bluuebunny/crossref_metadata_2025 huggingface dataset:
Interventions and imaging in patients with anatomic variations of cerebral circulation: a pictorial review
Authors: Shah Pratik , Shrivastava Manish , Kale Hrishikesh , Mundada Krishna
Published: May 2023

The cerebral arterial system shows a wide spectrum of variations. Minor degrees of anatomic differences can be seen in almost all patients. Recognition of these anatomic variants is essential for the following: evaluating collateral circulation; some anatomic variants may mimic pathology; increased risk for aneurysm formation with some variants (e.g. fenestration, persistent trigeminal artery); dealing with pathologies that can arise with these variations; and for preoperative planning. The anterior and posterior groups of intracranial circulation show numerous anastomoses that play a major role in maintaining adequate blood supply to the cerebral parenchyma. This review focuses on the imaging features of these variants as seen on computed tomography and magnetic resonance imaging with relevant digital subtraction angiography imaging. We also present some case illustrations where understanding of these variants contributed to providing appropriate management.
Distal End Cutter as an Arch Wire Utility Plier: A Clinical Tip
Authors: HC Kiran Kumar , Nayak Ashwath S.
Published: May 2023

Distal end cutter is an indispensable utility plier in the clinical armamentarium. The major challenges faced during utilization is its loss of cutting efficiency, fracture of the tip, and wearing of cutting edge of the plier. This article provides a simpler way of modifying it into an archwire securing and placement plier.
Data-Driven Web-Based Patching Management Tool Using Multi-Sensor Pavement Structure Measurements
Authors: Jha Sneha , Zhang Yaguang , Park Bongsuk , Cho Seonghwan , Krogmeier James V. , Bagchi Tandra , Haddock John E.
Published: May 2023

Automating pavement maintenance suggestions systems is challenging, especially for actionable recommendations such as patching location, depth, and priority. It is a common practice among state agencies to manually inspect road segments of interest and decide maintenance requirements based on the pavement condition index (PCI). However, standalone PCI only evaluates the pavement surface condition which, coupled with the variability in human perception of pavement distress, limits the accuracy and quality of current pavement maintenance practices. In this case, there is a need for multi-sensor data integrated with standardized pavement distress condition ratings. This study explores estimating the appropriate pavement patching strategy (i.e., patching location, depth, and quantity) by integrating pavement structural and surface condition assessment with pavement ratings of distress. In particular, it combines pavement structural condition parameters and falling weight deflectometer deflections with surface condition parameters, international roughness index, and cracking density, for a better representation of overall pavement distress conditions. Then, a pavement-specific, threshold-based patching suggestion algorithm is designed to suggest pavement maintenance operations. The thresholds were determined based on a reliability concept and were verified with the structural number ratio. The threshold values were then used in the patching suggestion algorithm to create patching suggestion tables. A web-based Patching Management Tool (PMT) was designed as an interactive tool to visualize these patching suggestion maps and analyze the pavement distress data using geographical maps and graphs. The PMT was validated with road surface and right-of-way images obtained from three-dimensional laser sensors, and it could successfully capture localized distresses in existing pavements.
Challenges Experienced by Nurses in Providing Pediatric Palliative Care: An Interpretive Phenomenological Analysis
Authors: Judith Roach Erna , Al Omari Omar , Elizabeth John Sheeba , Francis Frincy , Arulappan Judie , Shakman Lina , Al Hashmi Aysha , Al Sabei Sulaiman , Khalaf Atika
Published: May 2023

Objectives: Pediatric leukemia is the most common cancer among children younger than 14 years of age. Children with leukemia require palliative care as additional support from the health care team. Providing palliative care to children is challenging. Thus, this study explored the challenges experienced by nurses in providing pediatric palliative care to children with leukemia. Methods: Semi-structured face-to-face interviews were conducted on a purposive sample of 11 nurses in the hematology-oncology units of a tertiary care hospital in Oman. Results: Interviews were transcribed and analyzed using interpretive phenomenological analysis, which revealed three main themes and seven subthemes related to challenges in providing pediatric palliative care: Personal challenges: Nurses were unable to neutralize their emotions, which burdened them emotionally; due to multitasking, nurses were unable to manage their tasks within the expected time frame; nurses were stressful when they participated in explaining the diagnosis to the parents; and nurses felt powerless when the health condition of some children deteriorated. Educational challenges: Nurses felt unprepared to meet the physical/psychosocial aspects of caring for children with leukemia. Organizational challenges: Nurses stated that families and nurses required rooms to pray, rest, and read Quran, and they needed a private place to speak to families; and nurses mentioned that there are limited number of psychologists to meet the psychological and social needs of children and their families. Conclusion: Prioritizing and implementing strategies for a supportive workplace, guided clinical practice, and maximizing nurses’ satisfaction are crucial.
Priapism Associated With the Addition of Hydroxyzine to Risperidone: A Case Report
Authors: Elfessi Zane , Jhawar Archana , Martino Julie
Published: May 2023

Background: Hydroxyzine hydrochloride is a piperazine derivative antihistamine that is used in the treatment of anxiety. Its tendency to cause somnolence makes it an attractive option for patients with anxiety-induced insomnia. Despite its antihistamine activity, hydroxyzine is noted to have alpha-adrenergic antagonism activity. Other alpha-adrenergic inhibitors have been implicated in medication-induced priapism, including risperidone. Risperidone is a second-generation antipsychotic that primarily blocks serotonin and dopamine receptors, while also inhibiting alpha-1 and alpha-2 receptors with high affinity. Objective: We report a case of a first-of-its-kind case report of a patient who was stable on risperidone and presented with priapism after taking hydroxyzine nightly for the previous 10 days. Results: A 35-year-old male with a past psychiatric history of depression, generalized anxiety disorder, schizoaffective disorder, presented to the emergency department with priapism for 15 hours that required intracaveronsal phenylephrine hydrochloride and manual drainage to achieve detumescence. The patient was on a stable dose risperidone but reported taking hydroxyzine 50 mg nightly for anxiety and insomnia 10 days prior to emergency department admission. Upon resolution of the priapism, the patient stopped hydroxyzine, but continued risperidone. The patient had another prolonged erection 10 days after stopping hydroxyzine; however, he reported that it resolved spontaneously without intervention after 4 hours. Conclusion: This case report demonstrates the risk of addition of hydroxyzine to antipsychotics which can result in an increased risk of priapism or prolonged episodes.
Partnership types and coital frequency as predictors of gonorrhea and chlamydia among young MSM and young transgender women
Authors: Janulis Patrick , Goodreau Steven M , Morris Martina , Birkett Michelle , Phillips Gregory , Risher Kathryn , Mustanski Brian , Jenness Samuel M
Published: May 2023

Background

Sexually transmitted infections pose a major public health challenge in the United States and this burden is especially acute in subpopulations like young men who have sex with men (YMSM) and young transgender women (YTW). Yet, the direct behavioral antecedents of these infections are not well understood making it difficult to identify the cause of recent increases in incidence. This study examines how variations in partnership rates and the number of condomless sex acts are associated with STI infections among YMSM-YTW.

Method

This study leveraged 3 years of data from a large longitudinal cohort of YMSM-YTW. A series of generalized linear mixed models examined the association between the number of condomless anal sex acts, number of one-time partners, number of casual partners, and number of main partners and chlamydia, gonorrhea, or any STI.

Results

Results indicated the number of casual partners was associated with gonorrhea [aOR = 1.17 (95% CI: 1.08, 1.26)], chlamydia [aOR = 1.12 (95% CI: 1.05, 1.20)], and any STI [aOR = 1.14 (95% CI: 1.08, 1.21)] while the number of one-time partners was only associated with gonorrhea [aOR = 1.13 (95% CI: 1.02, 1.26)]. The number of condomless anal sex acts was not associated with any outcome.

Conclusion

These findings suggest the number of casual partners is a consistent predictor of STI infection among YMSM-YTW. This may reflect the quick saturation of risk within partnerships making the number of partners, rather than the number of acts, the more relevant factor for STI risk.
Intelligence Polygenic Score Is More Predictive of Crystallized Measures: Evidence From the Adolescent Brain Cognitive Development (ABCD) Study
Authors: Loughnan Robert J. , Palmer Clare E. , Thompson Wesley K. , Dale Anders M. , Jernigan Terry L. , Chieh Fan Chun
Published: May 2023

Findings in adults have shown that crystallized measures of intelligence, which are more culturally sensitive than fluid intelligence measures, have greater heritability; however, these results have not been found in children. The present study used data from 8,518 participants between 9 and 11 years old from the Adolescent Brain Cognitive Development (ABCD) Study. We found that polygenic predictors of intelligence test performance (based on genome-wide association meta-analyses of data from 269,867 individuals) and of educational attainment (based on data from 1.1 million individuals) predicted neurocognitive performance. We found that crystallized measures were more strongly associated with both polygenic predictors than were fluid measures. This mirrored heritability differences reported previously in adults and suggests similar associations in children. This may be consistent with a prominent role of gene–environment correlation in cognitive development measured by crystallized intelligence tests. Environmental and experiential mediators may represent malleable targets for improving cognitive outcomes.
Review of Recent Developments in Poly(Phenylene Sulphide)
Authors: Cebe Peggy
Published: May 2023

An extensive review of recent developments in the synthesis, crystallization, structure and morphology of poly(phenylene sulphide) (PPS) polymers is presented. There has been a vast proliferation of knowledge about such thermoplastic matrix materials and the more important findings are now discussed, mainly for the literature period 1985 onward. New understandings have emerged about the amorphous phase and its impact on polymer properties. Considerable data have been reported on the thermal properties of PPS too. PPS is expected to hold its position as one of the more important thermoplastics and to attract further research interest.
Effects of Structure and Microcracks on the Properties in Tension and Compression of Three-Dimensional Composites
Authors: Chou Shen , Chen Hong-En
Published: May 2023

Three dimensional carbon fibre/epoxy resin composites were prepared with either three-axis or five-axis three-dimensional carbon fibre fabrics (3D-3A & 3D-5A) in four woven gauges, and embedded with teflon® film in the fabric structures to simulate various types of microcrack. The mechanical properties of these 3-D composites were measured. The tensile properties of 3D-5A were 20% lower than those of 3D-3A, and the compressive properties of 3D-5A were 10% lower than those of 3D-3A. In addition, the 3-D composites had better resistance to fracture than 2-D composites. Micrographs of failed samples reveal that under compression, the fracture plane of a 3-D composite grows, not along the microcrack direction, but perpendicular to the loading direction and extends toward the free end. Whereas for 2-D composites, the fracture plane grows along the microcrack direction and extends obliquely toward the free end.
Shrinkage Control in Fibre Reinforced Polymers III: Carbon Fibre Reinforced Polyesters with Expanding Monomers and Low Profile Additives
Authors: Piggott M.R. , Zhou W. (Vincent)
Published: May 2023

Copolymers of polyester were made with two spiro orthocarbonates: cyclohexane and cyclohexene. They were also used to make unidirectional carbon fibre composites, and the properties of polymers and composites were compared with those made with a low profile additive (a copolymer of methyl and allyl methacrylates). The copolymers were not effective in reducing the shrinkage stress of the resin, except through a reduction in glass transition temperature. They gave composites with poor properties. The low profile additive was effective in reducing the shrinkage volume, but at the cost of a reduction in tensile strength. It did not affect the shrinkage stress very much, and did not have much effect on composite properties. Thus, while it is advantageous to use low profile additives with reinforced polyesters, it is not beneficial to use spiro orthocarbonate expanding monomers. Overall, the three papers in this series strongly suggest that, while controlling shrinkage stress may well be useful, it cannot be realized to any useful extent by using expanding monomers.
On Microcracking in Composite Laminates under Thermal and Mechanical Loading
Authors: McManus Hugh L. , Maddocks Jason R.
Published: May 2023

Composite laminates used in many applications are exposed to both thermal and mechanical loads. These loads can cause cracks in the matrix, changing the laminates’ properties. An analytical methodology is developed to predict microcrack density in a general laminate exposed to an arbitrary thermomechanical load history. The analysis uses a shear lag stress solution in conjunction with an energy-based cracking criterion. It is found that crack densities depend on the stress in the cracking ply group, regardless of the source of the stress. Crack densities are a nonlinear function of stress, however, so if both thermal and mechanical loads are present, the cracking response is coupled. Experimental investigation is used to verify the analysis. Correlation between analysis and experiment is generally excellent. The method successfully predicts the initiation of cracking and crack accumulation under both thermal and mechanical loads, in most ply groups in a variety of laminates, using a single set of ply material properties. The cases where the analysis and experiment do not agree shed some light on the limits of current modelling techniques. Given an understanding of these limits, the analysis appears to be a useful preliminary design tool.
In-Situ Composite Manufacture Using an Electrostatic Powder Spray Process and Filament Winding
Authors: Duvall Mark , Ramani Karthik , Bays Mark , Caillat Frederic
Published: May 2023

This paper details the development of a composite manufacturing process that uses an electrostatic powder spray technique to impregnate a continuous fibre tow with a thermoplastic polymer. The resulting towpreg undergoes intermediate forming to induce further wetout of the fibres by the polymer matrix. An on-line filament winding apparatus then consolidates the towpreg into a finished cylinder. Experimental results detail the effects of key spray coating parameters such as electrostatic corona voltage, powder velocity, and powder mass flowrate. The process demonstrates its effectiveness in coating and consolidating a variety of materials, including E-glass, S-glass, and carbon fibres.
Effect of Styrene Content and ZnO-Stearic Acid on the Dynamic Mechanical Properties of Electron Beam Vulcanised Styrene-Co-Butadiene Rubber
Authors: Abdel-Aziz M.M. , Youssef H.A. , Miligy A.A. El , Yoshii F. , Makuuchi K.
Published: May 2023

The dynamic mechanical properties of electron beam vulcanized Styrene-Co-butadiene rubber (SBR) in presence of different additives over a wide temperature range were investigated. Also, the effect of HAF carbon black, the ZnO-Stearic acid system, and styrene content on the other mechanical properties was studied. It was found that, the more pronounced contribution from by ZnO was in SBR (23.5% styrene) where the storage modulus and damping as well as tensile strength, elongation, tear strength, hardness and abrasion resistance were remarkably improved.

The high efficiency of ZnO toward SBR (23.5% styrene) compared with SBR (46% styrene) may be attributed to the enhancement of the crosslinking density as a result of there being more butadiene units in the former.
Continuous Manufacturing of Thermoplastic Composite Sheets
Authors: Ostgathe M. , Mayer C. , Neitzel M.
Published: May 2023

For high speed press forming of fibre reinforced thermoplastic sheet materials, a high impregnation quality is advantageous for utilisation of the potential regarding mechanical properties. Hence, the impregnation process is crucial to material properties and economy. In this paper the influence of process parameters on mechanical properties is investigated using an isobaric double belt press technique. Relevant process parameters are defined and varied using the Taguchi technique.

Evaluating impregnation quality with 3-point bending tests and micrographs, the influence and meaning of process parameters is specified. Process parameters are optimised regarding flexural stress and strength, and a process window for a fabric reinforced polyamide PA 12 is defined.
Rheology and Removability of New Sizing Agents Based on Polyvinyl Alcohol
Authors: El-Sisi F.
Published: May 2023

Two synthetic sizing agents based on polyvinyl alcohol (PVA) were prepared by direct radiation of acrylic acid (AA) or N-vinyl-2-pyrrolidone (VP) in the presence of predissolved PVA. The rheology, film resolubility and removability of these sizing agents were compared with those of PVA. It was found that (a) the flow behaviour of 10% aqueous solutions (at 80°C) of these materials is characterized by a non-Newtonian thixotropic property that shows a measurable shear thinning character, (b) the degree of thixotropy is arranged ascendingly according to the order PVA/PVP < PVA/PAA < PVA, (c) the solubility rate of PVA size films and size removability of these sizing agents (as a function of the nature of the size used) follow the decreasing order: PVA/PVP > PVA/PAA > PVA.
A Numerical Study of the Buckling and Failure Characteristics of Laminated Composites with Elliptical Holes
Authors: Kang Tae Jin , Yoo Jae Heung
Published: May 2023

An investigation of the buckling and failure characteristics of laminated composites with elliptical holes has been conducted. To predict critical buckling load and first ply failure load, we performed a three-dimensional finite element analysis. The critical buckling load and corresponding buckling modes were predicted by solving an eigen-value problem. After the buckling modes were calculated, the failure analysis was performed to estimate the first ply failure load as a post buckling response. To predict the first ply failure load, we used Tsai-Hill's failure criterion. All these numerical analyses were performed using the three dimensional finite element code “CompAna3D” developed in this research. Using CompAna3D, the effects of hole size, hole aspect ratio, and hole distance on the buckling and failure responses were evaluated numerically in thin laminated plates under compressive loading
EPDM Elastomers as Impact Modifiers for Contaminated, Recycled HDPE
Authors: Tall Stefan , Karlsson Sigbritt , Albertsson Ann-Christine
Published: May 2023

The value of recycled high-density polyethylene (HDPE) is lowered if it contains impurities of PP, PS or PET, hut the embrittlement (partial loss of ductility and toughness) that arises when HDPE is blended with these more rigid polymers can be counteracted by the addition of an impact modifier. In this work, two EPDM grades with different monomer compositions have been evaluated as impact modifiers to upgrade recycled HDPE. Both elastomers improved the tensile impact strength and elongation at yield, at the expense of reduced modulus and yield strength. These effects were more pronounced for an amorphous EPDM with 58 wt% ethylene than for a semicrystalline EPDM with 72 wt% ethylene. The reduced impact strength and yield elongation caused by up to 10% polystyrene or PET could be compensated for by adding an amount of amorphous EPDM equal to half the weight of the contaminant polymer.

The effect of EPDM modification on the morphology of the HDPE phase was studied by differential scanning calorimetry. The thermal history of the material is shown to be an important factor, influencing the ability of the HDPE to crystallise.
Raman Spectroscopy of Polymers*
Authors: Williams K.P.J. , Wilcock I.C.
Published: May 2023

Raman spectroscopy as a routine analytical method is now coming of age. Advances in Raman technology have meant that robust, user-friendly equipment can be manufactured at a reasonable cost. This article describes these advances as well as providing applications of Raman imaging microscope systems to polymer analysis.
Hydrogenated NBR (HNBR) in Power Steering Hose
Authors: Sandland Nick , Harris Stuart , Nakajima Kazu
Published: May 2023

This paper considers the relative performance of HNBR, NBR, CSM and CM Elastomers in a power steering environment. Also discussed are the effects of oxidised fluids and additive packages on the elastomer compound. The paper highlights recent changes in requirements for hoses in power steering applications and describes how HNBR can help hose manufacturers meet these requirements.
High Performance Environments: The Case for Polymeric Flexible Hoses*
Authors: Simmons David
Published: May 2023

The connecting elements, particularly hoses, in fluid power systems often endure most stress. The demands on hoses are increasing, requiring improved performance in difficult operating environments.

The various factors in high performance environments are examined: pressure, temperature, aggressive fluids, abrasion resistance, service lifetime, small installation and operating space and offshore conditions.

Following an analysis of the various elements in thermoplastic hose construction, the ability of thermoplastic hoses to fulfil the demanding factors in high performance environments is discussed.

It is concluded that thermoplastic hoses provide the optimum solutions to many application problems.
Perils of the Commercialised Private Healthcare Sector for Patients: Analysis of Patients’ Experiences from COVID-19 Pandemic in Maharashtra, India
Authors: Marathe Shweta , Kakade Dhananjay , Bhalerao Shakuntala , Pawar Kanchan
Published: May 2023

Although the ramifications of a weakly regulated, commercialised private sector have always been prevalent, the COVID-19 pandemic has further exposed its magnitude and implications for patients in India. Although much is being studied about the health system’s response to the pandemic, the recipient of the system, that is, the patient seems to be less attended in analysis. This article analyses patients’ experiences while seeking healthcare from the private sector in the context of state-imposed regulations over them during the pandemic. A qualitative study was conducted in Maharashtra, India and 30 in-depth interviews of patients who faced difficulties in availing treatment from private hospitals during the pandemic were conducted using purposive sampling. The study reveals the myriad of catastrophic challenges patients faced, their vulnerability and helplessness with private hospitals during the pandemic. It demonstrates the character of ruthless privatisation that operates in health care with rampant overcharging and the failure of regulation of the private sector during the crisis. The study concludes by pointing out the need for state intervention in the regulation of the private sector and emphasises the need to strengthen the public health system and place effective accountability mechanisms with the legal instrument to safeguard people’s interests from corporate privatisation.
Addressing 10 Myths About Pediatric Palliative Care
Authors: Sadler Kim , Khan Saadiya , AlGhamdi Khaled , Alyami Hamad Hussain , Nancarrow Lori
Published: May 2023

With advances in biomedical sciences, a growing number of conditions affecting children have evolved from being considered life-limiting to almost chronic diseases. However, improvements in survival rates often come at a cost of increased medical complexity and lengthy hospitalizations, which can be associated with a poorer quality of life. This is where pediatric palliative care (PPC) can play a significant role. PPC is a specialty of healthcare that focuses on the prevention and relief of suffering in children with serious conditions. Unfortunately, despite the well-identified need for PPC services across pediatric specialties, multiple misconceptions persist. Common myths about palliative care are identified and deconstructed in light of the most recent evidenced-based references in the field to provide guidance to healthcare providers to address these. PPC is often associated with end-of-life care, loss of hope, and cancer. Some healthcare providers and parents also believe that information like diagnosis should be withheld from children for their emotional protection. These examples of misconceptions hinder the integration of pediatric palliative care and its additional layer of support and clinical expertise. PPC providers have advanced communication skills, are able to instill hope in the face of uncertainty, are trained to initiate and implement individualized pain and symptom management plans, and understand how to improve the quality of life in children with serious illnesses. Improved awareness about the scope of PPC is needed to ensure that children benefit from the maximum expertise and support throughout their complex health trajectories.
School Leadership Waterloo Region Must Show Black Youth Their Lives Matter
Authors: Oba Funke , Miller Abigail , Lamirande Madeleine
Published: May 2023

This paper amplifies the voices of Black youth based on findings from a study on schooling experiences of Black youth in the Region of Waterloo, a mid-size Canadian community. Data for the qualitative study was collected using elder-facilitated youth dialogue (adaptation of focus group and Afrocentric sharing circles) and in-depth individual interviews. The findings show that the Black youth participants did not feel their lives matter in the eduational system due to discrimination, alienation, non-inclusive curriculum, absence of Black teachers and failure of school leadership to address systemic racism. Framed by Afrocentric and critical race theories, these findings enabled recommendations on how teachers can take leadership for supporting Black learners by recognizing and mitigating the effects of anti-Black-racism through culturally responsive teaching, emancipatory pedagogy, and politicized caring. The study contributes to an understanding of the need for equitable outcomes, intentional inclusion, and culturally responsive pedagogy that celebrates identity of Black students and enhances their sense of belonging.
Outcomes After Pharyngeal Flap Surgery in Children: A Comparison of Lined Versus Unlined Flaps
Authors: Fuller Colin , Reed Gardner J. , Speed Olivia , Thomason Ashlen , Zaniletti Isabella , Buckmiller Lisa , Johnson Adam , Hartzell Larry
Published: May 2023

Objective

The addition of a uvular flap (PFU) was hypothesized to improve outcomes over standard pharyngeal flap (PF) for correction of velopharyngeal dysfunction. We report differences in outcomes of PF vs PFU at our institution.

Design

Retrospective cohort study.

Setting

Tertiary children's hospital.

Patients

Children who underwent PF or PFU with the three highest-volume surgeons at our institution in 2004-2017.

Outcome measures

We examined differences in complications between groups, frequency and type of revision surgery, and speech-related measures including nasometry, pressure-flow testing (PFT) and perceptual speech analysis (PSA).

Results

160 patients were included, 41 PF and 119 PFU (including 18 with Hogan technique). Patients undergoing PFU were older (7.6 yr vs 6.0 yr; p  =  0.037) and more likely to have cleft palate (63/119 vs 14/41; p  =  0.047). There was no significant difference in complications. With PFU, a decrease in airspace contracting revision surgeries was noted, (4/119 vs 8/41; p  =  0.002) which drove a reduction in revision surgery of all types (7/119 vs 13/41; p  =  0.033). However, patients that did undergo revision surgery after PFU underwent more revision procedures (p  =  0.032). PSA scores were found to be lower (less hypernasal) after PFU (p  =  0.009) compared to PF. Objective speech measures had varying results, with nasometry demonstrating a significant difference between groups (p  =  0.001), while PFT (p  =  0.525) did not demonstrate a statistical difference.

Conclusion

The use of a uvular lining flap in pharyngeal flap surgery may be associated with improved long term surgical outcomes, including both improvements in subjective and objective testing and a lower rate of revision surgery, without increased complications.
Incorporating Velopharyngeal MRI into the Clinical Decision-Making Process for a Patient Presenting with Velopharyngeal Dysfunction Following a Failed Palatoplasty
Authors: Mason Kazlin N. , Black Jonathan
Published: May 2023

This clinical report describes the implementation of magnetic resonance imaging (MRI) to evaluate a patient with long-standing velopharyngeal dysfunction. She was referred to the craniofacial clinic at age 10 with no prior surgical history and subsequently completed a Furlow palatoplasty due to a suspected submucous cleft palate. However, results were unfavorable with minimal improvement in speech or resonance. The clinical presentation, treatment, outcomes, and contributions from MRI for secondary surgical planning are described. Addition of MRI into the clinical workflow provided insights into the anatomy and physiology of the velopharyngeal mechanism that were unable to be obtained from nasendoscopy and speech evaluation alone.
Statistical continuum damage healing mechanics (SCDHM)
Authors: Shojaei Amir , Voyiadjis George Z
Published: May 2023

Damage healing mechanics has been under tremendous development during the past decade in which many constitutive models for different classes of materials have been proposed in the literature. However, to bridge the gap between the physics of healing and the theoretical framework, the statistical nature of the damage healing mechanics must be considered. The statistical nature of the crack nucleation and propagation processes is well-known, and the healing mechanisms follow similar probabilistic processes. In general, the healing process consists of two steps: (I) sealing, in which the free crack surfaces are brought in contact with the help of external forces, and then, (ii) healing, which may include a variety of techniques including the flow of molten polymers or liquid healing agents into the crack free surface areas and solidifying. Both sealing and healing processes can be considered within statistical mechanics to include multiple uncertainties involved in the healing process. This work proposes a framework to integrate statistical mechanics into the continuum of damage healing mechanics. The proposed statistical damage healing mechanics may help designers and scientists to perform more realistic simulations for components under complex damage and healing cycles. The key outputs of the proposed statistical framework are (I) healing method choice, and (II) healing parameter optimization.
Adverse Events of SARS-CoV-2 Therapy: A Pharmacovigilance Study of the FAERS Database
Authors: Pannu Viraaj , Udongwo Ndausung , Imburgio Steven , Johal Anmol , Mararenko Anton , Pozdniakova Helen , Amin Tasnuva , Patel Swapnil , Hossain Mohammad , Mushtaq Arman , Liu Edward , Fune Jose M. , Heaton Joseph
Published: May 2023

Background:

Over the past 2 years of the several strategies recommended to help fight COVID-19, nirmatrelvir/ritonavir is a novel drug shown in the EPIC-HR phase 2 to 3 clinical trial to lower COVID-19-related death or hospitalization at day 28 when compared with placebo.

Objective:

Our study’s aim was to explore the reported adverse events (AEs) associated with nirmatrelvir/ritonavir use for COVID-19.

Method:

We conducted a retrospective analysis using the FDA Adverse Event Reporting System (FAERS) database for AEs, listing nirmatrelvir/ritonavir as the primary drug between January and June 2022. The primary outcome was the incidence of reported AEs associated with nirmatrelvir/ritonavir. The OpenFDA database was queried using Python 3.10 to collect the AEs and Stata 17 was used to analyze the database. Adverse events were analyzed by associated medication, with “Covid-19” excluded.

Results:

A total of 8098 reports were identified between January and June 2022. Most reported complaints in the AE system were COVID-19 and disease recurrence. The most common symptomatic AEs were dysgeusia, diarrhea, cough, fatigue, and headache. Event rates significantly rose between April and May. Disease recurrence and dysgeusia were the most commonly reported complaints for the top 8 concomitant drugs identified. Cardiac arrest, tremor, akathisia, and death were reported in 1, 3, 67, and 5 cases, respectively.

Conclusions and Relevance:

This is the first retrospective study done on reported AEs associated with nirmatrelvir/ritonavir use for COVID-19. COVID-19 and disease recurrence were the most reported AEs. Further monitoring of the FAERS database is warranted to periodically reassess the safety profile of this medication.
Risk of Acute Kidney Injury Based on Vancomycin Target Trough Attainment Strategy: Area-Under-the-Curve-Guided Bayesian Software, Nomogram, or Trough-Guided Dosing
Authors: Knight Joshua M. , Iso Tomona , Perez Katherine K. , Swan Joshua T. , Janak Charles E. , Ikwuagwu Judy O. , Musick William L.
Published: May 2023

Background:

Guidelines support area-under-the-curve (AUC) monitoring for vancomycin dosing which may lower overall doses and reduce acute kidney injury (AKI).

Objective:

The aim of this study was to compare incidence of AKI across 3 vancomycin dosing modalities: AUC-targeted Bayesian pharmacokinetic software, AUC-targeted empiric dosing nomogram, and trough-guided dosing using clinical pharmacists’ judgment.

Methods:

This retrospective study included adult patients with a pharmacy dosing consult who received ≥1 dose of vancomycin and ≥1 serum vancomycin level documented between January 1, 2018, and December 31, 2019. Patients with baseline serum creatinine ≥2 mg/dL, weight ≥100 kg, receiving renal replacement therapy, AKI prior to vancomycin therapy, or vancomycin ordered only for surgical prophylaxis were excluded. The primary analysis was incidence of AKI adjusted for baseline serum creatinine, age, and intensive care unit admission. A secondary outcome was adjusted incidence of an abnormal trough value (<10 or >20 μg/mL).

Results:

The study included 3459 encounters. Incidence of AKI was 21% for Bayesian software (n = 659), 22% for the nomogram (n = 303), and 32% for trough-guided dosing (n = 2497). Compared with trough-guided dosing, incidence of AKI was lower in the Bayesian (adjusted odds ratio [OR] = 0.72, 95% confidence interval [CI]: 0.58-0.89) and the nomogram (adjusted OR = 0.71, 95% CI: 0.53-0.95) groups. Compared with trough-guided dosing, abnormal trough values were less common in the Bayesian group (adjusted OR = 0.83, 95% CI: 0.69-0.98).

Conclusion and Relevance:

Study results suggest that use of AUC-guided Bayesian software reduces the incidence of AKI and abnormal trough values compared with trough-guided dosing.
Nevertheless, He Persisted: White Men and the Links Between Incumbency and Group Descriptive Representation
Authors: Phillips Christian D.
Published: May 2023

Descriptive representation is shaped by more than the number of seats group members win—it is also informed by how group members hold on to seats long after election day. Drawing from the literatures on women of color, women, and minorities in politics, this study argues that the relationship between incumbents and descriptive representation is different among groups that hold distinctive political positioning and power. To uncover those differences, the article introduces a new measure called descriptive maintenance, which accounts for a group’s ability to retain descriptive representation in a seat across unique group members and elections. This multidimensional approach expands current conceptualizations by treating incumbency and descriptive representation as interrelated, group-level, phenomena. This framework is tested using nearly 60,000 observations of state elections data in an analysis focused on a group of state legislative incumbents that has rarely been explicitly examined, and yet outnumbers all others: white men.
Utility of C4d Immunohistochemistry as an Adjunct Stain in Diagnostic Renal Pathology of Glomerular Diseases
Authors: Pradeep Immanuel , Srinivas Bheemanathi Hanuman
Published: May 2023

C4d is a byproduct of the activation of the classic and lectin complement pathways. Being routinely used as a marker for antibody-mediated rejection, the significance of C4d in native kidney disease is currently being widely studied. We evaluated glomerular and extraglomerular C4d staining in 82 biopsies of proliferative and nonproliferative glomerulonephritis diagnosed in our institution. The staining pattern of C4d was tabulated in various glomerular diseases. All biopsies of membranous nephropathy including membranous lupus nephritis (Class V) and immune complex-mediated membranoproliferative glomerulonephritis (MPGN) consistently showed C4d deposits along glomerular basement membrane mirroring the location of immunoglobulin and complement in these conditions. Conversely, other glomerular diseases like IgA nephropathy, postinfectious glomerulonephritis, focal segmental glomerulosclerosis, minimal change disease, and diabetic nephropathy showed variable mesangial and capillary wall C4d deposits. To summarize, the consistent pattern of C4d staining in membranous nephropathy (primary and secondary)and immune complex-mediated MPGN can be used as a valuable adjunct tool in establishing the diagnosis, especially when immunofluorescence findings are limited by inadequate sampling.C4d reactivity in other glomerular diseases are variable and may not aid as a diagnostic tool in renal biopsy evaluation.
Scars Run Deep: Problematic Morphology and Immunoprofile of Scars in Renal Oncocytomas
Authors: Sangoi Ankur R. , Nova-Camacho Luiz M. , Akgul Mahmut , Queipo Francisco J. , Aisa Gregorio , Garcia-Martos Maria , Panizo Angel
Published: May 2023

In some instances, the central scar of renal oncocytoma can demonstrate entrapped cells with unusual morphology and aberrant immunoprofile creating potential diagnostic confusion. Herein, 100 renal oncocytomas containing scars with embedded epithelial cells were identified from 6 institutions, including nephrectomies (64% partial, 36% radical) of similar laterality (left = 51%) and sex distribution (male = 56%), with patient ages ranging from 38 to 86 years (mean = 64.3years) and tumor sizes ranging from 2 to 16 cm (mean = 5.3 cm). Immunohistochemistry was performed on all tumors for KRT7, KIT, vimentin, and CA9 with staining intensity and extensity separately analyzed. Of 4 architectural patterns of cells within the scar, 60% showed tubular pattern. Of 4 cytologies within the scar, flat/elongated (49%) and cuboidal cells (40%) predominated. Within the scar, 62% showed eosinophilic cytoplasm, with 38% showing both cleared and eosinophilic cytoplasm; notably, 79% showed higher grade nuclei than typical oncocytes. A subset of scar cells showed mucinous-like basophilic secretions (19%). Compared to background renal oncocytoma, tumor cells within the scar were more often positive for vimentin, KRT7, and CA9 and more frequently negativity for KIT. Specifically, of the notable “aberrant” immunoprofiles, 79% showed KRT7 positivity/KIT negativity/vimentin positive, 84% showed vimentin positivity/CA9 positivity, and 78% showed KIT negativity/vimentin positivity/CA9 positivity. While encountering scars within renal oncocytomas is not uncommon, what is not well appreciated is the unique morphology and immunohistochemistry of tumor cells within the scar. Comparing tumor morphology and immunoprofile of the scar to the background oncocytoma is helpful to avoid interpretative confusion.
A statistical and reliability approach to vibration-based health monitoring in composite structures
Authors: Nobari Amin Ebrahim Salehzadeh , Aliabadi MH Ferri
Published: May 2023

In this paper, a novel statistical vibration-based damage detection method is developed considering uncertainties in measured resonance frequencies. The proposed method is based on the application of resonance frequencies as the most accurate and easiest measurable vibration feature. For proof of efficiency of the proposed method, case studies were undertaken using two identical composite plates, one delaminated and the other pristine. In this respect, the frequency response functions (FRFs) were measured and used as the main input to the Resonance Detection Algorithm as the proposed method. Applying these FRFs to a Resonance Detector Function can determine the resonant frequencies and their statistical distribution. Through the statistical distributions of the corresponding resonant frequencies, their reliability of detecting damage has been obtained via the beta distribution. By observing the damage detection reliability of the two sets of corresponding resonant frequencies, it has been determined that the changes in natural frequencies are due to structural changes and not random errors through measurement.
It’s not only about the leader: Oligarchized personalization and preference voting in Belgium
Authors: Dodeigne Jeremy , Pilet Jean-Benoit
Published: May 2023

Research on the electoral personalization of politics has stressed a trend towards a greater role of top prominent political figures (party leaders and ministers). This trend was described as centralized electoral personalization. Yet, this trend is merely one side of a more complex story. No leader attracts all voters’ support, and other candidates manage to stand out despite lower resources and visibility. Using a unique dataset of 47,239 actual ballot papers cast for the 2018 Belgian local elections, we show that candidate-level, list-level and district-level factors result in distinct preference voting behaviour. While these factors lead to unmistakable forms of (de-)centralized personalized forms of elections, we furthermore, show that intermediary situations distinctively emerge. A significant number of ‘subtop’ candidates stand out among candidates, by attracting support from voters who do not support the mere leader of the list. This ‘oligarchized personalization’ would deserve greater attention in the literature.
“A very risky queer thing to do”: In conversation with Ken Plummer
Authors: Stein Arlene , Kong Travis S. K.
Published: May 2023

A conversation about the different generational experiences of LGBT academics and the changing status of sexuality and queer studies. Ken Plummer, Arlene Stein and Travis Kong, longtime colleagues and sociologists of sexuality, share their insights. They discuss how different generational contexts and geographic locations shape sexuality studies. They acknowledge the ways Ken's work, and the efforts of his generation of activist-scholars, played a pivotal foundational role in establishing LGBT studies. They consider the relationship between queer theory and sociologies of homosexuality, and the growing importance of digital media. In conclusion, they discuss how neoliberalisation and authoritarian movements are impacting intellectual work.
Shear strengthening of normal steel reinforced concrete beams using post-tensioned metal straps fully wrapped around the beams
Authors: Abdullah Wrya
Published: May 2023

Using post-tensioned metal straps (PTMS) as a method of strengthening reinforced concrete building members is relatively new, however, it has been tested mostly on small specimens. Therefore, this study is an attempt to show the effectiveness of PTMS fully wrapped around medium- scale steel reinforced concrete (RC) beams to enhance their shear strength. For this purpose, four normal RC beams are constructed without transverse reinforcement with dimensions of 160 mm × 240 mm x 1050 mm which are width, depth, and length respectively. To strengthen the beams, PTMS is wrapped fully around the beams at different locations with different strip numbers. It is found that if used properly, PTMS can effectively alter the type of failure of the beams from a brittle shear failure to a ductile bending failure. Additionally, the load-carrying capacity of the beam can increase by 143%, 170%, and 182% by using two, four, and six strips of PTMS respectively. Moreover, the deflection capacity increases by 643%, 557%, and 653% by using two, four, and six straps of PTMS. Finally, after using PTMS on the beam there is a reduction in the number of cracks and the location of their appearance will be localized in the center of the beam.
Enforcing platform sovereignty: A case study of platform responses to Australia’s News Media Bargaining Code
Authors: Heylen KB
Published: May 2023

Australia’s News Media Bargaining Code requires Google and Facebook to negotiate payments with news publishers for news content appearing on the platforms. Facebook and Google lobbied against the code through a highly visible public-facing campaign which included a series of blogs, videos and pop-up communications across their interfaces including News Feeds, Google Search and Home Page, and You Tube, and culminated in Facebook banning Australian users from accessing Australian news and related content. This article presents the findings of a detailed study of platform discourse in response to the News Media Bargaining Code, using critical discourse analysis, and drawing on theoretical frameworks from Althusser, Foucault and Chun. It also investigates the role of the user interface in platform power, particularly how platform users are interpellated by digital platforms. The findings suggest Facebook and Google’s discursive strategies were deployed to protect, strengthen and enforce platform sovereignty. The case study offers lessons for platform regulation globally in understanding how platforms respond to legislation.
Exploring older adults’ ICT support: A mismatch between needs and provision
Authors: Geerts Nelly , Schirmer Werner , Vercruyssen Anina , Glorieux Ignace
Published: May 2023

Because findings in prior research are ambiguous, it remains unclear whether and under which circumstances formal and informal support sources help older adults with their Information and Communication Technology (ICT) use. Our qualitative interview study with 96 older adults (>65, including Internet users and non-users) aims to shed light on older adults’ ICT support by addressing two research questions: (Q1) What types of ICT support needs do older adults experience in their everyday lives? (Q2) For each type of need, who provides the support? Our results show that there are four analytically distinct types of support needs that are often conflated in the literature: motivational support, instructional support, technical support and support by proxy use. Each support type has its suitable support sources. To foster digital inclusion, older adults require access to the specific type(s) of support that fits their occurring need(s).