bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncertainty, Efficiency, and Stability of Mixed Traffic Flow: Stochastic Model-Based Analyses
Authors: Lu Liang , Zheng Fangfang , Liu Xiaobo
Published: January 2024

This paper proposes a stochastic model for mixed traffic consisting of human-driven vehicles (HVs), connected automated vehicles (CAVs), and degraded connected automated vehicles (DCAVs). The model addresses the issue that most of the current literature ignores: the degradation of CAVs, and the heterogeneity and uncertainty of HVs, CAVs, and DCAVs. The source of uncertainty was the heterogeneous behavior of HVs, CAVs, and DCAVs, captured using vehicle-specific car-following relations, that is, parametric uncertainty. The proposed model allowed for the explicit investigation of the uncertainty, efficiency, and stability of mixed traffic under various CAV penetration rates, different positions of CAVs in the traffic stream, and the different degradation levels of CAVs. The numerical experiment results showed that a larger CAV penetration rate helped to reduce uncertainty and improve the efficiency and stability of traffic flow. Furthermore, we investigated the impact of different position combinations of CAVs in the mixed traffic stream on traffic performance under four scenarios: 1) CAVs randomly distributed in the traffic stream, 2) CAVs forming a platoon traveling in the front of the traffic stream, 3) CAVs forming a platoon traveling in the middle of the traffic stream, and 4) CAVs forming a platoon traveling in the rear of the traffic stream. The results demonstrated that Scenario 2 gave the best performance in reducing uncertainty and improving efficiency and stability under different CAV penetration rates, whereas Scenario 4 performed the worst. Moreover, increasing degradation levels of CAVs negatively affected the reduction of uncertainty and improvement of efficiency and stability.
Fleet and Vertiport Sizing for an Urban Air Mobility Commuting Service
Authors: Kotwicz Herniczek Mark T. , German Brian J. , Preis Lukas
Published: January 2024

An understanding of fleet size and vertiport size sensitivity to demand and operational parameters is necessary to quantify the scalability of urban air mobility (UAM) services. In this work, we implement a bilevel rolling window fleet scheduling formulation that includes vertiport area as a secondary objective. We also present a simple vertiport area estimation methodology that leverages the fleet scheduling results and provides a lower bound on vertiport infrastructure area requirements. Lastly, we explore the sensitivity of fleet size and vertiport infrastructure requirements to several vehicle and operational parameters, including geographical demand distribution, daily passenger volume, vehicle passenger capacity, passenger aggregation window, battery charge rate, pad separation, and pad size. We find that, although the fleet size is reasonable for a UAM commuting service scaled to serve 10,000 passengers per day, vertiport area requirements are likely problematic under current sizing guidance from the Federal Aviation Administration, particularly area requirements for vertiports that serve as workplace hubs located in dense urban centers.
Traffic Performance Score: Measuring Urban Mobility and Online Predicting of Near-Term Traffic, like Weather Forecasting
Authors: Cui Zhiyong , Tsai Meng-Ju , Zhu Meixin , Yang Hao , Liu Chenxi , Yin Shuyi , Wang Yinhai
Published: January 2024

Measuring traffic performance is critical for public agencies which manage traffic and individuals who. This is the topic which the authors attempt to emphasize. One potential challenge for traffic prediction tasks is that short-term-incident-induced traffic pattern changes cannot be timely detected and the deployed model cannot adapt to the new traffic pattern. As for encountering long-term incidents, such as during COVID-19, traffic patterns are gradually changing, and the prediction model also needs to be periodically updated to avoid the so-called out-of-distribution problem. Therefore, the online training and predicting mechanisms can facilitate model updates, deployment of traffic prediction applications, and the planning of trips, especially when special events happen, such as the long-lasting COVID-19 pandemic. However, most existing traffic performance metrics narrowly focus on one aspect of the impacts but not comprehensive changes to the network. Further, during the pandemic, urban traffic patterns and travelers’ trip planning were dramatically affected and, thus, network-wide online traffic prediction became an urgent but more complicated task. To overcome such challenges, this study proposes a traffic performance score (TPS) incorporating multiple parameters for measuring both urban and freeway network-wide traffic performance. The TPS is compared with other metrics to show its superiority. To solve the challenging network-wide online traffic prediction task, this study also proposes an online training and updating strategy to predict network-wide traffic performance. Experimental results indicate that the proposed model with the online learning strategy outperforms existing methods in prediction accuracy and learning efficiency. In addition, the TPS measurement and its related online prediction functions are implemented on a publicly accessible platform and applied in real practice, which is another contribution of this work.
Heuristic for Railway Crew Scheduling With Connectivity of Schedules
Authors: Bansal Akshat , Anoop Kezhe Perumpadappu , Rangaraj Narayan
Published: January 2024

This paper addresses the crew scheduling for long-distance passenger train services. A heuristic with bin packing features is developed to generate repeatable crew schedules that satisfy the operational and crew allocation rules. By ensuring the connectivity of crew duties that can be repeated over periodic train schedules, a better estimate of the crew requirement in a region is also obtained. Further, the heuristic ensures a fair division of the total workload and creates long duty cycles, which also makes the process of cyclic rostering easier. The paper also presents an exact approach for crew scheduling using a combination of constraint programming and set covering formulations. The exact approach is not computationally viable for practical scale problem instances, but the heuristic generates good quality solutions (often very close to optimal) even on large data sets. We illustrate the approach on data from the Mumbai Division in Indian Railways and the computational results show that there is potential to reduce the total number of crew duties in the region by around 12%. The heuristic approach provides an efficient way to generate improved crew schedules every time there is a change in the train timetable.
Parameter design of continuous carbon fiber-reinforced phenolic resin composites via in situ-curing 3D printing technology
Authors: Dong Wencai , Bao Chonggao , Liu Rongzhen , Li Shijia
Published: January 2024

To improve the print quality and mechanical properties, the process parameters of the continuous carbon fiber-reinforced phenolic resin (CF/PF) composites were systematically investigated based on the in situ-curing 3D printing technology. The printing spacing and printing thickness affected the bonding between fiber bundles. Under the optimized parameters, the surface of the CF/PF composites was smooth and flat, without obvious gaps between the adjacent prepregs and printing layers. Especially, we optimized the resin impregnation temperature ( T i) and analyzed the influence mechanism on mechanical properties. With the increasing impregnation temperature, the resin content and the squeezing force applied to fiber bundles decrease, while the wettability between fiber and resin increases. The resin contents and the squeezing force play more important role on the mechanical properties of the CF/PF composites. With the combined influence of the above effects, the flexural strength of CF/PF composites reaches maximum value of 471.1 MPa under the impregnation temperature of 30°C, printing spacing of 0.80 mm, and printing thickness of 0.10 mm, with minimum defect volume, uniform distribution of fiber and resin, and appropriate fiber/resin interaction.
Criterion A and Non-Criterion A Racial Discrimination Experiences, Posttraumatic Stress Symptoms, and Posttraumatic Cognitions Among Black or African Americans
Authors: Wamser Rachel Ann , Richardson Julia
Published: January 2024

Racial discrimination is an unfortunately common experience for Black Americans with detrimental physical and mental health consequences. Prior research has established an association between discrimination and posttraumatic stress symptoms (PTSS); yet, trauma-related cognitions have not been studied. The majority of the existing empirical work in this area has not examined specific forms of discrimination experiences, despite potential key differences in these adversities. Relatedly, some forms of discrimination constitute “traumatic” events as defined by Criterion A for PTSD in the DSM-5 while others do not, and these distinctions have also been overlooked. Thus, the present study aimed to (a) examine discrimination, including specific types, in relation to PTSS and posttraumatic cognitions and (b) investigate whether Criterion A and non-Criterion A discrimination experiences were tied to PTSS and trauma-related thoughts. Participants were 172 undergraduate students who identified as Black or African American ( Mage = 25.11, SD = 8.25, range = 18–56; 84.9% female). Results indicated that while cumulative trauma was unrelated to PTSS, discrimination experiences were linked with higher PTSS and negative posttraumatic cognitions. Specifically, avoidance discrimination experiences were associated with both outcomes. Criterion A discrimination events were not tied to PTSS. These findings support previous research showing a link between racial discrimination and trauma-related outcomes. In addition, the results suggest that avoidance discrimination, while not classified as “traumatic,” may have an important contribution to PTSS and posttraumatic cognitions among Black individuals. The study underscores the need to address racial discrimination experiences, including microaggressions, within a traumatic stress context.
Testing the presence of cereal-type pollen grains in coastal pre-Elm Decline peat deposits: Fine-resolution palynology at Roudsea Wood, Cumbria, UK
Authors: Innes James , Rutherford Mairead , Ryan Peter , Rowley-Conwy Peter , Blackford Jeff
Published: January 2024

By the time of the Mid-Holocene Ulmus pollen decline (UD) ca. 5100 14C bp (ca. 5900 cal. BP), the Neolithic was becoming well established in Britain and Ireland. The importance of cereal cultivation as part of the initial neolithization process in the British Isles is uncertain, as archaeological sites of the first Neolithic remain elusive. Palaeoecologists have recorded cereal-type pollen grains in peat deposits that pre-date the UD significantly, but as some wild grasses can produce pollen that closely resembles cereal pollen grains, these early pollen records are not trusted as evidence of cereal cultivation. Some of these wild grass taxa grow in coastal wetland environments, making cereal-type pollen from such locations particularly open to question. This study uses fine-resolution palynology through a sequence of coastal hydroseral deposits that contain no evidence of human activity, to look for the presence of wild grass pollen of cereal size and morphology. Our results show that while such grains are not recorded at 1 cm resolution, at contiguous 2 mm resolution sampling sporadic occurrences of large grass pollen of possible cereal-type, resembling Hordeum, were detected. Morphology suggests that these cereal-type grains are of wild grass origin, almost certainly Glyceria, but their presence suggests that high-resolution analyses of coastal zone sediments will often discover cereal-type grains. Great care must be taken in identifying cereal-type pollen in coastal palaeo-wetland sediments, and rigorous identification protocols should be applied. Where grains could still be of cultivated cereal-type, the presence of other disturbance indicators is an important factor in inferring their origin.
Communicating uncertainties regarding COVID-19 vaccination: Moderating roles of trust in science, government, and society
Authors: Kim Jarim , Lee Jiyeon , Baek Jinha , Ju Jiyeon
Published: January 2024

This study examined how uncertainty affects information seeking and avoidance behaviors via information insufficiency in the COVID-19 vaccination context. It also investigated how trust in science, government, and society moderate the effects of information insufficiency. An online experiment with 131 Korean adults showed that uncertainty indirectly affects information seeking intentions via information insufficiency, which is moderated by science trust and governmental trust. It also showed that uncertainty indirectly affects information avoidance intentions via information insufficiency, which is moderated by social trust.
Counteracting climate denial: A systematic review
Authors: Mendy Laila , Karlsson Mikael , Lindvall Daniel
Published: January 2024

Despite scientific consensus on climate change, climate denial is still widespread. While much research has characterised climate denial, comparatively fewer studies have systematically examined how to counteract it. This review fills this gap by exploring the research about counteracting climate denial, the effectiveness and the intentions behind intervention. Through a systematic selection and analysis of 65 scientific articles, this review finds multiple intervention forms, including education, message framing and inoculation. The intentions of intervening range from changing understanding of climate science, science advocacy, influencing mitigation attitudes and counteracting vested industry. A number of divergent findings emerge: whether to separate science from policy; the disputed effects of emotions and the longitudinal impacts of interventions. The review offers guiding questions for those interested in counteracting denialism, the answers to which indicate particular strategies: identify the form of climate denial; consider the purpose of intervention and recognise one’s relationship to their audiences.
Hidden Reward: Affect and Its Prediction Errors as Windows Into Subjective Value
Authors: Vollberg Marius C. , Sander David
Published: January 2024

Scientists increasingly apply concepts from reinforcement learning to affect, but which concepts should apply? And what can their application reveal that we cannot know from directly observable states? An important reinforcement learning concept is the difference between reward expectations and outcomes. Such reward prediction errors have become foundational to research on adaptive behavior in humans, animals, and machines. Owing to historical focus on animal models and observable reward (e.g., food or money), however, relatively little attention has been paid to the fact that humans can additionally report correspondingly expected and experienced affect (e.g., feelings). Reflecting a broader “rise of affectivism,” attention has started to shift, revealing explanatory power of expected and experienced feelings—including prediction errors—above and beyond observable reward. We propose that applying concepts from reinforcement learning to affect holds promise for elucidating subjective value. Simultaneously, we urge scientists to test—rather than inherit—concepts that may not apply directly.
Cognitive Inertia: Cyclical Interactions Between Attention and Memory Shape Learning
Authors: Turner Brandon M. , Sloutsky Vladimir M.
Published: January 2024

In explaining how humans selectively attend, common frameworks often focus on how attention is allocated relative to an idealized allocation based on properties of the task. However, these perspectives often ignore different types of constraints that could help explain why attention was allocated in a particular way. For example, many computational models of learning are well equipped to explain how attention should ideally be allocated to minimize errors within the task, but these models often assume all features are perfectly encoded or that the only learning goal is to maximize accuracy. In this article, we argue for a more comprehensive view by using computational modeling to understand the complex interactions that occur between selective attention and memory. Our central thesis is that although selective attention directs attention to relevant dimensions, relevance can be established only through memories of previous experiences. Hence, attention is initially used to encode features and create memories, but thereafter, attention operates selectively on the basis of what is kept in memory. Through this lens, deviations from ideal performance can still be viewed as goal-directed selective attention, but the orientation of attention is subject to the constraints of the individual learner.
Religiosity, Spirituality or Environmental Consciousness? Analysing Determinants of Pro-environmental Religious Practices
Authors: Chavan Pravin , Sharma Anil
Published: January 2024

This study examines factors influencing pro-environmental practices for Ganesh idol immersion, a major Hindu religious celebration. The study explores whether environmental consciousness or spiritual beliefs and values are antecedents of pro-environment religious practices adopted for the Ganesh idol immersion. The survey used validated scales to assess spiritual beliefs, spiritual values, environmental consciousness and behaviour, and religious practices. Confirmatory factor analysis and Cronbach alpha ensured spiritual beliefs and values, environmental consciousness and behaviour, and the scale’s reliability and validity. The study has established a positive relationship between spiritual values, environmental consciousness and behaviour and pro-environmental religious practices. Spiritual belief inversely influences pro-environmental religious practices. The two-stage cluster analysis classifies respondents as environmental stewardship, pro-environmentalist, environment and religious neutral, extrinsic religiousness and intrinsic religiousness, aligning with established theory. Segmenting respondents into profiles provides insights to develop focused pro-environmental messaging that resonates across diverse audiences. These findings offer important practical implications for policymakers and environmental agencies seeking to balance religious traditions and ecological impact. Finally, the study advocates religious environmentalism to foster pro-environmental behaviour.
Resident and Caregiver Dyads Talk About Death and Dying in Assisted Living: A Typology of Communication Behaviors
Authors: Vandenberg Ann E. , Bender Alexis A. , Kemp Candace L. , Perkins Molly M.
Published: January 2024

Background

In the U.S., assisted living (AL) is increasingly a site of death, and anxiety about dying has been identified in long-term care residents and their caregivers. Communication about death and dying is associated with better quality of life and care at end of life (EOL).

Objective

To understand communication behaviors used by AL residents and their informal caregivers (i.e., family members or friends) related to death and dying, and address communication needs or opportunities applicable to EOL care in AL.

Design

A thematic analysis of in-depth interviews and fieldnotes from a subsample of data from a 5-year NIA-funded study.

Setting/Subjects

Participants included 15 resident-caregiver dyads from three diverse AL communities in Atlanta, Georgia in the U.S.

Measurements

Interview transcripts were coded for communication behavior. Concordances and discordances within dyads were examined.

Results

We identified a typology of four dyadic communication behaviors: Talking (i.e., both partners were talking with each other about death), Blocking (i.e., one partner wanted to talk about death but the other did not), Avoiding (i.e., each partner perceived that the other did not want to communicate about death), and Unable (i.e., dyads could not communicate about death because of interpersonal barriers).

Conclusions

Older residents in AL often want to talk about death but are blocked from doing so by an informal caregiver. Caregivers and AL residents may benefit from training in death communication. Recommendations for improving advance care planning and promoting better EOL communication includes timing these conversations before the opportunity is lost.
Three-dimensional quasi-static general solution for isotropic chemoelastic materials and their application
Authors: Fu Longming , Li Guocheng , Wang Sitong , Wang Hui , Ma He , Shao Xianji
Published: January 2024

Based on potential theory, the three-dimensional quasi-static general solution for isotropic chemoelastic materials is presented in this work. Through the three-dimensional general solution, the Green’s function for an isotropic chemoelastic material subjected to dynamic point loads is derived. This can serve as theoretical guidance for future engineering practices. Four functions constitute the expressions of the general solution that satisfy the harmonic functions and the quasi-static transport equation, respectively. The Green’s function for an isotropic chemoelastic material subjected to dynamic point loads is derived by combining the general solution with the chemical balance boundary conditions at infinity. It can be expressed in terms of the error function and elementary functions. Finally, the numerical results are provided, as shown in the contours. These results can be used to analyze the variation law in the coupling fields of isotropic chemoelastic materials. The corresponding analysis can provide a theoretical basis for elucidating the mechanism of the chemoelastic coupling problem in further work.
Effects of Astaxanthin Supplementation on Fatigue, Motor Function and Cognition: A Meta-Analysis of Randomized Controlled Trials
Authors: Liu Changjiang , Dong Xiaoling , Jia Jia , Ha Mei
Published: January 2024

Dietary astaxanthin supplementation has been demonstrated to have many beneficial and health-promoting effects. The purpose of this systematic review and meta-analysis was to assess the effect of astaxanthin supplementation on fatigue, cognition, and exercise efficiency. A total of 11 randomized controlled trials (RCTs) with 346 healthy participants were included. The random effects model and pooled standardized mean difference (SMDs) were used according to Hedge’s g for the meta-analysis, and a meta-regression was also conducted. The results of the two existing studies showed a positive trend for astaxanthin in subjective fatigue relief. The effects of astaxanthin supplementation for 8–12 weeks on cognitive accuracy were marginally significant (SMD: .12; 95% CI: −.02–.26) and on reaction time was not significant (SMD: −.08; 95% CI: −.26 to .10). Remarkably, astaxanthin supplementation combined with regular training could enhance the fat oxidation (SMD: 2.56; 95% CI: 1.24–3.89), and significantly improve the physical performance (SMD: .62; 95% CI: .17–1.06). The subgroup analysis further showed significantly greater benefits when performing the aerobic exercises performance (SMD: .45; 95% CI: .13–.76), when the dose was ≥ 20 mg (SMD: .37; 95% CI: .11–.63), and when the supplementation duration was > 12 weeks (SMD: .66; 95% CI: .13–.63). We conclude that astaxanthin supplementation could significantly enhance aerobic exercise efficiency, especially at higher doses and for longer durations. Further studies based on large sample sizes are imperatively warranted.
Hidradenitis Suppurativa Patient Referrals to a Canadian Community Dermatology Practice: A Retrospective Chart Review
Authors: Johnston Leah A. , Poelman Susan M.
Published: January 2024

Introduction:

Awareness of hidradenitis suppurativa (HS) among non-dermatology healthcare providers is essential to facilitate prompt diagnosis, treatment, and referral to dermatology for further management.

Objective:

The purpose of this study was to analyze recent referrals to a Canadian community dermatology practice and compare the diagnostic concordance rates for HS between dermatologists and non-dermatologists.

Methods:

This study was a single-centre, retrospective chart review that was completed at Beacon Dermatology in Calgary, AB. Patients who were referred by a non-dermatologist for suspicion of HS and/or were diagnosed with HS by a dermatologist at Beacon Dermatology for the first time between May 2020 and May 2023 were included. Referral letters and dermatology clinic notes were analyzed to extract patient demographics, suspected pre-referral and post-referral diagnoses, and interim management plans that were initiated by the referring provider.

Results:

A total of 451 patient charts with suspected and/or confirmed HS were retrieved from the clinic database. The median wait time from referral to the first dermatology appointment was 9.1 weeks. The average duration of HS symptoms was 7.3 years. HS was suspected by the referring provider and confirmed by a dermatologist in 286 cases (63%). Preliminary management was initiated in 60% of mild and 66% of moderate-to-severe cases.

Discussion:

Given the prolonged time to diagnosis of HS, increasing awareness among healthcare providers is essential. Furthermore, this study highlighted the low implementation rates for evidence-based treatment options in preliminary management plans. Ultimately, this study demonstrates the need for increased interdisciplinary education on HS management in Canada.
Optic nerve topography in multiple sclerosis diagnostic criteria: Existing knowledge and future directions
Authors: Vidal-Jordana Angela , Sastre-Garriga Jaume , Tintoré Mar , Rovira Àlex , Montalban Xavier
Published: January 2024

Current diagnostic criteria for multiple sclerosis (MS) do not consider the optic nerve as a typical topography for establishing the diagnosis. Recent studies have proved the utility of optic nerve magnetic resonance imaging, optical coherence tomography and visual evoked potentials in detecting optic nerve lesions during the early stages of MS. In addition, emerging evidence supports the inclusion of optic nerve topography as a fifth region to fulfil the dissemination in space criteria. Anticipating a modification in the McDonald criteria, it is crucial for neurologists to familiarize with the diagnostic properties of each test in detecting optic nerve lesions and understand how to incorporate them into the MS diagnostic process. Therefore, the objective of this article is to review the existing evidence supporting the use of these tests in the diagnostic process of MS and provide a practical algorithm that can serve as a valuable guide for clinical practice.
Effect of sawtooth trailing edge serrations on the reductions of airfoil broadband noise
Authors: Singh Sushil Kumar , Shankar Girija , Narayanmurthy Aadit , Baskaran Kabilan , Narayanan Subramania
Published: January 2024

The present paper examines the use of modified dual-wavelength sawtooth serrations introduced at the trailing edge (TE) of a National Advisory Committee for Aeronautics (NACA) 65 (12)-10 airfoil as a passive means for the control of airfoil broadband noise. The studies are conducted for different parameters such as serration wavelengths (λ), serration amplitudes (h) as well as (hꞌ) modified amplitude to determine the best serration parameter which provides higher noise reductions. The reduction of noise level brought by the modified dual-wavelength sawtooth serrations at the TE is about 4 dB, while it is about 3.3 dB for the simple ones. It reveals that the modified sawtooth can provide a substantial reduction of self-noise alongside the interaction noise over an extensive range of frequencies which indicates the existence of strong far-field destructive interference (i.e., feedback) from low to mid-frequency ranges (i.e., 1.5 - 5 kHz). The TE serrated airfoils show lower acoustic emissions as compared to baseline although they exhibit a common behavior for all emission angles. The large noise decrease provided by the dual-wavelength sawtooth may be because of the significant reductions in the scattering intensity of sound as well as strong far-field destructive interference owing to the presence of two roots between the two successive maximum amplitude peaks.
Automatic fault diagnosis of rolling bearings under multiple working conditions based on unsupervised stack denoising autoencoder
Authors: Wang Lei , Rao Hang , Dong Zhengcheng , Zeng Wenhui , Xu Fan , Jiang Li , Zhou Chao
Published: January 2024

In practical engineering, data often lack labels, resulting in difficulty in fault diagnosis. Because stack-denoising autoencoders possess robust feature extraction capabilities and resistance to interference, an automatic and unsupervised bearing fault diagnosis method based on the stack-denoising autoencoder without an output layer was proposed in this study. As the stacked denoising autoencoder is an unsupervised algorithm, this approach can reduce reliance on manually labeled data labels. Therefore, this study proposed a new method for automatic fault diagnosis. First, the bearing fault features of the rolling bearing were extracted using the stack denoising autoencoder without an output layer. Meanwhile, the dimensions of the features were directly reduced to two or three dimensions by several hidden layers, thereby reducing manual experience. Second, the labels extracted from the clustering model were selected as inputs for different classifier models to automatically identify different types of faults. Two open-source rolling bearing datasets under various conditions were used to validate the classification performance of the proposed method. Finally, its effectiveness was verified using the experimental results. Various indicators were used to evaluate the performance of the proposed method, and the results showed an automatic bearing fault diagnosis accuracy of up to 90% when using different models and working conditions. Among the two datasets, the classification model achieved the highest accuracies of 0.99667 and 0.97143 and the lowest accuracies of 0.98000 and 0.90476, respectively.
Instructional Coaches in Elementary Settings: Writing the Wave to Success with Self-Regulated Strategy Development for the Informational Genre
Authors: Ray Amber B , FitzPatrick Erin
Published: January 2024

Self-regulated strategy development (SRSD) is an evidence-based practice for writing that is effective in improving the writing performance of elementary students with learning disabilities and the broader student population. In this manuscript, we provide guidance for elementary instructional coaches in facilitating a schoolwide adoption of SRSD for writing instruction. We outline the steps for instructional coaches to conduct practice-based professional development and then discuss ways instructional coaches can support teachers and oversee schoolwide SRSD implementation. Finally, we present ways that instructional coaches can be a valuable resource for teachers in differentiating SRSD instruction to meet students’ needs and to track students’ growth. By fostering a schoolwide implementation, coaches can harness the power of additive knowledge, increase teacher knowledge of evidence-based pedagogical practices, and increase the writing skills of all students, including those with learning disabilities.
Exploring Preventive Health Care Utilization Among Black/African American Men
Authors: Jordan Harrell , Jeremiah Rohan , Watson Karriem , Corte Colleen , Steffen Alana , Matthews Alicia K.
Published: January 2024

Black/African American (BAA) men have the lowest life expectancy among other major demographic groups in the United States, with BAA male mortality rates 40% higher than their White male counterparts. Despite known benefits of preventive health care utilization, BAA men are 43% more likely to use the emergency department for usual care. Many intersecting factors like medical mistrust and religion have been identified as common barriers BAA men face in health care utilization with few studies exploring factors that impact their current preventive health care utilization. In addition, BAA men’s perceptions of health and ability to identify or seek help have always been disproportionately lower than other racial groups despite higher rates of preventable diseases. Using the tenets of the Andersen Healthcare Utilization Model, this cross-sectional study of 176 BAA men explores BAA men’s current preventive health care practices while examining the intersection of predisposing, enabling, and need factors on BAA men’s preventive health care utilization. While it is well known that higher income levels and higher education positively influence health care utilization, the intersection of religious affiliation and higher levels of medical mistrust was associated with BAA men’s decreased engagement with health care as religion posed as a buffer to health care utilization. This study demonstrated that BAA men’s perception of health differed by sexual orientation, educational status, and income. However, across all groups the participants’ perspective of their health was not in alignment with their current health outcomes. Future studies should evaluate the impact of masculine norms as potential enabling factors on BAA men’s preventive health care utilization.
Trigger Finger Release Using Wide-Awake Local Anesthesia No Tourniquet Versus Local Anesthesia With a Tourniquet: A Systematic Review and Meta-analysis
Authors: Levit Tal , Lavoie Declan C. T. , Dunn Emily , Gallo Lucas , Thoma Achilles
Published: January 2024

Trigger finger release (TFR) is a common hand surgery, historically performed using a tourniquet. Recently, wide-awake local anesthesia no tourniquet (WALANT) has gained popularity due to ostensible advantages such as improved patient pain, satisfaction, lower rate of complications, and decreased cost. This systematic review compares outcomes of WALANT for TFR with local anesthesia with a tourniquet (LAWT). MEDLINE, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched. All English-language peer-reviewed randomized and observational studies assessing TFR in adults were included. Quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Eleven studies (4 randomized controlled trials, 7 observational) including 1233 patients were identified. In the WALANT group, pain on injection was statistically nonsignificantly lower (mean difference [MD]: −1.69 points, 95% confidence interval [CI] = −4.14 to 0.76, P = .18) and postoperative pain was statistically lower in 2 studies. Patient and physician satisfaction were higher and analgesic use was lower in WALANT. There were no significant differences between groups for functional outcomes or rates of adverse events. Preoperative time was longer (MD: 26.43 minutes, 95% CI = 15.36 to 37.51, P < .01), operative time similar (MD: −0.59 minutes, 95% CI = −2.37 to 1.20, P = .52), postoperative time shorter (MD: −27.72 minutes, 95% CI = −36.95 to −18.48, P < .01), and cost lower (MD: −52.2%, 95% CI = −79.9% to −24.5%) in WALANT versus LAWT. The GRADE certainty of evidence of these results ranges from very low to low. This systematic review does not confirm superiority of WALANT over LAWT for TFR due to moderate to high risk of bias of included studies; further robust trials must be conducted.
Using Video-Reflexive Ethnography on an Acute Medical Unit: Methodological Challenges, Solutions and Opportunities within a Complex and Busy Clinical Setting
Authors: Dickson Jane , Mesman Jessica , Guthrie Bruce , Grant Suzanne
Published: January 2024

Video-Reflexive Ethnography (VRE) is an innovative and participatory research and improvement methodology that involves videoing in-situ work practices and collaboratively analysing this footage with participants during reflexive sessions. This involves participants ‘slowing down’, engaging reflexively with their everyday working practices, and taking time out to discuss issues collectively. VRE has increasingly been used across a range of different healthcare settings. However, one setting that has received less attention is the Acute Medical Unit (AMU). AMUs are busy short-stay hospital departments with very high patient throughput and large multidisciplinary teams where patients receive initial assessment, diagnosis and treatment before being moved to other wards or settings. The aim of this study was to examine how VRE as a research and improvement methodology can be applied, in the busy and complex setting of an AMU. In this paper we outline some of the methodological challenges encountered in this setting and discuss how these were transformed into opportunities and solutions. Then, we evaluate our work by using the four guiding principles at the heart of VRE (care, collaboration, reflexivity and exnovation) to test if, and how, the methodology can be used in such a complex and busy setting without losing its methodological rigor and impact. We show how it is possible to initiate and achieve the core principles of VRE in the complex and busy AMU setting through careful planning, constant revision of data collection methods, remaining highly flexible and adaptable to the spatial and temporal rhythms of the ward and being sensitive to hierarchical inter- and intra-professional relationships and vulnerabilities. Finally, we share recommendations for using VRE in other busy and complex settings.
‘A commitment to Equality, Diversity and Inclusion’: a conceptual framework for equality of opportunity in Patient and Public Involvement in research
Authors: Lignou Sapfo , Sheehan Mark , Singh Ilina
Published: January 2024

Many research institutions and funders have recently stated their commitment to actively support and promote ‘Equality, Diversity and Inclusion’ (EDI) in various aspects of health research including Patient and Public Involvement (PPI). However, translating this commitment into specific research projects presents significant challenges that existing approaches, practical guidelines and initiatives have not adequately addressed. In this paper, we explore how the lack of clear justifications for the EDI commitment in existing guidelines inadvertently complicates the work of those involved with PPI and we stress the need for conceptual clarity for any EDI effort to yield meaningful results. Our focus centres on the first principle of the EDI discourse, ‘equality’, particularly in the form of ‘equality of opportunity’ as outlined in current guidance provided by the National Institute of Health Research in the United Kingdom. We examine challenges related to justifying and implementing a general, unspecified commitment to equality of opportunity and explain that this reflects a lack of consensus regarding the moral value of PPI in research – a profound problem that remains unaddressed. We then discuss how the presence of several opposing moral perspectives on PPI, makes determining the most appropriate way of addressing barriers to involvement complex and controversial, raising ethical implications for the work of health researchers, PPI specialists and coordinators. Finally we make suggestions on how future research can enrich the concept of ‘equality of opportunity’ in PPI and improve practice. While our primary focus is on the NIHR, a strong advocate of PPI in research, this analysis will point to normative and ethical considerations that may be relevant to other research institutions and funding organisations aiming to promote equality of opportunity in their public and patient involvement strategies.
Use of double-balloon endoscopy and an endoscopic scoring system to assess endoscopic remission in isolated small bowel Crohn’s disease after treatment with infliximab
Authors: Han Wei , Hu Jing , Wu Juan , Zhang Peipei , Liu Qiuyuan , Hu Naizhong , Mei Qiao
Published: January 2024

Background:

It is unclear how clinical and endoscopic factors affect the attainment of endoscopic remission (ER) in patients with small bowel Crohn’s disease (SB-CD) who are infliximab-naïve.

Objectives:

We aimed to identify the effect of different factors on attaining ER using double-balloon endoscopy (DBE) evaluation.

Design:

A single-center retrospective observational study was conducted from 1 January 2018 to 30 November 2022. Among 262 patients who were screened for isolated SB-CD by baseline DBE, 108 patients were assessed for effectiveness during maintenance infliximab therapy by a second DBE evaluation.

Methods:

DBE findings before and after infliximab therapy were compared. ER was defined as a simple endoscopic score for CD (SES-CD) below 3, and segmental ER as SES-CD activity of 0. Multivariate regression with calculations of odds ratios (OR) was used to determine the impact of different factors on attaining ER.

Results:

In all, 41 patients (38.0%) achieved ER. An elevated C-reactive protein at week 6 was independently associated with a decreased probability of ER [OR: 0.86, 95% confidence interval (CI) = 0.75–0.98, p = 0.03]. Segmental ER of the terminal ileum, rather than the proximal ileum, was associated with a higher rate of ER (60.9% versus 38.2%, p = 0.01). High baseline SES-CD (⩾16) was unrelated to overall ER. For patients with disease in the terminal ileum, those with moderate/severe disease were less likely to attain segmental ER than those with mild disease [adjusted odds ratios (aOR): 0.27, 95% CI: 0.09–0.83, p = 0.02]. A large ulcer in the terminal ileum was associated with a lower rate of segmental ER (aOR: 0.18, 95% CI: 0.06–0.56, p = 0.01).

Conclusion:

For infliximab-naïve patients with SB-CD, the overall severity of the endoscopic score was unrelated to attainment of ER. Patients were less likely to attain segmental ER if they had greater endoscopic inflammation or larger ulcers in the terminal ileum.
Longitudinal genetically detectable minimal residual disease by fluorescence in situ hybridization confers a poor prognosis in myeloma
Authors: Cui Jian , Yu Tengteng , Lv Rui , Liu Jiahui , Fan Huishou , Yan Wenqiang , Xu Jingyu , Du Chenxing , Deng Shuhui , Sui Weiwei , Ho Matthew , Xu Yan , Anderson Kenneth C. , Dong Xifeng , Qiu Lugui , An Gang
Published: January 2024

Background:

Deeper depth of response (DpR) after induction therapy, especially gain of negative minimal residual disease (MRD), has been linked to prolonged survival in multiple myeloma (MM). However, flow-MRD examination focuses on the numbers but not on the biological characteristics of residual plasma cells (PCs).

Objectives:

To explore whether the genetic features of residual tumor cells affect the survival time of patients with MM.

Design:

A retrospective cohort study.

Methods:

We investigated the clonality of cytogenetic abnormalities (CAs) of the residual PCs using interphase fluorescence in situ hybridization (iFISH) in the National Longitudinal Cohort of Hematological Diseases in China (NCT04645199). Here, a longitudinal cohort of 269 patients with patient-paired diagnostic and post-induction iFISH results was analyzed.

Results:

Persistent CAs after induction therapy were detected in about half of the patients (118/269, 43%), and patients with undetectable CAs showed significantly improved survival compared with those with genetically detectable MRD [median progression-free survival (mPFS): 59.7 versus 35.7 months, p < 0.001; median overall survival (mOS): 97.1 versus 68.8 months, p = 0.011]. In addition, different patterns of therapy-induced clonal evolution were observed by comparing the clonal structure of residual PCs with paired baseline samples. Patients who maintained at a high risk during follow-up had the worst survival (mPFS: 30.5 months; mOS: 54.4 months), while those who returned to lower risk or had iFISH− at both time points had the best survival (mPFS: 62.0 months, mOS: not reached).

Conclusion:

These findings highlighted the prognostic value of genetic testing in residual tumor cells, which may provide a deep understanding of clonal evolution and guide clinical therapeutic strategies.
The impact of the HER2-low status on conditional survival in patients with breast cancer
Authors: Ma Teng , Liu Changgen , Ma Tianyi , Sun Xinyi , Cui Jian , Wang Lulu , Mao Yan , Wang Haibo
Published: January 2024

Introduction:

With recent advances in breast cancer (BC) treatment, the disease-free survival (DFS) of patients is increasing and the risk factors for recurrence and metastasis are changing. However, a dynamic approach to assessing the risk of recurrent metastasis in BC is currently lacking. This study aimed to develop a dynamically changing prediction model for recurrent metastases based on conditional survival (CS) analysis.

Methods:

Clinical and pathological data from patients with BC who underwent surgery at the Affiliated Hospital of Qingdao University between August 2011 and August 2022 were retrospectively analysed. The risk of recurrence and metastasis in patients with varying survival rates was calculated using CS analysis, and a risk prediction model was constructed.

Results:

A total of 4244 patients were included in this study, with a median follow-up of 83.16 ± 31.59 months. Our findings suggested that the real-time DFS of patients increased over time, and the likelihood of DFS after surgery correlated with the number of years of prior survival. We explored different risk factors for recurrent metastasis in baseline patients, 3-year, and 5-year disease-free survivors, and found that low HER2 was a risk factor for subsequent recurrence in patients with 5-year DFS. Based on this, conditional nomograms were developed. The nomograms showed good predictive ability for recurrence and metastasis in patients with BC.

Conclusion:

Our study showed that the longer patients with BC remained disease-free, the greater their chances of remaining disease-free again. Predictive models for recurrence and metastasis risk based on CS analysis can help improve the confidence of patients fighting cancer and help doctors personalise treatment and follow-up plans.
Prolonged progression-free survival achieved by gemcitabine, cisplatin, and albumin-bound paclitaxel for the treatment of advanced biliary tract cancers
Authors: Choi Jin Ho , Park Hwanhee , Park Joo Kyung , Lee Jong Kyun , Lee Kyu Taek , Lee Kwang Hyuck
Published: January 2024

Background:

A regimen of gemcitabine, cisplatin, and nab-paclitaxel (GPA) has shown promising results in patients with advanced biliary tract cancer (aBTC).

Objectives:

This study aimed to evaluate the benefit of GPA compared to a regimen of gemcitabine plus cisplatin (GP) in patients with aBTC.

Design:

Retrospective study.

Methods:

Patients with aBTC who received first-line chemotherapy with GPA or GP regimen at the Samsung Medical Center between July 2020 and June 2022 were included. The primary endpoint was progression-free survival (PFS).

Results:

In all, 37 patients were treated with GPA and 43 patients with GP. The GPA group showed significantly longer median PFS [12.0 months (95% CI, 7.2–16.8)] compared to the GP group [5.5 months (95% CI, 3.7–7.4; p = 0.007)]. The median overall survival (OS) was also longer in the GPA group [18.7 months (95% CI, 13.7–23.7)] than in the GP group [10.7 months (95% CI, 1.5–19.9); p = 0.021]. First-line chemotherapy with GPA was associated with longer PFS, while metastatic disease at initial diagnosis and post-treatment increase in CA 19-9 level were associated with worse PFS.

Conclusion:

The GPA regimen improved the PFS of patients with aBTC compared to the GP regimen but showed no significant benefit in terms of OS after adjusting for confounding variables. Further large-scale studies are required to establish optimal indications for GPA.