bluuebunny/crossref_metadata_2025 huggingface dataset:
Heterogeneity of State Stroke Center Certification and Designation Processes
Authors: Feldmeier Madeline , Kim Anthony S. , Zachrison Kori S. , Alberts Mark J. , Shen Yu-Chu , Hsia Renee Y.
Published: March 2024

BACKGROUND:

Stroke centers are critical for the timely diagnosis and treatment of acute stroke and have been associated with improved treatment and outcomes; however, variability exists in the definitions and processes used to certify and designate these centers. Our study categorizes state stroke center certification and designation processes and provides examples of state processes across the United States, specifically in states with independent designation processes that do not rely on national certification.

METHODS:

In this cross-sectional study from September 2022 to April 2023, we used peer-reviewed literature, primary source documents from states, and communication with state officials in all 50 states to capture each state’s process for stroke center certification and designation. We categorized this information and outlined examples of processes in each category.

RESULTS:

Our cross-sectional study of state-level stroke center certification and designation processes across states reveals significant heterogeneity in the terminology used to describe state processes and the processes themselves. We identify 3 main categories of state processes: No State Certification or Designation Process (category A; n=12), State Designation Reliant on National Certification Only (category B; n=24), and State Has Option for Self-Certification or Independent Designation (category C; n=14). Furthermore, we describe 3 subcategories of self-certification or independent state designation processes: State Relies on Self-Certification or Independent Designation for Acute Stroke Ready Hospital or Equivalent (category C1; n=3), State Has Hybrid Model for Acute Stroke Ready Hospital or Equivalent (category C2; n=5), and State Has Hybrid Model for Primary Stroke Center and Above (category C3; n=6).

CONCLUSIONS:

Our study found significant heterogeneity in state-level processes. A better understanding of how these differences may impact the rigor of each process and clinical performance of stroke centers is worthy of further investigation.
The stance and factors of international organizations towards countries from a Chinese perspective
Authors: Zhang Qin , Xue Haili , Wang Yaotian , Wang Yao , Zhang Ziqin , Qin Qinghua , Liang Haoguang
Published: March 2024

The degree and scope of constraints imposed by International Organizations (IOs) on States are increasing, and identifying the factors affecting the IOs’ stances on States is helpful to enhance the state's discourse power and influence in the international community. First, by coding the records of Regular Press Conferences of the Speaking Office of the Chinese Ministry of Foreign Affairs during the period of 20182022, we obtained a dataset of IOs’ stances on China-related events. Second, we constructed political relation, economic relation, and humanistic relation indicators to complement the influence factors, adopted the Bayesian logit model, and applied the Monte Carlo Markov chain algorithm and Gibbs sampling to analyze the probability of IOs’ positive stances towards China. The result shows that IOs’ category, length of establishment, functional position, and relationship with China are all related to their tendency of making a statement about China. In terms of the heterogeneity of event types, forum-type IOs are significantly inclined to give positive assessment compared to service-type IOs on events focusing on China's own development. Further analysis reveals that the model for analyzing and predicting the attitudes of IOs is more effective when the international situation is in a stable period.
We All Fall Down: The Dismantling of the Warsaw Pact and the End of
the Cold War in Eastern Europe
Authors: Miles Simon
Published: March 2024

Using new evidence from Czech, German, Hungarian, Polish, and Romanian archives, a reconstruction of Eastern European diplomacy at the end of the Cold War shows that it was not just the superpowers that shaped events during this pivotal period: the non-Soviet members of the Warsaw Pact also had agency. From 1989 to 1991, these states recognized that the world was changing and that their relationship with the Soviet Union, codified in the Warsaw Pact politico-military alliance, would impede their success in the post–Cold War world. Eastern European policymakers resolved to destroy the Warsaw Pact that bound them to the Soviet Union, and they decided to align with Western Europe. They also sought to exclude the Soviet Union from the European security architecture, including the Conference on Security and Co-operation in Europe. They sought security and wanted to hedge against a hard-line takeover in the Soviet Union; but their primary aim was to reap the West's economic benefits.
The Autograph of Ali Akbar Khitaʾi’s Khiṭāynāma (Book of China) and Its Manuscript Tradition
Authors: Budak Samet
Published: March 2024

This article discusses a poorly acknowledged autograph copy of the Khiṭāynāma by Ali Akbar Khitaʾi in Persian. Unlike most studies on the work, it argues that MS Istanbul, Aşir Efendi 249 (henceforth AE 249) in the Süleymaniye library is an autograph copy completed in 1516 and presented to Süleyman I (r. 1520–1566) when he was still a prince. It also argues that the author prepared two recensions for two patrons, Selim I (r. 1512–1520) and Süleyman I, around the same time. The article further demonstrates that the appellations sultan and shah were commonly used for Ottoman princes and appeared in various manuscripts. Hence AE 249’s usage of the term sultan for Süleyman is not an inconsistency casting doubt on the date of the manuscript and its character. The article additionally provides the most comprehensive list and information on Persian manuscripts of the original work and its two different Ottoman Turkish translations. In this way, it clarifies various confusing references to the manuscripts of the work in modern scholarship. Moreover, it provides a more secure foundation for future research on the Khiṭāynāma as well as on how to discuss the titles of Ottoman patrons and how to conceptualize them in manuscript studies. Ultimately, it hopes to demonstrate that the political context may provide insights to better deal with similar works from the era.
Survey of Major Diseases on Medicinal and Aromatic Plants Growing Areas of Ethiopia
Authors: Tefera Banchiamlak Nigussie
Published: March 2024

Medicinal and aromatic plants are industrial plant that are primarily used for therapeutic, aromatic and culinary purposes as components of cosmetics, medicinal products, health foods and other natural health products. Like other cereal crops, these potential medicinal and aromatic plants are constantly in grave danger from disease attack. The aim of this study was to assess the most prevalent diseases on prioritized medicinal and aromatic plants. Survey was conducted at Wondo Genet Agricultural research stations and herb growing companies in Ethiopia. Survey fields were observed from vegetative to maturity stage of the plant to assess the pest status. A total of 11 medicinal and aromatic plants were assessed in four different locations and these herbs were attacked by various diseases. Rust disease was the most serious problem on Aloe vera and Lemon grass, accounting for 30-40 percent of disease severity at Wondo Genet. In Butajira, powdery mildew was the most common disease found on sage, with a 20 percent severity. Downy mildew was recorded as a major disease on basil plants in Hawassa and Debre Zeit, with a 30-35 percent severity. Therefore, identification of the pathogen's causing agents and integrated disease management for the major recorded diseases of medicinal and aromatic plants needs further research.
Interaction with the Extratropics as a New Hypothesis for the Spectral Peak of the Madden–Julian Oscillation
Authors: Roundy Paul E. , De Castro Crizzia Mielle
Published: March 2024

The Madden–Julian oscillation (MJO) propagates eastward as a disturbance of mostly zonal wind and precipitation along the equator. The initial diagnosis of the MJO spectral peak at 40–50-day periods suggests a reduction in amplitude associated with slower MJO events that occur at lower frequencies. If events on the low-frequency side of the spectral peak continued to grow in amplitude with reduced phase speed, the spectrum would just be red. Wavelet regression analysis of slow and fast eastward-propagating MJO signals during northern winter assesses how associated moisture and wind patterns could explain why slow MJO events achieve lower amplitude in tracers of moist convection. Results suggest that slow MJO events favor a ridge anomaly over Europe, which drives cool dry air equatorward over Africa and Arabia as the active convection develops over the Indian Ocean. We hypothesize that dry air tracing back to this source, together with a longer duration of the events, leads to associated convection diminishing along the equator and instead concentrating in the Rossby gyres off the equator.

Significance Statement

The Madden–Julian oscillation (MJO) dominates the subseasonal variability of the tropical atmosphere. This work suggests that it favors maximum convective activity in the 40–50-day period range because lower-frequency MJO signals tend to import more cool dry air from the extratropics and along the equator, thereby weakening the slower events.
A Scale-Aware Parameterization of Restratification Effect of Turbulent Thermal Wind Balance
Authors: Yang Peiran , Jing Zhao , Yang Haiyuan , Wu Lixin
Published: March 2024

The vertical buoyancy flux Bf under the turbulent thermal wind (TTW) balance plays an important role in restratifying the surface mixed layer in winter. So far, most of the global ocean models are too coarse to resolve this process. In this paper, a scale-aware parameterization is proposed for and implemented in a hierarchy of regional ocean simulations over the winter Kuroshio Extension with horizontal resolutions ranging from 27 to 1 km. The parameterization depends on the Coriolis parameter, model-simulated turbulent vertical viscosity, horizontal density gradient, and a scaling relationship to adjust for the effects of model horizontal resolution on the simulated horizontal density gradient. It shows good skills in reconciling the difference between in the coarse-resolution simulations (27, 9, and 3 km) and in the 1-km simulation where is well resolved. Furthermore, implementation of the parameterization improves the simulated stratification in the surface mixed layer in coarse-resolution simulations.
The Role of Surface Potential Vorticity in the Vertical Structure of Mesoscale Eddies in Wind-Driven Ocean Circulations
Authors: Zhang Wenda , Griffies Stephen M. , Hallberg Robert W. , Kuo Yi-Hung , Wolfe Christopher L. P.
Published: March 2024

The vertical structure of ocean eddies is generally surface-intensified, commonly attributed to the dominant baroclinic modes arising from the boundary conditions (BCs). Conventional BC considerations mostly focus on either flat- or rough-bottom conditions. The impact of surface buoyancy anomalies—often represented by surface potential vorticity (PV) anomalies—has not been fully explored. Here, we study the role of the surface PV in setting the vertical distribution of eddy kinetic energy (EKE) in an idealized adiabatic ocean model driven by wind stress. The simulated EKE profile in the extratropical ocean tends to peak at the surface and have an e-folding depth typically smaller than half of the ocean depth. This vertical structure can be reasonably represented by a single surface quasigeostrophic (SQG) mode at the energy-containing scale resulting from the large-scale PV structure. Due to isopycnal outcropping and interior PV homogenization, the surface meridional PV gradient is substantially stronger than the interior PV gradient, yielding surface-trapped baroclinically unstable modes with horizontal scales comparable to or smaller than the deformation radius. These surface-trapped eddies then grow in size both horizontally and vertically through an inverse energy cascade up to the energy-containing scale, which dominates the vertical distribution of EKE. As for smaller horizontal scales, the EKE distribution decays faster with depth. Guided by this interpretation, an SQG-based scale-aware parameterization of the EKE profile is proposed. Preliminary offline diagnosis of a high-resolution simulation shows the proposed scheme successfully reproducing the dependence of the vertical structure of EKE on the horizontal grid resolution.
The Energy Transition and Support for the Radical Right: Evidence from the Netherlands
Authors: Voeten Erik
Published: March 2024

Energy transition policies often have distributional effects that could have electoral consequences. I study this issue in the context of a Dutch policy change that increased taxes on household natural gas consumption and redistributed the revenues as subsidies for renewables. Radical right parties were the only source of political opposition. A Differences-in-Differences (DiD) analysis with panel data from 2007-2020 shows that after the policy change renters with individualized utility bills became 5–6 percentage points more likely to vote for the radical right compared to renters with utilities included in their rents. Renters with individualized utility bills also became relatively less sympathetic towards the Green party and more concerned about price increases but they did not alter their left-right self-placements nor their views on immigration or the European Union. A secondary analysis finds similar effects for individuals (including home-owners) who are energy poor. This suggests an emerging economically rooted political cleavage over energy transition policies.
Spirituality as a key asset in promoting positive youth development: Advances in research and practice
Authors: Hay Samuel W , Lerner Jacqueline V , Lerner Richard M , Tirrell Jonathan M , Dowling Elizabeth M
Published: March 2024

Spirituality is a universal human experience. Within the process of development, the role of spirituality as a developmental asset is understudied in general and especially within majority world contexts. In this article, we frame advances in spirituality research and practice with youth around three pillars: (a) theory, (b) measurement, and (c) research about and evaluations of positive youth development (PYD) programs in low- and middle-income countries. We place PYD programs as associated with dynamic, relational developmental systems (RDS)-based models of human development, describe spirituality and the “Big Three” features of effective PYD programs as aligning to promote thriving, and discuss spirituality as a strength, as a key asset, in the lives of youth. We discuss advances in developmental methods and measures for describing, explaining, and promoting spirituality and PYD and offer a case study that responds to a United States Agency for International Development call for action and evaluations of spirituality within the context of a PYD program in the majority world. Considerations for future research about spirituality and youth development are discussed.
Employee engagement in voice at times of crisis: COVID-19 pandemic as an example
Authors: Ashmawy Iman Karam IM
Published: March 2024

Purpose: During crises and unpredictable events, organizational leadership faces time constraints for making decisions. Decisions are, therefore, often centralized. However, such centralized decision-making processes frequently deprive the organizations of vital inputs coming from the employees, who are usually closer to the problems and the customers. Therefore, this paper aims how employees engage in voice during a crisis, such as the COVID-19 pandemic that forced various organizations to resort to remote work without prior planning. Methodology: To explore how employees engage in voice during a crisis, like the COVID-19 pandemic, the study relied on qualitative analysis and used three focus groups with 15 participants working at a German international organization operating in Egypt as a bilateral development partner with the Egyptian government. The responses were later subject to content analysis. Findings: Unexpectedly, the COVID-19 pandemic has forced the employees to work remotely. Due to the availability of certain antecedents, the employees engaged in a promotive voice that was primarily informal, expressed individually and collectively, directed to managers and peers, and frequent at the onset of the pandemic but diminishing later on. Originality: The study offers in-depth insights into how a crisis like the COVID-19 pandemic changes the nature of work, the different antecedents that encourage the employees to engage in voice in times of crisis, and the nature of this voice during the crisis.
Estimation of vehicle tire effective rolling radius and vertical wheel/road contact force
Authors: Rabhi Abderrahmane El Djallil , Hartani Kada , Guettaf Yacine
Published: March 2024

In a vehicle, knowledge of physical wheel/road contact parameters is valuable for the design of dynamic control and active safety systems. In this paper, a new method is designed to estimate the effective rolling radius and the vertical wheel/road contact force using an extended Kalman filter and the Pacejka magic formula. Moreover, it allows the estimation of the longitudinal force, the rolling resistance force, and the longitudinal slip. The method is designed in four blocks. First, a comparison with other research is carried out to validate both the controller and quarter-vehicle model blocks. Then, the blocks of the extended Kalman filter and the Pacejka magic formula are applied to estimate all parameters. The relative mean estimation errors are calculated, and the results show that the developed method is capable of estimating all parameters simultaneously and in real-time with satisfactory accuracy.
Database-driven lightweight design for axle housing of heavy-duty truck
Authors: Zou Zhen , Xu Fengxiang , Wang Dewei , Fang Tengyuan , Jiang Zhoushun
Published: March 2024

Rapid and efficient design methods of axle housing are an increasingly important area for the lightweight design of heavy-duty trucks. Here, a database-driven lightweight design method for axle housing is developed. A theoretical analysis is conducted to explore the relationship between the shape and maximum stress of cross-sections. Subsequently, A double super-ellipse equation is applied to generate massive cross-sections with different shapes and sizes. The secondary development module is constructed to achieve the parametric modeling, finite element analysis, and result analysis of axel housing. Finally, the proposed database-driven lightweight design is employed to carry out the lightweight design of axel housing under different design criteria. The results show that compared to their counterpart, the mass of axel housing using Q345 and Q420 is decreased by 10.3% and 18.9%, respectively, and their maximum stress are declined by 32.9% and 20.8%, respectively, under the design criteria of equal strength. Under the design criteria of specified safety factors, the mass and maximum stress of axel housing are decreased by 11.7% and 25.0%, respectively. This investigation offers some important insights into the lightweight design of tube components.
Yarning about e-mental health tools: First Nations Australian youth perspectives of well-being and e-health
Authors: Wills Madeline N , Rodaughan Jessica , Jobson Laura , Adams Karen , Murrup-Stewart Cammi
Published: March 2024

This study implemented Indigenous research methods, including yarning, to understand First Nations youth’s perspectives of social and emotional well-being and how e-health can support their well-being. Six First Nations youth (aged 18–25 years, M = 21.33) based in Victoria, Australia, yarned with the First Nations researcher between April and July 2022. Yarns emphasised the importance of connection to family, Community, Mob, Country, and Spirit in maintaining and strengthening well-being. These findings were extended to yarns about e-health, where it was recommended that trust and cultural safety be considered in their design and implementation. These considerations should be explored in light of the ongoing impacts of colonisation, which contribute to fear and mistrust of governments experienced by First Nations youth. The findings provide meaningful contributions to the growing field of e-health and amplify First Nations voices to guide the development of culturally safe and effective e-health.
Production-related effects on the adhesive bondline performance of structural adhesives joining dissimilar materials
Authors: Griese M , Stammen E , Dilger K
Published: March 2024

Adhesive bonding is a commonly used technology for joining dissimilar materials. However, production-related effects on the performance of the bondline have to be considered for an accurate joint design. In case of an adhesive joint in an automotive multi-material body in white, these effects arise from the so-called mismatch in thermal expansion coefficients, which leads to distortions of the adhesive in an uncured state or even damage in the cured one. The distortion of the uncured adhesive in the normal direction is called the ‘viscous fingering effect’, which reduces the adhesively bonded cross section by changing the adhesive bondline's shape to thin ‘fingers’ and therefore influences the materials properties. To investigate the effect of viscous fingering on the modulus, strength and energy release rate, linear butt bonded specimens and Tapered Double Cantilever Beams (TDCB) with different elongations of the adhesive bondline in the viscous state are investigated. The results are used to parameterize a cohesive zone model (CZM) and perform numerical analysis of the TDCB specimen for validation and to build up a model of a dissimilar joint consisting of a steel hatprofile and an adhesively bonded aluminum panel subjected to thermal distortions.
Determination of Lorenz number of composite films based on copper chloride(II) in polyvinyl alcohol matrix
Authors: Tweissi Mohammed , Khoshman J.M. , Miqdad Husam , Adaileh Abeer
Published: March 2024

The electrical and thermal conductivities as well as Lorenz number of polyvinyl alcohol (PVA) composites have been investigated at different concentrations of the copper chloride II (0, 1, 3, 5, 7 and 12 wt-%). The powder of copper chloride II (CuCl2) was casted with the PVA polymer1. The electrical conductivity was measured by using the impedance technique, and it was studied as functions of the CuCl2 concentrations, applied frequency range of 100–7000 kHz, and temperature range of 30–100 °C. The activation energy ( Ea) was also determined for all the studied samples at applied frequency of 1000 kHz. It was found that the Ea decreased with increasing the CuCl2 concentration. Moreover, the thermal conductivity of the samples was studied as functions of the CuCl2 concentration and temperature. It was found that the thermal conductivity increased with increasing the CuCl2 concentrations and temperature. Using the measured values of the thermal and electrical conductivities of the studied samples, the relationship between the Lorenz number ( L) of the PVA and CuCl2 concentrations with constant temperature was also studied based on the Wiedemann–Franz law. The results showed that the L number increased with CuCl2 concentrations increase at constant temperature.
Damage detection and location using a simulated annealing-artificial hummingbird algorithm with an improved objective function
Authors: Chen Zhen , Wang Yikai , Zhang Kun , Chan Tommy HT , Wang Zhihao
Published: March 2024

Swarm intelligence algorithms and finite element model update technology are important issues in the field of structural damage detection. However, the complexity of engineering structural models normally leads to low computational efficiency and large detection errors in structural damage detection. To solve these problems, a simulated annealing-artificial hummingbird algorithm (SA-AHA) is proposed based on the artificial hummingbird algorithm (AHA). The Sobol sequence is used to improve the identification efficiency by optimizing the initial population distribution of the AHA. Then, the simulated annealing strategy is introduced to improve the detection accuracy by enhancing the global search ability of the AHA. In addition, a novel objective function is presented by combining modal flexibility residual, natural frequency residual, and trace sparse constraint of the structural model. Numerical simulations of a simply supported beam and a two-story rigid frame are carried out to verify the superiority of the proposed SA-AHA and the objective function. Simulation results demonstrate that the SA-AHA is better than the AHA in terms of damage computational efficiency and damage identification accuracy. Moreover, the new objective function can be more excellently applied to the SA-AHA than the previous one, which can be effectively used to locate and estimate the damage of the proposed SA-AHA in structure. Finally, experimental studies are carried out to verify the proposed method.
Step Climb Dosing Guidance From Simulation Studies on Lamotrigine Concentration Changes During Pregnancy
Authors: Kobayashi Eliane
Published: March 2024

[Box: see text]
People first: a participatory community approach on patient-reported outcomes in tuberculosis
Authors: Martín Dulce , Barbosa Pedro , Ramos João Pedro , Vieira Mariana , Duarte Raquel
Published: March 2024

Patient-reported outcomes (PROs) play a crucial role in understanding the impact of tuberculosis (TB) on both individuals and communities. Despite advances in TB treatment, conventional outcome definitions often overlook essential components of people with TB's experiences, leading to disparities in treatment understanding. The incorporation of PROs in TB scientific research can help bridge the gap between the health system and people's needs and expectations. PROs can offer valuable insights into non-observable constructs like health literacy, self-efficacy and overall wellbeing, contributing to the comprehensive assessment of diagnosis, treatment and research end-points. Participatory community approaches, such as Community-Based Participatory, emphasise the engagement and involvement of relevant stakeholders in designing interventions tailored to their needs. Key stakeholders, including healthcare professionals, researchers, clinical trial investigators, public health officials, and community health workers, TB survivors and people with TB, can play a vital role in promoting patient-centred care and engaging directly with the TB-affected community. An increased and cross-collaborative effort for the inclusion of PROs in TB research can entail their potential role in developing effective treatment regimens and promoting adherence, while maximising community engagement and improving outcomes for those affected by TB.
Watt-level continuous-wave antimonide laser diodes with high carrier-confined active region above 2.5 µm
Authors: Yu Hongguang , Yang Chengao , Chen Yihang , Wang Tianfang , Shi Jianmei , Cao Juntian , Geng Zhengqi , Wang Zhiyuan , Zhang Yu , Xu Yingqiang , Ni Haiqiao , Niu Zhichuan
Published: March 2024

Thanks to high performance above room temperature, antimonide laser diodes have shown great potential for broad application in the mid-infrared spectral region. However, the laser`s performance noticeably deteriorates due to the reduction of carrier confinement with increased emission wavelength. In this paper, a novel active region with higher carrier confinements both of electron and hole, by the usage of an indirect bandgap material of Al0.5GaAs0.04Sb as the quantum barrier, was put up to address the poor carrier confinement of GaSb-based type-I multi-quantum-well (MQW) diode lasers emission wavelength above 2.5 µm. The carrier confinement and the differential gain in the designed active region are enhanced as a result of the first proposed usage of an indirect-gap semiconductor as the quantum barrier with larger band offsets in conduction and valence bands, leading to high internal quantum efficiency and low threshold current density of our lasers. More importantly, the watt-level output optical power is obtained at a low injection current compared to the state of the art. Our work demonstrates a direct and cost-effective solution to address the poor carrier confinement of the GaSb-based MQW lasers, thereby achieving high-power mid-infrared lasers.
Proteomics of prostate cancer serum and plasma using low and high throughput approaches
Authors: Hamza Ghaith M. , Raghunathan Rekha , Ashenden Stephanie , Zhang Bairu , Miele Eric , Jarnuczak Andrew F.
Published: March 2024

Despite progress, MS-based proteomics in biofluids, especially blood, faces challenges such as dynamic range and throughput limitations in biomarker and disease studies. In this work, we used cutting-edge proteomics technologies to construct label-based and label-free workflows, capable of quantifying approximately 2,000 proteins in biofluids. With 70µL of blood and a single depletion strategy, we conducted an analysis of a homogenous cohort (n = 32), comparing medium-grade prostate cancer patients (Gleason score: 7(3 + 4); TNM stage: T2cN0M0, stage IIB) to healthy donors. The results revealed dozens of differentially expressed proteins in both plasma and serum. We identified the upregulation of Prostate Specific Antigen (PSA), a well-known biomarker for prostate cancer, in the serum of cancer cohort. Further bioinformatics analysis highlighted noteworthy proteins which appear to be differentially secreted into the bloodstream, making them good candidates for further exploration.
Feasibility of partial penectomy under local anesthesia: a case–control study
Authors: Anand Madhur , Goel Apul , Singh Bhupendra Pal , Aggarwal Swati , Kumar Manoj , Singh Vivek Kumar , Singh Vishwajeet
Published: March 2024

Background

To assess the feasibility of partial penectomy under local anesthesia and penile nerve blocks.

Methods

A total of 45 patients underwent partial penectomy under local anesthesia over the last 15 years at our institute. These patients were included in group A. We took 45 age-matched controls for comparison in group B. All patients underwent partial penectomy with the standard technique. The control group underwent partial penectomy under general or spinal anesthesia, and the intervention group underwent partial penectomy under local anesthesia. Patients’ tolerance to anesthesia and surgery was compared, and postoperative pain and other complications were assessed.

Results

Mean age was 53.5 years in group A (case) and 52.8 years in group B (controls). Out of 45 patients in group A, 9 were ASA I, 16 were ASA II, 8 were ASA III, and 12 were ASA IV patients. Out of control patients, 35 underwent surgery under spinal and 10 underwent surgery under general anesthesia. All patients tolerated the anesthesia and surgery well. The duration of anesthesia and surgery was shorter in group A (p < 0.05). Postoperative pain scores between the two groups were comparable after 6 h. Postoperative recovery was comparable in both groups, and hospital stays were shorter in local anesthesia/nerve block group but were statistically insignificant. There was no positive margin in any group.

Conclusion

Partial penectomy under local anesthesia is a satisfactory alternative in selected cases or with limited availability of anesthesia services.
Alteration of serotonin release response in the central nucleus of the amygdala to noxious and non-noxious mechanical stimulation in a neuropathic pain model rat
Authors: Tokunaga Ryota , Shibata Hideshi , Kurosawa Mieko
Published: March 2024

Previously, we found that serotonin (5-HT) release in the central nucleus of the amygdala (CeA) of anesthetized rats decreases in response to innocuous stroking of the skin, irrespective of stimulus laterality, but increases in response to noxious pinching applied to a hindlimb contralateral to the 5-HT measurement site. The aim of the present study was to determine whether intra-CeA 5-HT release responses to cutaneous stimulation were altered in an animal model of neuropathic pain induced by ligation of the left L5 spinal nerve. In anesthetized neuropathic pain model rats, stroking of the left hindlimb increased 5-HT release in the CeA, whereas stroking of the right hindlimb decreased it. Meanwhile, pinching of the left hindlimb increased intra-CeA 5-HT release irrespective of stimulus laterality. In conclusion, the present study demonstrated that intra-CeA 5-HT release responses to cutaneous stimulation are altered in an animal model of neuropathic pain.
Genetic mapping of deoxynivalenol and fusarium damaged kernel resistance in an adapted durum wheat population
Authors: Berraies Samia , Ruan Yuefeng , Knox Ron , DePauw Ron , Bokore Firdissa , Cuthbert Richard , Blackwell Barbara , Henriquez Maria Antonia , Konkin David , Yu Bianyun , Pozniak Curtis , Meyer Brad
Published: March 2024

Background

Fusarium head blight (FHB) infection results in Fusarium damaged kernels (FDK) and deoxynivalenol (DON) contamination that are downgrading factors at the Canadian elevators. Durum wheat (Triticum turgidum L. var. durum Desf.) is particularly susceptible to FHB and most of the adapted Canadian durum wheat cultivars are susceptible to moderately susceptible to this disease. However, the durum line DT696 is less susceptible to FHB than commercially grown cultivars. Little is known about genetic variation for durum wheat ability to resist FDK infection and DON accumulation. This study was undertaken to map genetic loci conferring resistance to DON and FDK resistance using a SNP high-density genetic map of a DT707/DT696 DH population and to identify SNP markers useful in marker-assisted breeding. One hundred twenty lines were grown in corn spawn inoculated nurseries near Morden, MB in 2015, 2016 and 2017 and the harvested seeds were evaluated for DON. The genetic map of the population was used in quantitative trait locus analysis performed with MapQTL.6® software.

Results

Four DON accumulation resistance QTL detected in two of the three years were identified on chromosomes 1 A, 5 A (2 loci) and 7 A and two FDK resistance QTL were identified on chromosomes 5 and 7 A in single environments. Although not declared significant due to marginal LOD values, the QTL for FDK on the 5 and 7 A were showing in other years suggesting their effects were real. DT696 contributed the favourable alleles for low DON and FDK on all the chromosomes. Although no resistance loci contributed by DT707, transgressive segregant lines were identified resulting in greater resistance than DT696. Breeder-friendly KASP markers were developed for two of the DON and FDK QTL detected on chromosomes 5 and 7 A. Markers flanking each QTL were physically mapped against the durum wheat reference sequence and candidate genes which might be involved in FDK and DON resistance were identified within the QTL intervals.

Conclusions

The DH lines harboring the desired resistance QTL will serve as useful resources in breeding for FDK and DON resistance in durum wheat. Furthermore, breeder-friendly KASP markers developed during this study will be useful for the selection of durum wheat varieties with low FDK and DON levels in durum wheat breeding programs.
Distributive randomization: a pragmatic fractional factorial design to screen or evaluate multiple simultaneous interventions in a clinical trial
Authors: Haviari Skerdi , Mentré France
Published: March 2024

Background

In some medical indications, numerous interventions have a weak presumption of efficacy, but a good track record or presumption of safety. This makes it feasible to evaluate them simultaneously. This study evaluates a pragmatic fractional factorial trial design that randomly allocates a pre-specified number of interventions to each participant, and statistically tests main intervention effects. We compare it to factorial trials, parallel-arm trials and multiple head-to-head trials, and derive some good practices for its design and analysis.

Methods

We simulated various scenarios involving 4 to 20 candidate interventions among which 2 to 8 could be simultaneously allocated. A binary outcome was assumed. One or two interventions were assumed effective, with various interactions (positive, negative, none). Efficient combinatorics algorithms were created. Sample sizes and power were obtained by simulations in which the statistical test was either difference of proportions or multivariate logistic regression Wald test with or without interaction terms for adjustment, with Bonferroni multiplicity-adjusted alpha risk for both. Native R code is provided without need for compiling or packages.

Results

Distributive trials reduce sample sizes 2- to sevenfold compared to parallel arm trials, and increase them 1- to twofold compared to factorial trials, mostly when fewer allocations than for the factorial design are possible. An unexpectedly effective intervention causes small decreases in power (< 10%) if its effect is additive, but large decreases (possibly down to 0) if not, as for factorial designs. These large decreases are prevented by using interaction terms to adjust the analysis, but these additional estimands have a sample size cost and are better pre-specified. The issue can also be managed by adding a true control arm without any intervention.

Conclusion

Distributive randomization is a viable design for mass parallel evaluation of interventions in constrained trial populations. It should be introduced first in clinical settings where many undercharacterized interventions are potentially available, such as disease prevention strategies, digital behavioral interventions, dietary supplements for chronic conditions, or emerging diseases. Pre-trial simulations are recommended, for which tools are provided.
The association between healthy beverage index and sarcopenia in Iranian older adults: a case-control study
Authors: Mahmoodi Marzieh , Shateri Zainab , Nouri Mehran , Vali Mohebat , Nasimi Nasrin , Sohrabi Zahra , Dabbaghmanesh Mohammad Hossein , Makhtoomi Maede
Published: March 2024

Background

Sarcopenia is a progressive disease with age-related loss of skeletal muscle mass, strength, and function. No study has investigated the association between healthy beverage index (HBI) and sarcopenia in older adults. Therefore, the present study aimed to investigate the association between HBI and sarcopenia in Iranian older adults.

Methods

In the present case-control study, 80 sarcopenic and 80 non-sarcopenic participants matched in sex were included. Body composition was measured using bioelectrical impedance analysis. Handgrip strength (HGS), skeletal muscle mass index (SMI), and gait speed were utilized to confirm sarcopenia. Also, a food frequency questionnaire was used to evaluate food intake. HBI score was calculated based on ten sub-components of the total beverages. Moreover, logistic regression was applied to assess the association between HBI and sarcopenia.

Results

In the crude model, we observed no significant association between HBI and the odds of sarcopenia. Still, after adjusting the confounders, the odds of developing sarcopenia decreased significantly in the second and last tertiles (T) (T2– odds ratio (OR) = 0.04, 95% confidence interval (CI): 0.01–0.25 and T3– OR = 0.10, 95% CI: 0.01–0.60).

Conclusions

Our findings indicated that HBI is inversely related to the chance of sarcopenia. Therefore, to reduce the odds of sarcopenia, it is recommended to consume healthy drinks such as fruit juices and milk.
Analysis of viral pneumonia and risk factors associated with severity of influenza virus infection in hospitalized patients from 2012 to 2016
Authors: Fullana Barceló M. I. , Artigues Serra F. , Millan Pons A. R. , Asensio Rodriguez J. , Ferre Beltran A. , del Carmen Lopez Bilbao M. , Reina Prieto J. , Riera Jaume M.
Published: March 2024

Background

Influenza viruses cause pneumonia in approximately one-third of cases, and pneumonia is an important cause of death. The aim was to identify risk factors associated with severity and those that could predict the development of pneumonia.

Methods

This retrospective, observational study included all adult patients with confirmed influenza virus infection admitted to Son Espases University Hospital during four influenza seasons in Spain (October to May) from to 2012–2016.

Results

Overall, 666 patients with laboratory-confirmed influenza were included, 93 (14%) of which were severe; 73 (10.9%) were admitted to Intensive Care Unit (ICU), 39 (5.8%) died, and 185 (27.7%) developed pneumonia. Compared to less severe cases, patients with severe disease: were less vaccinated (40% vs. 28%, p = 0.021); presented with more confusion (26.9% vs. 6.8%), were more hypoxemic (Horowitz index (PaO2/FiO2) 261 vs. 280), had higher C-reactive protein (CRP) (12.3 vs. 4.0), had more coinfections (26.8% vs. 6.3%) and had more pleural effusion (14% vs. 2.6%) (last six all p < 0.001). Risk factors significantly associated with severity were pneumonia [OR (95% CI) = 4.14 (2.4–7.16)], history of heart disease (1.84, 1.03–3.28), and confusion at admission (4.99, 2.55–9.74). Influenza vaccination was protective (0.53, 0.28–0.98). Compared to those without pneumonia, the pneumonia group had higher CRP (11.3 vs. 4.0, p < 0.001), lower oxygen saturation (92% vs. 94%, p < 0.001), were more hypoxic (PaO2/FiO2 266 vs. 281, p < 0.001), and incurred more mechanical ventilation, septic shock, admission to the ICU, and deaths (all four p < 0.001). Higher CRP and lower oxygen saturation were independent variables for predicting the development of pneumonia.

Conclusions

Pneumonia, history of heart disease, confusion and no influenza vaccination were independent variables to present complications in patients admitted with influenza infection.
Short-term effect of intravitreal dexamethasone implant in refractory diabetic macular edema
Authors: Moreno Jazmín Baca , Medina David Berrones , Rosellón-Escobar María Fernanda , García-Aguirre José Gerardo
Published: March 2024

Purpose

To evaluate the short-term effects (hours-days) of intravitreal dexamethasone implant (IDI) in eyes with diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) injections.

Methods

This was a prospective, single-arm, interventional clinical series. Eyes with DME and 3–9 injections of ranibizumab without a good response were included. Patients underwent a single IDI. Best-corrected visual acuity (BCVA) measurement, complete ophthalmic evaluation, and spectral-domain optical coherence tomography (SD-OCT) were performed at baseline, 2 h, 3 h, 24 h, 7 days, and 1 month. The main outcomes were change in central retinal thickness (CRT) on SD-OCT and BCVA.

Results

Fifteen eyes of 15 patients were included. Mean CRT decreased after treatment from 515.87 µm ± 220.00 µm at baseline to 489.60 µm ± 176.53 µm after 2 h (p = 0.126), and 450.13 µm ± 163.43 at 24 h (p = 0.006). Change in BCVA was from 0.85 ± 0.44 logMAR baseline to 0.58 ± 0.37 log MAR at 1 month (p = 0.003).

Conclusions

Eyes treated with IDI showed significant decrease in CRT detectable 1 day after injection. In some patients, the effect could be observed 3 h post-implantation.

Trial registration

Clinicaltrials.gov NCT05736081. Registered 20 February 2023, Retrospectively registered.
Predicting early endodontic treatment failure following primary root canal treatment
Authors: Jang Young-Eun , Kim Yemi , Kim Sin-Young , Kim Bom Sahn
Published: March 2024

Background

Understanding when and why endodontic treatments fail could help clinicians make prognoses and thus improve treatment outcomes. This study was aimed to assess potential predictors of early endodontic treatment failure. We explored factors contributing to the failure of initial root canal treatment were explored, with a specific emphasis on evaluating the influence of the time elapsed since the initial treatment.

Methods

This retrospective cohort study enrolled 1262 patients who sought endodontic treatment at our department and 175 patients were included for analysis. Potential causes of endodontic treatment failure were investigated, such as inadequate obturation quality, inadequate coronal status, the presence of additional untreated canals, anatomical complexity, instrument separation, iatrogenic perforation, cracks, and endodontic-periodontal lesions. The patients were divided into “short-term” and “long-term” groups depending on the time that had passed since the initial treatment (i.e., < 5 and > 10 years, respectively). The causes of failure in the short-term and long-term group were analyzed and compared using logistic regression analyses. Subgroup analysis was performed according to the number of years since the initial treatment in the short-term group to further investigate the association between the time and cause of failure (i.e., < 1, 2, 3, and 4 years, respectively).

Results

Untreated additional canals were present in 21.7% of all cases, and in 36.9 and 6.4% of cases in the short-term and long-term groups, respectively. Multivariable analysis showed that the presence of untreated additional canals was significantly associated with short-term compared to long-term failure. Untreated additional canals were also associated with endodontic failure within 1, 2, 3, and 4 years.

Conclusions

The presence of untreated additional canals was a predictor of endodontic failure within 5 years following initial root canal treatment. To optimize long-term prognosis, it is important to detect and treat all root canals during the initial treatment.
Implementation difficulties and solutions for a smart-clothes assisted home nursing care program for older adults with dementia or recovering from hip fracture
Authors: Lin Chung-Chih , Yang Ching-Tzu , Su Pei-Ling , Hsu Jung-Ling , Shyu Yea-Ing L. , Hsu Wen-Chuin
Published: March 2024

Background

Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. Smart clothing can provide feedback to family caregivers of older adults with disabilities who require in-home care.

Methods

This study describes the process of setting up a smart technology-assisted (STA) home-nursing care program, the difficulties encountered, and strategies applied to improve the program. The STA program utilized a smart-vest, designed specifically for older persons with dementia or recovering from hip-fracture surgery. The smart-vest facilitated nurses’ and family caregivers’ detection of a care receiver’s movements via a remote-monitoring system. Movements included getting up at night, time spent in the bathroom, duration of daytime immobility, leaving the house, and daily activity. Twelve caregivers of older adults and their care receiver participated; care receivers included persons recovering from hip fracture (n = 5) and persons living with dementia (n = 7). Data about installation of the individual STA in-home systems, monitoring, and technical difficulties encountered were obtained from researchers’ reports. Qualitative data about the caregivers’ and care receivers’ use of the system were obtained from homecare nurses’ reports, which were explored with thematic analysis.

Results

Compiled reports from the research team identified three areas of difficulty with the system: incompatibility with the home environment, which caused extra hours of manpower and added to the cost of set-up and maintenance; interruptions in data transmissions, due to system malfunctions; and inaccuracies in data transmissions, due to sensors on the smart-vest. These difficulties contributed to frustration experienced by caregivers and care receivers.

Conclusions

The difficulties encountered impeded implementation of the STA home nursing care. Each of these difficulties had their own unique problems and strategies to resolve them. Our findings can provide a reference for future implementation of similar smart-home systems, which could facilitate ease-of-use for family caregivers.