bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-yielding deflection calculation of flexural hybrid reinforced concrete with a combination of fiber reinforced polymer and steel bars
Authors: Liu Shui , Wang Xin , Ding Lining , Zhong Bin , Huang Huang , Wu Zhishen
Published: June 2024

Flexural hybrid reinforced concrete members with fiber reinforced polymer (FRP) and steel bars (hybrid-RC) exhibit significant post-yielding stiffness due to the contribution of tensile FRP bars. To predict the post-yielding deflection of hybrid-RC members, the Bischoff’s model for effective moment of inertia is extended into the post-yielding stage. Based on this extended model, expressions for equivalent moment of inertia, which consider the variation in stiffness along the member span with and without tension stiffening, are proposed. Obtaining close-formed solutions for the yielding moment of hybrid-RC cross sections, a critical parameter for determining the post-yielding effective moment of inertia, proves challenging due to the unknown state of compressive concrete. Therefore, a simplified equation to determine the yielding moment are proposed by regression of data derived from numerical sectional analyses. An experimental database including 92 hybrid-RC beams collected from published literature is established. The performance of the proposed equation for the yielding moment and expressions for the equivalent moment of inertia are evaluated using the database. The results indicate that the proposed equation can effectively predict the yielding moments of hybrid-RC beams. Furthermore, using a constant effective moment for predicting the post-yielding deflection is effective for the specimens with relatively high reinforcement ratios. The benefit of considering the stiffness variation along the member span is evident when dealing with lightly-reinforced concrete members.
Contents analysis of telemedicine applications in South Korea: An analysis of possibility of inducing selective or unnecessary medical care
Authors: Ju HyoRim , Seo Donghee , Kim Soojeong , Choi Juyoung , Kang EunKyo
Published: June 2024

The use of telemedicine and telehealth has rapidly increased since the start of the COVID-19 pandemic, however, could lead to unnecessary medical service. This study analyzes the contents of telemedicine apps (applications) in South Korea to investigate the use of telemedicine for selective or unnecessary medical treatments and the presence of advertising for the hospital. This study analyzed 49 telemedicine mobile apps in Korea; a content analysis of the apps’ features and quality using a Mobile Application Rating Scale was done. The study analyzed 49 mobile telemedicine apps and found that 65.3% of the apps provide immediate telemedicine service without reservations, with an average rating of 4.35. 87% of the apps offered selective care, but the overall quality of the apps was low, with an average total quality score of 3.27. 73.9% of the apps were able to provide selective care for alopecia or morning-after pill prescription, 65.2% of the apps for weight loss, and 52.2% of the apps for erectile dysfunction, with the potential to encourage medical inducement or abuse. Therefore, before introducing telemedicine, it is helpful to prevent the possibility of abuse of telemedicine by establishing detailed policies for methods and scope of telemedicine.
Longitudinal evaluation of an electronic audit and feedback system for patient safety in a large tertiary hospital setting
Authors: Soresi James , Murray Kevin , Marshall Theresa , Preen David B
Published: June 2024

Objective: This study sought to assess the impact of a novel electronic audit and feedback (e-A&F) system on patient outcomes. Methods: The e-A&F intervention was implemented in a tertiary hospital and involved near real-time feedback via web-based dashboards. We used a segmented regression analysis of interrupted time series. We modelled the pre-post change in outcomes for the (1) announcement of this priority list, and (2) implementation of the e-A&F intervention to have affected patient outcomes. Results: Across the study period there were 222,792 episodes of inpatient care, of which 13,904 episodes were found to contain one or more HACs, a risk of 6.24%. From the point of the first intervention until the end of the study the overall risk of a HAC reduced from 8.57% to 4.12% - a 51.93% reduction. Of this reduction the proportion attributed to each of these interventions was found to be 29.99% for the announcement of the priority list and 21.93% for the implementation of the e-A&F intervention. Discussion: Our findings lend evidence to a mechanism that the announcement of a measurement framework, at a national level, can lead to local strategies, such as e-A&F, that lead to significant continued improvements over time.
Sowing “seeds of doubt”: Cottage industries of election and medical misinformation in Brazil and the United States
Authors: Hassoun Amelia , Borenstein Gabrielle , Osborn Katy , McAuliffe Jacob , Goldberg Beth
Published: June 2024

We conducted ethnographic research with 31 misinformation creators and consumers in Brazil and the United States before, during, and after a major election to understand consumption and production of election and medical misinformation. This study contributes to research on misinformation ecosystems by focusing on poorly understood “micro-influencers” who create misinformation in peer-to-peer networks. We detail four key tactics that micro-influencers use. First, they disseminate “gray area” content rather than expert-falsified claims, using aesthetic and rhetorical tactics to evade moderation. Second, they post in small, closed groups where members feel predisposed to trust content. Third, they target consumers’ emotional and social needs. Finally, they post high volumes of short, repetitive content to plant “seeds of doubt” and build trust. We discuss the implications these micro-influencers have for misinformation interventions and platforms’ efforts to moderate misinformation.
Conceptualising risk-taking in educational settings for enabling pedagogies of courage
Authors: Cooke Mandy
Published: June 2024

Despite education discourses promoting risk-taking as a positive character trait, Australia has been identified as one of the most risk-averse countries in the developed world. This begs the question, why are Australians so risk averse? One reason may be a lack of common language and understanding about risk-taking, and an absence of risk-taking culture, in Australian educational settings. In this article, I continue an ongoing conversation about risk and risk-taking in educational contexts. I explore use of these terms in general education discourse and formal Australian education documents, revealing some positive inclusions and concerning silences. To help address the silences, I introduce the terms pedagogical risk-taking and pedagogies of courage. I propose these terms and their associated accounts as a framework for helping build a culture of risk-taking in educational settings – a shift that will help more Australian's embrace risk-taking for the benefit of individuals, the environment and society.
Development and prima facie validation of the Dementia-Specific Ethical Self-Efficacy scale for professional caregivers
Authors: Schou-Juul Frederik , Ferm Lucca-Mathilde Thorup , Boje Ida Rübot , Rise Jens Elmelund , Skov Sofie Smedegaard , Ritz Christian , Lauridsen Sigurd
Published: June 2024

Aim

To develop and validate a scale for measuring professional caregivers’ ethical self-efficacy in dementia care.

Background

Professional caregivers of people with dementia make ethical decisions on a day-to-day basis, and it is important that they feel confident when doing so. Moreover, confidence, or self-efficacy, influences caregivers’ behaviour and well-being and may be a predictor of competence. However, there is no scale for measuring ethical self-efficacy. This study aims to fill this gap.

Methods

This study concerns the development and prima facie validation of the Dementia-Specific Ethical Self-Efficacy (DemESE) scale. During development, we identified dementia-specific ethical principles and generated items representing ethical conflicts of principles. In the subsequent validation, we administered the scale to experts and professional caregivers in dementia care. We assessed the relevance of the scale using a content validity index and tested validity and reliability using Cronbach’s alpha. To further enhance validity, we compared the scale with analogous self-efficacy scales using Pearson’s correlation coefficient.

Results

The quantitative testing of DemESE revealed that the scale exhibited acceptable levels of internal consistency and reliability. This finding was supported by Cronbach’s alpha. In addition, the content validity index and Pearson correlation coefficient provided evidence of the scale’s relevance and validity.

Conclusion

The results suggest that DemESE is a promising tool for assessing professional caregivers’ ethical self-efficacy in dementia care and may be used to measure ethical self-efficacy – that is, confidence in ethical decision-making in dementia care.
A hierarchical Bayesian model updating method for bridge structures by fusing multi-source information
Authors: Luo Lanxin , Song Mingming , Li Yixian , Sun Limin
Published: June 2024

The expanding structural health monitoring (SHM) systems on bridge structures have provided an abundance of multi-source data for finite element model updating (FEMU). The SHM systems on bridges usually include surveillance cameras, vibration sensors (e.g., accelerometers, strain gauges, and displacement sensors), and sometimes a weight-in-motion (WIM) system. Currently, the majority of FEMU studies focus on identified modal parameters derived from vibration data, neglecting the incorporation of video and WIM data in the updating process, which impedes a thorough quantification of uncertainty associated with the structural parameters of interest. Therefore, this paper proposes a hierarchical Bayesian FEMU framework to comprehensively integrate a variety of information sources, including videos, WIM, and vibration data. The data features comprise the static deflections of the bridge under traffic load and modal parameters identified from acceleration measurements. The measured static deflections are extracted from raw displacement data using the locally weighted regression and smoothing scatterplots method. Computer vision-based technology is employed to pinpoint the location of vehicle load on the bridge, which is then integrated into a FEM to predict vehicle-load-induced static deflection. A two-stage Markov Chain Monte Carlo sampling approach is proposed to evaluate the high-dimensional posterior distribution efficiently. The effectiveness of the proposed method is demonstrated on a laboratory three-span bridge model. The results show that the hierarchical Bayesian FEMU can provide accurate estimation and uncertainty quantification on structural stiffness and mass parameters. The updated model accurately predicts both static deflection and modal parameters, exhibiting model-predicted variability in close alignment with the identified values for observed and unobserved responses. Remarkably, this holds true even for unseen loading conditions which are not included in the updating process. These observations validate the capability of the proposed method for multi-source data fusion and uncertainty quantification of real-world bridge structures under operational conditions.
Level-Headed: Correlating Antiseizure Medication Drug Concentrations With Adverse Effects and Seizure Response
Authors: Terman Samuel Waller
Published: June 2024

[Box: see text]
Shining a Light: Advancing Health Equity in Overlooked Epilepsy Communities
Authors: Kiriakopoulos Elaine T. , García Sosa Rebecca , Blank Leah , Johnson Emily L. , Gutierrez Camilo
Published: June 2024

Achieving equitable health in epilepsy requires addressing systemic barriers and social determinants of health to ensure that every person with epilepsy has the opportunity to attain their highest level of health. We review the literature on disparities that affect several minoritized groups living with epilepsy. Early solutions with the potential for modeling towards replication for low socioeconomic status population, non-English language preference communities, sexual and gender minorities, and rural and underserved communities with high social determinants of health burden are shared as examples to catalyze stakeholder investment in identifying and addressing health disparities across the spectrum of epilepsy at both the provider and health systems level. Further support for innovative research is needed to better delineate epilepsy prevalence, treatment access, and health outcomes among diverse populations. These data are essential for enabling the development and testing of evidence-based approaches that lessen disparities and support health equity for individuals impacted by epilepsy.
Comparison of Childless and Partnerless Vasectomy Rates Before and After Dobbs v. Jackson Women’s Health Organization
Authors: Nguyen Vi , Li Michelle K. , Leach Michelle C. , Patel Darshan P. , Hsieh Tung-Chin
Published: June 2024

The Supreme Court ruling Dobbs v. Jackson Women’s Health Organization (June 2022) overturned federal protection of abortion rights, resulting in significant impact on both male and female reproductive rights and health care delivery. We conducted a retrospective review of all patients who underwent vasectomy at a single academic institution between June 2021 and June 2023. Our objective was to compare the rates of childless and partnerless vasectomies 1 year before and after this ruling, as these men may be more susceptible to postprocedural regret. Of total, 631 men (median age = 39 years, range = 20–70) underwent vasectomy consultation. Total vasectomies pre- and post-Dobbs were 304 (48%) versus 327 (52%). Total childless and partnerless vasectomies pre- and post-Dobbs were 44 (42%) versus 61 (58%) and 43 (46%) versus 50 (54%). Vasectomy completion rate was slightly increased post-Dobbs (90% vs. 88%; p = .240). The post-Dobbs cohort had significantly less children (1.8 vs. 2.0; p = .031). Men in the post-Dobbs era were significantly more likely to be commercially insured (72% vs. 64%) and less likely to be uninsured (1% vs. 6%; p = .002). Men who underwent childless vasectomy were significantly more likely to be younger (36.4 vs. 39.8 years; p < .001). There was a significantly greater proportion of Hispanic and Black men in the partnerless cohort compared to the cohort with partners (24% vs. 19% and 9% vs. 2%; p = .002). In conclusion, patients should be counseled on the permanent nature of this procedure, underscoring need for effective and reversible male contraception.
Predictors of overall mortality after endovascular abdominal aortic repair – A single centre study
Authors: RAŠIOVÁ Mária , KOŠČO Martin , PAVLÍKOVÁ Veronika , HUDÁK Marek , MOŠČOVIČ Matej , KOČAN Ladislav
Published: June 2024

Objectives

A current and ongoing challenge is to reduce patient mortality after endovascular abdominal aortic repair (EVAR). This study aimed to assess the predictors of all-cause mortality after EVAR.

Methods

Data regarding the demographic characteristics, comorbidities, laboratory values, selected anatomical factors, post-EVAR treatment, surveillance and complications of patients who underwent elective EVAR for non-ruptured abdominal aortic aneurysm (AAA) between January 2010 and January 2021 were evaluated. Mortality was assessed until 10 October 2023. Multivariate analyses were performed after adjusting for age, hypertension, diabetes mellitus, dyslipidaemia, sex, smoking, number of lumbar arteries, patency of inferior mesenteric artery (IMA), IMA diameter and reinterventions.

Results

This study included 196 patients (183 men and 13 women) with a mean age of 72.4 ± 7.67 years. The overall mortality rate during a mean follow-up period of 5.75 ± 3.1 years was 50.0% ( N = 98). The 2-, 5- and 10-year mortality rates were 9.7%, 32.0% and 66.6%, respectively. The mortality rates decreased by 59% in patients with reinterventions (hazard ratio [HR]: 0.41; 95% confidence interval [CI]: 0.23–0.73; p = .002) and by 59% in patients treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (HR: 0.41; 95% CI: 0.26–0.66; p < .001). Chronic anticoagulation was associated with 2.09-fold higher mortality (HR: 2.09; 95% CI: 1.19–3.67; p = .010), and coronary artery disease (CAD) was associated with 1.74-fold higher mortality (HR: 1.74; 95% CI: 1.09–2.78; p = .021). Pre-EVAR AAA diameter and 1-year post-EVAR sac diameter were positively associated with mortality (HR: 1.05; 95% CI: 1.03–1.08; p < .001, and HR: 1.05; 95% CI: 1.03–1.07; p < .001, respectively), that is, an increase of pre-EVAR and/or 1-year post-EVAR AAA diameter by 1 mm was associated with a 5% higher risk of all-cause mortality.

Conclusions

Reinterventions and treatment with ACE inhibitors or ARBs may be associated with decreased post-EVAR mortality. A greater pre-EVAR, a post-EVAR AAA diameter, CAD and chronic anticoagulation were associated with higher all-cause mortality post-EVAR.
Scaling and interpreting treatment effects in clinical trials using restricted mean survival time
Authors: Karrison Theodore , Hu Chen , Dignam James
Published: June 2024

Background:

Restricted mean survival time is the expected duration of survival up to a chosen time of restriction [Formula: see text]. For comparison studies, the difference in restricted mean survival times between two groups provides a summary measure of the treatment effect that is free of assumptions regarding the relative shape of the two survival curves, such as proportional hazards. However, it can be difficult to judge the magnitude of the effect from a comparison of restricted means due to the truncation of observation at time [Formula: see text].

Methods:

In this article, we describe additional ways of expressing the treatment effect based on restricted means that can be helpful in this regard. These include the ratio of restricted means, the ratio of life-years (or time) lost, and the average integrated difference between the survival curves, equal to the difference in restricted means divided by [Formula: see text] These alternative metrics are straightforward to calculate and provide a means for scaling the effect size as an aid to interpretation. Examples from two randomized, multicenter clinical trials in prostate cancer, NRG/RTOG 0521 and NRG/RTOG 0534, with primary endpoints of overall survival and biochemical/radiological progression-free survival, respectively, are presented to illustrate the ideas.

Results:

The four effect measures (restricted mean survival time difference, restricted mean survival time ratio, time lost ratio, and average survival rate difference) were 0.45 years, 1.05, 0.81, and 0.038 for RTOG 0521 and 1.36 years, 1.17, 0.56, and 0.12 for RTOG 0534 with [Formula: see text] = 12 and 11 years, respectively. Thus, for example, the 0.45-year difference in the first trial translates into a 19% reduction in time lost and a 3.8% average absolute difference between the survival curves over the 12-year horizon, a modest effect size, whereas the 1.36-year difference in the second trial corresponds to a 44% reduction in time lost and a 12% absolute survival difference, a rather large effect.

Conclusions:

In addition to the difference in restricted mean survival times, these alternative measures can be helpful in determining whether the magnitude of the treatment effect is clinically meaningful.
Incidence of recurrent and chronic pancreatitis after acute pancreatitis: a systematic review and meta-analysis
Authors: Gagyi Endre-Botond , Teutsch Brigitta , Veres Dániel Sándor , Pálinkás Dániel , Vörhendi Nóra , Ocskay Klementina , Márta Katalin , Hegyi Péter Jenő , Hegyi Péter , Erőss Bálint
Published: June 2024

Background:

Acute pancreatitis (AP) has a high incidence, and patients can develop recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) after AP.

Objectives:

We aimed to estimate the pooled incidence rates (IRs), cumulative incidences, and proportions of RAP and CP after AP.

Design:

A systematic review and meta-analysis of studies reporting the proportion of RAP and CP after AP.

Data sources and methods:

The systematic search was conducted in three (PubMed, EMBASE, and CENTRAL) databases on 19 December 2023. Articles reporting the proportion of RAP or CP in patients after the first and multiple episodes of AP were eligible. The random effects model was used to calculate the pooled IR with 95% confidence intervals (CIs). The I2 value assessed heterogeneity. The risk of bias assessment was conducted with the Joanna Briggs Institute Critical Appraisal Tool.

Results:

We included 119 articles in the quantitative synthesis and 29 in the IRs calculations. Our results showed that the IR of RAP in adult patients after AP was 5.26 per 100 person-years (CI: 3.99–6.94; I2 = 93%), while in children, it was 4.64 per 100 person-years (CI: 2.73–7.87; I2 = 88%). We also found that the IR of CP after AP was 1.4 per 100 person-years (CI: 0.9–2; I2 = 75%), while after RAP, it increased to 4.3 per 100 person-years (CI: 3.1–6.0; I2 = 76%). The risk of bias was moderate in the majority of the included studies.

Conclusion:

Our results showed that RAP affects many patients with AP. Compared to patients with the first AP episode, RAP leads to a threefold higher IR for developing CP.

Trial registration:

Our protocol was registered on PROSPERO (CRD42021283252).
Unveiling the Anti-Diabetic Potential: A Comparative Study on the Vitamin and Amino Acid Profiles of Bioactive Compounds in Fermented and Raw Tamarind (Tamarindus indica L) Seeds
Authors: Nwanna Esther Emem , Aro Olayemi Philemon , Ogunsuyi Opeyemi Babatunde , Shodehinde Sidiqat A , Oboh Ganiyu
Published: June 2024

Objectives

Previous study have shown that the seeds of the tamarind tree ( Tamarindus indica) have anti-diabetic properties without any evidence on the processing method. This present study was carried out to investigate the effect of fermentation on antioxidant as well as anti-diabetic properties of Tamarind ( Tamarindus indica) seeds.

Methods

The sample was pulverized after five days of typical fermentation alongside raw sample and examined for its antioxidant and anti-diabetic properties. Antioxidant assays such as FRAP, ABTS, NO, and DPPH were carried out to determine the in-vitro inhibitory effects on diabetes-related enzymes α-amylase and α-glucosidase, while amino acids, proximate and minerals content were carried out.

Results

The findings revealed that fermentation changed the antioxidant properties of the seed powder. While total phenols and flavonoids decreased, inhibition was observed with α-amylase and α-glucosidase, although raw has higher results. Interestingly, the analysis of 18 amino acids on raw and fermented samples indicated an increase value with fermentation. Moreover, there were elevations in Zn, Mn, K, and vitamins C, D, E, and B1.

Conclusion

In summary, the study indicates that tamarind fermented seed powder holds promise for exerting anti-diabetic effects, likely due to its rich content of amino acids and vitamins endowed with antioxidant properties.
The utility of procalcitonin for identifying secondary infections in patients with influenza or COVID-19 receiving extracorporeal membrane oxygenation
Authors: Patel Kajal D. , Aden James K. , Sobieszczyk Michal J. , Marcus Joseph E.
Published: June 2024

Background:

Identifying secondary infections in patients receiving extracorporeal membrane oxygenation (ECMO) presents challenges due to the ECMO circuit’s influence on traditional signs of infection.

Objectives:

This study evaluates procalcitonin as a diagnostic marker for secondary infections in patients receiving ECMO with influenza or COVID-19 infection.

Design:

Single-center retrospective cohort study.

Methods:

All adult patients receiving veno-venous ECMO with underlying influenza or COVID-19 from November 2017 to October 2021 were included. Patient demographics, time receiving ECMO, culture data, and procalcitonin levels were examined. The first procalcitonin within 3 days of infection was compared to negative workups that were collected at least 10 days from the last positive culture. Furthermore, we compared procalcitonin levels by the type of pathogen and site of infection.

Results:

In this study, 84 patients with influenza or COVID-19 who received ECMO were included. A total of 276 procalcitonin labs were ordered in this cohort, with 33/92 (36%) of the secondary infections having an associated procalcitonin value. When comparing procalcitonin levels, there was no significant difference between the infection and negative workup groups [1 ng/mL (interquartile ranges, IQR: 0.4–1.2) versus 1.3 (0.5–4.3), p = 0.19]. Using 0.5 ng/mL as the cut-off, the sensitivity of procalcitonin was 67% and the specificity was 30%. In our cohort, the positive predictive value of procalcitonin was 14.5% and the negative predictive value was 84%. There was no difference in procalcitonin by type of organism or site of infection. Procalcitonin levels did not routinely decline even after an infection was identified.

Conclusion:

While procalcitonin is a proposed potential diagnostic marker for secondary infections in patients receiving ECMO, this single-center study demonstrated low sensitivity and specificity of procalcitonin in identifying secondary infections. Furthermore, there was no association of procalcitonin levels with etiology of infection when one was present. Procalcitonin should be used cautiously in identifying infections in veno-venous ECMO.
A review of dolutegravir-associated weight gain and secondary metabolic comorbidities
Authors: Jemal Mohammed
Published: June 2024

Dolutegravir is an integrase inhibitor and is recommended by the World Health Organization as the preferred first-line and second-line human immunodeficiency virus treatment in all populations. Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully understood. Growing evidence shows that this leads to a higher incidence of hyperglycemia, hypertension, and metabolic syndrome, along with elevated cardiovascular risk. Dolutegravir-based regimens, also associated with greater adipocyte differentiation and greater expression of markers associated with lipid storage, continue to be a problem among patients living with human immunodeficiency virus. The mechanisms by which certain antiretroviral therapy agents differentially contribute to weight gain remain unknown. Some clinical investigators speculate that dolutegravir could interfere with central nervous system appetite regulation (melanocortin-4 receptor) and insulin signaling, or may have better penetration of adipose tissue where they could exert a direct impact on adipose tissue adipogenesis, fibrosis, and insulin resistance. This review summarizes our current understanding of weight gain and fat changes associated with dolutegravir and its possible secondary metabolic comorbidities.
Tele-ECG improves diagnosis of acute coronary syndrome and ST-elevation myocardial infarction in Côte d’Ivoire
Authors: Diby K. F. , Gnaba A. , Ouattara P. , Ayegnon G. , Coulibaly A. , Tro G. , Dakoi S. A. , Sall F. , Adoubi A. , N’guessan K. E. , Ehua S. F. , Ohannessian R. , Moulin T.
Published: June 2024

Introduction

The emergence of cardiovascular risk factors in sub-Saharan Africa suggests an increasing incidence of acute coronary syndromes and STEMI. The aim of the study was to define the prevalence of STEMI and to describe the characteristics of patients diagnosed with STEMI within the tele-electrocardiogram (ECG) network in Côte d’Ivoire.

Method

A retrospective study was conducted from January 2015 to August 2019. All adult patients managed by one of the six hospitals within the telemedicine network who benefited from a remote interpretation of their ECG by the cardiology department of Bouaké University Hospital were included. The main reason for ECG interpretation, patient and ECG characteristics, diagnosis, response time and treatment were described.

Results

A total of 5649 patients were included. The prevalence of STEMI was 0.7% ( n = 44 cases) with a mean age of 58.6 ± 11.8 years and a M/F sex ratio of 1.93. Among STEMI patients, chest pain was the main reason for ECG testing (56.8%). Most ECGs were interpreted within 12 hours (72.8%). The anterior inter-ventricular artery location (59.1%, n = 26) was predominant. The Q wave of necrosis was absent in 18% ( n = 8) of cases. All patients received double anti-platelet aggregation and 50% ( n = 22) additional heparin therapy. No patient underwent primary angioplasty or thrombolysis, 65.9% ( n = 29) were referred to the Bouaké Cardiology Department and 34.1% ( n = 15) to the Abidjan Heart Institute. Scheduled angioplasty was performed in 20% ( n = 3) of patients in Abidjan.

Conclusion

Tele-ECG was an effective means of STEMI screening in Côte d’Ivoire. Systematic telethrombolysis of all patients diagnosed could improve their prognosis.
Nerva, a mobile application of gut-directed hypnotherapy for irritable bowel syndrome: User characteristics, patterns of use, and predictors of persistence
Authors: Simicich Lauren , Muniz Vanessa , Scheffrahn Katherine , Elkins Gary
Published: June 2024

Background

Hypnotic intervention for irritable bowel syndrome (IBS), or gut-directed hypnotherapy (GDH), is an effective treatment for improving IBS symptoms with minimal burden and risk in delivery to patients. The Nerva app, developed by Mindset Health, shows promise for dissemination and implementation of evidence-based GDH intervention for IBS.

Objectives

This study aimed to describe the demographic and clinical characteristics of Nerva app users, examine usage patterns, and explore potential factors associated with Nerva app usage.

Methods

A retrospective analysis of data was conducted of 14,898 individuals who downloaded and used the Nerva app between January 2022 and September 2022. Descriptive statistics and Chi-square tests of independence were calculated to examine demographic/clinical characteristics, usage patterns, and their associations to program persistence. Simple linear regression models were used for correlations of GI symptoms severity scores to user persistence.

Results

Users predominantly identified as female (77.2%; n = 11,503) and had a mean age of 38.59 years old ( SD = 13.38). Thirty-one percent of users persisted with the program, and a small statistically significant association was found between Nerva app program persistence and age, χ2 (6, N = 6745) = 164.82, p < 0.001, V = .16.

Conclusions

The present study found promising adherence rates for the Nerva app program within the first six weeks of use. Statistics in prevalence estimates of IBS agree with previous literature and significant associations were found between user/clinical characteristics and Nerva app program persistence.
A gamified cognitive behavioral therapy for Arabs to reduce symptoms of depression and anxiety: A case study research
Authors: Amer Nourhan A. , Shohieb Samaa M. , Eladrosy Waleed , Liu Shilong , Nam Yunyoung , Abdelrazek Samir
Published: June 2024

Background

Depression and anxiety are prevalent mental health issues addressed by online cognitive behavioral therapy (CBT) via mobile applications. This study introduces Sokoon, a gamified CBT app tailored for Arabic individuals, focusing on alleviating depression and anxiety symptoms (DASDs).

Objectives

The objectives of this study were to: Evaluate the effectiveness of Sokoon in reducing symptoms of depression and anxiety. Assess the usability of the intervention through user engagement and adherence to CBT skills.

Methods

A single-group pre–post design evaluated Sokoon's impact on adults with DASDs. In consultation with psychiatrists, Sokoon integrates evidence-based skills such as relaxation, gratitude, behavioral activation, and cognitive restructuring, represented by planets. Its design incorporates Hexad theory and gamification, supported by a dynamic difficulty adjustment algorithm. The study involves 30 participants aged 18–35 (86.7% female), specifically those with mild to moderate depression and anxiety.

Results

Based on a sample of 30 participants, Sokoon, a smartphone-based intervention, significantly reduced symptoms of depression and anxiety (d = 2.7, d = 3.6, p < 0.001). Over a two-week trial, participants experienced a notable decrease in anxiety and depressive symptoms, indicating the effectiveness of the model. Sokoon shows potential as a valuable tool for addressing DASDs.

Conclusion

Sokoon, the gamified CBT application, offers an innovative approach to increasing CBT skills adherence and engagement. By leveraging Hexad theory and gamification, Sokoon provides an enjoyable and engaging user experience while maintaining the effectiveness of traditional CBT techniques. The study findings suggest that Sokoon has a positive impact on reducing symptoms of depression and anxiety.
The history of Huawei in Italy through the lens of corporate nationality
Authors: Negro Gianluigi
Published: June 2024

This article aims to provide a historical dimension of the Italian public opinion on Huawei, and vice versa of the Chinese perception of Huawei’s role in Italy. Through a qualitative content analysis, the author examines Italian newspapers framing on Huawei as well as Chinese newspapers framing on the Italian telecommunication market before and after and after the signature of China—Italy memorandum of understanding in 2019. The research provides a periodization of three stages that highlights the evolution of the Chinese company in Italy and examines to what extent its activities can fit within the paradigm of imperialist actions. Based on a historical perspective, this contribution examines the perception of China’s digital infrastructure outside the Chinese borders, while also focusing on policy imaginaries through the corporate nationality theory and analyzing the rhetoric of “nationality” applied to a specific organizational behavior in the aggregation of different communities.
The Effects of Blended Learning Environment on College Students’ Learning Effectiveness: Exploring the Role of Behavioral Intentions and Self-Efficacy Through the UTAUT2 Model
Authors: Lv Na , Li Zhigang
Published: June 2024

With the rise of “Internet + Education,” blended learning has become a new trend in higher education. This study aims to explore how behavioral willingness and self-efficacy affect the learning effect of college students in this new learning mode. The Unified Theory of Acceptance and Use of Technology (UTAUT2) was used to construct a theoretical model, and data on the blended learning effectiveness of 167 college students from a university in Southwest China were collected through questionnaires, and the theoretical assumptions and model were verified using Structural Equation Modeling (SEM) in Smart PLS software. It was found that in blended learning, performance expectation, effort expectation, hedonic motivation and facilitation all significantly and positively affect college students’ behavioral intention of blended learning, which in turn positively affects the effect of blended learning, among which hedonic motivation is a more important influencing factor in the behavioral intention of blended learning. Self-efficacy also has a significant positive effect on blended learning effects. Finally, the study proposes countermeasures for teaching improvement from three aspects: teachers’ teaching design, students’ motivation and behavior, and optimization of e-learning platform content and function.
Art Students’ Technostress, Perceived Usefulness, Satisfaction, and Continuance Intention to Use Mobile Educational Applications
Authors: Wang Xinyi , Yu Xiaofan
Published: June 2024

Although learning with mobile educational applications (apps) has become popular in higher education, the factors accounting for students’ voluntary continuous usage have not yet been investigated fully. This study aims to understand art students’ continuance intention by combining the expectation-confirmation model (ECM) and the effect of technostress. A research model was proposed and verified with a sample of 339 undergraduates who majored in art from two Chinese universities. The results of structural equation modeling indicated that: (a) both perceived usefulness and satisfaction directly predict continuance intention, while perceived usefulness indirectly predicts continuance intention through the mediating effect of satisfaction; (b) Technostress has a direct negative effect on both perceived usefulness and continuance intention, but has no direct effect on satisfaction; (c) Technostress indirectly influence students’ continuance intention through the mediator of perceived usefulness and satisfaction. The theoretical and practical implications based on the findings are discussed.
An Understanding of Malaysian Cinemagoers in the Post COVID-19 Era by Using a Computational Ontology
Authors: Changsong Wang , Jinghong Low , Tan Poh Ling Aleena , Sukiman Muhammad Afiq Bin , Kerry Lucyann
Published: June 2024

Since the first phase of the lockdown in Malaysia, the cinema has been the place which best exemplifies the implementation of the control order in the venue-based sectors. After almost 2 years of physical distancing and lifestyle changes, the authority attempted to bring a new form of “ normal life” to its residents. Such a decision witnessed more economic sectors were permitted to reopen, cinema among them. This study employed a mixed-method approach which aims to identify the emerging factors which inform about Malaysian audiences’ perception of cinema-going in the context of the COVID-19 pandemic. It examines the audiences with the help of the Theory of Planned Behavior (TPB) as this theory claims that people are more likely to act in a certain way if they feel certain behaviors will lead to specific results that are in keeping with their values. This study identified the attitude toward cinema reopening and readiness toward visiting cinema are able to significantly predict all the related factors of cinemagoers’ willingness in the post COVID-19 era. The results informed on the concerns of their family members, friends, and those with whom they have regular physical contact have become the agent of decision-making in terms of cinema-going.
The 70 Years of Legal Education in China from 1949 to 2023: Historical Development, Current Issues and Future Innovations
Authors: Song Yuxia , Fan Haotian
Published: June 2024

China’s modern legal education system, characterized by its development over more than seven decades since the founding of New China, has undergone distinct stages including the initial period, stagnation and frustration, restoration and development, comprehensive development, and innovation and development. Based on both empirical and case studies, this article identifies issues in China’s modern legal education system such as the imbalanced distribution of educational resources, inadequacy in theoretical and practical teaching methods, as well as insufficient training for foreign-related legal talents. To address these challenges effectively, this article proposes innovative approaches, including deepening collaboration between academia and industry to narrow regional disparities in education provision; enhancing scenario-based applications of artificial intelligence (AI), the metaverse and other emergent technologies within the field of legal education; as well as aligning the goal of cultivating legal talents with global trends through comprehensive reform strategies. This article aims to offer a novel pathway for Chinese legal education to embrace globalization, while at the same time presenting a new paradigm for international scholars studying Chinese legal education.
Association between elevated fibrosis-4 index of liver fibrosis and risk of hemorrhagic stroke
Authors: Parikh Neal S. , Zhang Cenai , Bruce Samuel S. , Murthy Santosh B. , Rosenblatt Russell , Liberman Ava L. , Liao Vanessa , Kaiser Jed H. , Navi Babak B. , Iadecola Costantino , Kamel Hooman
Published: June 2024

Background:

Cirrhosis is associated with an increased risk of hemorrhagic stroke. Liver fibrosis, typically a silent condition, is antecedent to cirrhosis. The objective of this study was to test the hypothesis that elevated Fibrosis-4 (FIB-4) index, indicating a high probability of liver fibrosis, is associated with an increased risk of hemorrhagic stroke.

Methods:

We performed a cohort analysis of the prospective United Kingdom Biobank cohort study. Participants 40–69 years old were enrolled between 2007 and 2010 and had available follow-up data until March 1, 2018. We excluded participants with prevalent hemorrhagic stroke or thrombocytopenia. High probability of liver fibrosis was defined as having a value >2.67 of the validated FIB-4 index. The primary outcome was hemorrhagic stroke (intracerebral or subarachnoid hemorrhage), defined based on hospitalization and death registry data. Secondary outcomes were intracerebral and subarachnoid hemorrhage, separately. We used Cox proportional hazards models to evaluate the association of FIB-4 index >2.67 with hemorrhagic stroke while adjusting for potential confounders including hypertension, alcohol use, and antithrombotic use.

Results:

Among 452,994 participants (mean age, 57 years; 54% women), approximately 2% had FIB-4 index >2.67, and 1241 developed hemorrhagic stroke. In adjusted models, FIB-4 index >2.67 was associated with an increased risk of hemorrhagic stroke (HR, 2.0; 95% CI, 1.6–2.6). Results were similar for intracerebral hemorrhage (HR, 2.0; 95% CI, 1.5–2.7) and subarachnoid hemorrhage (HR, 2.2; 95% CI, 1.5–3.5) individually.

Conclusions:

Elevated FIB-4 index was associated with an increased risk of hemorrhagic stroke.
Public perceptions and expectations of urban park environments on children’s play: A GIS and text mining analysis on children’s activity in Atlanta’s parks using social media data
Authors: Yang Jue , Mu Lan , Grigsby-Toussaint Diana S
Published: June 2024

Outdoor activities confer mental, physical, and social health benefits to children. In urban areas, parks are vital for children to engage in outdoor activities. Understanding public perceptions and expectations of how urban park environments influence children’s activity could attenuate social and physical inequities and promote park use. Previous studies have used surveys and observational data to analyze preferences for children’s activity in parks. Crowdsourced online data and volunteered geographic information (VGI) could offer a valuable addition to or substitute for traditional approaches. Our study uses social media as a passive data collection method to ascertain public perceptions and expectations about children’s activity in Atlanta parks with a shorter timeframe, compared to a regular survey analysis. We collected 4026 Google Map reviews from 2017 to 2022 that related to children and applied text mining analysis to understand how people perceive children’s activity in Atlanta parks and how perceptions change across different environments. Ten topics were extracted that related to children’s activity in Atlanta parks: attitude, amenity, safety, social, pet, nature, recreational, water sports, water recreational, and sports. The attitude, social, and water recreational topics were the most widely discussed topics in all settings. However, in racially diverse and low-crime environments, discussions centered on pet, recreational, and sports, suggest the importance of tailored strategies to promote children’s activities in parks. Park planners and policymakers can use this approach and findings to evaluate and advocate for children’s activities in urban parks. Also, our work helps to expand survey analysis with passive data collection methods from small geographic scales to larger areas and to apply geoanalytics of big data and social media data in investigation research.
New methods for old questions: Predicting historical urban renewal areas in the United States
Authors: Xu Wenfei
Published: June 2024

Mid-20th century urban renewal in the United States was transformational for the physical urban fabric and socioeconomic trajectories of neighborhoods and its displaced residents. However, there is little research that systematically investigates its impacts due to incomplete national data. This article uses a multiple-model machine learning method to discover 204 new Census tracts that were likely sites of federal urban renewal, highway construction related demolition, and other urban renewal projects between 1949 and 1970. It also aims to understand the factors motivating the decision to “renew” certain neighborhoods. I find that race, housing age, and homeownership are all determinants of renewal. Moreover, by stratifying the analysis along neighborhoods perceived to be more or less risky, I also find that race and housing age are two distinct channels that influence renewal.
Methodological rift: Applying infrastructure activism's ‘skin in the game’ embodied art research methods to urban green infrastructure planning
Authors: Solomon Debra , Kaika Maria
Published: June 2024

In this article, we explore the extent to which applying embodied, ‘skin in the game’ methods used in infrastructure activism (a contemporary art practice) can help expand the toolkit of methods applied in action research on infrastructures, interactions between humans and more-than-humans and urban socio-environmental processes in planning. In particular, we focus on two cases of infrastructure activism: the Amsterdam Zuidoost Food Forest (VBAZO), in Amsterdam's South East, and the KRATER project in Ljubljana's city centre. In our discussion of these projects, we explore the embodied research practices that infrastructure activists have developed to change not only urban green infrastructures but also researcher-actors’ own perspectives.
Artificial Intelligence and Personality: Large Language Models’ Ability to Predict Personality Type
Authors: Murphy Max
Published: June 2024

Micro-targeting, which is when messages are specifically tailored to an individual based on the information that can be derived from their digital footprint, has become a prevalent practice in digital spaces. This communicative approach often centers around personality, the rationale being that individuals resonate with messages differently depending on their personality type. There has been research into whether machine learning methods can improve the detection of personality types, but insufficient analysis has focused on whether large language models enhance this technique even further. And so, this study examines the ability of GPT-3.5 and GPT-4, two of the models underpinning OpenAI's ChatGPT, to classify personality type. Using a publicly available dataset collected through the ‘PersonalityCafe’ forum, this paper found that GPT-3.5 and GPT-4 were able to perfectly classify 73% and 76% of the sample's personality type, respectively, simply by analyzing an individual's 50 most recent tweets—a level which is significantly better than random guessing and other machine learning models. This has important implications for communication scholarship because if LLMs enable actors to detect personality types more accurately, micro-targeting could become even more powerful and widespread. There is also a possibility for misuse by bad actors and privacy threats, so understanding these mechanisms is crucial for building safe artificial intelligence systems and safeguards against this.