bluuebunny/crossref_metadata_2025 huggingface dataset:
Vascular Reactivity Index as an Effective Predictor of Mortality in Patients With Septic Shock: A Retrospective Study
Authors: Jingyi Sun , Cunliang Gao , Biao Chen , Yingguang Xie , Jinluan Ma , Xiaohua Cao , Wenqiang Li
Published: March 2024

Background

Sepsis is a serious complication that occurs after trauma, burns, and infections, and it is an important cause of death in intensive care unit (ICU) patients. Despite many new measures being proposed for sepsis treatment, its mortality rate remains high; sepsis has become a serious threat to human health, and there is an urgent need to carry out in-depth clinical research related to sepsis. In recent years, it has been found that septic shock-induced vasoplegia is a result of vascular hyporesponsiveness to vasopressors. Therefore, this study intended to establish an objective formula related to vasoplegia that can be used to assess the prognosis of patients and guide clinical treatment.

Materials and Methods

A retrospective cohort study was conducted using data from 106 septic shock patients admitted to the ICU of Jining No. 1 People's Hospital from January 2020 to December 2022. The patients were divided into mortality and survival groups based on 28-day survival, and hemodynamics were monitored by the pulse index continuous cardiac output system. The dose and duration of vasopressors, major hemodynamic parameters, lactic acid (Lac) levels, and Sequential Organ Failure Assessment scores were recorded within 48 h of hospital admission. Multifactorial logistic regression was used to analyze the independent risk factors affecting the prognosis of patients, and the predictive value of the vascular response index (VRI) was analyzed by the receiver operating characteristic (ROC) curve.

Results

The differences between the survival and mortality groups in terms of age, sex ratio, body weight, ICU length of stay, distribution of infection sites, underlying disease conditions, baseline Lac levels, and some hemodynamic parameters were not statistically significant ( P > .05). The results of multifactorial logistic regression showed that the admission Acute Physiology and Chronic Health Evaluation II score, Lac level at 24 h of treatment, maximal vasoactive inotropic score at 24 h (VISmax24), maximal vasoactive inotropic score at 48 h (VISmax48), and VRI were independent risk factors affecting 28-day mortality. Within 48 h of receiving vasopressor therapy, the VRI was lower in the mortality group than in the survival group. The area under the ROC curve for the VRI was 0.86, and the best cutoff value of the VRI for predicting 28-day mortality was 32.50 (YI = 0.80), with a sensitivity of 0.90, a specificity of 0.90, and a better prediction of mortality than the other indicators.

Conclusions

The VRI is a good predictor of mortality in patients with septic shock, and a lower VRI indicates more severe vasoplegia, poorer prognosis, and higher mortality in patients with septic shock.
The effect of Bletilla striata polysaccharide on the physical and healing properties of curdlan-based hydrogel for wound healing
Authors: Shang Jin , Duan Liangliang , Zhang Weimin , Zhuang Qibin , Ren Xiaomei , Gu Dale
Published: March 2024

Bletilla striata polysaccharide (BSP) was added to curdlan to form a blend hydrogel through a simple heating-cooling procedure to improve the hydrophilicity and healing efficacy of curdlan-based hydrogel used in wound healing. We explored the interplay between BSP and curdlan, studied how BSP concentration affects the physical properties and microstructures of hydrogels, and examined the biocompatibility and healing properties of the blend hydrogel. It was proved that the hydrogel framework was primarily formed by ordered arranged curdlan molecules, with BSP uniformly dispersed and intertwined with curdlan through hydrogen bonding. This effectively improved its hydrophilicity and strengthened the microstructure. Curdlan was found to be compatible with BSP. The blend hydrogel B3Cd3 (containing 1.5% BSP and 1.5% curdlan, w/v) was identified as the optimal formulation based on its higher water adsorption, water retention, thermal stability and interconnected microstructure, and was thus selected for further research. In vitro experiments revealed the highest cell viability of L929 in B3Cd3 extracts compared to those extracts of single-component curdlan hydrogel (Cd). In vivo, animal studies indicated that the B3Cd3 accelerated wound healing compared to the control group by improving re-epithelialization and blood vessel regeneration. On Days 3 and 11, the therapeutic benefits of B3Cd3 exceeded those of the Cd group, and no significant differences were observed in wound healing rates between the B and B3Cd3 groups from Day 7. The study proves that BSP enhances the physical and healing properties, as well as cell proliferation, of the curdlan-based hydrogel. The blend hydrogel B3Cd3, with its exceptional properties, holds potential for future application as a material for non-infected wound healing.
Biographical-poetic journeys: A conversation with Yeison F. García López
Authors: Serrano Silvia M , García López Yeison F
Published: March 2024

Inspired by W. E. B. Du Bois’s notion of double consciousness, Yeison F. García López assumes multiple identities: Afro-Colombian and Afro-Spanish. This multiplicity allows García López to assert a politically active citizenship, articulated through his migrant journey, his Afro-descendant and Colombian heritage, and his connection with Madrid society. This conversation delves into how García López’s body of work as a poet, theorist, activist, and cultural agent contributes to an emerging Spanish, global, and transatlantic LatinX Latinity (LatinXness) from the Spanish capital. Overall, García López’s efforts shine a spotlight on Spain’s present-day plurality, highlighting the contributions of Africans and Afro-descendant people. He establishes connections among migrant communities of Latin American, Afro-descendant, and Asian origin as well as migrants from Eastern Europe descent, and Roma people and subverts Eurocentrism, colonialism, and white supremacy. García López’s publications and cultural initiatives serve as a platform to amplify the voices of Madrid’s migrant and racialized people, promoting culture as a form of resistance, healing, and empowerment.
What Makes an Ethical Account a Natural Law Ethical Account? Contemporary Ethics, Metaethics, and Normative Ethics
Authors: O’Connor John D.
Published: March 2024

What makes ethical accounts natural law ethical is, I argue, commonly misrepresented in teaching within much of the philosophical academy. Yet those immersed in the field of natural law and ethics rarely give definitions/brief characterisations of what makes ethical accounts natural law ethical. I suggest theoretical reasons for the lack. I argue that bringing natural law into ethics is best understood as leading to theoretically unitary accounts, not simply collections of positions detachable from each other: an overlooked and significant point when defending natural law ethical accounts. My arguments throughout rely on the metaethical/normative ethical distinction, which is relatively little used in the natural law literature. I argue that the distinction helps clarify what is distinctive of natural law ethical accounts in general, especially to the secular contemporary philosophical academy, where appreciation of natural law ethical accounts is commonly appreciably lower than in philosophical contexts with a religious ethos.
Hexagonal boron nitride nanosheets: Fabrication, thermal properties and application in polymers
Authors: Zhang Wenchao , Liang Yuan , Yue Dong , Feng Yu
Published: March 2024

Traditional thermally conductive materials are gradually losing their advantages as the electronics industry develops rapidly. Polymers are in urgent need of a material with high thermal conductivity, stable structure, good mechanical properties and oxidation resistance, which makes hexagonal boron nitride (h-BN) an excellent heat transfer filler for polymer composites. Boron nitride nanosheets (BNNS) are monolayers of hexagonal boron nitride, and theoretical studies have shown that BNNS have a higher thermal conductivity than h-BN (up to 400 Wm−1K−1, in-plane). This paper provides a comprehensive review of various methods for preparing BNNS, including mechanical exfoliation, liquid phase sonication exfoliation and chemical vapor deposition (CVD). In addition, various factors affecting the thermal conductivity of BNNS, including grain boundary, grain size and defects, are also discussed. Then, the influence of BNNS as filler on the thermal conductivity of the polymer was further discussed. Finally, this paper summarizes the existing BNNS applications and lists the application scenarios of BNNS in various fields. The purpose of this review is to summarize the previous work and put forward the prospect and future development direction of preparing high thermal conductivity BNNS-included polymer composites, so as to stimulate the research and improvement of new preparation methods for BNNS and promote its practical application as heat transfer materials.
Investigation of experimental and numerical analysis of thermal load of WEDM on all metals through process parameters on wire electrode temperature
Authors: Gupta Rajesh , Agrawal Sunil , Srinivas R , Yadav Anil Singh , Kumar Rajan , Abdullaev Sherzod Shukhratovich
Published: March 2024

The thermal load on wire electrode in a wire electrical discharge machining (WEDM) is the most important factor in predicting wire electrode breakage. Thermal failure of wire electrode may be expected when the maximum temperature of the wire crosses a critical value. The maximum temperature of wire electrode is a function of process parameters of the machine and hence the failure depends upon what settings we choose to run WEDM process. In this investigation, simulation is done using finite-difference thermal model for continuous pulse without clustering of the spark. The model is used for determining distribution of the temperature throughout the length of wire electrode and analyzed the significance of various factors on wire breakage. The outcome of the present simulation model is validated by comparing it with the works of other researchers followed by its validation through experiments. A parametric study is also done to determine the effect of input process parameters and their interaction on the temperature of the wire. For finding the interaction effect, analysis of variance analysis is carried out followed by developing an empirical model. The predictive performance of our simulation model and developed regression models is assessed by comparing them with experimental value. The regression model is found to be closer, with an average percentage deviation of −2.55% on the experimental dataset, compared to 2.64% for the simulation model. During the validation test, the minimum and maximum deviations are 0.08% and 0.20% for simulation versus regression model predictions, −3.31% and −1.65% for experimental versus predicted results, and 1.82% and 3.40% for simulation versus experimental results, respectively. It is observed through this study that temperature of wire electrode mainly depends on the intensity of sparks per unit area which is a function of the input parameters of the WEDM.
Analysis of radiative mixed convective heat transfer for non-Newtonian fluid with heat generation/absorption phenomena
Authors: Iftikhar Babar , Javed Tariq , Siddiqui Muhammad Arshad
Published: March 2024

The current work consists of investigating the heat generation/absorption and non-linear thermal radiation effects for two-dimensional mixed convective bi-viscosity fluid flow inside the C-shaped enclosure with uniformly heated left and linearly heated top and bottom walls. The physical flow problem is governed by applying the constitutive laws of bi-viscosity model, conservation of mass, momentum and energy balance equations. The governing non-linear coupled partial differential equations is transformed into the algebraic nonlinear system by using Galerkin's finite-element technique after eradicating the pressure terms via the penalty method, and then the Newton–Raphson technique is used to solve it. It is noted that at a low value of [Formula: see text] (which gives the high plasticity of the bi-viscosity liquid), only the primary circulations with intensity [Formula: see text] appeared, but at a high value of [Formula: see text] decreased the plasticity which caused enhanced buoyancy-driven that generate also the secondary bowls with intensity [Formula: see text] inside the enclosure. The heat transfer rate increased [Formula: see text] by an increase in the Reynolds number from [Formula: see text] to [Formula: see text]. The findings of this study will play a role in improving the thermal performance of microelectronic devices, cooling systems, food processing, solar collectors, and high performance boilers by tracing the energy transport trajectories through heatlines.
Distributed energy technologies, decentralizing systems and the future of African cities
Authors: Hermanus Lauren , Rose Cirolia Liza
Published: March 2024

Within global debates, decentralization with respect to renewable electricity is positioned as pivotal in overlapping calls for decarbonization, energy access and just transitions. The promise is that technologies that are smaller and distributed will deliver a range of benefits, including enabling infrastructural innovations and expanding sustainable access, notably by empowering local authorities. While shifting to low-carbon systems is imperative, in this paper we call for attention to the complexity, opportunities and risks of commonly celebrated experiments in distributed electricity technologies when applied to African contexts. We draw on the case of Uganda, unpacking a series of four innovative electricity projects currently under way. For each case, we look at the actors involved and the imagined relationship between the projects and the incumbent grid. From these cases, we argue that, in this African context characterized by contested urban governance and fragmented networks, careful attention to supporting urban scale institutional and infrastructural development is necessary, although in many cases bypassed.
Dr. Russell Davies (1914–1991): Pioneer of theatre recovery and of anaesthetics in Yugoslavia
Authors: Webster Holly Elizabeth , Cooper Maxwell John
Published: March 2024

Dr. Russell Davies is a largely forgotten pioneer of both post-operative theatre recovery but also a key figure in the establishment of anaesthetics services in Yugoslavia in the late 1940s. Davies spent the majority of his career working as an anaesthetist at Queen Victoria Hospital, East Grinstead, Sussex, England, later being promoted to the head anaesthetist role. Davies set up one of the first recovery wards in the United Kingdom at Queen Victoria Hospital, the ward being named after him in 1989. Here he became a founding member of the Guinea Pig Club, alongside Dr. Archibald McIndoe. The Guinea Pig Club was founded in 1941 to support airmen in the Second World War undergoing plastic surgery at Queen Victoria Hospital. Davies was crucial to the pastoral care of the Club, providing clinical care and guiding members over access to pensions they would have previously been denied. Little is recognised of Davies's achievement of establishing anaesthetics services in Yugoslavia. Davies and his contributions have been largely overlooked. Davies should be considered one of the foremost British anaesthetists of the 20th century.
‘Untarnished Regiment’? Divergent Perspectives on the Wehrmacht's 9th Infantry, 1939–1941
Authors: Olex-Szczytowski Matthew
Published: March 2024

We know more about 9th Infantry than about other regiments in the Wehrmacht. Its ‘Prussian’ officer cadre produced two wartime field marshals, 27 generals, and a president of Germany in 1984–94. Several erstwhile officers conspired ahead of the putsch on 20 July 1944. Traditional accounts suggested that the regiment was ‘untarnished’ and not implicated in National Socialist crimes. This paper tests this by drawing on unexplored or little-known German, Polish, Jewish, and ex-Soviet sources. It finds that 9th Infantry did not differ from peers in supporting and joining illegalities in 1939–41. Moreover, in facilitating repression and Jewish ghettos in Poland and in shooting Soviet POWs it exceeded ‘typical’ criminality. Distortions seen in the traditional accounts are deconstructed. Some persist today in Germany's public sphere.
Economical Approaches to Increasing Communication Instruction for Students With Autism Spectrum Disorder
Authors: Pinczynski Monique , Pennington Robert
Published: March 2024

Efforts to implement high-quality communication instruction for students with autism spectrum disorder (ASD) and complex communication needs (CCN) may be difficult for some educators with limited time and resources. In this article, we offer guidance on implementing several economic strategies that can be easily embedded into existing classroom routines to improve student communication outcomes. These strategies include (a) facilitating observational learning, (b) using instructive feedback, (c) embedding communication instruction throughout the school day, and (d) programming for generalization.
A Profile of Community College Students as Preservice Music Educators
Authors: Dansereau Diana R. , Sundblad Michael
Published: March 2024

The purpose of this explanatory sequential mixed-methods study was to provide a profile of preservice music educators who chose to attend community college and a description of factors that led to this choice. The study was framed by Perna’s college choice model and focused on participants’ experiences and the socioeconomic and educational contexts that predated their enrollment. Quantitative data were collected via a questionnaire to community college students who sought a career in music education ( N = 59). Qualitative data were gleaned from interviews with four participants. Most participants (77.97%) identified as White, 47.47% identified as female, the mean age was 21.90 years, and 50.85% were first-generation college students. Participants reported varying levels of cultural capital, with 54.24% receiving private lessons prior to college. Affordability, location, the opportunity to live at home, flexible scheduling, and prior positive experiences with the college were motivators for attending a community college.
Behavior, Paperwork, Instruction, and Supervision . . . Oh My! A Review of the Literature on Mentorship for Teachers of Children With EBD
Authors: Deger Gwendolyn K. , Moohr Michele , Riden Benjamin , Taylor Jonte’ C.
Published: March 2024

The role of a special educator is one of many different hats, including teacher, interventionist, comforter, parent, counselor, therapist, and administrator. These varying roles, particularly when working with students with emotional behavioral disorders, create one of the most emotionally taxing and challenging jobs in public education, which in turn leads to increased educator burnout and attrition. However, this does not need to be the fate of special educators. The purpose of this article is to (a) review one current support system widely implemented in the field for teachers of children with emotional behavioral disorders, (b) discuss the benefits of mentorship in the teaching workforce, (c) identify some of the barriers to mentorship, and (d) identify areas of reform for more effective mentorship practices.
Advancements in mRNA Vaccines: A Promising Approach for Combating Human Papillomavirus-Related Cancers
Authors: Iqbal Laraib , Jehan Minal , Azam Sumran
Published: March 2024

The human papillomavirus (HPV) is a typical sexually transmitted disease that affects different epithelial cells and can cause a number of health problems. HPV is mainly spread through sexual contact and is extremely contagious, even in the absence of obvious symptoms. It is linked to a number of malignancies, such as oropharyngeal, cervical, anal, vulvar, vaginal, and cutaneous as well as anogenital and cutaneous warts. Different vaccines targeting various HPV virus strains have been produced to prevent HPV infections. Vaccines can help prevent HPV-related illnesses, but they cannot cure malignancies that have already been caused by HPV. But new developments in mRNA vaccines have shown potential in combating malignancies linked to HPV. mRNA vaccines stimulate the immune system to identify and attack particular proteins present in viruses or tumour cells. The efficacy of mRNA vaccines in preventing HPV-related malignancies has been shown in preliminary experiments in mice. Additionally, in clinical trials aimed at individuals with HPV-related head and neck malignancies, personalised mRNA vaccines in combination with immune checkpoint drugs have demonstrated encouraging results. Even though mRNA vaccines have drawbacks and restrictions such as immunogenicity and instability, further research and development in this area has a great deal of promise for developing effective therapies for HPV-related malignancies.
Talking About Gene Drive in Uganda: The Need for Science Communication to Underpin Engagement
Authors: Hartley Sarah , Stelmach Aleksandra , Opesen Chris , Openjuru George Ladaah , Neema Stella
Published: March 2024

Uganda may host the world’s first field trials of gene drive mosquitoes for malaria control. Global North discourses pre-suppose African publics have access to information about gene drive and are ready to make decisions about its governance. We explore assumptions about the availability of this information in Uganda. We find a paucity of information available combined with a strong desire for information from lay publics. We discuss these findings in the context of Ugandan information infrastructures and political sensitivities to genetic technologies. If Ugandans are to decide about gene drive, they need independent information about the science to underpin engagement.
Delaying Suspension Syndrome Onset in Aerially Suspended Victims Through Leg Raising
Authors: Willihnganz Sophie B. , Ahmed Zubair , Lee Justine J.
Published: March 2024

Introduction

Suspension syndrome (SS) develops when venous blood pools in extremities of passively suspended individuals, resulting in presyncopal symptoms and potential unconsciousness or death independent of additional injuries. We investigated use of leg raising to delay onset of SS, as it can decrease venous pooling and increase cardiac return and systemic perfusion.

Methods

Participants were suspended in rock climbing harnesses at an indoor climbing wall in a legs-dangling control position or a legs-raised interventional position to compare physiological outcomes between groups. Participants were suspended for a maximum of 45 min. Onset of 2 or more symptoms of SS, such as vertigo, lightheadedness, or nausea, halted suspension immediately. We recorded each participant's heart rate, blood pressure, oxygen saturation, lower leg oxygen saturation, pain rating, and presyncope scores presuspension, midsuspension, and postsuspension, as well as total time suspended.

Results

There were 24 participants. There was a significant difference in total time suspended between groups (43.05±6.7 min vs 33.35±9.02 min, p=0.007). There was a significant difference in heart rate between groups overall ( p=0.012), and between groups, specifically at the midsuspension time interval (80±11 bpm vs 100±17 bpm, p=0.003). Pain rating was significantly different between groups ( p=0.05). Differences in blood pressure, oxygen saturation, lower leg oxygen saturation, and presyncope scores were not significant.

Conclusion

Leg raising lengthened the time individuals tolerated passive suspension and delayed symptom onset.
Safety Assessment of Capryloyl Salicylic Acid as Used in Cosmetics
Authors: Johnson Wilbur , Bergfeld Wilma F. , Belsito Donald V. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Peterson Lisa A. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Fiume Monice , Heldreth Bart
Published: March 2024

The Expert Panel for Cosmetic Ingredient Safety (Panel) reassessed the safety of Capryloyl Salicylic Acid in cosmetic products; this ingredient is reported to function as a skin conditioning agent. The Panel reviewed relevant data relating to the safety of this ingredient in cosmetic formulations, and concluded that the available data are insufficient to make a determination that Capryloyl Salicylic Acid is safe under the intended conditions of use in cosmetic formulations.
Brolucizumab effectiveness in pigment epithelium detachment due to exudative AMD in naïve treatment or non-responder patients
Authors: Furino Claudio , Albano Valeria , D’Addario Maria , Reibaldi Michele , Boscia Francesco , Alessio Giovanni
Published: March 2024

Purpose

To investigate outcomes after Brolucizumab injection in naïve treatment or non-responder patients with exudative age-related macular degeneration (AMD).

Methods

It is a retrospective, comparative, cohort study conducted at the tertiary referral center of the University Hospital Polyclinic of Bari, for 5 years, from November 2017 until May 2022. 41 eyes with wet-AMD (w-AMD) were included, undergoing anti-vascular endothelial growth factor (VEGF) intravitreal injections. The sample was divided into two groups, the Bro-Switch group, and the Bro-Naïve group. The Bro-Switch group previously received a slot of other anti-VEGF intravitreal drugs. The Bro-Naïve group received Brolucizumab (Bro) as the first treatment. The pigment epithelium detachment (PED) and the best-corrected visual acuity (BCVA) outcomes before and after Bro-injection were evaluated.

Results

A significant reduction in PED measurement was registered in all eyes treated with Bro-injection ( p = 0.35). The Bro-Naïve group improved better in PED measurement (mean difference: 297.92 ± 72,32) as compared to the Bro-Switch group (mean difference: 185.06 ± 11.07). On the contrary, no significant reduction in BCVA in the two groups was recorded ( p = 0.66).

Conclusion

We suggest Bro-injection for w-AMD as effective anatomical outcomes in PED flattening, but not similar in visual results. Although this study evaluated short-term outcomes, the hopeful results can lead to interesting medium-long time effects.
Plasticizing Pregnancy: Microplastics Identified in Expectant Mothers’ Feces
Authors: Hasanah Uswatun , Amqam Hasnawati , Septami AR Ervina , Chalid Maisuri , Aris Ahmad Zaharin
Published: March 2024

Introduction:

Microplastics may be present in food and drinks from various sources, exposing pregnant women to these particles. Consumption of contaminated food can lead to the ingestion of microplastics by pregnant women, potentially causing adverse health effects on the fetus. This study aims to investigate the presence of microplastics in the stools of pregnant women.

Methods:

The research was conducted in the Makassar City region of South Sulawesi, Indonesia. Thirty healthy pregnant women from 2 community health centers, Pattingalloang and Jumpandang Baru, participated in the study. Their stools were analyzed using Fourier Transform Infrared (FTIR) microspectroscopy to detect the presence of microplastics.

Result:

The analysis revealed the presence of a total of 359 microplastics in the participants’ stools, with particle counts ranging from 4 to 21 and sizes ranging from 0.2 to 4.9 mm per 25 g of stool. The polymers identified included Polyethylene Terephthalate (PET), Polyamide/Nylon, Polyethylene Chlorinated, HDPE, and Ethylene Propylene. The amount of microplastics varied significantly among groups with different levels of seafood consumption.

Conclusion:

Indonesian pregnant women have been exposed to some microplastic polymers.
Promoting policy evaluation across government: The contribution of the OECD recommendation to public policy evaluation
Authors: Salama Claire , Picalarga Silvia
Published: March 2024

Policy evaluation is now recognised by many governments as fundamental to ensuring that policies are informed by quality evidence. Nevertheless, the practice of policy evaluation is still difficult to systematise inside governments. Building on more than 20 years of work on this topic, the Organisation for Economic Co-operation and Development Recommendation on Public Policy Evaluation, adopted in 2022, represents the first international legal guidance on the topic. It identifies three essential pillars to ensure the impact of policy evaluation: institutionalisation, quality and use. This article explains how the Organisation for Economic Co-operation and Development Recommendation was developed, what these three pillars cover, and reflect on how the Organisation for Economic Co-operation and Development can further help countries developing a sound evaluation system.
How healthcare systems are experienced by autistic adults in the United Kingdom: A meta-ethnography
Authors: Radev Sarah , Freeth Megan , Thompson Andrew R
Published: March 2024

Autistic adults are at increased risk of both mental and physical health difficulties, and yet can face barriers to accessing healthcare. A meta-ethnographic approach was used to conduct a review of the existing literature regarding autistic adults’ experiences of accessing healthcare. Four databases were systematically searched for qualitative and mixed-method studies reporting on the experiences of autistic adults without a co-occurring learning disability accessing adult healthcare services within the United Kingdom. Fifteen studies met the inclusion criteria, and seven steps were used to systematically extract the data and then generate novel themes. Three superordinate themes were identified: Professionals’ lack of knowledge can be damaging, Need to reduce processing demands and Adaptation to improve engagement. This review highlights the wide-reaching damaging impact misdiagnosis, inadequate or inappropriate treatment, overwhelming environments and inaccessible systems can have on the well-being and ability of autistic adults to engage with treatment. The lack of autism knowledge and understanding experienced in interactions with healthcare professionals, along with autistic adult’s own communication and sensory processing differences, demonstrates the need for widely delivered training co-produced with autistic adults alongside bespoke and person-centred adaptations.

Lay abstract

Autistic adults are more likely to experience mental and physical health difficulties, and yet can find it difficult to get the support that they need. A meta-ethnographic approach was used to review the existing research on autistic adults’ experiences of accessing healthcare. Four databases were searched for qualitative and mixed-method studies which looked at the experiences of autistic adults who did not also have a learning disability when using healthcare services in the United Kingdom. Fifteen papers met the criteria to be included, and seven steps were used to analyse the information and develop new themes. Three main themes were identified: Professionals’ lack of knowledge can be damaging, Need to reduce processing demands and Adaptation to improve engagement. This review highlights how damaging misdiagnosis, inappropriate treatment, overwhelming environments and systems that are difficult to access can have on the well-being of autistic adults. Limited knowledge and understanding about autism knowledge among healthcare professionals along with autistic adult’s own communication and sensory differences indicate that there is a need for improved training developed with autistic adults and adaptations.
Fandom meets artificial intelligence: Rethinking participatory culture as human–community–machine interactions
Authors: Li Eva Cheuk-Yin , Pang Ka-Wei
Published: March 2024

Fandom as an interpretive community is the frontier for rich insights into the multi-layered interactions and practices between individual users, communities and intelligent machines. To understand the challenges and opportunities Artificial Intelligence (AI) presents to contemporary media and culture, we discuss how fans engage with AI, as fandom provides meaningful insights into interactions between individual technology users, the collective and machines. We propose rethinking participatory culture as human–community–machine interactions to understand the wider implications of AI to society and culture. We outline three emerging phenomena and potential consequences of fans’ engagement with AI: (1) fan labour made (un)easy, (2) parasocial interactions (un)familiarised and (3) realities (un)settled. Our conceptualisation transcends existing computer science research, which assumes technology users as isolated individuals and also fan studies, which largely focus on text-audience relationships and tend to take digital technologies for granted as the preconditions of fans’ creative and playful practices.
Integration of Network Pharmacology and Experimental Validation to Explore Jixueteng - Yinyanghuo Herb Pair Alleviate Cisplatin-Induced Myelosuppression
Authors: Liu Yi , Dai Shuying , Xu Yixiao , Xiang Yuying , Zhang Yao , Xu Zeting , Sun Lin , Zhang Gao-chen-xi , Shu Qijin
Published: March 2024

Jixueteng, the vine of the bush Spatholobus suberectus Dunn., is widely used to treat irregular menstruation and arthralgia. Yinyanghuo, the aboveground part of the plant Epimedium brevicornum Maxim., has the function of warming the kidney to invigorate yang. This research aimed to investigate the effects and mechanisms of the Jixueteng and Yinyanghuo herbal pair (JYHP) on cisplatin-induced myelosuppression in a mice model. Firstly, ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) screened 15 effective compounds of JYHP decoction. Network pharmacology enriched 10 genes which may play a role by inhibiting the apoptosis of bone marrow (BM) cells. Then, a myelosuppression C57BL/6 mice model was induced by intraperitoneal (i.p.) injection of cis-Diaminodichloroplatinum (cisplatin, CDDP) and followed by the intragastric (i.g.) administration of JYHP decoction. The efficacy was evaluated by blood cell count, reticulocyte count, and histopathological analysis of bone marrow and spleen. Through the vivo experiments, we found the timing of JYHP administration affected the effect of drug administration, JYHP had a better therapeutical effect rather than a preventive effect. JYHP obviously recovered the hematopoietic function of bone marrow from the peripheral blood cell test and pathological staining. Flow cytometry data showed JYHP decreased the apoptosis rate of BM cells and the western blotting showed JYHP downregulated the cleaved Caspase-3/Caspase-3 ratios through RAS/MEK/ERK pathway. In conclusion, JYHP alleviated CDDP-induced myelosuppression by inhibiting the apoptosis of BM cells through RAS/MEK/ERK pathway and the optimal timing of JYHP administration was after CDDP administration.
Contraception Requirements in Clinical Research Consent Forms: Assessing and Supporting Gender Inclusive Practices
Authors: Coffin Tara , Brower Erin , Adekar Sharad
Published: March 2024

Gender-diverse individuals are underserved in clinical research settings. Reliance on gendered language throughout the consent process for clinical research contributes to the marginalization of these populations. The research objective was to assess use of gender-inclusive language used to describe the contraception requirement in consent forms. We categorized and analyzed contraception language in 289 clinical trial consent forms using a deductive and summative content analysis approach. We found that 79% (n = 227) of consent forms contained gender-inclusive language, 80% (n = 231) used terms that fell under the biological sex language, and 91% (n = 264) used gendered language. No consent forms used exclusively gender-inclusive language and the majority 63% (n = 182) featuring a combination of all three language types. There were many consent forms which would have been entirely gender-inclusive language if section headings with references to biological-sex-specific contraceptives were excluded, suggesting that gender-inclusive language may be attainable with minor revisions.
The Perceval Sutureless Bioprosthetic Aortic Valve: Evolution of Surgical Valve Technology
Authors: Fialka Nicholas M. , EL-Andari Ryaan , Wang Shaohua , Dokollari Aleksander , Kent William D. T. , Fatehi Hassanabad Ali
Published: March 2024

Objective:

The surgical treatment of aortic stenosis continues to evolve, and sutureless aortic valve replacement (SUAVR) is an emerging technology. With the Perceval S (Corcym, London, UK) as the only true sutureless valve on the market, the objective of this review is to analyze the current literature on Perceval S. Focusing on valve design and deployment as well as applications of the technology for challenging pathology, clinical outcomes are assessed, including a comparison with transcatheter AVR (TAVR).

Methods:

PubMed and MEDLINE were searched by 3 authors for studies analyzing SUAVR from inception to May 19, 2023.

Results:

SUAVR facilitates minimally invasive surgery and offers an alternative strategy for patients with small aortic annuli. It also has a time-saving advantage for patients who require complex operations. SUAVR results in excellent long-term morbidity, mortality, durability, and hemodynamic function. In comparison with conventional surgical AVR (SAVR), SUAVR does have a greater risk of postoperative pacemaker implantation; however, increasing user experience and refinements in implantation technique have contributed to reductions in this outcome. SUAVR results in morbidity and mortality that is similar to rapid-deployment AVR. Midterm outcomes are superior to TAVR; however, further robust investigation into all of these comparisons is ultimately necessary.

Conclusions:

SUAVR bridges the gap in technology between SAVR and TAVR. The application of this exciting technology will undoubtedly grow in the coming years, during which additional investigation is paramount to optimize preoperative planning, valve deployment, and reintervention strategies.
Physical Activity and the Health of a Nation: A National Challenge and Collective Response
Authors: Webber Bryant J. , Bornstein Daniel B. , Kiel Mary Anne , Wilkins Robert C. , Bryant Cedric X.
Published: March 2024

Historic recruitment and retention challenges confront the U.S. military. In an invited panel discussion at Lifestyle Medicine 2023, we argued that widespread physical inactivity is contributing to these challenges, and that Lifestyle Medicine approaches should be part of the solution. Our aim in this commentary is to recapture the most salient messages from that discussion. First, we summarize significant epidemiologic studies that describe the scope of the problem among future recruits, current service members, and Veterans. Then, in the optimistic spirit that characterizes both the armed forces and Lifestyle Medicine communities, we outline several potential solutions. By increasing physical activity during the school day, using wearable technology to monitor and prompt health behaviors, addressing the other pillars of Lifestyle Medicine (especially sleep, nutrition, and stress management), aligning efforts with current health frameworks in the Departments of Defense and Veterans Affairs, and recruiting Lifestyle Medicine professionals, we are convinced that we can improve the health of our nation and, in so doing, strengthen military readiness and national security.
Investigating the roles of middle leaders in New South Wales public schools: Factor analyses of the Middle Leadership Roles Questionnaire
Authors: Nobile John De , Lipscombe Kylie , Tindall-Ford Sharon , Grice Christine
Published: March 2024

This article reports on factor analyses of the Middle Leadership Roles Questionnaire – School Edition (MLRQ-SE) that were conducted to test a theoretical model. This work was completed as part of a larger study that investigated the roles of formal middle-leadership positions in public schools of New South Wales, Australia. Quantitative data from an adapted version of the MLRQ-SE, which was completed by 2608 employees in formal middle leader positions in NSW public schools, were factor analysed to identify theorised roles and thereby confirm an overarching model of middle leadership roles as well as assist with ongoing refinement of the instrument's scales. Exploratory factor analyses identified seven salient roles of middle leaders. Confirmatory factor analyses of data from the two largest position categories supported the seven-role model for assistant principals and head teachers. While the scales within the MLRQ-SE were based on a wide review of previous research, the data reported here is from one educational jurisdiction in one country. However, the findings provide evidence for the existence middle leader roles often theorised in literature but to date not confirmed empirically. The findings also hold implications for policy, practice and future research regarding leadership development and recruitment.
Cine clips increase the detection of thyroid pyramidal lobe in routine thyroid sonogram
Authors: Yan Yi , He Xiaoou , Hu Kai , Frankel Jed , Liu Jian , Goubran Ashraf , Karlicki Fern
Published: March 2024

Background:

Identification and resection of the thyroid pyramidal lobe is important for thyroid cancer surgery in order to prevent interval cancer in residual thyroid tissue.

Purpose:

The purpose of this study was to determine how often a thyroid pyramidal lobe is found in patients with and without previous thyroidectomy and to optimise the protocol for identifying thyroid pyramidal lobes during routine thyroid ultrasonography.

Material and Methods:

In this prospective study, a total of 1579 patients who received routine thyroid ultrasound scans at a single centre were enrolled. A dedicated standard scanning protocol was established containing both static images of the anterior neck superior to the thyroid as well as a transverse cine loop starting from the isthmus to the hyoid bone. The presence and features of thyroid pyramidal lobes were evaluated and compared.

Results:

Detection rate of thyroid pyramidal lobes in patients without thyroidectomy improved from 39.5% (480/1215) to 49.7% (640/1215) with protocol adding cine-loop as compared to protocol without cine-loop. The cine-loops were particularly helpful in the detection of thyroid pyramidal lobes when it is separated from the main lobe or in thyroidectomy patients. By adding assessment with cine-loop into the dedicated protocol, we have further detected different pathologies occurring on thyroid pyramidal lobes including benign and malignant solid nodules and pseudo-nodules of Hashimoto’s thyroiditis.

Conclusion:

The addition of dynamic assessment with cine-loop increases the detection rate of thyroid pyramidal lobes. By paying attention to the thyroid pyramidal lobe in pre-operative diagnostic sonographic images, we can help to avoid incomplete removal of the thyroid gland during thyroidectomy.
What do leaders really want to learn in a workplace? A study of the shifting agendas of leadership coaching
Authors: Bachkirova Tatiana , Jackson Peter
Published: March 2024

Multiple theories of leadership postulate specific capability requirements with an expectation that leaders recognize the need for such capabilities and become motivated to develop them. In the workplace, leaders’ development is also expected to respond to the immediate demands of the organizational context. However, what leaders end up learning in the workplace remains largely unexplored. Hence our inquiry is into what leaders choose to learn, when they are in role and face the realities and demands of their immediate and wider environment. In line with Vygotsky’s sociocultural theory and concept of ‘perezhivanie’ we explore what actually becomes important for leaders to learn when they receive developmental support from a coach. We do this by identifying the content of coaching conversations: what is demonstrably discussed in coaching - the main themes of the actual coaching conversations and how the predominance of different themes changes over the coaching engagement. Based on the analysis of the sequencing of coaching themes in 153 organizational coaching engagements we discuss the dynamic interplay of the personal and the organizational agendas in the changing foci of leader learning. We propose a novel and theoretically-grounded explanation of leaders’ choices for learning in real complex environments. The results of uniquely gathered data and analysis challenge some current trends in the scholarship and praxis of leader development.
Safe usage of Mini ‘C’-arm in operating room environment: Implications for clinical practice
Authors: Naidu Jatin , Botchu Rajesh , Iyengar Karthikeyan P
Published: March 2024

Background:

Mini ‘C’-arm machine is an advanced medical imaging device used primarily for intraoperative imaging during surgical, orthopaedic and emergency care procedures. Since the technology is based on ionising radiation, safe usage of Mini ‘C’-arm machine is mandatory to protect patients and operating personnel.

Objective:

The main objective is to describe the various components related to patients, operator and equipment to ensure safe usage of Mini ‘C’-arm machine. A comprehensive search strategy using the PEO (Population, Exposure, Outcome) framework was conducted using Embase, PubMed, Google Scholar and ResearchGate databases to identify suitable literature. The keywords used for the search included ‘Fluoroscopy’, ‘Ionising Radiation’ and ‘surgical safety’.

Key findings:

Safe usage of Mini ‘C’-arm equipment involves components of operator training, operator safety, patient safety, radiation dose, operating room logistics, handling of images and auditing of Mini ‘C’-arm use.

Conclusion:

Mini ‘C’-arm provides an invaluable, portable imaging tool in a spectrum of general surgical and orthopaedic interventional procedures. However, safe usage of Mini ‘C’-arm machine requires a multifaceted approach including operator responsibility and safety, patient protection, equipment maintenance, radiation dose awareness, documentation and sound reporting mechanisms.
Choosing What You Like or Liking What You Chose? Sampling’s Impact on Evaluation and the Role of Idiosyncratic Reactions to Valent Stimuli
Authors: Niese Zachary Adolph , Hütter Mandy
Published: March 2024

Recent work incorporating autonomy into an evaluative conditioning procedure provided evidence of a sampling decision effect in which high-autonomy participants positively shifted their evaluations of frequently sampled conditioned stimuli (CSs), regardless of whether they were consistently paired with positive or negative unconditioned stimuli (USs). The current work modified this paradigm by also measuring participants’ evaluations of the sampled USs. Two experiments replicate the sampling decision effect for neutral CSs in a new variant of the paradigm while ruling out the alternative possibility that the effect is driven by idiosyncratic variance in participants’ reactions to the USs. In addition, Experiment 2 suggests that the sampling decision effect does not extend to the paired, valent stimuli. Together, these results further suggest that it is the act of sampling a stimulus more frequently that predicts a positive evaluative shift toward it.