bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoxia-associated markers in the prognosis of oral canine melanoma
Authors: Gola Cecilia , Maniscalco Lorella , Iussich Selina , Morello Emanuela , Olimpo Matteo , Martignani Eugenio , Accornero Paolo , Giacobino Davide , Mazzone Eugenio , Modesto Paola , Varello Katia , Aresu Luca , De Maria Raffaella
Published: April 2024

Canine oral malignant melanoma (COMM) is the most common neoplasm in the oral cavity characterized by local invasiveness and high metastatic potential. Hypoxia represents a crucial feature of the solid tumor microenvironment promoting cancer progression and drug resistance. Hypoxia-inducible factor-1α (HIF-1α) and its downstream effectors, vascular endothelial growth factor A (VEGF-A), glucose transporter isoform 1 (GLUT1), C-X-C chemokine receptor type 4 (CXCR4), and carbonic anhydrase IX (CAIX), are the main regulators of the adaptive response to low oxygen availability. The prognostic value of these markers was evaluated in 36 COMMs using immunohistochemistry. In addition, the effects of cobalt chloride–mediated hypoxia were evaluated in 1 primary COMM cell line. HIF-1α expression was observed in the nucleus, and this localization correlated with the presence or enhanced expression of HIF-1α-regulated genes at the protein level. Multivariate analysis revealed that in dogs given chondroitin sulfate proteoglycan-4 ( CSPG4) DNA vaccine, COMMs expressing HIF-1α, VEGF-A, and CXCR4 were associated with shorter disease-free intervals (DFI) compared with tumors that were negative for these markers ( P = .03), suggesting hypoxia can influence immunotherapy response. Western blotting showed that, under chemically induced hypoxia, COMM cells accumulate HIF-1α and smaller amounts of CAIX. HIF-1α induction and stabilization triggered by hypoxia was corroborated by immunofluorescence, showing its nuclear translocation. These findings reinforce the role of an hypoxic microenvironment in tumor progression and patient outcome in COMM, as previously established in several human and canine cancers. In addition, hypoxic markers may represent promising prognostic markers, highlighting opportunities for their use in therapeutic strategies for COMMs.
Using the PLUS Framework to support supervisors to make the most of practice education supervision: Experiences from Singapore
Authors: Dancza Karina M. , Hoo Corrine , Goh Xin En Jacintha , Tan Jervyn Charity , Shu Hui Lee , Lagui Masaoy Rialyn Fae , Chooi Yin Ong , Pei Qi Pay , Yong Mei Xing Sharmaine
Published: April 2024

Introduction:

Practice education is a crucial component of occupational therapy education, providing students with hands-on experience in real-world settings. Supervisors play a vital role in shaping students’ learning experiences, and the Professional Learning through Useful Support Framework, developed in the United Kingdom, serves as a guide for supervisors. However, its applicability in different cultural contexts remains uncertain. This qualitative study explores the perspectives and experiences of supervisors in Singapore who used the Professional Learning through Useful Support Framework to guide their supervision of students.

Method:

Nine new and five experienced supervisors participated in semi-structured interviews, during a 7-week practice education period. Interviews were transcribed and analysed using template analysis.

Findings:

Three themes were developed: The Professional Learning through Useful Support Framework brought awareness to supervisors’ supervisory techniques and guided their actions; The Professional Learning through Useful Support Framework gave permission to use a range of supervisory strategies; and The Professional Learning through Useful Support Framework could be used as a catalyst for enhancing support for supervisors.

Conclusion:

The Professional Learning through Useful Support Framework positively influenced supervisor communication and encouraged a purposeful approach to student supervision. Challenges emerged in implementing the concept of ‘safe failure’ due to cultural attitudes towards success, necessitating cultural adaptation. The study suggests introducing educational opportunities and ongoing support to use the Framework to enhance supervisor skills.
The non-decussating and decussating trigeminothalamic tracts in humans: A combination of connectome-based tractography and histological validation
Authors: Henssen Dylan J.H.A. , Pritsch Cynthia , Nazari Pouyan , Mulleners Wim , Vissers Kris
Published: April 2024

Background

Functional anatomical research proposed the existence of a bilateral trigeminal ascending system although the anatomy trajectories of the trigeminothalamic connections cranial to the pons remain largely elusive. This study therefore aimed to clarify the anatomical distributions of the trigeminothalamic connections in humans.

Methods

Advanced deterministic tractography to an averaged template of diffusion tensor imaging data from 1065 subjects from the Human Connectome Project was used. Seedings masks were placed in Montreal Neurological Institute standard space by use of the BigBrain histological dataset. Waypoint masks of the sensory thalamus was obtained from the Brainnetome Atlas.

Results

Tractography results were validated by use of the BigBrain histological dataset and Polarized Light Imaging microscopy. The trigeminothalamic tract bifurcated into a decussating ventral and a non-decussating dorsal tract. The ventral and dorsal tracts ascended to the contralateral thalamus and ipsilateral thalamus and reflected the ventral trigeminothalamic tract and the dorsal trigeminothalamic tract, respectively. The projection of the ventral trigeminothalamic tract and the dorsal trigeminothalamic tract to both thalami confirm the existence of a bilateral trigeminothalamic system in humans.

Conclusions

Because our study is strictly anatomical, no further conclusions can be drawn with regard to physiological functionality. Future research should explore if the dorsal trigeminothalamic tract and the ventral trigeminothalamic tract actually transmit signals from noxious stimuli, this offers potential in understanding and possibly treating neuropathology in the orofacial region.
Correction of Plane Strain Analyses for Corrugated Metal Culverts Subjected to Patch Loads
Authors: Liu Bujing , Brian Anderson J. , Davidson James S.
Published: April 2024

Today, culverts are often analyzed and designed using plane strain finite element analyses in which a transverse slice of the structure is simulated and assumed equal to any other slice. Although this works well for soil loads, in reality live loads are discrete pressure loads from tires, and the out-of-plane effects can be significant, especially when cover depths are relatively low. While current design specifications define minimum cover that precludes significant localized pressure effects on culverts, many culverts are currently in service that were constructed under very shallow cover depths. In this study, analyses of corrugated metal culverts under truck load were carried out using two-dimensional (2D) (plane strain) and three-dimensional (3D) finite element analyses to assess the difference between structural responses predicted by these two approaches. Thirty-six culvert models with different shapes, spans, and cover depths were created using both 2D and 3D meshes. A significant difference was found between the results of these two analysis methods. Specifically, the thrust from the 3D models under shallow cover can be as much as three times the thrust results from the 2D model, which is unconservative from a safety standpoint. An innovative explanation was provided to explicate the differences. Finally, to address the issue, a reduction ratio method was developed to correct the 2D results to match the corresponding 3D results so that the relatively simple plane strain approach can be used.
Incorporating Driving Behavior Metrics Derived from Naturalistic Driving Data into Macroscopic Safety Modeling
Authors: Medina Juan C. , (Srini) Srinivasan Raghavan , Saleem Taha , Lan Bo
Published: April 2024

This research leveraged datasets from the Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study (NDS) to explore the potential benefits of incorporating macroscopic measures derived from NDS into traditional safety modeling. Large datasets with traversals from more than 1,700 unique drivers were used to extract driving behavior on freeway segments. New sets of time series totaling over 1,600 h of driving were developed, including vehicle dynamics exclusively during car-following, while also tracking the spacing between the instrumented vehicle and the vehicle being followed. This paper focuses on the statistical modeling of crash frequency incorporating macroscopic metrics derived from the new time-series datasets as regards the mean, median, variance, and 85th percentile of vehicle spacing, vehicle speed, and traffic density. Results of this exploration indicate that an increase in the traffic density variance, an increase in the speed variance, and a decrease in the mean vehicle spacing had significant effects associated with increases in multi-vehicle crash frequencies. These results can be used to estimate the safety effect of countermeasures that may change speed, density, and or spacing, along with changes in annual average daily traffic (AADT).
Splice Length of Large Diameter Reinforcing Bars in Ultra-High-Performance Concrete
Authors: Freeman Christina , Potter William , Nolan Steven
Published: April 2024

Potential exists for construction time savings through replacement of cast-in-place substructure columns, piers, or both, with prefabricated bridge elements and systems. Cast-in-place substructure construction requires forming, placing steel, and pouring concrete at the construction site. Using prefabricated elements would decrease the extent of work required at the site and potentially reduce concrete curing time. This research furthers the effort to use ultra-high-performance concrete (UHPC) as a joining material for prefabricated bridge substructure elements. UHPC has a high early strength, requires less development or splice length than conventional concrete, and has been used previously for accelerated construction projects, such as bridge deck replacement with precast units. UHPC also has a discontinuous pore structure that reduces liquid ingress, significantly enhancing durability compared to conventional concrete. Although UHPC has been researched extensively, previous research for reinforcing bar splice and development lengths has focused on #9 and smaller diameter bars. Typically, larger diameter bars are used for substructures. This research determined the required splice lengths for large diameter steel deformed reinforcing bars embedded in UHPC based on 127 individual tests. Three primary variables were included in the testing matrix: bar size, bar spacing, and concrete cover. To achieve at least 75 kips per square inch (ksi) (517 MPa) reinforcing bar stress in UHPC with an early age strength of 14 ksi (97 MPa), the required embedment length ranges from 8 to 13 times the bar diameter and the corresponding splice length varies from 6 to 11 times the bar diameter, depending on the bar size and concrete cover.
Does Special Education Work? A Systematic Literature Review of Evidence From Administrative Data
Authors: O’Hagan Kaitlyn G. , Stiefel Leanna
Published: April 2024

Research increasingly seeks to answer the question: does special education work? This is different than asking if specific interventions have positive effects and instead aims to identify system-wide impacts. We systematically review published quantitative research on the impact of receiving special education services on student outcomes using large administrative data, as well as review the methodology used in existing research. The takeaway from the 15 included studies is that special education positively impacts student outcomes, and the growth of students receiving special education typically matched or exceeded the growth of their general education peers. Methods used in these studies were, however, quasi-experimental, so limitations to credibly causal claims remain. In addition, that relatively few studies met our inclusion criteria reflects the need for additional research, and we highlight methodological and substantive considerations for future work.
A Narrative Review of Aconite Poisoning and Management
Authors: Lawson Christine , McCabe Daniel J. , Feldman Ryan
Published: April 2024

Aconite poisoning refers to toxicity resulting from plants belonging to the Aconitum genus, which comprises over 350 different species of perennial flowering plants that grow in temperate mountainous areas of the northern hemisphere (North America, Europe, Asia). These plants contain a group of toxins known as aconite alkaloids, which encompass numerous closely related toxic compounds. Conventional teaching from toxicology textbooks has broadly classified these alkaloids based on their mechanism of action, often simplifying them as substances that prevent sodium channel inactivation. However, this is an oversimplified and sometimes inaccurate description, as some aconite alkaloids can act as sodium channel blockers. Aconite alkaloids have a long history of use as poisonous substances and have been historically employed for hunting, assassinations, traditional medicine, and self-inflicted harm. Toxicity can occur due to the consumption of traditional medicines derived from aconitum plants or the ingestion of aconite plants and their derivatives. The clinical manifestations of aconite poisoning may encompass gastrointestinal symptoms, sensory alterations, seizures, and life-threatening dysrhythmias that may not respond to standard treatments. Treatment is primarily supportive however evaluation and management of these patients should be personalized and carried out in collaboration with a toxicologist.
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock
Authors: Mergoum Anaas Moncef , Rhone Abigail Rebecca , Larson Nicholas James , Dries David J , Blondeau Benoit , Rogers Frederick Bolles
Published: April 2024

Shock is a life-threatening circulatory failure that results in inadequate tissue perfusion and oxygenation. Vasopressors and inotropes are vasoactive medications that are vital in increasing systemic vascular resistance and cardiac contractility, respectively, in patients presenting with shock. To be well versed in using these agents is an important skill to have in the critical care setting where patients can frequently exhibit symptoms of shock. In this review, we will discuss the pathophysiological mechanisms of shock and evaluate the current evidence behind the management of shock with an emphasis on vasopressors and inotropes.
Examining educational continuity in distance learning guidance documents: A content analysis of the Ministry of Education response to COVID-19 in Belize
Authors: Arzu Ethel Mae
Published: April 2024

This article examines educational continuity in distance learning guidance documents developed by the Ministry of Education, Culture, Science and Technology in Belize during school closure for the 2019–2020 school year. Documents that were purposefully developed as part of the ministry's response to school closure because of the pandemic were collected and analyzed. The four themes that emerged from the analysis—access to technology, home-based learning and resources, continuing professional development, and adjustments to instructional planning and academic policies—describe how the ministry's guidance documents on distance learning supported educational continuity in Belize during school closure for the 2019–2020 school year. The analysis also reveals that the ministry’s reachability effort relied heavily on low or no-tech modalities to ensure educational continuity in response to the pandemic.
Building Buying-in: Understanding the Anticipatory Socialization Phase of Workers in a Full-Life Organization
Authors: Ault Michael K.
Published: April 2024

This qualitative investigation explored the anticipatory socialization phase of volunteers in the missionary program of the Church of Jesus Christ of Latter-day Saints, a full-life organization. Constant comparative analysis revealed that participants experienced three phases of organizational identification within their anticipatory socialization phase: exposure, exploration, and engagement. In the exposure phase, participants were presented with socializing messages that taught participants the rules, expectations, and values of the organization. In this phase, participants accepted the organizational identity largely without reservation. In the exploration phase, participants questioned their organizational identity and explored alternative, varied, and competing identities. In this phase, participants pushed their organizational identity to the periphery of their social identity. Finally, in the engagement phase, participants recentered their organizational identity and committed to their membership in the organization. Identifying these phases assists organizations and individuals in understanding and developing organizational engagement.
Is REBT Useful for Reducing Adolescents’ Career Decision Difficulties and Distress? A Randomized Trial
Authors: Kulcsár Viktória , Dobrean Anca , Poetar Costina-Ruxandra , Ivan Cristina
Published: April 2024

The present study examined the efficacy of a 6-session Rational Emotive Behavior Therapy (REBT) career intervention program for high school students in reducing career decision-making difficulties and emotional distress. Nine classes of 11th graders in two Romanian public high schools ( N = 233) were randomly assigned to a REBT career intervention and a Regular career course. The data were collected in three waves: before and after the interventions and at a 6-month follow-up. Career decision-making difficulties decreased in both intervention groups post-intervention and at the 6-month follow-up. Worry and irrational beliefs decreased more in the REBT group at the 6-month follow-up. Emotional distress and negative dysfunctional emotions decreased in the REBT group both post-intervention and at the 6-month follow-up, but they increased in the Regular group. The Discussion explores factors that may contribute to the decreased career decision-making difficulties in both groups and the benefits of the REBT career intervention.
Older Adults’ Unmet Needs at the End of Life: A Cross-Country Comparison of the United States and England
Authors: Swearinger Hazal , Lapham Jessica L. , Martinson Melissa L. , Berridge Clara
Published: April 2024

Objectives: This study aimed to compare the end-of-life (EOL) experiences in concentration with place of death, for older adults in the U.S. and England. Methods: Weighted comparative analysis was conducted using harmonized Health and Retirement Study and English Longitudinal Study of Ageing datasets covering the period of 2006–2012. Results: At the EOL, more older adults in the U.S. (64.14%) than in England (54.09%) had unmet needs (I/ADLs). Home was the main place of death in the U.S. (47.34%), while it was the hospital in England (58.01%). Gender, marital status, income, place of death, previous hospitalization, memory-related diseases, self-rated health, and chronic diseases were linked to unmet needs in both countries. Discussion: These findings challenge the existing assumptions about EOL experiences and place of death outcomes, emphasizing the significance of developing integrated care models to bolster support for essential daily activities of older adults at the EOL.
Development, modeling and analysis of a differential lever-bridge amplification mechanism
Authors: Hou Beibei , Tong Yanchao , Liu Pengbo , Lu Shuaishuai , Xiao Guangchun , Yan Peng
Published: April 2024

The displacement amplification mechanism is commonly utilized in micro/nano-manipulating systems to enhance the output stroke of piezoelectric actuators. Aiming at large amplification ratio, this paper proposes a symmetrical dual-stage amplification mechanism consisting of a differential lever mechanism and a half-bridge mechanism. With consideration of the coupling effect between the dual-stage amplification mechanism, a kinematic modeling method is developed for the symmetrical differential lever-bridge hybrid (SDLBH) mechanism on top of the static balance and constraint conditions of the branch chain. In particular, the force-deformation relationship of the flexible hinge is derived according to the flexibility matrix method. Based on the path constraint conditions of the branch chain, the static equilibrium equation as well as the displacement constraint conditions are obtained. Consequently, the input-output model of the SDLBH mechanism is established, which is capable of accurately predicting the amplification ratio and the mechanical stiffness. Finite element simulations and real time experiments on the SDLBH prototype effectively validate the mechanical performance as well as the accuracy of proposed modeling method. The performance sensitivity of the developed SDLBH mechanism is further analyzed by the Taguchi method, aiming to offer the optimization guideline for real applications.
A new method for visually and real-timely measuring stress and load distributions in bolt with photoelastic technology
Authors: Wang Wenping , Xu Gang , Huang Ping
Published: April 2024

After analyzing the stress characteristics of the bolt, we determined that it can be regarded as experiencing a planar stress state due to the absence of circumferential stress. Consequently, a photoelastic bolt specimen was fabricated by taking a slice across its diameter. Using a photoelastic bench, we collected interference fringe images of the photoelastic specimen under different loads. This method enabled us to visually and continuously measure the stress distributions within the specimen in real-time. Additionally, the load distribution ratio of each tooth was derived. By comparing these results with those obtained through numerical simulation, we were able to validate the reasonability of the theoretical assumption regarding the load distribution of each tooth in the bolt. Our method establishes a solid foundation and can be effectively utilized for precise thread connection design.
Recovery of engine waste heat in low temperature environment of plug-in hybrid electric vehicle
Authors: Zhang Yan , Huang Jianglu , He Liange , Zhao Donggang , Zhao Yu
Published: April 2024

The performance and life of electric vehicle power batteries will be reduced at low temperatures, and the lower temperature in the electric vehicle will also affect the comfort of drivers and passengers. Taking into account the winter temperatures and the unique drive structure of the plug-in hybrid electric vehicle, a specially designed driving mode for low-temperature environment is implemented. Based on this drive mode, a plug-in hybrid electric vehicle (PHEV) integrated thermal management structure is proposed to heat the battery and the passenger compartment, thereby improving energy efficiency. A mathematical model is used to establish the entire vehicle thermal management system, which is then experimentally validated. Under the NEDC (New European Driving Cycle) at ambient temperatures of −5°C, −10°C, −15°C, and −20°C, the calculation results of engine waste heat utilization and PTC (Positive Temperature Coefficient) heating are compared and analyzed. The results show that the average heating rate of the thermal management system proposed in this study is 23% faster than that of PTC heating at low temperature. The SOC decreases to 63.43% when engine waste heat utilization is adopted. When PTC heating is used, the SOC decreases to 49.18%. However, the advantage of the faster rate of engine waste heat compared to PTC heating becomes less pronounced as the ambient temperature decreases.
An intelligent human-machine interaction-based longitudinal control strategy for autonomous vehicles
Authors: Liu Ping , Shu Hang , Tian Yunpeng , Zhang Yikang , Ding Weiping , Huang Haibo
Published: April 2024

In the foreseeable future, the anticipation is that intelligent vehicles will transition to a mode where the intelligent driving system collaborates seamlessly with the human driver. This harmonious integration between the driver and the intelligent control system holds paramount significance for the successful execution of driving tasks, ultimately contributing to the development of more advanced and user-friendly automobiles. A pivotal element in advancing from assisted to autonomous driving lies in the establishment of a human-machine co-driving mode. This research delineates a longitudinal control strategy tailored for intelligent vehicles featuring human-machine interaction. The approach involves the creation of a personalized safe distance model for car-following by collecting driver characteristic parameters. Focused on the car-following methodology, this study formulates the kinematics state space equation, performance index function, and constraint conditions governing car-following dynamics. Subsequently, a car-following control strategy is devised based on model predictive control (MPC), which is addressed through rolling optimization techniques. Building upon this foundation, a human-machine driving control strategy is proposed to dynamically allocate driving authorities in real-time. This strategy takes into account speed and vehicle distance risk as two-dimensional inputs, employing a cooperative driving control strategy within the dual-drive dual-control system. The proposed method was validated in a simulated environment.
‘Monkeypox 2.0’: Case series on a reconditioned virus causing sexually transmissible disease in urban population
Authors: Pakran Jaheersha , Alsaberi Amal Mohammed , AlFalasi Amani , Ibrahim Tarek Mohamed Karam Husein , Alnuaimi Amel Abdalla Eisa Fadl , Goturu Srikumar , Mohamed Muneer , Abraham Reena Mary , Sundaramurthi Vidya Lakshmi , Parambath Aneesh Kunnath , Jose Beena , Kamat Divya , Satish Thencheri Cheriath , Syeda Juwariya Tasneem , Gul Lubna , Mathias Rohini , Rasheed Vattiyamveetil Sajeela , Backar Shaheela , Krishna C Vijay , Al Dhabal Laila
Published: April 2024

Background

MPOX (Monkeypox) viral infection, a zoonotic disease previously confined to the African sub-continent, has caught attention worldwide recently due to its resurgence in a new ‘avatar’ among urban communities. Dermatologists in the U. A. E. started to see patients with fever and a self-limiting pustular necrotic rash that was negative for all other infectious investigations.

Methods

We performed a prospective observational multicenter clinical study of the demographics, skin manifestations, and outcomes of patients presenting with necrotic pustular lesions and/or fever.

Results

35 cases of PCR confirmed MPOX cases, mostly in the expatriate population, were followed up and found to have high-risk heterosexual contact on an average of 1 week prior to disease onset. We found that they have characteristic annular pustular lesions with necrotic center or “Smoke ring pustules’ in all cases. Lesion tenderness and predilection for the lower abdomen, pubic area, and genitalia were observed. Most cases were systemically stable, with fever lasting for an average of 4 days and elevated CRP levels. Genital lesions were prone to secondary bacterial infections. The disease was severe, with larger annular plaques in one of our patients found to be living with HIV.

Conclusions

The overall prognosis in healthy individuals is good, with lesions healing within an average of 2 weeks without scarring. ‘New world MPOX’ should be unclassified from zoonosis to a sexually transmitted infection (STI) capable of transmission in an urban population. Our findings can help in early clinical suspicion and differentiation from other STI’s for primary and secondary health care physicians.
Plasma serotonin precursors and metabolite are correlated with bone mineral density and bone turnover markers in patients with postmenopausal osteoporosis
Authors: Feng Qinying , Song Xiaoyu , Liu Li , Zhou Xinzhong , Chen Zhihao
Published: April 2024

Background

Serotonin (5-HT) precursors regulate bone remodeling. This study aims to investigate the correlation of plasma 5-HT precursors and metabolite with bone mineral density (BMD) and bone turnover markers in postmenopausal osteoporosis (PMOP) patients.

Methods

The age, body mass index (BMI), and years since menopause (YSM) were documented for 348 postmenopausal women in normal/osteopenia/osteoporosis (OP) groups, with lumbar spine and femoral neck BMD measured. Serum bone turnover markers (PINP/β-CTX) and plasma 5-HT, 5-HT precursors (Trp/5-HTP) and metabolite (5-HIAA) were measured by ELISA. OP patients were allocated to high/low expression groups following ROC analysis of 5-HT/Trp/5-HTP/5-HIAA. The relationship of plasma 5-HT/Trp/5-HTP/5-HIAA, BMD, and bone turnover markers with PMOP was analyzed using logistic regression analysis. The correlation of plasma 5-HT/Trp/5-HTP/5-HIAA with BMD and bone turnover markers was analyzed using Pearson’s correlation analysis, followed by logistic regression analysis of the relationship between plasma 5-HT/Trp/5-HTP/5-HIAA and BMD, bone turnover markers and PMOP.

Results

BMI, YSM, BMD and PINP, and β-CTX levels differed among groups. Levels of plasma 5-HT precursors/metabolite were increased in OP patients. Individuals with high 5-HT precursors/metabolite levels had low BMD and high PINP/β-CTX levels. The 5-HT precursors/metabolite negatively-correlated with BMD and positively-correlated with PINP/β-CTX. BMI, YSM, BMD, and PINP/β-CTX/Trp/5-HTP/5-HT related to PMOP and were independent risk factors for OP.

Conclusion

Plasma 5-HT precursors and metabolite negatively-correlate with BMD and positively-correlate with PINP/β-CTX in PMOP patients. Peripheral 5-HT precursors and metabolite level may be a new direction of treatment of PMOP and bone metabolism-related disorders.
Off-balance-sheet policies to the rescue: The role of statistical expertise for European public–private partnerships
Authors: Endrejat Vanessa
Published: April 2024

Off-balance-sheet policies are an important but understudied phenomenon that emerged from a technical subtlety in the calculation of public debt statistics. Taking the case of an exemplary European off-balance-sheet policy, public–private partnerships (PPPs), this paper analyzes the technocratic processes that allow the emergence of such debt-neutral instruments. In the aftermath of the sovereign debt crisis, off-balance-sheet policies have become an important policy tool for Member States in the European Economic and Monetary Union, enabling them to strike a balance between the perceived ‘public investment gap’ and the mantra of fiscal consolidation. The case study shows how the lack of political solutions to Europe’s investment-consolidation conundrum leaves it to technical experts to find workable solutions within the existing rules. The off-balance-sheet status of PPPs came under threat in 2014 but was reaffirmed through a coordinated effort by two strange bedfellows: the European Investment Bank (EIB), a promoter of PPPs, and Eurostat, the European authority responsible for public debt and deficit indicators. I argue that Eurostat and the EIB have entered into strategic cooperation to increase each other’s room for manoeuvre, diffuse political pressure and avoid bureaucratic overload. This paper contributes to a better understanding of the role of technocrats and their expertise, which shape the mutual relations between fiscal constraints and financialized investment policies in the European investor states.
Model reference sliding mode control for two-degree-of-freedom electro-hydraulic shaking table
Authors: Wang Zhepeng , Guan Guangfeng
Published: April 2024

The multi-axis electro-hydraulic shaking table (EHST) is capable of simulating complex vibration environments to assess product reliability under vibrational excitation. The random vibration control method plays a crucial role in simulating these environments. However, the unmolded disturbances and the nonlinearity of the system have a significant impact on the control accuracy of the EHST. Sliding mode control (SMC) can be used in single-input single-output electro-hydraulic servo systems (EHSS) to attenuate the influence of disturbance forces. The conventional SMC is not suitable for acceleration random vibration control of the multi-axis EHST because the coupling between the axes and the actuators and the null bias of the servo valve are not taken into account. A model reference sliding mode control (MRSMC) is presented in this paper based on the nonlinear dynamic model of the EHST. The MRSMC designed based on the backstepping method and Lyapunov theory is used to compensate for the disturbance forces and the null bias of the servo valve. Experimental acceleration random vibration responses show that the MRSMC enhances the accuracy of tracking the acceleration random signal.
Young Women's Experiences of Violence and Homelessness
Authors: Wendt Sarah , Natalier Kristin , Goudie Sharyn
Published: April 2024

This article explores the lived experience of young women navigating and surviving domestic and family violence (DFV) and homelessness. Promoting the voices of young women through in-depth interviews, this article considers their story of violence, abuse, homelessness, and sense of safety. Such stories enable reflection on the ability of services to provide personal, material, emotional, and cultural safety in a way that recognizes the intersecting impact of trauma before, during, and after experiences of DFV. We conclude by arguing that providing emotional and cultural safety through the relational aspects of service delivery is essential to developing a strong foundation for young women's futures.
Real-world treatment outcomes from nationwide Onco-colon Turkey registry in RAS wild-type patients treated with biologics second-line mCRC
Authors: Yildirim Mahmut Emre , Karadurmuş Nuri , Ökten İlker Nihat , Türk Hacı Mehmet , Urakçı Zuhat , Arslan Çağatay , Çelik Sinemis , Dane Faysal , Şendur Mehmet Ali Nahit , Bilir Cemil , Karabulut Bülent , Cicin İrfan , Çubukçu Erdem , Karaca Mustafa , Ozcelik Melike , Artaç Mehmet , Tanrikulu Eda , Alacacioglu Ahmet , Açıkgöz Özgür , Öven Başak , Geredeli Çağlayan , Çil Timucin , Harputluoğlu Hakan , Kefeli Umut , Bozkurt Oktay , Tural Deniz , Sakin Abdullah , Yalçın Şuayip , Gumus Mahmut
Published: April 2024

Backgrounds and Objectives

Colorectal cancer is one of the leading causes of mortality both globally and in our country. In Turkey, we conducted a multicenter investigation into the effectiveness of second-line treatments and real-life data for patients with RAS wild-type metastatic colorectal cancer (NCT04757311).

Materials and Methods

In this retrospective analysis, records from 28 centers were collected, and histopathological, molecular, and clinical characteristics were documented. Patients were categorized into groups based on their second-line biological treatments: anti-EGFR (Group A and Group B, panitumumab and cetuximab) and anti-VEGF (Group C, bevacizumab and aflibercept). They were then compared within these groups.

Results

A total of 588 patients with documented RAS wild-type status were evaluated. The median OS was 15.7, 14.3 and 14.7 months in Group A, Group B and Group C, respectively ( p  =  0.764). The median PFS of the patients in second-line setting that received panitumumab, cetuximab and bevacizumab/aflibercept were 7.8, 6.6 and 7.4 months, respectively ( p  =  0.848).

Conclusion

According to the results of our real-life data study, there is no significant difference in efficiency between the combination of biological agent and chemotherapy used in the second-line treatments.
Retrospective review of the toxicities and change in dosing patterns for pegaspargase in patients with acute lymphoblastic leukemia/lymphoma and T-cell lymphoma
Authors: Baek Grace , Kim Miryoung , Lee Madison , O’Connor Shan , Held Lauren , van der Laan Lars , Cassaday Ryan D
Published: April 2024

Introduction

Pegaspargase (PEG) is a key component of standard regimens for acute lymphoblastic leukemia/lymphoma (ALL) and extranodal natural killer/T-cell lymphoma (NKTCL). Emerging evidence suggests an opportunity to decrease incidence of PEG-associated toxicities with dose capping, but evidence is limited. This study aims to evaluate whether a significant difference in PEG-associated toxicities related to dosing strategy exists and to identify patient-specific or regimen-specific factors for PEG-related toxicity.

Methods

A retrospective analysis of PEG-associated toxicities was completed in adult patients with ALL or NKTCL who received PEG within Cancer and Leukemia Group B (CALGB) 10403 or modified dexamethasone, methotrexate, ifosfamide, L-asparaginase, etoposide (mSMILE) regimens at the UW Medical Center/Fred Hutchinson Cancer Center. PEG-associated toxicities that occurred through 8 weeks after PEG doses were noted.

Results

Twenty-eight patients received dose-capped PEG, and 29 received noncapped PEG. Fewer all-grade and grade 3/4 toxicities were observed in the dose-capped cohort. Grade 3/4 toxicities observed were hepatotoxicity, hyperglycemia, hypersensitivity, and hypertriglyceridemia. In addition, fewer grade 3/4 pancreatitis and thrombosis events occurred in the dose-capped cohort. Hypertriglyceridemia and hepatotoxicity were associated with the highest cumulative incidence proportions among all toxicities.

Conclusion

Dose capping of PEG was associated with a similar or later median onset for most toxicities, a less heterogeneic toxicity profile, and a lower recurrence of most toxicities upon PEG rechallenge compared to the non-dose-capped cohort. Standardizing PEG dose capping in the CALGB 10403 and mSMILE regimens may translate to improved tolerance compared to a historical standard of no dose capping PEG.
Acute Gastroenteritis Outbreak Among Colorado River Rafters and Backpackers in the Grand Canyon, 2022
Authors: Miko Shanna , Calderwood Laura , Dale Ariella P. , King Ronan F. , Maurer Matthew B. , Said Maria A. , Gebhardt Marette , Dyer Laurie P. , Maurer Wendy , Wikswo Mary E. , Mirza Sara A.
Published: April 2024

Introduction

From April 1 to May 31, 2022, Grand Canyon National Park received increased acute gastroenteritis reports. Pooled portable toilet specimens identified norovirus genogroups I and II. We sought to determine outbreak transmission contributors and individual risk factors while rafting or backpacking in the park.

Methods

Grand Canyon rafters and backpackers were surveyed online from June 13–July 8, 2022, and a Cox proportional hazards model was used to identify predictors associated with illness and adjusted for potential confounding factors.

Results

Among 762 surveys, 119 cases and 505 well persons submitted complete survey data. Illness among rafters was associated with interaction with ill persons during the trip (adjusted hazard ratio [adjHR] = 3.4 [95%CI 2.3–5.0]) and lack of any hand hygiene (1.2 [0.7–1.9]) or use of only sanitizer or water (1.6 [1.04–2.6]) before snacks. Younger rafters had higher illness rates compared to those ≥60 y (1.5 [1.2–1.8] for ages 40–59 and 2.2 [1.4–3.5] for ages <40 y).

Conclusions

Person-to-person transmission likely accounted for the widespread outbreak. Future outbreak mitigation efforts on river trips could focus on symptom screening before the trip starts, prompt separation of ill and well passengers, strict adherence to hand hygiene with soap and water, minimizing social interactions among rafting groups, and widespread outbreak notices and education to all park users.
Local Autonomy in Education Finance in a Mixed Economy: The Case of Vietnam
Authors: Nguyen-Hoang Phuong
Published: April 2024

Allocation mechanisms are crucial to shaping the effectiveness of a country's school finance system. In Vietnam, local authorities make their own decisions about allocating operating resources for pretertiary education. Despite this high level of control, there is a lack of comprehensive studies on how Vietnamese provinces allocate resources for their schools. This study aims to fill this gap by examining official legal documents from Vietnamese provinces, focusing on the allocation of operating funds to P-12 schools. The findings reveal significant variations in resource allocation across operating purposes (salary vs. nonsalary), grade levels, methods of accounting for scale economies, and different student subgroups, including those who are socio-economically disadvantaged students, gifted students, and with disabilities.
A Framework for Detecting Both Main Effect and Interactive DIF in Multidimensional Forced-Choice Assessments
Authors: Liu Kai , Zheng Yi , Wang Daxun , Cai Yan , Shi Yuanyuan , Xi Chongqin , Tu Dongbo
Published: April 2024

In recent decades, multidimensional forced-choice (MFC) tests have gained widespread popularity in organizational settings due to their effectiveness in reducing response biases. Detecting differential item functioning (DIF) is crucial in developing MFC tests, as it relates to test fairness and validity. However, existing methods appear insufficient for detecting DIF induced by the interaction between multiple covariates. Furthermore, for multi-category, ordered or continuous covariates, existing approaches often dichotomize them using a-priori cutoffs, commonly using the median of the covariates. This may lead to information loss and reduced power in detecting MFC DIF. To address these limitations, we propose a method to identify both main effect DIF and interactive DIF. This method can automatically search for the optimal cutoffs for ordered or continuous covariates without pre-defined cutoffs. We introduce the rationale behind the proposed method and evaluate its performance through three Monte Carlo simulation studies. Results demonstrate that the proposed method effectively identifies various DIF forms in MFC tests, thereby increasing detection power. Finally, we provide an empirical application to illustrate the practical applicability of the proposed method.
Reintroducing the “Tough Black Man” and Its Socio-Demographic, Race-Related, and Psychological Correlates
Authors: James Drexler
Published: April 2024

The “tough Black man” is expected to be physically strong, emotionally restrictive, resilient, and self-reliant. However, to date, limited research has examined the correlates of endorsing beliefs about the “tough Black man” among Black U.S. American men. To address this gap, this research examines the sociodemographic (i.e., age, sexual identity, income, education, and relationship status), race-related (i.e., racial identity, internalized racism, everyday discrimination, and race stigma consciousness), and psychological (i.e., self-esteem, locus of control, resilience, and depression symptoms) correlates of endorsing “tough Black man” beliefs in an internet-obtained sample of 329 Black U.S. American men (Mean age = 37.22). Multiple regression analysis showed that a more positive racial identity, greater internalized racism, and higher race stigma consciousness—but not everyday discrimination experiences—were associated with greater endorsement of “tough Black man” beliefs. Multivariate regression results showed that greater endorsement of “tough Black man” beliefs was associated with greater resilience, greater internal locus of control, and more depression symptoms, but not self-esteem. Last, exploratory findings showed that endorsing beliefs about the “tough Black man” did not vary by age, income, education, relationship status, or sexual identity. This study has implications for understanding Black masculinities, along with the psycho-social and psychological correlates of internalizing intersecting race and gender stereotypes among Black U.S. American men. Together, our research provides the opportunity to expand knowledge about how internalized stigma processes, beliefs about Black manhood, and the social-structural factors that might explain it, contribute to poor health among Black U.S. American men.
Late-onset Kjellin syndrome: Diagnosis of SPG11 on fundus examination
Authors: Brock Vincent , Wissocq Anna , Geoffre Nicolas , Marks Caroline , Canel Vincent , Huin Vincent , Smirnov Vasily M
Published: April 2024

Introduction

Spastic paraplegia (SPG) is a heterogenous group of neurodegenerative disorders, that may include ocular involvement. Here we report the clinical data of a patient with late-onset Kjellin syndrome, a peculiar form of hereditary SPG with macular dystrophy.

Materials and Methods

Clinical, functional and multimodal retinal imaging data were collected. Genetic testing was performed by Whole Exome Sequencing (WES).

Results

A 52-year-old female patient with SPG of unknown origin was referred for a progressive visual acuity loss. Multimodal fundus imaging revealed a peculiar macular dystrophy. Given the specific association of macular dystrophy and SPG, a Kjellin syndrome was suspected and genetic testing performed. WES revealed biallelic pathogenic variants in SPG11, co-segregating with disease in the family.

Conclusion

Careful ophthalmological examination prompted the diagnosis and guided molecular testing. This case underlines the importance of a neuro-ophthalmologic assessment in patients with SPG.
Case report: Introduction of an Ahmed valve implant tube into the ciliary sulcus using a guide-wire
Authors: Leite João , Figueiredo Ana , Reis Rita , Sampaio Isabel , Menéres Maria João
Published: April 2024

Background

Glaucoma is a progressive optic neuropathy and it is the main cause of irreversible blindness worldwide. Intraocular pressure (IOP) is the only modifiable one and trabeculectomy is commonly considered the surgical “gold standard” to decrease IOP. In particular cases, other kind of surgeries, as the Ahmed Glaucoma Valve (AGV) implant, are a reliable alternative. Usually, the silicone tube of AGV surgery is inserted into the anterior chamber. Sometimes it is necessary to place the AGV silicone tube in the ciliary sulcus, especially in cases of endothelial decompensation. This surgical procedure is not always easy to perform.

Case presentation

This article describes and presents a technique for inserting the AGV tube into the posterior chamber using a guide-wire, in a total of 12 cases are reported. This procedure has been mostly applied in a group of pseudophakic patients who need AGV placement to control elevated IOP. In exceptional situations, this procedure was applied in pseudophakic patients previously with AGV tube implanted in the anterior chamber and with loss of endothelial cells or in phakic patients with previously implanted AGV anterior chamber tube, simultaneously to cataract surgery.

Conclusion

The purpose of these cases presentations attended at our service is to demonstrate the passage of the AGV silicone tube was performed with the aid of a guide wire.