bluuebunny/crossref_metadata_2025 huggingface dataset:
Jelena Dokic's suicide-related social media post and the worldwide media's portrayal of a story of survival: a natural experiment
Authors: Ekstein Daniella , Posel Amy , Rain Sarina , Nicholas Angela , Pirkis Jane , Niederkrotenthaler Thomas , Schaffer Ayal , Sinyor Mark
Published: December 2023

Objective: Coverage and public communication about suicide represent a major public health concern given the potential for identification and imitation. Yet when celebrities survive a suicidal crisis, it presents an opportunity to model adaptive coping. Tennis star Jelena Dokic's June 2022 Instagram post recounting her experience overcoming suicidal thoughts represents a unique natural experiment to characterize media coverage of a celebrity survival event. Methods: We searched Google News and the entire University of Toronto library catalogue for articles about Dokic's post. We divided articles according to world region of publication: (a) Australia & New Zealand, (b) United States & Canada, and (c) United Kingdom & Ireland. We coded articles for content and used Chi-squared analyses to identify differences including adherence to responsible media reporting guidelines. Results: We identified 73 articles of which 71 were available for coding. Almost all articles positioned Dokic's story as one of survival and conveyed alternatives to suicide (94%). However, 56 (79%) highlighted a suicide method that Dokic mentioned in her post and 18 (25%) inaccurately described Dokic as disclosing that she had attempted suicide when her post only conveyed suicidal thoughts. In general, adherence to responsible reporting guidelines appeared stronger in articles published in Australia & New Zealand. Conclusions: We found that the international media extensively covered Dokic's story of survival including substantial helpful information but also some misinformation and content that violates responsible reporting guidelines. Greater adherence by media in Australia & New Zealand may be due to more robust implementation of responsible media guidelines in the region.
The ethical dilemma of modding digital games: A literature review of the creation and distribution of mods
Authors: Reisinho Pedro , Raposo Rui , Zagalo Nelson
Published: December 2023

In parallel with the rapid growth of the digital games market, the modding phenomenon has been gaining momentum. Mod culture, a manifestation of the convergence and the remix cultures, emerges as a way to adapt digital games to the needs of their players and incorporate content from other media, such as books, movies, or series, into the game world. This systematic literature review aims to discuss the ethical considerations of modding by understanding its impact on the overall gaming experience and comprehending how players and game companies perceive and respond to modders’ motivations. 15 studies from various scientific fields were analysed. Overall, mods impact the gaming experience in a variety of ways, ranging from educational purposes to deeper social concerns. While modders find motivation to create mods stemming from a myriad of reasons, including leisure and self-improvement, the stance taken by game companies, gaming communities, and players tends to discourage them from developing new mods and deter new modders who aspire to contribute with creative content. In conclusion, it remains important to recognise that specific ethical dilemmas linked to mod culture require in-depth debate to reach a consensus. Furthermore, other aspects demand more stringent scrutiny to ensure that we can all benefit from the enriching playground of personal experimentation and exploration that modding offers in this contemporary era of convergence.
Attendance at remote versus in-person outpatient appointments in an NHS Trust
Authors: Kerr Gabriele , Greenfield Geva , Hayhoe Benedict , Gaughran Fiona , Halvorsrud Kristoffer , Pinto da Costa Mariana , Rehill Nirandeep , Raine Rosalind , Majeed Azeem , Costelloe Ceire , Neves Ana Luisa , Beaney Thomas
Published: December 2023

Introduction

With the growing use of remote appointments within the National Health Service, there is a need to understand potential barriers of access to care for some patients. In this observational study, we examined missed appointments rates, comparing remote and in-person appointments among different patient groups.

Methods

We analysed adult outpatient appointments at Imperial College Healthcare NHS Trust in Northwest London in 2021. Rates of missed appointments per patient were compared between remote versus in-person appointments using negative binomial regression models. Models were stratified by appointment type (first or a follow-up).

Results

There were 874,659 outpatient appointments for 189,882 patients, 29.5% of whom missed at least one appointment. Missed rates were 12.5% for remote first appointments and 9.2% for in-person first appointments. Remote and in-person follow-up appointments were missed at similar rates (10.4% and 10.7%, respectively). For remote and in-person appointments, younger patients, residents of more deprived areas, and patients of Black, Mixed and ‘other’ ethnicities missed more appointments. Male patients missed more in-person appointments, particularly at younger ages, but gender differences were minimal for remote appointments. Patients with long-term conditions (LTCs) missed more first appointments, whether in-person or remote. In follow-up appointments, patients with LTCs missed more in-person appointments but fewer remote appointments.

Discussion

Remote first appointments were missed more often than in-person first appointments, follow-up appointments had similar attendance rates for both modalities. Sociodemographic differences in outpatient appointment attendance were largely similar between in-person and remote appointments, indicating no widening of inequalities in attendance due to appointment modality.
Interactive virtual reality training to improve socio-emotional functioning in adolescents with developmental language disorders: A feasibility study
Authors: Arts Elke , De Castro Bram O , Luteijn Ellen , Elsendoorn Ben , Vissers Constance TWM
Published: December 2023

Methods to effectively improve socio-emotional functioning by adolescents with developmental language disorders (DLD) are scarce. Current methods to improve socio-emotional functioning in adolescents with other neurobiological disorders seem less suitable, as these methods are highly language based. This study therefore examined the feasibility of the virtual reality (VR) training for socio-emotional skills: ‘InterAction’. The aims of the present study were to (1) examine whether interactive VR is a feasible training method for adolescents with DLD; (2) investigate adolescents’ appreciation of the VR training; (3) examine whether the virtual reality training facilitates the participants’ sense of presence during social practice situations in an interactive digital world; and (4) explore whether adolescents socio-emotional skills improved during the six-session training. A sample of nine adolescents (13–16 years) with DLD reported on their presence in VR contexts and their appreciation toward the VR training. They also completed weekly self-reports on their socio-emotional functioning. Results indicated that ‘InterAction’ was a feasible method to practice socio-emotional functioning with adolescents with DLD. Adolescents highly appreciated the VR training. In addition, adolescents rated the sense of presence as high in the VR training. The individual trajectories showed that improvements in the trained skills varied both between and within participants. The results were also not uniform between the specific skills trained. The findings suggest that interactive virtual reality training may be a promising tool for improving socio-emotional functioning in adolescents with DLD. Future studies should examine the positive indications of this study in a larger sample.
Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance
Authors: McDonald Brontë , Michelson Daniel , Lester Kathryn J
Published: December 2023

Emotionally-based school avoidance (EBSA) is an important driver of persistent school absenteeism and may have worsened in the context of COVID-19. This paper describes the development of a brief parent-focused psychosocial intervention with the goal to address the lack of accessible early interventions for EBSA. The developmental process used a person-based approach with two phases. In Phase 1, qualitative data were collected about intervention preferences and priorities from N = 10 parents and N = 7 practitioners in a series of co-design workshops. Phase 2 refined an intervention blueprint based on iterative consultations with N = 4 parents and N = 3 practitioners. Framework analysis was used to organise findings around key intervention parameters, including relevant mechanisms, content, and delivery methods needed to provide effective, acceptable and feasible support for families affected by EBSA. The resulting blueprint incorporates three online modules to be delivered over three weeks with each module consisting of psychoeducational videos, self-completed learning tasks and a corresponding coaching session. Respective module content includes: (i) self-care strategies to increase parent wellbeing and self-efficacy; (ii) parenting strategies to change behavioural patterns that maintain child distress and avoidance of school; and (iii) strategic communication strategies to increase the quality of home-school relationships. The blueprint has been developed into a full prototype for a forthcoming feasibility study.
Influence of the water spray particle diameter and flow rate on the smoke flow and the back-layering in tunnels with longitudinal ventilation
Authors: Gao Zihe , Wang Pu , Cai Jiajun , Liu Mingge , Li Linjie
Published: December 2023

When there is a fire in a tunnel, the heat released by the combustion is difficult to dissipate and the temperature inside the tunnel would rise rapidly. Longitudinal ventilation (LV) has been commonly adopted as the smoke control strategy in tunnel fires, which is essential to safeguard the tunnel structure and the trapped people. Besides the smoke control method by LV, the water mist system (WMS) can provide a powerful cooling effect for the high-temperature smoke in the tunnel. This article aims to investigate the impact of WMS on the smoke back-layering (BL) length with LV and the mutual effect process between the smoke spread and the WMS. The findings show that the BL length is restricted more effectively by the combined action of water mist and LV. Upon activation of the WMS, the water mist’s effect inhibits the smoke’s ability to spread upstream and causes the smoke layer to settle down, which disturbs the stability of the smoke layer. An unstable layer of smoke is more likely to be blown downstream by longitudinal ventilation. All water mist particle diameters show a significant reduction in smoke back-layering with an increased flow rate. The BL length would gradually reduce as the particle diameter is decreased. The tendency of flow rate and particle diameter on the BL length shows similar effects to the critical velocity ( Vcr). The Vcr is reduced with the rising flow rate and increased with expanding particle diameter.
Im/material and intimate relations: Considering ethnographic methodologies for already-surveilled communities
Authors: Kaur Harleen
Published: December 2023

In this autoethnography of ethnographic training and methodologies, I reflect upon unaddressed tensions in a Los Angeles County gurdwara ethnography, pursued as an intellectualized response to the 2012 Oak Creek gurdwara shooting. I theorize the gurdwara (and other similarly sociopolitically located spaces) as “already-surveilled,” where intimacy in a US white supremacist context must also be seen as a forced relation with the state surveillance apparatus. Analyzing field notes from the classroom and gurdwara, I offer three possible approaches to ethnographic inquiry: participant observation, bearing witness, and embodied conviction. I argue that, without an embodied approach, ethnographic approaches fail to incorporate analyses of power and precarity (the material), particularly for communities of belief (the immaterial). Finally, I offer a model for generating theoretical and methodological frameworks from embodied practices of belief or conviction—in this case, Sikh praxes of relation, knowing, and belief that are witnessed across various gurdwaras.
Unveiling the essence: Constructs of memorable wellness tourism experiences
Authors: Dahanayake Shakila , Wanninayake Bandara , Ranasinghe Ruwan
Published: December 2023

Existing studies on memorable tourism experiences (MTE) focus primarily on diverse niche tourism forms, although there is a dearth of evidence and studies on MTE in wellness tourism. The present research seeks to fill knowledge and empirical gaps in the field of wellness tourism and address theoretical inconsistencies by examining the key constructs that constitute memorable wellness tourism experiences (MWTE). An exploratory qualitative investigation was conducted to identify specific dimensions of MWTE. Data were gathered from international primary wellness tourists, selected through criterion-based snowball sampling, during October – December 2022, employing semi-structured interviews. Thematic analysis was performed based on grounded theory approach, using NVivo software for data analysis. Findings revealed ten dimensions; professionalism, meaningfulness, environmental aesthetics, refreshment, hedonism, hospitality, involvement, novelty, value for money, and authenticity with respective indicators (40). Opposing prior studies, study outcomes acknowledged professionalism and value for money as crucial MWTE determinants while revealing a new and intriguing determinant: environmental aesthetics. Identifying MWTE constructs fosters more in-depth insights into the aspects that constitute and reinforce wellness travel experiences. This profound knowledge may establish evidence-based decisions, policies, and practises that strengthen wellness tourists’ overall well-being and contentment.
The Social Validity of a Novel Caregiver Intervention to Support Episodic Memory in Autism: A Single-Case Study
Authors: Knox Sophie E. , Brien Ashley R. , Hutchins Tiffany L.
Published: December 2023

Episodic memory (EM) is the content of our personal narratives and is foundational to social communication. Research has repeatedly demonstrated EM challenges in individuals with autism. Meanwhile, it is well documented that a caregiver conversational style known as elaborative reminiscing facilitates EM development in children without autism. This study evaluated the efficacy and social validity of a novel elaborative reminiscing caregiver-mediated intervention to support EM in an 8-year-old girl with autism. Using a mixed-methods approach, we first examined qualitative and quantitative data to evaluate social validity. The caregiver’s subjective impressions of the goals, procedures, and outcomes suggested that the parent training had a high degree of social validity. Second, we evaluated child performance on standard assessments of EM. EM performance measures demonstrated improvements in EM following intervention, suggesting that the caregiver’s subjective impressions of efficacy were rooted in genuine advancements in her child’s EM abilities.
Preoperative Endoscopic Ultrasound-Guided Hepaticogastrostomy for Definite Biliary Drainage in Hilar Cholangiocarcinoma Laparoscopic Resection: A Hybrid Minimal-Invasive Technique
Authors: Tzedakis Stylianos , Belle Arthur , Berzan Diana , Nassar Alexandra , Dohan Antony , Coriat Romain , Sindayigaya Remy , Fuks David
Published: December 2023

Background and study aims

Laparoscopic approach of perihilar cholangiocarcinoma (PHC) is still challenging. We report the original use of a endoscopic hepaticogastrostomy (EHG) for definite biliary drainage in order to avoid biliary reconstruction.

Patients and methods

A 70-year-old man presenting with jaundice was referred for resection of a Bismuth type IIIa PHC. Repeated endoscopic retrograde cholangiopancreatography failed to drain the future liver remnant, enabling only right anterior liver section drainage. EHG was performed three weeks before surgery. A hepatogastric anastomosis was created, placing a half-coated self-expanding endoprosthesis between biliary duct of segment 2 and the lesser gastric curvature.

Results

A laparoscopic right hepatectomy extended to segment 1, common bile duct, and hepatic pedicle lymphadenectomy was performed. The left hepatic duct was sectioned and ligated downstream to the biliary confluence of segment 2-3 and 4 allowing exclusive biliary flow through the EHG. The patient was disease free at 12 months, postoperative outcomes were uneventful except three readmissions for acute cholangitis due to prosthesis obstruction.

Conclusions

EHG may be used as definite biliary drainage technique in laparoscopic PHC resection, at the expense of prosthesis obstruction and cholangitis.
Predictors of Progressing Toward Lifestyle Change Among Participants of an Interprofessional Lifestyle Medicine Program
Authors: Cheng Abby L , Dwivedi Mollie E , Martin Adriana , Leslie Christina G , Fulkerson Daniel E , Bonner Kirk H , Huecker Julia B , Salerno Elizabeth A , Steger-May Karen , Hunt Devyani M
Published: December 2023

Background

Therapeutic lifestyle change can be challenging, and not every attempt is successful.

Purpose

To identify predictors of making progress toward lifestyle change among patients who participate in a lifestyle medicine program.

Methods

This was a single-center, retrospective cohort study of 205 adults who enrolled in a goal-directed, individualized, interprofessional lifestyle medicine program. The primary outcome was whether, by the end of participation with the program, a patient reported making progress toward lifestyle change. Candidate predictors included sociodemographic, psychological, and health-related variables.

Results

Among 205 patients (median (IQR) age 58 (44-66) years, 164 (80%) female), 93 (45%) made progress toward lifestyle change during program participation. A predictor of making progress was being motivated by stress reduction (OR 2.8 [95% CI 1.1-7.6], P = .038). Predictors of not making progress included having a primary goal of losing weight (OR .3 [.2-.8], P = .012) and having a history of depression (OR .4 [.2-.7], P = .041).

Conclusions

To maximize a patient’s likelihood of successfully making lifestyle changes, clinicians and patients may consider focusing on identifying goals that are immediately and palpably affected by lifestyle change. Additional research is warranted to identify effective program-level approaches to maximize the likelihood of success for patients with a history of depression.
Efficacy of transvenous embolization of CSF-venous fistula in spontaneous intracranial hypotension: Case-series
Authors: Ellens Nathaniel R. , Schartz Derrek , Ismail Rahim , Kessler Alex , Ellika Shehenaz , Akkipeddi Sajal Medha K. , Rahmani Redi , Bender Matthew T.
Published: December 2023

Background

Spontaneous intracranial hypotension is a debilitating neurological condition which can be caused by a cerebrospinal fluid-venous fistula. Transvenous embolization is a promising technique to provide minimally invasive yet durable treatment.

Methods

A retrospective single-center case series was performed on all patients who underwent transvenous embolization of a cerebrospinal fluid (CSF)-venous fistula. Clinical and radiographic parameters, including Bern score, were reported preoperatively and at 3-month follow-up.

Results

Six patients underwent embolization of a CSF-venous fistula. All fistulae were located in the thoracic spine and technical success was achieved in all cases. Three patients had symptom resolution, two had significant improvement, and one had stable symptoms on follow-up. The mean Bern score was 6.83 (SD = 1.47) preoperatively and 1.83 (SD = 1.64) postoperatively with a mean improvement in Bern score of 5.0 (SD = 1.9, p = 0.0013).

Conclusions

CSF-venous fistulas are an increasingly recognized clinical entity which may be treated with transvenous embolization. This case series serves to further validate this technique and suggests it can be performed with similar outcomes in lower volume centers.
Analysis of the dynamic characteristics of the gear-shifting process under external excitation
Authors: Zhang Wei , Song Qiang , lai Wuxuan , Wang Mingsheng , Sun Peng
Published: December 2023

This study focuses on a novel clutchless and synchronizer-free drive system designed explicitly for pure electric vehicles. In contrast to the majority of previous research that solely considers internal excitations, this study not only incorporates various non-linear factors such as time-varying friction forces, time-varying mesh stiffness, and damping associated with internal excitations but also places significant emphasis on analyzing the impact of non-linear external excitations, including road surface unevenness and motor torque fluctuations, on the shifting process of the drive system. Subsequently, a non-linear dynamic model of the shifting process is established. In the modeling process, departing from the traditional two-degree-of-freedom quarter vehicle dynamics model, this study adopts an elastic tire-body and elastic tire-tread tire model, enabling the establishment of a highly accurate multi-degree-of-freedom quarter vehicle dynamics model. The simulation results indicate that road surface roughness and motor torque fluctuation significantly impact the gear-shifting process and the impact of road surface roughness increases with the level of roughness. Moreover, the effect of motor torque fluctuation on the gear-shifting process varies depending on different factors and is not simply additive. Consequently, when formulating and optimizing shifting strategies, it becomes imperative to consider various external factors. The research methodology integrates these factors into the dynamic analysis of the shifting process, providing a theoretical basis for developing effective shifting control strategies while considering external excitations.
Production and thermo-structural analysis of a hybridized natural fibre-based ceiling board for building applications
Authors: Jeremiah Lekwuwa Chukwuneke , Jude Ebieladoh Sinebe , Anthony Emeka Ezelue , Echezona Nnaemeka Obika , Onyemazuwa Andrew Azaka , Kingsley Chidi Nnakwo
Published: December 2023

Canewood and palm kernel fibre (PKF) have successfully been used as filler material for producing ceiling boards, with recycled low-density polyethylene (LDPE) as the binder. This work covered three aspects which are the optimization of process and production parameters, chemical, and thermal analysis of the utilized filler material. The production parameters considered are the percentage composition of both the binder and filler material while the process parameters studied are the press temperature, pressure and time. These parameters were optimized over both physical and thermal properties of the developed ceiling board which are thermal resistivity, water absorption and thickness swell. Thermal results for both the cane wood and PKF proved to be thermally stable up to temperatures as high as 325 and 310°C, respectively. The optimized ceiling board showed a thermal resistivity, water absorption and thickness swell of 16.192 W/M.K, 4.669 and 6.594% respectively, for a production and process parameters of 15% cane wood, 10% PKF, 75% LDPE, 6 min press time, 7 bar pressure and 198°C press temperature. The produced ceiling board showed a specific heat capacity, thermal energy and heat flux of 769.23 Jkg−1K−1, 60 W and 23.07 kWm−1 respectively. The findings imply that the LDPE filler materials are appropriate for use in ceiling board applications.
Manipulate mechanism design and synchronous motion application for driving simulator
Authors: Yao Shuangji , Wang Zhilong , Ceccarelli Marco , Yang Haojie , Zhao Ding Xuan
Published: December 2023

The manipulate load system of a helicopter driving simulator is a complex mechatronic system. To simulate the load system of the joystick more effectively, this study provides a new manipulate mechanism with automatic position reset function that integrates a spring system within the joystick. The load simulation of this manipulate mechanism can be achieved by designing the nonlinear coefficient of the spring in a reasonable manner, thereby eliminating the need for complex control of motor simulation and system time delay. This greatly simplifies the complexity of the system and effectively meets the requirements of real-time and accuracy. Initially, the new manipulate mechanism is described in detail through kinematic analysis. Then, dynamic simulation is conducted in ADAMS software to simulate the motion of the operation mechanism. Considering the active–passive relationships between the manipulate mechanism and the driving simulator, a mapping is established to achieve synchronized motion. The synchronized motion is subsequently evaluated and verified in MATLAB/Simulink. The results reveal that this new manipulate mechanism has high reliability and can effectively achieve synchronized motion with the driving simulator. The new manipulate mechanism will be useful in advancing research into the design of manipulate mechanism processes.
Perspectives of women as they navigate their path to principalship in Australian secondary schools
Authors: Thompson Pauline , Stokes Helen
Published: December 2023

In most countries around the world, teaching is a highly feminized profession. However, despite the higher percentage of female teachers in secondary schools, women continue to be under-represented in secondary principal roles. Similar to the United Kingdom, in Australia more than 60% of all teachers in secondary schools are female, and 40% of the principals in secondary schools are female. Furthermore, on average it takes female teachers 2.7 years longer to attain a principal role and consequently have a shorter career as a principal. Therefore, it is important to understand the pathway of female principals as they progress through middle leadership roles to senior leadership. This article investigates and reports on the career pathways of 14 female principals in Australian secondary schools. Each individual pathway to principalship was mapped out to specifically identify the types of middle leadership roles undertaken over each principal's career. The mapping of the pathways identifies the types of roles which were more commonly held by the female principals prior to senior leadership. Interviews with the principals enabled the identification of a range of shared challenges and affordances on their pathway to principalship.
Management of obesity: Going beyond eating less and moving more
Authors: Podlasek Anna
Published: December 2023

Overweight and obesity are defined as abnormal or excessive adipose tissue accumulation that results in a risk to health. This is caused not simply by poor lifestyle, but rather a complex interplay of health inequalities, genetic inheritance, as well as social and environmental factors. Excess weight significantly increases the risk of chronic illnesses, including cardiovascular diseases, diabetes, musculoskeletal disorders, and various types of cancer. Individuals with a body mass index (BMI) of 30–35 kg/m2 experience an average reduction in life expectancy of 2–4 years and for those with a BMI of 40–50 kg/m2, the decrease in life expectancy ranges from 8–10 years. Experts predict that by 2030, the UK will see 11 000 000 more adults affected by obesity, resulting in a significant increase in the cost of treating obesity-related diseases. This article provides a contemporary overview of obesity understanding and management in adults, including brief interventions, motivational interviewing, as well as pharmacological and surgical options.
Crossing barriers: the burden of inflammatory bowel disease across Western Europe
Authors: Kumar Aditi , Yassin Nuha , Marley Alexandra , Bellato Vittoria , Foppa Caterina , Pellino Gianluca , Myrelid Pär , Millan Monica , Gros Beatriz , Avellaneda Nicolas , Catalan-Serra Ignacio , El-Hussuna Alaa , Cunha Neves João A. , Roseira Joana , Cunha Miguel F. , Verstockt Bram , Bettenworth Dominik , Mege Diane , Brookes Matthew J.
Published: December 2023

An estimated 2.5–3 million individuals (0.4%) in Europe are affected by inflammatory bowel disease (IBD). Whilst incidence rates for IBD are stabilising across Europe, the prevalence is rising and subsequently resulting in a significant cost to the healthcare system of an estimated 4.6–5.6 billion euros per year. Hospitalisation and surgical resection rates are generally on a downward trend, which is contrary to the rising cost of novel medication. This signifies a large part of healthcare cost and burden. Despite publicly funded healthcare systems in most European countries, there is still wide variation in how patients receive and/or pay for biologic medication. This review will provide an overview and discuss the different healthcare systems within Western Europe and the barriers that affect overall management of a changing IBD landscape, including differences to hospitalisation and surgical rates, access to medication and clinical trial participation and recruitment. This review will also discuss the importance of standardising IBD management to attain high-quality care for all patients with IBD.
Anticoagulation Therapy in a Patient who had two Consecutive Strokes After Antibiotic Therapy for Infective Endocarditis: A Case Report
Authors: Albanna Abdalla Jamal , Jumah Ammar , Agarwal Utkarsh , Fana Michael , Kareem Samer Abdul , Miller Daniel
Published: December 2023

A 77-year-old male presented with altered mentation and was diagnosed with infective endocarditis. Echocardiography revealed aortic valve vegetations. While receiving inpatient antibiotic therapy, the patient experienced an acute ischemic stroke. Magnetic resonance imaging of the brain showed punctate embolic-appearing infarcts in the right cerebellum and in the left occipital, frontal, and parietal lobes. Anticoagulation was not initiated due to a high risk of hemorrhagic transformation. He was readmitted after being discharged due to another episode of altered mentation. Repeat echocardiography indicated increased size of aortic valve vegetations. The patient was then transferred to our hospital for surgical intervention of enlarging vegetations, however was deemed unsuitable for surgery. During hospitalization, he suffered another embolic stroke in the right frontal lobe. By this time, the patient had completed a full course of antibiotics for infective endocarditis, and additional antibiotics were deemed unnecessary by our infectious disease specialists. Literature review highlighted that residual vegetations carry a higher risk for stroke, but no clear guidelines were found on how to intervene or assess the risk of hemorrhage with anticoagulation in this population. Consequently, a decision was made to initiate anticoagulation, Follow-up imaging revealed no evidence of hemorrhagic transformation. Subsequently, the patient remained stable and was discharged to a rehabilitation center, where he did not experience any further events.
Evaluation of brain metastasis edema in breast cancer patients as a marker for Ki-67 and cell count—A single center analysis
Authors: Stojkova Marija , Behme Daniel , Barajas Ordonez Felix , Christ Sebastian M , March Christine , Surov Alexey , Thormann Maximilian
Published: December 2023

Background

Peritumoral edema is an important cause of morbidity and mortality in patients with breast cancer brain metastases (BCBM). The relationship between vasogenic edema and proliferation indices or cell density in BCBM remains poorly understood.

Purpose

To assess the association between tumor volume and peritumoral edema volume and histopathological and immunohistochemical parameters in BCBM.

Materials and Methods

Patients with confirmed BCBM were retrospectively identified. The tumor volume and peritumoral edema volume of each brain metastasis (BM) were semi-automatically calculated in axial T2w and axial T2-fluid attenuated inversion recovery (FLAIR) sequences using the software MIM (Cleveland, Ohio, USA). Edema volume was correlated with histological parameters, including cell count and Ki-67. Sub-analyses were conducted for luminal B, Her2-positive, and tripe negative subgroups.

Results

Thirty-eight patients were included in the study. There were 24 patients with a single BM. Mean metastasis volume was 31.40 ± 32.52 mL and mean perifocal edema volume was 72.75 ± 58.85 mL. In the overall cohort, no correlation was found between tumor volume and Ki-67 (r = 0.046, p = .782) or cellularity (r = 0.028, p = .877). Correlation between edema volume and Ki-67 was r = 0.002 ( p = .989), correlation with cellularity was r = 0.137 ( p = .453). No relevant correlation was identified in any subgroup analysis. There was no relevant correlation between BM volume and edema volume.

Conclusion

In patients with breast cancer brain metastases, we did not find linear associations between edema volumes and immunohistochemical features reflecting proliferation potential. Furthermore, there was no relevant correlation between metastasis volume and edema volume.
Quasi (-social) citizenship, the common travel area, and the fragmented protection of employment rights in the United Kingdom after Brexit
Authors: O'Connor Niall
Published: December 2023

Irish citizens living in the United Kingdom (UK) enjoy a privileged immigration status, which in turn facilitates access to a number of economic and social rights, perhaps most importantly a right to—and thereby rights in—work. European Union (EU) law played an important role in facilitating the latter, but with freedom of movement and the right to work of Irish citizens now dependent on the Common Travel Area (CTA) and associated legislative protections. This article argues that the CTA constitutes a workers’ rights ‘intervention’, which necessitates a clearer articulation of how this instrument fits within the wider context of post-Brexit UK employment law, including the rights deriving from the withdrawal arrangements governing the UK's departure from the EU. There are a number of asymmetries in the CTA that undermine its value as an employment rights conduit. Brexit, it is argued, has led to further fragmentation of the category of ‘Irish citizen’ in the UK, despite the purported recent recognition of such citizens as a distinct class within UK immigration law. More significantly, the CTA lacks normative purpose, and is a rather weak employment law instrument, in that it represents no more than a facilitation of national legislative intervention to ensure (roughly) equivalent treatment between British and Irish citizens in matters of employment (among other economic and social rights). The current CTA arrangements are thereby devoid of any underpinning (social) objectives or values and lack explicit recognition of their role as a facilitator of access to fundamental economic and social rights. Non-political, and rights-based conceptions of social citizenship are suggested as potential normative groundings for the CTA and derived (employment) rights in the absence of the protective framework offered by EU free movement and labour law.
Working through our differences: Limits of ontology in the ordinary lives of critical geographical theory
Authors: Bodden Shawn
Published: December 2023

You won’t get far in geographical theory today without bumping into one ontology or another. Metaphysical assertions about key spatial concepts – ‘space is open’, ‘community is exclusionary’, ‘the political is agonistic’ – guide empirical analysis. In this mode of theorising, the vocation of critical geography is to correct conceptual misunderstandings and thereby direct political action. Curiously perhaps, the geographer becomes one who – in the name of emancipatory projects – points people to their proper place. An alternative approach to critical theory might consider instead how people place themselves. Just such a concern animates the varied enterprises operating under the name of ordinary language philosophy. This article examines how philosophies of ordinary language might contribute to new avenues of geographical research by examining the relationship between Stanley Cavell's writings on the human voice as a site of embodied and passionate response and Clive Barnett's call for an action-theoretic approach to social inquiry as an alternative to ontological critique. Taken together, their work recommends a programme of inquiry into ordinary critical geographies: how people circumstantiate the meaning, worth and wisdom of their actions, and, in doing so, work to place themselves in the world.
Eradicate Helicobacter pylori first, or treat peptic ulcer disease?
Authors: He Xinjue , Li Lan , Lu Chao
Published: December 2023

Background:

Helicobacter pylori infection is very common worldwide, and about 10%–16% of these patients develop peptic ulcer disease. However, there is limited research on the impact of H. pylori eradication and peptic ulcer disease treatment sequencing.

Methods:

We conducted a retrospective study of adult patients diagnosed with H. pylori infection and peptic ulcer disease between October 2020 and April 2021 at our center. Data on primary treatment outcomes, including H. pylori eradication and peptic ulcer disease healing, were collected, and factors that may influence treatment outcomes were analyzed.

Results:

A total of 306 patients were included in this study. The sequence of H. pylori eradication and peptic ulcer disease treatment did not significantly affect the outcomes of H. pylori eradication and peptic ulcer disease healing. In addition, patient age, peptic ulcer disease type, clinic type and treatment regimen (including choice of proton pump inhibitor) had no significant impact on H. pylori eradication. However, patient gender and the choice of antibiotic combination proved to be key factors, as eradication rates were lower in female patients compared to males, and the combination of levofloxacin and clarithromycin was the least effective in eradicating H. pylori. Regarding peptic ulcer disease healing, the peptic ulcer disease type was an important influencing factor, since gastric ulcers being more likely to get cured completely compared to duodenal ulcers.

Conclusions:

The sequence of H. pylori eradication and peptic ulcer disease treatment does not significantly affect the primary outcomes. Patient gender and the choice of antibiotic combination are important factors in H. pylori eradication, whereas peptic ulcer disease type plays a key role in ulcer healing.
Geomorphic changes and socio-environmental impacts of recent sand mining in the Sakarya River, NW Turkey
Authors: Okur Hilal , Erturaç Mehmet Korhan , Nicoll Kathleen
Published: December 2023

Analysis of multi-temporal satellite images from 1980 to 2019, complemented by geomorphic mapping and field study, indicate that “loose sand” extraction of Sakarya River deposits from the Adapazarı Plain of NW Turkey significantly intensified during the last decade, and mining operations have caused complete and irreversible alteration of floodplain habitat in a total area amounting to ~970 hectares. Our reconstructions estimate the total amount of mined material over a 40-year period since 1980 as ~50 million m3, amounting to ~80 million tonnes of fluvial sand. These sand mine operations, like most around the world, are highly disruptive and destructive but remain unregulated, and neither extractions or environmental impacts are reported or monitored. Our independent study is first to directly assess sand extraction in altering the natural geomorphic setting of the Sakarya River and describe economic, environmental, and social impacts of mining operations. The high demand for loose sand used in cement and concrete infrastructure correlates with changes in Turkey’s political economy, which increasingly focused on construction during the last quarter of the 20th century. Extractive sand mining in this region has caused substantial land loss, soil erosion and water table alterations, which have made agricultural land unsuitable for cultivation, and even destroyed most of the farmland supporting the villages, eliminating the traditional farming practiced for millennia. Continuous mining operations cause constant noise, heavy vehicle traffic and pollution. Furthermore, sand removal from the Sakarya river environment has significantly diminished sediment transport offshore to its delta in the Black Sea; the lower sediment yield diminishes coastal beach nourishment and is accelerating coastal land erosion regionally. The Sakarya case study we describe illustrates the need for (1) improved oversight of human agency that destroys riverine settings; and (2) regulations regarding long term environmental and social impacts of sand mining.
“Big data see through you”: Sexual identifications in an age of algorithmic recommendation
Authors: Wang Shuaishuai , Spronk Rachel
Published: December 2023

On Douyin, China's domestic version of TikTok, straight users are being recommended queer content, and videos created by straight men are being recommended to queer viewers. As Douyin recommends videos based on users’ online activities (e.g., liking, sharing, or spending time watching a video) and networks (e.g., connections made on the platform), sexuality comes to be algorithmically interpreted and defined. This process differs from an understanding of gender and sexuality as more or less fixed classifications that are the result of what people register when entering a platform concerning their gender and sexual identifications. This article analyzes viewers’ and creators’ experiences and reflections on the algorithmic grouping of sexual orientation and erotic curiosity through the relational lens of configurations. Using two years of online observational data and in-depth interviews with 18 Douyin users, both straight and same-sex orientated, we found that a language-centered, semiotic approach alone cannot assist in capturing the reconfiguration of sexual identifications presently occurring in China, and most likely elsewhere. Sexual identifications are the result of a relational process in which desires (regardless of sexual orientation) and intimacy, content creation and consumption, platform vernaculars and affordances, and data and algorithms converge and clash. This process allows for an erotic curiosity that has not yet been named or normalized in language systems and therefore reconfigures how sexual identity or orientation come to be understood in relation to the ever-increasing presence of computational power.
Freezing out: Legacy media's shaping of AI as a cold controversy
Authors: Dandurand Guillaume , McKelvey Fenwick , Roberge Jonathan
Published: December 2023

Mainstream coverage of artificial intelligence often appears to emphasise the technologies’ benefit and economic potential over its growing downsides. How does a technology poised to be so disruptive become so uncritically embraced? Why is it, simply put, that artificial intelligence's representations in legacy media do not normally convey the controversialities otherwise found in research or policy debates? We introduce the concept of ‘freezing out’ to describe processes of translation that cool down debates over the merits of technology. Freezing out looks at the other side of controversy studies to study the production of uncontroversies or cold controversies rather than hot topics and debates. We use the coverage of artificial intelligence in Canadian national news outlets to analyse how controversiality becomes ‘frozen out’. Since Canadian academics won the prestigious ImageNet prize in 2012 introducing the modern turn toward machine learning approaches, Canada has promoted itself as a global leader. Using in-depth interviews with Francophone and Anglophone journalists as well as topic modelling on data collected from five major newspapers, we find that routine news making processes between journalists, experts, entrepreneurs, and governments build, maintain, and promote Canada's artificial intelligence ecosystem. Freezing out contributes to a broader interest in how heterogeneous actors traverse their domain of expertise across policy, media, and research circles to cool down artificial intelligence controversies.
Choreographing for public value in digital health?
Authors: Gross Nicole , Geiger Susi
Published: December 2023

Entanglements between public and private entities in digital health are not new, yet we do not have full insight into how these public-private dances are choreographed or what notions of public value drive governments’ appetite for investing into or collaborating with private digital health firms around health data. We examine key events, actors, public discussions, policy deliberations and regulations for over 30 years to find that European Union policy has paved an innovation-friendly path for technology companies entering healthcare. The recent pandemic has normalized these collaborations even further. The paper also finds that conceptualizations of public value in digital health mostly relate to economic aspects – markets, jobs and money. Other interpretations, such as public health, long-term sustainability or the common good, tend to be sidelined. The paper closes by considering whether the advent of the European Health Data Space will change this trajectory before giving suggestions on how a focus on public health value can be re-established.
Ventricular Assist Device Training and Emergency Management Among Pediatric Cardiac Intensive Care Physicians – Multicenter Cross-Sectional Survey
Authors: Esangbedo Ivie D. , Yu Priscilla , Choudhury Tarif A. , Tume Sebastian C. , Lasa Javier J.
Published: December 2023

Background/Aim: Pediatric cardiac intensive care physicians practicing at centers that implant ventricular assist devices (VAD's) are exposed to increasing numbers of VAD patients, with a significant number of VAD-days. We aimed to delineate pediatric cardiac critical care practices surrounding routine and emergency management of VADs. Methodology: We administered a multicenter cross-sectional survey of pediatric cardiac intensive care unit (CICU) physicians in the United States and Canada. Survey distribution occurred between August 31st and October 26th 2021. Results: A total of 254 CICU physicians received a formal invitation to participate, with 108 returning completed surveys (42.5% response rate). Responses came from CICU attending physicians at 26 separate institutions. Respondents' level of experience was well distributed across junior, mid-level, and senior staff: less than 5 years (38%), 5-9 years (25%), and >/= 10 years (37%). Most respondents had received formal training in the management of VAD patients (n = 93, 86.1%), with training format including fellowship (61%), simulation (36%), and national/international conferences (26.5%). Dedicated advanced cardiac therapies teams were available at the institutions of 97.2% of respondents. A total of 78/108 (72.2%) described themselves as “comfortable” or “very comfortable” in pediatric VAD management. While 63% (68/108) of respondents reported that they had never performed (or overseen the performance of) chest compressions in a pediatric patient with a VAD, 37% (40/108) reported performing CPR at least once in a VAD patient. Conclusion: With no existing international guidelines for emergency cardiovascular care in the pediatric VAD population, our survey identifies an important gap in resuscitation recommendations.