bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating a hermetic reciprocating compressor performance under variable lift limiter height using FSI method
Authors: Bacak Aykut , Pınarbaşı Ali , Dalkılıç Ahmet Selim
Published: March 2024

This study examines discharge line energy losses using advanced fluid-structure interaction methods to show how valve design parameters—length, thickness, and height—improve compressor performance. An innovative 3D fluid-structure Interaction model represents a self-acting hermetic reciprocating compressor's discharge valve as a beam element. The RNG k− ε model examines how reed valve thickness, length, compressor speed, and lift limiter height impact pressure pulsation and compressor efficiency. Under ASHRAE conditions, operating at a challenging temperature range of 54.4 to −23.3 °C, the study meticulously explores the intricate interplay of discharge valve characteristics. Specifically, varying valve thicknesses (0.127, 0.152, 0.178, and 0.2 mm) and lengths (14.722, 16.222, and 17.722 mm) are examined in conjunction with different compressor speeds (1300, 2100, and 3000 rpm) according to the design specifications. Upon meticulous examination of discharge line losses at a compressor speed of 1300 rpm, intriguing insights emerged. For lift limiter heights of 0.8, 1.05, and 1.25 mm, coupled with a valve length of 17.722 mm, the study unveiled remarkable average energy losses of −6.91%, 2.83%, and −8.52%, respectively. The exploration continued at 2100 rpm, revealing a dynamic pattern with average losses for the same lift limiter heights at 0.94%, −1.26%, and −4.43%, respectively. In a succinct summary, the valve in focus demonstrated a noteworthy disparity in discharge line losses, reaching a maximum variation of 9.15%, −3.83%, and −8.30% when operated at the challenging speed of 3000 rpm.
Eighteen Years of Joint Master of Health Professions Education Between Geographically Distanced Partners Lessons from a Matured Partnership
Authors: Waterval Dominique G. J. , Talaat Wagdy , Frambach Janneke M.
Published: March 2024

Many educational partnerships between institutes never reach the stage of maturity, with students often bearing the costs of such discontinued partnerships. Reasons can be multifold, including a loss of ambitions, finances, or changing personal aspirations of stakeholders. In 2022 a joint curriculum in health professions education between two geographically and culturally distanced institutes reached its 18th anniversary. What can be learned from this particular partnership in terms of deliberate strategic choices, if any, to overcome the challenges identified in the literature? This article applies an instrumental, in-depth case analysis using a theoretical framework of factors that impact the sustainability of educational curriculum partnerships. By doing so, this paper intends to reveal successful strategies and managerial decisions that might be beneficial to those aiming for a sustainable partnership in higher education.
Online peer-group mentoring: An innovative mentoring program within an Australian professional association
Authors: Turner David , Elliott Julie , Thomas Jill , Garner Susan , Donkers Martina , Roberts David , Demetriou Francesca
Published: March 2024

This article describes an online peer-group mentoring program to support career-long professional development, professional identity development, and stronger experiential peer-to-peer learning. It was developed in response to ongoing interest among members of the Australian Evaluation Society (AES), a professional association that aims to improve the theory, practice, and use of evaluation. It is intended to complement the technical training that can be provided through workshops or professional training and conventional one-on-one mentoring that members may access in other ways. Now in its third year, the program refined its focus and major objectives from promoting technical skills and knowledge to a broader focus on building professional networks, reducing professional isolation, and enhancing professional confidence. Two distinct approaches emerged from the first two years of the program, with each approach appealing to different participants. Some groups focused broadly on career development and professional network building, while others focused on topics of particular interest to participants. The peer-group approach is relevant to other professional associations in which practitioners tend to work alone or in small groups. Evaluation findings can inform other such associations about designing and implementing online group mentoring programs for their members.
Modern Requirements for the Professional Activity and Competence of a Social Teacher
Authors: Orynbekova Ainur S. , Menlibekova Gulbakhyt Zh. , Amanova Aray K. , Sarmurzin Yerbol Zh.
Published: March 2024

The purpose of this study lies in the theoretical investigation and consideration of modern requirements for the professional activity and competence of a social teacher in education. Employing qualitative methods, it explores personality-oriented, psychological-pedagogical, and practice-oriented approaches to enhance the preparatory process and professional development of social teachers. The results underscore the significance of ongoing professional development, flexibility in response to novel pedagogical approaches, and the creation of an all-encompassing competency framework that is in line with contemporary educational norms. The study emphasises how important social educators are to promoting social and individual growth through learning.
A Pilot Study of Pembrolizumab Combined With Stereotactic Ablative Radiotherapy for Patients With Advanced or Metastatic Sarcoma
Authors: Harris Jeremy P. , Park Jino , Ku Eric , Seyedin Steven , Stitzlein Russell , Goldin Amanda , Chen Wen-Pin , McLaren Christine , Chen Allen M. , Chow Warren
Published: March 2024

Objectives

Immunotherapy with immune checkpoint inhibitors has shown only limited success in the management of metastatic soft tissue sarcoma. Overall response rates (ORR) with single agent pembrolizumab were 18% and median PFS was 18 weeks on the clinical trial SARC028. One strategy to improve the responses to immunotherapy is with stereotactic body radiation therapy (SBRT), which can enhance the antitumor CD8 T cell response through the release of tumor-specific antigens, potentially priming a more diverse class of T cell receptors.

Methods

This is a phase 0, pilot prospective study taking place at a single center with 2 arms. In Arm A, patients are treated with pembrolizumab 400 mg IV infusion on day 1 of a 42-day cycle. Stereotactic body radiation therapy (SBRT) is delivered in 1-5 fractions starting on C1D15-28 and given every other day. In Arm B, patients who have started an immune checkpoint inhibitor within 60 days are treated with SBRT in addition to the current therapy.

Results

In this study we outline testing the feasibility of adding SBRT to pembrolizumab.

Conclusion

The ultimate goal of combination therapy is improved overall response, including tumors not treated with SBRT. This trial can be found registered online: NCT05488366.
The Consequences of Unmet Needs for Assistance With Daily Life Activities Among Older Adults: A Systematic Review
Authors: Huang Jing , Qian Xingxing , Choi Edmond Pui Hang , Chau Pui Hing
Published: March 2024

Many older adults are experiencing unmet needs for assistance with the activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Such unmet needs might threaten their physical and psychosocial well-being. We conducted a systematic review to provide a comprehensive picture of the health consequences of unmet ADL/IADL needs among older adults. Twenty-eight published articles were included for qualitative synthesis. We found that unmet ADL/IADL needs were consistently associated with higher health care utilization (e.g., hospitalization, medical spending) and adverse psychosocial consequences (e.g., anxiety, depression), while the findings of falls and mortality remain inconsistent. More studies are needed to draw firm conclusions and to allow for quantitative synthesis. This review advocates for more coordinated and comprehensive long-term care services for older adults. Future studies should explore how the adverse health outcomes identified in this review can be prevented or improved by adequately meeting older adults’ needs for assistance.
The Best Experiences Cannot be Planned: The Effect of Maximizing Vacation Planning on Consumer Satisfaction and Well-Being
Authors: Mitas Ondrej , Niemeyer Olivia , Kurtz Jaime
Published: March 2024

Maximizing theory differentiates between individuals who accept minimally sufficient purchase options and those who strive to maximize their value for money. Maximizers are less satisfied with their decisions and suffer diminished subjective well-being. We analyzed 376 questionnaires and conducted 12 interviews of working Germans to extend maximizing theory to vacations, which are more complex, experiential, and hedonic than products studied in previous research on maximizing. Path analysis of questionnaire data showed significant, negative indirect effects of maximizing on subjective well-being through aspects of the vacation decision process and subsequent vacation satisfaction. Deductive thematic analysis of interviews showed that maximizers’ time-consuming searching through alternatives created doubt and stringent expectations, thus explaining how maximizing degrades vacation satisfaction and subjective well-being. Thus, we suggest that individuals be conscious of the personal resources and expectations that they invest in vacation decisions. Furthermore, the tourism industry should emphasize inspiration and customization instead of variety.
Laser flare photometry in eyes receiving brolucizumab intravitreal injections for age related macular degeneration
Authors: Chadoulos Nikolaos , Dastiridou Anna , Mitsios Andreas , Tsinopoulos Ioannis , Kalogeropoulos Christos , Androudi Sofia
Published: March 2024

Purpose

To measure aqueous flare levels in treatment naïve eyes suffering from wet age- related macular degeneration (wAMD) treated with intravitreal brolucizumab.

Methods

Patients with treatment naïve wAMD in one eye were prospectively enrolled. Flare levels were measured with laser flare photometry at baseline, 1 day and 1 month after each of the 3 monthly injections during the loading phase.

Results

Twenty-two eyes from 22 patients aged 76.7 ± 6.0 years were enrolled. Flare values were 10.6 ± 3.7 photons/msec at baseline and 12.6 ± 5.8 photons/msec at the last follow up visit, 1 month after the third injection ( p = 0.289, repeated measures ANOVA). The mean change in flare after the first injection was 4.2 ± 3.6. photons/msec, 6.6 ± 8.9 photons/msec after the 2nd and 8.6 ± 20.8 photons/msec after the 3rd injection ( p = 0.640, repeated measures ANOVA). No patient had clinical signs of intraocular inflammation.

Conclusions

Eyes receiving brolucizumab injections for wAMD showed similar flare at baseline, during and 1 month after completion of three-monthly intravitreal injections. There was no evidence of subclinical inflammation during the loading phase of brolucizumab based on laser flare photometry measurements.
Revisiting the historic Métis-Syilx McDougall family in the Okanagan Valley, British Columbia, Canada
Authors: Legault (Red River Métis) Gabrielle
Published: March 2024

Contentions centering on rights claims on behalf of Métis, an Indigenous group descended from a distinct bicultural political nation in central Canada, continue within the traditional territory of the Syilx, a group Indigenous to the Okanagan Valley, British Columbia, Canada. This article revisits earlier work arguing that Métis in Kelowna pre-1900s were mostly absorbed into Syilx community, having no traditional territory within this region. Inclusion took place through marriage and common-law partnerships, but also through social and familial networks formed out of kin connections. Accounting for oral histories, genealogical records, and cultural inheritance and identity practices, Syilx philosophies of inheritance and Métis practices of relationality and matrilocality are cause for the McDougall family’s integration into Syilx communities, despite Canadian Government policies that dictated otherwise. Through decolonization and unlearning, this work acknowledges how colonial interference created and continues to reinforce divisions among First Nations and Métis peoples.
Rosacea: Pathogenesis and Therapeutic Correlates
Authors: Geng Ryan S. Q. , Bourkas Adrienn N. , Mufti Asfandyar , Sibbald R. Gary
Published: March 2024

Rosacea is a chronic inflammatory condition of which there is no cure. The pathogenesis of rosacea is likely multifactorial, involving genetic and environmental contributions. Current understanding suggests that pro-inflammatory pathways involving cathelicidins and inflammasome complexes are central to rosacea pathogenesis. Common rosacea triggers modulate these pathways in a complex manner, which may contribute to the varying severity and clinical presentations of rosacea. Established and emerging rosacea treatments may owe their efficacy to their ability to target different players in these pro-inflammatory pathways. Improving our molecular understanding of rosacea will guide the development of new therapies and the use of combination therapies.
Study on gear contact stiffness and backlash of harmonic drive based on fractal theory
Authors: Yang Congbin , Ma Honglie , Zhang Tao , Liu Zhifeng , Cheng Qiang
Published: March 2024

Contact stiffness and backlash in the harmonic drive significantly impact a robot's positioning accuracy and vibration characteristics. The height of the harmonic drive tooth pair is typically less than 1 mm, making the measurement and modeling of backlash and contact stiffness inherently complex. This paper proposes a contact stiffness and backlash model by establishing a correlation between fractal parameters and tooth contact load. To obtain the fractal roughness parameters of the real machined tooth surface, a combination of a noncontact optical profiler and the RMS method is employed. Subsequently, the study explores the influence of rough tooth surface and contact force fractal parameters on contact stiffness and gear backlash. The results demonstrate the substantial impact of surface topography parameters and contact force on contact stiffness and backlash. Specifically, an increase in the fractal dimension correlates with a reduction in gear backlash and contact stiffness. Conversely, the fractal roughness parameter exhibits the opposite effect. Notably, an increase in contact force enhances contact stiffness.
Friction stir extrusion of thin AA 7075-T6 into low-carbon steel: Effects of low weld pitch value
Authors: Shelton Austen , Strauss Alvin
Published: March 2024

Friction stir extrusion, a derivative process of friction stir welding, forms a mechanical joint between workpieces by forging one into a prefabricated geometry within the other. Thin sheet AA7075-T651 extrusion joints were made into an O-ring dovetail channel within a low-carbon steel workpiece. The effects of low weld pitch process parameters on joint characteristics between the extruded thin sheet AA7075-T651 and low-carbon steel were observed. The weld pitch was varied from 0.02 to 0.05 mm rev−1. No material mixing was observed. Tensile-shear test results were normalised by sample width. The 0.04 mm rev−1 weld pitch group yielded the highest average joint strength at 493 N mm−1. The weld pitch parameters reduced machine in-process forces without a large decrease in joint strength.
The impact of barrier arrangements on the transmission of respiratory infectious diseases in nursing homes in Hong Kong
Authors: Tao Yiqi , Zhong Folong , Miao Yijia , Tang Haida , Li Lingling
Published: March 2024

Respiratory infectious diseases have affected the health of the elderly. This study investigated the optimization of physical barriers as a low-cost design strategy to reduce the risk of infection in nursing homes for the elderly in Hong Kong, which were significantly affected by the outbreak of COVID-19. First, data on two types of rooms, single and multi-occupancy, were collected from a field investigation of typical local nursing homes. Subsequently, Computational Fluid Dynamics (CFD) simulations were employed to analyse the effects of various barrier heights on the propagation, suspension, deposition and elimination of aerosol particles in these room types, thereby evaluating infection risks. The findings reveal that in single-occupancy rooms, a barrier height of 2.1 m is effective in curtailing the spread of the virus over distances. Conversely, in multi-occupancy rooms, while a 1.8-m barrier is necessary, the rate of particle suspension is considerably higher, necessitating additional ventilation measures. Based on these findings, the study provides quantitative criteria for the implementation of physical barriers as a low-cost physical measure in nursing homes and provides recommendations for the effective prevention of respiratory infectious diseases through design modifications.
Design of a tracking controller for autonomous articulated heavy vehicles using a nonlinear model predictive control technique
Authors: Sharma Tarun , He Yuping
Published: March 2024

This article proposes a design of a tracking controller for autonomous articulated heavy vehicles (AAHVs) using a nonlinear model predictive control (NLMPC) technique. Despite economic and environmental benefits in freight transportation, articulated heavy vehicles (AHVs) exhibit poor directional performance due to their large sizes, multi-unit vehicle configurations, and high centers of gravity (CGs). AHVs represent a 7.5 times higher risk of traffic accidents than single-unit vehicles (e.g. rigid trucks, cars, etc.) in highway operations. Human driver errors cause about 94% of traffic collisions. However, little attention has been paid to autonomous driving control of AHVs. To increase the safety of AHVs, we design a novel NLMPC-based tracking controller for an AHV, that is, a tractor/semi-trailer combination, and this tracking controller is distinguished from others with the feature of controlling both the lateral and longitudinal motions for both the leading and trailing units. To design the tracking controller, a new prediction AHV model is developed, which represents both the lateral and longitudinal dynamics of the vehicle and captures its rearward amplification feature over high-speed evasive maneuvers. With the proposed tracking controller, the AAHV tracks the predefined reference path and follows a planned forward-speed scheme. Co-simulation demonstrates the effectiveness and robustness of the proposed NLMPC tracking controller.
What is a ‘good enough’ prison? An empirical analysis of key thresholds using prison moral quality data
Authors: Auty Katherine M. , Liebling Alison
Published: March 2024

Performance thresholds and minimum standards in prison have preoccupied policy makers and practitioners alike for some time. These standards are based on widely accepted statements of principle, but benchmarks are rarely set or explored empirically. Nor has there been any attempt to describe or define higher-end thresholds; the point at which outcomes become positive, or stated principles are achieved. In this study, we provide an empirical demonstration of how quality of life thresholds may be determined using data from 518 Measuring the Quality of Prison Life (MQPL) surveys conducted in prisons in England and Wales (2009–2020) and examine their relationship to five violence outcomes: serious prisoner on prisoner assaults, serious assaults on staff, self-harm incidents requiring hospital treatment, self-inflicted deaths, and homicides. The results suggested that thresholds exist for most of the MQPL dimensions. A set of lower ‘unsafe’ and higher ‘minimally safe’ thresholds were produced. We found that the scores of prisons below the lower threshold had a very strong relationship with each of our five serious forms of violence in prison. Similarly, prisons that did not manage to cross the ‘minimally safe’ threshold also had strong relationships with incidents of violence in their prison but were at slightly lower risk of those incidents occurring. Striking differences in mean incidents rates were found when comparing prisons below the lower threshold to prisons above the ‘minimally safe’ threshold. Our findings suggest that to operate a safe enough (and therefore legitimate) prison, a combination of harmony, security and professionalism dimensions above a certain threshold should be achieved.
Avascular Necrosis in Kidney Transplant Recipients is Associated With an Increased Risk of Patient Death
Authors: Dolma Sonam , Osman Fauzia , Zona Emily , Santos Angelie , Aziz Fahad , Garg Neetika , Mohamed Maha , Mandelbrot Didier , Parajuli Sandesh
Published: March 2024

Introduction: Avascular necrosis is a debilitating osseous complication in transplant recipients. Project Aim: This program evaluation sought to describe risk factors and adverse outcomes of avascular necrosis in kidney transplant recipients. Design: This was a retrospective evaluation of all recipients of kidneys and simultaneous pancreas and kidneys between 2001 and 2018 from a single center. Controls were selected based on the incidence density, sampling at a 1:3 ratio based on the post-transplant interval. Outcomes of interest were acute rejection, death-censored graft failure, and patient mortality. Results: A total of 88 kidney recipients had avascular necrosis and were compared with 257 controls. Most of the recipient's and donors’ baseline characteristics were similar between the groups, except calcineurin inhibitor-based immunosuppression was more prevalent, and non-white donors were less prevalent in the control group. Looking for risk factors for avascular necrosis, calcineurin inhibitor-based immunosuppression was associated with a lower risk for avascular necrosis in the univariate analysis, but this was not found after adjustment of multiple variables. In multivariate analysis, avascular necrosis was associated with an increased risk for patient death (hazard ratio: 1.68; 95% confidence interval: 1.16-2.44; P = .008) but not for acute rejection or death censored graft failure. Conclusion: Although limited by small sample size, this evaluation found avascular necrosis to be associated with an increased risk of patient death. This finding may be useful for the provider taking care of the patients and discussing the various outcomes after the transplant.
Comparison of Low-Dose Computed Tomography Versus Conventional-Dose Computed Tomography in the Evaluation of Distal Radius Fractures
Authors: Zeng Steven L. , Grier A. Jordan , Langdell Hannah C. , Blevins Kier M. , Tian William M. , French Robert J. , Mithani Suhail K. , Hammert Warren C. , Klifto Christopher S.
Published: March 2024

Background:

Distal radius fractures (DRFs) are common upper extremity fractures and often require surgical fixation when they are intraarticular. Preoperative computed tomography (CT) has emerged as a surgical planning tool to evaluate intraarticular DRFs. Although CT affords additional details, patients receive higher radiation doses than standard radiographs. We aim to develop a low-dose CT (LDCT) protocol, relative to the institutional standard-dose CT wrist for intraarticular DRFs although providing adequate detail for surgical decision-making.

Methods:

A single-institution prospective study was conducted on patients with intraarticular DRFs who underwent closed reduction and below-elbow splinting who otherwise would undergo wrist CT. Observations were defined as total measurements taken, with each view undergoing 44 measurements. Patients underwent 2 scans with a standard dose and a 10× dose reduction. Articular step and gap measurements were recorded in the sagittal and coronal images.

Results:

A total of 11 patients were enrolled (7 women and 4 men). The mean age was 55 years (SD = 20.1). There were a total of 4 reviewers: 1 attending surgeon, 2 resident physicians, and 1 student. When comparing LDCT and conventional-dose CT (CDCT), there were no significant differences in step and gap measurements across all reviewers.

Conclusion:

This study demonstrated that LDCT provides comparable imaging quality for surgical planning as a CDCT without significant diagnostic decay in the setting of DRFs. This comes with the added benefit of a 10-fold reduction in radiation exposure. These results suggest that LDCT is an opportunity to reduce effective radiation in patients although providing beneficial preoperative imaging.
Research on digital assembly method of large-caliber optomechanical systems
Authors: Yu WenTao , Chang YanYan , Li JinBo , Gong YuXin
Published: March 2024

Developing optomechanical systems with large-aperture output beams is increasingly important for deep space exploration, homeland defense, and modern warfare. However, the assembly process for such systems is becoming more challenging due to their complexity and size. Considering that traditional computer-aided assembly methods for optomechanical systems primarily prioritize debugging and testing, often overlooking the importance of feasibility analysis and verification in the assembly process, this paper presents a digital assembly method for large aperture optomechanical systems that integrates virtual assembly technology with misalignment error detection technology. By combining these two technologies, the proposed method aims to enhance the assembly process by providing a more comprehensive approach that includes feasibility analysis and verification, in addition to debugging and testing. Firstly, virtual assembly technology is utilized to simulate and validate the assembly process design of optomechanical systems. Secondly, a second-order sensitivity matrix method is proposed to achieve higher accuracy in solving misalignment compared to traditional methods. The new method is validated through simulation experiments on an off-axis beam expander system, showing superior solving accuracy compared to traditional approaches. Lastly, an actual assembly and adjustment platform is constructed, and the obtained assembly result exhibits a wavefront aberration RMS value better than 0.016λ (λ=632.8nm).
Thoracic endovascular repair of descending thoracic aorta aneurysm using thoracic stent graft in a challenging complex patient: An innovative access technique during an emergency using a mini-thoracotomy approach
Authors: Altoijry Abdulmajeed
Published: March 2024

Objectives

Repairing thoracic aortic aneurysms with endovascular aortic repair (TEVAR) is a safe and minimally invasive method with low morbidity and short postoperative recovery. We developed a novel method to treat descending thoracic aortic aneurysms using a mini-thoracotomy approach in complex patients with difficult access.

Methods

A 56-year-old male patient presented with a 3-day history of chest pain. His past surgical history included infrarenal aortic ligation and right axillobifemoral bypass. Thoracic computed tomography angiography (CTA) revealed a saccular aortic aneurysmal dilatation at zone 2 measuring 4.4 × 4 cm. Owing to his surgical history, vascular access through the femoral and iliac arteries or abdominal aorta was impossible. We developed a new technique using a left posterolateral mini-thoracotomy approach to gain vascular access and perform TEVAR, avoiding the need for an open thoracotomy repair.

Results and Conclusions

Thoracic CTA performed before discharge revealed complete aneurysmal exclusion and no endoleaks. Postoperative follow-up CTA (6 months and annually thereafter) revealed no aneurysm formation or aortic restenosis. The femoral artery, followed by the iliac artery, is the traditional access route for TEVAR. Left posterolateral mini-thoracotomy may be required as an alternative access in complex patients.
Too Anecdotal to Be True? Mechanical Turk Is Not All Bots and Bad Data: Response to Webb and Tangney (2022)
Authors: Keith Melissa G. , McKay Alexander S.
Published: March 2024

In response to Webb and Tangney (2022) we call into question the conclusion that data collected on Amazon’s Mechanical Turk (MTurk) was “at best—only 2.6% valid” (p. 1). We suggest that Webb and Tangney made certain choices during the study-design and data-collection process that adversely affected the quality of the data collected. As a result, the anecdotal experience of these authors provides weak evidence that MTurk provides low-quality data as implied. In our commentary we highlight best practice recommendations and make suggestions for more effectively collecting and screening online panel data.
The barriers to and facilitators of implementing early mobilisation for patients with delirium on intensive care units: A systematic review
Authors: Bennion Jacqueline , Manning Christopher , Mansell Stephanie K , Garrett Roger , Martin Daniel
Published: March 2024

Background:

Early mobilisation of critically ill patients remains variable across practice. This study set out to determine barriers to and facilitators of early mobilisation for patients diagnosed with delirium in the intensive care unit (ICU).

Methods:

A mixed-methods descriptive systematic review. Electronic databases (AMED, BNI, CINAHL Plus, Cochrane Library, Medline and EMBASE) were searched for publications up to 22nd December 2021. Independent reviewers screened studies and extracted data using Covidence Systematic Review Management software. Data were summarised according to frequency (n/%) of barriers and facilitators. Thematic analysis of qualitative studies was carried out in order to address the secondary aim. Quantitative studies were assessed using the GRADE quality assessment tool. Qualitative studies were analysed according to the GRADE-CERQual quality assessment tool. This study was prospectively registered on PROSPERO (CRD 42021227655).

Results:

Ten studies met the inclusion criteria. Quantitative findings demonstrated the presence of delirium was the most common reported barrier to early mobilisation. The most common facilitator was ICU staff experience of positive outcomes as a result of early mobilisation interventions. Thematic analysis identified six main themes that may describe potential meanings behind these findings: (1) knowledge, (2) personal preferences, (3) perceived burden of delirium, (4) perceived complexity, (5) decision-making and (6) culture.

Conclusion:

These findings highlight the reported need to further understand the impact and value of early mobilisation as a non-pharmacological intervention for patients diagnosed with delirium in ICU. Evaluation of early mobilisation interventions involving key stakeholders may address these concerns and provide effective implementation strategies.
Acceptability of and satisfaction with continuous glucose monitoring in pregnant women with type 2 diabetes mellitus: A service improvement project
Authors: Beriwal Sridevi , Re Federica , Gibson Sharon , Thanabalasingham Gaya , Owen Katharine R. , Houlden Ruth , Malakasis Anastasios , Hirst Jane E
Published: March 2024

Background

There are limited data regarding intermittently scanned continuous glucose monitoring (isCGM) in pregnancy for women with Type 2 diabetes. We have tested the acceptability and feasibility of an isCGM method using Libre device.

Method

In a hospital-based service improvement project, 23 pregnant women (March 2022-April 2023), with Type 2 diabetes got isCGM for monitoring from 20 weeks until delivery. Women completed a structured and validated questionnaire assessing satisfaction, equipment issue, relationship with diabetes team.

Results

Two-thirds of the women were satisfied with the convenience and found it reliable. 86% wanted to use it for future pregnancies, and 90% would recommend it to others. Sensor falls off was seen in three obese women and about a tenth felt the reliability was poor in extreme ranges of sugar levels. The relationship with the diabetes team was rated high.

Conclusion

isCGM could be a useful and well-received tool for improving glycaemic control in pregnancies with Type 2 diabetes.
Geographic differences in lung cancer: focus on carcinogens, genetic predisposition, and molecular epidemiology
Authors: Laguna Juan Carlos , García-Pardo Miguel , Alessi Joao , Barrios Carlos , Singh Navneet , Al-Shamsi Humaid O. , Loong Herbert , Ferriol Miquel , Recondo Gonzalo , Mezquita Laura
Published: March 2024

Lung cancer poses a global health challenge and stands as the leading cause of cancer-related deaths worldwide. However, its incidence, mortality, and characteristics are not uniform across all regions worldwide. Understanding the factors contributing to this diversity is crucial in a prevalent disease where most cases are diagnosed in advanced stages. Hence, prevention and early diagnosis emerge as the most efficient strategies to enhance outcomes. In Western societies, tobacco consumption constitutes the primary risk factor for lung cancer, accounting for up to 90% of cases. In other geographic locations, different significant factors play a fundamental role in disease development, such as individual genetic predisposition, or exposure to other carcinogens such as radon gas, environmental pollution, occupational exposures, or specific infectious diseases. Comprehensive clinical and molecular characterization of lung cancer in recent decades has enabled us to distinguish different subtypes of lung cancer with distinct phenotypes, genotypes, immunogenicity, treatment responses, and survival rates. The ultimate goal is to prevent and individualize lung cancer management in each community and improve patient outcomes.
Phosphaturic mesenchymal tumor with de novo liver metastases: a case report and literature review
Authors: Dwabe Sami , Chow Warren
Published: March 2024

Phosphaturic mesenchymal tumors (PMTs) are rare tumors that can cause tumor-induced osteomalacia (TIO) through overproduction of FGF23, a peptide hormone that causes renal phosphate wasting and reduced osteoblastic activity. The diagnosis of PMTs can be difficult to make as the presenting symptoms are non-specific. Although PMT is a rare entity, most cases are benign in nature, not requiring further intervention after surgery, as resection is typically curative. Here, we present a unique case of malignant PMT with de novo liver metastasis in a female patient who presented with TIO and underwent surgical resection of her primary lesion with subsequent regression of her liver metastasis. Moreover, we analyze a review of literature and discuss the importance of a timely diagnosis of this rare phenomenon. It is encouraged that providers strongly consider a diagnosis of PMT in patients with otherwise unexplained bone pain, fatigue, weakness, especially if accompanied with hypophosphatemia. Further studies are also warranted to identify prognostic factors that predict a PMT’s malignant potential as they may help identify possible therapeutic targets.
Human, all too human? Anthropocene narratives, posthumanisms, and the problem of “post-anthropocentrism”
Authors: Biswas Mellamphy Nandita , Vangeest Jacob
Published: March 2024

What role do contemporary narratives and counter-narratives play in policy regarding the Anthropocene crisis? Given the centrality of the anthropos in the Anthropocene, what conditions might make possible a “post-anthropocentric” or “non-anthropocentric” narrative? Tracing the production of both dominant and counter-narratives, the struggle for narrative power centers the role of the anthropos in the Anthropocene. The standard narrative—“strong anthropocentrism”—maintains humanist assumptions relating to the “control” and “cultivation” of the non-human. In contrast, counter-narratives, from both alter-humanist eco-centric and post-humanist positions, attempt to de-center human-centrism toward more egalitarian responses to the Anthropocene. Despite these attempts at de-centering human spheres of influence, this article argues that these counter-narratives maintain a “weak anthropocentrism,” given their maintenance of human volition and intentionality. The production of “post-anthropocentric” or “non-anthropocentric” narratives of the Anthropocene crisis would require speculative moves beyond the human: toward human abolition and disconnection.
Culinary Storytelling About the Local Cuisine of Phitsanulok, Thailand
Authors: Jongsuksomsakul Panida
Published: March 2024

Culinary tourism is part of cultural capital that could generate income for local communities if well developed. Persuasive media, presented in various ways, plays a vital role in this development. The objective of this research, to create media with interesting and informative content to persuade foreign tourists to explore local Phitsanulok cuisine. This information was in-depth interviews that were conducted with 32 government tourism officials, 9 Chief Executives of the Sub-district Administrative Organization, 2 French nationals who were qualified chefs, and other foreigners resident in the Province. The second stage included the design and production plans for media to be developed highlighting and presenting local cuisine from each of the nine districts. The planned media was refined under the theme “Phitsanulok, a culinary delight.” This process included two French nationals who were residents in the Province who had created a unique genre of Thai Chinese fusion food. The media were focused on storytelling by these and other residents who were local participants in the culinary scene in Phitsanulok Province, intending to provide a first-hand account of the local traditional cuisine, and the enhanced genre provided by the French chefs. These stories were evaluated by 7 academicians, 3 media experts, and 3 tourism entrepreneurs, also taking into account feedback and responses from 275 social network users. This showed that Phitsanulok has the potential to be developed into a cultural city, scoring 8.13 based on the UNESCO City of Gastronomy project accreditation guidelines.
Patient Perception of Social Media Use by Orthopaedic Surgeons: A Pilot Study
Authors: Johnson Alexander J. , Wharton Benjamin R. , Geraghty Elisabeth H. , Bradsell Hannah , Ishikawa Andrew , McCarty Eric C. , Bravman Jonathan T. , Frank Rachel M.
Published: March 2024

Background:

Social media (SM) use by orthopaedic surgeons is becoming increasingly common; nonetheless, it needs to be clarified how patients perceive the content posted by physicians.

Purpose:

To characterize SM content posted by orthopaedic surgeons while investigating patient perceptions of this content and how it may influence their health care decisions.

Study Design:

Cross-sectional study.

Methods:

Posts on SM outlets by orthopaedic surgeons were reviewed and categorized. A survey to assess patient perception of these categories was administered between December 2021 and February 2022 in the clinics of 3 orthopaedic surgeons. Survey results were analyzed for differences in patient SM use and perception of SM content types.

Results:

There were 250 completed surveys. SM use was high among all age groups; however, the 18 to 24 years (87.1%) and 25 to 34 years (86.4%) age groups were more likely than older age groups to report daily use ( P = .002). Overall, 17% of patients reported using SM to see information about their health care at least once per month, 21% reported reviewing the SM account of a physician at least once per month, 19% reported that they were likely or very likely to view the SM account of their physician, and 23% reported that SM content was likely or very likely to influence which physician they see. Patients held the most consistently positive view of posts that educated patients, discussed sports team coverage, and provided patient testimonials. Patients had consistently neutral views of posts educating colleagues, discussing presentations at national meetings, displaying aspects of surgeons’ personal lives, and supporting marginalized groups. Several post categories elicited highly polarized responses—including those discussing research publications and showing surgical techniques or pictures/videos taken during surgery. Respondents had a consistently negative response to posts making political statements.

Conclusion:

SM is likely a useful tool to help physicians interact with patients. Physicians who wish to interact with patients should consider posting content viewed most positively—including posts educating patients, discussing sports team coverage, and providing patient testimonials. Content that is viewed less favorably should be posted sparingly or with a sensitive tag.
Extended regular use of kinetic oscillation stimulation (KOS) in refractory chronic migraine: case report of a first, single-subject experience
Authors: Liaci Giorgio , Altamura Claudia , Brunelli Nicoletta , Fofi Luisa , Prudenzano Maria Pia , Vernieri Fabrizio
Published: March 2024

Background:

Kinetic Oscillation Stimulation (KOS) is a novel and non-invasive neuromodulation method for migraine therapy. Emerging evidence suggests that applying low-frequency intranasal vibrations to the sphenopalatine ganglion (SPG) could be a safe and effective option for migraine treatment.

Case report:

We present a case of a 60-year-old man affected by refractory chronic migraine with a history of failure or progressive ineffectiveness of multiple approved therapies. Given the limited available options, we proposed the patient a 6-week treatment cycle with KOS. After 1 month, monthly migraine days (MMD) dropped from 18 to 7, with significant pain reduction by week 6. However, the benefits were not sustained after discontinuation, requiring a second stimulation cycle after 3 months, which yielded an even faster and more significant response.

Conclusions:

This experience reveals KOS safety and effectiveness for long-term SPG neuromodulation, highlighting the potential of focusing treatment on the trigeminal-autonomic reflex (TAR) as a promising direction to pursue.
Rimegepant as an acute treatment in a refractory migraine patient non-responder to two anti-CGRP monoclonal antibodies and triptans: Case report and pharmacological considerations
Authors: Burgalassi Andrea , Vigani Giulia , Boccalini Alberto , De Cesaris Francesco , Mannaioni Guido , Chiarugi Alberto , Geppetti Pierangelo , Iannone Luigi Francesco
Published: March 2024

Background:

Small molecule receptor antagonists (gepants), or monoclonal antibodies (mAbs) against calcitonin gene-related peptide (CGRP) have recently become available for migraine prophylaxis and/or acute treatment. Considering their shared mechanisms of action, if the failure to an anti-CGRP(R) mAbs preclude the effectiveness of gepants or vice versa is still unknown. Herein, we report the first case of a patient with refractory migraine responsive to the acute use of rimegepant that previously failed two different anti-CGRP(R) mAbs and with no response to other acute treatments. Finally, we performed a literature review on the use of gepants in patients that failed other anti-CGRP and/or triptans.

Case:

A 56-year-old female with a long history of chronic migraine without aura, fulfilling the EHF definition for a diagnosis of refractory migraine. Overall, the patient treated five not-consecutive migraine attacks. All of them were treated according to the predefined criteria. The mean (±SD) NRS before rimegepant assumption was 7.8 ± 0.9, all attacks cause at least severe impairment at onset, and no rescue medications were used. Pain free at 2 hours was achieved in three out of five attacks (60.0%), with no recurrence of migraine in the following 24 hours. The patient reported also a sustained benefit the day after the drug assumption. The response pain free was achieved after a mean time of 13.3 ± 4.5 minutes considering only attacks successfully treated (three out of five attacks). No adverse events were reported.

Conclusions:

In conclusion, rimegepant for acute treatment may be a viable option in patients with partial or no response to triptans that failed preventive treatments targeting the CGRP pathway, regardless to ligand or receptor. The failure of anti-CGRP(R) mAbs does not necessarily preclude the use of gepants (acute and/or preventive), but further studies are urgently needed to provide evidence on the efficacy of these treatments in managing drug-resistant migraine and to identify novel treatments for patients.
Potting, power and imprisonment: Understanding the use of shit as a form of resistance
Authors: O’Mara Oscar
Published: March 2024

Prisons are places of power and resistance. When the staff oppress prisoners, the latter participate in various forms of resistance, such as violence, substance misuse, riots, or protests to communicate a sense of injustice. Many of these struggles have been documented and discussed at length, revealing and communicating the national and local structures that produce them. However, potting remains a taboo on the wings and in criminological literature, where the use of bodily fluids as a means of prisoners rejecting penal power is rarely discussed beyond macro-political contexts. Drawing on symbolic interactionism and phenomenological approaches to knowledge, this paper challenges that taboo and proposes that potting is an embodied expression of oppression, a symbolic representation of prisoners’ defilement and a physical transference of their sense of injustice. Potting is a pervasive and perverse form of resistance.
Carceral surveillance: Data flows within and beyond prison walls
Authors: Miranda Diana
Published: March 2024

In this article, we will analyse contemporary carceral surveillance dynamics, namely the increasing storage and exchange of prisoners’ biometric data. Drawing on qualitative research conducted in prisons, policing and security settings, we will explore how prisoners’ bodies are reduced to information and broken up into data flows. These flows move within and beyond prison walls, impacting how prisoner's data is shared (in)formally with other criminal justice actors (e.g. police forces). Such interstitial connections allow us to better explore the permeability and porosity of prison boundaries. Overall, we argue that prisoners’ data doubles are not spatially or physically restricted within cells and walls, as they circulate and are virtually managed at a distance. We urge to revisit and rethink the use of panoptic conceptual models when researching carceral spaces, its technological infrastructures and surveillance dynamics.
Treatment Outcomes of Patients With Overlapping Eosinophilic Esophagitis and Gastroesophageal Reflux Disease After Antireflux Surgery
Authors: Lee Christopher J. , Farrell Timothy M. , Dellon Evan S.
Published: March 2024

Background:

The relationship between eosinophilic esophagitis (EoE) and gastroesophageal reflux disease (GERD) is complex, and there are scant data about the role of fundoplication when GERD/EoE overlap. We aimed to describe treatment outcomes of patients with GERD/EoE overlap undergoing antireflux surgery.

Methods:

We conducted a retrospective cohort study of patients with overlapping EoE and GERD who had undergone laparoscopic fundoplications. Patient demographics, clinical characteristics, EoE history, and procedural/surgical data were extracted from the medical record. Endoscopic and histologic responses were assessed for pre- and post-operative endoscopies.

Results:

We identified 10 patients with GERD/EoE overlap who underwent antireflux surgery, and 9 patients underwent post-operative repeat EGD. All patients had heartburn and regurgitation symptoms that were refractory to PPI and/or persistent erosive disease, and also demonstrated signs/symptoms of EoE such as dysphagia (80%), food impaction (60%), fibrostenotic disease requiring dilation (70%), and lack of symptom or histologic response to topical steroids (70%). Patients demonstrated expected improvements in erosive esophagitis and hiatal hernia. The peak eosinophil count improved from 47.1 ± 35.9 eos/hpf to 7.8 ± 12.3 eos/hpf ( P = .02). Total EREFS score decreased from 3.0 ± 2.2 to 1.2 ± 2.3 ( P = .009).

Conclusions:

Patients who have GERD/EoE overlap can have endoscopic and histologic improvement in both conditions after fundoplication. This implies that in a subset of patients, GERD may drive an EoE response, and this must be recognized for successful treatment.