bluuebunny/crossref_metadata_2025 huggingface dataset:
Gun Violence in the COVID-19 Era: Using Multiple Databases to Describe the Experience in Buffalo, NY
Authors: L’Huillier Joseph C. , Nordin Andrew B. , Nair Veer V. , Cantor Brittany L. , Tadlock Bryan , Friend Brianna , Boccardo Joseph D. , Yu Jihnhee , Lukan James , Lillvis Denise F. , Bass Kathryn D.
Published: December 2024

Objectives

In 2020, the public health crises of gun violence and novel coronavirus (COVID-19) collided and interventions to decrease COVID-19 transmission displaced millions of Americans from normal activity. We analyzed the effects of COVID-19 and its resultant shutdowns on gun violence in Buffalo, NY.

Methods

We queried the Gun Violence Archive (GVA) and the hospital databases from the 2 level 1 trauma centers which serve Buffalo firearm victims between March 15th and June 24th, 2020 (“COVID”) and the same time period for years 2013 (hospital data)/2014 (GVA data) through 2019 (“pre-COVID”) and 2021 through 2022 (“post-COVID”). Data points collected included number of daily victims, victim age, gender, and morbidity/mortality. Bivariate and multivariate analyses were used to compare gun violence in these 3 periods.

Results

There were 518 and 913 victims in the GVA and hospital data sets, respectively. Bivariate analyses showed fewer incidents on Saturdays during the pandemic in both data sets ( P < 0.05). Multivariate analyses demonstrated no association between number of gun violence victims and time period in either data set ( P > 0.05).

Conclusions

There was no change in number of gun violence victims during the COVID-19 shutdowns compared to pre-COVID and post-COVID periods in Buffalo, NY. However, there was a change in the weekly temporality of gun violence during the COVID pandemic. Multiple databases are needed to accurately capture gun violence from an epidemiologic perspective.
The use of peripheral blood biomarkers for predicting the risk of immune-related adverse events in immune checkpoint inhibitor therapy
Authors: Duvall Louise E
Published: December 2024

Background

Immune checkpoint inhibitors (ICIs) have revolutionised oncology care, by enhancing the body’s T cell lymphocyte response against tumour cells. ICIs block the inhibitory signalling between tumour cells and the immune system, but consequently reduce immunological tolerance. Subsequently for some, this leads to immune-related adverse events (irAE), a spectrum term for autoimmune-like toxicities induced by ICIs that affects various tissues and organs. This limited narrative review will give a brief overview of immune checkpoint inhibitors and immune-related adverse events for laboratory professionals and review the current evidence for predictive biomarkers.

Methods

A limited narrative review was conducted by accessing Pubmed and Google from June 2023 to January 2024 to identify references published from database inception to January 2024. Language was restricted to English.

Results/findings

Professional guidance does not recommend any biomarkers for irAE prediction. Some studies have found an association between the prediction of irAE and interleukin six (IL-6), C-reactive protein (CRP), thyroid stimulating hormone (TSH), albumin, ferritin, full blood count metrics, and lactate dehydrogenase (LDH). However, these have often been single-centre retrospective studies. While an abundance of societal guidance has been produced, it is unclear what blood tests should be included within a baseline profile.

Conclusions

Presently, there is no singular biomarker routinely available in clinical laboratories that can predict the onset of irAE. A custom battery of tests may be more predictive, but evidence is currently lacking. In the meantime, due to the clinical significance of these complications, laboratory professionals should proactively support prospective studies.
God hasn’t died, it has merely been encapsulated – Psilocybin and ayahuasca in the psychedelic renaissance: Intersections between religion, indigenous cosmologies, spirituality, and science
Authors: SCURO Juan
Published: December 2024

This article traces the trajectories of psilocybin and ayahuasca in the context of the psychedelic renaissance. The bibliometric analysis reveals that academic publications on psilocybin fall primarily into the medical and scientific areas, whereas those devoted to ayahuasca derive mainly from humanities and social sciences. Second, the article argues that psilocybin and ayahuasca use is undergoing a process of secularization, leading to psychedelic use that is increasingly removed from its traditional cultural roots. This secularization manifests itself differently in the two cases: Psilocybin exhibits a higher degree of secularization than ayahuasca. Ayahuasca maintains strong ties to religious institutions and indigenous organizations deeply involved in its global spread, and it has undergone less medicalization than psilocybin. While the careful attention to setting in psilocybin clinical trials is noteworthy, this doesn’t necessarily imply an emphasis on traditional mushroom use settings. On the other hand, a form of ‘ayahuasca guardianship’ persists, manifested in individuals and groups actively maintaining and asserting their cultural authority over the plant’s significance and associated practices.
Down fabrics’ water-repellent modification and process optimization using the Taguchi method and grey relational analysis
Authors: Wang Jui-Wen , Ahmad Naveed , Kuo Chung-Feng Jeffrey
Published: December 2024

Down fabrics are the most natural form of thermal insulation due to their notable breathability. However, the primary issue with down jackets is their limited waterproofness. This study focuses on the down water-repellent process to improve the water-repellent qualities. The first stage discusses the single-quality optimization of process parameters using the Taguchi method. The down water-repellent process parameters for the experiment include the detergent, water-repellent agent, bridging agent and glacial acetic acid. The corresponding down fabric quality characteristics are water-repellent time, elasticity and oxygen number. The second stage was multi-quality optimization using Taguchi-based grey relational analysis. A grey relational grade is determined from the grey analysis. The optimized process parameters simultaneously led to a higher water-repellent, higher elasticity and lower oxygen number then verified through a confirmation experiment. According to experimental verification, the optimal process parameter combinations are: detergent concentration is 0.08% of bath ratio, weight ratio of water-repellent agent to down fabric is 5%, weight ratio of bridging agent to down fabric is 3% and glacial acetic acid concentration is 0.03% of the bath ratio. The corresponding optimal quality characteristics were: water repellency time of 120 min, elasticity of 18.4 cm/30 g and oxygen number of 0.8 mg/100 g. These were compared with the International Down and Feather testing laboratory standards used by the industry, which are water-repellent time of 60 min, elasticity of 14.5 cm/30 g and oxygen number of 10 mg/100 g. This study’s optimized water-repellent process’s qualities are much better than the industrial spec requirements for down fabrics.
Effect of curing process on the structure and properties of paper-based friction materials
Authors: Wang Yuxiang , Zhang Chunhui
Published: December 2024

As one of the three main components of paper-based friction materials, resin plays a crucial role in determining the material’s performance. Resin behavior varies under different curing conditions, affecting its properties and the overall performance of the material. To find the optimal curing process for paper-based friction materials, we studied the curing process and mechanism of polyamide-modified phenolic resin (PA–PF composite resin) and examined how the curing process influences the structure and properties of these materials. The findings indicate that paper-based friction materials cured at 160°C for 60 minutes show the highest fiber/resin interface bonding strength, with a tensile strength of 14.4 MPa, shear strength of 1.3 MPa, and a strength retention rate of 99.2% after reaching a stable permanent deformation rate. These materials also demonstrate stable dynamic mechanical thermal performance, including a storage modulus of 2758.6 MPa, a cross-linking density of 146343 mol/m³, and a glass transition temperature of 205.7°C. Furthermore, they have excellent compression resilience, with a low permanent deformation rate of 4.1%, and show a uniform pore distribution with a porosity rate of 57.1%. The wear rate is measured at 0.3 × 10−8 cm³/N · m, and the average dynamic friction coefficients are 0.3, 0.1, and 0.1 at pressures of 0.5 MPa, 1.9 MPa, and 3.0 MPa, respectively, with dynamic/static friction coefficient ratios of 0.9, 0.9, and 0.8.
Protocol for duplex ultrasound study of the pelvic veins in women
Authors: Gavrilov Sergey G , Moskalenko Yekaterina P , Kulikov Valery M , Chubchenko Sergey V , Karalkin Anatoly V
Published: December 2024

The article presents the technique of duplex ultrasound study (DUS) of the pelvic veins in patients with pelvic venous disorders (PeVDs). It provides basics of anatomy of pelvic veins and describes hemodynamic and anatomical parameters that should be assessed during DUS of pelvic veins.
Study on the use of intravascular ultrasound-guided coronary intravascular lithotripsy compared with rotational atherectomy: a single-center, retrospective study
Authors: Li Ben , Li Jiaxing , Hu Guangxin , Zhang Shichang , Ren Yongkang , Li Mingyang , Li Yinping , Jia Shaobin
Published: December 2024

Objective

This study aimed to compare the efficacy and safety of intravascular ultrasound (IVUS)-guided coronary intravascular lithotripsy and rotational atherectomy in treating severe coronary artery calcification.

Methods

A retrospective analysis of 60 patients who underwent percutaneous coronary intervention at the General Hospital of Ningxia Medical University from October 2022 to August 2023 was conducted. The patients were divided into two groups: 30 received IVUS-guided coronary intravascular lithotripsy and 30 underwent IVUS-guided rotational atherectomy. The primary endpoints comprised angiographic thrombolysis in myocardial infarction III flow and <30% stenosis post-percutaneous coronary intervention, and IVUS metrics, such as >80% stent expansion, avoiding high plaque burden or lipid-rich plaques, minimizing malapposition <0.4 mm/1 mm, and preventing tissue prolapse and dissection. Safety was assessed by complications and 1- and 6-month postoperative major adverse cardiovascular event rates.

Results

The primary endpoint was achieved in both groups. The treatment efficacy was 100% in all cases. At 1 and 6 months post-procedure, there was no significant difference in major adverse cardiovascular events, acute myocardial infarction, or stent thrombosis between the two groups.

Conclusion

IVUS-guided coronary intravascular lithotripsy is a safe and effective alternative to rotational atherectomy, potentially reducing certain complications.
Novel strategy for comprehensive therapy with sustainably complete response in a patient with limited-stage small cell lung cancer: a case report
Authors: Jiang Jianing , Gao Jinqi , Ben Jing , Wang Gang , Duan Wenqi , Liu Hao , Jin Qianchen , Wang Ruoyu , Lv Jinyan
Published: December 2024

Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor with the poorest prognosis among all types of lung cancer. Developing an effective comprehensive strategy remains a key focus. We herein present the first documented case of a 68-year-old man with limited-stage SCLC who has maintained a complete response (CR) for over 30 months to date. CR was achieved with first-line chemotherapy using etoposide and carboplatin combined with chest volumetric-modulated arc therapy. Maintenance therapy with anlotinib extended the progression-free survival to 20 months after first-line therapy. When resistance developed, second-line therapy with albumin-bound paclitaxel, carboplatin, and the immune checkpoint inhibitor durvalumab sustained CR for 7 months. Third-line therapy with etoposide and cisplatin combined with durvalumab has maintained CR to date.
Relationship between leukocyte count and renal function in patients with lupus nephritis: a retrospective study of Chinese adults
Authors: Chen Jianyu , Cao Rong , Guo Jianying , Liu Yang , Hu Haofei , Wan Qijun
Published: December 2024

Objective

To explore the relationship between leukocyte count and renal function in patients with lupus nephritis (LN).

Methods

We performed a retrospective cross-sectional study of 100 patients with LN admitted to the Department of Nephrology between 1 January 2015 and 30 December 2023. Based on tertile of leukocyte count, they were allocated to Low, Medium, or High groups. The demographic, clinical, and pathologic characteristics of the groups were compared and the relationship between leukocyte count and renal function was analyzed using multiple linear regression analysis.

Results

After adjustment for age, albumin, 24-hour proteinuria, serum complement factor 3, hemoglobin, blood pressure, systemic lupus erythematosus disease activity index score, and histologic parameters, a linear relationship was identified between leukocyte count and renal function (regression coefficient −2.852; 95% confidence interval: −5.161, −0.543). Therefore, for every 1 × 109/L increase in leukocyte count, the estimated glomerular filtration rate would decrease by 2.85 mL/minute.

Conclusion

There is an independent linear relationship between leukocyte count and renal function. Leukocyte recruitment into the kidney is a critical step in the progression of LN, and as the leukocyte count increases, renal function gradually declines. Leukocyte count may represent a sensitive biomarker of the progression and prognosis of LN.
Different doses of dexmedetomidine combined with propofol for older adults undergoing cardiac surgery: the impact on postoperative delirium
Authors: Wang Hong , Han Hong , Leng Yufang , Yao Jiaxi
Published: December 2024

Objective

This study retrospectively investigated the effects of different doses of dexmedetomidine combined with propofol on postoperative delirium in older adults undergoing cardiac surgery.

Methods

The medical records of 82 older adults undergoing cardiac surgery admitted to two hospitals between August 2019 and August 2022 were analyzed. The participants were divided into two groups based on the dexmedetomidine dose: group A (0.5 µg/kg dexmedetomidine + propofol) and group B (1.0 µg/kg dexmedetomidine + propofol). The mean arterial pressure (MAP), heart rate (HR), anesthesia depth index (NTI), and incidence of postoperative delirium (POD) at 7 days after surgery were compared.

Results

MAP and HR were significantly higher in group A than in group B during extubation and 10 minutes after extubation and significantly higher than the values before anesthesia induction. At all time points post-anesthesia induction, NTI was higher in group B than in group A, and the incidence of POD within 7 days after surgery was significantly higher in group A. The Prince–Henry pain scores were higher in group A than in group B at 1, 4, 24, and 48 hours after surgery.

Conclusions

Higher dexmedetomidine doses were associated with more stable hemodynamics and stronger effects on POD in older adults undergoing cardiac surgery.
Adenoid cystic carcinoma in the nasolacrimal duct: a case report
Authors: Son Seung-Myoung , Woo Chang Gok
Published: December 2024

Adenoid cystic carcinoma (ACC) rarely occurs in the nasolacrimal duct (NLD), and when it does, it has nonspecific manifestations. To the best of our knowledge, one case of ACC in the NLD has been reported in the literature. Herein, we report a second case of ACC in the left NLD, concerning a man in his late 60s. He presented with epiphora, and swelling and pain below the left medial canthus. Nasal endoscopy revealed bulging of the lateral wall in the left nasal cavity, with an intact nasal mucosa. Paranasal sinus computed tomography showed an enhancing mass at the epicenter of the left NLD, involving the maxillary sinus, inferior turbinate, and nasal cavity, with bony destruction. The patient underwent superomedial maxillectomy. The pathology was high-grade ACC. Despite undergoing five rounds of postoperative radiotherapy, the ACC recurred 11 months after the operation. Early identification is critical for reducing the morbidity and mortality of patients with ACC in the NLD.
Influence of coal particle composition and maceral associations on fluidity development during the coking process
Authors: Brooks Brody , Lomas Hannah , Lee Soonho , Steel Karen , Hapugoda Priyanthi , Hockings Kim , Tahmasebi Arash
Published: December 2024

Maceral composition is a key parameter used in the assessment of metallurgical coals and coke quality prediction. However, coal particles are typically a mix of different macerals and minerals. Fluidity development in coal particles depends on particle size and the extent of association between constituent maceral grains. As such, determining the composition of coal particles is crucial to understanding the drivers of thermoplastic fluidity. In this work, coal grain analysis (CGA) was used to determine the maceral grain compositional information of individual coal particles for two pairs of metallurgical coals demonstrating different thermoplastic behaviour, as determined by standard Gieseler fluidity and dilatation testing. Each pair was comprised of coals with comparable ranks and both similar (coals A and C) and dissimilar (coals B and D) maceral compositions. The experimental results showed that coals of finer vitrinite particle size and higher degrees of maceral grain association, i.e., finely dispersed macerals within coal particles, demonstrated lower dilatation and higher permeability. It was postulated that coals with close maceral associations are more prone to volatile gas escape during thermoplasticity, hindering bubble growth and thermoswelling while also increasing melt viscosity, leading to decreased Gieseler fluidity measurements. It was also observed that coals with different degrees of maceral grain associations demonstrate different thermoplastic behaviour, where the presence of pure forms of reactive macerals enhanced coal fluidity. Results suggest that some coals possess a higher “effective fluidity” than reported from standard Gieseler testing. Conversely, coals with limited maceral grain association and high compositions of vitrinite prolific particles benefit from enhanced bubble growth and coalescence. Apparent fluidities of such coals are more accurately represented by standard Gieseler testing.
The important role of self in cross-cultural investigations of affective experiences with music
Authors: Tang Jonathan
Published: December 2024

In the last decade, the construct of ‘culture’ was featured very prominently in music cognition research. However, researchers have adopted a narrow conceptualisation and a limited repertoire of methodologies when investigating ‘culture’. The purpose of this article is to expand on recommendations of Jacoby et al. and propose a novel approach to cross-cultural investigations of affective experiences with music. First, I critically examine how culture has been operationalised in previous studies and present a theoretical framework outlining aspects of culture within the music context. My proposed framework recognises that culture manifests in the individual, the music, and the environment and context, and that these components are continually and mutually constituting one another. Second, I argue that the self is constituted in relation to the cultures that one is part of and hypothesise ways that self-construal theory, as a way of operationalising the self, can enhance current understanding of how culture impacts affective experiences with music. The empirical evidence reviewed shows that self-construal influences motivation, cognition, and emotion outside of musical contexts, which may similarly impact music preferences, perceived emotions, and felt emotions with music. Finally, I reflect on the implications of this approach for future developments in music psychology theory and research. Self-construal, as a means of operationalising the self, can potentially elucidate similarities and differences in affective experiences with music both between and within cultural contexts. Examining the self can be a step-change to advance theory and cross-cultural understanding of affective experiences within music psychology.
Analysis of School Zone Crash Severities with an Equity Lens: A Random Parameters Modeling Approach
Authors: Farid Ahmed , Lin Emily , Pande Anurag
Published: December 2024

Because of the potentially higher loss of human years in collisions involving young children, school zone safety is a significant public health concern. Past studies have identified several factors that are associated with school zone crashes, including inadequate traffic controls, poor speed management, and lack of enforcement. However, school zone safety remains relatively unexplored as an equity issue. Toward that end, crash data about vulnerable road users (VRUs), (i.e., pedestrians/bicyclists) from elementary schools in Los Angeles County, California, U.S., were collected, alongside information about the proportion of students who were enrolled in the free and reduced cost meals program. The latter served as a proxy for the socioeconomic statuses of the schools’ neighborhoods. The severity outcomes of those VRU collisions were analyzed via the random parameters, or mixed, ordinal probit regression structure to gauge the impact of the crash-contributing factors on the injury severity risks. According to the results of this study, the socioeconomic status of the school’s neighborhood was found to induce mixed effects on the injury severity risk. As such, the results suggested that more detailed investigations on the interaction of the factors describing the crash characteristics with equity are required to propose appropriate road safety countermeasures. This is because the impact of the socioeconomic status of the schools on crash severity risk varied across the data.
I-METANET: Macroscopic Freeway Model for Real-Time Incident Impact Estimation and Traffic Management
Authors: Huang Yen-Lin , Cheng Yao , Chang Gang-Len
Published: December 2024

Macroscopic traffic flow models, notably METANET, have been instrumental in the real-time estimation and optimization of control strategies for recurrent traffic congestions owing to their computational efficiency and robust performance. Their embedded formulations, however, are not best tailored to capture the traffic dynamics during roadway lane blockage owing to incidents where rapid and surging queue waves often propagate to upstream segments at time-varying but much faster speeds than under recurrent traffic congestion. Therefore, this study introduces I-METANET for use in incident traffic modeling and management, grounded mainly in METANET’s core mechanism but with the following enhancements: (1) reflecting incident-induced merging behaviors and their significant but attenuate impacts on the speed propagation over upstream segments; (2) incorporating the concurrent impacts of the approaching upstream traffic flows and the downstream incident-incurred queue waves on a subject segment’s evolving speed; and (3) integrating the compound effects of ramp-flows’ weaving maneuvers and the presence of incident queues on an interchange segment’s traffic conditions. The proposed I-METANET, calibrated and evaluated by the field data from Interstate 4 (I-4) in Florida, has demonstrated its expected improvements over METANET under incident scenarios, based on the produced time-varying speeds and flow rates over each roadway segment during incident clearance periods. An extensive sensitivity analysis with respect to key parameters in I-METANET has also been conducted, and evaluation results have confirmed the robustness of I-METANET for simulating freeway traffic dynamics during incident-incurred traffic scenarios.
Efficacy and Safety of OnabotulinumtoxinA for the Treatment of Pediatric Upper and Lower Limb Spasticity: Results From 2 Open-Label, Long-term Extension Trials
Authors: Gormley Mark , Fehlings Darcy , Kim Heakyung , Bonikowski Marcin , Banach Marta , Gul Fatma , Meilahn Jill , Racette Brad , Huang Nuoyu , Niu Xiaomeng , James Lynn M. , Dimitrova Rozalina
Published: December 2024

Aim

To evaluate the efficacy and safety of onabotulinumtoxinA for treating upper and lower limb spasticity among pediatric patients in 2 open-label extension trials.

Methods

Patients aged <18 years received ≤5 doses of onabotulinumtoxinA (maximum: 8 U/kg [300 U], cycle 1; 10 U/kg [340 U], cycles 2-5) over 60 weeks. Week 6 efficacy endpoints included mean change from baseline in Modified Ashworth Scale–Bohannon and Modified Tardieu Scale scores, and mean Clinical Global Impression of Overall Change score. Adverse events and laboratory assessments of bone health were monitored.

Results

A total of 580 patients received onabotulinumtoxinA. Modified Ashworth Scale–Bohannon change from baseline ranged from −1.01 to −1.9. Modified Tardieu Scale change from baseline was 13.6 to 18.1 (ankle), 25.8 to 44.1 (elbow), and −5.0 to −26.3 (wrist). Clinical Global Impression of Overall Change scores were 1.5 to 2.2. The most common treatment-emergent adverse events were upper respiratory tract infection (16.9%) and nasopharyngitis (15.7%).

Interpretation

Repeat administration of onabotulinumtoxinA was safe and efficacious for treating upper and lower limb spasticity in children.
Fetal Alcohol Spectrum Disorder and Pediatric Neurology: Are We Missing the Connection? A Scoping Review
Authors: Burd Michael , Miles James , Myers Graysen , Engesether Bailey , Johnson Erika
Published: December 2024

Introduction

Pediatric neurology provides care for children with complex developmental disorders with environmental, genetic, metabolic, and teratogenic etiologies. Common neurodevelopmental conditions include attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder. However, only minimal attention from pediatric neurology journals has been devoted to fetal alcohol spectrum disorder. This is surprising because fetal alcohol spectrum disorder is a common neurodevelopmental disorder with a prevalence of between 1% and 5% of school-age children.

Methods

This scoping review had 2 objectives. Objective 1 was to estimate the number of articles reporting on fetal alcohol spectrum disorder in 8 well-respected pediatric neurology journals. Objective 2 was to determine how many patients from a single pediatric neurology practice referred to a clinic for diagnosis and management of neurobehavioral disorders received a diagnosis of ADHD, autism spectrum disorder, and fetal alcohol spectrum disorder.

Results

Objective 1, a survey of 8 prominent pediatric neurology journals until January 2024, found that a title and abstract search identified 1786 articles on the three topics. Papers on autism spectrum disorder (n =1043) accounted for 58.4% of the total. Papers on ADHD (n = 685) comprised 38.4% and articles on fetal alcohol spectrum disorder (n = 58) contributed just 3.3% of the total. Objective 2, a chart review of 40 patients from a single pediatric neurology clinic who were referred for developmental assessment and management, found that 40% had prenatal alcohol exposure and 20% received a diagnosis of fetal alcohol spectrum disorder. High rates of comorbidity between fetal alcohol spectrum disorder and ADHD of 21% and of fetal alcohol spectrum disorder and autism spectrum disorder of 2.5% were found.

Conclusions

Because fetal alcohol spectrum disorder is one of the most common causes of neurodevelopmental disorders, the limited attention to fetal alcohol spectrum disorder in pediatric neurology journals is concerning. This study suggests that in addition to ADHD and autism spectrum disorder, fetal alcohol spectrum disorder may also be a common diagnosis in pediatric neurology practice. Pediatric neurology journals may need to take active steps to increase content on fetal alcohol spectrum disorder. This could include editorials, invited commentaries, or topical reviews. Early recognition and diagnosis of fetal alcohol spectrum disorder allows for the implementation of specific interventions, which can improve the quality of life for patients and families.
Intersection decision model based on state adversarial deep reinforcement learning
Authors: Jiang Anni , Du Yu , Yuan Ying , Li Jiahong , Jiang Beiyan
Published: December 2024

The decision-making model for autonomous vehicles based on deep reinforcement learning faces challenges in robustness in complex and dynamic scenarios, such as crossroads. This study proposes a state adversarial deep reinforcement learning decision model for autonomous driving to address this concern. The model incorporates an adversarial state space standard deviation to accommodate the significant differences in the decision model’s state space between the initial and final steps. Adversarial state space standard deviation, coupled with real-time state space, creates an adversarial state space set. The decision model obtains an adversarial strategy under the adversarial state space set and integrates it with the strategy of the Twin Delayed Deep Deterministic Policy Gradient (TD3) algorithm. This simultaneous optimization of model parameters is designed to improve the robustness of the decision model for autonomous driving. Experimental validation was performed using the Carla simulation environment, involving the creation of four scenarios with varying traffic flow densities and collision rates. In these scenarios, the enhanced model achieved success rates ranging from 89.9% to 98.6%, with the average vehicle travel time staying below 10 s. By contrast, the TD3 and Soft Actor-Critic (SAC) models exhibited success rates between 78.4% and 93.4%, with average vehicle travel times ranging from 10.03 to 20.01 s. When tested across various scenarios, the improved model demonstrated greater robustness compared to the TD3 and SAC models.
A comparative study on mechanical properties of PLA, PETG, and carbon fiber prepared by fused deposition modeling
Authors: Balasrinivasan M , Varun Kumar A , Sathickbasha K
Published: December 2024

3D printing technology is a highly promising fast prototyping method. It is a technology that is rapidly being utilized for mass customization and manufacture of open-source designs in industries such as agriculture, healthcare, automobile, locomotive, aviation, and others. FDM is an additive manufacturing (AM) technology that creates a 3D physical object directly from a computer-assisted design (CAD) model by layering the feedstock, which is polymer filament material ejected through a nozzle. The test samples were made using Olivetti S2 3D printer and according to standard testing sizes like ASTM D638, ASTM D790, and ASTM D256. Mechanical properties: Three distinct materials, polylactic acid (PLA), carbon fiber-reinforced PLA, and carbon fiber-reinforced polyethylene terephthalate glycol (PETG) are evaluated through tensile test, flexural test, and impact test by varying the process parameters such as feed rate and infill pattern. PLA is a popular biodegradable biopolymer known for its high biocompatibility and sustainability. PETG material is a kind of chemical utilized in a variety of industrial processes due to its great durability, impact strength, and outstanding formability. It is preferred over various filaments because of its superior layer adherence and odorlessness. Carbon fiber-reinforced filament enhances structural components by providing high modulus, good surface finish, dimensional stability, and lightweight properties. This study revealed that at lower print speeds tensile strength in PLA has increased, especially with line infill parallel to the load. Conversely, at higher speeds weakened PETG-CF with triangular infill. PLA also showed superior flexural properties at lower speeds with line infill.
Dermoscopy of syphilitic chancre: Report of five cases
Authors: Chauhan Payal , Sharma Ria , Daroach Manju , Jindal Rashmi , Meena Dilip
Published: December 2024

Dermoscopy is a non-invasive tool which helps in the visualization of skin structures and patterns not visible to the naked eye. This study evaluates the effectiveness of dermoscopy in diagnosing primary syphilis, which typically presents as a painless ulcer at the site of Treponema pallidum inoculation. In this study, dermoscopic patterns such as vascular structures and background colour changes were analyzed in patients with confirmed primary syphilis. Results indicate that primary syphilis lesions often display unique dermoscopic features, including polymorphic vessels and orange, red-purple backgrounds. These patterns can facilitate the early detection and diagnosis of syphilis, improving clinical outcomes through earlier intervention. The study concludes that integrating dermoscopy into the clinical assessment of suspected syphilis lesions can enhance diagnostic accuracy.
Moisture Transmission Through Aramid, Polyethylene and Glass Fibre Reinforced Epoxy Laminates
Authors: Ghotra Joginder s. , Mackay Paul
Published: December 2024

The rates of transmission of water through epoxy resin laminates have been measured for three different kinds of fibrous reinforcements, and at two temperatures. The efficacy of four non-metallic moisture barrier layers has also been investigated. Of the organic fibre laminates, polyethylene fibre reinforced epoxy materials were the most resistant to moisture transport; but glass laminates were comparable if filled with 50 phr of alumina trihydrate. The durability of the barrier layers when subjected to mild mechanical abrasion and low energy impact after water transmission were also determined. Water transmission rate (WTR) values were always much higher at 65°C than at 30°C, and especially so in the case of the filled glass laminates. Impact and abrasion had a more severe effect on WTR at the higher than the lower temperature. All the barrier layers studied had a beneficial effect, but all require improved adhesion to the substrate in wet conditions.
Optimizing the Stabilization of LLDPE during Processing by Using Melt Flow Parameters*This paper was first presented at Addcon '98, held on 9th-10th November 1998 in London, UK
Authors: Thurmer A. , Malik J. , Dongiovanni E. , Stoll K.H.
Published: December 2024

Efficient stabilization packages are always applied in LLDPE film grades, in order to guarantee continuous processing without deterioration of the polymer’s properties.

The stabilization efficiency of three additive systems, containing different phosphorus stabilizers was studied. Analysing the changes in MFI (molecular weight) and in MFR (melt flow ratio, related to molecular weight distribution) after multiple extrusions leads to complex information about the parameters influencing the degradation behaviour of LLDPE. It was found that the molecular properties of the polyethylene can he significantly affected even by mild processing conditions during the first melt processing stage and that the performance of a processing stabilizer has to be assessed for its initial inhibition efficiency in processing.
PMR Polyimide Composites Reinforced with Three-Dimensional Carbon Fibre Fabrics
Authors: Chou Shen , Chen Hong-En , Huang Pao-I , Cheung Shu-Ling
Published: December 2024

Mechanical properties of three-dimensional carbon fabric/PMR polyimide composites were investigated in an effort to delineate the role of reinforcing fabric structure on the performance and durability of an ultra high performance 3D composite. There were four fabric structures evaluated: three-dimensional three-axial (3D-3A) and three-dimensional five-axial (3D-5A), both having 5.0 and 7.5 mm weave gauge. Composites made from these four fabric preforms and polyimide matrix resin were fabricated and tested under identical conditions. The mechanical properties were measured, including strength, modulus and work of rupture in tension and flexure at 25, 200, 300, 370 and 450°C. Our results showed that the 3D-3 A composites had higher tensile and flexural properties than their 3D-5A counterparts, with one exception: the 3D-5A materials showed better flexural work of rupture. The 3D-3A composites exhibited higher retention of mechanical properties at elevated temperatures, compared to the 3D-5A composite materials, indicating that the 3D-3A materials had better thermal oxidative stability. Most of the composites retained over 50% of their mechanical properties after 24 hours exposures at 370°C.
‘Infinite Trouble, Considerable Expense’: The British Adriatic Mission and the Evacuation of the Serbian Army, October 1915–February 1916
Authors: Pijade Chiaramonte Alexandre Benjamin
Published: December 2024

This article explores Britain's role in the events preceding the evacuation of the beleaguered Serbian army from Albania. Specifically it examines the hasty creation, in November 1915, of the British Adriatic Mission to resupply the Serbian army through Montenegro and Albania, supported by the Italian army and navy; and how this impulsive response was blighted by poor-planning, a lack of direction and incessant squabbling which almost ended in failure. It posits that, as a course of action, the Mission illustrates how the divergent interests of the Allies made the pursuit of a common strategic policy next to impossible.
Self-efficacy as a Catalyst: The Link between Transformational Leadership and Job Performance
Authors: Ali Khan Syed Md. Faisal , Khan Azhar
Published: December 2024

Several studies have examined the link between transformative leadership and professional success, but the role of self-efficacy in moderating this relationship has not been fully explored. This study aimed to examine the influence of self-efficacy on the association between transformational leadership and job performance using a sample of employees from various organisations. The data was analysed using SMART PLS4. The results illustrate that self-efficacy significantly moderates the relationship between transformational leadership and job performance. Specifically, individuals with higher levels of self-efficacy have more robust and favourable correlation between transformational leadership and job performance compared to those with lower levels. This study highlights the importance of self-efficacy in enhancing the impact of transformational leadership on job performance and provides valuable insights for organisations to improve their leadership practices and employee outcomes.
Designing Savings Accounts to Promote Asset Building for Individuals With Disabilities: Experimental Evidence on ABLE Accounts
Authors: Roll Stephen , Ferris Dan , Bufe Sam , Kondratjeva Olga
Published: December 2024

Benefit programs like Social Security Income (SSI) and Medicaid impose strict asset limits for eligibility, which create a substantial disincentive to save. Due to structural and systemic barriers, households with a member who has a disability (HMDs) are more likely to have low financial security. Achieving a Better Life Experience (ABLE) accounts, which are excluded from SSI and Medicaid asset tests up to a certain amount, seek to increase savings among HMDs. However, ABLE account take-up has been low, with less than 2% of eligible households participating. This article examines awareness levels of ABLE accounts and how the account structure itself may deter uptake. First, using national survey data of low-income tax filers, we find low awareness of ABLE accounts among low- and moderate-income (LMI) adults living in HMDs, which generally did not significantly differ across demographic and financial characteristics. Second, we test how annual fees and minimum account balance requirements affected self-reported likelihood of saving in an ABLE-type account. The results showed that annual fees significantly reduced the likelihood of saving but minimum balance requirements did not. This work has implications for policymakers, practitioners, and industry professionals interested in increasing savings without risking benefits eligibility for people with disabilities.
Evaluation of the Inaugural Pennsylvania School Nurse Mentorship Program
Authors: Hoke Alicia M. , Greenawalt Katie , VanDyke Erika , Zearfaus Angela , Sekhar Deepa L.
Published: December 2024

The role of a school nurse has evolved due, in part, to complex health conditions and the COVID-19 pandemic. In turn, nurse burnout and early retirement are contributing to school nurse shortages across the United States. Interprofessional support, training, and mentorship are needed to support school nurses new to the field. Thirty early-career Pennsylvania school nurses (15 mentors, 15 mentees) participated in a one-year mentorship and professional development program that included one-to-one mentorship and a five-part professional learning seminar series. Mentored pairs created mentorship action plans guided by the 21st Century School Nursing PracticeTM Framework. Participants completed mentored meetings with high fidelity (93% completion). Mentees and mentors reported high levels of satisfaction with their experience. Mentees’ confidence in performing action plan items improved after participating in the program. This study suggests mentorship among school nurses is a valuable strategy to increase confidence in practice and develop professional relationships.
Multidimensional Stressors Among Historically Marginalized Indigenous People in Highland Communities: Empirical Insights From the Q’ero of Peru
Authors: Aiello Parker , Ahmed Saleh , Meza Aranda Katherine Miluska
Published: December 2024

Indigenous peoples living in remote, highland communities in developing nations are faced with unprecedented stressors from a variety of sources that impact their economic, social, and cultural well-being. These stressors are multidimensional and do not exist in isolation. In this paper, we examine how climate change, the COVID-19 pandemic, and pre-existing socio-economic and political marginalization intersect and impact Peru’s high-altitude indigenous Q’ero communities. Semi-structured interviews conducted in Ocongate with a small community of Q’ero people shed light on the complexity of these multidimensional stressors. The findings highlight the presence of climate extremes, water scarcity, economic degradation, misinformation, and government distrust. These findings suggest that the Q’ero people, as well as other high-altitude indigenous communities, are facing increased vulnerability and impacts to their livelihood due to multidimensional stressors such as climate change, the coronavirus pandemic, and government neglect.
Insight into the Environmental Health Consciousness of Medical Students Regarding the Perceived Impacts of Climate Change on Human Health
Authors: Shariff Yumna , Mushtaq Muneeba , Shah Syed Muhammad Abdullah , Malik Hurais , Abdullah Muhammad , Jamil Muhammad Usama , Rehman Abdul , Hudaib Muhammad , Manahil  , Ahad Ahmad Umais , Mughal Sanila , Eljack Mohammed Mahmmoud Fadelallah
Published: December 2024

Climate change represents an unprecedented global public health crisis with extensive and profound implications. The Lancet Commission identified it as the foremost health challenge of the 21st century. In 2015, air pollution alone caused approximately 9 million premature deaths worldwide. Climate change also exacerbates extreme weather events, displacement, mental health disorders, disease vectors, food insecurity, and malnutrition, particularly impacting vulnerable developing countries like Pakistan due to its agricultural reliance, diverse topography, and limited resources. This study assesses Pakistani medical students’ perceptions of climate change’s health impacts. Conducted in February 2024, a cross-sectional survey of 632 students using a standardized questionnaire was employed via online Google Forms. The questionnaire was validated and an Exploratory Factor Analysis identified seven subscales of environmental health consciousness. The mean participant age was 21.17 years, with a balanced gender distribution. Students showed high environmental health consciousness (Mean = 35.6, SD = 5.2), with 88% attributing climate change to human activities and 89.1% anticipating serious future health impacts. Significant concerns included air quality-related illness (91%), water-availability illness (86%), healthcare disruption (85%), cold-related illness (83%), and flooding-related displacement (87%). Psychological impacts were acknowledged by 68%. Household income, age, and gender were significant predictors. These results highlight the need for integrating climate change and health education into medical curricula to prepare future healthcare providers.
The onset presentation of multiple sclerosis differs in Hispanic/Latinx Americans compared with non-Hispanic White Americans
Authors: Briggs Farren BS , Conway Devon S , Hersh Carrie M , Fitzgerald Kathryn C , Mowry Ellen , Cohen Jeffrey A , Ontaneda Daniel
Published: December 2024

Background:

Little is known about how multiple sclerosis (MS) presents in Hispanic/Latinx (HL) people with MS (pwMS).

Objective:

Compare age at onset (AAO) and onset severity between HL versus non-Hispanic White (NHW) pwMS.

Methods:

A cross-sectional study leveraged the MS PATHS registry spanning seven US tertiary care institutions. HL was subcategorized as HL White (HLW) and HL Other (HLO; all other races). Multivariable models examined relationships between ethnoracial variables and AAO and self-reported presenting disease course. Models were repeated restricting to those born ⩾1970.

Results:

The study population included 8231 pwMS, including 540 HL (200 HLW, 340 HLO). The sex distribution did not differ across ethnoracial subgroups. From the statistical models (1) HLO pwMS had an earlier AAO and a higher prevalence of initial progressive disease course than NHW pwMS; (2) among all HL pwMS, irrespective of race, AAO did not differ by sex or between relapsing and progressive MS at onset. In younger HLO adults (born ⩾1970), those with progressive MS at onset had an earlier AAO than those with relapsing MS; and (3) in HL pwMS there was no sex-bias in presenting disease course.

Discussion:

Distinct differences in the presentation of MS in HL compared with NHW individuals were observed.