bluuebunny/crossref_metadata_2025 huggingface dataset:
Sedated Colonoscopy may not be Beneficial for Polyp/Adenoma Detection
Authors: Han Jie , Cao Rongrong , Su Dongshuai , Li Yingchao , Gao Cong , Wang Ke , Gao Fei , Qi Xingshun
Published: October 2024

Background

Sedated colonoscopy has been increasingly selected. However, the effect of sedated colonoscopy on polyp/adenoma detection rate (PDR/ADR) remains controversial among studies.

Methods

In this retrospective study, the medical records of 11 504 consecutive patients who underwent colonoscopy at our department from July 1, 2021 to December 31, 2022 were collected. Patients were divided into sedated and unsedated groups according to the use of intravenous sedation during colonoscopy. Overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR were calculated. By adjusting for age, gender, body mass index, inpatient, screening/surveillance, cecal intubation time, colonoscopy withdrawal time ≥6 min, and an endoscopist’s experience ≥5 years, multivariate logistic regression analyses were performed to evaluate the association of sedated colonoscopy with overall PDR/ADR, right-side, transverse, and left-side colon PDR/ADR, and single and multiple PDR/ADR, where the absence of PDR/ADR was used as reference. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated.

Results

Overall, 2275 patients were included, of whom 293 and 1982 underwent sedated and unsedated colonoscopy, respectively. Multivariate logistic regression analyses showed that sedated colonoscopy was independently associated with lower overall PDR/ADR (OR = 0.640, 95% CI = 0.460-0.889, P = 0.008), right-side colon PDR/ADR (OR = 0.591, 95% CI = 0.417-0.837, P = 0.003), single PDR/ADR (OR = 0.659, 95% CI = 0.436-0.996, P = 0.048), and multiple PDR/ADR (OR = 0.586, 95% CI = 0.402-0.855, P = 0.005), but not transverse or left-side colon PDR/ADR.

Conclusion

Sedated colonoscopy may not be beneficial in terms of overall PDR/ADR, right-side colon PDR/ADR, and number of polyps/adenomas. Thus, it should be selectively recommended. Additionally, it should be necessary to explore how to improve the quality of sedated colonoscopy.
Active control for higher order micro sandwich beam with various cores integrated by piezoelectric layers based on MSGT on the Pasternak foundation
Authors: Jafari Mohammadjavad , Mohammadimehr Mehdi
Published: October 2024

In the present article, the vibration suppression of higher order micro sandwich beams based on modified strain gradient beam theory (MSGT) and Reddy/Timoshenko beam theories is developed. Three types of core, including honeycomb, foam, and porous for a micro sandwich beam, are considered. The core’s top and bottom are integrated by piezoelectric layers as actuator and sensor, respectively. Displacement fields are defined via third-order shear deformation beam theory (TSDBT) (or Reddy beam theory (RBT)) and first-order shear deformation beam theory (FSDBT) (or Timoshenko beam theory (TBT)). The governing equations of motion are derived using MSGT to consider the small-scale effect. To optimal approaches for the controller, state feedback is designed based on a linear quadratic regulator (LQR) in the state-space form. Moreover, the effect of various parameters, including small-scale parameters, three types of core, temperature changes, Pasternak foundation, density of core, dimensionless cell thickness ([Formula: see text]), and internal aspect ratio ([Formula: see text]), angles ([Formula: see text]) of honeycomb, and the porosity parameter is performed on the active control of the smart micro sandwich beam. The numerical results indicate that the parameters mentioned significantly affect the optimal vibration control of the smart micro sandwich beam. It is found that the lightweight cores have more attenuation of the transient response and faster settling time. By analyzing the effect of temperature changes on active vibration control of lighter core, it was found that the frequency decreases as the temperature increases. Also, by considering the Pasternak foundation, it is found that the time period without considering the elastic foundation is longer than when considering the elastic foundation, and the natural frequency is vice versa. Also, the settling time by considering the elastic foundation occurs earlier. In the active control field of smart micro beams, this theoretical investigation developed widely as a benchmark for experimental research and the manufacturing process.
What Happens When Child Abuse Pediatricians and CPS Investigators Collaborate? A Study of the Multidisciplinary Pediatric Education and Evaluation Consortium
Authors: Ramaiah Veena , Dworsky Amy , Bilka Kristen , Glick Jill
Published: October 2024

The Multidisciplinary Pediatric Education and Evaluation Consortium (MPEEC) is a medically directed program that mandates real-time interagency collaboration among child abuse pediatricians (CAPs), child protective services (CPS) investigators, and law enforcement. MPEEC provides consultation resulting in a definitive medical opinion regarding manner of injury when allegations of serious harm involving children less than three years old living in Chicago are reported to Illinois Department of Children and Family Services (DCFS). This study is the first to link data from a medically directed, inter-agency program with CPS investigations data to specifically examine the duration of CPS investigations and the level of concordance between the manner of injury as determined by CAPs and the investigation’s outcome when CPS investigators and medical professionals are required to formally collaborate. On average, MPEEC produced a written opinion 16 days from the time of referral and DCFS made a finding 45 days after receiving the MPEEC report for the 690 cases referred to MPEEC over a 3-year period. The concordance level ranged from 75–90%. Our results highlight the need for more analysis of linked data to promote efficiency and proficiency in CPS investigations.
Tensorial harmonic bases of arbitrary order with applications in elasticity, elastoviscoplasticity and texture-based modeling
Authors: Krause Maximilian , Böhlke Thomas
Published: October 2024

In continuum mechanics, one regularly encounters higher-order tensors that require tensorial bases for theoretical or numerical calculations. By using results from [Formula: see text] representation theory, we present a method to derive tensorial harmonic bases which unifies existing approaches in one framework. Applying this convention to symmetric second-order tensors results in a second-order harmonic basis which, for example, simplifies the depiction and numerical handling of stiffness tensors for most common material symmetries and reduces the computational effort involved in implementations of incompressible elastoviscoplastic material laws. The same convention can be applied to texture analysis to yield tensorial texture coefficients for both polycrystals and fiber-reinforced composites. Rotations of higher-order tensors are particularly efficient in harmonic bases as both material and index symmetries can be exploited. While special attention is given here to the examples of small-strain material laws and texture analysis, the framework is entirely general and can be used to simplify calculations in other physical contexts involving tensors of arbitrary order and symmetry. A Python implementation of the harmonic basis convention defined in this work is available as a Supplementary Material.
Comparative analysis of retinal microvascular parameters in healthy individuals with or without carotid artery stenosis or plaque
Authors: Fang Xiaoxia , Yang Fan , Huang Wei , Ling Saiguang , Liang Bing , Zeng Weizhong , Hu Huiling , Zhang Guoming
Published: October 2024

Purpose

To evaluate the correlations between retinal microvascular changes and carotid artery stenosis (CAS) with and without plaques using fundus photography.

Methods

Patients who had undergone bilateral carotid ultrasonography and bilateral fundus photography were divided into the following groups based on the carotid intima-media thickness (IMT) determined via ultrasonography in this retrospective, observational study: the control and CAS (comprising CAS with and without plaque subgroups) groups. The following retinal indicators were determined via fundus photography based on a deep learning algorithm: the arteriole-to-venule ratio (AVR), whole retinal fractal dimension (FD), arteriolar fractal dimension (AFD), venular fractal dimension (VFD), vascular density (VD), and VD within 3 mm (VD3mm) and 5 mm (VD5mm) from the macular fovea. The correlations between these indicators and IMT were also assessed.

Results

In total, 715 participants, comprising 313 participants with CAS (CAS group; 91 with plaque and 222 without plaque) and 402 participants without CAS (control group), participated in this study. AFD, VFD, and FD in the CAS group were significantly lower than those in the control group (all p < 0.001). VD, VD3mm, and VD5mm showed significant differences between the groups (all p < 0.05). VFD in the CAS with plaque group was lower than that in the group without plaque ( p = 0.014). VD3mm, and VD5mm showed significantly negative correlations with IMTmin in the CAS subgroup.

Conclusions

AFD, VFD, FD, VD, VD3 mm, and VD5 mm decreased, and fundus photography based on deep learning algorithm may provide new approaches for screening of CAS.
Outcomes-based contracts and the hidden turn to public value management
Authors: Kimmitt Jonathan , Muñoz Pablo
Published: October 2024

Despite long-standing criticisms of the paradigm, New Public Management (NPM) retains a strong influence over organizations in public administration. Social Impact Bonds (SIB) are an outcomes-oriented investment entity which has emerged from NPM with grand promises of social change. Building on a longitudinal case study of a health-based SIB, this paper identifies how key actors move away from NPM by resisting such management principles and shift toward Public Value Management (PVM). The paper finds that this is possible when the public interest and performance objectives are designed with a public value orientation whilst other NPM principles shift over time through resistance and negotiation. The paper provides insight into how key actors re-organize to embed public value in a financing and public service delivery structure that is often regarded as flawed and inefficient. The paper offers several contributions to public value literature, including the role of the state, as well as the emerging literature on SIBs and outcomes-based contracts.
Playing the scales: A strategy adopted by resistance coalitions for public value creation
Authors: Roglic Marija , Palpacuer Florence , Lacerda Daniel S.
Published: October 2024

Local actors can defend public value by mobilizing resistance coalitions against threats from higher spatial scales. Drawing on existing scholarship on resistance movements and public value creation, this paper proposes a theoretical framework for understanding how local actors can protect public value from threats of rescaling driven solely by hegemonic discourses and presents a strategy that we call “playing the scales.” Our case study analyzes a Local Action Group’s resistance to a state-imposed and EU-framed regulation that threatened local forms of value creation on the Croatian peninsula of Pelješac. Employing a longitudinal participatory approach, our findings outline the strategy of playing the scales, which involved three key tactics: gathering relevant knowledge from various scales; crafting an alternative narrative; and leveraging this narrative across scales to reshape the dominant organizational logic. The study contributes to the understanding of public value creation by showing how it can be defended by resistance coalitions that are capable of playing the scales. It also sheds light on alternative dynamics of rescaling that, rather than oppositional resistance to higher scales or attempts to scale up micro-practices can also be driven by trans-scalar alliances that inscribe the interests of local communities into dominant discourses.
Stimulating tourists’ senses for sustainable destination development: Combining embodied cognition theory and the S-O-R model
Authors: Wang Yaobin , Miao Haoyang , Wang Yaohua , Wu Ruoxue , Li Wenlin , Xiong Meiling
Published: October 2024

Tourists’ environmentally responsible behavior (ERB) is crucial for the sustainable development of destinations, and the external environment can alter individuals’ cognition and behavior through sensory perception. To investigate the impact of the natural environment on tourists’ ERB, a conceptual model was developed and validated from a sensory perspective by integrating the embodied cognition theory and the stimulus-organism-response model. The results of structure equation modeling indicated that, with the exception of auditory perception, tourists’ perceptions through each sense influenced ERB to varying degrees, mediated by memorable tourism experiences (MTEs) and environmental awareness. Additionally, the fuzzy-set qualitative comparative analysis method was employed to identify five distinct configurations associated with high ERB. Notably, MTEs and environmental awareness, driven by sensory perceptions, emerged as critical factors. While all senses played a role, none alone could singularly determine high ERB. The findings reveal the mechanism through which sensory perception influences tourists’ ERB and offer practical insights for destinations to integrate tourism resources by aligning with tourists’ sensory experiences to promote sustainable tourism.
How fan clubs manage the authenticity of fans’ identities in Chinese idol culture
Authors: Patrick Williams J. , Wang Jingya
Published: October 2024

While existing research on Chinese fan cultures has explored various aspects of fan identity and fan labor, little attention has been given to the role that identity authentication plays in mediating the relationships between fans and the idol industry. This study examines the influence of fan clubs on identity authentication and management within Chinese idol fandom. Drawing on theories of social identity and authenticity, we explore how Chinese fan clubs establish criteria for being a real fan based on emotional loyalty to, and financial and data labor support of, idols. We also show how fan clubs use social media to surveil and discipline fans whose behaviors jeopardize fan clubs’ work or idols’ commercial value. The findings contribute to cultural understandings of the organization of Chinese fandom generally, and more specifically of Chinese fan clubs’ intermediary roles in shaping fans’ everyday identities and practices.
System fragility analysis of highway bridge using multi-output Gaussian process regression surrogate model
Authors: Saida Taisei , Rashid Muhammad , Nishio Mayuko
Published: October 2024

This study presents a multi-output Gaussian process regression (GPR) surrogate model for seismic-fragility analysis of bridge structural systems. Multi-output GPR can model the correlations among multiple outputs, accuracy and stability are achieved with fewer training data, which reduces the computational cost of fragility analysis. Furthermore, the explainability of the constructed surrogate model is implemented by adopting an automatic relevance-determination (ARD) kernel in the GPR. The estimated hyperparameters can provide the contribution of the uncertainty of each input parameter to the outputs. The fragility analysis using the multi-output GPR surrogate model was verified by applying it to a seismic isolation highway bridge with multiple spans and a curved geometry. The effectiveness of the multi-output GPR was demonstrated by the construction of an accurate and stable surrogate model with 46 inputs and 28 outputs. The relative contributions of the uncertainties to the structural properties and input earthquake loads could also be understood. The fragility curves, at both the component and system levels, were appropriately obtained using a sufficient number of samples in a Monte Carlo calculation. Furthermore, the failure modes were evaluated, identifying which structural components contributed to the system failure. This enabled discussions on structural system failures from the viewpoint of the structural dynamic characteristics of the bridge and earthquake-load properties.
The radiological primary survey: A systematic approach and guide to reading torso computed tomography images in trauma for surgeons
Authors: James Joses Dany , Paul Joseph Chacko , Sathyakumar Kirthi , Purushothaman Vijayan , Kumar Vignesh , Sharma Srujan Lam , Nayak Sukria
Published: October 2024

Background

Trauma is a disease where time is of the essence. In many lower middle-income countries, definitive management and planning for trauma patients are often delayed after working hours because of either a lack of technicians to perform computed tomography (CT) scans or a lack of radiologists to interpret them. These lacunae can be bridged if more and more surgeons become confident in interpreting trauma CT images.

Method

In this narrative review, written in a ‘how to do it’ manner, we describe a way of doing a structured and quick ‘radiological primary survey’ of the torso CT, which we believe will help quickly identify major injuries systematically, thereby avoiding delays in management and forming a care plan. The method has been developed by a team of trauma surgeons and radiologists and stems from the DRS ABCDE technique used in interpreting trauma chest X-rays.

Result

The DRS ABCDE extrapolated to the trauma torso CT includes the following steps- Details, WRAP (W-windowing, R-Region, A-Axis, P-Phase), S- the Scout film, Airway, Breathing, Circulation, Disability and Extras.

Conclusion

The review will enable resident trainees and trauma care professionals to interpret trauma CTs using a structured approach.
Thermal fluctuations on the corrosion behaviour of 17-4PH stainless steel alloys fabricated via material extrusion additive manufacturing technique
Authors: Mwema Fredrick , Wambua Job , Bodunrin Michael O , Akinlabi Stephen , Jen Tien-Chien , Akinlabi Esther
Published: October 2024

Herein, the influence of fluctuating thermal conditions on the corrosion behaviour of 17-4PH stainless steel alloys manufactured via fused filament fabrication is reported. The printed samples were sintered and then exposed to different temperature-fluctuating conditions to simulate the application environment of such alloys. The first set of samples (A) was studied as-sintered, the second set of samples (B) was aged at 480°C for 3 h followed by quenching in water, the third set (C) was exposed to conditions of B followed by aging at 360°C for 3 h and quenching in water and the final set of samples (D) was exposed to conditions of C followed by aging at 200°C for 3 h, quenching in water, aging at 400°C for 3 h, and finally quenching in water. The surface roughness evolved with the temperature conditions. The optical microscopy revealed that sample B had a fine and homogenous distribution of precipitates. Sample B had the highest microhardness values followed by C, D, and A in that order. XRD analysis revealed the presence of retained FCC austenitic phases within the microstructure whose peaks became stronger with the increased thermal fluctuations. The potentiodynamic polarisation studies revealed a distinct linear Tafel region on the cathodic region and a dual-slope inflection point on the anodic region of the polarisation curves. Sample D exhibited the highest corrosion rate whereas sample B revealed the lowest. As such, exposing fused filament fabricated 17-4 PH SS to fluctuating temperature conditions leads to degradation of mechanical strength and corrosion resistance.
Preventing risk of placement breakdown and hospital admission in the management of distressed behaviour in dementia care: A qualitative case study with family and care-home staff
Authors: Nunn Katherine , Crooks Suzanne , Gilroy Donna
Published: October 2024

Objectives: Behaviours such as hitting-out and declining personal care are commonly exhibited by people living with dementia and are associated with care-giver stress and anxiety and care home placement breakdowns. Traditionally, pharmacological approaches have been used to manage behaviour; however, research indicates limited effectiveness. National guidelines recommend use of non-pharmacological interventions as first line treatment for distress, but further research is required to elucidate the components that lead to improved care for people living with dementia. This study aims to explore what works, examining case studies in which a non-pharmacological clinical intervention, the Newcastle Model, was used to understand and manage distressed behaviour in dementia care within care home settings. Method: A qualitative case study design was used. Three cases were selected from the Edinburgh Behaviour Support Service for their success in preventing care home placement breakdown during a distressed behaviour intervention in NHS Scotland. Family members and staff involved in the interventions within these cases were interviewed ( N = 6). Thematic analysis was used to analyse data. Findings: All participants reported positive outcomes from the intervention. Three key themes were identified, each with subthemes. Participants described a supportive, non-judgmental environment which allowed them to integrate knowledge about dementia and tailor interventions to the specific needs of the individual living with dementia. There was also a sense of family and staff coming together to unite with shared goals. A preliminary model of all of themes and their interactions is presented. Conclusion: The study supports use of biopsychosocial, formulation-led approaches in the understanding and treatment of complex behavioural presentations in community care settings. It suggests that clinicians should endeavour to facilitate safe and open environments for care home staff and family members, in order to promote attribution change and person-centered care, and to help mediate differences and conflict between staff and family members.
Treason, secession and wars of independence
Authors: Maguire Ruairi
Published: October 2024

Are (unilateral) secessionists traitors? In this paper, I first set out an account of treason that is, I argue, superior to competing accounts. This account is the disjunctive account, and it holds that someone is a traitor if he or she participates in activities that aim to subject the political community to which they belong to ongoing serious violations of self-determination, or which aim to commit widespread, systematic violations of the basic rights of individual members of that political community. I then apply this account to the case of unilateral secession. Unilateral secession, I argue, need not be treasonous, in part because it is difficult to explain how even many cases of unjustified unilateral secession necessarily violates the self-determination of the political community seceded from, or violates the basic rights of its members. I argue that this is true even when the secessionists fight a war of independence against their state.
Education and Democratic Consolidation: A Report on Early Results
Authors: Kim Yeaji
Published: October 2024

This article reports on the early results of a research project examining the interplay between education and democratic consolidation, with a particular focus on how this relationship is significantly influenced by a country’s economic status. It addresses a gap in the literature by investigating the role of education across diverse economic contexts, challenging the prevailing notion that education uniformly promotes democratic stability. This study replicates and extends Milan Svolik’s research, which concentrated on economic factors. By analyzing data from 98 countries between 1950 and 2008, the study demonstrates that transitional democracies face a higher risk of authoritarian reversal compared to their consolidated counterparts. The findings suggest that while education generally benefits democracy, its impact is more pronounced in transitional democracies, steering them toward democratic stabilization and progress. Moreover, the democratizing effect of education is even more potent in transitional democracies with low economic development. This pattern underscores the critical role of education as a strategic asset for reinforcing democratic stability in economically diverse contexts and advocates for targeted educational policies in transitional democracies that are most susceptible to authoritarian regression.
Effect of a nurse-led integrated care intervention on quality of life and rehospitalisation in patients with severe exacerbation of COPD—a pilot study
Authors: Schmid-Mohler Gabriela , Hübsch Christine , Braun Julia , Steurer-Stey Claudia , Aregger Celine , Schaer Dominik J. , Clarenbach Christian
Published: October 2024

Objective

To explore the feasibility and effect of a nurse-led integrated care intervention on health-related quality of life (QoL) and unplanned 90-day rehospitalisation in patients hospitalised due to acute exacerbation of COPD (AECOPD).

Method

A monocentric non-randomized parallel cluster design was applied. The primary endpoint was the difference between Chronic Respiratory Questionnaire (CRQ) Mastery Scores at hospital discharge and 13 weeks post-discharge. Secondary endpoints were differences between other CRQ scores, numbers of rehospitalisations and self-reported exacerbations. The study would end either 13 weeks after the full sample size was achieved or when study time ran out.

Results

The study was terminated before reaching the targeted sample size. Of 174 invitees, 69 (39.7%, 30 control, 39 intervention) consented to participate. Of those, 47 completed the study, 45 of whom had complete data sets for the primary endpoint. No differences in QoL scores, unplanned COPD-related rehospitalisations or unplanned all-cause rehospitalisations were detected. The mean number of self-reported moderate exacerbations was higher in the intervention group ( p = 0.006).

Conclusion

The pilot study had slow recruitment, high drop-out rates, and no significant effect on 3-month outcomes. Further research should focus on enhancing the current understanding of how to motivate and recruit patients in this setting.

ClinicalTrials.gov ID

NCT 04011332.
Mapping the Landscape of Trauma-Informed Care in Social Work: A Critical Scoping Review
Authors: Leotti Sandra M. , Wahab Stéphanie
Published: October 2024

Trauma-informed care (TIC) has gained significant traction in social work over the last decade, becoming a key organizing principle despite a dearth of empirical evidence attesting to its effectiveness. Addressing this paradox, our scoping review examines TIC’s conceptualization and application in the field, exploring its theoretical underpinnings and empirical support. We analyzed 131 peer-reviewed articles from 2012 to 2022, following Arksey and O’Malley’s framework, with inclusion criteria focused on English-language, peer-reviewed journal articles on TIC within U.S. social work. The identification of articles involved a systematic search across three online databases—Social Service Abstracts, Social Science Citation Index, and Social Work Abstracts—using the search terms “trauma informed*” and “social work” to capture relevant articles through keywords, subject headings, and titles. Our analysis revealed a broad understanding of trauma and a tendency toward emphasizing individual-level experiences, with infrequent acknowledgment of institutional or structural trauma. While TIC is applied across diverse domains, particularly in education and child welfare, its practical application lacks clarity and specificity. Critically, we found a reliance on the perceived prevalence of trauma rather than robust research to justify TIC’s adoption. The inconsistent use of theory, primarily at the micro-level, and the wide range of practices resembling established social work methods raise questions about TIC’s distinctiveness and unique contribution. Considering these findings, we urge a critical reassessment of TIC, focusing on its implications for practice and research.
Neuronal Excitability in Trisomy 21—Up or Down?
Authors: Stafstrom Carl E.
Published: October 2024

[Box: see text]
Access for Students with Extensive Support Needs to State-Adopted Grade-Level Standards and Curriculum in General Education Classes: A Content Analysis of the Literature
Authors: Gee Kathy , Burnette Kristin , Walker Virginia L. , Ryndak Diane , Fisher Mary , Baker Dale , Clausen Amy
Published: October 2024

In this article, we provide a summary of a literature review conducted to determine how the published literature, including research articles, conceptual articles, and chapters, (a) describes access to the state-adopted grade-level standards in general education classes for students with extensive support needs (ESN) and (b) discusses recommended processes for determining meaningful access to the state-adopted grade-level standards in general education classes for students with ESN. We reviewed a total of 554 pieces of published literature considered for inclusion in our summary. Based on our inclusion and exclusion criteria, we included 32 articles and chapters in the final analysis. The review yielded important information related to six themes, including (a) the language used to describe students with ESN; (b) the varying understandings, or perceptions, of what access to the state-adopted grade-level standards means; (c) the recommended steps in the processes that teams might use to provide access to the state-adopted grade-level standards, and the alignment between standards and Individualized Education Program goals; (d) the short- and long-term outcomes of access to and inclusion in the general education curriculum; (e) who is involved; and (f) the ways in which progress monitoring and assessment were implemented. We conclude with our recommendations for future research.
Complex Exercises Improve Cognition in People With Parkinson’s Disease and Freezing of Gait
Authors: Silva-Batista Carla , Almeida Filipe Oliveira de , Batista Alana , Barbosa Egberto Reis , Horak Fay B. , Ugrinowitsch Carlos
Published: October 2024

Background

Evidence has suggested that cognitive decline may be a risk factor for freezing of gait (FOG) in Parkinson’s disease (PD). Complex and challenging exercises have been suggested as potential rehabilitation strategies to decrease FOG severity and improve cognition; however, it is unknown whether improvement in cognition would explain decreased FOG severity following exercise.

Objective

In this secondary analysis, we evaluated the effects of the adapted resistance training with instability (ARTI-complex and challenging exercises) compared with traditional motor rehabilitation (TMR-without challenging exercises) on cognitive function in people with FOG of PD. We also verified whether cognitive improvement explains the decrease in FOG previously published.

Methods

Participants were randomized to either the experimental group (ARTI, n = 17) or the active control group (TMR, n = 15). Both training groups exercised 3 times a week for 12 weeks (80-90 minute each session). FOG severity (FOG ratio from inertial sensors during a 360° turning-in-place task), frontal lobe function (Frontal Assessment Battery [FAB]), global cognition (Montreal Cognitive Assessment [MoCA]), and attention and psychomotor speed (Digit Symbol Substitution Test [DSST]) were evaluated before and after interventions.

Results

Only the ARTI group improved FAB, MoCA, and DSST scores at posttraining. In addition, ARTI was more effective than TMR in improving FAB scores at posttraining. The changes in FAB scores explained the changes in FOG ratio following ARTI ( R2 = .43, P < .01).

Conclusions

This pilot study suggests that ARTI, a complex and challenging training, improves cognition in people with FOG of PD. Improvements in frontal lobe function with ARTI help explain decreased FOG severity.
Navigating the Complexities of School Leadership for Students With Disabilities
Authors: Stark Kristabel , Billingsley Bonnie
Published: October 2024

This case study delves into the complexities faced by Principal Williams, a newly appointed leader at Hudford Elementary School, as she navigates the challenges of providing high-quality education for students with disabilities in an elementary school. Under the Individuals with Disabilities Education Act (IDEA), each student with a disability is required to have access to the general education curriculum and specially designed instruction (SDI) that is tailored to the student’s unique needs. As Principal Williams steps into her role as leader of Hudford Elementary School, she has questions about the current service delivery model for students, the distribution of responsibilities across general and special education, and the extent of inclusion. She is considering her next steps, including how she will address some problematic working conditions experienced by special educators at the school. Through this case, readers gain insights into the complexity of supporting students with disabilities in a time of teacher shortages and learn about identifying the resources teachers need to fulfill their responsibilities.
Improved black-winged kite algorithm and finite element analysis for robot parallel gripper design
Authors: Haohao Ma , As’arry Azizan , Yanwei Feng , Lulu Cheng , Delgoshaei Aidin , Ismail Mohd Idris Shah , Ramli Hafiz Rashidi
Published: October 2024

This paper presents a comprehensive study on the design optimization of a robotic gripper, focusing on both the gripper modeling and the optimization of its parallel mechanism structure. This study integrates the Black-winged Kite Algorithm (BKA), Finite Element Analysis (FEA), Backpropagation Neural Network (BPNN), and response surface optimization techniques. The Good Point Set (GPS), nonlinear convergence factor, and adaptive t-distribution method improve BKA, which enhances exploration and exploitation performance, convergence speed, and solution quality. Subsequently, the parallel mechanism structure is designed to minimize the total mass, total deformation, and maximum equivalent stress. The central composite design (CCD) method was used to design the FEA experiment and establish the BKA-BPNN regression prediction model. The RMSE of this model’s training set and test set are 0.001615 and 0.0029328. A response surface optimization model is constructed to determine the best design solution. The optimized design achieves a 33.12% reduction in maximum equivalent stress, a 1.47% decrease in total mass, and a 0.16% reduction in maximum total deformation. This study provides valuable insights into the design optimization process for robotic grippers, showcasing the effectiveness of the proposed methodologies in enhancing performance while reducing mass and improving structural integrity.
Transnational chain ownership of news media: Integration and independence across borders in DPG media
Authors: Hendrickx Jonathan , Kammer Aske
Published: October 2024

So far, studies that investigate the effects of increased media ownership concentration across countries on corporations’ management have been limited in size and scope, particularly from a European perspective. To approach this research gap, we conduct and analyze a series of expert interviews with executives and chief personnel of one transnational European media. The findings allow us to shine light on how cultural and linguistic diversity and proximity play crucial roles in either fostering or limiting opportunities for synergy operations, digital transformation, and an internationally oriented management style of news media firms.
A retrospective real-world study on the safety and efficacy of budesonide orodispersible tablets for the induction therapy of eosinophilic oesophagitis
Authors: Geow Rachel , Arena Gina , Siah Chiang , Picardo Sherman
Published: October 2024

Background:

An orodispersible form of budesonide has recently been approved for the targeted treatment of eosinophilic oesophagitis in the United Kingdom, Europe, Australia, Canada and the United States, following favourable results from a randomised controlled trial. This is the first dedicated real-world study exploring the safety and efficacy of budesonide orodispersible tablets for induction therapy in the treatment of eosinophilic oesophagitis while providing insights into its management.

Objectives:

The primary objective was histologic remission, defined as less than 5 eosinophils per high-powered field. The secondary objectives included histologic response (>50% reduction in peak eosinophil count), clinical remission (complete resolution of symptoms documented on clinic letters), clinical response (improvements in symptoms as reported on clinical letters), endoscopic remission (Endoscopic Reference Score (EREFS) score = 0), and endoscopic response (improvement in EREFS score). The EREFS scores were calculated based on the severity and presence of rings, longitudinal furrows, strictures, oedema and exudates on endoscopic images. Adverse events and safety profiles were also recorded.

Design:

A multicentre cohort study examining the effectiveness of 1 mg, twice daily, budesonide orodispersible tablet induction therapy for the treatment of eosinophilic oesophagitis.

Methods:

Ethics approval was obtained through the Western Australia Health: Governance, Evidence, Knowledge, Outcomes system for assessment of Audit and Quality Activities. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Results:

A total of 43 patients (29 males, 14 females; median age 39) were recruited. Forty-one patients were included in the analysis. After induction therapy, 30 patients (73%) achieved histologic remission, and 35 patients (85%) demonstrated histologic response. Thirty-nine patients (95%) achieved clinical response, and 28 patients (68%) achieved clinical remission. An endoscopic response was seen in 37 patients (90%), and 16 patients (39%) achieved endoscopic remission. No significant adverse events were identified.

Conclusion:

Budesonide orodispersible tablet is an effective induction therapy for eosinophilic oesophagitis, as evidenced by its high histologic remission rate and favourable safety profile.
Should we be afraid of radiotherapy for hemorrhagic brain metastases? A narrative review
Authors: Łupicka Aleksandra , Kowalczyk Weronika , Cyman Bartosz , Spałek Mateusz
Published: October 2024

Brain metastases (BM) are the most common intracranial malignancies. They are responsible for death as well as impairment of quality of life and cognitive function. In some cases, BMs can cause intracranial hemorrhage, which is not only responsible for the acute onset of either a new focal neurological deficit or worsening of a preexisting focal deficit but also poses a new challenge in treatment planning and clinical management. The aim of this study was to evaluate the available treatment modalities and their efficacy in hemorrhagic brain metastases (HBMs) with special attention to radiotherapy. In this review, we searched PubMed, BMJ, NCBI, Springer, BMC Cancer, Cochrane, and Google Scholar for articles containing data on the diagnosis and treatment of patients with HBMs, excluding the pediatric population. Treatment strategies consist of neurosurgery, whole brain radiotherapy, and stereotactic techniques (fractionated stereotactic radiosurgery (fSRS)/stereotactic radiosurgery (SRS)). Although the optimal treatment strategy for HBMs has not been established, we found no convincing evidence that radiotherapy, especially fSRS/SRS, is contraindicated in HBMs. We concluded that fSRS/SRS is a promising option for patients with HBM, particularly when surgical intervention poses risks.
GLP-1 Receptor Agonists Models for Type 1 Diabetes: A Narrative Review
Authors: Furió-Novejarque Clara , Díez José-Luis , Bondia Jorge
Published: October 2024

Background:

Glucagon-like peptide 1 (GLP-1) is a hormone that promotes insulin secretion, delays gastric emptying, and inhibits glucagon secretion. The GLP-1 receptor agonists have been developed as adjunctive therapies for type 2 diabetes to improve glucose control. Recently, there has been an interest in introducing GLP-1 receptor agonists as adjunctive therapies in type 1 diabetes alongside automatic insulin delivery systems. The preclinical validation of these systems often relies on mathematical simulators that replicate the glucose dynamics of a person with diabetes. This review aims to explore mathematical models available in the literature to describe GLP-1 effects to be used in a type 1 diabetes simulator.

Methods:

Three databases were examined in the search for GLP-1 mathematical models. More than 1500 works were found after searching for specific keywords that were narrowed down to 39 works for full-text assessment.

Results:

A total of 23 works were selected describing GLP-1 pharmacokinetics and pharmacodynamics. However, none of the found models was designed for type 1 diabetes. An analysis is included of the available models’ features that could be translated into a GLP-1 receptor agonist model for type 1 diabetes.

Conclusion:

There is a gap in research in GLP-1 receptor agonists mathematical models for type 1 diabetes, which could be incorporated into type 1 diabetes simulators, providing a safe and inexpensive tool to carry out preclinical validations using these therapies.
Optimal treatment targets for lupus nephritis using per-protocol repeat kidney biopsy findings at 2 years and clinical data up to 5 years: a single-center observational study
Authors: Kagawa Hidetoshi , Yamanaka Ryutaro , Matsubara Ai , Inoue Tatsuyuki , Hayashi Reika , Kubota Natsuki , Hiromasa Tsutomu
Published: October 2024

Background:

The criteria for remission in both clinical and pathological contexts for lupus nephritis (LN) remain controversial.

Objectives:

To identify optimal short-term goals (remission criteria) for LN predicting long-term success at 5 years, using repeat kidney biopsy (Biopsy 2) and clinical data.

Design:

Single-center observational study.

Methods:

Twenty-three consecutive LN patients undergoing Biopsy 2 2 years post-induction therapy were evaluated. Two ideal long-term goals at 5 years were defined as: “A,” Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) = 0 and prednisolone (PSL) ⩽5 mg/day, and “B,” proteinuria ⩽0.2 g/day with a normal serum creatinine level and PSL ⩽5 mg/day. Histologically, the electron-dense deposit (EDD) score grades immune deposits based on their intensity, amount, and location. A score of ⩽1 was defined as “electron microscopy remission (ER).”

Results:

Conventional renal indices failed to predict long-term goals. The short-term goals with an accuracy (area under the curve: 95% confidence interval) of ⩾0.8 predicted long-term goals: “A at 5 years” (A-5y), A-2y (0.91: 0.79–1.00), DORIS-R-2y (0.87: 0.72–1.00), EDD score (0.85: 0.70–1.00), B-2y (0.83: 0.66–0.99), and SLEDAI-R-2y (0.82: 0.66–0.98) as well as “B at 5 years” (B-5y), A-2y (0.87: 0.73–1.00), B-2y (0.87: 0.73–1.00), EDD score (0.85: 0.69–1.00), and DORIS-R-2y (0.83: 0.67–0.99). EDD scores predicted A-5y, B-5y, and PSL dose at 5 years in proportion to the score. The clinical and histological goals aligned.

Conclusion:

The best predictive short-term goal was A-2y. Concordance between clinical remission (A-2y, B-2y, and DORIS-R-2y) and histological remission (ER) at 2 years suggests optimal short-term goals for LN.
Optimization and analysis of hysteretic energy dissipators in reinforced concrete frame structures of five, 10 and 15 stories
Authors: Dominguez-Santos David
Published: October 2024

Frame structures are especially affected by earthquakes, due to their low lateral resistance. The use of energy dissipators may be a suitable solution for these structures; however, the effectiveness of these devices is questionable in low-rise buildings. We therefore analyze the behavior of these devices in frame buildings with varying numbers of stories (five, 10 and 15 stories). The use of hysteretic dissipators is found to considerably reduce the displacements of the bare structures, in addition to significantly improving their resistance, although the absolute accelerations are not reduced. Taller, more slender structures require less rigid dissipators with lower yield forces than shorter, more rigid structures. The effectiveness of the dissipators is also demonstrated by increasing the number of stories of the structures. The effectiveness of the dissipators increases as the rigidity of the structure decreases, as observed for the highest frame structures considered in this research, or as also occurs with the characteristics of the seismic records, such as their impulsivity. A high level of rigidity of the structures (as in low-rise structures or those with a significant number of stiffening elements, such as walls or braces) may have a significant impact on the behavior of the dissipators, due to the low displacement of the bare structures, which reduces their effectiveness. Finally, given the complexity of the different designs for dissipators in the scientific literature, this research offers a new, simple way to design dissipators based on the structural characteristics of the bare frames. To carry out this research, a nonlinear static analysis (push-over) and dynamic analysis are carried out using two different characteristic records, as part of a search for the optimal characteristics of the devices and to analyze how each of them affects the structural behavior in buildings with different numbers of stories.
Venopulmonary extracorporeal membrane oxygenation for right ventricular support as a bridge to lung transplantation: A narrative review
Authors: Thuan Phan Quang , Nam Nguyen Hoai , Dinh Nguyen Hoang
Published: October 2024

This review evaluates the effectiveness of veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation strategy in patients undergoing veno-venous extracorporeal membrane oxygenation while awaiting lung transplantation. Examining indications, contraindications, and clinical outcomes, the study highlights potential benefits, drawing insights from successful cases in South Korea and the United States. Despite limited sample sizes, veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation emerges as a promising approach for further investigation in lung transplantation support. The review emphasizes its role in improving hemodynamic status, preventing complications during extended waiting periods, and presenting a cost-effective alternative to traditional methods, especially in developing countries. While in-hospital mortality rates range from 0% to 10%, comparable to other approaches, cautious optimism surrounds veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation, urging expanded research to solidify its standing in enhancing patient outcomes, reducing costs, and promoting transplant success.
Increasing incidence of syphilis: A case report of non-resolving papulosquamous rash and role of a biopsy in the prevention of delayed diagnosis
Authors: Bajwa Barinder K , Brown Chad R , Mirzanejad Yazdan , Shiau Carolyn J
Published: October 2024

Syphilis is a sexually transmitted infection that is undergoing a resurgence in Canada and around the world. If not diagnosed correctly, syphilis can progress to its secondary and tertiary stages, affecting numerous organ systems. We present a case of a 41-year-old female who developed a papulosquamous rash, initially diagnosed as varicella with progression to a widespread and painful rash over 3 months. Based on clinical, histological, and serological findings, she was later diagnosed with secondary syphilis and successfully treated with intramuscular penicillin. This case underscores the importance of accurate diagnosis and treatment of syphilis to prevent systemic complications. We advocate for increased awareness among frontline providers with a proactive approach to diagnosis and management, including thorough history and physical examination, low threshold for performing serological testing, biopsy for lesions that do not resolve as expected with management, and multidisciplinary involvement for complex presentations of syphilis.