bluuebunny/crossref_metadata_2025 huggingface dataset:
Telehealth Trials to Address Health Equity in Stroke Survivors
Authors: Sharrief Anjail Z. , Guzik Amy K. , Jones Erica , Okpala Munachi , Love Mary F. , Ranasinghe Tamra Ishan Jayenda , Bushnell Cheryl
Published: January 2023

Telehealth has seen rapid expansion into chronic care management in the past 3 years because of the COVID-19 pandemic. Telehealth for acute care management has expanded access to equitable stroke care to many patients over the past two decades, but there is limited evidence for its benefit for addressing disparities in the chronic care of patients living with stroke. In this review, we discuss advantages and disadvantages of telehealth use for the outpatient management of stroke survivors. Further, we explore opportunities and potential barriers for telehealth in addressing disparities in stroke outcomes related to various social determinants of health. We discuss two ongoing large randomized trials that are utilizing telehealth and telemonitoring for management of blood pressure in diverse patient populations. Finally, we discuss strategies to address barriers to telehealth use in patients with stroke and in populations with adverse social determinants of health.
Sex Difference in Capillary Reperfusion After Transient Middle Cerebral Artery Occlusion in Diabetic Mice
Authors: Zhu Wenbin , Davis Catherine M. , Allen Elyse M. , Feller Sarah L. , Bah Thierno M. , Shangraw Robert E. , Wang Ruikang K. , Alkayed Nabil J.
Published: January 2023

Background:

Type 2 diabetes (DM2) exacerbates stroke injury, reduces efficacy of endovascular therapy, and worsens long-term functional outcome. Sex differences exist in stroke incidence, response to therapy, poststroke microvascular dysfunction, and functional recovery. In this study, we tested the hypotheses that poor outcome after stroke in the setting of DM2 is linked to impaired microvascular tissue reperfusion and that male and female DM2 mice exhibit different microvascular reperfusion response after transient middle cerebral artery occlusion (MCAO).

Methods:

Transient MCAO was induced for 60 minutes using an intraluminal filament in young adult DM2 and nondiabetic control male and female mice. Capillary flux in deep cortical layers was assessed using optical coherence tomography–based optical microangiography (OMAG), and associated regional brain infarct size was evaluated by hematoxylin and eosin staining.

Results:

Compared to baseline, MCAO reduced absolute capillary red blood cell flux by 84% at 24 hours post-MCAO in male DM2 (
P
<0.001) but not male control mice. When normalized to pre-MCAO baseline, red blood cell flux 24 hours after stroke was 64% lower in male DM2 mice than male nondiabetic controls (
P
<0.01). In females, MCAO decreased capillary flux by 48% at 24 hours post-MCAO compared with baseline in DM2 (
P
<0.05) but not in control mice. Red blood cell flux of female DM2 mice did not differ from that of nondiabetic controls either before or 24 hours after MCAO. Furthermore, normalized capillary flux 24 hours after MCAO failed to differ between female DM2 mice and nondiabetic controls. Concomitantly, male but not female DM2 mice experienced 25% larger infarct in caudate-putamen versus respective nondiabetic controls (
P
<0.05).

Conclusions:

DM2 impairs capillary perfusion and exacerbates ischemic deep brain injury in male but not female young adult mice. Premenopausal females appear to be protected against DM2-related capillary dysfunction and brain injury.
Intracranial Artery Calcifications Profile as a Predictor of Recanalization Failure in Endovascular Stroke Treatment
Authors: Rodrigo-Gisbert Marc , Requena Manuel , Rubiera Marta , Khalife Jane , Lozano Prudencio , De Dios Lascuevas Marta , García-Tornel Álvaro , Olivé-Gadea Marta , Piñana Carlos , Rizzo Federica , Boned Sandra , Muchada Marian , Rodríguez-Villatoro Noelia , Rodríguez-Luna David , Juega Jesús , Pagola Jorge , Hernández David , Molina Carlos A. , Tomasello Alejandro , Ribo Marc
Published: January 2023

Background:

Acute ischemic stroke with large or medium-vessel occlusion associated with intracranial artery calcification (IAC) is an infrequent phenomenon presumably associated with intracranial atherosclerotic disease. We aimed to characterize IAC and its impact on endovascular treatment outcomes.

Methods:

We performed a retrospective cross-sectional study of consecutive patients with stroke treated with thrombectomy from January 2020 to July 2021 in our institution. We described IAC findings (length, density, and location pattern) on baseline noncontrast computed tomography. Patients were divided into 3 groups: IAC related to the occlusion location (symptomatic-IAC group), unrelated to the occlusion (asymptomatic-IAC group), and absence of any IAC (non-IAC group). We analyzed the association between the IAC profile and outcomes using logistic regression models. Intracranial angioplasty and stenting were considered rescue treatments.

Results:

Of the 393 patients included, 26 (6.6%) patients presented a symptomatic-IAC, 77 (19.6%) patients an asymptomatic-IAC, and in 290 (73.8%) patients no IAC was observed. The rate of failed recanalization (expanded Thrombolysis in Cerebral Infarction 0-2a) before rescue treatment was higher in symptomatic-IAC (65.4%) than in asymptomatic-IAC (15.6%;
P
<0.001) or non-IAC (13.4%;
P
<0.001). Rescue procedures were more frequently performed in symptomatic-IAC (26.9%) than in asymptomatic-IAC (1.3%;
P
<0.001) and non-IAC (4.1%;
P
<0.001). After adjusting for identifiable clinical and radiological confounders, symptomatic-IAC emerged as an independent predictor of failed recanalization (odds ratio, 11.89 [95% CI, 3.94–35.91];
P
<0.001), adoption of rescue procedures (odds ratio, 12.38 [95% CI, 2.22–69.09];
P
=0.004), and poor functional outcome (90-day modified Rankin Scale score ≥3; odds ratio, 3.51 [95% CI, 1.02–12.00];
P
=0.046).

Conclusions:

The presence of IAC related to the occlusion location is associated with worse angiographic and functional outcomes. Therefore, identification of symptomatic-IAC on baseline imaging may guide optimal endovascular treatment strategy, predicting the need for intracranial stenting and angioplasty.
Maternal Health Outcomes After Pregnancy-Associated Stroke: A Population-Based Study With 19 Years of Follow-Up
Authors: Yu Amy Y.X. , Nerenberg Kara A. , Diong Christina , Fang Jiming , Chu Anna , Kapral Moira K. , Edwards Jodi D. , Dancey Sonia R. , Austin Peter C. , Auger Nathalie
Published: January 2023

Background:

Pregnancy-associated stroke carries high short-term morbidity and mortality, but data on subsequent maternal outcomes are limited. We evaluated long-term maternal health outcomes after pregnancy-associated stroke.

Methods:

In this retrospective cohort study, we used administrative data to identify pregnant adults aged ≤49 years with stroke between 2002-2020 in Ontario, Canada and 2 comparison groups: (1) non-pregnant female patients with stroke and (2) pregnant patients without stroke. Patients who survived the index admission were followed until 2021. After propensity score matching, we used Cox regression with a robust variance estimator to compare pregnant patients with stroke and the 2 comparison groups for the composite outcome of death and all-cause non-pregnancy readmission. Where proportional hazard assumption was not met, we reported time-varying hazard ratios (HR) with 95% CIs by modeling the log-hazard ratio as a function of time using restricted cubic splines.

Results:

We identified 217 pregnant patients with stroke, 7604 non-pregnant patients with stroke, and 1 496 256 pregnant patients without stroke. Of the 202 pregnant patients with stroke who survived the index stroke admission, 41.6% (6.8 per 100 person-years) subsequently died or were readmitted during follow-up. Median follow-up times were 5 years (pregnancy-associated stroke), 3 years (non-pregnant stroke), and 8 years (pregnant without stroke). Pregnant patients with stroke had a lower hazard of death and all-cause readmission compared with non-pregnant patients with stroke at 1-year follow-up (HR, 0.64 [95% CI, 0.44–0.94]), but this association did not persist during longer-term follow-up. Conversely, pregnant patients with stroke had higher hazard of death and readmission compared with pregnant patients without stroke at 1-year follow-up (HR, 5.70 [95% CI, 3.04–10.66]), and this association persisted for a decade.

Conclusions:

Stroke during pregnancy is associated with long-term health consequences. It is essential to transition care postpartum to primary or specialty care to optimize vascular health.
Worsened Stroke Outcome in a Model of Preeclampsia is Associated With Poor Collateral Flow and Oxidative Stress
Authors: Cipolla Marilyn J. , Tremble Sarah M. , DeLance Nicole , Johnson Abbie C.
Published: January 2023

Background:

Preeclampsia increases the incidence of maternal stroke, a devastating condition that is on the rise. We investigated stroke outcome in a model of experimental preeclampsia with and without treatment with clinically relevant doses of magnesium sulfate (experimental preeclampsia+MgSO
4
) compared to normal late-pregnant and nonpregnant rats.

Methods:

Transient middle cerebral artery occlusion was used to induce focal stroke for either 1.5 or 3 hours. Infarct volume and hemorrhagic transformation were determined as measures of stroke outcome. Changes in core middle cerebral artery and collateral flow were measured by dual laser Doppler. The relationship between middle cerebral artery perfusion deficit and infarction was used as a measure of ischemic tolerance. Oxidative stress and endothelial dysfunction were measured by 3-nitrotyrosine and 8-isoprostane, in brain and serum, respectively.

Results:

Late-pregnant animals had robust collateral flow and greater ischemic tolerance of brain tissue, whereas experimental preeclampsia had greater infarction that was related to poor collateral flow, endothelial dysfunction, and oxidative stress. Importantly, pregnancy appeared preventative of hemorrhagic transformation as it occurred only in nonpregnant animals. MgSO
4
did not provide benefit to experimental preeclampsia animals for infarction.

Conclusions:

Stroke outcome was worse in a model of preeclampsia. As preeclampsia increases the risk of future stroke and cardiovascular disease, it is worth understanding the influence of preeclampsia on the material brain and factors that might potentiate injury both during the index pregnancy and years postpartum.
Stroke in Women and Unique Risk Factors
Authors: Bushnell Cheryl D. , Kapral Moira K.
Published: January 2023

There has been a plethora of studies focused on female-specific risk factors and sex differences in stroke published in the past year. This article summarizes several of those novel studies which provide new knowledge about the field of stroke in women. The Nurses’ Health Study II provides new data on the association between laparoscopically proven endometriosis and future stroke, accounting for the mediation effects of hysterectomy and oophorectomy. In a cohort of women from China, the relationship between hysterectomy, oophorectomy, and stroke is further clarified, accounting for the age at which the procedure is performed. The UK Biobank study provides new information on the relationship between oral contraceptive and hormone replacement therapy and stroke, with analytical techniques that focus on the timing of events related to duration of exposure. Finally, 2 new meta-analyses address the question of whether sex differences exist in the presentation of stroke symptoms.
Commitment Phrase: Linking Proposition to Illocutionary Force
Authors: Miyagawa Shigeru , Hill Virginia
Published: January 2023

This article provides empirical support for the projection of a Commitment Phrase (CommitP) in the field that maps the conversational pragmatics at the periphery of clauses. Krifka (2015, 2019, 2020) proposes CommitP as a projection that maps the speaker’s commitment to act on the proposition insofar as the speaker has evidence for the truth condition or expects the addressee to produce and commit to such evidence. CommitP replaces Ross’s (1970) idea that the speaker/addressee is related to the proposition by a speech-act predicate such as declare. Krifka argues for the alternative approach primarily on theoretical grounds. This article verifies and validates this proposal on the basis of Japanese sentence-final particles and Romanian speechact particles. We extend our analysis beyond these languages that overtly mark CommitP to English, which does not, by proposing an analysis of so-called biased questions that incorporates CommitP.
The Interaction Between Optimism and Pessimism Predicted the Perceived Risk of Infection During the Covid-19 Pandemic: An Exploratory Cross-Sectional Study
Authors: Simione Luca , Gnagnarella Camilla , Spina Giulia , Bersani Giuseppe
Published: January 2023

In this study, we examined the relationship between optimism and pessimism associated with the Covid-19 pandemic, mental health, and perceived risk of infection. In particular, we tested the hypothesis that, when optimism and pessimism were high during the pandemic period, a worse mental health and a higher perception of risk would be reported. To this end, a convenience sample of 374 Italian adults was enrolled. Measures included perceived stress, optimism, and pessimism associated with the development of the pandemic situation, as well as the perceived risk of Covid-19 infection. The results showed that optimism and pessimism were associated with perceived stress and Covid-19 risk perception while controlling for demographic variables. Optimism and stress were negatively related, while pessimism was positively related to both stress and risk perception. Furthermore, the interaction between optimism and optimism was significant, with a higher perception of risk in the presence of both high optimism and pessimism, and a lower perception of risk with high optimism and low pessimism. These results support the hypothesis that optimism and pessimism interacted in predicting Covid-19 risk perception and show that they should be measured as partially correlated but independent constructs in future investigations.
Global Narratives of Ecological Modernization: The Construction of Climate Change op-eds in China Daily and the New York Times
Authors: Moscato Derek , Valencia Ricardo
Published: January 2023

This study assesses the journalistic sources contributing to international climate change op-eds in tandem with narratives arising from this prominent platform for media elites and institutions. Through a theoretical lens of ecological modernization, this paper conducted a mixed methodological analysis featuring descriptive quantitative analysis and a subsequent narrative analysis. The authors first analyzed a dataset of 305 op-eds published by the New York Times and China Daily between January 2016 and October 2019. The authors also assessed the narratively-constructed themes embedded within selected op-eds leading up to the United States’ departure from the Paris Agreement. These narratives, which featured appeals to a global ecological modernization, are (1) Humankind's shared economic destiny; (2) The new globalization and diplomacy; (3) The looming climate catastrophe. While the New York Times and China Daily featured different op-ed contributors and climate topics, both publications helped to construct larger unifying narratives about the role of climate change in global politics, economy, and society.
Computed tomography-based texture assessment for the differentiation of benign, borderline, and early-stage malignant ovarian neoplasms
Authors: He Ziying , Chen Jia , Yang Fei , Pan Xinwei , Liu Chanzhen
Published: January 2023

Objective

This study was performed to examine the value of computed tomography-based texture assessment for characterizing different types of ovarian neoplasms.

Methods

This retrospective study involved 225 patients with histopathologically confirmed ovarian tumors after surgical resection. Two different data sets of thick (5-mm) slices (during regular and portal venous phases) were analyzed. Raw data analysis, principal component analysis, linear discriminant analysis, and nonlinear discriminant analysis were performed to classify ovarian tumors. The radiologist’s misclassification rate was compared with the MaZda (texture analysis software) findings. The results were validated with the neural network classifier. Receiver operating characteristic curves were analyzed to determine the performances of different parameters.

Results

Nonlinear discriminant analysis had a lower misclassification rate than the other analyses. Thirty texture parameters significantly differed between the two groups. In the training set, WavEnLH_s-3 and WavEnHL_s-3 were the optimal texture features during the regular phase, while WavEnHH_s-4 and Kurtosis seemed to be the most discriminative features during the portal venous phase. In the validation test, benign versus malignant tumors and benign versus borderline lesions were well-distinguished.

Conclusions

Computed tomography-based texture features provide a useful imaging signature that may assist in differentiating benign, borderline, and early-stage ovarian cancer.
Odontogenic-like neoplasms of the rabbit cheek: pathological features and comparison to cutaneous trichoblastoma and jaw-associated ameloblastoma
Authors: Murphy Brian G. , Swan Emily , Affolter Verena K. , Ayala Sergio , Jennings Samuel , Cartoceti Andrew , LaDouceur Elise E. B.
Published: January 2023

Odontogenic neoplasms demonstrate unique histopathological features and are thought to arise from the germinal tissues of the developing tooth germ, effectively restricting their anatomic origin to the tooth-bearing regions of the jaw and directly associated soft tissues of the oral cavity. Ectopic odontogenic-like neoplasms located in the skin of cats, rabbits, and human beings challenge these assumptions. Here we describe the clinical, pathological, and immunohistochemical features of 6 spontaneously occurring odontogenic-like neoplasms arising in the cutaneous tissue of the cheek in client-owned pet rabbits, including ameloblastoma-like (n = 3), ameloblastic fibroma-like (n = 2), and ameloblastic carcinoma-like neoplasms (n = 1). Microscopically, all the cheek tumors featured neoplastic epithelium exhibiting odontogenic architectural structures (plexiform ribbons, anastomosing trabeculae, follicles, cysts, and irregular structures with rounded botryoid protuberances) and 1 or more cardinal odontogenic epithelial features (basal palisading, antibasilar nuclei, and central stellate reticulum–like cells). The pancytokeratin, cytokeratin 5/6, cytokeratin 14, and vimentin immunohistochemical patterns of these odontogenic-like lesions were most similar to those of jaw-associated ameloblastoma and differed from those of cutaneous trichoblastoma. All neoplasms were narrowly excised, and for lesions with clinical follow-up information, none had evidence of recurrence 1–7 months after surgical removal. Although evidence suggests that these odontogenic-like tumors of the rabbit cheek may be derived from ectopic rests of transformed tooth germ, the histogenesis of these lesions remains unresolved.
Transforming the perioperative medicine care model: The Singapore experience
Authors: Sim Xiu LJ , Kwa Charlene XW , He Yingke , Ng Kai L , Sim Eileen Y , Abdullah Hairil R
Published: January 2023

More than 300 million surgeries are performed worldwide annually. Established perioperative centres in the UK, USA and Australia have demonstrated the impact of improving perioperative care in reducing costs, increasing patient satisfaction and improving population health. Likewise, the surgical burden of care in Asia is increasing, but with sociocultural, economic and epigenetic differences compared to the west. As Singapore’s largest hospital, the Singapore General Hospital pre-admission perioperative clinic sees about 20,000 patients annually. We aim to illustrate Singapore General Hospital’s perioperative model of care to contribute to the paucity of literature describing perioperative programme implementation within Asia, and to encourage the cross-sharing of perioperative practices internationally. Our perioperative framework navigates risk assessment, risk counselling, and mitigation of health, medical and functional risks to better patients’ perioperative outcomes and population health. We have implemented evidence-based pathways for common conditions such as anaemia and malnutrition, including a multidisciplinary programme for the elderly to tackle frailty and reduce length of stay. We describe how we have enhanced local risk profiling with the Combined Assessment of Risk Encountered in Surgery surgical risk calculator derived locally using a gradient boosting machine learning model. Finally, we report clinical outcomes of these interventions and discuss further challenges and new initiatives at each tier of our perioperative model. Our perioperative care model provides a framework that other centres can adopt to promote value-driven care, while catering for differences in the Asian population, thereby promoting evidence-based improvements in the area of perioperative medicine.
Michael A. Perelman (1939–2020): A Tribute
Authors: Keaney Michael , Öncü T. Sabri , Barkin David
Published: January 2023

JEL Classification: B32, B50
Unions, Monitoring, and Deferred Compensation: Evidence From California School Districts
Authors: Bruno Paul
Published: January 2023

Public agencies vary considerably in the extent to which they defer compensation until later in workers’ careers and often heavily backload compensation even when frontloaded compensation would likely be more efficient. I use two-way fixed effects models and detailed longitudinal data on collective bargaining agreements, salaries, and fringe benefits in public school districts in California to test two common theories about the prevalence of deferred public sector compensation. I find no evidence that stronger unions bargain for more backloaded compensation on average. However, I find suggestive evidence that unions may prefer to bargain for more backloaded compensation when their members are more veteran. I find no support for the theory that administrators prefer to defer compensation when employee performance is more difficult to monitor. These results suggest that other explanations for the backloadedness of public sector compensation may hold more promise, though they also call for additional empirical investigation.
Evaluation of Early Tocilizumab Effect on Multiorgan Dysfunction in Critically Ill Patients With COVID-19: A Propensity Score-Matched Study
Authors: Aljuhani Ohoud , Korayem Ghazwa B. , Altebainawi Ali F. , Al Harthi Abdullah , Badreldin Hisham A. , Alsalloum Muath A. , Eljaaly Khalid , Alharbi Aisha , Aljehani Rowina , Vishwakarma Ramesh , Alenazi Abeer A. , Alalawi Mai , Alissa Abdulrahman , Al Aamer Kholoud , Al Enazi Huda , Almusallam Mohammed , Alshehri Abdulaziz , Bukhari Rawan , Alasmari Ghaday , AlQahtani Maha M. , Al Shammari Sultanah , Alsulaymi Hatim O. , Al Sulaiman Khalid
Published: January 2023

Background: Tocilizumab (TCZ) has been proposed as potential rescue therapy for severe COVID-19. No previous study has primarily assessed the role of TCZ in preventing severe COVID-19-related multiorgan dysfunction. Hence, this multicenter cohort study aimed to evaluate the effectiveness of TCZ early use versus standard of care in preventing severe COVID-19-related multiorgan dysfunction in COVID-19 critically ill patients during intensive care unit (ICU) stay. Methods: A multicenter, retrospective cohort study includes critically ill adult patients with COVID-19 admitted to the ICUs. Patients were categorized into two groups, the treatment group includes patients who received early TCZ therapy within 24 hours of ICU admission and the control group includes patients who received standard of care. The primary outcome was the multiorgan dysfunction on day three of the ICU admission. The secondary outcomes were 30-day, and in-hospital mortality, ventilator-free days, hospital length of stay (LOS), ICU LOS, and ICU-related complications. Results: After propensity score matching, 300 patients were included in the analysis based on predefined criteria with a ratio of 1:2. Patients who received TCZ had lower multiorgan dysfunction score on day three of ICU admission compared to the control group (beta coefficient: −0.13, 95% CI: −0.26, −0.01, P-value = 0.04). Moreover, respiratory failure requiring MV was statistically significantly lower in patients who received early TCZ compared to the control group (OR 0.52; 95% CI 0.31, 0.91, P-value = 0.02). The 30-day and in-hospital mortality were significantly lower in patients who received TCZ than those who did not (HR 0.56; 95% CI 0.37, 0.85, P-value = 0 .006 and HR 0.54; 95% CI 0.36, 0.82, P-value = 0.003, respectively). Conclusion: In addition to the mortality benefits associated with early TCZ use within 24 hours of ICU admission, the use of TCZ was associated with a significantly lower multiorgan dysfunction score on day three of ICU admission in critically ill patients with COVID-19.
Urine Output and Mortality in Patients Resuscitated from out of Hospital Cardiac Arrest
Authors: Sarma Dhruv , Tabi Meir , Rabinstein Alejandro A. , Kashani Kianoush , Jentzer Jacob C.
Published: January 2023

Background

Limited data exist regarding urine output (UO) as a prognostic marker in out-of-hospital-cardiac-arrest (OHCA) survivors undergoing targeted temperature management (TTM).

Methods

We included 247 comatose adult patients who underwent TTM after OHCA between 2007 and 2017, excluding patients with end-stage renal disease. Three groups were defined based on mean hourly UO during the first 24 h: Group 1 (<0.5 mL/kg/h, n = 73), Group 2 (0.5−1 mL/kg/h, n = 81) and Group 3 (>1 mL/kg/h, n = 93). Serum creatinine was used to classify acute kidney injury (AKI). The primary and secondary outcomes respectively were in-hospital mortality and favorable neurological outcome at hospital discharge (modified Rankin Scale [mRS]<3).

Results

In-hospital mortality decreased incrementally as UO increased (adjusted OR 0.9 per 0.1 mL/kg/h higher; p = 0.002). UO < 0.5 mL/kg/h was strongly associated with higher in-hospital mortality (adjusted OR 4.2 [1.6−10.8], p = 0.003) and less favorable neurological outcomes (adjusted OR 0.4 [0.2−0.8], p = 0.007). Even among patients without AKI, lower UO portended higher mortality (40% vs 15% vs 9% for UO groups 1, 2, and 3 respectively, p < 0.001).

Conclusion

Higher UO is incrementally associated with lower in-hospital mortality and better neurological outcomes. Oliguria may be a more sensitive early prognostic marker than creatinine-based AKI after OHCA.
Improved flame retardancy and smoke suppression properties of phenolic resin by incorporating MoO3 particles
Authors: Yang Xiong , Zhi Maoyong , Li Yuchuan , Xin Hui , Fan Rong , Chen Xiantao , Liu Quanyi , He Yuanhua
Published: January 2023

Phenolic resin (PF) is widely used in aerospace, composite materials, and other fields. However, large amount of heat and smoke are produced during its combustion process, which is an important factor limiting its usage. To solve this problem, additive flame retardant MoO3 has been incorporated into PF for improving its flame retardancy and smoke suppression properties. Thermogravimetric analyses results show that the T5% of PF composites was gradually decreased from 264°C to 184°C and the char yield of PF-10% MoO3 is 57 wt.%, higher than that of neat PF (50 wt.%). The PF composites with 10 wt.% MoO3 passed UL-94 V-0 rating with a limiting oxygen index value of 29.8%. Meanwhile, the total heat release and total smoke production of PF-10% MoO3 are 37.60 MJ/m2 and 5.79 m2 respectively, which are reduced by 30.5% and 24.8% compared with neat PF. Only 10 wt.% MoO3 provide a 56.5% reduction (from 255 to 111) in maximal smoke density, meaning the good smoke suppression properties of MoO3. The pyrolysis products components are determined by thermogravimetric analysis combined with Fourier transform infrared spectroscopy. Furthermore, the micromorphology and chemical structure of char residue are also investigated by scanning electron microscopy, x-ray diffraction and Raman spectroscopy techniques. The promoting carbonization effect of MoO3 significantly reduces the heat release and toxic smoke production of PF composites.
Consumable pin-friction stir spot welding of Al-Mg-Si alloy via pre-created hole and refilling: Microstructure evolution, defects, and shear/tensile failure load
Authors: Baghdadchi Amir , Movahedi Mojtaba
Published: January 2023

Since Al-Mg-Si alloys are widely used in the transportation industry, it is important to produce a sound and robust weld between the sheets of these alloys. The focus of this work is on the tensile-shear and cross-tension strengths of the consumable pin-friction stir spot welds (CP-FSSWs) without an exit-hole between the Al-6061 aluminum sheets. Before welding, a hole was created at the joint region in the base sheets and then, it was filled using a rotating consumable pin. The tensile-shear, cross-tension, and microhardness tests were employed to evaluate the mechanical properties of the spot welds. The results showed that the pre-created hole was entirely filled during the welding process. While a complete bond was formed between the consumable pin and the lateral surface of the hole, there were three distinct regions at the interface of the pin and the bottom of the hole: complete bond, kissing bond, and defects. Enhancement of the tool rotational speed decreased the area of the complete bond in the weld compared to the other regions. A linear relationship existed between the bonding area and weld failure load in the cross-tension test. The proposed relationship approved the impact of the swirly region at the interface of the base sheets on the weld strength. While in the cross-tension test, the weld failure load decreased from ∼2800 to ∼1950 N, it improved from ∼10,500 to ∼12,000 N in the tensile-shear test with enhancement of the tool rotational speed from 700 to 2000 rpm. The hardness measurements demonstrated that there was no common heat affected zone softening after CP-FSSW.
Assembling prevention: Technology, expertise and control in postwar Guatemala
Authors: Hochmüller Markus
Published: January 2023

This article examines the technopolitics of prevention in postwar Guatemala. In the 2010s, experts and policymakers shifted security governance in Central America’s most populous country towards anticipation. Against the background of rising gang violence, they implemented a set of sociopolitical and techno-material measures – based on the latest crime-control technologies, new policing strategies and urban design methods – in Guatemala’s most violent municipalities. The stated goals were to reconstruct state sovereignty and to improve public security by strengthening community resilience and inducing positive behavioural change in ‘at-risk’ citizens. Zooming in on the case of Villa Nueva, the article examines the emergence and effects of Guatemala’s ‘prevention assemblage’. It demonstrates that this technopolitical project has failed, as prevention turned into a new layer of control that shifted responsibility to local communities, further securitized urban spaces and populations, and reproduced exclusionary and repressive security governance.
Optimization design and stability analysis for a new class of inerter-based dynamic vibration absorbers with a spring of negative stiffness
Authors: Wu Liting , Wang Kai
Published: January 2023

This article investigates the parameter optimization problem for a novel inerter-based dynamic vibration absorber (IDVA) system with a grounded negative stiffness spring, which can be applied to many vibration control systems, such as building vibrations, bridge vibrations, vehicle suspensions, etc. The passive mechanical network in the IDVA system of this article is the parallel connection of a passive spring and a three-element damper-spring-inerter series network. First, the motion equations of the IDVA system are established based on Newton’s second law, and the transfer function in the dimensionless form is derived. Then, the H ∞ optimization problem is formulated for the given values of the mass ratio and negative stiffness ratio. Since it is found that the frequency response curves of this system pass through four fixed points that are independent of the damping ratio, the extended fixed-point method is adopted to optimize the system. Then, the analytical solutions of the optimal parameter values in terms of the mass ratio and negative stiffness ratio are derived, and the necessary and sufficient condition for the IDVA system with optimal parameter values to be stable is obtained by the Hurwitz criterion. Compared with other four optimal DVAs in the existing literature, the optimal IDVA system with a grounded negative stiffness spring can provide better H ∞ performance, and the numerical examples illustrate that the system can provide better time-domain performances under random excitations.
Improving the lubrication of WSNb nanocomposite coatings by the in-situ oxygen shielding effect at elevated temperatures: A combined study with density functional theory simulations
Authors: Zhu Jianing , Zeng Qunfeng , Zhang Bin , Yan Chao , He Wanjun , Lin Naiming
Published: January 2023

In order to improve the lubrication performance of the WS2-based coatings at elevated temperature, the mechanisms of enhancing the tribological performance of WSNb coatings at elevated temperatures are investigated. The WSNb coating doped with 11.9 at.% Nb exhibited excellent anti-friction and wear resistance, achieved a low coefficient of friction of 0.02 at 400 °C, and its wear resistance was much better than that of WS2-based coatings. The Nb metal and its sulfide in the coating are more sensitive to oxygen than WS2 at 400 °C, which reduces the oxygen concentration between the friction pairs and protects the WS2 lubricating phase from being oxided. In addition, Nb enhances the hardness and Young's modulus of the coatings through the solid solution strengthening effect, generating a more continuous and stable lubricating film during the silding process. First-principles calculation results demonstrated that the Nb spontaneously forms Nb-S bonds with S atoms in the coating. The molecular details of the Nb-S formation have been investigated in depth.
Effect of telemonitoring on readmissions for acute exacerbation of chronic obstructive pulmonary disease: A randomized clinical trial
Authors: Andersen Frank D , Trolle Christian , Pedersen Asger Roer , Køpfli Maria L , Børgesen Sanne , Jensen Michael S , Hyldgaard Charlotte
Published: January 2023

Introduction

Acute exacerbations of chronic obstructive pulmonary disease are associated with high morbidity and mortality. Telemonitoring may reduce the frequency of hospitalization. The aim of this study was to investigate the effect of telemonitoring on hospitalization rates for acute exacerbations of chronic obstructive pulmonary disease.

Methods

Patients were recruited during hospitalization and equally randomized to telemonitoring or usual care. Telemonitoring participants recorded symptoms and monitored oxygen saturation, heart rate, peak expiratory flow, and body weight. Alerts were generated if readings breached thresholds. Acute exacerbations of chronic obstructive pulmonary disease hospitalizations during the 6 months intervention were compared using logistic regression, and time to first hospitalization was assessed using Cox proportional hazard modeling. The incidence rates for acute exacerbations of chronic obstructive pulmonary disease hospitalization were compared using a negative binomial regression model with between-group comparisons expressed as incidence rate ratios. The telemonitoring group was used as reference.

Results

A total of 222 patients were randomized. 37/112 (33%) in the control group and 31/110 (28%) in the telemonitoring group experienced acute exacerbations of chronic obstructive pulmonary disease hospitalization during the intervention period, odds ratio of 1.26, confidence interval 0.71–2.23, p = 0.4. No difference was seen in time to first hospitalization, hazard ratio 1.23, CI 0.77–1.99, p = 0.4. The number of hospitalizations in the intervention period was 66 in the control group and 42 in the telemonitoring group, with incidence rate ratio 1.42, confidence interval 1.04–1.95, p = 0.03. Adjustment for dyspnea score, smoking, and cohabitation status did not change the results, incidence rate ratio 1.44, confidence interval 1.05–1.99, p = 0.02.

Discussion

Patients who received telemonitoring experienced significantly fewer acute exacerbations of chronic obstructive pulmonary disease hospitalizations, although the overall risk of having at least one hospitalization and the time to first hospitalization was similar between the two groups.
Introducing an “invisible enemy”: A case study of knowledge construction regarding microplastics in Japanese Wikipedia
Authors: Fu Mengyuan , Yang Kunhao , Fujigaki Yuko
Published: January 2023

Microplastics, a novel global environmental problem, has become a fast-developing research field with worldwide investments. With scientific development, social science studies are expected to contribute to developing more effective communication on microplastics. Among various media, this article focused on Wikipedia and discussed one particular situation—when the language of Wikipedia differs from the language of mainstream information sources. Inspired by actor network theory, we analyzed the revision history of the Japanese Wikipedia article on microplastics from 2014 to 2020 and elucidated how knowledge of microplastics was textually constructed. We found editors’ reluctance to disprove and update the latest scientific knowledge in edit actions, as well as problems and flaws existing in the created knowledge that shows limited enforcement of Wikipedia policies. Based on the findings, we urge more attention to improving the public knowledge of fast-developing science, especially when the knowledge construction might encounter a cross-language context.
Interrogating “the nation” in European online education: Topological forms and movements
Authors: van de Oudeweetering Karmijn , Decuypere Mathias
Published: January 2023

This paper was inspired by empirical encounters with students and teacher-administrators who engaged with an online European education initiative, which raised questions about whether and how their practices were situated as local, transnational, or national(ist) endeavors. The conceptual, theoretical, and methodological resources of social topology and critical border studies guided our inquiry by a focus on bordering practices and how these generate spatiotemporal forms and movements, and evoked a typical national form which is characterized as a singular, stable, linear, and flat “topography.” An innovative methodology is deployed to scrutinize how practices with this online, European initiative continue, challenge or complement that typical national form. The findings demonstrate how the use of topographical indexes and tropes (re-)materialized characteristics of these typical national forms, while the combination with topological relations introduced multiplicities and “levels” in these forms. Moreover, spherical forms, bouncing movements, and tunneling movements challenged the singularity, stability, linearity, and flatness of the typical national form. Building on these findings, the paper sets forth the argument that this online European education initiative mainly challenges the enactment of nationalism in classrooms by encouraging learning and thinking through translocalities, which accentuates distances and differences that are being crossed without appealing to the typical imaginary of the “nation” with linear, stable, flat borders.
Condition-based structural health monitoring of offshore wind jacket structures: Opportunities, challenges, and perspectives
Authors: Leng Jiaxuan , Gardoni Paolo , Wang Mengmeng , Li Zhixiong , Królczyk Grzegorz , Feng Shizhe , Incecik Atilla , Li Weihua
Published: January 2023

Structural health monitoring (SHM) has been recognized as a useful tool for safety management and risk reduction of offshore wind farms. In complex offshore environment, jacket structures of offshore wind turbines are prone to damages due to corrosion and fatigue. Effective SHM on jacket structures can substantially reduce their operation risk and costs. This work reviews the latest progress on the SHM of offshore wind jacket structures. The achievements in the structural damage identification, location, quantification, and remaining useful life (RUL) estimation are respectively introduced in detail, and existing challenges are discussed. Possible solutions to the challenges using the Digital Twin (DT) technology are put forward. The DT is able to mirror a real jacket structure into a virtual model, and Bayesian updating can refresh the virtual model parameters in real-time to keep consistency between virtual model and physical structure; then, just-in-time SHM can be carried out for jacket structures by performing damage detection, location, quantification, and RUL estimation using the virtual model. As a result, the DT may provide engineers and researchers a practicable tool for safety monitoring and risk reduction of fixed foundation offshore wind structures.
“We’re Here to Take Care of Our Community”: Lessons Learned From the U.S. Federal Health Center Covid-19 Vaccine Program
Authors: Crane Johanna T. , Fabi Rachel , Pacia Danielle , Neuhaus Carolyn P. , Berlinger Nancy
Published: January 2023

Equitable access to vaccination is crucial to mitigating the disproportionate impact of Covid-19 on low-income communities and people of color in the United States. As primary care clinics for medically underserved patients, Federally Qualified Health Centers (FQHCs) emerged as a success story in the national effort to vaccinate the U.S. public against Covid-19. In February 2021, the Federal Health Center Covid-19 Vaccine Program began allocating vaccine supply directly to FQHCs in an effort to improve vaccine equity. This qualitative study documents how FQHCs in two states successfully mitigated barriers to vaccine access, responded to patient concerns about vaccination, and worked to maintain and grow community trust in a climate of uncertainty and fear during early vaccine roll-out to the general population. Using a socio-ecological model, we show how FQHCs intervened at multiple levels to advance vaccine equity, revealing valuable lessons for health promotion practice in primary care settings or underserved communities. Our findings provide descriptive context for existing quantitative evidence showing FQHCs’ greater success in vaccinating people of color, and foreground valuable and innovative strategies for trustworthy health communication practices and equitable resource allocation to medically underserved patients and populations.
The Beginning of Everything: Finding the Seizure Onset
Authors: Dulko Elzbieta , Beenhakker Mark
Published: January 2023

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High Altitude Carotid Body Tumors Growth During active Surveillance
Authors: Gonzalez-Urquijo Mauricio , Hinojosa-Gonzalez David E. , Fabiani Mario Alejandro , González-González Mirna , Cardenas-Figueroa Edgar Geovanny , Rosero-Aguirre Veronica Alexandra , Viteri-Pérez Victor Hugo
Published: January 2023

Background

The gold standard for patients with carotid body tumors (CBT) is surgical resection; nevertheless, some patients are unfit for surgery or, for other reasons, could not be operated on. Active surveillance has been known to be a reasonable strategy for these cases. This study aimed to evaluate tumor growth in unoperated patients with CBTs.

Methods

A retrospective review of all unoperated patients with CBT from a single academic hospital diagnosed between 2014 and 2021 was performed. Results of nonparametric testing were presented using the median and ranges for Mann-Whitney-U or Kruskal-Wallis. Significance was defined as a 2-tailed P < .05.

Results

The cohort included a total of 31 patients, with a median age of 60 years (range: 37-80 years), of which 27 (87.1%) were females. The patients live at a median altitude of 2800 meters (range: 2756-2980 meters) above sea level. Twenty (64.5%) patients had Shamblin I tumors, eight (25.8%) patients had Shamblin II tumors, and three (9.7%) patients had Shamblin III tumors. Median CBT volume at diagnosis was 14.1 cm3 (range: .9 - 213.3 cm3). Median volume at diagnosis of symptomatic tumors was substantially larger than asymptomatic tumors, 49.2 cm3 vs 7.9 cm3, respectively (P = .03). Median growth of the tumors during a median 15-month follow-up (range: 3-43 months) was 3.3 cm3 (range: 0-199.9 cm3). Overall, 77% (n = 24) of the CBTs grew at least 1 cm3.

Conclusion

Most patients in the present study had tumor growth by at least 1 cm3, with a median tumor growth of 3.3 cm.3 In the present study tumor growth was shown to be greater than other low altitude CBT active surveillance studies; therefore, surgical resection should be recommended in patients with CBT living at high altitudes.
Gym-Based Training Interventions for Anterior Cruciate Ligament Injury Reduction in American Football Players
Authors: Josse Cameron M.
Published: January 2023

Injuries to the anterior cruciate ligament (ACL) of the knee are one of the most prominent injuries affecting players in American football. One primary aim of training to reduce injury risk is to provide exercises for players on attaining the highest athletic performance with the least orthopedic stress. This review article on ACL injury reduction protocols focuses on the protective and performance-enhancing biomechanical patterns during simple exercises used in a gym-based setting, in the following areas: single-leg balance and trunk stability, single-leg jumping/plyometrics, and reflexive strength training. This supplementary training, as part of a sports performance program, might include training to develop maximum strength, explosive power, acceleration, maximum velocity, bioenergetic endurance qualities, mobility/flexibility, agility, and sport skill acquisition.
Opportunity in COVID-19 crisis: Moving away from chalk and talk to technology-integrated teaching in Nepalese higher education institutions
Authors: Thapaliya Mukti , Adhikari Sanjaya , Rana Lal
Published: January 2023

This qualitative study explored teachers’ use of technology to manage teaching and learning activities during COVID-19 in Nepalese higher education institutions. To this end, 11 teachers from three universities located in five provinces of Nepal were purposefully selected. Their experiences of using technological tools were explored through semi-structured interviews and document analysis. The findings show that the implementations of online teaching and learning to manage students’ learning loss during the COVID-19 were marred by paradoxical policy, insufficient resources, teachers’ attitudes, socio-psychological issues, the lack of trained teachers and connection among technology, curriculum, pedagogy and assessment. Interestingly, the findings demonstrate that the teachers have taken the COVID-19 crisis as an opportunity for learning to use technologies in their teaching and learning activities. Based on these findings, we suggest that the government of Nepal needs to design an action plan to facilitate free mental health and wellbeing counseling programmes for students and teachers, provide sufficient devices with internet access to their students and train teachers and staff on how they can blend technologies, pedagogies and contents.