bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and study of moving-iron torque motor for two-dimensional proportional servo valve
Authors: Xie Shulin , Luo Wei , Song Zhankai , Li Sheng , Ruan Jian
Published: January 2025

This paper proposes a novel moving-iron torque motor designed for two-dimensional (2D) valves. The torque motor features a strap spring in place of the traditional return spring, effectively reducing the overall number of springs. The unique design allows the torque motor to return to its circumferential neutral position through the return torque generated by the strap spring. In order to analyze the torque-displacement characteristics of the torque motor, an analytical model is established, and a simulation model is constructed based on the equivalent magnetic circuit method, which takes into account the magnetic leakage at the control coil and the working air gap. In order to select a strap spring that matches the stiffness of the magnetic spring of the torque motor, the structural parameters of the spring are optimized using the response surface method with multi-objective optimization, and finally three springs with different stiffnesses are manufactured according to the optimization results. The experimental results show that the maximum step-up time of the torque motor is 20.6 ms, the maximum step-down time is 21.6 ms, the maximum hysteresis loop is 12.5%, and the maximum linearity is 20%. In order to improve the −3dB cut-off frequency of the torque motor, this paper adopts the current closed-loop control method, and increases the maximum cut-off frequency not exceeding 25 Hz in the open-loop mode to 110 Hz.The hysteresis loop and linearity of the torque motor decrease with the increase of the spring stiffness. The amplitude frequency −3dB cutoff frequency increases with increasing spring stiffness.
Barriers and Motivators: Investigating the Impact of Personal and Perceptual Factors on Media Career Choices in Bangladesh
Authors: Mursalin Khandakar Rubyat , Huda Md. Nasimul
Published: January 2025

This research examines the individual and societal factors influencing students’ decisions to pursue careers in the media sector in Bangladesh. While media has evolved significantly since the 1990s, the nation faces a shortage of competent journalists, with traditional journalism increasingly replaced by social media. This study delves into understanding the motivations and barriers faced by journalism students at 16 universities across Bangladesh, using a sample of 340 respondents. Factor and regression analyses revealed that students’ enjoyment of their major and past media experiences significantly predicted their likelihood of pursuing a media career. Perceptions of media fairness and accuracy positively influenced career interest, while distrust in media had a negative effect. The importance of media for democracy did not significantly impact career choice. This highlights the critical role of personal interest and media perceptions in shaping students’ career decisions.
The Roles of Empathy and Theory of Mind in Sexual Violence Perpetration: An Integrated Social Information Processing Framework
Authors: Tibbels Sarah , Benbouriche Massil
Published: January 2025

Empathy is an aspect of social cognition which has gained much attention to explain sexual violence perpetration, with research resulting in mixed and contradictory findings. Another aspect of social cognition, which has been linked to, and even used synonymously with, cognitive empathy is Theory of Mind (ToM). However, research is severely lacking on the role which ToM may play in sexual violence. Hence, in order to elucidate such issues, following a theoretical discussion of these concepts, we propose an integrated Social Information Processing (SIP) framework to understand how empathy and ToM may be involved in sexual violence perpetration. This framework includes the steps laid out by Crick and Dodge’s original SIP model, the emotional processes emphasised by Lemerise and Arsenio, the empathy stages identified by Marshall and colleagues, and our propositions concerning the role played by ToM. In this theoretical article, we argue that ToM and empathy are primarily involved in earlier SIP stages, but may have repercussions on subsequent stages as SIP is cyclical. Nonetheless, greater research is needed to conclusively identify where deficits lie. In terms of clinical implications, we recommend that empathy and ToM be targeted in interventions (primary, secondary and tertiary) using cognitive-behavioural therapy principles which are involved in, and affect, SIP.
Clamping Catheter Versus Free Drainage for Patients With Neurogenic Bladder With Indwelling Urinary Catheter: A Meta-Analysis
Authors: Cao Weiwei , Lei Min , Yu Yanfei , Cheng Weizhen , Huang Rong , Liu Kun
Published: January 2025

Background: In the clinical setting, individuals with neurogenic bladder dysfunction commonly utilize indwelling urinary catheters for urinary management. The comparative efficacy of catheter clamping versus continuous free drainage in this patient population is yet to be established. This meta-analysis aims to explore the efficacy and safety of catheter clamping versus natural drainage in patients with neurogenic bladder, to provide evidence to support the treatment and nursing care of these patients. Methods: Two researchers conducted a literature search in Clinicaltrials et al. databases for Randomized Controlled Trials (RCTs) comparing clamping of the catheter to free drainage in patients with neurogenic bladder who have indwelling urinary catheters. The RCT bias risk assessment tool recommended by the Cochrane Handbook was used for quality assessment. RevMan 5.3 software were used for meta-analysis. Results: A total of 8 RCTs involving 772 patients with neurogenic bladder were enrolled. Catheter clamping significantly increased the volume of first urination in patients [MD = 52.86, 95%CI (42.30, 63.41), p < .001]. The difference in time to first urination [SMD = 0.10, 95%CI (−0.68, 0.89), p = .80], residual urine volume [MD = −5.18, 95%CI (−17.27, 6.90), p = .40], incidence of urinary retention [MD = 1.07, 95%CI (0.30, 3.87), p = .92], the incidence of urinary tract infection [RR = 1.38, 95%CI (0.64, 2.97), p = .42] between the catheter clamping group and the natural drainage group were not statistically significant. The results of Egger’s regression analysis indicated no evidence of statistical publication bias. Conclusion: In light of the existing body of evidence, the routine practice of catheter clamping in catheterized patients with neurogenic bladder is not recommended.
The appropriateness of self-care policy for urinary tract infections among women from racialised minorities and low-income households in the United Kingdom: A qualitative study
Authors: Pacho Agata , Mays Nicholas , Glover Rebecca E
Published: January 2025

Objectives

Urinary tract infections (UTIs) can negatively impact quality of life, especially when recurring. Patients often seek medical advice to relieve painful symptoms. UTIs are also the second most common reason antibiotics are prescribed in English primary care. However, overuse and long-term use of antibiotics for suspected UTIs in women can lead to antibiotic-resistant bacteria, making future treatments less effective. The UK’s 2019-24 Antimicrobial Resistance National Action Plan aims to raise public awareness about the risks of overusing antibiotics and encourages self-care for minor infections, like uncomplicated UTIs. We explored how feasible and appropriate this approach is.

Methods

The transcripts from four online focus groups and 19 one-to-one online interviews involving 25 racialised minority and/or low-income women were analysed thematically. Meetings with lay members of the public with similar socio-demographics and experiences to those we planned on recruiting for the research helped to orientate the study, refine its materials and enhance its recruitment strategies.

Results

All participants spoke about UTI-related anxieties, which they experienced differently depending on the frequency and the course of UTI episodes, and how knowledgeable they were about the symptoms. Participants often practised self-care for UTIs before seeking professional advice. They saw consultations with health care professionals as valuable for managing the symptoms of UTIs and navigating self-care options. Those with recurrent UTIs felt they could recognise when they required antibiotics and, therefore, they felt they could take responsibility for minimising overprescribing. Barriers to self-care included high pressure working days and not being able to take time off work to recover.

Conclusions

Participants in our study were often able to self-diagnose and assess the severity of their symptoms, which makes them partners in efforts to improve antibiotic stewardship. They still valued consulting professionals for advice and support about their UTIs, irrespective of whether they received a prescription.
Exploration of motivation to be physically active among overweight adolescents in Switzerland
Authors: Sejdija Shahadije , Maggio Albane BR
Published: January 2025

Motivation plays an important role in the field of medicine, as it significantly influences behavior change, such as becoming more physically active. This study aimed to investigate the role of motivation in engagement in a physical activity and its impact on quality of life for adolescents suffering from obesity. We assessed the time dedicated to physical activities, the type of motivation, and the relationship between those factors and their quality of life. Seventy-two adolescents aged 12–18 years (51% girls) participated in the study. Fifteen percent of the sample (11/72) were overweight, 56% ( n = 40) were affected by obesity and 29% ( n = 21) by severe obesity. We found that adolescents were mostly driven to engage in physical activity by self-determined motivation, but those affected by severe obesity were more motivated by external factors. Moreover, there was a disparity in physical activity engagement between genders, with boys being more active than girls. Finally, our data demonstrated that physical exercise contributed to improving quality of life of our population. This study demonstrates that self-determined motivation plays a significant role in promoting physical activity among adolescents with overweight or obesity, with notable differences between genders. Encouraging intrinsic motivation can improve physical functioning and quality of life.
“A good client gets arrested a lot”: Constructing and maintaining profitable subjects through marking and surveillance
Authors: Deckard Faith M
Published: January 2025

Criminal legal processing is an arduous classification, supervision, and extraction cycle increasingly administered by private entities. This article spotlights processing within commercial bail and uncovers profitable subjects—people (re)identified as future assets—as a stratifying and elusive construction with implications for criminal legal experiences. Bail agents deploy marking and surveillance like other legal professionals to process people. However, a profit objective and financial risk framework give rise to distinct applications. First, a shift in marking occurs in which legal involvement operates as credit and stratifies people into “classification situations” where they unevenly, and sometimes counterintuitively, access resources. Second, marked individuals are matched to different forms of surveillance that deviate in the degree of felt hassle and punishment. Surveillance is used for people to repeatedly prove their profitability in an environment where a dominant perception is that defendants are liabilities. Consequently, few can avoid the conditions that define their varying and unequal experiences.
Pulmonary rehabilitation healthcare professionals understanding and experiences of the protected characteristics of service users: A qualitative analysis
Authors: Drover Holly , Singh Sally J , Orme Mark W , Daynes Enya
Published: January 2025

Background

Health inequalities can affect access and uptake to pulmonary rehabilitation (PR). An individual’s protected characteristics (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation) may contribute to health inequalities. Healthcare professionals (HCPs) experiences of the inclusivity and representativeness of PR services and knowledge of protected characteristics are unknown, however are vital for the identification and resolution of health inequalities. This qualitative study explored HCPs understanding of protected characteristics and their perception of the inclusivity, representativeness and equitable benefit of their PR services.

Methods

Semi-structured qualitative interviews were conducted in person or via videoconferencing with HCPs involved in PR from two healthcare providers. Interviews were analysed using reflexive thematic analysis.

Results

12 interviews were conducted with physiotherapists ( n = 6), occupational therapists ( n = 2), nurses ( n = 2) and exercise physiologists ( n = 2). Participants had a median (IRQ) age of 43 (13) and 75% ( n = 9) were female. Four themes were generated. 1: ‘I don’t really know as much as I should’ [about protected characteristics]; 2: It’s uncomfortable collecting protected characteristics…; 3: ‘I don’t think [service users] are as representative as they could be’; 4: A conventional rehabilitation programme does not meet the needs of all.

Conclusions

This study highlighted several challenges in HCPs understanding of protected characteristics and the representativeness of PR that must be addressed to ensure equity. Strategies, to understand barriers in accessing PR that limit representativeness should be explored.
Hybrid Arch Aneurysm Repair With Ascending Aortic Wrap and TEVAR
Authors: Shazly Omar El , Porez Florent , Ramadan Ramzi , Le Houérou Thomas , Gaudin Antoine , Costanzo Alessandro , Fabre Dominique , Guihaire Julien , Haulon Stéphan
Published: January 2025

Introduction:

Management of patients with large aortic arch aneurysms who are considered high risk for frozen elephant trunk technique have been challenging, especially when they have a dilated ascending aorta (AA) that precludes total endovascular branched repair (arch BEVAR). A viable option in our armamentarium is wrapping of the AA (AW), and zone 0 Ishimaru TEVAR.

Methods:

Retrospective analysis of our aortic database from 2013 to 2024 to select high-risk patients with aortic arch aneurysm that had an AW and TEVAR. We performed CTA analysis before and after wrapping and TEVAR, and last available CTA. The primary end points were 30-day mortality and stroke.

Results:

A total of 12 patients had AA wrap and TEVAR, with supra-aortic vessels (SAVs) debranching (open or endovascular). In 9 patients, the indication for treatment was a large arch atherosclerotic aneurysm, and in 3 patients a dissecting arch aneurysm depicted during follow-up of AW initially performed for acute type A dissection (51.5 months on average between the wrap and the TEVAR). Average age was 72.9 years. Ascending aorta wrap and TEVAR were performed concomitantly in 3/12 patients, including 2 patients with rupture. It was staged in the other 9 patients. The average diameter of the AA pre-wrap was 47.7 (41.3-57), and post-wrap 35.6 (31.9-43) mm. The wrap provided an average seal length of 68.5 (38.4-97.4) mm. A total of 34 SAV were successfully debranched. No type 1 or 3 endoleaks were depicted on completion angiogram. Within the first 30 days, no strokes were diagnosed, and 1 patient with Horton disease died of cardiac arrest on postoperative day 7. Three patients required early reinterventions, including redosternotomy in 2 patients. Mean follow-up (FU) was 28 months (1-75). During FU, 1 patient developed a left vertebral artery steal phenomenon requiring a carotid subclavian bypass, and another patient died of an unknown cause.

Conclusion:

Ascending aorta wrap technique with debranching of the SAVs and zone 0 TEVAR might be a good option in patients at high risk for open replacement of the AA and with unfavorable proximal seal zone for a total endovascular repair.

Clinical Impact

In the current study, we describe the treatment of aortic arch aneurysms in patients considered at high risk for open replacement of the aortic arch and also not candidate for complete endovascular arch repair (arch BEVAR). Ascending aorta wrap with surgical or endovascular debranching of SAVs and zone 0 TEVAR was performed in 12 patients with favorable outcomes. It should thus be considered a treatment option in this subset of fragile patients with unfavorable proximal seal zone for total endovascular repair. This technique does not require cardiopulmonary bypass (CPB) support, neither aortic cross-clamping
Translation, Cross-Cultural Adaptation, and Validation of the Kannada Version of the Exercise Adherence Rating Scale (EARS-Kn) Among Head and Neck Cancer (HNC) Survivors in a Tertiary Care Setup in India
Authors: Pai Hritika D. , Kumar K Vijaya , Mithra Prasanna , Samuel Stephen Rajan , Athiyamaan Mariappan Senthiappan , Godfrey Emma Louise
Published: January 2025

Background:

Adherence in rehabilitation services includes attending appointments, regularly performing prescribed exercises, and correct exercise execution. The Exercise Adherence Rating Scale (EARS) has been adapted into several languages, but there is lack of a standardized tool for various Indian languages and cultural contexts, particularly for use with cancer survivors. With the anticipated 57.7% rise in cancer cases by 2040, this study aims to address this gap.

Aims and objectives:

To cross-culturally adapt EARS to Kannada (EARS-Kn) and evaluate its validity and reliability amongst HNC survivors enrolled in the Multimodal Oncology Rehabilitation Exercise—MORE© Program.

Methodology:

Following Beaton guidelines, the EARS tool was adapted to Kannada. 34 HNC survivors engaged in the MORE© program. Internal consistency (Cronbach’s ⍺) and construct validity (Exploratory Factor Analysis, EFA) were assessed. The Receiver Operating Curve (ROC) determined cut-off scores, sensitivity and specificity of the EARS-Kn.

Results:

The EARS-Kn demonstrated a Cronbach’s-⍺ value of .93. The EFA revealed a one-factor solution with eigenvalues exceeding one and 70.1% loading. The area under the curve (AUC) was 0.908. A cut-off score of 17 was established, with 95.83% sensitivity and 80% specificity.

Conclusion:

The EARS-Kn version showed strong validity and reliability among Kannada-speaking HNC survivors, indicating its potential to enhance the understanding of exercise adherence among them. Future studies could explore the EARS-Kn version among diverse populations prescribed various rehabilitation regimes. Studies could also further investigate psychometric properties of the EARS in different Indian languages among cancer survivors, which would help improve survivorship outcomes.
Navigating Children’s Risky Play: A Comparative Analysis of Saudi Mothers and Fathers
Authors: Alarawi Rana M. , Lane Shelly J. , Sharp Julia L. , Hepburn Susan , Bundy Anita
Published: January 2025

Despite documented benefits for development, children are engaging in considerably fewer risky play activities. Research on parent gender and children’s risky play is inconsistent. Gender and cultural context shape how individuals perceive and tolerate children’s risky play. Little research exists on gender disparities in approaches to risky play in Eastern cultures, including Saudi Arabia. The study’s objective was to examine gender variations in Saudi parents’ willingness and tolerance for children’s risky play. It included 85 parents: 41 fathers and 44 mothers. Differential Item Functioning analysis revealed a statistically significant difference between mothers and fathers on three Factors Affecting Tolerance of Risk in Play Scale items. While interaction effects and predictors were not significant ( p = .22–.97), the overall multiple regression model significantly predicted parents’ risk tolerance ( p = .04). Within the context of other factors, gender appeared to play a complex and indirect role in determining parents’ risk tolerance.
Estimation of and clinical consensus on the meaningful motor progression threshold on MDS-UPDRS Part III
Authors: Trundell Dylan , Davies Evan W. , Barrett Louise , Zanigni Stefano , Shariati Nima , Rogers Rebecca , Monnet Annabelle , Moore Emma , Pross Nathalie , Pagano Gennaro , Cano Stefan , Nikolcheva Tania
Published: January 2025

Background

To understand changes in the underlying progression of early Parkinson's disease, it is important to derive estimates of the threshold for meaningful motor progression on the MDS-UPDRS Part III in OFF medication state.

Objective

To estimate this threshold using two approaches: anchor-based analyses, and clinical consensus via a modified Delphi panel.

Methods

For the anchor-based analyses, data from a Phase II clinical trial were used. Mean and median MDS-UPDRS Part III change scores were calculated for those participants rated as ‘Minimally worse’ on the Clinical Global Impression of Improvement (using the first visit rated as ‘Minimally worse’ or worse, and at Weeks 24 and 52). Cumulative data up to Week 104 were used to assess the difference between motor progressors’ and non-progressors’ change scores on motor-related outcomes. For the modified Delphi panel, a panel of 13 expert clinicians received an online survey in two rounds and provided responses anonymously.

Results

For the anchor-based analyses, estimates of meaningful change ranged from 4−6 points. Numerically worse change scores were identified on motor-related outcomes for participants who had experienced motor progression compared with those who had not. For the modified Delphi panel, consensus was reached in Round 2, with 92% agreeing that 5 points is suitable to define a clinically meaningful motor progression threshold.

Conclusions

Results of the anchor-based analyses and modified Delphi panel were consistent, supporting a meaningful motor progression threshold of a worsening of 5 points on the MDS-UPDRS Part III (OFF medication state) in an early Parkinson's disease population.
A possible pathway to freezing of gait in Parkinson's disease
Authors: Factor Stewart A , Weinshenker David , McKay J Lucas
Published: January 2025

Freezing of gait (FOG), a common, perplexing gait disorder observed in Parkinson's disease (PD), is a leading cause of injurious falls and contributes significantly to social isolation. Unlike other PD cardinal features, FOG appears to develop independently, and its heterogeneity presents challenges for both definition and measurement. The pathophysiological mechanisms underlying FOG remain poorly understood, limiting the development of effective treatments. Although the roles of specific, targetable biomarkers in FOG development remain unidentified, evidence suggests that it is likely multimodal, potentially involving extranigral transmitter circuits. The diversity of FOG phenotypes may also reflect underlying differences in pathophysiology. In this paper, we first present evidence that FOG may occur independently of dopaminergic influence. We then review an expanding body of research supporting the hypothesis that FOG arises from a dysfunctional pathophysiological feedback loop, involving norepinephrine (NE) depletion, neuroinflammation, and amyloid-β (Aβ) accumulation. This biological disruption occurs concurrently with, but distinct from, the primary dopaminergic pathology of PD. When they occur on the background of dopamine loss, the interactions between NE, Aβ, and inflammation, as observed in Alzheimer's disease models, may similarly play a critical role in the development of FOG in PD and could serve as pathobiological markers. The proposed changes in the pathophysiological loop might even precede its onset, highlighting the need for further investigation. A deeper understanding of the involvement of Aβ, NE, and inflammatory markers in FOG could pave the way for rapid clinical trials to test existing amyloid-clearing therapies and noradrenergic drugs in appropriate patient populations.
Effects of 6 months of endurance exercise on motor function, exercise capacity, and autonomic function based on presence of autonomic dysfunction in individuals with early Parkinson's disease
Authors: Griffith Garett J , Mehta Niyati , Lamotte Guillaume , McKee Kathleen E , Suttman Erin , Haus Jacob M , Joslin Elizabeth , Balfany Katherine , Kohrt Wendy M , Christiansen Cory L , Melanson Edward L , Chahine Lana M , Christou Demetra D , Patterson Charity G , Corcos Daniel M
Published: January 2025

Background

Endurance exercise improves aerobic capacity (VO2peak) and motor symptoms in people with early Parkinson's disease (PD). Some people with PD exhibit signs of chronotropic incompetence (CI), which may impact exercise-induced benefits.

Objective

We investigated whether CI in people with early PD influences the change in motor signs, VO2peak, and peak heart rate (HR) following 6 months of endurance exercise.

Methods

We performed secondary analyses of the Study in Parkinson's Disease of Exercise (SPARX), which randomized people with early PD into a high-intensity endurance exercise [80–85% of peak HR], moderate-intensity endurance exercise [60–65% of peak HR], or usual care group. MDS-UDPRS Part 3 score, VO2peak, and heart rate (HR) response to maximal cardiopulmonary exercise testing (CPET) were analyzed at baseline and following 6 months of exercise. Participants were divided into three groups: 1) normal chronotropic response at baseline, 2) CI at baseline, and 3) taking medications with a known negative chronotropic effect regardless of CI status.

Results

Data from 119 individuals (64.0 ± 9.0 years, 57.1% male, 0.3 years since diagnosis [median]) were analyzed. There were no differences among the groups in change in MDS-UPDRS motor score ( p = 0.953), VO2peak ( p = 0.965), or peak HR ( p = 0.388). People randomized into the high-intensity group improved VO2peak compared to usual care ( p < 0.001adj) regardless of CI status.

Conclusions

Baseline CI did not alter responses to endurance exercise in those with early PD, suggesting that the beneficial effects of endurance exercise on disease progression and VO2peak in people with early PD apply equally to people with CI.
Effectiveness of Mobile Health Applications for Cardiometabolic Risk Reduction in Urban and Rural India: A Pilot, Randomized Controlled Study
Authors: Ranjani Harish , Avari Parizad , Nitika Sharma , Jagannathan Narayanaswamy , Oliver Nick , Valabhji Jonathan , Mohan Viswanathan , Chambers John Campbell , Anjana Ranjit Mohan
Published: January 2025

Introduction:

mHealth technology has the potential to deliver personalized health care; however, data on cardiometabolic risk factors are limited. This study aims to assess the effectiveness of mobile health applications (apps) on cardiometabolic risk factor reduction in adults aged 25 to 60 years in urban and rural India.

Methods:

The study design was a pilot randomized controlled trial conducted in Tamil Nadu, India. Smartphone users (25-60 years) with basic literacy and at high risk of developing diabetes (Indian Diabetes Risk Score ≥30 and/or fasting blood sugar [FBS] 100-125 mg/dL) were recruited. Four mobile apps (two commercially available, two novel) for cardiometabolic risk reduction were evaluated. Primary outcome (weight loss) was analyzed using intention-to-treat analysis with post hoc analysis and logistic regression models adjusted for confounders.

Results:

A total of 5264 participants were screened, and 610 were recruited into the study. Participants (7%) dropped out largely due to the COVID-19 pandemic. Data from 567 participants were used for the final analysis. In the intention-to-treat analysis, a significant reduction in body weight was observed in the intervention group as compared with control, more so in the urban (−2.40 kg, 95% confidence interval [CI] = [−3.10, −1.69], P < .001) compared with rural population (−1.19 kg, 95% CI = [−1.55, −0.82], P < .001). Intervention group participants showed significant reductions in body mass index, waist circumference, blood pressure, FBS, total serum cholesterol, and a positive effect on dietary and physical activity behaviors compared with controls.

Conclusions:

mHealth interventions can reduce diabetes risk, improve cardiometabolic health, and improve lifestyle behaviors in South Asian populations.

Trial Registration:

The trial is registered with the Central Trials Registry, India (CTRI/2020/03/024327).
Translation, Validity, and Reliability of the Indonesian Version of the Shoulder Pain and Disability Index (SPADI)
Authors: Deviandri Romy , Daud Afrianto , Utami Tania Nugrah , Octarina Putri , Aminata Iman W. , Alkaff Firas Farisi
Published: January 2025

Background:

The Shoulder Pain and Disability Index (SPADI) is a widely used 13-item shoulder-specific patient-reported outcome measure for shoulder pain disorders. The English version of SPADI is easy to use and demonstrates excellent measurement properties for clinical and research settings.

Purpose:

To translate and culturally adapt an Indonesian version of SPADI (SPADI-IDN) and then validate its use in Indonesian patients.

Study Design:

Cohort study (Diagnosis); Level of evidence, 2.

Methods:

Through a forward and a backward translation process, the validity of the questionnaire was investigated. The study population was 100 patients with shoulder pain who were treated in a hospital in Indonesia. The patients were asked to fill out the SPADI-IDN during their visit. To evaluate the validity of SPADI-IDN, the patients were also asked to fill out the Medical Outcomes Study 12-Item Short-Form Health Survey and the Oxford Shoulder Score. To assess the test-retest reliability, the same patients were asked to fill out the SPADI-IDN questionnaire again 1 week later. The assessment of construct validity, test-retest reliability, internal consistency, floor and ceiling effect, and measurement of error followed the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) guidelines. The Bland-Altman method was used to explore absolute agreement.

Results:

Of the 100 eligible patients, all were used to assess construct validity, and 87 patients (87%) were used to assess test-retest reliability. Almost every established hypothesis about the correlations between SPADI-IDN and other questionnaires could be confirmed, implying good construct validity. No floor or ceiling effects were found. The intraclass correlation value was 0.99, indicating strong test-retest reliability. A Cronbach α was 0.95, indicating a good internal consistency. The Bland-Altman analysis did not reveal any bias. The standard error of measurement and the minimal detectable change at the individual and group levels were 2.65, 7.3, and 0.7, respectively.

Conclusion:

The SPADI-IDN represents a valid and reliable tool for measuring pain and disability in patients with shoulder pain disorders.
Building Narratives of Effectiveness and Customer Orientation at the Interface of Different Actors in the Lifestyle Guidance Service Process
Authors: Tiusanen Heli , Ryynänen Sanna , Suhonen Marjo
Published: January 2025

Co-production is expected to lead to more efficient and effective services. In response, this study aims to describe and understand the construction of effectiveness and the manifestation of customer orientation among the actors involved in the service process of lifestyle guidance. A qualitative narrative study was designed, and data were collected through the thematic interviews (n = 9) with the management, employees and customers of a Finnish public healthcare and social welfare organisation. The main narratives were as follows: (1) Shared value creation narrative, (2) Organisational strategy and customer meeting narrative, (3) Service co-production narrative and (4) Effective service process narrative. Based on the context, input, process and product (CIPP) model, they construct a plot narrative about the customer's need for individual guidance and the goal of transferring responsibility to the organisation. They create cross-pressure on the service process of lifestyle guidance. Achieving the effectiveness of lifestyle guidance requires the service provider to ensure the service is implemented more flexibly between general, self-directed and individually supportive guidance.
A historic case of relapsing-remitting Alzheimer's disease in an adolescent attributed to scarlet fever
Authors: Lathe Richard , Balin Brian
Published: January 2025

We draw attention to a historic case of a boy who suffered from scarlet fever (typically caused by the bacterium Streptococcus pyogenes) at age 7 years and went on to develop the symptoms of Alzheimer's disease (AD). His physicians believed that the subsequent dementia was related to the infection. After death at 24 years of age, postmortem brain examination revealed abundant AD-type senile plaques and fibrils, formally confirming AD. Other potential causes of early-onset dementia are discussed, but these are distinct from patient E.H. This case is pertinent regarding the current debate about the potential role of infection in AD.
Effect of soft sediments modeling on the seismic response of a 3D mid-rise RC building: high-resolution physics-based ground-motion simulations and empirical factors
Authors: Matinrad Pezhman , Petrone Floriana
Published: January 2025

Ground-motion simulations have progressively become a key resource in earthquake engineering. Nevertheless, the challenge of accurately simulating ground motions in regions with low shear-wave velocities, such as basins and shallow sediments, persists and is often constrained by the associated computational demands. Motivated by the potential unavailability of suites of simulations resolving low velocities for a specific region or site of interest, this work assesses the implications of using different approaches for modeling low shear-wave velocities on structural response. Two methods are investigated: one relies on simulation models capable of resolving low shear-wave velocities, while the other combines simulations that resolve high shear-wave velocities with empirical site amplification factors. An M7 Hayward Fault strike-slip earthquake in the San Francisco Bay Area and a three-dimensional ten-story reinforced concrete building are used as case study. Findings from this work demonstrate significant differences in the prediction of ground-motion intensities and building responses (from moderate to extensive damage) when different modeling methods are employed. Such differences manifest at sites with low shear-wave velocities as well as at stiff sites in their vicinity. This is caused by the concurrent effect of the specificity of the seismic velocity structure for the considered region and wave propagation, which is adequately captured only by the simulation model incorporating the (target) low shear-wave velocity. Evidence from this study indicates that empirical factors should be used and processed (i.e., transfer functions tapering) with consideration for the specific geological characteristics of the domain of interest, especially in regions lacking representation in the databases of historical records, such as the San Francisco Bay Area. From a structural engineering perspective, these insights contribute to a better understanding of the complexities involved in soft sediment modeling and its implications in structural engineering applications.
Experimental study and numerical simulation of precast segmental bridge columns with different design details for high seismic zones
Authors: Wang Zhiqiang , Wu Chengjun , Gao Qi , Qu Hongya
Published: January 2025

In this study, five 1/3-scale bridge column specimens are experimentally and numerically investigated, which includes one cast-in-place (CIP) reference and four precast segmental columns with different design details. The four precast segmental bridge columns are of the same design details in terms of dimension and mild reinforcement, while different number of segments, various full-length connection rebar grades, presence of prestressing force, and two types of shear keys are compared. Seismic performance of the five specimens is compared under the same quasi-static cyclic loading protocol. Based on the experimental results, the precast segmental specimen solely using mild reinforcement exhibits similar seismic performance to the CIP reference, while segmentation slightly reduces post-yield stiffness and dissipated energy but increases the self-centering capability. Implementation of prestressing force significantly improves the self-centering capability of the columns, and higher grades of steel also increase the overall strength of the columns. Less number of segments in the column will lead to better structural integrity with smaller joint opening widths and higher energy dissipation capacity. A new finite element model is also proposed, and maximum deviation from test results is less than 2% in terms of stiffness and peak strength. This demonstrates that the Parallel material for rebar modeling and ZeroLength element for joint interface (including bond–slip behavior of rebar) simulation are both effective.
Common Hereditary Variants of the APOE Gene and Posttransplant Outcome in Acute Myeloid Leukemia
Authors: Ronnacker Julian , Grau Michael , Klasmeier Maximilian , Klesse Christian , Baldauf Henning , Abert Stefan , Berdel Andrew F. , Füsser Friederike T. , Sandmann Sarah , Albring Jorn C , Reicherts Christian , Call Simon , Marx Julia , Floeth Matthias , Esseling Eva , Kolloch Lina , Berning Philipp , Scheller Annika , Wethmar Klaus , Schmidt Hartmut , Schlüter Bernhard , Berdel Wolfgang E. , Ostendorf Benjamin N. , Tavazoie Sohail F. , Mikesch Jan-Henrik , Lenz Georg , Fleischhauer Katharina , Schetelig Johannes , Stelljes Matthias , Schliemann Christoph
Published: January 2025

Apolipoprotein E (APOE) has multiple functions in metabolism and immunoregulation. Its common germline variants APOE2, APOE3 and APOE4 give rise to three functionally distinct gene products. Previous studies reported yin-yang roles of APOE2 and APOE4 in immunological processes, but their effects in hematopoietic stem cell transplantation (HSCT) have never been studied. We performed APOE genotyping in two contemporary cohorts of 348 and 447 patients with acute myeloid leukemia (AML) who had received allogeneic HSCT and evaluated associations of recipient and donor APOE genetic variation with posttransplant outcome. Patients who carried at least one APOE2 allele had a higher risk of posttransplant death compared to APOE4 carriers in the discovery (hazard ratio [HR] 2.09, P = .024) and validation cohorts (HR 1.96, P = .040). Detrimental APOE2 effects were driven by an increased risk of severe chronic graft-versus-host disease (GvHD; HRadj 1.85, P = .034) and non-relapse death (HRadj 1.72, P = .044). In non-APOE2 recipients, transplantation of an APOE2-positive allograft was associated with an increased incidence of grade III-IV acute GvHD (HRadj 2.82, P = .012) and severe chronic GvHD (HRadj 2.54, P = .022) compared to APOE2-negative grafts. In summary, the APOE2 allele, typically considered a longevity gene in the general population, was associated with a higher risk of acute GvHD (HRadj 2.75, P = .002), chronic GvHD (HRadj 2.57, P = .001), and posttransplant mortality (HRadj 1.79, P = .004), when present either in the host or transplanted from the donor.
Particle size distribution of Japanese cedar chip converted from boards using a disc chipper and its relationships with disc rotation speed and board feed speed
Authors: Matsuda Yosuke , Matsumura Yukari , Yanagida Takashi , Fujimoto Kiyohiko
Published: January 2025

The effects of disc chipper rotation speed and raw material feed speed on the particle size distribution of wood chips produced were investigated to develop an efficient technique for producing ideal sized chips for the stable operation of combined heat and power plants. The particle size distribution of wood chips was measured using a screening method and approximated to a Rosin–Rammler distribution to calculate the median of the chip. The results suggest that chip size decreased as the rotation speed increased from 560 to 720 rpm, but no clear effect of feed speed on the chip size was observed. The Rosin–Rammler equation was found to be appropriate to explain the size distribution of wood chips. Two types of screening sieves, woven wire mesh sieve and perforated plate sieve, were used for the screening. It was found that the woven wire mesh sieve may underestimate the size of the chip, although the Rosin–Rammler equation derived from the woven wire mesh sieve was able to be converted to the equation for the perforated plate sieve.
Predicting the risk of hematoma expansion in acute intracerebral hemorrhage: the GIVE score
Authors: Yang Tian-Nan , Lv Xin-Ni , Wang Zi-Jie , Hu Xiao , Zhao Li-Bo , Cheng Jing , Li Qi
Published: January 2025

Background

Numerous noncontrast computed tomography (NCCT) markers have been reported and validated as effective predictors of hematoma expansion (HE). Our objective was to develop and validate a score based on NCCT markers and clinical characteristics to predict risk of HE in acute intracerebral hemorrhage (ICH) patients.

Methods

We prospectively collected spontaneous ICH patients at the First Affiliated Hospital of Chongqing Medical University to form the development cohort (n = 395) and at the Third Affiliated Hospital of Chongqing Medical University to establish the validation cohort (n = 139). We adopted a revised HE definition, incorporating the standard definition of HE (> 6 mL or > 33%) and intraventricular hemorrhage (IVH) expansion (any new IVH or IVH expansion ≥ 1 ml). The predictive score was formulated based on the parameter estimates derived from the multivariable logistic regression analysis.

Result

The Glasgow Coma Scale, island sign, ventricular hemorrhage and time elapsed from onset to NCCT scan (GIVE) score was created as a total of individual points (0–6) based on Glasgow Coma Scale (2 points for ≤ 11), island sign (1 point for presence), ventricular hemorrhage (1 point for presence), and time elapsed from onset to NCCT scan (2 points for ≤ 2.5 h). The c statistic was 0.72(95% confidence interval [CI], 0.66–0.78) and 0.73(95% CI, 0.63–0.82) in the development and validation cohorts, respectively.

Conclusion

A six-point scoring algorithm has been developed and validated to assess the risk of HE in patients with ICH. This scoring system facilitates the rapid and accurate identification of patients at increased risk for HE.
Outcome of Er, Cr:YSGG laser and antioxidant pretreatments on bonding quality to caries-induced dentin
Authors: Moharam Lamiaa M. , Salem Haidy N. , Abdou Ahmed , Afifi Rasha H.
Published: January 2025

Background

This study aimed to assess the influence of different pretreatment protocols and antioxidants application on the shear bond strength (SBS) of universal adhesive to sound (SoD) and caries-induced dentin (CID).

Methods

One hundred and twenty posterior teeth had their occlusal enamel removed, then the specimens were divided into two main groups according to dentin substrates; SoD and CID, three subgroups according to pretreatments protocols control (no pretreatment), NaOCl-treated, and Er, Cr:YSGG-treated and two divisions according to antioxidant application (with and without sodium ascorbate (SA) application). All-Bond Universal (ABU) universal adhesives was applied in self-etch (SE) mode then resin composite discs were built. The specimens were stored in distilled water for 24-hr at 37°C before SBS testing. Three-way ANOVA and Tukey HSD tests were used for data analysis (a = 0.05).

Results

6% NaOCl resulted in a significant reduction in SBS in SoD without antioxidant application. 10% SA application showed significant increase in SBS for 6% NaOCl group only in SoD. Laser application recorded a significantly higher SBS compared to 6% NaOCl group without or with antioxidant application, while 10% SA application revealed a significant increase in SBS for control group only.

Conclusions

Er, Cr:YSGG laser irradiation followed by antioxidant application has the potential to enhance the bonding quality of both tested dentin substrates. NaOCl application has significantly compromised the bonding to SoD and CID substrates.
Combining theory and usability testing to inform optimization and implementation of an online primary care depression management tool
Authors: McCleary Nicola , Presseau Justin , Perkins Isabelle , Mutsaers Brittany , Kendall Claire E. , Yamada Janet , Gillis Katharine , Green Douglas
Published: January 2025

Background

The ‘Ottawa Depression Algorithm’ is an evidence-based online tool developed to support primary care professionals care for adults with depression. Uptake of such tools require provider behaviour change. Identifying issues which may impact use of an innovation in routine practice (i.e. barriers to and enablers of behaviour change) informs the selection of implementation strategies that can be deployed with the tool to support use. However, established theory-informed barriers/enablers assessment methods may be less well suited to identifying issues with tool usability. User testing methods can help to determine whether the tool itself is optimally designed. We aimed to integrate these two methodological approaches to i) identify issues impacting the usability of algorithm; and ii) identify barriers to and enablers of algorithm use in routine practice.

Methods

We conducted semi-structured interviews with primary care professionals in Ottawa, Canada. To evaluate usability, participants used a written patient scenario to work through the algorithm while verbalizing their thoughts (‘Think Aloud’). Participants were then asked about factors influencing algorithm use in routine practice (informed by the Theoretical Domains Framework). We used the codebook approach to thematic analysis to assign statements to pre-specified codes and develop themes pertaining to usability and routine use.

Results

We interviewed 20 professionals from seven practices. Usability issues were summarised within five themes: Optimizing content and flow to align with issues faced in practice, Enhancing the most useful algorithm components, Interactivity of the algorithm and embedded tools, Clarity of presence, purpose, or function of components, and Navigational challenges and functionality of links. Barriers to and enablers of routine use were summarised within five themes: Getting to know the algorithm, Alignment with roles and pathways of influence, Integration with current ways of working, Contexts for use, and Anticipated benefits and concerns about patient communication.

Conclusions

Whilst the Ottawa Depression Algorithm was viewed as a useful tool, specific usability issues and barriers to use were identified. Supplementing a theory-based barriers/enablers assessment with usability testing provided enhanced insights to inform optimization and implementation of this clinical tool. We have provided a methods guide for others who may wish to apply this approach.