bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-view graph convolutional networks based on multi-source information fusion for mechanical fault diagnosis
Authors: Song Shanshan , Zhang Shuqing , Wu Xiang
Published: September 2024

Data-driven intelligent diagnosis methods have demonstrated significant success within prognostics and health management systems due to their powerful feature representation and non-linear fitting capabilities. However, most existing methods employ simple fusion strategies and neglecting data structure considerations, which lead to incomplete feature representations for final diagnostic decisions. In this article, we address these limitations by proposing a multiview graph convolutional network [Formula: see text] framework based on multi-source information fusion for fault diagnosis of key components in mechanical equipment. This is achieved through joint research on sample graph and feature graph learning. First, convolution neural networks named the SharedNet module are leveraged to extract multi-source features, and then the deep features are concatenated in a fully connected layer. After that, we construct multi-view initial graphs to combine the correlations between samples and features to mine rich graph topology structure. Then, we redesign the graph learning strategy to further increase the robustness and generalizability of the proposed method. Finally, extensive experimental results on the multi-information datasets show that our proposed [Formula: see text] can not only outperform the state-of-the-art methods of comparison but also extract multi-view graph topology and feature representations for fault diagnosis.
An integrated approach for mechanical fault diagnosis using maximum mean square discrepancy representation and CNN-based mixed information fusion
Authors: Wang Chengcheng , Li Xueyi , Yuan Peng , Su Kaiyu , Xie Zhijie , Wang Jinjiang
Published: September 2024

Bearings are an essential component of modern industry and cross-domain diagnosis of bearings holds significant importance. However, in practical applications, issues such as insufficient training data and differences between equipment present challenges. Transfer learning has become one of the effective methods to address these problems. This article proposes a fault diagnosis method that combines maximum mean square discrepancy (MMSD) measurement with the convolutional neural network (CNN) with mixed information (MIXCNN). MIXCNN enhances spatial position discrimination through deep convolution and achieves cross-channel information interaction using traditional convolution. The introduction of residual connections reduces information loss, while increasing network depth focuses on highly distinguishable features. MMSD constructs a metric that comprehensively reflects the mean and variance information of data samples in the reproducing kernel Hilbert space, thereby enhancing domain confusion. Experimental results show that this method achieves high diagnostic accuracy in various transfer tasks, with a maximum accuracy of 99.29%, providing reliable support for bearing fault diagnosis.
Trash Feet and Mesenteric Ischemia as a Rare Manifestation of a Complicated Abdominal Aortic Aneurysm: A Case Report
Authors: Bignamini Elisa , Catasta Alexandra , Giovannacci Luca , Robaldo Alessandro , Prouse Giorgio
Published: September 2024

Background

Abdominal aortic aneurysms and atheromatous plaques are well-established potential culprits in the development of cholesterol embolization. This embolic phenomenon can result in the occlusion of peripheral arteries in the forefoot or toes, commonly referred to as “trash foot”.

Case

A 61-year old patient exhibited severe symptoms and signs of lower limb and mesenteric ischemia, represented clinically by abdominal pain, hematochezia, and bilateral plantar necrotic lesions, attributed to embolization from a previously unknown large infrarenal abdominal aortic aneurysm. Diagnosis was confirmed by performing angio-CT of the abdomen, an angiologic examination, as well as colonoscopy. The patient underwent open surgical repair of the aortic aneurysm and received intravenous prostanoids, resulting in a successful outcome with resolution of bowel ischemia and complete recovery of bilateral foot lesions with no tissue loss.

Conclusion

Cholesterol embolization syndrome seldom manifests with its complete clinical spectrum. Identifying and addressing the underlying cause is crucial, with a focus on potential abdominal aortic aneurysms. A combined approach involving surgical repair and prostanoid therapy may offer a viable option for patients experiencing severe manifestations.
Biological Medicines Prepared Using Vibration Processing Are Able to Influence Their Targets Without Direct Contact With Them
Authors: Don Elena , Zakharova Svetlana , Yaroshenko Sabina , Petrova Anastasia , Tarasov Sergey
Published: September 2024

Recently, there has been a radical change in understanding of the nature of drugs based on highly diluted solutions. It has been established that their activity does not depend on the content of the original substance in dilutions, but is a consequence of the technological processing (TP) of dilutions with vibration, which accompanies each dilution during the preparation of solutions and, among others, leads to the formation of nanoparticles with certain properties. Repeated vibration treatment leads to the appearance of modifying activity that is absent in the original substance, and these effects of TP solutions can be exerted without direct contact with their targets, which clearly indicates the physical nature of the TP solution’s activity. In the framework of this article, a statistically significant effect of TP antibodies to the insulin receptor on glucose consumption by CHO cells both with and without contact exposure, as compared with control ( P < 0.05) was shown in the vast majority of the experiments. The obtained results shed light on a possible source of activity of drugs based on TP antibodies, which should be associated with the applied vibration effect and can manifest itself both with contact exposure and without it.
Experimental study of the effects of a particle filter in front of automotive radiator on its cooling performances and cooling drag
Authors: Montaigne Quentin , Chalet David , Bouedec Antoine , Raimbault Vincent , Thébault Eric , Junginger Bernd
Published: September 2024

According to the World Health Organization (WHO), air pollution is the single greatest worldwide health risk especially in urban environments. In these areas, the vehicle traffic significantly contributes to the fine dust concentration in the ambient air. While the current legislation focuses mainly on the exhaust emission of vehicles, 85% of the overall fine dust emissions originating from brakes, tires, and road abrasion are not yet regulated. In this context, an integrated particulate filter system fitted into previously unused installation spaces in frontend of a vehicle in front of the radiator allows to compensate a part of the particle emissions of a vehicle try to reach the neutral emission. Add filter is not without consequences for the cooling performances. This study aims to assess the impact of the particulate filter system on the radiator cooling performances and cooling drag coefficient. An experimental setup was developed to characterize an automotive radiator with and without particle filter in terms of power and velocity distribution. Cooling capacity of the radiator depends clearly of the airflow through the radiator. Filter increases the pressure drop and decreases airflow. Hence, the heat power exchange can be reduced up to 10% for a pressure drop level almost twice. The airflow inlet inside engine compartment is not beneficial for aerodynamic aspect. By increasing pressure drop, the cooling drag coefficient can be reduced up to 10% when a filter covers entirely the radiator surface. The results indicate that the filter affects the cooling capacity of the radiator, which can require modifications to the cooling system strategy.
A lightweight color and geometry feature extraction and fusion module for end-to-end 6D pose estimation
Authors: Zuo Guoyu , Liu Hong , Li Jiangeng
Published: September 2024

Although advancements in red–green–blue-depth (RGB-D)-based six degree-of-freedom (6D) pose estimation methods, severe occlusion remains challenging. Addressing this issue, we propose a novel feature fusion module that can efficiently leverage the color and geometry information in RGB-D images. Unlike prior fusion methods, our method employs a two-stage fusion process. Initially, we extract color features from RGB images and integrate them into a point cloud. Subsequently, an anisotropic separable set abstraction network-like network is utilized to process the fused point cloud, extracting both local and global features, which are then combined to generate the final fusion features. Furthermore, we introduce a lightweight color feature extraction network to reduce model complexity. Extensive experiments conducted on the LineMOD, Occlusion LineMOD, and YCB-Video datasets conclusively demonstrate that our method significantly enhances prediction accuracy, reduces training time, and exhibits robustness to occlusion. Further experiments show that our model is significantly smaller than the latest popular 6D pose estimation models, which indicates that our model is easier to deploy on mobile platforms.
The complexity of the student counselor system in China’s higher education: A case study on restrictions and possible flexibility in ideological education
Authors: Xiaoxin Du
Published: September 2024

Student counselors in Chinese higher education serve as conduits for providing political guidance and indoctrinating students with socialist values. Their primary role is to administer citizenship education as a means of political socialization, encompassing both ideological and organizational aspects. This article examines this phenomenon within the context of a specific university’s historical trajectory, drawing upon qualitative data to present a nuanced understanding of its complexities. Through this case study, the article sheds light on various approaches to citizenship education and offers valuable insights into the landscape of Chinese higher education amidst globalization. It reveals the coexistence of constraints and flexibility in ideological education within this context, shaped by the intricate interactions between student counselors and students. These dynamics are driven by the imperative of stability maintenance mandated by both the state and the university. The pragmatic approaches adopted by student counselors in their daily work serve as means to facilitate its implementation.
‘Shifting logics in criminal justice’: Introduction to the special issue
Authors: Skinns Layla , Rice Lindsey , Robinson Gwen , Bottoms Anthony E
Published: September 2024

In this piece, we introduce a special issue celebrating Professor Joanna Shapland’s 40-year contribution to criminology and criminal justice. It is derived from an international conference hosted by the Centre for Criminological Research at the University of Sheffield on ‘Shifting Logics in Criminal Justice’, which took place on 12–14 April 2023. In the introduction, we reflect on Joanna Shapland’s contributions to the fields of victims, restorative justice, desistance and policing, before providing an overview of the seven papers in the special issue that examine these key themes in her research. There are three papers on the theme of desistance, respectively, by Robin G�lnander, Stephen Farrall and Laura Abrams; two on on policing by Pieter Leloup, and by Jacque de Maillard and Megan O’Neill; and two on restorative justice by Rebecca Banwell-Moore, and by Joanna Shapland, Jamie Buchan, Steve Kirwood and Estelle Zinsstag.
Interpretation of electrocardiogram
Authors: Lashrf Abdullah , Salim Abdallah
Published: September 2024

Working in general practice requires clinicians to make treatment decisions based on electrocardiogram (ECG) findings together with clinical symptoms. This article provides an overview of the basic principles of interpreting an ECG and the clinical presentations commonly encountered in general practice. The article aims to equip GPs with the necessary knowledge and skills to confidently identify common ECG abnormalities and make informed decisions regarding patient care. By delving into the fundamentals of ECG analysis, we aim to bridge the gap between theoretical knowledge and practical application, enabling GPs to deliver better patient outcomes.
Efficacy and safety of patent foramen ovale closure for mitigating migraine: a systematic review and meta-analysis of randomized trials and observational studies
Authors: Silalahi Todung Donald Aposan , Hariyanto Timotius Ivan
Published: September 2024

Background:

Although often asymptomatic, patent foramen ovale (PFO) may cause disabling migraine symptoms. Evidence regarding PFO closure for prevention of migraine is still ambiguous and conflicting.

Objectives:

This study aims to analyze the efficacy and safety of PFO closure for mitigating migraine symptoms.

Design:

This is a systematic review and meta-analysis of randomized clinical trials (RCTs) and observational studies.

Data sources and methods:

A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until March 12, 2024. This review incorporates literature that examines the comparison between PFO closure and control with outcome data related to migraine. We employed random-effect models to analyze the standardized mean difference (SMD) and odds ratio (OR) for presentation of the outcomes.

Results:

A total of five RCTs and six observational studies were incorporated. The results of our meta-analysis showed higher reduction of monthly migraine attacks from baseline (SMD −0.34; 95% CI: −0.51, −0.18, p < 0.0001, I2 = 19%) and monthly migraine days from baseline (SMD −0.30; 95% CI: −0.53, −0.08, p = 0.009, I2 = 0%) among PFO closure than control. However, the complete resolution of migraine (especially based on the evidence from RCTs; p = 0.24), HIT-6 score ( p = 0.08), and MIDAS score ( p = 0.15) did not differ significantly between two groups of intervention. The majority of adverse events reported were atrial fibrillation and access site infection/bleeding that only occurred in small proportions of patients (⩽5%).

Conclusion:

This study suggests better efficacy of PFO closure in reducing monthly migraine attacks and days with similar safety profile when compared to control.

Registration:

PROSPERO (CRD42023453635).
Complications and revision rates after total shoulder arthroplasty are similar between patients with and without diabetes mellitus
Authors: Sanii Ryan , Kasto Johnny , Castle Joshua P , Jay Jordan , Burdick Gabriel , Muh Stephanie J
Published: September 2024

Purpose

There is wide variability in the conclusions of studies examining the effects of diabetes mellitus (DM) on outcomes of shoulder arthroplasty (SA). The objective of this study was to determine if there are differences in complication profiles between patients with DM and those without undergoing anatomic and reverse total SA.

Methods

A retrospective review of patients undergoing SA in a single center from January 2014 to December 2019 was performed. Patients were then stratified into two cohorts, patients with controlled DM (mean hemoglobin A1C < 7%) and those without. Outcomes analyzed included intraoperative complications, postoperative complications, and revision surgery rates. Emergency department (ED) visits and hospital readmissions within 30 days were also recorded.

Results

A total of 595 patients underwent SA. No significant difference was found between the diabetes ( n = 151) and control group ( n = 444) with regard to length of stay ( P = .168), complications ( P = .286), infection rate ( P = .977), 30-day ED visits ( P = .789), and readmissions ( P = .230). The average time to revision was 26.8 months in the diabetes group and 26.6 months in the control group ( P = .989).

Conclusions

Following SA patients with controlled DM showed no increased risk of postoperative infection, ED visitation,hospital readmission, and revision surgery rate when compared to non-diabetics.

Level of evidence

Level III—retrospective cohort.
Lateralization and inclination angle in reverse arthroplasty—what do we know?
Authors: Ekelund Anders L , Poncet Didier
Published: September 2024

Since the original Grammont design of a reverse shoulder arthroplasty there has been a trend to decrease inclination angle from 155° to 145 or 135°. Furthermore, lateralization on the glenoid side has been advocated. These changes decrease the risk for impingement between humerus and the inferior part of the glenoid (notching). These changes were also made to improve restoration of rotation. However, there is very little evidence that rotation has improved due to these changes. A negative effect of lateralization is that it increases the risk for glenoid loosening. Furthermore, the stress on acromion increases which may lead to more acromion or scapula spine fractures. More randomized studies are needed to define optimal design of a reverse shoulder arthroplasty.
ChatGPT provides acceptable responses to patient questions regarding common shoulder pathology
Authors: Ghilzai Umar , Fiedler Benjamin , Ghali Abdullah , Singh Aaron , Cass Benjamin , Young Allan , Ahmed Adil Shahzad
Published: September 2024

Background

ChatGPT is rapidly becoming a source of medical knowledge for patients. This study aims to assess the completeness and accuracy of ChatGPT's answers to the most frequently asked patients’ questions about shoulder pathology.

Methods

ChatGPT (version 3.5) was queried to produce the five most common shoulder pathologies: biceps tendonitis, rotator cuff tears, shoulder arthritis, shoulder dislocation and adhesive capsulitis. Subsequently, it generated the five most common patient questions regarding these pathologies and was queried to respond. Responses were evaluated by three shoulder and elbow fellowship-trained orthopedic surgeons with a mean of 9 years of independent practice, on Likert scales for accuracy (1–6) and completeness (rated 1–3).

Results

For all questions, responses were deemed acceptable, rated at least “nearly all correct,” indicated by a score of 5 or greater for accuracy, and “adequately complete,” indicated by a minimum of 2 for completeness. The mean scores for accuracy and completeness, respectively, were 5.5 and 2.6 for rotator cuff tears, 5.8 and 2.7 for shoulder arthritis, 5.5 and 2.3 for shoulder dislocations, 5.1 and 2.4 for adhesive capsulitis, 5.8 and 2.9 for biceps tendonitis.

Conclusion

ChatGPT provides both accurate and complete responses to the most common patients’ questions about shoulder pathology. These findings suggest that Large Language Models might play a role as a patient resource; however, patients should always verify online information with their physician.

Level of Evidence

Level V Expert Opinion.
Reconstruction of Maxillary Bone Defects With Cellular Bone Matrix Allografts
Authors: Marschall Jeffrey S. , Davis Stephen S. , Rysavy Oscar , Kushner George M.
Published: September 2024

Study Design

Retrospective Cohort Study.

Objective

Reconstruction of maxillary bone defects can be completed with vascularized and non-vascularized autografts. Cellular bone matrix allografts (CBMs), which have lineage committed bone cells, has risen as an alternative. The purpose of this study was to describe our experience and to determine the success of CBM based maxillary reconstruction in a variety of clinical scenarios.

Methods

A retrospective cohort study was designed and implemented using data from subjects who presented to the University of Louisville and were treated with a CBM for maxillary reconstruction from 2019 to 2023. Subjects were excluded if they were not treated with a CBM, data were not complete, or postoperative follow-up time was less than 3 months. Descriptive statistics were calculated for each variable. To measure the associations between the risk factors and graft success, Fisher’s exact test was implemented. A P-value of <0.05 was considered significant.

Results

The sample included 48 subjects. The mean age of all subjects was 43 ± 24 years. Overall, 42 (87.5%) cases were successful. The perioperative antibiotic administered ( P = 0.02), etiology ( P = 0.021), and the addition of platelet rich fibrin or autograft as an adjunct influenced CBM success ( P = 0.039).

Conclusions

CBMs are a viable option for reconstruction of maxillary bone defects. CBMs may be an alternative to autografts.
Deaf beki humor: A pastoral-theological articulation of pagbabangong-dangal—resurrection
Authors: Meneses Kristine C.
Published: September 2024

Humor is underexplored in theology. Thus, this study re-examines the Christian concept of resurrection through the lens of dignity, grounded in the lived experiences of select Filipino Deaf LGBT individuals. An exploration of their beki (queer) humor can enrich our orthodoxic pastoral-theological approach with this group whose location is pegged in the margins. In probing their beki humor experiences and expressions, this article rethinks the Christian core concept of resurrection as pagbabangong-dangal (uplifting one’s dignity) where its point of departure is hiyâ (generally accepted as “shame”). However, for Virgilio Enriquez, hiyâ is dignity or propriety, a nuance that was not promoted or studied further. Hence, this article will explore beki humor from the perspective of hiyâ taken as dignity and further explore its contour with resurrection. In this context, it is apt to inquire, how might Deaf beki humor enrich our theopastoral articulation of resurrection as pagbabangong-dangal?
Demographic and clinical associations of autoimmune diseases in rheumatoid arthritis patients: Insights from a tertiary care hospital in Saudi Arabia from 2019 to 2023
Authors: Alghofaili Nouf , Ismail Samaher , Aladnani Abdullah , Alfarsi Abdullah , Aqabawi Sally , Shahat Ghofran , Zakariyah Abeer , Alhazmi Ahmed , Albeshri Tariq
Published: September 2024

Background:

Rheumatoid arthritis is a severe inflammatory arthritis that causes irreversible damage to joints and bones, resulting in deformities and disabilities. Population-based studies on the co-occurrence in patients with rheumatoid arthritis are lacking despite shared mechanisms with other autoimmune diseases.

Objectives:

This study aimed to determine the prevalence and association of autoimmune diseases among patients with rheumatoid arthritis and explore the associations between autoimmune diseases and treatment options for rheumatoid arthritis.

Method:

This retrospective study was conducted from 2019 to 2023 at King Fahad Armed Forces Hospitals, Jeddah, Saudi Arabia. Data were cleaned in Excel and analyzed using IBM SPSS version 29. The activity of the disease was assessed through clinical manifestations, laboratory findings, and its associations with other autoimmune diseases.

Results:

Our study included 365 patients with rheumatoid arthritis, predominantly female (89%), and observed diverse demographics and comorbidities. Prevalent conditions included diabetes mellitus (28.2%), hypertension (27.3%), and dyslipidemia (14.7%). Other autoimmune diseases were present in 24.9% of patients, with notable associations with age at rheumatoid arthritis diagnosis and endocrine, rheumatology/dermatology, and pulmonary disorders ( p < 0.001). Treatment approaches varied, with prednisolone (24.4%) and methotrexate (55.1%) being predominant. No significant associations were observed between autoimmune disorders and specific treatment modalities ( p > 0.05).

Conclusion:

Our study provides a thorough overview of rheumatoid arthritis in a large cohort, revealing demographic trends, comorbidities, autoimmune disease prevalence, treatment preferences, and associations. Relationships with age at rheumatoid arthritis diagnosis and other autoimmune diseases were noted. Treatment approaches varied, with no significant associations between autoimmune disorders and specific modalities.
Drug-induced subacute cutaneous lupus erythematosus secondary to Dupilumab: A case report
Authors: Waugh Miranda , Gavigan Geneviève
Published: September 2024

We present the case of a 63-year-old male with known rheumatoid arthritis, diabetes, hypertension, and peripheral neuropathy who developed drug-induced subacute cutaneous lupus erythematosus secondary to Dupilumab for his chronic hand dermatitis.
Pilomatricoma presenting as a giant cutaneous horn in an 8-year-old child: A case report and literature review
Authors: Crawford Madeleine , Shi Jincheng , Kakadekar Archan , Sutherland Ashley
Published: September 2024

Pilomatricoma is an uncommon benign adnexal tumor of childhood. We report a case of pilomatricoma presenting as a large, recurrent painful cutaneous horn on the neck of an 8-year-old boy treated with surgical excision. On histopathology, classical features of pilomatricoma along with transepidermal elimination and perforation were shown. We propose that perforating pilomatricoma and pilomatrical horn represent equivalent clinical and pathological entities. The diagnosis of perforating pilomatricoma should be considered in pediatric patients presenting with a cutaneous horn.
Present state and perceived future use of teledentistry in long-term care facilities in Japan: A cross-sectional study
Authors: Okumura Takuma , Nakagawa Kazuharu , Yoshimi Kanako , Saito Mitsuko , Ito Kayoko , Itoda Masataka , Takeuchi Kenji , Mizutani Shinsuke , Yoshida Mitsuyoshi , Watanabe Yutaka , Tohara Haruka
Published: September 2024

Objectives

Teledentistry could be effective in managing oral health through the provision of oral hygiene instruction and diagnostic services. This study aimed to assess the perception and usefulness of teledentistry in Japanese long-term care facilities.

Methods

We conducted a questionnaire survey to compare related factors of the usefulness of teledentistry and identify issues in its implementation. We chose 1000 facilities using a stratified random sampling method. The questionnaires were sent to the facilities in August 2021 and collected in December of the same year. Responses to the questionnaire items regarding the usefulness of teledentistry for oral management were divided into three groups according to the answer: perceiving teledentistry as “useful,” “not useful,” or “neither,” including facilities that do not currently use teledentistry.

Results

In total, 26.1% (261) responded to the questionnaire, and among these, 184 facilities answered the question regarding the usefulness of teledentistry. Only two of these facilities implemented teledentistry. Facilities with dental hygienists ( p = 0.040) and those that receive insured medical treatment: reimbursement for oral feeding maintenance II ( p = 0.040) tended to perceive teledentistry as useful in the management of patients with coronavirus disease. The higher the number of services that responded to the question “what kind of services do you think can be provided via teledentistry?” the higher the percentage of “useful” responses.

Conclusions

Although only a few facilities use teledentistry, many long-term care facilities perceive it as useful even without using it. The presence of dental hygienists and interprofessional work done with reimbursement for oral feeding maintenance II contributed to the perception of the usefulness of teledentistry in long-term care facilities.
Sleep well, worry less: A co-design study for the development of the SMILE app
Authors: Cormier Marcus , Orr Matt , Kaser Alanna , MacDonald Hannah , Chorney Jill , Meier Sandra
Published: September 2024

Objective

With the coronavirus disease 2019 pandemic exacerbating mental health concerns, the prevalence rates of anxiety and sleep problems have increased alarmingly among youth. Although 90% of patients with anxiety experience sleep problems, current interventions for anxiety often do not target sleep problems in youth. Given this lack, we designed the SMILE app, an intervention that addresses both anxiety and sleep problems simultaneously.

Methods

As users’ perspectives are essential to ensure app engagement and uptake, the features, designs, and functions of the SMILE app were evaluated using a participatory app design approach. Participants ( N = 17) were youth aged 15 to 25 who reported co-morbid anxiety and sleep issues above clinical thresholds. After completing an online screening survey assessing demographics, anxiety, and sleep problems, participants shared app feedback through group-based, semi-structured co-design sessions. Qualitative analyses were conducted to identify common themes from participants’ feedback.

Results

While participants expressed enthusiasm for the SMILE app's features, particularly the Visualization, Journaling, and Psychoeducation features, and their variety, they criticized the design aspects of the app, such as the font and text amount. Most participants stated they would use the SMILE app or recommend it to a friend.

Conclusion

By actively involving the target population in the design process, the SMILE app has the potential to notably improve the mental well-being of youth, though further research and development are required to realize this potential fully.
Effects of Savings on Depressive Symptoms Among Homeless People in Korea: Using Propensity Score Matching
Authors: Choi Jungtae , Han Chang-Keun , Kang Sion
Published: September 2024

Researchers have found that the accumulation of assets through savings may serve a vital function in enhancing mental health and well-being. However, the question of how the status of savings affects the level of depressive symptoms in homeless persons remains largely unexplored. This study examines the relationship between savings and depressive symptoms in homeless individuals by utilizing the 2016 National Survey on Homeless People. We employed propensity score matching to reduce selection bias and multivariate logistic regression to probe the effects of savings on depressive symptoms. We found that after taking into account the covariates, a lower level of savings was associated with a higher level of depressive symptoms. Our findings imply that an asset-based policy orientated toward those facing homelessness could have a significant effect on reducing depressive symptoms.
COVID-19 Hospitalization Outcomes for Long-Term Care Facility Residents With Dementia: Mediation by Pre-existing Health Conditions
Authors: Yin Cheng , Mpofu Elias , Brock Kaye , Ingman Stan
Published: September 2024

Background: This study explores COVID-19 emergency admission and length of hospital stay hospitalization outcomes for Long-Term Care Facility (LTCF) residents with dementia. Methods: Utilizing a cross-sectional case control design, we employed logistic regression to analyze Texas Inpatient Public Use Data File (PUDF) for 1,413 dementia patients and 1,674 non-dementia patients (>60 years) to predict emergency admission and length of hospital stay with mediation by pre-existing conditions. Results: LTCF residents with dementia have a higher likelihood of COVID-19 emergency admission and shorter hospital stays. Adjusting for confounders of demographics, health insurance, and lifestyle, dementia diagnosis remained significantly associated with emergency admission and shorter hospital stays with preexisting conditions. Conclusion: Findings underscore the heightened risk for adverse COVID-19 hospitalization care disparities with dementia. Targeted health support programs for LTCF residents with dementia should aim to improve their COVID19 hospitalization outcomes, treating pre-existing health conditions and reducing their risk for excess mortality.
Possibilities: A commentary on creative aging
Authors: McGovern Justine
Published: September 2024

This commentary offers a critical and personal perspective on Adams-Price and Morse’s “Creativity, aging, context and culture: Reimagining creativity in everyday life in older adults.” The commentary provides a close reading of the authors’ premise which argues for bridging creativity theory and research on creative aging. The commentary also suggests next steps, emphasizing the need to engage with contemporary issues of privilege and discrimination.
Transformation in marginal zone lymphoma: results from a prospective cohort and a meta-analysis of the literature
Authors: Bommier Côme , Link Brian K. , Gysbers Brianna J. , Maurer Matthew J. , Larson Melissa C. , Khurana Arushi , Wang Yucai , Thompson Carrie A. , Chihara Dai , Alderuccio Juan P. , Koff Jean L. , Epperla Narendranath , Conconi Annarita , Lossos Izidore S. , Nowakowski Grzegorz S. , Feldman Andrew L. , Habermann Thomas M. , King Rebecca L. , Cerhan James R.
Published: September 2024

Marginal zone lymphoma (MZL) includes extranodal MZL (EMZL), splenic MZL (SMZL), and nodal MZL (NMZL) subtypes. Histologic transformation (HT) to large B-cell lymphomas is well documented but with a large variability in published cumulative incidence rates. We report results from the Molecular Epidemiology Resource (MER) cohort on the cumulative incidence of HT (with death as competing risk) and the associated risk factors and outcomes. We also conducted a meta-analysis of available studies on the cumulative incidence of HT. From 2002 to 2015, 529 patients with MZL were enrolled in the MER study (69% EMZL, 16% SMZL, and 15% NMZL). The 10-year overall survival (OS) from diagnosis was 66%. HT occurred in 21 patients with a 5-year and 10-year cumulative incidence of 2.7% (95% confidence interval [CI], 0.02-0.05) and 3.6% (95% CI, 0.02-0.06), respectively. HT was associated with an increased risk for death (subdistribution hazard ratio [HR], 3.95; 95% CI, 2.06-7.55). Predictors of HT were ≥2 extranodal sites and mucosa-associated lymphoid tissue International Prognostic Index score ≥2. The OS was 79% at 5 years and 55% at 10 years after HT. In the meta-analysis of 12 studies (6161 patients), the 5- and 10-year cumulative incidence of HT across all subtypes were 5% (95% CI, 0.05-0.06) and 8% (95% CI, 0.07-0.09), respectively. These rates were lower in EMZL (3% and 5%) than in SMZL (7% and 13%) and NMZL (9% and 13%). Although HT is relatively uncommon in the first decade after MZL diagnosis, it is associated with an inferior outcome and needs new approaches for prevention and management.
Outcomes in children with provoked venous thrombosis and antiphospholipid antibodies: findings from the Kids-DOTT trial
Authors: Betensky Marisol , Mosha Maua , Tarango Cristina , Verma Anupam , Bhat Rukhmi , Kucine Nicole E. , Nakano Taizo , Nakar Charles , Woods Gary , Amankwah Ernest , Brandão Leonardo R. , Schulman Sam , Goldenberg Neil A.
Published: September 2024

Few studies have prospectively evaluated the incidence and outcomes in children with provoked venous thromboembolism (VTE) and transient or persistent antiphospholipid antibodies (aPLs). We compared outcomes of patients aged <21 years with a first-episode acute provoked VTE and positive aPL at diagnosis, enrolled in the Multicenter Evaluation of the Duration of Therapy for Thrombosis in Children trial. aPLs were tested at enrollment and, when positive, repeated at 6 weeks after VTE diagnosis. Subsequent testing was performed at the discretion of the treating hematologist. Of 524 patients, 116 (22%) had positive aPLs at enrollment. At follow-up, 70 (60%) had transient (n = 66) or low-titer aPLs (n = 4), 11 (10%) had persistent aPLs meeting the criteria for antiphospholipid antibody syndrome (APS), and 35 (30%) had no repeat testing. Patients with APS were older (15.8 vs 9.9 years; P = .014) and had a statistically significant higher risk of symptomatic recurrent VTE (18% vs 1%; odds ratio [OR], 12.2; 95% confidence interval [CI], 1.4-108; P = .025) and a statistically nonsignificant but clinically meaningful difference in the risk of anticoagulant-related clinically relevant bleeding (9% vs 0%; OR, 20.1; 95% CI, 0.7-558; P = .077) compared with those in the transient or low-titer aPL group. In conclusion, aPLs are common in young patients with acute provoked VTE and are mostly transitory and clinically insignificant. Patients with APS and provoked VTE appear to have an increased risk of recurrent VTE compared with patients with transitory or low-titer aPLs. Future collaborative studies should investigate the optimal VTE management for children with provoked VTE who meet the criteria for APS. The trial was registered at www.ClinicalTrials.gov as #NCT00687882.
New drugs, new challenges in cystic fibrosis care
Authors: Fajac Isabelle , Burgel Pierre-Régis , Martin Clémence
Published: September 2024

Cystic fibrosis (CF) is a genetic disease caused by variants in the gene encoding for the CF transmembrane conductance regulator (CFTR) protein, a chloride and bicarbonate channel. CFTR dysfunction results in a multiorgan disease with the main clinical features being exocrine pancreatic insufficiency and diffuse bronchiectasis with chronic airway infection leading to respiratory failure and premature death. Over the past decades, major progress has been made by implementing multidisciplinary care, including nutritional support, airway clearance techniques and antibiotics in specialised CF centres. The past decade has further seen the progressive development of oral medications, called CFTR modulators, for which around 80% of people with CF are genetically eligible in Europe. CFTR modulators partially restore ion transport and lead to a rapid and major improvement in clinical manifestations and lung function, presumably resulting in longer survival. CFTR modulators have been game-changing in the care of people with CF. However, many questions remain unanswered, such as the long-term effects of CFTR modulators, especially when treatment is started very early in life, or the new CF-related disease emerging due to CFTR modulators. Moreover, severe complications of CF, such as diabetes or cirrhosis, are not reversed on CFTR modulators and around 20% of people with CF bearCFTRvariants leading to a CFTR protein that is unresponsive to CFTR modulators. Challenges also arise in adapting CF care to a changing disease. In this review article, we highlight the new questions and challenges emerging from this revolution in CF care.
Digital health delivery in respiratory medicine: adjunct, replacement or cause for division?
Authors: Ottewill Ciara , Gleeson Margaret , Kerr Patrick , Hale Elaine Mac , Costello Richard W.
Published: September 2024

Digital medicine is already well established in respiratory medicine through remote monitoring digital devices which are used in the day-to-day care of patients with asthma, COPD and sleep disorders. Image recognition software, deployed in thoracic radiology for many applications including lung cancer screening, is another application of digital medicine. Used as clinical decision support, this software will soon become part of day-to-day practice once concerns regarding generalisability have been addressed. Embodied in the electronic health record, digital medicine also plays a substantial role in the day-to-day clinical practice of respiratory medicine. Given the considerable work the electronic health record demands from clinicians, the next tangible impact of digital medicine may be artificial intelligence that aids administration, makes record keeping easier and facilitates better digital communication with patients. Future promises of digital medicine are based on their potential to analyse and characterise the large amounts of digital clinical data that are collected in routine care. Offering the potential to predict outcomes and personalise therapy, there is much to be excited by in this new epoch of innovation. However, these digital tools are by no means a silver bullet. It remains uncertain whether, let alone when, the promises of better models of personalisation and prediction will translate into clinically meaningful and cost-effective products for clinicians.
Pulsed Unipolar-Polarisation Plasma Electrolytic Polishing of Ni-Based Superalloys: A Proof of Conception
Authors: Zhou Chuanqiang , Qian Ning , Su Honghua , He Jingyuan , Ding Wenfeng , Xu Jiuhua
Published: September 2024

The enhanced performance of aerospace equipment drives parts development towards integration, complexity, and structural optimization. This advancement promotes metal near-net fabrication technologies like wire electrical discharge machining (WEDM) and 3D printing. However, the high initial surface roughness from WEDM or 3D printing poses significant challenges for the high-performance surface finishing required. To effectively reduce the surface roughness of the workpieces with high initial surface roughness, this paper proposes pulsed unipolar-polarisation plasma electrolytic polishing (PUP-PEP). The study examined the material removal mechanisms and surface polishing quality of PUP-PEP. This technique combines the high current density and material removal rate of the electrolytic polishing mode with the superior surface polishing quality of PEP through voltage waveform modulation. For an Inconel-718 superalloy part fabricated by WEDM, PUP-PEP reduced surface roughness from Ra 7.39 μm to Ra 0.27 μm in 6 min under optimal conditions. The roughness decreased from Ra 7.39 μm to Ra 0.78 μm in the first 3 min under pulsed unipolar-polarisation voltage, resulting in a remarkable 233% increase in efficiency compared to that with conventional PEP. Subsequently, the voltage output voltage is transformed into a constant voltage mode, and PEP is continued based on PUP-PEP to finally reduce the workpiece surface roughness value to Ra 0.27 μm. The proposed PUP-PEP technology marks the implementation of ‘polishing’ instead of conventional rough-finish machining processes, presenting a new approach to the surface post-processing of metal near-net fabrication technologies.
Assessment of prolonged safety and tolerability of erenumab in migraine patients in a long-term open-label study (APOLLON)
Authors: Göbel Hartmut , Schlegel Eugen , Jaeger Kathrin , Ortler Sonja , Leist Lea
Published: September 2024

Background

Efficacy and safety of human monoclonal antibody erenumab used for migraine prophylaxis have been shown in clinical studies. APOLLON is an open-label, multi-center, single arm study, which permits dose adjustments of erenumab and includes an option for a drug holiday. The findings contribute to the accumulating long-term evidence regarding erenumab’s tolerability and safety profile in individuals experiencing episodic and chronic migraines.

Methods

The study population consisted of adult patients with episodic or chronic migraine, who had successfully completed the HER-MES study (NCT03828539). Patients were treated with erenumab for 128 weeks at a flexible dose of either 70 mg or 140 mg. Treatment discontinuation attempts were allowed as voluntary single treatment interruption (‘drug holiday’) of up to 24 weeks.

Results

701 patients were enrolled in APOLLON. The exposure associated incidence rate (EAIR) of adverse events (AEs) (N = 601) per 100 subject years was 101.71 (95% CI [92.28; 111.14]) meaning a patient could expect having about one adverse event per each year of treatment. EAIR was higher in females (n = 524, EAIR: 104.40, 95% CI [93.93; 114.86]) than in males (n = 77, EAIR: 86.55, 95% CI [65.39; 107.71]) and increased with initial monthly migraine days (MMD) and prior prophylactic treatment failures. A total of 155 patients discontinued erenumab treatment during open-label treatment phase. Of these, 29 were due to AEs (4.1% of total cohort) and out of these 65.5% (N = 19) were considered treatment-related. Safety parameters were in line with HER-MES data and did not reveal new safety signals. Drug holidays were realized by 108 patients (15.4%), of which 64.8% (N = 70) returned to treatment. The mean number of monthly headache days (MHDs), MMDs, and days with acute headache medication significantly increased during drug holiday. After resumption of erenumab treatment, a rapid reduction of the migraine parameters was observed.

Conclusions

APOLLON provides long-term safety and tolerability data confirming the beneficial safety profile of erenumab over a period of 128 weeks. In addition, reversibility of migraine deterioration during drug holiday was shown and most patients returned to their treatment with similar response rates compared to initial treatment.

Trial registration

ClinicalTrials.gov ID: NCT04084314 (https://clinicaltrials.gov/study/NCT04084314), First submitted: 2019-09-06.
Empowering vision: the impact of nursing-led educational program on patients with dry eye syndrome
Authors: Rabie Emad Abd El Gawad Ali , ElRazkey Jehan Y. , Ahmed Heba Abdelmowla
Published: September 2024

Background

Dry eye syndrome (DES) is a widespread ocular condition affecting the general population. It is a complex disorder affecting the eye surface, characterized by a tear film imbalance and ocular symptoms such as eye ache, burning, irritation, dryness, blurred vision, and foreign body sensation. DES can reduce visual acuity, increase the risk of ocular infection, and significantly impact daily activities and quality of life.

Aim

Determine the impact of nursing-led educational program on the management of DES and patients’ health outcomes including the intensity of DES symptoms and their influence on visual-related functions.

Methods

The study was conducted with a quasi-experimental design. Sixty adult patients diagnosed with DES were selected using a convenience sampling method. Two tools were employed for the collection of data. Tool I: Precipitating factors of DES structured interview schedule. Tool II: Ocular surface disease index (OSDI) to assess ocular irritation symptoms associated with DES and their effect on functions related to vision.

Results

A statistically significant decrease in the mean scores of OSDI in the study group two weeks after the implementation of the educational program regarding the ocular symptoms, functions associated with vision, environmental triggers, and overall score of OSDI.

Conclusion

Implementing an educational program for DES is effective in relieving symptoms, boosting patients’ understanding of managing symptoms effectively, and maintaining eye health. Therefore, patients must be instructed on dry eye early detection and management to enhance health-related outcomes and self-care practices.

Registration

ClinicalTrials.gov: NCT06288945.