bluuebunny/crossref_metadata_2025 huggingface dataset:
Battery only electric traction for freight trains - A technical and operational assessment
Authors: Barbosa Fábio C.
Published: March 2023

The rail transport industry has been required to engage with the world effort to reduce the climate effects, as well as the reduction of criteria pollutant and noise emissions, which strongly affects the populations nearby the rail infrastructure. Electric powertrains have been widely used by railways, with its inherent efficiency and cleanliness. However, the required infrastructure has restricted its use to medium to large density traffic corridors, given the large infrastructure and maintenance costs involved. Light to medium loaded rail stretches and large freight rail corridors, running in rural areas, have adopted the diesel-electric powertrain approach, that relies on an onboard diesel generator, with the inherent environmental negative effects, especially to the rail nearby communities. In this context, alternative traction technologies, such as Hybrid-Electric Rail, Hydrogen Fuel Cell Rail and Battery Only Electric Rail, have been considered by the rail industry as potential alternatives. The BOER route, due to the recent battery technology breakthroughs (associated with performance improvements and reduced costs) is set as a promising alternative and has a potential do be used as a decarbonization strategy for both passenger and freight rail systems at low to medium density traffic lines. Nevertheless, the BOER technology sets great challenges, given the high energy and power required by rail vehicles, as well as the harsh rail operational environment, with huge effects on the performance, charging infrastructure requirements, fleet availability, costs, as well as the environmental sustainability associated with the mining and disposal of materials required by the battery chemistries. This paper presents, based on the state of the art available technical literature, an unbiased review of the BOER technology and an assessment of its potential for the freight rail industry, highlighting the associated technical, operational and environmental challenges.
A feature pseudo-fusion method for intelligent fault diagnosis of electro-hydraulic switch machine inspired by contrastive learning
Authors: Wen Weigang , Liu Yang , Bai Yihao , Meng Qingzhou
Published: March 2023

The railway system is an important part of the transportation system. Its scheduling process is carried out by the switch machines. The accuracy of determining the health status of the switch machines is related to the operational efficiency and reliability of the whole system. However, manual fault diagnosis for these machines is always unstable and expensive. The intelligent fault diagnosis (IFD) method can perform accurate fault diagnosis at low cost and high efficiency, but requires a large amount of labeled data. In this case, this study realizes the Feature Pseudo-Fusion (FPF) of left and right oil pressure signals of the electro-hydraulic switch machine. It uses contrastive learning to regularize the feature representation of original signals. Based on FPF, a fault diagnosis method applicable to electro- hydraulic switch machines is constructed. This method reduces the need for labeled data laterally without introducing additional measurement content to the field signal acquisition system. The effectiveness of FPF and the superiority of the fault diagnosis method have been verified through experiments.
Primary syphilis of the oropharynx mimicking a neoplasm
Authors: Hasegawa Kohei , Murata Kenya , Ogawa Yoshihiko
Published: March 2023

Syphilis is surging in Japan and worldwide among both homosexual and heterosexual individuals. Diagnosis can be challenging because syphilis is “the great imitator” and clinical manifestations are highly variable. Oral manifestations of syphilis are usually seen in the second stage and the primary syphilis in the oral cavity is rare. We describe a heterosexual man with isolated tonsillar lesions initially misdiagnosed as pharyngeal lymphoma and subsequently diagnosed as primary syphilis. Clinicians should be aware that isolated oropharyngeal involvement can occur in the primary syphilis and can mimic a neoplasm.
Generalized fiducial inference for the restricted mean survival time
Authors: Bebu Ionut , Diao Guoqing , Hamasaki Toshimitsu
Published: March 2023

The standard modeling approach for time-to-event outcomes subject to censoring is based on the hazard function, with hazard ratios capturing the effect of exposures on the risk of outcome. The restricted mean survival time, defined as the expected time to event up to a pre-specified time horizon, provides an alternative useful summary of time-to-event outcomes. Restricted mean survival time can be estimated nonparametrically and can be used to compare groups or interventions when the proportional hazards (PHs) assumption does not hold. Moreover, even when the proportional hazards assumption holds, the restricted mean survival time, an additive measure of risk, provides additional information to the hazard ratio, which is a measure of relative risk that can be difficult to interpret in absence of an estimate of the reference risk. Herein, a generalized fiducial approach is proposed for restricted mean survival time, and its asymptotic properties are investigated. Numerical simulations show the proposed approach provides one- and two-sided confidence intervals with coverage probabilities close to nominal values and controls the type-I error for two-group comparisons even for small sample sizes with a low number of events. Data from a type 1 diabetes study is used for illustration.
Prevalence of Treatment of Early Childhood Caries among Children with Cleft Lip and/or Cleft Palate in Manitoba
Authors: Surtie Fareea , Ebadi Mohammadhassan , Klus Bradley A. , Schroth Robert J
Published: March 2023

Objective

To determine the prevalence of treatment of early childhood caries (ECC) using general anesthesia (GA) in children with cleft lip and/or palate (CL/P).

Design

Retrospective chart review of children followed by the Manitoba Cleft Lip and Palate Program (MCLPP) to determine the frequency of treatment for ECC under GA.

Setting

Children's Hospital, Winnipeg, Canada (a tertiary care centre).

Patients

Children registered with MCLPP between January 1, 2008- December 31, 2019.

Interventions

The chart review collected data on the following variables: sex, date of birth, postal code, type of cleft, whether child had treatment of ECC using GA, age at the time of GA, and cost of treatment.

Main outcome measures

Association of CL/P with ECC.

Results

Overall, 441 children had CL/P. 17% had isolated cleft lip (CL), 46% had isolated cleft palate (CP), and 37% had both cleft lip and palate (CLP). Overall, 24.3% of children with CL/P underwent dental surgery using GA while 14.5% underwent dental surgery to treat ECC between 12-59 months of age. When compared to a reference of Canadian healthy children 12-59 months of age, a child with CL/P was 15 times more likely to require GA to treat ECC.

Conclusion

Treatment for caries under GA in children with CL/P is common. In the children with CL/P the rates of GA for treatment of ECC are significantly higher when compared to the general population. Children with CL/P require comprehensive oral health prevention to reduce the risk for caries and the need for treatment under GA.
Considerations in Building a School-Based Vision Program
Authors: Ambrosino Christina M. , Callan Jonathan , Wiggins Tresa M. S. , Repka Michael X. , Collins Megan E.
Published: March 2023

The burden of childhood visual impairment and disparities in access to pediatric vision care remain pressing issues in the United States. School-based vision programs (SBVPs) serve as one approach to advancing health equity. Operating at the intersection of schools and healthcare, SBVPs can increase access to pediatric vision services, improve academic performance, and facilitate referrals to community vision care providers. To maximize their impact, SBVPs must tailor their services to the individual needs and resources of local school communities. School nurses, who have strong ties to school health care services and the school community, are trusted partners in building SBVPs. This article aims to facilitate SBVP development, implementation, and sustainability processes by offering guidance for school nurses and other stakeholders who aim to build a SBVP, support local programs, or learn more about how SBVPs operate.
School Nurse Experiences and Changes to Practice During the COVID-19 Pandemic
Authors: Morse Brenna L. , Meoli Anne , Samuel Cynthia , Carmichael Amanda
Published: March 2023

School nurses have faced many professional challenges during the COVID-19 pandemic. Focus group interviews were employed as a data collection method in this qualitative study to describe the perspectives of school nurses during the pandemic. Themes relevant to school nurse experiences and suggestions for change were identified. School nurses have demonstrated their essential role in facilitating health for students, staff, and families. Policymakers and the public must recognize this value. School nurses are encouraged to leverage opportunities for visibility within and beyond their own communities to enhance recognition of their role. School nurses should also lead the development of additional resources such as web-based health content and practice guidelines. Providing school nurses with resources needed to support their practice is essential so that, in turn, students may be cared for.
A Single-Center Bleeding Comparison of Warfarin Plus Aspirin or Clopidogrel Following Coronary Artery Bypass Grafting and Surgical Valve Replacement
Authors: Zieminski Joseph J. , Mara Kristin C. , Wamsley Kyle S. , Stulak John M. , Nei Scott D.
Published: March 2023

The optimal antithrombotic therapy following combined coronary artery bypass graft (CABG) and surgical valve replacement (SVR) surgery remains unclear. The aim of this single-center, retrospective cohort study was to assess the safety and effectiveness of a vitamin K antagonist (VKA) plus either aspirin or clopidogrel in patients following combined CABG and SVR. The primary endpoint was the occurrence of bleeding within six months. The secondary endpoint was the occurrence of CV death, stroke, acute coronary syndrome (ACS), or valve dysfunction. Outcomes were identified by pre-specified ICD codes. A total of 629 patients were included in the analysis, with 583 patients receiving aspirin and 46 patients receiving clopidogrel. Bleeding occurred in 1.7% of patients receiving aspirin and in 0% of patients receiving clopidogrel (p  =  0.99). CV death, stroke, ACS, or valve dysfunction occurred in 3.1% of patients receiving aspirin and 4.3% of patients receiving clopidogrel (p  =  0.65). In this study, there were no differences in the safety or effectiveness of a VKA plus either aspirin or clopidogrel following combined CABG and SVR.
Analyses of synchronous motion characteristics for a two-rigid-body vibration system with three co-rotating eccentric rotors mounted on two different rigid bodies
Authors: Yu Le , Hou Yongjun
Published: March 2023

In this paper, the synchronous motion characteristics of a two-rigid-body vibration system with three vibrating motors installed on two different vibrating rigid bodies are investigated. First, differential equations of the system are deduced according to the Lagrange equation, and their steady-state solutions are obtained. Next, the synchronization theories of the system are obtained via the average method, and the stability conditions are deduced via the Lyapunov’s stability theory. The structural parameters of the system are brought into the theoretical derivation results. Finally, the theory and simulation are mutually verified by the electromechanical coupling simulation model. The results show that the system can implement stable synchronous motion when the system parameters satisfy the synchronization and stability conditions. In the resonance region (i.e., [Formula: see text] or [Formula: see text]), the support spring stiffnesses [Formula: see text] and [Formula: see text] significantly affect the synchronous motion characteristics of the system. The phase differences [Formula: see text] and [Formula: see text] bifurcate in the regions R2, R5, and R6. However, the bifurcation phenomena have almost no effect on the steady-state responses. The parameters in the regions R3, R4, R7, and R8 are of great values in engineering applications.
“I Can’t Vote if I Don’t Leave My Apartment”: The Problem of Neighborhood Violence and its Impact on the Political Behavior of Black American Women Living Below the Poverty Line
Authors: Moffett-Bateau Alex J.
Published: March 2023

Prior research examining political behavior outside of the United States, has shown that violence can have a mixed impact on political engagement. Building on that work, this research examines whether violence shapes the political lives of poor Black women within the United States. I argue, neighborhood violence in the United States can and often does, shape the political behavior of Black women living below the poverty line in public housing. I use ethnographic data to parse out a conceptual framework which articulates connections between residential violence experienced by Black women living in poverty and their politics. Ultimately, my analysis shows violence can cause isolation and harm, and in doing so dampen political engagement. When residents experienced high levels of violence and did not feel a sense of belonging or connection to their neighborhood, they rarely engage d in visible political behaviors. However, residents who expressed a sense of connection to their neighborhood continued to engage in politics. Those residents who had interpersonal relationships within their residential neighborhood, frequently maintained and sometimes further developed their individual politics, despite and sometimes in response to, personal experiences with residential violence.
Clarification of Faber series and related applications to complex variable methods in two-dimensional elasticity
Authors: Dai Ming , Schiavone Peter
Published: March 2023

Faber series are used extensively in the application of complex variable methods to two-dimensional elasticity theory, for example, in the mechanical analysis of composite materials where Faber series representations of complex potentials lead to convenient expressions for the corresponding displacement and stress distributions. In many cases, the use of the Faber series is combined with conformal mapping techniques which “transfer” a boundary value problem defined in the elastic body (physical plane) to a simpler problem posed in an imaginary plane characterized by the conformal mapping. In several instances in the literature, however, little attention has been paid to the domain of definition of the Faber series in the imaginary plane leading often to misunderstandings and erroneous conclusions regarding the concept and feasibility of the use of the Faber series. In this paper, we present a thorough and rigorous examination of the representation of the Faber series in both the physical (occupied by the material) and imaginary (defined by the conformal mapping) plane. In addition, we show that replacing a truncated Faber series by a truncated Taylor series does not induce any additional errors in the numerical analysis of the corresponding boundary value problem. We anticipate that the discussion in this paper will help clarify any existing misinterpretations regarding the application of the Faber series and help further extend their use to a range of problems in composite mechanics.
The effect of over- and undertreatment of hypothyroidism on hospitalization outcomes of patients with decompensated heart failure
Authors: Kagansky Dana , Or Karen , Elkan Matan , Koren Shlomit , Koren Ronit
Published: March 2023

The effect of over- and undertreatment of hypothyroidism on hospitalization outcomes of patients with acute decompensated heart failure (HF) has not been evaluated yet. We conducted retrospective cohort analyses of outcomes among 231 consecutive patients with treated hypothyroidism who were admitted to internal medicine departments of Shamir Medical Center with HF (2011–2019). Patients were divided into three groups according to their thyroid-stimulating hormone (TSH) levels: well treated (TSH: 0.4–4 mIU/L), overtreated (TSH: <0.4 mIU/L), and undertreated (TSH: >4 mIU/L). The main outcomes were mortality and recurrent hospitalization within 3 months. Among 231 patients, 106 were euthyroid, 14 were overtreated, and 111 undertreated. Patients’ mean age was 79.8 ± 9.4 years. In-hospital mortality occurred in 4.7% in euthyroid patients, 14.3% in the overtreated group, and 10.7% in the undertreated group (p = 0.183). Differences in 30-day (p = 0.287) and 90-day (p = 0.2) mortality or recurrent hospitalization (p = 0.438) were not significantly different as well. However, in patients who were markedly undertreated and overtreated (TSH: >10 mIU/L or below 0.4 mIU/L) compared with 0.4–10 mIU/L, a significant increase in 90-day mortality was observed (33.3% vs 15.1% p = 0.016). Treatment status was independently associated with 90-day mortality after controlling for confounders with an adjusted odds ratio of 3.55 (95% confidence interval: 1.39–9.06). Although mild under- or overtreatment of hypothyroidism does not have a significant detrimental effect on hospitalization outcomes of patients with acute decompensated HF, markedly under- and overtreatment are independently associated with rehospitalizations and 90-day mortality. Larger cohorts are needed to establish the relationship between treatment targets and hospitalization outcomes of patients at risk for HF hospitalization.
A mismatch: Why non-tenured teachers are ill-prepared to deal with the perceived job insecurity of students in the humanities
Authors: Crone Vincent CA
Published: March 2023

Most of the instructional workforce within the humanities in countries like the United States, United Kingdom, Australia, and The Netherlands comprises non-tenure track appointments. This commentary is a starting point in thinking about what the meaning and consequences are of far-reaching casualization for humanities education. Based on my experience as a supervisor of non-tenured early-career teachers in the humanities and on an international exploration of the position of the so-called precariat, I describe the competing, and perhaps irreconcilable, discourses on the importance of the humanities for society and the labour market which these non-tenured teachers must navigate. These discourses put especially non-tenured academics, who are themselves in a very precarious, in an even more disempowered space that is not only detrimental to these non-tenured teachers but also to the students who must learn to deal with perceived job insecurity.
The impact of employability on Humanities, Arts and Social Sciences degrees in Australia
Authors: McCormack Silvia , Baron Paula
Published: March 2023

In Australia, Humanities, Arts and Social Sciences (HASS) faculties are under pressure to demonstrate that their degrees result in employable graduates. Employability has become a key strategic goal of all universities and is driving federal government funding changes. We surveyed 17 Directors of Learning and Teaching in HASS across Australia’s 37 public universities to ascertain their views on how employability has affected HASS. Our thematic analysis of questionnaire results reveals a highly complex and, at times, contradictory picture of the relationship between HASS and employability.
Non-covalent chemical functionalization of micron-sized styrene-butadiene rubber with silica particles via solid-state cryogenic mixing process
Authors: Bakir Mete
Published: March 2023

The effective, high-value reutilization of reclaimed rubber, obtained from end-of-life tires, in the production of new high-performance tires remains an environmental and technological challenge. Cryogenically ground micron-sized rubber particles demonstrate a significant promise to realize satisfactory physical performance measures in reclaimed rubber-based tires. However, the maximum useable content of the cryogenically ground micron-sized rubber particles to be incorporated into tires is strictly limited by their ineffective interfacial chemical interactions with the host pristine rubber matrix during the post-polymerization process. Here, this work presents the non-covalent chemical functionalization of the cryogenically ground micron-sized styrene-butadiene rubber particles with reactive silica particles via a solid-state cryogenic mixing process. The highly-scalable solid-state mixing process enables the sufficiently uniform and near-homogenous distribution of the silica particles on the micron-sized rubber particles. Scanning electron microscope images highlight the micron-sized rubber particles decorated with individual silica particles. Fourier transform infrared and solid-state nuclear magnetic resonance spectra of the functionalized micron-sized rubber particles demonstrate a non-covalent conjugation mechanism between the silica and rubber particles in which the chemical fingerprint of the prime rubber backbone chains remains chemically intact. The chemically functionalized cryogenically ground micron-sized rubber particles possess reactive silica particle sites that are ultimately designed to facilitate the participation of the recycled rubber particles in post-polymerization processes with host matrix which shall allow higher loading levels than the state-of-the-art configurations.
The effect of coach–athlete fit on the coach–athlete relationship in team sport: Role of trust in coach
Authors: Lee Seungjoo , Kwon Sungho , Jang Dojin , Kwon Hyojung
Published: March 2023

The purpose of this study was to verify the structural relationship among trust in coach, coach–athlete fit, and coach–athlete relationship. It verified the mediating effect trust in coach on relationships, in relation to coach–athlete fit and coach–athlete relationship. A total of 190 soccer players (N = 190, male; 135, female; 55) registered with the Korea Football Association responded to the survey; and their career in soccer about 6.8 years. Data analysis was conducted using descriptive statistics, confirmatory factor analysis, correlation analysis, structural equation modeling. As expected, coach–athlete fit and trust in coach were significantly related to coach–athlete relationship; in addition, the structural relationship among the three variables was significant. Finally, mediating effect of trust in coach between coach–athlete fit and coach–athlete relationship was showed significantly.
Not much “I” in “Team”: Content analysis of pregame speeches in American football
Authors: Havira Phil , Brewer Britton W. , Van Raalte Judy L. , Jennison Donovan , France Thaddeus J.
Published: March 2023

Although researchers have explored the effects of coach pregame speeches, little is known about the actual content, delivery, and environmental context of the speeches themselves. This study was a descriptive analysis of 127 ( n = 77 intercollegiate, n = 37 high school, and n = 13 cinematic) American football pregame speeches. The speeches were viewed, transcribed, coded, and analyzed via the Linguistic Inquiry and Word Count (LIWC2015) software program. Actual speeches were compared with natural speech norms and speeches appearing in movies pertaining to American football. In general, the pregame speeches were characterized by use of confident, analytical, motivational, emotionally tinged language that is collectively oriented and present and future focused. The speeches delivered to high school teams were substantially similar to those delivered to intercollegiate teams. The actual speeches differed from natural speech on numerous variables and from the cinematic speeches on some descriptive variables. The findings suggest that actual American football pregame speeches are fundamentally similar to cinematic American football pregame speeches and constitute a distinct form of communication that is tailored to the unique demands of the situation.
Living well with dementia
Authors: Morris Charlotte , Tomkow Louise , Blakeman Thomas
Published: March 2023

The number of people living with dementia (PLWD) in the UK is projected to increase rapidly. Much of the contact PLWD and their carers have with the health service is through primary care. The primary care team plays an important role helping people to ‘live well with dementia’. ‘Living well with dementia’ will mean something different for everyone; a holistic, person-centred view of the concept is needed. Important aspects this concept include remaining physically/socially active, understanding the diagnosis and being involved in care decisions. Safe prescribing and regular, high-quality reviews are markers of good dementia care and support people to ‘live well’. ‘Living well’ also incorporates avoidance of adverse health outcomes, including hospitalisation, falls and delirium. As dementia prevalence increases, many more people will be living with the condition, or caring for someone with it. Supporting people with dementia and their carers to ‘live well’ needs to be a primary care priority. This article discusses ways to facilitate achievement of better support for patients living with dementia.
Generalized Eosinophilia Following Moderna COVID-19 Vaccine Administration: A Case Report
Authors: Hojberg Yvonne , Abdeljaber Mahmuod , Prahlow Joseph A.
Published: March 2023

Coronavirus disease 19 (COVID-19) vaccination is considered an important part in improving health outcomes globally. While various adverse events following vaccination against COVID-19 have been reported, eosinophilic diseases have rarely been documented in the literature and are poorly understood. Although vaccination is lauded as being “safe,” it has become apparent that adverse reactions related to the vaccines can have detrimental health effects for certain individuals. We present a case of a death related to multiple severe preexisting comorbidities, complicated by new-onset gastrointestinal complaints which were temporally associated with recent COVID-19 vaccination and did not subside, but worsened prior to death. Autopsy revealed evidence of eosinophilic enteritis, associated with ascites, as well as eosinophilic inflammation elsewhere, including the lungs and heart. Histological examination revealed abundant eosinophils in tissues, including the small intestines, epicardium, and lungs. Whether or not the eosinophilic inflammatory process was caused by the recent vaccination cannot be stated with certainty; however, the temporal association between vaccination, symptom onset/progression, and death, and the literature which suggests a possible association between coronavirus vaccination and eosinophilic reactions leads to the conclusion that this death might have been related to an adverse reaction to COVID-19 vaccination.
Mechanical Evaluation of Commercially Available Fibrin Sealants for Cartilage Repair
Authors: Amirhekmat Arya , Brown Wendy E. , Salinas Evelia Y. , Hu Jerry C. , Athanasiou Kyriacos A. , Wang Dean
Published: March 2023

Objective

Fibrin sealants are routinely used for intra-articular surgical fixation of cartilage fragments and implants. However, the mechanical properties of fibrin sealants in the context of cartilage repair are unknown. The purpose of this study was to characterize the adhesive and frictional properties of fibrin sealants using an ex vivo model.

Design

Native bovine cartilage-bone composites were assembled with a single application of Tisseel or Vistaseal. Composites were tested in tension and lap shear. In addition, the coefficient of friction (COF) was measured in a native cartilage annulus model alone and with minced cartilage. Finally, the effect of a double application of fibrin sealant was evaluated.

Results

There were no significant differences in tensile modulus, ultimate tensile strength (UTS), shear modulus, or ultimate shear strength (USS) between the 2 fibrin sealants. Both fibrin sealants demonstrated a UTS and USS of <8 and <30 kPa, respectively. There were no differences in COF between the sealants when tested alone or with minced cartilage. A double application of fibrin sealant did not alter the mechanical properties compared with a single application of fibrin sealant.

Conclusions

Fibrin sealant adhesive properties are not affected by the sealant type studied or the number of applications in a bovine cartilage-bone model. Fibrin sealant tribological properties are not affected by sealant type or the addition of minced cartilage. The adhesive properties of Tisseel and Vistaseal were less than those desired for the in vivo fixation of cartilage repair implants. These findings motivate the development of an improved cartilage-specific adhesive for cartilage repair applications.
Across the Cyberwaves: Twitter Campaigns for Gaeilge
Authors: McMonagle Sarah , Ní Bhroin Niamh
Published: March 2023

Research increasingly shows how speakers and learners of minority languages exploit online spaces to forge communication networks and create and consume content in languages that are otherwise marginalized from central societal domains. While the connectivity afforded by internet technologies is imperative to computer-mediated communication, culturally authentic content and expressions of identity are central to meaning-making processes that may influence online participation (or not) in a particular language. We examine participation in two Twitter campaigns for the Irish language—both conceived to increase the visibility of Irish online but with drastically different outcomes. Using the Twitter interface to conduct a content analysis of tweets bearing the respective campaign hashtags, we reveal the discretionary approach to online engagement exhibited by minority-language users and explicate some of the social and communicative practices that contributed to the success of one campaign over the other, bolstered by a comprehensive campaign infrastructure and semantically enticing features.
Chinese Anti-Westernism on social media
Authors: Lehman-Ludwig Anna , Burke Abigail , Ambler David , Schroeder Ralph
Published: March 2023

The Chinese Communist Party and its supporters are increasingly using social media platforms to shape China’s public image. This online image is a means of strengthening domestic nationalism and of projecting “soft power” abroad. This paper examines various forms of anti-Westernism that are central to this image-making. It analyzes several recent topics—the Belt and Road Initiative, climate change, the COVID-19 vaccine, the Beijing Olympics, and the conflict in Ukraine—on the r/Sino subreddit page of Reddit and compares them with two online news outlets, the South China Morning Post and China Daily. The paper focuses on how these media frame the contest between a rising China and a failing West, so creating a discourse that competes with the negative portrayals of China outside the country. The paper contrasts the aggressive strengthening of China’s image against the West on social media with more sober accounts of the same topics in China’s official media and in commercial news outlets. The contribution of the paper is to document an emerging online anti-Westernism that is playing an increasing role in the changing geopolitical landscape.
Conception of Wisdom Resources Among Chinese Emerging and Young Adults
Authors: Hu Chao , Zhang Haotian , Huang Chengli , Munroe Melanie , Feng Zhe , Ge Yanying , Tian Yipeng
Published: March 2023

Emerging adults’ approaches to personal development in life may be revealed in their conception of wisdom resources (WRs), i.e., factors that lead to the development of wisdom. We explored the conception of WRs among 453 Chinese emerging and young adults aged 18–30. Participants completed an online questionnaire covering 19 potential WRs proposed by experts in the psychological study of wisdom and non-experts in Western and Chinese cultures. Participants indicated how much they agreed these factors lead to wisdom development. Afterward, they reported additional WRs not listed. The results revealed that “willingness to learn” was the most endorsed WR, while “religious/spiritual experience” was the least. Moreover, the conception of WRs varied significantly across different genders, ages, and education levels. Finally, although the conception of WRs among our participants was similar to that among Western laypeople, participants reported culturally unique WRs (e.g., motivation to pursue positive experiences, physical and psychological health). These findings may inspire future research on emerging adults’ wisdom development.
Local Intraoperative Marrow-Derived Augmentation for Primary Rotator Cuff Repair: An Updated Systematic Review and Meta-analysis of Studies From 2010 to 2022
Authors: Le Breton Stephen , Forlizzi Julianne , Bono Olivia , MacAskill Meghan , Mousad Albert , Kush Sophie , O’Brien Makenzie , Christensen Alaia , Mithoefer Kai , Ramappa Arun , Ross Glen , Shah Sarav S.
Published: March 2023

Background:

Recurrent tears of the rotator cuff pose a substantial problem despite advances in repair technique. Biologic augmentation via marrow stimulation or vented anchors may strengthen the suture-tendon junction and improve healing rates of native tissue, thereby enhancing outcomes of primary surgical repair.

Purpose:

To provide a focused systematic review and meta-analysis of local, intraoperative marrow-derived augmentation techniques in clinical primary rotator cuff repair.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review of PubMed, Embase, and Cochrane was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 2131 studies from 2010 to 2022, focused on either marrow stimulation or vented anchors, were isolated and classified as either preclinical or clinical. Meta-analysis was performed for comparative marrow stimulation and vented anchor studies. Heterogeneity was tested through calculation of I 2.

Results:

A total of 13 clinical studies were included in the review. All 9 comparative studies included in the meta-analysis demonstrated high methodologic quality or a low risk of bias. The pooled retear rate across all 9 clinical studies for patients undergoing marrow stimulation was 11%. For the 5 studies in the meta-analysis, the pooled retear rates were 15% for marrow stimulation and 30% for controls. Meta-analysis demonstrated a significant difference in the overall retear rate that favored marrow stimulation (odds ratio [OR], 0.41; 95% CI, 0.25-0.66; P = .0003; I 2 = 0%). Similarly, meta-analysis of the Constant score at final follow-up demonstrated a statistically significant difference between the 2 groups that favored a higher Constant score in the marrow stimulation group (mean difference, 2.84; 95% CI, 1.02-4.66; P = .002; I 2 = 29%). Vented anchors demonstrated improved ossification and bone density at the anchor site, but no difference in outcomes or retear. Pooled retear rates were 22.5% for vented anchors and 27.8% for controls.

Conclusion:

Current evidence demonstrates that marrow-stimulation techniques may have a positive impact on healing and retear rate, while vented anchors have a muted impact relative to nonvented anchors. Although available evidence is limited and more research is needed, findings to date suggest that marrow stimulation techniques may be an inexpensive, straightforward technique to consider in qualifying patients to prevent rotator cuff retears.
Therapist Resilience in an Ever-Changing World: A Systematic Review
Authors: Cronin Sarah , Allen Thomas , Hou Jian-Ming , Walker Lily
Published: March 2023

Given the demands of a helping professions amidst an ever-changing world, therapists need resilience now more than ever. This systematic literature review had two purposes: to explore the international evidence of internal characteristics that contribute to therapist resilience and to investigate the common ground between previous literature about therapist resilience and the newly identified characteristics of highly resilient therapists. In all, 29 peer-reviewed original research articles were systematically collected and coded for themes. In all, 10 overarching themes were identified: (a) connection to community, (b) pursuit of continual growth, (c) emotional boundaries, (d) emotional support, (e) humor, (f) integration of personal and professional, (g) meaning and purpose, (h) positive sense of self, (i) self-awareness, and (j) spirituality. The themes reinforced the four core characteristics of highly resilient therapists. Implications to foster therapist resilience and ideas for future research are discussed.
Lateral Extra-Articular Tenodesis via an All-Suture Anchor
Authors: Dulas Matthew , Vinod Amrit V , Athiviraham Aravind
Published: March 2023

Background:

In young patients, anterior cruciate ligament (ACL) reconstruction often results in graft failure. This may be due, in part, to concomitant injury to anterolateral complex (ALC) of the knee leading to rotatory laxity. The modified Lemaire lateral extra-articular tenodesis (LET) technique is intended to address the anterolateral rotatory instability due to injury to the ALC and to protect the ACL graft and meniscus.

Indications:

The International Anterolateral Complex Consensus Group Meeting identified 4 appropriate indications for the modified Lemaire LET procedure: revision ACL, high-grade pivot shift, generalized ligamentous laxity/genu recurvatum, and young patients returning to pivoting activities.

Technique Description:

The technique consists of harvesting an 8-cm long by 1-cm wide graft from the iliotibial band. The graft is released proximally and remains attached distally to Gerdy’s tubercle. The graft is then passed deep to the lateral collateral ligament (LCL) from distal to proximal. The graft is then affixed to a point proximal and posterior to the lateral femoral epicondyle with an all-suture button. The graft is then tensioned with knee at 30° of flexion and neutral rotation, and then secured in place.

Results:

With the modified Lemaire LET, there was previously concern for overconstraint and lateral compartment degeneration. However, recent studies have shown that there is no increased risk for these complications with the LET procedure. The STABILITY trial found that the addition of LET to ACL reconstruction significantly reduces re-rupture and residual laxity when compared with ACL reconstruction alone. Moreover, the addition of LET to ACL reconstruction can restore native knee kinematics.

Conclusion:

The addition of the modified Lemaire LET technique to traditional ACL reconstruction is a safe and effective adjunct that reduces the occurrence of graft rupture, addresses residual rotational laxity, and can restore native knee kinematics in appropriately indicated patient populations.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Effect of interactive, multimedia-based home-initiated education on preoperative anxiety inchildren and their parents: a single-center randomized controlled trial
Authors: Hou Huiyan , Li Xie , Song Yun’an , Ji Yingying , Sun Menglian , Wang Dan , Jiao Jiali , Qu Jifang , Gu Hongbin
Published: March 2023

Background

Anesthesiologists need to appreciate the impact of preoperative anxiety in children. The present study aimed to explore whether interactive multimedia-based home-initiated interventions could effectively relieve preoperative anxiety in pediatric patients.

Methods

In this prospective study, we compared preoperative anxiety between two groups of children aged 4–9 years. Children in the control group received a question-and-answer (Q&A) introduction, and children in the intervention group received multimedia-based home-initiated preoperative education using comic booklets, videos, and coloring game books. Differences in anxiety between the two groups were evaluated by the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) at four time points: in the ophthalmology outpatient clinic before intervention as the baseline (T0); in the preoperative waiting area (T1); at the time of separating from their parents and moving to the operating room (T2); and at the time of anesthesia induction (T3). Parental anxiety was assessed by the Self-rating Anxiety Scale (SAS) and Visual Analog Scale (VAS) at T0 and T2. Other related information was collected by questionnaire.

Results

Eighty-four children who underwent pediatric strabismus in our center between November 2020 and July 2021 were included in this study. An intention-to-treat (ITT) analysis was performed on data from 78 enrolled children. Children in the intervention group exhibited lower m-YPAS-SF scores at T1, T2, and T3 than those in the control group (all p < 0.001). By using a mixed-effect model with repeated measurement (MMRM) after adjusting the m-YPAS score at T0 as a covariate, the interventional effect in terms of themYPAS-SF score was also significant over time (p < 0.001). The percentage of children with perfect induction compliance (ICC = 0) in the intervention group was significantly higher than that in the control group [18.4% vs. 7.5%], and poor induction compliance (ICC>4) was lower (2.6% vs. 17.5%, p = 0.048). The mean parental VAS score at T2 in the intervention group was significantly lower than that in the control group (p = 0.021).

Conclusions

Interactive multimedia-based home-initiated intervention could reduce preoperative anxiety in children and improve the quality of anesthesia induction based on ICC scores, which may in turn impose a positive impact on parental anxiety.
Estimating individualized treatment effects from randomized controlled trials: a simulation study to compare risk-based approaches
Authors: Rekkas Alexandros , Rijnbeek Peter R. , Kent David M. , Steyerberg Ewout W. , van Klaveren David
Published: March 2023

Background

Baseline outcome risk can be an important determinant of absolute treatment benefit and has been used in guidelines for “personalizing” medical decisions. We compared easily applicable risk-based methods for optimal prediction of individualized treatment effects.

Methods

We simulated RCT data using diverse assumptions for the average treatment effect, a baseline prognostic index of risk, the shape of its interaction with treatment (none, linear, quadratic or non-monotonic), and the magnitude of treatment-related harms (none or constant independent of the prognostic index). We predicted absolute benefit using: models with a constant relative treatment effect; stratification in quarters of the prognostic index; models including a linear interaction of treatment with the prognostic index; models including an interaction of treatment with a restricted cubic spline transformation of the prognostic index; an adaptive approach using Akaike’s Information Criterion. We evaluated predictive performance using root mean squared error and measures of discrimination and calibration for benefit.

Results

The linear-interaction model displayed optimal or close-to-optimal performance across many simulation scenarios with moderate sample size (N = 4,250; ~ 785 events). The restricted cubic splines model was optimal for strong non-linear deviations from a constant treatment effect, particularly when sample size was larger (N = 17,000). The adaptive approach also required larger sample sizes. These findings were illustrated in the GUSTO-I trial.

Conclusions

An interaction between baseline risk and treatment assignment should be considered to improve treatment effect predictions.
Real-world management and outcomes of older patients with locally advanced esophageal squamous cell carcinoma: a multicenter retrospective study
Authors: Saito Yuki , Hamamoto Yasuo , Hirata Kenro , Yamasaki Makoto , Watanabe Masaya , Abe Tetsuya , Tsubosa Yasuhiro , Hamai Yoichi , Murakami Kentaro , Bamba Takeo , Yoshii Takako , Tsuda Masahiro , Watanabe Masayuki , Ueno Masaki , Kitagawa Yuko
Published: March 2023

Background

Neoadjuvant chemotherapy (NAC) followed by surgery is the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). Chemoradiotherapy (CRT) is an alternative treatment approach. However, both treatments are associated with toxicity, and the optimal treatment for older patients with ESCC is unknown. This study aimed to evaluate the treatment strategies and prognosis of older patients with locally advanced ESCC in a real-world setting.

Methods

We retrospectively evaluated 381 older patients (≥ 65 years) with locally advanced ESCC (stage IB/II/III, excluding T4) who received anticancer therapy at 22 medical centers in Japan. Based on age, performance status (PS), and organ function, the patients were classified into two groups: clinical trial eligible and ineligible groups. Patients aged ≤ 75 years with adequate organ function and a PS of 0–1 were categorized into the eligible group. We compared the treatments and prognoses between the two groups.

Results

The ineligible group had significantly shorter overall survival (OS) than the eligible group (hazard ratio [HR] for death, 1.65; 95% confidence interval [CI], 1.22–2.25; P = 0.001). The proportion of patients receiving NAC followed by surgery was significantly higher in the eligible group than in the ineligible group (P = 1.07 × 10–11), whereas the proportion of patients receiving CRT was higher in the ineligible group than in the eligible group (P = 3.09 × 10–3). Patients receiving NAC followed by surgery in the ineligible group had comparable OS to those receiving the same treatment in the eligible group (HR, 1.02; 95% CI, 0.57–1.82; P = 0.939). In contrast, patients receiving CRT in the ineligible group had significantly shorter OS than those receiving CRT in the eligible group (HR, 1.85; 95% CI, 1.02–3.37; P = 0.044). In the ineligible group, patients receiving radiation alone had comparable OS to those receiving CRT (HR, 1.13; 95% CI, 0.58–2.22; P = 0.717).

Conclusions

NAC followed by surgery is justified for select older patients who can tolerate radical treatment, even if they are old or vulnerable to enrollment in clinical trials. CRT did not provide survival benefits over radiation alone in patients ineligible for clinical trials, suggesting the need to develop less-toxic CRT.
Machine learning integrations develop an antigen-presenting-cells and T-Cells-Infiltration derived LncRNA signature for improving clinical outcomes in hepatocellular carcinoma
Authors: Wang Xiaodong , Chen Ji , Lin Lifan , Li Yifei , Tao Qiqi , Lang Zhichao , Zheng Jianjian , Yu Zhengping
Published: March 2023

As a highly heterogeneous cancer, the prognostic stratification and personalized management of hepatocellular carcinoma (HCC) are still challenging. Recently, Antigen-presenting-cells (APCs) and T-cells-infiltration (TCI) have been reported to be implicated in modifying immunology in HCC. Nevertheless, the clinical value of APCs and TCI-related long non-coding RNAs (LncRNAs) in the clinical outcomes and precision treatment of HCC is still obscure. In this study, a total of 805 HCC patients were enrolled from three public datasets and an external clinical cohort. 5 machine learning (ML) algorithms were transformed into 15 kinds of ML integrations, which was used to construct the preliminary APC-TCI related LncRNA signature (ATLS). According to the criterion with the largest average C-index in the validation sets, the optimal ML integration was selected to construct the optimal ATLS. By incorporating several vital clinical characteristics and molecular features for comparison, ATLS was demonstrated to have a relatively more significantly superior predictive capacity. Additionally, it was found that the patients with high ATLS score had dismal prognosis, relatively high frequency of tumor mutation, remarkable immune activation, high expression levels of T cell proliferation regulators and anti-PD-L1 response as well as extraordinary sensitivity to Oxaliplatin/Fluorouracil/Lenvatinib. In conclusion, ATLS may serve as a robust and powerful biomarker for improving the clinical outcomes and precision treatment of HCC.