bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive Behavioral Sleep Self-Management Intervention for Young Adults With Type 1 Diabetes (NCT04975230)
Authors: Griggs Stephanie , Hernandez Estefania , Bolton Pamela J. , Strohl Kingman P. , Grey Margaret , Kashyap Sangeeta R. , Li Chiang-shan R. , Hickman Ronald L.
Published: February 2023

The purpose of this study was to explore perceptions of the first dose of a cognitive behavioral sleep self-management intervention (CB-sleep) among young adults aged 18 to 25 years with type 1 diabetes (T1D). We used a qualitative descriptive approach to conduct in-depth semi-structured focused interviews with a purposive sample of 16 young adults with T1D, transitioning from adolescence to early adulthood. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis. Participants described their sleep knowledge (previous, new, and additional), sleep health goals, along with barriers and facilitators of the CB-sleep intervention. Based on these results, we suggest CB-sleep is a useful modality with the potential to support sleep self-management in young adults with T1D during this complex life transition. Furthermore, CB-sleep could be incorporated into an existing diabetes self-management education and support program after pilot testing and determining efficacy to improve sleep and glycemic health.
Accuracy and Interrater Agreement of Registered Nurses’ Assignment of Apgar Scores to Standardized Clinical Vignettes
Authors: Michel Alexandra D. , Lowe Nancy K.
Published: February 2023

The purpose of our study was to test whether registered nurses assign the correct Apgar score when provided all pertinent data, whether they assign an Apgar score even if all pertinent data are not provided, and to evaluate the Apgar score’s interrater agreement. We conducted a REDCap survey and provided nurses with color photograph/vignette combinations of neonates, some of which lacked pertinent data points needed to correctly assign Apgar scores. Over 90% of study participants assigned Apgar scores even if data points for heart rate or respiratory effort were omitted. Participants’ correct assignment of the component score for respiratory effort was affected by the description of the respiratory effort and whether neonatal heart rate was known. Interrater agreement was generally low to moderate. Our findings are consistent with earlier findings and support the conclusion that the Apgar score requires significant revision or needs to be retired and replaced.
From Lived Experience: Listening to Stories of Healing From Middle Eastern Immigrant IPV Survivors
Authors: Ozturk Burcu , Nelson-Gardell Debra
Published: February 2023

Intimate partner violence (IPV) affects all communities, but immigrant communities can be distinctively more vulnerable. This study explores the coping strategies of 10 immigrant Middle Eastern Immigrant Survivors of IPV in the United States. A phenomenological design was utilized to explore Middle Eastern immigrant IPV survivors coping strategies. The study participants had similar and different experiences with formal resources and informal help-seeking behaviors. These study results recommended that there is a considerable need for future research to extend the study of this population as well as an urgent need to increase accessible resources to empower immigrant IPV survivors.
Clinical outcomes of trifocal toric intraocular lenses
Authors: Tañá-Rivero Pedro , Rodríguez-Carrillo María Dolores , Tañá-Sanz Pedro , Ruiz-Santos María , Tañá-Sanz Santiago
Published: February 2023

The purpose of this report is to summarize the visual and refractive outcomes of patients with trifocal toric intraocular lens (IOL) implants. A peer-reviewed literature search in different databases was carried out to identify clinical publications reporting outcomes of patients with this type of implant. The analysis considered information on the sample of eyes, type and power of the trifocal toric IOLs, biometric preoperative data, postoperative refraction, rotational stability, visual acuity at different distances and other analyses undertaken, such as contrast sensitivity or quality of vision questionnaires. 20 clinical studies, encompassing a total of 1404 eyes implanted with three commercially available trifocal toric IOLs, were included in this review. The analysis assessed the outcomes reported for the AT LISA tri toric 939MP IOL, involving 3 articles and 313 eyes; the FineVision toric POD FT IOL, with 7 articles studying 370 eyes, and the AcrySof IQ PanOptix toric IOL, involving 11 articles and 721 eyes. Our assessment of the outcomes of the various studies indicates that the efficacy of the refractive correction (both sphere and cylinder) and visual acuity at different distances was similar between the IOL models. The same was found for the patients’ quality of vision and satisfaction levels, in addition to photic phenomena reported. The outcomes summarized in this report lead us to conclude that the use of trifocal toric IOLs allows complete visual restoration over a wide range of distances.
Progression of bilateral morning glory syndrome associated with unilateral persistent fetal vasculture: A case report of long term follow-up in an infant
Authors: Ran Hongyun , Ren Jiantao , Li Shuchan , Han Haitao , Liu Hangyu , Ai Zhaohui , Jiang Keke , Zhang Jie
Published: February 2023

Purpose

To describe a case of Bilateral Morning Glory Syndrome (MGS) associated with Unilateral Persistent Fetal Vasculature (PFV) in a 3-day old neonate.

Observations

A 3-day-old neonate was found bilateral retinal abnormalities due to neonatal eye screening. Dilated fundus exam showed bilateral optic disc dysplasia with the persistent hyaloid vessels in right eye at first. With the progress of the disease, optic disc was enlarged with central umbilication which with a similar anomalous radiating peripapillary vascular appearance, the persistent hyaloid vessels in vitreous cavity of right eye gradually disappear, a large amount of exudation can be seen in the posterior pole retina with macular movement in both eyes. Bilateral vitrectomy was performed in this case, then the condition of the neonate's both eyes is stable until 1 year old.

Conclusions and Importance

This is a rare case that showing the development of MGS and PFV and the relationship between these two diseases. In addition, we completely observed the whole process of the change of the persistent hyaloid vessels in the vitreous cavity of a case of MGS associated with PFV.
Occupational Exposure to Blood and Body Fluids Among Nurses in the Emergency Department and Intensive Care Units of Public Hospitals in Addis Ababa City: Cross-sectional Study
Authors: Adal Ousman , Abebe Asmamaw , Feleke Yohannes
Published: February 2023

Aims and Objectives:

This study investigated occupational exposure to blood and body fluids among nurses at the emergency department and intensive care units of public hospitals in Addis Ababa city.

Methods:

A cross-sectional study was conducted from June 18, 2021 to September 20, 2021. A simple random sampling method and semi-structured, self-administered questionnaires were used to collect the data, which were analyzed using SPSS version 25. A binary logistic regression model was used to identify factors associated with exposure to blood and body fluids on the AOR with a 95% confidence interval at a P-value of <.05.

Patient and Public Involvement:

No patients were involved in this study.

Results:

Of the total study participants (260), 198 (76%) nurses had been exposed to blood and body fluids in their professional live, and 167 (64%) were exposed to blood and body fluids in the last 12 months. Being male (AOR = 2.88, 95% CI: (1.35, 6.12), lacking access to handwashing facilities (AOR = 5.02, 95% CI: (3.73, 14.51)), not consistently wearing all the required types of personal protective equipment (AOR = 6.21, 95% CI: (2.39, 9.55)), and the lack of the required personal protective equipment (AOR = 5.53, 95% CI: (1.87, 10.38)) were all significant factors that were positively associated with exposure to blood and body fluids.

Conclusion:

This study showed that a higher proportion of nurses in the emergency department and intensive care unit were exposed to blood and body fluids in the study setting. Most nurses do not consistently wear all the required types of personal protective equipment, putting them at a higher risk of acquiring blood-borne pathogens. The authors recommended that there is a need to implement and strengthen appropriate and consistent use of all required personal protective equipment during any procedure, and patient care to reduce exposure to blood and body fluids.

Relevance to Clinical Practice:

This study provides baseline information for other action-based studies to assess exposure to blood and body fluids among nurses in emergency and intensive care units.

Strobe Checklist:

This manuscript was prepared based on the strobe checklist guidelines.

Impact Statement:

The study’s findings and recommendations might be used for healthcare providers, non-governmental organizations, and policymakers for appropriate planning and interventions to minimize or safeguard nurses’ exposure to blood and body fluids.
The emerging fault line of alternative news: Intra-party division in Republican representatives’ media engagement
Authors: Cowburn Mike , Knüpfer Curd B.
Published: February 2023

Intra-party factionalism and media fragmentation have emerged as two major trends in U.S. politics, especially on the right. We explore potential connections between these developments by analyzing the engagement of Republican members of the US House of Representatives with far-right alternative news media during the 116th Congress. We develop three discrete measures to scale representatives’ engagement using hyperlinks to news media on Twitter, demonstrating their validity against existing positional data: roll-call voting, ideological caucus membership, and political rhetoric. We then apply our scales empirically, showing that representatives with further-right media engagement became increasingly radical in their online communication during the Trump presidency. Representatives with more moderate media engagement did not radicalize in this way. These results suggest a dynamic relationship that reflects the ‘dual function’ of elite-media relations, where partisan elites serve as receivers of information and transmitters of intra-party signals in a fragmented media environment.
The mutual configuration of affordances and technological frames: Content creators in the Chilean influencer industry
Authors: Arriagada Arturo , Siles Ignacio
Published: February 2023

Examining the case of the Chilean influencer industry, this paper argues for situating affordances within a wider context in which the features of platforms acquire meanings. Our analysis focuses on two dynamics. On the one hand, we examine how the Chilean influencer industry is shaped by a ‘technological frame’ that structures the valence of affordances. We show that affordances are neither ‘naturally’ nor ‘neutrally’ imagined by actors but rather culturally located within technological frames that shape the discourses, values, and practices from which they obtain cultural meaning. On the other hand, we analyze how affordances provide a material support for the temporal and spatial expansion of these technological frames. Thus, cultural contexts and platforms’ features mutually configure each other in ways that have not always been recognized in the scholarly literature about affordances. We situate negotiations about what it means to be an influencer in Chile, the role of intermediaries (eg branding agencies), communication with followers, and the global influencer industry as part of this mutually constitutive relationship.
An efficient method for predicting wheel-rail forces in coupled nonlinear train-track-bridge system using artificial neural networks
Authors: Zhang Xun , Wang Lidong , Han Yan , Xu Guoji , Cai Chunsheng , Liu Hanyun
Published: February 2023

Wheel-rail forces are an essential indicator for vehicle safety evaluation. The calculation of wheel-rail forces for the coupled nonlinear train-track-bridge system using the direct numerical integration method is time-consuming, hindering the timely safety and reliability assessment of train operations. In this paper, an efficient method based on the nonlinear autoregressive with exogenous input artificial neural network (NARX-ANN) was proposed to predict the nonlinear wheel-rail force of trains on bridges caused by track irregularity. Firstly, samples of track irregularity time history were randomly generated using the stochastic harmonic function method. The vertical and lateral wheel-rail forces of the coupled nonlinear train-track-bridge system were calculated by numerical integration. Secondly, the NARX-ANN model was established and trained with a small number of randomly selected wheel-rail force samples. Finally, the wheel-rail forces obtained by numerical integration were regarded as the ground truth to verify the prediction accuracy of the NARX-ANN model. The influence of training configuration, initial output, and the number of time delays on prediction accuracy was systematically analyzed. The results showed that the NARX-ANN model could accurately predict the time history of wheel-rail forces. In addition, its computational efficiency is 19.35 times higher than that of the numerical integration method. It is hoped that this study can guide the stochastic analysis of the train–track–bridge system.
A narrative review of damage control resuscitation for paediatric trauma patients in Iraq and Afghanistan from 2001 to 2016
Authors: Wright Annie Mae , Ramage Lisa , Barratt Jon , Grier Gareth , Hughes Amy
Published: February 2023

Introduction

Requirement for blood transfusion in the injured paediatric civilian population is rare. Therefore, a substantial evidence base underpinning damage control resuscitation (DCR) in paediatric patients is lacking. Published outcome data originating from Iraq and Afghanistan offer a unique opportunity to study large cohorts of children who received DCR. It is hoped that by collating the data, this review will inform pre-deployment medical training and support the development of paediatric specific DCR guidelines, which can be used in all trauma environments.

Methodology

A comprehensive search of the literature was conducted using online databases, grey literature searching and screening of reference lists. Papers discussing blood product, crystalloid or tranexamic acid (TXA) administration in paediatric patients injured in Iraq and Afghanistan from 2001to present were included.

Results

Eighteen papers were included – all were retrospective studies of data from military trauma databases. Most children that received massive transfusion were male (73.4%), injured in Afghanistan (69.9%) by explosives (60.4%) with a median age of 9 years. A definition of paediatric massive transfusion of 40 ml/kg of all blood products within 24 h was developed. Massive transfusion rates were high (15.7% of children). Whole blood administration occurred in 4% of patients requiring blood transfusions. Low crystalloid volumes in combination with balanced blood product ratios were associated with improved survival, along with the use of whole blood and TXA.

Conclusion

The review offers insight into the paediatric population likely to require DCR and the optimal DCR strategies to be used in their management.
Effect of gradient structure on additively manufactured auxetic and hybrid auxetic structure for energy absorption applications
Authors: Bagewadi Santosh S , Bhagchandani Ranjeet Kumar
Published: February 2023

Additive manufacturing is the most widely used approach to fabricating cellular structures. Research interests in auxetics are increasing due to their unique properties like impact energy absorption. In this work, a novel approach to enhance the mechanical properties of auxetics is proposed. A hybrid auxetic structure is proposed that is the combination of a re-entrant and a conventional honeycomb unit cell. A uniaxial quasi-static compression study is carried out on auxetics and hybrid auxetic structures loaded along the x and y directions. The deformation patterns of the structures are discussed to understand the failure modes. The results showed that the hybrid structure possesses better compressive strength and specific energy absorption than the auxetic structure. Experimental results are closely matching with numerical results. Subsequently, the deformation mode is discussed to understand the structural failure.
Assembling Islamic practice in a Swahili urban landscape, 11th–16th centuries
Authors: LaViolette Adria , Fleisher Jeffrey B. , Horton Mark C.
Published: February 2023

Spanning c. 1050–1500 CE, a burgeoning Swahili community called Chwaka built a sequence of four mortared coral mosques in their town of wattle-and-daub houses on Pemba Island, Tanzania. The mosques’ placement, construction, and use played an active role in creating and strengthening an Islamic community and help us define changes in social practice within the town and the larger polity in which it existed. It is argued that the construction of each mosque was an act of assembling, drawing people, other-than-human things and affective social practices together in ways that help tell an urban story. This research provides insights into the residents’ socioeconomic and cultural priorities and the town’s changing relationship with villagers from the surrounding region, contributing to understandings of Swahili urbanism and urban practice.
Crafting professionals: Logics of professional development in craft higher education
Authors: England Lauren
Published: February 2023

This article explores how the presence of competing logics in craft higher education (HE) influences educational provision and student experience. Findings are presented from four craft HE case studies across England, including analysis of degree programme specifications and module curricula and interviews with educators, current students and recent graduates conducted in 2018. The article presents how these logics influence employability-focused teaching in craft curricula and how this impacts time, space and facilities allocated to physical craft work. Key tensions identified include perceptions and measurement of graduate “success”, the impact on skill development and studio space and (dis)engagement with professional development training. The article concludes with reflection on how this relates to the perceived value of arts degrees, but argues that the responsibility to “prepare” students for craft careers cannot lie solely with HE providers.
On burning ground: Theatre of the Oppressed and ecological crisis in Bolivia
Authors: Cole Alastair , Fontana Lorenza , Hirzel Max , Johnston Caleb , Miramonti Angelo
Published: February 2023

In this essay, we report on a 2022 creative research collaboration in which we deployed Augusto Boal’s models of Theatre of the Oppressed and Forum Theatre to generate community dialogue and action on issues sparked by ecological crisis in Bolivia’s Chiquitanía. Extremely fragile to anthropogenic action, the Chiquitanía is home to one of the world’s largest dry forests, which is experiencing profound and recurrent wildfires. Responding to this ongoing crisis, the project brought together participants from migrant, Indigenous and campesino communities to share their lived (and sometimes-conflicting) experiences of wildfires. Theatrical techniques and exercises were utilised to elicit narratives and embodied testimonials, which were developed by participants into a series of short Forum Theatre plays performed throughout the Chiquitanía. We posit that Boal’s Theatre of the Oppressed offers researchers and artists dynamic ways of working with narratives and bodies, while Forum Theatre presents a rich public sphere in which communities can not only stage dialogue but also explore, imagine and rehearse collective action.
Optical frequency domain reflectometry sensing for damage detection in long-span bridges using influence surface
Authors: Cai Qinlin , Zhu Songye
Published: February 2023

With the development of optical frequency-domain reflectometry (OFDR)-based distributed strain sensing technology and static influence line (IL) measurement concept, the special influence surface (IS) measurement, a function of sensing and force locations, has become technically feasible. This study investigated, for the first time, damage detection in long-span bridges using the special IS constructed on the basis of the OFDR-based distributed sensing. The damage detection performance of IS was validated through numerical and experimental case studies on a scaled physical Tsing Ma bridge (TMB) model. First, the special IS concept was elaborated. The scaled TMB model was then introduced as a representative long-span bridge. Subsequently, the IS characteristics of different bridge components of the scaled TMB were analyzed using the finite element model (FEM). Various IS-based indices, including strain IS (SIS) and displacement IS (DIS), were applied to hypothetical damage scenarios where the bottom and top chords were subjected to severe damage in the FEM. The extracted ISs successfully realized damage localization with relatively great sensitivities. For comparison, the modal parameters were also output for damage detection. In the experimental section, an OFDR-based distributed sensor was placed along the top chord of one middle grid in the scaled TMB model to construct the SIS. The SIS changes could accurately localize the single, double, and triple bottom-chord damages. The numerical and experimental results demonstrated the feasibility and effectiveness of the OFDR-constructed special SIS for damage detection, indicating that IS is a promising damage indicator for long-span bridges, promoting the development of distributed sensing techniques in structural health monitoring for real-bridge applications.
Characterization and reliability of internet resources on pulmonary rehabilitation for individuals with chronic lung disease
Authors: Da Silva Tania , Lokhandwala Ashira , Al Kaabi Noor , Semenchuk Julie , Goobie Gillian C , Camacho Encarna , Reid W Darlene , Fisher Jolene H , Ryerson Christopher J , Rozenberg Dmitry
Published: February 2023

Background

Individuals with lung disease commonly use the internet as a source of health information on pulmonary rehabilitation (PR). The objective of this study was to characterize internet resources on PR, and to assess the content, readability, and quality of patient-directed PR resources.

Methods

The first 200 websites for the search term ‘pulmonary rehabilitation resources and exercise’ were analyzed on Google, Yahoo, and Bing. Website content was assessed based on 30 key components of PR from the 2013 and 2021 international consensus statements. Website quality was determined using DISCERN, JAMA benchmarks, and Global Quality Scale (GQS).

Results

66 unique PR websites were identified with the two most common categories being scientific resources (39%) and foundation/advocacy organizations (33%). The average reading level of websites was 11 ± 3. PR content varied significantly across websites (mean range 13.4–21.5). Median DISCERN total score and GQS score were 4 (IQR 3-4) and 3.5 (IQR 2-4), respectively, representing moderate-good quality. Foundation/advocacy websites had higher DISCERN and GQS scores compared to other websites.

Conclusion

Foundation/advocacy websites had the highest quality and reliability metrics; however, the higher-than-recommended reading levels may compromise patient comprehension and utilization. This study provides critical insight on the current state of online PR health-related information.
Machine Learning-Based Quality Assurance for Automatic Segmentation of Head-and-Neck Organs-at-Risk in Radiotherapy
Authors: Luan Shunyao , Xue Xudong , Wei Changchao , Ding Yi , Zhu Benpeng , Wei Wei
Published: February 2023

Purpose/Objective(s): With the development of deep learning, more convolutional neural networks (CNNs) are being introduced in automatic segmentation to reduce oncologists’ labor requirement. However, it is still challenging for oncologists to spend considerable time evaluating the quality of the contours generated by the CNNs. Besides, all the evaluation criteria, such as Dice Similarity Coefficient (DSC), need a gold standard to assess the quality of the contours. To address these problems, we propose an automatic quality assurance (QA) method using isotropic and anisotropic methods to automatically analyze contour quality without a gold standard. Materials/Methods: We used 196 individuals with 18 different head-and-neck organs-at-risk. The overall process has the following 4 main steps. (1) Use CNN segmentation network to generate a series of contours, then use these contours as organ masks to erode and dilate to generate inner/outer shells for each 2D slice. (2) Thirty-eight radiomics features were extracted from these 2 shells, using the inner/outer shells’ radiomics features ratios and DSCs as the input for 12 machine learning models. (3) Using the DSC threshold adaptively classified the passing/un-passing slices. (4) Through 2 different threshold analysis methods quantitatively evaluated the un-passing slices and obtained a series of location information of poor contours. Parts 1-3 were isotropic experiments, and part 4 was the anisotropic method. Result: From the isotropic experiments, almost all the predicted values were close to the labels. Through the anisotropic method, we obtained the contours’ location information by assessing the thresholds of the peak-to-peak and area-to-area ratios. Conclusion: The proposed automatic segmentation QA method could predict the segmentation quality qualitatively. Moreover, the method can analyze the location information for un-passing slices.
Challenging the Linear Model of Peacebuilding Planning: The Case of Jerusalem
Authors: Brenner Noam , Kübler Torge , Nassar Tariq
Published: February 2023

The complexity of planning and implementing peacebuilding processes has been discussed using various approaches, for example, adaptive peacebuilding, and the “local turn” in peacebuilding. These theories argue that peacebuilding is a nonlinear and contextual process, contrary to the linear, static conception of the liberal peace paradigm. This paper contributes to this field and seeks to learn how peacebuilding processes can be planned better, by integrating the concepts of adaptive and urban peacebuilding. Using action research and organizational ethnographic analysis of an EU-funded peacebuilding process between Palestinians and Israelis in Jerusalem, this article lays out four general steps to improve planning for future peacebuilding initiatives: (1) integrate flexibility; (2) balance inherent asymmetries; (3) “localize” planning; and (4) plan for indirect alternatives. In conclusion, we discuss the implications for peacebuilding processes in other contested and settler-colonial cities.
Evaluation of the Efficiency of a Joystick-Guided Robotic Scope Holder Compared to That of Human Scopists: A Prospective Trial
Authors: Kudo Takuya , Kanaji Shingo , Harada Hitoshi , Ohmura Yasushi , Sawada Ryuichiro , Urakawa Naoki , Goto Hironobu , Hasegawa Hiroshi , Yamashita Kimihiro , Matsuda Takeru , Oshikiri Taro , Kakeji Yoshihiro
Published: February 2023

Purpose

This study aimed to compare motions of the laparoscope tip during a laparoscopic task in a training box using a recent joystick-guided robotic scope holder to those manipulated by human scopists. We hypothesized that laparoscopic manipulation could be positively affected by robotic scope holders due to the elimination of unintentional movement.

Methods

Twelve surgeons participated as operators, and eight medical doctors participated in this study. Among the human scopists, five were trained surgeons and three were novices who had no experience with laparoscopic surgery. A validated laparoscopic task was used to evaluate the path length of the laparoscope tip using an optical position tracker and operative time. The operators performed the designated camera task under three different laparoscopic manipulations: using a joystick-guided robotic scope holder, expert human scopists, and novice scopists.

Results

The median path lengths (cm) of the laparoscopic tip were 94.0, 110.0, and 122.2 in the robotic scope holder, expert, and novice groups, respectively. The path lengths in the robotic scope holder group were significantly shorter than those in the other groups (P < .01). The median operative times (seconds) were 136.6, 66.4, and 62.3 in the robotic scope holder, expert, and novice groups, respectively. The operative time of the robotic scope holder group was significantly longer than that of the other groups (P < .001).

Conclusion

A robotic scope holder can provide shorter camera movement owing to the stable holding and intentional scope manipulation by the operator, although it requires a longer operative time than a human assistant.
The Functional Luminal Imaging Probe (FLIP): A Good Tool for Adjustment of anal Canal Dimensions During Operative Management of Fecal Incontinence
Authors: Farag Ahmed , Mashhour Abdrabou N , Raslan Mohamed M , Khalifa Ahmed Sayed , Elbarmelgi Mohamed Yehia
Published: February 2023

Purpose

Fecal incontinence is a troublesome problem in the field of colorectal surgery. The main aim of this study was to adjust the anal canal resistance during operative management of anal incontinence using Endo-FLIP.

Methods

This was a prospective cohort study held at Cairo university hospital. Hundred forty-eight incontinent patients treated by different surgical procedures were included. During the procedure the Endo-FLIP was applied to adjust the anal canal dimensions (ACL and ACD) so the ACR could be adjusted based on the flow equation. These were also assessed pre-operatively with Endo-FLIP system and the flow equation calculator. The clinical severity of the disease and outcome after surgical procedures were assessed and correlated to the physiologic parameters.

Results

ACL, ACD and ACR had had significant correlations to the degree of incontinence ( P < .001). ACL, ACD and ACR showed statistically significant change with primary repair and gluteus maximus transposition operations. After treatment of fecal incontinence, in good responders’ group, the mean resting anal canal resistance increased significantly to 4649.05 ± 1161.49 (postoperative) while in poor responders’ group it was 1919.9 ± 1077.73.

Conclusions

The Endo-flip can be used to measure the anal canal geometric parameters (ACL and ACD) and then anal canal resistance could be calculated by the flow equation – pre-and post-operatively- which help the adjustment of the surgical repair of sphincter injury in fecal incontinence patients which may improve the surgical outcome.
Flat-panel dual-energy head computed tomography in the angiography suite after thrombectomy for acute stroke: A clinical feasibility study
Authors: DiNitto Julie , Feldman Michael , Grimaudo Heather , Mummareddy Nishit , Ahn Seoiyoung , Bhamidipati Akshay , Anderson Drew , Ramirez-Giraldo Juan Carlos , Fusco Matthew , Chitale Rohan , Froehler Michael T
Published: February 2023

Background

Management of large vessel occlusion (LVO) patients after thrombectomy is affected by the presence of intracranial hemorrhage (ICH) on post-procedure imaging. Differentiating contrast staining from hemorrhage on post-procedural imaging has been facilitated by dual-energy computed tomography (DECT), traditionally performed in dedicated computed tomography (CT) scanners with subsequent delays in treatment. We employed a novel method of DECT using the Siemens cone beam CT (DE-CBCT) in the angiography suite to evaluate for post-procedure ICH and contrast extravasation.

Methods

After endovascular treatment for LVO was performed and before the patient was removed from the operating table, DE-CBCT was performed using the Siemens Q-biplane system, with two separate 20-second CBCT scans at two energy levels: 70 keV (standard) and 125 keV with tin filtration (nonstandard). Post-procedurally, patients also underwent a standard DECT using Siemens SOMATOM Force CT scanner. Two independent reviewers blindly evaluated the DE-CBCT and DECT for hemorrhage and contrast extravasation.

Results

We successfully performed intra-procedural DE-CBCT in 10 subjects with no technical failure. The images were high-quality and subjectively useful to differentiate contrast from hemorrhage. The one hemorrhage seen on standard DECT was very small and clinically silent. The interrater reliability was 100% for both contrast and hemorrhage detection.

Conclusion

We demonstrate that intra-procedural DE-CBCT after thrombectomy is feasible and provides clinically meaningful images. There was close agreement between findings on DE-CBCT and standard DECT. Our findings suggest that DE-CBCT could be used in the future to improve stroke thrombectomy patient workflow and to more efficiently guide the postoperative management of these patients.
Higher education and active citizenship in five European countries: How institutions, fields of study and types of degree shape the political participation of graduates
Authors: Mühleck Kai , Hadjar Andreas
Published: February 2023

Higher education is expected to contribute to graduates becoming active citizens of democratic societies. Still, little is known about how heterogeneities within higher education are connected to political participation. This study centres on differences in the type of institution, kind of degree and field of study and their relationship with variations in political participation. Considering five European countries – Austria, Croatia, the Czech Republic, Malta and Norway – it investigates how civic skills and social background explain differences in political participation. The results indicate an impact of higher education characteristics on political participation. University graduates, master’s-level graduates and graduates in humanities and social sciences have higher participation levels. Counter-intuitively, there is no universal association of civic skills with participation. The comparative perspective reveals that mechanisms differ by country. Norway, as a less segregated country, shows a weaker association of political participation and type of institution than Austria, as a more segregated country.
Autocorrelation in category judgement
Authors: Laming Donald
Published: February 2023

Jesteadt et al. discovered a remarkable pattern of autocorrelation in log estimates of loudness. Responses to repeated stimuli correlated to about +0.7, but that correlation was much reduced (0.1) following large differences between successive stimuli. The experiment reported here demonstrates the same pattern in absolute identification without feedback; if feedback is supplied, the pattern is much muted. A model is proposed for this pattern of autocorrelation, based on the premise: “There is no absolute judgment of sensory magnitudes; nor is there any absolute judgment of differences/ratios between sensory magnitudes.” Each stimulus in an experiment is compared with its predecessor, greater, less than, or about the same. The variability of that comparison increases with the difference in magnitude between the stimuli, so the assessment of a stimulus far removed from its predecessor is very uncertain. The model provides explanations for the apparent normal variability of sensory stimuli, for the “bow” effect and for the widely reported pattern of sequential effects. It has applications to the effects of stimulus range, to the difficulty of identifying more than five stimuli on a single continuum without error, and to inspection tasks in general, notably medical screening and the marking of examination scripts.
Hybrid Closed Loop Using a Do-It-Yourself Artificial Pancreas System in Adults With Type 1 Diabetes
Authors: Nanayakkara Natalie , Sharifi Amin , Burren David , Elghattis Yasser , Jayarathna Dulari K , Cohen Neale
Published: February 2023

Objective:

There is increasing use of open-source artificial pancreas systems (APS) in the management of Type 1 diabetes. Our aim was to assess the safety and efficacy of the automated insulin delivery system AndroidAPS (AAPS), compared with stand-alone pump therapy in people with type 1 diabetes. The primary outcome was the difference in the percentage of time in range (TIR, 70-180 mg/dL). Secondary aims included mean sensor glucose value and percent continuous glucose monitor (CGM) time below range (TBR, <70 mg/dL).

Research Design and Methods:

This open-label single-center randomized crossover study (ANZCTR, Australian New Zealand clinical trial registry, ANZCTR-ACTRN12620001191987) comprised 20 participants with type 1 diabetes on established pump therapy, assigned to either stand-alone insulin pump therapy or the open-source AAPS hybrid closed-loop system for four weeks, with crossover to the alternate arm for the following four weeks. The CGM outcome parameters were measured by seven-day CGM at baseline and the final week of each four-week study arm.

Results:

Twenty participants were recruited (60% women), aged 45.8 ± 15.9 years, with mean diabetes duration of 23.9 ± 13.2 years, baseline glycated hemoglobin (HbA1c) 7.5% ± 0.5% (58 ± 6 mmol/mol) and mean TIR 62.3% ± 12.9%. The change in TIR from baseline for AAPS compared with stand-alone pump therapy was 18.6% (11.4-25.9), ( P < .001), TIR 76.6% ± 11.7%, 58.0% ± 15.6%, for AAPS and stand-alone pump, respectively. Time glucose <54 mg/dL was not increased (mean = −2.0%, P = .191). No serious adverse events or episodes of severe hypoglycemia were recorded.

Conclusions:

This clinical trial of the open-source AAPS hybrid closed-loop system performed in an at-home setting demonstrated comparable safety to stand-alone pump therapy. The glycemic outcomes of AAPS were superior with improved TIR, and there was no significant difference in TBR compared with stand-alone pump therapy.
Increasing Frequency of Hemoglobin A1c Measurements in Hospitalized Patients With Diabetes: A Quality Improvement Project Using Lean Six Sigma
Authors: Khan Sara Atiq , Demidowich Andrew P. , Tschudy Megan M. , Wedler Joyce , Lamy Wilson , Akpandak Iniuboho , Alexander Lee Ann , Misra Isha , Sidhaye Aniket , Rotello Leo , Zilbermint Mihail
Published: February 2023

Background:

The American Diabetes Association (ADA) recommends measuring A1c in all inpatients with diabetes if not performed in the prior three months. Our objective was to determine the impact of utilizing Lean Six Sigma to increase the frequency of A1c measurements in hospitalized patients.

Methods:

We evaluated inpatients with diabetes mellitus consecutively admitted in a community hospital between January 2016 and June 2021, excluding those who had an A1c in the electronic health record (EHR) in the previous three months. Lean Six Sigma was utilized to define the extent of the problem and devise solutions. The intervention bundle delivered between November 2017 and February 2018 included (1) provider education on the utility of A1c, (2) more rapid turnaround of A1c results, and (3) an EHR glucose-management tab and insulin order set that included A1c. Hospital encounter and patient-level data were extracted from the EHR via bulk query. Frequency of A1c measurement was compared before (January 2016-November 2017) and after the intervention (March 2018-June 2021) using χ2 analysis.

Results:

Demographics did not differ preintervention versus postintervention (mean age [range]: 70.9 [18-104] years, sex: 52.2% male, race: 57.0% white). A1c measurements significantly increased following implementation of the intervention bundle (61.2% vs 74.5%, P < .001). This level was sustained for more than two years following the initial intervention. Patients seen by the diabetes consult service (40.4% vs 51.7%, P < 0.001) and length of stay (mean: 135 hours vs 149 hours, P < 0.001) both increased postintervention.

Conclusions:

We demonstrate a novel approach in improving A1c in hospitalized patients. Lean Six Sigma may represent a valuable methodology for community hospitals to improve inpatient diabetes care.
Contactin-Associated Protein-Like 2-Related Peripheral Nerve Hyperexcitability Associated With Charcot-Marie-Tooth Type 4F
Authors: Ferrara Joseph M. , Wiid Michael , Burke Sean
Published: February 2023

Contactin-associated protein-like 2 autoimmunity is an uncommon disorder resulting in peripheral nerve hyperexcitability or encephalitis. In a fifth of cases, onset may be provoked by thymoma, but other associations are largely unknown. We report a patient with anti-contactin-associated protein-like 2-related peripheral nerve hyperexcitability arising in the setting of Charcot-Marie-Tooth type 4F and discuss potential mechanisms underlying the association.
Validating Existing Scales for Identification of Acute Stroke in an Inpatient Setting
Authors: Sari Adriana , Saleh Velez Faddi G. , Muntz Nathan , Bulwa Zachary , Prabhakaran Shyam
Published: February 2023

Background and Purpose

A significant proportion of strokes occur while patients are hospitalized for other reasons. Numerous stroke scales have been developed and validated for use in pre-hospital and emergency department settings, and there is growing interest to adapt these scales for use in the inpatient setting. We aimed to validate existing stroke scales for inpatient stroke codes.

Methods

We retrospectively reviewed charts from inpatient stroke code activations at an urban academic medical center from January 2016 through December 2018. Receiver operating characteristic analysis was performed for each specified stroke scale including NIHSS, FAST, BE-FAST, 2CAN, FABS, TeleStroke Mimic, and LAMS. We also used logistic regression to identify independent predictors of stroke and to derive a novel scale.

Results

Of the 958 stroke code activations reviewed, 151 (15.8%) had a final diagnosis of ischemic or hemorrhagic stroke. The area under the curve (AUC) of existing scales varied from .465 (FABS score) to .563 (2CAN score). Four risk factors independently predicted stroke: (1) recent cardiovascular procedure, (2) platelet count less than 50 × 109 per liter, (3) gaze deviation, and (4) presence of unilateral leg weakness. Combining these 4 factors into a new score yielded an AUC of .653 (95% confidence interval [CI] .604-.702).

Conclusion

This study suggests that currently available stroke scales may not be sufficient to differentiate strokes from mimics in the inpatient setting. Our data suggest that novel approaches may be required to help with diagnosis in this unique population.
The Between-Person and Within-Person Effects of Intergroup Contact on Outgroup Attitudes: A Multi-Context Examination
Authors: Friehs Maria-Therese , Bracegirdle Chloe , Reimer Nils Karl , Wölfer Ralf , Schmidt Peter , Wagner Ulrich , Hewstone Miles
Published: February 2023

The extensive literature on the contact hypothesis reports a positive association between intergroup contact and outgroup attitudes, yet it remains unknown whether this association reflects within-person (i.e., situational changes within individuals) or between-person (i.e., stable differences between individuals) effects. To investigate this question, we applied (random-intercept) cross-lagged panel models in two studies featuring different samples, measurements, and contexts. We found longitudinal contact–attitude associations in cross-lagged panel models, which cannot differentiate within-person and between-person effects. In random-intercept cross-lagged panel models, we identified between-person effects but not within-person effects. These results conflict with the contact hypothesis, which assumes that contact leads to intra-individual attitude change. We further investigated whether between-person effects represent spurious correlations caused by potential confounders (demographic characteristics, personality, and intergroup ideologies), but found that this was not the case. Our findings highlight the need to further investigate within-person effects and potential explanations of between-person differences in contact and attitudes.
Imagination and sociodramatic play using Minecraft and FaceTime as a digitally-mediated environment
Authors: Caughey Jane , McLean Karen , Edwards Susan
Published: February 2023

This research investigates how children located in separate homes use the psychological function of imagination to engage in sociodramatic play using networked digital technologies. Specifically, it examines how 7- to 8-year-old children create imaginary play situations in the same Minecraft: Education Edition digitally-mediated environment whilst synchronously using the FaceTime video-communication tool to discuss their play. Drawing on cultural-historical conceptualizations of play, findings identified in this study describe how children reworked and combined elements of reality via imagination to enable online sociodramatic play. This study provides theoretical insight into how adults may best foster children’s imagination in digitally-mediated environments to support online sociodramatic play, of especial benefit to children during periods of lockdown associated with the global pandemic.
Business intelligence and geographic information systems in the banking industry: A case study of home loan valuation
Authors: Chaiprasert Araya , Chongwatpol Jongsawas
Published: February 2023

This case is designed to illustrate how to utilize a business intelligence framework and a geographic information system (GIS) to make better decisions in the banking industry. The case started when Jong, the senior certified analytic professional, and Kampu, the GIS solutions expert were drafting a proposal presentation to help ABC Bank of Thailand improve its home loan appraisal process. The current appraisal process was time-consuming and the appraisal value from the internal and external appraisers were very different as the appraisal process relied heavily on the opinions and judgements from all appraisal staffs. Currently, there was a home loan application pending for Hugo, the appraisal manager of ABC Bank of Thailand, to make the decision on the final appraised value. This was a great opportunity for Jong and Kampu to revisit the current appraisal process and to demonstrate how business intelligence and GIS could aid in the appraisal decision. Additionally, the proposed GIS-based BI dashboard allowed the appraisal team to the analyze data-related to the appraised property in real-time. Eventually, Jong and Kampu had to make a decision on what appraised value Hugo should recommend to the home loan committee members.