bluuebunny/crossref_metadata_2025 huggingface dataset:
Advice to the Earl of Rutland on his travels
Authors: Vickers Brian
Published: December 2024

Letter I

My Lord,

I hold it for a principle in the course of intelligence of state,° not to discourage men of mean sufficiency° from writing unto me, though I had at the same time very able advertisers;° for...
Of the Colours of Good and Evil [Selections]
Authors: Vickers Brian
Published: December 2024

In deliberati ves° the point is, what is good and what is evil, and of good what is greater, and of evil what is the less.

So that the persuader’s labour is to make things appear good or evil, and that in higher or...
Poems and Psalms
Authors: Vickers Brian
Published: December 2024

‘The world’s a bubble’
The Last Book or Act
Authors: Sidney Sir Philip
Published: December 2024

The dangerous division of men’s minds, the ruinous renting of all estates, had now brought Arcadia to feel the pangs of uttermost peril (such convulsions never coming but that the life of that government draws near his necessary period), when to the honest and...
Niccolò Machiavelli to Zanobi Buondelmonti and Cosimo Rucellai, Greetings
Authors: Machiavelli Niccolò
Published: December 2024

I am sending you a present which, though it may not meet my obligations to you, is of such a kind that it is, without a doubt, the best gift Niccolò Machiavelli could send to you, for in it I have conveyed as much as...
On the Religion of the Romans
Authors: Machiavelli Niccolò
Published: December 2024

Although Rome had Romulus as its first organizer, and, like a daughter, had to recognize that she owed her birth and upbringing to him, since the heavens judged that Romulus’ institutions would not suffice for so great an empire, they inspired the Roman senate to...
Well-Organized Republics Establish Rewards and Punishments for Their Citizens but Never Compensate One With the Other
Authors: Machiavelli Niccolò
Published: December 2024

The merits of Horatius were very great, since with his skill he had overcome the Curiatii; his offence was atrocious, since he murdered his sister. The Romans, nevertheless, were so angered by this homicide that they put him on trial for his life despite the...
Weak Republics Are Indecisive and Do Not Know How to Reach Decisions; If They Ever Do Take Sides, This Arises More by Necessity Than by Choice
Authors: Machiavelli Niccolò
Published: December 2024

With a very serious plague in Rome, it seemed to the Volscians and the Aequi that the time had come to attack Rome, and after these two peoples had raised an enormous army, they attacked the Latins and the Hernici, and after laying waste to...
It Is a Bad Example Not to Observe a Law that Has Been Passed, Especially on the Part of Its Author; and It Is Extremely Harmful to the Ruler of a City to Open New Wounds Every Day
Authors: Machiavelli Niccolò
Published: December 2024

When the agreement had been made to return Rome to its ancient form of government, Virginius summoned Appius to appear before the people to argue his case. He appeared, accompanied by many noblemen, and Virginius ordered him to be imprisoned. Appius then began to cry...
No One Council or Magistrate Should Be Capable of Blocking Legal Actions in Cities
Authors: Machiavelli Niccolò
Published: December 2024

When Titus Quinctius Cincinnatus and Cnaeus Julius Mento were consuls* in Rome, they blocked all the legal actions of that republic by being disunited. Realizing this, the senate supported the creation of a dictator to do what their disagreements prevented them from doing....
The Multitude Is Wiser and More Constant Than a Prince
Authors: Machiavelli Niccolò
Published: December 2024

Nothing is more unreliable or inconstant than a crowd of people: so affirms our Livy, like all the other historians. It often occurs that in recounting the deeds of men we see the crowd has condemned someone to death and has later lamented this fact...
Whether It Is Preferable, Fearing an Assault, to Start a War or to Await Its Outbreak
Authors: Machiavelli Niccolò
Published: December 2024

I have overheard men very experienced in warfare debate this question on occasion: if there are two princes of almost equal power and the bolder one has declared war on the other, what would be the best choice for the second prince: to wait for...
How Far the Soldiers of Our Times Have Strayed from Ancient Institutions
Authors: Machiavelli Niccolò
Published: December 2024

The most important battle the Roman people ever fought in any war with any nation was the one they fought with the Latin peoples during the consulate of Torquatus and Decius. Every argument confirms that, just as the Latins became slaves by having lost the...
To What Extent the Romans Avoided a Middle Course of Action in Passing Judgements on Subjects for Some Incident Requiring Such a Verdict
Authors: Machiavelli Niccolò
Published: December 2024

‘The situation in Latium was already one where peace and war were equally intolerable.’*

Of all the unhappy situations, the most unhappy is that of a prince or a republic reduced to a state where it can neither accept the peace nor continue...
Fortresses Are Generally Much More Harmful Than Useful
Authors: Machiavelli Niccolò
Published: December 2024

To the wise men of our times, it will perhaps seem a matter not well considered that the Romans, in their desire to secure themselves from the peoples of Latium and the city of Privernum, did not think of building fortresses, which would...
Victory Should Be Sufficient for Prudent Princes and Republics, for Most Often When It Does Not Suffice, They Lose
Authors: Machiavelli Niccolò
Published: December 2024

Employing insulting words against the enemy arises, in most instances, from an insolence you gain either from victory or from the false hope of victory; this false hope makes men err not only in their speech but also in their actions. For when this kind...
In Order for a Religion or a Republic to Have a Long Life, It Is Often Necessary to Bring It Back to Its Beginnings
Authors: Machiavelli Niccolò
Published: December 2024

It is very true that all the things of this world have a limited existence, but those which go through the entire cycle of life ordained for them by heaven are generally those which do not allow their bodies to fall into disorder but maintain...
The Reasons Why the French Have Been and Are Still Considered More Than Men at the Outset of a Battle and, Later on, Less Than Women
Authors: Machiavelli Niccolò
Published: December 2024

The ferocity of that Gaul who provoked some Roman, near the River Anio, to engage him in combat, and then the struggle between him and Titus Manlius, reminds me of what Livy says on many occasions: that is, at the beginning of a battle the...
If a Republic Is to Be Kept Free, Each Day It Requires New Measures; and the Good Qualities for Which Quinctius Fabius Was Called Maximus
Authors: Machiavelli Niccolò
Published: December 2024

Every day in a great city, as has been said many times, accidents necessarily arise that require a physician, and the more important such accidents are, the more necessary it is to find the wisest physician. If such accidents ever arose in any city, they...
Letters on the Sunspots
Authors: Galilei Galileo
Published: December 2024

First Letter of Galileo Galilei to Mark Welser* Concerning the Sunspots, in Reply to His Letter

Illustrious Sir and worshipful patron,

The letter which you were so kind as to send to me three months ago has long remained unanswered, as various impediments have...
The Complete Fairy Tales
Authors: Perrault Charles
Published: December 2024

Charles Perrault’s versions gave classic status to the humble fairy tale, and it is in his telling that the stories of Little Red Riding-Hood, Sleeping Beauty, Cinderella and the rest have been passed down from the seventeenth century to the present day. Perrault’s tales were enjoyed in the salons of Louis XIV as much as they were loved in the nursery, and it is their wit, humour, and lively detail that capture the imagination of adult and child alike. They transmute into vivid fantasies the hidden fears and conflicts by which children are affected: fears of abandonment, or worse, conflicts with siblings and parents, and the trials of growing up.

In addition to the familiar stories, this edition also includes the three verse tales - the troubling account of patient Griselda, the comic Three Silly Wishes, and the notorious Donkey-Skin. This new translation by Christopher Betts captures the tone and flavour of Perrault’s world, and the delightful spirit of the originals.
Puss in Boots
Authors: Perrault Charles
Published: December 2024

A
miller who had three children left nothing for them to inherit, except for the mill, a donkey, and a cat. These bequests did not take long to share out, and neither the solicitor nor the notary* were called in: their fees...
The Land of Caldilhe
Authors: Mandeville John
Published: December 2024

Now, I’ve described and mentioned many countries on this side of the kingdom of Cathay, many of which are obedient to the Great Khan. Now I shall describe regions, countries, and islands that are beyond the land of Cathay. Therefore, should one go from...
Vafthrudnir’s Sayings
Authors: Larrington Carolyne
Published: December 2024

As the Seeress’s Prophecy, Sayings of the High One, and Grimnir’s Sayings show, Odin is characterized by his obsessive quest for wisdom, particularly for information about Ragnarok. In this poem he sets off, against his wife’s advice, disguised as...
Fetal MRI deep learning segmentation of body and lung in congenital diaphragmatic hernia
Authors: Bischoff Leon M , Nowak Sebastian , Mader Maximilian , Theis Maike , Vollbrecht Thomas , Isaak Alexander , Kuetting Daniel , Pieper Claus C , Geipel Annegret , Kipfmueller Florian , Strizek Brigitte , Sprinkart Alois M , Luetkens Julian A
Published: December 2024

Purpose

To determine if deep learning (DL) segmentation of total fetal body volume (TFBV) and total fetal lung volume (TFLV) in fetuses with congenital diaphragmatic hernia has comparable performance to manual segmentation.

Materials and Methods

A total of 208 fetal MRI studies with congenital diaphragmatic hernia, acquired between August 2007 and September 2023, were retrospectively included. TFBV and TFLV were extracted from manual tissue segmentations in balanced gradient echo and single shot T2-weighted turbo spin echo sequences. MRI studies were split into training (n = 188) and hold-out test data (n = 20). Wilcoxon signed-rank test was used to compare manual and DL-based segmentations by 2 U-Nets. Manual and DL segmentation times were noted and compared using Student’s t-test. The observed/expected ratio of the total lung volume (O/E TLV) as a prognostic marker for postnatal survival was calculated. Outcome predictions of O/E TLV for postnatal death were assessed with univariate regression analysis.

Results

Manual segmentation times were higher compared to DL segmentations (30 ± 7 minutes versus 0.25 ± 0.05 minutes, P < .001). Manual and DL-based TFBV were similar (1317 ± 498 mL versus 1306 ± 491 mL; P = .04; Dice score: 0.98 ± 0.01). TFLV (19.4 ± 11.5 mL versus 18.7 ± 12.4 mL; P = .11; Dice score: 0.84 ± 0.09) and O/E TLV (39.3 ± 18.1 mL versus 37.7 ± 19.1 mL, P = .13) were not significantly different. Postnatal mortality was negatively associated with higher manual O/E TLV (odds ratio: 0.97; 95% confidence interval [CI], 0.96–0.98; P < .001) and DL O/E TLV (odds ratio: 0.97; 95% CI, 0.96–0.98; P < .001).

Conclusion

DL for body and lung segmentation in fetuses with congenital diaphragmatic hernia allows reliable and rapid calculations of the observed/expected ratio and equally predicts prognostic outcome.
On modes of disease transmission and the hidden shape of pandemics: A review of Asymptomatic by Joshua Weitz
Authors: Ogbunugafor C. Brandon
Published: December 2024

The importance of asymptomatic transmission was a key discovery in our efforts to study and intervene in the COVID-19 pandemic. In Asymptomatic (Johns Hopkins University Press, 2024), Joshua Weitz uses this aspect of SARS-CoV-2 natural history to discuss many counterintuitive characteristics of the pandemic. In this essay, I engage the arguments in the book, and discuss why asymptomatic transmission is such a critical dimension of the study of infectious diseases. I explore ideas contained within Asymptomatic and connect them to related issues in evolutionary virology and disease ecology, including epistemic uncertainty and the evolution of virulence. Furthermore, I comment on the broader messages in the text, including the gap between scientific knowledge and social understanding.
Addiction
Authors: Glasner Suzette
Published: December 2024

Addiction: What Everyone Needs to Know provides an overview
of the key concepts surrounding addiction. It primarily aims to clarify the polarizing and misleading
information dominating public opinion with regard to addiction. University of California’s Associate
Professor of Psychiatry Suzette Glasner-Edwards raises important questions related to addiction and
answers them in an accessible yet empirically informed manner. Addiction: What Everyone Needs to
Know also presents the forms of treatments and complications aimed toward addiction after
discussing the origins of addiction. It indicates that the straightforward work and sound guidelines are
primarily aimed at the general public alongside health professionals and policymakers.
What Does Vaping Do to the Brain and Behavior?
Authors: Glasner Suzette
Published: December 2024

This chapter considers the impact of vaping on
the brain and behavior. It mentions juuls and e-cigarettes as widely known vaping
devices. Vaping devices are what people use to inhale or breathe in an aerosol, which
usually contains nicotine, flavorings, and other chemicals. The chapter also explores
the health risks of dabbing, wherein people smoke or vape marijuana extracts, and
dripping, wherein people produce and inhale vapors by placing e-liquid drops directly
onto heated atomizer coils. It offers treatments for tobacco cessation that are
relatively easy for smokers to access, such as medications, behavioral therapy, or a
combination of both approaches.
What Do Opioids Do to the Brain and Behavior?
Authors: Glasner Suzette
Published: December 2024

This chapter examines the impact of opioids on
the brain and behavior. It starts with the dangerous and widespread impact of opioids in
the media that dramatically plagued the nation for over eight years. Commonly used
prescription opioids are prescription analgesics, heroin, and synthetic opioids. The
chapter mentions the prevalence of opioid usage among teens due to curiosity, peer
pressure, and the desire to fit in with friends. It cites that medications combined with
behavioral counseling are the most effective treatment approach for opioid use
disorders, before suggesting several Food and Drug Administration (FDA) approved
medications such as buprenorphine, methadone, and extended-release naltrexone.
Metals
Authors: Weis Judith S.
Published: December 2024

The major sources of metal pollution are discussed
(industrial sources; mining, including the new threat of deep-sea mining; and atmospheric
deposition). Highly contaminated sites are described, including the tragic events that occurred
in the 1960s in Minamata Japan, which made the world aware of the health consequences of mercury
pollution. Various toxic effects in marine animals, including developmental and neurotoxic
effects on invertebrates and fish, are covered. The importance of where in cells the metals are
stored is discussed in terms of its influence on the degree of toxicity. Ways of reducing
metal-polluted sediments, such as capping, natural attenuation, confined aquatic disposal, and
phytoremediation are discussed.
Pesticides and Industrial Organic Chemicals
Authors: Weis Judith S.
Published: December 2024

The early insecticides—chlorinated hydrocarbons—were
persistent, bioaccumulative, and toxic to many other forms of life, and the book Silent
Spring by Rachel Carson awoke the world to the problems of chemical pollution in
the 1960s. These chlorinated hydrocarbons were eventually banned. Since then, newer pesticides
are less persistent, but nevertheless still toxic to many non-target species including marine
life, especially crustaceans which are related to insects. Industrial organic chemicals that are
not meant to be pesticides may have similar devastating effects on marine and terrestrial
animals, including developmental problems and endocrine disruption. Some of these are
chlorinated, like polychlorinated biphenyls (PCBs), which have also been banned, and dioxin,
which was never made on purpose but is created accidentally as a byproduct of other chemical
reactions.
Puerto Rico as a US Commonwealth Since 1952
Authors: Duany Jorge
Published: December 2024

This chapter examines the politics and economy of Puerto
Rico as a US Commonwealth since 1952. The United Nations removed Puerto Rico from its list of
non-self-governing territories, so the Island was officially no longer considered a US colony
after its new Commonwealth status was proclaimed on July 25, 1952. The Commonwealth formula did
not substantially alter the Island’s legal, political, and economic dependence on the United
States. Thus, under Commonwealth status, Puerto Rico continued to be an unincorporated territory
that belonged to but was not a part of the United States. Moreover, Puerto Rico meets most of
the objective and subjective criteria of conventional views of the nation. The chapter then
introduces Operation Bootstrap, Puerto Rico's industrialization program.
Cardiovascular Effect of Drugs Used to Treat Alzheimer’s Disease
Authors: Eng Shirley , Aifuwa Esewi , Frishman William H. , Aronow Wilbert S.
Published: December 2024

This review examines the cardiovascular effects of the mainstay drugs used to treat Alzheimer’s disease (AD), namely cholinesterase inhibitors (ChEIs) and memantine. ChEIs represent the current first-line treatment for AD. Memantine is typically reserved for moderate to severe AD. Conventionally, ChEIs are thought to increase vagal tone, resulting in an increased risk of cardiac side effects such as bradycardia. However, emerging evidence suggests that ChEIs may offer a protective role on overall cardiovascular mortality in patients with dementia. Similarly, memantine, which is an N-methyl-D-aspartate receptor antagonist, has demonstrated cardioprotective properties in animal studies, raising the question of its clinical applications. Recently, aducanumab and lecanemab, antiamyloid-β monoclonal antibodies that aim to slow the progression of disease, have been Food and Drug Administration-approved for the treatment of AD. This review explores the current evidence regarding potential cardiovascular risks and protective effects of ChEIs and memantine in the treatment of AD, as well as the cardiovascular effects of aducanumab and lecanemab.
Retinal Racemosal Hemangioma Associated with Intracranial Vascular Malformation (Wyburn -Mason Syndrome) – Case Report
Authors: Arredondo-Cardona Susan D. , Contreras-Duque Natalia , Martínez-Blanco Alexander M. , Bonilla-Escobar Francisco J.
Published: December 2024

Purpose:

To describe a case of Wyburn-Mason syndrome in a young child with initially declined treatment leading to delayed intervention.

Methodology:

Case report.

Results:

We report a 6-year-old boy with mild periocular trauma following a fall, who was incidentally found to have a retinal arteriovenous malformation (AVM) associated with a brain AVM, indicative of Wyburn-Mason Syndrome. The patient's visual exam was unremarkable except for a visual acuity of 20/150 in the right eye, corrected to 20/60, and 20/30 in the left eye, along with mild proptosis and facial asymmetry. Radiosurgical management was proposed but declined by the caregivers due to fear of complications. Eighteen months later, the patient presented with neurological deterioration, manifesting as left hemiparesis. The patient received antiangiogenic therapy with sirolimus (inhibitor of the mammalian target of rapamycin, mTOR) and underwent a catheter-based embolization procedure that partially occluded the brain AVM without complications. The patient showed partial recovery of strength but experienced a deterioration in visual acuity in the right eye to 20/400.

Conclusion:

This report highlights an extremely rare malformation that associates ocular and cerebral vascular malformations. It underscores the importance of correlating various signs and symptoms to suspect it and emphasizes the need for adherence and follow-up.
An Infiltrative Choroidal Lesion
Authors: Li Yanliang , Gabr Hesham , Mieler William F
Published: December 2024

Purpose:

To present a distinctive case of primary choroidal lymphoma diagnosed by choroidal biopsy with MYD88 testing

Methods:

We describe the case of a 55-year-old male with unilateral progressive blurry vision. Fundus examination found a whitish/yellowish infiltrative lesion in the posterior pole with macular edema, which had interval improvement with oral prednisone, followed by worsening on OCT with persistent subretinal hyper-reflective materials.

Results:

As the initial Pars plana vitrectomy/vitreous biopsy and choroidal fine needle aspiration biopsy (FNAB) were inconclusive, the second FNAB was performed with an additional MYD88 genetic test and revealed a rare in-frame deletion of MYD88 (p.D288_T294del) in the choroidal sample.

Conclusion:

The diagnosis of PCL was eventually established. After treatment with methotrexate, followed by external beam radiotherapy, the choroidal infiltrate was normalized on B scan.
The Organic Farmer Safety, Health & Life Questionnaire (OFSHLQ): A Tool for an Expanded Paradigm on Occupational Safety and Health
Authors: Mas Francisco Soto , Hsiao Yu-Yu , Ji Ming , Zhao Shixi
Published: December 2024

Objective

Develop and validate a multidimensional tool consistent with an expanded occupational safety and health (OSH) paradigm.

Methods

Systematic development process; cross-sectional survey design for psychometric properties. Exploratory factor analyses (EFA) and reliability estimates on key theoretical constructs.

Results

The Organic Farmer Safety, Health & Life Questionnaire (OFSHLQ) is a population-specific, theory-based, multilevel tool that integrates work and life dimensions. The development process contributed to face and content validity. The EFA identified 11 scales with acceptable factor loadings. Reliability estimates across scales ranged from 0.58 to 0.92.

Discussion

OFSHLQ integrates traditional dimensions of OSH and other intrapersonal, interpersonal, and contextual factors that contribute to overall workers’ health and well-being.

Conclusion

OFSHLQ constitutes a resource for traditional OSH surveillance and research, and is also consistent with an expanded paradigm of OSH.
Economic Evaluations of Worksite Health Centers: A Systematic Review
Authors: Jiang Hanzi , Schwirtlich Tim , Beestrum Molly , French Dustin D. , McHugh Megan
Published: December 2024

Objective

To systematically review the cost-effectiveness or return on investment (ROI) from worksite health centers (WHCs) in the US.

Methods

We searched four databases and the grey literature for studies that conducted economic evaluation and provided economic outcomes of US-based WHCs. The quality and risk of bias were assessed using JBI Critical Appraisal Tools of Economic Evaluations.

Results

Ten studies met the inclusion criteria. Nine reported WHCs were cost-effective or yielded positive ROI for employers, with annual cost savings per WHC ranging from $35,479 to $2,124,723 and ROI from $1.09 to $15.88 per $1 of investment. Key contributors to higher ROI included company size, utilization, and duration of operations.

Conclusion

WHCs may provide economic savings for large employers. Future studies should consider clinical effectiveness and service quality and investigate the specific mechanisms driving employer cost savings.

Protocol Registration: PROSPERO (CRD42024506086)
Psychosocial risks and resources at work and employee wellbeing in the context of the COVID-19 pandemic: time series of cross-sections
Authors: Ervasti Jenni , Airaksinen Jaakko , Pentti Jaana , Kausto Johanna , Joensuu Matti , Oksanen Tuula , Kivimäki Mika , Vahtera Jussi
Published: December 2024

Objective

We examined the relationships between psychosocial factors and employee wellbeing in the context of the COVID-19 pandemic.

Methods

Survey data were from Finnish public sector employees from 2018 (T1 = before), 2020 (T2 = during), and 2022 (T3 = after the pandemic) (n = 29,360). Employee wellbeing was measured with self-rated health, work ability, and recovery from work. The generalized linear models using Poisson distribution were adjusted for age, sex, socioeconomic status, obesity, and health behaviors.

Results

Psychosocial factors were associated with suboptimal employee wellbeing in every timepoint. The association between high effort-reward imbalance and suboptimal work ability was strongest during the pandemic (risk ratio 1.53, 95% confidence interval 1.47-1.59). The association between high job strain and suboptimal recovery from work was stronger during the pandemic (1.49, 1.46-1.52) than post-pandemic (1.45, 1.43-1.48).

Conclusions

Job stress had the strongest associations with suboptimal wellbeing during the pandemic.
Robotic-Assisted Microsurgery in Gender-Affirming Phalloplasty
Authors: Wellenbrock Sascha , Ozturk Mahmut , Sohn Michael , Puehse Gerald , Cremers Jann-Frederik , Wessel Kai , Hirsch Tobias , Kueckelhaus Maximilian
Published: December 2024

Genital gender-affirming masculinization surgeries require handling of small vessels and nerves handling in deep planes. Since the introduction of the Symani Surgical System for robotic-assisted microsurgery in clinical practice, its value in handling small and deep vessels via additional distal motion axes, motion scaling, and tremor elimination has been demonstrated. We combined the Symani with the robotic exoscope RoboticScope to achieve maximum flexibility and ergonomics for the microsurgeon. Here, we present the initial application of robotic-assisted microsurgery for gender-affirming phalloplasty. The Symani and the RoboticScope were used to perform the end-to-side nerve coaptation of the lateral antebrachial cutaneous nerve to the dorsal nerve of the clitoris with five epineural 9.0 Ethilon sutures. Arterial anastomosis to the deep inferior epigastric artery (DIEA) was completed in an end-to-end fashion with six 8.0 Ethilon sutures. Cephalic vein anastomosis to the great saphenous vein was performed manually in an end-to-end fashion using a 3.5-mm coupler. The time for nerve coaptation was 17 minutes; for arterial anastomosis, 26 minutes; and for vein anastomosis, 6 minutes. Time for flap ischemia was 157 minutes. Incision to closure was performed in 401 minutes. Symani's tremor elimination and motion scaling support precise arterial anastomosis and nerve coaptation. The additional degrees of freedom distal to the tips of the instruments enable flexible operation in deep planes, such as the periclitoral space. Combining Symani with a robotic exoscope enables a comfortable remote positioning for the surgeon. The presented case demonstrates feasibility and encourages further exploration to elucidate the potential benefits of this robotic-assisted technique.
Increasing Popularity of Tattoo-Only Nipple-Areolar Complex Reconstruction
Authors: Byrnes Yasmeen M. , Lin Yu An , Kwon Catherine M. , Agarwal Nitesh , Wang Shengxuan , Kauffman Christian A.
Published: December 2024

Background

Nipple-areolar complex (NAC) reconstruction can be broadly categorized into surgical reconstruction, tattooing, or both. NAC tattooing has shown continued advances recently, resulting in increased discussion of tattoo-only methods within the literature.

Objective

This study aims to quantify recent trends in choice of NAC reconstruction and explore driving factors.

Methods

Patients who underwent postmastectomy breast and NAC reconstruction between January 2007 and December 2021 at a single academic institution were reviewed and grouped based on method of NAC reconstruction: (1) surgical-only, (2) tattoo-only, and (3) both surgical and tattoo. Trends were assessed in each group using Poisson regression.

Results

The study included 138 patients; 17.4% (n = 24) were in the surgical-only group, 16.7% (n = 23) tattoo-only, and 65.9% (n = 91) both surgical and tattoo. Over the 15-year period, patients receiving tattoo-only NAC reconstruction significantly increased (β = 0.173, P < 0.0001), while those receiving both surgical and tattoo significantly decreased (β = −0.064, P = 0.007). There were no significant changes in surgical-only (β = 0.013, P = 0.563) or total (any type) NAC reconstruction (β = −0.013, P = 0.503). Rates of breast reconstruction significantly increased (β = 0.062, P < 0.0001). Variables such as autologous versus implant-based, unilateral versus bilateral, revision number, and radiation were stable over time and were not significantly associated with NAC reconstruction method.

Conclusions

There is a significant trend toward tattoo-only and away from surgical-only reconstruction over the past 15 years, highlighting the importance of access to tattoo-based NAC reconstruction as part of comprehensive breast reconstruction care. The less invasive nature of tattooing and increase in tattoo quality are possible reasons for the increase in popularity.
Morphine Versus Nalbuphine as Intra-Articular Medications Following Temporomandibular Joint Arthrocentesis: A Randomized Clinical Trial
Authors: Bahaa Moataz , Ghanem Amr Amin , Abdelhameed Abdelrahman Mohamed Fahmy , Eissa Ahmed Adel Soliman , El Badawy Fatma Mostafa
Published: December 2024

Purpose:

This study aimed at comparing the therapeutic effect of nalbuphine in comparison to morphine after Temporomandibular joint (TMJ) arthrocentesis in patients with anterior disc displacement without reduction (ADDwoR).

Materials and Methods:

Twenty-four female patients diagnosed with ADDwoR. Patients were treated with TMJ arthrocentesis then randomly divided into parallel groups. Group (A) received an intra-articular injection of 2 mL 10 mg morphine and group (B) received an intraarticular injection of 2 mL 10 mg nalbuphine. Each patient was assessed in terms of maximum mouth opening (MMO), lateral excursions and pain according to visual analogue scale (VAS). Follow-up was made at the intervals of 1 week 1 month, 3 months and 6 months.

Results:

A vast improvement was attained in both groups in all assessment variables with a significant value at the end of the follow-up period in comparison to the preoperative assessment values. Yet there was an insignificant difference between both groups regarding the assessment criteria. However insignificant yet the scales tip slightly towards nalbuphine group.

Conclusion:

Nalbuphine is a highly potent and effective analgesic to be administered post TMJ arthrocentesis in patients with closed lock and highly comparable to that of morphine.
A Clinical Prediction Model For Short-Term Prognosis In Patients With Non Acute Myocardial Infarction Related Cardiogenic Shock
Authors: Wang Xiaoke , Fan Xiaojuan , Wu Taibo , Che Shaopeng , Shi Xue , Liu Peining , Liu Junhui , Luo Yongbai , Wu Yue , Lan Beidi
Published: December 2024

Background

While acute myocardial infarction (AMI) is widely recognized as the primary cause of Cardiogenic Shock (CS), Non-AMI related CS has been excluded from the majority of CS studies. Information on its prognostic factors remains largely understudied, and it is necessary to focus on these patients to identify the specific risk factors. In this study, we aimed to build and validate a predictive nomogram and risk classification system.

Methods

1298 patients and 548 patients with CS from the Medical Information Mart for Intensive Care IV (MIMIC-IV) and MIMIC-III databases were included in the study after excluding patients with acute myocardial infarction. Lasson and logistic regression analysis were used to identify statistically significant predictors which were finally involved in the nomogram. The predictive performance of the nomogram was validated by calibration plots and was compared with other scoring systems by AUC and DCA curves.

Results

Age, heart rate, WBC count, albumin level, lactic acid level, GCS Score, 24 h urine output, and vasopressor use were identified as the most critical factors for in-hospital death. Based on these results, a nomogram was established for predicting in-hospital mortality. The AUC value of the nomogram was 0.806 in the training group and 0.814 and 0.730 in the internal and external validation sets, respectively, which were significantly higher than those of other commonly used Intensive Care Unit scoring systems (SAPSII, APSIII, and SOFA).In addition, the survival curve showed significant differences in the 30-day survival of the three risk subgroups divided by the nomogram.

Conclusion

For non-AMI associated CS, a predictive nomogram and risk classification system were developed and validated, and the nomogram demonstrated good performance in prognostic prediction and risk stratification.
A Risk Score Using a Cell-based Assay Predicts Long-term Over-immunosuppression Events in Kidney Transplant Recipients
Authors: Désy Olivier , Thivierge Marie-Pier , Béland Stéphanie , Desgagnés Jean-Simon , Bouchard-Boivin François , Gama Alcino , Houde Isabelle , Lapointe Isabelle , Côté Isabelle , Lesage Julie , De Serres Sacha A.
Published: December 2024

Background.

Infections and cancer are major causes of premature death in organ recipients. However, there have been few advances in personalized immunosuppressive therapy. We previously reported that a cell-based assay measuring CD14+16+tumor necrosis factor-α+ monocytes after peripheral blood mononuclear cell (PBMC) incubation with Epstein-Barr virus peptides has a high sensitivity for detecting over-immunosuppression (OIS) events in kidney recipients in the short term. We aimed to develop a risk score for predicting long-term events.

Methods.

We studied 551 PBMC samples from 118 kidney recipients. Following random allocation to a testing and training set, we derived a risk function for the delineated tertiles of low, intermediate, and high risk of OIS based on age and CD14+16+tumor necrosis factor-α+ cells.

Results.

Patients were followed for a median of 6.3 y (25th–75th percentiles: 3.7–8.3 y). Of these, 40 (34%) experienced an OIS event. The validation indicated that the risk score was well calibrated, with an absolute risk of 21%, 41%, and 61% in the low-, intermediate-, and high-risk categories, respectively (P = 0.03). In sensitivity analyses, the risk score was robust to alternative definitions of OIS ranging from mild to severe. In particular, when restricted to life-threatening OIS, the proportion of events varied from 5% to 27% among the low- and high-risk categories, respectively (P = 0.01).

Conclusions.

Using a combination of age and in vitro PBMC response to Epstein-Barr virus peptides allows a substantial shift in the estimated risk of OIS events.
Idiopathic Intracranial Hypertension Is Associated With an Increased Risk of Hypertensive Pregnancy Disorders
Authors: Shaia Jacqueline K. , Trinh Ilene P. , Alam Taseen A. , Rock Jenna R. , Chu Jeffrey Y. , Kaelber David C. , Singh Rishi P. , Talcott Katherine E. , Cohen Devon A.
Published: December 2024

Background:

Idiopathic intracranial hypertension (IIH) mainly occurs in women of a reproductive age who are overweight or obese. As pregnancy occurs in this age group, it is important to understand whether there are associations between IIH and pregnancy. The purpose of this study was to determine the incidence of IIH development during a pregnancy and whether IIH is associated with hypertensive disorders of pregnancy (HDP).

Methods:

In this retrospective cohort analysis, electronic health records from a tertiary care center were used to identify patients with IIH. Patients who had a diagnostic code for IIH or papilledema and were seen between June 1, 2012, and September 1, 2023, were included. After meeting the revised Dandy diagnostic criteria, patients were evaluated for a history of pregnancy before, during, or after their IIH diagnosis and hypertensive disorders including preeclampsia/eclampsia, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, and hypertension. Incidence and risk ratios (RR) were calculated comparing patients with IIH with controls without IIH. To corroborate these results while controlling for obesity and migraine, the TriNetX platform housing more than 100 million patients was used to design a case–control analysis evaluating the odds of an IIH patient having an HDP.

Results:

Two hundred ninety-two IIH patients with a prior pregnancy were identified of which 7% developed new onset IIH during pregnancy. Patients had increased risks of all HDP including eclampsia (RR: 12.92, 95% CI: 5.35, 31.22), preeclampsia (2.39, CI 1.84, 3.10), and HELLP syndrome (6.72, CI 2.16, 20.90) compared with controls. Patients with IIH also had higher risks of ectopic pregnancies and miscarriages (P < 0.05). When controlling for obesity and migraine, patients continued to have increased odds of all HDP and eclampsia (P < 0.05).

Conclusions:

Patients with IIH had an increased risk of having an HDP, especially eclampsia and HELLP syndrome highlighting a need for increased clinical monitoring of these patients during pregnancy.
Effect of powder recycling on corrosion mechanism of plasma sprayed Ni625-WC composite coatings
Authors: Wang Qin-Ying , Ma Wen-Qi , Chai Hui , Zhang Xing-Shou , Xi Yu-Chen , Bai Shu-Lin
Published: December 2024

Purpose

This study aims to investigate the effect of powder recycling on the microstructure of plasma-sprayed Ni625-WC composite coating and to verify the feasibility of Ni625-WC powder recycling by comparing the corrosion resistance of the coatings in high-temperature and pressure CO2 environment.

Design/methodology/approach

Recycling powder is an efficient way to improve the utilization rate of metal powder during plasma spraying. The plasma-sprayed Ni625-WC composite coatings with original powder (OC) and recovered powder (RC) were analytically compared by using scanning electron microscope (SEM) equipped with an energy-dispersive spectroscopy, X-ray diffractometer, and X-ray photoelectron spectroscopy. The corrosion resistance of the Ni625-WC composite coatings was characterized in a self-designed high-temperature and pressure autoclave by an electrochemical workstation.

Findings

The results showed that there is massive M23C6 in OC and acicular M23C6 in RC. The WC particles in RC are more uniformly distributed, and the area ratios of WC particles to Inconel 625 matrix are 2.37% higher than OC. RC showed high corrosion resistance, and the recycling of Ni625-WC powder is feasible.

Originality/value

The feasibility of Ni625-WC powder recycling was verified from the microstructure evolution and electrochemical behavior of the coatings.
Influence of locus of control on green buyer behaviour: mediating role of motivation and the moderating role of health consciousness
Authors: Backer Sabana , Prasanth A.P.
Published: December 2024

Purpose

The study investigates the role of locus of control and motivation in predicting green buyer behaviour using social cognitive theory. The study also examines the mediating role of motivation and the moderating role of health consciousness in the relationship between motivation and green consumer behaviour.

Design/methodology/approach

To test the postulated relationships in the study, responses were collected from 410 customers. The study tested validity through confirmatory factor analysis and examined various hypotheses through Process Macros.

Findings

The analysis revealed that the locus of control of the buyer increases green buyer behaviour. The study established a positive relationship between internal and external locus of control and intrinsic and extrinsic motivation, impacting green buyer behaviour. The study also identified evidence supporting the mediating role of intrinsic and the extrinsic motivation and the moderating influence of health consciousness.

Practical implications

The study expands upon current theory by illustrating the association between intrinsic and extrinsic motivation and customers' green purchasing behaviour. It enhances existing literature by identifying health consciousness as a personal factor influencing the connection between motivation and eco-friendly purchasing, urging marketers and policymakers to promote green buying.

Originality/value

To the best of the authors’ knowledge, no prior studies have examined the effect of internal and external locus of control on green buyer behaviour. Through identifying the mediating mechanism and health consciousness as a personal factor, the study enhances both theoretical understanding and practical applications.
3D reconstruction of building interiors based on scan-to-BIM and generative design for as-built building
Authors: Cai Weilang , Hua Dongqi , Li Sihao , Xue Shiwei , Xu Zhao
Published: December 2024

Purpose

BIM technology has a huge potential for improving the renovation efficiency for as-built buildings. However, due to the absence of raw design drawings and the complex interior environment, it is difficult to implement 3D reconstruction of building interiors in interior renovation projects. Therefore, this study proposes a 3D reconstruction framework of building interiors, with an aim to generate building interiors building information modeling (BIM) models quickly and accurately based on scan-to-BIM and generative design.

Design/methodology/approach

The proposed framework begins by reconstructing interior structured elements based on the scan-to-BIM process including collecting accurate information of as-built buildings by laser scanning, obtaining point clouds of structured elements through deep learning and developing an efficient dynamo algorithm workflow for generating structured elements BIM model. For unstructured elements, intelligent layout design and efficient BIM generation are conducted by combining the BIM tools and generative design.

Findings

The successful implementation of the proposed framework in a conference room demonstrated the feasibility of the proposed framework. The semantic segmentation scheme based on deep learning also exhibited excellent recognition and high efficiency for interior structured elements. Furthermore, it is proved that the combination of scan-to-BIM and generative design has high application value in the 3D reconstruction of building interiors.

Originality/value

On one hand, a feasible framework is proposed to generate BIM model of building interiors, improve interoperability among different software tools, streamline the complexity of the scan-to-BIM process and meet the reconfiguration requirement of unstructured elements layout scheme in interior renovation projects. On the other hand, the use of BIM and various emerging technologies can drive digital transformation and further advance the industrialization process of interior renovation in as-built buildings.
Service design in the context of sustainable production and consumption: a case study of elderly fall-protection clothing
Authors: Wang Mingrun , Shaari Nazlina , Abidin Sazrinee Zainal , He Yan
Published: December 2024

Purpose

This study aims to identify the superior service strategies for elderly people in the context of sustainable production and consumption, thereby providing the principles for optimizing the service system of elderly fall-protection clothing.

Design/methodology/approach

This study adopted a new service design methodology that integrates a Kansei Engineering methodology and a customer life cycle. The Kansei Engineering methodology can use psychological methods to grasp customer feelings (or needs) and then transfer the collected data to the design domain by using multivariate statistical analyses. The customer life cycle can simulate all the service activities required by a new service system systematically and logically. In terms of the hypothetical scenarios provided by the customer life cycle, the Kansei Engineering methodology can collect service design elements more effectively and logically, thereby making the Kansei Engineering methodology more adaptable to the requirements of service design and sustainable design.

Findings

The research findings are the service strategies required for a new service system of elderly fall-protection clothing, as well as a new service design methodology that integrates a Kansei Engineering methodology and a customer life cycle.

Research limitations/implications

Designing a service system involves more than just figuring out what service strategies consumers desire; it includes examining how the business integrates resources to help those strategies be implemented. This study’s limitation is that it only looks at service strategy development; more research will probably conclude the study on how businesses integrate resources to support service strategy implementation.

Practical implications

Elderly fall-protection clothing companies can refer to the service strategies and new knowledge outlined in this study to optimize their service systems.

Originality/value

The research results of this study fulfilled the research gap in the service design of elderly fall-protection clothing. Furthermore, this study developed a new design framework for Kansei Engineering methodology, enriching a new Kansei Engineering methodology for service design.
Investigating the impact of different types of live-streaming marketing on consumers' intention to purchase clothing
Authors: Wu Hongyan , Yu Fei
Published: December 2024

Purpose

This paper aims to study the impact of the interaction effects between live-streaming marketing and clothing type on consumers' intention to purchase clothing, and the mediating effect of internalization and identification on the relationship between them.

Design/methodology/approach

This paper conducts a scenario experiment to 486 consumers who had experience in purchasing clothing on the live-streaming platform and employs the analysis of variance, structural equation model and multivariate regression model.

Findings

Our findings reveal that professional live-streaming marketing (PLSM) can better stimulate consumers' intention to purchase formal clothing than entertainment live-streaming marketing (ELSM) does. Compared with PLSM, ELSM can better stimulate consumers' intention to purchase casual clothing. When PLSM promotes formal clothing, it triggers the internalization mechanism of consumers, so as to improve their purchase intention. When ELSM promotes casual clothing, it triggers consumers' identification mechanism, so as to improve their purchase intention.

Originality/value

This paper helps to identify the differences in the impact of different types of live-streaming marketing on consumers' intention to purchase different types of clothing, as well as the mediating role of internalization and identification mechanisms. This paper provides a theoretical reference for clothing firms to strategically select the appropriate type of live-streaming marketing.