bluuebunny/crossref_metadata_2025 huggingface dataset:
Migrant deaths in the name of law
Authors: Fine Shoshana , Lindemann Thomas
Published: February 2024

While many studies have investigated the problem of migration deaths, to our knowledge attention has never focused on how political actors appeal to law to legitimize these deaths. In our empirical enquiry, we interrogated how the European Commission legitimizes its role in migrant deaths in the Mediterranean through appeals to law. One compelling function of law in this legitimization process is that it presents a narrative as logical and objective. A second aspect of legitimization through law is related to its moral function. Instead of regretting not being more active in saving migrant lives, the European Commission inversed the moral charge, presenting itself as guarantor of law and order that saves migrants if they respect legality. We argue that political actors do not simply submit passively to laws but that laws can also be a resource for the legitimization of what might seem at first glance immoral – in this case an implicit ‘right’ not to protect.
Early, Rapid or Global? Internationalization Speed and SME’s Performance
Authors: Romanello Rubina , Balboni Bernardo , Chiarvesio Maria , Paul Justin
Published: February 2024

The article investigates the impact of three dimensions of the speed of internationalization speed – the entry timing, the initial speed and the pace of international expansion – on the performance of exporting small‐ and medium‐sized enterprises (SMEs). To this purpose, we adopt a mixed-method approach analysing quantitative and qualitative data on Italian-exporting SMEs. The results show that entry timing, which is not relevant per se, moderates the positive impact of the initial speed on SME’s performance. Furthermore, a higher pace of international expansion is negatively related to the performance of SMEs. Building on the early internationalization literature, the study contributes to the existing literature on performance outcomes of the speed of internationalization of SMEs. The study has managerial implications for managers and entrepreneurs who are planning to internationalize.
Building a reputation for trustworthiness: Experimental evidence on the role of the feedback rate
Authors: Jiao Ruohuang , Przepiorka Wojtek , Buskens Vincent
Published: February 2024

In 25 years, research on reputation-based online markets has produced robust evidence on the existence of the so-called reputation effect, that is the positive relation between online traders’ reputations and these traders’ market success in terms of sales and prices. However, there is an ongoing debate on what the size of the reputation effect means. We argue that the rate of truthful feedback that traders leave after completed transactions is negatively related to the size of the reputation effect. The higher the rate of truthful feedback, the quicker will untrustworthy traders be screened and disincentivized to enter the market. With mostly trustworthy traders entering the market, buyers will demand smaller price discounts from market entrants without a good reputation. We test this mechanism empirically in two laboratory experiments. In both experiments, we systematically vary the probability with which information about sellers’ behavior in an economic trust game is recorded and shown to future interaction partners of these sellers. In the second experiment, we introduce competition among sellers by allowing buyers to choose one of two sellers in each interaction. We find that sellers give discounts to buyers to build or repair their reputation and that sellers who give discounts or have a good reputation are trusted more. However, we do not find support for our hypothesis that a higher feedback rate significantly decreases sellers’ propensity to give discounts. We argue and show in exploratory analyses that this is likely due to the high level of unconditional trust buyers exhibit towards sellers without a reputation. Yet, seller competition increases the propensity to offer discounts among sellers without a reputation the most.
Preoperative Amiodarone and Primary Graft Dysfunction in Heart Transplantation
Authors: Servais Abigail , Lundgren Scott , Bowman Stephanie , Stoller Douglas , Burdorf Adam , Hyden Marshall , Lowes Brian , Zolty Ronald , Klepser Don , Brink Heidi
Published: February 2024

Background:

Preoperative amiodarone effects on postorthotopic heart transplant (OHT) outcomes remain controversial.

Objective:

The purpose of this study was to determine the effect of cumulative pre-OHT amiodarone exposure on severe primary graft dysfunction (PGD).

Methods:

We retrospectively reviewed adult OHT recipients between August 2012 and June 2018. Primary outcome was severe PGD in patients receiving amiodarone at 3, 6, and 12 months prior to OHT compared with those not receiving amiodarone. Secondary outcomes included intensive care unit (ICU) and hospital length of stay, duration of mechanical ventilation, early graft failure (EGF), mortality at 3, 6, and 12 months post-OHT, and 30-day incidence of postoperative tachyarrhythmias, bradycardia, permanent pacemaker implantation, and rejection.

Results:

Incidence of severe PGD was 12.5% in those who received amiodarone compared to 6.8% in those who did not (14 vs 6, P = 0.18). Cumulative preoperative amiodarone significantly increased the odds of severe PGD at 3 months (odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.001-1.06; P = 0.044) and 6 months (OR: 1.02, 95% CI: 1.003-1.044; P = 0.024) in a multivariate logistic regression. Patients on amiodarone had significantly higher rates of postoperative bradycardia (13.4% vs 4.5%, P = 0.03).

Conclusion and Relevance:

A trend toward increased PGD was present in patients receiving preoperative amiodarone. This finding combined with the regression showing significantly increased odds of PGD with increasing 3 and 6 month cumulative amiodarone dose is clinically concerning. Escalation of care with pacemaker implantation was required more frequently in patients on pre-OHT amiodarone.
Sotatercept for Pulmonary Arterial Hypertension in the Inpatient Setting
Authors: Torbic Heather , Tonelli Adriano R.
Published: February 2024

Patients with pulmonary arterial hypertension (PAH) who are admitted to the hospital pose a challenge to the multidisciplinary healthcare team due to the complexity of the pathophysiology of their disease state and PAH-specific medication considerations. Pulmonary arterial hypertension is a progressive disease that may lead to death as a result of right ventricular (RV) failure. During acute on chronic RV failure it is critical to decrease the pulmonary vascular resistance with the goal of improving RV function and prognosis; therefore, aggressive PAH-treatment based on disease risk stratification is essential. Pulmonary arterial hypertension treatment for acute on chronic RV failure can be impacted by end-organ damage, hemodynamic instability, drug interactions, and PAH medications dosage and delivery. Sotatercept, a first in class activin signaling inhibitor that works on the bone morphogenetic protein/activin pathway is on track for Food and Drug Administration approval for the treatment of PAH based on results of recent trials in where the medication led to clinical and hemodynamic improvements, even when added to traditional PAH-specific therapies. The purpose of this review is to highlight important considerations when starting or continuing sotatercept in patients admitted to the hospital with PAH.
Exact closed-form dynamic stiffness matrix of damaged frames comprising Timoshenko–Ehrenfest beams
Authors: Cannizzaro Francesco , Fiore Ilaria , Caddemi Salvatore , Caliò Ivo
Published: February 2024

The present work proposes the extension of an exact distributional model for cracked beams to include the local influence on axial deformation on shear deformable beams. Axial, shear and flexural concentrated flexibilities are taken into account to model the damaged sections. Shear deformability is accounted for by adopting the Timoshenko–Ehrenfest model and exact closed-form solution of the mode shapes for multiple cracked beams are derived. On this ground, the final achievement of the work consists in the original formulation of the Dynamic Stiffness Matrix (DSM) with multiple cracked sections in exact closed form. The closed-form expression of the DSM allows the assemblage of the global DSM of a structure to conduct the free vibration analysis of damaged framed structures as well as for the study of frames with semi-rigid joints. This approach has the advantage to avoid any numerical procedure for the construction of the DSM as well as the introduction of further degrees of freedom (dofs) in correspondence of the damaged sections, keeping the size of the problem the same as in the intact configuration. Natural frequencies of the frames are determined by means of the Wittrick–Williams algorithm (W–W), then the mode shapes and modal forces are subsequently obtained in closed form. The proposed approach is validated with results available in literature for two portal frames characterized by the presence of cracks and semi-rigid joints, respectively. Finally, the potentiality of the approach, also in view of practical applications, is demonstrated analysing a multi-storey frame with semi-rigid connections.
Comparative analysis between data-driven and visual-based approach in drone propeller imbalance detection
Authors: Mohd Ghazali Mohamad H. , Tamilselvam Dinagaran , Rahiman Wan
Published: February 2024

Early monitoring of the drone’s critical components, such as the motor, propeller, and electronic speed controller (ESC), can prevent unwanted accidents from happening to the drone. A failure of one of the drone’s components may lead the drone to crash. The fault detection approach can be made by analyzing certain parameters such as vibration, acoustic, current, and speed. In this paper, a comparative analysis between data-driven and visual-based approaches in detecting an imbalanced propeller in the drone is presented. The analysis will focus on vibration and acoustic parameters, with the use of CZN-15 and ADXL335 MEMS sensors to capture vibration and acoustic data, respectively. The Silky EvCam vibration camera will be used for the visual-based approach. Experimental results demonstrated that both data-driven and visual-based approaches could detect the imbalanced UAV propeller. There is a shift of vibration frequency when imbalances occur in the UAV propeller. However, in the ground and thrust modes, the acoustic-based method has an accuracy of 54% and 93%, respectively, which is lower compared to the vibration-based (100% accuracy in both modes) and visual-based techniques.
Investigating the impact of probiotic on neurological outcomes in Rett syndrome: A randomized, double-blind, and placebo-controlled pilot study
Authors: Wong Lee Chin , Hsu Chia-Jui , Wu Yen-Tzu , Chu Hsu-Feng , Lin Jui-Hsiang , Wang Hsin-Pei , Hu Su-Ching , Tsai Ying-Chieh , Tsai Wen-Che , Lee Wang-Tso
Published: February 2024

This pilot study investigates the feasibility and assesses the impact of Lactobacillus plantarum PS128 probiotics on the neurological function in Rett syndrome. We conducted a randomized, double-blind, and placebo-controlled trial on Rett syndrome with MECP2 mutation aged between 1 and 50 years in Taiwan. In this pilot study, twice-daily L. plantarum PS128 or placebo was administered for 16 weeks. In addition to feasibility, we also assessed the changes utilizing the Mullen Scales of Early Learning. In total, 36 participants were finally randomized into L. plantarum PS128 (n = 18) or placebo (n = 18) groups. At the end of intervention, the retention rates were 100% for L. plantarum PS128 and 94.44% for placebo, with withdrawal rates of 5.56% for the placebo group. Both groups tolerated well, except for one L. plantarum PS128 participant who reported loose stool. The probiotic group showed a change of 2.19 ± 3.76, while the placebo group had −0.85 ± 5.09 (p = 0.051) in the total age-equivalent scores of Mullen Scales of Early Learning. There was a significant difference in the change of the total score on the Burke–Fahn–Marsden Movement Scale between probiotc group and placebo group (−12.19 ± 12.12 vs −4.59 ± 4.20, p = 0.020). In leg dystonia, the probiotic group exhibited a change of −4.11 ± 5.11 compared with −0.38 ± 1.50 in the placebo group (p = 0.008). Our findings affirm the feasibility of L. plantarum PS128 in Rett syndrome. Future clinical trials are mandatory to further explore its long-term impact on Rett syndrome.

Lay abstract

Rett syndrome often involves gastrointestinal symptoms and gut microbiota imbalances. We conducted a study to explore the feasibility of probiotic Lactobacillus plantarum PS128 and the impact on neurological functions in Rett syndrome. The results of our investigation demonstrated that the supplementation of probiotic L. plantarum PS128 was feasible and well tolerated, with 100% retention rate and 0% withdrawal rate. In addition, there was only one participant who had loose stool after taking L. plantarum PS128. Further, there was a tendency to enhance overall cognitive developmental level, as assessed using Mullen Scales of Early Learning. In addition, it significantly improved dystonia, as assessed using the Burke–Fahn–Marsden Movement Scale, in comparison with the placebo group. This study provides a strong foundation for future research and clinical trials exploring the potential of L. plantarum PS128 probiotics as a complementary therapy for individuals with Rett syndrome.
Polyphonic storying with human and more-than human co-collaborators
Authors: Molloy Murphy Angela , Parnell Will , Callaway-Cole Larisa , Quintero Elizabeth
Published: February 2024

We believe that our most powerful approach to defy the erasure of people, knowledges, and open ways of living and being is generative storying together with children and families, educators, and the more-than-human. Storying takes many forms and is about more than overcoming coloniality or the earthly survival of humans. It is about taking a stance with a “citizenship of strangers” to compose more equitable, care-filled, and relational ways of living, especially with young children and their families. Thinking with storying as a liberatory and transformative process, we believe the perspectives of our human and more-than-human co-collaborators—the people, places, and materialities that collectively co-create these stories—are urgently required to offer satellites of hope amid the darkness and to practice living in radical relationality and a project of love.
Does the addition of convex uniplanar screws in hybrid constructs improve 3D surgical correction in thoracic adolescent idiopathic scoliosis posterior fusion?
Authors: Simon Laurie , Finoco Mikael , Julien-Marsollier Florence , Happiette Adèle , Simon Anne-Laure , Ilharreborde Brice
Published: February 2024

Purpose:

Hybrid techniques using thoracic sublaminar bands have proved their efficacy in adolescent idiopathic scoliosis posterior fusion, but clinical axial correction sometimes remained disappointing. One solution found was “the frame technique” and the second alternative was the replacement of the convex sublaminar bands by periapical uniplanar screws. The goal of this study was to compare clinical and radiological outcomes of both techniques in a consecutive cohort of adolescent idiopathic scoliosis patients.

Methods:

All patients undergoing primary posterior fusion for thoracic adolescent idiopathic scoliosis between January 2017 and March 2020 were included. Two groups were compared: Group 1 with thoracic sublaminar bands only and Group 2 with periapical uniplanar screws. All patients underwent standing stereoradiographs. The main frontal, sagittal, and axial (apical vertebra rotation) radiological parameters of interest were analyzed. Functional outcomes were assessed using the Scoliosis Research Society 30 score.

Results:

A total of 147 adolescents were included (Group 1, n = 73 and Group 2, n = 74 patients). In the frontal plane, a greater reduction index was observed in Group 2 (68% versus 62%, p < 0.001) as well as a better apical axial correction (67.8% versus 46.6%, p = 0.03). The number of thoracoplasty performed was reduced (6.7% versus 20.5%, p = 0.02) in Group 2, with a significant decrease in the rate of mechanical complication. No significant loss of correction was observed during follow-up in any of the group.

Conclusion:

The adjunction of convex uniplanar screws at the periapical levels improved the three-dimensional surgical correction of thoracic adolescent idiopathic scoliosis treated with hybrid constructs.

Level of evidence:

level III, retrospective comparative study
Dermatofibrosarcoma protuberans: Case series in a tropical setting and review of literature
Authors: Ashindoitiang John Adi , Canice Nwagbara Victor Ikechukwu , Ipeh Ugbem Theophilus , Owusu George Peter , Asuquo Maurice Efana
Published: February 2024

Dermatofibrosarcoma protuberans (DFSP) is an infrequent cutaneous tumour that may involve subcutaneous fat and in some cases fascia, muscles and bone. The infrequent occurrence lessens its clinical awareness in addition to its clinical semblance to many common cutaneous lesions. It is characterized by proclivity for local recurrence. We evaluated the clinical presentation and treatment outcomes of six consecutive cases of DFSP with histologic diagnosis in the University of Calabar Teaching Hospital, Calabar seen between January 2013 and December 2022. This was compared with total cutaneous malignances in the same period. The six consecutive patients comprised of two males and four females (M = F: 1:2) whose ages ranged from 21 to 57 years (mean of 36.5 years) and accounted for 7% of cutaneous malignancies. The site distribution was trunk (back) involved in 3 (50%) of the patients, limbs 3 (50%); upper 1 (17%) and lower limb 2 (33%). Clinical presentation was in the form of firm cutaneous mass with some ulcerated lesions that bled and some fungated. 50 percent of the patients presented with recurrent lesions and in all there was no regional lymphadenopathy or evidence of metastasis. There was a patient with Neurofibromatosis- 1 who had a huge fungated limb lesion offered amputation, four had wide local excision and one incision biopsy. Follow up was poor and the period ranged from 2 to 14 months (mean 7 months). Dermatofibrosarcoma protuberans is an uncommon tumour with clinical semblance to other cutaneous lesions. Early presentation, preoperative histologic diagnosis will enhance the goal of ensuring adequate excision. Adjuvant therapy with Imatinib with or without adjuvant radiotherapy are recommended in the treatment plan in view of the frequency of late presentation with advanced recurrent lesions and poor follow up.
Patients’ awareness of recovery mediates the link between clinical and level of functional remission in schizophrenia to a larger extent in those treated with long-acting antipsychotics
Authors: Mallet Jasmina , Dondé Clément , Dubertret Caroline , Gorwood Philip
Published: February 2024

Background:

Clinical remission is a step towards functional remission for subjects with schizophrenia. While recovery is both a subjective personal journey and a clinical outcome to be targeted, data on patient self-rated outcomes are scarce.

Objectives:

(i) To determine the extent to which the association between clinical and functional remission is mediated by the subjective experience of recovery as reported by patients versus their relatives or their psychiatrist and (ii) to assess differences according to treatment, specifically with oral antipsychotics only versus long-acting injectable antipsychotics (LAIs).

Design:

Clinical observational study.

Methods:

Community-dwelling participants with schizophrenia enrolled in the EGOFORS cohort ( N = 198) were included. Clinical symptoms and remission were assessed using the Positive and Negative Syndrome Scale. Functional remission was assessed with the Functional Remission of General Schizophrenia Scale. Awareness of recovery was assessed with one question ‘What percentage of recovery do you think you have now (from 0% – no recovery – to 100% – full recovery)?’, asked of the patient, also of the patient’s close relative, and the psychiatrist. We used mediation analyses, taking into account the type of pharmacological treatment.

Results:

Remission criteria and perceived remission measures were significantly correlated, both within and between groups ( r > 0.330). The patient’s awareness of recovery mediated the relationship between clinical remission and level of functional remission, while the level of recovery according to psychiatrists or close relatives did not. The direct effect of clinical remission on the level of functional remission became non-significant when taking into account the mediator (patients’ awareness of recovery) in the group of patients with LAI ( t = 1.5, p = 0.150) but not in the group of patients with other treatments ( t = 3.1, p = 0.003).

Conclusion:

Patients with LAIs may be more efficient in reporting their level of functional remission. Higher patient awareness could be an interesting candidate to explain this. However, as the study was cross-sectional, such a proposal should be tested with a more specifically designed protocol, such as a long-term cohort.
New-onset of pemphigus following COVID-19 infection: A case report
Authors: Pastukhova Elena , Ghazawi Feras M
Published: February 2024

COVID-19 has been implicated in various cutaneous autoimmune diseases. Pemphigus is a group of autoimmune blistering diseases that target the desmosomal complexes. Pemphigus triggered by COVID-19 has been seldom reported in the literature and remains both a diagnostic and therapeutic challenge. We report a case of COVID-19-induced pemphigus that responded well to prednisone and mycophenolate mofetil after 9 months from initial presentation. On histologic examination, both intercellular and basement membrane staining were noted. Indirect immunofluorescence staining was positive against the intercellular cement of the stratified epithelium from monkey esophagus. We hypothesize that COVID-19 stimulated the release of multiple pemphigus antigens, which resulted in the unusual histologic pattern reported in the present case. Although malignancy should be suspected when features of paraneoplastic pemphigus, such as basement membrane staining on direct immunofluorescence, are noted, it may also be a histologic pattern of pemphigus secondary to COVID-19 that clinicians may consider.
The paradox of seeking help: Socioeconomic inequality in medical crowdfunding in the era of the mobile internet
Authors: Cheng Cheng , Ren Yifei
Published: February 2024

In recent years, the emergence of mobile-internet-based crowdfunding has provided a new way for the poor to obtain emergency relief for medical needs. Despite a number of reported scams, medical crowdfunding has made an important contribution to society. Public opinion and sentiment highlight two practical issues: Are the resources being directed to the people who need them the most? And how can we optimize medical crowdfunding? To tackle these questions, we focus on the issue of how the socioeconomic status (SES) of help-seekers affects their online medical crowdfunding outcomes. We ask three research questions: What is the correlation between the SES of help-seekers and their fundraising outcomes? What are the underlying mechanisms? Is there a possible path for the optimization of medical crowdfunding outcomes? Our dataset includes 1930 fundraising cases from a large medical crowdfunding platform in China. The study finds significant differences in crowdfunding outcomes among different socioeconomic groups. Higher SES brings higher donation amounts, higher proportions of fundraising targets reached, a higher number of donations received, and more shares on social media. This socioeconomic gradient in crowdfunding outcomes contradicts the social expectation of prioritizing help to the neediest in medical crowdfunding. Mediation analysis also shows that offline interpersonal networks play an important intermediary role. While appealing case narratives are helpful, they are not an intermediary mechanism that links family SES with crowdfunding outcomes. Further analysis also finds that such a socioeconomic gradient seems to weaken when crowdfunding that begins within a private network of offline acquaintances on WeChat moves to public platforms.
Redistar Versus Velocity
Authors: Fatma Sabeeha
Published: February 2024

The case discusses the pitfalls of hasty decisions taken to achieve instant success. The case also highlights how unethical practices erode the image of the organization and sets in malicious culture. The Radiance Group, founded by Sarabhai Karmarkar (1930–2005), one of the largest private sector companies in India, with petroleum and energy as it core business, has always been an ambitious company. Sarabhai, the founder of the company, was a man of high aspirations. Since the very inception of the company, Radiance Industries Limited’s only vision was Profit Maximization. Sarabhai Karmarkar believed in utilitarian philosophy which preaches that end justifies the means.

After the demise of Sarabhai, Vithalbhai Karmarkar, eldest son of Sarabhai, became the director of the company. He was an intelligent and sharp minded young man, full of new ideas and energy. He wanted to explore new ideas and diversify into new products and markets. In his haste to make Radiance grow exponentially, Vithalbhai committed many mistakes which proved to be fatal for the brand.

The case discusses the setbacks that strategic myopia can lead to. The case further discusses the long-term damage that unethical means can cause. The case emphasizes upon the importance of ethical conduct for gaining customer’s loyalty and trust.
Public Knowledge About White-Collar Crime in France and the US: A Cross-National Comparison
Authors: Michel Cedric
Published: February 2024

The few studies that measured public knowledge about white-collar crime and its consequences suggested a positive relationship between awareness and punitiveness. However, the participants were found to be, at best, only partially informed about upper-class criminality. Almost a decade later, whether public levels of information have increased is unknown. The present study proposes to (1) capture current levels of public knowledge about white-collar crime in the US and (2) determine if such knowledge is unique or shared by French citizens. A total of 1068 subjects, half of them from the US and the other half from France, answered an online survey that measured their awareness and acceptance of several key evidence-based facts about white-collar crime. Although US participants were found to be more knowledgeable than their French counterparts, they were still largely misinformed about elite deviance and more likely to endorse various myths. These findings imply that more work needs to be done to educate the public about this serious social issue and dispel unfounded beliefs which might affect legal responses to upper-word offenses.
Percutaneous Transcatheter Therapy in a Case of Lutembacher’s Syndrome
Authors: Nadkarni Pranav , Parab Michelle Viegas , Naik Guruprasad
Published: February 2024

Lutembacher’s syndrome is a rare condition and is most often treated surgically. Due to the advances in percutaneous procedures, this form of management is desired which has the advantage of decreased morbidity and is aesthetically superior. In this case report of percutaneous treatment for a Lutembacher’s patient the percutaneous transvenous mitral commissurotomy and atrial septal defect device closure was done with minimal technical difficulties and with excellent post-procedure results.
Similarities and differences among selected gemmological varieties of chalcedony: chemistry, mineralogy and microstructure
Authors: Monico Sara , Cantaluppi Marco , Diella Valeria , Gatta G. Diego , Adamo Ilaria , Fumagalli Patrizia , Marinoni Nicoletta
Published: February 2024

This study describes a new variety of chalcedony with a unique inhomogeneous bluish green hue, named aquaprase. It was discovered in Africa and is considered to be a valuable addition to the gem trade. A multi-methodological approach was used to examine its chemistry, mineralogy and microstructure, which were then compared to those of chrysoprase and agate, two of the most popular varieties of chalcedony. Optical microscopy revealed a complex microstructural heterogeneity in the different colour intensity areas/bands of aquaprase and agate, whereas chrysoprase exhibited a more homogeneous coexistence of micro- and cryptocrystalline quartz. High-resolution synchrotron XRD was essential for highlighting the complex assemblage of various types of α-quartz in aquaprase and agate (which differ in terms of crystal size and/or cell parameters). Micro-Raman spectroscopy revealed α-quartz and moganite in all three varieties of chalcedony and the presence of the nickel-bearing layered silicate mineral, willemseite, in chrysoprase, which is responsible for its green colouration. The chemical analysis displayed a homogeneous composition of agate, as well as high levels of nickel content in the chrysoprase variety. Aquaprase showed significant amounts (ppm by weight) of trace elements (Al, Mg, Na, K, Ca, Ti, U and Fe) characteristic of its formation environment, as well as high values of Cr, which are thought to be the cause of its bluish green colouration.
Extraction frequent patterns in trauma dataset based on automatic generation of minimum support and feature weighting
Authors: Kohzadi Zahra , Nickfarjam Ali Mohammad , Arani Leila Shokrizadeh , Kohzadi Zeinab , Mahdian Mehrdad
Published: February 2024

Purpose

Data mining has been used to help discover Frequent patterns in health data. it is widely used to diagnose and prevent various diseases and to obtain the causes and factors affecting diseases. Therefore, the aim of the present study is to discover frequent patterns in the data of the Kashan Trauma Registry based on a new method.

Methods

We utilized real data from the Kashan Trauma Registry. After pre-processing, frequent patterns and rules were extracted based on the classical Apriori algorithm and the new method. The new method based on the weight of variables and the harmonic mean was presented for the automatic calculation of minimum support with the Python.

Results

The results showed that the minimum support generation based on the weighting features is done dynamically and level by level, while in the classic Apriori algorithm considering that only one value is considered for the minimum support manually by the user. Also, the performance of the new method was better compared to the classical Apriori method based on the amount of memory consumption, execution time, the number of frequent patterns found and the generated rules.

Conclusions

This study found that manually determining the minimal support increases execution time and memory usage, which is not cost-effective, especially when the user does not know the dataset's content. In trauma registries and massive healthcare datasets, its ability to uncover common item groups and association rules provides valuable insights. Also, based on the patterns produced in the trauma data, the care of the elderly by their families, education to the general public about encountering patients who have an accident and how to transport them to the hospital, education to motorcyclists to observe safety points in Recommended when using a motorcycle.
Exploring the usability of the virtual reality module LEAF CAFÉ: a qualitative think-aloud study
Authors: Siette Joyce , Campbell Christopher , Adam Patrick J. , Harris Celia B.
Published: February 2024

Background

The global healthcare system faces increasing strain from our ageing population, primarily due to the growing prevalence of age-related health conditions such as dementia. While modern healthcare technology offers potential solutions, it frequently lacks user-friendliness for older adults. Virtual Reality (VR) has emerged as a promising tool for diagnosing cognitive impairment, offering innovative solutions where traditional methods may fall short. This study explores older adults’ perspectives on the usability of a newly designed VR module for cognitive assessment.

Methods

During a 100-min session, participants were asked to engage and complete recall and recognition tasks within the VR module (think-aloud approach) and provide feedback upon completion (semi-structured interviews). Audio materials were transcribed for analysis and recordings of the users’ interactions with the module were annotated to provide additional context. These combined textual data were analysed using content coding and thematic analysis to identify themes that reflect how participants used the module’s features and what features are desirable to support that process better.

Results

Participants (N = 10; Mean age = 73.3, SD = 7.53, range = 65–83 years) perceived the VR module as user-friendly and endorsed its potential as a cognitive screener due to its engaging and immersive nature. Older adults highlighted three key aspects of the module: the usefulness of the platform’s ability to offer a comprehensive and reliable evaluation of an individual’s cognitive abilities; the need to present concise and relevant content to optimise engagement and use; and the importance of overcoming barriers to support implementation. Suggested game improvements centred on food recognition and adjusting difficulty levels. Barriers to implementation included technology challenges for older adults and concerns about the game’s suitability for everyday scenarios. Participants stressed the need for reliable implementation strategies, proposing locations such as libraries and advocating for home-based screening.

Conclusion

Continued improvements in accessibility suggest that VR tools could help with diagnosing cognitive impairment in older adults. Using a simulated environment to assess cognitive status might fill the gap between current diagnostic methods, aiding treatment planning and early intervention. However, these findings should be approached cautiously, as more research is needed to fully grasp the potential impact of VR tools in this context.
Extended use of point-of-care technology versus usual care for in-home assessment by acute community nurses in older adults with signs of potential acute respiratory disease: an open-label randomised controlled trial protocol
Authors: Smedemark Siri Aas , Laursen Christian B. , Jarbøl Dorte Ejg , Rosenvinge Flemming S. , Andersen-Ranberg Karen
Published: February 2024

Background

Due to ageing-related physiological changes, diagnosing older adults is challenging. Delayed disease recognition may lead to adverse health outcomes and increased hospitalisation, necessitating the development of new initiatives for timely diagnosis and treatment of older adults. Point-of-care technology, such as focused lung ultrasound scan and bedside analysis of blood samples (leucocytes with differential count, electrolytes, and creatinine) conducted in the patients’ home, may support clinical decision-making, and potentially reduce acute hospital admissions.

We present the protocol for a randomized controlled trial, which aims at assessing the effect of focused lung ultrasound scan and bedside blood analysis during in-home assessments among older adults with signs of potential acute respiratory disease on hospital admissions.

Method

We will use a parallel open-label, individually randomised controlled trial design in an acute community healthcare setting. The trial will initiate on October 2022 and is expected to end one year later. The study population will include older adults (65 + year), with at least one of the following inclusion criteria: Cough, dyspnoea, fever, fall, or rapid functional decline. Expected study sample will comprise 632 participants. Participants in the control group will receive usual care, while the intervention group will undergo extended point-of-care technology (focused lung ultrasound scan and bedside venous blood analysis), in addition to usual care.

The primary outcome is acute hospital admission within 30 days follow-up. Secondary outcomes include readmissions, mortality, length of hospital stay, hospital-free days, complications during hospital admission, treatment initiations or changes, functional level, re-referrals to the acute community healthcare service, and contacts to the primary care physician. A tertiary outcome is the diagnostic accuracy of Acute Community Nurses for conducting focused lung ultrasound compared with a specialist. Outcomes will be analysed as intention-to-treat.

Discussion

To our knowledge, this is the first randomised controlled trial examining the effect of extended use of point-of-care technology conducted in an in-home setting. We expect that the results may contribute to the development of new interventions aiming to improve timely diagnostics, treatment decisions, and reduce acute hospital admissions.

Trial Registration

www.clinicaltrials.org NCT05546073 (Date of registration: September 19th, 2022).
Optimising diagnosis and management of kidney disease: an implementation trial of a clinical decision support system future health today
Authors: Wallace Hannah , Wang Qiumian , Botha Tanita , Hunter Barbara , Lumsden Natalie , Nelson Craig
Published: February 2024

Background

Chronic kidney disease affects more than 10% of the world’s population and is a non-communicable disease of global concern and priority. There is a significant implementation gap between best practice guideline recommendations and current kidney disease management. Previous research has shown the need to partner with primary care to improve education, collaboration, and kidney disease awareness. This implementation trial will explore use of an innovative clinical decision support software, Future Health Today, to improve screening, diagnosis, and management of kidney disease in primary care. The program will be supported by tertiary care outreach services. The primary aim is to test the hypothesis that the Future Health Today implementation program will improve screening, diagnosis, and management of kidney disease. Secondary aims are to evaluate primary care satisfaction and broader health service impacts.

Methods

This pre-post implementation trial using an interrupted time series design will evaluate the clinical and service outcomes of Future Health Today, using a mixed methods study in twenty general practices with an estimated population size of 150,000. Deidentified patient data will be extracted from participating practices to examine the primary aims of the study. Surveys and semi-structured interviews with general practice will inform secondary hypotheses. Data linkage between primary care and tertiary care data will examine the broader health service impacts.

Discussion

This investigator driven trial will assess the impact of Future Health Today software coupled with education and clinical outreach support. Investigators hypothesise that there will be improvement in appropriate screening, diagnosis, and management of kidney disease. This program has the potential to be scaled more broadly.

Trial Registration

Australian New Zealand Clinical Trial Registry: ACTRN12623001096640.
Action recommendations review in community-based therapy and depression and anxiety outcomes: a machine learning approach
Authors: Spinrad Amit , Taylor C. Barr , Ruzek Josef I. , Jefroykin Samuel , Friedlander Tamar , Feleke Israela , Lev-Ari Hila , Szapiro Natalia , Sadeh-Sharvit Shiri
Published: February 2024

Background

While the positive impact of homework completion on symptom alleviation is well-established, the pivotal role of therapists in reviewing these assignments has been under-investigated. This study examined therapists' practice of assigning and reviewing action recommendations in therapy sessions, and how it correlates with patients’ depression and anxiety outcomes.

Methods

We analyzed 2,444 therapy sessions from community-based behavioral health programs. Machine learning models and natural language processing techniques were deployed to discern action recommendations and their subsequent reviews. The extent of the review was quantified by measuring the proportion of session dialogues reviewing action recommendations, a metric we refer to as “review percentage”. Using Generalized Estimating Equations modeling, we evaluated the correlation between this metric and changes in clients' depression and anxiety scores.

Results

Our models achieved 76% precision in capturing action recommendations and 71.1% in reviewing them. Using these models, we found that therapists typically provided clients with one to eight action recommendations per session to engage in outside therapy. However, only half of the sessions included a review of previously assigned action recommendations. We identified a significant interaction between the initial depression score and the review percentage (p = 0.045). When adjusting for this relationship, the review percentage was positively and significantly associated with a reduction in depression score (p = 0.032). This suggests that more frequent review of action recommendations in therapy relates to greater improvement in depression symptoms. Further analyses highlighted this association for mild depression (p = 0.024), but not for anxiety or moderate to severe depression.

Conclusions

An observed positive association exists between therapists’ review of previous sessions’ action recommendations and improved treatment outcomes among clients with mild depression, highlighting the possible advantages of consistently revisiting therapeutic homework in real-world therapy settings. Results underscore the importance of developing effective strategies to help therapists maintain continuity between therapy sessions, potentially enhancing the impact of therapy.
Effects of meteorological factors on influenza transmissibility by virus type/subtype
Authors: Yan Ze-Lin , Liu Wen-Hui , Long Yu-Xiang , Ming Bo-Wen , Yang Zhou , Qin Peng-Zhe , Ou Chun-Quan , Li Li
Published: February 2024

Background

Quantitative evidence on the impact of meteorological factors on influenza transmissibility across different virus types/subtypes is scarce, and no previous studies have reported the effect of hourly temperature variability (HTV) on influenza transmissibility. Herein, we explored the associations between meteorological factors and influenza transmissibility according to the influenza type and subtype in Guangzhou, a subtropical city in China.

Methods

We collected influenza surveillance and meteorological data of Guangzhou between October 2010 and December 2019. Influenza transmissibility was measured using the instantaneous effective reproductive number (Rt). A gamma regression with a log link combined with a distributed lag non-linear model was used to assess the associations of daily meteorological factors with Rt by influenza types/subtypes.

Results

The exposure-response relationship between ambient temperature and Rt was non-linear, with elevated transmissibility at low and high temperatures. Influenza transmissibility increased as HTV increased when HTV < around 4.5 °C. A non-linear association was observed between absolute humidity and Rt, with increased transmissibility at low absolute humidity and at around 19 g/m3. Relative humidity had a U-shaped association with influenza transmissibility. The associations between meteorological factors and influenza transmissibility varied according to the influenza type and subtype: elevated transmissibility was observed at high ambient temperatures for influenza A(H3N2), but not for influenza A(H1N1)pdm09; transmissibility of influenza A(H1N1)pdm09 increased as HTV increased when HTV < around 4.5 °C, but the transmissibility decreased with HTV when HTV < 2.5 °C and 3.0 °C for influenza A(H3N2) and B, respectively; positive association of Rt with absolute humidity was witnessed for influenza A(H3N2) even when absolute humidity was larger than 19 g/m3, which was different from that for influenza A(H1N1)pdm09 and influenza B.

Conclusions

Temperature variability has an impact on influenza transmissibility. Ambient temperature, temperature variability, and humidity influence the transmissibility of different influenza types/subtypes discrepantly. Our findings have important implications for improving preparedness for influenza epidemics, especially under climate change conditions.
Treatment strategies for simple elbow dislocation - a systematic review
Authors: Breulmann Franziska Lioba , Lappen Sebastian , Ehmann Yannick , Bischofreiter Martin , Lacheta Lucca , Siebenlist Sebastian
Published: February 2024

Background

Current treatment concepts for simple elbow dislocation involve conservative and surgical approaches. The aim of this systematic review was to identify the superiority of one treatment strategy over the other by a qualitative analysis in adult patients who suffered simple elbow luxation.

Study design

A systematic review in accordance with the PRISMA guidelines and following the suggestions for reporting on qualitative summaries was performed. A literature search was conducted using PubMed and Scopus, including variations and combinations of the following keywords: elbow, radiohumeral, ulnohumeral, radioulnar, luxation, and therapy. Seventeen studies that performed a randomized controlled trial to compare treatment strategies as conservative or surgical procedures were included. Reviews are not selected for further qualitative analysis. The following outcome parameters were compared: range of motion (ROM), Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand outcome measure (Quick-DASH), recurrent instability, pain measured by visual analog scale (VAS) and time to return to work (RW).

Results

Early mobilization after conservative treatment strategies showed improved ROM compared to immobilization for up to 3 weeks after surgery with less extension deficit in the early mobilization group (16° ± 13°. vs. 19.5° ± 3°, p < 0.05), as well as excellent clinical outcome scores. Surgical approaches showed similar results compared to conservative treatment, leading to improved ROM (115 vs. 118 ± 2.8) and MEPS: 95 ± 7 vs. 92 ± 4.

Conclusion

Conservative treatment with early functional training of the elbow remains the first-line therapy for simple elbow dislocation. The surgical procedure provides similar outcomes compared to conservative treatment regarding MEPS and ROM for patients with slight initial instability in physical examination and radiographs. People with red flags for persistent instability, such as severe bilateral ligament injuries and moderate to severe instability during initial physical examination, should be considered for a primary surgical approach to prevent recurrent posterolateral and valgus instability. Postoperative early mobilization and early mobilization for conservatively treated patients is beneficial to improve patient outcome and ROM.