bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review of Topical Tapinarof for the Treatment of Plaque Psoriasis
Authors: Grossmann Meghan C. , Pixley Jessica N. , Feldman Steven R.
Published: April 2023

Objective:

This article reviews the efficacy and safety of 1% tapinarof cream for plaque psoriasis.

Data sources:

A literature search was conducted from August 2022 to February 2023. The terms tapinarof, VTAMA, benvitimod, GSK2894512, DMVT-505, and WBI-1001 were queried in PubMed. ClinicalTrials.gov was searched to identify ongoing or unpublished studies.

Study selection and data extraction:

All clinical trials written in English and relevant to pharmacology, efficacy, and safety were included.

Data synthesis:

In two 12-week phase III clinical trials, disease severity assessed by a Physician’s Global Assessment (PGA) score of clear or almost clear and a 2-point PGA improvement was 35.4% and 40.2% at week 12 in the 2 trials, respectively. In the 40-week, open-label extension trial, the efficacy and safety results were similar: 40.9% of patients achieved a PGA of 0 at least once during the trial, and 58.2% of patients with PGA ≥ 2 achieved PGA 0/1 at least once.

Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:

Tapinarof is a topical aryl hydrocarbon receptor agonist and a first-in-class, potentially promising treatment for plaque psoriasis recently approved by the U.S. Food and Drug Administration.

Conclusion:

Compared with placebo, tapinarof may be an effective and safe topical treatment for mild to severe plaque psoriasis. Head-to-head trials to compare the efficacy and adverse effect profile of tapinarof to other topical treatments are still needed, as are investigation in patients with recent or current use of phototherapy or biologic or nonbiologic systemics. Cost and adherence to treatment may be barriers for treatment efficacy.
Gender and Content Differences in Domain and Focus of Homework Used in Couple Therapy
Authors: Mennenga Kayla D. , Tambling Rachel R. , Johnson Lee N. , Anderson Shayne R.
Published: April 2023

The assignment of tasks, or therapeutic homework, by a mental health professional for clients to complete provides clients with an opportunity to practice targeted skills or apply lessons learned in therapy sessions to practical situations. While the assignment of homework by mental health professionals is commonplace, less is known about the content domain of homework, or how homework might be distributed in terms of focus or actor. We present the results of an examination of the gender, focus, and thematic content distributions for individuals of homework tasks in a sample of ( n = 66) individuals in heterosexual couples engaged in couple therapy. Findings suggested that most of the between-session activities completed are specific and clear in nature and are focused on skill-building tasks. The outcome of the homework was nearly equally split between couples and individuals, suggesting that participants, while in couple therapy, were also engaged in some personal development. Women reported more self-improvement work compared to men, and men reported more behavioral targeted in-between session activities. Findings provided a preliminary indication that much of the work done by clients between sessions did not seem to have been explicitly assigned by a therapist. Implications for therapists and suggestions for homework provision are discussed.
Immune-Related Genes’ Prognostic, Therapeutic and Diagnostic Value in Ovarian Cancer Immune-Related Gene Biomarker in Ovarian Cancer
Authors: Ding Bo , Yan Wenjing , Shen Siyuan , Meng Dan , Chen Xue , Wang Shizhi , Shen Yang
Published: April 2023

Objectives

The abnormal expression of immune-related genes (IRGs) plays an important role in the occurrence and progression of ovarian cancer (OC), which is the main cause of mortality among gynecological cancer patients. This study aims to establish a prognostic risk model and comprehensively analyze the relationship between OC risk score and prognosis, immune cell infiltration (ICI) and therapeutic sensitivity in OC.

Methods

We retrospectively evaluated the clinicopathological characteristics of consecutive OC patients in the Cancer Genome Atlas (TCGA) database. First, the prognostic risk model was constructed by bioinformatics methods. And then, we systematically assessed model robustness, and correlations between risk score and prognosis, and immune cell infiltration. The ICGC cohort was used to verify the prognostic risk model. Finally, we evaluated their value in the treatment of OC immunotherapy and chemotherapy.

Results

A total of 10 IRGs were identified to construct the prognostic risk model. Survival analysis revealed that patients in the low-risk group had a better prognosis ( P < .01), and the risk score might be considered an independent predictor for predicting the prognosis. In addition, risk scores and patient clinical information were used to construct clinical nomograms, improving the prediction’s precision. We also explored the relationship between the risk score and ICI, immunotherapy and drug sensitivity.

Conclusions

Collectively, we identified a novel ten IRGs signature that may be applied as a prognostic predictor of OC, thereby benefiting clinical decision-making and personalized treatment of patients.
Adaptive neural network independent joint-based control for an ODE-PDE rigid-flexible manipulator with multiple constraints
Authors: Liu Shuyang , Yang Honglei , Liu Zhijie , Langari Reza , Li Yuanchun
Published: April 2023

This paper deals with the adaptive neural network control of a nonlinear rigid-flexible manipulator subject to external disturbances and multiple constraints. The system dynamic is modeled by ordinary and partial differential equation (ODE and PDE) based on Hamilton’s Principle. An adaptive neural network sliding mode control strategy is designed to estimate the unknown disturbances and uncertain parameter. The sliding surface consisting of angular error, angular velocity error, and end-point vibration information is proposed based on the energy analysis of the flexible beam. The tangent barrier Lyapunov function is used to ensure the angle errors and end-point deflection within the restrictions. It is shown that the joint motion and vibration of the flexible beam can be adjusted only with an independent joint control input, and no boundary force input is required for vibration suppression. The stability is obtained by semi-group theory and LaSalle’s Invariance Principle. Simulation results demonstrate the effectiveness of the control strategy.
Does circle priming improve smart infusion pump and electronic health record interoperability for chemotherapy in a pediatric hematology/oncology setting?
Authors: Agedal Kaitlyn J , Steidl Kelly E , Burgess Jeni L , Seabury Robert W , Wojnowicz Sarabeth R
Published: April 2023

Introduction

The objective of this project was to assess the percentage of interoperability compliance within our pediatric hematology/oncology patient care areas for intravenous chemotherapy medications before and after the implementation of circle priming.

Methods

We conducted a retrospective quality improvement project at an inpatient pediatric hematology/oncology floor and outpatient pediatric infusion center before and after implementation of circle priming.

Results

There was a statistically significant increase in percent interoperability compliance for the inpatient pediatric hematology/oncology floor from 4.1% prior to implementation of circle priming to 35.6% after (odds ratio 13.1 (95% CI, 3.96−43.1), p < 0.001), as well as for the outpatient pediatric infusion center from 18.5% to 47.3%, respectively (odds ratio 3.9 (95% CI, 2.7−5.9), p < 0.001).

Conclusion

Implementation of circle priming has significantly increased the percentage of interoperability compliance for intravenous chemotherapy medications in our pediatric hematology/oncology patient care areas.
Intracerebral de novo arterio-venous malformations as a side effect of bevacizumab
Authors: Elmali Aysenur , Gocmen Rahsan , Kilickap Saadettin , Yazici Gozde
Published: April 2023

Introduction

Bevacizumab is a monoclonal antibody for the vascular endothelial growth factor receptor and is utilized in the treatment of various tumors. Gastrointestinal perforation/fistula, heart failure, hemorrhage, hypertension, proteinuria/nephrotic syndrome, thromboembolism, posterior reversible encephalopathy syndrome, and necrotizing fasciitis are serious side effects of bevacizumab. Bevacizumab associated de novo brain arterio-venous malformation formation has not been documented in the literature.

Case report

Here, we presented a 35-year-old female patient with recurrent high-grade glial tumor who developed multiple supra- and infratentorial de novo arterio-venous malformations after receiving the last dose of bevacizumab.

Management & Outcome

Intervention options for the adverse effect were limited. In fact, there was no chance of intervention because the patient died for another reason.

Discussion

Based on this experience, it can be hypothesized that bevacizumab may induce de novo arterio-venous malformations in the brain as a result of arterial and venous thrombotic effects. Additional studies should be done to clarify the causal relationship between bevacizumab and arterio-venous malformations in primary brain tumors.
Sexual Misconduct: What Does a 20-Year Review of Cases in Quebec Reveal about the Characteristics of Professionals, Victims, and the Disciplinary Process?
Authors: Martin Geneviève Manuela , Beaulieu Isabelle
Published: April 2023

While there is a considerable body of literature on sexual aggression, we know much less about the violation of sexual boundaries within professional relationships. To address this knowledge gap, the characteristics of cases of sexual misconduct in the province of Quebec were extracted, based on a search of published disciplinary decisions between 1998 and 2020, using the legal databases CANLII and SOQUIJ. The search yielded 296 decisions including 249 male and 47 female members from 22 professional orders, and involving 470 victims. Results indicate that male professionals approaching mid-career accounted for a greater proportion of cases of sexual misconduct. Moreover, physical and mental health professionals were overrepresented in cases, as were female adult victims. Acts of sexual misconduct concerned mostly sexual touching and intercourse and occurred during consultations. Female professionals were more inclined to establish romantic and sexual relationships with clients than their male counterparts. Of the 92.0% of professionals found guilty of at least one count of sexual misconduct, two thirds eventually returned to practice. Following the guilty verdict, few faced rehabilitative measures. Recommendations are provided for the prevention of sexual recidivism and the accompaniment of victims of sexual misconduct throughout the disciplinary process.
Vitalizing to Learn for Service Proactivity: Not All Forms of Organizational Support Are Equal
Authors: Hwang Pin-Chyuan , Han Ming-Chuan
Published: April 2023

Addressing the association between proactive vitality management (PVM) and proactive customer service performance (PCSP), this study focuses on how informal field-based learning (IFBL) mediates the relationship between PVM and PCSP and examines how perceived organizational supports for strengths use (POS for strengths use) and perceived organizational support for deficit correction (POS for deficit correction) may moderate said relationship. Using a sample of 225 supervisor–subordinate matched data collected from Taiwanese travel agencies, IFBL was found to mediate the positive relationship between PVM and PCSP. POS for deficit correction also positively moderated the pathway of the mediated relationship. These findings offer novel research directions by integrating studies on proactivity and on both types of POS (i.e., for strengths use and deficit correction), thereby elucidating previously unexplored theoretical predictions.
Trends in Subcutaneous Tumour Height and Impact on Measurement Accuracy
Authors: Brough Daniel , Amos Hope , Turley Karl , Murkin Jake
Published: April 2023

Tumour volume is typically calculated using only length and width measurements, using width as a proxy for height in a 1:1 ratio. When tracking tumour growth over time, important morphological information and measurement accuracy is lost by ignoring height, which we show is a unique variable. Lengths, widths, and heights of 9522 subcutaneous tumours in mice were measured using 3D and thermal imaging. The average height:width ratio was found to be 1:3 proving that using width as a proxy for height overestimates tumour volume. Comparing volumes calculated with and without tumour height to the true volumes of excised tumours indeed showed that using the volume formula including height produced volumes 36X more accurate (based off of percentage difference). Monitoring the height:width relationship (prominence) across tumour growth curves indicated that prominence varied, and that height could change independent of width. Twelve cell lines were investigated individually; the scale of tumour prominence was cell line-dependent with relatively less prominent tumours (MC38, BL2, LL/2) and more prominent tumours (RENCA, HCT116) detected. Prominence trends across the growth cycle were also dependent on cell line; prominence was correlated with tumour growth in some cell lines (4T1, CT26, LNCaP), but not others (MC38, TC-1, LL/2). When pooled, invasive cell lines produced tumours that were significantly less prominent at volumes >1200 mm3 compared to non-invasive cell lines ( P < .001). Modelling was used to show the impact of the increased accuracy gained by including height in volume calculations on several efficacy study outcomes. Variations in measurement accuracy contribute to experimental variation and irreproducibility of data, therefore we strongly advise researchers to measure height to improve accuracy in tumour studies.
Correlates of Insulin Resistance in Nascent Metabolic Syndrome
Authors: Adams-Huet Beverley , Jialal Ishwarlal
Published: April 2023

Background:

Metabolic Syndrome (MetS), a major global problem, is a cluster of cardio-metabolic risk factors that predisposes to both type 2 diabetes mellitus (T2DM) and premature atherosclerotic cardiovascular disease (ASCVD). Insulin resistance is a major underpinning of MetS.

Objectives:

We investigated the relationship between insulin resistance and biomarkers of inflammation, oxidative stress, free fatty acids (FFA) levels and adipokine dysregulation in a cohort of nascent MetS.

Design:

This was a cross-sectional study comparing patients with MetS with matched controls.

Patients and Methods:

Participants included 47 patients with MetS and 41 controls. Persons with diabetes, ASCVD, smoking and macro-inflammation were excluded. Fasting blood was obtained for both plasma and monocyte isolation. Homeostasis model assessment insulin resistance index (HOMA-IR) was calculated from fasting glucose and insulin levels.

Results:

The patients were insulin resistant as determined by a valid measure, HOMA-IR. HOMA-IR increased with increasing severity of MetS and correlated with cardio-metabolic features, hsCRP, FFA levels, and adipose tissue insulin resistance. Insulin resistance also correlated with biomarkers of oxidative stress and both circulating and cellular biomarkers of inflammation. Receiver operating Characteristic (ROC) curve analysis revealed that HOMA-IR was an excellent predictor of MetS with an area under the curve of 0.80.

Conclusion:

In our patients with nascent MetS we show that they have significant insulin resistance. Based on our findings, elevated FFA levels, oxidative stress and inflammation could contribute to the insulin resistance.
Reciprocal relations between past behavior, implicit beliefs, and habits: A cross-lagged panel design
Authors: Hamilton Kyra , Phipps Daniel J , Loxton Natalie J , Modecki Kathryn L , Hagger Martin S
Published: April 2023

The current study assessed cross-lagged relationships between binge drinking, implicit beliefs, and habit in undergraduate university students ( N = 105). Students completed self-report survey and implicit measures in lab visits 3 months apart. A structural equation model revealed cross-lagged relations between habit and behavior, and some evidence for a reciprocal relationship between implicit beliefs and habit. Implicit beliefs were related to alcohol behavior across time, but no cross-lagged relationship was observed. Findings provide preliminary support for recent advances in habit theory, suggesting that implicit beliefs and habit may develop in tandem or even share common knowledge structures and schemas.
Motivational interviewing in child sexual abuse investigations: Approaches shown to increase suspect engagement and information gathering during police interviews
Authors: Humann Michael , Alison Emily , Alison Laurence , Surmon-Böhr Frances , Ratcliff Joshua , Christiansen Paul , Tejeiro Ricardo
Published: April 2023

On average, more than 200 child sex offences were recorded by UK police every day in 2020, and investigations for offences including rape, online grooming and sexual assault against children in the United Kingdom (UK) increased by 57% from 2014/15 to 2019/20. The interview process is central to information gathering, but empirical research regarding the obtention of information through child sexual abuse (CSA) suspect interviewing is still limited. The current study analyses 45 hours of interviews with CSA suspects focusing on behaviours consistent (and inconsistent) with motivational interviewing (MI) using the Observing Rapport-Based Interpersonal Techniques coding manual. In line with previous research demonstrating the efficacy of MI with terrorist suspects, this article focuses on the same four key interviewer skills identified in the therapeutic literature (reflective listening, summarising, rolling with resistance and developing discrepancies). It looks at their effects on information yield (information of intelligence value) and suspect engagement. Results revealed that the four MI-consistent behaviours increased information gain. Also, approaches antithetical to MI (including assumptive questioning, judgemental summaries, fighting resistance and accusatory challenges) had a significant negative impact on suspect engagement and, by extension, reduced yield – potentially by creating suspect reactance (where the individual is motivated to regain a freedom they feel is being threatened). Hence, MI approaches are efficacious for information-gathering efforts, and using an approach antithetical to the spirit of motivational interviewing (like pressuring, confronting and judging) with CSA suspects will always make things worse.
Resisting hyperreality? Talking to young children about YouTube and YouTube Kids
Authors: O’Connor Jane , Fotakopoulou Olga , Johnston Kelly , Kewalramani Sarika , Ludgate Shannon
Published: April 2023

This article reports on a study investigating how 13 young children in English-speaking countries (England, Scotland, Australia and the USA) watch and engage with digital content on YouTube and YouTube Kids. Given the increasing amount of time children spend viewing these platforms, and related concerns around the commercial algorithms that direct their viewing choices, the research aims were to understand how young children make choices about what to watch, and to explore the extent of their comprehension of the constructed, ‘unreal’ nature that characterises a large proportion of these videos, particularly those presented by children (micro-celebrities). Using child-centred methodologies, the research was carried out by parent-researchers, and the findings were analysed and interpreted using elements of Baudrillard's theory of hyperreality. The study found that the children selected videos for a variety of reasons, including those related to their ‘real-life’ interests, and were largely able to discern between the real and the hyperreal in videos by drawing on existing frames of reference and applying their developing knowledge and understanding of the world. The article provides insights into young children’s experiences, understandings and preferences around using YouTube and YouTube Kids, and extends Baudrillard’s perspectives on the hyperreal from postmodernism into a post-digital conceptual realm.
Understanding hydrogen jet dynamics for direct injection hydrogen engines
Authors: Lee Sanguk , Hwang Joonsik , Bae Choongsik
Published: April 2023

The energy paradigm is shifting toward carbon-free and low-emission alternative fuels. Among the many candidates, hydrogen is considered a promising option thanks to its favorable fuel properties, including zero carbon content, high gravimetric energy density, and fast flame speed, despite its technical fuel production and storage challenges. Direct injection technology has been identified as the best approach for applying hydrogen in combustion engines to overcome the accompanying issues, such as backfire and low energy density. However, studies have yet to be conducted on hydrogen jet behavior in direct injection systems, specifically, studies that elucidate engine design and injection parameter optimization in the combustion system. Therefore, we aimed to assess hydrogen jet behavior through experiments and computational approaches comprehensively. Hydrogen was injected at 10 MPa using the direct injection method into a constant volume chamber under a quasi-steady ambient condition. Z-type high-speed Schlieren imaging was performed using a high-speed camera to visualize the hydrogen jet structure, which depicted the hydrogen jet’s vapor intermittency and vortex structure. We also performed a computational fluid dynamics (CFD) simulation to understand the aerodynamics of the jet. The results showed the formation of vortical flow in the inner core region, where the pressure was comparatively lower than that on the outer side of the jet. Our further investigation of the injection strategy showed that multiple injections were more beneficial in forming a favorable hydrogen-air mixture near the spark plug than a single injection case.
The contributions of the analysis of alienation to the social critique of labour in neoliberal capitalism
Authors: Tekin Nial
Published: April 2023

From a sociological perspective, this paper attempts to contribute to the discussion on work and democracy led by Axel Honneth. Through Honneth’s analyses, this text focuses particularly on the concept of alienation. The central argument is that the analysis of alienation can provide critical insights into the limitations of democratic practices within contemporary organizations of work. The paper draws on empirical and theoretical debates in sociology to demonstrate the concept of alienation as a lens for analysing the complex relationships between labour and democracy.
‘But dragons don’t exist, do they?’: Preschoolers’ focus in determining whether a picturebook is a non-fiction or not
Authors: Backman Anna
Published: April 2023

Preschoolers are offered few opportunities to become acquainted with non-fiction books, and when they are given the possibility to read non-fiction picturebooks, these are often fictionalised in one way or another. The fictionalisation of children’s non-fiction blurs the boundaries between fiction and non-fiction picturebooks. This could mean that children’s early opportunities to experience how different kinds of books, pictures and texts can be used and produced for different purposes are also blurred. Against this background, reading activities are designed in this study in which a group of five-year-olds is introduced to fiction and non-fiction picturebooks side by side. The study aims to contribute to an understanding of how children distinguish and experience different kinds of picturebooks when they are introduced to differences between them, and answers the research question: What is in focus when preschoolers determine whether a picturebook is a non-fiction or not? The analysis shows that the depiction (whether the picturebook depicts imaginary constructs or established knowledge) is in focus when preschoolers make this determination . This gives the children in the reading activities the opportunity to experience different kinds of picturebooks, but also to question whether non-fiction picturebooks depicting imaginary constructed (‘made up’) things, characters and events are non-fiction and to evaluate the reliability of such fictionalised non-fiction picturebooks.
Intimate Partner Violence and Immigration in the United States: A Systematic Review
Authors: Morrison Abigail M. , Campbell Julia K. , Sharpless Laurel , Martin Sandra L.
Published: April 2023

This systematic review sought to describe the prevalence of intimate partner violence (IPV) victimization among immigrants in the United States (U.S.) and the prevalence of IPV perpetration among immigrants in the U.S. PsycInfo, PubMed, Global Health and Scopus databases were searched for peer-reviewed literature that quantitatively examined IPV in relation to immigration. Twenty-four articles were included in the final review. Past-year IPV victimization rates among immigrants ranged from 3.8% to 46.9% and lifetime IPV victimization rates ranged from 13.9% to 93%; past-year IPV perpetration rates ranged from 3.0% to 24.8% and the one lifetime IPV perpetration rate was 12.8%. Estimates varied widely by country of origin, type of violence measured, and measure used to quantify IPV. Reliance on small convenience samples is problematic when trying to determine the true prevalence of IPV among immigrants. Epidemiological research is needed to improve the accuracy and representativeness of findings.
Competitive Risk Model Nomogram to Predict Prognosis in Patients Aged Over 65 Years with nonmetastatic Cervical Cancer: A SEER Population-Based Study
Authors: Jiao Shengyuan , Guo Li , Da Fei , Gao Qiaohui , Ren Zhenghua , Wang Jianyu , Fu Quanwei , Liu Junye
Published: April 2023

Objective: The prognostic factors for elderly patients with cervical cancer differ from those of younger patients. Competitive risk events could cause biases in the Cox proportional hazards (PH) model. This study aimed to construct a competitive risk model (CRM) nomogram for patients aged > 65 years with nonmetastatic cervical cancer. Methods: We retrospectively analyzed data extracted from the Surveillance, Epidemiology, and End Results (SEER) database and a total of 1856 patients from 18 cancer registries across the United States diagnosed between 2010 and 2015 were included. Kaplan–Meier analysis and log-rank tests were used to compare intergroup survival. Univariate and multivariate Cox proportional regression analyses were performed to identify independent prognostic factors. The cumulative incidence function (CIF) and Fine and Gray's test were used to determine the impact of competitive risk events on prognosis. The CRM nomogram was internally and externally validated using time-dependent receiver operator characteristic (ROC) curve (time-AUC), Brier scores, Harrell's concordance index (C-index), calibration curve, and decision curve analysis (DCA). Results: Analyses revealed that histology, age, the International Federation of Gynaecologists and Obstetricians (FIGO) stage, number of in situ malignancies, chemotherapy, radiotherapy (RT), and surgery were independent prognostic factors. The CRM nomogram accurately predicted 1-year, 3-year, and 5-year disease-specific survival (DSS). The C-indexes and Brier scores of the CRM nomogram were 0.641 and 0.094, respectively, at the 1-year cut-off in the training set. The time-AUC of the CRM nomogram at the 1-year, 3-year, and 5-year intervals in the training set were 77.6%, 77.3%, and 74.5%, respectively. The calibration curve demonstrated a favorable concordance. DCA suggested that the nomogram had a good net benefit. Therefore, the Cox model underestimated the weight of risk factors compared to CRM. Conclusions: This study presents the CRM nomogram to predict DSS in patients aged > 65 years with nonmetastatic cervical cancer. It can help clinicians implement more accurate personalized diagnostic and treatment modalities for elderly patients with cervical cancer.
Comparative Effectiveness of Combined and Single Neurostimulation and Traditional Dysphagia Therapies for Post-Stroke Dysphagia: A Network Meta-Analysis
Authors: Banda Kondwani Joseph , Wu Ko-Chiu , Jen Hsiu-Ju , Chu Hsin , Pien Li-Chung , Chen Ruey , Lee Tso-Ying , Lin Sheng-Kai , Hung Shih-Han , Chou Kuei-Ru
Published: April 2023

Background

Comparative therapeutic benefits of combined and single neurostimulation therapies including neuromuscular electrical stimulation (NMES), pharyngeal electrical stimulation (PES), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and traditional dysphagia therapy (TDT) remain unknown in post-stroke dysphagia (PSD) rehabilitation. Therefore, we performed the first network meta-analysis (NMA) to determine comparative effectiveness of combined and single neurostimulation and traditional dysphagia therapies for PSD.

Methods

A frequentist NMA model was performed with therapy effect sizes presented as standardized mean differences (SMD) and corresponding 95% confidence interval (95% CI) for therapy comparisons while netrank function ranked the therapies in R-Software. Meta-regression models for study characteristics were analyzed using Bayesian NMA Model.

Results

Overall, 50 randomized controlled studies with 2250 participants were included. NMES + TDT 3.82 (95% CI, 1.62-6.01), tDCS + TDT 3.34 (95% CI, 1.09-5.59), rTMS + TDT 3.32 (95% CI, 1.18-5.47), NMES 2.69 (95% CI, 0.44-4.93), and TDT 2.27 (95% CI, 0.12-4.41) demonstrated very large effect in improving swallowing function. NMES + TDT −0.50 (95% CI, −0.68 to −0.32, rTMS + TDT −0.44 (95% CI, −0.67 to −0.21), TDT −0.28 (95% CI, −0.46 to −0.10), and NMES −0.19 (95% CI, −0.34 to −0.04) demonstrated medium to small effect in reducing pharyngeal transit time (PTT). rTMS −0.51 (95% CI, −0.93 to −0.08) demonstrated medium effect in reducing oral transit time (OTT). No significant therapy comparison differences were found for reducing aspiration/penetration. The highest ranked therapy was NMES + TDT for better swallowing function and reduction of PTT, rTMS for reduction of OTT, and tDCS + TDT for reduction of aspiration/penetration. Therapeutic effects of the therapies were moderated by frequency, sessions, and duration.

Conclusion

Combined therapies including NMES + TDT, tDCS + TDT, and rTMS + TDT demonstrate better therapeutic effect for improved swallowing function and reduction of PTT, OTT, and aspiration/penetration for PSD.
Effect of Robot-Assisted Gait Training on Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Yang Fu-An , Lin Chien-Lin , Huang Wan-Chien , Wang Hsun-Yi , Peng Chih-Wei , Chen Hung-Chou
Published: April 2023

Background

In recent meta-analyses, robot-assisted gait training for patients with multiple sclerosis (MS) have yielded limited clinical benefits compared with conventional overground gait training.

Objective

To investigate the effect of robot-assisted gait training for patients with MS on clinical outcomes through a systematic review and meta-analysis.

Methods

We searched for relevant studies in the PubMed, EMBASE, Cochrane Library, and Physiotherapy Evidence Database databases from their inception to April 7, 2022. We selected studies that (1) included participants with MS, (2) used robot-assisted gait training as the intervention, (3) included conventional overground gait training or another gait training protocol as control treatment, and (4) reported clinical outcomes. Continuous variables are expressed as standardized mean differences with 95% confidence intervals. Statistical analyses were performed using RevMan 5.4 software.

Results

We included 16 studies enrolling 536 participants. Significant improvement was observed in the intervention group, with low heterogeneity at the end of the intervention with regard to walking velocity (standardized mean difference [SMD]: 0.38, 95% confidence interval [CI]: [0.15, 0.60]), walking endurance (SMD: 0.26, 95% CI [0.04, 0.48]), mobility (SMD: −0.37, 95% CI [−0.60, −0.14]), balance (SMD: 0.26, 95% CI [0.04, 0.48]), and fatigue (SMD: −0.27, 95% CI [−0.49, −0.04]). The results of subgroup analyses revealed improvements in these outcomes for the intervention group using grounded exoskeletons. No significant differences were noted in all the outcomes between the groups at follow-up.

Conclusions

Robot-assisted gait training with grounded exoskeletons exerts a positive short-term effect and is an adequate treatment option for patients with MS.
Anatomical Variations of the First Dorsal Compartment in de Quervain Tenosynovitis
Authors: Liu Christina , Moye Stephen , Blazar Philip , Earp Brandon E. , Zhang Dafang
Published: April 2023

Background:

De Quervain tenosynovitis of the wrist is a common pathology. The primary aim of this study is to determine the prevalence of extensor pollicis brevis and abductor pollicis longus (APL) anatomical variations in association with de Quervain tenosynovitis. The secondary aim was to compare additional patient-specific factors associated with de Quervain tenosynovitis.

Methods:

This retrospective study included 172 patients with de Quervain tenosynovitis who underwent first dorsal compartment release and 179 patients with thumb carpometacarpal (CMC) arthritis who underwent thumb CMC arthroplasty between August 1, 2007, and May 1, 2022. The CMC group was chosen as the control group because the study surgeons perform APL suspensionplasty as the primary procedure for thumb CMC arthritis, allowing for a comparison group without de Quervain tenosynovitis. Exclusion criteria included patients undergoing revision surgery, patients undergoing thumb CMC procedure other than APL suspensionplasty, and patients with both CMC and first dorsal compartment diagnoses. Demographics, clinical variables, and intraoperative findings were collected through retrospective chart reviews.

Results:

Patients in the de Quervain tenosynovitis group tended to be younger (51 years, range: 23-92 years vs 63 years, range: 28-85 years), women (86.1% vs 77.1%), and more commonly of African American or black race (15.7% vs 3.9%) and Asian race (5.2% vs 0%). There was a higher prevalence of tendon subcompartments (79.1% vs 64.2%), but fewer number of APL slips (38.3% vs 20.7% 2 or fewer slips) seen in the de Quervain tenosynovitis group.

Conclusion:

Anatomical variation exists between patients with and without de Quervain tenosynovitis. The presence of tendon subcompartments but not an increased number of tendon slips is associated with de Quervain tenosynovitis.
Research on the application of impedance control in flexible grasp of picking robot
Authors: Zhuang Min , Li Ge , Ding Kexin , Xu Guansheng
Published: April 2023

Aiming at the damage of fruit picking robot during the picking process, an impedance control method of picking robot with parameter self-tuning is proposed. The rheological properties of fruit during picking by manipulator were studied by Burger’s viscoelasticity theory, and the variation characteristics of fruit deformation during picking, as well as the changing law between fruit contact force and deformation were obtained. On this basis, the impedance control system model of the picking manipulator is established, and the impedance controller is designed. Finally, by constructing the self-correcting change function of impedance parameters, the influence of different impedance parameters on the change of the contact force is studied, and then the control system is improved and designed. The simulation and experimental results show that the established impedance control system model can effectively realize the non-destructive grasping of fruit, and has high grasping accuracy. The expected grasping force is smoother, the overshoot of the contact force is greatly reduced, and the adjustment time is also shortened, which indicates that the control method proposed in this paper has certain application value in the control of picking robots.
Unsteady free convection in a composite enclosure having flexible wall
Authors: Alhashash Abeer , Saleh Habibis
Published: April 2023

Transient free convection in a composite enclosure having a cold flexible plate and a hot rigid plate is simulated numerically. It is assumed that the flexible plate is hyper-elastic. A porous layer with various sizes and permeabilities is attached to the rigid plate. The enclosure is filled with water. Fluid flow in the fluid domain was governed by the Navier–Stokes equations, and the flow within a saturated porous layer was governed by the Brinkman-Forchheimer extended Darcy model. The unsteady continuity, momentum, and energy equations are solved using the Arbitrary-Lagrangian-Eulerian (ALE) approach based on the fluid-structure interaction (FSI). It is found that the development of convective flow goes through initial, transitional, and stationary states. Each state interval is shifted by varying the Darcy number and Rayleigh number. In the transitional state, the deformation of the flexible parts reaches its maximum bending. The profile of the flexible plate at steady state is in a sinusoidal shape for the non-Darcy regime, while it is in an asymmetric parabolic shape for the Darcy regime. The steady state is reached for [Formula: see text], [Formula: see text], and [Formula: see text] before [Formula: see text].
Mathematical model for graphene nanofluid flow over a stretching surface with velocity slips thermal convective and mass flux conditions
Authors: Makhdoum Basim M , Khan Waleed , Khan Waris , Fadhl Bandar M
Published: April 2023

Nowadays graphene is emerging as one of the most exciting nanomaterial due to its continuous 29 electrically conducting behavior even at zero carrier concentration. With this initiation, we investigate the flow of magnetohydrodynamic (MHD) water, water−30%EG, water−50%EG, graphene nanofluid over a stretched surface with thermal convection, and zero mass flux conditions and velocity slips comprising motile microorganisms and nanoparticles. Thermal radiation and Arrhenius activation energy are also be under consideration. The governing fluid equations are solved by Homotopy analysis method (HAM) and computed numerically with shooting technique after employing appropriate transformations. The consequence of numerous physical parameters on velocity, concentration, temperature, and density of motile microorganisms graphs as well as table are used for ethylene glycol based and water-based graphene nanoparticles. Additionally, numerically analyze the designed skin friction, Nusselt number, Sherwood number, and density of motile microorganisms. It is observed that due to heat generation and temperature the improvement of the nonlinear convection variable improves the wall friction. It is also originate that increasing the volume fraction of nanoparticles effectively boosting the thermal conductivity of water−50%EG when compared with water−30%EG and water nanofluids. Ethylene glycol based graphene nanofluids take less time for process as compared to water based nanofluids.
The myometrial–cervical ratio: Can a simple sonographic measurement improve diagnosis of adenomyosis in a regional setting?
Authors: Sewell Megan , Mooney Samantha , Cvejic Erin , Stone Kate
Published: April 2023

Introduction:

Adenomyosis is histologically defined by the presence of endometrial glands and stroma in the myometrium. Ultrasound findings of adenomyosis are being redefined to better diagnose adenomyosis pre-operatively.

Methods:

A single-centre retrospective study was performed at a regional hospital. The myometrial–cervical ratio was calculated on pre-operative ultrasounds, and histopathology reviewed for each case. Logistic regression was used to estimate the association between the myometrial–cervical ratio and adenomyosis confirmed on histopathology, and the area under the receiver operating characteristic curve was calculated. Comparisons were performed based on the presence of fibroids on ultrasound.

Results:

Complete data were available for 136 benign hysterectomies between 1 January 2015 and 31 December 2020. When the myometrial–cervical ratio was treated as a continuous variable in a logistic regression of adenomyosis on histopathology, there was no statistical evidence (χ2(1) < 0.01, p = 0.98) of an association. When cases including fibroids in the myometrial–cervical ratio were excluded, there was a non-significant association between myometrial–cervical ratio and adenomyosis on histopathology (odds ratio = 3.435, 95% confidence interval = 0.964, 12.235; χ2(1) = 3.62, p = 0.057); area under the receiver operating characteristic = 0.637 (95% confidence interval = 0.504, 0.770). The optimal myometrial–cervical ratio cutpoint was 1.875 (95% confidence interval = 1.698, 2.051), which achieved 71.43% sensitivity and 60.00% specificity. There was strong statistical evidence (χ2(1) = 9.02, p = 0.003) that the myometrial–cervical ratio outperformed standard pre-operative ultrasound identification of adenomyosis.

Conclusion:

While accuracy remains suboptimal, the myometrial–cervical ratio outperformed standard ultrasound diagnostic features of adenomyosis in a regional setting. The myometrial–cervical ratio may offer a simple imaging measurement for adenomyosis in inexperienced hands when fibroids are absent.
Fetal echogenic bowel: Is there a national consensus on identification and reporting?
Authors: Sevens Trudy Jane , Chudleigh Trish
Published: April 2023

Introduction:

Saving Babies’ Lives Care Bundle Version 2 highlights the importance of correct identification and reporting of echogenic bowel to improve maternal and newborn outcomes. Yet there is no national consensus to guide sonographers in identifying and reporting fetal echogenic bowel. This two-phase study aims to develop a national consensus to guide sonographers on the identification, classification and reporting of fetal echogenic bowel during the Fetal Anomaly Screening Programme (FASP) second trimester anomaly scan. Phase 1 results are presented capturing the national current practice of sonographers in its identification.

Methods:

An online questionnaire survey was deployed to capture numerical and free text data. Data analysis was by descriptive statistics. Participants were recruited via social media and through professional networks and organisations.

Results:

A total of 95 participants completed the questionnaire during an 11-week period. Common practice across England included sonographers using a subjective method for identifying fetal echogenic bowel and making comparisons to fetal bone. However, there was wide variance in the fetal bone used and the transducer frequency typically used to assess bowel echogenicity. Confirmation of echogenic bowel was made at the 20-week scan in 58% of cases, 32% following fetal medicine department review with the remaining 10% unsure when confirmation occurred.

Conclusion:

While there is common practice in identifying and report echogenic fetal bowel in some areas, there remains disparity within sonographer practice in England’s national screening service. This study allowed baseline data to be collated, providing the first steps towards development of guidance for sonographers in identifying and reporting this appearance.
Antitussive efficacy of the current treatment protocol for refractory chronic cough: our real-world experience in a retrospective cohort study
Authors: Zhang Mengru , Morice Alyn H. , Si Fengli , Zhang Li , Chen Qiang , Wang Shengyuan , Zhu Yiqing , Xu Xianghuai , Yu Li , Qiu Zhongmin
Published: April 2023

Background:

The management of refractory chronic cough (RCC) is a great challenge. Neuromodulators have long been used for RCC with imperfect efficacy.

Objectives:

We summarized the outcomes of the current treatments used at our specialist cough clinic, which provides a guideline-led service and real-world experience for the future management of RCC.

Design:

This is a single-centre retrospective observational cohort study.

Methods:

Consecutive RCC patients (the first clinic visit between January 2016 and May 2021) were included into this observational cohort study. Medical records in the Chronic Cough Clinical Research Database were fully reviewed using uniform criteria. The included subjects were followed-up for at least 6 months after the final clinic visit via instant messages with the link to self-scaled cough-associated questionnaires.

Results:

Overall, 369 RCC patients were analysed with a median age of 46.6 years and a cough duration of 24.0 months. A total of 10 different treatments were offered. However, 96.2% of patients had been prescribed at least one neuromodulator. One-third of patients had alternative treatments prescribed given the poor response to the initial therapy and 71.3% favourably responded to at least one of the treatments. Gabapentin, deanxit, and baclofen had comparable therapeutic efficacy (56.0%, 56.0%, and 62.5% respectively; p = 0.88) and overall incidences of adverse effects (28.3%, 22.0%, and 32.3% respectively; p = 0.76). However, 19.1 (7.7–41.8) months after the last clinic visit, 65.0% reported improvement (24.9%) or control of their cough (40.1%); 3.8% reported a spontaneous remission and 31.2% still had a severe cough. Both HARQ ( n = 97; p < 0.001) and LCQ ( n = 58; p < 0.001) demonstrated marked improvement.

Conclusion:

Trying different neuromodulators is a pragmatic strategy for RCC, which helped around two-thirds of patients. Relapse is common on withdrawal or reduction of dosage. Novel medication for RCC is an urgent clinical need.

Plain language summary

This is the first report that fully represented a guideline-led treatment protocol for refractory chronic cough (RCC) based on a large series of patients, which evaluated the short- and long-term effects of the currently available treatments for RCC. We found that the therapeutic trial of different neuromodulators is a pragmatic strategy, which helped around two-thirds of patients. Gabapentin, deanxit (flupentixol/melitracen), and baclofen had similar therapeutic outcomes. This study may offer real-world experience for the future management of RCC.