bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-scale modeling and strengthening–toughening mechanism of ductile–ductile-layered configuration composites
Authors: Peng Yahui , Zhao Haitao , Lichaoran Guan , Cao He , Yuan Mingqing , Ouyang Qiubao , Chen Ji’an
Published: August 2024

The mechanical behaviors of novel submicron silicon carbide (SiCsm)/ aluminum (Al)-micron silicon carbide (SiCm)/2024Al composites with a ductile–ductile-layered configuration are studied using experimental and multi-scale numerical simulation methods. To study the strengthening–toughening mechanism of the composites, we establish multi-scale representative volume elements (RVEs) at microscopic and mesoscopic scales in ABAQUS finite element software, where the micro-RVE contains SiCsm, Al matrix, and SiCsm/Al interfaces, which are used to predict the mechanical property of the SiCsm/Al element and the meso-RVE contains homogeneous cylindrical SiCsm/Al elements, SiCm, 2024 aluminum (2024Al) matrix, SiCm/2024Al interfaces, and layer interfaces. The tensile stress–strain relationship, damage, and failure behavior of the SiCsm/Al-SiCm/2024Al composites are simulated, which is consistent with the experimental tensile test results. A series of finite-element models of SiCsm/Al-SiCm/2024Al composites is established whose mechanical properties are calculated and the strengthening–toughening mechanism is analyzed. An optimization design method of synergizing microscopic mechanical properties with structural configuration has been developed for the strengthening–toughening trade-off of ductile–ductile-layered configuration composites, and the strengthening–toughening design of the SiCsm/Al-SiCm/2024Al composites is realized.
Effect of an improved multistage thermo-mechanical processing on microstructure and mechanical property of TiB2/Al-Cu composites
Authors: Chen Songyi , Chen Shaoxuan , Wang Dengbiao , Chen Kanghua
Published: August 2024

An improved multistage thermomechanical processing including multitemperature rolling and solution heat treatment, severe cold rolling and short-time aging heat treatment, of in-situ TiB2/Al-Cu composites have been proposed to modify matrix grain size, TiB2 particle distribution and precipitates. The average grain size of multitemperature rolling process was about 2 times smaller than that of conventional high temperature rolling. Additional, severe cold rolling prior to aging heat treatment was beneficial to form homogeneous distribution TiB2 particles. The strength and ductility of TiB2/Al-Cu composites were significantly increased by the improved multistage thermomechanical processing due to the formation of finer recrystallized grains, more homogeneous distribution of TiB2 particles and finer aging precipitates.
How do primary care clinicians approach hospital admission decisions for people in the final year of life? A systematic review and narrative synthesis
Authors: Davies Rachel , Booker Matthew , Ives Jonathan , Huntley Alyson
Published: August 2024

Background:

The final year of life is often associated with increasing health complexities and use of health services. This frequently includes admission to an acute hospital which may or may not convey overall benefit. This uncertainty makes decisions regarding admission complex for clinicians. There is evidence of much variation in approaches to admission.

Aims:

To explore how Primary Care clinicians approach hospitalisation decisions for people in the final year of life.

Design:

Systematic literature review and narrative synthesis.

Data sources:

We searched the following databases from inception to April 2023: CINAHL, Cochrane Library, Embase, MedLine, PsychInfo and Web of Science followed by reference and forward citation reviews of included records.

Results:

A total of 18 studies were included: 14 qualitative, 3 quantitative and 1 mixed methods study. As most of the results were qualitative, we performed a thematic analysis with narrative synthesis. Six key themes were identified: navigating the views of other stakeholders; clinician attributes; clinician interpretation of events; the perceived adequacy of the current setting and the alternatives; system factors and continuity of care.

Conclusion:

This review shows that a breadth of factors influence hospitalisation decisions. The views of other stakeholders take great importance but it is not clear how these views are, or should be, should be balanced. Clinician factors, such as experience with palliative care and clinical judgement, are also important. Future research should focus on how different aspects of the decision are balanced and to consider if, and how, this could be improved to optimise patient-centred outcomes and use of health resources.
Prenatal diagnosis and genetic counseling of a de novo 10q11.21q11.23 duplication associated with a normal phenotype
Authors: Ouyang Liu , Li Yan , Liu Fangfang , Zeng Qin
Published: August 2024

Copy number variants (CNVs) are an important source of normal and pathogenic genome variations. Unbalanced chromosome abnormalities are either gains or losses of large genomic regions that do not or only minimally clinically affect the individual. Noninvasive prenatal testing (NIPT) is widely used in the screening of common fetal chromosome aneuploidy. One example is the duplication of 10q11.21q11.23, which includes the 10q11.2 region. This region contains a complex set of low-copy repeats that may lead to various genomic alterations through non-allelic homologous recombination. In this report, we present a case of a de novo 10q11.21q11.23 duplication with a normal phenotype. This case may be helpful for prenatal diagnosis and genetic counseling. A combination of NIPT, prenatal ultrasound, karyotype analysis, copy number variation sequencing, and genetic counseling is helpful for the prenatal diagnosis of CNVs.
Characterization of Degraded Ballast Strength: A Field Application of Ground Penetrating Radar and Dynamic Cone Penetration
Authors: Kim Youngdae , Wiggins Robert , Byun Yong-Hoon , Qamhia Issam I. A. , Tutumluer Erol , Beasley Jeremy , Cisko Abby , Kashani Hamed , Langlois Ryan , Harrell Michael J.
Published: August 2024

Ballast performance and lifecycle are influenced by aggregate breakdown-related degradation or fouling and moisture accumulating in track substructure, necessitating effective monitoring and characterization methods. Recent research supported by the U.S. Army Engineer Research and Development Center has focused on investigating condition assessment technologies and developing innovative solutions to ensure railway infrastructure performance. This paper presents a combined application of ground penetrating radar (GPR), the Smart Dynamic Cone Penetrometer (DCP) with an automatic depth measurement system, and the PANDA® penetrometer for comprehensive ballast condition evaluations. The GPR scans covered 43.5 km (27 mi) of railway track, and two types of DCP tests were executed at 15 distinct locations within the Fort Campbell Army installation in Kentucky. The analyses focused on understanding the depth profiles of the track substructure with particular attention given to ballast depth, fouling index (FI), moisture content, and ballast strength. The GPR surveys yielded relative moisture content (RMC) and FI depth profile heatmaps, revealing a correlation between these two variables. A comparative analysis of the Smart DCP and PANDA penetrometer results was conducted, identifying interfaces between the ballast and subballast layers. The study explores the impact of RMC and FI on ballast strength, particularly beyond a critical penetration depth from the ballast surface. Finally, a Gaussian function model is proposed to represent the California Bearing Ratio as a function of the FI and RMC. These findings offer potential for predictive assessments of ballast strength based on FI and moisture content.
Reading Between the Lines: An Exploratory Pilot Study of a Co-creation Approach to Life Story Work in Aged Care in Australia
Authors: Golenko Xanthe , Manchha Asmita , Fowke Anna , Johnstone Georgina , Lowthian Judy A.
Published: August 2024

Life story work (LSW) uses a narrative, reminiscence approach to capturing memories from one’s life and has shown positive outcomes for participants. However, LSW in aged care has been criticized for being resource intensive, often involving care staff using pre-determined process and output formats. This pilot study explored participants’ lived experiences of a novel co-creation approach to LSW conducted predominantly with university students and older adults in residential aged care and retirement communities, producing multi-modal outputs. Within a 12-month period, 33 LSW projects were completed (21 books, 5 posters, and 7 digital stories). Semi-structured interviews ( n = 44) explored participants’ lived experience of completing a LSW project. Findings indicate that working with students and adopting a flexible, co-creation approach that empowers participants to make decisions, engage in learning and reflection, and build meaningful relationships can maximize opportunities for transformative impacts, and enable providers to offer a LSW program despite finite resources.
Procedural Modeling in Urban Digital Twins as a Tool for Visualization, Analysis, and Public Engagement: Examining a Housing Policy in California
Authors: Hajrasouliha Amir , Amos Dave
Published: August 2024

This article showcases the versatility of procedural modeling techniques in urban planning beyond their traditional use in visualization, such as an analytical tool and potentially a public engagement tool. The study demonstrates the potential of a specific California housing development state policy, Senate Bill 9 (SB9), which authorizes certain property owners to divide their land into two lots and erect two residences on each. Results of a California city’s parametric modeling indicate that procedural modeling can visualize the implications of land use regulation in an analytical and intelligible way to planning practitioners and the public.
Mechanical behavior of sisal glass-reinforced polymer composites under tensile loading and geometric irregularities
Authors: Tamilvendan D. , Ravikumar A.R. , Munimathan ArunKumar , Ganesh M.
Published: August 2024

The study aims to evaluate the tensile behavior of sisal glass-reinforced polymer composites with varying geometric irregularities. Composite laminates were fabricated using a hand layup technique, incorporating sisal fiber woven reinforcement and ortho-phthalic unsaturated polyester resin. The laminates, configured with 7 and 9 layers, were subjected to tensile testing with and without 6 mm and 12 mm diameter central holes and double holes spaced at 6.2 mm, 12 mm, and 48 mm intervals. The tensile tests were conducted using an electromechanical test system, and the results were analyzed to determine the ultimate tensile strength, modulus of elasticity, and failure strain for each specimen type. The findings revealed significant differences in tensile strength depending on the presence and size of the holes. Specimens with central holes exhibited a reduction in tensile strength, with the extent of strength reduction dependent on the hole diameter. Larger holes resulted in more severe stress concentrations, leading to greater strength degradation. Double-hole specimens showed similar strength reduction patterns, with closer spacing exacerbating the stress concentration effects. The residual strength ratio (RSR) for different configurations conformed to expected values for fiber-reinforced composites with circular hole-type defects. The study underscores the critical impact of geometric irregularities on the mechanical performance of sisal glass-reinforced polymer composites. These findings can guide the development of design strategies to mitigate the adverse effects of stress concentrators, thereby enhancing the reliability and durability of these materials in practical applications.
Tibial post loading increases the risk of aseptic loosening of posterior-stabilized tibial prosthesis
Authors: Chen Zhenxian , Han Jianian , Zhang Jing , Peng Yinghu , Guo Lei , Chen Shibin , Jin Zhongmin
Published: August 2024

Aseptic loosening is the primary cause of failure following posterior-stabilized total knee arthroplasty. It is unclear whether tibial post loading of posterior-stabilized prosthesis increases the risk of aseptic loosening of the tibial prosthesis. The purpose of this study is to investigate the biomechanical effects of tibial post loading on the tibial prosthesis fixation interface during level walking, squatting, stair descent, and standing up-sitting down activities. In this paper, finite element models with and without post were established to compare the effects of tibial post loading on the von Mises stress of the proximal tibia, shear stress of the cement, and the bone-prosthesis interface micromotion during four physiological activities. The tibial post loading had an insignificant influence on tibial biomechanics and bone-prosthesis interface micromotion during leveling walking activity. However, compared to the insert without post condition, tibial post loading significantly increased the maximum tibial von Mises stress, the maximum shear stress in the medial of cement, and the bone-prosthesis interface peak micromotion by 912.84%, 612.77%, and 921.09%, respectively, at the moment of the maximum flexion angle for the stair descent activity, and 637.92%, 351.43%, and 519.13%, respectively, at the moment of the maximum flexion angle for the standing up-sitting down activity. Tibial post loading increased the risk of postoperative aseptic loosening of tibial prosthesis in patients with posterior-stabilized total knee arthroplasty, and it was recommended that the post-cam contact mechanism of posterior-stabilized prosthesis should be optimized to reduce the biomechanical impact of tibial post loading on tibial prosthesis fixation.
Experiences of Nurses and Midwives Who Support Bereaved Parents During Perinatal Deaths in Ghana: A Descriptive Phenomenological Study
Authors: Mohammed Latifa , Dzando Gideon , Awiagah Sherrif Kwame
Published: August 2024

Introduction

Globally, perinatal death presents a profound challenge for healthcare and healthcare professionals, requiring enormous clinical expertise and mental fortitude. The complexity involved in balancing professionalism, empathy, and the human face pose significant emotional challenges for nurses and midwives. Perinatal deaths in Ghana remain high and have adversely impacted the achievement of Sustainable Development Goal 3. Nurses and midwives play a central role in the Ghanaian healthcare system, and understanding their experiences in providing care to grieving mothers can provide valuable data for enhancing bereavement support as well as promoting quality improvement in clinical care.

Objective

To explore the experiences of nurses and midwives who support bereaved parents during perinatal deaths in Ghana.

Methodology

A descriptive-phenomenological approach was used to explore the lived experiences of the participants. Twelve participants were purposively recruited from the neonatal and intensive care unit of a District Hospital in northern Ghana. Interviews were conducted using a semi-structured interview guide. The data was analyzed iteratively using the thematic analysis approach.

Findings

Six themes emerged from the interviews with the study participants. The six themes were personal experience of perinatal death, emotional impact on the nurses and midwives, parental reactions and coping, blame and guilt, the impact on work, and long-lasting psychological impact. The themes reflect the emotional and practical experiences encountered by the nurses and midwives when supporting bereaved parents and the impact of such experiences on their well-being.

Conclusion

Perinatal bereavement support is a core responsibility of the nurses and midwives who work in maternal and neonatal units. Despite an improvement in perinatal death globally, the rates are still of great concern in Sub-Saharan Africa. Ironically, the experiences of nurses and midwives who support parents in times of perinatal death are lacking in Sub-Saharan Africa. This study sheds light on the experiences of nurses and midwives who support parents during perinatal death in a Ghanaian context, highlighting the importance of supporting these healthcare professionals.
How to Achieve Person-Centered Care for People Using Home Care Services: A Narrative Review
Authors: Bassul Carolina , Gannon Judy , Kelly Yvonne , Williams Michelle , Morrissey David , McKee Joyce , O’Rourke Niamh , Flynn Rachel
Published: August 2024

It is well accepted that the preferred place of care for many people is in their own homes and that home care services have the potential to allow people to remain in their own homes for as long as possible. This narrative review aimed to summarize the existing literature on person-centered practices in home care and develop a conceptual framework, based on The Health Information and Quality Authority’s (HIQA) standards development principles, to achieve high-quality person-centered home care. A narrative review was conducted using the academic databases Embase, APA PsychInfo, Social Services Abstracts and CINAH. A qualitative content analysis was used to analyze and synthesize the findings. In total 39 studies were included in this narrative review. This review emphasizes four key principles for person-centered home care. A human-rights based approach ensures care is delivered with dignity, respect, and non-discrimination, guaranteeing equitable access for all. The safety and wellbeing principle focuses on preventing health decline and harm, while promoting the overall well-being of the care recipient. Responsiveness centers on how staff identify and address individual needs, with their skills and competencies playing a crucial role. Finally, the accountability principle underlines the importance of strong leadership, clear governance, and effective collaboration between home care and other services. The approach of using principles as a framework to underpin this study can inform policymakers, home care providers and others in good practice in upholding person-centered care during the development of home care policy and care delivery.
Batched sparse direct solver design and evaluation in SuperLU_DIST
Authors: Boukaram Wajih , Hong Yuxi , Liu Yang , Shi Tianyi , Li Xiaoye S
Published: August 2024

Over the course of interactions with various application teams, the need for batched sparse linear algebra functions has emerged in order to make more efficient use of the GPUs for many small and sparse linear algebra problems. In this paper, we present our recent work on a batched sparse direct solver for GPUs. The sparse LU factorization is computed by the levels of the elimination tree, leveraging the batched dense operations at each level and a new batched Scatter GPU kernel. The sparse triangular solve is computed by the level sets of the directed acyclic graph (DAG) of the triangular matrix. Batched operations overcome the large overhead associated with launching many small kernels. For medium sized matrix batches with not-so-small bandwidth, using an NVIDIA A100 GPU, our new batched sparse direct solver is orders of magnitude faster than a batched banded solver and uses less than one-tenth of the memory.
Using fiber optic sensors to monitor the quality of resistance spot welding joints
Authors: Zeng Boyi , Wang Yanjun , Ye Lei , Yang Shanglu
Published: August 2024

Resistance spot welding (RSW) is a widely used technique in the automotive industry. The weld size is the critical parameters for evaluating the quality of RSW. In this study, an innovative non-destructive inspection method based on fiber-optic sensing was proposed. The relationship between the change of the fiber optic sensor signals during the welding process and the weld size is established. The results show that there is a strong correlation between the maximum wavelength change of the fiber optic sensing signal during the welding process and the weld size. The method shows good generalizability to different welding parameters and materials. In addition, the signal vibration difference can accurately predict the occurrence of expulsion.
Anatomical Feasibility of Percutaneous Arteriovenous Fistula Formation in Korea
Authors: Moon Ki Yoon , Jang Eun Ju , Lee Seung Hoon , Han Hong Suk , Park Sun Cheol , Kim Jang Yong , Yun Sang Seob
Published: August 2024

Introduction

Currently, there are two types of percutaneous arteriovenous fistula (pAVF) formation systems approved by the FDA: Ellipsys and WavelinQ. Although these systems are already in use in Europe or the United States, they have not been approved for use in Korea yet. For this reason, this study aimed to check anatomical feasibility of these systems for Korean population prior to their actual use.

Methods

Consecutive patients who received ultrasound vein mapping for arteriovenous fistula formation from June 2021 to June 2022 were included. The anatomical feasibility of each system was confirmed according to the manufacturer’s instructions for use (IFU).

Results

Upper extremity ultrasonography was performed for a total of 83 patients to determine their feasibility for pAVF formation. Of these patients, 65.1% were feasible for pAVF formation with appropriate deep communicating vein (DCV) and outflow. Among them, 57.8% were feasible for the Ellipsys system and 54.2% were feasible for the WavelinQ system. Most patients who were infeasible for pAVF formation had a DCV of small size. Ulnar vessels were more suitable than radial vessel for WavelinQ (54.2% vs 33.7%, P-value = .012). The most common reason for not meeting the criteria was a small vein size at the access site.

Conclusions

More than half of all patients were feasible for pAVF formation in this study. Ellipsys had a higher feasibility than WavelinQ, although they showed no significant difference in the feasibility. If these devices are imported into Korea, it will be a good opportunity for many patients to reduce the surgical burden and create AVFs more easily through these procedures.
The effects of attentional focus instructions on approach jump performance
Authors: Liu Hanwen , Arnett Scott , Tolusso Dano , Woodard Kaylee
Published: August 2024

Introduction

Attentional focus has been shown to significantly influence motor learning and performance, with external focus instructions enhancing performance compared to internal focus instructions. Research has also demonstrated that novice performance is improved when instructed to focus on skill execution processes rather than outcomes. However, this effect remains untested in complex jumping skills crucial to numerous sports.

Purpose

This study aimed to investigate the effect of internally and externally directed process and outcome focus instructions on approach jump height and approach speed in novice participants.

Methods

Twelve individuals aged 18 to 22 participated across three sessions: Familiarization, Test Session 1, and Test Session 2. During the test sessions, participants executed approach jumps in various conditions, each emphasizing specific cues: External Focus-Outcome, Internal Focus-Outcome, External Focus-Process, and Internal Focus-Process. Jump-and-Reach Height, Estimated Jump Height by Flight Time, and Approach Speed were assessed through 2 × 2 repeated measures ANOVAs.

Results

External focus and outcome conditions led to the highest jump-and-reach height ( p < .05). Process conditions yielded faster approach speed compared to outcome conditions ( p < .001), irrespective of internal or external focus direction. Estimated jump height by flight time was similar across all conditions.

Conclusions

The study suggests that benefits of external focus and process instructions for novices may apply only to certain performance variables in complex motor skills.

Practical Applications

Practitioners can optimize novices’ performance using various process- and outcome-based instructions. External, outcome-based cues enhance overall task performance, while process-based cues may improve specific technical components.
Network- and CFD/CAA-modelling of the high frequency flame response in multi-jet combustors
Authors: Rosenkranz Jan-Andre , Neu Jonas , Sattelmayer Thomas
Published: August 2024

Low order networks are widely used for linear stability analysis of combustors in the low frequency limit. High frequency stability analysis, however, is limited to cost-intensive numerical or experimental methods, since derivation of analytical solutions is either cumbersome or impossible. The article at hand provides a quasi-two-port network model for the effective modal acoustic pressure and axial velocity normalised with the transverse acoustic field for cylindrical combustors. This network modelling approach includes transfer matrices of acoustic area jumps, ducts for longitudinal, standing and spinning transverse and mixed mode wave propagation. The purely acoustic transfer matrices are validated with a generic non-reactive experiment. On the basis of phase-locked [Formula: see text] images of an engine-similar multi-jet combustor with a forced T1 mode, a locally distributed flame response model is derived, which is reduced to a global flame transfer matrix. A locally resolved convective flame response model is implemented in a numerical model in order to verify the provided theory by the comparison of the analytical and numerical flame transfer matrix for the high-frequency regime.
Sacrificial cladding design for blast mitigation using low density crushable core systems
Authors: Ousji Hamza , Belkassem Bachir , Aminou Aldjabar , Pyl Lincy , Dhouibi Mohamed , Lecompte David
Published: August 2024

The aim of this study is to define a simple approach to select an adequate sacrificial cladding configuration (front plate and crushable core parameters) to protect a given structure against a blast load. A simplified one-dimensional model, denoted, the Load-Cladding-Structure (LCS) model is investigated and the effect of the fluid-structure interaction (FSI), the loading rate (LR) and the sacrificial cladding-structure interaction are examined. Strong blast load and two low-density crushable cores are considered: (i) a polyurethane foam (PU), and (ii) a metallic beverage can (MBC). Small scale experimental results are analysed and compared to analytical models. This shows that: (i) the LCS model is a non-conservative model, (ii) both the FSI and the LR have to be considered, and (iii) the use of an adequate sacrificial cladding converts the hazardous blast load into a relatively lower pressure applied over a longer time span. Hence, simple steps are provided to select the front plate characteristics and the crushable core plateau stress and thickness, as a function of the blast load intensity and the structure properties.
The central role of price fairness for cost transparency strategy: What is the effect of conventional versus Fairtrade products and construal level?
Authors: Casteran Gauthier
Published: August 2024

Insufficient information and understanding regarding a product’s price components can lead to negative perceptions of the fairness of the price and subsequent negative behaviors toward the product. Cost transparency is a way to disclose these components and enhance price fairness and, in turn, behaviors. Previous research rarely tests the role of price fairness in the cost transparency process and limits itself to studying conventional products without considering other product types (e.g. Fairtrade products). Moreover, the moderating effect of consumers’ characteristics (such as the construal level) is also lacking. To fill these gaps, we run two online experiments. We find that price fairness fully mediates the cost transparency–purchase intention relationship. We further find that this effect is stronger for Fairtrade products than for conventional products and that this enhanced effect is stronger for consumers with high construal level compared to consumers with low construal level. We discuss theoretical and managerial implications.
Overseas Chinese parent wanghong on Douyin: Discursive constructions of diasporic parenthood
Authors: Zhao Xinyu
Published: August 2024

This article explores how overseas Chinese parent wanghong (网红, internet celebrities) document, curate, and share their everyday life of parenting on Douyin, one of the most actively used short video platforms in China. Wanghong in this article refers to Chinese parents who were born in China and have migrated outside of the country with children or to form families, and who have attracted online audience and fame by sharing their everyday family life with children and as parents. Despite the technological boundaries between Douyin and its international counterpart (i.e. TikTok), many overseas Chinese, particularly the ‘new migrants’, were found to be avid users and content creators of digital platforms designed for the Chinese domestic market in their everyday life. This article begins with a critical review of emerging studies on diasporic wanghong/internet celebrities and the social constructions of ‘parenting’. Employing a multimodal discourse analysis approach, it then analyses a total of 27 videos posted by overseas Chinese parent wanghong on Douyin. Creators of these videos are physically located in 13 different countries. The analysis shows that while these videos construct diasporic parenthood in different ways, they share a common narrative to responsiblise parental obligations and decisions. The article discusses how these wanghong videos discursively construct and interpellate desirable qualities of ‘diasporic parenthood’, which draw on the various aspects of parent wanghong’s everyday experiences, observations, and values to distinguish themselves from parents within China.
Anterior Labrum Periosteal Sleeve Avulsion Lesions of the Shoulder: A Scoping Review
Authors: Rajagopalan Senthilvelan , Chodavarapu Mounika N.S. , Kambhampati Srinivas B.S. , Chinta Shyam Kumar , Kamineni Srinath
Published: August 2024

Background:

Anterior labrum periosteal sleeve avulsion (ALPSA) lesion of the shoulder is defined as a labral avulsion with an intact periosteum of the glenoid neck resulting in medial malattachment of the labrum, which is both nonanatomic and nonfunctional. It is relatively rare compared with Bankart lesions, and its results are usually reported in combination with other anterior labroligamentous lesions in the literature.

Purpose:

To (1) assess the size and scope of the literature on ALPSA lesions, (2) highlight the importance of this lesion, and (3) distinguish between ALPSA and Bankart lesions in diagnostic and treatment strategies.

Study Design:

Scoping review; Level of evidence, 4.

Methods:

The PubMed, Scopus, Embase, and Google Scholar databases were searched with the keywords “ALPSA,”“anterior labrum periosteal sleeve avulsion,”“anterior labral periosteal sleeve avulsion,” and “anterior labroligamentous periosteal sleeve avulsion” lesion. Duplicate articles and those that did not meet the inclusion criteria were excluded, resulting in the identification of 42 relevant articles. Their references were analyzed for further data curation.

Results:

This scoping review demonstrated that ALPSA lesions are difficult to clinically identify. Magnetic resonance angiography in the adduction internal rotation position is the most sensitive and specific imaging modality for identification. Optimal views are the anterosuperior portal for accurate identification and the anteroinferior portal for surgical repair during arthroscopy. Treatment begins with correctly identifying the labrum, in contradistinction to dense reactive fibrous tissue, and reattaching the labrum to the correct anatomic glenoid footprint. Chronic lesions with bone loss require either bone block or soft tissue augmentation procedures.

Conclusion:

There is paucity of exclusive literature on ALPSA lesions. It is important to distinguish this lesion from the Bankart lesion as it is associated with worse outcomes. The higher failure rates of ALPSA lesion repair indicate that the current repair techniques require further refinement to improve the outcomes to the standard of Bankart lesions.
Association between personality type and patient-reported outcomes (PRO) in patients with atrial fibrillation
Authors: Yan Qing , Liang Jiaqi , Yuan Yide , Li Yuan , Fan Jiali , Wu Wenhuan , Xu Pan , Wang Qunrang , Xue Jiahong
Published: August 2024

Background

Atrial Fibrillation (AF) is known to be associated with a negative emotional state. Patient-reported outcomes (PROs) are important tools for evaluating the endpoints of AF management. This study aims to examine the correlation between personality types and PROs in patients with AF.

Methods

All included subjects were newly diagnosed with AF fewer than one month, and their personality types were assessed using the Eysenck Personality Questionnaire (EPQ). Quality of life (QoL) was measured using the Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire. Anxiety and depression were assessed using the General Anxiety Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. We constructed stepwise linear regression analyses for factors related to the QoL and emotional state in patients with AF.

Results

A total of 531 AF patients completed the survey and were categorized into four groups based on their personality types. Of these patients (mean age: 67.12 ± 10.93 years, 50.28% male), 357 (67.23%) had paroxysmal AF, and 16.95% (n = 90) had a sanguine personality. Compared to patients with other personality types, those with a sanguine personality had the highest average AFEQT scores (P < 0.001) and the lowest scores of GAD-7 and PHQ-9 scales (P < 0.05). Furthermore, multiple linear regression analyses suggested that sanguine personality was also independently associated with better QoL and emotional states (P < 0.05).

Conclusion

There is a significant association between the personality types and PROs in AF patients.
Antibiotic utilization at an orthopedic inpatient department in a large governmental hospital in the north of the West Bank, Palestine; a retrospective observational study
Authors: Masalma Raed , Ghanim Ahmad , Jarrar Mahmoud , Zidan Thabet , Alkaiyat Abdulsalam , Abdalla Mazen , M. Jaber Mohammad , Qattawi Ismail , Joudeh Nagham , Khayyat Rasha
Published: August 2024

Background

Studies evaluating the patterns of antibiotic consumption are becoming increasingly necessary as a result of the increased use of antibiotics and development of antibiotic resistance globally. This study aimed to evaluate the use of antibiotics in in terms of both quantity and quality at the largest surgical hospital in the north of the West Bank, Palestine.

Methods

An observational retrospective study with a total population sampling method was conducted to collect data from the inpatients of the orthopedic departments of a large governmental hospital in the northern West Bank, Palestine. The data were collected from patients’ files and evaluated using the anatomical therapeutic chemical and defined daily dose (ATC/DDD) methodology, and the drug utilization 90% (DU90%) index. The ATC/DDD methodology, designed by the World Health Organization (WHO), as a well-trusted and standardized tool that allows measuring and comparing antibiotic utilization across different contexts. Antibiotic prescriptions were classified using the World Health Organization Access, Watch and Reserve classification (WHO AWaRe).

Results

Of the 896 patients who were admitted to the hospital in the year 2020 and included in the study, 61.9% were males, and 38.1% were females. The percentage of patients who received antibiotics was 97.0%, and the overall antibiotic usage was 107.91 DDD/100 bed days. The most commonly prescribed antibiotic was cefazolin (50.30 DDD/100 bed days), followed by gentamicin (24.15 DDD/100 bed days) and ceftriaxone (17.35 DDD/100 bed days). The DU90% segment comprised four different agents. Classification of antibiotics according to the WHO AWaRe policy revealed that 75.9% of antibiotics were prescribed from the access list.

Conclusion

This study comes as part of the efforts exerted to combat the growing problem of antibiotic resistance in Palestine. Our results showed that the consumption of antibacterial agents in the orthopedic unit at a large governmental hospital in Palestine was relatively high. The results of this study provide valuable insights for the decision-makers to create policies aimed at regulating antibiotic prescriptions. This study also aims to provide a look into the antibiotic prescription patterns, offering a clearer understanding of the current situation of antibiotic consumption in Palestine. It also emphasizes the need for antibiotic stewardship and surveillance programs.
Molecular characterization of NDM and OXA-48-like-producing Klebsiella pneumoniae ST16 and hypervirulent ST337 clone among two patients; a case report
Authors: Sokhanvari Sarvenaz , Bagheri Atiyeh , Badmasti Farzad , Solgi Hamid
Published: August 2024

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, requiring the use of last-resort antibiotics such as colistin. However, there is concern regarding the emergence of isolates resistant to this agent. The report describes two patients with urinary tract infection (UTI) and ventilator-associated pneumonia (VAP) infection caused by CRKP strains. The first case was a 23-year-old male with UTI caused by a strain of ST16 co-harboring blaCTX-M, blaTEM, blaSHV, blaNDM, blaOXA-48-like genes. The second case was a 39-year-old woman with VAP due to hypervirulent ST337-K2 co-harboring blaSHV, blaNDM, blaOXA-48-like,iucA, rmpA2 and rmpA. The patients’ general condition improved after combination therapy with colistin (plus meropenem and rifampin, respectively) and both of them recovered and were discharged from the hospital. This study highlights the necessary prevention and control steps to prevent the further spread of CRKP strains should be a priority in our hospital.
Peritoneal and renal DKK3 clearance in peritoneal dialysis
Authors: Ehleiter Hagen , Miranda Julia , Boes Dominik , Scheidt Uta , von Vietinghoff Sibylle , Schwab Sebastian
Published: August 2024

Background

Urinary Dickkopf 3 (DKK3) excretion is a recently established biomarker of renal functional development. Its excretion into the peritoneal cavity has not been reported. We here studied DKK3 in peritoneal dialysis.

Methods

DKK3 was assessed in serum, urine and dialysate in a prevalent adult peritoneal dialysis cohort and its concentration analyzed in relation to creatinine and clinical characteristics.

Results

Highest DKK3 concentrations were found in serum, followed by urine. Dialysate concentrations were significantly lower. Dialysate DKK3 correlated with both other compartments. Serum, dialysate and urine values were stable during three months of follow-up. Continuous ambulatory dialysis (CAPD) but not cycler-assisted peritoneal dialysis (CCPD) volume-dependently increased peritoneal DKK3 in relation to creatinine. RAAS blockade significantly decreased urinary, but not serum or peritoneal DKK3.

Conclusion

Our data provide a detailed characterization of DKK3 in peritoneal dialysis. They support the notion that the RAAS system is essential for renal DKK3 handling.
Navigating weight, risk and lifestyle conversations in maternity care: a qualitative study among pregnant women with obesity
Authors: Sandsaeter Heidi L. , Eik-Nes Trine Tetlie , Getz Linn Okkenhaug , Magnussen Elisabeth Balstad , Rich-Edwards Janet W. , Horn Julie
Published: August 2024

Background

Pregnant women with obesity face heightened focus on weight during pregnancy due to greater risk of medical complications. Closer follow-up in maternety care may contribute to reduce risk and promote health in these women. The aim of this study was to gain a deeper insight in how pregnant women with obesity experience encounters with healthcare providers in maternity care. How is the received maternity care affected by their weight, and how do they describe the way healthcare providers express attitudes towards obesity in pregnancy?

Methods

We conducted in-depth interviews with 14 women in Trøndelag county in Norway with pre-pregnancy BMI of ≥ 30 kg/m2, between 3 and 12 months postpartum. The study sample was strategic regarding age, relationship status, education level, obesity class, and parity. Themes were developed using reflexive thematic analysis. The analysis was informed by contextual information from a prior study, describing the same participants’ weight history from childhood to motherhood along with their perceptions of childhood quality.

Results

This study comprised of an overarching theme supported by three main themes. The overarching theme, Being pregnant with a high BMI: a vulnerable condition, reflected the challenge of entering maternity care with obesity, especially for women unprepared to be seen as “outside the norm”. Women who had grown up with body criticism and childhood bullying were more prepared to have their weight addressed in maternity care. The first theme, Loaded conversations: a balancing act, emphasizes how pregnant women with a history of body criticism or obesity-related otherness proactively protect their integrity against weight bias, stigma and shame. The women also described how some healthcare providers balance or avoid weight and risk conversations for the same reasons. Dehumanization: an unintended drawback of standardized care makes apparent the pitfalls of prioritizing standardization over person-centered care. Finally, the third theme, The ambivalence of discussing weight and lifestyle, represent women’s underlying ambivalence towards current weight practices in maternity care.

Conclusions

Our findings indicate that standardized weight and risk monitoring, along with lifestyle guidance in maternity care, can place the pregnant women with obesity in a vulnerable position, contrasting with the emotionally supportive care that women with obesity report needing. Learning from these women’s experiences and their urge for an unloaded communication to protect their integrity highlights the importance of focusing on patient-centered practices instead of standardized care to create a safe space for health promotion.
Higher phosphate concentrations as in aqueous humor of diabetic patients increase intraocular lens calcification
Authors: Buhl Rebecca , Yildirim Timur Mert , Schickhardt Sonja Katrin , Britz Leoni , Lieberwirth Ingo , Auffarth Gerd Uwe , Khoramnia Ramin
Published: August 2024

Background

Clinical evidence suggests an association between phosphate concentrations in aqueous humor and the risk of intraocular lens (IOL) calcification. To test this hypothesis the influence of different phosphate concentrations on IOL calcification was evaluated in an in vitro electrophoresis model.

Methods

20 IOLs of two hydrophilic IOL models (CT Spheris 204, Zeiss; Lentis L-313, Oculentis) and one hydrophobic control IOL model (Clareon CNA0T0, Alcon) were exposed to physiologic and elevated phosphate concentrations, similar to diabetic aqueous humor. IOL calcification was analyzed by alizarin red staining, von Kossa staining, scanning electron microscopy, energy dispersive x-ray spectroscopy and transmission electron microscopy with electron diffraction.

Results

Higher phosphate concentrations were associated with IOL calcification. Analyses of IOL surfaces and cross-sections documented calcification in no CT Spheris and 4 Lentis IOLs following exposure to 10 mM Na2HPO4, compared with 7 and 11 positive analyses following exposure to 14 mM Na2HPO4, respectively. Furthermore, a clear association between IOL calcification and the duration of electrophoresis was demonstrated, confirming increased phosphate concentrations and duration of exposure as risk factors of IOL calcification.

Conclusions

Findings suggest that higher phosphate concentrations in aqueous humor, as seen in diabetic patients, contribute to an increased IOL calcification risk, potentially explaining clinical observations showing an increased risk of IOL calcification in patients with diabetes.
The impact of health insurance on hypertension care: a household fixed effects study in India
Authors: Feng Zixuan , Chen Qiushi , Jiao Lirui , Ma Xuedi , Atun Rifat , Geldsetzer Pascal , Bärnighausen Till , Chen Simiao
Published: August 2024

Introduction

Hypertension is highly prevalent in India, but the proportion of patients achieving blood pressure control remains low. Efforts have been made to expand health insurance coverage nationwide with the aim of improving overall healthcare access. It is critical to understand the role of health insurance coverage in improving hypertension care.

Methods

We used secondary data from the nationally representative sample of adults aged 15–49 years from the 2015–2016 National Family Health Survey (NFHS) in India. We defined the hypertension care cascade as four successive steps of (1) screened, (2) diagnosed, (3) treated, and (4) controlled, and operationalized these variables using blood pressure measurements and self-reports. We employed household fixed effect models that conceptually matched people with and without insurance within the household, to estimate the impact of insurance coverage on the likelihood of reaching each care cascade step, while controlling for a wide range of additional individual-level variables.

Results

In all 130,151 included individuals with hypertension, 20.4% reported having health insurance. For the insured hypertensive population, 79.8% (95% Confidence Interval: 79.3%-80.3%) were screened, 49.6% (49.0%-50.2%) diagnosed, 14.3% (13.9%-14.7%) treated, and 7.9% (7.6%-8.2%) controlled, marginally higher than the percentages for the uninsured 79.8% (79.5%-80.0%), 48.2% (47.9%-48.6%), 13.3% (13.1%-13.5%), and 7.5% (7.4%-7.7%) for each cascade step, respectively. From the household fixed effects model, health insurance did not show significant impact on the hypertension care cascade, with the estimated relative risks of health insurance 0.97 (0.93–1.02), 0.97 (0.91–1.03), 0.95 (0.77–1.30), and 0.97 (0.65–1.10) for each cascade step, respectively. We further performed stratified analyses by sociodemographic and behavioral risk factors and a sensitivity analysis with district fixed effects, all of which yielded results that confirmed the robustness of our main findings.

Conclusions

Health insurance did not show significant impact on improving hypertension care cascade among young and middle-aged adults with hypertension in India. Innovative strategies for overcoming practical barriers to healthcare services in addition to improving financial access are needed to address the large unmet need for hypertension care.