bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma metabolomics for the assessment of the progression of non-small cell lung cancer
Authors: Zhang Yingtian , Cheng Yaping , Qin Liqiang , Liu Yuanliang , Huang Sijia , Dai Liya , Tao Jialong , Pan Jie , Su Cunjin , Zhang Yusong
Published: November 2022

Objectives

Non-small cell lung cancer (NSCLC) is a leading type of lung cancer with a high mortality rate worldwide. Although many procedures for the diagnosis and prognosis assessment of lung cancer exist, they are often laborious, expensive, and invasive. This study aimed to develop an ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC–MS/MS)-based analysis method for the plasma biomarkers of NSCLC with the potential to indicate the stages and progression of this malignancy conveniently and reliably.

Methods

A total of 53 patients with NSCLC in early stages (I–III) and advanced stage (IV) were classified into the early and advanced groups based on the tumor node metastasis staging system. A comprehensive metabolomic analysis of plasma from patients with NSCLC was performed via UPLC–MS/MS. Principal component analysis and partial least squares–discriminant analysis were conducted for statistical analysis. Potential biomarkers were evaluated and screened through receiver operating characteristic analyses and correlation analysis. Main differential metabolic pathways were also identified by utilizing metaboanalyst.

Results

A total of 129 differential metabolites were detected in accordance with the criteria of VIP ≥ 1 and a P-value of ≤ 0.05. The receiver operating characteristic curves indicated that 11 of these metabolites have the potential to be promising markers of disease progression. Apparent correlated metabolites were also filtered out. Furthermore, the 11 most predominant metabolic pathways with alterations involved in NSCLC were identified.

Conclusion

Our study focused on the plasma metabolomic changes in patients with NSCLC. These changes may be used for the prediction of the stage and progression of NSCLC. Moreover, we discussed the metabolic pathways wherein the altered metabolites were mainly enriched.
Modeling and analysis of high-frequency dynamic characteristics of double isolation rubber mounts
Authors: Liu Xiao-Ang , Sun Jiawei , Shi Wei , Qian Xuepeng , Chen Daliang , Chen Guang
Published: November 2022

Rubber mounts are the vital component to reduce the vibration translated from the powertrain to the vehicle body. The dynamic stiffness of the conventional rubber mount increase with the increase of the excitation frequency, and form a peak under high-frequency excitation in the battery electric vehicle (BEV). So the double isolation rubber mount has gradually been used in the BEV powertrain to improve the vibration isolation performance in the high-frequency range. Compared with conventional rubber mounts, the double isolation rubber mount has smaller dynamic stiffness in the high-frequency range. However, the traditional simulation model of the dynamic characteristics cannot consider the influence of the metal bracket of the double isolation rubber mount on the dynamic characteristics. Therefore, it is necessary to carry out the modeling and analysis of the dynamic characteristics simulation model of the double isolation rubber mount. In this paper, a general dynamic model of double isolation rubber mounts is proposed to describe the high-frequency dynamic characteristics. In this general dynamic model, the complex stiffness element representing the viscoelasticity of rubber is expressed using the fractional derivative model and the Maxwell model, respectively, and two high-frequency dynamic models are established. Two model parameter identification methods are proposed for high-frequency dynamic models of double isolation rubber mounts, and the identification results are compared and analyzed. Then, two high-frequency dynamic models are used to simulate the high-frequency dynamic characteristics of double isolation rubber mounts. The simulation results show that both high-frequency dynamic models can calculate the high-frequency dynamic characteristics of double isolation rubber mounts. Among them, the dynamic model based on fractional derivative elements has relatively high accuracy, and the dynamic model based on Maxwell elements has relatively high stability. The high-frequency dynamic characteristic modeling method of double isolation rubber mounts presented in this paper is helpful to the vibration and noise analysis of electric vehicle powertrain systems under high-frequency excitation.
Approximate optimal energy management with a high-precision vehicle speed prediction algorithm
Authors: Feng Jian , Han Zhiyu , Wu Zhenkuo , Li Minqing
Published: November 2022

A predictive energy management strategy is proposed for plug-in hybrid electric vehicles, which adopts a new high-precision vehicle speed prediction algorithm and a real-time reference state of charge (SOC) trajectory planning method. The speed prediction algorithm includes a modified Markov model based on vehicle speed features recognized by the self-organizing map neural network method, Fourier approximation, and moving average filtering. The prediction accuracy of the algorithm, measured by the root mean square error, is improved by 32.28% and 23.33%, respectively, over that of the standard Markov model when the prediction time is 5 and 10 s. To approach the optimal management strategy for improved vehicle fuel economy, the radial basis function neural network method is utilized to correlate the 10 s predicted vehicle speed with the trajectory slope of the suboptimal SOC for obtaining the reference SOC trajectory, which is applied to the adaptive equivalent consumption minimization strategy based on SOC feedback. The simulation indicates that the fuel consumption by using the proposed energy management strategy is very close to that by the theoretical suboptimal strategy with the shooting method, which leads to a superior fuel economy among the strategies studied.
Comparison of IMU set-ups for the estimation of gait spatio-temporal parameters in an elderly population
Authors: Digo Elisa , Panero Elisa , Agostini Valentina , Gastaldi Laura
Published: November 2022

The increasing average age emphasizes the importance of gait analysis in elderly populations. Inertial Measurement Units (IMUs) represent a suitable wearable technology for the characterization of gait by estimating spatio-temporal parameters (STPs). However, the location of inertial sensors on the human body and the associated algorithms for the estimation of gait STPs play a fundamental role and are still open challenges. Accordingly, the aim of this work was to compare three IMUs set-ups (trunk, shanks, and ankles) and correspondent algorithms to a gold standard optoelectronic system for the estimation of gait STPs in a healthy elderly population. In total, 14 healthy elderly subjects walked barefoot at three different speeds. Gait parameters were assessed for each IMUs set-up and compared to those estimated with the gold standard. A statistical analysis based on Pearson correlation, Root Mean Square Error and Bland Altman plots was conducted to evaluate the accuracy of IMUs. Even though all tested set-ups produced accurate results, the IMU on the trunk performed better in terms of correlation ( R ≥ 0.8), RMSE (0.01–0.06 s for temporal parameters, 0.03–0.04 for the limp index), and level of agreement (−0.01 s ≤ mean error ≤ 0.01 s, −0.02 s ≤ standard deviation error ≤ 0.02 s), also allowing simpler preparation of subjects and minor encumbrance during gait. From the promising results, a similar experiment might be conducted in pathological populations in the attempt to verify the accuracy of IMUs set-ups and algorithms also in non-physiological patterns.
Bypassing NIR pre-processing optimization with multiblock pre-processing ensemble approaches
Authors: Mishra Puneet
Published: November 2022

Pre-processing near-infrared spectral data is a major part of near-infrared data modelling. A wide range of pre-processings are available to deal with both the additive and the multiplicative effects. However, practitioners have majorly focused on the selection of the best pre-processing technique or their combination. Data pre-processed with different pre-processings carry complementary information; hence, a natural solution to avoid pre-processing selection and to learn complementary information is the ensemble modelling. Recently, multiblock data fusion modelling-inspired ensemble techniques have gained momentum and several innovative approaches have been proposed for modelling near-infrared data. This article provides a state of the art of the new multiblock modelling-inspired pre-processing ensemble techniques. Their novelties and pitfalls are also discussed.
The New T Cell Subset Opens a New Realm for Tumor Immunotherapy
Authors: Zhu Huanjin , Zeng Chong , Wang Weidong
Published: November 2022

Immunotherapy with immune checkpoint inhibitors had achieved great success. However, only a subset of patients responds positively to these therapies. The latest study published on Nature by Chou and colleagues found a new T cell subset from tumor-infiltrating T cells which lack PD-1 on the cell surface and potent cytotoxic activities against tumor cells. This finding provides a novel insight into the development of new therapies for tumors that do not respond to immune checkpoint blockade in the future.
Nurses and Outreach Workers’ Stigmatizing Attitudes in Needle Syringe Programs in Kazakhstan
Authors: Primbetova Sholpan , Darisheva Meruyert , Gatanaga Ohshue , Gilbert Louisa , Davis Alissa , Wu Elwin , Hunt Timothy , Terlikbayeva Assel , McCrimmon Tara , Dasgupta Anindita , Cordingley Olivia M , El-Bassel Nabila
Published: November 2022

Purpose: This paper examines differences in attitudes, stigma, and discrimination towards people living with HIV (PLWH) in needle and syringe programs (NSPs) in Kazakhstan to help inform HIV care interventions in these settings. Method: We collected data on HIV/AIDS attitudes using a modified Health Policy Project Standardized Brief Questionnaire with two subscales: attitudes within the health facility environment in a facility caring for PLWH, and opinions about PLWH. Results: Outreach workers were significantly more likely than nurses to report health professionals disparaging PLWH, and having stigmatizing attitudes towards PLWH. Outreach workers LWH were significantly more likely to report HIV discrimination in the NSP, and male staff was significantly more likely to have negative opinions of PLWH. Conclusions: Assessing different staff attitudes of nurses versus outreach workers, male versus female staff, and HIV positive versus negative staff and conducting follow-up training may decrease stigma and improve attendance at harm reduction programs.
Identifying Key Domains and Implementation Challenges for a Live Discharge From Hospice Protocol
Authors: Wladkowski Stephanie P. , Enguídanos Susan , Schroepfer Tracy A.
Published: November 2022

Background: Hospice agencies lack an explicit live discharge process to guide practitioners in transitioning these patients and their primary caregivers (PCGs) out of hospice care. Based on previous research and input from an advisory committee, a live discharge protocol (LDP) was drafted with .three general areas of assessment: 1) concrete services; 2) psychosocial assessment; and 3) 30-day post discharge follow-up phone call. This study sought to gather perspectives from hospice social workers on the proposed assessment components and other needs in implementing a LDP. Methods: Purposive, convenience sampling occurred over 4 months. Participants were hospice social workers (n = 14) recruited through personal and professional contacts and social media. Four focus groups were conducted via Zoom. Data was analyzed using thematic analysis. Results: Three major themes appeared: 1) benefits and challenges of having a structured discharge protocol (n = 14); 2) need for specific LDP roles across team members (n = 11); and 3) education and clear boundaries for both patients/PCGs and professionals (n = 9). Conclusions: All three assessment components of the preliminary LDP were deemed necessary by participants; however, implementation challenges were both unique for each agency and reflective of the broader hospice culture. Further research is needed to measure the impact of the LDP.
Application of the Toxic Stress Schema: An Exemplar for School Nurses
Authors: Childs Gwendolyn D. , DeSocio Janiece , Sloand Elizabeth , Gary Faye , Burke Pamela J. , Outlaw Freida H. , Snethen Julie A. , Lewandowski Linda A. , Bowen Felesia R.
Published: November 2022

For many children of color, the cumulative impact of pre-existing stressors, disparities, and pandemic-related losses has contributed to a toxic level of stress. Toxic stress can disrupt healthy brain development making children vulnerable to physical and mental health problems. School nurses are the primary health professionals who interact with children daily during the academic year, which positions them to identify risk factors within the social determinants of health that contribute to the development of toxic stress. The Toxic Stress Schema (TSS) provides a framework for assessment and care planning related to social determinants of health and potential sources of stress and/or buffering support for the physical and mental well-being of children. A case study approach is used to demonstrate the application of the TSS to school nursing and provide the basis for conceptualizing a plan of care and identifying resources to support the child's physical and mental health.
Childhood Small-Vessel Primary Angiitis of the Central Nervous System: Overlap With MOG-Associated Disease
Authors: Gilani Ahmed , Kleinschmidt-DeMasters Bette K.
Published: November 2022

Background:

Childhood (c) primary angiitis of the central nervous system (PACNS) is a rare condition that most often affects small vessels (SV), is nearly exclusively lymphocytic, and devoid of vessel necrosis. Diagnosis of cSV-PACNS is challenging. We noted possible histological overlap of cSV-PACNS with myelin oligodendrocyte glycoprotein disease (MOGAD) on biopsy, prompting a 10-year retrospective review of our experience.

Materials and Methods:

Database-search for brain biopsy cases, age <18 years, performed for an acquired neurological deficit with suspicion of vasculitis, with histological evidence of lymphocytic small-vessel inflammation.

Results:

We identified 7 patients; 2/7 were serum-positive for anti-MOG antibodies and 1/7 for anti-NMDA antibodies. The remaining 4/7 proved to be idiopathic lymphocytic vasculitis/cSV-PACNS. All 7 showed overlapping features of lymphocytes permeating parenchymal SV walls, vessel wall distortion without fibrinoid necrosis, and absence of microglial clusters or intravascular thrombi. Tissue infarction was confined to a single case of idiopathic lymphocytic vasculitis. Although demyelination was diligently sought, only subtle demyelination was identified in the 2 MOGAD cases and absent in the remainder.

Conclusion:

There is considerable histological overlap between cSV-PACNS and at least some cases of MOGAD or anti-NMDA-encephalitis; at diagnosis, the differential should include cSV-PACNS but correct classification requires post-biopsy serological testing.
A transcriptome-Based Deep Neural Network Classifier for Identifying the Site of Origin in Mucinous Cancer
Authors: Ahn Taejin , Kim Kidong , Kim Hyojin , Kim Sarah , Park Sangick , Lee Kyoungbun
Published: November 2022

Purpose:

There is a lack of tools for identifying the site of origin in mucinous cancer. This study aimed to evaluate the performance of a transcriptome-based classifier for identifying the site of origin in mucinous cancer.

Materials And Methods:

Transcriptomic data of 1878 non-mucinous and 82 mucinous cancer specimens, with 7 sites of origin, namely, the uterine cervix (CESC), colon (COAD), pancreas (PAAD), stomach (STAD), uterine endometrium (UCEC), uterine carcinosarcoma (UCS), and ovary (OV), obtained from The Cancer Genome Atlas, were used as the training and validation sets, respectively. Transcriptomic data of 14 mucinous cancer specimens from a tissue archive were used as the test set. For identifying the site of origin, a set of 100 differentially expressed genes for each site of origin was selected. After removing multiple iterations of the same gene, 427 genes were chosen, and their RNA expression profiles, at each site of origin, were used to train the deep neural network classifier. The performance of the classifier was estimated using the training, validation, and test sets.

Results:

The accuracy of the model in the training set was 0.998, while that in the validation set was 0.939 (77/82). In the test set which is newly sequenced from a tissue archive, the model showed an accuracy of 0.857 (12/14). t-SNE analysis revealed that samples in the test set were part of the clusters obtained for the training set.

Conclusion:

Although limited by small sample size, we showed that a transcriptome-based classifier could correctly identify the site of origin of mucinous cancer.
The Final Word on sports podcasts: Audience perceptions of media engagement and news consumption
Authors: English Peter , Burgess Jacqueline , Jones Christian
Published: November 2022

Sports podcasting has spread rapidly over the past decade and reflects how sports media have been quick to embrace new technologies. Despite being a relatively recent medium, podcasts have expanded the sports field with their format and content. The rise in podcast shows and episodes has been noticeable, but less is known, particularly in an academic context, about the audience's desire for sports news and information. Utilising the audience of The Final Word, a global podcast focusing on cricket, this study will examine perceptions of media engagement and news consumption through a survey of 333 listeners. The Final Word is a popular podcast that has gained critical acclaim for its content and format, and is hosted by two cricket writers, who are based in Australia and the United Kingdom. The findings provide important global insights and descriptive results of the habits and perceptions of listeners in relation to media engagement and news consumption of a journalistic podcast
Culture and politics in overlapping frames for the future: Multi-dimensional activist organizing and communicating on climate change in Aotearoa New Zealand
Authors: Munshi Debashish , Cretney Raven , Kurian Priya , Morrison Sandra L , Edwards Alvina
Published: November 2022

Responding to climate change requires us to reimagine not only our future on a planet that is rapidly changing, but also how we organize to create political change. The climate movement and those involved in climate activism frame action on climate change in a diverse manner, articulating multiple possibilities for, and means to achieve, a different society. This article explores the ways in which activist groups in Aotearoa New Zealand work with cultural values and political imagination to organize themselves in framing the future to communicate and mobilize change. Our research identifies four key frames – rebel, reform, rebuild, and ruin – that shape the approaches taken by activists in order to resist the status quo and achieve radical change. We show how activists frame climate action and draw on culture to negotiate the political intersections of organizing for change, as well as how these frames overlap to create “in-between spaces.” Examining these in-between spaces reveals multiple and contextual visions of political change, emphasizing the importance of the cultural contexts of Aotearoa and the possibilities that arise from imagining different futures.
Identity, money, or governance? Explaining secessionist parties’ rhetorical strategies
Authors: Ferreira Carles
Published: November 2022

Under what conditions do secessionist parties advance identity, socioeconomic or political frames for constitutional change? By performing a Qualitative Comparative Analysis (QCA) of 93 party manifestos from six Western regions, the results identify a key variable that plays an important role in rhetorical strategies: the governmental status of the party. In linguistically distinctive regions, parties tend to put forward identity frames when in opposition. Instead, being in office is a condition for framing their position in socioeconomic terms. The results concerning political frames are highly complex, although patterns around office holding have also been identified. Hence, the present article shows that office-seeking strategies imply a fundamental change in how these parties frame their claims. Minority nationalist parties take the opportunity of being in office to enhance their credibility as governing parties by downplaying identity issues in favour of a more inclusive and policy-oriented appeal.
Changing masculinities? Using caring masculinity to analyse social media responses to the decline of men in Australian primary school teaching
Authors: Hookway Nicholas Samuel , Cruickshank Vaughan
Published: November 2022

Commentators have predicted that Australian male primary school teachers will be extinct within 50 years. Drawing upon sociological ideas about the emergence of ‘caring masculinities’, this article qualitatively examines popular Australian understandings about male primary school teachers, their importance, why they are declining and whether, and how, this gender imbalance can be addressed. The study analyses data from 541 comments posted in response to nine online media pieces on male primary school teachers in Australia. The article shows that commenters believe men teaching young children experience stigmatised masculine identities but misplace the cause of this as the result of women and anti-feminist ‘anti-male bias’ rather than the constraining impact of hegemonic masculinity. The article suggests that until more caring and progressive forms of masculinity are culturally and economically valued in Australia we will see little change in the numbers of men entering primary school teaching.
The influence of conservation agency resources on officer entry and training requirements
Authors: Rossler Michael T , Foster Jacob T , Suttmoeller Michael J
Published: November 2022

The current inquiry examines the influence that agency characteristics (e.g. hunting and fishing license sales, total revenue) have on the minimum entry and training standards established by those agencies (e.g. minimum education, academy type, physical standards). Open source data were collected from each state's conservation agency through an extensive internet search and directly contacting agencies. Findings indicated a significant relationship between the number of fishing license and hunting license holders and both the minimum education standards set by the agency and their academy modality ( p ≤ .05). Conversely, no significant relationships were found between revenue from license sales and any entry or training requirements. In addition, neither the number of license holders nor revenue was shown to be statistically significant among minimum physical standards for entry-level work as a conservation officer. Thus, the number of license holders appears to be more influential over the minimum education requirements and academy type versus generated revenue. This indicates that demand placed on natural resource organizations may have a greater effect than the revenue they generate.
Who is afraid of dataveillance? Attitudes toward online surveillance in a cross-cultural and generational perspective
Authors: Kalmus Veronika , Bolin Göran , Figueiras Rita
Published: November 2022

This article compares surveillance-related experiences and attitudes of two generations of media users in countries with different historical surveillance regimes (Estonia, Portugal, and Sweden) and analyzes the predictors of the attitudes toward contemporary surveillance. A large-scale online survey ( N = 3221) reveals that attitudes toward online state and corporate surveillance are interrelated; the two attitudinal components are, however, generation-specific, having different predictors. Tolerance toward state surveillance is more characteristic of the older group, being predicted by trustful and obedient attitudes toward state authorities and institutions. Tolerance toward corporate dataveillance is more characteristic of the younger group, being predicted by active and self-confident media use. While the socio-historical context molds the intergenerational gaps in surveillance-related experiences and attitudes, individual-level experiences of state surveillance do not predict tolerance toward either type of contemporary surveillance, suggesting that global techno-cultural developments are probably more powerful factors than past experiences in forming generation-specific attitudes.
Signaling silence: Affective and cognitive responses to risks of online activism about corruption in an authoritarian context
Authors: Dal Aysenur , Nisbet Erik C. , Kamenchuk Olga
Published: November 2022

Networked authoritarian governments’ use of digital repression creates uncertainty and amplifies risk signals for ordinary citizens using social media for political expression. Employing theoretical frameworks from the risk and decision-making literature, we experimentally examine how citizens perceive and respond to the risks of low-effort forms of online activism in an authoritarian context. Our online field experiment demonstrates that emotional responses to the regime’s risk signals about online activism drive decision-making about contentious online political expression as compared with cognitive appraisal of risk. Moreover, the relationship between anticipatory emotions and contentious online political expression varies significantly depending on individuals’ involvement with the controversial topic of expression. We discuss the importance of emotions and citizen risk judgments for understanding online activism within networked authoritarian contexts.
Why do student perceptions of academic performance improve? The influence of acquired competences and formative assessment in a flipped classroom environment
Authors: Ruiz-Jiménez Mª. Carmen , Licerán-Gutiérrez Ana , Martínez-Jiménez Rocío
Published: November 2022

The university system must be able to respond to the growing demand for graduates with certain skills that guarantee their employability. A key requirement of this goal is the use of different teaching-learning methods, such as the flipped classroom methodology. However, although some studies have shown the advantages of this model, more research is needed to identify the reasons for these positive effects and the contexts in which it works best. In this paper, we analyse the perceptions of students of six undergraduate subjects at the University of Jaén (Spain) concerning their acquired competences and the formative assessment received in a flipped classroom environment. In addition, we analyse whether these two variables influence these student perceptions of achieving better academic outcomes. The results show that both aspects explain student perceptions of better performance and are key elements in the provision of a better learning environment. In this way, these results contribute to the literature concerning the positive effects of a flipped classroom on the teaching-learning process in higher education.
Conceptualizing access to community-based supports from the perspectives of people living with young onset dementia, family members and providers
Authors: Novek Sheila , Menec Verena
Published: November 2022

People living with young onset dementia and their families have significant support needs, but experience difficulties accessing services. This study explored the process of accessing community-based services drawing on semi-structured interviews with people living with dementia, family members and providers in Winnipeg, Canada. Data analysis involved a combination of inductive coding and theoretical analysis using the candidacy framework as a conceptual lens. Forced to navigate services that do not recognize people with young onset dementia as a user group, participants experienced ongoing barriers that generated continuous work and stress for families. Access was constrained by information resources geared towards older adults and restrictive eligibility criteria that constructed people with young onset dementia as “not impaired enough” or “too impaired”. At the organizational level, fragmentation and underrepresentation of young onset dementia diminished access. Our findings underscore the need for continuous, coordinated supports alongside broader representation of young onset dementia within research, policy, and practice. We conclude with a discussion of how the candidacy theory could be extended to account for the social and political status of user groups.
The correlation between the Big Five personality traits and political information exposure
Authors: Zhao Yang
Published: November 2022

In the era of media convergence, Internet users’ levels of access to current political information are diverse. Based on selective exposure theory, this study employed K-means clustering and multinomial logistic regression and 2017 Chinese National Survey Data Archive data to study the correlation between the Big Five personality traits and political information exposure. The results showed that Internet users can be divided into three types, according to the frequency of their access: comprehensive, domestic modern, and apathetic. Netizens with high extroversion were correlated with regular browsing of current political information from comprehensive accesses. Those with high agreeableness were correlated with a preference for current political information as relayed by domestic modern media. Those with high levels of neuroticism were correlated with paying little attention to current political information.
Understanding Attitudes, Beliefs, Behaviors, and Barriers to Hearing Loss Care Among Hispanic Adults and Caregivers
Authors: Burnham Raquel , Gamero Yesenia , Misurelli Sara , Pinzon Maria Mora , Lor Maichou
Published: November 2022

Introduction: While 9.5 million U.S. Hispanic adults have hearing loss, limited research has focused on their hearing care experiences. This study examines the attitudes, beliefs, behaviors, and barriers to hearing care among Hispanic adult patients with hearing loss (HL) and their caregivers. Methods: In a qualitative study, participants were recruited through community organizations, social media, and word of mouth. Participants were interviewed through virtual platforms and audio recorded. The recording was then transcribed verbatim in Spanish, translated to English, and analyzed using a hybrid deductive and inductive content approach. Results: The 12 participants (age 35–92, 83.3% female) comprised seven individuals with HL and three family caregivers. Most participants attributed HL to aging and genetics, and most shared a stigmatized community attitude toward HL that silenced any discussion of it. Barriers to hearing care included high cost, lack of insurance, and language barriers. These resulted in negative experiences with providers and poor access to hearing tests and auditory devices. Conclusions: The study's findings suggest a need to improve access to comprehensive low-cost hearing services and education in the Hispanic community. Additionally, unique challenges of this community should be addressed to promote hearing health and self-management.
“At Least Somebody Sees You as a Hero”: Fatherhood Stress and Well-Being in Ghana
Authors: Bowen Anna , Chen Y. Michael , Kodam Ruth Sally , Odoi Julius Amesimeku , Anto-Ocrah Martina
Published: November 2022

Fathers’ mental health and behaviors influence child development and partner well-being, yet paternal stress and well-being are frequently overlooked; especially in non-Western settings. The aim of this mixed-methods study was to quantitatively assess the impact of parenting stress on fathers’ overall well-being in Ghana, West Africa; while qualitatively delving into their lived experiences as fathers. We used a qual/quant mixed-methods approach in this study. The study was conducted in three distinct locations in Ghana (a) Ada, a rural community on the Southeastern coast; (b) Kumasi, an urban setting in upper Southern Ghana; and (c) Sunyani, a peri-urban setting in West-central Ghana. Paternal stress was measured with the Aggravation in Parenting Scale (APS) and well-being was assessed using the Secure Flourishing Index (SFI). Textual data from focus group interviews were sorted using inductive coding and aggregated into overarching themes. Thirty-eight Ghanaian fathers ages 21 to 74 years participated in the study, average age 43 (±12.12 SD), median 39.5. Correlation analyses showed a strong, negative association between paternal stress and well-being ( R = −0.63; p < .0001), which was supported in linear regression models (β = −1.04; 95% CI: −1.62, −0.45; p<.0001). Emergent themes of fatherhood stress included financial (employment, food, education, and health care), social (norms and expectations), and psychological (mental work, discipline, relationships, and coping strategies) stressors. A fourth overarching theme of pride and joy in parenting permeated the interviews. Ghanaian fathers with higher parenting stress experience lower overall well-being. Identified stressors could guide interventions that bolster the well-being of fathers and their families.
LVIS EVO stent-through-balloon after hydrocoil embolization of intracranial aneurysms: One-year results
Authors: Mosimann Pascal J , Yamac Elif , Wallocha Marta , Ayad Ahmed , Chapot René
Published: November 2022

Background and purpose

To evaluate the durability and safety of complete intracranial aneurysm occlusion at one year using the low-profile braided intracranial LVIS EVO stent.

Materials and methods

This is a retrospective, monocentric, observational study of unruptured wide-necked intracranial aneurysms treated with the LVIS EVO stent-through-balloon technique after balloon-assisted hydrocoil embolization. Imaging and clinical data were assessed by two blinded independent neuroradiologists and neurologists, respectively. Primary endpoint was complete angiographic occlusion on day 0 and at 12 months. Secondary endpoints included clinical safety using the modified Rankin scale (mRS), ischemic and hemorrhagic adverse events, parent vessel stenosis > 50% or occlusion and retreatment rate.

Results

103 aneurysms in 103 patients were included (53 years-old, 77% women). Mean aneurysm size and neck were 7 and 4 mm, respectively. Complete occlusion was 97% initially and 90% at 12 months, with pending follow up in 17.5% patients. Five patients (5%) with partially stented necks were retreated with a second stent in a T-configuration. Two stents failed to open initially and were immediately retrieved. Asymptomatic parent vessel occlusion and severe in-stent stenosis occurred in 1% and 3%, respectively. The 12-month procedure-related permanent neurological deficit and mortality rates (mRS 3–6) were 2% and 1%, respectively. There was one fatal bleeding but no large ischemic complications.

Conclusion

Delivering the LVIS EVO stent through a dual lumen balloon after balloon-assisted hydrocoil embolization yields a high and stable rate of complete aneurysm occlusion at one year with a reasonable immediate and delayed complication rate.
Robust LPV-H∞ control for active steering of tram with independently rotating wheels
Authors: Yang Zhe , Lu Zhenggang , Sun Xiaojie , Zou Jinbai , Wan Heng , Yang Minglai , Zhang Haigang
Published: November 2022

A new methodology is proposed in this study for active steering of a tram with independently rotating wheels (IRWs). This methodology has been developed specifically to improve the tram’s steering capability and to reduce wheel-rail wear. The tram is represented by a complex dynamic model with a diverse range of operating conditions, and traditional active steering methods cannot ensure that the tram can remain well-controlled throughout the entire range of operating conditions. The linear parameter-varying (LPV)- H∞ control method proposed in this paper uses variable parameter theory to represent the nonlinearity, the parameter uncertainty, and the external force changes in the IRW. The LPV- H∞ steering controller can not only ensure the robustness of the uncertain system, but also can balance the complexity and the performance of the controller. This allows the tram to offer good steering performance under various running conditions. The simulation results presented in this research show that application of the proposed control method improves the running performance of the tram and reduces the wheel-rail wear significantly on both straight and curved tracks when compared with the passive case.
Outcomes of open and endovascular infra-inguinal revascularization are poor in young patients with atherosclerotic peripheral artery disease but do not differ between genders
Authors: Yuan Fang , Tracci Margaret C , Clouse W Darrin , Robinson William P
Published: November 2022

Objectives

The effect of gender on the outcomes of revascularization procedures in young patients with premature atherosclerotic peripheral arterial disease (PAD) is not known. The objective of this study was to compare short-term and long-term outcomes between young males and females undergoing infra-inguinal revascularization procedures.

Methods

We examined postoperative outcomes of male and female PAD patients under the age of 55 who underwent infra-inguinal revascularization procedures at a single tertiary institution from 2011 to 2019. Primary outcomes included 30-day morbidity, patency of the revascularization procedures, and major adverse limb events (MALE). Secondary outcomes included survival, amputation rate, reintervention rate, improvement of ankle-brachial index (ABI), and number of reinterventions.

Results

Eighty-one infra-inguinal revascularization procedures (46 endovascular and 35 open procedures) were reviewed including 45 procedures in 37 males and 36 procedures in 31 females. Fifty-three (65.4%) of the procedures were performed in patients with chronic limb-threatening ischemia symptoms. The rest were treated for life-disabling claudication. The female patients were younger, had higher body mass index, and were more likely to have diabetes, hyperlipidemia, or chronic obstructive pulmonary disease in comparison to males. Thirty-day major adverse cardiovascular event was 0.0% and MALE was 16.0%. Mean follow-up was 806.2 days. At 1 year, primary patency was 34.4 ± 6.2%, primary assisted patency was 52.7 ± 6.5%, secondary patency was 61.8 ± 6.3%, and MALE-free rate was 47.0 ± 6.4%. For secondary outcomes at 1 year, amputation-free rate was 92.5 ± 3.2%, reintervention-free rate was 50.2 ± 6.4%, and survival was 96.2 ± 2.6%. By the end of the study, overall mortality rate was 14.8% and major amputation rate was 13.6%. No major differences were observed between males and females among these outcomes. A smaller improvement in ABI after revascularization was noted in females compared to males (female 0.2 ± 0.2 vs male 0.4 ± 0.2, p = .04). Among patients who required reintervention, females required a higher number of reinterventions than males (female 1.7 ± 2.5 vs male 0.8 ± 1.1, p = .03).

Conclusions

There were no significant differences in short-term and long-term outcomes between males and females under the age of 55 after infra-inguinal revascularization. Poor patency, high MALE rate, and high mid-term mortality, and amputation rates after revascularization in young PAD patients highlight the need for improved strategies to treat premature PAD.
Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program
Authors: Ayoub Christian Habib , Dakroub Ali , El-Asmar Jose M. , Ali Adel Hajj , Beaini Hadi , Abdulfattah Suhaib , El Hajj Albert
Published: November 2022

Background:

The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures.

Objectives:

We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy.

Design and Methods:

Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons–National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017. Patients were categorized according to a calculated MELD score. The primary outcomes of this study were 30-day postoperative mortality, morbidity, and length of hospital stay following radical cystectomy. For further sensitivity analysis, propensity score matching was used to yield a total of 1387 matched pairs and primary outcomes were also assessed in the matched cohort.

Results:

Compared with patients with a MELD < 10, those with MELD ⩾ 10 had significantly higher rates of mortality [odds ratio (OR) = 1.71, p = 0.004], major complications (OR = 1.42, p < 0.001), and prolonged hospital stay (OR = 1.29, p < 0.001) on multivariate analysis. Following risk-adjustment for race, propensity-matched groups revealed that patients with MELD score ⩾ 10 were significantly associated with higher mortality (OR = 1.85, p = 0.008), major complications (OR = 1.34, p < 0.001), yet similar length of hospital stay (OR = 1.17, p = 0.072).

Conclusion:

MELD score ⩾ 10 is associated with higher mortality and morbidity in patients undergoing radical cystectomy compared with lower MELD scores. Risk-stratification using MELD score may assist clinicians in identifying high-risk patients to provide adequate preoperative counseling, optimize perioperative conditions, and even consider nonsurgical alternatives.
Concordance between coding sources of burn size and depth across Australian and New Zealand specialist burn services
Authors: Perkins Monica , Cleland Heather , Gabbe Belinda J , Tracy Lincoln M
Published: November 2022

Background

The percentage of total body surface area (%TBSA) burned and burn depth provide valuable information on burn injury severity.

Objective

This study investigated the concordance between The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes and expert burn clinicians in assessing burn injury severity.

Method

We conducted a retrospective population-based review of all patients who sustained a burn injury between July 1, 2009, and June 30, 2019, requiring admission into a specialist burn service across Australia and New Zealand. The %TBSA burned (including the percentage of full thickness burns) recorded by expert burn clinicians within the Burns Registry of Australia and New Zealand (BRANZ) were compared to ICD-10-AM coding.

Results

20,642 cases (71.5%) with ICD-10-AM code data were recorded. Overall, kappa scores (95% confidence interval [CI]) for burn size ranged from 0.64 (95% CI 0.63–0.66) to 0.86 (95% CI 0.78–0.94) indicating substantial to almost perfect agreement across all %TBSA groups. When stratified by depth, the lowest agreement was observed for < 10% TBSA and < 10% full thickness (kappa 0.03; 95% CI 0.02–0.04) and the highest agreement was observed for burns of ≥ 90% TBSA and ≥ 90% full thickness (kappa 0.72; 95% CI 0.58–0.85).

Conclusion

Overall, there was substantial agreement between the BRANZ and ICD-10-AM coded data for %TBSA classification. When %TBSA classification was stratified by burn depth, greater agreement was observed for larger and deeper burns compared with smaller and superficial burns.

Implications

Greater consistency in the classification of burns is needed.
Contesting the ‘Promotion’ and ‘Protection’ of Human Rights: A Critical Understanding of the ASEAN–EU Relationship through Representational Force
Authors: Stacey Jamie D.
Published: November 2022

How do we explain ASEAN – a non-western, traditionally ‘weak’ actor – and the degree to which it has successfully co-opted the EU into accepting its approach to human rights? This article considers the question of human rights in the ASEAN–EU relationship. It does so by reappraising the literature on constructivism and comparative regionalism, embracing the move beyond norm diffusion and Europe to norm contestation and local actors, namely ASEAN. Building on the literature of contestation, it operationalises Mattern's model of Representational Force to analyse the case study of the ASEAN–EU relationship from the 1990s to the establishment of AICHR in 2009 and beyond where we can see contestation in action. Interestingly, through the contestation over the ‘promotion’ and ‘protection’ of human rights, there is significant scope to see how it is ASEAN that has largely co-opted the EU into supporting a uniquely ‘ASEAN’ approach to human rights in Southeast Asia.
Acteoside Alleviates Renal Fibrosis by Inhibiting β-Catenin/CTGF Signaling Pathway in UUO Rats
Authors: Jiang Yuecheng , Lin Xin , Mao Yan , Zhao Jianqiu , Zhang Guihua , Yu Jiali , Dong Rong , Zha Yan
Published: November 2022

Objective: Acteoside (ACT) has been reported to regulate the inflammation and immune response. The study aims to explore the effect of ACT on renal fibrosis in unilateral ureteral obstruction (UUO) rats. Methods: Eighteen Sprague-Dawley rats were randomly divided into 3 groups: sham group, opened the abdominal cavity and sutured abdominal; UUO group, performed UUO surgery; and ACT + UUO group, ACT (40 mg/kg) was given by gavage every day after UUO surgery. After 2 weeks of rat model construction, urine and blood samples were collected for biochemical analysis, while kidney tissues were harvested for hematoxylin and eosin (H&E), Masson's trichrome, and immunohistochemistry staining. The expression of connective tissue growth factor (CTGF), alpha smooth muscle actin (α-SMA), collagen III, heat shock protein 47 (HSP47), and β-catenin in the renal tissue was detected and the correlation between these proteins was analyzed. Results: ACT improved the parameters of renal function in UUO rats, including decreased creatinine and urea nitrogen, and declined urinary protein. Pathological analysis suggested that ACT improved the conditions of renal tubule lesion (including structure destruction, atrophy and lumen obstruction), renal interstitial fibrosis and inflammatory cell infiltration in UUO rats. It also down-regulated the expressions of fibrin-related proteins β-catenin, CTGF, α-SMA, collagen III, and HSP47. Correlation analysis found that β-catenin and CTGF were correlated with the expressions of α-SMA, collagen III, and HSP47. Conclusions: ACT could alleviate renal fibrosis in UUO rats probably via inhibiting β-catenin/CTGF signaling pathway.