bluuebunny/crossref_metadata_2025 huggingface dataset:
Printed Circuit Board Defect Detection Algorithm Based on yolov5s Structure Improvement
Authors: Guo Rui-Qiang , Zhang Ya-Pin , Hu Jing-Qi , Ji Pei-Yong , Li Min
Published: April 2024

In terms of the existing PCB defect detection algorithm in complicated model structure with huge numbers of parameters slow speed, low detection accuracy and other problems, an improved PCB defect detection algorithm which is based upon yolov5s is proposed. Taking the yolov5s model
as the main framework, the Omni-Dimensional Dynamic Convolution (OdConv) structure is used to replace the backbone of the original model, and the Convolutional Block Attention Module (CBAM) attention mechanism is introduced after the Conv layer of the Neck network. CBAM attention mechanism
is brought in after the Conv layer of the Neck network (Neck), and the Focal-EIoU Loss function is modified by the Complete Intersection and Merger Ratio Loss (CIoU Loss) function, and different weights are assigned to high-quality samples and low-quality samples respectively, which solves
sample imbalance existing in the target detection problem, and the results show that this algorithm is comparable to the original model. Experiments are conducted and the results show that this paper’s algorithm improves the mAP by 1.9%, speeds up by 47.75Fps, decrease the model size
by 13.26 M, and reduces the computation volume by 12.3 G compared to yolov5s at IoU = 0.5.
Real-Time Detection Method for Saturation Speed of Air-Core Coil Current Transformer
Authors: Shi Guang , Chen Nian , Jiang Baolan
Published: April 2024

Traditional methods generally rely on a fixed threshold to determine whether the current transformer is saturated. However, this threshold based judgment method is difficult to adapt to different working conditions and changes in current waveforms. In view of the different characteristics
of current transformer and the diversity of working environment, it may not be accurate to judge its saturation state only by relying on a fixed threshold. In order to improve the efficiency of current transformer speed saturation detection and reduce the error, a new type of air core coil
current transformer speed saturation real-time detection method is proposed. Based on the working and current characteristics of the fast saturation current transformer, the discrete Fourier algorithm is used to suppress power frequency interference signals, with the fundamental frequencies
set to 45 Hz and 55 Hz respectively, in order to separate the signal from power frequency interference and reduce the interference intensity of the power frequency interference signal; Identify all faults and saturation points, and extract effective data segments. The wavelet transform characteristics
of the secondary current waveform of current transformer in saturated and unsaturated states are deeply studied. By analyzing the changes of different operating conditions and current waveforms, more discriminant features are extracted by using the characteristics of wavelet transform, so
as to realize the real-time and accurate detection of saturation state. The results indicate that after adopting the proposed method, the highest accuracy of data segment extraction reached 97%; The maximum detection error is only 4%. The detection time is only 1.31 s. This indicates that
the proposed method improves the detection performance and is practical.
Characterization of Titanium Dioxide Thin Films Grown on Glass Substrate by Gasified-Thermal-Carrier-Assisted Evaporation Technique: Impact of Deposition Time
Authors: Mohammed Ali Mohammed Khalil
Published: April 2024

In this study, a gasified thermal carrier assisted vapor deposition technique has been used to deposit titanium dioxides thin films of 90, 270, and 480 nm, thicknesses on glass substrates at growth times of 1, 2, and, 3 hours respectively. Varied nondestructive techniques were employed
to investigate the impacts of deposition time on the structural, optical, and electrical properties of the TiO2 thin films. X-ray diffraction (XRD) showed that crystals of a polycrystalline nature were preferentially oriented along the (101) direction. The analysis of the chemical
composition of the films by energy-dispersive X-ray (EDX) spectroscopy demonstrated very pure TiO2 thin films that were free of contamination and impurities. The SEM images indicated that the TiO2 thin films were cluster forms, with increasing sizes of with the growth
times of 1, 2, and, 3 hours, and these times produced thicknesses of 90, 270, and 480 nm, respectively. The study of the optical properties using ultraviolet-visible (UV-Vis) spectroscopy revealed a thickness-inverse relationship between the films’ optical transmittance levels (from
92% to 78%) and their corresponding energy bandgaps. The electrical properties of the TiO2 films were analyzed via a Hall effect measurement system. The electrical resistivity levels of the films were highly correlated with the thicknesses of the films. The lowest value of electrical
resistivity for the highest thinness was 55×103Ω· cm. The films showed high densities of carriers, with concentrations of 85×1012 to 35×1013 N (cm−3), and sufficiently low shift resistance levels. According to
the obtained results, three hours, which led to the growth of a 270 nm thickness, could be considered as the ideal deposition time for TiO2 thin films for solar cell applications.
Back on the Streets: Examining Emergency Department Return Rates for Unhoused Patients Discharged After Trauma
Authors: Park Stephen , Kim Sean , Kim Hye Kwang , Tabarsi Emiliano , Hom Brian , Gallagher Shea , Ugarte Chaiss , Clark Damon , Schellenberg Morgan , Martin Matthew , Inaba Kenji , Matsushima Kazuhide
Published: April 2024

Background

The unhoused population is at high risk for traumatic injuries and faces unique challenges in accessing follow-up care. However, there is scarce data regarding differences in Emergency Department (ED) return rates and reasons for return between unhoused and housed patients.

Methods

We conducted a 3-year retrospective cohort study at a level-1 trauma center in a large metropolitan area. All patients who presented to the ED with traumatic injuries and were discharged without hospital admission were included in the study. The primary outcome was ED returns for trauma-related complications or new traumatic events <6 months after discharge. Patient characteristics and study outcomes were compared between housed and unhoused groups.

Results

A total of 4184 patients were identified, of which 20.3% were unhoused. Compared to housed, unhoused patients were more likely to return to the ED (18.8% vs 13.9%, P < .001), more likely to return for trauma-related complications (4.6% vs 3.1%, P = .045), more likely to return with new trauma (7.1% vs 2.8%, P < .001), and less likely to return for scheduled wound checks (2.5% vs 4.3%, P = .012). Of the patients who returned with trauma-related complications, unhoused patients had a higher proportion of wound infection (20.5% vs 5.7%, P = .008). In the regression analysis, unhoused status was associated with increased odds of ED return with new trauma and decreased odds of return for scheduled wound checks.

Conclusions

This study observed significant disparities between unhoused and housed patients after trauma. Our results suggest that inadequate follow-up in unhoused patients may contribute to further ED return.
Emergency Surgical Treatment and Triage: Targeting Optimal Outcomes for Emergency Surgical Patients From Index Encounter Through Definitive Care
Authors: Kliewer Jaclyn , Luque Ilko , Javier Mariel A. , Moorefield Amanda , Mendez Hector , Martinez Zulmari , Oster Jacob , Rangel Alexis , Morejón Orlando
Published: April 2024

Background

Patients with emergency surgical conditions (ESCs) experience higher complication rates than those without emergency conditions. Our purpose was to improve time-based key performance indicators (KPIs) of care for ESC patients, including diagnostic workup, empiric stabilization, and referral to definitive care.

Methods

A rapid response program (ESTAT) was developed to screen for and coordinate optimal, timely care for a spectrum of high-risk ESCs, from the patient’s index clinical encounter up to definitive care. The Mann-Whitney test assessed whether any differences in KPIs were statistically significant ( P < .05) before compared to after the implementation of ESTAT.

Results

98 patients were identified: 44 in ESTAT group (70% age ≥55, 57% male); 54 in control group (57% age ≥55, 44% male). There were significant decreases from time of index clinical encounter to resuscitation (5 min. vs 34 min., P < .001), to diagnostic imaging (52 min. vs 1 hr. 19 min., P = .004), and to definitive care (2 hr. 17 min. vs 3 hr. 51 min., P = .007) in the ESTAT group compared to the control group, respectively.

Discussion

Improving time-based KPIs for delivery of clinical services is a common goal of medical emergency response systems (MERS) in numerous specialties. Implementation of an ESTAT program provides a screening tool for at-risk patients and reduces time to stabilize, diagnose and triage to definitive surgical intervention. These time benefits may ultimately translate to reduced complication rates for ESC patients. ESTAT may also represent a patient onboarding mechanism for surgical specialty verification programs promoted by quality improvement committees of various professional societies.
Effects of a Math Single-Case Intervention on Word Problem-Solving in Students With Learning Disabilities and Emotional and Behavioral Disorders
Authors: Barwasser Anne , Schulze Sarah , Gieseler Chiara , Grünke Matthias
Published: April 2024

Word problem-solving is one major area in mathematics that has been identified as being particularly challenging for students, specifically for those with learning disabilities (LDs) and emotional and behavioral disorders (EBD). This study aims at evaluating the effects of a strategic math intervention with concept maps on the ability to solve word problems (addition and subtraction problems, number range of thousand) among students with LDs and EBD from the eighth grade. A multiple-baseline design across participants ( N = 9) was applied to evaluate the intervention, which was held three times a week over a 6-week period. Overall, the results demonstrated a functional relation between the amount of correctly solved word problem tasks and the intervention. All nine students improved in word problem-solving, as evidenced by the fact that more tasks were solved, with a higher score in the intervention phase compared with the baseline (between-case standardized mean difference was 1.84; 95% confidence interval [1.24, 2.44]). The social validity data display that all students found the intervention helpful but also partly exhausting. The limitations and implications of this study are discussed.
Ballistic behaviour of hybride carbon/basalt fiber reinforced epoxy-hBN composite
Authors: Bakal Gumus Fatma , Yapici Ahmet
Published: April 2024

Ballistic behaviours of hybrid composite armors were investigated through experiments. The effects of hexagonal boron nitride (h-BN) nanopowders and number of layers on ballistic performance were examined. Four types of armors were manufactured by hand lay-up and vacuum bagging technique: 60 layers of fabric (30 layers carbon and 30 layers basalt fabrics) with 0% h-BN (1-A) and 1% h-BN (1-B), also 100 layers of fabric (50 layers carbon and 50 layers basalt fabrics) with 0% h-BN (2-A) and 1% h-BN (2-B) with epoxy resin. Ballistic impact tests were performed on the armors using a 9 mm full metal jacket projectile. The densities of the ballistic plates are 1.53, 1.56, 1.61 and 1.65 respectively. After three shots to each plate, the average hole depths were 5.55 mm on the 1-A coded plate, 4.34 mm on the 1-B armor, 4.68 mm on the 2-A plate, and 4.69 mm on the 2-B armor. All of the armors were able to confront for the velocities between [Formula: see text] m/s successfully. However, the h-BN showed a significant influence on the overall ballistic performance of composite armors. It has been found that the penetration depth decreases with the addition of h-BN. Also SEM-EDS mapping and XRD analysis were used to characterize the hybrid composites.
Evaluating English-language morphological awareness assessments
Authors: Hudson Kam Carla L. , Sadlier-Brown Emily , Clark Shannon , Jang Chelsea , Demmans Epp Carrie , Thomson Jenny
Published: April 2024

Many studies have shown that morphological knowledge has effects on reading comprehension separate from other aspects of language knowledge. This has implications for reading instruction and assessment: it suggests that children could have reading comprehension difficulties that are due to a lack of morphological knowledge, and thus, that explicit instruction of morphology might be helpful for them, indeed for all children. To find children who might especially benefit from specific instruction in morphology, we would need good tests of morphological knowledge. We evaluated a set of morphological awareness assessments to determine whether they conclusively tapped into morphological knowledge, and found that it was not possible to be certain that they were accurately targeting morphological knowledge.
Performance analysis of ARIMA Model for wind speed forecasting in Jerusalem, Palestine
Authors: Alsamamra Husain R. , Salah Saeed , Shoqeir Jawad H.
Published: April 2024

Palestine lacks sufficient conventional energy sources that meet the daily needs of the Palestinian people, and consequently, it heavily relies on neighboring countries for its supply with energy compensations. Wind energy is recognized as an abundant, effective, and eco-friendly power source, but it poses several challenges in harnessing due to the inherent variability of wind characteristics. The main objective of this research study is to delve into the wind energy landscape in Palestine, and to offer some insights into the feasibility of wind speed forecasting for implementing sustainable energy solutions, with a special focus on ARIMA; a widely used statistical method for time series forecasting. It specifically explores the potential of using ARIMA models to forecast wind speed using a data captured from a meteorological station located in east Jerusalem, Palestine for a duration of 2 years—January 1, 2021 to December 31, 2022. To find the optimal values of ARIMA parameters (p, d, q) for the considered study site, a set of experiments were conducted and the model's forecasting accuracy was evaluated using three metrics: RMSE, MAE, and the coefficient of determination (R2). The results have shown that ARIMA (21,2) emerges as the most accurate structure with an input period that demonstrates superior estimation with minimal RMSE (1.74), minimal MAE (1.58) and higher R2 (0.76) values. This means that the optimal estimation is achieved when an autoregressive process is based on the previous two lagged observations and the moving average process incorporates the dependency between the observation and the residual error from a second-order moving average applied to the lagged observations. These findings give valuable insights into the feasibility and precision of wind speed forecasting models for sustainable energy solutions, and emphasize the potential for harnessing wind energy in the region as clarified by ARIMA forecasting accuracy.
Fostering university-public administration links through local case studies in executive education
Authors: Vegi da Conceição Marcelo , Beja Manuel , Mamede Ricardo Paes
Published: April 2024

The gap between public managers and academics has long been a topic of discussion in the field of public affairs. This article presents a successful strategy to bridge this gap: the creation and use of local case studies in executive education for Portuguese public managers. We found that the creation process, which included interviews with practitioners, allowed them to reflect on their work from the framework of academic theories. As for the use of cases in the classroom, the local aspect of the case studies - set in Portuguese institutions, and shaped by the local values, mores, and norms - fostered the appropriation of the subject matter and enhanced the sharing of experiences and ideas, combining academic theory with tacit knowledge from the field. We discuss examples of the observed benefits, as well as the challenges and possibilities of replicating the strategy in other contexts.
Test Security and the Pandemic: Comparison of Test Center and Online Proctor Delivery Modalities
Authors: Becker Kirk A. , Liu Jinghua , Jones Paul E.
Published: April 2024

Published information is limited regarding the security of testing programs, and even less on the relative security of different testing modalities: in-person at test centers (TC) versus remote online proctored (OP) testing. This article begins by examining indicators of test security violations across a wide range of programs in professional, admissions, and IT fields. We look at high levels of response overlap as a potential indicator of collusion to cheat on the exam and compare rates by modality and between test center types. Next, we scrutinize indicators of potential test security violations for a single large testing program over the course of 14 months, during which the program went from exclusively in-person TC testing to a mix of OP and TC testing. Test security indicators include high response overlap, large numbers of fast correct responses, large numbers of slow correct responses, large test-retest score gains, unusually fast response times for passing candidates, and measures of differential person functioning. These indicators are examined and compared prior to and after the introduction of OP testing. In addition, test-retest modality is examined for candidates who fail and retest subsequent to the introduction of OP testing, with special attention paid to test takers who change modality between the initial attempt and the retest. These data allow us to understand whether indications of content exposure increase with the introduction of OP testing, and whether testing modalities affect potential score increase in a similar way.
Perceived Spousal Support and Activities of Daily Living in Individuals With COPD
Authors: Efil Sevda , Kalkan Ugurlu Yasemin , Akça Doğan Derya , Budak Dilek
Published: April 2024

Background:

The relationship between perceived spousal support and activities of daily living in patients with chronic obstructive pulmonary disease (COPD) is unclear.

Purpose:

The aim of this study was to explore the relationship between spousal support perceived by those with COPD and their activities of daily living.

Methods:

This study was a cross-sectional and descriptive study. Data collection was conducted between September 2022 and April 2023. A Data Gathering Form, the Spousal Support Scale, and the London Chest Activity of Daily Living Scale were used to collect data. A total of 132 adults were included in this study.

Results:

The mean (SD) scores of individuals with COPD for perceived spousal support and activities of daily living were 62.40 (14.66) and 32.91 (15.72), respectively. Levels of perceived spousal support and activities of daily living varied according to sex, employment status, admission to the emergency service or hospitalization, use of antidepressants, and the severity of the illness ( P < .05). Those with better spousal support felt less dyspnea when performing the activities of daily living ( r = −0.205, P < .05).

Conclusions:

Knowing the potential factors affecting perceived spousal support and activities of daily living can provide an opportunity to determine appropriate strategies to increase the level of independence of individuals with COPD. Educational interventions to help spouses understand COPD may help increase spousal support.
Unraveling the interplay of emotions in art and music: An event-related potential investigation
Authors: De Benedetto Francesco , Ghiraldini Eleonora , Capizzi Nausicaa , Proverbio Alice Mado
Published: April 2024

The study examined the impact of music’s emotional content on the aesthetic experience of visual artworks during combined stimulation. The hypothesis posited that incongruity of emotional states induced by music would impede accurate comprehension of emotional aspect of artworks. A total of 18 university students were presented with 192 paintings and 20 emotionally congruent or incongruent musical excerpts. Both paintings and music were validated as belonging to four emotional categories with different valence (positive vs negative) and arousal (high vs low). ERP data showed that visual N170 and auditory N400 were modulated by stimuli emotional valence and that negative visual stimuli attracted more attention than positive ones (larger P300). The multimodal LP was modulated by the stimulus emotional congruence, with larger responses to positive than negative congruent pairs. During multimodal artistic simulation, the most active brain areas were the left middle frontal gyrus, superior frontal gyrus, right precuneus, and right middle temporal gyrus. Taken together, these results suggest that visual stimuli with negative valence attract more attention than positive ones and that congruent pairs are more pleasant than incongruent. Also, these findings suggest that the neural basis of the emergence of aesthetic sensations may be similar for both auditory and visual emotional processing.
Equivocal diagnostics: Making a ‘good’ point-of-care test for elimination in global health
Authors: Street Alice , Taylor Emma Michelle
Published: April 2024

What is a diagnostic test for? We might assume the answer to this question is straightforward. A good test would help identify what disease someone suffers from, assist health providers to determine the correct course of treatment and/or enable public health authorities to know and intervene in health at the level of the population. In this article, we show that what a specific diagnostic test is for, the value it holds for different actors, and what makes it good, or not, is often far from settled. We tell the story of the development and design of a rapid antibody test for onchocerciasis, or river blindness, tracking multiple iterations of the device through three configurational moments in the framing of onchocerciasis disease and reshaping of the global health innovation ecosystem. Efforts to build that ecosystem for diagnostics are often premised on the notion that public health needs for diagnostics are pre-given and stable; the challenge is seen to be how to incentivize investment and find a customer base for diagnostics in under-resourced settings. By contrast, we show that for any disease, diagnostic needs are both multiple and constantly in flux, and are unlikely to be met by a single, stand-alone product. In the case of the onchocerciasis Ov-16 rapid test, the failure to recognize and address the multiplicity and instability of diagnostic needs in the innovation process resulted in the development of a rapid point of care test that might be manufactured, procured and used, but is unloved by public health experts and commercial manufacturers alike. The equivocal value of the onchocerciasis rapid test, we suggest, reveals the inadequacy of the current global health innovation ecosystem for developing diagnostic ‘goods’.
Return to Sports in Patients Aged 50 Years or Younger After Robotic-Assisted Patellofemoral Arthroplasty: A 10-Year Experience Reporting High Clinical Benefits and High Patient Satisfaction With Return to an Active Lifestyle
Authors: Noyes Frank R. , Fleckenstein Cassie M. , Nolan Joseph
Published: April 2024

Background:

Limited data are available on return to sports and patient psychometric ratings of success after patellofemoral arthroplasty (PFA) in younger patients with high expectations to return to an active lifestyle.

Purpose/Hypothesis:

The purpose of this article was to determine the role of PFA and its success in meeting patient expectations regarding the return to low-impact recreational sports and an active lifestyle in younger, active patients. It was hypothesized that PFA would allow younger patients to return to low-impact sports and an active lifestyle and achieve high patient psychometric ratings.

Study Design:

Case series; Level of evidence, 4.

Methods:

In this 10-year prospective study (2009-2018), robotic-assisted PFA was performed on 44 patients (32 women and 12 men; n = 51 consecutive knees), with a mean age of 37.2 years (range, 21-50 years). The follow-up rate was 98%, with a mean of 5.3 years (range, 2-9.3 years). Primary clinical outcomes were as follows: the validated Cincinnati Knee Rating System sports activity and symptom rating scales, patient psychometric ratings of the substantial clinical benefit (SCB), and the Patient Acceptable Symptom State (PASS). Secondary outcomes were the Cincinnati Knee Rating System occupational rating, visual analog pain scale, and the 12-Item Short Form Health Survey. Survivorship was defined by conversion to total knee replacement (TKR).

Results:

Before PFA, 78% of patients (35/45 knees) were symptomatic and unable to perform recreational sports, with only 20% of patients (9/45 knees) performing some low-impact sports. After PFA, 80% of patients (36/45 knees) were able to perform low-impact sports, and 7% (3/45 knees) performed jumping-pivoting sports ( P < .001). The SCB scored by the patient showed 87% of knees as good, very good, or normal. On the PASS analysis, 89% of patients (95% CI, 76%-96%) were “pleased,” and 93% (95% CI, 82%-99%) would undergo surgery again. There were clinically relevant improvements in symptoms of pain, swelling, and giving way ( P = .0001). Preoperatively, 91% of knees had moderate to severe pain with activities of daily living, and only 11% of knees had pain at the follow-up. Five of the 50 knees (10%) underwent TKR conversion with one patient lost to follow-up.

Conclusion:

PFA resulted in a high return of patients to low-impact sports with high SCB and PASS psychometric ratings. The robotic-assisted 3-dimensional preoperative planning allowed precise intraoperative trochlear implant alignment in knees with severe trochlear dysplasia. PFA is recommended as an alternative treatment in younger patients with end-stage symptomatic patellofemoral arthritis.

Registration:

NCT02738476 (ClinicalTrials.gov identifier).
Assessment of Frailty Among Older Adults in the Physical Activity Daily Trial
Authors: Jones Raymond , Enogela Ene M. , Zumbro Emily L. , Soukhamneut Phonchit , Richardson Caroline R. , Buford Thomas W. , Jackson Elizabeth A.
Published: April 2024

Frailty is common among cardiac patients; however, frailty assessment data from patients with peripheral arterial disease (PAD) are limited. The purpose of this observational study was to identify the prevalence and factors related to frailty in addition to unique frailty marker groupings in a cohort of sedentary adults with PAD. We grouped three PAD-relevant frailty characteristics using Fried’s frailty phenotype −1) exhaustion, (2) weakness, and (3) slowness—and observed the prevalence of pre-frailty (1–2 characteristics) and frailty (3 characteristics) in the PAD cohort. Of the 106 participants, 34.9% were robust/non-frail, 53.8% were pre-frail, and 2.8% were frail. Exhaustion (33.3%) was the most occurring characteristic followed by weakness (20.0%) and slowness (5.0%). The grouping of weakness + slowness (10.0%) was the most prevalent followed by exhaustion + weakness (8.3%) and exhaustion + slowness (5.0%). Among pre-frail participants, ankle brachial index was correlated with a reduction in gait speed.
Computational analysis of erosion wear on unbounded flexible pipe of different curvature angles
Authors: Ananya Latchupatula , Patel Vivek Kumar
Published: April 2024

For industries using multi-phase transportation pipelines, erosion has been identified as one of the main challenges. Thus, extensive experimental and computational studies on slurry erosion wear have been conducted already for smooth pipes, particularly bends and junctions which were more susceptible to erosion wear because of the flow of multi-phase, but findings of erosive wear rate on the unbounded flexible pipe are not yet established. The purpose of the current study is to examine the effects of slurry wear on the unbounded flexible pipe material using CFD analysis when multi-phase fluid is flowing in the UFP at different curvature angles (30°, 50°, 70°, 90°). Flow speed (2 ms−1, 4 ms−1, 6 ms−1, 8 ms−1, 10 ms−1) and concentration (5%, 10%, 15%) were the key variables taken into account, and is discovered that these characteristics had a substantial effect on the flexible pipe. Further, to analyze how particle collision tendency affects the erosion wear rate of UPF when compared to smooth pipe, the streamlines for the UFP and smooth pipe are extracted.
Wild lagomorphs as potential sources of Francisella tularensis in an urban zoo: a case study
Authors: Maddock Kelli J. , Rickey Caitlin V. , Pecoraro Heidi L.
Published: April 2024

A 9-y-old captive male Pallas’ cat ( Otocolobus manul) had a 1-mo history of worsening lameness and was euthanized. The animal was submitted to the North Dakota State University–Veterinary Diagnostic Laboratory for autopsy with differential diagnoses of suspected degenerative joint disease or neoplasia. Autopsy revealed icteric tissues and pinpoint foci in the liver, spleen, and all lung lobes. PCR testing was positive for Francisella tularensis, the causative agent of tularemia. Additional cases of tularemia were later identified in wild eastern cottontail rabbits found dead at the same urban zoo. Tularemia has been reported in captive non-human primates and rodent populations with one case linked to wild lagomorph exposure, which was likely the route of exposure in our Pallas’ cat case. Tularemia is an occupational risk for zoo staff and laboratorians. Pest management and disease surveillance of wild lagomorph populations in zoos are important preventive measures.
The Devil in the Details: Changes Under Stable Trends of Femicide in Italy During COVID-19 Lockdowns
Authors: Cocco Edoardo , Rigoni Clara , Bolzani Federico , Hashimoto Yuji Z. , Caneppele Stefano
Published: April 2024

In recent decades, the issue of violence against women has increasingly drawn the attention of international and national legislators and policymakers. The term “femicide” became widespread in the early 2000s and was incorporated into the criminal codes of several countries. The onset of the COVID-19 pandemic and the subsequent social distancing measures raised significant concerns about their impact on women’s safety. This study examines the effect of COVID-19 confinement measures on femicide trends in Italy, a country which adopted stringent COVID-19 confinement measures and, since 2019, implemented new legislation to counteract violence against women. Using two data sets—one from the Italian Ministry of Interior containing 1,382 cases of female homicides (2013–2022) and another from Italian NGOs detailing 1,253 femicides according to media coverage (2012–2022)—the study employs autoregressive integrated moving average (ARIMA) analysis to assess monthly trends alongside the stringency index for COVID-19 containment efforts. The findings reveal that, although overall femicide rates remained stable during lockdowns, there was a significant shift in victim–perpetrator relationships. Specifically, from March to May 2020, there was a decline in femicides by former partners, offset by an increase in those by cohabiting partners. These results underscore the complexity of femicide and the need for further research on various facets of violence against women. This includes the potential escalation of physical and psychological violence during lockdowns, influenced by forced proximity and substance abuse in domestic environments.
Autonomous artificial intelligence versus teleophthalmology for diabetic retinopathy
Authors: Musetti Donatella , Cutolo Carlo Alberto , Bonetto Monica , Giacomini Mauro , Maggi Davide , Viviani Giorgio Luciano , Gandin Ilaria , Traverso Carlo Enrico , Nicolò Massimo
Published: April 2024

Purpose: To assess the role of artificial intelligence (AI) based automated software for detection of Diabetic Retinopathy (DR) compared with the evaluation of digital retinography by two double masked retina specialists. Methods: Two-hundred one patients (mean age 65 ± 13 years) with type 1 diabetes mellitus or type 2 diabetes mellitus were included. All patients were undergoing a retinography and spectral domain optical coherence tomography (SD-OCT, DRI 3D OCT-2000, Topcon) of the macula. The retinal photographs were graded using two validated AI DR screening software (Eye Art TM and IDx-DR) designed to identify more than mild DR. Results: Retinal images of 201 patients were graded. DR (more than mild DR) was detected by the ophthalmologists in 38 (18.9%) patients and by the AI-algorithms in 36 patients (with 30 eyes diagnosed by both algorithms). Ungradable patients by the AI software were 13 (6.5%) and 16 (8%) for the Eye Art and IDx-DR, respectively. Both AI software strategies showed a high sensitivity and specificity for detecting any more than mild DR without showing any statistically significant difference between them. Conclusions: The comparison between the diagnosis provided by artificial intelligence based automated software and the reference clinical diagnosis showed that they can work at a level of sensitivity that is similar to that achieved by experts.
Fetal Sex as Moderating Factor for the Relationship Between Maternal Childhood Trauma and Salivary Kynurenic Acid and Tryptophan in Pregnancy: A Pilot Study
Authors: Pedraz-Petrozzi Bruno , Lamadé Eva Kathrin , Marszalek-Grabska Marta , Trzpil Alicja , Lindner Ole , Meininger Pascal , Fornal Emilia , Turski Waldemar A , Witt Stephanie H , Gilles Maria , Deuschle Michael
Published: April 2024

Traumatic experiences and fetal development influence tryptophan (TRP) and its neuroactive byproduct, kynurenic acid (KYNA). Maternal TRP metabolite levels during pregnancy vary by fetal sex, with higher concentrations in mothers carrying male fetuses. This pilot study aimed to explore the relationship between offspring sex, maternal childhood trauma, and maternal salivary KYNA and TRP levels during pregnancy. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to determine KYNA and TRP levels in maternal saliva samples collected from 35 late-pregnancy participants. Maternal childhood trauma was assessed using the Childhood Trauma Questionnaire, including subscales for emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. Among mothers pregnant with boys, salivary KYNA significantly correlated with physical and emotional neglect, and salivary TRP with emotional neglect. No significant correlations were found in mothers who delivered female offspring. Significant associations of childhood trauma and offspring sex were found for salivary KYNA but not TRP concentrations. Mothers with higher trauma levels who delivered boys exhibited higher levels of salivary KYNA compared to those with lower trauma levels. Moreover, mothers with higher trauma levels who delivered boys had higher salivary KYNA levels than those with higher trauma levels who delivered girls. This pilot study provides evidence of an association between maternal childhood trauma and TRP metabolism, measured in saliva, especially in mothers pregnant with boys. However, longitudinal studies with larger sample sizes are required to confirm these results.
The legal framework for the production of alcohol for personal use within the European Union
Authors: Kilian Carolin , Braddick Fleur , Rehm Jürgen
Published: April 2024

Aim: This paper provides an overview of the legal framework for alcohol produced for personal use in European Union (EU) Member States. Methods: We reviewed the national excise duty legislations of EU Member States and conducted an online mapping survey, in which 10 alcohol experts from seven EU Member States plus Iceland participated. Results: We found that the production of alcohol for personal use is tax exempt in 12 jurisdictions, with four countries stipulating a maximum volume of alcohol that can be produced for personal use. The most common alcoholic beverages concerned were beer and wine, while only one country set a tax exemption for spirits. The results were complemented by the alcohol expert mapping survey; tax exemptions were reported for two additional Member States. Conclusion: Legal exemptions for the production of alcohol for personal use were established in every second EU Member State and may therefore contribute to the unrecorded consumption of alcohol in these countries. In light of the detrimental health effects of alcohol, economic interests to support the local small-scale production of alcohol have to be carefully evaluated against public health interests.
Loose bolt localization and torque prediction in a bolted joint using lamb waves and explainable artificial intelligence
Authors: Hu Muping , Yue Nan , Groves Roger M.
Published: April 2024

With the increasing application of artificial intelligence (AI) techniques in the field of structural health monitoring (SHM), there is a growing interest in explaining the decision-making of the black-box models in deep learning-based SHM methods. In this work, we take explainability a step further by using it to improve the performance of AI models. In this work, the results of explainable artificial intelligence (XAI) algorithms are used to reduce the input size of a one-dimensional convolutional neural network (1D-CNN), hence simplifying the CNN structure. To select the most accurate XAI algorithm for this purpose, we propose a new evaluation method, feature sensitivity (FS). Utilizing XAI and FS, a reduced dimension 1D-CNN regression model (FS-X1D-CNN) is proposed to locate and predict the torque of loose bolts in a 16-bolt connected aluminum plate under varying temperature conditions. The results were compared with 1D CNN with raw input vector (RI-1D-CNN) and deep autoencoders-1D-CNN (DAE-1D-CNN). It is shown that FS-X1D-CNN achieves the highest prediction accuracy with 5.95 mm in localization and 0.54 Nm in torque prediction, and converges 10 times faster than RI-1D-CNN and 15 times faster than DAE-1D-CNN, while only using a single lamb wave signal path.
Unveiling the Impact of Seizures While Driving: A Retrospective Cohort Study on Type, Frequency, and Consequences in People With Epilepsy Prior to Diagnosis
Authors: Milligan Tracey A.
Published: April 2024

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Weight Inclusive Thinking for Fitness Spaces (WIT FITS): A Three-Month Follow-Up of a Weight Stigma Intervention for Exercise Professionals
Authors: Lima Fogaca Janaina , Zuest Luciana , Lee Saemi , Squires Nikole , Clifford Dawn
Published: April 2024

Among the few interventions that exist to decrease weight stigma in exercise settings, none include a long-term follow-up to assess if changes are sustained. The aim of this study was to assess if a weight stigma intervention that showed success in improving fat attitudes among university recreation center professionals had sustained effects after three months, compared to a control group. Participants were 46 university recreation center professionals who took the Fat Attitudes Assessment Toolkit before completing a two-hour self-paced online intervention or control course, after course completion, and at a three-month follow-up. At follow-up, participants in the intervention group showed significant improvement in total fat attitudes, F(2, 88) = 7.94, p < .001, η2p = 0.15 and in fat acceptance, F(2, 88) = 4.25, p = .017, η2p = 0.09. Future studies should further develop interventions and assess results in larger samples and after longer periods of time.
Can Patients Rely on ChatGPT to Answer Hand Pathology–Related Medical Questions?
Authors: Jagiella-Lodise Olivia , Suh Nina , Zelenski Nicole A.
Published: April 2024

Background:

In recent years, ChatGPT has become a popular source of information online. Physicians need to be aware of the resources their patients are using to self-inform of their conditions. This study investigates physician-graded accuracy and completeness of ChatGPT regarding various questions patients are likely to ask the artificial intelligence (AI) system concerning common upper limb orthopedic conditions.

Methods:

ChatGPT 3.5 was interrogated concerning 5 common orthopedic hand conditions: carpal tunnel syndrome, Dupuytren contracture, De Quervain tenosynovitis, trigger finger, and carpal metacarpal arthritis. Questions evaluated conditions’ symptoms, pathology, management, surgical indications, recovery time, insurance coverage, and workers’ compensation possibility. Each topic had 12 to 15 questions and was established as its own ChatGPT conversation. All questions regarding the same diagnosis were presented to the AI, and its answers were recorded. Each question was then graded for both accuracy (Likert scale of 1-6) and completeness (Likert scale of 1-3) by 10 fellowship trained hand surgeons. Descriptive statistics were performed.

Results:

Overall, the mean accuracy score for ChatGPT’s answers to common orthopedic hand diagnoses was 4.83 out of 6 ± 0.95. The mean completeness of answers was 2 out of 3 ± 0.59.

Conclusions:

Easily accessible online AI such as ChatGPT is becoming more advanced and thus more reliable in its ability to answer common medical questions. Physicians can anticipate such online resources being mostly correct, however incomplete. Patients should beware of relying on such resources in isolation.
Effect of two-phase flow lubrication on sealing performance of spiral groove mechanical seal under high speed and low temperature conditions
Authors: Wang Jianlei , Lei Longsheng , Li Jianke , Liu Chenyang , Jia Qian , Fan Xingyu , Cui Yahui
Published: April 2024

The function of the turbo-pump shaft within the liquid rocket engine is rendered exceedingly complex due to the operation in an environment characterized by drastically low temperatures, elevated velocities, and high pressures. Given these operational conditions, it is highly plausible that a two-phase flow might form within the liquid film located on the terminal face of the mechanical seal. This liquid-vapor mixture significantly modifies the fluid lubrication pattern across the end faces and poses consequential implications on the overall sealing stability. In this study, the phase change characteristics of the fluid in the seal clearance were investigated based on the Laminar and Mixture multi-phase flow models in a spiral groove mechanical seal. The behaviors of two-phase flow characteristics and phase transition under extreme temperature, rotational speed and pressure with liquid nitrogen media were studied. The sealing performance was quantified through metrics including the leakage rate, opening force, and internal gas phase volume ratio. The findings offered valuable insights into the role of operational conditions in influencing the phase change of the liquid film. Moreover, we discerned and explicated the intricate interconnections between the leakage rate, the opening force, and the phase change behavior of the liquid film.
A case of hyponatraemia cured by delivery
Authors: Pavey Julian , Morton Adam
Published: April 2024

Hyponatraemia is the most common electrolyte abnormality in pregnancy. In severe cases, it can result in significant maternal and fetal morbidity and mortality. The prevalence of hyponatraemia in pregnancy has been estimated to be 0.27%, with the major causes being hyperemesis gravidarum in the first half and preeclampsia in the latter half of pregnancy. Pregnancy-specific causes of the syndrome of inappropriate antidiuretic hormone release include preeclampsia, prolonged labour, caesarean section, postpartum haemorrhage, cortisol deficiency and oxytocin. Excess water intake can also lead to hyponatraemia during labour, a period of excess antidiuretic hormone secretion. A case of idiopathic severe hyponatraemia with biochemistry consistent with inappropriate antidiuretic hormone secretion progressing during the third trimester with rapid spontaneous resolution post-partum is presented.
GP continuity: The keystone of general practice
Authors: Sidaway-Lee Kate , Pereira Gray Sir Denis , Khan Nada , Abraham Lispeth , Evans Philip
Published: April 2024

Continuity of care has long been recognised as a core feature of general practice. Relational continuity is associated with multiple, overlapping benefits for patients, doctors and society. Continuity increases trust, patient satisfaction and adherence to advice, while reducing hospital use and deaths. Repeated consultations are needed with a patient for a GP to acquire enough ‘accumulated knowledge’ to develop a sense of continuing responsibility. This fosters GP sensitivity and mutual understanding, which enable GPs to provide ‘higher-level’ quality of care. However, the level of continuity is reducing in UK general practice. This article provides the context of international research on continuity of care and describes ways to improve continuity.
Total hip replacement in a cat with contralateral pelvic limb amputation
Authors: Bourbos Alexandros , Piana Francesco , Langley-Hobbs Sorrel Judith
Published: April 2024

Case summary

A 10-year-old male neutered domestic shorthair cat, which had previously had its contralateral pelvic limb amputated, was treated for coxofemoral degenerative joint disease (DJD) with a total hip replacement. The long-term outcome was favourable and no complications were recorded. Interestingly, the contralateral coxofemoral joint left at the time of the previous amputation developed DJD and became a source of pain for the cat and was subsequently excised.

Relevance and novel information

This case report shows that total hip replacement is a viable option in cats with coxofemoral DJD and a contralateral limb amputation. Retained joints in amputated limbs may develop osteoarthritis and be a source of pain for a cat.
Critical success factors for creating sustainable digital health applications: A systematic review of the German case
Authors: Schramm Lukas , Carbon Claus-Christian
Published: April 2024

Objective

The Covid-19 pandemic has accelerated the adoption of digital technologies to address social needs, leading to increased investments in digital healthcare applications. Germany implemented a special law called the “Digitales Versorgungsgesetz” (DVG—Digital Supply Act) in 2019, which enables the reimbursement of digital health applications, including digital therapeutics (DTx), through a fast-track process. The Federal Institute for Drugs and Medical Devices (BfArM), the German federal authority responsible for overseeing digital health applications, has implemented legislative adjustments since the law's introduction, which have increased requirements for these applications and potentially led to the removal of some from the directory as well as a slowdown in the addition of new ones. To counteract this trend, this work aimed to identify key success factors for digital health applications (DiGAs).

Methods

This research identifies critical success factors through a structured literature review for developing sustainable digital health applications within the European healthcare systems, specifically DiGAs. The study aims to support the ongoing digital transformation in healthcare.

Results

The identified success factors that significantly impact the sustainability of DiGAs include patient-centered design, application effectiveness, user-friendliness, and adherence to data protection and information security regulations using standardized approaches. These factors are crucial in preventing the failure of DiGA manufacturers in European countries.

Conclusion

By considering and implementing these critical success factors, DiGA manufacturers can enhance their chances of long-term success and contribute to the digital transformation of the healthcare system in Europe.