bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of Pore Structure in the Evaporated Stage of Wood-Derived Carbon
Authors: Yang Tian-Shu , Hu Jin-Bo , Yu Zhao-Yang , Liu Gong-Gang , Liu Yuan , Zhang Ming-Long , Liao Yuan-Yuan , Chang Shan-Shan
Published: June 2022

Major water loss in the first stage of wood-derived carbon preparation had a direct impact on pore structure during the subsequent pyrolysis of biochar materials. To explore the changes in pore space at this stage, poplar was used as the subject of this study. The pore morphology before
and after water evaporation was quantitatively characterized by scanning electron microscope, nitrogen adsorption method, and mercury injection method. Both the fractal dimensions of the multistage pores were obtained by the Frenkel-Halsey-Hill model and the thermodynamic relationship model.
The results showed as follows: the adsorption isotherms were presented the mixed type of II and IV after supercritical drying, indicating the mesopores and macropores of wood. The adsorption isotherms after conventional drying were characterized a type II, which was inferred to the reduced
mesopores compared to supercritical drying. The hysteresis loops of all wood samples were examined for the H3 type, which was deduced from the presence of slit-like pores. After treatment at 103±2 °C, the porosity and its connectivity properties are reduced by the mercury pressure
data. For <50 nm the pore size distribution of the samples shows a shoulder peak at around 6.5 nm. Simultaneously, the pore structure is significantly deformed and the pore size distribution produces smaller peaks at 3014 and 12510 nm. The pore fractal dimension increases in the <50
nm stage. The fractal dimension of pores decreases when the pore size is 50 nm~5 μm. Stability of the pore fractal dimension in the pore size >50 nm stage. This indicates that the conventional drying treatment made the micropore complexity increase, and leads to a reduced or invariable
pore structure complexity for the >50 nm. The fractal analysis could assist in better analyzing the changes of pore structure and provide a new perspective for studying the pore structure in the carbonation stage.
Delivery Strategy of Magnetically Targeted Nanoparticles Based on Umbilical Cord Mesenchymal Stem Cells
Authors: Tian Mei , Lian Yunfei , Gao Jing , Yu Fengxiang , Song Ge , Cao Jin , Li Juan , Ullah Aftab , Qi Xueyong
Published: June 2022

The delivery of therapeutic cancer agents via nanomaterials has received significant attention. However, because of the absence of tumour targeting, tumour treatment strategies are still not satisfactory. Umbilical cord mesenchymal stem cells are inherently prone to migrate to malignant
sites, enabling them to deliver antitumour drugs effectively. Therefore, it is expected to be a promising tool for tumour targeting. In this study, we constructed magnetic drug-loaded nanoparticles comprised of ferroferric oxide and doxorubicin, which were ingested by umbilical cord mesenchymal
stem cells and precisely delivered to the tumour sites. Here, we physicochemically characterized the nanoparticles for the particle size, biocompatibility and cellular uptake. The umbilical cord mesenchymal stem cells migration and homing ability before and after drug loading were evaluated.
The anti-cancer effect of stem cells loaded with nanoparticles was determined using MCF-7 cells. In vitro studies, the magnetic drug-loaded nanoparticles complex on tumour cells revealed that umbilical cord mesenchymal stem cells could transport magnetic drug-loaded nanoparticles to
induce robust apoptosis.
Skill of Medium-Range Forecast Models Using the Same Initial Conditions
Authors: Magnusson L. , Ackerley D. , Bouteloup Y. , Chen J.-H. , Doyle J. , Earnshaw P. , Kwon Y. C. , Köhler M. , Lang S. T. K , Lim Y.-J. , Matsueda M. , Matsunobu T. , McTaggart-Cowan R. , Reinecke A. , Yamaguchi M. , Zhou L.
Published: June 2022

In the Different Models, Same Initial Conditions (DIMOSIC) project, forecasts from different global medium-range forecast models have been created based on the same initial conditions. The dataset consists of 10-day deterministic forecasts from seven models and includes 122 forecast dates spanning one calendar year. All forecasts are initialized from the same ECMWF operational analyses to minimize the differences due to initialization. The models are run at or near their respective operational resolutions to explore similarities and differences between operational global forecast models. The main aims of this study are 1) to evaluate the forecast skill and how it depends on model formulation, 2) to assess systematic differences and errors at short lead times, 3) to compare multimodel ensemble spread to model uncertainty schemes, and 4) to identify models that generate similar solutions. Our results show that all models in this study are capable of producing high-quality forecasts given a high-quality analysis. But at the same time, we find a large variety in model biases, both in terms of temperature errors and precipitation. We are able to identify models whose forecasts are more similar to each other than they are to those of other systems, due to the use of similar model physics packages. However, in terms of multimodel ensemble spread, our results also demonstrate that forecast sensitivities to different model formulations still are substantial. We therefore believe that the diversity in model design that stems from parallel development efforts at global modeling centers around the world remains valuable for future progress in the numerical weather prediction community.
Modeled Interannual Variability of Arctic Sea Ice Cover is within Observational Uncertainty
Authors: Wyburn-Powell Christopher , Jahn Alexandra , R. England Mark
Published: June 2022

Internal variability is the dominant cause of projection uncertainty of Arctic sea ice in the short and medium term. However, it is difficult to determine the realism of simulated internal variability in climate models, as observations only provide one possible realization while climate models can provide numerous different realizations. To enable a robust assessment of simulated internal variability of Arctic sea ice, we use a resampling technique to build synthetic ensembles for both observations and climate models, focusing on interannual variability, which is the dominant time scale of Arctic sea ice internal variability. We assess the realism of the interannual variability of Arctic sea ice cover as simulated by six models from phase 5 of the Coupled Model Intercomparison Project (CMIP5) that provide large ensembles compared to four observational datasets. We augment the standard definition of model and observational consistency by representing the full distribution of resamplings, analogous to the distribution of variability that could have randomly occurred. We find that modeled interannual variability typically lies within observational uncertainty. The three models with the smallest mean state biases are the only ones consistent in the pan-Arctic for all months, but no model is consistent for all regions and seasons. Hence, choosing the right model for a given task as well as using internal variability as an additional metric to assess sea ice simulations is important. The fact that CMIP5 large ensembles broadly simulate interannual variability consistent within observational uncertainty gives confidence in the internal projection uncertainty for Arctic sea ice based on these models.

Significance Statement

The purpose of this study is to evaluate the historical simulated internal variability of Arctic sea ice in climate models. Determining model realism is important to have confidence in the projected sea ice evolution from these models, but so far only mean state and trends are commonly assessed metrics. Here we assess internal variability with a focus on the interannual variability, which is the dominant time scale for internal variability. We find that, in general, models agree well with observations, but as no model is within observational uncertainty for all months and locations, choosing the right model for a given task is crucial. Further refinement of internal variability realism assessments will require reduced observational uncertainty.
Reducing Emergency Department Length of Stay in Critically Injured Pediatric Trauma Patients: A Quality Improvement Initiative
Authors: Castle Jennifer T. , Levy Brittany E. , Wilt Wesley S. , Draus John M.
Published: June 2022

Background

Efficient transfer of adult trauma patients to the intensive care unit (ICU) is associated with decreased emergency department (ED) length of stay (ED LOS) and improved patient outcomes. While well studied in adults, quality improvement (QI) initiatives focused on the rapid transfer of pediatric trauma patients are lacking. We report the effect of institutional system changes directed at expediting the transfer of pediatric trauma patients to the pediatric ICU (PICU).

Methods

This initiative commenced in 2013. Preliminary data regarding ED LOS for pediatric trauma patients were collected from January through December 2012 as the pre-implementation cohort. Using the plan-do-study-act (PDSA) framework of QI, the first PDSA cycle was implemented in January 2013. In subsequent PDSA cycles, we implemented the mandatory attendance of the PICU charge nurse and the PICU attending physician to all highest-level pediatric trauma activations. Throughout, ED LOS was collected and mapped on a run chart. ED LOS and variance were compared between all cycles of implementation.

Results

One hundred and fifty-one pediatric patients arrived or were upgraded to the highest-level pediatric trauma activation and admitted to the PICU from 2012 through 2019. We observed a decrease in median ED LOS of 105 minutes between the pre- and post-implementation groups. With each PDSA cycle, we observed a decrease in median ED LOS and variation.

Conclusion

The inclusion of the PICU charge nurse and attending physician at highest-level pediatric trauma activations facilitated more rapid access to the PICU with decreased ED LOS.
Character and Trust in Crisis Leadership: Probing the Relationships Among Character, Identification-Based Trust, and Perceptions of Effectiveness in Political Leadership During the COVID-19 Pandemic
Authors: Seijts Gerard , de Clercy Cristine , Miller Ryan
Published: June 2022

The COVID-19 pandemic provided an opportunity to explore the relationships among character, identification-based trust, and perceptions of leadership effectiveness in the context of crisis leadership. Focusing on the leadership of Canadian Prime Minister Justin Trudeau, we first explore whether Canadians of voting age believe character is important in political leadership during the pandemic. Second, we examine voter perceptions of the importance of the dimensions of character identified by Crossan et al. (2017) and to what extent voters perceive Trudeau demonstrates the behaviors associated with these dimensions. Third, we explore the role of identification-based trust in the relationship between character and perceptions of leadership effectiveness. Fourth, we study the relationships between character, trust, and effectiveness during dynamic conditions where the stakes for citizens with respect to health and social well-being are high. The results of our study connect character to trust and perceived effectiveness of a political leader during a crisis.
Eugene Debs and the Socialist Republic
Authors: O’Shea Tom
Published: June 2022

I reconstruct the civic republican foundations of Eugene Debs’s socialist critique of capitalism, demonstrating how he uses a neo-roman conception of freedom to condemn waged labour. Debs is also shown to build upon this neo-roman liberty in his socialist republican objections to the plutocratic capture of the law and threats of violence faced by the labour movement. This Debsian socialist republicanism can be seen to rest on an ambitious understanding of the demands of citizen sovereignty and civic solidarity. While Debs shares some of the commitments of earlier American labour republican critics of capitalism, he departs from them in his thoroughgoing commitment to common democratic ownership of productive property. His socialist republicanism remains valuable today for its ability to illuminate features of plutocratic control, judicial autocracy, and the regime of property best suited to suppressing economic domination. I conclude that Debs not only deserves a prominent place in an emerging radical republican canon but presents a distinctive contrast with many of his Marxist contemporaries and offers a compelling challenge to recent liberal, plebeian, and socialist forms of republicanism.
Juvenile Probation Officer Perceptions of Parental Involvement in Juvenile Probation and With Contingency Management
Authors: Ingel Sydney N. , Davis Lynnea R. , Rudes Danielle S. , Taxman Faye S. , Hartwell Taylor N. , Drazdowski Tess K. , Mccart Michael R. , Chapman Jason E. , Sheidow Ashli J.
Published: June 2022

Probation is a common sanction for youth substance users, and as such, juvenile probation officers (JPOs) shoulder much of the burden for treatment and rehabilitation. To improve youth outcomes and alleviate some of the burden, JPOs may seek parental involvement in the probation and substance use desistance processes. Using focus group data, we analyzed JPO perceptions of the role parents play in contingency management (CM)—an incentive system designed to produce and reward decreased substance use—and whether they perceived any value in CM. We found that most JPOs perceived parental involvement as critical to the success of both substance use treatment and CM for youth. Our findings also suggest JPOs found parental involvement in CM valuable given that CM was employed on nonstudy clients and future clients. This has implications for the practicality and sustainability of CM as a youth probation intervention.
Special Issue on the Pathobiology of Laboratory Nonhuman Primates: A Review of Species, Substrain, Geographical Origin, Age, and Modality-Related Factors
Authors: Chamanza Ronnie , Amuzie Chidozie J. , Chilton Jennifer , Engelhardt Jeffery A.
Published: June 2022

Nonhuman primates (NHPs) are utilized in nonclinical safety testing due to their phylogenetic proximity to humans and similarity in physiology and anatomy. However, ethical considerations and the increased demand for NHPs, coupled with the current shortage in their supply, have increased the calls to minimize their use. In addition, the increased demand and supply shortage of NHPs have increased the use of animals sourced from different geographical origins, and animals of different ages, which can complicate the interpretation of study results. Coupled with the relative uniqueness of findings induced by novel therapeutic modalities, there is an increasing need for a deeper understanding of the systemic pathobiology of NHPs. Here we provide a brief preview of the two main themes discussed in this special issue, which include the influence of geographical origin, age, and sex on background pathology, clinical pathology reference values, other relevant toxicology endpoints, and organ system pathology.
Predictors of respiratory failure after thoracic surgery: a retrospective cohort study with comparison between lobar and sub-lobar resection
Authors: Pezzuto Aldo , Trabalza Marinucci Beatrice , Ricci Alberto , Ciccozzi Massimo , Tonini Giuseppe , D’Ascanio Michela , Guerrieri Giulio , Chianese Maria , Castelli Silvia , Rendina Erino Angelo
Published: June 2022

Objective

Only approximately 15% of patients with lung cancer are suitable for surgery and clinical postoperative outcomes vary. The aim of this study was to investigate variables associated with post-surgery respiratory failure in this patient cohort.

Methods

Patients who underwent surgery for lung cancer were retrospectively studied for respiratory function. All patients had undergone lung resection by a mini-thoracotomy approach. The study population was divided into two subgroups for comparison: lobectomy group, who underwent lobar resection; and sub-lobar resection group.

Results

A total of 85 patients were included, with a prevalence of lung cancer stage IA and adenocarcinoma histotype. Lobectomy (versus sub-lobar resection), the presence of chronic obstructive pulmonary disease (COPD), and a COPD assessment test (CAT) score >10, were all associated with an increased risk of respiratory failure. The partial pressure of arterial oxygen decreased more in the lobectomy group than in the sub-lobar resection group following surgery, with a significant postoperative between-group difference in values. Postoperative CAT scores were also better in the sub-lobar resection group.

Conclusions

Post-surgical variations in functional parameters were greater in the group treated by lobectomy. COPD, high CAT score and surgery type were associated with postoperative development of respiratory failure.
A declaration for all seasons: The IFLA Statement on Libraries and Intellectual Freedom
Authors: Byrne Alex
Published: June 2022

A quarter century after the momentous establishment of IFLA’s Committee on Free Access to Information and Freedom of Expression is an appropriate time to reflect on the landmark IFLA Statement on Libraries and Intellectual Freedom. The Statement consciously broadened IFLA’s remit, locating intellectual freedom as a fundamental human right and a core responsibility of the library profession that operates within libraries’ commitments to diversity and plurality. As the examples discussed in this essay illustrate, the Statement continues to be relevant and is truly a declaration for all seasons. The concerns to be addressed encompass an extensive range of social justice concerns – concerns that are global and cover all elements of the library and information sector. Addressing those concerns and promoting intellectual freedom demands the intervention of trusted information agents to assist communities to use the Internet wisely and for the widest possible benefit. It demands the profession’s concerted action, coupled with regular reporting and discussion in the library and information science literature. The profession has a challenging but vital role in preserving one of humanity’s most precious rights: intellectual freedom.
Development and Evaluation of Non-Traditional Pedestrian Timing Treatments for Coordinated Signalized Intersections
Authors: Gavric Slavica , Sarazhinsky Denis , Stevanovic Aleksandar , Dobrota Nemanja
Published: June 2022

Pedestrian signal timings are one of the major issues to be addressed when developing signal timing plans. So far, two different treatments of pedestrian timings for coordinated systems exist. The first treatment accommodates pedestrian timing within the cycle. Therefore, it requires longer cycle lengths that usually increase the total delay on the network. In contrast, the second treatment uses shorter cycle lengths sufficient to serve vehicular demand only. The problem with the latter is that the concurrent phase is usually not long enough to serve pedestrians. Thus, with every pedestrian call, a follow-up transition process occurs, affecting cycle lengths and coordination quality. This study develops two novel pedestrian timing treatments to overcome the problems of the traditional ones. Novel pedestrian treatments utilize a cycle length optimized to cover necessary times for vehicular phases, although pedestrian timings may require longer time intervals. However, when pedestrian calls occur, their minimum safety timings are accommodated within such a shorter cycle, and thus the transition process is not required. Our study evaluates the proposed and traditional pedestrian timing treatments using a corridor of five signalized intersections in West Valley City, Utah. Various experiments were conducted in a microsimulation environment VISSIM and collected results were statistically compared. Results show the promising property of the proposed treatments, as they outperformed the traditional pedestrian timing treatments. Therefore, further investigation of these pedestrian timing treatments is warranted. Future research should investigate possibilities of implementing similar treatments to fully actuated control systems on various networks and traffic conditions.
Book review: Jangkhomang Guite, Against State, Against History: Freedom, Resistance, and Statelessness in Upland Northeast India
Authors: Thakur Amrendra Kumar
Published: June 2022

Jangkhomang Guite, Against State, Against History: Freedom, Resistance, and Statelessness in Upland Northeast India, New Delhi: Oxford University Press, 2019, 364 pp., ₹1,095, ISBN: 9780199489411.
Rational Number Interventions for Students With Mathematics Difficulties: A Meta-Analysis
Authors: Rojo Megan , King Sarah , Gersib Jenna , Bryant Diane P.
Published: June 2022

Understanding rational numbers is critical for secondary mathematics achievement. However, students with mathematics difficulties (MD) struggle with rational number topics, including fractions, decimals, and percentages. The purpose of this systematic review was to describe the instructional foci of rational number interventions, determine the overall effect size, and explore potential moderators. Forty-three studies were included and 150 effect sizes were meta-analyzed using robust variance estimation. The majority of studies focused on teaching fraction magnitude and arithmetic. An overall effect size of g = 1.02 [0.80, 1.25] was found for rational number interventions favoring treatment conditions over business as usual control. Proximal measures contributed to higher effect sizes than distal measures. Limitations included a high number of fraction interventions contributing to the overall effect size and a large amount of heterogeneity among study effect sizes.
Just a Little Healthy Competition: Teacher Perceptions of Competition and Social Comparison in the Classroom
Authors: Goegan Lauren D. , Daniels Lia M.
Published: June 2022

The use of competition to motivate students is common but debated. The purpose of the study was: (a) to examine to whom teachers attribute the common emphasis on competition and (b) to explore the reasons teachers give to minimize competition or not in their classrooms. Teachers attribute the focus on competition least to teachers and then increasingly to students, principals, parents, and school boards. Teachers who try to minimize competition identify the importance of learning and individualization, and those who do not, promote competition as healthy and helpful. Results are discussed in terms of classroom practices and future research.
Radiomic Features Based on MRI Predict Progression-Free Survival in Pediatric Diffuse Midline Glioma/Diffuse Intrinsic Pontine Glioma
Authors: Wagner Matthias W. , Namdar Khashayar , Napoleone Marc , Hainc Nicolin , Amirabadi Afsaneh , Fonseca Adriana , Laughlin Suzanne , Shroff Manohar M. , Bouffet Eric , Hawkins Cynthia , Khalvati Farzad , Bartels Ute , Ertl-Wagner Birgit B.
Published: June 2022

Purpose: Biopsy-based assessment of H3 K27 M status helps in predicting survival, but biopsy is usually limited to unusual presentations and clinical trials. We aimed to evaluate whether radiomics can serve as prognostic marker to stratify diffuse intrinsic pontine glioma (DIPG) subsets. Methods: In this retrospective study, diagnostic brain MRIs of children with DIPG were analyzed. Radiomic features were extracted from tumor segmentations and data were split into training/testing sets (80:20). A conditional survival forest model was applied to predict progression-free survival (PFS) using training data. The trained model was validated on the test data, and concordances were calculated for PFS. Experiments were repeated 100 times using randomized versions of the respective percentage of the training/test data. Results: A total of 89 patients were identified (48 females, 53.9%). Median age at time of diagnosis was 6.64 years (range: 1–16.9 years) and median PFS was 8 months (range: 1–84 months). Molecular data were available for 26 patients (29.2%) (1 wild type, 3 K27M-H3.1, 22 K27M-H3.3). Radiomic features of FLAIR and nonenhanced T1-weighted sequences were predictive of PFS. The best FLAIR radiomics model yielded a concordance of .87 [95% CI: .86–.88] at 4 months PFS. The best T1-weighted radiomics model yielded a concordance of .82 [95% CI: .8–.84] at 4 months PFS. The best combined FLAIR + T1-weighted radiomics model yielded a concordance of .74 [95% CI: .71–.77] at 3 months PFS. The predominant predictive radiomic feature matrix was gray-level size-zone. Conclusion: MRI-based radiomics may predict progression-free survival in pediatric diffuse midline glioma/diffuse intrinsic pontine glioma.
An improved target-oriented path planning algorithm for wheeled mobile robots
Authors: Jin Ye , Yue Ming , Li Weijie , Shangguan Jinyong
Published: June 2022

This paper proposes a target posture-oriented path planning method, where an improved A* algorithm and an optimized dynamic windows approach (DWA) are used at the global and local planning aspects, respectively. The method enables wheeled mobile robots (WMRs) to plan an optimal path under different posture situations which can shorten the time of achieving navigation task in certain scene. On the hand of global path planning, target posture and orientation information are added into A* algorithm to obtain appropriate path. At the level of local path planning, based on DWA, evaluation functions are optimized to make the robot movement adapting to curve global path and dynamic obstacle. By introducing rotation index to evaluate experiment results, the tests verify that WMRs can reasonably plan more efficient path compared with traditional path planning method, by satisfying various posture demand with the aid of the proposed target posture-oriented A* algorithm, and quickly avoid dynamic obstacles via the optimized DWA. Therefore, the proposed algorithm can be effectively applied to WMRs to execute various target posture demands navigation tasks.
Intensive, telemedicine-based, self-management program for rural, underserved patients with diabetes mellitus: Re-entry of retired endocrinologists into practice
Authors: Santen Richard J , Nass Ralf , Cunningham Cindy , Horton Carla , Yue Wei
Published: June 2022

Introduction

Endocrinology workforce data demonstrate a substantial gap in the number of practicing endocrinologists, a phenomenon particularly affecting patients with diabetes in rural, financially challenged, underserved areas. We evaluated the concept that retired endocrinologists could re-enter practice part time and utilize telemedicine in collaboration with personnel in Federally Qualified Community Health Center clinics to conduct an intensive self-management program and provide 6-month concurrent care for patients with diabetes.

Methods

The program involved intensive glucose control measures and education in diabetes, nutrition, and lifestyle changes over a 6-month period. Key elements included comprehensive initial telehealth evaluations, frequent phone calls, and collaboration with certified diabetes care and education specialists, referring providers, referring-clinic staff, and the University of Virginia Telehealth Center.

Results

The mean A1C in the 139 patients completing the 6-month self-management program decreased from 10.3 ± 1.94% to 7.78 ± 1.51% p < 0.0001. The number of treatment modalities per patient ranged from one to five with several different regimens utilized. The majority of patients maintained the reduction in A1C levels without recidivism over a mean follow-up of 16 months after discharge. Strategies using meal replacements are being implemented to facilitate weight loss.

Discussion

This program resulted in improved A1C levels of patients with diabetes in rural, financially challenged, underserved areas; met recidivism goals; and provided a practical template to reduce the workforce gap of endocrinologists in those areas.
Nudging towards news diversity: A theoretical framework for facilitating diverse news consumption through recommender design
Authors: Mattis Nicolas , Masur Philipp , Möller Judith , van Atteveldt Wouter
Published: June 2022

Growing concern about the democratic impact of automatically curated news platforms urges us to reconsider how such platforms should be designed. We propose a theoretical framework for personalised diversity nudges that can stimulate diverse news consumption on the individual level. To examine potential benefits and limitations of existing diversity nudges, we conduct an interdisciplinary literature review that synthesises theoretical work on news selection mechanisms with hands-on tools and implementations from the fields of computer science and recommender systems. Based thereupon, we propose five diversity nudges that researchers and practitioners can build on. We provide a theoretical motivation of why, when and for whom such nudges could be effective, critically reflect on their potential backfire effects and the need for algorithmic transparency, and sketch out a research agenda for diversity-aware news recommender design. Thereby, we develop concrete, theoretically grounded avenues towards facilitating diverse news consumption on algorithmically curated platforms.
Finite-difference analysis of stresses of a non-uniform functionally graded material circular disk rotating in the magneto-thermal environment: An equal mass study
Authors: Sarkar Pranta Rahman , Rahman Akm Samsur
Published: June 2022

The stress field of a functionally graded material rotating disk is studied for different cases of non-uniform thickness variation in the magneto-thermal environment. Three different cases of thickness variation are considered by assuming the variation of non-uniform thickness profiles to be linear, rational, and exponential functions of radius. The mass of the functionally graded material disk is considered equal in all cases of uniform/non-uniform thickness variation. The finite-difference method is used to obtain the numerical results for an Al/Al2O3 functionally graded material disk of fixed-free boundary conditions. The resultant thermo-elastic analysis has shown that the decrease in outer end thickness significantly increases circumferential stress at that end. In the absence of a magnetic field, for the disk with thin outer end thickness minimum stress intensity can be found with linearly varying thickness profile, and high intensity of circumferential stress in case rational and exponential variation of thickness profiles can significantly be reduced with an optimum magnetic field. The transient stress fields and the effect of material properties are also analyzed in detail. All the analyses showed that along with affecting the magnitude, the presence of the magnetic field changes the location and nature of maximum stress in the disk. Finally, results are compared with the finite-element method and available analytical results to verify the analysis.
Epidemiology, Treatment, and Outcome of Pancreatic Squamous Cell Carcinoma and Pancreatic Adenocarcinoma: A Propensity Score-Matching Analysis Based on SEER-Database
Authors: Wang Yuqing , Zhou Yuwen , Chen Yueyun , Xia Ruolan , Liu Jiyan
Published: June 2022

Background: Pancreatic squamous cell carcinoma (PSCC) is a rare pancreatic malignancy compared to most common pancreatic adenocarcinoma (PAC). Aims: To analyze the prognostics factors of PSCC and compare PAC with PSCC in demographic patterns, clinicopathologic characteristics and treatment modalities. Methods: Data of PSCC and PAC patients from January 1, 2004 to December 31, 2015 were extracted from Surveillance, Epidemiology and End Results (SEER) database for case-control study. Kaplan-Meier method and Cox proportional hazards analysis were used in survival analysis. A 1:3 propensity-score matching (PSM) was performed to compare the overall survival (OS) and cancer specific survival (CSS) between PAC and PSCC in each variable. Results: PAC patients (n = 38 968) and PSCC patients (n = 124) were analyzed. After PSM, 372 PAC patients and 124 PSCC patients were obtained. PSCC tends to happen to elders, white and female with a predilection site of pancreatic head, followed by tail, then body. PSCC have a higher proportion to be poorly differentiated and metastatic when diagnosed. The prognosis of PSCC patients was significantly worse than PAC patients in both univariate and multivariate analyses. Surgery and chemotherapy were independent prognostic factors for PSCC. Conclusions: PSCC patients were identified associated with a worse prognosis than PAC patients. PSCC tend to be poorly differentiated and more easily to be metastatic. Surgery and chemotherapy may be effective therapies to improve the OS of PSCC significantly.
Anti-oxidant Effect of High Dilutions of Arnica montana, Arsenicum Album, and Lachesis Mutus in Microglial Cells in Vitro
Authors: Paumier Anne , Verre Justine , Tribolo Sandra , Boujedaini Naoual
Published: June 2022

Microglial cells play important roles in inflammatory responses. The level of oxidative stress is a well-known marker of inflammation. Homeopathic medicines are often used clinically to alleviate inflammation. We evaluated the anti-oxidative effect of high dilutions of Arnica montana (Arnica m.), Arsenicum album (Arsenicum a.), and Lachesis mutus (Lachesis m.) on production of reactive oxygen species (ROS) in inflamed microglial cells in vitro. Microglial cells, on exposure to lipopolysaccharide (LPS), have induced production of ROS compared with resting cells. The dilutions significantly reduced the oxidative stress by decreasing the level of ROS produced. Arnica m. 1C, 3C, 5C, 7C, 9C, and 30C dilutions had a range of ROS reduction between 15 and 42.1%; Arsenicum a. 3C, 5C, 7C, 15C, and 30C dilutions had a range of ROS reduction between 17.6 and 35.3%; and Lachesis m. 3C, 5C, 7C, 9C, 15C, and 30C dilutions had a range of ROS reduction between 25 and 41.7%. To summarize, the dilutions with the greatest effect were Arnica m. 1C (42.1%), Arsenicum a. 30C (35.3%), and Lachesis m. 7C (41.7%). Arnica m., Arsenicum a., and Lachesis m. did not have the same effect on ROS production and were not dose-dependent.
Risk factors and prediction algorithm for advanced neoplasia on screening colonoscopy for average-risk individuals
Authors: Ukashi Offir , Pflantzer Barak , Barash Yiftach , Klang Eyal , Segev Shlomo , Yablecovitch Doron , Kopylov Uri , Ben-Horin Shomron , Laish Ido
Published: June 2022

Background:

Screening with colonoscopy for all average-risk population is probably not cost-effective due to the limited sources and over-generalization of the risk, and risk stratification can be used to optimize colorectal cancer screening.

Objectives:

We aimed to assess risk factors for advanced neoplasia (AN) and a classification tree algorithm to predict the risk.

Design:

This is a retrospective cross-sectional study.

Methods:

This study was composed of consecutive asymptomatic average-risk individuals undergoing first screening colonoscopy between 2008 and 2019. Detailed characteristics including background diseases, habits, and medications were collected. We used multivariable logistic regression to investigate the associations between clinical variables and the presence of AN and built a classification algorithm to predict AN.

Results:

A total of 3856 patients were included (73.2% male, median age 55). Adenoma and AN detection rate were 15.8% and 3.4%, respectively. On multivariable analysis, predictors of AN [odds ratio (OR), 95% confidence interval (CI)] were age (1.04, 1.01–1.06, p = 0.003), male sex (2.69, 1.56–4.64, p < 0.001), and smoking (1.97, 1.38–2.81, p  < 0.001). A classification tree algorithm showed that smoking was the most important risk factor for prediction of AN (4.9% versus 2.4%, p < 0.001), followed by age with a cutoff value of 60 in the smokers (8.4% versus 3.8%, p = 0.001) and 50 in the non-smokers (2.9% versus 0.9%, p = 0.004).

Conclusion:

Smoking habits, old age, and male gender are highly associated with an increased risk for AN and should be incorporated in the individualized risk-assessment to adapt a screening program.
Design and validation of a new scale for prehospital evaluation of stroke and large vessel occlusion
Authors: Shao Yanqi , Zhang Zheyu , Jin Bo , Xu Jingsi , Peng Deqing , Geng Yu , Zhang Jungen , Zhang Sheng
Published: June 2022

Background:

Rapid recognition of acute stroke and large vessel occlusion (LVO) is essential in prehospital triage for timely reperfusion treatment.

Objective:

This study aimed to develop and validate a new screening tool for both stroke and LVO in an urban Chinese population.

Methods:

This study included patients with suspected stroke who were transferred to our hospital by emergency medical services between July 2017 and June 2021. The population was randomly partitioned into training (70%) and validation (30%) groups. The Staring-Hypertension-atrIal fibrillation-sPeech-weakneSs (SHIPS) scale, consisting of both clinical and medical history information, was generated based on multivariate logistic models. The predictive ability of the SHIPS scale was evaluated and compared with other scales using receiver operating characteristic (ROC) curve comparison analysis.

Results:

A total of 400 patients were included in this analysis. In the training group ( n = 280), the SHIPS scale showed a sensitivity of 90.4% and specificity of 60.8% in predicting stroke and a sensitivity of 75% and specificity of 61.5% in predicting LVO. In the validation group ( n = 120), the SHIPS scale was not inferior to Stroke 1-2-0 ( p = 0.301) in predicting stroke and was significantly better than the Cincinnati Stroke Triage Assessment Tool (C-STAT; formerly CPSSS) and the Prehospital Acute Stroke Severity scale (PASS) (all p < 0.05) in predicting LVO. In addition, including medical history in the scale was significantly better than using symptoms alone in detecting stroke (training group, 0.853 versus 0.818; validation group, 0.814 versus 0.764) and LVO (training group, 0.748 versus 0.722; validation group, 0.825 versus 0.778).

Conclusion:

The SHIPS scale may serve as a superior screening tool for stroke and LVO identification in prehospital triage. Including medical history in the SHIPS scale improves the predictive value compared with clinical symptoms alone.
Racial and ethnic differences in the pharmacologic management of osteoarthritis: rapid systematic review
Authors: Vina Ernest R. , Tsoukas Philip H. , Abdollahi Shahrzad , Mody Nidhi , Roth Stephanie C. , Redford Albert H. , Kwoh C. Kent
Published: June 2022

Background:

Racial and ethnic disparities in osteoarthritis (OA) patients’ disease experience may be related to marked differences in the utilization and prescription of pharmacologic treatments.

Objectives:

The main objective of this rapid systematic review was to evaluate studies that examined race/ethnic differences in the use of pharmacologic treatments for OA.

Data sources and methods:

A literature search (PubMed and Embase) was ran on 25 February 2022. Studies that evaluated race/ethnic differences in the use of OA pharmacologic treatments were included. Two reviewers independently screened titles and abstracts and abstracted data from full-text articles. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Results:

The search yielded 3880 titles, and 17 studies were included in this review. African Americans and Hispanics were more likely than non-Hispanic Whites to use prescription non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for OA. However, compared to non-Hispanic Whites with OA, African Americans and Hispanics with OA were less likely to receive a prescription for cyclooxygenase-2-selective NSAIDs and less likely to report the use of joint health supplements (i.e. glucosamine and chondroitin sulfate). There were minimal/no significant race/ethnic differences in the patient-reported use of the following OA therapies: acetaminophen, opioids, and other complementary/alternative medicines (vitamins, minerals, and herbs). There were also no significant race differences in the receipt of intra-articular therapies (i.e. glucocorticoid or hyaluronic acid). However, there is limited evidence to suggest that African Americans may be less likely than Whites to receive opioids and intra-articular therapies in some OA patient populations.

Conclusion:

This systematic review provides an overview of the current pharmacologic options for OA, with a focus on race and ethnic differences in the use of such medical therapies.
Remote Research: Resources, Intervention Needs, and Methods in People with Diabetes and Peripheral Neuropathy
Authors: Bohnert Kathryn L. , Zellers Jennifer A. , Jeong Hyo Jung , Chen Ling , York Alexa , Hastings Mary K.
Published: June 2022

Background:

Stay-at-home orders associated with the SARS-CoV-2 (COVID-19) pandemic were particularly important for older adults with type 2 diabetes, at risk for severe COVID-19 complications. In response, research shifted to remote telehealth methodology. Study participant interests, equipment needs, and ability to adapt methods to the remote/telehealth environment were unknown. Study purposes to assess (1) resource needs (internet/devices accessibility), (2) future telehealth interests, and (3) ability to adapt common research and clinical measures of glycemic control, physical function, activity measures, and quality of life outcomes to a telehealth setting.

Method:

Twenty-one participants with type 2 diabetes and peripheral neuropathy were recruited from a longitudinal study (11 female; age: 66.3 ± 8.3 years; DM: 15.1 ± 8.7 years). Technology needs and future telehealth interests were assessed. A glycemic measure (HbA1c), a five-times chair rise, a one-week activity monitor, and surveys (self-efficacy, depression, and balance) were collected. All aspects of the study were completed remotely over email and video/phone call.

Results:

Twelve participants used computers; nine used phones for study completion. Participants had the following resource needs: connectivity (n = 3), devices (n = 6), and technical support (n = 12). Twenty people expressed interest in participating in future telehealth studies related to balance, exercise, and diabetes management. Methodological considerations were primarily the need for assistance for participants to complete the home HbA1c test, five-time chair rise, wearable activity monitoring, and surveys.

Conclusions:

Older adults with type 2 diabetes and peripheral neuropathy would need technological and personal assistance (connection, device, guidance) to complete a long-term telehealth intervention. Despite technology needs, participants were interested in telehealth interventions.

Clinical Trial:

Parent study, “Metatarsal Phalangeal Joint Deformity Progression—R01 (NCT02616263) is registered at https://clinicaltrials.gov/ .
Insulin Requirements for Basal and Auto-Correction Insulin Delivery in Advanced Hybrid Closed-Loop System: 4193 Days’ Real-World Data of Children in Two Different Age Groups
Authors: Karakuş Kağan Ege , Yeşiltepe Mutlu Gül , Gökçe Tuğba , Eviz Elif , Can Ecem , Muradoğlu Serra , Hatun Şükrü
Published: June 2022

Background:

The insulin requirements of people with type 1 diabetes (T1D) can vary throughout the day due to factors such as biorhythm, exercise, and food intake. The MiniMed 780G system delivers micro boluses to adjust basal insulin and delivers auto-correction boluses to meet insulin needs when micro bolus increases are insufficient. Through analysis of MiniMed 780G data, this study investigates the variations in insulin requirements throughout the day.

Methods:

4193 days’ pump and continuous glucose monitoring (CGM) data of 34 children using MiniMed 780G were collected from Medtronic CareLink. Micro and auto-correction boluses were analyzed on an hourly basis for two age groups: below nine years old and above nine years old. Glycemic metrics were analyzed based on International CGM consensus.

Results:

The mean age was 12.3 years and mean duration of diabetes was 6.1 years. The mean time in range (TIR) and glucose management indicator (GMI) were 80.5% and 6.6%, respectively. The micro bolus (basal) ratio between 05.00 and 07.00 was significantly higher than the ratio between 10.00 and 03.00 ( P < .01), whereas micro bolus was significantly lower between 19.00 and 21.00 than those between 00.00 and 10.00 ( P < .001). The auto-correction ratio between 21.00 and 00.00 was significantly higher than those between 03.00-17.00 ( P < .001) and 19.00-21.00 ( P = .008), whereas auto-correction was significantly lower between 07.00 and 10.00 than those between 10.00 and 03.00 ( P < .001). The micro bolus ratio was significantly higher in children below nine years old than in children above nine years old between 21.00-00.00 ( P = .026) and 00.00-03.00 ( P = .003).

Conclusion:

The basal insulin need follows a diurnal pattern with two significantly different periods—high between 00.00 and 10.00 and low between 10.00 and 00.00. The auto-correction rates are low between 05.00 and 10.00 and show an increasing pattern peaking between 21.00 and 00.00. These findings are compatible with the dawn and reverse dawn phenomena.
Management of Open Ankle Fractures in Elderly Patients With a Fibula Nail is a Safe and Reliable Technique
Authors: Odeh Abdulrahman , Archer James , Budair Basil , Marsh Alastair , Fenton Paul
Published: June 2022

Background:

Ankle fractures are becoming more common in the elderly and their management is frequently challenging. There is increasing evidence of good outcomes following fibula nail fixation in the management of ankle fractures. The use of a fibula nail in open fractures comes with potential advantages such as minimal soft tissue dissection, early rehabilitation, and decreased wound complications. We aimed to assess their use in the management of open ankle fractures in the elderly.

Methods:

A review of patients aged 60 years or older with an open ankle fracture treated with a fibular nail at a major trauma center was conducted. All patients were managed with joint Orthopaedic and Plastic Surgical input to determine their optimal management. Functional outcome scores, postoperative complications, and re-operation rates were determined.

Results:

Fifteen patients were identified with a mean age of 76 years. Patient-reported outcomes (Olerud and Molander Score) were calculated in 73% of patients. Our results demonstrated excellent outcome scores (>91) in 1 patient, good outcome scores (61-90) in 7 patients, and fair outcome scores (31-60) in 3 patients. There were no postoperative complications or re-operations within our study group.

Conclusion:

This article is the largest series presenting the outcomes of fibula nails in the management of open ankle fractures in elderly patients. We conclude that it can be used as a treatment option to safely manage open ankle fractures in the elderly. It provides a stable fixation, early weight-bearing, low risk of postoperative complications while maintaining good patient-reported functional outcomes.

Level of Evidence:

Level 4
Concurrent facial nerve palsy and uvula deviation after paediatric dental rehabilitation–A case report
Authors: Long Melody Huiyi , Khor Melissa Mei-Yi , Challa Satish Kumar Reddy
Published: June 2022

Introduction

Facial nerve palsy is a rare, but known complication resulting from local anaesthesia (LA) infiltration during dental surgery. Its incidence is reported to be 1–1.1%, with short or long-term effects.

Case Report

A 6 years old well child underwent elective dental rehabilitation under general anaesthesia. For extractions, he received LA infiltration to the anterior part of the hard palate. In the immediate post-operative period, he presented with left sided facial droop and uvula deviation to the left with no hoarseness of voice or ptosis. His neurological symptoms resolved within 3 h of the administration of LA. He was reviewed on the same day by the paediatric neurologist. No further investigations were required. He was discharged well the next day.

Conclusion

Transient facial nerve palsy and uvula deviation, while rare, can occur after a dental procedure. For paediatric patients, the neurologist’s input helps with parental assurance.