bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of combined vibration-suppression method for vehicle vertical comprehensive performance
Authors: Nie Shida , Chen Qian , Liu Kaiqi , Zhuang Ye , Li Keqiang
Published: September 2024

The constraint of invariant points leads to the trade-off between ride qualities and road-holding, limiting the improvement of vehicle comprehensive performance. This study presents a combined vibration-suppression method (CVSM) to address this issue. The CVSM includes a mechanical method (MM) and a control method (CM). The MM uses a tuned mass damper to eliminate the performance constraint. A multi-objective sliding mode controller functions as the CM to enhance comprehensive performance. In this paper, the nonlinear model of the MM is established, and a detailed dynamics analysis is conducted to provide insight into the constraint elimination theory. Then, the CM is designed to suit the novel suspension structure, improving both ride quality and road-holding. Analytical results show that the MM can share energy consumption with the suspension around the invariant point, which is the key to constraint elimination. Based on this, the CM increases the energy consumption efficiency of the MM. As a combination, the CVSM is more than just a simple sum of the two methods; they complement each other to improve overall performance.
Experimental and simulation study of energy loss mechanism of low pressure ratio radial turbine
Authors: Xie Wenping , Yang Mingyang , Zhang Kun , Deng Kangyao
Published: September 2024

Low-pressure ratio conditions are commonly encountered in radial turbines. When operating at low pressure ratio condition, a significant portion of the turbine energy loss occurs as residual velocity loss in the form of swirling flow at the outlet pipe. Typically, this energy can be recovered by the next stage turbine or reduced by the diffuser. However, there is a lack of experimental and simulation studies on the swirling flow at the outlet of turbines. The mechanism governing the changing pattern of swirling flow remains unclear, limiting the effective utilization and reduction of residual velocity loss. This study conducts theoretical and experimental research on turbine outlet swirling flow. Firstly, this paper introduces a novel two-dimensional hot-wire anemometry stepping mechanism for measuring swirling flow at a turbine outlet cross-section. Experimental results demonstrate that the proposed measurement method effectively captures the morphological changes of turbine outlet swirling flow. The results indicate a strong coupling relationship between axial and circumferential velocity. Subsequently, to elucidate the reasons for the coupling of velocity in two directions and the development of swirling flow in the outlet pipeline, simulations of turbine performance under different velocity ratio conditions were conducted. Results show that under a wide range of velocity ratios, not only does the direction of the turbine outlet swirling flow change, but it also leads to the swirl number exceeding the critical swirl ratio under high velocity ratio conditions, resulting in the formation of a central recirculation zone (CRZ) at the pipe outlet. The main cause of the strong coupling effect between velocities in two directions is attributed to the increased swirl intensity leading to enhanced adverse pressure gradients at the core of the vortex. Lastly, a model describing the variation of VGT turbine outlet swirling flow is established, indicating a linear relationship between the swirl number and the velocity ratio, with a steeper change as the pressure ratio decreases.
Enhanced quadrotor motion analysis through extended
Authors: Saibi Ali , Belaidi Hadjira , Kobzili Elhaouari , Demim Fethi , Allam Ahmed , Attouche Nesrine , Belkacemi Malak , Nemra Abdelkrim
Published: September 2024

This paper aims to develop a stable quadrotor’s flight controller using the ESP32 microcontroller, enabling wireless guidance through a Graphical User Interface (GUI) on Raspberry Pi. In this context, an Extended Kalman Filter (EKF) with a nonlinear control model is employed to estimate the angular velocity and speed of the quadrotor. Simulationswere conducted using two nonlinear controllers (BackStepping Controller (BSC) and Sliding Mode Controller (SMC)) across various scenarios to prove the efficiency of the proposed method for trajectory tracking. The performance was analyzed using Root Mean Square Error (RMSE) and compared to previous works. It was noticed that in the both control scenarios, the estimated states followed the desired instructions, although a potential overshoot was noted in the case of SMC. Additionally, two control approaches were practically implemented. The first approach utilizes the classical Proportional Integral Derivative (PID) technique, while the second approach employs the modern Backstepping technique. The results demonstrate that both control approaches deliver satisfactory performance and responsiveness in stabilizing the quadrotor in real-world scenarios. However, it has been noticed that the Backstepping controller achieves higher performance, whereas, the PID controller’sperformance is constrained by tuning and model limitations.
Novel Strategies for Spatiotemporal and Controlled BMP-2 Delivery in Bone Tissue Engineering
Authors: Qi Jingqi , Wu Hongwei , Liu Gengyan
Published: September 2024

Bone morphogenetic protein-2 (BMP-2) has been commercially approved by the Food and Drug Administration for use in bone defects and diseases. BMP-2 promotes osteogenic differentiation of mesenchymal stem cells. In bone tissue engineering, BMP-2 incorporated into scaffolds can be used for stimulating bone regeneration in organoid construction, drug testing platforms, and bone transplants. However, the high dosage and uncontrollable release rate of BMP-2 challenge its clinical application, mainly due to the short circulation half-life of BMP-2, microbial contamination in bone extracellular matrix hydrogel, and the delivery method. Moreover, in clinical translation, the requirement of high doses of BMP-2 for efficacy poses challenges in cost and safety. Based on these, novel strategies should ensure that BMP-2 is delivered precisely to the desired location within the body, regulating the timing of BMP-2 release to coincide with the bone healing process, as well as release BMP-2 in a controlled manner to optimize its therapeutic effect and minimize side effects. This review highlights improvements in bone tissue engineering applying spatiotemporal and controlled BMP-2 delivery, including molecular engineering, biomaterial modification, and synergistic therapy, aiming to provide references for future research and clinical trials.
Bayes in the Age of Intelligent Machines
Authors: Griffiths Thomas L. , Zhu Jian-Qiao , Grant Erin , Thomas McCoy R.
Published: September 2024

The success of methods based on artificial neural networks in creating intelligent machines seems like it might pose a challenge to explanations of human cognition in terms of Bayesian inference. We argue that this is not the case and that these systems in fact offer new opportunities for Bayesian modeling. Specifically, we argue that artificial neural networks and Bayesian models of cognition lie at different levels of analysis and are complementary modeling approaches, together offering a way to understand human cognition that spans these levels. We also argue that the same perspective can be applied to intelligent machines, in which a Bayesian approach may be uniquely valuable in understanding the behavior of large, opaque artificial neural networks that are trained on proprietary data.
Open-Heart Surgery in Jehovah's Witness Patients
Authors: Chikada M. , Furuse A. , Kotsuka Y. , Yagyu K.
Published: September 2024

Open-heart surgery has been performed since 1975 on 25 patients who are Jehovah's Witnesses by religion. The patients' ages ranged from 6–60 years, and their body weights from 18–51 kg. Surgical procedures included correction of congenital heart disease in 14 patients and valve repair or replacement in 11. Six procedures were reoperations. The lowest mean haematocrits. during perfusion and the postoperative period, were 22.7% (range 15.0–31.0%) and 27% (range 16.0–36.0%), respectively. Twenty-four patients survived and are alive and well. One patient died of low output failure before discharge. The blood return system reduced blood loss. Five of the patients who underwent cardiac surgery received recombinant erythropoietin before and after surgery, leading to higher postoperative haematocrits. In one patient, a haematocrit which fell to 16.9% after surgery was raised to 27% by administration of erythropoietin, without blood transfusion. In two recent cases, high doses of aprotinin were used during surgery, resulting in better haemostasis after cardiopulmonary bypass. Copyright © 1996 The International Society for Cardiovascular Surgery.
Influence of Arterial Disease, Age and Active Ulceration on Venous Refilling Time Measured by Photoplethysmography
Authors: Stacey M. C. , Rashid P. , Hoskin S. E. , Pearce C. A.
Published: September 2024

This study investigated the influence of arterial disease, patient age and the presence of a venous ulcer on venous refilling time as measured by photoplethysmography. Refilling time was evaluated in 157 control limbs, in 133 limbs with venous disease, in 17 limbs with arterial disease and in 20 limbs with mixed disease (arterial and venous disease) as the cause of ulceration. Refilling time reduced progressively with age in control subjects and was significantly shorter over the age of 50 years. Limbs with venous disease alone had a significantly shorter refilling time when compared with controls (Mann-Whitney U test, P < 0.01); however, there was no alteration in refilling time with age. Limbs with arterial disease, without clinical evidence of venous insufficiency, had a shorter refilling time when compared with controls but a longer refilling time compared with those with venous disease (P < 0.01). The refilling time in patients with mixed ulcers did not differ from those with venous ulcers (P < 0.265). Refilling time measured when an ulcer was present was not significantly different to that measured after the ulcer had healed (P = 0.59). Venous refilling time normally reduces with age but is not affected by arterial disease or the presence of an ulcer. Copyright © 1996 The International Society for Cardiovascular Surgery.
Non-Penetrating Traumatic Tricuspid Regurgitation after Mitral Valve Replacement
Authors: Fujiwara T. , Murakami T. , Kanazawa S. , Katsumura T.
Published: September 2024

A case of traumatic rupture of the tricuspid chordae tendineae with severe regurgitation in a patient who previously had mitral valve replacement is presented. In this case, it is strongly suggested that a firm pericardial adhesion of the anterior right ventricular wall became a factor of the disruption of the tricuspid valve under a slight precordial blow. Copyright © 1996 The International Society for Cardiovascular Surgery.
Surgical Repair of a Coronary Sinus Diverticulum not Associated with Wolff-Parkinson-White Syndrome
Authors: Hamano K. , Fujimura Y. , Suzuki K. , Katoh T. , Tsuboi H. , Esato K.
Published: September 2024

Diverticulum of the coronary sinus is rare. A 58-year-old man without Wolff-Parkinson-White syndrome underwent repair of a coronary sinus diverticulum accompanies by mitral regurgitation. The coronary sinus diverticulum had been identified 6 years earlier and had enlarged over time. At surgery, the neck of the diverticulum was closed, and the mitral valve replaced with a CarboMedics prosthetic valve (diameter, 29 mm). This the first case report of the surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome. Copyright © 1996 The International Society for Cardiovascular Surgery.
Subclavian Artery Injury Caused by a Screw in a Clavicular Compression Plate
Authors: Johnson B. , Thursby P.
Published: September 2024

A 22-year-old man presented with left-arm ischaemia, 22 months after placement of a clavicular compression plate for a fractured left clavicle. Digital subtraction angiography revealed a distal subclavian artery injury which, during surgery, was found to be caused by a screw in the compression plate. Ligation of the subclavian artery followed by carotid-axillary bypass resulted in a symptom-free left arm. Copyright © 1996 The International Society for Cardiovascular Surgery.
Winning the transition: Strategic state action in France and Germany amid the low carbon transition and energy shock
Authors: McDaniel Sean , Bailey Daniel
Published: September 2024

European economies are in flux, destabilized by the low carbon transition (LCT) and post-Ukraine energy shock. How are states responding to this instability? This article contributes to emerging environmentally focused Comparative Capitalisms (CC) scholarship by developing a novel framework for analysing how state action is shaped by the demand-competitiveness-energy nexus. We comparatively examine the cases of France and Germany since 2022, drawing upon 19 elite interviews and documentary analysis of stakeholder accounts, to advance three arguments. First, it is essential for CC frameworks to integrate energy supply dynamics to understand state action and processes of capitalist development. Second, the asymmetric impact of the LCT on France and Germany has shaped distinct state-led capitalist restructuring designed to protect and extend national competitive advantages. For Germany, this has primarily involved ‘greening’ its existing export-led model of growth, whereas French state actors are attempting to advance its interests via the ‘strategic autonomy’ (SA) agenda at the domestic and regional levels. Finally, the energy shock has initiated more interventionist state action in Germany that exposes critical instabilities in its export-led growth model. This analysis has significant implications for CC scholarship and its understanding of capitalist development by illustrating the significance of energy supply dynamics and advancing understanding of how disequilibrium can be theorized within the literature.
Palliative Care and the Self-Fulfilling Prophecy in Stroke Patients: is There Anything to Fear? A Retrospective Study of Patients Who Died During Hospitalization in a Quaternary Care Hospital
Authors: Tramonte Maiara Silva , Carvalho Ana Claudia Pires , Pucci Gabriela Figueiredo , Pinheiro Mariana Soares , Fornazari Ana Elisa Vayego , Villas Boas Gustavo Di Lorenzo , Lange Marcos Christiano , Minicucci Marcos Ferreira , Bazan Rodrigo , Lopes Laura Cardia Gomes
Published: September 2024

Background and Purpose

Primary palliative care (PC) aims to improve the quality of life for patients with acute ischemic stroke but is often misinterpreted as withdrawal of care. The self-fulfilling prophecy withdrawal bias is feared in this context of PC’s early implementation. This study evaluates stroke patients who died in the hospital to determine the impact of PC evaluation.

Methods

A retrospective descriptive analysis of patients who died from acute ischemic stroke was conducted. The study included patients aged ≥18 years admitted to the Stroke Unit of a quaternary hospital in Brazil from January 2017 to December 2018. The impact of PC assessment on outcomes was analyzed, with significance set at 5%.

Results

Among the patients who died during hospitalization as a result of an ischemic stroke (n = 77), 39 (%) were assessed by the palliative care team. There was no difference in the total length of stay or duration of antibiotic therapy. Logistic regression corrected for significant variables from the univariate analysis revealed that PC evaluation was associated with a 31-fold increase in opioid use ( P < 0.001), a nearly 14-fold increase in discharges to the ward, and a threefold reduction in ICU length of stay ( P = 0.011).

Conclusion

PC team involvement was associated with higher rates of discharge to the floors, inferring more time spent with family and increased opioid use, suggesting better symptom control, without reducing the overall length of stay or duration of antibiotic therapy. This underscores that PC does not equate to withdrawal of care.
Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (MIS-DMDO) for the Prevention and Treatment of Chronic Plantar Diabetic Foot Ulcers
Authors: Biz Carlo , Belluzzi Elisa , Rossin Alessandro , Mori Fabiana , Pozzuoli Assunta , Bragazzi Nicola Luigi , Ruggieri Pietro
Published: September 2024

Background:

Diabetic foot is one of the major complications of diabetes, affecting 15% of patients with diabetes. This study aims to evaluate and compare the clinical and radiographic outcomes of patients with diabetes affected by forefoot plantar preulcerative or ulcerative lesions who have undergone minimally invasive distal metatarsal diaphyseal osteotomy (MIS-DMDO) to assess its efficacy in the prevention and treatment of chronic plantar diabetic foot ulcers (CPDFUs).

Methods:

The study included 60 patients, 38 with preulcers and 22 with ulcers, with at least 2 years of clinical and radiologic follow-up. Clinical outcomes were assessed using the European Foot and Ankle Society (EFAS) score, the Foot Function Index (FFI), and the Manchester-Oxford Foot Questionnaire (MOXFQ). The radiographic evaluation was performed according to the Maestro criteria.

Results:

Both groups improved in clinical and radiologic outcomes when comparing baseline measurements to those at the final follow-up. There were no statistical differences between preulcer and ulcer groups in terms of both clinical and radiologic outcomes, with the only exception being FFI, which was lower in the preulcerative group. In multivariate analysis, gender and glycated hemoglobin (HbA1c) were predictors of better outcomes. Specifically, FFI and MOXFQ ( P < .05) exhibited larger improvements in females, while Maestro 1 and 2 were better in patients with lower HbA1c ( P < .05). All patients were considered healed at the final follow-up.

Conclusion:

Carefully performed minimally invasive distal metatarsal diaphyseal osteotomy can be an effective approach to the care of impending or chronically present plantar diabetic foot ulcers.
Comparative Efficacy and Long-Term Oncological Safety of Extended Right Hemicolectomy Versus Left Colectomy for Splenic Flexure Adenocarcinoma: A Systematic Review and Meta-Analysis
Authors: Chaouch Mohamed Ali , Krimi Bassem , Gouader Amine , Bhiri Hanen , Barel Elise , Akouz Faiza Khemissa
Published: September 2024

Background

Splenic flexure adenocarcinoma poses unique challenges in surgical management due to its location and lymphatic drainage. This study compared the efficacy and oncological safety of extended right hemicolectomy (ERC) and left colectomy (LC) for treating this condition.

Methods

This study followed the PRISMA and AMSTAR 2 guidelines. Key outcomes included postoperative mortality, morbidity, severe complications, operative results, pathological findings (R0 resection, lymph nodes), and oncological results (overall survival and disease-free survival at 3 and 5 years).

Results

Twelve non-randomised studies were included involving 1710 patients (713 ERC group, 997 LC group). The analysis showed that ERC was associated with more lymph nodes and a lower conversion rate. However, there were no significant differences between ERC and LC in terms of mortality, morbidity, severe complications, anastomotic leak, wound infection, ileus, reoperation, R0 resection, hospital stay, and overall and disease-free survival rates.

Conclusions

ERC and LC are comparable in terms of postoperative and long-term oncological outcomes for splenic flexure adenocarcinoma, with ERC potentially producing a higher lymph node harvest rate and a lower conversion rate. ERC could be suggested for a better stage of the disease and when the surgical team considers the laparoscopic approach.
‘A name was banned. Nothing more!’: identity, democracy and banning white supremacists in Germany
Authors: Meier Anna A.
Published: September 2024

Calls for governments to proscribe white supremacist actors as ‘terrorists’ have increased in recent years, yet little attention has been paid to whether proscription of such actors ‘works’ and what consequences may arise from expanding counterterrorism apparatuses in this way. What happens when states bring violent white supremacist organisations under the counterterrorism umbrella? Using original data on Germany’s 70-year practice of banning white supremacists as ‘anti-constitutional’, this article uses the vehicle of terrorist proscription to explore the political work done by treating white supremacists as ‘terrorists’ in a legal, not only a discursive, sense. I argue that placing security efforts against white supremacists alongside questions of constitutionality and democracy invokes larger debates about German values and identity, rendering visible the role of white supremacy in constructing the German nation. Banning white supremacist organisations, then, becomes a policy instrument that provides a veneer of combating violence without confronting the embedded nature of the ideology underlying that violence. My findings that bans are overwhelmingly symbolic and offer little in the way of deeper political change have implications not only for German security policy, but also for cross-national studies of terrorist proscription and combating white supremacy in all of its manifestations.
Classroom environment and engagement in the EFL writing context: The mediating role of goal orientations
Authors: Zhong Shuneng , Zhan Shuangjuan
Published: September 2024

Although second language (L2) engagement has received increasing attention, L2 writing engagement has been rarely investigated. Based on the social-cognitive theory, environmental sources could influence individuals’ motivations which in turn affect their engagement. However, factors contributing to L2 writing engagement have not been thoroughly understood. The present study investigated the associations between three dimensions of classroom environment (teacher support, student cohesion, and task orientation) and L2 writing engagement as well as the mediation roles of mastery and performance approach goals among 721 Chinese learners of English as a foreign language (EFL). Structural equation model analysis suggested that task orientation was the most influential environmental factor; it could not only directly influence EFL writing engagement, but could also indirectly influence it through mastery and performance goals. Teacher support could only indirectly influence engagement through mastery and performance goals. With dimensions of EFL writing engagement disentangled, teacher support negatively predicted agentic engagement but not the other three dimensions. However, mastery and performance goals fully mediated the path from teacher support to behavioral, emotional, and cognitive engagement. Task orientation had positive effects on all aspects of writing engagement and most of the effects could be carried by the two types of goal orientations. Implications and future directions are also discussed.
With great power comes great accountability: Network positions, victimization, perpetration, and victim-perpetrator overlap in an online multiplayer game
Authors: Liu Mingxuan , Sun Qiusi , Williams Dmitri
Published: September 2024

Can players’ network-level parameters predict gaming perpetration, victimization, and their overlap? Extending the Structural Hole Theory and the Shadow of the Future Effect, this study examines the potential advantages and accountability conferred by key network metrics (i.e., ego network size, brokerage, and closure) and their behavioral implications. Using longitudinal co-play network and complaint data from 55,760 players in an online multiplayer game over two months, the findings reveal that higher network size is associated with greater perpetration and reduced victimization. Network closure is linked to reduced involvement in both perpetration and victimization, while network brokerage is linked to increased involvement in both. The overlap of perpetration and victimization is predicted by higher network size and lower closure. Theoretically, this study complements existing research on gaming toxicity from a structural perspective. Practically, the findings underscore the importance of considering network elements, particularly network closure, in designing interventions to mitigate gaming toxicity.
The interactive effects of drawing task, prompt format, and visual aids on video-based learning: Attention and drawing accuracy as mediators
Authors: Zhang Yi , Pi Zhongling , Xu Ke , Pan Yun , Yang Jiumin
Published: September 2024

This study investigated the effects of open- and closed-book learning conditions either accompanied by visual aids or without on learners’ attention, drawing accuracy, and learning performance. Participants were 127 undergraduate learners randomly assigned to view either an open- or closed-book prompt, who then watched either a video lecture accompanied by visual aids or one without (i.e. visuals provided vs. no visuals). The results showed that for learners who were provided with visual aids, compared to the open-book condition, those in the closed-book condition demonstrated higher eye blink rate as well as improved immediate and delayed test scores. However, this advantage was not observed in the condition with no visual materials. Mediation analysis showed that increased immediate test scores in the visuals provided condition was due partly to improved drawing accuracy. Multiple mediation analyses showed that the open-book with visuals provided condition led to lower eye blink rate, increased fixation count, and improved drawing accuracy, which collectively resulted in decreased immediate test performance. These findings have implications for educators and instructional designers regarding how to tailor effective learning strategies; specifically, educators could consider using closed-book learning conditions with visual aids to enhance learners’ attention and improve their learning performance.
‘What are nurses’ and healthcare workers’ cultural understandings of dementia?’ An integrative literature review
Authors: Jenkins Catharine , Smythe Analisa
Published: September 2024

Aim: to explore the range of cultural understandings of dementia held by people providing nursing care globally.Background: There is a worldwide shortage of nurses and healthcare workers, resulting in extensive global mobility among the workforce. Cultural competence is expected of nurses who serve diverse populations and although self-awareness is recognised as crucial in developing this ability, the focus has tended to be on the identity of the patient and adjusting care according to their specific needs. However, taken-for-granted assumptions drive unconscious judgements and therefore behaviour so nurses’ dementia-related understandings are worthy of exploration.Design: An integrative literature review, comprising five stages: problem identification; literature search; data evaluation; data analysis; and presentation of the findings.Methods: Six databases were searched for original research published between 1997 and 2023. Studies which focus on qualified/registered and unqualified/unregistered healthcare workers’ cultural understandings of dementia were included. Studies were evaluated using a tool designed for the critical assessment of qualitative research. Data was extracted using a bespoke spreadsheet. Conventional content analysis was undertaken to develop a synthesised summary of the findings of the studies.Findings: 11 papers met the inclusion criteria. Content analysis led to identification of two main themes: ‘Stigma as a common factor in cultural perceptions of dementia’, and ‘Stigma derived from cultural perceptions has consequences for people living with dementia’.Conclusion: An international perspective facilitated insight into alternative perceptions of the nature of dementia and care responses. A version of the ‘Relationship Centred Care’ model, expanded to include the wider community, could support theoretical and practical recommendations for culturally congruent approaches to care. Further research is required to examine the usefulness of incorporating this approach internationally.Reporting Method: The authors followed the ENTREQ reporting guidelines (Tong et al., 2012).
On swirl mach number effects on acoustic-vortical waves
Authors: Campos LMBC , Lau FJP
Published: September 2024

The propagation of sound in a uniform flow with rigid body swirl has been considered in the approximation of low swirl Mach number [Formula: see text],where the swirl Mach number [Formula: see text] is specified by the angular velocity [Formula: see text], stagnation sound speed [Formula: see text] and radial distance r; in this case the mass density and sound speed in the mean flow are constant, and the convected wave equation is solved in terms of Bessel functions. In this paper the restriction on swirl Mach number is relaxed from [Formula: see text] to [Formula: see text], thus keeping O ([Formula: see text]) terms in the mean flow, mass density and sound speed, that become non-uniform; the acoustic vortical wave equation is no longer the convected wave equation, and is extended to this case and solved in terms of generalized Bessel functions. The radial dependence to second order in the swirl Mach number is specified by a generalized Bessel differential equation for decoupled acoustic or vortical modes and for acoustic-vortical waves to first order in the swirl Mach number. The solutions are obtained: (i) for finite radius in terms of generalized Bessel and Neumann functions, that determine the radial wavenumbers, natural frequencies and normal eigenfunctions for cylindrical or annular ducts with rigid or impedance wall boundary conditions; (ii) asymptotically for large radius in terms of generalized Hankel functions, specifying the growth of amplitude with radius either as a power law or as an exponential of one-half of the square of the swirl Mach number. Thus the compressible uniform mean flow with rigid body rotation is spatially unstable in the radial direction; it is also unstable in time for cut-on modes with real axial wavenumbers and cut-off modes with imaginary axial wavenumbers. Compared with acoustic waves the acoustic-vortical waves have more modes, some with complex rather than real eigenvalues leading to instabilities.
Where Small Powers Travel? Understanding Jordan’s High-Level Diplomatic Visit Patterns
Authors: Balci Ali
Published: September 2024

Where do leaders of smaller powers travel abroad? By examining high-level leader visits of a small power, we gain an understanding of the determinants of their foreign policy orientations. Existing literature on this topic is primarily qualitative. This study focuses on Jordan, using a comprehensive dataset of high-level visits from 1989 to 2023 to test and revise assumptions about small power foreign policy. We find that Jordan’s foreign policy priorities include ensuring national survival amid regional volatility, maintaining regime security in a country with a majority refugee population, securing economic aid to bolster fiscal stability, and demonstrating solidarity with Muslim countries. These findings highlight the importance of security and economic needs, as well as cultural and regional affiliations, in shaping Jordan’s foreign relations.
Hybrid Biatrial Ablation Versus Catheter Ablation for Patients With Nonparoxysmal Atrial Fibrillation and Enlarged Left Atrium
Authors: Yu Chunyu , Li Haojie , Zeng Zhiwei , Zheng Lihui , Wu Lingmin , Ding Ligang , Yao Yan , Zheng Zhe
Published: September 2024

Objective:

There is no consensus on the optimal ablation strategy for nonparoxysmal atrial fibrillation (NPAF) with enlarged left atrium. We aimed to explore whether hybrid ablation (HA) of combined thoracoscopic surgical ablation with catheter ablation (CA) was superior to CA alone in these patients.

Methods:

Patients with NPAF and left atrial diameter (LAD) ≥45 mm who underwent hybrid biatrial ablation or CA procedure from June 2014 to July 2021 were included in this study. Propensity score matching was applied to select patients in each group. The primary endpoint was freedom from atrial tachyarrhythmias after procedures.

Results:

After propensity score matching, 52 patients with enlarged left atrium (median LAD = 51 mm) were enrolled in each group. The median follow-up was 36 months. The probability of freedom from atrial tachyarrhythmias at 12, 24, and 36 months on antiarrhythmic drugs (AADs) was 70.1%, 65.4%, and 62.6% in the HA group and 34.3%, 29.4%, and 22.0% in the CA group, respectively ( P < 0.001); off AADs was 57.1%, 52.7%, and 50.0% in the HA group and 25.0%, 16.2%, and 11.5% in the CA group ( P < 0.001); on AADs after redo CA was 76.2%, 73.7%, and 73.7% in the HA group and 43.6%, 43.6%, and 38.2% in the CA group, respectively ( P < 0.001); off AADs after redo CA was 62.5%, 60.1%, and 60.1% in the HA group and 30.4%, 25.1%, and 20.9% in the CA group, respectively ( P < 0.001).

Conclusions:

For patients with NPAF and enlarged left atrium, hybrid biatrial ablation was superior to CA in sinus rhythm maintenance even if redo CA was performed.
Is There a Relationship Between Body Mass Index and Eating Disorder Symptoms in Professional Male Fashion Models?
Authors: Ralph-Nearman Christina , Hooper Madison A. , Achee Margaret , Tomarken Andrew , Filik Ruth
Published: September 2024

This study is the first to examine the utility of body mass index (BMI) as an indicator of eating disorder (ED) pathology and fitness for employment for professional male fashion models. We assessed the relationship between experimenter-measured BMI, muscle mass, body fat percentage, and ED severity (EDE-Q score) in male models and nonmodels. Except for higher eating concern, the two groups displayed similar EDE-Q scores after controlling for age. Models relative to nonmodels endorsed significantly greater frequency of compulsive exercise and self-induced vomiting as a means of controlling shape or weight. BMI was a poor indicator of body fat percentage in models. Lower BMI in models, and higher BMI in nonmodels, was associated with higher EDE-Q scores. Interestingly, all the male models with clinically significant EDE-Q scores (≥4.0) had >18.5 experimenter-measured BMI. Higher muscle mass in models, and lower muscle mass in nonmodels, was associated with higher EDE-Q scores. Inversely, lower percentage body fat in models, and higher percentage body fat in nonmodels, was associated with higher EDE-Q scores. BMI, muscle mass, and percentage body fat were associated with ED tendencies in male models and nonmodels. Findings also suggest males with clinical ED symptoms would be overlooked if only low BMI (<18.5) was considered. These results may guide the development of more effective mandates to safeguard models’ wellbeing, and men generally.
Research on the influence of environment temperature and running condition on the driving range of battery electric vehicle
Authors: Jin Guoqing , Zhao Chen , Zhang Xing , Deng Xing , Wang Tao , Zhang Bo , Luo Baoquan , Huang Tao
Published: September 2024

Reduction of the driving range under either cold temperature or real-world running condition has become the biggest challenge for battery electric vehicle (BEV). In this paper, a simulation platform that combines a kinematics model, a thermal management model, and extracted typical running conditions has been established to estimate the energy flows inside the electric vehicle under cold temperature and real-world running condition. Three vehicles have been selected to validate the accuracy of the simulation platform, giving an accuracy between 90.6% and 96.6% according to different running conditions. Under highway running condition, the driving range could be reduced by 54%. Under urban running condition, when the environment temperature drops down to −20°C, the driving range is only 49.1% of that under 20°C. In addition, there could be a 4.4% increase in driving range if the target cabin temperature could be decreased from 28°C to 20°C. According to simulation, the application of motor waste heat recovery, internal gas recirculation, and heat pump, could increase the driving range at −7°C under urban running condition by 3.5%, 2.9%, and 3.9%, indicating a 10.3% improvement in total. This has been validated via experimental test after implementing these three approaches onto the test vehicle.
Wheel loader seat damping control research based on ADRC
Authors: Bin Chen , Wei Tao
Published: September 2024

This paper proposes a new type of damped multi-mode switching damper based on a high-speed switching solenoid valve. The structural design of the damper is completed, and its working principle of realizing different damping modes is analyzed. A damping characteristic model of the damper is constructed, and the change rule of the damping characteristic of the multi-mode switching damper is analyzed. The seat suspension of a wheel loader is equipped with a damper that is controlled by a damping strategy. A 10-degree-of-freedom mixed-logic dynamic model of the seat suspension system is established using HYSDEL, and a multi-mode switching damper is employed. The weight coefficients are adjusted using a self-immunity control strategy, and the hybrid model predictive control method is used to complete the damping control strategy. Simulation results show that, compared with the fuzzy control strategy, the designed wheel loader seat suspension damping active disturbance rejection control (ADRC) strategy not only effectively reduces the root-mean-square (RMS) value of the driver’s vertical vibration acceleration up to more than 40% at different speeds and shock conditions, but also effectively reduces the driver’s vertical vibration acceleration. The ADRC strategy is a robust approach that achieves the desired control objective of the system.
Incorporation of a specialist mental health clinical pharmacist within a primary care network: patient referrals, prescribing decisions, and clinical outcomes
Authors: Henry Rebecca , Baldwin David S.
Published: September 2024

Background:

The benefit of generalist pharmacists working within primary care networks (PCNs) and with general practitioners (GPs) is established. We wished to evaluate the contributions and potential benefits of a specialist mental health care prescribing pharmacist within PCNs.

Method:

We prospectively collected data, on clinical and demographic characteristics, referral sources, interventions, outcomes (objective and subjective), and patient feedback, from 466 completed patients, in one PCN by one specialist mental health pharmacist (working 0.5 whole time equivalent), over 15 months.

Results:

Referrals originated from multiple sources, including GPs, other members of the PCN mental health team, and community mental health teams (CMHTs). Two-thirds of treated patients were female; the most frequent age band was 18–30 years; the most common diagnosis was mixed depression and anxiety. Patients with diagnoses of mixed anxiety with depression or personality disorder needed more appointments than those with anxiety or depression. A range of evidence-based treatments were prescribed, including non-formulary medicines, and those medicines are more typically initiated or recommended in secondary care settings. The most frequently started medications were antidepressants (principally fluoxetine and duloxetine), followed by antipsychotics (principally quetiapine and aripiprazole): the most common dosage increases were for sertraline and quetiapine. Common non-medication recommendations were for cognitive behavioral therapy, cognitive behavioral therapy for insomnia, and other psychological therapies. Patient feedback was generally positive.

Discussion:

Developing and implementing a service incorporating a specialist mental health pharmacist within a PCN mental health team is potentially valuable in improving patient care quality, reducing workload for GPs and CMHTs, and enabling faster access to secondary care initiated and recommended medications. This innovative service addressed several national targets, including prevention, early intervention, and access to quality compassionate care.
Coadministration of isavuconazole and sirolimus in allogeneic hematopoietic stem cell transplant recipients
Authors: Farina Francesca , Acerbis Andrea , Oltolini Chiara , Chiurlo Matteo , Xue Elisabetta , Clerici Daniela , Marktel Sarah , Mastaglio Sara , Bruno Alessandro , Piemontese Simona , Diral Elisa , Orofino Giorgio , Campodonico Edoardo , Corti Consuelo , Teresa Lupo Stanghellini Maria , Scarpellini Paolo , Dell’Acqua Raffaele , Castagna Antonella , Peccatori Iacopo , Ciceri Fabio , Greco Raffaella
Published: September 2024

Background:

Invasive fungal infections (IFIs) represent a major cause of morbidity among allogeneic hematopoietic stem cell transplantation (allo-HSCT). Isavuconazole (ISA) is a broad-spectrum triazole with favorable safety profile.

Objectives and design:

Herein, we evaluate the real life coadministration of ISA and sirolimus in allo-HSCT recipients in a single-center retrospective analysis, describing clinical efficacy, safety, and therapeutic drug monitoring (TDM) of both drugs.

Methods:

All consecutive allo-HSCT recipients who received the coadministration of ISA and sirolimus for at least 2 weeks between July 2017 and December 2022 were included in this retrospective analysis. TDM was longitudinally performed during treatment. IFIs were classified according to the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus criteria.

Results:

A total of 51 recipients were included in the analysis. A total of 17 patients received ISA as continuous antifungal treatment for IFI diagnosed before transplant: one patient experienced a probable invasive pulmonary aspergillosis, and one patient switched from ISA to liposomal amphotericin B for a possible IFI. A total of 34 patients started ISA as antifungal therapy for IFI diagnosed after transplant. Sixteen of 34 were treated for a proven/probable breakthrough IFI during mold-active prophylaxis: 6/16 patients died for IFI after a median of 51 days of ISA. Eighteen of 34 started ISA as empirical therapy for a possible IFI: 15/18 patients were alive with resolution of infection after 6 weeks, 1 died for disease progression, and 2 had empirically changed antifungal therapy due to pneumonia progression. Clinical and radiological response rate was 68% after 90 days from IFI diagnosis. No toxicities related to drug–drug interaction have been registered in patients reaching concomitant therapeutic levels of ISA and sirolimus.

Conclusion:

The coadministration of ISA and sirolimus was safe and feasible in this cohort, confirming favorable clinical efficacy in patients with multiple-drug coadministration.
Tug of war between clozapine and CYP450 inducers: A case report
Authors: Taneja Gaurav , Leontieva Luba
Published: September 2024

The management of schizoaffective disorder bipolar type often involves a combination of pharmacotherapy and psychotherapy. Clozapine, an effective antipsychotic for treatment-resistant schizophrenia, and oxcarbazepine, a mood stabilizer, is a commonly prescribed medication. We present a case report of a 56-year-old male with schizoaffective disorder bipolar type who experienced subtherapeutic clozapine levels despite dose adjustments, leading to deteriorating symptoms. Oxcarbazepine, a weak CYP450 inducer, likely contributed to the subtherapeutic levels. Additionally, the pharmacogenetic analysis revealed a CYP1A2 *1F/*1F genotype, indicating normal activity with a potential for decreased serum levels and adverse events in the presence of inducers. The patient was eventually stabilized on a regimen of lithium, paliperidone, and quetiapine, avoiding oxcarbazepine. This case highlights the importance of considering individual patient factors, including pharmacogenetics when managing treatment-resistant patients. Monitoring serum clozapine levels and assessing enzyme activity before initiating therapy may help optimize treatment outcomes and minimize adverse events.
End-of-Life Care Among Patients With Kidney Failure on Maintenance Dialysis: A Retrospective Population-Based Study
Authors: Hafid Shuaib , Isenberg Sarina R. , Fernandes Aleisha , Gallagher Erin , Webber Colleen , Joseph Meera , Sood Manish M , Bruni Adrianna , Davis Janet L. , Warmels Grace , Downar James , Gayowsky Anastasia , Jones Aaron , Manuel Doug , Tanuseputro Peter , Howard Michelle
Published: September 2024

Background:

Nephrologists routinely provide end-of-life care for patients with kidney failure (KF) on maintenance dialysis. Involvement of primary care and palliative care physicians may enhance this experience.

Objective:

The objective was to describe outpatient care patterns in the last year of life and the end-of-life acute care utilization for patients with KF on maintenance dialysis.

Design:

Retrospective cohort study using population-level health administrative data.

Setting & Participants:

Outpatient and inpatient care during the last year of life among patients who died between 2017 and 2019, receiving maintenance dialysis in Ontario, Canada.

Measurements:

The primary exposure is patterns of physician specialties providing outpatient care in the last year of life. Outcomes include outpatient encounters in the last year of life, acute care visitation in the last month of life, and place of death.

Methods:

We reported the count and percentage of categorical outcomes and the median (interquartile range) for numeric outcomes. We produced time series plots of the mean monthly percentage of encounters to different specialties stratified by physician specialty patterns. We evaluated differences in outcomes by physician specialty patterns using analysis of variance (ANOVA) and Pearson’s chi-square tests ( P < .05, two-tailed).

Results:

Among 6866 patients, the median age at death was 73, 36.1% were female, and 87.8% resided in urban regions. Three patterns emerged: a primary care, nephrology, and palliative care triad (25.5%); a primary care and nephrology dyad (59.3%); and a non-primary care pattern (15.2%). Palliative care involvement is concentrated near death. Of all, 81.4% spent at least 1 day in hospital or emergency department in the last month, but those with primary care, palliative care, and nephrology involvement had the fewest acute care deaths (65.8%).

Limitations:

Outpatient care patterns were defined using physician billing codes, potentially missing care from other providers.

Conclusions:

Nephrology and primary care predominantly manage outpatient care in the last year of life for patients with KF on maintenance dialysis, with consistent acute care use across care patterns except for the place of death. Future research should explore associations between patterns of care and end-of-life outcomes to identify the most optimal model of care for patients with KF on maintenance dialysis.
The Theory of Corporate Social Advocacy (CSA) Success: A Guide to CSA Success Using Moral Foundations Theory, Balance Theory, and CSA Authenticity
Authors: Parcha Joshua M.
Published: September 2024

Corporate social advocacy (CSA) can be sometimes successful—and sometimes unsuccessful—for corporations. These conflicting outcomes of CSA place corporations and their managers in a difficult position: When a corporation engages in CSA, how will the corporation and its managers know if the CSA is going to be successful or unsuccessful? To answer this dilemma, the purpose of this article is to provide a theoretical basis for what leads to CSA being more or less successful. The article looks at how an individual is likely to react to a corporation’s CSA by combining moral foundations theory, balance theory, and CSA authenticity. The main contribution of the theory of CSA success is that it discovers and maps out the first routes by which CSA can be done successfully, as well as provides guidance on how to identify where the CSA went off course if the CSA is determined to be unsuccessful.