bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Safety and Effectiveness of Urea and Tolvaptan for the Management of Hyponatremia
Authors: Scalla Paolo A , Palma Stephanie M , Dittmar Erika , Zamora Francis J , Trimino Estela
Published: April 2024

Background: The optimal management of euvolemic and hypervolemic hyponatremia remains controversial. The effectiveness of the vasopressin receptor antagonist tolvaptan on serum sodium normalization has been well described in the literature, although the associated risk of serum sodium overcorrection limits its use. Urea has been proposed as an alternative treatment option due to its milder serum sodium raising effects and adverse event profile. Objective: This study aimed to compare urea and tolvaptan for their serum sodium raising effects and potential for overcorrection. Methods: In a multicenter retrospective review, 46 hospitalized patients who received either urea or tolvaptan for the management of hyponatremia were evaluated for the rate of serum sodium normalization and overcorrection. Results: Mean serum sodium concentrations at baseline were 125.91 mEq/L and 123.83 mEq/L for patients treated with urea and tolvaptan, respectively. After 12 hours, tolvaptan was associated with a significantly higher rate of serum sodium increase compared with urea (5.05 mEq/L vs 1.10 mEq/L; P = .001). However, no statistically significant differences were observed in the mean change in serum sodium concentrations at 24 hours, 48 hours, or with the proportion of patients who reached a serum sodium concentration of 135 mEq/L. Overcorrection rates were significantly higher with tolvaptan compared with urea at 43% and 9%, respectively. Conclusion: The results of this study suggest that urea has a comparable effectiveness profile to tolvaptan for the management of hyponatremia with a significantly reduced risk of overcorrection.
A novel pellet-based 3D printing of high stretchable elastomer
Authors: Zhang Jianxun , Luo Shengyang
Published: April 2024

Elastomers, known for their high stretchability and flexibility, are widely used in high-tech applications. However, traditional manufacturing methods for elastomeric part production have limitations. 3D printing, particularly fused deposition modeling (FDM), offers a promising alternative by allowing the fabrication of customized elastomers with desired shapes and properties. Conventional filament-based FDM techniques struggle to print elastomers. This article presents a novel approach for 3D printing polyolefin elastomer (POE) using a direct pellet printing technique. A customized pellet printer with a pneumatic pressure feeding system was used that eliminates filament buckling issues commonly associated with conventional filament-based 3D printing methods. The mechanical properties and microstructure of the printed parts were analyzed to evaluate the suitability of the technique for producing high-quality elastomeric components. SEM images indicated a high-quality and accurate printing method; however, there are micro-holes between the raster due to the high shrinkage rate of POE and increasing the nozzle temperature improves the print quality. The mechanical properties of the printed samples exhibited remarkable formability, with elongation reaching up to 1965%. It is also found that as the nozzle temperature increased, the strength, elongation, and bonding between layers improved significantly. This innovative 3D printing technique has the potential for various applications such as soft robotics and wearable electronics.
A study of angle parametric optimization of the composite honeycomb on turbine blade tip
Authors: Kong Qingguo , Ning Jiaxin , Sun Xiaopeng , Pan Xiande , Sun Shuang , Lu Lehan , Si Haixu
Published: April 2024

To reduce the secondary flow loss of the high-pressure turbine caused by the tip leakage flow, the design of the composite honeycomb tip has been experimentally and numerically examined in this study. The arrangement angle of the composite honeycomb is defined and optimized using the radial basis function and genetic algorithm. The tip flow field of the high-pressure turbine blade with a 2.128 mm clearance is simulated by CFX 18.0, and the arrangement angle of the composite honeycomb is optimized to obtain a lower loss. Moreover, the flat tip, basic honeycomb tip, and optimized honeycomb tip are tested in a low-speed cascade test facility. The results show that the vortices and radial velocity induced by the honeycomb structure cavity increase the kinetic energy loss of the leakage flow and reduce the leakage flow rate. Compared with the basic honeycomb, the optimized honeycomb has a supplemental blocking effect on the tip leakage flow by reducing the crosswise pressure gradient in the blade tip. The optimized honeycomb also changes the outlet angle of the leakage flow in the tip clearance, reduces the leakage vortex, and the total pressure loss is further reduced by 2.5%.
“Friends? Supported. Partner? Not so much …”: Women's experiences of friendships, family, and relationships during perimenopause and menopause
Authors: Hayfield Nikki , Moore Hannah , Terry Gareth
Published: April 2024

In recent years, there has been increased cultural interest in perimenopause and menopause. The importance of peri/menopause in many women's lives makes this topic particularly pertinent for feminist psychologists. Some feminist scholars have acknowledged both physical and psychological factors as important aspects of women's experiences within their wider social and cultural contexts. However, consideration of relational aspects during peri/menopause remains sparse. We report our research exploring peri/menopausal women's experiences of friendships, family, and relationships. Thematic analysis was used to analyse responses to an online qualitative survey in which 71 mainly British women participated. In our analysis, we discuss the Menopause Sisterhood and how these women described social support as grounded in embodied experiences shared with other women. However, there were tensions concerning partners, whose understanding varied, which we report in the second theme: Accounting for (lack of) partner support: Men as heroes (or as absolved of any blame). We discuss the importance and implications of our findings for feminist scholars and psychologists more widely.
A multiscale micromechanical progressive elastic-damage model for cementitious composites featuring superabsorbent polymer (SAP)
Authors: Xu Aiqing , Man Xiaoyan , Ju J Woody
Published: April 2024

A multiscale micromechanics-based progressive damage model is developed to investigate the overall mechanical behavior and the interfacial microcrack evolutions of the cementitious composites featuring superabsorbent polymer (SAP) under uniaxial tension. Elastic properties, progressive damage process, and homogenization procedure of cementitious composites are systematically integrated in this model. The effective elastic moduli of the composites are determined based on a multiscale micromechanical framework. According to the small strain assumption, the total strain tensor and the elastic-damage compliance tensor are additively decomposed into elastic and damage-induced components. The damage-induced strains and compliances are then deduced from micromechanics. To characterize the progressive elastic-damage induced by microcracks, stages of microcrack propagation are identified from the interface contact stress and the matrix cleavage stress. The complex potentials and stress intensity factors for kinked interface cracks are derived from the distributed dislocations method. By implementing the homogenization process, the macroscopic mechanical behavior is obtained from the micro/mesoscale. The results indicate that the material parameters have clear mechanical significance. Different parameters, such as the SAP addition ratio, aggregate content, initial interfacial crack size, and initial interfacial crack location, are revealed to be influential in the overall mechanical behavior of the composites. The proposed model can be generalized to other particle-reinforced composites with different constituent properties, which can potentially contribute to the design and optimization of durable composites.
A new predictive intelligent controller and path planning for mobile robots
Authors: Ahmadi Balootaki Mohammad , Rahmani Hossein , Moeinkhah Hossein , Mohammadzadeh Ardashir
Published: April 2024

This paper studies the synchronization and control of chaotic systems, and a new chaotic-based path is designed for Mobile robots (MRs). The chaotic systems are used to design an unpredictable path for a class of patrol MRs. To enhance security, multiple chaotic systems with a chaotic switching mechanism are introduced for path planning. The main challenge is that the dynamics of MRs are entirely unknown. The physical dynamics are not reliable in practice, because many parameters in MR dynamics are changed due to unknown environmental conditions such as noisy sensors, time delays, friction, and non-ideal actuators. Also, the chaotic switching of reference signals between chaotic signals imposes a high dynamic perturbation. So, a powerful fractional-order predictive controller on the basis of type-3 (T3) fuzzy-logic systems (FLSs) is developed. The estimation and prediction errors of T3-FLSs are compensated by a designed parallel compensator. T3-FLSs are online tuned such that stability is ensured, and the defined cost function for prediction controller is minimized. The suggested scheme is implemented on a real-world MR, and the results demonstrate the febrility and the accuracy. Also, in several simulations, the efficacy of the designed controller is examined. The simulation and experimental results show that the accuracy is improved more than 70% in comparison with conventional predictive controllers under noisy signals and uncertain dynamics.
A novel vibration barrier for low-frequency surface waves in the ground
Authors: Wang Yeshun , Chen Xiaobin , Meng Fei , Yi Liqin , Li Taifeng , Xie Kang , Tang Lubo
Published: April 2024

As for certain engineering scenarios, such as open-air quarries and underground pipeline areas, vibration barriers are in urgent need. However, their design and construction face various challenges, especially for attenuating surface waves with low frequencies. Inspired by the topography of hills and periodic phononic crystal structures, a novel vibration barrier consisting of periodic soil strips is proposed. Firstly, utilizing the finite element method and the theory of periodic structures, the dispersion band diagram is calculated for the periodic soil strips. The corresponding band gap mechanisms are discussed by the displacement field of modes in the lower boundary of band gaps. Besides, a simplified model and a theoretical expression are proposed to analyze the minimum frequency of the band gaps. Through frequency domain analysis, the influence of the damping of soil strips on isolation effects is examined, and the dissipated energy is also quantified using a spatial Fast Fourier Transform. Finally, a comparison of the isolation effect between soil strip barriers and typical trench barriers is conducted. The results show that periodic soil strips can exhibit several band gaps, within which surface waves (SWs) can be effectively isolated. Soil strip barriers exhibit similar or even better vibration isolation effects compared to trench barriers, especially for isolating low-frequency vibrations. This study enhances our understanding of surface wave mitigation using periodic barriers and provides fresh insights for designing seismic metamaterials.
Evaluation of colitis induced by immune-checkpoint inhibitors therapy in melanoma patients by an overall grading scale
Authors: Nguyen Trang L. , Tew Alice , Kirton Laura , Steven Neil
Published: April 2024

Background

Colitis was the third most common immune-related adverse effect in melanoma patients treated with immune-checkpoint inhibitor (ICI). With the limitation of real-world data in the UK population, this study was conducted in a UK hospital where a fresh colitis guidance was introduced to evaluate the overall grading (OG) to assess colitis severity and guide the treatment.

Aims

This study aimed to investigate colitis severity by Common Terminology Criteria for Adverse Events (CTCAE) grade and overall grade at time of presentation. Colitis treatment and outcome were evaluated to compare the impact of these two categories.

Methods

A single-center, retrospective observational study was performed in melanoma patient developing colitis symptoms.

Results

A total of 44 advanced melanoma patient with colitis symptoms were included. Median time to colitis onset was 67 days (range 4–890). Majority of patients developed G1/ G2 of CTCAE scale (70.4%) but moderate or severe overall grade (84.1%). There were 65.9% of patients treated with steroids, and 38.2% with infliximab and 4.5% with vedolizumab. The median time of colitis resolution was 28 days (range 0–282). Both treatment modality and time to resolution were associated with severity of colitis assessed by complete OG(p<0.0001) rather than CTCAE grading (p>0.05).

Conclusions

This study provided a comprehensive description about ICI-induced colitis management in a single center of the UK. The more completed OG was proposed to stratify colitis patient and guide the investigation and treatment decision at presenting time, replacing the old CTCAE grading.
Pedagogical strategies used by an outstanding mathematics teacher: a case study in Region IV of Chile / Estrategias pedagógicas utilizadas por una profesora destacada en matemáticas: un estudio de caso en la IV Región de Chile
Authors: Videla Ronnie , Leyton Guillermo , Rossel Sebastián
Published: April 2024

How does a maths teacher rated as outstanding according to the ‘DocenteMás’ Performance Assessment System of Chile semiotically mediate her seventh-grade students’ learning? With the goal of answering this question, this article used a qualitative, ethnographic case study method to describe the pedagogical strategies of the teacher and her students when covering the thematic unit on numbers and operations in primary school. The results show that the pedagogical strategies emerge from the communicative interaction in the classroom via a local and a global dynamic. With regard to the local dynamic, the pedagogical strategies discovered include exposition, experiential articulation and arithmetic understanding. In the global dynamic, pedagogical strategies of semiotic mediation like metaphors, question series and joint understanding of knowledge stood out.
Imagining inclusion in the university setting: plural discourse among Spanish university lecturers / Imaginar la universidad inclusiva: pluralidad de discursos del profesorado universitario español
Authors: Martínez-Usarralde María-Jesús , Lloret-Catalá Carmen , Torrico María García-Cano , Jiménez-Millán Azahara
Published: April 2024

Diversity management is a core priority in the definition of international education policies, and educational inclusion is a strategic indicator of quality and excellence. As a contribution to improving educational inclusion in higher education, this study seeks to map out the opinions and positions expressed by university lecturers regarding their teaching action in the classroom with respect to educational diversity and inclusion. To this end, qualitative research was designed and developed in eight Spanish public universities. A total of 17 interviews and eight focus group were held, analysing and interpreting the output by means of mixed deductive and emerging thematic analysis. Findings indicate two stances or positions expressed, identified as conventional logic and critical logic, which point to different conceptions of diversity held by the lecturers, the purpose of inclusion in university and its justification, the difficulties they encounter and their proposals for improvement. Global integrated approaches are necessary for the institutionalization of inclusion, despite conceptual confusion, poor training and institutional difficulties encountered by teachers in the classroom.
Analysing the teaching-learning process in the university virtual classroom at the beginning of the COVID-19 pandemic / Analizando el proceso de enseñanza-aprendizaje en el aula virtual universitaria al inicio de la pandemia de COVID-19
Authors: González-Zamar Mariana-Daniela , Abad-Segura Emilio
Published: April 2024

The scientific community is facing one of its greatest challenges to solve a global health problem such as the COVID-19 pandemic. This situation has generated an unprecedented volume of publications. The impact of COVID-19 on teaching has meant that moments of social contact have disappeared in exchange for meetings, classes, exams or virtual meetings. In this scenario, the university virtual classrooms when reopened will not be the same. The aim of the study was to identify the scientific publications on the teaching-learning process in university virtual classrooms during the period from 2019 to mid-2020, that is, from its beginnings until June 2020. For this, a bibliometric analysis of the scientific literature was performed. The number of publications in the period of the pandemic in the most diverse disciplines is reported, as well as the interaction between research clusters. The COVID-19 pandemic has revealed the serious deficiencies of our educational system, due to the poor theoretical-methodological preparation of teachers, and, in addition, it has revealed the fallacy that the constructivist model is the only way to educate our students.
Between a ‘flexible’ and ‘rigid’ interpretation of the list of prohibited grounds of discrimination under article 21(3) of the constitution of Uganda: Uganda Law Society and 12 others v Attorney General [2024] UGCC 2 (13 February 2024)
Authors: Mujuzi Jamil Ddamulira
Published: April 2024

Article 21 of the Constitution of Uganda (1995) provides for the right to freedom from discrimination. Article 21(3) provides that for the purposes of Article 21, discrimination ‘means to give different treatment to different persons attributable only or mainly to their respective descriptions by sex, race, colour, ethnic origin, tribe, birth, creed or religion, or social or economic standing, political opinion or disability.’ Article 45 of the Constitution provides that ‘[t]he rights, duties, declarations and guarantees relating to the fundamental and other human rights and freedoms specifically mentioned in this Chapter shall not be regarded as excluding others not specifically mentioned.’ In Uganda Law Society and 12 others v Attorney General (13 February 2024), the Constitutional Court invoked Article 45 and held that the list of prohibited grounds under Article 21(3) is not exhaustive. In this article, the author relies on the drafting history of Article 21(3), the jurisprudence of the Supreme Court on Article 21(3) and the literal interpretation of Article 21(3) to argue that the list of prohibited grounds in Article 21(3) is exhaustive and that the Constitutional Court erred when it held to the contrary. The author argues further that Article 45 should not be relied on to read rights into the Constitution. It should be applicable to statutory or common law rights.
Conceptualising queer activist critiques of Pride in the Two-Thirds World: Queer activism and alternative Pride organising in South Africa, Mumbai, Hong Kong and Shanghai
Authors: Conway Daniel
Published: April 2024

This article explores queer critiques of LGBT Pride in the ‘Two-Thirds World’, drawing from ethnographic data, focussing on under-researched contexts and analysing common and divergent themes in queer critiques of Pride globally. Criticisms of corporate involvement and capitalist appropriation of Pride are replicated in the case studies; there is also a complex politics of necessity, precarity, and pragmatism. ‘Mainstream’ Prides reflect and can exacerbate racial and class divisions and be a well-rewarded career path for its organisers. The article analyses the radical politics of ‘alternative’ queer Prides and argues for the importance of continually tracing the ideological impacts of Pride, engaging with the dynamics of global capitalism, and highlighting the struggles of queer grassroots activists.
VR technology and humanitarian crisis: Political ideology and the intention to donate in the case of the Syrian refugee crisis
Authors: Borah Porismita , Irom Bimbisar , Yoon Joo Lee , Lee Danielle Ka Lai , Mu Di , Vishnevskaya Anastasia , Yel Eylul , Price Ron
Published: April 2024

Scholars have studied the role of technology in humanitarian crises and have noted an increase in positive attitudes and behavior. Of interest to us is Virtual Reality (VR). We set out to understand the role of VR technology and its relationships with empathy, sympathy, and donation intention in case of the Syrian refugee crisis. We conducted two experimental studies to examine these relationships, where participants watched “Clouds Over Sidra” a VR film for the United Nations. The participants in the VR condition watched the documentary using VR, while in the non-VR condition, participants watched the documentary on a computer. Our results indicate a complex picture. It seems that VR technology can increase empathy and sympathy in participants, which can lead to a higher intention to donate. However, when we tested the relationship with political ideology as a moderator, empathy did not hold. In a moderated mediation model, we found that VR technology increased sympathy, which led to higher intention to donate. This relationship was moderated by political ideology, such that self-reported liberals scored high on donation intention in both the VR and non-VR groups. However, among conservatives, participants in the VR condition showed higher intention to donate.
Moving from local to global: The examples of the United Nations Sustainable Development Goals and the Okanagan Charter
Authors: Squires Vicki
Published: April 2024

The United Nations Sustainable Development Goals (SDGs) set forth 17 broad goals that we should pursue globally to ensure the health of the planet and of humankind. Within each goal, several targets are identified. This article explores the overarching framework of the SDGs as a guide to ensuring human and planetary health. The one goal, Goal #3: Global Health and Wellbeing was described in more detail. Simultaneous to the development of the SDGs, a health promotion framework, the Okanagan Charter, was launched. The Okanagan Charter similarly identifies the calls to action and principles that are the foundation of the work. This article explores briefly the origins of the Okanagan Charter and describes the study that was conducted to explore the implementation of the Charter at the first 10 campuses to sign on to the Charter. The findings identify that systems approaches require leadership and engaged champions, effective communication structures, dedicated resources, work across silos, and development of targets and measures to gauge progress; these structures are crucial for effective systems approaches to complex initiatives such as holistic health promotion strategies. The article concludes with a discussion about future directions for the crucial health promotion agenda.
Association Between Adverse Childhood Experiences and Academic Performance Among Children and Adolescents: A Global Meta-Analysis
Authors: Qu Guangbo , Shu Liqin , Liu Haixia , Ma Shaodi , Han Tiantian , Zhang Huimei , Huang Christy , Wang Jun , Yang Linsheng , Sun Yehuan
Published: April 2024

This study was conducted to quantify the association of adverse childhood experiences (ACEs) and the academic performance of children and adolescents. The literature was systematically searched in six electronic databases, and a meta-analysis was conducted. Twenty studies with a total of 1,196,631 children and adolescents from five countries were included. Meta-analysis showed that ACE score was positively associated with poor academic achievement, grade repetition, and special education support. Compared with children and adolescents without any ACE, those with one or more ACE had a significantly higher risk of poor academic achievement (pooled odds ratio [OR]: 1.45, 95% confidence interval [CI] [1.13, 1.85], I2 = 82.6%) and grade repetition (pooled OR: 1.36, 95% CI [1.29, 1.43], I2 = 71.0%). Moreover, all types of ACEs were positively associated with poor academic achievement and grade repetition. In addition, there was a significant dose-response relationship between the ACE score and the risk of poor academic achievement. This study supported that ACE had a significant impact on the academic performance of children and adolescents. Based on these findings, we recommend that early screening of ACEs for children and adolescent is critical and appropriate support and prevention in education should be developed for those with ACEs. Further studies are needed to further explore the long-term effect of ACEs on education and its gender differences.
Pararenal Aortic Thrombus in Patients Undergoing Aortic Aneurysm Repair With Chimney Technique
Authors: Benedetto Filippo , Spinelli Domenico , Barillà Chiara , Fittipaldi Alessandra , Maria Castellana Federica , De Caridi Giovanni
Published: April 2024

Introduction:

Chimney technique (chimney graft in abdominal aortic aneurysm repair [ChEVAR]) can be used to treat patients with pararenal aortic aneurysm unfit for open surgery and not suitable for custom-made fenestrated endograft. Since almost 1 in 5 patients undergo a reintervention within 3 years, features associated with higher risk of complications need to be investigated to tailor the follow-up schedule to each patient. The aim of our study was to assess the impact of mural thrombus in the pararenal aorta on perioperative and follow-up complications after ChEVAR.

Methods:

All consecutive patients undergoing ChEVAR at our center from 2015 to 2022 were included in this retrospective study. Collected variables included number of target vessels, stent graft size, presence, and severity of mural thrombus in pararenal aorta, which was reported with a scoring system from 0 to 10 based on thrombus type, thickness area, and circumference Analyzed outcomes included perioperative and follow-up complications.

Results:

Thirty-one patients underwent ChEVAR during the study period. In 4 patients the indication for ChEVAR was type 1A endoleak after a previous endovascular aneurysm repair (EVAR). The number of target vessels was 1 in 17 patients (55%), 2 in 12 (39%), 3 in 1 (3%), and 4 in 1 (%). The mean mural thrombus score was 5.9. Complications were the following: type 1A endoleak in 4 cases (13%), chimney stent complications in 7 cases (23%) (including partial or total thrombosis, intrastent stenosis, displacement), renal function worsening during follow-up in 8 cases (26%). Overall survival was 90% at 2 years. Patients with severe mural thrombus showed lower freedom from ChEVAR-related complications (28% vs 59% at 2 years, p=0.023).

Conclusions:

The presence of severe pararenal aortic mural thrombus was associated with lower freedom from ChEVAR-related complications in patients undergoing ChEVAR for pararenal aortic aneurysm repair. Further research with a larger number of patients is required to confirm these results.

Clinical Impact

The analysis of severity of mural thrombus in pararenal aorta, which was reported with a scoring system from 0 to 10 based on thrombus type, thickness area and circumference, can be useful and can be represent an important predictor element for complications in patient submitted to Chimney tecnique; in fact the presence of severe pararenal aortic mural thrombus was associated with lower freedom from ChEVAR-related complications in patients undergoing ChEVAR for pararenal aortic aneurysm repair. Then, in patient with pararenal aortic aneurysm, a preoperative evaluation could be focused on severity of mural thrombus to minimize the complications in ChEVAR tecnique or to change the surgical strategy.
Differences in In-Hospital and Follow-Up Outcomes Between Non-A Non-B Aortic Dissection and Type B Aortic Dissection Treated by Endovascular Based Treatment
Authors: Li Gen , Li Jun , Deng Hongping , Wei Xiang , Li Na
Published: April 2024

Objectives

Non-A non-B aortic dissection (AD) is a rare and life-threatening medical emergency, and it has been controversial whether it should be managed as type B aortic dissection (TBAD). The study aims to compare in-hospital and follow-up outcomes between patients with non-A non-B AD and those with TBAD treated by endovascular based treatment (EBT).

Methods

From January 2017 to December 2021, 96 consecutive patients with non-A non-B AD met the inclusion criteria and underwent EBT. Patients with TBAD were matched to patients with non-A non-B AD at a 1:1 ratio using propensity score matching analysis to correct for baseline confounding factors. The primary endpoint was all-cause mortality. Aortic-related events were defined as dissection-related death, aortic rupture, retrograde type A aortic dissection, reintervention, and type Ia endoleak.

Results

Patients with non-A non-B AD required more TEVAR-related adjunctive procedures compared to TBAD patients during EBT and they required a longer ICU length of stay (36.0 vs 24.0 hours, P < .05) as well as a longer hospitalization (8.0 vs 7.0 days, P < .05) after EBT. There was no statistical difference in overall survival after EBT for patients with TBAD and non-A non-B AD. However, compared to patients with TBAD, non-A non-B AD patients had a higher rate of reintervention and experienced more aortic-related late events during follow-up.

Conclusion

Patients with non-A non-B acute AD who are treated with EBT do not have higher in-hospital or follow-up mortality rates compared to patients with type B AD. However, there is an increased risk of reintervention and aortic-related late events after the intervention during follow-up.
Impact of the economic crisis on the health-related quality of life of adults in Lebanon: An observational cross-sectional study
Authors: Sukarieh Rand , Hatem Georges , Hajar Nisrine , Al-Hajje Amal , Chehabeddine Mouna , Sukarieh Mohamad Bassam , Awada Sanaa
Published: April 2024

Background: The economic crisis imposed changes to afford necessities like food, housing, and healthcare, leading to a decline in the physical and mental health of the population.

Objectives: This study assessed the impact of the economic crisis on Lebanese adults’ health-related Quality of Life (QoL) and the predictors of lower scores.

Methods: A cross-sectional study targeted 561 adults using a uniform questionnaire for data collection and a Short Form 8-item survey.

Results: The sample comprised 77.9% females and 22.1% males. More than half of the sample reported a decrease in their income compared to the period before the crisis, and most participants reported that the economic turmoil highly impacted their access to healthcare services (63.0%), medication (51.5%), and food (56.5%) in addition to other necessities. Participants had lower Mental Component (MC) than Physical Component (PC) scores (55.5 and 69.0, respectively). Those highly impacted by the economic crisis in accessing medication had 1.76 times higher odds of lower PC scores than others (OR 1.76, 95% CI: 1.07–3.21). As regards the impact of the economic crisis on the MC scores, significantly higher odds of a lower MC score were noted among those highly impacted by the economic crisis in terms of access to medication (OR 2.12, 95% CI: 1.14–3.95), to food (OR 1.79, 95% CI: 1.1.12–2.87), and encountering water shortage (OR 1.65, 95% CI: 1.01–2.71).

Conclusion: Lebanese adults’ QoL suffered physically and psychologically amid the economic crisis. The study underscores the need for accessible and affordable essential healthcare services and necessities.
Influence of flange deflection wear and the economy-oriented reversing control policy
Authors: Lei Lei , Song Dongli , Tang Yong , Wang Tao , Zheng Zejun , Jiang Xinkun
Published: April 2024

In this paper, we describe the phenomenon of deflection wear of the wheel flange and analyze the causes according to actual line conditions, and the influence of deflection wear of wheel flange is analyzed from the perspective of safety and economy of trains by combining dynamic modeling and simulation. The degree of deflection wear of wheel flange is divided into different grades. Based on the reliability-cost function, the influence of economy is quantified and introduced into the analysis of deflection wear as an index. We establish an economic model of flange deflection wear and cutting amount of reprofiling (FDW-CA). Based on the deflection wear prediction model and FDW-CA model, we model the economy-oriented reversing control policy. To verify the feasibility and validity of the control policy. The measured data before and after the reversing policy are analyzed. The results indicate that the cutting amount of wheelset is reduced from 11.2 to 6.6 mm on average for single reprofiling, and the saving is more than 40%. The reversing control policy can reduce the cutting amount of wheelset, reduce the limit probability of wheelset, extend the life of the wheelset, and reduce the operation and maintenance cost of the wheelset, and further provide basis for wheelset spare planning.
Autism in ICU
Authors: Baruah Rosaleen
Published: April 2024

Autism is a lifelong neurodevelopmental condition. Autistic people face challenges as patients in the intensive care unit (ICU) and as providers of healthcare in the ICU. This article describes the experience of autistic people using a neurodiversity-affirming approach. Using the ‘Autistic SPACE’ framework, the needs of autistic people are described in terms of sensory needs, need for predictability, need for autistic acceptance, communication differences and how to approach them, and the benefits of a person-centred empathy-based approach to autistic people. The approach to autistic patients is described in terms of reasonable adjustments within a framework of positive risk taking. For supervisors and managers of autistic healthcare professionals, autism-friendly adjustments to training and working practice, with rationales, are suggested.
The sequential antifracturative treatment: a meta-analysis of randomized clinical trials
Authors: Fassio Angelo , Gatti Davide , Biffi Annalisa , Ronco Raffaella , Porcu Gloria , Adami Giovanni , Alvaro Rosaria , Bogini Riccardo , Caputi Achille P. , Cianferotti Luisella , Frediani Bruno , Gonnelli Stefano , Iolascon Giovanni , Lenzi Andrea , Leone Salvatore , Michieli Raffaella , Migliaccio Silvia , Nicoletti Tiziana , Paoletta Marco , Pennini Annalisa , Piccirilli Eleonora , Rossini Maurizio , Brandi Maria Luisa , Corrao Giovanni , Tarantino Umberto
Published: April 2024

Background:

Subjects with a fragility fracture have an increased risk of a new fracture and should receive effective strategies to prevent new events. The medium-term to long-term strategy should be scheduled by considering the mechanisms of action in therapy and the estimated fracture risk.

Objective:

A systematic review was conducted to evaluate the sequential strategy in patients with or at risk of a fragility fracture in the context of the development of the Italian Guidelines.

Design:

Systematic review and meta-analysis.

Data sources and methods:

PubMed, Embase, and the Cochrane Library were investigated up to February 2021 to update the search of a recent systematic review. Randomized clinical trials (RCTs) that analyzed the sequential therapy of antiresorptive, anabolic treatment, or placebo in patients with or at risk of a fragility fracture were eligible. Three authors independently extracted data and appraised the risk of bias in the included studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Effect sizes were pooled in a meta-analysis using fixed-effects models. The primary outcome was the risk of refracture, while the secondary outcome was the bone mineral density (BMD) change.

Results:

In all, 17 RCTs, ranging from low to high quality, met our inclusion criteria. A significantly reduced risk of fracture was detected at (i) 12 or 24 months after the switch from romosozumab to denosumab versus placebo to denosumab; (ii) 30 months from teriparatide to bisphosphonates versus placebo to bisphosphonates; and (iii) 12 months from romosozumab to alendronate versus the only alendronate therapy (specifically for vertebral fractures). In general, at 2 years after the switch from anabolic to antiresorptive drugs, a weighted BMD was increased at the lumbar spine, total hip, and femoral neck site.

Conclusion:

The Task Force formulated recommendations on sequential therapy, which is the first treatment with anabolic drugs or ‘bone builders’ in patients with very high or imminent risk of fracture.
Colorimetric Barium Detection of Gunshot Residues on Cadaveric Human Skin: A Pilot Application for Forensic Purposes
Authors: Tambuzzi Stefano , Gentile Guendalina , Boracchi Michele , Andreola Salvatore , Zoja Riccardo
Published: April 2024

Introduction:

In this study we microscopically investigated, for the first time ever, the colorimetric detectability of barium of gunshot residues (GSR) on cadaveric human skin with gunshot wounds.

Methods:

For this purpose we used two different colorimetric techniques known in the literature, namely 0.2% sodium rhodizonate (Na-R-Ba 0.2%) and sodium rhodizonate in alcoholic environment (Na-R-Ba OH 0.2%). At the same time, we have also coupled it with scanning electron microscopy with energy dispersive X-ray (SEM/EDX) analysis and the colorimetric study for the detection of lead of GSR. These techniques were applied to 16 victims who died from gunshot injuries, as well as to a control group.

Results:

SEM/EDX demonstrated the presence of lead in all cases and barium in 11 of the 16 cases. The subsequent colorimetric technique with Na-R-Ba 0.2% did not show the barium of GSR in any case, unlike the Na-R-Ba OH 0.2% technique. This latter, in fact, has demonstrated the presence of this metal in 2 cases (18%). No microscopic case of false positive was recorded.

Conclusion:

The evidence obtained with Na-R-Ba OH 0.2% makes this method, applied here for the first time ever, worthy of further study. Meanwhile, although this technique can certainly be applied, it cannot be separated from the contextual colorimetric investigation for lead and the use of more sophisticated techniques.
Intermediate-Term Clinical Outcomes of High-Density Autologous Chondrocyte Implantation in Patients with Concomitant Anterior Cruciate Ligament Reconstruction and Focal Chondral Lesions
Authors: Guillén-Vicente Isabel , Herros-García Ramón , Guillén-Vicente Marta , Ruiz Borja , Lopez-Alcorocho Juan Manuel , Rodríguez-Iñigo Elena , Barrera Adrián , Fernández-Jaén Tomás F. , Abelow Steve , Guillén-García Pedro
Published: April 2024

Objective

To investigate intermediate-term clinical results in patients with concomitant anterior cruciate ligament (ACL) reconstruction and chondral defect treated with high-density autologous chondrocyte implantation (HD-ACI) compared to patients without ACL tear but with a chondral lesion and HD-ACI treatment.

Design

Forty-eight patients with focal chondral lesions underwent HD-ACI (24 with ACL reconstruction after an ACL injury and 24 with an intact ACL). Follow-up assessments occurred at 6, 12, and 24 months. Patient-reported knee function and symptoms were assessed using the International Knee Documentation Committee (IKDC) questionnaire, pain was measured using the Visual Analog Scale (VAS), and adverse events were monitored. Physical activity was assessed using the Tegner Activity Level Scale, and cartilage healing was evaluated with the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.

Results

No significant adverse events occurred during follow-up. Both groups showed significant improvements at 2 years compared to baseline (VAS: 8.0 ± 1.3 to 1.4 ± 2.0 [normal ACL]; 7.4 ± 2.3 to 2.1 ± 2.3 [ACL reconstruction]; IKDC: 39.2 ± 10.6 to 76.1 ± 22.0 [intact ACL]; 35.6 ± 12.1 to 74.6 ± 20.9 [ACL reconstruction]). Patients in both groups exceeded the minimal clinically important difference (MCID) for IKDC scores. The Tegner Activity Level Scale decreased immediately after surgery and increased after 2 years, with 70.6% (normal ACL) and 89.5% (ACL reconstruction) returning to their preinjury activity levels. No significant differences in the MOCART score were observed between the groups.

Conclusions

ACL reconstruction does not appear to reduce the outcomes (at 2 years) of HD-ACI.
Exploitative Leadership and Vertical Knowledge Withholding: Examining Multiple Mediational Effects
Authors: Khalid Komal , Aftab Saima
Published: April 2024

This study analyzes the relationship between employee’s perceptions of exploitative leadership and their vertical knowledge withholding and the mediating roles of employee’s perception of job insecurity, organizational injustice, and hostile attribution bias. A time lag study was conducted to test hypotheses by data collection in three phases from the 402 employees working in three service sectors (i.e., banking, telecommunication, and higher education) of Pakistan. Results of statistical analysis showed that (i) employees who experience high levels of exploitation from leaders are more likely to withhold knowledge; (ii) exploitative leadership has a significant influence on hostile attribution bias, perceived job insecurity, organizational injustice; (iii) perceived job insecurity and perceived organization injustice function as strong mediators between the relationship of exploitative leadership and vertical knowledge withholding; and, (iv) hostile attribution bias acts as a strong mediator between exploitative leadership and perceived job insecurity. This study explains the connection between employees’ perceptions of exploitative leadership and resultant knowledge withholding tendency, with specific consideration of individual and organizational factors to explain this process. The organizations should develop a culture within the organization that discourages knowledge withholding practices and motivates positive leader-employee relationships.
The Influence of the Satisfaction of the Master’s Training Environment on the Increment of Research Skill: An Empirical Study from Central China
Authors: Li Xiaoyu , Yang Pengcheng , Gao Yudong , Jing Linfang
Published: April 2024

With the increase in master’s degree enrollment in China, ensuring the realization of value-added research skills of master’s degree students with limited educational resources has become an urgent problem. We developed hypotheses and tested the mediating effect of academic passion (AP) in the role of training environment satisfaction (TES) on research skill increment (RSI) and the moderating role of academic self-efficacy (ASE) using the perspective of Research Training Environment Theory (RTE). We used a structured questionnaire to collect responses from 911 master’s students from universities in central China, including 458 males (50.27%) and 453 females (49.73%), and 66.41% of the subjects were between the ages of 23 and 26. Our findings indicate that TES significantly impacts RSI and can influence RSI via a partially mediated effect of AP. In addition, we determined the moderating effect of ASE between the effects of the three variables. Based on RTE theory, we introduced the concept of value-add assessment and combined the two to realize the expansion of RTE theory. This study has implications for administrators and individuals in graduate education. It can help administrators make changes to the management model or methods of graduate education, as well as provide some inspiration for developing and improving master’s students’ research skills.
Autogenous structural bone graft reconstruction of ≥ 10-mm-deep uncontained medial proximal tibial defects in primary total knee arthroplasty
Authors: Dewidar Ahmed Abdel-Monem , Mesregah Mohamed Kamal , Mesriga Mustafa Mohamed , El-Behiry Ahmed Mohamed
Published: April 2024

Background

Management of uncontained medial proximal tibial defects during primary total knee arthroplasty (TKA) can be challenging, especially for defects ≥ 10 mm in depth. This study sought to assess the outcomes of autogenous structural bone grafts to address these defects.

Materials and methods

In this prospective study, patients with uncontained medial proximal tibial defects ≥ 10 mm in depth undergoing TKA were managed by autogenous structural bone grafts fixed by screws and were followed up for at least 36 months. Patients were followed-up clinically with Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, radiological follow-up was done to assess bone graft union and implant stability.

Results

The study included 48 patients with a mean age of 69.2 ± 4.5 years. The mean body mass index (BMI) was 31.4 ± 3.7 kg/m2. The mean defect depth was 17 ± 3.6 mm. With a mean follow-up period of 52.2 ± 12.3 months, the median KSS improved significantly from 30 preoperatively to 89, P < 0.001. The median WOMAC score reduced significantly from 85 preoperatively to 30.5, P < 0.001. The mean ROM increased significantly from 73 ± 12.4 preoperatively to 124 ± 8.4 degrees, P < 0.001. The mean graft union time was 4.9 ± 1 months. No significant complications were reported.

Conclusions

Autogenous bone graft reconstruction is a safe and effective method of addressing uncontained medial proximal tibial defects in primary TKA.

Level of evidence

Level IV.
Targeted inhibition of the PI3K/AKT/mTOR pathway by (+)-anthrabenzoxocinone induces cell cycle arrest, apoptosis, and autophagy in non-small cell lung cancer
Authors: Li Xiao-Qian , Cheng Xiao-Ju , Wu Jie , Wu Kai-Feng , Liu Tie
Published: April 2024

Non-small cell lung cancer (NSCLC), characterized by low survival rates and a high recurrence rate, is a major cause of cancer-related mortality. Aberrant activation of the PI3K/AKT/mTOR signaling pathway is a common driver of NSCLC. Within this study, the inhibitory activity of (+)-anthrabenzoxocinone ((+)-ABX), an oxygenated anthrabenzoxocinone compound derived from Streptomyces, against NSCLC is demonstrated for the first time both in vitro and in vivo. Mechanistically, it is confirmed that the PI3K/AKT/mTOR signaling pathway is targeted and suppressed by (+)-ABX, resulting in the induction of S and G2/M phase arrest, apoptosis, and autophagy in NSCLC cells. Additionally, the augmentation of intracellular ROS levels by (+)-ABX is revealed, further contributing to the inhibition of the signaling pathway and exerting inhibitory effects on tumor growth. The findings presented in this study suggest that (+)-ABX possesses the potential to serve as a lead compound for the treatment of NSCLC.

Graphical abstract