bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Reasoning: Patients’ and Care Partners’ Perceptions of Diagnostic Accuracy in Emergency Care
Authors: Dukhanin Vadim , McDonald Kathryn M. , Gonzalez Natalia , Gleason Kelly T.
Published: November 2023

Objectives

In the context of validating a measure of patient report specific to diagnostic accuracy in emergency department or urgent care, this study investigates patients’ and care partners’ perceptions of diagnoses as accurate and explores variations in how they reason while they assess accuracy.

Methods

In February 2022, we surveyed a national panel of adults who had an emergency department or urgent care visit in the past month to test a patient-reported measure. As part of the survey validation, we asked for free-text responses about why the respondents indicated their (dis)agreement with 2 statements comprising patient-reported diagnostic accuracy: 1) the explanation they received of the health problem was true and 2) the explanation described what to expect of the health problem. Those paired free-text responses were qualitatively analyzed according to themes created inductively.

Results

A total of 1,116 patients and care partners provided 982 responses coded into 10 themes, which were further grouped into 3 reasoning types. Almost one-third (32%) of respondents used only corroborative reasoning in assessing the accuracy of the health problem explanation (alignment of the explanation with either test results, patients’ subsequent health trajectory, their medical knowledge, symptoms, or another doctor’s opinion), 26% used only perception-based reasoning (perceptions of diagnostic process, uncertainty around the explanation received, or clinical team’s attitudes), and 27% used both types of reasoning. The remaining 15% used general beliefs or nonexplicated logic (used only about accurate diagnoses) and combinations of general reasoning with perception-based and corroborative.

Conclusions

Patients and care partners used multifaceted reasoning in their assessment of diagnostic accuracy.

Implications

As health care shifts toward meaningful diagnostic co-production and shared decision making, in-depth understanding of variations in patient reasoning and mental models informs use in clinical practice.

Highlights

An analysis of 982 responses examined how patients and care partners reason about the accuracy of diagnoses they received in emergency or urgent care. In reasoning, people used their perception of the process and whether the diagnosis matched other factual information they have. We introduce “patient reasoning” in the diagnostic measurement context as an area of further research to inform diagnostic shared decision making and co-production of health.
‘County lines’: racism, safeguarding and statecraft in Britain
Authors: Koch Insa , Williams Patrick , Wroe Lauren
Published: November 2023

Government policies relating to dealers in ‘county lines’ drugs trafficking cases have been welcomed as a departure from punitive approaches to drugs and ‘gang’ policing, in that those on the bottom rung of the drugs economy of heroin and crack cocaine are no longer treated as criminals but as potential victims and ‘modern slaves’ in need of protection. However, our research suggests not so much a radical break with previous modes of policing as that the term ‘county lines’ emerged as a logical extension of the government’s racist and classist language surrounding ‘gangs’, knife crime and youth violence. Policies implemented in the name of safeguarding the vulnerable also act as a gateway for criminalisation not just under drugs laws but also modern slavery legislation. The government’s discovery of, and responses to, ‘county lines’ hinge on a moral crisis in the making, which ultimately deepens the state’s pre-emptive and violent criminalisation of the ‘Black criminal other’ at a time of deep political crisis.
Improving Simulation Models of Unsignalized Intersections on Rural Multilane Highways through Calibration Using Naturalistic Driving Study Data from Strategic Highway Research Program 2
Authors: Yang Fangjian , Zhou Huaguo
Published: November 2023

The aim of this study is to create a calibration method for traffic simulation models of two crucial movements at unsignalized intersections on rural divided highways. This analysis draws on data from the Naturalistic Driving Study, specifically direct left turn (DLT) movements at conventional intersections and right turn followed by U-turn (RTUT) movements at restricted crossing U-turn (RCUT) intersections. Using 453 naturalistic trips from 79 drivers, the speed trajectory, stopping behavior, lane utilization, and acceleration and deceleration rates were analyzed. Three-step and four-step calibration methods were then developed for the Vissim simulation models for DLT and RTUT movements, respectively, which were verified by comparison with naturalistic driving data. The calibrated Vissim models were verified by comparing the naturalistic driving speed trajectories of DLT and RTUT movements. The results show that calibrated models can improve the operational analysis for overall unsignalized intersections on rural multilane divided highways.
Changes in renal volume post Percutaneous nephrolithotomy based on ultrasonography and its correlation with glomerular filtration rate (GFR)
Authors: Dey Pankaj Kanti , Mondal Soumya , Pal Dilip Kumar
Published: November 2023

Introduction:

Percutaneous nephrolithotomy (PCNL) is considered to be the gold standard management for renal calculi. The purpose of this study is to comprehend the overall alterations in renal volume occurring after PCNL. The changes in the kidney’s total volume in individual patients will be examined by ultrasonography pre and postoperatively, and it will be correlated with GFR.

Materials and methods:

It was a prospective observational study performed over 70 participants, conducted at the department of Urology of a tertiary care hospital in Eastern India. Each patients were evaluated with pre and post PCNL USG for kidney volume and GFR. The data was statistically evaluated by SPSS software.

Results:

The preoperative and post operative calculated mean GFR was 96.030 ± 18.922 ml and 86.681 ± 16.938 ml,volume was 127.258 ± 25.705 and 123,678 ± 26.357 respectively . There was statistically significant decrease in GFR and volume following PCNL. It also shows that patients who underwent single puncture PCNL had significantly less decrease in GFR and kidney volume compared to multiple puncture PCNL. Moreover, the calculated mean change in GFR and volume were significantly less seen in single puncture—one step dilatation and single puncture—serial dilatation as compared to multiple puncture—one step dilatation and multiple puncture—serial dilatation.

Conclusion:

Our study showed that there was significant changes in the renal volume and GFR following PCNL . So, a sonographic estimation of renal dimensions and GFR calculation after PCNL will help in the prognosis and further follow up of patients. A Single puncture had a better operative outcome and less adverse consequences with respect to GFR, volume change and for renal function as compared to multiple puncture.
Experimental investigation of simple foam-stacked in drilling process for carbon fiber reinforced plastic
Authors: Kang Yun Seok , Kim Dong Chan , Mun Hui Chan , Park Hyung Wook , Seo Jaewoo
Published: November 2023

Carbon fiber reinforced plastics (CFRPs) have a variety of uses in aerospace and automobile industries for their outstanding mechanical properties. Although the defects occur during machining CFRP, drilling CFRP is necessary to assemble individual parts. Delamination is a major defect that degrades the strength of structures; it must be avoided when drilling CFRP. In this study, a new approach was proposed to reduce delamination defects using foam when drilling CFRP laminates. Three different types of foams were used to support CFRP laminate during drilling process. The thrust force and extent of tool wear on the cutting-edge of the drill bit were measured and analyzed. The thrust force decreased during foam-stacked CFRP drilling, but there was no significant difference in tool wear. The delamination factors acquired from the exit morphologies of the drilled holes of the CFRP by comparing them with and without foam as a back-up plate. The delamination factor increased as the number of holes drilled in the CFRP increased. The delamination factor decreased to 35.9% with the use of extruded polystyrene foam as a back-up plate, based only on drilling CFRP; hence, the delamination damage when drilling CFRP can be effectively reduced by supporting foam.
Development and Validation of a Predictive Model for Acute Kidney Injury in Sepsis Patients Based on Recursive Partition Analysis
Authors: Lai Kunmei , Lin Guo , Chen Caiming , Xu Yanfang
Published: November 2023

Background

Sepsis-associated acute kidney injury (SA-AKI) is a critical condition with significant clinical implications, yet there is a need for a predictive model that can reliably assess the risk of its development. This study is undertaken to bridge a gap in healthcare by creating a predictive model for SA-AKI with the goal of empowering healthcare providers with a tool that can revolutionize patient care and ultimately lead to improved outcomes.

Methods

A cohort of 615 patients afflicted with sepsis, who were admitted to the intensive care unit, underwent random stratification into 2 groups: a training set (n = 435) and a validation set (n = 180). Subsequently, a multivariate logistic regression model, imbued with nonzero coefficients via LASSO regression, was meticulously devised for the prognostication of SA-AKI. This model was thoughtfully rendered in the form of a nomogram. The salience of individual risk factors was assessed and ranked employing Shapley Additive Interpretation (SHAP). Recursive partition analysis was performed to stratify the risk of patients with sepsis.

Results

Among the panoply of clinical variables examined, hypertension, diabetes mellitus, C-reactive protein, procalcitonin (PCT), activated partial thromboplastin time, and platelet count emerged as robust and independent determinants of SA-AKI. The receiver operating characteristic curve analysis for SA-AKI risk discrimination in both the training set and validation set yielded an area under the curve estimates of 0.843 (95% CI: 0.805 to 0.882) and 0.834 (95% CI: 0.775 to 0.893), respectively. Notably, PCT exhibited the most conspicuous influence on the model's predictive capacity. Furthermore, statistically significant disparities were observed in the incidence of SA-AKI and the 28-day survival rate across high-risk, medium-risk, and low-risk cohorts ( P < .05).

Conclusion

The composite predictive model, amalgamating the quintet of SA-AKI predictors, holds significant promise in facilitating the identification of high-risk patient subsets.
Lament, Liturgy, and the Shape of Theological Repentance: A Response to Anthony Reddie
Authors: Shin Sarah
Published: November 2023

In this reflection, I respond to Anthony Reddie's reflections and assertions about the sacramentality of black flesh in a world shaped by white supremacy. I locate myself as Korean American and refer to my experience of ministering to university students during the rise of Black Lives Matter in the US. Instead of offering cognate claims for the sacramentality of Asian flesh, I ask what theological repentance should look like in light of the historical profaning of the black body. Using the work of two black American artists, jazz musician Robert Glasper and painter Titus Kaphar, I offer beginning reflections on how our liturgies and practices need to change as part of theological repentance—including lament.
An investigation on the performance of bio-mimicked rake surface structured tool during machining of hard-to-cut materials
Authors: Ranjan Priya , Hiremath Somashekhar S.
Published: November 2023

The current work seeks to improve the machining characteristics of tool by generation of various geometrical structures on cemented carbide tool's rake face. A total of three different structures: (a) bio-mimicked micro-crescent structure, (b) micro-dimple structure, and (c) micro-groove structure, are generated using laser micro-machining technique on rake surface of tool. Dry turning tests were performed using the structured tool and conventional tool during cutting of AISI 420 workpiece material. The effect of various geometrical textures on chip-tool contact area, surface roughness, cutting force, morphology of chip and residual stress have been compared with respect to conventional tool. Results indicate that crescent-shaped bio-mimicked structured tool indicated better cutting performance in decreasing contact area of chip-tool by 43.6%, tangential force by 15.38%, feed force by 20.22%, and average surface roughness by 8.81% relative to the conventional tool. The machined surface of structured tool also indicated lower generation of residual stress of 419.3 MPa in cutting direction and 316.9 MPa in feed direction relative to 608.3 MPa in cutting and 375.5 MPa in feed direction using conventional tool machined surface. Segmented chips were produced during all machining conditions, and crescent-shaped structured tool indicated least chip reduction coefficient of 1.08 compared to 1.57 in the case of conventional tool. The results of the current study are very essential for expanding the application of bio-mimicked structured cutting tools for cutting different hard to machine materials.
Factors associated with discussing HIV pre-exposure prophylaxis (PrEP) among Jamaican medical providers
Authors: Walcott Melonie M , Tieu Hong-Van , Tipre Meghan , Nandi Vijay , Davis Alissa , Wu Elwin , Wheatle Marceleen , Frye Victoria , Figueroa J Peter
Published: November 2023

Background

The Ministry of Health and Wellness of Jamaica has endorsed the use of pre-exposure prophylaxis (PrEP) as an HIV prevention strategy; however, PrEP was not included in the national HIV prevention program in 2021.

Methods

A cross-sectional online study involving physicians in Jamaica was conducted in 2021 to describe PrEP awareness, beliefs, attitudes, and practices. The study also assessed individual and social factors associated with discussing PrEP with patients and willingness to prescribe PrEP.

Findings

The mean age and standard deviation (SD) of the 69 physicians who completed the survey were 45.5 ± 13.6 years. Most of the participants (80%) reported that they were somewhat familiar with PrEP. PrEP attitude and perceived comfort in prescribing PrEP were moderate among participating physicians, with a mean and SD of 3.9 ± 0.8 and 3.6 ± 0.9 respectively. Six percent of physicians reported that they had prescribed PrEP and 17% had discussed PrEP with their patients in the past year. However, most (90%) reported that they were willing to prescribe PrEP after being informed about it. In the unadjusted model, identifying as Christian (compared to non-Christian) and reporting stronger homophobic beliefs were associated with reduced odds of discussing PrEP with patients. In the multivariable model, only homophobia remained statistically significant (OR, 0.24; 95% CI: 0.07–0.63).

Conclusion

The findings suggest that physicians in Jamacia may be willing to prescribe PrEP; however, homophobia is a barrier to discussions, underscoring the need for the Ministry of Health and Wellness to recognize the role that homophobia plays in the national HIV program to further reduce HIV incidence in Jamaica.
A data-based fault detection scheme for the stratospheric airship control system
Authors: Hu Jichen , Zhu Ming , Zheng Zeiwei , Chen Tian
Published: November 2023

This brief proposed an innovative fault detection method based on analytical data for the stratospheric airship control system. The control system considered is subject to both space disturbance and nonlinear characteristics; the faults of sensors and actuators are all taken into account. The proposed method is developed in two phases. In the first phase, the moving window kernel principal component analysis is employed to construct the fault detection model with the training data under normal operating conditions and update the fault detection model online until abnormal data are detected. Second, a fault detection model updating mechanism is designed to reduce computational complexity and cost with a clustering algorithm, which compounds the mean shift clustering with weighted Euclidean distance to reflect the data density distribution feature to make the updating to be adaptive. Finally, the proposed method is applied to detect fault for an illustrative simulation stratospheric airship control model. The fault detection results validate the effectiveness of proposed fault detection method for different sensor and actuator fault cases. Comparing to some extended moving window kernel principal component analysis method, the proposed method reduces the computational cost significantly.
Racial/ethnic and socioeconomic disparities in colorectal cancer screening in a large organization with universal insurance before and during the coronavirus disease 2019 pandemic
Authors: Levi Zohar , Abu-Frecha Naim , Comanesther Doron , Backenstein Tania , Cohen Arnon D , Eizenstein Sapir , Flugelman Anath , Weinstein Orly
Published: November 2023

Objectives

Israel is regarded as a country with a developed economy and a moderate income inequality index. In this population-based study, we aimed to measure the inequalities in colorectal cancer screening within Clalit Health, an organization with universal insurance, before and during the coronavirus disease 2019 pandemic.

Setting

Retrospective analysis within Clalit Health Services, Israel.

Methods

We evaluated the rate of being up to date with screening (having a colonoscopy within 10 years or a fecal occult blood test within 1 year) and the colonoscopy completion rate (having a colonoscopy within 6 months of a positive fecal occult blood test) among subjects aged 50–75 in 2019–2021.

Results

In 2019, out of 918,135 subjects, 61.3% were up to date with screening; high socioeconomic status: 65.9% (referent), medium-socioeconomic status: 60.1% (odds ratio 0.81, 95% confidence interval 0.80–0.82), low-socioeconomic status: 59.0% (odds ratio 0.75, 95% confidence interval 0.74–0.75); Jews: 61.9% (referent), Arabs: 59.7% (odds ratio 0.91, 95% confidence interval 0.90–0.92), Ultraorthodox-Jews: 51.7% (odds ratio 0.77, 95% confidence interval 0.75–0.78). Out of 21,308 with a positive fecal occult blood test, the colonoscopy completion rate was 51.8%; high-socioeconomic status: 59.8% (referent), medium-socioeconomic status: 54.1% (odds ratio 0.79, 95% confidence interval 0.73–0.86), low-socioeconomic status: 45.5% (odds ratio 0.60, 95% confidence interval 0.56–0.65); Jews: 54.7% (referent), Ultraorthodox-Jews: 51.4% (odds ratio 0.91, 95% confidence interval 0.90–0.92), Arabs: 44.7% (odds ratio 0.77, 95% confidence interval 0.75–0.78). In 2020–2021, there was a slight drop in the rate of being up to date with screening, while most of the discrepancies were kept or slightly increased with time.

Conclusions

We report significant inequalities in colorectal cancer screening before and during the coronavirus disease 2019 pandemic in Israel, despite a declared policy of equality and universal insurance.
Research on the assessment of music performance from Maria Manturzewska’s early experiments to more recent studies
Authors: Chmurzyńska Małgorzata
Published: November 2023

The assessment of music performance by experts is vital for the measurement of performers’ achievements both in the course of their training and in the context of competitions. More than 350 international piano competitions are held every year, in which the main task of the jury is to judge performances as they take place in the moment, without taking into account any other information such as performers’ previous competition successes. A vast body of evidence shows that many factors influence such judgments. In this article, I discuss these factors, as first identified in early and comparatively little-known research by Maria Manturzewska, the first Polish music psychologist (1930–2020). The principal purpose of her studies was to examine the inter- and intra-rater reliability of judges’ scores in the 6th International Fryderyk Chopin Piano Competition (IFCPC), held in Warsaw in 1960, and in an experiment in which the judges were, respectively, 28 competition jurors and a panel of 10 experts (2 competition jurors, a participant in the competition, and 8 further outstanding pianists). Based on the analysis of the jurors’ scores in the competition and those of the experts, Manturzewska found low values for both inter- and intra-rater reliability: different judges assessed the same performances in different ways, as did experts hearing the same performance on two occasions. Manturzewska proposed several explanations for the discrepancies between judges’ assessments. Not only have her students and collaborators continued her work by testing and verifying some of her hypotheses, but more recent research conducted outside Poland has also done so. In conclusion, although some kinds of objective measurement can be made using new tools and technologies, human judges with their own competences, ability to evaluate, value systems, preferences, and a sense of fairness and morality will always be needed for reliable and accurate assessments.
Maria Manturzewska’s model of the lifespan development of professional musicians in the light of recent research and cultural changes
Authors: Gembris Heiner
Published: November 2023

The lifespan trajectory of musical achievement in the field of classical music and the factors that promote or hinder the development of talent in music are the focus of Manturzewska’s model of the lifespan development of professional musicians. This article aims to describe Manturzewska’s model briefly, relate it to recent research, and explore the extent to which it fits the diversity of musical careers of contemporary professional musicians. A brief depiction of the developmental model provides insight into the six developmental phases of the model and the factors that influence them. Recent research investigating talent development and career research in music suggests that Manturzewska’s theoretical model is largely consistent with findings from expertise research, research examining the determinants of musical development, and current models of talent development. The development of musicians with traditional careers as orchestral musicians in permanent, full-time employment or as successful soloists in contemporary musical culture is likely to be represented largely accurately in Manturzewska’s model. However, the diversity of typical portfolio careers, characterized by simultaneous irregular musical and non-musical activities in musical and non-musical fields, cannot be depicted in a single, more-or-less linear development model. Appropriate research, especially long-term studies that model the lifetime development of professional musicians (not only) in classical music, is lacking. Furthermore, Manturzewska’s model addresses important aspects that have been insufficiently studied by others, such as the development of professional musicians in the second half of life, and provides a sound and inspiring basis for future research.
Evaluation of a mental health service reform program, the Pathways to Community Living Initiative, for people with severe mental illness and complex needs
Authors: Williams Kathryn E , Kobel Conrad , Westera Anita , O’Shea Peri , Thompson Cristina , Jackson Kate , Murray Robyn
Published: November 2023

Objective

The Pathways to Community Living Initiative (PCLI) aims to reform mental health care for people with severe and persistent mental illness (SPMI) and complex needs. This study reports independent evaluation findings on transitions from hospital and practice change in mental health services.

Methods

Data for this mixed-methods evaluation were obtained from administrative collections and semi-structured interviews with PCLI program managers, teams and executive leads; aged care managers; and leaders in inpatient, community and older people’s mental health services.

Results

Between July 2015 and December 2020, 674 participants (67% of those eligible for the PCLI) were transitioned from hospital to community. Of those transitioned, 21 required subsequent long-stay admissions. The PCLI introduced resources, clearly defined processes, and state-wide networks to guide changes in practice which are becoming embedded in the operations and governance of mental health services across New South Wales.

Conclusions

Severe and persistent mental illness and complex needs can be managed in community settings with highly individualised planning and care, supported by specialised clinical teams in partnership with mental health, aged care and disability services. Evaluation findings highlight the importance of continued investment in rehabilitation psychiatry.
The Utility of Pneumatic Cavity Volume in the Treatment of Exudative Otitis Media in Children with Cleft Palate
Authors: Oyake Koichiro , Amari Yasunobu , Sakikawa Aya , Sugitani Izumi , Inoue Yukiko , Shimura Tomotaka , Kawamura Yojiro , Kobayashi Hitome , Shimane Toshikazu , Kobayashi Sei
Published: November 2023

Objective

Measure the volume of air-containing space in children with cleft palate and assess age-related changes, recurrence rate of otitis media with effusion (OME) after tube removal, and temporal bone development trend based on time of tube placement.

Design

Interventional prospective study.

Setting

Cleft Lip and Palate Center at a Tertiary-level institution.

Patients/Participants

One hundred sixty-eight ears of 86 patients who visited our center from January 2018 to December 2019.

Interventions

We performed tympanometry (impedance audiometry) after tube placement.

Main Outcome Measures

Recurrence (at least one episode of OME after tympanic membrane closure), tympanic cavity volumes, and timing of tube placement.

Results

The mean air-containing cavity volume was 1.62 mL, 2.99 mL, and 3.29 mL in patients aged 1, 2, and 3 years, respectively. A rapid increase in volume was observed around 2 years of age. Twenty-two (42.3%) of the 52 ears with pneumatic cavity volumes <3 mL, and four (14.3%) of the 28 ears with pneumatic cavity volumes ≥3 mL had recurrence. Tubes were placed at ages <1 year and ≥1 year in 28 and 62 ears, respectively. The pneumatic cavity volume tended to be greater in the ears with tube placement at age <1 year.

Conclusion

This study provided insights into using pneumatic cavity volume measurements to determine the appropriate timing for tube removal. Tubes should be placed as early as possible (before the age of 2 years) for prolonged OME associated with children with cleft palate.
Theoretical Relationships among Developmental Assets, Well-Being and Thriving: Scoping Review of the Strength-Based Perspective
Authors: Dejenie Meseret Ayalew , Abebe Amare Sahle , Getahun Dawit Asrat
Published: November 2023

This review was conducted to assess the status and contribution of positive youth development. This review considered the philosophy, theoretical models, and existing research methods of positive youth development. The purpose of the review was to indicate the models used, methods applied, and identify the gaps. Our analysis of the existing literature showed that the strength-based perspective, particularly, the developmental asset model has been given much attention in the literature. In addition, literature revealed that developmental assets indicated to predict thriving outcomes and well-being. On the other hand, well-being predicted thriving outcomes too. However, the mediation role of well-being in the relationship between experience to assets and thriving outcome needs further investigation.
Open vs Minimally Invasive Resection of the First Metatarsocuneiform Joint: An Anatomical Study
Authors: Schilde Sebastian , Arbab Dariusch , Felsberg Maria , Kielstein Heike , Delank Karl-Stefan , Gutteck Natalia
Published: November 2023

Background:

The modified Lapidus arthrodesis is a standard procedure to correct middle to severe hallux valgus (HV) deformities. Recently, minimally invasive techniques of first metatarsocuneiform joint (MCJ) resection using a Shannon burr were described. The primary goal of this study is to compare the anatomical efficacy and safety of first MCJ resection using a straight 2 × 13-mm Shannon burr and minimally invasive technique (MIS) vs an open technique using an oscillating saw.

Methods:

Ten pairs of fresh frozen cadaveric feet were randomly assigned to open or MIS first MCJ resection with subsequent systematic dissection. For the MIS procedure, a dorsomedial approach was used and for the open procedure a medioplantar approach was used. Cartilage removal was investigated by analyzing standardized scaled photographs of the resected articular surfaces with ImageJ software. Nearby structures at risk were analyzed for iatrogenic violation: tibialis anterior (TA), extensor hallucis longus (EHL) and peroneus longus (PL) tendons, and the Lisfranc ligament complex (LLC).

Results:

In the MIS group, the median cartilage resection was 85.9% at the cuneiform and 85.6% at the metatarsal bone compared to 100% cartilage resection in open technique ( P < .01). Iatrogenic damage of the LLC, EHL, and TA tendons was not found in any group. The PL tendon was thinned out (<25% of tendon thickness) in 4 cases (40%) in the open group and in 1 case (10%) in the MIS group. A safe zone of 3.0 mm between the articular surface of the cuneiform bone and the LLC was identified, which can be resected without putting the LLC at risk when performing lateral-based wedge resections.

Conclusion:

In this cadaver study with the procedures performed by an experienced foot and ankle surgeon, and using 2 different surgical approaches, we found general parity between the Shannon burr MIS technique vs oscillating saw open technique techniques with more risk to the PL with our open technique and approximately 15% less cartilage resection with our MIS technique.

Level of Evidence:

Level V, cadaver study.
Outcomes of Platelet-Rich Plasma Infiltration and Weightbearing Cast Immobilization in Distal Tibialis Anterior Tendinopathy: A Prospective Cohort Study
Authors: Desomer Lies , van Beek Nathalie , Van Riet Anne , Verfaillie Stefaan
Published: November 2023

Background:

Distal tibialis anterior tendinopathy (DTAT) is a chronic condition that may lead to functional impairment and secondary forefoot deformities when left untreated. Current clinical practice is mainly guided by case reports and small retrospective case series; little consensus exists on which treatment protocol is most effective. This study aims to assess a conservative treatment for DTAT consisting of PRP infiltration and walking cast immobilization.

Methods:

This prospective study included 18 feet in 18 patients, recruited between September 2020 and September 2022 at a single institution. Ultrasonography was performed; leukocyte-poor PRP was infiltrated around the tibialis anterior tendon insertion. Walking cast immobilization was used for 3 weeks after infiltration, followed by eccentric exercises of the DTAT, and gastrocnemius-soleus muscle complex stretching. Clinical findings, visual analog scale (VAS), Foot Function Index (FFI), and American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scores were recorded at inclusion, and 6 and 12 weeks after PRP infiltration. Minimal clinically important difference (MCID) limits were researched to assess clinical relevance of statistical outcomes. Means were determined for age, sex, and body mass index (BMI). One-way repeated measures ANOVA was performed over time for FFI, AOFAS, and VAS scores.

Results:

Mean age was 65 years with a mean BMI of 25. Tendon thickening and hypoechogenicity were the most commonly reported ultrasonographic findings. Significant improvement from baseline VAS (VASrest: 4.71 ± 2.7, VASactivity: 5.66 ± 2.5) to 12 weeks follow-up (VASrest: 2.14 ± 2.7, VASactivity: 3.34 ± 2.5) was found. Both AOFAS and FFITotal improved significantly from baseline (AOFAS: 66.9 ± 3.3, FFITotal: 32.9 ± 3.3) to 6-week follow-up (AOFAS6w: 79.4 ± 3.3, P = .019; FFITotal: 19.4 ± 3.3, P = .011). No statistically significant further improvement was found at 12 weeks compared to 6 weeks’ follow-up. Two (11%) patients chose operative treatment because of persisting symptoms.

Conclusion:

We found that PRP infiltration with walking cast immobilization as a first-line treatment was associated with general early symptom improvement.

Level of Evidence:

Level IV, case series.
New Insights Into The Evolution of Chloroplast Genomes in Ochna Species (Ochnaceae, Malpighiales)
Authors: Nhat Nam Nguyen , Hoang Danh Nguyen , Minh Thiet Vu , Do Hoang Dang Khoa
Published: November 2023

Ochnaceae DC. includes more than 600 species that exhibit potential values for environmental ecology, ornamental, pharmaceutical, and timber industries. Although studies on phylogeny and phytochemicals have been intensively conducted, chloroplast genome data of Ochnaceae species have not been fully explored. In this study, the next-generation sequencing method was used to sequence the chloroplast genomes of Ochna integerrima and Ochna serrulata which were 157 329 and 157 835 bp in length, respectively. These chloroplast genomes had a quadripartite structure and contained 78 protein-coding genes, 30 tRNAs, and 4 rRNAs. Comparative analysis revealed 8 hypervariable regions, including trnK_UUU-trnQ_UUG, rpoB-psbM, trnS_GGA-rps4, accD-psaI, rpl33-rps18, rpl14-rpl16, ndhF-trnL_UAG, and rps15-ycf1 among 6 Ochnaceae taxa. Additionally, there were shared and unique repeats among 6 examined chloroplast genomes. The notable changes were the loss of rpl32 in Ochna species and the deletion of rps16 exon 2 in O. integerrima compared to other taxa. This study is the first comprehensive comparative genomic analysis of complete chloroplast genomes of Ochna species and related taxa in Ochnaceae. Consequently, the current study provides initial results for further research on genomic evolution, population genetics, and developing molecular markers in Ochnaceae and related taxa.
Salad Fingers: Pre-YouTube digital uncanny and the ‘weird’ future of animation
Authors: Balanzategui Jessica , Albarrán-Torres César
Published: November 2023

In 2004, artist David Firth launched the lo-fi animation Salad Fingers in the user-generated content sharing platform Newgrounds. The series, focused on a strange, unsettling narrative about a character that acts as a child but commits unhinged violent acts, went on to become viral in the earliest days of YouTube. Created with the software Flash (launched by Macromedia and then acquired by Adobe), which generates vector images, Salad Fingers is a significant stylistic and generic contribution to the early period of participatory digital cultures. The series operates as a bridge between analogue and digital artforms that privilege the sensorial over narrative cohesion, while also cultivating a distinctive ‘uncanny-weird’ mode tied to early participatory digital cultures, trends that perdure in contemporary animation. We articulate how Salad Fingers operates in the distinctive ‘digital uncanny’, an aesthetic and cultural mode that would become pervasive in visual media cultures on YouTube and beyond.
Medication adherence in patients with mental disorders: A systematic review and meta-analysis of telemedicine interventions
Authors: Moulaei Khadijeh , Bahaadinbeigy Kambiz , Sharifi Hamid
Published: November 2023

Background and objective

Telemedicine interventions have emerged as a promising solution to improve medication adherence by providing remote support and monitoring of patients with mental disorders. This study aims to investigate the effectiveness of telemedicine interventions in enhancing medication adherence among patients with mental disorders.

Methods

PubMed, Scopus, and Web of Science were searched systematically. After deleting the double-included studies, two researchers independently selected articles and extracted data using a standardized data collection form. The risk of bias in the included studies was assessed using the Mixed Methods Appraisal Tool. The intervention effects were combined using a random effects model. Standardized mean differences (Hedges's g) between the treatment and control groups were calculated. Heterogeneity variance was estimated using the Q test and I2 statistic. The analysis was performed in Stata version 17.0.

Results

Out of the 1088 articles retrieved, nine studies were included in the analysis. Overall, telemedicine interventions demonstrated a statistically significant improvement in medication adherence among patients with mental disorders (Hedges’ g = 0.25, 95% confidence interval: 0.12–0.38, p-value: < 0.01). The type of mental disorder was a significant moderator of the heterogeneity between studies ( p = 0.022).

Conclusion

Telemedicine interventions have a positive impact on medication adherence in patients with mental disorders by offering remote support and monitoring. Integrating telemedicine into mental healthcare can enhance overall adherence rates, leading to improved management of mental disorders.
An evaluation of early marriage and the mental state of Roma women: A cross-sectional study
Authors: İnel Manav Ayşe
Published: November 2023

Early marriage (i.e., at less than 18 years of age) is a significant global problem threatening the well-being of women. This cross-sectional study evaluated early marriage and the mental health of Roma women in Adana, Turkey. Data were collected between March 2019 and September 2019 using the Descriptive Characteristics Form and the Brief Symptom Inventory. We interviewed 272 married Roma women over 18 years of age, of whom 59.6% ( n = 162) had married before the age of 18 years; of these, 14.2% had done so before the age of 15. Significant positive correlations were found between the duration of the marriage and measures of interpersonal sensitivity, somatization, depression, anxiety, phobia, paranoid ideation, psychoticism, and the Global Severity Index in the women who had married early. Among women who married after 18, the duration of marriage had a significant positive relationship with somatization and phobic anxiety. Early marriage and a longer duration of marriage were associated with more symptoms of psychological distress.
Pilgrimage for an autism diagnosis: A study of Venezuelan parents’ experiences
Authors: Montiel-Nava Cecilia , Vargas Irina , Gonzalez-Avila Zoila , Montenegro María Cecilia , Ramírez Ana C.
Published: November 2023

It cannot be assumed that the experience of having an autistic child is the same across countries since demographic and systemic factors are as diverse as the manifestation of ASD symptomatology. This study explores the lived experiences of 20 Venezuelan parents after receiving an autism diagnosis for their child. Applied thematic analysis was used to analyze parental attitudes, challenges in identifying their child's delay, access to diagnostic services, beliefs towards autism, professional evaluations, family support, and perceptions toward health and educational services for autistic children. Venezuelan parents reported a generalized lack of autism awareness, an unsupportive school system, and judgment from their extended family. Despite the universal health coverage in the country, Venezuelan parents commented on the scarcity of services, as well as the lengthy and costly processes to receive an ASD diagnosis. The results support previous research findings showing that socioeconomic factors influence how parents experience the process of obtaining an autism diagnosis for their children. For most Venezuelan parents, it might imply a long journey in which limited resources and knowledge about autism will determine its route and length. For parents, cultural values and spiritual and religious beliefs will serve as both coping mechanisms and barriers to accessing services.
LES study on traveling wave wall control for the wake of flow around a 3D circular cylinder at high Reynolds number
Authors: Xu Feng , Liu Xin , Chen Wen-Li , Duan Zhong-Dong , Ou Jin-Ping
Published: November 2023

Flow around a cylinder is an important research problem in fluid mechanics. However, studies on traveling wave wall (TWW) flow control for the wake generated by the flow around a 3D cylinder remain limited. This study performs large eddy simulation (LES) to investigate the wake characteristics of flow around a three-dimensional (3D) circular cylinder with the TWW. The influence of the main control parameters of TWW on the aerodynamic forces and wake of the 3D cylinder is analyzed. The wake characteristics of the 3D cylinder at Re = 4 × 104 are obtained, and the traveling wave propagating downstream is achieved on the rear surface of the 3D cylinder using dynamic mesh. The control effects of wave amplitude, number of waves, and wave velocity of the traveling wave on the aerodynamic forces of the cylinder are analyzed, and the optimal control parameter combination is determined. The results demonstrate that the TWW control method completely eliminates the spanwise 3D flow characteristics of the cylinder when the amplitude ratio, number of waves, and velocity ratio are 0.02, 4, and 1.5, respectively. Moreover, it effectively suppresses the flow separation on the cylinder surface, eliminates the wake vortex, and suppresses vortex-induced vibration (VIV).
Working time reduction: Employers’ perspectives and eco-social implications – ten cases from Hungary
Authors: Hidasi Kata , Venczel Tímea , Antal Miklós
Published: November 2023

Working time reduction (WTR) refers to an increasingly popular group of eco-social policies, with various potential implications for social security and sustainable welfare depending on the details of implementation. Despite the growing number of international examples, WTRs constitute a countertrend in Hungary where the government aims to create a ‘work-based society’. In this context, we investigate whether and how companies launch WTRs, and study their effects. Our approach is comparative and explorative. We draw on interviews with managers of 10 companies to understand the motivations behind WTRs. In addition, we use 34 interviews and two focus groups conducted at four companies, considering impacts on employees’ workload and working conditions. We show that the drivers, mechanisms and impacts of WTRs differ by company size. There is far more diversity among smaller companies, where the attitudes of managers and personal relationships are decisive. Larger companies either choose low-risk WTRs that offer low gains, or target further growth and potentially cause a reduction of sectoral output while maximising profit. The latter may be the first example of profit-driven degrowth in the literature. Insights generated here can be useful to understand the potential reasons for, and barriers to, a more widespread adoption of WTRs, as well as the role of positive and negative impacts on workers in this process. We argue that this is important not only for social and economic outcomes, but also for the environment, since WTRs are necessary for a precautionary approach to sustainability. We highlight the limitations of current WTRs, in order to catalyse thinking about more radical variants.
What's in it for me? The perceived investment value of business angels
Authors: Falcão Rui , Moreira António Carrizo , Carneiro Maria João
Published: November 2023

Besides the extraordinary impact of Business Angels (BAs) as the leading contributors to fund entrepreneurship at the early stage, the value BAs perceive from their investment activity has not yet been fully explored. Based on a new holistic perspective resulting from marketing and consumer behaviour, this article builds on the concept of perceived investment value to create a new instrument that measures the overall value perceived by BAs in their investing activity. Data were collected through a survey questionnaire with 849 BAs from 79 countries. The instrument created was tested through Structural Equation Modelling. The results reveal that: (i) BAs are not purely financial investors and expect more than just money from their activity, as self-esteem, entrepreneurship, emotion and altruism are the main dimensions that explain angel perceived investment value (APIV), with economic and functional dimensions being the least influential; (ii) APIV positively influences their job satisfaction; and (iii) angels satisfied with their jobs are more likely to reinvest their money and engage in positive word-of-mouth. A multigroup comparison was implemented, validating the results for males and females, novices and veterans and light and heavy investors.
Three-stage hyperelliptic Kalman filter for health and performance monitoring of aeroengine under multi-source uncertainty
Authors: Rui-Qian Sun , Lin-Feng Gou , Zong-Yao Liu , Xiao-Bao Han
Published: November 2023

Aeroengine operation is inevitably subject to multi-source uncertainty, which consists of epistemic uncertainty related to the aeroengine and stochastic uncertainty associated with the control system. This paper presents a solution for health and performance monitoring under multi-source uncertainty to ensure the safety and reliability of aeroengine whole-life operation in complex environments. Based on the hyperelliptic Kalman filter (HeKF), optimal health monitoring is achieved by treating health parameters as the augmented state. Meanwhile, the conservativeness-reduced output prediction is realized with the extra estimation of the unknown state function bias caused by probabilistic system parameters. Considering the computational effort can be significantly reduced by designing a multi-stage filter, the three-stage hyperelliptic Kalman filter (ThSHeKF) is finally developed, achieving high accuracy health parameter estimation and adaptive performance prediction under multi-source uncertainty. Open-loop and closed-loop numerical simulations demonstrate the effectiveness of the proposed ThSHeKF-based health and performance monitoring with high estimation accuracy. Furthermore, compared to the most commonly used extended Kalman filter (EKF), Monte Carlo (MC) experiments shows that the proposed ThSHeKF is less conservative, has better robustness, and is superior in adaptive monitoring under multi-source uncertainty.
Biomimetic swirl device and hydrogen enrichment effects on LPG fueled engine
Authors: Hadjkacem Sahar , Jemni Mohamed Ali , Driss Zied , Abid Mohamed Salah
Published: November 2023

Inspired by the humpback-whale flipper which enables robust aerodynamic force production, we propose a biomimetic blade design for small Biomimetic Swirl Device (BSD) added on gaseous engine inlet system. Such system can achieve robustness in aerodynamic performance for the intake flow. Therefore, the BSD design has an important impact on swirl generation inside the engine cylinder which its geometry was defined by a wavelength, leading edge radius and amplitude. For this reason, a numerical analysis method, by means a computational fluid dynamics 3D modeling technique, was utilized to study the in-cylinder flow characteristics investigating the optimal BSD geometry. Moreover, the effect of Hydrogen on in-cylinder flow characteristics of liquefied petroleum gas (LPG) bi-fuel engine has been examined using the BSD. In this research, five designs of the BSD with the dimensionless amplitude A* varied at 0.08, 0.12, 0.16, 0.2 and 0.24 were compared with the model without BSD to investigate its effect on the air-LPG flow inside the combustion chamber. The results showed that the BSD with A* = 0.2 created more turbulence, in-cylinder velocity, swirl in the combustion chamber than the other designs. Simulation results indicated also that LPG-30% H2 blend with BSD added gives the optimal in-cylinder flow characteristics of the TKE, the velocity and the swirl ratio.