promotes RR. PDLCs transmit excessive force into inflammation signals through TLR4/NFκB/NLRP3 pathway, inducing PDLC pyroptosis, which directly promotes odontoclast formation and subsequent RR or promotes M1 polarization to indirectly trigger odontoclastogenesis and RR.
Continuity of Clinician Type and Intrapartum Experiences During the Perinatal Period in California
Authors: Ranchoff Brittany L. , Paterno Mary T. , Attanasio Laura B.
Published: January 2024

Introduction

Continuity of care with an individual clinician is associated with increased satisfaction and better outcomes. Continuity of clinician type (ie, obstetrician‐gynecologist or midwife) may also impact care experiences; however, it is unknown how common it is to experience discontinuity of clinician type and what its implications are for the birth experience. We aimed to identify characteristics associated with having a different clinician type for prenatal care than for birth and to compare intrapartum experiences by continuity of clinician type.

Methods

For this cross‐sectional study, data were from the 2017 Listening to Mothers in California survey. The analytic sample was limited to individuals with vaginal births who had midwifery or obstetrician‐gynecologist prenatal care (N = 1384). Bivariate and multivariate analysis examined characteristics of individuals by continuity of clinician type. We then examined associations of clinician type continuity with intrapartum care experiences.

Results

Overall, 74.4% of individuals had the same type of clinician for prenatal care and birth. Of individuals with midwifery prenatal care, 45.1% had a different birth clinician type, whereas 23.5% of individuals who had obstetrician‐gynecologist prenatal care had a different birth clinician type. Continuity of clinician type was positively associated with having had a choice of perinatal care clinician. There were no statistically significant associations between clinician type continuity and intrapartum care experiences.

Discussion

Findings suggest individuals with midwifery prenatal care frequently have a different type of clinician attend their birth, even among those with vaginal births. Further research should examine the impact of multiple dimensions of continuity of care on perinatal care quality.
An investigation into the correlation between early‐to‐mid pregnancy exercise combined with cognitive behavioral therapy and anxiety levels and quality of life in patients
Authors: Mei Qiuying , Chen Xiaobo , Liu Lifang , Xiao Guilan
Published: January 2024

Objective

The aim of this study was to investigate the effects of exercise combined with cognitive behavioral therapy (CBT) on anxiety and quality of life in pregnant women.

Methods

This study adopted a prospective randomized controlled trial design, and divided 60 pregnant women in the first and second trimesters into two groups. The control group received routine prenatal education, and the experimental group added moderate exercise and CBT on the basis of routine prenatal education. All participants completed the Hamilton Anxiety Rating Scale (HARS) and World Health Organization Quality of Life‐BREF (WHOQOL‐BREF) at the start of the study (baseline) and at 6 weeks after the intervention.

Results

Baseline data, scores on HARS, and scores on WHOQOL‐BREF were found to be consistent among the two groups of patients prior to the intervention (all P > 0.05). Following the intervention, the implementation of exercise combined with CBT resulted in significant improvements in anxiety levels within the experimental group, particularly with respect to aspects such as anxious mood, tension, insomnia, cognitive function, cardiovascular symptoms, and gastrointestinal symptoms (all P < 0.05). Similarly, the combination of exercise and CBT led to significant enhancement in the quality of life in the experimental group, particularly in areas such as physical health, psychological health, and environmental factors (all P < 0.05). Nevertheless, no significant disparities were observed between the two groups in terms of fears, depressive mood, muscular and sensory somatic symptoms, respiratory symptoms, genitourinary symptoms, autonomic symptoms, behavior during the interview, and social relationships (all P > 0.05).

Conclusion

Exercise combined with CBT can effectively reduce the anxiety of pregnant women and improve their quality of life, which has important clinical significance for improving the mental health and quality of life of pregnant women in the first and second trimesters.
A systematic review and meta‐analysis on the efficacy of sleep interventions to treat suicidal ideation
Authors: Mournet Annabelle M. , Kleiman Evan M.
Published: January 2024

Researchers at the intersection of sleep and suicide research have advocated for investigation of sleep disturbances as a therapeutic target for the purposes of treating and preventing suicide. This study aims to provide the first systematic review and meta‐analysis on the efficacy of sleep interventions to treat suicidal ideation. This systematic review and meta‐analysis, registered with the International Prospective Register of Systematic Reviews, was conducted in PsycINFO, through Ovid. A sample of eight articles were deemed eligible and a total of 21 effect sizes were included. Egger's test suggested that no publication bias was present (b = 0.3695; p = 0.0852). The pooled effect size for sleep treatments on suicidal ideation was small (g = −0.0931, p = 0.3047). Significant heterogeneity was present (I2 = 44.13%), indicating the need for moderator analyses. Treatment type (medication versus psychotherapy; g = −0.2487, p = 0.3368), sex (g = −0.0007; p = 0.9263), and race (g = −0.0081; p = 0.1624) were all considered as moderators and were all found to be insignificant. This meta‐analysis revealed that initial studies exploring the efficacy of sleep interventions on suicidal ideation demonstrate small effect sizes. Despite this, the handful of studies included in this review nonetheless highlight this as an important area for continued exploration. The use of larger and more diverse samples, as well as intentionally designing sleep‐related interventions to improve ideation and behaviour, have the potential to enhance the efficacy of sleep interventions for this novel purpose.
Clinical characteristics and risk factors for late‐onset pneumocystis jirovecii pneumonia in kidney transplantation recipients
Authors: Zhu Xiaofeng , Xie Mengshu , Fan Jiaqi , Geng Bei , Fei Guangru , Zhou Qianqian , Wu Huimei , Liu Xuehan , Jiang Xuqin
Published: January 2024

Background

Pneumocystis jirovecii pneumonia (PJP) is a common and troublesome complication of kidney transplantation. In the era of prophylaxis, the peak incidence of PJP after kidney transplantation and specific characteristics of late‐onset PJP have always been debated.

Methods

We performed a retrospective study by analysing the data of post‐transplantation pneumonia in adult kidney transplantation recipients between March 2014 and December 2021 in The Affiliated First Hospital of University of Science and Technology of China (USTC). A total of 361 patients were included and divided into early‐onset PJP, late‐onset PJP and non‐PJP groups. The characteristics of each group and related risk factors for the late‐onset patients were investigated.

Results

Some patients developed PJP 9 months later with a second higher occurrence between month 10 and 15 after transplantation. Compared with non‐PJP, ABO‐incompatible and cytomegalovirus (CMV) viremia were significantly associated with late onset of PJP in multivariate analysis. The use of tacrolimus, CMV viremia, elevated CD8(+) T cell percent and hypoalbuminemia were risk factors for late PJP. Receiver operating characteristic curve analysis demonstrated that a combination of those factors could increase the sensitivity of prediction remarkably, with an area under the curve of 0.82, a sensitivity of 80% and a specificity of 83%.

Conclusions

PJP could occur months after kidney transplantation. ABO‐incompatible transplant recipients are at high risk of PJP. In the later stages of transplantation, CMV viremia, T lymphocyte subsets percentage and serum albumin levels should be monitored in patients using tacrolimus.
Epigenomic and epigenetic investigations of food allergy
Authors: Chun Yoojin , Lee Jo Hsuan , Bunyavanich Supinda
Published: January 2024

As a potential link between genetic predisposition, environmental exposures, and food allergy outcomes, epigenetics has been a molecular variable of interest in ongoing efforts to understand food allergy mechanisms and outcomes. Here we review population‐based investigations of epigenetic loci associated with food allergy, focusing on established clinical food allergy. We first provide an overview of epigenetic mechanisms that have been studied in cohorts with food allergy, predominantly DNA methylation but also microRNA. We then discuss investigations that have implemented epigenome‐wide approaches aimed at genome‐wide profiling and discovery. Such epigenome‐wide studies have collectively identified differentially methylated and differentially regulated loci associated with T cell development, antigen presentation, reaction severity, and causal mediation in food allergy. We then discuss candidate‐gene investigations that have honed in on Th1, Th2, T regulatory, and innate genes of a priori interest in food allergy. These studies have highlighted methylation changes in specific candidate genes as associated with T regulatory cell activity as well as differential methylation of Type 1 and Type 2 cytokine genes associated with various food allergies. Intriguingly, epigenetic loci associated with food allergy have also been explored as potential biomarkers for the clinical management of food allergy. We conclude by highlighting several priority directions for advancing population‐based epigenomic and epigenetic understandings of food allergy.
Genetics of preschool wheeze and its progression to childhood asthma
Authors: Wolters Alba A.B. , Kersten Elin T.G. , Koppelman Gerard H.
Published: January 2024

Wheezing is a common and heterogeneous condition in preschool children. In some countries, the prevalence can be as high as 30% and up to 50% of all children experience wheezing before the age of 6. Asthma often starts with preschool wheeze, but not all wheezing children will develop asthma at school age. At this moment, it is not possible to accurately predict which wheezing children will develop asthma. Recently, studying the genetics of wheeze and the childhood‐onset of asthma have grown in interest. Childhood‐onset asthma has a stronger heritability in comparison with adult‐onset asthma. In early childhood asthma exacerbations, CDHR3, which encodes the receptor for Rhinovirus C, was identified, as well as IL33, and the 17q locus that includes GSDMB and ORMDL3 genes. The 17q locus is the strongest wheeze and childhood‐onset asthma locus, and was shown to interact with many environmental factors, including smoking and infections. Finally, ANXA1 was recently associated with early‐onset, persistent wheeze. ANXA1 may help resolve eosinophilic inflammation. Overall, despite its complexities, genetic approaches to unravel the early‐onset of wheeze and asthma are promising, since these shed more light on mechanisms of childhood asthma‐onset. Implicated genes point toward airway epithelium and its response to external factors, such as viral infections. However, the heterogeneity of wheeze phenotypes complicates genetic studies. It is therefore important to define accurate wheezing phenotypes and forge larger international collaborations to gain a better understanding of the pathways underlying early‐onset asthma.
Chloroplast K+/H+EXCHANGE ANTIPORTER 3 modulates abscisic acid‐induced reactive oxygen species generation in guard cells
Authors: Yamada Naotaka , Onjo Michio , Sonoike Kintake , Shimazaki Ken‐ichiro , Iwai Sumio
Published: January 2024

Reactive oxygen species (ROS) are important signaling molecules in stomatal closure. In a previous report, we demonstrated that ROS generated through photosynthetic electron transport (PET) act as signaling molecules in abscisic acid (ABA)‐induced stomatal closure. However, the mechanism by which ABA induces ROS generation through PET remains unclear. Here, we assessed the possibility that chloroplast K+/H+ EXCHANGE ANTIPORTER 3 (KEA3) functions in ABA‐induced ROS generation in guard cells, resulting in stomatal closure. KEA3 localizes to a thylakoid membrane and allows proton efflux from the thylakoid lumen by K+/H+ antiport, regulating photosynthesis by proton motive force. KEA3 loss‐of‐function mutants (kea3‐1 and kea3‐2) were impaired in ABA‐induced ROS generation of guard cells and stomatal closure. The small molecule electroneutral K+/H+ antiporter nigericin induced ROS generation in guard cells and stomatal closures in the kea3 mutants. This study demonstrates that KEA3 is an important factor for ABA‐induced ROS generation in guard cells and stomatal closure.
Classifying participatory methods in social care regulation
Authors: Dolev Hilla , Benish Avishai
Published: January 2024

This article examines the regulation–participation nexus in social care services. Participatory forms of social care regulation have been expanding over the past 20 years, but the literature on this trend remains scarce. To fill this gap, we developed an analytical framework for classifying participatory regulation methods. This framework is based on two axes, one drawn from the literature on regulation (the regulatory tasks), and the other from the literature on service user participation (the levels of participation). Using this framework and combining a systematic review of the literature with a case study of the Care Quality Commission in England, we identified and classified 12 participatory methods in three main regulatory tasks (monitoring, standard setting and enforcement). Our classification shows most of the participatory methods are concentrated in monitoring tasks, less in standard setting and least of all in regulatory enforcement. It also highlights the uniqueness of the goals and logics of participation in the regulatory context and the tendency towards the instrumental aspect of information gathering rather than the political aspect of participation. The article concludes by explaining our findings and suggesting future directions in developing the research agenda on the regulatory‐participation nexus.
Prevention strategies for vasovagal reaction in whole blood donors: A quadri‐armed randomised control trial
Authors: Meher Radheshyam , Patidar Gopal Kumar , Chaurasia Rahul , Pandey Hem Chandra , Hazarika Anjali
Published: January 2024

Introduction

Vasovagal reaction (VVR) is a frequently encountered generalised donor adverse reaction, associated with donor deterrence towards future donation. Several mitigation strategies for prevention of VVR were tried but still not standardised. This quadri‐armed randomised study evaluated the utility of water ingestion, applied muscle tension (AMT) and combination of both in preventing the VVR among blood donors.

Methods

A quadri‐armed randomised controlled trial was performed on 4320 whole blood donors. Blood donors of 18–65 years of age were randomised into four groups based on the interventions performed i.e., control with no intervention (Group 1, n = 1081), water ingestion (Group 2, n = 1082), AMT (Group 3, n = 1070) and combined intervention (Group 4, n = 1087). VVR during and immediately after blood donation were observed along with assessment of risk factors in blood donors and the effectiveness of interventions were analysed.

Results

The incidence of VVR observed 1.6% in our study, with the highest occurrence in the control group (2.5%) and the lowest in the combined intervention group (0.9%). Multivariable logistic regression revealed that the control group donors faced a 1.38‐fold greater risk of VVR compared to those receiving interventions (OR: 1.38, 95% CI: 1.10–1.75). Other risk factors included younger age (OR: 1.5, 95% CI: 1.05–2.17), first‐time donation (OR: 5.7, 95% CI: 1.66–5.74), prior history of VVR (OR: 2.5, 95% CI: 10.4–101.52).

Discussion/Conclusion

The combined approach of water ingestion and AMT proved significantly more effective in VVR prevention compared to individual interventions.
Osteosarcoma of the wing in a sulfur‐crested cockatoo
Authors: Hastain Sydney A. , Mumm Lauren , Ozawa Sarah , Petritz Olivia , Gaudette Chris , Troan Brigid V. , Stowe Devorah M.
Published: January 2024

A 26‐year‐old female sulfur‐crested cockatoo (Cacatua galerita) was evaluated for vocalizing through the night and extending her right wing. Physical examination revealed a large, firm mass extending from the humerus to the distal aspect of the elbow. Computed tomography confirmed a large aggressive mass of the right distal humerus with a large soft tissue component, severe osteolysis, and adjacent periosteal proliferation. Fine‐needle aspirates of the mass were most compatible with sarcoma, and osteosarcoma was prioritized. An unstained slide was treated with nitroblue tetrazolium chloride/5‐bromo‐4‐chloro‐3‐indolyl phosphate toluidine salt‐phosphatase (NBT/BCIP) substrate for ALP detection and was strongly positive, confirming a diagnosis of osteosarcoma. A month later, the patient underwent wing amputation and arrested during recovery from anesthesia. Post‐mortem examination and histopathology were consistent with osteosarcoma. This case report highlights a rare occurrence of osteosarcoma in a cockatoo as well as its cytologic and histologic features. Additionally, this report provides support for NBT/BCIP application in ALP‐expressing tumors, a cytochemical stain that has been minimally investigated in avian species.
Ethical issues when conducting health research with military personnel: a scoping review protocol
Authors: Townsend Michelle L. , Green Heidi , Fabrianesi Belinda , Braunack-Mayer Annette
Published: January 2024

Objective:

The objective of this scoping review is to understand the scope and nature of evidence in relation to the ethical issues that arise when conducting health research with military personnel.

Introduction:

Ethical obligations in human research have been debated for centuries. Historically, research conducted with military personnel has led to ethical controversies regarding autonomy, harm, and informed consent. In particular, the power dynamics, hierarchical nature, and culture that are inherent in military structures may compromise the voluntary nature of research participation.

Inclusion criteria:

This scoping review will include all sources of evidence that identify ethical issues, such as autonomy, beneficence, non-maleficence, and justice, within health research with military personnel, including reservists. This review will exclude sources of evidence on health research conducted during combat or on new technologies for fighting in wars.

Methods:

This scoping review will be conducted in accordance with the JBI methodology for scoping reviews. A 3-step search strategy will be used to obtain both published and unpublished sources of evidence. Two independent reviewers will screen sources of evidence against the inclusion and exclusion criteria. No limits on language will be applied; we will use Google Translate to translate sources of evidence in languages other than English. Sources of evidence published since 1964 will be included. Data will be extracted using a purpose-designed spreadsheet and the results will be summarized descriptively and presented in tabular format.

Review registration:

Open Science Framework https://osf.io/db85p
Physiological determinants of mechanical efficiency during advanced ageing and disuse
Authors: Venturelli Massimo , Morgan Garrett R. , Tarperi Cantor , Zhao Jia , Naro Fabio , Reggiani Carlo , Donato Anthony J. , Richardson Russell S. , Schena Federico
Published: January 2024

This study aimed to determine which physiological factors impact net efficiency (ηnet) in oldest‐old individuals at different stages of skeletal muscle disuse. To this aim, we examined ηnet, central haemodynamics, peripheral circulation, and peripheral factors (skeletal muscle fibre type, capillarization and concentration of mitochondrial DNA [mtDNA]). Twelve young (YG; 25 ± 2 years), 12 oldest‐old mobile (OM; 87 ± 3 years), and 12 oldest‐old immobile (OI; 88 ± 4 years) subjects performed dynamic knee extensor (KE) and elbow flexors (EF) exercise. Pulmonary oxygen uptake, photoplethysmography, Doppler ultrasound and muscle biopsies of the vastus lateralis and biceps brachii were used to assess central and peripheral adaptations to advanced ageing and disuse. Compared to the YG (12.1 ± 2.4%), the ηnet of lower‐limb muscle was higher in the OM (17.6 ± 3.5%, P < 0.001), and lower in the OI (8.9 ± 1.9%, P < 0.001). These changes in ηnet during KE were coupled with significant peripheral adaptations, revealing strong correlations between ηnet and the proportion of type I muscle fibres (r = 0.82), as well as [mtDNA] (r = 0.77). No differences in ηnet were evident in the upper‐limb muscles between YG, OM and OI. In view of the differences in limb‐specific activity across the lifespan, these findings suggest that ηnet is reduced by skeletal muscle inactivity and not by chronological age, per se. Likewise, this study revealed that the age‐related changes in ηnet are not a consequence of central or peripheral haemodynamic adaptations, but are likely a product of peripheral changes related to skeletal muscle fibre type and mitochondrial density.

image

Key points

Although the effects of ageing and muscle disuse deeply impact the cardiovascular and skeletal muscle function, the combination of these factors on the mechanical efficiency are still a matter of debate.

By measuring both upper‐ and lower‐limb muscle function, which experience differing levels of disuse, we examined the influence of central and peripheral haemodynamics, and skeletal muscle factors linked to mechanical efficiency.

Across the ages and degree of disuse, upper‐limb muscles exhibited a preserved work economy. In the legs the oldest‐old without mobility limitations exhibited an augmented mechanical efficiency, which was reduced in those with an impairment in ambulation. These changes in mechanical efficiency were associated with the proportion of type I muscle fibres.

Recognition that the mechanical efficiency is not simply age‐dependent, but the consequence of inactivity and subsequent skeletal muscle changes, highlights the importance of maintaining physical activity across the lifespan.
Rational Design of Hoisting Drums
Authors: Waters Everett O.
Published: January 2024

The main problem of hoisting-drum design resolves itself into two parts: determination of flange shape and thickness, and determination of the thickness of the drum body. Other factors, such as brake, clutch, and bearings, have already been investigated and are therefore not considered in this paper.

The correct proportioning of drum flanges is obviously dependent upon the side pressure brought to bear against them, by the coils of rope wound about the drum. In other words, flange thickness is a function of (a) rope tension and (b) depth of winding. Previous theoretical investigations have recognized these factors, but have failed to take account of the friction between adjacent coils of rope, and between rope and drum, which tends to hold the coils in position without the aid of the flanges, and have also disregarded the flattening of the inside coils under pressure from the outer layers. This flattening, which is quite appreciable on account of the soft core of hoisting rope, results in a shortening of the inner coils, thereby relieving them of a part of their tension, and reducing the pressure against the flanges.

A theoretical formula is deduced for the total pressure against a drum flange caused by the winding-on of rope to a given depth and under a given initial tension. Two other formulœ are then deduced, which relate this total pressure to the flange thickness and the maximum allowable tensile and shearing stresses in the material. By means of these formulæ a flange of the usual straight-sided or the mushroom type may be designed to withstand safely the pressure of the rope wound upon the drum.

The drum body is subjected to combined stresses, since it is under compression from the coils wound upon it, under tension due to the lateral pressure against the flanges, and under combined torsion and bending caused by the load which is to be hoisted. Formulæ are derived which may be used to obtain the correct thickness both at the center of the drum, where the normal stresses are greatest, and at the ends of the drum, where the shearing stresses are most prominent.

In order to check the theoretical formula for flange pressure, tests were made with small-size rope wound upon a special drum, which was so arranged that the side thrust against one flange could be directly measured while the rope was being wound on or unwound. These tests show conclusively that formulæ for flange pressure which do not take account of rope friction and flattening give excessively large results.
Policies for Future Power Development
Authors: Jackson John Price
Published: January 2024

The primary purposes of this paper are (1) to present the problem created in this country by the present acute shortage of central-station electric power, and the large growth of demand for such power; and (2) to set forth the physical, public, and financial relationships that appear essential for relieving the present stress and meeting the continually enlarging demand with reasonable economy and conservation of natural resources and labor. The first purpose is dealt with in the first half of the paper, and includes a comparison with the situation in England. Treatment called for by the second purpose begins with the heading Natural Power Districts, and extends to the end of the paper. The latter is largely an exposition of the possibilities and advantages of unified power systems for supplying the power required by natural power districts.
Capacity and Efficiency Limitations of Stokers Using Mid-West Coals
Authors: Wilson John E.
Published: January 2024

According to the author, less progress has been made in the direction of securing efficient combustion than in any other immediately connected with stoker service. In the case of natural-draft chain-grate stokers the greatest losses are those due to the dry chimney gases and the carbon in the ash, and the possibility of making a material gain in the efficiency lies to a great extent in the ability to reduce these two losses. A certain amount of air admitted over the fire has been found advantageous when high-volatile coals are used, such as those found in the Middle West.

Capacity is governed principally by the available draft and ratio of total boiler heating surface to the grate area. Chain-grate stokers provided with forced draft operate successfully under continuous high rating, respond quickly to load requirements, and will successfully burn coal containing a large percentage of ash which fuses at a comparatively low temperature.

Underfeed forced-draft stokers in the Mid-West districts have a large number of very satisfactory operating records to their credit both from an efficiency and a capacity standpoint. Some types of overfeed stokers have also been used with good success in this section where only a limited capacity was required and suitable coal was available.

The necessity of securing improved refractories as well as improving the furnace design is emphasized by the difficulties encountered with the brickwork when forced firing is employed, and it is possible that these may prove factors governing the capacity which will be obtained in future installations.
The Hydraucone Regainer, Its Development and Applications in Hydroelectric Plants
Authors: White W. M.
Published: January 2024

Those familiar with hydroelectric power-house operation where curved draft tubes are employed cannot have failed to notice the boiling and disturbance of the water at the outlet from the curved tubes, which disturbance is clearly an evidence of inefficiency and loss of energy. The device described in this paper — the hydraucone regainer — provides a means for efficiently recovering the energy discharged from the runner for useful effect on the water wheel within the limited space available in the power-house foundations.

This new method of regaining pressure from velocity of fluids in motion consists in causing the stream flow to impinge upon some definite shape, either flat, conical or concave, thus changing its direction, and then placing an envelope around this shape so formed upon the particular base used, which envelope conforms to the shape of the fluid at entrance and gradually recedes from what would be the normal or free shape of the non-enclosed fluid impinging upon the particular base used; the effect of this gradually diverging envelope being to change the velocity head of fluids flowing at high velocity into its entrance into pressure and low velocity at its exit.

The field of application of the hydraucone regainer, according to the author, will be greater on low-head plants, although it is now being installed in connection with two 40,000-hp. units which are to operate under a head of 421 ft. Hydraucone regainers are now in operation or in course of construction in a number of plants to operate under heads varying from 8 ft. to 421 ft. and with waterwheels developing from 150 to 40,000 hp.

The paper gives very complete particulars of the long series of experiments resulting in the development of the hydraucone regainer, as well as data of a series of tests made at the Holyoke Testing Flume showing the increase in power-plant efficiency obtained by its use.
Process Charts: First Steps in Finding the One Best Way to Do Work
Authors: Gilbreth Frank B. , Gilbreth L. M.
Published: January 2024

The process chart is a device for visualizing a process as a means of improving it. Every detail of a process is more or less affected by every other detail; therefore the entire process must be presented in such form that it can be visualized all at once before any changes are made in any of its subdivisions. In any subdivision of the process under examination, any changes made without due consideration of all the decisions and all the motions that precede and follow that subdivision will often be found unsuited to the ultimate plan of operation.

In the present paper the authors point out the place of the process chart in management and present established working data used successfully in numerous working installations for many years. They also point out its simplicity, field of application, its relation to standardization, etc., etc.

While the process-chart methods will be helpful in any kind of work and under all forms of management, the best results can come, the authors state, only where there is a mechanism of management that will enforce and make repetitive the conditions of the standards.
Centrifugal Casting
Authors: Cammen Leon
Published: January 2024

The paper describes the process of centrifugal casting of hollow metal objects. The author first takes up the field of centrifugal casting and the history of the development of the art, which he follows by a discussion of the mechanics of the problem and a description of the operation of the casting machine. He then takes up the thermal conditions in the mold and the field of application of hot-mold centrifugal casting, and closes with a discussion of the manufacture of plates by the centrifugal casting process.

In appendices to the paper are given a bibliography of the subject, a list of patents, some of the mathematics covering the cases of casting about a vertical and about a horizontal axis, and the forces acting on the liquid metal in the direction of the axis of the mold, a discussion of temperature control in the casting and in the mold, and an analysis of the stresses in the mold.
A New System of Helical Involute Gearing for Use on Metal Planers
Authors: Cardullo Forrest E.
Published: January 2024

In this paper the author gives particulars of a system of helical gearing designed by him for use on metal planers, in which the directions of rotation and the helical angles of the several gears are so chosen as to counterbalance and minimize end thrust, advantage being taken at the same time of the end thrust to counterbalance the side thrust of the cutting tools. The tooth form adopted is an involute having a 14½-deg. pressure angle, a pinion addendum of 3/2 p in. and a pinion dedendum of 1/2 p in., p being of normal diametral pitch. The advantages of this form of tooth for the work in question are enumerated at length and dimensions of a pinion, gear and rack designed according to the principles set forth in the paper are given in tabular form.
Overfeed Stokers of the Inclined Type
Authors: Bouton Geo. I.
Published: January 2024

In this paper the author discusses the development and present construction, and method of operation, of the front- and side-feed types of inclined overfeed stokers. Three side-feed stokers are described, with an illustration of a Dutch-oven type of setting. It is stated that 200 per cent of boiler rating can be obtained with 0.3 in. to 0.5 in. draft loss through the fuel bed, and that when forced draft is applied, it should be done with proper regard to air circulation and the maintenance of suction above the fire. Three front-feed stokers are also described, with an illustration of a setting with ignition arch, and an explanation of combustion control by varying the stroke of the coal pusher and the angle of rotation of the bars. The effect of the flux content of ash in determining the fusion temperature is also discussed.