bluuebunny/crossref_metadata_2025 huggingface dataset:
Unraveling Mechanisms of Cryptogenic Stroke at the Genetic Level: A Systematic Literature Review
Authors: Ernst Johanna , Ehrenreich Hannelore , Weissenborn Karin , Grosse Gerrit M.
Published: July 2023

Background

A substantial proportion of ischemic strokes remain cryptogenic, which has important implications for secondary prevention. Identifying genetic variants related to mechanisms of stroke causes may provide a chance to clarify the actual causes of cryptogenic strokes.

Methods and Results

In a 2‐step process, 2 investigators independently and systematically screened studies that reported genetic variants in regard to stroke causes that were published between January 1991 and April 2021. Studies on monogenetic disorders, investigation of vascular risk factors as the primary end point, reviews, meta‐analyses, and studies not written in English were excluded. We extracted information on study types, ancestries, corresponding single nucleotide polymorphisms, and sample and effect sizes. There were 937 studies screened, and 233 were eligible. We identified 35 single nucleotide polymorphisms and allele variants that were associated with an overlap between cryptogenic strokes and another defined cause.

Conclusions

Associations of single variants with an overlap between cryptogenic stroke and another defined cause were limited to a few polymorphisms. A limitation of all studies is a low granularity of clinical data, which is of major importance in a complex disease such as stroke. Deep phenotyping is in supposed contradiction with large sample sizes but needed for genome‐wide analyses. Future studies should attempt to address this restriction to advance the promising approach of elucidating the cause of stroke at the genetic level. Especially in a highly heterogenous disease such as ischemic stroke, genetics are promising to establish a personalized approach in diagnostics and treatment in the sense of precision medicine.
Cardiovascular Disease Burden and Major Adverse Cardiac Events in Young Black Patients: A National Analysis of 2 Cohorts 10 Years Apart (2017 Versus 2007)
Authors: Vyas Ankit , Desai Rupak , Went Terry Ricardo , Wiltshire Dwayne , Priyadarshni Shivani , Shalaby Mostafa , Khalife Wissam
Published: July 2023

Background

We aim to compare the burden of cardiovascular disease risk factors and major adverse cardiac events and in‐hospital outcomes among young Black patients (aged 18–44 years) hospitalized in 2007 and 2017 using data obtained from the National Inpatient Sample database.

Method and Results

Comparison of the sociodemographic characteristics, comorbidities, and inpatient outcomes, including major adverse cardiac events (all‐cause mortality, acute myocardial infarction, cardiogenic shock, cardiac arrest, ventricular fibrillation/flutter, pulmonary embolism, and coronary intervention), between 2017 and 2007 was performed. Multivariable analyses were performed, controlling for potential covariates. A total of 2 922 743 (mean age, 31 years; 70.3% women) admissions among young Black individuals were studied (1 341 068 in 2007 and 1 581 675 in 2017). The 2017 cohort had a younger population (mean, 30 versus 31 years;
P
<0.001), more male patients (30.4% versus 28.8%;
P
<0.001), and patients with higher nonelective admissions (76.8% versus 75%;
P
<0.001), and showed an increasing burden of traditional cardiometabolic comorbidities, congestive heart failure, chronic pulmonary disease, coagulopathy, depression, along with notable reductions in alcohol abuse and drug abuse, compared with the 2007 cohort. The adjusted multivariable analysis showed worsening in‐hospital outcomes, including major adverse cardiac events (adjusted odds ratio [aOR], 1.21), acute myocardial infarction (aOR, 1.34), cardiogenic shock (aOR, 3.12), atrial fibrillation/flutter (aOR, 1.34), ventricular fibrillation/flutter (aOR, 1.32), cardiac arrest (aOR, 2.55), pulmonary embolism (aOR, 1.89), and stroke (aOR, 1.53). The 2017 cohort showed a decreased rate of percutaneous coronary intervention/coronary artery bypass grafting and all‐cause mortality versus the 2007 cohort (
P
<0.001).

Conclusions

In conclusion, young Black patients have had an increasing burden of cardiovascular disease risk factors and worsened in‐hospital outcomes, including major adverse cardiac events and stroke, in the past decade, although with improved survival odds.
Whole‐Body Magnetic Resonance Imaging Assessment of the Contributions of Adipose and Nonadipose Tissues to Cardiovascular Remodeling in Adolescents
Authors: Hauser Jakob A. , Burden Samuel J. , Karunakaran Ajanthiha , Muthurangu Vivek , Taylor Andrew M. , Jones Alexander
Published: July 2023

Background

Greater body mass index is associated with cardiovascular remodeling in adolescents. However, body mass index cannot differentiate between adipose and nonadipose tissues. We examined how visceral and subcutaneous adipose tissue are linked with markers of early cardiovascular remodeling, independently from nonadipose tissue.

Methods and Results

Whole‐body magnetic resonance imaging was done in 82 adolescents (39 overweight/obese; 36 female; median age, 16.3 [interquartile range, 14.4–18.1] years) to measure body composition and cardiovascular remodeling markers. Left ventricular diastolic function was assessed by echocardiography. Waist, waist:height ratio, and body mass index
z
scores were calculated. Residualized nonadipose tissue, subcutaneous adipose tissue, and visceral adipose tissue variables, uncorrelated with each other, were constructed using partial regression modeling to allow comparison of their individual contributions in a 3‐compartment body composition model. Cardiovascular variables mostly related to nonadipose rather than adipose tissue. Nonadipose tissue was correlated positively with left ventricular mass (
r
=0.81), end‐diastolic volume (
r
=0.70), stroke volume (
r
=0.64), left ventricular mass:end‐diastolic volume (
r
=0.37), and systolic blood pressure (
r
=0.35), and negatively with heart rate (
r
=−0.33) (all
P
<0.01). Subcutaneous adipose tissue was associated with worse left ventricular diastolic function (
r
=−0.42 to −0.48,
P
=0.0007–0.02) and higher heart rates (
r
=0.34,
P
=0.007) but linked with better systemic vascular resistance (
r
=−0.35,
P
=0.006). There were no significant relationships with visceral adipose tissue and no associations of any compartment with pulse wave velocity.

Conclusions

Simple anthropometry does not reflect independent effects of nonadipose tissue and subcutaneous adipose tissue on the adolescent cardiovascular system. This could result in normal cardiovascular adaptations to growth being misinterpreted as pathological sequelae of excess adiposity in studies reliant on such measures.
Israeli Oncocyclus irises: Phylogenetic relationships and evolutionary history
Authors: Volis Sergei , Zhang Yong-Hong , Deng Tao , Yusupov Ziyoviddin
Published: July 2023

Oncocyclus is a large group of bearded irises with poorly known phylogeny and evolutionary history. In Israel, Iris sect. Oncocyclus comprises eight species belonging to three aggregates. We used a combination of approaches to resolve the phylogenetic relationships of these species and indicate the evolutionary forces responsible for their origin. We sequenced the whole chloroplast genomes of species and integrated a phylogenetic tree with results of genetic (AFLP) divergence, degree of reproductive isolation, and species distribution modeling. Our findings suggest that quantitative and even qualitative morphological characters, such as flower color, are unreliable diagnostic traits for Oncocyclus taxonomy; that some recognized species comprise more than one species; and that group evolution did not involve the origin of distinct flower aggregates. A lack of pre-zygotic reproductive isolation agrees with the very low variability of the Oncocyclus plastome, suggesting that Israeli Oncocyclus species are very young. Homoploid hybridization followed or preceded by long periods of geographic isolation, and local selection likely contributed to speciation in Oncocyclus. In the group evolutionary history, importance of homoploid hybridization and local selection differed among species, but limited gene flow played a crucial role for all species.
Further addition to the crabronid fauna of Saudi Arabia (Hymenoptera: Apoidea (Spheciformes): Crabronidae), with new genera and species records, and the description of two new species
Authors: EL-GHIET USAMA M. ABU , GADALLAH NEVEEN S. , GASIB ABDULMAJEED M. , FIFI ZARRAG I. A. AL- , EDMARDASH YUSUF A.
Published: July 2023

The present study is based on specimens collected from the Farasan Archipelago (southwestern Saudi Arabia), and Sala Mountain (Jazan) using Malaise traps. Eleven species in six genera and two subfamilies (Bembicinae, Crabroninae) are recorded. The genera Ammatomus A. Costa (with one species), Solierella Spinola (with two species), and Nysson Latreille (with a new species) are first recorded from Saudi Arabia. Tachysphex nitidior de Beaumont, is also first record from Saudi Arabia. Two new species: Miscophus sauditus Gadallah and Edmardash, and Nysson arabicus Gadallah and Edmardash are described and illustrated. All eleven species are new to the Farasan Archipelago.
Diagnostic features, previous records to species already known from Saudi Arabia, and overall distributions are given. Illustrations of the recorded species are also provided.
Large-Scale Circulations and Dry Tropical Cyclones in Direct Numerical Simulations of Rotating Rayleigh–Bénard Convection
Authors: Velez-Pardo Martin , Cronin Timothy W.
Published: July 2023

The organization of convection into relatively long-lived patterns of large spatial scales, like tropical cyclones, is a common feature of Earth’s atmosphere. However, many key aspects of convective aggregation and its relationship with tropical cyclone formation remain elusive. In this work, we simulate highly idealized setups of dry convection, inspired by the Rayleigh–Bénard system, to probe the effects of different thermal boundary conditions on the scale of organization of rotating convection, and on the formation of tropical cyclone–like structures. We find that in domains with sufficiently high aspect ratios, moderately turbulent (), moderately rotating () convection organizes more persistently and at larger scales when thermal boundary conditions constrain heat fluxes rather than temperatures. Furthermore, for some thermal boundary conditions with asymmetric heat fluxes, convection organizes into persistent vortices with the essential properties of mature tropical cyclones: a warm core, high axisymmetry, a strong azimuthal circulation, and substantially larger size than individual buoyant plumes. We argue that flux asymmetry results in a persistent and localized input of buoyancy, which allows spatially aggregated convection to sustain a warm core in a developing large-scale vortex. Crucially, the most intense and axisymmetric cyclone forms for setups where the bottom heat flux is enhanced by the nearby flow and the top boundary is insulating, as long as the convective Rossby number is higher than about 1. Our results demonstrate the great potential for dialogue between classical turbulence research and the study of convective aggregation and tropical cyclones.

Significance Statement

On Earth, atmospheric convection frequently organizes into large spatial patterns that persist for several days, like tropical cyclones. However, many aspects of this process of organization and its link to tropical cyclone formation are not fully understood. In this work, we use numerical simulations of simple setups of rotating convection without moisture to study the minimal conditions that produce large-scale convective organization, and the spontaneous formation of tropical cyclone–like structures. We find that the latter form more readily for a particular set of controlling parameters and thermal boundary conditions. Our approach seeks to narrow the disciplinary gap between tropical cyclone physics and traditional turbulence research, by bringing together methods, questions, and results that are of potential interest to both.
Complex-order PID controller design for enhanced blood-glucose regulation in Type-I diabetes patients
Authors: Saleem Omer , Iqbal Jamshed
Published: July 2023

Type-I Diabetes (TID) is a chronic autoimmune disease that elevates the glucose levels in the patient’s bloodstream. This paper formulates a fractional complex-order Proportional-Integral-Derivative (PID) control strategy for robust Blood Glucose (BG) regulation in TID patients. The glucose-insulin dynamics in blood plasma are modeled via the Bergman-Minimal-Model. The proposed control procedure employs the ubiquitous fractional order PID controller as the baseline BG regulator. The design flexibility of the baseline regulator to effectively normalize the BG levels is enhanced by assigning complex orders to the integral and differential operators instead. The resulting Complex Order PID (CO-PID) regulator strengthens the controller’s robustness against abrupt variations in the patient’s BG levels caused by meal disturbances or sensor noise. The controller parameters are numerically optimized offline. The aforesaid propositions are justified by performing credible simulations in which the proposed controller is tasked to effectively track a set point value of 80 mg/dL from an initial state of hyperglycemia under various disturbance factors. As compared to the FO-PID controller, the CO-PID controller improves the reference tracking-error, transient recovery-time, and control expenditure by 13.1%, 33.4%, and 28.1%, respectively. The simulation results validate the superior reference-tracking accuracy of the proposed CO-PID controller for BG regulation.
Past and Present Group Exclusion and Conflict: Group Marginalization, Opportunity, and Islamic State Foreign Fighter Mobilization
Authors: Edgerton Jared F.
Published: July 2023

Researchers and policymakers have increasingly recognized foreign fighter mobilization as a national security threat to foreign states and domestic populations. Yet, scholars remain divided on the motivations of foreign combatants, arguing that fighters may be motivated by grievances, opportunity, or material incentives. The motivations of foreign fighters may be especially complex, as they are engaging in a conflict outside of their state. I analyze how historical and present-day group exclusionary policies and opportunity shape mobilization. To do so, I leverage novel data consisting of individual fighter data of Islamic State volunteers fighting in Iraq and Syria. Consistent with my theoretical framework, I find that a higher rate of Islamic State fighters come from areas where Sunni Muslims were denied access to political power and have greater state capacity.
Disability Acceptance and Affirmation Among U.S. Adults With Learning Disabilities and ADHD
Authors: Zapata Mercedes A. , Worrell Frank C.
Published: July 2023

Personal disability identity is a predictor of psychosocial functioning among adults with predominantly physical disabilities. In the present study, we examined personal disability identity in adults with learning disabilities (LD) and/or attention-deficit/hyperactivity disorder (ADHD). In samples of 541 adults with LD, 475 with ADHD, and 433 with comorbid LD and ADHD, we examined the structural validity of disability acceptance and disability affirmation scores and the association between these scores and anxiety/depression, life satisfaction, and general self-efficacy. Factor analyses supported a 4-item disability acceptance and 3-item disability affirmation scale in LD-only and ADHD-only samples. Among adults with LD or ADHD, disability affirmation was a meaningful predictor of life satisfaction, and disability acceptance predicted general self-efficacy. Disability identity attitudes are worthy of clinical and scholarly attention in adults with LD and ADHD, and adults with comorbid LD and ADHD may warrant special consideration in the personal disability identity literature.
Predicting Prison Misconduct With the Psychological Inventory of Criminal Thinking Styles: A Meta-Analysis
Authors: Walters Glenn D.
Published: July 2023

A meta-analysis of six prison samples using the Psychological Inventory of Criminal Thinking Styles (PICTS) general criminal thinking, proactive criminal thinking, and reactive criminal thinking scales to predict disciplinary infractions was performed. Results showed evidence of significant associations between all three PICTS scales and prison misconduct, whereas the magnitude of effect ranged from small (all infractions) to very small (interpersonal aggression infractions). Although there were no signs of heterogeneity in the results, sex, race, and length of follow up served as moderators. The apparent contradiction of moderator effects in a meta-analysis with no evidence of heterogeneity is discussed.
Continuous textile manufacturing method for twisted coiled polymer artificial muscles
Authors: Mersch Johannes , Witham Nicholas S , Solzbacher Florian , Gerlach Gerald
Published: July 2023

Twisted, coiled polymer actuators (TCPAs) are a promising type of fiber-based actuators with high energy density, low material costs, and good recyclability; however, current manufacturing methods limit the length and stability of TCPAs, hampering their potential for large-scale textile applications. To overcome this limitation, we propose a textile manufacturing method based on the false-twisting principle, allowing for continuous and rapid production of highly twisted monofilaments. Additionally, this process enables the plying of two or more twisted monofilaments together, as well as the integration of wires for heating and sensing purposes. The resulting twist-stable plies can then be mandrel-coiled and annealed to create a new class of TCPAs with three superimposed levels of helicity, in contrast to the usual two levels.

In this study, we investigate the impact of the additional helix level and various factors, including twist density, annealing temperature, cooling speed, and chirality, on the contractility of these TCPAs. Furthermore, due to the twist-stability of the plied yarns, they can be processed on standard textile machines, enabling the manufacture of TCPAs with multiple active yarns that can form contracting artificial muscles using a circular braiding machine. Our key findings reveal that the twisted monofilament coils can contract up to 60%, and higher twist density leads to improved performance for monofilament TCPAs. Notably, this phenomenon is not observed in plied-yarn TCPAs, where varying levels of twist on the monofilament and yarn helix level result in enhanced contractile performance.

Overall, this work presents a novel textile manufacturing method for producing twist-stable TCPAs with good contractile performance, providing insights into the design and fabrication of advanced fiber-based actuators for potential applications in large-scale textiles, robotics, and biomedical devices.
Online Activism and Connective Mourning: An Examination of the #EndSARSMemorial Protests in Nigeria
Authors: Uwalaka Temple , Joe Sarah , Amadi Fred A. , Amadi Confidence Chinedu
Published: July 2023

This study explores how Nigerians used social media platforms to mourn and memorialize protesters who were killed during the 2020 EndSARS protests in Nigeria. Data for this study are from tweets (N = 67,678) that were scraped from the hashtags, “#EndSARSMemorial2” and “LekkiMassacre” and online semi-structured interviews (N = 30) with digital activists in Nigeria. Results show that the most frequently tweeted words were “rest in peace,” “heroes,” “who gave the order,” and “#EndSARSMemorial2.” Five themes emerged from the interview data, and they include anger and sympathy, mourning and remembering, connecting in the shared humanity of the deceased, and pledges to be better humans and citizens. The paper shows that high centrality, high density of reciprocity, and low modularity illustrate online mourners’ ability to stimulate commonality through decentralized and loose networks that allow for solidarity building during mourning and the personalization of mourning. Evoking some aspects of crisis network effects theory, this study concludes that when collective mourning occurs, individuals have more reciprocal relationships on a dyadic level and that the network has low modularity as such a network effect occurs when there is a shock that creates uncertainty in the system.
Learning, living and working with dyspraxia and ADHD: A neurodiverse dramatherapist’s comment on the formal education system
Authors: Maslin Ellen
Published: July 2023

The environment of formal education systems can be a difficult place for neurodiverse individuals to exist, navigate and thrive. This clinical comment explores the impact of these structures on individuals with attention-deficit hyperactivity disorder (ADHD). The evolutionary theory underpins the article’s argument that ADHD ‘symptoms’ could be considered adaptive depending on their environment, yet a plethora of neurodiverse people experience feelings of failure and negative life trajectories, so it is imperative that education systems reconsider their structures. To further support the case for educational restructuring, trauma-informed research is used to highlight flaws in the United Kingdom’s mainstream education system that parallels the gaps that neurodiverse learners fall through. This article uses an autoethnographic lens to look at the problems within these structures and how they impact both learners and employees, from children to adults. The Sesame Approach to Drama and Movement Therapy (DMT-Sesame) is considered as a comparative structure, which focuses on the body, creative freedom, exploration, authenticity, and individuality, and could accentuate the quality of many neurodiverse traits. DMT-Sesame could therefore inspire the changes that ought to be made to formal educational structures, whereby learning environments are accessible to every individual and enable self-discoveries that support successful development.
Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review
Authors: Gibson Watt Tilly , Gillanders David , Spiller Juliet A , Finucane Anne M
Published: July 2023

Background:

People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief. Traditional approaches to address psychological concerns aim to modify dysfunctional thinking; however, this is limited in palliative care, as often concerns area valid and thought modification is unrealistic. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at promoting acceptance and valued living even in difficult circumstances. Evidence on its value in palliative care is emerging.

Aims:

To scope the evidence regarding Acceptance and Commitment Therapy for people with advanced progressive illness, their caregivers and staff involved in their care.

Design:

Systematic scoping review using four databases (Medline, PsychInfo, CINAHL and AMED), with relevant MeSH terms and keywords from January 1999 to May 2023.

Results:

1,373 papers were identified and 26 were eligible for inclusion. These involved people with advanced progressive illness ( n = 14), informal caregivers ( n = 4), palliative care staff ( n = 3), bereaved carers ( n = 3), and mixed groups ( n = 2). Intervention studies ( n = 15) showed that Acceptance and Commitment Therapy is acceptable and may have positive effects on anxiety, depression, distress, and sleep in palliative care populations. Observational studies ( n = 11) revealed positive relationships between acceptance and adjustment to loss and physical function.

Conclusion:

Acceptance and Commitment Therapy is acceptable and feasible in palliative care, and may improve anxiety, depression, and distress. Full scale mixed-method evaluation studies are now needed to demonstrate effectiveness and cost-effectiveness amongst patients; while further intervention development and feasibility studies are warranted to explore its value for bereaved carers and staff.
Evaluation of the Minimum Number of Local Driving Cycles Required to Represent the Traffic of Distinct Cities: A Case Study of Two Brazilian Metropolises
Authors: de Andrade Guilherme Medeiros Soares , Santos Maurício Pereira Magalhães de Novaes , Araújo Fernando Wesley Cavalcanti de , Magnani Fábio Santana
Published: July 2023

This study aimed to determine whether a single local driving cycle (LDC) can effectively represent different cities in the same country, in both urban and highway routes, and for cars and motorcycles. To achieve this, experienced drivers drove different monitored vehicles (five cars and three motorcycles) on seven selected routes in two Brazilian states (Pernambuco and São Paulo State), collecting 170 h of speed data in urban and highway routes during peak and off-peak hours. Using the micro-trip and Markov chain methods, LDCs were then developed based on the collected real-world data. The kinematic and energy parameters of different route groupings were compared, revealing that two LDCs, one for cars and one for motorcycles, could be used to represent all urban routes. However, each highway route required a unique LDC. When compared with standard driving cycles adopted in Brazil, the created LDCs presented a coefficient of variation of 13%–46% in kinematic characteristic parameters, highlighting the need for developing LDCs to better represent Brazilian traffic.
Factors Associated With Domestic Violence Against Women at Different Stages of Life: Findings From a 19-Year Longitudinal Dataset From the MINIMat Trial in Rural Bangladesh (2001–2020)
Authors: Ziaei Shirin , Antu Jannatul Ferdous , Mamun Mahfuz Al , Parvin Kausar , Naved Ruchira Tabassum
Published: July 2023

Despite the abundance of literature, longitudinal studies evaluating the factors associated with domestic violence (DV) at different stages and over longer periods of women’s lives are rare. We evaluated factors associated with physical and sexual DV during pregnancy, at 10-year, and 18-year follow-ups after pregnancy and within a 19-year period of life using a cohort of women ( n = 1,126) who participated in the Maternal and Infant Nutrition Interventions, Matlab trial in rural Bangladesh. Data on women’s experience of DV, social and economic characteristics, empowerment, and family condition were recorded in a similar manner during pregnancy and at 10- and 18-year follow-ups, using standard questionnaires. Multivariate logistic regression models and generalized estimating equations were used to evaluate factors associated with women’s experience of physical and sexual violence at each discrete time point and over a period of 19 years, respectively. During pregnancy, women were more likely to experience violence if they were members of microcredit programs/non-governmental organizations (NGOs), living in an extended family and had lower wealth status. At the 10- and 18-year follow-ups, higher levels of decision-making and higher wealth status were protective against the experience of violence. At the 18-year follow-up, women with larger age differences from their husbands were less likely to experience violence, while membership in microcredit programs/NGOs was associated with higher odds of experiencing violence among women. Within a period of 19 years, a higher level of education, living in an extended family, higher decision-making level and higher wealth index were protective against the experience of violence, while membership in microcredit programs/NGOs was a risk factor. In conclusion, this study showed that correlates of violence might change at different time points in women’s life. Thus, policies and programs should consider the stage of women’s lives while planning interventions for addressing violence against women.
Analytical method for assembly-induced deformation prediction of composite bolted joints with assembly gap
Authors: Yang Yuxing , Ma Yuxin , Liu Zhen , Bao Yongjie , Wang Jinlong , Chen Chen
Published: July 2023

Shimming position and amount have a significant influence on the weight and mechanical performance of the thin-walled product that having assembly gap during aerospace components assembly process. An analytical method for assembly-induced deformation prediction of the bolted composite joints with assembly gap was developed. The assembly-induced deformation under the preloading force was computed as bending deformation and bolt head compression deformation by evaluating whether assembly gap can be eliminated and whether the calculating point is within the conical and spherical envelope of the fastener. The proposed method was validated by the preloading experiment of three-bolt composite joints with relative error less than 10%. Then it was applied to analyse the assembly-induced deformation of a composite box structure including composite spars and skins. Under the guide of the analytical result, shimming assembly of the composite box structure was carried out. The proposed analytical method has a good application prospect to predict the assembly-induced deformation during preloading process for composite/composite joints or composite/metal joints.
Integrated fire/flight control coupler design for armed helicopters based on improved non-monotone adaptive trust region algorithm with distributionally robust optimization
Authors: Zhou Zeyu , Wang Yuhui , Chen Mou , Wu Qingxian
Published: July 2023

Aiming at enhancing the extent of military automatization and the effectiveness of armed helicopters in complex battlefield environment, integrated fire/flight control (IFFC) coupler connects the fire control system and the flight control system which is used to generate the optimal flight command signals. However, it is difficult to obtain satisfactory flight command signals within a certain firing accuracy due to the unavoidable uncertain information in battlefield environment. In this paper, a new IFFC scheme is proposed for armed helicopters against complex combat by using the idea of distributionally robust optimization combined with the framework of trust region. Initially, a vector equation and coordinate transformation are employed to acquire the relative motion model of the IFFC coupler problem in complex battlefield environment. Moreover, an improved performance index is designed according to the constraints, and the original non-convex problem is handled by the Taylor formula combined with an improved BFGS (Broyden–Fletcher–Goldfard–Shanno) algorithm. Considering the uncertain parameters during optimization, the non-linear distributionally robust optimization is transformed into a linear matrix inequality optimization problem based on the worst-case conditional value-at-risk (WC-CVaR) approximation. Then, an algorithmic framework with a non-monotone adaptive trust region algorithm is given to obtain the optimal flight command signals. Finally, a simulation example is given to illustrate the effectiveness of the proposed approach.
Trade unions, digitalisation and country effects: A comparative study of banking in Norway and the UK
Authors: Lloyd Caroline , Payne Jonathan
Published: July 2023

The resurgence of debate around digitalisation and work has seen the role of unions in the ‘social shaping of technology’ attracting renewed interest. A key question concerns how far national institutions influence unions’ ability to shape digitalisation in particular sectors and workplaces. Using a multi-level analysis that emphasises the inter-relationships between institutions, union power, resources and agency, this article compares the role of two unions in the banking sector in Norway and the UK. Drawing on interviews with national officers and workplace representatives, it addresses their involvement in decision-making processes and ability to influence outcomes in relation to digital monitoring and surveillance. The research findings highlight the continued salience of ‘country effect’ as evidenced by the Norwegian union’s more prominent role in shaping better worker outcomes.
Hyaluronic Acid Fillers to Correct Cleft Lip Asymmetry in Adults: Description of Technique and Patient Reported Outcome Measure Using CLEFT-Q
Authors: Thomson Richard M , Jovic Thomas H , Eckhardt Charlotte , O’Neill Tomás
Published: July 2023

Objective

To determine the efficacy of hyaluronic acid (HLA) lip filler to correct subtle cleft lip asymmetries in adults using a validated patient reported outcome measure (PROM).

Design

Prospective cross sectional.

Setting

UK National Health Service.

Patients, Participants

Over 18 years old with repaired cleft lip and dissatisfaction of their lip appearance.

Interventions

HLA lip filler injection.

Main Outcome Measures

A validated, cleft specific PROM, the lip module of CLEFT-Q™ prior to treatment and again after six weeks.

Results

24 patients included. A mean total CLEFT-Q™ score pre-procedure was 14.9 (Stand deviation (SD) = 4.91) and 24 (SD = 6.08) post-procedure. Difference in mean total score pre- and post-procedure were statically significant ( P = .0001) in all domains on the CLEFT-Q™. No adverse outcomes.

Conclusion

HLA filler to correct subtle cleft lip asymmetries in adults is a simple low risk technique, which can significantly improve the patient's perception of lip appearance.

Conclusion

HLA lip filler to correct subtle cleft lip asymmetries in adults is a simple technique, low risk procedure which can significantly improve the patient's perception of lip appearance.
Sphenoid Sinus Volumes of Patients with Unilateral Cleft Lip and Palate
Authors: Erturk Ahmet Faruk , Goksel Sevde , Yelken Kendirci Merve , Ozcan Ilknur
Published: July 2023

Objective

There is only one study in the literature in which 3D evaluation of sphenoid sinus volume in patients with cleft lip and palate was used. This shows that this issue has not been adequately evaluated. The present study aimed to compare the volume of the sphenoid sinuses in patients with cleft lip and palate on cone-beam computed tomography images, and to compare them with healthy controls. The high variability of sphenoid sinus volumes poses a risk for iatrogenic lesions during surgical procedures. Because the degree of pneumatization due to increased volume increases the likelihood of exposure of vital neurovascular structures such as the internal carotid artery, maxillary nerves, and optic nerves.

Design

Retrospective cohort study.

Setting

University Hospital.

Patients

A total of 64 patients (32 cleft palate, 32 controls) over 18 years of age who had sphenoid sinuses in the image area were included in our study.

Outcomes

Sphenoid Sinus Volume.

Results

When the groups were compared in terms of total sinus volume, there was a statistically significant difference between them. Total sinus volume was significantly mean 2.806,87 mm lower in patients with cleft lip and palate compared to the healthy group ( P = .015).

Conclusion

To be aware this lower volume of the sphenoid sinus in cleft lip and palate patients will be useful for the surgical approach to sphenoid sinus. However, the literature on the subject is insufficient, more comprehensive clinical and radiological studies are needed on a larger sample.
Efficacy and Safety of Immune Checkpoint Inhibitors Combined With Chemotherapy as First-line Treatment for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Network Meta-analysis of Randomized Controlled Trials
Authors: Sun Hong , Bu Fengjiao , Li Ling , Zhang Xiuwen , Xin Xiu , Yan Jingchao , Huang Taomin
Published: July 2023

Background

Different clinical trials for recurrent or metastatic nasopharyngeal carcinoma have studied different combinations of immuno-oncology in first-line treatment, but the optimal choice has not been determined.

Objective

To systematically examine and compare the efficacy and safety of different immune checkpoint inhibitors (ICIs) combined with chemotherapy as first-line treatment for recurrent or metastatic nasopharyngeal carcinoma.

Methods

Several electronic databases were systematically searched up to February 2023. Articles meeting the inclusion criteria were included.

Results

Three RCTs were eligible in the study. Compared with placebo plus gemcitabine-cisplatin (GP), toripalimab plus GP (HR = 0.59, 95% CI: 0.37-0.95) was significantly associated with a better OS. Tislelizumab plus GP generated best progression-free survival (PFS) benefit (HR = 0.50, 95% CI: 0.37-0.67), greatest improvement in 1-year PFS rate (RR = 3.00, 95% CI: 1.84-5.22), and objective response rate (ORR) (RR = 1.26, 95% CI: 1.04-1.53) over the placebo plus GP. Furthermore, tislelizumab plus GP appeared to be safer than toripalimab plus GP and camrelizumab plus GP in terms of adverse events (AEs)-grade ≥3, treatment-related AEs (TRAEs)-grade ≥3, serious AEs (SAEs), treatment-related SAEs (TRSAEs), and AEs leading to discontinuation of treatment.

Conclusion and Relevance

In recurrent or metastatic nasopharyngeal carcinoma, programmed death 1 (PD-1) inhibitors plus GP as first-line treatment have better survival outcomes than placebo plus GP with comparable toxicity. Toripalimab plus GP shows the best OS benefit over placebo plus GP, while tislelizumab plus GP generates the best PFS, 1-year PFS rate, ORR, and safety. Tislelizumab plus GP could be the best choice among the ICIs combined with chemotherapy regimens as first-line treatment in recurrent or metastatic nasopharyngeal carcinoma.
Clinical and Pathological Characteristics and Prognosis of Lung Adenocarcinoma With High-Grade Fetal Features: A Retrospective Analysis
Authors: Gu Yumei , Zhang Shu , Liang Xiaolong , Zhao Hongying , Li Xue , Lu Jun
Published: July 2023

Fetal adenocarcinoma of the lung is a rare tumor. The clinical and pathological characteristics, treatment, and prognosis of patients with lung adenocarcinoma with fetal lung-like morphology were retrospectively investigated. The tumors of 9 patients with lung adenocarcinoma contained fetal lung-like morphology. One patient had pure-type high-grade fetal adenocarcinoma. Two patients had more than 50% high-grade fetal adenocarcinoma. Six specimens accounted for < 50% of the high-grade fetal features. It occurred in 7 men and 2 women. The median age at diagnosis was 62.0 years. Thyroid transcription factor-1 was frequently expressed in 8 specimens. All 9 specimens showed high rates of immunopositivity for β-catenin and E-cadherin. Three specimens showed nuclear β-catenin staining. Some patients showed immune expression of CDX2, α-fetoprotein (AFP), SALL4, and Glypican-3. Three of these specimens were diffusely strongly positive for p53, including 1 mixed-type high-grade fetal adenocarcinoma and 2 lung adenocarcinomas with high-grade fetal features. However, the other 6 patients had wild-type p53, including 1 pure-type high-grade fetal adenocarcinoma. PD-L1 was not expressed in all patients. Epidermal growth factor receptor mutations were detected in 1 patient. All patients were diagnosed using surgical samples. During the follow-up period of 36 months (range: 1-92 months), 3 patients received chemotherapy. One patient underwent radiotherapy. Two patients experienced recurrences. No patient died. PD-L1 expression status suggests a poor response to immune checkpoint therapy. The prognosis of the patient was relatively good.
Cross-domain diagnosis of roller bearing faults based on the envelope analysis adaptive features and artificial neural networks
Authors: Najim Haider Suhail , Alsalaet Jaafar K
Published: July 2023

Traditional machine learning techniques depend on both the training data and the target data having the same data distribution and feature space. The performance may be unsatisfactory if there is a discrepancy in data distribution between the training data and the target data, which is known as a cross-domain learning issue. In this study, a technique for addressing this issue based on using the envelope analysis features coded as inputs to the Artificial Neural Networks (ANN) is presented. Specifically, three major cross-domain difficulties were resolved, including defect identification of different roller bearing types, rotating speeds, and loading conditions. The envelope approach is used to extract more distinguishing features at fundamental fault frequencies from the original signal, with the benefit of derived features being independent of both roller bearing type and operating conditions of rotating machines. The diagnosis outcomes were achieved experimentally through three different types of rollers bearing. Meanwhile, for each bearing type, three data sets were obtained at three different rotational speeds with different levels of fault categories to simulate all the cross-domain tasks. Moreover, the ANN model was trained using data of a particular bearing type and a certain operating state, whereas data of other bearing types were utilized to test the cross-domain performance of the proposed technique. At the same loading condition, the results indicate a 99.5% average success rate for bearing Koyo 1205, a 98.33% average accuracy for bearing NU 205, and a 97.3% average accuracy for the defective bearing kit. Furthermore, the results indicate that the suggested technique can deliver accurate cross-domain detection. Also, the experimental results proved that the suggested technology is a potential strategy for industrial applications.
Assessing floor contamination by antineoplastic agents in a Japanese medical institution specializing in cancer treatment
Authors: Maeda Akimitsu , Hori Kyoko , Sone Yumiko , Hashimoto Naoya , Uchida Kosaku
Published: July 2023

Introduction

This study investigated the extent of contamination with antineoplastic agents on floor surfaces of the ward and the outpatient chemotherapy center of a Japanese cancer center to evaluate healthcare workers’ risk of occupational exposure to antineoplastic agents outside of the designated drug preparation areas.

Methods

In this study conducted at Aichi Cancer Center, the amount of fluorouracil detected on various floor surfaces was measured using liquid chromatography—tandem quadrupole mass spectrometry. Areas around the toilets were cleaned with a surfactant two or three times a day, whereas other floor surfaces were cleaned only with dry and wet mops.

Results

Fluorouracil was detected on all surveyed floor surfaces, with particularly high amounts detected around the toilet areas in the ward. Additionally, areas with more human traffic tended to have higher fluorouracil contamination.

Conclusions

This survey suggested that antineoplastic agent contamination occurring through patient excretions might spread throughout the hospital with human traffic. Therefore, controlling the spread of antineoplastic agent contamination in hospitals should include the review of measures to mitigate contamination around toilets and to implement effective cleaning methods for floor surfaces.
Carfilzomib-induced life-threatening lung injury in refractory multiple myeloma
Authors: Ghasoub Rola , Benkhadra Maria , Kassem Nancy , Alshurafa Awni , Elsabah Hesham
Published: July 2023

Introduction

Carfilzomib is a second-generation selective proteasome inhibitor that is commonly used in the treatment of relapsed or refractory multiple myeloma. Carfilzomib is associated with respiratory side effects, such as cough, dyspnea, and upper respiratory tract infection. However, severe pulmonary toxicity is rare and is only reported in a few case reports.

Case report

Here, we present a case of a 65-year-old male with refractory multiple myeloma who developed a life-threatening lung injury during his third cycle of carfilzomib. The patient presented with a decreased level of consciousness and was found to have Type I respiratory failure. He was admitted to the intensive care unit, where he was intubated. Blood cultures and viral panel were negative. The patient received a prolonged course of antibiotics with 2 days of hydrocortisone.

Management and outcomes

After discharge, repeated myeloma workup showed disease progression and carfilzomib was reintroduced. The next day, he presented with fever, vomiting, and hypoxia. Chest x-ray showed congestive lung changes with patchy airspace opacities. Repeated echocardiography showed normal ejection fraction with moderate pulmonary hypertension (RVSP 46 mm Hg). The patient was transferred again to the ICU and kept on continuous positive airway pressure. Antibiotics were started, and blood cultures and respiratory viral panels were negative for any infectious organism. The patient improved in terms of inflammatory markers and oxygen requirements. Treatment with carfilzomib was stopped permanently.

Discussion

Pulmonary toxicity associated with carfilzomib in patients with multiple myeloma can be potentially life-threatening. The mechanism with which carfilzomib induces lung-related AEs is still not fully understood. In our patient, carfilzomib-induced lung injury was evident after rechallenging the patient with carfilzomib, in the radiographic x-ray changes and the new onset moderate pulmonary hypertension. Healthcare providers should be encouraged to report rare adverse events in order to identify the risk factors that can predispose patients to the development of these adverse events.
Consumers’ Intentions to Spread Negative Word of Mouth About Dynamic Pricing for Services: Role of Confusion and Unfairness Perceptions
Authors: Bambauer-Sachse Silke , Young Ashley
Published: July 2023

This paper examines the effects of dynamic pricing versus simple price differentiation for services through price confusion and price unfairness perceptions on price-disadvantaged consumers’ intentions to spread negative word of mouth (WOM); we additionally differentiate between these customers based on specific service purchase frequency. To test our hypotheses regarding price confusion as an important driver of undesirable consumer reactions to differential pricing for services and as a precedent of price unfairness perceptions, we conduct one qualitative study and three quantitative studies. The findings provide key theoretical insights indicating that 1) dynamic pricing leads to more price confusion than simple differential pricing and 2) price confusion triggers price unfairness perceptions that increase consumers’ intentions to spread negative WOM. For frequently purchased services, the pricing tactic’s effects on intentions to spread negative WOM are based mainly on price confusion; for infrequently purchased services, the intentions to spread negative WOM are based primarily on unfairness perceptions. The major managerial insight of our findings is that dynamic pricing should be avoided or limited when there is a high likelihood of reputation damage through negative WOM among price-disadvantaged customers.