bluuebunny/crossref_metadata_2025 huggingface dataset:
20-Year trends in the social participation of the oldest old
Authors: Augustsson Erika , Fors Stefan , Rehnberg Johan , Lennartsson Carin , Agahi Neda
Published: August 2024

Aims:

To investigate 20-year trends in social participation among the oldest old (77+ years) in Sweden and assess the extent to which changes in educational attainment and functional abilities explain these trends.

Methods:

Seven waves of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) spanning 2002–2021 were used with a repeated cross-sectional design. To analyse the association between time and social participation we employed the Karlson–Holm–Breen method of decomposition. The study focused on informal social participation (contact with friends and family), leisure participation (public or semi-public gatherings), and formal participation (organisational engagement and study circle attendance).

Results:

Both leisure and informal participation peaked in 2014 and declined in 2021, influenced by the COVID-19 pandemic, whereas formal participation showed a slight increase in 2021. Total participation increased at least until 2011. Overall, older adults have increased their levels of social participation in recent decades, disregarding the influence of the pandemic. Decomposition analysis revealed that population-level changes in educational attainment and functional abilities explained a substantial portion of the observed trends.

Conclusions:

As the proportion of older adults continues to rise, it becomes increasingly important to understand the developments and drivers of behavioural change in the older population. As more people are socially active, there may be increasing differences between those participating and those not – which could lead to increased inequalities. The observed trend in increasing participation, influenced by changes in education and health, emphasises the importance of fostering age-friendly environments and addressing potential social inequalities among older adults.
Using process model to define the legislative framework of electronic prescription in the Czech Republic
Authors: Berger Jiří , Bruthans Jan , Vojtěch Adam , Kofránek Jiří
Published: August 2024

Defining legislation for electronic prescription systems (EPS) is inherently challenging due to conflicting interests and requirements. The study aimed to develop a comprehensive EPS within the Czech healthcare framework, integrating legislative, process, and technical aspects to ensure security, user acceptability, and compliance with health regulations. A process modeling tool based on hierarchical state machines was employed to create a detailed process architecture for the EPS. Key participants, scenarios, and state transitions were identified and incorporated into a process model using the Craft.CASE based on the BORM methodology. The final process architecture model facilitated interdisciplinary communication and consensus-building among stakeholders, including healthcare professionals, IT specialists, and legislators. The model served as a foundation for the legislative framework and was included in the explanatory memorandum for the draft amendment to the Pharmaceuticals Act. The use of hierarchical state machines and process modeling tools in developing healthcare legislation effectively reduced misunderstandings and ensured precise implementation. This method can be applied to other complex legislative and system design projects, enhancing stakeholder communication and project success.
Improving the academic resilience of hospital nursing interns through a hybrid multi-criteria decision analysis model
Authors: Ye Mao , Xu Weifang , Feng Lili , Liu Siqi , Yang Jianhong , Chuang Yen-Ching , Tang Fuqin
Published: August 2024

Purpose: To identify the main variables affecting the academic adaptability of hospital nursing interns and key areas for improvement in preparing for future unpredictable epidemics. Methods: The importance of academic resilience-related variables for all nursing interns was analyzed using the random forest method, and key variables were further identified. An importance-performance analysis was used to identify the key improvement gaps regarding the academic resilience of nursing interns in the case hospital. Results: The random forest showed that five items related to cooperation, motivation, confidence, communication, and difficulty with coping were the main variables impacting the academic resilience of nursing interns. Moreover, the importance-performance analysis revealed that three items regarding options examination, communication, and confidence were the key improvement areas for participating nursing interns in the case hospital. Conclusions: For the prevention and control of future unpredictable pandemics, hospital nursing departments can strengthen the link between interns, nurses, and physicians and promote their cooperation and communication during clinical practice. At the same time, an application can be created considering the results of this study and combined with machine learning methods for more in-depth research. These will improve the academic resilience of nursing interns during the routine management of pandemics within hospitals.
An approximation technique for solving anti-symmetric constant force and anti-symmetric quadratic nonlinear oscillators
Authors: Huq Md Ashraful , Hasan M Kamrul , Alam MS
Published: August 2024

Earlier, an approximation technique was presented for solving strong nonlinear oscillator equations. Due to arising algebraic complexities, the method fails to determine suitable solutions of some nonlinear oscillators such as quadratic oscillators, the cubical Duffing oscillator of softening springs, and pendulum equations. Then, rearranging an algebraic equation related to amplitude and frequency, the method covers the noted problems. In this article, the latter technique is applied to handling anti-symmetric constant force oscillators and anti-symmetric quadratic nonlinear oscillators.
How is joint laughter ‘pre’ to advice-giving: A sequential pattern that centralizes trouble in student supervision
Authors: Jian Zhiying
Published: August 2024

This conversation analytic study identifies a sequential pattern, where the construction of laughable is succeeded by joint laughter between students and supervisors, and is used to anticipate the exposure of trouble and advice-giving. Drawing from authentic supervision meetings in UK institutions, this study identifies key features that appeal joint laughter: (1) students’ disaligment with formal supervisory questions and (2) supervisors’ disruption of students’ consistency of talk to point out something problematic. Both warranting further unpacking, these two types of interactional trouble make the activity of advice-giving relevant. This study not only contributes to the properties of laughable, but also to the sequential environmental prerequisites for advice-giving in supervision interaction.
Fisher embedding shift-invariant dictionary learning for weak feature recognition in bearing health monitoring
Authors: Zhang Xin , Wu Lei , Long Hao , Yang Tao , Shi Haiyang , Yang Laihao
Published: August 2024

Dictionary learning has gained widespread attention in weak feature recognition for bearing health monitoring due to its advantages of possessing fewer parameters, simple and efficient algorithms, and strong interpretability. However, conventional methods often fail to fully utilize the interclass and intraclass characteristics of dictionary atoms and do not take into account the shift-invariance of the dictionary, which in turn limits their performance. To address these challenges, a new method named Fisher embedding shift-invariant dictionary learning (FESIDL) is proposed in article. Specifically, Fisher constraints are imposed on both atoms and coding coefficients to promote their discriminability, and the dictionary optimization is designed based on singular value decomposition to make the learned dictionary shift-invariant and more discriminative. Finally, FESIDL simultaneously utilizes the reconstruction error and coding coefficient vector as classification criteria to ensure a high classification accuracy. Two experiments are conducted, and the results demonstrate the effectiveness and stability of the proposed method for weak feature recognition in bearing health monitoring when compared to several advanced methods in the field.
Co-Kriging strategy for structural health monitoring of bridges
Authors: Novais Henrique Cordeiro , da Silva Samuel , Figueiredo Eloi
Published: August 2024

Computational models are crucial in applied science and engineering, offering valuable insights on the behavior of strutures and mechanical systems. However, their effectiveness is often hindered by complexity and substantial time required for execution. Metamodeling, or surrogate modeling, is a practical strategy to optimize computational time and resources. This approach involves substituting a complex model with a metamodel, that is, a simplified function that mimics the behavior of the original model, thereby significantly expediting the evaluation process. One widely utilized method is Gaussian Process Regression (GPR), also known as Kriging, which has demonstrated effectiveness in numerous structural health monitoring (SHM) applications. However, achieving accurate predictions for a target variable (e.g., damage-sensitive feature) often requires a significant amount of past data or well-calibrated models of the structure under analysis, presenting challenges and high costs. Therefore, the innovation presented in this article is applying a co-Kriging method, a multivariate extension of ordinary Kriging that leverages the covariance between two or more related datasets. This is an efficient decision-making process in various fields, especially when the co-variable is more cost-effective to measure than the target variable. Three distinct applications are presented here, showcasing the efficacy of the co-Kriging methodology. Two of these applications focus on generic mathematical functions. The third pertains to a real-world scenario involving the correlation of the natural frequencies of a concrete bridge under varying thermal conditions. Across all three scenarios, co-Kriging emerges as a robust method, consistently yielding superior results compared to ordinary Kriging.
Enhanced damage localization in plate-like concrete structures leveraging modified delay-and-sum method
Authors: Zhang Minghui , Zhou Deyuan , Sun Xiangtao , Yang Ziqian , Kong Qingzhao
Published: August 2024

With the purpose of achieving the precise and quantitative damage monitoring in the concrete medium, the methodology based on the stress wave has secured its popularity and utilized prevailingly. This study introduces a modified delay-and-sum (DAS) damage localization method and a mesolevel concrete numerical model that incorporates the inherent randomness of polygon aggregates distribution. In order to realize the localization of multiple impairments within concrete, the propagation characteristics of stress waves are leveraged to present a damaged subarea determination strategy. This strategy serves as an initial processing stage for damage localization by discerning the effective sensing paths. Additionally, the proposed damage probability distribution function integrated with damage information obtained from the effective sensing paths are employed to accurately pinpoint the location of damage in concrete. Moreover, concrete is comprehensively regarded as a three-phase composite material consisting of aggregate, mortar, and the interface transition zone. By employing mesolevel numerical models, the intricate interaction between stress waves and the internal structures of concrete is revealed. Subsequently, response signals are extracted from the mesolevel concrete models, and meticulous numerical validations are conducted to assess the efficacy of the proposed method. Furthermore, experimental tests are conducted on a concrete slab equipped with embedded tubular piezoelectric transducers. The results demonstrate that the proposed method achieves accurate damage localization with minimal artifact and interference area, surpassing the capabilities of conventional DAS methods. This study validates the potential and feasibility of the proposed method in accurately locating multiple impairments within concrete.
Establishing Tolerance for Orthotics Casting in a Child With Autism Spectrum Disorder and Idiopathic Toe Walking
Authors: Udzella Natashja , Kovalic Katherine , Hirst Heather , Luiselli James K.
Published: August 2024

Failure to tolerate medical practices and healthcare routines can deter pediatric patients with neurodevelopmental disabilities from receiving required services. This case study evaluated behavioral intervention to establish tolerance of casting procedures in a 10-year-old boy with autism spectrum disorder (ASD) so that custom ankle-foot orthotics could be prepared as treatment for his idiopathic toe walking. At baseline, casting could not be completed because the boy displayed unsafe resistant behavior. An intervention plan combining graduated exposure, positive reinforcement, and non-contingent access to preferred objects allowed the boy to tolerate a simulated casting protocol and actual casting performed by an orthotist. Service practitioners who implemented intervention rated the plan positively.
Association Between red Cell Distribution Width/Albumin Ratio and Diabetic Lower Extremity Ulcers (DLEU) among US Outpatients in the NHANES: A Retrospective Cross-Sectional Study
Authors: Huang Dali , Wang Kang , Deng Ting , Yang Ting , Cao Jinmin
Published: August 2024

Objective

Diabetic foot ulcers are common chronic complications of diabetes mellitus that can lead to amputation and death in severe cases. There is limited research on the relationship between the red cell distribution width/albumin ratio and diabetic lower-extremity ulcers. The few studies that have been conducted have been in single-center inpatient settings and there is limited research in outpatient settings. This study investigated this relationship in adult outpatient clinics in the United States.

Methods

A retrospective cross-sectional study was conducted with 1624 participants of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Three logistic regression models were developed to assess the association between red cell distribution width/albumin ratio and diabetic lower-extremity ulcers. The ratio was analyzed as a continuous and categorical variable. Stratified analyses were performed based on age, sex, HbA1c level, and body mass index.

Results

The study included 1624 adults, with a mean age of 65.0 ± 12.0 years, of whom 58.8% were male. The prevalence of diabetic lower-extremity ulcers was 8.0% ( n = 131). Compared with individuals with a lower red cell distribution width/albumin ratio in T1(2.32,2.93), the adjusted OR values for the ratio and ulcers in T2(2.94,3.26), T3(3.27,7.42), and 2.07 (95% CI = 1.19∼3.61), 2.92 (95% CI = 1.63∼5.23). The association between the ratio and ulcers exhibited a non-linear relationship (nonlinear, P = .028).

Conclusion

These results support the hypothesis of an S-shaped relationship between red cell distribution width/albumin and diabetic lower-extremity ulcers. Monitoring the RDW/Albumin ratio could be crucial for preventing diabetic lower-extremity ulcers in outpatient settings. Regular assessments may help identify high-risk patients early, enabling timely interventions. Future studies should further assess these two factors and their underlying mechanisms.
Part 1: Pushing the boundaries of neurointerventional surgery: A historical review of the work of Dr Gerard Debrun
Authors: Madapoosi Adrusht , Sanchez-Forteza Anthony , Mrad Tatiana Abou , McGuire Laura Stone , Theiss Peter , Tshibangu Mpuekela , Charbel Fady , Alaraj Ali
Published: August 2024

French-American neurointerventionalist and pioneer, Dr Gerard Debrun, laid the groundwork for treatments which have become irreplaceable in neurointerventional surgery today. This article aims to outline the career of Dr Debrun while highlighting his accomplishments and contributions to the field of neurointerventional surgery. We selected relevant articles from PubMed authored or co-authored by Dr Debrun between 1941 and 2023. All included articles discuss the accomplishments and contributions of Dr Debrun. Dr Debrun began his career in France by investigating neurointerventional techniques, most notably the intravascular Detachable Balloon Catheter (DBC). His work was recognized by renowned neurosurgeon Dr Charles Drake, who recruited him to London, Ontario. Dr Debrun created the foundation for homemade manufacturing of DBCs, building on one of the largest series for use of DBCs in cerebrovascular disease. Dr Debrun spent time as faculty at Massachusetts General Hospital (MGH) and Johns Hopkins Hospital, before arriving at the University of Illinois Chicago (UIC) where he remained until his retirement. Dr Debrun's subsequent contributions included the calibrated-leak balloon catheter, pioneering of glue embolization, setting the foundation for preoperative AVM embolizations, and as an early adopter of the Guglielmi detachable coil (GDC), including mastering the balloon remodeling technique for wide neck aneurysms. Dr Debrun established the first integrated neurointerventional surgery program at UIC, establishing a well sought-after fellowship program. Dr Debrun lectured extensively and was a prolific writer on neurointerventional surgery throughout this career. His contributions established the foundation for several techniques which have since become standard practice in present-day neurointerventional surgery.
Fate assessment of the ectatic common iliac artery using flared limb during endovascular aneurysm repair
Authors: Kim Choshin , Park Yang-Jin , Park Joon-Kee , Kim Young-Wook , Kim Dong-Ik , Yang Shin-Seok , Park Taek Kyu , Choi Seung-Hyuk
Published: August 2024

Objectives

This study aimed to evaluate the outcomes and anatomical predictors of the complications of flared limb (FL) use for ectatic common iliac arteries accompanied by abdominal aortic aneurysm treated with endovascular aneurysm repair (EVAR).

Methods

In this single-center retrospective study, we reviewed data from 391 patients (638 limbs) treated between 2005 and 2020. The cohort was divided into two groups. The standard limbs (SLs, n = 403) included stent graft (SG) of <20 mm in diameter and the FLs ( n = 235) included stent graft of ≥20 mm in diameter. Complications within 30 days were investigated as the short-term outcome. Limb events during follow-up including type Ib endoleak (EL), type IIIa EL, and limb occlusion were compared between SLs and FLs using log-rank test.

Results

Early results indicated that the FL group had a significantly higher incidence of intraoperative type Ib EL at 5.1% (12), than 1.7% (7) in the SLs ( p = .016). For 19 patients in whom intraoperative type Ib EL was discovered, SG extension alone or internal iliac artery embolization was all performed before completing the procedure. Overall, we noted one case of type Ib EL and two cases of limb events in each group at 30 days. Over a median follow-up of 39 months, 31 (4.9%) events (17 type Ib EL, 2 type IIIa EL, and 12 limb events), 13 (5.5%) in FLs and 18 (4.5%) in SLs ( p = .984), were observed. The FLs had significantly higher rates of aortic sac enlargement, with 46 (19.6%) cases for FLs and 36 (8.9%) for SLs ( p < .001). The Kaplan–Meier analysis revealed significant differences at 5 years in SLs versus FLs for freedom from type Ib EL (96.6% vs 82.4%, respectively; p < .001) and no difference in freedom from limb events (94.7% vs 84.5%, respectively; p = .519). Furthermore, no difference was observed for overall survival and aneurysm-related mortality.

Conclusions

Although an FL for EVAR is used to treat dilated iliac arteries, there is an increased risk of intraoperative and late type Ib EL and aortic sac enlargement. Long-term close follow-up is mandatory, especially in the patients who undergo EVAR using FLs.
Understanding how nurses can effectively utilise social media for increasing public involvement, recruitment and impact dissemination of Clinical Research Trials
Authors: Jackson Jessica Eve , Moreton Joshua , Barnett Nicola , Hurst Matthew
Published: August 2024

Background:

The methodologies for clinical research trials are evolving to greater usage of social media platforms, providing opportunities to incorporate smart technologies in their delivery. Research Nurses should consider how they can utilise platforms for public engagement in trials.

Aim:

To explore the experiences of social media platforms and clinical research trials in a healthy population group, to gain insight into how clinical researchers can utilise these platforms professionally and ethically.

Methods:

Using a critical realist qualitative focus group design with template analysis, we recruited 16 healthy members of the public aged 18–75 years. The data expands upon their thoughts and behaviours regarding social media platforms with their understanding of clinical research.

Results:

Three main themes along with their specific subthemes (1) Design: Patient and Public Involvement (Subtheme: Understanding of clinical research, Diversity of social media users), (2) Implementation: Recruitment to active studies, (Subtheme: Motivators for volunteering, Trustworthy), (3) Dissemination: Impact and Awareness of Results, (Subtheme: Information overload, Motivations for users to share information).

Conclusions:

This study has highlighted the need to consider the way different population groups use social media platforms and the information they share when looking to engage them in clinical research trials.
Civil Sphere Values and Moral Responsibility in Cultural Production: The Curation of Music Festivals Today
Authors: Haynes Jo , Woodward Ian
Published: August 2024

Music festivals are a ubiquitous aspect of music economies and wider processes of cultural participation and community regeneration. They are now sites for exploring wider issues related to the environment, inequality, diversity and representation. Whereas contemporary literature productively draws on and reworks classical categories such as ritual, excess, and carnivalesque to frame the significance and meaning of music festivals, it has yet to coherently address how civil sphere values such as democracy, solidarity and justice are incorporated into their design and curation. In this article, focusing on the curatorial strategies of festival organisers, we examine the narratives and practices through which music festivals frame wider social issues as part of the event’s ethos. Drawing on interview data with festival organisers located in Britain and Denmark, our analysis indicates how moral and civil values are internalised as an important discourse of festival curation and the practical management of music festivals. A fundamental requirement is that curators produce events that are both economically and culturally sustainable as well as resonating with important social and cultural issues. The major analytical contribution of this article is to identify and address this central tension faced by music festivals around balancing cultural, economic and civil values within their events. Applying the conceptual resources of civil sphere theory, we point to an alternative way of thinking about what constitutes the music festival today.
Exploring the psycho-social wellbeing of journalists in Kashmir within the context of neoliberalism
Authors: Boga Dilnaz
Published: August 2024

Journalists from India-administered Kashmir have endured the psycho-social brunt of living in a militarized zone. Restrictions imposed on the media by the governing class in a neoliberal milieu function to regulate the narrative on the conflict with the help of agenda setting. This analysis identifies themes of direct, indirect and structural violence, and shows how psychological symptoms such as anxiety, alienation, hypervigilance, helplessness, depression and trauma emerge from them. Employing thematic analysis coupled with a deductive approach, the author highlights how working conditions of the journalists shape their psycho-social wellbeing. In-depth interviews with Kashmiri photojournalists, journalists and editors (print and digital) and secondary sources, such as local and international studies on the psychological wellbeing of the population in general, demonstrate the psycho-social wellbeing of journalists in the Kashmir Valley.
The First 100 Children Treated in a Newly Established Pediatric Vertigo Center
Authors: Alnoury Mohammed K. , Salameh Samer , Ostrovska Aleksandra , Gurberg Joshua
Published: August 2024

Background

Correctly diagnosing dizziness in children is essential for appropriate management; nevertheless, healthcare professionals face challenges due to children’s limited ability to describe their symptoms and their cooperation during physical examination. The objective of this study is to describe the first 100 patients seen at a newly established pediatric vertigo center.

Methods

This is a retrospective review of a consecutive series of 100 patients seen at our pediatric vertigo clinic in a tertiary referral center from August 2019 until June 2022. Comprehensive clinical data were collected. The diagnoses were established by 2 pediatric otolaryngologists based on validated diagnostic criteria. Trends in diagnosis, investigation, and treatment of these patients were analyzed.

Results

A total of 100 children were included in the study. Vestibular migraine was the most common diagnosis (20%) followed by benign paroxysmal vertigo of childhood (14%). Eleven patients had combined pathologies. Fifteen out of 70 children (21%) had abnormal audiograms, 30 out of 48 children (62.5%) had abnormal vestibular testing, and 6 out of 31 (19%) patients had abnormal imaging. Fifty-one children received medical treatment, 23 received vestibular physiotherapy, and 9 patients had particle repositioning maneuvers; moreover, 17 of these patients received multimodal treatment.

Conclusions

Our analysis suggests that imaging and audiology testing have relatively low yield in the assessment of pediatric vertigo. On the other hand, vestibular testing detected a high proportion of abnormalities, such as saccadic pursuit, vertical nystagmus, central positional nystagmus, and abnormal directional preponderance, particularly associated with vestibular migraine. Given the complexity of diagnosing vertigo in children, it is critical to establish multidisciplinary specialized centers capable of providing accurate diagnosis and treatment for these children.
Discovery of α-Glucosidase/Acetylcholinesterase Inhibitors from a Traditional Herbal Prescription of Qi-Li-Qiang-Xin Capsule by Time-Based Fractionation and Enzymatic Activity Assay
Authors: Song Hui-Peng , Zhao Ming-Yue , Xu Zhi-Li , Zhang Jia-Nuo , Wang Wen-Yu , Ding Zi-Xuan , Wang Ying , Zhan Li-Bin , Chen Xi , Li Ruo-Nan , Chen Yue-Hua
Published: August 2024

Objectives

The aim is to discover α-glucosidase/acetylcholinesterase inhibitors as lead compounds from a traditional herbal prescription of Qi-Li-Qiang-Xin capsule (QLQX).

Methods

A novel strategy combining time-based fractionation, LC-QTOF-MS, enzymatic activity assay, molecular docking and component-target association analysis was performed to discover α-glucosidase/acetylcholinesterase inhibitors from QLQX. Time-based fractionation combined with enzymatic activity assay was used to find the distribution period of active compounds in the herbal prescription. LC-QTOF-MS was used to analyze the structure of active compounds. Molecular docking was applied to explore the interaction between active compounds and targets.

Results

According to time-based fractionation, the active components of QLQX for acetylcholinesterase were primarily concentrated in the highly polar region, whereas the active components for α-glucosidase were predominantly found in the moderately polar area. A total of 33 compounds were identified by comparing with chemical reference substances. Dihydrotanshinone Ⅰ (16.98 µM), hydroxysafflor yellow A (84.57 µM), salvianolic acid A (76.62 µM) and cryptotanshinone (112.68 µM) were identified as acetylcholinesterase inhibitors from QLQX. Similarly, rosmarinic acid (62.29 µM), isochlorogenic acid A (17.95 µM), 4,5-dicaffeoylquinic acid (117.93 µM), danshensu (207.88 µM), salvianolic acid A (1.31 µM), 3,4-dicaffeoylquinic acid (91.71 µM), formononetin (67.26 µM), ginsenoside Rd (3.43 µM), ginsenoside Rb1 (26.37 µM) and ginsenoside F1 (18.79 µM) were discovered as α-glucosidase inhibitors. Notably, salvianolic acid A inhibited both acetylcholinesterase and α-glucosidase. The results of molecular docking indicated that hydrogen bonds, hydrophobic interactions and Pi-Pi T-shaped interactions were crucial for inhibiting acetylcholinesterase. Meanwhile, hydrogen bonds, hydrophobic interactions and Pi-Pi stacked interactions were significant in suppressing α-glucosidase.

Conclusion

QLQX contains numerous acetylcholinesterase and α-glucosidase inhibitors, demonstrating its potential therapeutic benefits for Alzheimer's disease and diabetes.
Implementing a rapid cord compression Magnetic Resonance Imaging protocol in the emergency department: Lessons learned
Authors: Mishra Shruti , Srinivasan Ashok , Kelsey Lauren , Bojicic Katherine , Masotti Maria , Chen Qiaochu , Hoeffner Ellen , Kronick Steven , Gomez-Hassan Diana
Published: August 2024

Background & Purpose

(1) Evaluate efficacy of an abbreviated total spine protocol in triaging emergency department (ED) patients through retrospective evaluation. (2) Describe patient outcomes following implementation of a rapid cord compression protocol.

Methods

(1) All contrast-enhanced total spine magnetic resonance imaging studies (MRIs) performed on ED patients ( n = 75) between 10/1–12/31/2022 for evaluation of cord compression were included. Two readers with 6 and 5 years of experience blindly reviewed the abbreviated protocol (comprised of sagittal T2w and axial T2w sequences) assessing presence of cord compression or severe spinal canal stenosis. Ground truth was consensus by a neuroradiology fellow and 2 attendings. (2) The implemented rapid protocol included sagittal T1w, sagittal T2w Dixon and axial T2w images. All ED patients ( n = 85) who were imaged using the rapid protocol from 5/1–8/31/2023 were included. Patient outcomes and call-back rates were determined through chart review.

Results

(1) Sensitivity and specificity for severe spinal canal stenosis and/or cord compression was 1.0 and 0.92, respectively, for reader 1 and 0.78 and 0.85, respectively, for reader 2. Negative predictive value was 1.0 and 0.97 for readers 1 and 2, respectively. (2) The implemented rapid cord compression protocol resulted in 60% reduction in imaging time at 1.5T. The call-back rate for additional sequences was 7%. In patients who underwent surgery, no additional MRI images were acquired in 82% of cases (9/11).

Conclusions

Implementing an abbreviated non-contrast total spine protocol in the ED results in a low call-back rate with acquired MRI images proving sufficient for both triage and treatment planning in most patients.
Impact of early COVID-19 pandemic events in Singapore on clinic attendance and default rates in a hospital-based ambulatory paediatrics service
Authors: Koura Rachana , Davis Courtney
Published: August 2024

Background

While the impact of COVID-19 on health care seeking behaviour has been well documented in adult studies, little is known about the impact of COVID-19 on ambulatory paediatric care in South East Asia.

Objective

To analyse the impact of early COVID-19 events on weekly clinic attendance volumes and default rates in the ambulatory paediatric service of a large tertiary teaching hospital in Singapore.

Methods

We used independent t tests to compare the weekly aggregate clinic attendance and default rates of the different time periods of the early COVID-19 pandemic (early COVID-19, movement controls, release of movement controls).

Results

The total weekly clinic attendance decreased significantly and default rates increased significantly during the early COVID-19 period prior to the implementation of movement controls. During the period of movement controls, the first visit default rate remained significantly increased despite the postponement of all non-essential first visits. Post movement controls, both the first and follow up visits rebounded to pre-COVID 19 levels. The default rate for follow up visits was significantly lower than baseline in the post movement control period.

Conclusions

Decreased utilization of ambulatory paediatric care in Singapore in a pandemic has implications for future pandemic preparedness including both health care resource allocation and health communication.
Enforcement of international sanctions as the third pillar of the anti-money laundering framework. An unannounced effect of the AML reform and the Sanctions Directive
Authors: Tosza Stanisław
Published: August 2024

The recently adopted Sanctions Directive harmonises definitions and penalties for violations of restrictive measures with the aim of ensuring that criminal law can be used to enforce international sanctions in the European Union. It has also made violations of restrictive measures a predicate offence of money laundering. In parallel, the anti-money laundering (AML) framework is undergoing a significant reform, which includes the adoption of the first AML Regulation (previous legal acts being directives) containing AML duties of obliged entities as well as the establishment of an EU AML Authority. Also, for the first time, due diligence obligations as regards international sanctions will be included among these duties. The combined reading of the Sanctions Directive and the AML Regulation indicates that those duties will be even greater, which will have an outstanding impact on obliged entities, in particular of the financial sector. In fact, the extent of those obligations would justify calling enforcement of sanctions the third pillar of the AML framework. Yet, this aspect – and its consequences – remained fully under the radar of the legislative process. The objective of this article is, first, to examine the role of the AML framework in the enforcement of international sanctions, especially after the Sanctions Directive and the AML Regulation start to be applied and, second, to analyse the impact of including enforcement of international sanctions in the AML framework, on the entities subject to its duties and other actors affected by this framework.
Storage tank response to large-scale blast: Validation of numerical analysis
Authors: Rogers Alexander , Cannon Laura , Newman John , Metcalfe Chris , Dimech Alessandro , Munro David , Fay Stephen , Taggart Chris
Published: August 2024

To predict the consequences of large-scale explosions, it is desirable to understand the response of various industrial and civil structures to blast loading. To this end, a numerical study was undertaken to investigate the sensitivity of response of one such class of structure, storage tanks, to the following factors: geometry, fill level and loading. In support of this study, a series of scaled tests was conducted. These tests were used to confirm key damage mechanisms and provide validation data. Output from subsequent simulations of the scaled tests showed good agreement with equivalent experimental results. An outline of the initial numerical study, a description of the experimental programme and an overview of the subsequent validation exercise are presented and discussed.
ANDROID and A/G ratio are correlated with sarcopenia among type 2 diabetes patients
Authors: Zhang Dongxiao , Li Chen , Hu Wenchao , He Lanjie
Published: August 2024

Background:

Fat distribution plays an important role in impaired glucose tolerance. Android adiposity (ANDROID) and gynoid adiposity (GYNOID) have been proven to be linked with insulin resistance. A higher risk of sarcopenia is associated with type 2 diabetes mellitus (T2DM). In this study, ANDROID, GYNOID, and ANDROID to GYNOID ratios (A/G ratios) were evaluated in T2DM patients to determine if they were associated with sarcopenia.

Methods:

We recruited 1086 T2DM patients, measured skeletal muscle index (SMI), ANDROID, GYNOID, and collected clinical data.

Results:

T2DM patients with 119 male subjects had sarcopenia (20.24%), and 72 female subjects had sarcopenia (16.51%). All patients with T2DM who had high ANDROID and A/G ratios were at a reduced risk of sarcopenia. The SMI showed a correlation with ANDROID and A/G ratios among subjects with T2DM.

Conclusion:

ANDROID and A/G ratios are inversely related to sarcopenia in T2DM patients.
Exploring Kenyans’ interactions with misinformation on WhatsApp
Authors: Mudavadi Kevin C. , Tully Melissa , Lomoywara David B.
Published: August 2024

The abundance of misinformation spreading online has precipitated a need to investigate experiences with misinformation in more closed spaces like those found on WhatsApp. Based on interviews with Kenyan adults, this study examines participants’ perceptions of misinformation circulated on WhatsApp and its potential consequences, interactions with misinformation, and decision-making. Findings indicate that participants perceive sharing misinformation on WhatsApp as a means of telling others about what is happening around them. Participants acknowledged the dangers of misinformation spread on WhatsApp but were wary of correcting it because of family and friend dynamics; they were afraid of humiliation or embarrassment; they assumed that the information had not spread to too many others; and they perceived some misinformation as harmless memes.
An infected intradural dermoid cyst associated with a complete dermal sinus of the posterior cranial fossa: A case report and literature review
Authors: Mallak Etab , Almhethawy Haneen , Martini Nafiza , Alsharhan Raeed
Published: August 2024

Posterior fossa dermoid cysts are uncommon benign congenital abnormalities. Meningitis is seen as a primary symptom in these situations, more rarely we can find cerebral abscesses. In this case, we describe a 4-year-old Syrian boy who presented with headaches and frequent vomiting as his major complaints. No indication of cerebellar injury was present. He had signs of hydrocephalus like grade III bilateral papilledema but did not develop meningitis. The patient was diagnosed with a complete dermal sinus of the posterior cranial fossa in combination with an infected intradural dermoid cyst and a secondary abscess formation. In Conclusion, the preoperative diagnosis of infected dermoid cysts and dermal sinus tracts lacking signs of infection or meningitis poses challenges, particularly when accompanied by hydrocephalus that can resemble cerebellar tumors. Thorough preoperative assessment is vital for these complex cases.
First case of feline cryptococcosis in Bosnia and Herzegovina
Authors: Glavinić Aida , Šupić Jovana , Alić Amer , Spahija Nermina , Maksimović Alan , Šunje-Rizvan Amila
Published: August 2024

Case summary

A 2-year-old domestic longhair crossbred female cat was referred for a second opinion on a non-healing surgical wound after left eye enucleation. In addition to the left orbital lesion, ulcerative granular masses protruding from the left nostril and on the base of the left ear were noted. A diagnosis of cryptococcosis was established using histopathological examination and a latex cryptococcal antigen agglutination test. The cat was successfully treated with itraconazole.

Relevance and novel information

Cryptococcosis, commonly reported in Australia, western Canada and the western USA, is rarely reported in companion animals in Europe. This marks the first report of cryptococcosis in cats in Bosnia and Herzegovina, emphasising the need to raise awareness within the veterinary community, both local and regional, about this disease.
How to establish digital health ecosystems from the perspective of health service-organizations: A taxonomy developed based on expert interviews conducted as modified Delphi approach
Authors: Huettemann Robin , Sevov Benedict , Meister Sven , Fehring Leonard
Published: August 2024

Objective

Digital health ecosystems may be the next revolution in improving citizens’ well-being, health delivery, data management, and health system processes, but solutions have not yet been broadly established. Reasons could be that health service-organizations have misaligned interests or lack capabilities. This study investigates reasons from a multi-health-service-organization perspective, differentiating between payers, insurers, healthcare providers, and innovators, detailing the expected value-adds, preferred participation roles, and required capabilities including a rating assessment.

Methods

Findings are based on a taxonomy development methodology, which combines a literature review with semi-structured qualitative expert interviews, conducted using a modified Delphi approach. Interviews were thematically analysed.

Results

In total, 21 experts across the four health service-organization groups were interviewed. The capability taxonomy includes a total of 16 capabilities, categorized in three themes: ‘Health market’, ‘organizational’, and ‘technology and informatic’. Providers expect a value-add from strengthening their health process economics through efficiency gains but reveal the largest capability gaps, especially in ‘interoperability’ and ‘platform’. Innovators’ ‘technology and informatic’ capabilities complement well with those of payers for the ‘health market’.

Conclusions

We present a health service-organization-specific three-stage approach for establishing digital health ecosystems. Payers and insurers should address their ‘technology and informatic’ capability gaps, using technical enablers or forming new entities to reduce dependencies from legacy information technology systems. Innovators should clarify their monetization models and create positive awareness for their services, possibly entering the market directly. Providers must address interoperability issues and may require incentives to encourage their participation. Findings suggest governmental policymakers to prioritize three health policy initiatives.
Re-hospitalization factors and economic characteristics of urinary tract infected patients using machine learning
Authors: Lee Yul Hee , Baik Young Seo , Kim Young Jae , Shi Hye Jin , Moon Jong Youn , Kim Kwang Gi
Published: August 2024

Objective

Urinary tract infection is one of the most prevalent bacterial infectious diseases in outpatient treatment, and 50–80% of women experience it more than once, with a recurrence rate of 40–50% within a year; consequently, preventing re-hospitalization of patients is critical. However, in the field of urology, no research on the analysis of the re-hospitalization status for urinary tract infections using machine learning algorithms has been reported to date. Therefore, this study uses various machine learning algorithms to analyze the clinical and nonclinical factors related to patients who were re-hospitalized within 30 days of urinary tract infection.

Methods

Data were collected from 497 patients re-hospitalized for urinary tract infections within 30 days and 496 patients who did not require re-hospitalization. The re-hospitalization factors were analyzed using four machine learning algorithms: gradient boosting classifier, random forest, naive Bayes, and logistic regression.

Results

The best-performing gradient boosting classifier identified respiratory rate, days of hospitalization, albumin, diastolic blood pressure, blood urea nitrogen, body mass index, systolic blood pressure, body temperature, total bilirubin, and pulse as the top-10 factors that affect re-hospitalization because of urinary tract infections. The 993 patients whose data were collected were divided into risk groups based on these factors, and the re-hospitalization rate, days of hospitalization, and medical expenses were observed to decrease from the high- to low-risk group.

Conclusions

This study showed new possibilities in analyzing the status of urinary tract infection-related re-hospitalization using machine learning. Identifying factors affecting re-hospitalization and incorporating preventable and reinforcement-based treatment programs can aid in reducing the re-hospitalization rate and average number of days of hospitalization, thereby reducing medical expenses.
Trends in life expectancy and life disparity in the older population in China by regions, 1981–2020
Authors: Yan Yuteng
Published: August 2024

This paper examines the trends in life expectancy and life disparity among the older population in China and its sub-national regions based on China National Population Census data from 1981 to 2020, using the life disparity indicator developed by Zhang and Vaupel. It is shown that, first, the life expectancy of the older population in both China and its sub-national regions has experienced a significant upward trend; however, the growth is uneven across regions. Second, life disparities due to deaths among the elderly in China and its sub-national regions followed a downward trend, but life disparities due to deaths among the elderly as a ratio of total life disparities increased, indicating an increasing importance of deaths among the elderly in life disparities amid overall mortality improvements. Third, multiple linear regression models indicate that variations in life expectancy and life disparity among the older population across regions in China may stem from uneven development in the health transition process and resulting disparities. The eastern region of China has experienced a faster health transition compared to the western region, as evidenced by the greater impact of investments in medical facilities and economic development levels on increasing old-age life expectancy and reducing old-age life disparities in the eastern region. This paper reveals that the life expectancy and life disparity of China's older population has improved considerably over the past four decades, and its relatively lagging improvement compared to that of developed countries over the same period may be related to the relatively lagging health transition in the western region of the country.
Intergenerational caregiving among “sandwich grandparents” in China
Authors: Xu Hongwei
Published: August 2024

“Sandwich grandparents” are middle-aged and older adults who have both living parents (or parents-in-law) and young grandchildren. They are faced with competing demands for caregiving from multiple generations. This study examines the prevalence, trends, and patterns of caregiving by sandwich grandparents in China. Drawing on nationally representative longitudinal data, this study estimates that more than 150 million Chinese adults aged 45 and older were sandwich grandparents in 2011. Among them, more than 17 million were dual caregivers who provided care to their own older parents and young grandchildren simultaneously. These numbers fluctuated considerably between 2011 and 2018. This study further tests the associations between three aspects of intergenerational solidarity and caregiving patterns among Chinese sandwich grandparents. Longitudinal regression analysis reveals a significant association between normative solidarity and intergenerational caregiving, but no evidence of functional or structural solidarity at work.