bluuebunny/crossref_metadata_2025 huggingface dataset:
Tokens or Trailblazers: Identity Construction of Occupants of New Inclusion-Driven Roles
Authors: Pazzaglia Federica , Sonpar Karan , Kulkarni Mukta , Maheshwari Navya
Published: September 2024

New roles birthed by organizational inclusion initiatives present an interesting puzzle. On the one hand, they hold the promise to foster inclusion objectives more directly through their formalization in the organizational structure. On the other hand, they tend to be ambiguous as to what occupants are expected to do and how to reconcile this with existing organizational goals and processes. Therefore, they create a burden for their occupants to create a role identity that legitimizes who they are and what they do. To address this puzzle, we draw on a qualitative study of early occupants of the newly created role of lady officer within the Indian military. We find that their role identity construction involved negotiating an optimal balance between professional and inclusion-informed identities through discursive and embodied identity work. Role occupants’ identity work initially emphasized elements of their professional identity and subsequently infused elements of departure informed by their views of the role. In doing so, they sought to shape interpretations of the role and craft a sense of role legitimacy. Our key contribution lies in developing an emergent theory of identity construction by occupants of inclusion-focused roles, illustrating their efforts to craft a role identity and a sense of legitimacy for their role and themselves in it amid challenges posed by role ambiguity and by societal and organizational tensions.
Valuing What You Risk and Risking What You Value: Advancing a research agenda for risk studies
Authors: Jarzabkowski Paula , Unger Corinne , Meissner Katie
Published: September 2024

Risk studies have rapidly expanded in the last few decades. Yet this growth is characterized by fragmentation in the literature despite it being a central concept for a vast array of organizations, where their success or failure to manage risk is considered central to thriving, surviving or collapsing. We take this opportunity provided by the Perspectives format to engage with a selection of six diverse papers published in Organization Studies over four decades. Drawing from these papers, we trace the evolution of risk research in relation to its epistemic bases in either metrics or values and the strategic focus on risk as either harm or opportunity. Inspired by the tensions between each of these bases, our review of the selected articles illustrates the dynamic entanglement of these ostensibly distinct and polarized strategic and epistemic bases of risk studies. We then develop a conceptual framework to map the field of risk research and propose avenues for future research. Our framework enables us to propose a stronger focus on risk taking for opportunity, warn against becoming overly focused on the metrics for controlling harm especially in the face of enticing visualizations of harmful risk, and strongly assert values as an important epistemic basis for risk studies. As these values may be hidden or visible, we emphasize the importance of understanding whose values are foregrounded in proposing a research agenda for reclaiming societal benefit. This latter focus is a neglected area of risk studies yet is vitally important in addressing the big societal issues of our time.
Aspirin may be more suitable for patients with major depression: Evidence from two-sample Mendelian randomization analysis
Authors: Zhu Haohao , Qu Yucai , Zhou Qin , Du Zhiqiang , Zhou Zhenhe , Jiang Ying
Published: September 2024

Objective:

Utilizing two-sample Mendelian randomization (TSMR) analysis, this study aims to explore the potential bidirectional causal relationship between common nonsteroidal anti-inflammatory drugs (paracetamol, ibuprofen, aspirin) and major depression (MD) from a genetic standpoint.

Methods:

We employed summarized data from a Genome-Wide Association Study (GWAS) of European populations. The inverse variance weighted (IVW) method was used for TSMR analysis; outcomes were evaluated based on p-value, OR (Odds Ratio), and 95% confidence interval (95% CI).

Results:

From a genetic perspective, the study found that the use of paracetamol and ibuprofen increased the risk of MD (IVW (MRE): OR = 2.314, 95% CI: 1.609–3.327; p = 6.07E-06) and (IVW (MRE): OR = 2.308, 95% CI: 1.780–3.653; p = 0.002), respectively. No significant causal relationship was found between aspirin and MD ( p > 0.05). Reverse TSMR analysis found that MD increased the genetic predisposition to use paracetamol, ibuprofen, and aspirin (IVW (MRE): OR = 1.042, 95% CI: 1.030–1.054, p = 3.07E-12), (IVW (FE): OR = 1.015, 95% CI: 1.007–1.023, p = 1.13E-04), (IVW (MRE): OR = 1.019, 95% CI: 1.009–1.030, p = 4.22E-04), respectively. Other analytical methods and sensitivity analyses further supported the robustness and reliability of these findings.

Conclusion:

This study provides preliminary genetic evidence through bidirectional TSMR analysis that MD increases the genetic predisposition to use paracetamol, ibuprofen, and aspirin, aiding clinicians in devising preventive strategies against the misuse of non-steroidal anti-inflammatory drugs. Moreover, we found that the use of paracetamol and ibuprofen increases the risk of MD, whereas aspirin did not. This suggests a crucial clinical implication: clinicians treating MD patients could opt for the relatively safer aspirin over paracetamol and ibuprofen.
Collaborative Autonomous Overtaking System for Mixed Traffic Environments
Authors: Lamouik Imad , Ameur Chahinaze , Yahyaouy Ali , Sabri Abdelouahed
Published: September 2024

This paper explores the challenges associated with executing safe overtaking maneuvers. To address these concerns, we introduce a collaborative autonomous overtaking system that leverages Vehicle-to-Vehicle (V2V) communication alongside a camera-based approach for detecting surrounding vehicles. Our approach involves sharing captured images among vehicles to ensure secure overtaking, eliminating blind spots for the overtaking vehicle. The system employs potential field algorithms for path generation and model predictive control to optimize vehicle control throughout the maneuver. Through simulations in various traffic scenarios, we validate the efficacy of the proposed system, showcasing significant improvements in traffic flow and safety, notably enhancing the system safety. This research contributes to the seamless integration of autonomous systems into existing traffic setups by incorporating a camera-based vehicle detection system and reducing reliance on traditional LiDAR and radar technologies.
Tall and Fall Versus Drop and Drive Strategy in College Baseball Pitchers for Velocity and Elbow Valgus Torque
Authors: Giordano Kevin , Nebel Adam R. , Fava Anthony , Oliver Gretchen D.
Published: September 2024

Background:

Depending on anthropometrics and coaching style, pitchers are taught to pitch with a stride strategy that are traditionally classified as “tall and fall” or “drop and drive” for the purpose of maximizing pitch velocity.

Purpose/Hypothesis:

The purpose of this study was to determine the effects of stride strategy (tall and fall vs drop and drive) in college baseball pitching on pitch velocity and elbow valgus torque. It was hypothesized that pitch velocity and elbow valgus torque would increase as pitchers aligned more with the tall and fall technique.

Study Design:

Controlled laboratory study.

Methods:

Markerless motion capture data were recorded on 64 collegiate pitchers (height, 1.89 ± 0.06 m; weight, 93.06 ± 9.44 kg) during game play at the host institution during the 2023 season. Peak magnitudes of body center of mass (COM) vertical displacement were determined using a straight-line trajectory between peak knee height and lead foot contact and used as a continuous variable. Pitchers were required to throw ≥4 fastballs during their outing to be included in the analysis. Multilevel modeling was used to determine associations between peak magnitudes of positive and negative vertical displacement of COM on pitch velocity and elbow valgus torque. Every fastball throughout the season with biomechanics data for each pitcher was included in the multilevel model.

Results:

Fastball velocity was mean ± SD 90.68 ± 2.90 mph (40.54 ± 1.29 m/s). Mean maximal negative vertical COM displacement was −0.91 ± 0.47 inches (−0.023 ± 0.012 m), which occurred 18.1% ± 5.75% of the way between peak knee height and stride foot contact. Mean maximal positive vertical COM displacement was 1.73 ± 1.14 inches (0.044 ± 0.029 m), which occurred 65.7% ± 7.8% of the time from peak knee height to stride foot contact. Positive COM displacement (β = 0.54; P < .001) and timing of peak positive COM displacement (β = 1.82; P = .023) reduced interpitcher variance by 9.9% and improved the ability of our model to predict fastball velocity. Negative COM displacement improved the ability of our model to predict ball velocity (β = −0.45; P = .021). Vertical COM displacement did not influence elbow valgus torque.

Conclusion:

Increasing vertical COM displacement in either the positive or the negative direction resulted in increased fastball velocity but did not result in greater elbow valgus torque. This indicates that the stride method may be used for performance enhancement but is unlikely to influence ulnar collateral ligament injury risk in college baseball pitchers.

Clinical Relevance:

Clinicians should not use stride mechanics as an injury risk indicator or diagnostic factor in injury etiology for college baseball pitchers.
Korean Behavior Assessment System for Children 3rd Edition Teacher Rating Scales-Child Form: A Validation Study
Authors: Baek Sung-eun , Ahn Christine Myung-hee
Published: September 2024

The purpose of this study was to evaluate the reliability and validity of the Korean Behavior Assessment System for Children 3rd Edition Teacher Rating Scales-Child Form (K·BASC-3 TRS-C). We used the generalized partial credit model based on item response theory (IRT) to examine the internal validity of the scale’s items and the latent trait in a sample of Korean children ( n = 318). Findings based on IRT provided strong evidence for the discriminative characteristics of the items. Additionally, the results revealed that the difficulty and discrimination of most items were appropriate, and the reliability of the K·BASC-3 TRS-C was excellent. Concurrent validity was tested using the Teacher’s Report Form for Ages 6–18 (TRF). Support for the external validity of subscale scores was found. A separate sample of 105 Korean children was used to examine the concurrent validity of a subset of the K·BASC-3 TRS-C subscales related to Anxiety, Hyperactivity, and Attention Problems demonstrated strong concurrent validity with TRF of related constructs. Other relevant findings, practical implications regarding the use of the K·BASC-3 TRS-C, and suggestions for future research are included in the discussion.
Cerebral Sinus Venous Thrombosis in Pediatric Acute Lymphoblastic Leukemia: Incidence, Clinical Characteristics, and Long-term Neurologic Outcomes
Authors: Johnson-Bishop Lindsay , Karakas Cemal , Kralik Stephen F , Cohen Clay T , Zobeck Mark , Park Nick , Rabin Karen , Pehlivan Davut , Bhar Saleh
Published: September 2024

Objective

To describe the incidence, clinical characteristics, and long-term outcomes of cerebral sinus venous thrombosis in children with acute lymphoblastic leukemia.

Methods

This was a retrospective cohort study comprising pediatric patients with newly diagnosed or first-relapse acute lymphoblastic leukemia who developed cerebral sinus venous thrombosis at Texas Children's Hospital from 2002 to 2019.

Results

Nineteen cases (1.7%) with cerebral sinus venous thrombosis were identified in all pediatric patients with acute lymphoblastic leukemia (n = 1129). Increased risk of cerebral sinus venous thrombosis was observed with age >10 years ( P = .006). Twelve cases (63%) occurred during the induction, 4 (21%) during maintenance, and 3 (16%) during the consolidation phases of leukemia therapy. Seizures (10/19) and headaches (9/19) were the most common presenting symptoms. After treatment with anticoagulation therapy, we observed full resolution of thrombosis in 10 (53%) and partial resolution in 8 patients (42%). Long-term neurologic outcomes at follow-up in the 14 patients who survived included normal neurologic examinations (n = 10), epilepsy (n = 3), and focal neurologic deficits (n = 2). The death occurred in 5 individuals.

Conclusion

Cerebral sinus venous thrombosis is a notable complication of pediatric acute lymphoblastic leukemia therapy. Older age (>10 years) was a risk factor for developing cerebral sinus venous thrombosis. Despite variable patient presentations and treatment durations, favorable clinical outcomes were observed in most patients after the treatment with anticoagulation for a minimum of 3 months.
“This Time It Was Different:” Creating a Multidisciplinary, Trauma-Informed, Victim-Centered Approach to Sexual Assault Cold Case Investigations and Prosecutions
Authors: Campbell Rebecca , Gregory Katie , Engleton Jasmine , Javorka McKenzie , Goodman-Williams Rachael
Published: September 2024

Police and prosecutors recommend that sexual assault survivors have a medical forensic exam and the collection of a sexual assault kit (SAK; also known as a “rape kit”) to preserve biological evidence (e.g., semen, blood, saliva, hair) if they want to pursue criminal prosecution. However, law enforcement personnel do not routinely submit SAKs to crime laboratories for forensic DNA testing. Instead, they often place untested kits in storage and close many of these reported cases after minimal investigation. Current estimates indicate there are 300,000 to 400,000 untested SAKs in law enforcement agencies throughout the United States. In response to this national problem, the U.S. Department of Justice created the Sexual Assault Kit Initiative (SAKI) Project to support kit testing, re-investigation, and prosecution of these “cold case” sexual assaults. The SAKI program also provides training and technical assistance to police, prosecutors, and victim advocates on how to use a multidisciplinary, trauma-informed, and victim-centered approach in cold case prosecutions. This study examined the extent to which one SAKI-funded site implemented these three guiding principles in their interactions with victims while prosecuting cold case sexual assaults. We conducted semistructured qualitative interviews with N = 32 sexual assault survivors from the first cohort of cold cases that were re-opened and prosecuted in this jurisdiction. Nearly all cases ( n = 31) ended in a guilty plea or trial conviction, and the vast majority of survivors indicated that they had positive experiences with the SAKI team. Survivors noted that they were listened to, believed, supported, and well-prepared by a multidisciplinary team of practitioners who were personally invested in their cases and in their well-being. Implications for creating multidisciplinary, trauma-informed, and victim-centered approaches with other communities are discussed.
College Behind Bars: A Historiography of Higher Education in Prison
Authors: Conway Patrick Filipe , Lally Marisa
Published: September 2024

This article presents a synthesized historiography of higher education in American prisons, exploring interactions of federal, state, and institution-level policies within six specific states: California, Illinois, Massachusetts, Mississippi, New York, and Texas. We define considerations for researchers, policymakers, and advocates regarding efforts to sustain educational access for incarcerated students. Findings suggest access is inextricably linked to policies relying on the social construction of crime and incarceration. As such, sole reliance on federal support may be detrimental for programs. A focus on diversifying funding sources will likely better ensure the long-term durability of support for higher education in prison programming.
Community Leadership and Donor-Advised Funds: Navigating Logics of Donor Services and Community Leadership in Community Foundations
Authors: Wu Viviana Chiu Sik
Published: September 2024

The growth of donor-advised funds provides an increasingly robust source of philanthropic capital for community foundations, but its impact on their leadership roles remains unknown. To what extent do community foundations maintain community leadership amid increasing pressure to accommodate donor wishes? Drawing on the institutional logics perspective and historical accounts, I theorize that community foundations are hybrids—they operate by combining the field-level logics of donor services and community leadership at varying degrees. Through an exploratory mixed-methods design, I analyzed the text data from annual reports and administrative data from the 990 forms of 482 community foundations. The findings reveal a positive association between the logic of donor services and leadership practices; specifically, foundations with a strong donor service logic, as indicated by the ratio of donor-advised fund (DAF)-funded grants, tend to exhibit a broader range of leadership activities. This study reveals that these logics not only coexist but may also mutually reinforce each other within the community foundation field.
New automatic sketching method for planetary gear train
Authors: Huang Xuewen , Ye Zhizheng , Xu Haocong , Ye Bingliang , Cui Rongjiang , Sun Liang
Published: September 2024

At present, the synthesis results of planetary gear train are saved in the form of adjacency matrices. Research on the sketching method of gear train mechanism is lacking. Adjacency matrices are not conducive to the kinematic analysis and evaluation of gear train mechanism. This study presents a new method for automatic sketching of planetary gear trains by generating a gear distribution matrix. The sketching rules of gears and planet carriers are established based on the structure characteristics. The gear is reasonably distributed by analyzing the gear meshing path and gear level. Thereafter, an algorithm of sketching for the planet carrier is proposed to avoid the line crossing between the planet carrier and gears. This study is beneficial in improving the design efficiency of planetary gear trains.
The feature extraction method based on quadratic wavelet packet energy entropy and t-SNE for bearing fault diagnosis
Authors: Cao Jiahao , Zhang Xiaodong , Yin Runsheng , Ma Zhichun
Published: September 2024

Rolling bearings are widely used in machinery and equipment, how to extract the feature and identify the fault of rolling bearings have become essential issues for ensuring the safe operation of rotation machinery. The fault signals of rolling bearings present nonlinear and non-smooth characteristics which introduce certain challenges to extracting the fault signal. To completely extract the features of signal, this study proposes a novel feature extraction method based on quadratic wavelet packet energy entropy (QWPEE) and t-distributed stochastic neighbor embedding (t-SNE) for bearing fault identification. Firstly, the vibration signals are divided into various node signals by wavelet packet decomposition (WPD). Next, the wavelet packet energy entropy (WPEE) of each node signal in the last layer is extracted to form the initial QWPEE feature vector. After that, the original QWPEE feature data are fused by the t-SNE method to obtain the final feature data set. Finally, the support vector machine (SVM) is employed to identify the states of the bearing fault. The experiments of bearing fault are created to ascertain the performance of the proposed methodology. The experimental outcomes demonstrate that the proposed methodology is efficacious in accurately identifying states of rolling bearing fault.
Electromechanical braking systems and control technology: A survey and practice
Authors: Jing Houhua , Lin Qinggan , Liu Mingqi , Liu Haifeng
Published: September 2024

The electromechanical braking system (EMB) is a dry braking system derived from the electro-hydraulic braking system. It deviates from the conventional hydraulic circuit, using a motor drive mechanism to directly actuate the caliper for clamping braking. EMB has advantages in assembly, maintenance, response speed, and control accuracy. Its notable features include enhanced smoothness and scalability, making it a representative research focus in the latest generation of braking systems. This article systematically reviews the EMB structure, friction modeling, clamping force estimation and control, and redundancy technology, and conducts practical research. Firstly, the trial prototype of the self-developed EMB actuator was completed. Then, the friction and clamping characteristics were analyzed through experimental testing. Finally, several typical contact point detection and clamping force control methods were applied and verified. This article provides in-depth analysis and practice on key issues related to EMB, clarifying the current research problems and challenges.
Complex motion design and control of aircraft model suspended with cable-driven parallel robot at high AoAs
Authors: Dong Wenzhao , Wang Xiaoguang , Wang Jiajun , Lin Qi
Published: September 2024

Modern advanced fighters are characterized by the post-stall maneuverability with multi-degree-of-freedom (M-DOF) at high angles of attack (AoAs), which is generally difficult to simulate with the traditional sting suspension method in wind tunnel due to its limited M-DOF capability and dynamics. This paper studies the complex motion control of an aircraft model suspended with a novel cable-driven parallel robot (CDPR) to reappear some typical agile maneuvers with high AOAs and large amplitudes. The tasks include modeling the unsteady aerodynamics, designing the desired motion command, and developing the robust control law. Firstly, the kinematic and dynamic equations of CDPR are given, and the state-space representation of aerodynamic forces and moments for unsteady aircraft motion is established. Subsequently, an angular motion involving rolling around the velocity vector is proposed, and a typical M-DOF motion trajectory is also designed. To deal with modeling uncertainties and external disturbances, a robust feedback controller is constructed by integrating the computed-torque control law with extended state observer (ESO), and its stability is analyzed using the Lyapunov function. ADAMS simulations and numerical investigations conducted on the CDPR validate the effectiveness of the proposed methods and controller.
A comprehensive assessment of working fluids selection in heat pipe-assisted battery thermal management systems: An integrated Multi-criteria decision-making approach
Authors: Kumar Rajat , Dwivedi Ankur , Sethi Muneesh , Mehra Kuber Singh , Goel Varun
Published: September 2024

Heat pipes are becoming increasingly popular for managing thermal conditions of electric car battery packs because of their durability, superconductive ability, low maintenance requirements, and lifespan. In this work, suitable working fluid for heat pipes has been identified using multi-criteria decision-making (MCDM) methods for 15 working fluids (Helium, Hydrogen, Oxygen, Nitrogen, Propane, Ethane, Ethanol, R123, Methanol, Toluene, Acetone, (FC-72), Ammonia, (HFE-7000), and water) as potential alternatives and nine decision attributes (thermal conductivity, specific heat capacity, compatibility with heat pipe material, phase change temperature, latent heat of vaporization (LHV), density, viscosity, surface tension, and cost). The criteria weights determined by Criteria importance through inter-criteria correlation (CRITIC) and analytical hierarchy process (AHP) schemes were utilized to prioritize considered working fluids through the application of Multi-Objective Optimization basis on Ratio Analysis (MOORA), Preference ranking organization method for enrichment evaluation (PROMETHEE) and weighted aggregated sum product assessment technique (WASPAS) ranking methods. The findings indicated that water is the best alternative, followed by ammonia. Cost emerged as the most convincing criterion, followed by the compatibility of heat pipe material. The qualitative analysis showed that the integrated weight-based PROMETHEE-II method is the most effective framework for this decision problem, followed by the MOORA and WASPAS methods.
The Safety of Combined Cardiac and Vascular Operations: How Much is too Much?
Authors: Gangemi James J. , Kron Irving L. , Ross Scott D. , Tribble Curtis G. , Kern John A.
Published: September 2024

Objective:

The purpose of this study was to identify factors correlating with a poor outcome following combined cardiac and vascular procedures.

Methods:

We reviewed 45 consecutive patients undergoing combined cardiac and vascular operations. These included cardiac/CEA ( n = 27), cardiac/AAA ( n = 13), cardiac/AAA/one other vascular reconstruction ( n = 4), and cardiac/renal artery bypass ( n = 1). Group 1 included all patients with no morbidity or mortality ( n = 41) and Group II included patients who died or suffered significant morbidity (stroke, renal failure) ( n = 4).

Results:

Overall mortality was 4.4% (2/45). These two patients underwent cardiac surgery combined with two additional vascular procedures (cardiac/AAA/other). In patients undergoing cardiac/CEA or cardiac/AAA, there were no deaths and one stroke (contralateral to CEA). Group II had significantly decreased ejection fraction (39% ± 6% vs 52% ± 1%) and an increased number of procedures (2.75 vs 2.04).

Conclusions:

Combined cardiac surgery and vascular reconstruction can be performed safely. However, multiple vascular reconstructions or the presence of decreased ejection fraction increased operative risk.
A Novel Technique for Intraaortic Balloon Pump Placement via the Left Axillary Artery in Patients Awaiting Cardiac Transplantation
Authors: H'Doubler Peter B. , H'Doubler William Z. , Bien Richard C. , Jansen Donald A.
Published: September 2024

In order to circumvent the problems associated with long-term femoral intraaortic balloon pump (IABP) placement we have developed and used a new technique of IABP placement. Over the past three years 13 patients awaiting cardiac transplantation have had placement of IABP via a vein cuff sewn to the left axillary artery. Thirteen patients have undergone IABP placement using this technique. The average duration of IABP support was 37 days (range 10–86 days). Ten patients were successfully transplanted. All patients were allowed to sit, stand and ambulate with assistance. No neurologic complications occurred. There were no episodes of sepsis related to balloon or insertion site. No patient had limb ischemia during IABP counterpulsation. Left axillary artery IABP insertion via a vein cuff portal is a straightforward technique with minimal complications. This method serves as a bridge to cardiac transplantation in a gravely ill group of patients while preserving patient mobility during the waiting period for a donor heart.
Early Experience with Left Ventricular Volume Reduction Surgery in Syria
Authors: Kabbani S. S. , Izzat M. B. , Jamil H. , Hammoud A. , Nabhani F. , Kabbani L. S.
Published: September 2024

Objective:

To review our early experience with left ventricular volume reduction surgery (the Batista operation) in the management of patients with end-stage heart failure.

Methods:

Between December 1996 and April 1998, 10 patients (9 males, mean age 32 yr) with advanced symptomatic cardiomyopathy underwent left ventricular volume reduction surgery at Damascus University Cardiovascular Surgical Center. The cause of cardiomyopathy was idiopathic in three patients, valvular in four, ischemic in two, and viral myocarditis in one patient. Concomitant procedures included aortic valve replacement in four patients, mitral valve repair in six patients, and coronary artery bypass grafting in two patients.

Results:

All patients survived the procedure. Echocardiography prior to discharge documented significant improvement in ejection fraction in all but two patients. Mean follow-up was 7.6 months. After discharge, three patients developed progressive congestive heart failure to which they subsequently succumbed, and two more patients died suddenly late postoperatively. Only two patients continue to show both clinical and echocardiographic evidence of improvement.

Conclusion:

Left ventricular volume reduction surgery cannot be freely advocated until better means are found to identify patients who will benefit from the procedure, and proper prophylaxis against fatal postoperative complications can be afforded.
Combined Transdiaphragmatic MIDCAB with Right Gastroepiploic Artery and Abdominal Aortic Aneurysm Repair
Authors: Gürbüz Ali , Kirali Kaan , Tuncer Altug , Şişmanoǧlu Mesut , Yakut Cevat
Published: September 2024

Combined surgical repair for large abdominal aortic aneurysm and severe symptomatic coronary artery disease is a safe and effective procedure. Simultaneous operation for minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair were performed on a 75-yr-old man. First, we harvested the right gastroepiploic artery and passed it through the diaphragma for the right coronary artery revascularization on the beating heart. We then repaired the large abdominal aortic aneurysm (8 cm in diameter) using a Dacron tubular Y-graft. Using the arterial graft and off-pump technique reduces operation time and prevents complications of cardiopulmonary bypass in elderly patients with large abdominal aortic aneurysm, while the combined approach shortens hospital stay and cost.
Cryptogenic Salmonella-Infected Ruptured Aortic Aneurysms
Authors: van Dam van Isselt E. F. , Moll F. L. , Bast T. J.
Published: September 2024

Salmonella-infected ruptured aortic aneurysms are a difficult surgical problem. Five patients with Salmonella-infected ruptured aortic aneurysms are presented. All patients were initially treated by in situ graft replacement, wide debridement of the infected aortic tissue and long-term systemic antibiotic therapy. The surgical technique of choice in acute situations, such as a rupture of the aneurysm, remains controversial. In the recent literature 26 reported cases were reviewed. Based on our clinical experience and these case reports, in situ bypass reconstruction can be justified as a surgical technique that gives at least a good short-term prognosis.
Infrainguinal Reconstructions: Influence of Surgical Experience on Outcome
Authors: Luther M. , Lepäntalo M.
Published: September 2024

Objectives:

To evaluate the influence of surgical experience and operation technique on the outcome of infrainguinal reconstructions.

Design:

A longitudinal observational study of patients undergoing reconstructions to the popliteal and crural arteries.

Setting:

A regional hospital and an academic referral centre.

Materials:

392 patients undergoing 442 reconstructions, 218 to the popliteal and 228 to the crural vessels.

Chief outcome measures:

Graft patency and leg salvage.

Main results:

At the popliteal level. 5-year patency after autogenous vein reconstruction was 76%. No difference was found between in situ and transposed vein reconstructions, but prosthetic reconstructions had a worse patency. At the crural level, 5-year patency for in situ vein, transposed vein and prosthetic bypass were 66, 55 and 21%, respectively. Corresponding leg salvage for chronic critical leg ischaemia was 91% with vein and 55% with prosthetic reconstruction at popliteal level, and 66 and 33% at the crural level. Surgical experience improved the outcome, as 3-year patency for in situ and transposed vein bypasses to the popliteal level were 82 and 95% for experienced surgeons, and 53 and 75% for less experienced surgeons. Corresponding leg salvage rates for reconstructions to the popliteal and crural levels were 85 and 67% for experienced surgeons, and 61 and 52% for less experienced surgeons.

Conclusions:

Outcome of infrainguinal reconstructions is influenced by the reconstruction level. Surgical experience and choice of the appropriate reconstruction technique can improve outcome.
Experience with Cryopreserved Arterial Allografts in the Treatment of Prosthetic Graft Infections
Authors: Nevelsteen A. , Feryn T. , Lacroix H. , Suy R. , Goffin Y.
Published: September 2024

The authors present a retrospective study on 30 patients with prosthetic graft infection. Included are 25 patients with aortic graft infection, three with infection of a femorodistal bypass and two with infected axillofemoral grafts. There were 23 isolated primary prosthetic graft infections and seven aorto-enteric fistulas. Treatment consisted of graft excision and replacement with cryopreserved arterial homografts, harvested from brain-death multi-organ donors. The in situ technique was used in 27 cases. Eight patients died postoperatively and two deaths were from allograft related complications. The operative mortality rate was 11% for isolated aortic graft sepsis and the early limb salvage rate was 100%. Persistent or recurrent infection was noted in two cases. The mean follow-up of the series was 24.5 months and occlusive complications occurred in five patients (23%). which resulted in two major amputations. Serial CT scans showed abnormalities in six of the 22 survivors, all of them related to the aortic segment of the allograft. It is concluded that in situ reconstruction with cryopreserved arterial allografts represents an acceptable alternative, especially in the treatment of isolated aortic graft sepsis. Continued follow-up towards late deterioration and/or occlusive complications remains mandatory.
Critical Lower Limb Ischaemia following Excision of the Rectum
Authors: Khaira H. S. , Silverman S. H. , Obeid M. L.
Published: September 2024

Critical lower limb ischaemia can occur following rectal surgery by a number of mechanisms. Patients with aortoiliac stenosis or occlusion may be dependent on collateral circulation to the lower limbs from the visceral arteries supplying the descending colon, sigmoid colon and the rectum. Division of these collaterals can precipitate critical ischaemia of the Jeg. This is an uncommon scenario but one that should be considered in arteriopaths undergoing rectal surgery. Two cases of this complication are reported and the mechanisms discussed.
The Aetiology of Raynaud's Phenomenon
Authors: Turton E. P. L. , Kent P. J. , Kester R. C.
Published: September 2024

The literature on Raynaud's phenomenon (RP) describes a complex and confusing picture of abnormalities that has suggested a multifactorial aetiology. Current research suggests that the underlying disorder is related to a local fault at the level of the digital microcirculation. It is likely that many of the biological changes described in RP are secondary manifestations of this primary abnormality. The strong familial relationship of RP suggests a genetic link although this has not yet been characterized. An overactivity of the sympathetic nervous system appears less likely as a candidate for the primary abnormality and dysfunction at the level of the nerve, and vessel wall may be more important. Digital cutaneous neurones show a deficient release of the vasodilatory calcitonin gene related peptide in PR. This may represent a primary fault that is confounded by other factors, which are influenced by cold or emotional triggers. Vasoconstricting substances such as catecholamines, endothelin-1 and 5-hydroxytryptamine, which may all be released in response to cold exposure, could cause digital artery closure and the associated symptoms of RP. In some cases, this would trigger a cascade of neutrophil and platelet activation, which through the release of inflammatory mediators, contribute to the endothelial damage seen with more severe RP. It is hypothesised that disturbance to the intricate functioning of the endothelium, and secondary compensation at local or systemic level, may appear over time. There is, therefore, still a need to differentiate the true aetiological factors from those that are causal associations with Raynaud's phenomenon. Progress is slowly being made with better understanding of the intricacies between these factors and the microcirculation. Deepening our comprehension of the ‘normal’ mechanisms that influence microvascular blood flow is necessary to develop a better understanding of the pathophysiology of Raynaud's phenomenon.
Lumbar Sympathectomy Performed by Means of Videoscopy
Authors: Wronski J.
Published: September 2024

Sympathetic denervation has fallen into disfavour for operations. Dorso-perivertebral, paravertebral or retroperitoneal approaches are only of historic importance. The oblique retroperitoneal approach is popular because it provides good visibility, at the expense of a long skin incision. A videoscopic procedure has now been developed for lumbar sympathectomy. A transverse skin incision of 3–4 cm is made in the hypochondrium, lateral to the rectus sheath. The abdominal muscles are split along their fibres. The transversalis fascia is opened and the peritoneum is carefully peeled back. A trocar is then introduced laterally from the skin incision, and under visual control the sympathetic trunk is exposed. After identifying the ganglia, L2 and L3 are coagulated together with the part of the sympathetic trunk that joins them. The suction drainage is not required nor are balloons to develop the operation field, which is not insufflated. Patients undergo rehabilitation much more easily because of reduced wound pain and they leave hospital quickly. The method only requires basic videoscopy instruments.
Value of Preoperative EEG for Carotid Endarterectomy
Authors: Illig K. A. , Burchfiel J. L. , Ouriel K. , DeWeese J. A. , Shortell C. K. , Green R. M.
Published: September 2024

Purpose:

This study was designed to determine whether the preoperative, baseline electroencephalogram (EEG) can be used for intraoperative decision making during carotid endarterectomy, and to identify circumstances where the EEG can be eliminated.

Methods:

The charts of all patients undergoing carotid endartectomy at the authors' institution from June 1991 to May 1995 were reviewed to identify those patients that had adequate pre- and intraoperative EEG monitoring. EEGs during 331 carotid endartectomies in 303 patients were coded without knowledge of outcome; primary and secondary endpoints were EEG changes with clamping and clinical outcome, respectively.

Results:

The incidence of mortality and major neurological morbidity was 1.8%. Baseline-EEGs were abnormal in 105 patients (32%). Whereas baseline-EEG changes were highly predictive of EEG changes after anesthetic induction ( P < .0001), they were not predictive of EEG changes with clamping or of clinical outcome. Prior stroke (CVA) predicted abnormal baseline-EEGs ( P < .0001) and abnormal post-anesthetic EEGs ( P < .0001) but did not predict changes with clamping or perioperative CVA. EEG changes with clamping occurred during 18% of operations; such changes were predicted only by contralateral occlusion ( P < .0016) and EEG changes during a prior contralateral carotid endartectomy ( P < .0001). The only variable that predicted an adverse neurological outcome was the presence of contralateral occlusion, which increased the likelihood of a perioperative neurological event seven-fold ( P = .0038). Clinical outcomes in the 57 of 105 patients with abnormal baseline-EEGs and the 49 of 83 with prior CVA who were shunted were not different from those who were not.

Conclusions:

baseline-EEG is not of value for the prediction of adverse events during carotid endartectomy and can be eliminated. Because contralateral occlusion is highly predictive of changes with clamping, and patients undergoing a second carotid endartectomy will usually manifest EEG changes identical to those at the first, operative EEG monitoring can also be eliminated from both these circumstances. Finally, prior stroke does not lead to a higher incidence of clamp-induced EEG changes, and thus is not an indication for shunting in and of itself.
Blends of Poly(ether ether ketone ketone) and Poly(p-phenyiene sulphide): Addition of Poly(ether ether ketone) Oligomer
Authors: Fang Zhijie , Shibata Mitsuhiro , Takahashi Shigeyuki , Yosomiya Ryutoku
Published: September 2024

The effect on compatibility of the addition of poly(ether ether ketone) (PEEK) oligomer to poly(ether ether ketone ketone) (PEEKK)/polv(p-phenylene sulphide) (PPS) blends has been investigated. Viscoelastic measurements and differential scanning calorimetry (DSC) of PEEKK/PPS blends show that the blends are completely immiscible over the whole composition range. When PEEK oligomer (5-20 phr) is added to the PEEKK/PPS (40/60) blend as the third component, its compatibility and flexural properties are considerably improved. This result is consistent with SEM micrographs of the blends. IR spectral analysis of the blends suggests that PEEK oligomer does not react with either PPS or PEEKK. DSC data for PEEKK/PEEK oligomer (40/10) and PPS/PEEK oligomer (60/10) blends suggest that PEEK oligomer may act as a non-reactive compatibilizer for the PEEKK/PPS blend.
Properties of Metal-Polyaniline Schottky Barriers
Authors: Campos M. , Bello Braz
Published: September 2024

Schottky barrier diodes have been fabricated using doped polyaniline as the semiconductor and aluminium as the metal. Polyaniline was doped with H2SiF6acid at room temperature to form a p-type semiconductor. On a sandwich-type device, the junction at Au/polyaniline/Au showed ohmic characteristics, while the junction at Al/polyaniline/Au gave rectifying behaviour. Electrical characterization has been carried out and electronic parameters, including the barrier height and ideality factor as a function of temperature and acid concentrations, have been determined. Optical absorption spectroscopy was also used to determine any acid-doping effect.
Low Velocity Impact Characterization of Unreinforced Vinyl Ester 411-350 and 411-C50 Resin Systems
Authors: Motuku M. , Janowski G.M. , Vaidya U.K. , Mahfuz H. , Jeelani S.
Published: September 2024

The room temperature impact response of DERAKANE 411-350 and 411-C50 vinyl ester (VE) unreinforced resin systems has been investigated as a function of impact energy level, sample thickness, matrix material and catalyst system. The response of unreinforced resin plaques to impact loading was investigated using the impact load histories, impact plots and fractography analysis. The maximum load or peak contact force, energy-to-maximum load, total energy and deflection-at-maximum load increased in a nearly parabolic manner with an increase in impact energy level, whereas time-to-maximum load or impact duration at the peak load decreased linearly. Total energy-to-impact energy ratio, i.e. the non-dimensional energy plots, changed in a step-wise manner with impact energy. The slope of the load-deflection (load-time) traces, which is related to the impact modulus or relative stiffness of the material, increased with impact energy level and sample thickness. The change of slope with impact energy level and sample thickness indicated the dependence of impact modulus on the impact energy level and target geometry. The threshold impact energy levels, which were associated with the onset of catastrophic matrix failure and extensive tensile strength losses, were identified from the impact plots. Multiple radial cracking, perforations in the form of a truncated cone at the point of impact and damage resulting from the supports were identified as the dominant failure characteristics in both resin systems. The DERAKANE 411-350-vinyl ester resin system was found more damage resistant than the 411-C50 system. The impact response and the failure characteristics were insensitive to the catalyst system.
The Improvement of Compatibility in Glass Reinforced PA 6/PP Blends
Authors: Andreeva M.B. , Novotortzeva T.N. , Kalugina E.V. , Tochin V.A. , Gurinovich L.N. , Andreeva T.I. , Kalinina I.G. , Gumargalieva K.Z. , Zaikov G.E.
Published: September 2024

This article deals with the properties of 30% w/w glass reinforced compatibilized blends of polypropylene (PP) and polyamide (PA6). Rheological properties (melt flow index and melt stability), mechanical properties (tensile strength, flexural strength and impact strength) of PA6/PP blends were investigated. The influence of potential compatibilisers (4,4,-diphenylmethanecarbodiimide (OCDI), 4,4’-diphenylmethanebismaleimide (BMI) and 2,2’-(1,4-phenylene)-bisoxazoline (BOX)) on the mechanical properties and thermal stability of unreinforced and glass reinforced polymer blends was investigated too. We tried to study the structure of the glass reinforced composites by mercury intrusion porosimetry. The influence of compatibilisers on the molecular weight of PA6 was studied hy GPC and the chemical structure of the blends was investigated by NMR and IR-spectroscopy. Addition of OCDI and BOX (chain extenders) preserves the product structure as they react with the active and carbonyl groups of PA6. BMI has the lower reactivity. Grafting of BMI to PP chains improves the compatibility in PA6/PP blends and increases PP adhesion to glass fibres.
Moral injury and mental health outcomes in nurses: A systematic review
Authors: Anastasi Giuliano , Gravante Francesco , Barbato Paola , Bambi Stefano , Stievano Alessandro , Latina Roberto
Published: September 2024

Introduction: Moral injury involves the adverse psychological, biological, spiritual, behavioural, and social consequences of actions that violate moral values. It can lead to anxiety, depression, burnout, and post-traumatic stress disorder. Nurses, who often face ethical dilemmas, are particularly vulnerable. Despite its significance, the relationship between moral injury and mental health outcomes in nurses remains underexplored. Aim: This systematic review aimed to describe the associations among moral injury, anxiety, depression, and quality of life in nurses. Methods: The review was registered in PROSPERO (CRD42023438731) and was conducted following the PRISMA guidelines. A literature search was performed in December 2023 across PubMed, CINAHL, Scopus, and Web of Science. Peer-reviewed primary research involving nurses, published in English or Italian, without time restrictions, was considered eligible. The risk of bias and the quality of evidence were assessed using the Joanna Briggs Institute checklist and the GRADE approach. Results: Out of 4730 articles identified, eight met the inclusion criteria. The analysis revealed significant positive associations between moral injury, anxiety, and depression, along with a significant negative association with quality of life. Conclusion: These findings highlight the need for healthcare systems to implement strategies that mitigate moral injury among nurses. Future research should prioritize longitudinal studies to explore causal relationships and develop targeted interventions. Additionally, standardizing the concept and measurements of moral injury is crucial for enhancing the comparability and understanding of this phenomenon.