bluuebunny/crossref_metadata_2025 huggingface dataset:
THE IMPORTANCE OF ANATOMICAL CHARCOT RECONSTRUCTION UTILIZING STANDARDIZED OSTEOTOMIES TO IMPROVE SURGICAL OUTCOMES
Authors: Kosa P. , Ahluwalia R. , Reichert I.
Published: June 2024

Introduction

Charcot neuroarthropathy is a debilitating condition that frequently leads to skeletal instability, and has an increased risk of ulceration leading to infection and amputation. However, surgical reconstruction may offer limb salvage and restauration of an ulcer-free, plantigrade stable foot for functional weight-bearing. We report on our case series according to a prospective protocol and analyse factors leading to a favourable outcome.

Methods

We report a prospective follow-up of 62 patients undergoing Charcot reconstruction, May 2014- Jan 2022, by two surgeons. Peripheral vascular disease was routinely assessed using Duplex scan and major arterial disease was treated before reconstruction. Utilising 3D modelling, pre-operative planning and standardised osteotomies, we performed anatomical correction with radiological evidence. Definitive fixation was undertaken with internal fixation to stabilise the hindfoot. Multivariant analysis was performed to assess risk factors for failure (P>0.05 statistical significance).

Results

59 feet were included, 3 patients did not progress to definitive surgery and 3 patients had bilateral surgery. 62.7% patients were male with an average age of 56, 88.13% had Type 2 diabetes, 56% were hypertensive, 14% were on dialysis. Twenty (54.1%) single stage reconstructions had pre-operative ulceration, 3 pts had ischaemic heart disease and 36 pts had evidence of peripheral arterial disease. 81% of patients achieved normalisation of the 3 out of 4 anatomical angles (P<0.05). Two patients (3.1%) required metalwork removal for infection and limb salvage, 11 (18.6%) had delayed wound healing. Survivorship was 97% at 3yrs, and 94% at 6yrs, however if pre-existing vascular disease was present, it was 94% at 3yrs 85.3% at 6yrs. All patients were mobile at a 3 years mean follow up.

Conclusion

Careful patient selection, multidisciplinary team and anatomic reconstruction led to predictable outcomes and functional limb salvage. Pre-operative vascular compromise led to a slight reduction in survivorship, but no major amputation.
CLINICAL OUTCOMES OF AUTOLOGOUS OSTEOCHONDRAL TRANSPLANTATION FOR OSTEOCHONDRAL LESIONS OF THE TALUS: AN AGE-BASED MULTIVARIABLE ANALYSIS
Authors: Azam M. , Colasanti C. , Butler J. , Weiss M. , Brodeur P. , Kennedy J.
Published: June 2024

Introduction

The purpose of this study was to examine trends in patient characteristics and clinical outcomes that occur with age as a statistical variable when performing autologous osteochondral transplantation (AOT) for the treatment of osteochondral lesions of the talus (OLT).

Methods

A retrospective cohort study for AOT procedures on 78 patients from 2006 to 2019. was conducted Clinical outcomes were evaluated via FAOS scores. A multivariable linear regression was used to assess the independent factors predictive of the first post-operative FAOS after AOT. The independent variables included pre-operative FAOS, age, defect size, shoulder lesion, cystic lesion, prior traumatic injury, and history of microfracture surgery. A p-value <.05 was considered significant and 95% confidence limits (95% CL) for regression coefficient estimates (est.) were calculated.

Results

78 patients were included with a mean age of 35.5 ± 13.6years at a mean follow-up was 54.4 ± 18.9 months. The mean pre-operative FAOS was 54.3 ± 19.4 and the mean post-operative FAOS was 83.4 ± 13.6. The mean defect size was 109.3±62.4 mm2. The multivariable linear regression showed that the pre-operative FAOS was associated with a higher post-operative FAOS (est., 95% CL: 0.16, 0.012 – 0.307; p=0.034). Defect size (est., 95% CL: −0.05, −0.097 – −0.003; p=0.0358), having a shoulder lesion (est., 95% CL: −9.068, −15.448 – −2.688; p=0.006), or having a prior microfracture surgery (est., 95% CL: −7.07, −13.118 – −1.021; p=0.0226) were associated with a lower post-operative FAOS.

Conclusion

Patient age was not an independent risk factor for inferior clinical outcomes after AOT for OLT. Additionally, cystic lesions, or lesions with a traumatic aetiology were not significantly associated with post-operative FAOS. Having a shoulder lesion had the largest marginal effect on post-operative FAOS. These findings provide important information for providers when counseling and selecting patients for AOT procedure for treatment of OLT.
LONG-TERM FOLLOW-UP, REOPERATIONS, AND PATIENT-REPORTED OUTCOMES FOLLOWING REVISION SURGERY FOR FAILED TOTAL ANKLE ARTHROPLASTIES
Authors: Somanathan A. , Sharp B. , Saedi F. , Loizou C. , Brown R. , Kendal A.
Published: June 2024

Introduction

Primary ankle arthroplasty (TAR) is increasingly used to treat end-stage ankle arthritis. Reported revision rates of TAR vary from 8.5% to 11.1% at 9 years. Revision surgery remains technically challenging with options ranging from simple joint debridement to tibio-talar-calcaneal fusion. The efficacy of these procedures remains unclear and there is no consensus on optimal revision options.

Methods

A retrospective cohort study was performed of all patients undergoing surgery for a failed primary TAR at the Nuffield Orthopaedic Centre (2004–2021). TAR failure was determined by clinical assessment, serial radiographs and CT scans. Primary outcome measures included type and time of index surgery post TAR. Secondary outcomes included frequency of re-operations, post-operative complications, patient reported outcomes and union rate (for revision arthrodesis procedures).

Results

70 failed TARs in 69 patients (35M:34F, mean 65.7 years, s.d.=11.6) underwent re-operation a mean of 6.24 years (range 1–30) post primary. In total, 107 operations were performed including revision fusion (n=50), revision arthroplasty (n=14), bearing exchange (n=9) and joint clearance (n=9). The overall revision fusion union rate was 73.5% over a mean of 12.5 months (s.d.=7.6). 16/23 (69.6%) Tibio-Talo-Calcaneal and 9/12 (75%) ankle fusions (previous subtalar/triple fusion) using a hindfoot nail united over a mean 11.4 months (s.d.=6.0) and 15 months (s.d.=9.48) respectively. Only 64% of ankle fusions using screws alone united (mean=10.6 months, s.d.=8.14). The average post-operative MOXFQ score was 28.3 (s.d.=19.3). 73% said the operation improved their function and would recommend it to a friend/family member.

Conclusion

Despite low post-operative MOXFQ scores, over 70% of patients were satisfied with re-operation for a failed TAR. Over 26% of all TAR revision fusions fail to unite with the highest non-union rates observed post ankle arthrodesis with screws alone (36.4%).
MANAGEMENT OF FAILED TOTAL ANKLE ARTHROPLASTY AND MASSIVE BONE CYSTS USING IMPACTION BONE GRAFTING AND THE INVISION TOTAL ANKLE REVISION SYSTEM
Authors: Gordon C. , Raglan M. , Dhar S. , Lee K.
Published: June 2024

Objective

The purpose of this study was to determine the outcomes of revision ankle replacements, using the Invision implant and impaction allograft for massive talar dome defects following primary ankle replacement failure. Outcomes were assessed in terms of bone graft incorporation; improvement in patient reported outcome measures (PROMs); and survivorship of the revision ankle arthroplasty.

Methods

A retrospective review of prospectively collected data identified eleven patients who had massive bone cysts and underwent revision of a failed primary total ankle replacement to the Invision revision system, combined with impaction grafting using morselized femoral head allograft. These revisions occurred at a single high volume ankle arthroplasty centre. Computed tomography (CT) scans were used to assess bone graft incorporation and the Manchester-Oxford Foot Questionnaire (MOXFQ) and EQ-5D scores were used pre and post operatively to assess PROMs.

Results

The mean follow up was 18 months (12–48months). In all eleven patients, improvement was reported in the post-operative MOXFQ and EQ-5D scores. CT scans showed bone graft incorporation in all cases. None of the patients have required further surgery and are continue to do well clinically at latest follow up.

Conclusions

In the short term, this study confirms revision ankle replacements with the Invision prosthesis and impaction with morselized femoral head allograft is a suitable revision option for primary ankle replacement failure with massive talar bone loss. Long term follow up continues of these complex patients.
A comparative study based on control system for a pulse detonation engine
Authors: GAUR Vibhanshu Dev , PATHAK Mayur , JINDAL Tejinder Kumar
Published: June 2024

Pulse Detonation Engine has been a point of interest in the propulsion industry for some time and the interest has been rising due to its better output and results. But any system can perform its task efficiently based on the efficiency of its control system. In this paper we have presented a comparative study between multiple control systems- one based on Bluetooth technology, the other based on infrared sensor technology and one based on wired electrical system. For the wireless system, the signal received from either of the media is passed to the various sensors and systems connected through an Arduino board that further controls the solenoid valves and ignition system. Primarily, a control system circuit is developed using Arduino board and different sensors to connect the fuel supply and ignition system. In the next stage, Bluetooth sensors are connected using an android app and then an infrared sensor based system is integrated with the Arduino to control the engine and the performance of the two systems are compared. Whereas for wired system, every sub system is controlled through optical wires including the solenoid valves, the injection system and the sensors.
Particularities of Rotorcraft in Dealing with Advanced Controllers
Authors: PAVEL Marilena D.
Published: June 2024

Advanced nonlinear controllers are a desirable solution to rotorcraft flight control as they can solve the system high nonlinear dynamic behavior. However, conventional nonlinear controllers such as Nonlinear Dynamic Inversion (NDI) controller heavily rely on the availability of accurate model knowledge and this can be problematic for rotorcraft. Therefore, incremental control theory can solve the modelling errors sensitivity by relying on the information obtained from the sensors instead. The paper applied the Incremental Nonlinear Dynamic Inversion (INDI) controller to rotorcraft case. It will be demonstrated that, for rotorcraft, the incremental nonlinear controllers depend on the delays introduced in the controller by the rotor dynamics. To correct this behaviour, residualization and synchronization methods need to be applied accordingly in order to remove the effects of rotor flapping (disctilt) dynamics from the controller. These particularities of rotorcraft in dealing with advanced controllers shows that incremental nonlinear controllers can have relatively small stability robustness margin and careful controller design is needed in order to account properly for rotorcraft time delays and unmodelled dynamics.
La “aparición” de las mujeres en los juicios por delitos de lesa humanidad en Argentina
Authors: Martinez Magarzo Quimey
Published: June 2024

Argentina ha tenido una larga y compleja historia de juzgamiento de aquellos que llevaron adelante de delitos de lesa humanidad en la última dictadura cívico militar en el país, en la cual se han dado marchas y contramarchas. En cada una de sus etapas las mujeres han tenido un rol distinto y sus voces han emergido de formas diversas: su sufrimiento específico respecto a los crímenes sexuales en centros clandestinos de detención ha delineado una parte de la historia que debe ser atendida para construir una memoria que de cuenta del dolor generizado (y/o del género en el dolor), así como de las posibilidades de su enunciación en un proceso penal.
El encierro como contexto de aprendizaje: el caso Liberté, el revés del experimento Stanford
Authors: Perlo Claudia , Carlín María Celeste , Carmona Diego
Published: June 2024

En este trabajo referimos un caso que forma parte de nuestras investigaciones enmarcadas en el encierro como contexto de aprendizaje. Se trata del “Caso Liberté” que se encuentra en la Unidad Nro. 15 del Complejo Penitenciario de Máxima Seguridad de Batán, perteneciente al Servicio Penitenciario Bonaerense. Los objetivos son visibilizar dicho caso, buscar nuevas comprensiones sobre las posibilidades y limitaciones de su crecimiento y desarrollo y ofrecer orientaciones que permitan mejorar y adecuar esta experiencia discrepante para ser multiplicada en otros contextos. La metodología cualitativa se desarrolla a través del diseño de la investigación-acción-participativa. Se ha trabajado con fuentes primarias tales como entrevistas en profundidad a personas involucradas en este caso en diferentes roles; como así también grupos focales y observaciones de campo. Se utilizan también fuentes secundarias tales como datos estadísticos proporcionados por organismos oficiales en torno a la cuestión. En el cuerpo del trabajo en primer lugar, hacemos un desarrollo teórico que profundiza en la comprensión del encierro como un contexto de aprendizaje. Seguidamente hacemos referencia al experimento de Stanford donde analizamos el fracaso de los modelos punitivistas. Posteriormente, presentamos el Caso Liberté relevando la experiencia autogestiva que allí se lleva a cabo. Hacia el final del trabajo, buscamos demostrar que el Caso Liberté no sólo constituye el revés del caso Stanford, sino que implica otros reveses a las políticas penitenciarias actuales, a los cuáles estas últimas deberían prestar atención para su indispensable transformación.
A lo mejor no ha llovido tanto
Authors: Martín Muñoz Jesús
Published: June 2024

En este comentario se estudian dos sentencias que enjuician la conducta de dos mujeres que han introducido cocaína en España actuando como «mulas». Pese a la sospecha de que pudieran ser víctimas de trata de seres humanos, en ningún momento del proceso se plantea esta posibilidad. Esto da lugar a que tengan que colaborar con las autoridades para ver atenuada su responsabilidad. Sin embargo, como los resultados de su cooperación son distintos, la condena que reciben es muy diferente. Esto pone de relieve las dificultades que existen en el ordenamiento jurídico español para moderar el reproche penal que las víctimas de trata puedan merecer por los delitos cometidos en su situación de explotación.
Service-learning in Central European Catholic Universities. Cases from Poland and Germany
Authors: Hoth de Olano Christiane , Łysiak Małgorzata
Published: June 2024

Service-learning (SL) contributes to systematically anchoring and expanding transfer activities of universities (Third Mission) and cooperation with external community partners in teaching and beyond. Accordingly, SL is considered the silver bullet of holistic education and is increasingly implemented in higher education institutions worldwide, regardless of subject disciplines. This paper illustrates the importance of SL as one of the strategies to fulfill the Third Mission at the Catholic Universities in Lublin (KUL), Poland, and in Eichstätt-Ingolstadt (KUEI), Germany, and shows potentials of this concept in the education of students of psychology, didactics and pedagogy. Based on examples of good practice from teaching formats of the three disciplines at KUL and KUEI, concepts and models of SL are outlined.
Avances y desafíos de la institucionalización del aprendizaje-servicio en la Universidad Católica de la Santísima Concepción de Chile
Authors: Cea Echeverría Patricio , Muñoz Marcia
Published: June 2024

Este trabajo tiene por objetivo realizar un levantamiento de los avances en la adopción del aprendizaje-servicio en la Universidad Católica de la Santísima Concepción para conocer su nivel de institucionalización y cómo se ha implementado. La metodología incluyó la aplicación de la rúbrica de institucionalización propuesta por Furco y la rúbrica de evaluación de los proyectos de aprendizaje-servicio elaborada por el GREM de la Universidad de Barcelona. La población encuestada incluyó miembros de la Comisión de Aprendizaje-Servicio institucional, docentes que han aplicado la metodología de aprendizaje-servicio, estudiantes y socios comunitarios. Además, se realizaron dos grupos focales para complementar la información obtenida. En la medida que se consolida el aprendizaje-servicio se espera incorporar mecanismos de monitoreo de los avances de su institucionalización y evaluación de la calidad e impacto de los proyectos desarrollados, tanto en la formación de los estudiantes como en las comunidades beneficiadas.
El Corpus léxico del español de Colombia CorlexCo y su aplicación a la investigación sobre el español LE y L2
Authors: Nieto Martín Gloria Viviana
Published: June 2024

En este artículo se presenta el Corpus léxico del español de Colombia CorlexCo (https://clicc.caroycuervo.gov.co/corpus/CorlexCo) del Instituto Caro y Cuervo, herramienta que recopila combinaciones léxicas con criterio integral, es decir, las propias del país y también las compartidas con otros países hispanoamericanos y con el español general. No se limita a los colombianismos. Se trata de un macroproyecto iniciado en 2019 y desarrollado en fases anuales sucesivas. Por “combinaciones léxicas” nos referimos a todo tipo de unidades pluriverbales (compuestos, colocaciones, construcciones con verbo soporte, locuciones, paremias y fórmulas rutinarias). Los datos proceden de cinco fuentes de consulta: (1) diccionarios generales, escolares, dialectales, fraseológicos y combinatorios, (2) casi doscientos cincuenta repertorios léxicos del español de Colombia, (3) más de ciento cincuenta investigaciones académicas sobre el léxico de Colombia, (4) corpus lingüísticos y (5) el dominio http://www.google.com.co. Con respecto a la aplicación del CorlexCo, por una parte, puede usarse en planeación curricular, diseño de materiales didácticos y procesos de evaluación de español como lengua extranjera y segunda lengua (para indígenas y sordos); por otra, puede constituirse en obra de referencia de aprendientes, profesores, editores, traductores y, especialmente, de lingüistas que investiguen sobre el español LE y L2. En el apartado 1 se resume el estado actual de la lexicografía dialectal en Colombia. En el apartado 2 se describen las características principales del CorlexCo, la selección del tipo de unidades léxicas para cada fase anual, la selección de las entradas y la anotación, y se ilustra su uso con varios tipos de búsqueda. En el apartado 3 se muestra su aplicación a la investigación sobre español LE y L2. Este corpus es un recurso abierto que se actualiza periódicamente y que ofrece a la comunidad académica una descripción ampliada del léxico de Colombia.
Observation of interband Kelly sidebands in coupled-ring soliton microcombs
Authors: Gao Maodong , Yuan Zhiquan , Yu Yan , Jin Warren , Ji Qing-Xin , Ge Jinhao , Feshali Avi , Paniccia Mario , Bowers John E. , Vahala Kerry J.
Published: June 2024

Kelly sidebands are a special type of dispersive wave that appear in
mode-locked systems and they have recently been observed by pulsed
excitation in integrated microcombs. Here, Kelly sidebands are
generated by continuous-wave excitation in a partially coupled
racetrack-resonator microcomb. The coupled-racetrack system supports
two optical bands so that, in contrast to earlier studies, the soliton
and Kelly sideband reside in distinct bands. The resulting interband
excitation of the Kelly sidebands relaxes power requirements and
continuous-wave sideband excitation is demonstrated. Tuning of
sideband spectral position under pulsed excitation is also studied.
Numerical simulation and the experiment show that the sidebands rely
upon symmetry breaking caused by partial coupling of the two-ring
system. More generally, multiband systems provide a new way to
engineer Kelly sidebands for spectral broadening of microcombs.
Moiré one-dimensional photonic crystal topology composed of holes with different sizes
Authors: Okayama Hideaki , Onawa Yosuke , Shimura Daisuke
Published: June 2024

The characteristics of Moiré one-dimensional photonic crystal (1DPhC) based on topological structure is described. The two 1DPhC lattices with different hole sizes and periods are overlapped to form a 1D Moiré lattice. The filter response of the device changes with the relative position and period difference of two lattices. The resonance mode is excited in two unique positions in the1D Moiré lattice. Higher Q value is attained by smaller period difference and optimized hole size ratio. The Q value can be almost an order higher than the conventional topological 1DPhC resonator. The device shows high sensitivity of 270 nm/RIU against clad refractive index change which may be beneficial to be used as an optical sensor. Sensor sensitivities of 450 to 660 nm/RIU are obtained by using slot waveguide structures.
A regime switch error correction model to project sea level rise
Authors: Fu Raymond , Fu Ken
Published: June 2024

Climate scientists employ various techniques to study the sea level rise (SLR), one of which is semi-empirical approach where the historical relationship between the SLR and global temperature is extracted from the data and parameterized for future SLR projections. It has been documented that semi-empirical models tend to have large variations in the projections depending on the data and methodologies. This study examines the statistical properties of the data used to construct the semi-empirical models and propose a new specification as a regime switch error correction model. We show that the proposed model has sound statistical foundation and good performance. The out-of-sample model projection of cumulative SLR from 2001–2020 is within 10% of the actual SLR. The model projects that in 21st century, the average and the 5%-95% range (in parenthesis) cumulative sea level rise will be 0.28m (0.20–0.36m), 0.41m (0.33–0.48m), or 0.68m (0.60–0.76m), respectively, under the SSP1-2.6/2-4.5/5-8.5 scenarios. These projections are aligned with IPCC AR5 while lower than IPCC AR6. They are also within the range of the projections in recent studies.
Reproductive and child health transition among selected empowered action groups states of India: A district-level analysis
Authors: Pandey Bindhy Wasini , Yadav Ganesh , Tripathi Niharika , Pathak Praveen Kumar
Published: June 2024

Background

Health is an inseparable part of life and central to all life supporting systems. The reproductive and child health shares a major portion of public health cases that is crucial for socio-economic development. Studies on reproductive and child health have traditionally been focused on demographic aspects using socio-economic parameters. Given the emphasis of Sustainable Development Goal (SDG)-3 on health and well-being, it is imperative to understand the geo-spatial dimension with the visible transition of key health indicators of fertility, maternal and infant/child health in the high burdened districts within these high focus Empowered Action Group (EAG) states of Rajasthan, Madhya Pradesh, Uttar Pradesh and Bihar that make up nearly 40% of India’s population with relatively laggard health status.

Methodology

This paper aims to understand the status and trend of key reproductive and child health indicators and vital statistics based on the recent representative demographic surveys. We intend to undertake a district level spatio-temporal analysis by developing District Composite Health Profile (DCHP) using Composite Index Method on selected 13 equally weighted key reproductive and child health indicators. The study has been carried out using data from National Family Health Survey-4 (2015–16) and National Family Health Survey-5 (2019–21) survey rounds. We employed geo-spatial techniques i.e. Moran’s–I, and univariate LISA to comprehend the geographical clustering of high and low health burden districts and their heterogeneities at the district level.

Results/Conclusions

The study highlights emerging inter-districts, and inter-state disparities over survey periods. With consistent improvement in the selected EAG states over time, the overall reproductive and child health status through DCHP along with each indicator was relatively better in the states of Rajasthan and worse in Bihar. Districts along the Terai belt in Uttar Pradesh and Bihar consistently performed sluggish during survey rounds. The geo-spatial clustering follows the political boundary of states, albeit with intra-state variations. Monitoring of key health indicators using composite index method provides a useful leverage for identifying priority districts/regions for universal health access that should also consider geographical space as an important policy dimension.
An efficient scheme for nonlinear shock wave model in a fractal domain under Caputo fractional operator
Authors: Nadeem Muhammad , Alsayaad Yahya
Published: June 2024

This paper introduces a refined approach for obtaining the analytical solution of the nonlinear shock wave model incorporating fractal derivatives. The Fractal Yang Variational Iteration Strategy (FYVIS) is utilized to obtain the approximate solution of a fractal model in the form of a series under Caputo fractional operator. The suggested method is the composition of the fractal Yang transform and the variational iteration approach. By using the two-scale fractal theory, we transform the fractal model into its traditional problem and then apply the yang transform to generate a recurrence relation. The variational iteration approach is now suitable to handle this recurrence relation without imposing any hypotheses or restrictions on variables. The derived results by the proposed scheme are shown in terms of series solution. Numerical calculations verify the accuracy and consistency of the suggested approach, demonstrating its excellent performance. The dynamic behavior of fractal components is explored by evaluating absolute errors and presenting two-dimensional diagrams across the fractal domain. This investigation underscores that the suggested technique offers an efficient and user-friendly solution for solving the nonlinear shock wave model involving fractal derivatives.
The causal relationship between autoimmune diseases and age-related macular degeneration: A two-sample mendelian randomization study
Authors: Li Linrui , Zhang Mingyue , Gu Moxiu , Li Jun , Li Zhiyuan , Zhang Rong , Du Chuanwang , Lv Yun
Published: June 2024

Objective

The aim of this study is to investigate the potential causal relationship between autoimmune diseases, including systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, and Type 1 diabetes, and age-related macular degeneration (AMD). By utilizing the two-sample Mendelian Randomization (MR) approach, we endeavor to address this complex medical issue.

Methods

Genome-wide association study (GWAS) data for autoimmune diseases and AMD were obtained from the IEU Open GWAS database and the FinnGen consortium. A series of stringent SNP filtering steps was applied to ensure the reliability of the genetic instruments. MR analyses were conducted using the TwoSampleMR and MR-PRESSO packages in R. The inverse-variance weighted (IVW) method served as the primary analysis, complemented by multiple supplementary analyses and sensitivity tests.

Results

Within the discovery sample, only a statistically significant inverse causal relationship between multiple sclerosis (MS) and AMD was observed (OR = 0.92, 95% CI: 0.88–0.97, P = 0.003). This finding was confirmed in the replication sample (OR = 0.85, 95% CI: 0.80–0.89, P = 3.32×10−12). No statistically significant associations were detected between systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, and Type 1 diabetes and AMD.

Conclusion

Strong evidence is provided by this study to support the existence of an inverse causal relationship between multiple sclerosis and age-related macular degeneration. However, no causal evidence was found linking other autoimmune diseases with AMD. These findings not only offer novel insights into the potential etiological mechanisms underlying AMD but also suggest possible directions for future clinical interventions.
Cost-effectiveness analysis of granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced febrile neutropenia in patients with breast cancer in Taiwan
Authors: Tseng Tzu-Hsuan , Chiang Shao-Chin , Hsu Jason C. , Ko Yu
Published: June 2024

Objectives

To examine the cost-effectiveness of using granulocyte colony-stimulating factor (G-CSF) for primary or secondary prophylaxis in patients with breast cancer from the perspective of Taiwan’s National Health Insurance Administration.

Methods

A Markov model was constructed to simulate the events that may occur during and after a high-risk chemotherapy treatment. Various G-CSF prophylaxis strategies and medications were compared in the model. Effectiveness data were derived from the literature and an analysis of the National Health Insurance Research Database (NHIRD). Cost data were obtained from a published NHIRD study, and health utility values were also obtained from the literature. Sensitivity analyses were performed to assess the uncertainty of the cost-effectiveness results.

Results

In the base-case analysis, primary prophylaxis with pegfilgrastim had an incremental cost-effectiveness ratio (ICER) of NT$269,683 per quality-adjusted life year (QALY) gained compared to primary prophylaxis with lenograstim. The ICER for primary prophylaxis with lenograstim versus no G-CSF prophylaxis was NT$61,995 per QALY gained. The results were most sensitive to variations in relative risk of febrile neutropenia (FN) for pegfilgrastim versus no G-CSF prophylaxis. Furthermore, in the probabilistic sensitivity analysis, at a willingness-to-pay threshold of one times Taiwan’s gross domestic product per capita, the probability of being cost-effective was 88.1% for primary prophylaxis with pegfilgrastim.

Conclusions

Our study suggests that primary prophylaxis with either short- or long-acting G-CSF could be considered cost-effective for FN prevention in breast cancer patients receiving high-risk regimens.
Validation of the Arabic language version of the Audio Processor Satisfaction Questionnaire (APSQ) for hearing implant users
Authors: Alasmi Abdulaziz , Saleh Shaza , Anderson Ilona , Abdelsamad Yassin , Hagr Abdulrahman
Published: June 2024

Objective

Audio processors (AP) are the external components of hearing implants. User satisfaction with the performance and comfort of their AP is a critical factor in ensuring daily use, which leads to improved hearing outcomes. The aim of this study was to construct and validate an Arabic language translation of the APSQ for use among Arabic-speaking clinicians and patients.

Design

The original APSQ was translated into the Arabic language using cross-cultural adaptation measures. The final questionnaire was administered to CI users in electronic form.

Study sample

117 CI users (64 female) participated. A total of 179 ears were assessed.

Results

High levels of satisfaction with audio processors were observed among CI users. Item and scale analyses indicate that this version of the APSQ measure a homogeneous and valid construct.

Conclusion

The Arabic version of the APSQ captures user satisfaction with hearing implant audio processors.
Performance optimization for an optimal operating condition for a shell and heat exchanger using a multi-objective genetic algorithm approach
Authors: Venkatesh B. , Kiran Ajmeera , Khan Mudassir , Rahmani Mohammad Khalid Imam , Upadhyay Laxmi , Babu J. Chinna , Narayana T. Lakshmi
Published: June 2024

In this study, shell and heat exchangers are optimized using an integrated optimization framework. In this research, A structured Design of Experiments (DOE) comprising 16 trials was first conducted to systematically determine the essential parameters, including mass flow rates (mh, mc), temperatures (T1, t1, T2, t2), and heat transfer coefficients (€, TR, U). By identifying the first four principal components, PCA was able to determine 87.7% of the variance, thereby reducing the dimensionality of the problem. Performance-related aspects of the system are the focus of this approach. Key outcomes (€, TR, U) were predicted by 99% R-squared using the RSM models. Multiple factors, such as the mass flow rate and inlet temperature, were considered during the design process. The maximizing efficiency, thermal resistance, and utility were achieved by considering these factors. By using genetic algorithms, Pareto front solutions that meet the requirements of decision-makers can be found. The combination of the shell and tube heat exchangers produced better results than expected. Engineering and designers can gain practical insight into the mass flow rate, temperature, and key responses (€, TR, U) if they quantify improvements in these factors. Despite the importance of this study, it has several potential limitations, including specific experimental conditions and the need to validate it in other situations as well. Future research could investigate other factors that influence system performance. A holistic optimization framework can improve the design and engineering of heat exchangers in the future. As a result of the study, a foundation for innovative advancements in the field has been laid with tangible improvements. The study exceeded expectations by optimizing shell and heat exchanger systems using an integrated approach, thereby contributing significantly to the advancement of the field.
Naringin from Ganshuang granule inhibits inflammatory to relieve liver fibrosis through TGF-β-Smad signaling pathway
Authors: Wang Fuchun , Gan Jian , Li Rui , Yang Rui , Mao Xiaorong , Liu Shuang , Chen Yu , Duan Zhongping , Li Junfeng
Published: June 2024

Objective

The present study aims to investigate the specific protective effects and underlying mechanisms of Ganshuang granule (GSG) on dimethylnitrosamine (DMN)-induced hepatic fibrosis in rat models.

Methods

Hepatic fibrosis was experimentally evoked in rats by DMN administration, and varying dosages of GSG were employed as an intervention. Hepatocellular damage was assessed by measuring serum levels of aminotransferase and bilirubin, accompanied by histopathological examinations of hepatic tissue. The hepatic concentrations of platelet-derived growth factor (PDGF) and transforming growth factor-β1 (TGF-β1) were quantitated via enzyme-linked immunosorbent assay (ELISA). The expression of α-smooth muscle actin (α-SMA) within hepatic tissue was evaluated using immunohistochemical techniques. The levels of hepatic interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and a spectrum of interleukins (IL-2, IL-4, IL-6, IL-10) were quantified by quantitative real-time PCR (qRT-PCR). Additionally, hepatic stellate cells (HSCs) were cultured in vitro and exposed to TNF-α in the presence of naringin, a principal component of GSG. The gene expression levels of tissue inhibitor of metalloproteinase-1 (TIMP-1) and matrix metallopeptidase-1 (MMP-1) in these cells were also quantified by qRT-PCR. Proliferative activity of HSCs was evaluated by the Cell Counting Kit-8 assay. Finally, alterations in Smad protein expression were analyzed through Western blotting.

Results

Administration of GSG in rats with fibrosis resulted in reduced levels of serum aminotransferases and bilirubin, along with alleviation of histopathological liver injury. Furthermore, the fibrosis rats treated with GSG exhibited significant downregulation of hepatic TGF-β1, PDGF, and TNF-α levels. Additionally, GSG treatment led to increased mRNA levels of IFN-γ, IL-2, and IL-4, as well as decreased expression of α-SMA in the liver. Furthermore, treatment with naringin, a pivotal extract of GSG, resulted in elevated expression of MMP-1 and decreased levels of TIMP-1 in TNF-α-stimulated HSCs when compared to the control group. Additionally, naringin administration led to a reduction in Smad expression within the HSCs.

Conclusion

GSG has the potential to mitigate fibrosis induced by DMN in rat models through the regulation of inflammatory and fibrosis factors. Notably, naringin, the primary extract of GSG, may exert a pivotal role in modulating the TGF-β-Smad signaling pathway.
Probability and kinetics of rupture and electrofusion in giant unilamellar vesicles under various frequencies of direct current pulses
Authors: Bhuiyan Md. Tariqul Islam , Karal Mohammad Abu Sayem , Orchi Urbi Shyamolima , Ahmed Nazia , Moniruzzaman Md. , Ahamed Md. Kabir , Billah Md. Masum
Published: June 2024

Irreversible electroporation induces permanent permeabilization of lipid membranes of vesicles, resulting in vesicle rupture upon the application of a pulsed electric field. Electrofusion is a phenomenon wherein neighboring vesicles can be induced to fuse by exposing them to a pulsed electric field. We focus how the frequency of direct current (DC) pulses of electric field impacts rupture and electrofusion in cell-sized giant unilamellar vesicles (GUVs) prepared in a physiological buffer. The average time, probability, and kinetics of rupture and electrofusion in GUVs have been explored at frequency 500, 800, 1050, and 1250 Hz. The average time of rupture of many ‘single GUVs’ decreases with the increase in frequency, whereas electrofusion shows the opposite trend. At 500 Hz, the rupture probability stands at 0.45 ± 0.02, while the electrofusion probability is 0.71 ± 0.01. However, at 1250 Hz, the rupture probability increases to 0.69 ± 0.03, whereas the electrofusion probability decreases to 0.46 ± 0.03. Furthermore, when considering kinetics, at 500 Hz, the rate constant of rupture is (0.8 ± 0.1)×10−2 s-1, and the rate constant of fusion is (2.4 ± 0.1)×10−2 s-1. In contrast, at 1250 Hz, the rate constant of rupture is (2.3 ± 0.8)×10−2 s-1, and the rate constant of electrofusion is (1.0 ± 0.1)×10−2 s-1. These results are discussed by considering the electrical model of the lipid bilayer and the energy barrier of a prepore.
A qualitative examination of the experiences and perspectives of interprofessional primary health care teams in the distribution of the COVID-19 vaccination in Ontario, Canada
Authors: Ashcroft Rachelle , Donnelly Catherine , Sheffield Peter , Lam Simon , Kemp Connor , Adamson Keith , Brown Judith Belle
Published: June 2024

Background

Primary health care (PHC) teams contributed to all phases of the COVID-19 vaccination distribution. However, there has been criticism for not fully utilizing the expertise and infrastructure of PHC teams for vaccination distribution. Our study sought to understand the role PHC teams had in the distribution of the COVID-19 vaccine in Ontario, Canada. The key objective informing this study was to explore the experiences and perspectives of interprofessional PHC teams in the distribution of COVID-19 vaccination across Ontario.

Methods

A qualitative approach was used for this study, which involved 39 participants from the six health regions of the province. Eight focus groups were conducted with a range of interprofessional healthcare providers, administrators, and staff working in PHC teams across Ontario. The sample reflected a diverse range of clinical, administrative, and leadership roles in PHC. Focus groups were audio-recorded and transcribed, while transcriptions were then analyzed using thematic analysis.

Results

We identified the following four themes in the data: i) PHC teams know their patients; ii) mobilizing team capacity for vaccination, iii) intersectoral collaborations, and iv) operational challenges.

Conclusions

PHC teams were an instrumental component in supporting COVID-19 vaccinations in Ontario. The involvement of PHC in future vaccination efforts is key but requires additional resourcing and inclusion of PHC in decision-making. This will ensure provider well-being and maintain collaborations established during COVID-19 vaccination.
Prevalence of depression and associated factors among obstetric care providers at public health facilities in the West Arsi Zone, Ethiopia: Cross-sectional study
Authors: Alemu Solomon Seyife , Jarso Mohammedamin Hajure , Adem Zakir Abdu , Tesfaye Gebremeskel Mulatu , Workneh Yadeta Alemayehu , Gezimu Wubishet , Hussen Mustefa Adem , Gemeda Aman Dule , Teferi Sheleme Mengistu , Wedajo Lema Fikadu
Published: June 2024

Background

Depression is a severe and treatable mental illness that significantly affects individuals’ daily activities. Obstetric care providers are the most vulnerable group for depression because they work in an emergency to save two lives at a time, share the stress of women during labor, and are at great risk for contamination.

Objectives

To assess depression and associated factors among obstetric care providers working in public health facilities.

Method and materials

A cross-sectional study was conducted among 423 obstetric care providers working in public health facilities found in the West Arsi Zone, Ethiopia, from June 1 to 30, 2023. Study participants were selected through a simple random sampling technique. A pretested, face-to-face interviewer-administered structured questionnaire was used to collect data. Bi-variable and multivariable logistic regression analyses were employed to identify factors associated with depression. The level of statistical significance was declared at P < 0.05 with a 95% CI.

Conclusions and results

Overall, the prevalence of depression among obstetric care providers was 31.1% (95% CI: 26.6%, 35.5%). Marital status not in union (AOR = 2.86, 95%CI: 1.66, 4.94), working more than 40 hours per week (AOR = 2.21, 95%CI: 1.23, 3.75), current substance use (AOR = 2.73, 95%CI: 1.64, 4.56), not being satisfied with their job (AOR = 3.52, 95%CI: 2.05, 6.07) and having burnout symptoms (AOR = 5.11, 95%CI: 2.95, 8.83) were factors significantly associated with depression.

Recommendations

We recommend that health professionals take care of themselves and avoid substance use. We also recommended that stakeholders enhance job satisfaction and avoid burnout by implementing various programs, like raising wages for workers, increasing staff members, offering various benefits, and regularly monitoring issues that arise.
Home range, habitat use and capture-release of translocated leopards in Gir landscape, Gujarat, India
Authors: Ram Mohan , Sahu Aradhana , Srivastava Nityanand , Chaudhary Rohit , Jhala Lahar , Zala Yashpal , Venkataraman Meena
Published: June 2024

Understanding the spatial ecology of translocated leopards (Panthera pardus fusca) is crucial for their conservation and the effective assessment of conflict management strategies. We investigated the home range and habitat preferences of five radio-collared leopards (n = 5; 2 males; 3 females) in the Gir landscape. Additionally, we examined the usefulness of the capture-release strategy for these animals. We assessed home range and habitat selection using kernel density estimation (at 95% and 50% levels) and compositional analysis. Our findings revealed that leopards exhibited distinct patterns of movement, often returning to their original capture site or nearby locations or exploring new areas within 3 to 25 days, covering distances ranging from 48 to 260 km. The average home range (95% FK) was estimated at 103.96±36.37 (SE) km2, with a core area usage (50% FK) of 21.38±5.95 km2. Seasonally, we observed the largest home ranges during summer and the smallest during winter. Males exhibited larger home ranges (95% FK, 151±64.28 km2) compared to females (56.18±14.22 km2). The habitat analysis indicated that agricultural areas were consistently preferred in the multi-use landscape at the 2nd order habitat selection level. Additionally, habitat around water bodies was highly favoured at the 3rd order, with distinct variations in habitat selection observed during day and night. This study highlights the significance of riverine and scrubland habitats, as leopards exhibited strong preferences for these habitats within their home ranges. We emphasize the importance of conserving natural habitat patches, particularly those surrounding water bodies. We also report on the characteristics of the capture-release strategy and provide our observations indicating no escalated aggression by leopards’ post-release. In conclusion, this study evaluates widely employed approaches to conflict mitigation and suggests the continuous review and assessment of management strategies for mitigating human-leopard conflicts.
Immersive drawing: Mark-making beneath the surface
Authors: Borg Trevor
Published: June 2024

Drawing evokes notions of mark-making on a surface. This paper explores an immersive and fluid kind of mark-making that originates beneath the surface, gradually emerging to reveal what is going on at a deeper level more specifically under the sea. Immersive mark-making arises from below in the form of undercurrents, generating ripples that progressively and delicately make their way up as they glimmer and reflect the light penetrating the surface of the water. Hand gestures contribute to fluid movements that form tiny, frothy bubbles, each containing a reflective space awaiting to be explored and delved into. The fleeting bubbles are so delicate and elusive that their elegant movement can hardly be absorbed by the naked eye. A camera is needed to catch these special moments lasting only a few seconds and which can never be replicated. The current set of immersive charcoal drawings documents the result of swift mark-making gestures below the surface of the Mediterranean Sea captured by a submerged action camera. What the collection of photographs reveals is a universe made of miniscule worlds, drifting and rolling in a playful unchoreographed manner before vanishing into thin air. The poetic passage, both agitated and graceful, allows for drawing in water. It comprises shapes and rhythms, light and darkness, shifts and stillness, aspects we rarely have the time to reflect upon. The ensuing discussion presents the findings emanating from beneath by bringing to the surface of the paper the liquid cosmos generated by drawing in water.
Drawing and installation on the British Peak District: Self, environment and a mobile working kit
Authors: Kussmaul Sabine
Published: June 2024

This text reports about my practice-based doctoral research project exploring the question ‘How can the relationships between self and the outdoor environment of Bakestonedale Moor manifest in a creative arts practice from drawing and installation?’. I have developed a drawing and installation practice as the bearer and expression of my relationship with the outdoor places of the British Peak District in the vicinity of Pott Shrigley. This led to the development of the ‘mobile working kit’, a collection of modules fashioned from paper, string, wood and fabric, which I use to make drawings and mark the land with sculptural additions. My outdoor art-making events may only last a few hours but I later exhibit its artefacts as indoor art displays complemented by photographs and videos from the outdoor sites. I provide descriptions of two drawing activities outdoors, first, using a three-dimensional fence-like paper sculpture as a drawing surface and, second, drawing on a ground-based paper platform. These examples of art-making are then contextualized in reference to Barad’s concept of intra-activity where material changes in the world are understood to occur in co-constitutional negotiation of all active components. I use this concept and Barad’s understanding of performativity to describe process in art-making and in geological, meteorological and biological changes outdoors. I then relate these positions to current performance drawing in reference to the role of the artist and how the arts practice determines her connection to the outdoor environment.