bluuebunny/crossref_metadata_2025 huggingface dataset:
Data reflexivity as work-in-progress: A relational, life-course approach to people’s encounters with datafication
Authors: Das Ranjana
Published: August 2024

Datafication, across private and public sectors demonstrably touches upon, and indeed, alters, with profound consequences, diverse domains of people’s daily lives. However, also, increasingly, critical scholarship on datafication is the locus of careful attention to not solely platform and algorithmic power but also people’s sociocultural practices to make sense of, cope with, feel and show new literacies with data and datafied systems. It is in this context of genuinely listening to what people do with, through and around data, and to what end, that this special issue invites us to ponder the notion of data reflexivity. In this paper, I adopt a working definition of data reflexivity as – a vernacular and relational set of practices and strategies in relation to data and data infrastructures, working with, within and sometimes against platforms, where, such practices and strategies morph and change across the life course, through a web of cross-cutting relationships with individuals, communities and institutions. I draw upon illustrative instances from a project in England which explored parents’ perspectives on personal data and algorithms in the context of raising children. First – I suggest that we approach data reflexivity through a relational lens rather than as an individual and inward-looking strategy, where such relationality is experienced in relation to institutions, individuals, families, friendships, and networks. Second – I suggest that we look at data reflexivity as a fluid, lifelong journey – where a life course approach enables us to consider how data reflexivity morphs, adapts and transitions through the course of life, involving numerous acts of unspectacular, ephemeral agency. I conclude with a reminder that attention to data reflexivity, or indeed, more broadly, people’s agency, must not mean a shift of focus away from scrutinising and holding accountable, powerful institutions, both public and private.
Investigation of source ambiguity of floor noises in a box-frame concrete building from the perspective of junction attenuations: A real case field experiment
Authors: Cho Jongwoo , Song Kwonsik , Park Moonseo , Ahn Changbum R , Kim Tae Wan
Published: August 2024

This study investigated impact source ambiguity in box-frame multifamily buildings, prevalent in densely populated areas, by examining the transmission of heavy-impact noise and its relationship with junction attenuations across five floors. Contrary to the decline in noise levels with increased distance from the impact source, our findings uncover an intriguing deviation in the behaviour of vibration response levels. Surprisingly, vibrations are often intensified, rather than diminished, with distance. Notably, upon examining each room, instances where non-structural or thin concrete walls exhibited the highest vibration responses were frequently observed. Such instances were particularly prevalent in rooms not directly adjacent to the impact source. This trend markedly impedes residents’ ability to pinpoint the origin location of impact noises. This study reveals an unexpected weakening and reversal of distance attenuation in vibration, linked to the increasing number of valid flanking paths as the junction distance grows. The findings suggest that increasing slab thickness for noise insulation may unintentionally complicate source identification due to diminished junction attenuation in thicker horizontal components compared to vertical ones. To enhance acoustic comfort in such housing, this study recommends minimizing valid flanking paths through improved junction design, addressing an often-overlooked issue of source ambiguity of floor noises.
Factors Affecting Compression of the Left Subclavian Artery Bridging Stent In Zone 2 Fenestrated Endovascular Arch Repair
Authors: Nana Petroula , Giordano Antonino , Panuccio Giuseppe , Torrealba José I. , Rohlffs Fiona , Kölbel Tilo
Published: August 2024

Introduction:

Left subclavian artery (LSA) preservation during thoracic endovascular aortic repair (TEVAR) has been related to low morbidity. This study investigated the incidence of LSA stent compression in patients managed with fenestrated endovascular arch repair (f-Arch) and evaluated the impact of anatomic and technical factors on LSA stent outcomes.

Methods:

A single-center retrospective analysis of patients managed with single-fenestration devices (Cook Medical, Bloomington, IN, USA) for LSA preservation, between January 1, 2012 and November 30, 2023, was conducted. Anatomic (arch type, bovine arch, distance between the LSA and most proximal bone structure, left common carotid artery and aortic lesion, take-off angle, diameter, thrombus, calcification, dissection, tortuosity) and technical parameters (stent type, diameter, length, relining, post-dilation) were evaluated. Stent compression was any ≥50% stenosis (using center luminal line) of the stent compared with its initial diameter. Clinical outcomes included stroke and upper limb ischemia at 30 days and follow-up. Technical outcomes included stent compression and need for reintervention.

Results:

Fifty-four cases were included. Only balloon-expandable covered stents were used, and relining during the index procedure was performed in 18%. No stroke or arm ischemia was recorded. One stent compression was detected at 30 days. During follow-up, no stroke or arm ischemia was diagnosed. Nine cases (18%) presented stent compression, with a mean time of stent-compression diagnosis at 18 months (interquartile range [IQR]=37, range=1–58 months) after the index procedure. Five (56%) underwent secondary relining. Follow-up after reintervention was uneventful. Lower distance to the nearest bone structure (compression group [CG]: 11.7±8.9 mm vs non-compression group [NCG]: 23.0±7.8 mm, p=0.003) and higher tortuosity index (CG: 1.3±0.4 vs NCG: 1.2±0.1, p=0.03) were associated with LSA stent compression.

Conclusion:

LSA stent compression in patients managed with f-Arch affected 1 in 5 cases, without clinical consequences. Distance to the nearest bone structure and higher tortuosity were associated with LSA stent compression.

Clinical Impact

Fenestrated endovascular arch repair for the preservation of the left subclavian artery (LSA) in patients needing landing within the aortic arch has been performed with encouraging outcomes. This analysis showed that LSA stent compression is met in 18% of patients, without though any clinical consequence. Pre-operative anatomic parameters, as lower distance to the nearest bone structure and higher tortuosity index affect negatively LSA stent performance while stent parameters seem to have no impact.
The Effect of Time Pressure on Surgical Skill Retention in Novices: A Randomized Controlled Trial
Authors: Molzahn Allyson G. , Lovett Marissa K. , Biffar David , de Oliveira Almeida Gustavo , Hamilton Allan J.
Published: August 2024

Background

There are limited opportunities to practice surgical skills and techniques in residency. Therefore, it is important to explore strategies which optimize surgical simulation experiences to enhance learning outcomes and skill retention.

Methods

Novice medical students (n = 29) were recruited to participate in a Fundamentals of Laparoscopic Surgery (FLS) peg transfer task training. Participants were randomly assigned to a control group, practicing the peg transfer task independently, or an experimental group, practicing with time pressure. Participant skill assessments were completed before the training, after the training, and 8-weeks after the training. Subjective and objective stress measurements were taken in the form of self-report surveys and heart rate variability data, respectively.

Results

For all the skill assessment measurements, there was no difference between groups in performance on the FLS task. Both groups showed improvement in performance after the training compared to before. The experimental group reported higher stress during and after the training period compared to the control group; however, there was no difference between groups on heart rate variability metrics.

Conclusion

Time pressure while practicing an FLS task did not significantly impact learning acquisition or retention. However, the experimental group reported higher levels of stress. This preliminary study suggests time pressure does not confer an enhanced surgical skill learning experience for novices.
Kosovo’s path to Jerusalem: Orientalist political communication and the free world discourse
Authors: Jegić Denijal
Published: August 2024

This article proposes that the Kosovar political communication toward Israel exemplifies Kosovo’s positioning as a proxy for the US, and highlights the significance and simultaneous absence of Palestine in the meaning-making of Kosovo’s political identity and its place in the world. Through an analysis of Kosovo’s recent political communication toward Israel, the author suggests that the Kosovar political elite has applied the Orientalist discourse of the ‘free world’ in order to establish analogies between Kosovo and Israel as brave and threatened democracies defending Western civilization and frontiers. A detailed engagement with the position of Muslim-majority Kosovo at Europe’s periphery and Palestine as a site of European settler-colonialism situates the current narrative presented by the Kosovar political elite within the broader contexts of colonialism, Orientalism and Islamophobia, with particular focus on the 2020 Washington Agreement brokered by US President Donald Trump.
Effects of the Pathways for African American Success Program: Reductions in Adolescent Depression Through the Promotion of Racial Equity-Informed Parenting and Racial Pride
Authors: Berkel Cady , Murry Velma McBride , Hanebutt Rachel , Thomas Nalani , Debreaux Marlena , Gonzalez Catherine
Published: August 2024

African American adolescents face persistent disparities in depression and related behavioral health outcomes, which have been attributed to experiences with discrimination. The integrative model for the study of stress in Black American families provides a comprehensive perspective on how historical and current discrimination has direct and indirect effects on child behavioral health. Culturally based protective mechanisms (e.g., racial socialization) have been demonstrated to buffer adolescents from the negative effects of discrimination. The Pathways for African American Success (PAAS) program was developed as a scalable eHealth preventive intervention to facilitate parents’ use of strategies to protect their children from exposure to racism and the disproportionate consequences of risk behaviors, which we label as racial equity-informed parenting. Using data from a randomized effectiveness trial of PAAS and following stress and resilience approaches, we tested multiple hypotheses about the nature of discrimination as a source of risk, as well as program-driven improvements in adolescent racial pride as a source of protection. Our risk model indicated adolescent depression was associated with their own (direct) and their parents’ (indirect) experience of discrimination. Mediation analyses showed that program-driven improvements in adolescent racial pride served as a risk reducer/compensatory factor. Findings of moderation analyses, however, showed the negative effects of discrimination, even when racial pride was high. Implications for theory and cultural tailoring of evidence-based preventive interventions are presented.
Child Home Safety in Hispanic and Rural Communities Along the Texas–Mexico Border: A Community Health Worker Intervention
Authors: Gaddy Yvonne , Marquez Daniela , Vasquez Denise , Corona Adriana , Brown Louis D.
Published: August 2024

Low-income children are among the most affected by unintentional injuries. Although these injuries are preventable, outreach to low-income families in Hispanic and rural communities can be challenging. Community Health Workers (CHWs) are effective partners in reaching these populations. This study sought to determine whether a CHW-led intervention would reduce common hazards that increase the risk of unintentional injuries in low-income rural Hispanic homes along the Texas–Mexico border. CHWs conducted home visits to assess for injury hazards and distribute safety devices to 47 families with children ages 0 to 5 in five low-income rural border communities. CHWs provided follow-up assessments and support 30 days later. Analyses examined changes in the proportion of hazards from visits 1 to 2, with relative risks estimating the impact of safety devices on hazard reduction. Findings showed a 26.2% reduction in the total number of common hazards present in homes from visit 1 to visit 2 ( p < .001). There was a 70% reduction in the overall risk of a hazard being present at visit 2, relative to visit 1 ( relative risk = 0.30, 95% CI [0.28, 0.33], p < .001). This study suggests that tailored CHW interventions can reduce home safety hazards. CHWs are well suited to inform hard-to-reach Hispanic and rural populations, addressing feelings of distrust and promoting acceptance of recommended environmental changes. More rigorous evaluations of this intervention strategy are needed.
The Mood-Behavior Model: Assessing Mood-Related Mobilization of Self-Regulation of Weight-Loss Behaviors Within Community-Based Obesity Treatments
Authors: Annesi James J.
Published: August 2024

Increasing understanding of self-regulation processes within behavioral obesity treatments is required to improve consistently inadequate outcomes. The mood-behavior model proposes that, under conditions of goal striving and mood awareness, enhanced mood will mobilize self-regulation resources. That was tested within community-based obesity treatments where increased exercise might enhance mood, and increased self-regulation could improve weight-loss behaviors. Women with obesity participating in treatments focusing on either moderate exercise and self-regulation (Exercise/Self-Regulation [Exercise/SR] group, n = 42) or education on healthy eating and (to a lesser extent) exercise (Usual Care group, n = 48) were assessed on psychological and behavioral changes over 6 months. Significant overall improvements in negative mood, self-regulation for exercise and controlling eating, exercise, and fruit/vegetable intake were significantly greater in the Exercise/SR group. Using aggregated data ( N = 90), at baseline, negative mood did not significantly predict self-regulation. However, at months 3 and 6, negative mood significantly predicted both self-regulation for exercise and self-regulation for controlling eating. The addition of the group as a predictor significantly increased the explained variances. Increase in self-regulation for exercise significantly mediated the prediction of increased exercise via earlier reduction in negative mood. When group was entered into that model, it significantly moderated the mood-self-regulation and mood-exercise relationships. Increase in self-regulation for controlling eating significantly mediated the prediction of increase in fruit/vegetable intake via reduction in negative mood. Group marginally moderated the mood-self-regulation relationship only. Findings supported viability of the mood-behavior model in a field-based setting and suggested a need to facilitate improved mood to increase participants’ self-regulatory skill usage within obesity treatments.
Modification of polymethylmethacrylate bone cement with halloysite clay nanotubes
Authors: Hamdy Tamer M.
Published: August 2024

Background

Polymethylmethacrylate (PMMA) bone cement is used in orthopedics and dentistry to get primary fixation to bone but doesn’t provide a mechanically and biologically stable bone interface. Therefore, there was a great demand to improve the properties of the PMMA bone cement to reduce its clinical usage limitations and enhance its success rate. Recent studies demonstrated that the addition of halloysite nanotubes (HNTs) to a polymeric-based material can improve its mechanical and thermal characteristics.

Objectives

The purpose of the study is to assess the compressive strength, flexural strength, maximum temperature, and setting time of traditional PMMA bone cements that have been manually blended with 7 wt% HNT fillers.

Methods

PMMA powder and monomer liquid were combined to create the control group, the reinforced group was made by mixing the PMMA powder with 7 wt% HNT fillers before liquid mixing. Chemical characterization of the HNT fillers was employed by X-ray fluorescence (XRF). The morphological examination of the cements was done using a scanning electron microscope (SEM). Analytical measurements were made for the compressive strength, flexural strength, maximum temperature, and setting time. Utilizing independent sample t-tests, the data was statistically assessed to compare mean values (p < 0.05).

Results

The findings demonstrated that the novel reinforced PMMA-based bone cement with 7 wt% HNT fillers showed higher mean compressive strength values (93 MPa) and higher flexural strength (72 MPa). and lower maximum temperature values (34.8 °C) than the conventional PMMA bone cement control group, which was (76 MPa), (51 MPa), and (40 °C), respectively (P < 0.05). While there was no significant difference in the setting time between the control and the modified groups.

Conclusion

The novel PMMA-based bone cement with the addition of 7 wt% HNTs can effectively be used in orthopedic and dental applications, as they have the potential to enhance the compressive and flexural strength and reduce the maximum temperatures.
Treatment of temporomandibular joint internal derangement using MESNA injection
Authors: Mosleh Ahmed A.
Published: August 2024

Introduction

The development of temporomandibular disorders specifically emphasizes the biochemical changes occurring in the synovial fluid at different stages of temporomandibular joint disease. Research has indicated that inflammation may be a primary reason behind the pain and dysfunction in temporomandibular joint diseases. Since its clearance several years ago, MESNA (sodium 2-mercaptoethanesulfonate) has been used in various formulations as a mucolytic drug in the respiratory domain. It operates by disrupting the disulfide bonds present between polypeptide chains within mucus. MESNA exhibits minimal tissue distribution, with the material being swiftly and thoroughly eliminated via the kidneys.

Objectives

To assess the efficacy of injecting MESNA directly into the Temporomandibular Joint to treat internal derangement.

Materials and methods

A randomized clinical trial was conducted on sixty patients who exhibited non-responsiveness to conventional treatment and were diagnosed with TMJ anterior disc displacement with reduction. The patients were chosen from the outpatient clinic of the Oral and Maxillofacial Surgery Department at Tanta University Faculty of Dentistry. Two equal groups of patients were randomly assigned to each other. Group I (Mesna group) received intra-articular injection with MESNA solution. Group II (Standard group) received arthrocentesis with lactated ringer solution followed by injection of Hyaluronic Acid (HA). The data was gathered by functional examinations such as maximum interincisal opening (MIO) and clicking. A Visual Analogue Scale (VAS) assessed pain severity before and after treatments.

Results

Both MESNA and HA showed significant improvement up to six months of the follow-up compared to preoperative status, as evidenced by better mouth opening, lateral excursion, lower clicking, and reduced pain score in patients with TMDs. MESNA showed significant improvement during follow-up compared to HA.

Conclusion

Compared to HA, MESNA showed a more noticeable improvement during the follow-up period.
Nomogram prediction for periodontitis in Chinese pregnant women with different sociodemographic and oral health behavior characteristics: a community-based study
Authors: Shi Qiao , Cai Yu , Wang Xiaoxuan , Liu Guojing , Luan Qingxian
Published: August 2024

Background

Periodontitis is associated with poor pregnancy outcomes, indicating periodontal health as an important health concern for pregnant women. Herein, this study identified risk indicators for periodontitis and developed a nomogram for predicting the risk of periodontitis in pregnancy by analyzing periodontitis and associated factors in pregnant women.

Materials and methods

A community-based cross-sectional study was conducted by including 438 pregnant women at 10–36 gestational weeks from Langfang, China. Pregnant women were examined for periodontal status, and their demographic, socioeconomic, and oral health behavior data were collected. Potential influencing factors of periodontitis were analyzed with univariate and multivariate logistic regression analyses. A nomogram was developed, followed by the assessment of its validation and discriminatory abilities.

Results

The prevalence of periodontitis was 59.8% in pregnant women. Periodontitis-associated variables in pregnant women were gestational age, non-first pregnancy, daily tooth brushing frequency of ≤ 1 before pregnancy, and annual frequency of periodontal treatment < 1 (including no periodontal treatment). The risk of periodontitis was positively associated with gestational age (OR = 1.28, 95% CI = 1.17–1.39, p < 0.001). Pregnancy history showed a strong positive association (OR = 6.57, 95% CI = 1.22–35.43, p = 0.03). Daily tooth brushing frequency before pregnancy was also positively associated with periodontitis (OR = 1.54, 95% CI = 1.03–2.79, p = 0.05). Additionally, the annual frequency of periodontal treatment exhibited a positive association, with higher odds observed for those with less frequent treatment (OR = 2.28, 95% CI = 1.25–4.14, p = 0.05; OR = 7.37, 95% CI = 3.04–22.06, p < 0.001). These four factors were used to develop a nomogram for predicting periodontitis in pregnant women. The area under the receiver operating characteristic curve of the nomogram was 0.855 and 0.831 in the training and testing cohorts, respectively, reflecting the superior prediction accuracy of the nomogram. The calibration curve and decision curve analysis demonstrated the good performance and net benefit of the nomogram.

Conclusion

Risk factors for periodontitis in pregnant Chinese women include gestational age, non-first pregnancy, lower frequency of daily tooth brushing before pregnancy, and lower frequency of periodontal treatment. An easy-to-use nomogram with acceptable accuracy can allow for the prediction of periodontitis risk in pregnant Chinese women.

Clinical relevance

With the assistance of this nomogram, clinicians can evaluate the risk of periodontitis in pregnancy, thereby offering more tailored oral health education to women of reproductive age.
Robustness quantification of a mutant library screen revealed key genetic markers in yeast
Authors: Trivellin Cecilia , Torello Pianale Luca , Olsson Lisbeth
Published: August 2024

Background

Microbial robustness is crucial for developing cell factories that maintain consistent performance in a challenging environment such as large-scale bioreactors. Although tools exist to assess and understand robustness at a phenotypic level, the underlying metabolic and genetic mechanisms are not well defined, which limits our ability to engineer more strains with robust functions.

Results

This study encompassed four steps. (I) Fitness and robustness were analyzed from a published dataset of yeast mutants grown in multiple environments. (II) Genes and metabolic processes affecting robustness or fitness were identified, and 14 of these genes were deleted in Saccharomyces cerevisiae CEN.PK113-7D. (III) The mutants bearing gene deletions were cultivated in three perturbation spaces mimicking typical industrial processes. (IV) Fitness and robustness were determined for each mutant in each perturbation space. We report that robustness varied according to the perturbation space. We identified genes associated with increased robustness such as MET28, linked to sulfur metabolism; as well as genes associated with decreased robustness, including TIR3 and WWM1, both involved in stress response and apoptosis.

Conclusion

The present study demonstrates how phenomics datasets can be analyzed to reveal the relationship between phenotypic response and associated genes. Specifically, robustness analysis makes it possible to study the influence of single genes and metabolic processes on stable microbial performance in different perturbation spaces. Ultimately, this information can be used to enhance robustness in targeted strains.
Patient socio-demographics and clinical factors associated with malaria mortality: a case control study in the northern region of Ghana
Authors: Peprah Nana Yaw , Mohammed Wahjib , Adu George Asumah , Dadzie Dora , Oppong Sammy , Barikisu Seidu , Narh Joel , Appiah Stephen , Frimpong James , L. Malm Keziah
Published: August 2024

Background

Ghana is a malaria-endemic country with the entire population at risk. The Northern region of the country recorded the highest malaria case fatality rate (CFR) for two consecutive years: 1.11% in 2013 and 1.07% in 2014. Even though the National Malaria Elimination Programme (NMEP) has achieved a reduction in malaria mortality, the existence of high case fatality in the Northern region was alarming. This study, therefore, aimed to determine the factors associated with malaria mortality in the northern region of Ghana to institute control measures.

Methods

An unmatched case control study was conducted from July 2015 to August 2015. The study population consisted of patients admitted to health facilities for severe malaria in the Northern region of Ghana. A case was defined as a patient diagnosed with severe malaria at an eligible health facility who died as a result of malaria. A control was a patient diagnosed with severe malaria admitted to an eligible health facility who did not die. Health facilities that recorded CFRs of 1.0% and above were randomly sampled for this study, after which, 10 cases and 20 controls were recruited from each health facility. Information on cases and controls was then abstracted from hospital records using an electronically deployed abstraction tool. Continuous variables were expressed as means and medians, and categorical variables as frequencies and proportions. Multivariable logistic regression was used to assess the strength of the association between malaria mortality and factors predictive of malaria mortality. A p-value of < 0.05 was considered statistically significant.

Results

In all, a total of 95 cases and 190 controls participated in this study. The median ages of cases and controls were 4.1 years (IQR = 21.6) and 5.7 years (IQR = 18.2), respectively. Fifty-four (56.8%) cases were females, while 93 (49.0%) of the controls were females. Factors associated with malaria mortality included: duration of hospital stay less than 24 h [aOR: 12.0, 95% CI (5.9–24.6)], severe pallor [aOR: 2.3, 95% CI (1.1–4.6)], children under 5 years [aOR: 2.8, 95% CI (1.4–5.6)], oral Artesunate/Amodiaquine administration [aOR: 0.4, 95% CI (0.2–0.9)] and sepsis as an additional diagnosis [aOR: 4.1, 95% CI (1.8–9.5)].

Conclusion

Predictors of malaria mortality in the Northern region include children under 5 years, severe pallor, sepsis as an additional diagnosis, and use of oral anti-malarial. Patients with severe pallor and sepsis as co-morbidities should receive proactive management. The NMEP and its partners should implement measures to strengthen the referral system, anaemia prevention and management, and retrain health workers on malaria case management. Malaria control interventions targeted at under five children in the region should be reviewed and enhanced.
Spatiotemporal patterns and association with climate for malaria elimination in Lao PDR: a hierarchical modelling analysis with two-step Bayesian model selection
Authors: Rotejanaprasert Chawarat , Malaphone Vilayvone , Mayxay Mayfong , Chindavongsa Keobouphaphone , Banouvong Virasack , Khamlome Boualam , Vilay Phoutnalong , Vanisavaeth Viengxay , Maude Richard J.
Published: August 2024

Background

The government of Lao PDR has increased efforts to control malaria transmission in order to reach its national elimination goal by 2030. Weather can influence malaria transmission dynamics and should be considered when assessing the impact of elimination interventions but this relationship has not been well characterized in Lao PDR. This study examined the space–time association between climate variables and Plasmodium falciparum and Plasmodium vivax malaria incidence from 2010 to 2022.

Methods

Spatiotemporal Bayesian modelling was used to investigate the monthly relationship, and model selection criteria were used to evaluate the performance of the models and weather variable specifications. As the malaria control and elimination situation was spatially and temporally dynamic during the study period, the association was examined annually at the provincial level.

Results

Malaria incidence decreased from 2010 to 2022 and was concentrated in the southern regions for both P. falciparum and P. vivax. Rainfall and maximum humidity were identified as most strongly associated with malaria during the study period. Rainfall was associated with P. falciparum incidence in the north and central regions during 2010–2011, and with P. vivax incidence in the north and central regions during 2012–2015. Maximum humidity was persistently associated with P. falciparum and P. vivax incidence in the south.

Conclusions

Malaria remains prevalent in Lao PDR, particularly in the south, and the relationship with weather varies between regions but was strongest for rainfall and maximum humidity for both species. During peak periods with suitable weather conditions, vector control activities and raising public health awareness on the proper usage of intervention measures, such as indoor residual spraying and personal protection, should be prioritized.
Improving oxygenation in a patient with respiratory failure due to morbid obesity by applying airway pressure release ventilation: a case report
Authors: Nobe Ryosuke , Ishida Kenichiro , Togami Yuki , Ojima Masahiro , Sogabe Taku , Ohnishi Mitsuo
Published: August 2024

Introduction

Morbidly obese patients occasionally have respiratory problems owing to hypoventilation. Airway pressure release ventilation is one of the ventilation settings often used for respiratory management of acute respiratory distress syndrome. However, previous reports indicating that airway pressure release ventilation may become a therapeutic measure as ventilator management in morbid obesity with respiratory failure is limited. We report a case of markedly improved oxygenation in a morbidly obese patient after airway pressure release ventilation application.

Case report

A 50s-year-old Asian man (body mass index 41 kg/m2) presented with breathing difficulties. The patient had respiratory failure with a PaO2/FIO2 ratio of approximately 100 and severe atelectasis in the left lung, and ventilator management was initiated. Although the patient was managed on a conventional ventilate mode, oxygenation did not improve. On day 11, we changed the ventilation setting to airway pressure release ventilation, which showed marked improvement in oxygenation with a PaO2/FIO2 ratio of approximately 300. We could reduce sedative medication and apply respiratory rehabilitation. The patient was weaned from the ventilator on day 29 and transferred to another hospital for further rehabilitation on day 31.

Conclusion

Airway pressure release ventilation ventilator management in morbidly obese patients may contribute to improving oxygenation and become one of the direct therapeutic measures in the early stage of critical care.
Research on visual experience evaluation of fortress heritage landscape by integrating SBE–SD method and eye movement analysis
Authors: Xu Xiang , Dong Rui , Li Zhixing , Jiang Yuxiao , Genovese Paolo Vincenzo
Published: August 2024

Urbanization has led to homogenizing heritage site landscapes, and the protective measures have become disconnected from public needs. Additionally, the complex and diverse overall characteristics of heritage sites and the uneven distribution of values across different areas are related to the lack of landscape experience assessment. The “subjective + objective” cognitive evaluation and visual perception framework that adopts the Scenic Beauty Estimation Procedure-Semantic Differential (SBE–SD) method and eye-tracking analysis can compensate for the limitations of a single evaluation method by integrating quantitative and qualitative analysis. This research takes the Yi’an Fortress in Zhangpu County, Fujian Province, as the object and examines the visual experiences of different areas and types of landscapes within the Yi’an Fortress. The findings reveal several key insights: (1) Significant differences were found in the landscape experiences of different areas within the heritage site. The visual experience score of the core building area of Yi’an Fortress is (1.01) > the heritage entrance area (0.897) > the residential area (0.841) > the natural ecological area (0.784), indicating that the natural ecological area should be the focus of future protection and development efforts, with a particular emphasis on enhancing the ‘landscape aesthetic’ and ‘landscape cultural’ aspects. (2) The landscape experience scores can be used to understand the reasons for the differences in participants’ experiences of different landscapes. The architectural heritage landscape of the Yi’an Fortress scored highest in the experience evaluation due to its superior performance in terms of ‘landscape form’ factors. The cultural decorative landscape scored next, while the garden greening landscape scored the lowest, due to their poorer performance in terms of ‘landscape form’ and ‘landscape aesthetics’. (3) The eye-tracking data was consistent with the results of the subjective evaluation, validating the “subjective + objective” cognitive evaluation and visual perception framework, employing the SBE–SD method and eye-tracking analysis is a scientific and effective method for assessing the visual experience of heritage landscapes. These results provide a scientific basis for the heritage planners and managers of the Yi’an fortress to improve the landscape environment, better meet public needs, and preserve the unique character of this vital cultural resource. Furthermore, this study offers a new research method and approach for the protection of other heritage landscapes.
Interactions with educational chatbots: the impact of induced emotions and students’ learning motivation
Authors: Yin Jiaqi , Goh Tiong-Thye , Hu Yi
Published: August 2024

Educational chatbots (EC) have shown their promise in providing instructional support. However, limited studies directly explored the impact of EC on learners’ emotional responses. This study investigated the induced emotions from interacting with micro-learning EC and how they impact learning motivation. In this context, the EC interactions encompassed greetings, biology learning content delivery, self-evaluation, and feedback. This study employed a between-subject experimental design involving 62 college students. Participants were randomly assigned to either the Metacognitive EC group, receiving metacognitive feedback, or the Neutral EC group, receiving neutral feedback. The results of T-tests demonstrated significant differences in specific induced emotions between the two groups while some similarities exist. Importantly, it unveiled that both Metacognitive EC and Neutral EC interactions evoked a spectrum of positive, negative, and ambivalent emotions, in which positive emotions surpassed the induced negative emotions. In general, metacognitive feedback induced fewer negative emotions than neutral feedback. PLS analysis supported the relationships between induced emotions and intrinsic motivation, with positive emotion, ambivalent emotions, and negative emotions influencing interest motivation, which, in turn, shaped other motivational components, including perceived competence, perceived value, and perceived pressure. However, the influence of positive emotion on interest was weaker in the Metacognitive than in the Neutral EC. In conclusion, the study revealed how induced emotions impact motivations and showed that the presence of metacognitive feedback reduced negative emotions and promoted motivation. These findings highlight the need for positive emotion element design and appropriate feedback that will impact learning motivations during educational chatbot interactions.
Evaluation of renewable energy technologies in Colombia: comparative evaluation using TOPSIS and TOPSIS fuzzy metaheuristic models
Authors: Moreno Rocha Christian Manuel , Arenas Buelvas Daina
Published: August 2024

The study investigates the weighting and hierarchization of renewable energy sources in specific geographical regions of Colombia using the TOPSIS and Diffuse TOPSIS metaheuristic models. 5 regions were analyzed, two of them with different scenarios: Caribbean 1 and 2, Pacific 1 and 2, Andean, Amazonian and Orinoquia. The results reveal significant differences in the evaluation of technologies between the two models. In the Caribbean 1, Diffuse TOPSIS gave a higher score to Solar Photovoltaics, while TOPSIS favored Hydropower. In the Caribbean 2, Solar Photovoltaic obtained similar scores in both models, but Wind was rated better by TOPSIS. In the Pacific Region 1, Biomass and large-scale Hydropower led according to both models. In the Pacific 2, Solar Photovoltaic was better evaluated by TOPSIS, while Wind was preferred by Diffuse TOPSIS. In the Andean Region, large-scale hydroelectric and Solar photovoltaic plants obtained high scores in both models. In the Amazon, Biomass led in both models, although with differences in scores. In Orinoquia, Solar Photovoltaic was rated higher by both models. The relevance of this research lies in its ability to address not only Colombia's immediate energy demands, but also in its ability to establish a solid and replicable methodological framework. The application of metaheuristic methods such as TOPSIS and TOPSIS with fuzzy logic is presented as a promising strategy to overcome the limitations of conventional approaches, considering the complexity and uncertainty inherent in the evaluation of renewable energy sources. By achieving a more precise weighting and hierarchization, this study will significantly contribute to strategic decision-making in the implementation of sustainable energy solutions in Colombia, serving as a valuable model for other countries with similar challenges.
Urethral duplication with a large cystic dorsal penile mass in a newborn: a case report
Authors: Govender Saveshree
Published: August 2024

Background

Urethral duplication is a rare urogenital anomaly with varying anatomical orientations leading to diverse clinical presentations. We present a case of urethral duplication in a neonate featuring a large dorsal cystic mass on the penis, an unusual presentation.

Case presentation

A term male neonate with a prenatally diagnosed 10 × 10 cm genitourinary cystic mass was delivered via caesarean section. Examination revealed a large cystic mass extending dorsally from the pubic symphysis over a flattened, elongated penile shaft with a single urethral opening in the glans and undescended testes. A size 6-French feeding tube inserted into the urethra drained the bladder.

Urethral communication with the cystic mass was confirmed via voiding cystourethrogram and cyst enlargement noted during voiding. Cyst fluid analysis indicated a urinary origin. Computed tomography and ultrasound were not diagnostic. Initial imaging revealed a dorsal cystic mass projecting from the pubic symphysis without bladder connection.

Surgical intervention at 3 weeks revealed a Type IIA-2 urethral duplication, with a dorsal hypoplastic urethra communicating with the posterior urethra. Correction included resection of the dorsal urethra, cyst excision, and reconstruction of the penis with the orthotopic ventral urethra and bilateral orchidopexies.

Satisfactory functional and cosmetic outcomes were observed at 2 and 8 months after surgery.

Conclusion

This case highlights the significance of identifying unique urethral duplication presentations. The novel occurrence of Type IIA-2 urethral duplication terminating in a dorsal cystic mass underscores diagnostic complexity, surgical intricacies, and aesthetic considerations associated with such cases.
Frequency of internet use and hypertension risk among men and women in Kenya: an analysis of the 2022 demographic and health survey
Authors: Okyere Joshua , Ayebeng Castro , Okantey Christiana , Dickson Kwamena Sekyi
Published: August 2024

Background

The proliferation of internet use in the 21st century has brought about a pluralistic effect on health. Users of the internet are more exposed to health information, thus, making them more health literate and more likely to adopt healthy behaviors. However, frequent use of the internet has been found to adversely affect mental health (e.g., depression), social wellbeing, and obesity. Yet, the link between internet use and physical health outcomes such as hypertension remains less explored. We examined the association between frequency of internet use and hypertension risk among women and men in Kenya using data from the 2022 Kenyan demographic and health survey.

Results

Overall, the prevalence of hypertension was higher among women (1,398 [8.69%]) compared to men (504 [3.49%]). Those who reported using the internet often reported higher prevalence of hypertension (women: n = 638 [10.49%]; men: n = 279 [3.98%]). The mean age was 29.3 years (SD = 9.6) for women and 29.9 years for men (SD = 10.9). After adjusting for potential confounders, women who reported often using the internet also demonstrated a significant association [AOR = 1.21; 95%CI: 1.03–1.43]. However, we found no significant association between frequency of internet use and hypertension among men after adjusting for confounders.

Conclusion

Our study concludes that frequent use of internet is positively associated with hypertension risk among women but not men. Policymakers may consider implementing guidelines or regulations to promote healthy internet usage habits and encourage breaks or limits on screen time, especially for individuals at risk of hypertension (i.e., older women of reproductive age, women with higher education, married and previously married women, those in affluent households, parous women, those who consume alcohol and those overweight/obese). Healthcare providers should educate patients about the potential health consequences of prolonged internet usage and incorporate discussions about screen time management into routine clinical encounters.
Cultural and social factors associated with generalized anxiety disorder among adolescent mothers during the postpartum period in Malawi: a cross-sectional survey
Authors: Tembo Chimwemwe , Portsmouth Linda , Burns Sharyn
Published: August 2024

Background

The postnatal period is an important time for adolescent mothers to regain their health as they adjust to life with their infants. However, it is also a time when mothers are vulnerable to mental health problems. Generalized anxiety disorders (GADs) are among the common mental disorders that can impact mothers. Anxiety disorders can have adverse effects on a child’s cognitive development. However, there is a scarcity of studies pertaining to anxiety disorders among adolescent mothers in Malawi.

Methods

A cross-sectional survey was conducted among adolescent postnatal mothers aged ≤ 19 years to establish the prevalence of probable GAD and identify cultural and social factors that influence anxiety in this population. Adolescent mothers were recruited from the Mitundu Rural Hospital catchment area in Lilongwe district, Malawi. A two-stage random sampling method was employed: clinics were randomly selected, and participants were recruited via systematic random sampling. The Generalized Anxiety Disorder (GAD-7) scale was used to assess anxiety. Data were analyzed using SPSS version 27.

Results

Of the 395 adolescent mothers who participated, 34% were aged 14–17. The prevalence of probable GAD (GAD-7 ≥ 10) was 31.9%. Increased social support decreased the odds of probable GAD (aOR 0.95, 95% CI: 0.91–0.98, p < 0.001). Experiencing intimate partner violence (IPV) increased the likelihood of probable GAD (aOR 4.80, 95% CI: 1.23–18.82, p = 0.02), while those who had contact with a health worker postnatally (aOR 0.38, 95% CI: 0.17–0.83, p = 0.02) and those who were “not prayerful” (aOR, 0.43, 95% CI: 0.21–0.87, p = 0.02) were less likely to report probable GAD.

Conclusions

Given that the prevalence of probable GAD among adolescent mothers in Malawi is higher compared to the global estimates of their peers, policies and guidelines that prioritize the maternal mental health of adolescent mothers in Malawi are required. The findings also highlight the importance of enhancing social support among family and community. Co-designed mental health promotion, prevention, and early interventions to involve health workers and religious leaders are recommended.
Association of Initial and Changes in Serum A-FABP Level With the Development and Improvement of Presarcopenia
Authors: Hu Tingting , Xu Yiting , Li Xiaoya , Xiao Yunfeng , Wang Yufei , Bao Yuqian , Ma Xiaojing
Published: August 2024

Context

Several cross-sectional studies have reported the association between serum adipocyte fatty acid–binding protein (A-FABP) level and presarcopenia. However, data on the effects of serum A-FABP level and its changes over time on the development and improvement of presarcopenia are scarce.

Objective

This study aimed to explore the association of serum A-FABP level with the incidence and improvement of presarcopenia in a community-based cohort, and further investigated the association of changes in serum A-FABP level with the incidence and improvement of presarcopenia.

Methods

This longitudinal cohort study included 1496 adults (41.2% men; median age, 58 [53-63] years) in 2013 to 2014 and was followed up to 2015 to 2016. Participants underwent serum A-FABP level measurements at baseline and a follow-up visit. Visceral fat area (VFA) was measured using magnetic resonance imaging. Skeletal muscle mass (SMM) was estimated by bioelectrical impedance analysis and converted to a skeletal muscle index (SMI). Presarcopenia was defined as SMI less than 1 SD of the sex-specific mean for the young reference group.

Results

During an average follow-up period of 2.1 years, baseline serum A-FABP level was positively associated with the incidence of presarcopenia (standardized by weight: risk ratio [RR] 3.22; 95% CI, 1.96-5.38; standardized by VFA: RR 2.11, 95% CI, 1.29-3.51) and negatively associated with the improvement of presarcopenia (standardized by weight: RR 0.66; 95% CI, 0.45-0.97; standardized by VFA: RR 0.71; 95% CI, 0.54-0.94), regardless of whether SMM was standardized by weight or VFA. Moreover, changes in serum A-FABP level provided additional information on the incidence and improvement of presarcopenia, independent of baseline serum A-FABP level (all P < .05).

Conclusion

Baseline serum A-FABP level and its changes were positively associated with the incidence and negatively associated with the improvement of presarcopenia.