bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal preventive maintenance policy for leased equipment for free with minimum quantity of consumables purchasing commitment by the lessee
Authors: Tlili Lazhar , Anis Chelbi , Bouazizi Mokhles
Published: March 2023

Purpose

This paper deals with a particular type of leasing contracts according to which an equipment is leased for free with the condition for the lessee to purchase a predetermined minimum quantity of consumables during each leasing period. Maintenance actions are performed by the lessor and borne by him. Imperfect preventive maintenance is carried out every t time units throughout the leasing period. Minimal repairs are performed following equipment failures. At the end of the leasing period, an overhaul which restores the equipment to “as good as new” state is performed. The equipment is leased many times during its life cycle. The purpose of this paper is to determine the values of the decision variables for the lessor, which are the preventive maintenance (PM) period and the minimum quantity of consumables to be sold to ensure profit.

Design/methodology/approach

A mathematical model is developed to express the expected maintenance cost per time unit incurred by the lessor as well as his expected profit over the equipment life cycle. The optimal PM period minimizing the maintenance cost is determined first. Then, given the corresponding minimum maintenance cost, the minimum quantity of consumables (the lessor's break-even point) to be purchased by the lessee is computed. A numerical example and a sensitivity study are presented, and the obtained results are discussed.

Findings

The outcome of this work is supposed to help the lessors determining two key values to be included in each leasing contract, namely: (1) the periodicity according to which they will commit to perform preventive maintenance actions such that their average total cost of maintenance is minimized, (2) the minimum quantity of consumables that the lessee must commit to purchasing during the leasing period. This quantity must be between the break-even point and the maximum quantity associated with the capacity of the equipment.

Practical implications

Practically, the objective of this work is first to determine the optimal strategy to be adopted by the lessor in terms of effort relating to PM and second to determine the minimum quantity of consumables that the lessee must purchase during the leasing period such as profit is insured for the lessor.

Originality/value

This type of leasing (for free) has not been addressed in the literature particularly when considering maintenance strategies.
Film-induced tourism – the impact the of animation, cartoon, superhero and fantasy movies
Authors: Florido-Benítez Lázaro
Published: March 2023

Purpose

The aim of this paper is to analyze the interrelationship between film-induced tourism and visits to theme parks by tourists and examine the most viewed movies worldwide (2010–2022) which are related with theme parks and their attractions.

Design/methodology/approach

The methodology used in this study is a set of qualitative and quantitative indicators for measuring the most visited theme parks worldwide and the most viewed movies that have allowed to answer the research questions.

Findings

This research provides a new contribution to tourism and entertainment industries. Results have shown that film-induced tourism can be the perfect marketing tool to attract more tourists to theme parks through movies and their real or fictional characters represented in films such as Marvel, Minions, Avatar, Harry Potter and Disney, amongst many others. These famous characters are part of theme park’s rides to attract tourists to visit film theme parks These rides allow users to travel in a fantasy experience and interact with film characters of cartoons or fictions. There is a high correlation between film-induced tourism and theme parks’ attractions. Film-induced tourism provides great benefits to the society, theme parks, cinemas and tourist destinations. Indeed, movies help to increase the number of visitors to theme parks. In 2019, 215 million people visited the top 20 theme parks worldwide analyzed in this study, this figure is quite lucrative to entertainment and tourism sectors, local and regional economies where these theme parks are localized.

Originality/value

This study presents the importance of theme parks at tourist destinations because theme parks are an extension of movies, thus is, the end of the physical perfect experience at theme parks which began in a movie seat or on your TV/videogame/PC screens.
The new monies of the startup world: Future‐focused tech ventures as experiments in personal worth
Authors: Chua Emily H.C.
Published: March 2023

The tech startup is a globally admired and emulated form of enterprise, celebrated for its capacity to turn lines of digital code into lean and lucrative businesses. Drawing on recent work in the anthropology of money, I argue that the tech startup's rise is not only leading people to pursue new ways of making money but also giving rise to new constructions of the character and value of money itself. The article follows two startup founders in Singapore – where technocratic state authorities actively encourage citizens to found startup ventures – over three years of developing and marketing their products and attempting to raise investment funds. I show how the founders’ conceptions of the monies at play in their ventures led them to stake not only their economic futures, but also the social and moral worth of their persons on their startup's success. Emerging startup sectors thus draw people into more far‐reaching forms of self‐experimentation than the discourses of entrepreneurial risk and economic reward that surround them let on.
Contingent coordination in crisis: Experiences of Qingdao control command in governing COVID‐19 in China
Authors: Li Yanwei , Song Yunpeng
Published: March 2023

Coordination is one of the most challenging crisis management issues governments face worldwide. In this contribution, we examine the coordination mechanism applied by Qingdao control command in China to fight against COVID‐19. Its coordination is implemented contingently via five different approaches: achieving compromises through a centralized tiered meeting system, developing standard operating procedures through issuing documents, encouraging pragmatic problem‐solving through improvisation, establishing routines through finding shortcuts, and following commands and suggestions from higher‐up. Two perspectives, the structural‐institutional and cultural perspectives, have been applied to explain the choice of the contingent coordination mechanism. Our study contributes to the existing crisis coordination literature through substantiating the approaches underlying contingent coordination and providing a preliminary explanation of it.
Intestinal stem cell aging at single‐cell resolution: Transcriptional perturbations alter cell developmental trajectory reversed by gerotherapeutics
Authors: Choi Jiahn , Houston Michele , Wang Ruixuan , Ye Kenny , Li Wenge , Zhang Xusheng , Huffman Derek M. , Augenlicht Leonard H.
Published: March 2023

The intestinal epithelium consists of cells derived from continuously cycling Lgr5hi intestinal stem cells (Lgr5hi ISCs) that mature developmentally in an ordered fashion as the cells progress along the crypt‐luminal axis. Perturbed function of Lgr5hi ISCs with aging is documented, but the consequent impact on overall mucosal homeostasis has not been defined. Using single‐cell RNA sequencing, the progressive maturation of progeny was dissected in the mouse intestine, which revealed that transcriptional reprogramming with aging in Lgr5hi ISCs retarded the maturation of cells in their progression along the crypt‐luminal axis. Importantly, treatment with metformin or rapamycin at a late stage of mouse lifespan reversed the effects of aging on the function of Lgr5hi ISCs and subsequent maturation of progenitors. The effects of metformin and rapamycin overlapped in reversing changes of transcriptional profiles but were also complementary, with metformin more efficient than rapamycin in correcting the developmental trajectory. Therefore, our data identify novel effects of aging on stem cells and the maturation of their daughter cells contributing to the decline of epithelial regeneration and the correction by geroprotectors.
Glutamate levels in the ventromedial prefrontal cortex and resting‐state functional connectivity within reward circuits in alcohol‐dependent patients
Authors: Hu Yiting , Dong Fang , Xue Ting , Zhou Mi , Huang Ruoyan , Sui Feng , Guo Qiang , Hou Wenbao , Cai Wenlong , Yuan Kai , Wang Hongde , Yu Dahua
Published: March 2023

Great progress has been made in understanding the neural mechanisms associated with alcohol‐dependent (AD) patients. However, the interactions within the reward circuits of the patients need further exploration. Glutamatergic projections from the prefrontal cortex to some brain regions are present in the reward circuit. However, little is known about the potential implications of glutamate levels in the prefrontal cortex on abnormal interactions within reward circuits in AD patients. To determine the potential roles of reward circuits in drinking, we investigated differences in resting‐state functional connectivity (RSFC) and multivariate Granger causality analysis between 20 AD patients and 20 healthy controls (HC). The neuroimaging findings were then correlated with clinical variables (alcohol use disorder identification test). The ventromedial prefrontal cortex (VmPFC) is believed to play a critical role in addiction disorders, and glutamatergic projections from the prefrontal cortex to several regions of the brain are present in reward circuits. Proton magnetic resonance spectroscopy was also performed to assess the difference in glutamate levels in VmPFC between AD patients and HC. The results showed that the strength of functional connectivity in the reward circuit was generally attenuated in AD patients, and the reciprocal enhancement of activity between the right insula, left thalamus and VmPFC was found to be significantly greater in AD patients. It is worth noting that although glutamate levels in the VmPFC did not show significant differences between the two groups, the level of glutamate in the VmPFC was significantly correlated with RSFC. We hope that the current findings will help us to develop new intervention models based on the important role of the VmPFC in AD.
RNA sequencing analysis of the longissimus dorsi to identify candidate genes underlying the intramuscular fat content in Anqing Six‐end‐white pigs
Authors: Wang Y. L. , Hou Y. H. , Ling Z. J. , Zhao H. L. , Zheng X. R. , Zhang X. D. , Yin Z. J. , Ding Y. Y.
Published: March 2023

Intramuscular fat (IMF) is a significant marker for pork quality. The Anqing Six‐end‐white pig has the characteristics of high meat quality and IMF content. Owing to the influence of European commercial pigs and a late start in resource conservation, the IMF content within local populations varies between individuals. This study analyzed the longissimus dorsi transcriptome of purebred Anqing Six‐end‐white pigs with varying IMF content to recognize differentially expressed genes. We identified 1528 differentially expressed genes between the pigs with high (H) and low (L) IMF content. Based on these data, 1775 Gene Ontology terms were significantly enriched, including lipid metabolism, modification and storage, and regulation of lipid biosynthesis. Pathway analysis revealed 79 significantly enriched pathways, including the Peroxisome proliferator‐activated receptor and mitogen‐activated protein kinase signaling pathways. Moreover, gene set enrichment analysis indicated that the L group had increased the expression of genes related to ribosome function. Additionally, the protein–protein interaction network analyses revealed that VEGFA, KDR, LEP, IRS1, IGF1R, FLT1 and FLT4 were promising candidate genes associated with the IMF content. Our study identified the candidate genes and pathways involved in IMF deposition and lipid metabolism and provides data for developing local pig germplasm resources.
Omalizumab treatment in combination with any other biologics: Is it really a safe duo?
Authors: Koç Yıldırım Sema , Erbağcı Ece , Hapa Aslı
Published: March 2023

Background

Chronic spontaneous urticaria (CSU) is a mast cell‐mediated disease, which is sometimes associated with various inflammatory disorders. Omalizumab is a commonly used biological agent, which is a recombinant, humanized, monoclonal antibody against human immunoglobulin E. However, there are only few reports about the combination of omalizumab for CSU with any other biologics for accompanying inflammatory diseases in the literature. The aim of this study was to evaluate the patients whose treatment of omalizumab for CSU were combined with any other biologics for associated inflammatory disorders and to describe whether these combinations might have any safety concerns.

Methods

We conducted a retrospective cohort study of adult patients with CSU treated with omalizumab concurrently using another biological agent for their other dermatological conditions.

Results

Thirty‐one patients, 19 women and 12 men, were evaluated. The mean age was 45.13 years. The median duration of omalizumab was 11 months. Biological agents which patients were treated other than omalizumab were as follows: adalimumab biosimilar (n = 3), ustekinumab (n = 4), secukinumab (n = 17) and ixekizumab (n = 7). The median duration of concurrent use of omalizumab and other biologics was 8 months. None of the drug combinations was stopped because of side effects.

Conclusion

This observational study demonstrated that omalizumab treatment for CSU in combination with any other biological agents for dermatological disorders appeared to be well tolerated without any major safety concerns.
Women entrepreneurship: Mumpreneurs cruising the COVID‐19 pandemic in Indonesia
Authors: Tan Jacob Donald , Yew John Lee Kean
Published: March 2023

Learning from experiences is key towards the discovery of enterprising knowledge for mumpreneurs in emerging economies such as Indonesia, where most of the entrepreneurship literature is still relatively scant. In discussing entrepreneurial learning of entrepreneurs who are in motherhood, also known as mumpreneurs, these studies require the consideration of gender distinction of women. The term “mumpreneurs” refers to women who embrace the identity of a mother and an entrepreneur, and these two identities engender role conflicts for them. Thus, this phenomenology study explored seven mumpreneurs' experiences of their struggles and strategies to survive the pandemic. The findings shed light on the pandemic impacts and perseverance experiences that mumpreneurs must withstand to maneuver the encountered challenges. This study presents an entrepreneurial learning framework for mumpreneurs by providing pedagogical guidance and inspiration to enable them cruise past future crisis environments. This framework is ultimately crucial in contributing to the ongoing discussions at the academics, practitioners, and policymakers' levels to advise and support mumpreneurial activities that are substantial to the country's economy.
The impact of international students on housing markets
Authors: Mocanu Tatiana , Tremacoldi‐Rossi Pedro
Published: March 2023

We study the impact of the 2005–2015 international student boom in US universities on local housing markets. By constructing a sample of American college towns characterizing rarely studied local markets in small urban areas, we show that international students exogenously sustained demand for rentals and residential investment, representing counter‐cyclical shocks during the Great Recession. Exploiting the historical distribution of foreign enrolment across college towns and country‐of‐origin networks, we find that international students increased rents by 1.3% and home prices by 2.5% relative to the housing boom peak, translating into home equity gains of $4,000. An analysis exploiting within‐city dynamics reveals that neighbourhoods near campus absorbed international inflows by replacing single‐family homes with apartment rentals.
Implications for biological invasion of non‐native plants for sale in the world's largest online market
Authors: Banerjee Achyut Kumar , Lee Tien Ming , Feng Hui , Liang Xinru , Lin Yuting , Wang Jiakai , Yin Minghui , Peng Hao , Huang Yelin
Published: March 2023

Internet trade is increasingly recognized as a dispersal pathway of non‐native plant species that is difficult to monitor. We sought to identify non‐native flora present in the Chinese online market, the largest e‐commerce market globally, and to decipher the effect of existing trade regulations, among other variables, on e‐trading patterns and to inform policy. We used a comprehensive list of 811 non‐native plant species in China present in 1 of the 3 phases of the invasion continuum (i.e., introduced, naturalized, and invasive). The price, propagule types, and quantities of the species offered for sale were retrieved from 9 online stores, including 2 of the largest platforms. Over 30% of the non‐native species were offered for sale in the online marketplaces; invasive non‐native species dominated the list (45.53%). No significant price difference was observed across the non‐native species of the 3 invasion categories. Among the 5 propagule types, a significantly higher number of non‐native species were offered for sale as seeds. The regression models and path analyses consistently revealed a direct positive effect of the number of uses and species’ minimum residence time and an indirect effect of biogeography on the pattern of trade in non‐native plant species when minimal phylogenetic signal was detected. A review of the existing phytosanitary regulations in China revealed their inadequacy in managing e‐trading of non‐native plant species. To address the problem, we propose integration of a standardized risk assessment framework that considers perceptions of stakeholders and is adaptable based on continuous surveillance of the trade network. If implemented successfully, the measures could provide a template for other countries to strengthen trading regulations for non‐native plant species and take proactive management measures.
Estimating the value of sodium‐glucose cotransporter‐2 inhibitors within the context of contemporary guidelines and the totality of evidence
Authors: McEwan Phil , Foos Volker , Martin Becky , Chen Jieling , Evans Marc
Published: March 2023

Aims

To comprehensively estimate the cost‐effectiveness of sodium glucose cotransporter‐2 (SGLT2) inhibitor usage in the management of type 2 diabetes mellitus (T2DM) at established clinical review points, incorporating the totality of proven health benefits.

Materials and methods

This study considered the cardio‐ and reno‐protective effects of SGLT2 inhibitors using the Cardiff type 2 diabetes model. Conventional cost‐effectiveness evaluations were undertaken for eligible populations at relevant intensification points reflecting the 2022 guidelines versus the 2015 National Institute of Health and Care Excellence (NICE) guidelines; incremental cost‐effectiveness ratio lifetime trajectories and timepoints for complete cost‐offset were estimated for each pathway. Treatment effects, utility decrements and costs (applied additively and discounted at 3.5%) were sourced from the published literature.

Results

For all subpopulations on treatment pathways reflecting the NG28‐2022 guidelines, SGLT2 inhibitor introduction was cost‐effective, becoming cost‐saving between 2 and 16 years post‐initiation. Despite increases in pharmacy costs, predicted lifetime costs were lower than for pathways reflecting the NG28‐2015 guidelines, driven by a reduction in heart failure hospitalization and chronic kidney disease costs. Incremental gains in quality‐adjusted life years (ranging from 0.58–1.12) resulted in dominance for the updated NG28‐2022 guidance in all scenarios.

Conclusions

Our results show that SGLT2 inhibitors have the potential to lower healthcare costs while improving health outcomes in eligible patient subpopulations.
Can motor proficiency testing predict sports injuries and sports‐induced bleeds in people with haemophilia?
Authors: Versloot Olav , Blokzijl Johan , Timmer Merel , Schuuring Marleen , van Galen Karin , Kremer Hovinga Idske , van der Valk Paul , van Vulpen Lize , Schutgens Roger , van Koppenhagen Casper , van der Net Janjaap , Fischer Kathelijn
Published: March 2023

Introduction

Predicting the risk of sports injuries and sports‐induced bleeds (SIBs) in people with haemophilia (PWH) may support clinical counselling.

Aim

To assess the association between motor proficiency testing and sports injuries and SIBs and to identify a specific set of tests for predicting injury risk in PWH.

Methods

In a single centre, prospective study male PWH aged 6–49 playing sports ≥1x/week were tested for running speed and agility, balance, strength and endurance. Test results below −2Z were considered poor. Sports injuries and SIBs were collected for 12 months while 7 days of physical activity (PA) for each season was registered with accelerometers. Injury risk was analysed according to test results and type of physical activity (%time walking, cycling, running). Predictive values for sports injuries and SIBs were determined.

Results

Data from 125 PWH (mean [± SD] age: 25 [± 12], 90% haemophilia A; 48% severe, 95% on prophylaxis, median factor level: 2.5 [IQR 0–15]IU/dl) were included. Few participants (n = 19, 15%) had poor scores. Eighty‐seven sports injuries and 26 SIBs were reported. Poor scoring participants reported 11/87 sports injuries and 5/26 SIBs. The current tests were poor predictors of sports injuries (Range PPV: 0%–40%), or SIBs (PPV: 0%–20%). PA type was not associated with season (activity seasonal p values > .20) and type of PA was not associated with sports injuries or SIBs (Spearman's rho < .15).

Conclusion

These motor proficiency‐ and endurance tests were unable to predict sports injuries or SIBs in PWH, potentially due to few PWH with poor results and low numbers of sports injuries and SIBs.
Health‐related quality of life in persons with haemophilia in Afghanistan
Authors: Hosseini Sayed Mohammad Reza , Mousavi Sayed Hamid , Mesbah‐Namin Seyed Alireza , Tabibian Shadi , Dorgalaleh Akbar
Published: March 2023

Introduction

Haemophilia is the most common severe congenital bleeding disorder and can significantly influence patients’ quality of life. The health‐related quality of life (HRQoL) is a multi‐dimensional concept that assess effect of different aspects of health status, including physical, mental, and social domains. Identification of the factors affecting the HRQoL of Persons with Haemophilia (PWH) can guide health care system to better management of patients.

Aim

The aim of the present study is to evaluate HRQoL in PWH in Afghanistan.

Methods

This cross‐sectional study was conducted on 100 PWH in Kabul City, Afghanistan. Data were collected using 36‐Item‐Short‐Form Health Survey (SF‐36) questionnaire and analysed using correlation coefficients and regression analysis.

Results

The mean scores for the SF‐36 questionnaire 8 domains range from 33 ± 38.3 to 58.15 ± 20.5. The highest mean value belongs to physical function (PF) (58.15), whereas the lowest is related to restriction of activities due to emotional problems (RE) (33.00). A significant association (p < .005) was observed between all domains of SF‐36 and patients’ age except for PF (p = .055) and general health (GH) (p = .75). A significant association was also observed between all HRQoL domains and the severity of haemophilia (p < .001). The severity of haemophilia was the significant predictor for Physical Component Summary (PCS) and Mental Component Summary (MCS) (p < .001).

Conclusion

Due to the reduced HRQoL in Afghan PWH, special attention by health care system should be paid to improve patients’ quality of life.
Dermoscopic approach for differential diagnosing of autoimmune bullous disease: pemphigus vulgaris, pemphigus foliaceus, and IgA pemphigus
Authors: Gharib Khaled , Nassar Amani , Youssef Ayman , Bessar Hagar
Published: March 2023

Introduction

Dermoscopy is a noninvasive technique for the evaluation of different pigments and microstructures of the epidermis, dermoepidermal junction, and papillary dermis that are not apparent to the naked eye, which therefore improves diagnostic accuracy.

Aim of the study

This study aims to describe the characteristic dermoscopic features of bullous diseases and analyze the characteristic dermoscopic features of bullous diseases of the skin and hair.

Patients and methods

A descriptive study was conducted to describe and analyze the characteristic dermoscopic features of bullous diseases in the Zagazig University Hospitals.

Results

This study enrolled 22 patients. Dermoscopy revealed yellow hemorrhagic crusts in all patients and white yellow structure with red halo in 90.9% of patients. Pemphigus vulgaris patients were identified by the presence of dermoscopic clues such as bluish deep discoloration, tubular scaling, black dots, hair casts, hair tufts, yellow dots with whitish halos (fried egg sign) and yellow follicular pustules that are not seen in pemphigus foliaceus and IgA pemphigus.

Discussion

Dermoscopy is an important tool that serves as a link between clinical and histopathological diagnoses, and it can easily be used in daily practice. Several suggestive dermoscopic features can help in the differential diagnosis of autoimmune bullous disease but only after making a provisional clinical diagnosis. Dermoscopy is a very useful tool in the differentiation of pemphigus subtypes.
Bacterial and viral infections among adults hospitalized with COVID‐19, COVID‐NET, 14 states, March 2020–April 2022
Authors: Shah Melisa M. , Patel Kadam , Milucky Jennifer , Taylor Christopher A. , Reingold Arthur , Armistead Isaac , Meek James , Anderson Evan J. , Weigel Andy , Reeg Libby , Como‐Sabetti Kathryn , Ropp Susan L. , Muse Alison , Bushey Sophrena , Shiltz Eli , Sutton Melissa , Talbot H. Keipp , Chatelain Ryan , Havers Fiona P. ,   the CDC COVID‐NET Surveillance Team
Published: March 2023

Background

Bacterial and viral infections can occur with SARS‐CoV‐2 infection, but prevalence, risk factors, and associated clinical outcomes are not fully understood.

Methods

We used the Coronavirus Disease 2019‐Associated Hospitalization Surveillance Network (COVID‐NET), a population‐based surveillance system, to investigate the occurrence of bacterial and viral infections among hospitalized adults with laboratory‐confirmed SARS‐CoV‐2 infection between March 2020 and April 2022. Clinician‐driven testing for bacterial pathogens from sputum, deep respiratory, and sterile sites were included. The demographic and clinical features of those with and without bacterial infections were compared. We also describe the prevalence of viral pathogens including respiratory syncytial virus, rhinovirus/enterovirus, influenza, adenovirus, human metapneumovirus, parainfluenza viruses, and non‐SARS‐CoV‐2 endemic coronaviruses.

Results

Among 36 490 hospitalized adults with COVID‐19, 53.3% had bacterial cultures taken within 7 days of admission and 6.0% of these had a clinically relevant bacterial pathogen. After adjustment for demographic factors and co‐morbidities, bacterial infections in patients with COVID‐19 within 7 days of admission were associated with an adjusted relative risk of death 2.3 times that of patients with negative bacterial testing. Staphylococcus aureus and Gram‐negative rods were the most frequently isolated bacterial pathogens. Among hospitalized adults with COVID‐19, 2766 (7.6%) were tested for seven virus groups. A non‐SARS‐CoV‐2 virus was identified in 0.9% of tested patients.

Conclusions

Among patients with clinician‐driven testing, 6.0% of adults hospitalized with COVID‐19 were identified to have bacterial coinfections and 0.9% were identified to have viral coinfections; identification of a bacterial coinfection within 7 days of admission was associated with increased mortality.
Examining shifts in conceptual knowledge, procedural knowledge and procedural flexibility in the context of two game‐based technologies
Authors: Chan Jenny Yun‐Chen , Closser Avery H. , Ngo Vy , Smith Hannah , Liu Allison S. , Ottmar Erin
Published: March 2023

Background

Prior work has shown that middle school students struggle with algebra and that game‐based educational technologies, such as DragonBox and From Here to There!, are effective at improving students' algebraic performance. However, it remains unclear which aspects of algebraic knowledge shift as a result of playing these games and what game design features support algebraic learning.

Objective

Using the data from a randomized controlled trial conducted in the 2020–2021 academic year, we (a) examined students' relative performance on assessment items measuring conceptual knowledge, procedural knowledge and procedural flexibility in algebraic equation solving, and (b) identified changes in these aspects of algebraic knowledge after playing DragonBox or From Here to There!.

Methods

Eight hundred eighty‐seven seventh‐graders were randomly assigned to playing DragonBox or From Here to There! for nine 30‐min sessions throughout the school year. Students also completed a pretest, midtest and posttest measuring their algebraic knowledge.

Results and Conclusion

First, prior to the intervention, students scored the highest on procedural knowledge and lowest on conceptual knowledge. Second, students significantly improved and maintained learning gains on conceptual knowledge throughout the intervention. Their performance on procedural knowledge and procedural flexibility items increased at midtest but decreased at posttest. Third, the pattern of results was consistent for students in the DragonBox and From Here to There! conditions, suggesting that both games may support students' conceptual understanding of algebra. The findings have implications for research and practice on supporting algebraic learning through game‐based technologies during and beyond educational disruptions.
CAD/CAM full‐mouth rehabilitation of an elderly patient: One‐piece digital complete denture meets multilayered zirconia with gradient technology
Authors: Edelhoff Daniel , Schubert Oliver , Stimmelmayr Michael , Schweiger Josef
Published: March 2023

Objective

This article highlights a CAD/CAM complete‐mouth rehabilitation in an 82‐year‐old patient by means of a complete maxillary prosthesis and mandibular implant‐ and tooth‐supported fixed restorations made from multilayered zirconia.

Clinical Considerations

Comprehensive complete‐mouth rehabilitations in elderly patients with adaptation of the occlusal vertical dimension (OVD) often present particular challenges. This applies especially when exacting functional and esthetic requirements are to be met and the treatment should not cause the patient too much effort, still ensuring the highest level of quality and efficiency and a low intervention rate.

Conclusion

The digital approach used for the present patient allowed for an efficient treatment procedure, facilitated virtual evaluations using a face‐scan, and enhanced the predictability of the prosthodontic outcome. The approach enabled some steps required in the conventional protocol to be omitted, resulting in a straightforward clinical treatment with minimal strain on the patient.

Clinical Significance

Because of the comprehensive recording of extraoral and intraoral data, for example with a facial scanner, it was possible to transfer a digital replica of the patient to the dental laboratory technician. With this protocol, many steps can be performed in the absence of the real patient.
Missed opportunities for diagnosis of hepatitis B and C in individuals diagnosed with decompensated cirrhosis or hepatocellular carcinoma
Authors: Mnatzaganian George , MacLachlan Jennifer H , Allard Nicole , Brown Chelsea , Rowe Stacey , Cowie Benjamin C
Published: March 2023

Background and Aim

This study aimed to assess utilization of health‐care services in people with decompensated cirrhosis (DC) or hepatocellular carcinoma (HCC) and a “late diagnosis” of hepatitis B or hepatitis C.

Methods

Hepatitis B and C cases during 1997–2016 in Victoria, Australia, were linked with hospitalizations, deaths, liver cancer diagnoses, and medical services. A late diagnosis was defined as hepatitis B or hepatitis C notification occurring after, at the same time, or within 2 years preceding an HCC/DC diagnosis. Services provided during the 10‐year period before HCC/DC diagnosis were assessed, including general practitioner (GP) or specialist visits, emergency department presentations, hospital admissions, and blood tests.

Results

Of the 25 766 notified cases of hepatitis B, 751 (2.9%) were diagnosed with HCC/DC, and hepatitis B was diagnosed late in 385 (51.3%). Of 44 317 cases of hepatitis C, 2576 (5.8%) were diagnosed with HCC/DC, and hepatitis C was diagnosed late in 857 (33.3%). Although late diagnosis dropped over time, missed opportunities for timely diagnosis were observed. Most people diagnosed late had visited a GP (97.4% for hepatitis B, 98.9% for hepatitis C) or had a blood test (90.9% for hepatitis B, 88.6% for hepatitis C) during the 10 years before HCC/DC diagnosis. The median number of GP visits was 24 and 32, and blood tests 7 and 8, for hepatitis B and C, respectively.

Conclusions

Late diagnosis of viral hepatitis remains a concern, with the majority having frequent health‐care service provision in the preceding period, indicating missed opportunities for diagnosis.
Evaluation of peer‐mediated systems navigation for ageing families of individuals with developmental disabilities
Authors: Marsack‐Topolewski C. , Milberger S. , Janks E. , Anderson N. , Bray M. , Samuel P. S.
Published: March 2023

Background

As individuals with intellectual and developmental disabilities (I/DD) age, services often diminish, with many family caregivers experiencing challenges finding and navigating services. The purpose of this study was to examine the benefits of a state‐wide family support project for ageing caregivers (50+) of adults with I/DD in accessing and using services.

Method

A one‐group pre‐test–post‐test design was used to determine if participation in the MI‐OCEAN intervention grounded in the Family Quality of Life (FQOL) theory reduced ageing caregivers' (n = 82) perceptions of barriers to accessing, using and needing formal services.

Results

After participating in the study, there was a reduction in reported barriers to accessing services. There was also greater use and reduced need for 10 of the 23 listed formal services.

Conclusions

Findings indicate that a peer‐mediated intervention grounded in FQOL theory can be beneficial in empowering ageing caregivers by reducing perceived barriers to accessing services and increasing their use of advocacy and support services.
The afterlives of political violence in Argentina: The gendered body and everyday cruelty
Authors: Savloff Leyla
Published: March 2023

While the last decade in Argentina saw an expansion of civil rights and an increased awareness of gendered violence, prison conditions for women deteriorated. A prominent example took place in Buenos Aires in May 2014 when thirty women in ‘Unidad 31’ were violently transferred to make space for men convicted of crimes against humanity during the last military dictatorship (1976‐1983). This event reveals how the repercussions of the last military dictatorship continue to unfold, displaying new iterations of military power. As former military men settled into a women's prison, the privileges of high‐ranking men expose how the afterlives of political violence reproduce gendered inequities in the prison system and, more broadly, in Argentine society. Drawing on three years of ethnographic fieldwork (2014‐2017), I consider how acts of resistance carried out by feminist collectives expose historical trauma and contemporary expressions of political violence.
Proposing novel dorsal Proatlas‐manifestations: Description and classification of three rare phenomena in humans
Authors: Wolf‐Vollenbröker Michael , Filler Timm Joachim , Prescher Andreas
Published: March 2023

The craniocervical junction (CCJ) of humans and other vertebrates is a developmental restless region. Due to complex phylogenetic and ontogenetic processes, many anatomical variations can be found in that transitional area. Therefore, newly described variants must be registered, named, and classified into existing concepts explaining their genesis. This study aimed to describe and classify anatomical peculiarities that have not or rarely been reported on before in the literature. This study is based on the observation, analysis, classification, and documentation of three rare phenomena of three different human skull bases and upper cervical vertebrae, which come from the body donor program of the RWTH Aachen. As a result, three osseous phenomena (accessory ossicles, spurs, and bridges) at the CCJ of three different body donors could have been documented, measured, and interpreted. Due to extensive collecting efforts, careful maceration, and accurate observation, it is still possible to add new phenomena to the long list of Proatlas‐manifestations. Further on, it could have been shown again that these manifestations can cause damage to the elements of the CCJ due to altered biomechanic conditions. Finally, we have succeeded in showing that phenomena can exist that can imitate the presence of a Proatlas‐manifestation. Here, a precise differentiation between Proatlas‐based supernumerary structures and the results of fibroostotic processes is necessary.
Satisfaction outcomes for patients and physicians following use of a new hyaluronic acid fillers
Authors: Torre Elena , Vetrano Stefano , Vertué Stefano , Zazzaron Michela , Russo Rosalba
Published: March 2023

Background

The aesthetic appearance of the skin, with the emergence of wrinkles, blemishes, and infraorbital hollowing, can be a cause of social distress and is a process exacerbated by aging. The presence of skin imperfections and aging is partly due to a loss of hyaluronic acid (HA), which normally contributes to a maintain a healthy and voluminous skin. Attempts to restore volume and revert the signs of aging have therefore focused on the use of dermatologic fillers based on HA.

Aim

Here, we tested the safety and efficacy of MelHA®‐Monophasic Elastic Hyaluronic Acid (Concilium FEEL® filler products) containing HA at different concentrations and injected at different sites according to recommendations.

Methods

Five different physicians assessed 42 patients across five different medical facilities in Italy, where they performed the treatment and assessed the patients after a follow‐up visit. Safety and efficacy of the treatment and change in quality of life after treatment were evaluated with two surveys, one directed to medical personnel, and one directed to patients.

Results

Our results show that, across all products and personalized treatments, patients', physicians' and “independent photography reviewer” satisfaction was very high and that the treatment show a favorable safety profile.

Conclusion

These results are promising and suggest the use of Concilium Feel® filler products can contribute to an increased self‐esteem and quality of life in aging patients.
The Distribution of and Access to Free Meal Sites Serving School Aged Children During the COVID‐19 Pandemic: Evidence From Texas
Authors: Toossi Saied
Published: March 2023

Background

The COVID‐19 pandemic disrupted access to school meal programs, putting children and adolescents at greater risk for food and nutrition insecurity. In response, the US Department of Agriculture (USDA) waived restrictions on where free meal sites (FMS) operating through its summer meal programs could locate. This study assesses whether and how the distribution of FMS across communities and access to them changed after the waiver.

Methods

This study used administrative and survey data on all FMS and census tracts in Texas for July 2019, before the waiver, and July 2020, after the waiver. Changes in the characteristics of tracts hosting an FMS and the share within accessible range of a site were evaluated using t‐tests. These were supplemented with multilevel conditional logit models linking tract characteristics to the likelihood of hosting an FMS and estimates for the number of children and adolescents with access to an FMS.

Findings

More FMS were operating after the waiver, and these were spread across a wider range of census tracts. An estimated 213,158 additional children and adolescents gained access to an FMS, including those at highest risk for food and nutrition insecurity.

Implications for School Health Policy

Relaxing restrictions on the location of FMS can expand children and adolescent's access to meals during expected and unexpected disruptions to school meal programs.
High School Students' and Teachers' Mental Health Literacy Levels in Istanbul, Turkey: A Comprehensive Analysis
Authors: Arslan Seyma , Karabey Selma
Published: March 2023

BACKGROUND

Mental health literacy is important for awareness of mental illnesses in adolescence, which is the initial period of mental disorders. Determining the levels of mental health literacy guides studies in activities promoting mental health. This study aimed to determine the mental health literacy levels of high school students and teachers and related factors.

METHODS

Our study is a cross‐sectional study. A total of 1051 people (students and teachers) were included in the Fatih District of Istanbul were included in our study. The mental health literacy levels of the participants were evaluated with the Mental Health Literacy Questionnaire. This questionnaire includes scenarios about mental problems called “vignettes” and questions about them.

RESULTS

Students' recognition percentages of depression, schizophrenia, and social phobia vignettes were found to be 28.1%, 46.5%, and 5.9%, respectively. For the person who was described in the vignettes, the “family physician” was chosen as the least by students and teachers. A statistically significant relationship was found between students' mental health literacy levels and sex, grade, father education levels, and experiencing vignette similar issues (p < .005). Additionally, teachers who were not school administrators and experienced vignette similar issues levels were higher (p < .005).

CONCLUSIONS

These results showed us that mental health literacy levels are low in high schools. School‐based intervention studies on this issue are of critical importance. In addition, it is seen that individuals do not consider asking for help with mental health problems from primary care services. This shows the inadequacy of the integration of primary health care services and mental health services.
Mechanisms of cognitive behavioural therapy for insomnia
Authors: Altena Ellemarije , Ellis Jason , Camart Nathalie , Guichard Kelly , Bastien Célyne
Published: March 2023

Although much is known now about behavioural, cognitive and physiological consequences of insomnia, little is known about changes after cognitive behavioural therapy for insomnia on these particular factors. We here report baseline findings on each of these factors in insomnia, after which we address findings on their changes after cognitive behavioural therapy. Sleep restriction remains the strongest determinant of insomnia treatment success. Cognitive interventions addressing dysfunctional beliefs and attitudes about sleep, sleep‐related selective attention, worry and rumination further drive effectiveness of cognitive behavioural therapy for insomnia. Future studies should focus on physiological changes after cognitive behavioural therapy for insomnia, such as changes in hyperarousal and brain activity, as literature on these changes is sparse. We introduce a detailed clinical research agenda on how to address this topic.
The use of current knowledge and non‐invasive testing modalities for predicting at‐risk non‐alcoholic steatohepatitis and assessing fibrosis
Authors: Kugelmas Marcelo , Noureddin Mazen , Gunn Nadege , Brown Kimberly , Younossi Zobair , Abdelmalek Manal , Alkhouri Naim
Published: March 2023

There is ongoing recognition of the burden of non‐alcoholic fatty liver disease (NAFLD) and non‐alcoholic steatohepatitis (NASH), with fibrosis being the most important histological feature that is associated with progression to cirrhosis and the occurrence of major adverse liver outcomes. Liver biopsy is the gold standard applied to detect NASH and determine the stage of fibrosis, but its use is limited. There is a need for non‐invasive testing (NIT) techniques to identify patients considered at‐risk NASH (NASH with NAFLD activity score > 4 and ≥ F2 fibrosis). For NAFLD‐associated fibrosis, several wet (serological) and dry (imaging) NITs are available and demonstrate a high negative predictive value (NPV) for excluding those with advanced hepatic fibrosis. However, identifying at‐risk NASH is more challenging; there is little guidance on how to use available NITs for these purposes, and these NITs are not specifically designed to identify at‐risk NASH patients. This review discusses the need for NITs in NAFLD and NASH and provides data to support the use of NITs, focusing on newer methods to non‐invasively identify at‐risk NASH patients. This review concludes with an algorithm that serves as an example of how NITs can be integrated into care pathways of patients with suspected NAFLD and potential NASH. This algorithm can be used for staging, risk stratification and the effective transition of patients who may benefit from specialty care.
Regeneration of pavement surface textures using M‐sigmoid‐normalized generative adversarial networks
Authors: Lu Jiale , Pan Baofeng , Ren Weixin , Liu Quan , Liu Pengfei , Oeser Markus
Published: March 2023

The high cost of collecting surficial textures has been the bottleneck problem for many decades. To bridge this gap, this study aims to propose a complete framework based on the generative adversarial networks (GANs) architecture for texture regeneration using limited texture data samples. Four variants of the GAN were compared to achieve the best regeneration performance. Prior to running GAN, specifically improved data augmentation and modified sigmoid normalization operations were dedicated to avoiding the loss of texture information and the non‐convergence problem. After running GAN, the estimation metrics were introduced and discussed separately to quantitatively evaluate the rationality and diversity of the regenerated textures. The results demonstrated that the use of improved data augmentation and normalization methods significantly enhanced the regeneration capability of GAN, and more importantly the skewed distribution of surficial heights which is not achievable by present texture regeneration methods was most effectively regenerated by deep regret analytic GAN with well generalization ability. Our study provides a promising choice to generate virtually realistic pavement surface textures.