bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical behaviors and flammability of perlite filled recycled high-density polyethylene composites
Authors: Barçin Sergen , Sen Subhayu , Thomas Vinoy , Pillay Selvum , Ning Haibin
Published: September 2024

Recycled high density polyethylene (rHDPE) has found increasing use in various applications due to its low cost and abundant availability. However, it possesses low mechanical properties and inferior flame resistance. This work uses the approach of adding a low-cost additive (perlite) into the rHDPE to improve those properties and studies the mechanical behaviors and fire resistance of the perlite filled rHDPE composites while still maintaining low cost. Composites with different ratios of perlite to rHDPE (neat rHDPE, 1:10 perlite/rHDPE ratio; and 2:10 perlite/rHDPE ratio) were produced through twin extrusion process and compression molding processes. The composites were tested in their performance in tension and flexure as well as flame resistance. The testing results showed that the tensile modulus increased from 0.89 (neat rHDPE) to 1.14 GPa (composite with 2:10 perlite/rHDPE ratio), while the tensile strength showed a slight increase as well. The flexural modulus of the composite increased by approximately 37.5% with the addition of perlite. However, the impact resistance decreases with increasing perlite amount added in the rHDPE. Finally, the flame resistance was found to increase by around 20% with the incorporation of perlite. These findings suggest that perlite is a promising cost-effective additive material for enhancing the tensile and flexural properties and flame retardancy of rHDPE.
The Expanding Domains of Degraded Work in the United States: Constructing a More Comprehensive Typology of Non-standard Employment Arrangements
Authors: Gonos George
Published: September 2024

The spread of non-standard employment (NSE) is widely considered to have contributed to the deterioration of labor standards. Yet, in the United States, there is no definitive roster of non-standard work arrangements and no reliable estimate of the size of the non-standard workforce. For over 25 years, the US Bureau of Labor Statistics (BLS) has produced artificially low estimates of employers’ use of ‘alternative employment arrangements’. Its 2018 Contingent Work Supplement (CWS) reported that since 1995 the proportion of US workers in these arrangements had declined. This article proposes a more systematic framework for understanding NSE in the United States and fleshes out a more comprehensive typology better suited toward addressing the needs of policymakers and labor activists. It fundamentally reorients the study of NSE by recognizing that so-called ‘alternative’ arrangements are abusive and more aptly understood as degraded work arrangements (DWAs). The article then explores the key categories of DWAs and provides a deeper analysis of one group, dissociative arrangements, that enable the flourishing use of ‘non-employee’ workers. Concluding sections address the undertheorized state of this subject area and the challenge of union organizing in fractured labor markets.
Do economic growth, the legal system, and energy consumption lessen the ecological footprint? Evidence from South Korea
Authors: Damak Obadiah Ibrahim , Eweade Babatunde Sunday
Published: September 2024

This study explored the ecological footprint in South Korea, and it lacks substantial research on its ecological footprint, which illustrates the environmental impact of its economic growth, adherence to the rule of law, adoption of renewable energy, and exportation of petroleum. To this end, the study examined the relationship between GDP growth, rule of law, renewable energy, and petroleum exports in South Korea using dataset spanning between 1990 and 2022. The study employed the Autoregressive Distributed Lag (ARDL), robustness tests (fully modified ordinary least squares, dynamic ordinary least squares, and canonical cointegrating regression) including the Granger Causality. Based on the outcomes of the ARDL method (i) the rule of law and the use of renewable energy sources dampens ecological footprint, (ii) GDP upsurges ecological footprint in the long run, (iii) fuel exports improved the ecological footprint in the short-run. The Granger Causality test shows that there is unidirectional relationship between economic growth, renewable energy consumption, rule of law, and ecological footprint which means that ecological footprint Granger causes all the explanatory variables investigated. The findings highlight the importance of well-coordinated policy implementation by policymakers in order to stop Korea's notable environmental degradation. Policy makers should invest in the renewable energy sector; South Korea should actively support the execution of strict legal guidelines and the growth of renewable energy sources.
Ovarian Cancer Patient-Derived Organoids Used as a Model for Replicating Genetic Characteristics and Testing Drug Responsiveness: A Preliminary Study
Authors: Chang Yu-Hsun , Wu Kun-Chi , Wang Kai-Hung , Ding Dah-Ching
Published: September 2024

This study aimed to explore the role of ovarian cancer patient-derived organoids (PDOs) in their replicating genetic characteristics and testing drug responsiveness. Ovarian cancer PDOs were cultured in Matrigel with a specialized medium. The successful rate and proliferation rate were calculated. Morphology, histology, and immunohistochemistry (IHC) (PAX8, P53, and WT1) were used to identify the tumor characteristics. Gene sequencing, variant allele frequency (VAF), and copy number variation were used to explore the mutation profile. The sensitivity to chemodrugs (carboplatin, paclitaxel, gemcitabine, doxorubicin, and olaparib) was conducted. Successful generation of organoids occurred in 54% (7/13) of attempts, encompassing 4 high-grade serous carcinomas (HGSC), 1 mucinous carcinoma (MC), 1 clear cell carcinoma (CCC), and 1 carcinosarcoma. The experiments used six organoids (3 HGSC, 1 CCC, 1 MC, and 1 carcinosarcoma). The derived organoids exhibited spherical-like morphology, and the diameter ranged from 100 to 500 μm. The histology and IHC exhibited the same between organoids and primary tumors. After cryopreservation, the organoid’s growth rate was slower than the primary culture (14 days vs 10 days, P < 0.01). Targeted sequencing revealed shared DNA variants, including mutations in key genes, such as BRCA1, PIK3CA, ARID1A, and TP53. VAF was similar between primary tumors and organoids. The organoids maintained inherited most copy number alterations. Drug sensitivity testing revealed varying responses, with carcinosarcoma organoids showing higher sensitivity to paclitaxel and gemcitabine than HGSC organoids. Our preliminary results showed that ovarian cancer PDOs could be successfully derived and histology, mutations, and diverse copy numbers of genotypes could be faithfully captured. Drug testing could reveal the individual PDO’s responsiveness to drugs. PDOs might be as valuable resources for investigating genomic biomarkers for personalized treatment.
Single Center Experience on Eversion versus Standard Carotid Endarterectomy: A Prospective Non-Randomized Study
Authors: Radak Djordje , Radević Božina , Sternić Nadežda , Vučurević Goran , Petrović Branko , Ilijevski Nenad , Radičević Sandra , Nešković Aleksandar N. , Bojić Milovan
Published: September 2024

Background and purpose:

The prospective studies that have compared the outcomes of eversion and standard longitudinal carotid endarcterectomy (CEA) have been few and small and available data to reach definitive conclusions are still scarce. This prospective, non-randomized study sought to compare eversion and standard CEA for early and late mortality and morbidity and the incidence of late restenosis.

Methods:

Between 1992 and 1997. we performed 2806 CEAs in 2469 patients (2124 eversion CEAs in 1859 patients and 682 standard CEAs in 610 patients). All patients underwent preoperative neurological examination and cervical duplex scanning. Patients were followed up by neurological evaluation and duplex scanning at 1 and 6 months after CEA, and yearly afterwards.

Results:

Demographics and neurologic inidications for CEA were similar in both groups. Mean clamping time was shorter in the eversion CEA group (13.5 ± 6.1 vs 19.9 ± 19.1 min, P < 0.001). Early (30-day) postoperative mortality due to major stroke was lower after eversion CEA (10/2124 vs 9/682, P = 0.037), as well as total cardiovascular mortality (16/2124 vs 12/682, P= 0.038). Early carotid occlusion was more frequent in standard CEA group (12/2124 vs 11/682, P = 0.017), as well as total early morbidity (112/2124 vs 53/682, P < 0.001). During follow-up (mean 56 months, range 6–92). restenosis rate was lower in the eversion CEA group (0.5 vs 1.8%, P= 0.006).

Conclusions:

Our data indicate that eversion CEA as compared to standard CEA technique is associated with lower total cardiovascular perioperative mortality and mortality due to major stroke, shorter clamping time, lower early occlusion rate, and lower late restenosis rate.
Carotid Endarterectomy and Local Anaesthesia: Reducing the Disasters
Authors: Love A. , Hollyoak M.A.
Published: September 2024

Purpose:

The study was designed to assess one surgeon's operative mortality and morbidity for carotid endarterectomy using local anaesthetic (LA) compared to general anaesthetic (GA) techniques.

Method:

Data were collected prospectively from 200 patients undergoing LA carotid surgery compared with 243 patients undergoing carotid surgery using GA technique. Indication for surgical, pathology, postoperative morbidity and mortality was assessed.

Results:

No major strokes or deaths occurred in the LA group (0/200). Significantly more major strokes and/or deaths occurred in the GA group (11/243, 4.5%; P= 0.016). Significant less shunt usage was associated with LA (LA 18/200. 9% versus 94/243. 39%: P =0.001). The absense of a shunt was associated with more major events in the GA group (5/143, P = 0.001. Age greater than 74 yr was associated with greater major events (4/31. P = 0.002). No significant difference in the frequency of cardiovascular complications was observed (LA. 15/200 (7.5%) vs GA. 19/243(7.8%); P = 0.924).

Conclusion:

Local anaesthesia enables the surgeon to assess the level of cerebral perfusion with an awake patient, gives greater assurances of cerebral protection during arterial clamping and a provides for a more relaxed and cautious endarterectomy and repair. This study demonstrates reduction in mortality and major stroke events in patients operated on with these conditions.
Comparison of Bioprosthesis and Mechanical Valves, a Meta-Analysis of Randomised Clinical trials
Authors: Kassaï B. , Gueyffier F. , Cucherat M. , Boissel J.-P.
Published: September 2024

The main purpose of this meta-analysis was to compare the outcomes of patients who randomly received mechanical valves or bioprosthesis, over a long-term clinical follow-up.

We found only three trials meeting our selection criteria with a total of 1229 patients (8069.5 patient-yr). Bleeding was more frequent in patients with mechanical prostheses both after Syr (RR = 2.6; IC = [1.9;3.5]; P <0.0001) and 11 yr (RR = 1.6; IC = [1.2:2.2]; P < 0.001) of follow-up. However, the increased risk of bleeding at 11 yr was only statistically significant with mechanical prostheses in the aortic position (RR = 1.93; IC = [1.36:2.74]; P = 0.0002). Reoperation was significantly more frequent in patients with bioprosthesis after 11 yr follow-up (RR = 0.4; IC = [0.3;0.6]: P < 0.001). Endocarditis was more frequent after 11 yr (RR = 0.6; IC = [0.3;0.95]; P < 0.05) in patients with mechanical prostheses but these results were heterogeneous between mitral and aortic valves. The choice of valve type does not significantly influence survival.
The Mayo Vascular Center Experience
Authors: Hallett J. W. , Rooke T. W. , Koch M.
Published: September 2024

American medicine is trending toward an increasing number of specialty care centers. Cancer centers, transplant centers, and sports medicine centers are only a few common examples. Vascular centers are relatively new entities that are forming for obvious reasons. As the general population ages, peripheral vascular disease has become more prevalent. Several types of medical, surgical, and radiological specialists are involved in the diagnosis and treatment of such patients. Creating multispecialty vascular centers is one method to focus expert care on the patient, to alleviate some of the turf battles between specialties, and to contain burgeoning Medicare costs.
Radical Debridement and Omental Transposition for Post Sternotomy Mediastinitis
Authors: d'Udekem Y. , Lengele B. , Noirhomme P. , El Khoury G. , Vanwijck R. , Rubay J. E. , Dion R.
Published: September 2024

Objective:

Reported mortality for postoperative mediastinitis treated by debridement alone can reach 40%. The authors' experience with radical debridement and omental transposition is reviewed.

Methods:

Between May 1990 and August 1996, 14 patients with untractable mediastinitis had a transfer of the greater omentum: 11 after coronary artery bypass grafting (CABG) (6 bilateral internal thoracic arteries ITA grafts), one after a heart transplant, one after an aortic valve replacement and CABG, and one after a repair of the aortic isthmus related to a motor vehicle accident. The mean age was 63 ± 8 years. Infection was proven in all patients by cultures of intraoperative specimens. Two patients had such a large sternal defect that no primary closure could be attempted. The remaining 12 patients had a mean of 1.4 ± 0.7 previous debridement. Five patients had a total sternectomy. After radical debridement, the omentum was transferred over the entirety of the wound and covered with a meshed thin skin graft. All patients had a minimum of 4 weeks of i.v. antibiotic therapy.

Results:

There was no operative death. Apart from one focal necrosis and one traumatic dehiscence of the omentum, there was no hospital complication. Sepsis was controlled in all patients. The median hospital stay was 31 days (range 20–154 days). At a median follow-up of 20 months (range: 6–44 months), there were two late deaths: one sudden and unexpected death and one after a re-do CABG. The remaining patients had resumed their previous activities. One patient had developed an incisional hernia and another underwent further surgery for cosmetic reasons.

Conclusion:

Radical debridement and omental transposition may achieve a cure for postoperative mediastinitis with good mid-term results.
Aortic Arch Aneurysms: Surgical Results and Follow Up in 56 Patients
Authors: Caimmi Ph. , Zanetti P.P. , Castenetto E. , Di Rosa E. , Trucano G. , di Summa M.
Published: September 2024

From January 1989 to December 1994, 56 patients, 43 male and 13 female, mean age 61.21 ± 10.05 years, underwent surgical procedures on the aortic arch at our institution. Forty-six patients underwent emergency or urgent operations, fourty-four of them presented acute aortic dissections involving the aortic arch. All operations were performed in cardiopulmonary by-pass, 39 operations in deep hypothermic circulatory arrest. 10 in deep hypothermic circulatory arrest and hypothermic retrograde cerebral perfusion. The overall hospital mortality was 17.9% (10 patients). The main causes of hospital mortality were: multiorgan failure (3 patients) and major neurological damage (2 patients). In the group of patients that underwent hypothermic retrograde cerebral perfusion there was no major neurological damage. In the follow up there were no deaths and 4 reoperations related to the aortic pathology. The cerebral protection represents the main problem in the aortic arch surgery. The deep hypothermic circulatory arrest is an effective method to reduce the cerebral and visceral ischemia, in particular in acute dissection; nevertheless this method leads to more bleeding complications and lengthening of the cardiopulmonary bypass in time. In our experience, the hypothermic retrograde cerebral perfusion associated with deep hypothermic circulatory arrest appears to be a useful method to prevent cerebral damage. However this procedure needs further investigation.
Nursing professions’ distinctive ethical standards: Exploring a code of ethics
Authors: Yakov Gila , Halevi Hochwald Inbal , Rashi Tsuriel , Shachaf S , Sela Y , Halperin O
Published: September 2024

This article presents an examination of the ethical code of nursing in Israel, focusing on the nurse-patient, nurse-colleague, and nurse-professional leadership relationships. This article offers for the first English translation of the Israel Nursing Association’s Code of Ethics to facilitate international scholarly discussion, and to critique this Code through the lens of Asa Kasher’s philosophical test, thereby examining its completeness and practical utility. As it stands today, the code lacks clarification of the professional ethical uniqueness of nursing. To address this gap, the article adopts a philosophical approach using Kasher’s test named the Three Components of the Practical Ideal to distill the distinctive ethical obligations imposed on nursing professionals. The article highlights the importance of professionalism in nursing, encompassing expertise, autonomy, and recognition, as emphasized in the Code of Ethics. However, the current code does not explicitly delineate the unique requirements specific to nursing. Thus, the article proposes the integration of these explicit requirements into the Code of Ethics through collaborative efforts. Furthermore, it emphasizes the crucial role of nursing education and training programs in fostering professional identity formation based on the strengthening of the commitment to relevant ethical principles. The article contributes to the advancement of nursing ethics by providing a comprehensive framework for understanding and implementing proper ethical conduct within the nursing profession.
Individual Entrepreneurial Orientation: Scale Development and Validation
Authors: Clark Daniel R. , Covin Jeffrey G. , Pidduck Robert J.
Published: September 2024

Recent research introduced and laid the foundation for a new individual-level entrepreneurial orientation conceptualization (Ind.EO) within the entrepreneurial orientation family of constructs. Building directly from this work, this article theoretically defines a measurement model for the construct and develops and validates a scale. We define and measure disposition-based behavior constructs for autonomy, competitiveness, innovativeness, proactiveness, and risk-taking, thus providing psychometrically validated tools that support research in the burgeoning Ind.EO domain. Scale items are generated deductively from our definitions, and then tested through four data collections with academics, the lay population, entrepreneurs, and business managers. Strong validation data across these multiple samples support the utility of the final 17 items and that they can be used to measure Ind.EO. Furthermore, we provide unique theoretical insights regarding the value of the autonomy and competitiveness components of Ind.EO and investigate the core personal values associated with Ind.EO.
A Commentary on Santuzzi et al., 2024: Managing Uncertainty for Disability Disclosures
Authors: Thomas Benjamin J. , Biermeier-Hanson Benjamin
Published: September 2024

In their focused study on the effect of organizational language on workers’ behaviors related to disclosing a disability, Santuzzi and coauthors (2024) explore how employees with disabilities (EWD) weigh the decision to disclose their conditions to employers. We advance this work by offering a relevant theoretical perspective, Uncertainty Management Theory (UMT; Lind & Van den Bos, 2002) for considering EWD’s decisions to disclose. UMT holds that employees strongly look for cues of workplace procedural and interactional justice, in moments of uncertainty. We assert that disclosing one’s disability in moments like those studied by Santuzzi and colleagues (2024) pose high uncertainty for employees who look for signals of just treatment. We explore those processes as they relate to disability disclosure and introduce practical suggestions for organizations to reduce uncertainty surrounding disability disclosure.
Impact of the COVID-19 Pandemic on Pennsylvania School Nurse Management of Student Immunization Requirements
Authors: Hoke Alicia M. , VanDyke Erika , Mellott Elle , Strick Janine , Sekhar Deepa L.
Published: September 2024

School nurses play a significant role in the coordination of school-entry immunization requirements across the United States. The COVID-19 pandemic changed the school landscape and introduced additional responsibilities to a school nurse's workload. We conducted a cross-sectional survey with n = 110 Pennsylvania school nurses to explore the impact of the COVID-19 pandemic on school-entry immunization compliance management. Qualitative and quantitative data indicated increased difficulty obtaining school-entry immunization data ( n = 52) and reduced school-level enforcement of immunization compliance ( n = 30). We also observed increases in the percentage of students enrolled with an immunization exemption in Kindergarten, 7th, and 12th grades between the 2019–2020 and 2020–2021 school years. However, few respondents (15%) offered school-located immunization clinics (SLIC) for school-entry-required immunizations. While the benefits of SLICs are documented, the capacity required to execute recommended actions may be limited among school nurses—particularly post-COVID-19 pandemic. School nurses may need additional support to address these gaps.
Minimally Invasive vs Open First Ray Dorsiflexion Osteotomy: Radiographic Outcomes and Early Complications Report
Authors: Raza Marium , Ranganathan Noopur , Ashkani-Esfahani Soheil , Miller Christopher P.
Published: September 2024

Background:

There is limited literature comparing open and minimally invasive surgical (MIS) techniques for first ray dorsiflexion osteotomy (DFO). This study is the first of its kind to report early healing and complication rates of patients undergoing MIS vs open first ray DFO.

Methods:

A retrospective cohort review of 28 patients who underwent a first ray DFO procedure at an academic medical center between 2015 and 2024 was conducted. Demographic factors and medical comorbidities were recorded. Radiologic parameters were measured along with healing. Postoperative healing and outcomes were identified through medical record review.

Results:

Thirteen open and 15 MIS DFO procedures were performed. At follow-up, all osteotomies were healed with no wound or infection complications. There was no significant difference in hardware removal rates, 7.7% for open and 6.7% for MIS. The change in lateral Meary angle was 10.5 ± 3.9 and 9.7 ± 4.3 for the open and MIS groups, respectively ( P = .61). The calculated dorsal closing wedge resection was 3.5 mm and 4.1 mm for open and MIS, respectively ( P = .26).

Conclusion:

This study showed no significant differences in healing or complication rates in the short term between MIS and open surgery, with comparable magnitude of correction, suggesting similar ability for the MIS technique to correct first ray alignment. Further studies are needed to determine long-term outcomes.
Naturalistic Observations of Human Driving Perceptions and Vehicle Kinematics at Stop Sign-Controlled Intersections
Authors: Figueroa Jacinto Rosemarie , Kappler Elizabeth , Petroskey Karla , Arndt Steve , Leipold Tara
Published: September 2024

Understanding the human factors of how drivers perceive hazards and behave at stop sign-controlled intersections is essential for developing effective roadway features. This study aimed to evaluate the naturalistic behaviors of drivers at stop sign-controlled intersections and to assess the speeds at which drivers maneuvered through stop signs when no cross-traffic was present. To this end, 62 vehicles were analyzed in two, two-lane, four-way roadway intersections in Michigan. Results of this study indicate that most drivers slow to non-zero minimum speeds before traveling through an intersection and measurably encroach beyond stop lines. Assessment of lines of sight and visual obstructions at the subject intersections indicate that drivers’ perceptions of risk, evaluation of potential hazards, and cost of compliance ultimately impact behavior, as seen through vehicle kinematics.
MEF2A restrains cisplatin resistance in gastric cancer cells by modulating NFKBIA/NF-κB signaling pathway
Authors: Chu Chenghao , Zhang Yongwei , Yu Ruiran , Liu Bin , Wang Bin , Xu Zhangxuan , Chin Kai Ling
Published: September 2024

Cisplatin (DDP) resistance represents a pivotal contributing factor to chemotherapy failure and adverse patient outcomes in gastric cancer (GC). The objective of the present study was to investigate the roles and underlying mechanisms of myocyte enhancer factor 2A (MEF2A) in DDP resistance in GC. GC cell line AGS and MKN-45 cells were applied to construct DDP-resistant cells. CCK-8, colony formation, and flow cytometry methods were validated for determining the IC50 value of DDP and cell survival of GC cells. qRT-PCR and western blotting analysis quantified the molecular levels at mRNA and protein, respectively. Chromatin immunoprecipitation and dual-luciferase assays validated the molecular relationship between MEF2A and NF-κB inhibitor alpha (NFKBIA). Roles of MEF2A in in vivo were performed employing a xenograft model. The results showed that NFKBIA was greatly decreased in DDP-resistant AGS and MKN-45 cells compared to their respective parental cells. Increasing NFKBIA expression impaired the IC50 value of DDP and cell survival in DDP-resistant cells, while these alterations were rescued upon TNF-α treatment. Mechanistically, MEF2A acts as a transcriptional activator of NFKBIA, which led to the reduction of phosphorylation of p65 and cytoplasmic retention. Moreover, MEF2A overexpression promoted the sensitivity of GC cells to DDP and tumor growth, whereas these effects were partially reversed by NFKBIA silence. Collectively, MEF2A mitigated the DDP resistance in GC cells by modulatory actions on the NFKBIA/NF-κB signaling, shedding light on MEF2A/NFKBIA might be a promising intervention target for improving DDP resistance in GC.
Academic activism in time of war: Voices from Ukraine
Authors: Costas Jana , Prokhorova Anna , Stepanenko Viktor , Sudyn Danylo , Yermolenko Volodymyr , Zaremba-Kosovych Hanna
Published: September 2024

This piece sheds light on the significance of academic activism in time of war. Drawing on the voices of Ukrainian academics, we explore different practices of academic activism in Ukraine and develop interrelations of synergy, overshadowing, and decoupling between academia and activism. In the extreme context of war, the relationship between academia and activism, typically conceptualized as symbiotic, may manifest frictions that threaten to undermine academia as a realm of critical reflection and contemplation. Following this, we call on scholars to reject the notion of academic activism as a departure from the so-called ivory tower, and to defend that citadel as a prerequisite and bulwark for the activism they practice.
Numerical investigation of flash formation and asymmetrical cooling in resistance projection welding
Authors: Avedissian Nicholas Queiroz , Gao Xuesong , Walker Luke , Okigami Fernando , Zhang Wei , Krakauer Bruce W
Published: September 2024

In resistance projection welding, the softened material is squeezed out from the joint area. The two workpieces being joined together often have different geometries, leading to asymmetrical cooling. The flash formation and asymmetrical cooling are not well quantified in the literature. This study developed a coupled electrical-thermal-mechanical model with adaptive remeshing and glued contact activation techniques for projection welding of steel fitting to a steel shell. The model was used to calculate the evolution of temperature distribution in the fitting and shell for welds made under two different hold times. The cooling rates were then inputted into a literature model to predict the joint hardness values, which correlated well with the experimental data. Additionally, the main factors for the accurate prediction of flash shape and size were the use of temperature-activated glued contact and high-temperature flow stress. Specifically, a combination of no glued contact and low flow stress can lead to an overprediction of the flash geometry.
Bearing fault diagnosis method based on improved meta-ResNet and sample weighting under noise label
Authors: Xie Suchao , Wang Jiacheng , Li Yaxin , Yang Lingzhi
Published: September 2024

Traditional methods often require the presetting of a weight function based on the dataset to address the issue of noisy labels. However, these methods often encounter challenges related to poor generalization capability. To overcome this obstacle, we propose an improved meta-residual network and sample weighting (SWMeta-IResNet) approach for bearing fault diagnosis. This method leverages singular value decomposition (SVD) matrix decomposition technology to design a global SVD pooling layer. By replacing the max-pooling layer in the original ResNet, this layer effectively reduces the parameter count and enhances the correspondence between feature maps and categories. This method trains the network through alternating input of a small number of unbiased, cleanly labeled samples (meta-samples) and noisy labeled samples. By automatically learning the weight function mapping relationship between the training loss and sample weight from the data, it adaptively learns weights from the meta-samples to improve accuracy. Experimental results on three datasets demonstrate that, even with a noise label rate of 40%, SWMeta-IResNet achieves significant improvements in average accuracy compared to the original ResNet model. Specifically, it enhances the average accuracy by 14.5%, 11.94%, and 6.38%, respectively, yielding accuracy rates of 86.48%, 82.23%, and 94.35%. Moreover, in the bearing failure task with noisy labels, this method exhibits substantial improvements in accuracy and showcases excellent generalization performance across different datasets. As a result, SWMeta-IResNet proves to be highly applicable and effective in addressing the challenges posed by noisy labels in diverse scenarios.
Psychotherapy with a Caregiver of a Spouse with Parkinson’s Disease: Integrating Systems and Individual Approaches
Authors: Plys Evan , Syme Maggie
Published: September 2024

Family caregivers of persons with neurocognitive disorders sometimes experience heightened emotional burden (i.e., caregiver burden), presenting with symptoms of depression and anxiety. The stress of caregiving may be heightened among those who identify as women, who experience disproportionate rates and consequences of the caregiving role. This case study highlights the use of Caregiver Family Therapy (CFT; i.e., a systems-directed approach targeting the caregiver role and network) and Cognitive Behavioral Therapy (CBT; i.e., an individual-directed approach targeting maladaptive cognitions) with a cisgender White woman caregiving for her spouse, a cisgender man with Parkinson’s disease. The patient reported elevated caregiver burden, depression, and anxiety at intake. Treatment targeted modifications to the caregiving role, maladaptive cognitions, and behavioral activation, often with a focus on the role of gender in shaping the caregiving role and core beliefs about caregiving. Over 20 sessions, the patient reported reductions in anxiety (Geriatric Anxiety Inventory = −6), depression (Geriatric Depression Scale-30 = −10), and caregiver burden (Zarit Burden Interview-12: −20), which were maintained over two booster sessions (6 weeks). This case highlights the benefit of integrating systems- and individual-focused psychotherapies with caregivers as well as the important role of gender in addressing caregiving-related psychological distress.
Goal Concordant Care: A Cross-Sectional Study Evaluating Correlates of Concordant Care and Association With Satisfaction and Outcomes
Authors: Julian Kaitlyn R. , Kwong Jeffrey W. , Leversedge Chelsea , Zhuang Thompson , Schroeder Nicole , Kamal Robin N. , Shapiro Lauren M.
Published: September 2024

Background:

The concordance between patient and physician goals has been associated with improved outcomes in many chronic diseases. The purpose of this study was to evaluate the association between goal concordant care, patient satisfaction, and patient experience and to analyze factors associated with goal concordant care in hand and upper extremity surgery.

Methods:

New patients who were 18 years or older were invited to participate. Goal concordant care was defined as the patient’s previsit treatment goal matching the primary treatment received. The χ2 tests were used to evaluate the association between goal concordant care and patient satisfaction and patient experience. We conducted univariable logistic regression to evaluate variables for their association with concordance and multivariable logistic regression for variables that were significantly associated in the initial analyses to evaluate their aggregate influence on concordance.

Results:

In total, 169 patients enrolled. The rate of goal concordant care was 62%; concordance was not associated with patient satisfaction or experience. Age, sex, English proficiency, health literacy, education level, employment and relationship status, pain self-efficacy, symptom duration, functional disability, and patient-centered decision-making were not associated with concordant care. Patients with annual income less than $50,000 had significantly higher odds of goal discordant care.

Conclusion:

Patients with lower income had more than 3 times the odds of receiving discordant care. However, discordant care was not associated with patient satisfaction or experience. Further studies on other pertinent outcomes are needed in orthopedic surgery (eg, treatment adherence). Known care disparities based on socioeconomic status may be mediated through care discordance and should be investigated.
The Comparative Performance of Large Language Models on the Hand Surgery Self-Assessment Examination
Authors: Chen Clark J. , Sobol Keenan , Hickey Connor , Raphael James
Published: September 2024

Background:

Generative artificial intelligence (AI) models have emerged as capable of producing human-like responses and have showcased their potential in general medical specialties. This study explores the performance of AI systems on the American Society for Surgery of the Hand (ASSH) Self-Assessment Exams (SAE).

Methods:

ChatGPT 4.0 and Bing AI were evaluated on a set of multiple-choice questions drawn from the ASSH SAE online question bank spanning 5 years (2019-2023). Each system was evaluated with 999 questions. Images and video links were inserted into question prompts to allow for complete AI interpretation. The performance of both systems was standardized using the May 2023 version of ChatGPT 4.0 and Microsoft Bing AI, both of which had web browsing and image capabilities.

Results:

ChatGPT 4.0 scored an average of 66.5% on the ASSH questions. Bing AI scored higher, with an average of 75.3%. Bing AI outperformed ChatGPT 4.0 by an average of 8.8%. As a benchmark, a minimum passing score of 50% was required for continuing medical education credit. Both ChatGPT 4.0 and Bing AI had poorer performance on video-type and image-type questions on analysis of variance testing. Responses from both models contained elements from sources such as PubMed, Journal of Hand Surgery, and American Academy of Orthopedic Surgeons.

Conclusions:

ChatGPT 4.0 with browsing and Bing AI can both be anticipated to achieve passing scores on the ASSH SAE. Generative AI, with its ability to provide logical responses and literature citations, presents a convincing argument for use as an interactive learning aid and educational tool.
Shining light on neurovascular disease
Authors: Siddiqui Adnan H , Andersson Tommy
Published: September 2024

Tortuosity and fragility of the intracranial vasculature have precluded the application of novel intravascular imaging modalities during the treatment of cerebrovascular pathologies. In other circulatory beds, these technologies have transformed clinical and therapeutic decision-making. A new report demonstrates the clinical use of high-resolution intravascular imaging in the human cerebrovasculature using neuro optical coherence tomography. This technology provides an unprecedented opportunity to examine the luminal dimensions of cerebrovascular disease. We expect that the neurointerventional community will rapidly adopt this technology—similar to wider adoptions by other vascular specialties—for both a better understanding of underlying disease and clarity of endovascular therapeutic safety and effectiveness.
Risk of major adverse cardiovascular events and all-cause mortality under treatment with GLP-1 RAs or the dual GIP/GLP-1 receptor agonist tirzepatide in overweight or obese adults without diabetes: a systematic review and meta-analysis
Authors: Stefanou Maria-Ioanna , Palaiodimou Lina , Theodorou Aikaterini , Safouris Apostolos , Fischer Urs , Kelly Peter J. , Dawson Jesse , Katan Mira , Katsanos Aristeidis H. , Lambadiari Vaia , Giannopoulos Sotirios , Alexandrov Andrei V. , Siasos Gerasimos , Tsivgoulis Georgios
Published: September 2024

Background:

Among the currently approved antiobesity medications, the glucagon-like-peptide-1 receptor-agonists (GLP-1 RAs) liraglutide and semaglutide, and the dual glucose-dependent-insulinotropic-polypeptide (GIP)/GLP-1 RA tirzepatide have been suggested to reduce cardiovascular-risk in overweight or obesity without diabetes.

Objectives:

The objective of this study was to evaluate the cardio- and neuroprotective potential of these novel agents in the nondiabetic overweight/obese adult population.

Data sources and methods:

A systematic review and meta-analysis of randomized-controlled clinical trials (RCTs) was performed to estimate the risk of major adverse cardiovascular events (MACE), all-cause and cardiovascular mortality in overweight or obese adults without diabetes treated with GLP-1 or GIP/GLP-1 RAs (vs placebo). Secondary outcomes included the risk of myocardial infarction (MI) and stroke.

Results:

Sixteen RCTs (13 and 3 on GLP-1 RAs and tirzepatide, respectively) comprising 28,168 participants were included. GLP-1 or GIP/GLP-1 RAs reduced MACE (odds ratio (OR): 0.79; 95% confidence interval (CI): 0.71–0.89; p < 0.01; I2 = 0) and all-cause mortality (OR: 0.80; 95% CI: 0.70–0.92; p < 0.01; I2 = 0), while there was a trend toward lower cardiovascular-mortality (OR: 0.84; 95% CI: 0.71–1.01; p = 0.06; I2 = 0%) compared to placebo. Additionally, GLP-1 or GIP/GLP-1 RAs reduced the odds of MI (OR: 0.72; 95% CI: 0.61–0.86; p < 0.01; I2 = 0%) and nonfatal-MI (OR: 0.72; 95% CI: 0.61–0.85; p < 0.01; I2 = 0%); while no associations between antiobesity treatment and fatal-MI, stroke, nonfatal, or fatal stroke were uncovered.

Conclusion:

GLP-1 and GIP/GLP-1 RAs reduce cardiovascular-risk and all-cause mortality in overweight or obese adults without diabetes. Additionally, GLP-1 RAs and GIP/GLP-1 RAs attenuate the risk of MI. Since data on stroke are still limited, future RCTs are warranted to evaluate the neuroprotective potential of these novel antiobesity agents.

Trial registration:

PROSPERO CRD42024515966.
Landscape of C-MET overexpression in non-small cell lung cancer: a large-scale study of clinicomolecular features and prognosis based on Chinese data
Authors: Zhan Shuting , Li Jianfu , Cheng Bo , Li Caichen , Feng Yi , Fan Lei , Xiong Shan , Zeng Wenchuang , Cai Qi , Xiang Yang , Wang Huiting , Li Chunyan , Chen Peiling , Zheng Xin , Fu Wenhai , Hao Zhexue , He Jianxing , Liang Wenhua
Published: September 2024

Background:

Real-world data on C-MET protein overexpression in non-small cell lung cancer (NSCLC) patients, particularly among the Asian Chinese population, are limited.

Objectives:

This study aimed to evaluate the clinicomolecular characteristics and prognosis of C-MET overexpression in Chinese NSCLC patients, focusing on those with positive C-MET overexpression (immunohistochemistry (IHC) 3+).

Design:

A retrospective and observational study.

Methods:

Data were collected from NSCLC patients diagnosed at the First Affiliated Hospital of Guangzhou Medical University between November 2006 and April 2021. We identified C-MET overexpression using IHC and C-MET overexpression positivity was defined as IHC 3+ with ⩾50% tumor cells. Additionally, patient genotypes were collected for subgroup analysis.

Results:

Data from 9785 NSCLC patients were collected. C-MET (−) accounted for 5% (503/9785), C-MET (+) for 27% (2654/9785), C-MET (++) for 36% (3464/9785), and C-MET (+++) for 32% (3164/9785). Genetic testing was available for 4326 patients. Wild-type was observed in 37% (1591 cases), with epidermal growth factor receptor ( EGFR) abnormalities being the most common at 49% (2127 cases). Positive C-MET overexpression correlated significantly with women ( p < 0.001), early-stage ( p = 0.003), adenocarcinoma ( p < 0.001), and driver mutations ( p < 0.001). Patients with anaplastic lymphoma kinase ( ALK) alterations had a higher occurrence of C-MET overexpression positivity (57.1%). Positive C-MET overexpression was significantly associated with EGFR ( p < 0.001), ALK ( p < 0.001), and KRAS alterations ( p = 0.024). Compared to C-MET overexpression (IHC 0), C-MET overexpression (IHC 2+) (hazard ratio (HR) = 0.455, p < 0.001) and C-MET overexpression (IHC 3+) (HR = 0.569, p < 0.001) were correlated with better overall survival in overall NSCLC patients, especially for C-MET overexpression (IHC 2+).

Conclusion:

Our study elucidates the clinicomolecular characteristics and prognosis of C-MET overexpression in NSCLC patients, particularly those with positive C-MET overexpression (IHC 3+). This provides insight into the prevalence of C-MET overexpression in Chinese NSCLC patients and offers a basis for considering C-MET overexpression as a prognostic and predictive marker in NSCLC.
Production time and practicability of 3D-Printed wrist orthoses versus low temperature thermoplastic wrist orthoses
Authors: von Haller Marianne , Couchman Louise , Honigmann Philipp
Published: September 2024

Introduction

In recent years, three-dimensional (3D) printing has emerged as a new manufacturing technique for orthoses, showing comparable stability and wearing comfort to traditional orthoses. However, the lengthy designing and printing process is assumed to take more time than the common practice of manufacturing low-temperature thermoplastic orthoses (LTTOs). The aim of this prospective cross-sectional study was to compare the production time of 3D-printed orthoses (3DPO) to LTTOs.

Methods

The active and passive time needed to manufacture the orthoses was measured in a clinical setting. 17 orthoses (8 3DPOs and 9 LTTOs) were included in the data analysis.

Results

The mean total production time of a 3DPO (12:14:50h total time; 0:44:35h active production time) was significantly longer than in LTTOs (0:14:14h; p < 0.001).

Discussion

The longer production time might be a hurdle regarding the implementation of 3DPOs in hand therapy. Although 3D-printing might become more cost- and time-efficient due to future developments in technology and growing experience, some practical advantages of LTTOs prevail, such as the fast and efficient provision of orthoses and the adaptability of the material if subsequent changes are needed. A combination of both manufacturing techniques may be a feasible solution to provide patient-centred orthosis provision in future hand therapy practice.
Metabolic-associated fatty liver disease and pregnancy complications: new challenges and clinical perspectives
Authors: Zhang Yang , Bu Yifan , Zhao Rui , Han Cheng
Published: September 2024

The term metabolic-associated fatty liver disease (MAFLD), with a global prevalence estimated at 38.77%, has gradually replaced the traditional concept of non-alcoholic fatty liver disease (NAFLD). Compared to the general population, the incidence of MAFLD is notably higher among pregnant women, posing potential risks to both maternal and neonatal health. This review summarizes the latest research on MAFLD, focusing on its association with pregnancy complications. Additionally, it provides a comparative analysis with previous studies on NAFLD, presenting a comprehensive perspective for clinical management. Findings suggest that pregnant women with MAFLD face a higher risk of gestational hypertension and cesarean delivery compared to those with NAFLD, while the risk for gestational diabetes mellitus remains similar between the two conditions. Additionally, MAFLD is associated with an increased likelihood of delivering large-for-gestational-age infants and heightened risks of preterm birth and low birth weight. Current treatment strategies for MAFLD focus on lifestyle modifications, such as dietary adjustments and increased physical activity. However, there is an urgent need for the development of safe and effective pharmacological treatments, particularly tailored toward pregnant women. Future research should delve deeper into the causal relationships between MAFLD and pregnancy complications and explore optimal therapeutic approaches to improve outcomes for mothers and their infants.
Global research on wearable technology applications in healthcare: A data-driven bibliometric analysis
Authors: Meng Fanyu , Cui Zhiying , Guo Haoxin , Zhang Ye , Gu Zhengmin , Wang Zhongqing
Published: September 2024

Background

In recent years, with the advancement of technological innovation and the widespread application of semiconductor materials, wearable technology has emerged as a significant branch in healthcare, demonstrating considerable potential for further development. This analysis aims to explore the global scientific trends on wearable technology applications in healthcare.

Methods

Scientific publications on wearable technology applications in healthcare from 1 January 2003 to 31 December 2022 were retrieved from the Web of Science Core Collection. A total of 19,426 publications were included in the bibliometric analysis. VOSviewer and CiteSpace were used to conduct bibliometric and visualized analysis. Key metrics such as country, institution, author co-authorships, cited references, journal citations, and keyword co-occurrences were selected for analytical emphasis.

Results

The United States of America and China emerged as the top two contributing countries, with significantly higher publication compared to other countries/regions. Chinese Acad Sci and Sensors are the institution and journal with the largest number of publications, respectively. Najafi, Bijan is the most active author. Research hotspots of wearable technology were divided into four clusters based on the co-occurrence analysis of keywords: (1) Wearable Technology for Detecting and Monitoring Human Physiological Parameters; (2) Wearable Technology for Human Chronic Disease Detection and Management; (3) Wearable Technology Exercise Health and Sports Rehabilitation Therapy under Intervention; and (4) The Technical Realization of Accuracy Enhancement in Wearable Technology.

Conclusions

The number of annual publications on wearable technology applications in healthcare has increased over the past 20 years. This analysis identified the status, trends, hot topics, and frontiers of wearable technology applications in healthcare. These findings will help researchers quickly identify emerging themes and offer new insights into the future development of wearable technology in healthcare.