bluuebunny/crossref_metadata_2025 huggingface dataset:
Life Stressors as Predictors of Community College Students’ Course Outcomes: The COVID-19 Pandemic as a Focusing Event
Authors: Wladis Claire , Manly Catherine A. , Hachey Alyse C. , Conway Katherine M.
Published: September 2024

Background or Context:

The COVID-19 pandemic may be considered a focusing event that has drawn greater attention to the physical and mental health of community college students.

Purpose, Objective, Research Question, or Focus of Study:

This study examined community college students’ self-reported life stressors pre- and post-pandemic-onset to identify any reported differences, both in occurrence and in impact on course completion.

Research Design:

Surveys were collected after the COVID-19 pandemic onset at the City University of New York’s largest community college. The 529 students enrolled in STEM subjects were asked about potentially stressful life events experienced during spring 2020 and how strongly these impacted the time or energy they had for their studies (response rate 88.2%).

Conclusions or Recommendations:

Students’ reporting of the presence of life stressors, as well as their rating of the impact on their studies, were significantly predictive of subsequent course outcomes. However, stressors reported as beginning prior to the pandemic had a larger and more significant relationship with course outcomes than those reported as beginning after pandemic onset. Further, stressors were already highly prevalent prepandemic, with over three-quarters of students reporting them. Although the pandemic may have drawn attention to the existence and impact of stressors, it may simply be a focusing event that drew heightened attention to a pre-existing issue. Results from this study indicate that life stress may significantly impact the outcomes of community college students even outside of pandemic conditions, suggesting that this is a critical area for community colleges to address.
Automated Deep Learning-Based Finger Joint Segmentation in 3-D Ultrasound Images With Limited Dataset
Authors: Karageorgos Grigorios M. , Qiu Jianwei , Peng Xiaorui , Yang Zhaoyuan , Ghose Soumya , Dentinger Aaron , Xu Zhanpeng , Jo Janggun , Ragupathi Siddarth , Xu Guan , Abdulaziz Nada , Gandikota Girish , Wang Xueding , Mills David
Published: September 2024

Ultrasound imaging has shown promise in assessing synovium inflammation associated early stages of rheumatoid arthritis (RA). The precise identification of the synovium and the quantification of inflammation-specific imaging biomarkers is a crucial aspect of accurately quantifying and grading RA. In this study, a deep learning-based approach is presented that automates the segmentation of the synovium in ultrasound images of finger joints affected by RA. Two convolutional neural network architectures for image segmentation were trained and validated in a limited number of 2-D images, extracted from N = 18 3-D ultrasound volumes acquired from N = 9 RA patients, with sparse ground truth annotations of the synovium. Various augmentation strategies were employed to enhance the diversity and size of the training dataset. The utilization of geometric and noise augmentation transforms resulted in the highest dice score (0.768 [Formula: see text]0.040, N = 6), as determined via six-fold cross-validation. In addition, the segmentation model is used to generate dense 3-D segmentation maps in the ultrasound volumes, based on the available sparse annotations. The developed technique shows promise in facilitating more efficient and standardized workflow for RA screening using ultrasound imaging.
Exploring the intersection of digital and environmental challenges: Understanding their convergence through habitus
Authors: Ruiu Maria Laura , Ragnedda Massimo
Published: September 2024

This paper explores the intertwined nature of digital and environmental dimensions within Bourdieu’s concept of habitus to address contemporary global challenges. Controversial evidence exists regarding the environmental impact of digitalization, reflecting contrasting theoretical approaches at societal and individual levels. The paper examines how digital practices’ environmental impact depends on usage types, with implications for lifestyles and values. It revises the concept of habitus to encapsulate the complex interaction between digital and environmental fields, facilitating users’ awareness and behavioral responses.
Government chatbot: Empowering smart conversations with enhanced contextual understanding and reasoning
Authors: Lian Zhixuan , Wang Fang
Published: September 2024

Currently, an increasing number of governments have adopted question answering systems (QASs) in public service delivery. As some citizens with limited information literacy often express their questions vaguely when interacting with a chatbot, it is necessary to improve the contextual understanding and reasoning ability of government chatbots (G-chatbots). This goal can be achieved through the optimisation of the matching between question, answer and context. By incorporating the Relational Graph Convolutional Networks (R-GCNs) and fuzzy logic, this study proposes a multi-turn dialogue model that introduces a re-question mechanism and a subgraph matching algorithm. The experiment results show that the model can improve the contextual reasoning ability of G-chatbots by about 10% and generate answers in a more explainable way. This study innovatively integrates a question–answer–context matching approach, re-question mechanism into the MTRF-G-chatbot model, reducing barriers to citizens’ access to government services and enhancing contextual reasoning abilities.
Do you still find me physically attractive? Partners’ daily perceptions of attractiveness during the transition to parenthood
Authors: Blickman Rachel S. , Gleason Marci E. J. , Neff Lisa A.
Published: September 2024

The transition to parenthood is characterized by physical changes and altered sexual dynamics that may be associated with a tendency for new parents to underestimate their partner’s physical attraction to them and/or be more attuned to daily changes in their partner’s attraction. To examine this possibility, this study assessed directional bias and tracking accuracy in new parents’ perceptions of their partner’s daily physical attraction to them. Fifty-nine couples completed 21-day diary tasks during pregnancy, 2 weeks after childbirth, and 15 weeks after childbirth (i.e., up to 63 diary days). Both mothers and fathers experienced increased appearance insecurity and decreased sexual frequency and sexual satisfaction across the transition. Moreover, at times when new parents reported higher appearance insecurity or lower sexual satisfaction, they underestimated their partner’s physical attraction to them, but were not more likely to notice day-to-day fluctuations in their partner’s attraction. Results highlight the misperceptions that can occur during this pivotal life transition.
The Use of Nudge Strategies in Improving Physicians’ Prescribing Behavior: A Systematic Review and Meta-analysis
Authors: Hallett Maya Fey , Kjær Trine , Bjørnskov Pedersen Line
Published: September 2024

Background

Nudges have been proposed as a method of influencing prescribing decisions.

Purpose

The purpose of this article is to 1) investigate associations between nudges’ characteristics and effectiveness, 2) assess the quality of the literature, 3) assess cost-effectiveness, and 4) create a synthesis with policy recommendations.

Methods

We searched health and social science databases. We included studies that targeted prescribing decisions, included a nudge, and used prescribing behavior as the outcome. We recorded study characteristics, effect size of the primary outcomes, and information on cost-effectiveness. We performed a meta-analysis on the standardized mean difference of the studies’ primary outcomes, tested for associations between effect size and key intervention characteristics, and created a funnel plot evaluating publication bias.

Synthesis

We identified 21 studies containing 25 nudges. In total, 62 of 85 (73%) outcomes showed a statistically significant effect. The average effect size was −0.22 standardized mean difference. No studies included heterogeneity analyses. We found no associations between effects and selected study characteristics. Study quality varied and correlated with study design. A total of 7 of 21 (33%) studies included an evaluation of costs. These studies suggested that the interventions were cost-effective but considered only direct effects. We found evidence of publication bias.

Limitations

Heterogeneity and few studies limit the possibilities of statistical inference about effectiveness.

Conclusions

Nudges may be effective at directing prescribing decisions, but effects are small and health effects and cost-effectiveness are unclear. Future nudge studies should contain a rationale for the chosen nudge, prioritize the use of high-quality study designs, and include evaluations of heterogeneity, cost-effectiveness, and health outcomes to inform decision makers. Moreover, preregistration of the protocol is warranted to limit publication bias.

Highlights

Nudging as a method to improve prescribing decisions has gained popularity during the past decade. We find that nudging can improve prescribing decisions, but effect sizes are mostly small, and the size of derived health outcomes is unclear. Most studies use feedback and error-stopping nudges to target excessive opioid or antibiotic prescribing, making heterogeneity analyses across nudge types difficult. Further research on the cost-effectiveness of nudges and generalizability is needed to guide decision makers considering nudging as a tool to guide prescribing decisions.
The utility of ultrafast MRI and conventional DCE-MRI for predicting histologic aggressiveness in patients with breast cancer
Authors: Kim Seong Gwang , Park Ah Young , Jung Hae Kyoung , Ko Kyung Hee , Kim Yunju
Published: September 2024

Background

Prediction of histologic prognostic markers is important for determining management strategy and predicting prognosis.

Purpose

To identify important features of ultrafast and conventional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) that can predict histopathologic prognostic markers in patients with breast cancer.

Material and Methods

Preoperative MRI scans of 158 consecutive women (mean age = 54.0 years; age range = 29–86 years) with 163 breast cancers between February 2021 and August 2022 were retrospectively reviewed. Inter-observer agreements for ultrafast MRI parameters were analyzed by two radiologists. The qualitative and quantitative MRI parameters were correlated with histopathologic prognostic markers including molecular subtypes and histologic invasiveness.

Results

Inter-observer agreements for ultrafast MRI parameters were excellent (intraclass correlation coefficients of area under the kinetic curve [AUC], maximum slope [MS], maximum enhancement [ME], and slope = 0.987, 0.844, 0.822, and 0.760, respectively). Triple-negative breast cancers (TNBC) were significantly associated with rim enhancement (odds ratio [OR] = 9.4, P = 0.003) and peritumoral edema (OR = 17.9, P = 0.002), compared to luminal cancers. Invasive cancers were associated with lesion type-mass, increased delayed washout, angiovolume, ME, slope, MS, and AUC, compared to in situ cancers. In regression analysis, the combination of MS (>46.2%/s) (OR = 5.7, P = 0.046) and delayed washout (>17.5%) (OR = 17.6, P = 0.01), and that of AUC (>27,410.3) (OR = 9.6, P = 0.04), delayed washout (>17.5%) (OR = 8.9, P = 0.009), and lesion-type mass (OR = 4.6, P = 0.04) were predictive of histologic invasiveness.

Conclusion

Conventional DCE-MRI with ultrafast imaging can provide useful information for predicting histologic underestimation and aggressive molecular subtype. MS and AUC on ultrafast MRI can be potential imaging markers for predicting histologic upgrade from DCIS to invasive cancer with high reliability.
Implementing innovation in project-based learning in electro-mechanical engineering education
Authors: Mahtani Kumar , Guerrero José M. , Decroix Julien
Published: September 2024

This study investigates the implementation of project-based learning (PBL) in electro-mechanical engineering education, emphasizing the modeling and application of an innovation process to enhance student engagement, motivation, and employability. Initially, the innovation process was systematically modeled using Structured Analysis and Design Technique (SADT) to manage and organize skills, knowledge, and resources effectively. This model was subsequently applied in an educational experience focused on highly technical aspects such as energy conversion modeling, mechanical improvements, material science, and efficiency analysis. These aspects were primarily applied in the context of permanent magnet synchronous machines employed in electric vehicle (EV) axles. The SADT modeling allowed for a clear delineation of the innovation phases, ensuring a structured approach to project execution. Statistical analysis of the PBL approach indicated significant improvements in student performance, with a 25% increase in problem-solving skills and a 30% enhancement in critical thinking abilities. The case study demonstrated that industry-oriented projects significantly boost student satisfaction, particularly in problem definition and solution identification, leading to a more engaging and effective learning experience.
EMPOWERING END-OF-LIFE CONVERSATIONS: The Role of Specialized Nursing Teams in Facilitating Code Status Changes at Discharge
Authors: Wintz Diane , Schaffer Kathryn B. , Wright Kelly , Nilsen Stacy L.
Published: September 2024

Objectives: Hospitalized patients may require goals of care (GOC) or Advance Health Care Planning (ACP), which can be time-consuming and emotionally tolling for providers. A nursing team specializing in code status (CODE), GOC, and ACP was developed to provide meaningful support for patients and families and decrease provider burden. Interest in CODE, GOC, ACP, and effectiveness of a nursing team to lead these conversations prompted this study. Methods: A collaborative nursing team was trained to address CODE, GOC, and ACP with patients demonstrating illness or geriatric syndrome. This team conducted 3 visits per patient on average during hospitalization using structured CODE templates to establish longer term goals and document what matters in the healthcare journey. Comprehensive narratives for ACP and GOC were included in charting, syncing the medical team, nursing, patient, and family. Consults were tracked over nine months with data reviewed retrospectively from medical charts. Descriptive analyses of cohort demographics, CODE and outcomes were completed. Results: The study group comprised 3342 patients between October 2022 and June 2023. Patients ranged in age from 18–106 years, with majority (88%) age 65 years and older. Mean length of stay (LOS) was 6.8 days with CODE documented for 91% upon admission. Of the 3166 older adults with known CODE on admission, 946 (30%) changed CODE by discharge, of which 95% were de-escalated. 83% of older patients arriving with limited CODE maintained limitations at discharge, with a small portion converting to comfort (16%). Conclusion: Employing a focused nursing team to conduct CODE, GOC, and ACP conversations may be an effective use of time and resources and result in de-escalation of resuscitation orders for patients demonstrating illness or geriatric syndrome.
One and Done? An Evaluation of the Clinical Outcomes of Single- and Multi-Dose Dalbavancin Use in the Pediatric Population
Authors: Morrisette Taylor , Alghamdi Shahad , Maree Megan B. , Dixon Terry C. , Thacker Stephen A.
Published: September 2024

Staphylococcus aureus is a leading cause of invasive bacterial infections in the pediatric population. In general, data surrounding the use of newly approved antimicrobials within children are lacking. Dalbavancin is a long-acting lipoglycopeptide that shows promise for off-label use in adults given its unique pharmacokinetics and in vitro potency against common Gram-positive isolates; however, evidence to supports its use in children is limited. We report the use of dalbavancin in three pediatric cases in patients aged 17 months of age, 3 years of age, and 11 years of age. All infections were caused by S. aureus (66.7% methicillin-resistant S. aureus) representing varied disease, including an osteoarticular infection and catheter-related bloodstream infection. Furthermore, all patients had pediatric infectious diseases involvement. Following the utilization of DAL, high clinical success and low rates of adverse effects were observed with high patients’ and parents’ satisfaction. While larger, confirmatory real-world studies are needed, our findings support safe off-label DAL use in select pediatric patients.
Analyzing the effect of different shielding atmospheres on fiber laser welding parameters for modified 9Cr-1Mo steel
Authors: S Rakesh , S Raghuraman
Published: September 2024

The present research aims to investigate the influence of and the relationship between welding speed ( v), focal position ( FP), and laser power ( LP) as input parameters for fiber laser to weld P91 under pure argon and CO2 shielding atmospheres using response surface methodology and using the desirability approach; optimization of input parameters has been performed to maximize the depth of penetration ( DP) while minimizing the top bead width ( TW) and heat-affected zone width ( HW). The results indicate that laser power ( LP) has the most significant impact on depth of penetration ( DP), whereas welding speed ( v) affects top bead width ( TW) and heat-affected zone width ( HW). The optimal combination of parameters under argon shielding results in a significantly low heat input of 48 J/mm (0.048 kJ/mm) and 50 J/mm (0.050 kJ/mm) pure argon and CO2 shielding atmospheres, respectively. Despite the difference in heat input being only 4.08%, an 11.618% increase in DP is observed under the CO2 shielding atmosphere. Due to the high-speed nature of the welding process (argon: 82.65 mm/s and CO2: 79.283 mm/s) combined with the significant reduction in heat input, the heat-affected zone is limited to a mere width of 0.203 mm under an argon shielding atmosphere and 0.263 mm under the CO2 shielding atmosphere compared with that reported in the other welding processes without the dissolution of precipitates in the fusion boundary of heat-affected zone. Microstructural characterization of the fusion zone has revealed the presence of an untempered lath martensite structure with precipitate dissolution. The precipitate dissolution has resulted in grain coarsening of 47.76% in argon weld and 39.65% in CO2 weld compared with the base metal grain size of 6.07 µm.
Prevalence and correlates of prenatal HIV testing among female sex workers in Nigeria
Authors: Olakunde Babayemi O. , Adeyinka Daniel A. , Ujam Chukwugozie , Ejeckam Chukwuebuka , Cherkos Ashenafi S. , Ndukwe Chinwedu D. , Adesina Adediran , Green Kalada , Anenih James O.
Published: September 2024

Background

Female sex workers (FSWs) face a significant and persistent risk of contracting HIV. While evidence indicates high rates of pregnancy among FSWs in sub-Saharan Africa, studies on the coverage of HIV testing during pregnancy among them are sparse. The objective of this study was to estimate the prevalence of prenatal HIV testing and determine the associated factors among FSWs in Nigeria.

Methods

This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey (IBBSS) among key populations in Nigeria. We performed weighted descriptive statistics and multivariable binary logistic regression to assess the associations between prenatal HIV testing and sociodemographic characteristics, risk behaviours, HIV knowledge and risk awareness, stigma, and access to healthcare.

Results

Of the 1598 FSWs included in the study, 71.0% (95%CI = 68.7%–73.1%) had HIV testing during their last pregnancy. In the regression model, tertiary education (aOR = 2.98, 95%CI = 1.48–6.01), consistent condom use (aOR = 1.95, 95%CI = 1.39–2.75), and receipt of antenatal care (aOR = 35.52, 95%CI = 23.40–53.92) were associated with higher odds of prenatal HIV testing. Compared with the South South geopolitical zone, FSW residing in South East (aOR = 3.38, 95%CI = 1.80–6.35), South West (aOR = 2.97, 95%CI = 1.88–4.68), North Central (aOR = 4.43, 95%CI = 2.80–7.01), North East (aOR = 4.22, 95%CI = 1.64–10.34), North West (aOR = 4.40, 95%CI = 2.59–7.48) had higher odds of reporting prenatal HIV testing. However, being a non-brothel-based FSW (aOR = 0.66, 95%CI = 0.47–0.92), and engaging in sex work during pregnancy (aOR = 0.45, 95%CI = 0.31–0.66) were significantly associated with lower odds of prenatal HIV testing.

Conclusions

The prenatal HIV testing among FSWs in this study was suboptimal. The results highlight the need to improve access to antenatal care and implement regional and typology-specific interventions to bridge the gap in prenatal HIV testing among FSWs.
From Stars to Dogs: A Data Analytic Approach to Identifying “Out-Of-Favor” Products on E-Commerce Platforms
Authors: Ivanov Anton , Ghoshal Abhijeet , Kumar Akhil
Published: September 2024

Online retail platforms are increasingly challenged by the proliferation of low-quality products, which may damage their reputation and sales. To address this problem, we propose a system architecture to proactively identify products that are likely to go “out of favor.” Our approach uses historical data to extract useful information from customer ratings and textual reviews. Available data are fed into a state-of-the-art deep learning sequence model to forecast future ratings. We then analyze rating trends, extracting hyperparameters that a binary classifier uses to label products as “out-of-favor” or not. We tested this system on an Amazon dataset comprising nearly 800,000 observations across 2826 electronics products. Our results show that the Long Short-Term Memory (LSTM) model excels in forecasting future product ratings compared to other benchmarks. Ablation analysis shows sentiment-related features significantly improve rating forecasts by up to 40%, with review topics adding 10% and other review characteristics, 4%. Counterintuitively, topic extraction from reviews does not provide substantial benefits, despite the heavy computational resources it requires. Finally, the two-stage classification process, which leverages time-series data and rating trends, offers a more stable and robust performance than conventional single-stage methods. We provide considerations for system architecture development through robustness checks ensuring its resilience to stressors. Our experiments indicate that rating trends can change in subtle ways over time, leading a promising “star” product to turn into a liability (“dog”). E-commerce platforms can use the proposed system architecture proactively to identify and remove potentially dubious products instead of waiting to take reactive action.
Effectiveness of combined targeted and hormonal therapies for post-menopausal women with hormone receptor-positive and HER2-negative advanced breast cancer: A systematic review and meta-analysis of RCTs
Authors: Okwor Vitalis , Okwor Chika Juliet , Ukwuoma Maryjane , Nweke Martins
Published: September 2024

Objective

we aim to synthesize available evidence on the effectiveness of hormonal plus targeted therapies for post-menopausal women with hormone receptor-positive and HER2-negative advanced breast cancer.

Data Sources and Methods

We searched the following databases: Medline, PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, and African Journal. Only studies that investigated the effectiveness of hormonal therapy combined with targeted therapy for HR+/HER2- advanced breast cancer treatment were included. The outcomes were progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). A random-effect meta-analysis model was employed. Statistical analysis was performed using Comprehensive Meta-analysis version 3.

Results

24 studies were included in the meta-analysis with an overall sample size of 7635. Median PFS, OS and ORR were found to be significantly increased in the combination group compared to hormonal monotherapy [SMD = 6.072 (95% CI = 3.785–8.360), p < 0.001], [SMD = 1.614 (95% CI = 0.139–3.089), p = 0.032] and [OR = 1.584 (CI 1.134–2.213), p = 0.007] respectively. Subgroup analysis showed a significant difference in PFS and ORR between patients who received “hormonal therapy + CDK4/6 inhibitors” vs hormonal therapy only [SMD = 6.015 (CI 3.069–8.960), p < 0.001], (OR = 1.828 (CI 1.030–3.243), p = 0.039] respectively.

Conclusion

Compared with hormonal monotherapy, targeted plus hormonal therapy significantly improves PFS, OS and ORR in postmenopausal women with HR+/HER2- advanced breast cancer.
Evaluation of voriconazole therapeutic drug monitoring in malignant hematology patients
Authors: Flores Jerome , Flank Jacqueline , Polito Samantha , Dhillon Patwant , Pang Ian , Ho Lina , Yee Karen WL
Published: September 2024

Introduction

Malignant hematology (MH) patients are susceptible to invasive fungal infections due to prolonged neutropenia and immunosuppressive therapies, which may require voriconazole therapy. Although voriconazole therapeutic drug monitoring (TDM) is common, evidence describing this practice is limited. The primary objective of this study was to describe the current practice of voriconazole TDM in MH patients at the Princess Margaret Cancer Centre (PM).

Methods

A retrospective chart review was conducted for MH inpatients initiated on voriconazole at PM between November 1st, 2019 and November 13th, 2020. Data regarding voriconazole doses, levels, dose changes, and adverse effects were collected. The primary endpoint was the proportion of patients with initial voriconazole levels within therapeutic range (1–5 mg/L).

Results

Fifty-six patients were included in the study. The most common reason for starting voriconazole was possible invasive fungal infection (44 patients, 78.6%). Fifty-one patients (91.1%) received a loading dose of voriconazole, averaging 386.5 ± 78.5 mg. The average maintenance dose was 242.1 ± 45.7 mg. An average of 2.6 ± 2.9 levels were drawn per patient with an average level of 3.2 ± 2.4 mg/L. Forty-one patients (73.2%) had an initial voriconazole level within therapeutic range and 90 out of 145 total levels (62.1%) were within therapeutic range. There were 52 dose modifications made; 31 (60.8%) doses adjusted, 12 (23.5%) doses held, and 9 (17.6%) doses discontinued. For the 31 dose adjustments, 26 (83.9%) had a level redrawn and 17 (65.4%) of those levels were within therapeutic range. Twenty-three (41.1%) patients developed adverse effects, 8 (34.8%) of which were associated with supratherapeutic levels. Of these 23 patients, 19 (33.9%) experienced transaminitis, 3 (5.4%) experienced both transaminitis and neurotoxicity, and 1 (1.8%) experienced photopsia.

Conclusion

Overall, 41 (73.2%) patients achieved an initial voriconazole level within therapeutic range. Of these 41 patients, 30 (73.2%) remained within therapeutic range for the duration of their inpatient voriconazole therapy. These findings suggest that the current practice of voriconazole TDM at our institution is yielding largely positive results, but still has room for improvement.
The impact of two methods on pain and anxiety during short peripheral cannula placement: A randomized controlled trial
Authors: Rişvan Mihriban , Su Serpil
Published: September 2024

Aim and objectives:

This study aimed to determine the impact of virtual reality glasses and ball squeezing methods on reducing pain and anxiety in adult patients undergoing short peripheral cannula placement.

Methods:

The pretest-posttest parallel group randomized controlled experimental study was conducted in a university hospital with 111 patients. Patients were randomly assigned to one of three groups: the VR group ( n = 37), the ball squeezing group ( n = 37), and the control group ( n = 37). Descriptive information form, Numeric Rating Scale, Visual Analogue Scale for Anxiety, and State-Trait Anxiety Inventory-State were used for data collection.

Results:

There was no statistically significant difference between the groups in terms of sociodemographic characteristics ( p > 0.05). The pain score of the patients in the control group was found to be statistically significantly higher than that of the patients in the virtual reality glasses and ball squeezing groups ( p < 0.05). While the mean anxiety scores of the virtual reality glasses and ball squeezing groups significantly decreased after the intervention, they increased significantly in the control group ( p < 0.05).

Conclusions:

The study found that virtual reality glasses and ball squeezing were effective distraction methods to reduce pain and anxiety in patients undergoing short peripheral cannula placement.
Residual flow of the radial artery in the presence of an arterial catheter: A single-centre retrospective observational study
Authors: Elli Stefano , Modaffari Francesca , Vellata Luca , Melziade Luisa Ilaria , Bongiovanni Luca , Atanasio Ilaria , Lucchini Alberto , Citterio Stefano , Giustivi Davide
Published: September 2024

Background:

Arterial catheterisation is a common procedure used to manage critically ill patients. The radial artery, both for its favourable anatomical position and the presence of ulnar collateral circulation, is the most used. While there is a consensus for a catheter/vein ratio of ⩽33% for venous catheterisation, there are no strong indications for arterial catheterisation. Some authors have hypothesised that a catheter/artery ratio of less than 45% is advisable. This study aimed to explore the relationship between residual flow in the Radial Artery, the catheter/artery ratio, and ulnar compensation.

Methods:

This retrospective observational study included patients with radial artery catheters in general wards and intensive care units of a tertiary hospital in Italy. Residual flow in the radial artery was calculated by measuring the Peak Systolic Velocity and diameter of the artery at the midpoint of the arm. The reverse Barbeau test was used to assess the residual perfusion. The sample was stratified and analysed to the catheter/artery ratio being greater or less than 33% and 45% and to the score obtained during the reverse Barbeau test.

Results:

The data obtained showed a significant statistical correlation between residual flow, catheter/artery ratio, and the reverse Barbeau test ( p < 0.0001 and p = 0.0074 respectively). Almost 80% of the sample had a catheter with an exit site less than 4 cm from the wrist crease.

Conclusion:

Adhering to the current guidelines, especially using ultrasound to ensure a catheter/artery ratio of at least 45%, can help maintain preserved perfusion through the cannulated radial artery. Ulnar compensation appears to be crucial for maintaining good tissue perfusion and should always be evaluated before catheterisation. Therefore, further studies are warranted.
The feasibility of a novel method to remove circumferentially ruptured balloons during ultrasound-guided percutaneous transluminal angioplasty for arteriovenous dialysis access
Authors: Chen Bo , Tu Bo , Lai Qiquan , Chen Ling , Gao Xuejing , Zhou Yu , Zhang Xi , Wan Ziming
Published: September 2024

Objective:

Angioplasty balloon rupture is a rare complication during percutaneous transluminal angioplasty (PTA). Conventional approach to retrieve circumferentially ruptured balloons is open surgery. This study examined the feasibility of a novel approach which can remove ruptured balloon during PTA in vascular access.

Methods:

This retrospective study analyzed 35 patients of a total 6465 patients that underwent ultrasound-guided PTA with a circumferential balloon rupture from February 2016 and August 2023. The patients underwent surgery (Group I, n = 13) or the novel method (Group II, n = 22) for balloon retrieval. Kaplan–Meier curve was used to assess the primary patency rates of the two groups.

Result:

The total incidence of circumferential balloon rupture was 0.5% in our center. Balloon retrieval was successful in both groups with no complications except one case had an infection in the surgical wound. Kaplan–Meier curve analysis showed that the post-intervention primary patency rates of the two methods were not significantly different ( p > 0.05). There was a significant difference between pre-operation and post-operation brachial arterial flow ( p < 0.001).

Conclusion:

The feasibility of the novel technique for retrieval of circumferential ruptured balloons during ultrasound-guided PTA is validated. The technique enables less invasive retrieval and continuation of PTA.
The Rapidly Evolving Treatment Landscape of Metastatic Hormone-Sensitive Prostate Cancer
Authors: Yu Eun-mi , Patel Ishan , Hwang Min Woo , Polani Faran , Aragon-Ching Jeanny B
Published: September 2024

The management of metastatic hormone-sensitive prostate cancer (mHSPC) or castration-sensitive prostate cancer (mCSPC) has become increasingly complex with the tremendous progress that has been made in this space within the past few decades. In the early days of androgen deprivation therapy (ADT), ADT monotherapy was the mainstay for treatment of advanced prostate cancer. However, novel hormone therapies in the form of androgen receptor pathway inhibitors (ARPI) have emerged; vaccine therapy, chemotherapy with docetaxel and cabazitaxel, and radioactive ligands have shaped the treatment of metastatic prostate cancer in the last decade. Following the initial approval of several drugs for use in metastatic castration-resistant prostate cancer (mCRPC) in combination with primary ADT, these agents were studied and subsequently approved for use in mCSPC. Therefore, ADT monotherapy no longer constitutes an optimal therapeutic option for otherwise fit patients who present with mCSPC. We focus on the treatment of first-line de novo mHSPC or mCSPC and explore frontline doublet and triplet therapy and the pivotal trials that led to their United States Food and Drug Administration approval.
SNAI2 as a Prognostic Biomarker Based on Cancer-Associated Fibroblasts in Patients With Lung Adenocarcinoma
Authors: Li Tian-Tian , Hao Qing-Gang , Teng Zhao-Wei , Liu Yuan , Wu Jia-Fan , Zhang Jun , Yang Li-Rong
Published: September 2024

Background:

Lung adenocarcinoma (LUAD) is a common type of malignant tumor with therapeutic challenges. Cancer-associated fibroblasts (CAFs) promote LUAD growth and metastasis, regulate the tumor immune response, and influence tumor treatment responses and drug resistance. However, the molecular mechanisms through which CAFs control LUAD progression are largely unknown. In this study, we aimed to determine the correlations between CAF-related genes and overall survival (OS) in patients with LUAD.

Methods:

We acquired the gene expression data and clinical information of 522 patients with LUAD patients from The Cancer Genome Atlas (TCGA) and 442 patients with LUAD from the Gene Expression Omnibus (GEO) databases. CAF infiltration levels were assessed using the Microenvironment Cell Population (MCP) counter, the Estimating the Proportions of Immune and Cancer cells (EPIC) algorithm, and Tumor Immune Dysfunction and Exclusion (TIDE) scores. A CAF-related gene network was constructed using the Weighted gene co-expression network analysis (WGCNA). Based on the CAF-related genes, univariate Cox regression and Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression analyses were performed to identify prognostic genes. Gene expression levels within the prognostic model were validated using the Cancer Cell Line Encyclopedia (CCLE) databases and Western blotting.

Results:

Our results demonstrated that high CAF scores were associated with lower survival rates in patients with LUAD. Gene modules that were highly correlated with high CAF scores were closely associated with tissue characteristics and extracellular matrix structures in LUAD. In addition, correlations between CAF scores and responses to immunotherapy and chemotherapy were observed. Finally, we found that SNAI2 expression was higher in lung cancer tissues than in normal tissues.

Conclusion:

Deepening our understanding of the influence of CAFs on tumor progression and treatment response at the molecular level can aid the development of more effective therapeutic strategies. This study provides important insights into the functional mechanisms of action of CAFs in LUAD and highlights their clinical implications.
The efficacy of mobile applications for reducing depression in adolescents and young adults: A meta-analysis of randomized control trials
Authors: Lee Ching-Hua Julie , Bazan Maria , Wong Jolene , Yoshida Takuto , Jantarabenjakul Watsamon , Lin Sheng-Yi , Papatheodorou Stefania
Published: September 2024

Background

Mobile applications for mental health have the potential to aid people with mental health disorders, especially depression, by providing them with tools and coping mechanisms. Adolescents and young adults, being at risk of depressive symptoms and leading mobile users, are among the main targets of using mobile applications to alleviate symptoms.

Objective

This study aimed to evaluate the impact of mobile application–based psychological interventions in reducing depression symptoms in adolescents and young adults compared to those not exposed to the intervention.

Methods

We conducted a meta-analysis focusing on mobile applications for reducing depressive symptoms. We searched two databases: MEDLINE and EMBASE and included randomized controlled trials conducted in English among participants aged 18–35 years old who were assessed for depressive symptoms using a validated screening measure and used mobile applications–based psychological interventions. Two of six independent reviewers conducted study selection, data extraction, and bias assessment. A pooled mean standardized difference (Cohen's d) and 95% CI were calculated using random-effects meta-analysis. Risk of bias was assessed using I2 statistics and forest plot. Egger's test was used for assessing publication bias.

Results

After screening 740 references, we identified 12 trials with 1869 participants, with a mean age of participants ranging from 14.70 to 25.1 years. The interventions ranged from cognitive behavioral therapy (CBT)-based mobile apps to interactive story-telling apps and apps delivering a mix of CBT, interpersonal psychotherapy for adolescents, and dialectical behavior therapy elements. Control groups included information-only, waitlist, no intervention, and treatment as usual. Seven studies used Patient Health Questionnaire-9 (PHQ-9) to assess the severity of depressive symptoms, while the other five used different scales. There was no evidence of publication bias ( p = 0.325). The mobile applications reduced depression score by 0.08 units of standardized difference more than the control, with a 95% CI of −0.19 to 0.03 ( p = 0.294, I2 = 15.4%) using standardized mean difference (SMD) as the effect estimate. In a sensitivity analysis including only studies that used PHQ-9, we found a similar trend, SMD −0.72 (95%CI −1.48 to 0.03). However, both findings were not significant.

Conclusions

Current evidence is insufficient to support mobile applications to relieve depression symptoms in adolescents and young adults. Further trials with larger sample size are needed to confirm our findings of a positive trend. With emerging technologies and the high exposure of apps in this population, mobile applications for depression hold promise for the future of treatment and awareness of mental health disorders in this population.
Effect of smart technology attributes on work-related behaviors through perceived usefulness: Moderating roles of perceived risk and hotel affiliation
Authors: Zhang Xinyan , Tavitiyaman Pimtong , Xu Jing (Bill) , Tsui Bruce
Published: September 2024

Hotels have speeded up technology adoption in response to the COVID-19 hit. This study attempts to understand whether smart technologies adopted by hotels enhance employees’ work-related behaviors (i.e., productivity, satisfaction, and retention) in the post-pandemic era. Through the lens of the Technology Acceptance Model (TAM), this study examines the relationships between smart technology attributes (STAs), hotel employees’ perceived usefulness (PU) of smart technology, and work-related behaviors (WBs). The moderating effects of perceived risk and hotel affiliation on the relationships are also investigated. Results from a survey of 272 hotel employees in Hong Kong indicate a positive influence of STAs on hotel employees’ PU, which in turn enhances their WBs. Furthermore, perceived risk and hotel affiliation are found to have a moderating effect on the relationships between STAs and PU. Theoretical contributions, managerial implications, and the limitations of this study are discussed.
Drivers of universal health coverage in Makueni county, Kenya: Lessons for the Global South
Authors: Kamau Esther , Harris Joseph , MacNaughton Gillian , Sprague Courtenay
Published: September 2024

All UN member States committed to realizing universal health coverage (UHC) when they included UHC as Target 3.8 in the Sustainable Development Goals in 2015. However, the global commitment to UHC has not been matched with action on the ground. According to the World Health Organization, about half of the world population lacks full coverage for essential health services. To accelerate progress toward UHC, a close understanding of factors that drive adoption of UHC policies at the national and local levels is essential. The purpose of this study was to investigate the impetus for establishing a sub-national health insurance program in Kenya—the Makueni county government health insurance program (MakueniCare)—which led to increasing the percentage of the county population with health insurance, the majority of whom live in poverty, from 8.8% in 2013 to 91% in 2018. This qualitative case study drew on Kenyan law and policy documents as well as semi-structured interviews with 30 key informants in government and NGOs to understand the drivers that led to the establishment of MakueniCare. Findings revealed that several drivers—namely, global norms, decentralization, democratic competition, and the strategic action of social change-minded leaders—coalesced to influence the adoption of MakueniCare. The study offers timely insights into the factors driving UHC in Makueni, Kenya and lessons for other low- and middle-income countries working toward UHC.
Collective autonomy through school leader unions (2006–2021): Comparative case study from Sweden and Norway
Authors: Sundberg Rikke A
Published: September 2024

For several decades, there has been a global trend of the devolution of autonomy to local leadership levels. The topic has consequently gained attention in educational research, showing the complexity and multi-layered nature of the phenomenon. Nevertheless, empirical research has focused largely on individual leadership or institutional school autonomy, overlooking school leader unions’ collective autonomy at the intersection between leadership levels and as a link between policy and practice. This paper aims to explore the communication and formation of collective autonomy through school leader unions in their mediating role between policy and practice, under shifting national policy contexts with increased global policy influence. Attention is drawn to union magazines and how they have depicted the issue over time, analysing texts on assessment from nearly 300 issues through a two-fold conceptualisation of collective autonomy as the capacity to influence policy and control individual professionalism. The results highlight the possibility of unions functioning as mediators between policy and practice, national and local, when collective autonomy is not too restricted. The study calls for further empirical research on collective autonomy, paying attention to the intricate relationship between policy, collectivism and individual leadership practice.
Integrated design method for protection against vibration of offshore platform plate structure
Authors: Deng Ziwei , Jia Xuchen , Li Zijian , Sun Xu , Pang Fuzhen , Zhang Baocheng
Published: September 2024

The paper integrates the modal avoidance method, pedestal design method, and dynamic vibration absorber theory to investigate vibration control technology for offshore platform plate structures. We develop an integrated design method for vibration suppression by controlling the vibration excitation load, vibration transmission, and vibration energy dissipation. Firstly, a modal avoidance design is implemented to suppress vibration transmission along the propagation path of the plate structure. Subsequently, pedestal optimization is conducted for pedestal structure to attenuate vibration excitation at the input end. Finally, dynamic vibration absorber theory is employed to control dominant vibration frequency responses further and achieve multi-target vibration control. Case simulation results demonstrate that the integrated design method reduces the acceleration vibrations level at 113.75, 145.61, and 153 Hz, and this method could guide multi-objective vibration control in offshore platform plate structures.
Combined failure identification of intermediate bearing in aeroengine based on wavelet transform, second-order difference, and 1D-LBP
Authors: Yu Mingyue , Fang Minghe , Guo Guihong
Published: September 2024

Intermediate bearing is one of key parts in double-rotor aeroengine, whose running state usually can only be monitored by casing signals. As the fault characteristic information detected from casing is weak and complex, it is generally difficult to be dug correctly. One-dimensional local binary pattern (1D-LBP) can depict failure information from the perspective of local feature extraction. Currently, the study on the application of 1D-LBP in fault identification is mostly based on original signals; due to the influence of component signals irrelevant to fault and noise, the fault information in original signals is weak and complex; besides, 1D-LBP is rather sensitive to noise, which is extremely possible to cause insufficient extraction of local textural features and the difficulty to identify a fault. To solve this problem and make it possible to precisely identify the fault of intermediate bearing of real aeroengine, the paper has proposed the combined method of wavelet transform (WT), second-order difference with 1D-LBP. WT is highly uncertain to determine the decomposition layer number. To solve the difficulty, correlation coefficient was introduced. Meanwhile, casing vibration signal was subjected to WT. Furthermore, because vibration signal often went with impact components in a bearing failure and second-order difference of signals was sensitive to impact feature, component signals obtained by WT were subjected to second-order difference operation. Additionally, taking advantage of 1D-LBP, second-order differences of signals were locally binarized with average value as criterion. Finally, 1D-LBP signals were re-transformed to decimal 1D local texture signals (1D-LTS). These 1D-LTS can embody local feature information of signals. According to the spectrum of 1D-LTS, combined failure type of intermediate bearing was identified. Through the comparison with WT and classical 1D-LBP method, and failure analysis after disassembly of aeroengine, the effectiveness and engineering applicability of proposed method have been verified.