bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of health risk experienced by urban taxi drivers to whole-body vibration and multiple shocks
Authors: Salehi Sahlabadi Ali , Azrah Keykāvus , Mehrifar Younes , Poursadeghiyan Mohsen
Published: May 2024

This cross-sectional study was done aiming at determining the exposure of taxi drivers to vibration on 35 safe taxis (19 cars with engine volume of 1.325 L, 9 cars with engine volume of 1.645 L, and 7 cars with engine volume of 1.761 L). Measurements were based on ‘ISO 2631-1’ on seats’ pans, by Castel GA2005 vibrometer. The results through two different evaluative methods indicated moderate exposure levels, corresponding to suggestive Health Guidance Caution Zone (HGCZ) in ‘ISO 2631-1’. Evaluation of exposure to the WBV among taxi drivers, in the taxis with low and high mean acceleration values, using the VDV method is preferred over the R.M.S method. In lower accelerations, in all conditions, the mean of the reckoned values in the VDV method was less than the R.M.S method, and in higher accelerations, where there are more differences, and the CF values were higher (PAIK 1761 cars), again the assessed mean duration in the VDV method is less than R.M.S method. In higher accelerations and with fewer crest factors, this matter didn’t hold, and the allowed time in the R.M.S method became lower.
Neural adaptive dynamic surface control for position tracking of electrohydraulic servo systems based on extended state observer
Authors: Liu Liyan , Shen Gang , Wang Wei , Li Xiang , Zhu Zhencai
Published: May 2024

High-performance motion tracking of electro-hydraulic servo systems plays an important role in developing industrial technology. However, the system itself has parameter uncertainty, uncertain nonlinearity, and measurement noise, significantly decreasing the performance of conventional controllers designed based on nominal models. To improve the tracking performance of electro-hydraulic servo systems, an adaptive dynamic surface control method combining extended state observer and radial basis function neural network is proposed. Firstly, an extended state observer combining neural network output and parameter adaptation technology is designed without the need for speed and pressure feedback to observe the system’s unknown state variables and nonlinear matched disturbance. The design of neural networks is used to approximate mismatched disturbance with significant nonlinearity online. Then, the proposed extended state observer is introduced into the neural adaptive backstepping design, effectively compensating for simultaneous matched and mismatched disturbances, thereby suppressing most of the uncertain nonlinearity of the system. Meanwhile, online update of uncertain parameters further improves the tracking performance of the controller. In addition, the introduction of dynamic surface overcomes the “explosion of complexity” issue in backstepping design. The rigorous stability of the closed-loop system is proved by the Lyapunov stability theory. Finally, the effectiveness of the proposed controller is validated through comparative experiments on valve-controlled hydraulic cylinder.
Distributed l2−l∞ filtering over wireless sensors based on adaptive event triggering
Authors: Li Zhongqi , Zhu Fengzeng , Zhang Ancai , Pang Guochen
Published: May 2024

This paper investigates the design problem of a set of distributed filters. These adaptive event-triggered (AET) filters have the [Formula: see text] property and are suitable for sensor networks characterized by random measurement data loss and dynamic topology switching. In a distributed filtering network, each local filter estimates the system’s state not only relying on the node’s individual information but also using information from neighboring nodes in the network topology. The adaptive event triggering condition is determined by the combination of the latest release data of the filter itself, the estimated value of the current moment, and the latest release data of the neighboring nodes. The event triggering mechanism adopts a threshold adaptive adjustment scheme, which dynamically changes the threshold parameter according to the filtering error under the premise of guaranteeing the filter performance, thus maximally saving the network communication resources. Initially, we used a binary sequence to describe the random loss of sensor measurements, and a Markov chain is used to describe the switching of the filtering network topology. Secondly, a Lyapunov function is created to examine the [Formula: see text] performance index of the filtering error system and investigate its mean square exponential stability. Subsequently, the distributed filter is formulated, and its parameters are determined using the linear matrix inequality approach. Ultimately, the validity of the proposed method is substantiated through numerical illustrations.
An ARDL Method for Evaluating Bangladesh’s Economic Growth Concerning Female Secondary Education
Authors: Dhar Soma , Sarker Tapan
Published: May 2024

The purpose of this study is to investigate the association between Bangladesh’s economic growth and female secondary education. For this reason, the effects of female secondary education, female labour force participation rate, and female fertility rate on Bangladesh’s Real GDP growth rate are investigated over the years 1995–2021, using a quantitative approach. A long-term relationship between the variables is demonstrated by the Auto Regressive Distributive Lag (ARDL) Cointegration Model, wherein the fertility rate is negatively significant and the female participation rate in the labour force and secondary education are positively significant on the real GDP growth rate. The study uses the Error Correction Model (ECM) to record the speed of adjustment. There is short-run adjustment throughout the entire system, as indicated by the statistically significant and theoretically correct sign of the error correction term coefficient. A more thorough examination is necessary as the Causality test reveals an unanticipated unidirectional association between female secondary education and economic growth.
Book review: K. A. Busia, The Challenge of Africa
Authors: Mohanty Sasmita
Published: May 2024

K. A. Busia, The Challenge of Africa (New York: Routledge Taylor and Francis Group in Cooperation with BFI Publication, 2023), 151 pp., ₹7,140.00. ISBN 978-1-032-24793-9 (Hardback), ISBN 978-1-032-24851-6 (Paperback), ISBN 978-1-003-28040-8 (e-book).
Evolution of the damage precursor based on the felicity effect in shale
Authors: Gautam PK , Dwivedi Rishabh , Garg Peeyush , Majumder Dipaloke , Agarwal Siddhartha , McSaveney Maurice , Singh TN
Published: May 2024

Damage precursors during hydraulic fracturing in shale gas reservoirs may be better understood if the deformation, failure, and acoustic emission (AE) characteristics under cyclic loading are known. Therefore, the purpose of this paper is to investigate the quantitative damage based on the Felicity effect under constant stress lower limit uniaxial cyclic loading-unloading rates (0.5, 1.0, 1.5, 2.0, and 2.5 kN/s). Variations in the b-value and the spatiotemporal evolution of cumulative AE were also used to observe how shale fractures formed. The findings reveal that during the unloading stage, there are many cumulative AE events when the stress level is low (≤1.50 kN/s) but that this number drops significantly when the stress level increases above (>2.0 kN/s). The AE amplitude, AE counts, and cumulative AE energy of each cycle in a loading-unloading test show an increasing trend, but the rate increases in the last cycle. During the whole process of loading and unloading, the Kaiser effects were present in the 3rd cycle at stress levels (≤1.5 kN/s). Still, the Felicity effect appeared in the 2nd and 1st cycles during 2.0 and 2.5 kN/s cyclic loading. The Kaiser effect occurs in the linear elastic stage, while the Felicity effect occurs in the crack initiation and crack damage stage. Furthermore, the Felicity ratio (FR) variations during shale deformation and failure can be divided into four phases: (Phase I = 1.01 ≥ FR > 0.89), (Phase II = 0.89 ≥ FR > 0.48), (Phase III = 0.48 ≥ FR > 0.23), and (Phase IV = FR ≤ 0.23). The b-value is relatively higher under the loading rate below (≤1.50 kN/s), indicating an increase in the number of small AE events. In contrast, the fact that the b-value is relatively smaller under the loading rate above (>2.0 kN/s) indicates that, the number of large AE events increases the number of cracks and fractures. These findings provide important design references for damaged precursors during hydraulic fracturing in shale gas reservoirs.
Experimental test and analysis of impact suppression for hydraulic-driven leg using a new MR damper with multi-channels
Authors: Huang Hui , Yang Xin , Ma Baizhou , Xiao Lanfang , Chen Shumei , Li Yuzheng , Lin Xiufang
Published: May 2024

When hydraulic-legged robots move under high loads on irregular ground, they are vulnerable to ground impacts. Vibration affects the motion performance of the robot and damages its mechanical structure. This study aims to improve the properties of vibration absorption and impact resistance of hydraulic-legged robots. Because the traditional MR damper (MRD) has small output in finite volume, a novel MRD with a multistage flow channel (MFC-MRD) can output a large damping force designed. First, an MRD prototype was designed for a mechanical leg’s driving joint. Subsequently, the system is analyzed theoretically, and a semi-active control strategy is designed and simulated. Finally, the vibration and impact resistance of the prototype were tested. The experimental results show that in the signal tracking experiment, the maximum overshoot under semi-active control was reduced by 53.0%, and the settling time was reduced by 76.9% compared with the passive control. The impact test reduced the maximum displacement fluctuation by 41.09%, and the buffer time is only 0.24 s.
Emotional Clarity and Psychopathology in Women Who Have Experienced Physical Intimate Partner Violence
Authors: Joseph Annie-Lori , Jerram Matthew W. , Valera Eve M.
Published: May 2024

Intimate partner violence (IPV) is a chronic, traumatic stressor related to posttraumatic stress (PTS), depression, and anxiety. As psychological symptoms are exacerbated in those with poor emotional clarity, the present study evaluates the relationship between emotional clarity and PTS, dissociation, depression, and worry in women who experienced at least one instance of physical IPV ( n = 88). Hierarchical regression analyses, controlling for childhood trauma, IPV abuse severity, and IPV-related brain injury, found that lack of emotional clarity was significantly related to greater PTS, dissociative experiences, depression, and worry. Results suggest that emotional clarity may be a relevant therapeutic target for individuals with a history of IPV and psychological distress.
Assessing the causal relationship between obesity and hypothyroidism using Mendelian randomization
Authors: Li Xin , Li Huilin , Hong Tao , Li Zanlin , Wang Zhi
Published: May 2024

To explore the causal relationship between obesity and hypothyroidism and identify risk factors and the predictive value of subclinical hypothyroidism (SCH) in obese patients using Mendelian randomization, this study employed five Mendelian randomization methods (MR Egger, Weighted Median, Inverse Variance Weighted, Simple Mode, and Weighted Mode) to analyze clinical data from 308 obese patients at the People’s Hospital of Xinjiang Uygur Autonomous Region, from January 2015 to June 2023. Patients were divided based on thyroid function tests into normal (n = 173) and SCH groups (n = 56). Comparative analyses, along with univariate and multivariate logistic regression, were conducted to identify risk factors for SCH in obese patients. A significant association between obesity and hypothyroidism was established, especially highlighted by the inverse variance weighted method. SCH patients showed higher ages, thyroid-stimulating hormone levels, and thyroid autoantibody positivity rates, with lower T4 and FT4 levels. Age, FT4, thyroid autoantibodies, TPO-Ab, and Tg-Ab were confirmed as risk factors. The predictive value of FT4 levels for SCH in obesity was significant, with an Area Under the Curve (AUC) of 0.632. The study supports a potential causal link between obesity and hypothyroidism, identifying specific risk factors for SCH in obese patients. FT4 level stands out as an independent predictive factor, suggesting its utility in early diagnosis and preventive strategies for SCH.
Decoding medical educators’ perceptions on generative artificial intelligence in medical education
Authors: Cervantes Jorge , Smith Blake , Ramadoss Tanya , D’Amario Vanessa , Shoja Mohammadali M. , Rajput Vijay
Published: May 2024

Generative AI (GenAI) is a disruptive technology likely to generate a major impact on faculty and learners in medical education. This work aims to measure the perception of GenAI among medical educators and to gain insights into its major advantages and concerns in medical education. A survey invitation was distributed to medical education faculty of colleges of allopathic and osteopathic medicine within a single university during the fall of 2023. The survey comprised 12 items, among those assessing the role of GenAI for students and educators, the need to modify teaching approaches, GenAI’s perceived advantages, applications of GenAI in the educational context, and the concerns, challenges, and trustworthiness associated with GenAI. Responses were obtained from 48 faculty. They showed a positive attitude toward GenAI and disagreed on GenAI having a very negative effect on either the students’ or faculty’s educational experience. Eighty-five percent of our medical schools’ faculty responded to had heard about GenAI, while 42% had not used it at all. Generating text (33%), automating repetitive tasks (19%), and creating multimedia content (17%) were some of the common utilizations of GenAI by school faculty. The majority agreed that GenAI is likely to change its role as an educator. A perceived advantage of GenAI in conducting more effective background research was reported by 54% of faculty. The greatest perceived strengths of GenAI were the ability to conduct more efficient research, task automation, and increased content accessibility. The faculty’s major concerns were cheating in home assignments in assessment (97%), tendency for blunder and false information (95%), lack of context (86%), and removal of human interaction in important feedback processes (83%). The majority of the faculty agrees on the lack of guidelines for safe use of GenAI from both a governmental and an institutional policy. The main perceived challenges were cheating, the tendency of GenAI to make errors, and privacy concerns.

The faculty recognized the potential impact of GenAI in medical education. Careful deliberation of the pros and cons of GenAI is needed for its effective integration into medical education. There is general agreement that plagiarism and lack of regulations are two major areas of concern. Consensus-based guidelines at the institutional and/or national level need to start to be implemented to govern the appropriate use of GenAI while maintaining ethics and transparency. Faculty responses reflect an optimistic and favorable outlook on GenAI’s impact on student learning.
An experimental study of multi-core composite aluminium honeycomb sandwich panels under low-velocity impacts
Authors: Pandey Akhileshwar , Singh Ashutosh , Upadhyay A.K. , Shukla K.K.
Published: May 2024

This paper aims to evaluate the impact response of the multi-core composite sandwich panels from low-velocity experiments. Geometrical parameters of sandwich panels like cell size, cell height, and facesheet thickness are varied and their effect on peak load, energy absorption, and efficiency is reported in this article. The effect of impact energy variation ongraded and non-graded types of sandwich panels is also studied. Based on these experiments suitable recommendations are given for impact energy absorber applications. From a crashworthiness point of view, graded multi-core composite sandwich panels are found to be more effective than non-graded ones.
The man for the job. How working-class men express masculinity in the normative ambivalence of an occupational limbo
Authors: Sanson David , Le Breton Claire
Published: May 2024

This paper draws on an ethnography of a French industrial factory to examine how working-class men trapped in context of indefinite in-betweeneness, framed as an “organizational limbo,” navigate the multiple ambivalent norms at play. It explores how this confusing situation engenders ways to express masculinity that differ from the discursive and corporal manners that the literature usually associates with virility affirmation among French industrial workers. The data indeed show that, in the complex context under study regulated by differing and sometimes contradictory standards, being “the man for the job” has various and ambivalent meanings: workers paradoxically fail to be perceived “as real men” when they rely on a single set of practices expressing an immutable form of masculinity. The paper uncovers how these blurred, contradictory expectations and attitudes combine to drag workers into a spiral of unresolved gender politics. In so doing, this work opens up further research avenues on the role of in-betweenness and hybridity in the lived practices of contemporary class-gender identity formations.
Cognitive demand in parent–child shared book reading and home language development among dual language learners in low-income immigrant families
Authors: Mak Emily , Mauer Ezra , Luo Rufan , Zhou Qing , Uchikoshi Yuuko
Published: May 2024

Aims and objectives:

The existing literature indicates that shared book reading is associated with benefits in children’s home language development. Parents play a significant role in shaping children’s language outcomes. The purpose of this study was to investigate the relations among the quality of parents’ shared book reading, children’s language output, receptive vocabulary, and expressive vocabulary outcomes in the home language of dual language learners (DLLs) to inform book reading practices that can support DLLs’ early home language development.

Methodology:

36 Mexican American (43–67 months) and 31 Chinese American (38–70 months) DLLs and their mothers, who were home language dominant, were recruited from Head Start programs, which are federally funded programs that provide early childhood education to low-income children, in Northern California.

Data and analysis:

Utterances produced by the parents during parent–child shared book reading were coded for cognitive demand levels. DLLs’ home language expressive vocabulary and receptive vocabulary and information about parents’ demographics and parent–child shared reading frequency were collected. Correlations and hierarchical regression analyses were computed.

Findings/conclusions:

The findings demonstrated possible cultural differences in mothers’ book reading quality regarding cognitive demand. Although maternal statements and questions were not significantly associated with DLLs’ home language receptive and expressive vocabulary for both groups, asking yes/no, referential, and inferential questions were more likely to evoke more language output from DLLs.

Originality:

This study extends the literature on home language development of low-income DLLs during parent–child shared reading, as only a few studies have investigated the significance of shared reading in the home language.

Significance/implications:

The findings of this study yield important implications for parents’ shared reading practices with low-income DLLs. Using all levels of cognitively demanding speech and encouraging DLLs to talk during shared reading may benefit their home language development.
No such thing as peacetime: Notes on Gaza, Hannah Arendt and cultural studies
Authors: McRobbie Angela
Published: May 2024

This comment piece, prompted by the ongoing conflict in Gaza and the terrible toll of lives of Gazan people following the Hamas attack on Israel on 7 October 2023, argues that the field of cultural studies has its origins in a notion of post-war peacetime and that this has created a vocabulary deficit in regard to war, genocide and state violence. Paul Gilroy and Stuart Hall have confronted patterns of violence in regard to the urban environment and the policing of Black youth as well as the escalation in day-to-day authoritarianism and the rise of the right. There is a strong case to be made however for the field of cultural studies to more fully draw on political philosophy including Middle East scholarship to engage more directly with the politics of occupation, settler colonialism, neo-nationalism and the far right.
Between acute medicine and municipal alcohol treatment: Cross-sectoral collaborations regarding patients with alcohol problems
Authors: Sivertsen Ditte Maria , Becker Ulrik , Andersen Ove , Kirk Jeanette Wassar
Published: May 2024

Aim: The aim was to examine cross-sectoral collaborations of a Danish emergency department (ED) and two municipal treatment centres in the uptake area regarding patients with alcohol problems. Methods: The study was a qualitative exploratory study. We conducted individual interviews with ED nurses and secretaries ( n = 21) and group interviews ( n = 2) in municipal alcohol treatment centres with three and four participants, respectively. Interviews were analysed, first with qualitative content analysis, then by applying the analytical concept “boundary object”. Results: Three themes emerged: (1) Responsibilities in practice; (2) Professional contrasts; and (3) The social nurse in a unique position. Themes illuminated a low degree of collaboration characterising the intersectoral work. Blurred responsibilities, challenged communication and acute versus long-term focus were some of the factors not supporting cross-sector collaborations. However, the function of the social nurse was highly appreciated in both sectors and plays a central role. Nonetheless, implicit limitations of this function entail that not all patients with alcohol problems are referred and handled within an ED setting. Conclusions: Overall, we found a lack of collaborative work between healthcare professionals in ED and municipalities for patients with alcohol problems. However, the “social nurse” function was greatly valued in both sectors due to a mediating role, since healthcare professionals in both sectors experienced lack of organisational structures supporting collaborative network, perceived temporal barriers, limited knowledge exchange and differences in approaches to patients.
Impact of oral administration of calcitriol to prevent symptomatic hypocalcemia after total thyroidectomy: Systematic review and meta-analysis
Authors: Dadkhah Parisa A. , Farshid Amirali , Khademi Reza , Yaghoubi Shayan , Asadzadeh Ailin , Moharamnejad Nima , Jadidian Faezeh , Ziaei Seyed A. , Haghshoar Sepehr , Salimi Omid , Shafagh Seyyed-Ghavam , Rabiei Negin , Shahsavari Saleh , Shokravi Samin , Maroufi Zahra , Deravi Niloofar , Erabi Gisou , Naziri Mahdyieh
Published: May 2024

Background:

One of the most common complications of total thyroidectomy is post-operative transient or persistent hypoparathyroidism that can cause symptomatic hypocalcaemia. To prevent this complication, shorten the period of hospitalization and reduce morbidity, routine supplementation of oral vitamin D and calcium has been suggested. This systematic review and meta-analysis aims to critically assess the association between pre-operative calcitriol supplementation and post-operative hypocalcaemia.

Methods:

Randomized controlled trial studies were identified by searching PubMed, Scopus, and Google Scholar databases up to 30 March 2023. Screening of titles, abstracts, and full texts of articles were performed, and data were extracted for a meta-analysis.

Results:

This meta-analysis includes data from nine randomized controlled trials with a total of 1259 patients but with significant heterogeneity. The results demonstrate that calcium levels were higher in patients who had pre-operative calcitriol supplementation, with a weighted mean difference (WMD) 0.18 (95% confidence interval (CI) = 0.00, 0.37). Pre-operative calcitriol supplementation did not lead to significant changes in parathyroid hormone (PTH) levels, with WMD −0.49 (95% CI: −1.91, 0.94).

Conclusion:

Pre-operative calcitriol supplementation leads to higher calcium levels, but the high heterogeneity of the included studies (79% to 98.7%) could affect the results.
Influence of operating conditions in nonlinear vibration of a drill-string
Authors: Almeida Simone Faria , Vignoli Lucas Lisbôa
Published: May 2024

In this work, the vibrational analysis of an oil drill-string is carried out concerning nonlinear and nonsmooth dynamical model with coupled axial-torsional modes. This study aims to investigate the influence of operating conditions to avoid bit-bounce and stick-slip phenomena. A discrete lumped dynamic model with two degrees of freedom is considered. Dry friction and the possibility of loss of contact between the bit and the formation introduce two nonsmooth conditions into the system. Numerical simulations are performed to obtain the dynamic responses and to evaluate critical operating conditions. A parametric analysis is carried out to determine the influence of the weight on the drill bit and the angular velocity of the rotary table on the severity of critical vibrations for different drilling depths. A map is obtained, where normal operation, stick-slip, and bit-bounce responses are defined, allowing a choice of suitable parameters so that the drill-string does not experience critical vibration issues. The results indicate that the safety region, where normal operation is realized, depends on the drilling depth. However, when the angular velocity of the rotary table is equal to 10 rad/s and the weight on the drill bit is greater than 55 kN ensures normal operation for any drilling depth.
A novel fiber Bragg grating-based smart clamp with macro strain measurement: design, modeling, and application to incipient looseness detection
Authors: Zhang Li , Wang Ze-Chao , Wei Qin , Li Rui-Ya , Zhou Zu-De , Yan Wang-Ji , Qu Yong-Zhi , Hong Liu
Published: May 2024

Ensuring the safety and optimal performance of hydraulic pipelines, particularly in aircraft, is of paramount importance. The challenge of detecting incipient looseness in fasteners within a time-varying temperature environment has garnered widespread recognition, making it a focal point in the field of structural health monitoring. In this study, we propose an innovative solution—a smart clamp based on Fiber Bragg Grating (FBG). This clamp aims to detect incipient looseness in hydraulic pipe systems by measuring its macro strain. Notable advantages include its ability to avoid the chirping of the FBG, the ease of building a distributed sensing network, especially for the blind-hole connected structure, and its applicability for monitoring clamps connected with small-diameter bolt. The analytical model of the clamp under the preload of the connected bolt, along with the unique condition for the measurement, is provided. Demonstrating a force resolution [Formula: see text], the clamp exhibits a strong capability in detecting incipient looseness. Furthermore, environmental temperature interference is mitigated by configuring two FBGs. Conducting application experiments in a hydraulic system, the results indicate that the proposed clamp can effectively detect the loosening and tightening processes in real time, even under the time-varying temperature environment.
Acceptable Thresholds: Learning From Critical Disability Methodology to Inform Embodied, Qualitative Research
Authors: Heilig Leah , Sandell Hardesty Kathleen
Published: May 2024

The writers of this article were brought together by questions of pain. Informed by our own experience with research on difficult and personally meaningful topics, this article explores the value and risks of emotional commitment in qualitative research methods and the corporeal consequences that can result from this commitment. We consider how stress informs an embodied practice of qualitative research, taking into account the thresholds and limits of the body and how these limits shape and transform data collection and analysis. While we endorse the importance of subjectivity in research, we investigate the tension between when physical effects of stress are necessary and needed and when they are harmful to the researcher. This exploration of embodiment has made us question practices of accessibility in the training and process of conducting difficult, personally demanding work. We turn to critical disability methodology to better understand the embodied consequences of research, arguing that researchers often experience continuous negotiation between their own physical well-being and their emotional and identity-based commitments. Tenets from critical disability methodology help resist the dehumanization and mechanization of qualitative researchers by focusing on, rather than ignoring, the body. We emphasize a need for more instructional practices that directly and routinely acknowledge the tension between embodiment and subjectivity in research and that embolden researchers to speak of them, to consider them in their research protocols, and ultimately to determine their own acceptable thresholds. Our goal is to enact more equitable and inclusive qualitative research practices that account for physical and emotional pain.
Visual perceptual learning is enhanced by training in the illusory far space
Authors: Zafarana Antonio , Lenatti Carmen , Hunt Laura , Makwiramiti Munashe , Farnè Alessandro , Tamè Luigi
Published: May 2024

Visual objects in the peripersonal space (PPS) are perceived faster than farther ones appearing in the extrapersonal space (EPS). This shows preferential processing for visual stimuli near our body. Such an advantage should favour visual perceptual learning occurring near, as compared with far from observers, but opposite evidence has been recently provided from online testing protocols, showing larger perceptual learning in the far space. Here, we ran two laboratory-based experiments investigating whether visual training in PPS and EPS has different effects. We used the horizontal Ponzo Illusion to create a lateralized depth perspective while participants completed a visual search task in which they reported whether or not a specific target object orientation (e.g., a triangle pointing upwards) was present among distractors. This task was completed before and after a training phase in either the (illusory) near or far space for 1 h. In Experiment 1, the near space was in the left hemispace, whereas in Experiment 2, it was in the right. Results showed that, in both experiments, participants were more accurate after training in the far space, whereas training in the near space led to either improvement in the far space (Experiment 1), or no change (Experiment 2). Moreover, we found a larger visual perceptual learning when stimuli were presented in the left compared with the right hemispace. Differently from visual processing, visual perceptual learning is more effective in the far space. We propose that depth is a key dimension that can be used to improve human visual learning.
Enhanced versus standard hydration in acute ischemic stroke: REVIVE—A randomized clinical trial
Authors: Lin Leng Chieh , Lee Tsong-Hai , Huang Yen Chu , Tsai Yuan Hsiung , Yang Jen Tsung , Yang Lan Yan , Pan Yu-Bin , Lee Meng , Chen Kuan-Fu , Hung Yu-Cheng , Cheng Hsien-Hung , Lee I-Neng , Lee Ming Hsueh , Chiu Tefa , Chang Yeu-Jhy , Goh Zhong Ning Leonard , Seak Chen-June
Published: May 2024

Rationale:

Early neurological deterioration (END) within 72 h of stroke onset is associated with poor prognosis. Optimizing hydration might reduce the risk of END.

Aims:

This study aimed to determine in acute ischemic stroke patients if enhanced hydration versus standard hydration reduced the incidence of major (primary) and minor (secondary) END, as well as whether it increased the incidence of early neurological improvement (secondary), at 72 h after admission

Sample size estimate:

A total of 244 participants per arm.

Methods and design:

A prospective, double-blinded, multicenter, parallel-group, randomized controlled trial conducted at four hospitals from April 2014 to July 2020, with data analyzed in August 2020. The sample size estimated was 488 participants (244 per arm). Ischemic stroke patients with measurable neurological deficits of onset within 12 h of emergency department presentation and blood urea nitrogen/creatinine (BUN/Cr) ratio ⩾ 15 at point of admission were enrolled and randomized to 0.9% sodium chloride infusions of varying rates—enhanced hydration (20 mL/kg body weight, one-third given via bolus and remainder over 8 h) versus standard hydration (60 mL/h for 8 h), followed by maintenance infusion of 40–80 mL/h for the subsequent 64 h. The primary outcome measure was the incidence of major END at 72 h after admission, defined as an increase in National Institutes of Health Stroke Scale of ⩾ 4 points from baseline.

Results:

Overall, 487 participants were randomized (median age 67 years; 287 females). At 72 h, 7 (2.9%) in the enhanced hydration arm and 5 (2.0%) in the standard hydration developed major END (p = 0.54). The incidence of minor END and early neurological improvement did not differ between treatment arms.

Conclusion and relevance:

Enhanced hydration did not reduce END or improve short-term outcomes in acute ischemic stroke.

Trial Registration:

ClinicalTrials.gov (NCT02099383, https://clinicaltrials.gov/study/NCT02099383 )
Optimising postoperative care: Same-day discharge after transurethral resection of the prostate
Authors: Malshy Kamil , Balen Alejandra , Golijanin Borivoj , Jentzsch Maximilian , Greenberg Rachel , Kazal Frances , Glebocki Richard , Danaher Katherine , Spence Ryland , Hyams Elias , Golijanin Dragan , Pareek Gyan , Eaton Samuel
Published: May 2024

Introduction:

This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate.

Materials and Methods:

Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge). Logistic regression analysis was performed, controlling for clinicodemographic factors. Student’s t-test compared continuous bladder irrigation and catheter dwell times.

Results:

A total of 459 patients were identified between 2016 and 2021, 280 in Group 1 and 179 in Group 2, with median ages of 71.0 (interquartile range 36–92) and 72.0 (interquartile range 47–101) years (p = 0.067), respectively. Same-day discharge rates notably increased post-2018 (p = 0.025). Median prostate tissue resected in Group 2 was 7.1g (3.4–12.4g) and in Group 1 was 4.9g (2.4–10.2g; p = 0.034). While continuous bladder irrigation >1 hour was significantly lower in Group 1 than Group 2 (96.8% versus 27.4%; p = 0.0001), catheter dwell times were comparable (70.1 and 70.8 hours, respectively). Control-adjusted results showed a 40% reduction in emergency department representation odds for Group 1 compared with Group 2 (odds ratio = 0.60; 95% confidence interval = 0.37–0.99; p = 0.04). Length of stay was not significantly associated with hospital readmissions (p = 0.11). Continuous bladder irrigation for <1 hour in Group 1 was associated with a reduced emergency department representation (odds ratio = 0.43; 95% confidence interval = 0.197–0.980) but not readmission (odds ratio = 0.413; 95% confidence interval = 0.166–1.104).

Conclusions:

Same-day discharge post-transurethral resection of the prostate may be a viable and safe option for carefully selected patients.
Treatment of mixed and refractory post-tuberculosis tracheobronchial stenosis with L-shaped silicone stents: case series and a literature review
Authors: Zhang Changwen , Li Wentao , Li Yu , Fang Ni , Xu Mingpeng , Ke Lan , Li Lifang , Liu Guangnan
Published: May 2024

The two patients included in the study had mixed and refractory post-tuberculosis tracheobronchial stenosis (PTTS), having experienced unsuccessful interventional therapies such as balloon dilation and V-shaped stent placement before the operation. Following the secure placement of L-shaped silicone stents, examinations with a fiberbronchoscope during the first and third months post-operation revealed a significant reduction in bronchial mucosa inflammation for both patients. Additionally, the opening diameter of the upper and lower branch segments increased, and chest CT scans indicated a noticeable absorption of left pulmonary lesions. Three months post-operation, fiberbronchoscopy confirmed the stable fixation of the stent without any movement. The patients exhibited substantial improvements in pulmonary function, dyspnea index, and blood gas analysis, with no reported adverse complications. After 7 months, a follow-up fiberbronchoscope for one case revealed excellent stent fixation. Simultaneously, the chest CT scan indicated favorable re-expansion. The placement of L-shaped silicone stents proves effective in preventing displacement, alleviating airway stenosis or obstruction, and ensuring the safety and efficacy of PTTS treatment – particularly in cases where V-shaped silicone stent placement has failed. To our knowledge, this is the first study describing the L-shaped silicone stent in two patients with PTTS.
Combined medical-interventional approaches for the management of complex fungal balls: a case series as a viable alternative in non-surgical patients
Authors: Dumoulin Elaine , Thornton Christina S. , MacGregor John H. , Tremblay Alain , Chan Chrystal , MacEachern Paul R. , Kelly Margaret M. , Somayaji Ranjani , Parkins Michael D. , Mody Christopher H.
Published: May 2024

Intracavitary pulmonary aspergilloma is a persistent and life-threatening infection that carries a mortality rate of up to 15%. It occurs when Aspergillus species gain entry to an existing lung cavity. In the absence of definitive treatment, patients may succumb to severe complications such as massive hemoptysis, cachexia, or secondary infections. Aspergillomas often show limited response to antifungal medications, mainly due to insufficient drug concentrations within the cavities. Surgery is frequently the preferred treatment option, but it poses significant risks, and many individuals are ineligible due to underlying health issues. We present the most extensive non-surgical fungal ball cohort to date, managed using an innovative multimodal strategy that combines antifungal therapy before and after bronchoscopic debulking. This was a cross-sectional observational study. For those who cannot undergo surgery, our medical center has pioneered a multimodal approach to aspergilloma resection. This approach combines bronchoscopic endoscopy with antifungal therapy and has been applied successfully to more than 18 patients that are presented in this series. The median age of the cohort was 58 years (range: 32–73), with an equal sex distribution. The mean percent predicted FEV1 was 65.3%. The mean follow-up duration was 3.6 years (range: 0.5–10 years). The cohort receiving antifungals systematically prior to debridement showed a reduction of the pre-existing cavity (40.38 mm versus 34.02 mm, p = 0.021). Across the 18 patients during the follow-up period, 94% remained recurrence-free (defined by symptoms and radiology). Our study fills a critical knowledge gap regarding the significance of initiating antifungal treatment before bronchoscopic debulking and presents a viable approach in these cases for which there is a current unmet therapeutic need.
Microbiota restoration therapies for recurrent Clostridioides difficile infection reach an important new milestone
Authors: DuPont Herbert L. , DuPont Andrew W. , Tillotson Glenn S.
Published: May 2024

Microbiota restoration therapy has become a standard treatment for recurrent Clostridioides difficile infection (rCDI). In this article, we review the studies supporting the licensure of two live biotherapeutic products (LBPs) designed to prevent rCDI and to provide clinicians with a perspective on their differences. PubMed was reviewed on 1 October 2023, for all papers published concerning the current Food and Drug Administration allowance of the use of fecal microbiota transplantation (FMT) and the studies that led to the licensure of RBX2660 (REBYOTA™), generic name, fecal microbiota, live-jslm, and SER-109 (VOWST™), generic name, fecal microbiota spores, live-brpk. OpenBiome continues to produce fecal products for patients with rCDI at their treatment sites, and the American Gastroenterology Association has a National Registry focused on long-term safety of administering fecal microbiota products. The science behind the licensing of fecal microbiota, live-jslm, a consortium of fecal anaerobes found in stool augmented with strains of Bacteroidetes and fecal microbiota spores, live-brpk, a mixture of 50 species of purified Firmicutes spores is reviewed. Both products appear to be safe in clinical trials and effective in reducing rCDI episodes by mechanisms established for FMT, including normalization of α- and β-diversity of the microbiome and by increasing fecal secondary bile acids. The different makeup of the two LBPs suggests that rCDI responds to a variety of engrafting microbiota which explains why nearly all donors in FMT of rCDI are generally effective. Fecal microbiota, live-jslm has also been shown to successfully treat rCDI in elderly patients with advanced comorbidities. With the licensure of two novel LBPs, we are entering a new phase of microbiota replacement therapy. Having standardized manufacturing and proper monitoring of products, harnessing the microbiome to control and prevent disease has a new beginning.
Automated Insulin Delivery Systems in Pediatric Type 1 Diabetes: A Narrative Review
Authors: Adolfsson Peter , Hanas Ragnar , Zaharieva Dessi P. , Dovc Klemen , Jendle Johan
Published: May 2024

This narrative review assesses the use of automated insulin delivery (AID) systems in managing persons with type 1 diabetes (PWD) in the pediatric population. It outlines current research, the differences between various AID systems currently on the market and the challenges faced, and discusses potential opportunities for further advancements within this field. Furthermore, the narrative review includes various expert opinions on how different AID systems can be used in the event of challenges with rapidly changing insulin requirements. These include examples, such as during illness with increased or decreased insulin requirements and during physical activity of different intensities or durations. Case descriptions give examples of scenarios with added user-initiated actions depending on the type of AID system used. The authors also discuss how another AID system could have been used in these situations.
Inconsistency in the Reporting Terminology of Adverse Events and Complications in Hallux Valgus Reconstruction: A Systematic Review
Authors: AlMeshari Abdulmohsen , AlShehri Yasir , Anderson Lindsay , Willegger Madeleine , Younger Alastair , Veljkovic Andrea
Published: May 2024

Surgical complications are inevitable in any surgical subspecialty. Throughout the years, many classification systems have been developed to better understand and report such complications. The aim of this systematic review is to investigate the variability and frequency of reporting terms used to describe adverse events and complications in hallux valgus reconstruction. We hypothesized that the terms used would be highly inconsistent, which further promotes a need for a standardized terminology reporting system. Studies related to hallux valgus reconstruction outcomes that met our predetermined inclusion criteria were investigated to identify and report the related adverse terms and complications. Adverse terms and complications were grouped into 9 categories. Of the 142 studies included, 376 distinct terms that described adverse events or complications related to hallux valgus reconstruction were identified. Of these, 73.4% (276/376) were mentioned only once in their respective studies. Five of 376 terms were mentioned in at least 25% of the papers, and only 2 of 376 were mentioned in at least 50%. The most frequently reported adverse events were “Recurrence,” mentioned in 77 of 142 studies (54%), followed by “Nonunion,” mentioned in 76 of 142 studies (53%). The most reported category was “Bone/Joint” with 135 related terms, mentioned in 135 of 376 of the papers (95.1%). The terminology used in reporting adverse events and complications in surgical hallux valgus correction was highly inconsistent and variable. This represents yet another barrier in accurate reporting of these terms, and subsequently a difficult analysis of the outcomes related to hallux valgus reconstruction. To overcome these challenges, we suggest developing a standardized terminology reporting system.

Levels of Evidence: Level III; systematic review of Level III studies and above
Dual Toxidrome of Anti-cholinergic Storm and Neuroleptic Malignant Syndrome: A Therapeutic Challenge Overcome by Intrathecal Neostigmine
Authors: Vojjala Nikhil , Malegaonkar Srikant Kashinath , Arora Kajal , Sehgal Inderpaul Singh , Pannu Ashok Kumar
Published: May 2024

Anticholinergic toxicity and neuroleptic malignant syndrome (NMS) are common toxidromes in medical emergencies. However, their co-occurrence, resulting in a dual toxidrome, is rare and presents significant diagnostic and therapeutic challenges. We present the case of a 23-year-old young male with polysubstance dependence, admitted following combined trihexyphenidyl and risperidone toxicity. He was diagnosed with a dual toxidrome of anticholinergic storm and NMS. Treatment of NMS included lorazepam and bromocriptine. Due to the unavailability of physostigmine, the preferred antidote for anticholinergic syndrome, intrathecal neostigmine was administered. The patient subsequently recovered and was discharged. This case highlights the complexity of managing dual toxidromes and the need for alternative therapeutic strategies in resource-limited settings.