bluuebunny/crossref_metadata_2025 huggingface dataset:
Accelerated strategies for impact identification of composite laminate using sparse sensor networks and model-based virtual time reversal
Authors: Yu Zexing , Sun Jiaying , Yue Maoling , Xu Chao
Published: November 2024

Barely visible impact damages are notorious threats to the health of composite structures. Detection of the impact is critical to promise the performance of composite structures. Recently, the authors proposed an impact identification method based on sparse sensor networks and virtual time reversal, which is verified on composite laminates. However, the computational demands of virtual time reversal simulations pose a notable limitation to this approach. To improve the efficiency of the method, several acceleration measures are developed in this article. First, the re-emitted wavefield analysis is accelerated using a frequency-domain method rather than the time-domain simulation, which largely reduces the computational costs. Subsequently, the GPU parallel acceleration algorithm is configured to further improve the efficiency. The proposed acceleration strategy is experimentally validated by various impact events on a composite laminate. The results render that the proposed acceleration strategy can promise the accuracy of the results of impact identification while significantly promoting computational efficiency, in which the time consumption plummets to only 1.94 s. Moreover, factors affecting the efficiency of the proposed method are discussed. The time consumption is positively correlated with the number of sensors involved in the identification. In addition, as the number of candidate points increases, the GPU encounters difficulty in handling all complex matrix operations simultaneously, leading to a substantial rise in computation time. Furthermore, the effect of signal lengths on the efficiency is minimal and largely negligible.
Exploring Rural, Black Women’s Lived Experiences With Physical Activity and Nutrition: A Photo-Elicitation Study
Authors: Das Bhibha M. , Simpson Kelsey C. , Sastre Lauren R.
Published: November 2024

Eastern North Carolina (ENC) residents have higher rates of type 2 diabetes, lower life expectancy, less physical activity (PA), and higher food insecurity than the rest of North Carolina. Black individuals in ENC may face health disparities due to systemic and societal barriers to PA and a nutritious diet; modifiable behaviors that may improve overall health. The purpose of this study was to explore the lived experiences of rural Black women who live in ENC and who meet the criteria for overweight and obesity in the context of PA and healthful diet promotion. Photo-elicitation was used to explore this population’s specific experiences with PA and nutrition, including barriers and facilitators, through photos and focus groups. Participants (N = 14; 43.5 ± 8.7 years old; body mass index (BMI) = 34.6 ± 5.9 kg/m2) were Black women in the rural Southeastern United States. Recruitment strategies included community outreach, listservs, social media, and word of mouth. Using photos submitted, our team conducted focus groups and completed content analyses to identify themes to tailor the development of a future health promotion program for Black women. Overarching themes were (a) Reframing the Mindset, (b) Accountability, and (c) Cultural Relativity. Findings demonstrate that Black women living in rural areas desire culturally relevant PA and nutrition programming focusing on healthy lifestyles versus weight loss. Future practice and research should utilize these findings to develop and examine the health impact of a health promotion program designed for Black women by Black women on PA levels, diet quality, and quality of life.
Diagnostic Value of Maximal Systolic Acceleration Measurements in the Follow-up of Complex Endovascular Aortic Repair: Illustration of a Concept
Authors: Willems Siem A. , Brouwers Jeroen J. W. M. , Hamming Jaap F. , Hinnen Jan Willem , van der Vorst Joost R. , van Schaik Jan
Published: November 2024

Purpose:

After complex endovascular aortic repair (cEVAR), long-term surveillance is advocated to monitor for potential (stent-related) complications. Although various imaging modalities are used, computed tomography angiography remains the standard in current clinical practice worldwide. However, radiopaque markers can cause metal artifacts and scattering, hampering assessment of patency of side branches. The maximal systolic acceleration (ACCmax) is a relatively new duplex ultrasound (DUS) parameter measured distal to a stenosis, avoiding in-stent assessment and scattering. The aim of this article is to illustrate the potential diagnostic utility of the ACCmax after cEVAR and visceral artery stenting in general.

Technique:

The ACCmax is measured at the maximal slope of the upstroke during the systolic phase in arterial flow. By manually connecting 2 points, a tangent line is created in which the maximal acceleration is automatically calculated and expressed in m/s2. A higher value reflects better arterial perfusion proximal to its measurement point. One measurement of a visceral artery takes about 5 minutes.

Conclusion:

ACCmax measurements can be a useful addition during DUS follow-up after cEVAR or visceral artery stenting, possibly decreasing radiation exposure, nephrotoxicity, and health care costs.

Clinical Impact

Long-term surveillance after complex endovascular aortic repair (cEVAR) is necessary to monitor for potential (stent-related) complications. Although CTA is the most common modality for imaging, metal artifacts and scattering can hamper the assessment of stent patency. The maximal systolic acceleration (ACCmax) is a duplex ultrasound based parameter that reflects arterial perfusion proximal to its measurement point. Due to its noninvasive nature, it can be a useful addition during follow-up after cEVAR or visceral artery stenting, possibly decreasing radiation exposure, nephrotoxicity and health care costs as well.
Blue Zone Loma Linda: Assessing the Relationship Between Lifestyle and Oral Health
Authors: Akkidas James , Kaur Antervir , Sood Gaurav , Taheri Sadaf , Ko Julia , Sulaiman Raghad , Oyoyo Udochukwu , Kwon So Ran
Published: November 2024

Objectives: Assess the relationship between lifestyle and oral health-related quality-of-life (OHRQoL) of residents in a blue zone, Loma Linda. Methods: A cross-sectional study was conducted using a questionnaire including demographics, lifestyle, and Oral Health Impact Profile (OHIP-14). Lifestyle cumulative scores ranged from 8-32, lower scores indicating greater conformity to Power 9® lifestyle, characterized by observing Sabbath, time with friends, volunteering, exercising, eating lots of plants, eating meat in moderation, drinking a lot of water, snacking on nuts, and eating an early dinner. OHIP-14 assessed OHRQoL, with scores from 0-56. Negative binomial regression was used, with significance of alpha = 0.05. Results: A total of 350 surveys were collected. Cumulative lifestyle showed a mean of 13.9. Spending time with friends was the most adhered to activity (96%) while the least followed was having early dinners (71.2%). Asians (Mean = 14.2) had significantly higher lifestyle scores than Whites (Mean = 13.7). The mean OHIP-14 was 7.01. Whites had lower OHIP-14 scores than Asians, indicating better OHRQoL. Race, nut consumption and exercise were significant predictors for increased OHRQoL ( P < 0.05, in all instances). Conclusions: Loma Linda residents adhere well to the Power 9® lifestyle. There are significant predictors such as nut consumption and exercise for increased OHRQoL.
Structural design of a polymer matrix composite ship propeller
Authors: Cuellar Posada Julio , Marín Jiménez Santiago , Meza Juan Manuel
Published: November 2024

This work presents the structural design of a propeller, with its profile established using the OpenProp software for a 5 m long competition catamaran at a speed of 5.5 m/s. The materials selected using the Ashby method were polymer matrix composites, and the chosen manufacturing method was vacuum bagging. The determination of the stacking sequence was initially done using panel theory and the macromechanics of composite materials. The stacking sequence was then optimized using the finite element method with Abaqus CAE. Experimental validation was conducted through instrumented cantilever bending tests on both specimens and the blade. The finite element results showed errors of less than 5% compared to the experimental measurements, thus validating the simulations and allowing the blade to be designed with static safety factors greater than eight under operational service conditions.
Optimization of heat transfer in a channel with stretching walls using a magnetized tetra-hybrid nanofluid
Authors: Shutaywi Meshal , Raza Jawad , Lund Liaquat Ali , Shah Zahir , Vrinceanu Narcisa , Deebani Wejdan
Published: November 2024

Nanoparticles have numerous applications and are used frequently in different cooling, heating, treatment of cancer cells and manufacturing processes. The current investigation covers the utilization of tetra hybrid nanofluid (aluminium oxide, iron dioxide, titanium dioxide and copper) for Crossflow model over a vertical disk by considering the shape effects (bricks, cylindrical and platelet) of nanoparticles, electro-magneto-hydrodynamic effect and quadratic thermal radiation. The present study is devoted to present the mathematical formulation of the tetra-hybrid nanofluid flow in a porous channel with stretching/shrinking walls. The present inspection model is derived from given partial differential equations (PDEs) and then transformed into a system of ordinary differential equations (ODEs) by incorporating similarity variables. The transformed ODEs are solved using the bvp4c methodology, which yields numerical results. From the obtained results it is observed that the maximum amount of [Formula: see text] happens when there is slightly increase in [Formula: see text] with stretched wall that is [Formula: see text]. A high radiation value indicates a considerable contribution from radiative heat transfer, whereas stretching and shrinking increase and reduce the size of the boundary. The combined impact caused an increase in the Nusselt number. The graphical and tabular representations are used to explain the physical behaviour of various model parameters. Previous outcomes are also contrasted with the current outcomes.
Various shapes of whiteness: A new look at racism and its institutional operation in Israeli academia
Authors: Abu-Rabia-Queder Sarab , Hager Tamar
Published: November 2024

This article explores theoretical concepts that reveal the power structures within Israeli academia. Rather than employing the conventional framework that emphasizes practices of discrimination and underrepresentation to explain the ongoing preference for the dominant Western, white Jewish group and its cultural capital over Jewish and Arab Palestinian minorities, we propose a new theoretical perspective. By integrating whiteness theory, critical race theory, intersectionality and settler colonial paradigms, the article illustrates how this framework can effectively analyse academic epistemology and social dynamics. We then introduce the subsequent articles in this issue as examples of the successful application of these concepts, highlighting how they expose the concealed and sophisticated exercise of organizational power that aligns with the norms of the dominant culture, to the detriment of minority students and faculty.
Dynamic reliability measures of weighted k-out-of-n system with heterogeneous components and its application to solar power generating system
Authors: Bisht Vaibhav , Singh S B
Published: November 2024

In the realm of dynamic reliability analysis, this research paper presents a novel mathematical model for the weighted k-out-of- n system with two heterogeneous components also said to be weighted ( k1, k2)-out-of- n repairable system. This innovative framework comprises two distinct component types, whose simultaneous functioning yields system operation if and only if the cumulative weight of the operational type 1 component is at least k1, and that of the type 2 component is at least, k2. Each component type has a number of distinct individual components with variable states that change over time, making the state probabilities of those components time-dependent. By employing an algorithm grounded in L z-transform, dynamic reliability measures comprising reliability, availability, mean expected performance, and expected profit are derived for the system taken into consideration. This study also introduces a pioneering connection between the L z-transform and queueing theory and extends its implications to various intricate engineering systems meeting the established criteria.
Bexotegrast in people with idiopathic pulmonary fibrosis (IPF): a plain language summary of publication of the INTEGRIS-IPF study
Authors: Lancaster Lisa , Cottin Vincent , Ramaswamy Murali , Wuyts Wim A. , Jenkins R. Gisli , Scholand Mary Beth , Kreuter Michael , Valenzuela Claudia , Ryerson Christopher J. , Goldin Jonathan , Kim Grace Hyun J. , Jurek Marzena , Decaris Martin , Clark Annie , Turner Scott M. , Barnes Chris N. , Achneck Hardean E. , Cosgrove Gregory P. , Lefebvre Éric A. , Flaherty Kevin R.
Published: November 2024

What is this summary about?

This plain language summary shares results from a clinical study called INTEGRIS-IPF that was published in the American Journal of Respiratory and Critical Care Medicine in 2024. This study looked at a medicine called bexotegrast (beck-so-teh-grast) as a possible treatment for idiopathic pulmonary fibrosis (i-dee-uh-pa-thick pul-muh-ner-ee fie-bro-sis; IPF). Bexotegrast is an investigational medicine, which means that it is being studied and has not yet been approved by the US Food and Drug Administration (FDA), for people with IPF to take as a treatment. IPF is a chronic, progressive lung disease that makes it hard to breathe and gets worse over time. There is no cure for IPF, treatment includes symptom management and consideration for the use of nintedanib or pirfenidone, which may decrease the pace of disease progression.

The study compared bexotegrast to a placebo (a treatment that looks identical to the medicine but has no medicinal effect) to look at how well it works and how safe it is in treating people with IPF. Most people in the study also took one of two medicines that are already approved by the FDA for IPF, pirfenidone or nintedanib.
A case of generalized cat scratch disease in a patient with ulcerative colitis on immunosuppressive therapy
Authors: Rošić Despalatović Bruna , Bratanić Andre , Božić Dora , Vilović Katarina , Kunac Nenad , Ardalić Žarko
Published: November 2024

Cat scratch disease (CSD) is a zoonotic disease transmitted to humans, usually via scratches or bites. Bartonella henselae is the primary causative agent. It causes a mild, self-limiting disease. In immunocompromised patients, the course of the infection can be more serious because of the suppressed antibacterial response, causing a life-threatening disease. A 54-year-old male patient presented with ulcerative colitis. Five days after receiving the first dose of infliximab 400 mg intravenously and 0.5 mg/kg methylprednisolone, he presented with enlarged axillary lymph nodes and colliquation of the intraabdominal lymph node with intrahepatic colliquating areas caused by B. henselae after cat bites. Long-term treatment with multiple antibiotics and prednisolone resulted in clinical improvement and regression of the liver and intra-abdominal lymph nodes. After further treatment for ulcerative colitis, we assessed the possibility of reintroducing immunosuppressive therapy. Adalimumab was introduced after consulting an infectious disease specialist. At the follow-up visit, the patient was in remission of ulcerative colitis and without signs of reactivation of bartonellosis. Diseases such as CSD with a benign clinical appearance and prognosis can develop a severe and life-threatening course in immunocompromised patients. This requires a complex understanding of the immune processes in such patients, and the reintroduction of immunosuppressive therapy after successful treatment of CSD probably does not increase the risk of reactivation.
Factors influencing Chinese doctors to use medical large language models
Authors: Qu Shujuan , Liu Lin , Zhou Min , Zhou Chuting , Campy Kathryn S.
Published: November 2024

Objective

The integration of medical large language models (MLLMs) into healthcare has garnered global interest, however, the determinants of their adoption by medical professionals remain underexplored. This study aims to elucidate the factors influencing doctors’ intention to utilize MLLMs, encompassing both psychological determinants and demographic attributes.

Methods

An extended theoretical model was developed using constructs derived from the Technology Acceptance Model (TAM) and five constructs. A hybrid online and offline survey was conducted from March to December 2023, including 955 Chinese medical practitioners. Structural equation modeling was utilized to test the research hypotheses.

Results

The measurement model exhibited satisfactory reliability and validity, with fit indices meeting scholarly standards. Perceived ease of use emerged as a significant predictor of both perceived usefulness and satisfaction. Content quality was identified as a substantial influence on perceived satisfaction but did not significantly predict perceived usefulness. Technical support and social influence were found to significantly affect perceived usefulness without directly impacting satisfaction. Perceived usefulness positively influenced both satisfaction and usage behavior, while perceived risk had a negative effect. A significant relationship between perceived satisfaction and usage behavior was established, with gender, age, education, and professional title moderating this relationship.

Conclusions

The study provides empirical evidence for understanding the adoption of MLLMs by Chinese doctors, offering management implications for future technical research, development, and implementation in the medical field.
Increased Steps in Japanese Older Adults Associated with Improved Winter Sleep Quality
Authors: Harai Nozomi , Okuma Hideyuki , Tsuchiya Kyoichiro , Matsuoka Satoshi , Kashiwagi Kenji
Published: November 2024

Objective: We aimed to assess seasonal and age-related variations in sleep quality using Fitbit data and offer lifestyle recommendations for enhancing winter sleep quality. Methods: Fitbit sleep and activity data of 51 participants randomly recruited from members of the Association for Research in Supporting System of Chronic Disease, a nonprofit organization in the Yamanashi Prefecture of Japan, were collected and retrospectively analyzed from July to December 2022. Sleep stage targets were set at 10% to 25% for deep sleep, 50% to 60% for shallow sleep, and 20% to 25% for REM sleep. Participants were categorized into improved, unchanged, and worsened groups based on sleep stage unit changes between August and December. Results: The median (interquartile range) age was 71 (68–74) years old. There were eight participants in the improved group, 23 in the unchanged group, and nine in the worsened group. The improved group showed significantly more steps (990 ± 1,102 steps/day, p = .039) in December than in August, while the worsened group showed fewer steps (−507 ± 1,638 steps/day, p = .38). Conclusion: Increasing step count in winter may improve sleep quality, as assessed by sleep stage. Further research considering potential confounders and factors affecting winter sleep is needed to support and extend these findings.
Countering Holocaust Trivialization: How Educational Resources Support Teachers in the Context of Political Extremism
Authors: Eargle Jeffrey C. , Rubin Daniel Ian
Published: November 2024

In this study, we used Terrance L. Furin’s concept of transformational countering to examine six Holocaust education resources designed to address Holocaust trivialization and antisemitism. While academic comparisons are useful to helping students understand challenging content, superficial Holocaust analogies for political purposes are identified as Holocaust trivialization. Given that the current context consists of a growing white nationalist movement characterized by authoritarianism, antisemitism, and conspiracy theories, we enter the study understanding that Holocaust trivialization and far-right extremism must be understood together. We, therefore, examined the type of support teachers receive from Holocaust and human rights organizations in countering extremism and Holocaust trivialization. After analyzing the six resources, our findings demonstrate that resources produced to counter Holocaust trivialization become quickly outdated given the rapid evolution of extremism. Also, findings indicate that teachers receive stronger support in countering extremism and Holocaust trivialization from organizations that focus broadly on supporting human rights compared to the organizations that focus exclusively on Holocaust education.
The Relationship Between Defensive Pessimism, Goal Orientation, and Self-Esteem Among Nursing Students
Authors: Atta Mohamed Hussein Ramadan , Rushdan Esraa Elsayed , Elzohairy Nadia Waheed
Published: November 2024

Introduction

Academic achievement in nursing students is significantly influenced by their self-esteem and goal orientation. Defensive pessimism, a strategy where students set low expectations to prepare for potential failure, helps them stay motivated and focused. While this cognitive strategy can boost effort and performance, its relationship with self-esteem and goal orientation remains underexplored among nursing students, revealing a gap in understanding how these factors interact to influence academic success.

Objective

Assess the level and relationship between defensive pessimism, goal orientation, and self-esteem among nursing students at the Faculty of Nursing.

Method

Four hundred students were included in the research using a stratified sampling method followed by a simple randomization sampling technique to select 100 students from each academic year. Tools: The Defensive Pessimism Questionnaire, the Goal Orientation Scale, and the Self-Esteem Scale were used.

Results

56.28% of participants had a low level of defensive pessimism, about two-thirds (62.30%) had a low level of goal orientation, and 70.0% of the students had a mild level of self-esteem. In addition, higher levels of defensive pessimism are significantly associated with stronger goal orientation ( r = .291, p < .001) but lower self-esteem ( r = −.246, p < .001). Additionally, self-esteem is significantly positively correlated with mastery-performance approach goals ( r = .335, p < .001; r = .142, p < .001) and significantly negatively correlated with mastery-performance avoidance goals ( r = −.351, p < .001; r = −.041, p < .001).

Conclusion

These findings highlight the complex interplay between defensive pessimism, goal orientation, and self-esteem in nursing students. Understanding these relationships is crucial for developing targeted interventions to enhance academic achievement and psychological well-being among nursing students, potentially by fostering adaptive goal-setting strategies and addressing the impacts of defensive pessimism on self-esteem.
Dental Health Adjuncts and Care: Exploring Access Among Asylum Seekers and Refugees in London, United Kingdom
Authors: Hurry K.J. , Longley N. , Cinardo P. , Chowdhury H. , Ward A. , Eisen S.
Published: November 2024

Aims:

This work examines and describes dental health among people seeking asylum and refugees (PSAR) who are evaluated by the Respond service. This includes access to and use of oral health products, access to dental care, and experience of dental pain.

Materials and Methods:

The Respond service pilot offered holistic health assessments to PSAR in temporary accommodation within North Central London between July 2021 and March 2023. Relevant data were extracted from anonymized health records of individuals seen by Respond. Data were analyzed with SPSS (version 28.0.0.0; IBM) to produce descriptive statistics and regression models.

Results:

An overall 1,390 PSAR were included; 78.7% were male. The mean ages of adults and children were 31.6 and 6.8 y. Seventy-seven countries of birth were reported, most commonly Iran (23.1%). Over two-thirds (67.1%) of PSAR were not accompanied by family members; only 17.2% had UK family links. The mean travel duration was 769.3 days; migration reasons were multifactorial, including persecution (31.2%) and conflict (20.5%). In addition, 77.3% of PSAR reported having access to a toothbrush; only 50.8% indicated routinely brushing their teeth, with 38.9% having seen a dentist in <36 mo. Dental pain was common (28.8%). Only 45.8% of children (<16 y) had access to a toothbrush, 32.3% were brushing their teeth twice daily, and 9.7% cited dental pain. Logistic regression identified significant predictors of routine toothbrushing, access to dental care, and dental pain. Female PSAR were more likely to routinely brush their teeth (adjusted odds ratio [OR], 3.19; P < 0.001) and access dental care (adjusted OR, 0.57; P < 0.05). PSAR aged 30 to 39 y (adjusted OR, 1.97; P < 0.05) and those with informal travel modes (adjusted OR, 1.82; P < 0.001) were more likely to experience pain.

Conclusion:

There is variation in the dental experience of PSAR, but a significant proportion are failing to perform routine toothbrushing, are not regularly accessing dental care, and are experiencing dental pain. Knowledge Transfer Statement: The results of this analysis suggest that there is variation in the dental experience of people seeking asylum and refugees, but many are failing to perform routine toothbrushing, are not regularly accessing dental care, and are experiencing dental pain.
Long-term Outcomes After Total Ankle Arthroplasty: A Systematic Review
Authors: Lee Michael S. , Mathson Lucas , Andrews Clark , Wiese Dylan , Fritz Jessica M. , Jimenez Andrew E. , Law Brian
Published: November 2024

Background:

Total ankle arthroplasty has emerged as a treatment to successfully treat ankle arthritis. Recent studies have reported more than 40 000 total ankle arthroplasties (TAAs) being performed between 2009 and 2019 in the United States. Although recent studies have reported favorable patient-reported outcomes at short- and midterm follow-up, there is a paucity of aggregate literature reporting on long-term patient-reported outcomes (PROs) after TAA. The purpose of this review is to report an aggregate of literature on minimum 10-year patient-reported outcomes after TAA.

Methods:

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) were queried in June 2024. Primary research articles were included if they reported minimum 10-year PROs or satisfaction for patients who underwent primary TAA and were written in English. Survivorship was reported based on implant failure, which was determined uniquely by each study.

Results:

Eight studies met the inclusion criteria. A total of 595 ankles with a range of average ages from 51 to 73.7 years were included in the study with follow-up ranging from a minimum of 10 years to a minimum of 20 years. Six of the 8 studies reported average follow-up ranging from 11.9 to 15.8 years. Two of the 8 studies reported significant improvement in PROs following surgery. Survivorship at a minimum of 10-year follow-up ranged from 66% to 94.4%. Average time to implant failure ranged from 4.6 to 13.8 years.

Conclusion:

Patients undergoing primary TAA were reported to have generally improved PROs at minimum 10- year follow-up. However, they demonstrated variable rates of survivorship ranging from 66% to 94.4%. Of those experiencing implant failure, average time to failure ranged from 4.6 to 13.8 years. Survivorship should be interpreted with caution because of varying definitions between studies. Further studies should seek to standardize the definition of survivorship and reporting of PROs to allow for effective analysis of heterogeneity.
Dell Technologies: Public to Private and Back to Public
Authors: Tripathi Nitya Nand , Kumar Abhay , Wadhwa Shalini
Published: November 2024

The case study discusses the buyout strategy of Dell Inc. Dell Inc. was a market leader in PCs in the early 2000s. Due to a substantial change in technology, the market share of PCs declined significantly, and Dell missed opportunities and recorded a decline in sales of over 10% from November 2012 to January 2013 due to a fall in shipments. After analysing the complex circumstances, Mr Michael Dell, CEO and Chairman of Dell Inc., decided to convert the publicly traded company into a private company in 2013 through a buyout deal. On 28 December 2018, Dell was again listed on the New York Stock Exchange for trading through a tracking stock strategy. The case study deals with several ups and downs of the company and also provides a platform to discuss the various benefits of buyouts.
Navigating Both/And and Either/Or Approaches in Response to Paradoxical Demands: A meta-both/and approach
Authors: Krautzberger Marc , Tuckermann Harald
Published: November 2024

Paradox scholars increasingly argue that organizations should not only adopt both/and approaches to manage paradoxes but also consider either/or approaches as valid alternatives. However, previous research indicates that both/and and either/or approaches are based on contradictory beliefs and organizational structures, making it difficult to leverage them effectively. By integrating the concepts of the decision paradox and reflective episodes into paradox theory, we propose a process model for navigating paradox through a “meta-both/and” approach. Our model explains how both/and and either/or approaches can be regarded as serious alternatives, systematically integrated into an organization, and applied to address paradoxical demands. We advance the understanding of the paradoxical relationship between both/and and either/or approaches and the structures that facilitate their effective application in managing paradoxes.
Is Screening for GERD Necessary in All Asymptomatic Lung Transplant Candidates?
Authors: Balinski Aaron , Gessessew Hayalneh , El Halabi Maan , Malamood Mark
Published: November 2024

Background:

Gastroesophageal reflux disease (GERD) is a known contributor to allograft dysfunction after lung transplantation. Evaluation for GERD has been advocated for all lung transplant candidates. The aim of this study is to evaluate the outcomes of GERD testing in lung transplant patients without GERD symptoms and determine if a subset can skip/defer these tests.

Methods:

A retrospective chart review was conducted on lung transplant candidates who had pre- transplant GI evaluation at our institution between 2019 and 2022. Adult patients were included if they reported no GERD symptoms and completed GERD screening with Multichannel intraluminal impedance-pH testing. Demographics and results of prior testing were collected for included patients. Results were analyzed using STATA.

Results:

176 patients met inclusion criteria. 88 (50%) tested positive for GERD and 88 (50%) tested negative. 68/88 (77.3%) were positive by pH alone. Only 20/176 (11%) had elevated reflux episodes and were recommended to undergo anti-reflux procedures. There were no statistically significant differences in evaluated variables differentiating GERD+ versus GERD- patients.

Conclusion:

Lung transplant candidates without symptoms concerning for GERD tested positive for GERD 50% of the time with no reliable pre-test characteristics to stratify patients. The large majority of positive results were from high acid exposure time alone without elevated reflux episodes—a low risk phenotype for allograft dysfunction. Only 11% had increased reflux episodes and thus were recommended for anti-reflux procedures. Thus, deferring GERD screening in asymptomatic low-risk candidates until post-transplant is unlikely to impact clinical management while benefiting patients and health systems.
Community Health Agents Dismantling Gender Norms in a Machismo Society
Authors: Allen Elizabeth M. , Van Skiba Michael J. , Frisancho Ariel , Llanten Claudia , Izarra Cecilia
Published: November 2024

Background

Community health agents (CHAs) play a crucial role in healthcare delivery and can also impact societal gender norms. This study aims to understand CHAs’ perceptions of gender roles and norms to identify long-term strategies for women’s empowerment.

Methods

We conducted 90-min focus group discussions (FGDs) among CHAs in Peru. FGDs illuminated women’s perceptions of gender roles and how to empower women in communities.

Results

In total, 53 CHAs participated across six FGDs. CHAs noted that women face significant barriers, are treated disrespectfully, and relegated to domestic roles. Ideal gender norms were described as having access to education, increasing voice, inclusion in decision-making, and independence. Changing gender norms requires that men, women, families, and communities support women’s progress in society.

Conclusions

CHAs are in a unique and powerful position to drive social change. Understanding CHAs perceptions can help develop effective strategies for women’s empowerment.
Oral administration of butylated hydroxytoluene induces neuroprotection in a streptozotocin-induced rat Alzheimer’s disease model via inhibition of neuronal ferroptosis
Authors: Faraji Parisa , Parandavar Elham , Kuhn Hartmut , Habibi-Rezaei Mehran , Borchert Astrid , Zahedi Elham , Ahmadian Shahin
Published: November 2024

Background

Alzheimer’s disease (AD) is the most common human neurodegenerative disorder worldwide. Owing to its chronic nature, our limited understanding of its pathophysiological mechanisms, and because of the lack of effective anti-AD drugs, AD represents a significant socio-economic challenge for all industrialized countries. Neuronal cell death is a key factor in AD pathogenesis and recent studies have suggested that neuronal ferroptosis may play a major patho-physiological role. Since ferroptosis involves free radical-mediated lipid peroxidation, we hypothesized that enteral administration of the radical scavenger butylated hydroxytoluene (BHT) might slow down or even prevent the development of AD-related symptoms in an in vivo animal AD model.

Material and methods

To test this hypothesis, we employed the rat model of streptozotocin-induced AD and administered butylated hydroxytoluene orally at a dose of 120 mg/kg body weight. Following BHT treatment, neuronal cell death was induced by bilateral stereotactic intraventricular injection of streptozotocin at a dose of 3.0 mg/kg body weight. Three weeks after surgery, we assessed the learning capabilities and the short-term memory of three experimental groups using the conventional y-maze test: (i) streptozotocin-treated rats (BHT pre-treatment), (ii) streptozotocin-treated rats (no BHT pre-treatment), (iii) sham-operated rats (BHT pre-treatment but no streptozotocin administration). After the y-maze test, the animals were sacrificed, hippocampal tissue was prepared and several biochemical (malonyl dialdehyde formation, glutathione homeostasis, gene expression patterns) and histochemical (Congo-red staining, Nissl staining, Perls staining) readout parameters were quantified.

Results

Intraventricular streptozotocin injection induced the development of AD-related symptoms, elevated the degree of lipid peroxidation and upregulated the expression of ferroptosis-related genes. Histochemical analysis indicated neuronal cell death and neuroinflammation, which were paralleled by aberrant intraneuronal iron deposition. The streptozotocin-induced alterations were significantly reduced and sometimes even abolished by oral BHT treatment.

Conclusion

Our data indicate that oral BHT treatment attenuated the development of AD-related symptoms in an in vivo rat model, most probably via inhibiting neuronal ferroptosis. These findings suggest that BHT might constitute a promising candidate as anti-AD drug. However, more work is needed to explore the potential applicability of BHT in other models of neurodegeneration and in additional ferroptosis-related disorders.
Effect of Process Parameters on the Mechanical Properties of Simultaneous Double-Sided Friction Stir Welding Joints
Authors: Meng Shaofei , Zhao Huihui , Dong Jiyi , Liu Wu , Liu Haitao , Xiao Juliang
Published: November 2024

Currently, conventional single-sided friction stir welding is primarily suitable for joining thin plate aluminum alloys, and its application to thick plates is still challenging in terms of welding efficiency and joint mechanical properties. Simultaneous double-sided friction stir welding (SDS-FSW) is a high-efficiency joining technique specifically developed for welding thick plates. However, there is little research on the influence of SDS-FSW process parameters on the joint mechanical properties. In this study, a 12 mm thick AA6061-T6 aluminum alloy and dual robot welding equipment are used to conduct SDS-FSW experiments exploring the influence of rotational speed $$\omega$$
ω
and welding speed v on the mechanical properties and microstructure. The results show that when the welding parameters are $$\omega$$
ω
 = 800 r/min and v = 60–80 mm/min, smooth and defect-free thick plate aluminum alloy SDS-FSW joints can be obtained, and the macroscopic morphology of the joints is distributed in a “dumbbell” shape. The grain size in the weld nugget zone increases with increasing welding heat input. The microhardness distribution in the joint displays a “W” shape, and the hardness value of the weld nugget zone can reach 67% to 86% of that of the base metal (BM). The junction between the thermo-mechanically affected zone and the heat affected zone is the weakest region of the joint, with the lowest hardness being approximately 51% of that of the BM. When the welding parameters are $$\omega$$
ω
 = 800 r/min and v = 140 mm/min, the SDS-FSW joint has the highest tensile strength, reaching 78.43% of the BM strength and exhibiting ductile fracture characteristics. This research indicates that acceptable weld strength in thick aluminum alloys can be achieved via the SDS-FSW joining mechanism, highlighting its significant potential for industrial applications.
No difference in surgical time and total theatre time between robotically assisted and computer assisted total knee arthroplasty
Authors: Haslhofer David Johannes , Anelli-Monti Victoria , Hausbrandt Peter , Kammerlander Christian , Klasan Antonio
Published: November 2024

Introduction

A number of studies have demonstrated a significant reduction of surgical time for robotically assisted surgery (RAS) total knee arthroplasty (TKA) after the learning curve between 6 and 43 cases. It is unknown if the logistics of RAS produce a longer total theatre time since published literature only reflects the surgical time. It is also unknown how RAS surgical and total theatre times compare with computer assisted surgery (CAS) TKA.

Methods

This is a prospective study of 524 consecutive patients undergoing a CAS or a RAS TKA using the same cementless implant. We recorded age, sex, body mass index (BMI), incision time of the first case, total surgical time, total theatre time, length of stay and 90-day complication and readmission rate.

Results

During the study period, 205 CAS and 199 RAS TKA were performed. There was no difference at baseline in age (p = 0.546), sex (p = 0.920) or BMI (p = 0.791). Surgical time for CAS was 78.3 (± 22.2) min and for RAS was 80.1 (± 25.7) min, p = 0.451. Total theatre time for CAS was 117.4 (± 27.8) min and 119.3 (± 30.7) min for RAS, p = 0.515. There was no difference in length of stay (p = 0.674), 90-day complication (p = 0.530) or readmission rate (p = 0.930). There was a difference in skin-incision average time for the first case (p = 0.022).

Conclusions

Although theatre set-up for the first case is 5 min longer, RAS-TKA does not prolong the surgical time or total theatre time when compared with CAS-TKA. There was no reduction in case volume since the introduction of robotics.

Level of evidence

III.
Promoting tomato resilience: effects of ascorbic acid and sulfur-treated biochar in saline and non-saline cultivation environments
Authors: Ikram Muhammad , Minhas Asif , AL-Huqail Arwa A. , Ghoneim Adel M. , Mahmood Sammina , Mahmoud Esawy , Tahira Maryam , Mehran Muhammad , Maqsood Muhammad Faizan Khurram , Rauf Abdul , Ali Waqar
Published: November 2024

The resilience of tomato plants under different cultivation environments, particularly saline and non-saline conditions, was investigated by applying various treatments, including 0.5% Ascorbic Acid (AsA) and 1% Sulphur-treated Biochar (BS). The study evaluated parameters such as fruit length, diameter, yield per plant and pot, Total Soluble Solids (TSS) content, chlorophyll content, electrolyte leakage, enzyme activities (Superoxide Dismutase - SOD, Peroxidase - POD, Catalase - CAT), and nutrient content (Nitrogen - N%, Phosphorus - P%, Potassium - K%). Under saline conditions, significant enhancements were observed in fruit characteristics and yield metrics with the application of AsA and BS individually, with the combined treatment yielding the most substantial improvements. Notably, AsA and BS treatments exhibited varying effects on TSS levels, chlorophyll content, electrolyte leakage, and enzyme activities, with the combination treatment consistently demonstrating superior outcomes. Additionally, nutrient content analysis revealed notable increases, particularly under non-saline conditions, with the combined treatment showcasing the most significant enhancements. Overall, the study underscores the potential of AsA and BS treatments in promoting tomato resilience, offering insights into their synergistic effects on multiple physiological and biochemical parameters crucial for plant growth and productivity.
Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review
Authors: Bhutada Kiran , Venkateswaran Mahima , Atim Maureen , Munabi-Babigumira Susan , Nankabirwa Victoria , Namagembe Flavia , Frøen J. Frederik , Papadopoulou Eleni
Published: November 2024

Background

In 2016, the World Health Organization (WHO) recommended increasing antenatal care (ANC) visits from four to eight to reduce maternal morbidity and mortality. However, many low-middle income countries (LMICs), including Uganda, struggle to achieve even the basic four ANC visits. To further improve ANC attendance, understanding the perceptions and beliefs of end users is crucial. This systematic review explores the perceptions, experiences, and behavior of pregnant or previously pregnant women, their families and healthcare workers on ANC attendance in Uganda.

Methods

The review includes qualitative and quantitative studies published from January 2012 to September 2022. Outcomes include early initiation of ANC visits and any attendance or utilization of routine ANC services. The Critical Appraisal Skills Programme (CASP) checklist was used to assess the quality of included studies.

Results

We searched 7 databases, identified 725 references and assessed 107 in full text for eligibility based on selected inclusion criteria. Forty-seven studies were eligible and are included in this review. Quantitative findings highlight socioeconomic factors like occupation, wealth index, and marital status as key determinants of ANC uptake and timely uptake of care, favoring higher wealth, younger age, marriage, and media access. Qualitative evidence reveals challenges to ANC attendance including financial constraints, cultural beliefs, gendered decision-making, and geographical distance from healthcare facilities. Potential solutions involve financially empowering women, providing reliable ANC equipment and medication, and community engagement and education.

Conclusions

This review offers valuable insights for policymakers and healthcare providers seeking to tailor interventions that address the unique needs and challenges faced by pregnant women, their families, and healthcare workers in Uganda. By doing so, it may enhance ANC accessibility and quality, ultimately aligning with the WHO’s recommendation of eight ANC contacts (ANC8) and contributing to reducing maternal morbidity and mortality rates.
Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study
Authors: McIntyre Daniel , Quintans Desi , Kazi Samia , Min Haeri , He Wen-Qiang , Marschner Simone , Khera Rohan , Nassar Natasha , Chow Clara K.
Published: November 2024

Background

Healthcare policy implemented during the COVID-19 pandemic may have impacted the health of patients with heart failure. Australian data provide a unique opportunity to examine service disruption independent of significant COVID-19 burden. This study aimed to examine heart failure care during the pandemic in New South Wales (NSW).

Methods

Analysis of hospital utilisation among patients aged ≥ 18 years with a primary diagnosis of heart failure conducted using linked administrative health records from hospital admission, emergency department, non-admitted services, and mortality data collections. Health service utilisation and outcomes were compared “Pre-pandemic” (PP): 16th March 2018 – 28th August 2019 and “During pandemic” (DP): 16th March 2020 – 28th August 2021. Mortality data were available until December 2021.

Results

Heart failure-related ED presentations and hospital admissions were similar between the periods (PP = 15,324 vs DP = 15,023 ED presentations, PP = 24,072 vs DP = 23,145 hospital admissions), though rates of admission from ED were lower DP (PP = 12,783/15,324 (83.4% [95% CI 82.8-84.0]) vs DP = 12,230/15,023 (81.4% [95% CI 80.8-82.0%]). There was no difference according to age, sex, rurality, or socioeconomic status. Outpatient volume reduced DP (PP = 44,447 vs DP = 35,801 occasions of service), but telehealth visits increased nearly threefold (PP = 5,978/44,447 (13.4% [95% CI 13.1-13.8%]) vs DP = 15,901/35,801 (44.4% [95% CI 43.9-44.9%]) with highest uptake among the wealthy and those in major cities. Time to heart failure-related ED presentation, hospitalisation or all-cause mortality following index admission was longer DP (PP = 273 [IQR 259, 290] days, DP = 323 [IQR 300, 342] days, HR 0.91 [95% CI 0.88, 0.95]).

Conclusions

Policies implemented DP had minimal impact on volumes of inpatient heart failure care in NSW hospitals, but there were fewer admissions from ED and reduced volumes of publicly funded outpatient care. A rapid shift from patient-facing to remotely delivered care enabled compliance with restrictions and was associated with increased time to heart failure-related adverse events, but access was not afforded equally across the socio-demographic spectrum.