bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects from Time Dependence of Ice Nucleus Activity for Contrasting Cloud Types
Authors: Waman Deepak , Deshmukh Akash , Jadav Arti , Patade Sachin , Gautam Martanda , Phillips Vaughan , Bansemer Aaron , Jakobsson Jonas
Published: March 2023

The role of time-dependent freezing of ice nucleating particles (INPs) is evaluated with the “Aerosol–Cloud” (AC) model in 1) deep convection observed over Oklahoma during the Midlatitude Continental Convective Cloud Experiment (MC3E), 2) orographic clouds observed over North California during the Atmospheric Radiation Measurement (ARM) Cloud Aerosol Precipitation Experiment (ACAPEX), and 3) supercooled, stratiform clouds over the United Kingdom, observed during the Aerosol Properties, Processes And Influences on the Earth’s climate (APPRAISE) campaign. AC uses the dynamical core of the WRF Model and has hybrid bin–bulk microphysics and a 3D mesoscale domain. AC is validated against coincident aircraft, ground-based, and satellite observations for all three cases. Filtered concentrations of ice (>0.1–0.2 mm) agree with those observed at all sampled levels. AC predicts the INP activity of various types of aerosol particles with an empirical parameterization (EP), which follows a singular approach (no time dependence). Here, the EP is modified to represent time-dependent INP activity by a purely empirical approach, using our published laboratory observations of time-dependent INP activity. In all simulated clouds, the inclusion of time dependence increases the predicted INP activity of mineral dust particles by 0.5–1 order of magnitude. However, there is little impact on the cloud glaciation because the total ice is mostly (80%–90%) from secondary ice production (SIP) at levels warmer than about −36°C. The Hallett–Mossop process and fragmentation in ice–ice collisions together initiate about 70% of the total ice, whereas fragmentation during both raindrop freezing and sublimation contributes <10%. Overall, total ice concentrations and SIP are unaffected by time-dependent INP activity. In the simulated APPRAISE case, the main causes of persistence of long-lived clouds and precipitation are predicted to be SIP in weak embedded convection and reactivation following recirculation of dust particles in supercooled layer cloud.
Understanding Arctic Sea Ice Thickness Predictability by a Markov Model
Authors: Wang Yunhe , Yuan Xiaojun , Bi Haibo , Ren Yibin , Liang Yu , Li Cuihua , Li Xiaofeng
Published: March 2023

The Arctic sea ice decline and associated change in maritime accessibility have created a pressing need for sea ice thickness (SIT) predictions. This study developed a linear Markov model for the seasonal prediction of model-assimilated SIT. It tested the performance of physically relevant predictors by a series of sensitivity tests. As measured by the anomaly correlation coefficient (ACC) and root-mean-square error (RMSE), the SIT prediction skill was evaluated in different Arctic regions and across all seasons. The results show that SIT prediction has better skill in the cold season than in the warm season. The model performs best in the Arctic basin up to 12 months in advance with ACCs of 0.7–0.8. Linear trend contributions to model skill increase with lead months. Although monthly SIT trends contribute largely to the model skill, the model remains skillful up to 2-month leads with ACCs of 0.6 for detrended SIT predictions in many Arctic regions. In addition, the Markov model’s skill generally outperforms an anomaly persistence forecast even after all trends were removed. It also shows that, apart from SIT itself, upper-ocean heat content (OHC) generally contributes more to SIT prediction skill than other variables. Sea ice concentration (SIC) is a relatively less sensitive predictor for SIT prediction skill than OHC. Moreover, the Markov model can capture the melt-to-growth season reemergence of SIT predictability and does not show a spring predictability barrier, which has previously been observed in regional dynamical model forecasts of September sea ice area, suggesting that the Markov model is an effective tool for SIT seasonal predictions.
Single-layer neural-network based control of agricultural mobile robot
Authors: Gökçe Celal Onur
Published: March 2023

In this study, we propose a novel controller architecture and design for the automatic control of agricultural mobile robots to be used in farms and greenhouses. There are two novelties of this study. The first novelty is a completely new type of controller architecture proposed in which reference inputs and measured outputs are fed separately independent from each other to the controller. The controller architecture currently used in the literature uses only the difference between reference and measurement which is the error signal. The proposed architecture in this study is completely novel in the sense that not only the error information is used in the controller but also the information in reference inputs and information in measured outputs are used separately. This means a completely new type of look to control system by utilizing the information maximally in order to achieve superior performance. This performance boost is shown in the paper where the proposed architecture achieves up to 2000% better performance compared with state-of-the-art controllers. Second, controller architecture is grown to a complex structure from an initially simple PID structure. Using the maximal information comes with the cost of computational complexity to design the controller. The second novelty of growing the controller from initially simple PID equivalent controller tackles this difficulty by making the problem tractable and efficient to compute. This way the proposed novel controller can be designed within minutes in a commercially available laptop computer. The proposed controller is tested on a simulated agricultural mobile robot and results are compared with a previous state-of-the-art optimal controller. It is believed that the proposed architecture will be dominant in future automatic controllers and make current state-of-the-art controllers obsolete. This is because of the full utilization of information in controller design which results in robust disturbance rejection performance.
SF-YOLOv5: Improved YOLOv5 with swin transformer and fusion-concat method for multi-UAV detection
Authors: Ma Jun , Wang Xiao , Xu Cuifeng , Ling Jing
Published: March 2023

When dealing with complex trajectories, and the interference by the unmanned aerial vehicle (UAV) itself or other flying objects, the traditional detecting methods based on YOLOv5 network mainly focus on one UAV and difficult to detect the multi-UAV effectively. In order to improve the detection method, a novel algorithm combined with swin transformer blocks and a fusion-concat method based on YOLOv5 network, so called SF-YOLOv5, is proposed. Furthermore, by using the distance intersection over union and non-maximum suppression (DIoU-NMS) as post-processing method, the proposed network can remove redundant detection boxes and improve the efficiency of the multi-UAV detection. Experimental results verify the feasibility and effectiveness of the proposed network, and show that the mAP trained on the two datasets used in experiments has been improved by 2.5 and 4.11% respectively. The proposed network can detect multi-UAV while ensuring accuracy and speed, and can be effectively used in the field of UAV monitoring or other types of multi-object detection applications.
Race and Subprime Lending Frequency: Understanding Subprime Lending's Role in the St. Louis Vacancy Crisis
Authors: Morgenstern Glen , Becker Charles
Published: March 2023

Using loan-level data, this analysis considers the intersection of race, subprime home loans, and the current vacancy crisis in St. Louis, Missouri. Borrowers in Black areas in the north of St. Louis City and St. Louis County received subprime home loans at higher frequencies during the subprime boom period of 2003–2007 than those in White areas, with differences in balloon loans especially stark. Specifically, borrowers in Black neighborhoods received subprime loans more frequently than those with equal FICO scores in White neighborhoods. As a result of these differential loan terms, North City and inner ring “First Suburb” areas saw more foreclosure and borrower payment delinquency, which in turn were highly associated with home vacancy, controlling for other risk factors. However, foreclosure was no longer a significant predictor of home vacancy after controlling for demographic factors and FICO score, indicating that the unequal loan terms may have driven much of the increase in home vacancy in the St. Louis area since the Great Recession.
Dynamic decision modeling of production and marketing in low-carbon supply chains considering delay effects
Authors: Zhou Xideng , Zhan Lizhen , Shu Hui , Peng Yuan
Published: March 2023

This article deals with a dynamic decision-making model for a low-carbon supply chain which consists of a manufacturer and a platform retailer. Consideration of delay effects, a delayed differential equation for the effect of low-carbon investment efforts (LIE) in R&D and low-carbon promotional effort (LPE) on low-carbon goodwill (LG) is developed. Moreover, Hamilton's function is applied to solve the decision problem of optimal control. In the model, the differences between the agency selling and reselling patterns are analyzed by comparing LIE, LPE, LG, and net discounted profit. The commission system is a key measure for dynamic decision making on low-carbon products, while the commission rate is also an important reference point for decision making on cooperation patterns. In contrast to the findings of previous studies, this article derives specific thresholds for commissions. Furthermore, this study considers delay effects from a dynamic perspective. The findings show differences in both decentralized and centralized decision-making solutions for supply chains as the delay time changes. The proposed models are analyzed mathematically and numerical examples are illustrated to justify the feasibility of the model in reality. This study provides new insights into the choice of platform sales patterns for firms to develop agency selling and reselling partnership solutions in practice.
Functional dyeable polypropylene fabric development and process parameter optimization. Part II: Development of graphene thermal insulation dyeable polypropylene fabric with process parameter optimization
Authors: Chen Shih-Hsiung , Kuo Chung-Feng Jeffrey
Published: March 2023

This series of studies developed a nanographene modified dyeable polypropylene yarn with far-infrared properties making it suitable for winter clothing fabrics. In this paper, part II, the dyeable polypropylene granules developed in part I are used as a base material and, with the addition of graphene nanopowder, melt-mixed and melt-spun to produce 75 d/24 f fully drawn yarn. The physical properties of the yarn, namely, yarn count, tensile strength, elongation at break, far-infrared emissivity, and far-infrared temperature rise, are investigated, and the impact of the melt-spinning process parameters, namely, graphene nanopowder content, mold temperature, melt temperature, gear pump speed, hot roller speed and take-up speed on the quality of the yarn, is determined. The Taguchi method, combined with gray relational analysis, is used to design experiments through which an optimal set of melt-spinning process parameters maximizing the multi-characteristic quality of the yarn is obtained. This optimized nanographene modified dyeable polypropylene yarn has a tensile strength of 3.5 g/d, elongation at break of 41.0%, yarn count of 75.3 d, far-infrared emissivity of 82%, far-infrared temperature rise of 21.0°C, washing fastness grade of 3–4 and surface resistance of 3 × 108 Ω.
Translational Choices and Interpretation in Galatians 1:13–16: An Appraisal
Authors: Förster Hans
Published: March 2023

Standard translation appears to disambiguate the text of Gal 1:13–16 in a way that stresses or even interprets Paul's words to mean that he had left Judaism when he wrote Galatians. Arguably, the text might not indicate that Paul had left behind his Jewish identity, but that he had grown in his understanding of it. Thus, while standard translations are faithful to a traditional understanding of Paul and his “conversion” from Judaism to Christianity, a less explicit translation might be also true to the source text. This observation may be important beyond this specific passage: It might also raise fundamental questions about possible concepts of “faithful renderings” within Bible translation.
The Impact of Legal-Financial Obligations on Relationships With Family, Friends, and Acquaintances: A Qualitative Study of Community Supervised Men With Sexual and Nonsexual Offense Convictions
Authors: Giuffre Andrea
Published: March 2023

System-impacted individuals often rely on others to provide financial support, which aids in the payment of legal-financial obligations (LFOs). LFOs comprise the fines, fees, restitution, surcharges, and assessments imposed on individuals who come into contact with the criminal legal system. Limited evidence suggests that this support can prompt stress and negative emotions for system-impacted individuals and their families. This study examines the process by which a matched sample of 125 men convicted of sexual offenses and nonsexual offenses in Missouri obtain financial support from others and how that process impacts their relationships. Secondary qualitative analysis of interviews with these men reveals that financial support may be governed by resource-sharing norms and LFOs can burden those who cannot pay by indebting them to others and adding “relational work” to their lives.
Treatment of Olfactory Disorders After SARS – CoViD 2 Virus Infection
Authors: Schmidt F. , Azar C. , Goektas O.
Published: March 2023

Objective

The benefit of a nasal corticosteroid in the treatment of persistent post-infectious smell disorders is not as clear in previous studies as is assumed for olfactory training. This study would therefore like to describe the treatment strategies using the example of a persistent olfactory dysfunction as a result of a proven infection with SARS-CoViD-2-virus.

Methods

Twenty patients (average age of 33.9 ± 11.9 years) with hyposmia were included in this study from December 2020 to July 2021. Every second patient received additionally a nasal corticosteroid. The two resulting randomized groups of equal size were screened with the TDI test, a 20-item taste powder test for the assessment of retronasal olfaction and otorhinolaryngological examination. The patients were asked to train twice daily using a standardized odor training kit and followed up after 2 months and 3 months, respectively.

Results

We documented a significant overall improvement in olfactory ability over the investigation period in both groups. While the TDI score steadily increased on average under the combination therapy, the rise under olfactory training alone was initially steeper. This short-term interaction effect over mean two months was not statistically significant. According to Cohen, however, a moderate effect (eta 2 = 0.055, Cohen`s d = 0.5) can still be assumed. This effect could be explained by a possibly higher compliance at the beginning of the sole olfactory training due to the lack of further drug treatment offers. When the training intensity decreases, the recovery of the sense of smell stagnates. Adjunctive therapy ultimately outweighs this short-term benefit.

Conclusions

The results reinforce the recommendation of early and consistent olfactory training on patients with dysosmia due to COVID-19. For continuous improvement of the sense of smell, an accompanying topical treatment seems at least to be worth consideration. The results should be optimized with larger cohorts and using new objective olfactometric methods.
Energy absorption behavior of oil palm empty fruit bunch fiber-reinforced composites subjected to low-velocity impact
Authors: Abdul Rahman Mohd Khairul Faizi , Abdul Majid Mohd Shukry , Abu Bakar Shahriman , Md Tamrin Shamsul Bahri , Israr Ahmad Haris Ahmad , Ng Yee Guan , Mohamad Razlan Zuradzman
Published: March 2023

In this study, oil palm empty fruit bunch (OPEFB)-reinforced composites were subjected to a low-velocity impact test to study their energy absorption characteristics. Two sets of OPEFB-reinforced composite specimens were used, comprising 30:70 and 40:60 fiber/epoxy fractions. One set of specimens was treated with a 3% NaOH solution. The drop impact responses, fragmentation characteristics, energy absorptions, and residual strengths of both sets of specimens were analyzed. Drop impact tests were performed using three different energy levels, namely, 10, 13, and 16 J. In general, the results indicated that all the untreated specimens absorbed higher energy than that of the treated specimens, thus suffering severe surface and structural damage. This result is attributed to the treated specimens providing a better interlocking mechanism between the matrix and fibers and dissipating the impact energy through the impactor. Regarding fiber loading, all the 30:70 fiber/epoxy composites exhibited slightly less energy absorption than the 40:60 fiber/epoxy composites.
An Appraisal of pH triggered Bacitracin drug release, through composite hydrogel systems
Authors: Gul Rabail , Mir Mariam , Ali Murtaza N
Published: March 2023

Comparative investigations on environmentally triggered drug delivery and wound healing characteristics of flexible hydrogel composites, Chitosan-Gelatin (C/G) and 2-Hydroxyethyl Methacrylate-Gelatin (H/G); are presented here. These composites, prepared through facile synthesis and curing methods, indicate the potential to smartly respond to the pH changes in wounds by releasing drug simultaneously and aiding in faster healing. An in-vitro investigation of the composite characteristics were included testing for Equilibrium Water Capacity Studies, Fourier Transform Infrared Spectroscopy (FTIR) investigations as well as UV based drug release and gravimetric hydrogel degradation profiles. This was followed by cutaneous application testing of the hydrogel systems in balb-c mice. Observations and testing results indicated the potential applicability of the hydrogel systems as dressings for topical/transdermal applications, provided that further detailed in-vivo characteristics are accounted for.
Combatting sectarianism from the ground up: The Northern Irish Green and White Army and the football carnival
Authors: Bell John , Somerville Ian , Hargie Owen
Published: March 2023

This paper draws upon participant observation data conducted before and after all 10 qualifying matches for the 2016 UEFA European Football Championship to explore the dynamics underpinning the Northern Irish Green and White Army (GAWA) football carnival. Supplemented by interviews with Northern Ireland fans themselves and informed by the dramaturgical perspectives of Erving Goffman, the paper contends that the anti-sectarian ‘norms’ of GAWA football fandom are dominant in public spaces before matches when the GAWA ‘performance team’ are visible to one another and their audience within a geographically circumscribed space. In a post-match evening context however, various ‘cliques’ of supporters enact their own social rules within a ‘back-stage’ environment of more relaxed peer-to-peer surveillance. These at times transgress the established norms of GAWA fan behaviour. The paper acknowledges that inappropriate supporter behaviour, even within small groups, can damage the wider image of football teams and their supporters in ‘impression management’ terms. But rather than imposing top-down ‘solutions’ which are often devised with limited input from supporters, we suggest that football governing bodies, associations and clubs should look to work in partnership with supporters to identify creative ways in which supporters can be resourced to proactively become ‘norm entrepreneurs’ and challenge inappropriate behaviour from within.
Physical Activity on Prescription “Not a Quick Fix”: School Nurses’ Experiences of Promoting and Tailoring Physical Activity to Children in Swedish Compulsory School
Authors: Wiklund Emelie , Wiklund Maria , Hedenborg Susanna
Published: March 2023

This study aimed to explore school nurses’ experience of using physical activity on prescription with children in Swedish compulsory school. Semistructured interviews were conducted with 24 school nurses who had the educational qualification to prescribe physical activity. The analysis resulted in one overarching theme, “A delicate process of tailoring physical activity on prescription to a child's social context,” and two categories: “Promoting joyful physical activity through individualization and support” and “Dealing with dilemmas and challenges,” with related subcategories. The results demonstrate the importance of tailoring prescribed physical activity to each individual child, their living conditions, and the school context. In addition, they highlight the nurses’ working conditions and collaborations as important prerequisites when initiating physical activity on prescription. In conclusion, the results suggest that school nurses perceive physical activity on prescription as a useful tool in the school context, but it needs to be tailored to each individual child.
Medical Outcomes of Acute Aspirin Single Substance Poisoning in Pediatric Patients
Authors: Daniel-McCalla Shawnée N. , Parbuoni Kristine A. , Leonard James , Morgan Jill A. , Kishk Omayma A. , Biggs Jessica M. , Anderson Bruce D.
Published: March 2023

Background:

A consensus guideline on salicylate poisoning recommends referring patients to the emergency department if they ingested 150 mg/kg of aspirin. The dose of aspirin associated with severe poisoning in pediatric patients has not been investigated.

Objective:

This study aims to associate medical outcomes with aspirin overdoses in patients 5 years old and younger.

Methods:

A retrospective review of data on pediatric patients with single substance aspirin exposures reported from poison centers across the country was conducted. The primary endpoint was to associate aspirin doses with medical outcomes. Secondary endpoints included evaluation of the signs, symptoms, and treatments of ingestion and their association with medical outcomes.

Results:

There were 26 488 included exposures with aspirin exposures resulting in no effect (92.5%), minor effect (6.0%), moderate effect (1.4%), major effect (0.2%), and death (0.02%). There were 8921 cases with available weight-based dosing information. Median doses associated with no effect, minor effects, moderate effects, major effects, and death ranged between 28.4 and 40.9 mg/kg, 52.5 and 82.3 mg/kg, 132.1 and 182.3 mg/kg, 132.3 and 172.8 mg/kg, and 142.2 and 284.4 mg/kg, respectively. Minor effect and moderate effect exposures were more likely to have alkalinization documented compared to no effect exposures (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.41-2.17; OR = 1.79, 95% CI = 1.12-2.86). There was no difference in rates of alkalinization between minor and moderate exposures (OR = 1.02, 95% CI: 0.61-1.7).

Conclusions and relevance:

Reevaluation of the current recommendation of 150 mg/kg for referral to a healthcare facility is necessary for pediatric acute salicylate overdoses.
Biliary Atresia in an Infant Presenting With Kabuki Syndrome: An Autopsy Report and Review of the Literature
Authors: Tralongo Pietro , De Bartolo Debora , Silvestri Nicola , Mercuri Giulia , Oliva Antonio , Arena Vincenzo
Published: March 2023

Biliary atresia (BA) is an inflammatory obliterative cholangiopathy which is very common during neonatal and infancy period. We present an autopsy report of a BA in an infant suffering from a genetic syndrome.
Serum levels of interleukin-18 in diabetic retinopathy patients: A meta-analysis
Authors: Jiang Yingling , Zhou Lihua , Yao Li
Published: March 2023

Purpose

To assess the relationship between plasma interleukin-18 (IL-18) levels and the risk of diabetic retinopathy (DR).

Materials and methods

PubMed, Embase, Web of science, and Cochrane were reviewed systemically from inception to August 2022. Searches were performed using a combined term that included all spellings of “diabetic retinopathy,” and “interleukin-18”. Eligible studies were retrospective studies reporting changes in IL-18 levels between the DR group and the control group. The healthy controls had no identifiable DR disease. Pooled outcomes were reported as standard mean difference (SMD) with 95% confidence intervals (CI) with a random-effects model. Heterogeneity was assessed using the I2 statistics, and it was considered significant if I2 > 75%. Publication bias was evaluated using funnel plots and Begg's and Egger's tests. A meta-analysis was conducted using STATA 12.0 (StataCorp LLC, College Station, TX, USA).

Results

7 studies and four countries incorporated 160 cases, and 119 controls were incorporated in this meta-analysis. When comparing subjects without DR, those with DR tended to have higher serum IL-18 levels (SMD = 3.41, 95% CI = 1.84–4.97). Publication bias indicated that no publication bias existed in the study.

Conclusions

Elevated circulating IL-18 levels may be one of the significant risk factors positively correlated with the development of DR. Future studies should clarify the mechanism behind this trend.
Efficacy and safety of UT-DSAEK combined with Carlevale's sutureless scleral fixation IOL
Authors: Vaiano Agostino S , Greco Antonio , Greco Andrea , Toro Maria E , Leto Marco G , Savini Giacomo
Published: March 2023

Purpose

To evaluate a novel surgical combination of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and sutureless scleral fixation for Carlevale intraocular lens (SSF-Carlevale IOL) implantation to manage corneal endothelial decompensation when there is a concomitant need for secondary IOL fixation.

Methods

Clinical data collected from 10 eyes of 9 patients with bullous keratopathy (BK) who underwent combined UT-DSAEK and SSF-Carlevale IOL implantation in a single procedure were retrospectively analyzed. Anterior chamber IOL (4 cases), aphakia (4 cases, 1 of which associated with PEX), and previous trauma (2 cases) were the conditions responsible for BK. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), central corneal thickness (CCT), graft thickness (GT) and complications were recorded over a 12-month follow-up period.

Results

In 90% (9/10) of eyes graft clarity was maintained during follow-up. The mean CDVA improved significantly (p < 0.0001) from 1.78 ± 0.76 logMAR preoperatively to 0.53 ± 0.3 logMAR at 12 months. ECD on average decreased from 2575 ± 125.3 cells/mm2 (donor tissue) to 1697 ± 133.3 cells/mm2 in 12 months. The mean CCT decreased from 870 ± 200 µm to 650 µm ± 9 at 12 months (ANOVA, p = 0.0005).

Conclusions

Combined UT-DSAEK and SSF-Carlevale IOL implantation was associated with good corneal graft survival and IOP control, with few complications. These findings suggest that this surgical approach is a practical option for patients requiring both treatment for corneal endothelial dysfunction and secondary IOL implantation.
Humoral immune responses remain quantitatively impaired but improve qualitatively in anti-CD20-treated patients with multiple sclerosis after three or four COVID-19 vaccinations
Authors: Otto Carolin , Schwarz Tatjana , Jeworowski Lara M , Schmidt Marie L , Walper Felix , Pache Florence , Schindler Patrick , Niederschweiberer Moritz , Krumbholz Andi , Rose Ruben , Drosten Christian , Ruprecht Klemens , Corman Victor M
Published: March 2023

Objective:

To analyze anti-SARS-CoV-2-S1-IgG levels, avidity, Omicron BA.2 variant neutralizing capacity, and SARS-CoV-2-specific T cells in anti-CD20-treated patients with multiple sclerosis (aCD20pwMS) after two, three, or four COVID-19 vaccinations.

Results:

Frequencies of aCD20pwMS with detectable SARS-CoV-2-S1-IgG increased moderately between two (31/61 (51%)), three (31/57 (54%)), and four (17/26 (65%)) vaccinations. However, among patients with detectable SARS-CoV-2-S1-IgG, frequencies of high avidity (6/31 (19%) vs 11/17 (65%)) and Omicron neutralizing antibodies (0/10 (0%) vs 6/10 (60%)) increased strongly between two and four vaccinations. SARS-CoV-2-specific T cells were detectable in >92% after two or more vaccinations

Conclusion:

Additional vaccinations qualitatively improve SARS-CoV-2 antibody responses.
Telemedicine is associated with reduced socioeconomic disparities in outpatient clinic no-show rates
Authors: Qin Jimmy , Chan Carri W , Dong Jing , Homma Shunichi , Ye Siqin
Published: March 2023

Introduction

The global pandemic caused by coronavirus (COVID-19) sped up the adoption of telemedicine. We aimed to assess whether factors associated with no-show differed between in-person and telemedicine visits. The focus is on understanding how social economic factors affect patient no-show for the two modalities of visits.

Methods

We utilized electronic health records data for outpatient internal medicine visits at a large urban academic medical center, from February 1, 2020 to December 31, 2020. A mixed-effect logistic regression was used. We performed stratified analysis for each modality of visit and a combined analysis with interaction terms between exposure variables and visit modality.

Results

A total of 111,725 visits for 72,603 patients were identified. Patient demographics (age, gender, race, income, partner), lead days, and primary insurance were significantly different between the two visit modalities. Our multivariable regression analyses showed that the impact of sociodemographic factors, such as Medicaid insurance (OR 1.23, p < 0.01 for in-person; OR 1.03, p = 0.57 for telemedicine; p < 0.01 for interaction), Medicare insurance (OR 1.11, p = 0.04 for in-person; OR 0.95, p = 0.32 for telemedicine; p = 0.03 for interaction) and Black race (OR 1.36, p < 0.01 for in-person; OR 1.20, p < 0.01 for telemedicine; p = 0.03 for interaction), on increased odds of no-show was less for telemedicine visits than for in-person visits. In addition, inclement weather and younger age had less impact on no-show for telemedicine visits.

Discussion

Our findings indicated that if adopted successfully, telemedicine had the potential to reduce no-show rate for vulnerable patient groups and reduce the disparity between patients from different socioeconomic backgrounds.
Therapeutic alliance in videoconferencing psychotherapy compared to psychotherapy in person: A systematic review and meta-analysis
Authors: Seuling Patrik D , Fendel Johannes C , Spille Lukas , Göritz Anja S , Schmidt Stefan
Published: March 2023

Introduction

Videoconferencing psychotherapy (VCP) delivers treatment to individuals with limited access to face-to-face mental healthcare. VCP's effectiveness has been demonstrated for various disorders and therapeutic interventions. However, there is contradictory evidence regarding the therapeutic alliance in VCP as compared to psychotherapy in person (PIP). This meta-analysis examines whether therapeutic alliance differs by psychotherapy's delivery format, namely VCP versus PIP.

Methods

We searched five databases for trials comparing the therapeutic alliance in VCP and PIP, wherein the therapeutic alliance was rated by either patients or therapists or both. Eighteen publications were included, and the difference between VCP and PIP was assessed. Furthermore, we tested possible moderators of the difference in therapeutic alliance between VCP and PIP by meta-regression, and we assessed the risk of bias of this meta-analysis.

Results

The meta-analysis revealed no statistically significant difference in the therapeutic alliance between VCP and PIP for alliance ratings by patients (SMD = −0.09; 95% CI = −0.26; 0.07) as well as by therapists (SMD = 0.04; 95% CI = −0.17; 0.25). No significant moderators were found.

Discussion

In this meta-analysis, VCP and PIP did not differ with respect to the therapeutic alliance as rated by either patients or therapists. Further research is required into mechanisms driving the therapeutic alliance in VCP and PIP.
Design and evaluation of non-digital gamification to support collaborative morphological analysis
Authors: Qiao Shen , Yeung Susanna Siu-sze , Chu Samuel Kai Wah
Published: March 2023

Limited vocabulary leads to decreased performance and motivation in reading comprehension among students who learn English as a foreign language (EFL). Morphological analysis provides an effective means to problem-solve the meanings of unknown words and support reading comprehension. This study designed the non-digital gamification approach based on the five game features proposed by Richard E. Mayer to support collaborative morphological analysis. It compared the effects of a non-digital gamified and conventional morphological analysis intervention on reading outcomes and intrinsic motivation. An explanatory sequential mixed-method research design was adopted. Two classes from a secondary school in China were recruited and assigned to either the experimental group receiving the non-digital gamified programme ( N = 52) or the control group receiving a conventional non-gamified programme ( N = 52). Each group received its assigned programme for a total of ten 55-minute sessions. Evaluations of morphological analysis, reading comprehension and intrinsic motivation were conducted before and after the intervention. Results showed that the gamified group had significantly better performance in reading comprehension but not in morphological analysis. Furthermore, the gamified group had significantly higher perceived intrinsic motivation in terms of relatedness and autonomy than the non-gamified group, but not in perceived competence. The qualitative analyses based on student interviews suggested that in designing gamification, it’s important to facilitate peer interaction, create task value and take students’ negative emotions into account. The findings support the implementation of gamified morphological analysis instruction in general reading instruction for EFL students and underscore future directions in designing non-digital gamification.
COVID-19, geopolitics and risk management: Towards framing a reciprocal, coordinated, responsive and empathetic international education sector
Authors: Tran Ly Thi , Nguyen Diep Thi Bich , Blackmore Jill , He Baogang , Vu Huy Quan
Published: March 2023

Geopolitics is shaping the international education landscape. International education has trationally been used as a tool to boost transnational cooperation, foster multilateral and global ties, and reduce tensions between nations. Such a role has been eroded and international education has been weaponised in the context of escalating political turbulences and disputes over the COVID-19 pandemic. In particular, the relationship between Australia and China, with international student flows interrupted due to COVID-19, is overshadowed by escalating geopolitical tensions in the Indo-Pacific region. Based on a qualitative study, this article examines stakeholders’ views on the responses of the Australian international education sector and universities to emerging geopolitical tensions. The conjuncture of geopolitics, COVID-19 and Australia's former government responses magnified a sense of crisis for universities and the international education sector as it was at risk because of their financial reliance on international students. Based on the findings, recommendations are made for the framing of a reciprocal, coordinated, responsive and empathetic international education sector to mitigate geopolitical risks and ensure more sustainable and ethical development for the sector.
Study on the toroidal helix and manufacturing method of enveloping hourglass worm tooth surface
Authors: Chen Yan , Wang Xinhua , Ma Huili
Published: March 2023

As a complex space enveloped surface, the tooth surface of dual-lead helical gear enveloping hourglass worm is characteristic with difference tooth profile, unequal pitch and variable tooth thickness. To grasp the geometry characteristics and precision manufacturing method of it, the analytical method for toroidal helix is presented. The mathematical model of toroidal helix is developed, and the geometry characteristics of helix angle, axial tooth thickness, and tooth surface undercutting are analyzed. The helix angle of toroidal helix presents the convex shape, and the undercutting characteristic is affected by the pressure angle, helix angle, transmission ratio, and normal modulus. Based on the toroidal helix of tooth surface, the precision manufacturing method is proposed, and the measuring method is developed. The hourglass worm sample was manufactured and measured, and the transmission accuracy of hourglass worm drive is tested. The results show that the manufacturing and measuring method of toroidal helix is effective and feasible.
Neoadjuvant immunotherapy in resectable non-small-cell lung cancer
Authors: Chen Lanyi Nora , Wei Alexander Z. , Shu Catherine A.
Published: March 2023

The advent of immune checkpoint inhibition has pushed the treatment paradigm for resectable non-small-cell lung cancer (NSCLC) toward neoadjuvant therapy. A growing number of promising trials have examined the utility of neoadjuvant immunotherapy, both alone and in combination with other modalities such as radiation therapy (RT) and chemotherapy. The phase II LCMC3 and NEOSTAR trials demonstrated a role for neoadjuvant immunotherapy in inducing meaningful pathologic responses, and another phase II trial established the feasibility of combining neoadjuvant durvalumab with RT. Significant interest in neoadjuvant chemoimmunotherapy resulted in the conduct of multiple successful phase II trials including the Columbia trial, NADIM, SAKK 16/14, and NADIM II. Across these trials, neoadjuvant chemoimmunotherapy led to high rates of pathologic response and improved surgical outcomes without compromising surgical timing or feasibility. CheckMate-816, which was a randomized phase III trial studying neoadjuvant nivolumab in addition to chemotherapy, definitively established a benefit for neoadjuvant chemoimmunotherapy compared to chemotherapy alone for resectable NSCLC. Despite the growing literature and success of these trials, several outstanding questions remain, including the relationship between pathologic response and patient survival, the role of biomarkers such as programmed death ligand 1 and circulating tumor DNA in determining patient selection and treatment course, and the utility of additional adjuvant therapies. Longer follow-up of CheckMate-816 and other ongoing phase III trials may help address these questions. Ultimately, the complexity of managing resectable NSCLC highlights the importance of a multidisciplinary approach to patient care.
Assessment of Patellar Vascularity after Patellar Cartilage Restoration via Lateral Parapatellar Approach: Analysis Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging
Authors: Uppstrom Tyler J. , Breighner Ryan E. , Fletcher Connor , Mintz Douglas N. , Strickland Sabrina A.
Published: March 2023

Objective

Patellofemoral cartilage restoration procedures, including osteochondral allograft, particulated juvenile cartilage, and matrix-induced autologous chondrocyte implantation, have been shown to be effective treatments for patellofemoral cartilage lesions. However, concerns exist regarding disruption of the patellar vascular supply and secondary stabilizers of the patellofemoral joint during medial parapatellar approaches, especially when combined with a lateral release. A lateral parapatellar approach affords the possibility of avoiding disruption of the medial blood supply to the patella, while also allowing laterally-based soft tissue stabilization procedures. The purpose of this study was to investigate in vivo changes in patellar vascularity following patellofemoral cartilage restoration procedures performed via a lateral parapatellar approach via use of dynamic contrast-enhanced magnetic resonance (MR) imaging.

Design

This study is a prospective case series of 5 adult patients undergoing patellofemoral cartilage restoration procedures via a lateral parapatellar approach with pre-operative and post-operative dynamic contrast-enhanced MR imaging to assess changes in patellar vascularity. Secondary outcomes included knee range of motion, need for revision surgery, and complications.

Results

There was no significant post-operative difference in patellar vascularity in patients undergoing patellofemoral cartilage restoration procedures via a lateral parapatellar approach, as evaluated by qualitative MR imaging.

Conclusion

Our results suggest that a lateral parapatellar approach for cartilage restoration procedures may preserve patellar vascularity, while also allowing for lateral release to be performed through the same incision.
7T MRI in transient ischemic attacks: Have we only seen the tip of the iceberg?
Authors: Lakhani Dhairya A , Zhou Xiangzhi , Tao Shengzhen , Westerhold Erin M , Eidelman Benjamin H , Vibhute Prasanna , Singh Sandhu Sukhwinder Johnny , Middlebrooks Erik H
Published: March 2023

Transient ischemic attack (TIA) has gained significant attention recently due to the increased incidence of subsequent stroke. However, there are many nonvascular clinical mimics of TIA, creating a need for improved biomarkers to identify a vascular origin. Following the recent approval of ultra-high field (UHF) 7T MRI in clinical practice, several clinical studies have highlighted its added utility in neuroimaging compared to lower-field 1.5T and 3T MRI, particularly in epilepsy and multiple sclerosis. Our case series of three patients with TIA illustrates that 7T MRI can depict small areas of intracortical microhemorrhages and microinfarctions, which could not be resolved with 3T or 1.5T MRI. There are currently no reports of intracortical localization of microhemorrhages in patients with TIA. This discovery may enhance our understanding and characterization of cerebrovascular abnormalities in TIAs. In addition, UHF imaging could potentially be utilized to distinguish transient neurological episodes secondary to cerebrovascular events from other differential considerations. Our cases highlight the underestimation of imaging abnormalities in cases of TIA and support the potential expanded application of clinical 7T to assess patients with TIA. Future studies are necessary at 7T redundant to determine the true incidence of such lesions in TIA and to examine the correlation between cortical microhemorrhages and subsequent ischemic stroke, hemorrhagic events, and neurocognitive impairment.
The EPPO and the equality of arms between the prosecutor and the defence
Authors: Ramos Vânia Costa
Published: March 2023

This piece looks at the principle of equality of arms in EPPO proceedings, arguing that it should be looked at as a mandate for maximisation rather than only as a requirement of meeting certain minimum standards. It advocates for addressing the imbalance in a three-fold manner: in the short term, i) it is up to the EPPO itself to set its bar high and harmonise practices and procedures in a way that maximises the respect for the principle of equality of arms, by strengthening and harmonising the rights of defence; in the medium-term ii) to create a strong and harmonised set of procedural safeguards that addresses the systemic flaw and the fragmented legal protection, including the right to effective judicial review and substantive remedies, but also safeguards for intrusive acts of evidence-gathering, seizure and detention; and iii) to set avenues of direct access for the accused to the Court of Justice of the EU in respect of EU Law in EPPO proceedings. It concludes with the author’s wish that the establishment of a single prosecution office will be counterbalanced by the enfranchisement of citizens with a robust single Charter of defence rights, including a strong and pro-active global defence, and effective remedies under a single legal area, including access to a truly European Court: One Single Office, One Single Charter, One Single Global Defence, One Single Court.
Should we undertake surveillance for HCC in patients with MAFLD?
Authors: Norero Blanca , Dufour Jean-François
Published: March 2023

Over the last decade, metabolic-associated fatty liver disease (MAFLD) has become an important public health issue worldwide. In many countries, MAFLD has become the most common cause of chronic liver disease. On the contrary, hepatocellular carcinoma (HCC) mortality is rising. Liver tumors have become the third cause of cancer mortality worldwide. HCC is the most frequent liver tumor. While the burden of HCC related to viral hepatitis is declining, the prevalence of MAFLD-related HCC is rising rapidly. Classical screening criteria for HCC consider cirrhotic, advanced fibrosis, and viral hepatitis patients. Metabolic syndrome with liver involvement or MAFLD is associated with a higher risk of HCC development, even in the absence of cirrhosis. The question about the cost effectiveness of surveillance for HCC in MAFLD is yet not fully answered. There are no guidelines that address the question of when to start or how to define the population who can benefit of surveillance for HCC in MAFLD patients. This review aims to revise the evidence of HCC development in MAFLD. It hopes to be a step closer to defining screening criteria for HCC in MAFLD.
Co-design of the web-based ‘My Knee’ education and self-management toolkit for people with knee osteoarthritis
Authors: Goff Anthony J , De Oliveira Silva Danilo , Ezzat Allison M , Crossley Kay M , Pazzinatto Marcella F , Barton Christian J ,   Lived Experience Group and Health Professional Group
Published: March 2023

Objective

Describe the co-design process and learnings related to developing the web-based Translating Research Evidence and Knowledge (TREK) ‘My Knee’ education and self-management toolkit for people with knee osteoarthritis.

Co-design process

Stage (i): Understand and define; systematically reviewed education interventions in published trials; appraised web-based information about knee osteoarthritis; and used concept mapping to identify education priorities of people with knee osteoarthritis and physiotherapists. Stage (ii): Prototype; created a theory-, guideline- and evidence-informed toolkit. Stage (iii): Test and iterate; completed three co-design workshops with end-users (i.e., people with knee osteoarthritis and health professionals); plus an expert review.

Results

The toolkit is available at myknee.trekeducation.org. Stage (i) identified the need for more accurate and co-designed resources to address broad education needs generated during concept mapping, including guidance on surgery, dispelling common misconceptions and facilitating engagement with exercise therapy and weight management. A theory- and research-informed prototype was created in Stage (ii) to address broad learning and education needs. Stage (iii) co-design workshops ( n =  15 people with osteoarthritis and n =  9 health professionals) informed further content creation and refinement, alongside improvements to optimise usability. Expert opinion review ( n =  8) further refined accuracy and usability.

Conclusions

The novel co-design methodology employed to create the TREK ‘My Knee’ toolkit facilitated the alignment of the content and usability to meet the broad education needs of people with knee osteoarthritis and health professionals. This toolkit aims to improve and facilitate engagement with guideline-recommended first-line care for people with knee osteoarthritis. Future work will determine its effectiveness in improving clinical outcomes in this population.