bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilience-Based Approach to the Measurement of Headway Inconsistency
Authors: Kim Jeric Taehyung , Moon Sedong , Kim Dong-Kyu
Published: July 2024

Maintaining a consistent headway is a primary goal in bus operation, but it poses a significant challenge because of fluctuating traffic conditions and uneven passenger demand. This leads to inconsistent headways and even bus bunching, resulting in negative consequences such as increased travel time and reduced vehicle capacity. Various control strategies have been developed to alleviate headway inconsistencies, but most of them have focused on whether an inconsistency occurs while overlooking its duration. This study proposes a resilience-based approach to measure headway inconsistencies considering both the depth and duration of the impacts with deviations from the optimal headway. The approach is devised to analyze the cumulative impacts of inconsistent headways comprehensively. It goes beyond addressing only extreme cases, such as bus bunching, and considers persistently uneven headways. We first identify vehicle trajectories from smart card data, then compute deviations from the center of the preceding and following vehicles as an index of impact. Using the concept of resilience, cumulative impacts are measured and their distribution is utilized to set the failure criterion. The approach is applied to 320 bus lines in Seoul to measure the deviations of headways and is used to analyze the characteristics of the bus lines and links where inconsistencies frequently occur. The proposed method enables transportation planners to identify factors that can lead to headway inconsistency, facilitating tailored and data-informed planning processes. This study provides a comprehensive framework that recognizes line-specific and link-specific factors, thereby contributing to enhancing the reliability and efficiency of public transportation systems.
Performance and Productivity Analysis of the European Union Transport Sector: Evidence on Static and Dynamic Decision Models
Authors: Gökgöz Fazıl , Yalçın Engin
Published: July 2024

The transportation sector is a major cause of environmental deterioration and a key source of economic growth. A thorough balance should be provided between economic growth and energy consumption for long-term sustainability. In this regard, multi-criteria decision-making (MCDM) and Malmquist productivity index (MPI) techniques, which can deal with conflicting criteria simultaneously and determine productivity changes, respectively, were employed. In addition, ingrained and novel MCDM approaches simultaneously evaluated European Union (EU) countries’ transport sustainability. EU countries were driven into two equal groups based on their economic development level. Both MCDM techniques are in harmony as regards performance rankings for both groups. MCDM results indicate that highly industrialized members of the EU, such as Germany and France, are top performers as regards transportation sustainability level. The MPI technique findings show that Germany and Poland stand out with their effective dynamic performance figures. In conclusion, Germany performs well as regards both static and dynamic performance. In the transportation field, decision techniques enable stakeholders and decision-makers to construct comprehensive management plans and attain a nuanced understanding of industry performance and productivity.
Relationship Between Gut Microbiota and Pancreatitis: A Systematic Review
Authors: Zhang Xu , Armel Tcheudjeu Temagna , Tyagi Gaurav
Published: July 2024

Background and Aims:

The human gastrointestinal system hosts a rich and diverse microbial community, surpassing a staggering 10[ 14 ] bacteria, collectively harbouring more than 5,000,000 genes. The aim of this study is to carry out a systematic review of human studies in order to investigate the correlation between the gut microbiota and pancreatic disorders.

Materials and Methods:

To systematically compile relevant research between 2011 and 2022, a thorough exploration of the MEDLINE and EMBASE databases was executed. The initial search results, encompassing all identified studies, were meticulously scrutinised, including a comprehensive review of their reference lists to ensure the completeness of our search. Initially, our search strategy yielded a total of 114 items. Subsequent refinement involved the removal of 58 duplicate articles identified in both searches. Following a meticulous screening process involving title, abstract and keyword assessments, 36 studies progressed to the next phase of evaluation. However, this cohort underwent further scrutiny, leading to the exclusion of 11 studies categorised as reviews or case reports, 5 in languages other than English that have been published and 20 that did not investigate the microbiome. As a result, a focused set of 20 papers emerged for in-depth evaluation for eligibility.

Results:

The demographic profile of the patients revealed that nearly half were men, with an average age of 52 years (interquartile range of 44-56). The interquartile range further ranged from 45% to 52%, reflecting the distribution of ages within the group. Among the studies scrutinising acute pancreatitis, gallstones emerged as the predominant cause in 9 out of 15, while 7 studies focusing on chronic pancreatitis found no evidence of gallstones.

Conclusion:

This comprehensive, systematic investigation has furnished robust evidence substantiating the intricate connection between pancreatitis and the microbiota.
The Portrayal of Women in Adult Learning 1989–2022: A Literature Review
Authors: Baumgartner Lisa M. , Shang Lihua
Published: July 2024

Women’s workforce and higher education participation have increased in the past 30 years. This article reviews the literature on women in Adult Learning from 1989 through 2022. Key findings include that women were portrayed as marginalized, deficient, learners, educators, juggling social roles, and resilient. Various positionalities marginalized women, including gender, race, class, ethnicity, immigrant status, and religion. The intersection of positionalities affected women’s lives. Findings have implications for researchers and practitioners.
The Changing Care of Older Adults With Bipolar Disorder: A Narrative Analysis
Authors: Warner Aaron , Palmier-Claus Jasper , Holland Carol , Tyler Elizabeth , Rhodes Verity , Settle Geoff , Lobban Fiona
Published: July 2024

Older adults with bipolar disorder experience distinct challenges compared to younger age groups with bipolar disorder. They potentially require adaptations to the care they receive. This study aimed to explore experiences of care and changing care needs in older adults with bipolar disorder. People with bipolar disorder (aged ≥60) were recruited through three NHS Trusts in the North West of England, charity organisations, a confidential university participant database, and social media. Participants completed single time-point biographical narrative interviews, which were analysed using narrative analysis. Sixteen participants’ accounts led to the creation of four themes: (1) ‘Navigating the disruption caused by diagnosis’; (2) ‘The removal of services that provided hope’; (3) ‘Later life: We are on our own now’; and (4) ‘Changing care needs in later life: We still need support’. The care needs of older adults with bipolar disorder appear to change over time, and services often fail to offer adequate, tailored care for this group at present. Current support requires adaptation to be effective and appropriate and to enable this group to age well in later life.
Motivators, Barriers, and Facilitators to Choosing Care in VA Facilities Versus VA-Purchased Care
Authors: Slatore Christopher G. , Scott Jennifer Y. , Hooker Elizabeth R. , Disher Natalie , Golden Sara , Govier Diana , Hynes Denise M.
Published: July 2024

Many Veterans receive Department of Veterans Affairs (VA)-purchased care from non-VA facilities but little is known about factors that Veterans consider for this choice. Between May 2020 and August 2021, we surveyed VA-purchased care-eligible VA patients about barriers and facilitators to choosing where to receive care. We examined the association between travel time to their VA facility and their choice of VA-purchased care (VA-paid health care received in non-VA settings) versus VA facility and whether this association was modified by distrust. We received 1,662 responses and 692 (42%) chose a VA facility. Eighty percent reported quality care was in their top three factors that influenced their decision. Respondents with the highest distrust and who lived >1 hr from the nearest VA facility had the lowest predicted probability (PP) of choosing VA (PP 15%; 95% confidence interval: 10%–20%). Veterans value quality of care. VA and other health care systems should consider patient-centered ways to improve and publicize quality and reduce distrust.
Antimicrobial management in patients undergoing therapeutic plasma exchange: A Cross-Sectional Nationwide Survey
Authors: Balaban Ugur , Kara Emre , Pinar Asli , Ozcebe Osman Ilhami , Demirkan Kutay , Unal Serhat
Published: July 2024

There is little evidence of antimicrobial elimination via therapeutic plasma exchange (TPE) and no guidelines for antimicrobial optimal dosing in patients undergoing TPE. We aimed to assess current practices and knowledge regarding antimicrobial management during TPE. A structured online survey was conducted from May to November 2023, and physicians were invited to participate through national scientific platforms and professional societies. One hundred five participants completed the survey, of whom 61% were infectious disease physicians, with 68.6% having more than 10 years of experience. That the TPE procedure could significantly affect plasma concentrations of antimicrobial agents was reported by 74.3% of the respondents. Among the physicians, 42.9% suggest antimicrobial dose adjustment, and 38.1% recommend temporarily discontinuing antimicrobial drug administration during TPE. Therapeutic drug monitoring was recommended by 33.3% of the respondents for certain antimicrobials, mainly glycopeptides and aminoglycosides, in patients undergoing concurrent TPE. Furthermore, 59.3% of physicians sometimes consult with another healthcare professional for treatment management, most commonly a pharmacist or a clinical pharmacist and an infectious diseases specialist. The core questions regarding potential drug-, procedure-, and patient-related antimicrobial elimination factors via TPE were responded to accurately by less than half of the physicians. It was clear that they had a lack of clinical practices and knowledge regarding antimicrobial management during TPE. To ensure the therapeutic efficacy of antimicrobials and avoid treatment failure, physicians should improve their practice strategies and consider antimicrobial elimination factors with TPE in this data-poor setting.
Randomized clinical trials and related concepts in clinical research
Authors: Nogueiras-Álvarez Rita
Published: July 2024

Clinical research is a key factor in healthcare progress, as it contributes toward improving our knowledge on the prevention, etiology, and treatment of different conditions. Healthcare professionals and researchers should be familiar with this specific terminology and procedures of clinical research to understand and be able to evaluate clinical trial results and make decisions using up-to-date recommendations. To do so, they must be familiar with different methodological aspects: from establishing the type of design, the study population, and the groups to be studied, to understanding the randomization and blinding processes. Additionally, when it comes to communicating the results and publishing them, it is also necessary to know how to do it adequately to ensure transparency. This work includes a description of different concepts commonly used in clinical research, particularly in the clinical trials field, in an attempt to compile different topics by providing a brief and accessible overview.
The Role of Language in the Social and Academic Functioning of Children With ADHD
Authors: Jepsen Ida Bonnerup , Brynskov Cecilia , Thomsen Per Hove , Rask Charlotte Ulrikka , Jensen de López Kristine , Lambek Rikke
Published: July 2024

Objective:

To provide an in-depth examination of whether pragmatic, expressive, receptive, and narrative language are associated with the social and academic functioning of children with ADHD.

Method:

Children with ADHD ( n = 46) and neurotypical comparison (NC) children ( n = 40) aged 7 to 11 years completed tasks measuring expressive, receptive, and narrative language, while parents rated pragmatic language and social- and academic functioning.

Results:

Children with ADHD differed significantly from NC children on pragmatic language, expressive language, receptive language, and narrative coherence. An examination of indirect effects revealed that a significant proportion of the association between ADHD and social functioning was shared with pragmatic language, while a significant proportion of the association between ADHD and academic difficulties was shared with pragmatic language as well as with expressive language.

Conclusion:

This preliminary study supports the clinical relevance of language in relation to the academic- and social functioning of children with ADHD.
Aggravated Systemic Inflammation and Atherogenicity in African Patients Living With Type 2 Diabetes and Hypertension Comorbidity
Authors: Groenewald Ernst J , Nkambule Bongani B , Nyambuya Tawanda M
Published: July 2024

Objective:

To explore routinely measured markers of systemic inflammation in hypertension (HTN) and type 2 diabetes (T2D) comorbidity, and their association with atherogenicity.

Methods:

This study included a total of 70 patients with T2D which were categorised into 2 groups, that is with T2D and with HTN comorbidity (T2D + HTN) (n = 35/group). All measured laboratory parameters were determined using standardised methods.

Results:

The neutrophil/lymphocyte ratio (NLR) was elevated in patients with T2D + HTN when compared to those with T2D ( P = .0494). This was also the case with C-reactive protein (CRP) levels ( P < .0001) and systemic immune-inflammation (SII) index ( P = .0298). Notably, the majority of patients with T2D + HTN [63% (n = 22)] were classified as having an intermediate or high atherogenic index of plasma (AIP). The correlation analysis of systemic inflammation showed significant associations between CRP and age (r = .24, P = .0477); CRP and red blood cell count (r = −.4, P = .0455), and SII and systolic blood pressure (SBP) (r = .33, P = .0056). However, there was no association between inflammatory profiles and lipograms ( P > .05). We further assessed predictors for an elevated AIP using mutivariable regression model adjusted for age, SBP, CRP and SII. Only NLR was a significant predictor of AIP (β = .287, SE: 0.1, P = .0046).

Conclusion:

HTN comorbidity in T2D is associated with exacerbated levels of inflammation and atherogenicity. NLR is a significant independent risk factor for increased atherogenicity in patients with T2D. Therefore, the use of therapeutic strategies that target and alleviate inflammation in patients with T2D and HTN comorbidity is imperative in reducing the initiating and progression of cardiovascular events (CVEs).
Cutaneous Melanoma Mortality-to-Incidence Ratio and Its Association With Socioeconomic and Healthcare Factors in Canada: A National Ecological Study
Authors: Conte Santina , Le Michelle , Moustaqim-Barrette Amina , Ghazawi Feras M. , Muntyanu Anastasiya , Lagacé François , Alakel Akram , Rahme Elham , Glassman Steven J. , Litvinov Ivan V.
Published: July 2024

Introduction:

The mortality-to-incidence ratio (MIR) can be used to approximate healthcare inequities and is helpful to understand/compare cancer survival between geographic regions/jurisdictions. We investigated cutaneous melanoma (CM) outcomes through MIR analysis in Canadian jurisdictions and census divisions (CDs) between 1992 and 2016.

Methods:

Data were obtained from the national databases from 1992 to 2016 for all Canadian jurisdictions, except Quebec. Age-standardized overall and median MIRs were calculated per province per year, while crude MIRs were calculated for CDs. Generalized linear regression models were conducted to study the effect of province and year on MIR, while a mixed effect regression model was used to determine how healthcare and socioeconomic factors affect MIR, while accounting for possible clustering effects (eg, year and province).

Results:

We identified 106,015 CM cases and 20,570 CM deaths between 1992 and 2016. National MIR from 1992 to 2016 demonstrated a significant linear decrease ( P value < .0001). The national median MIR was 15.4 (ie, 0.154 × 100), whereby Manitoba (19.9), Ontario (19.5), Saskatchewan (18.5), British Columbia (16.1), and Newfoundland and Labrador (15.9) demonstrated higher MIRs than the Canadian average. CDs with the highest MIRs were commonly identified in the southern regions of provinces. No healthcare or socioeconomic factors were found to be significantly associated with higher MIR at the provincial level.

Conclusion:

MIRs have decreased at the national and provincial levels in recent decades, which is reassuring. Higher MIRs were noted in select rural CDs and in the Canadian territories, reinforcing the importance of proper dermatological care in all parts of the country.
Engaging undergraduate students in preprint peer review
Authors: Holford Dawn , McLean Janet , Holcombe Alex O , Puebla Iratxe , Kempe Vera
Published: July 2024

Authentic assessment allows students to demonstrate knowledge and skills in real-world tasks. In research, peer review is one such task that researchers learn by doing, as they evaluate other researchers’ work. This means peer review could serve as an authentic assessment that engages students’ critical thinking skills in a process of active learning. In this study, we had students write peer reviews of preprints, scaffolded by a rubric. Agreement between the students and academics was reasonable, and active student involvement was high. The results suggest that use of peer review in undergraduate classes should be explored more. It likely facilitates students’ ability to evaluate the quality of scientific studies, encourages active learning about the scientific process and shows potential for contributing to publicly-available assessment of scientific studies.
An output-only damage identification method based on reinforcement-aided evolutionary algorithm and heterogeneous response reconstruction
Authors: Zhang Guangcai , Gao Shuai , Wan Chunfeng , Kang Jianfei , Xie Liyu , Xue Songtao
Published: July 2024

The absence of excitation measurements may pose a huge challenge in the application of many damage identification methods since it is difficult to acquire the external excitations, such as wind load, traffic load. To deal with this issue, a novel output-only structural damage identification approach based on reinforcement-aided evolutionary algorithm and heterogeneous response reconstruction with Bayesian inference regularization is developed. On the one hand, heterogeneous measurements (e.g., displacements, strains, accelerations) are rescaled and reconstructed with the aid of Bayesian inference regularization technique. Structural damages are identified by minimizing the discrepancies between the measured and reconstructed responses. On the other hand, to solve the optimization-based inverse problem, a reinforcement-aided evolutionary algorithm, named Q-learning hybrid evolutionary algorithm (QHEA), integrating Jaya algorithm, differential algorithm, and Q-learning algorithm is proposed as search tool. To validate the feasibility and applicability of the proposed method, numerical studies on a three-span beam structure and laboratory tests on a five-story steel frame structure are carried out. The effects of data rescaling and data fusion on response reconstruction and damage identification are also investigated. The results clearly demonstrate the superiority of QHEA over other heuristic algorithms and heterogeneous data fusion over a single type of measurement. It is shown that both the locations and extents of the damaged elements can be accurately identified by the proposed method without the information of input force.
Navigating Gender and Sectarian Affiliation: An Analysis of Young Voters’ Bias Against Female Politicians in Lebanon
Authors: Saadi Fatimah
Published: July 2024

In May 2018, a record-breaking number of 86 women candidates ran for parliamentary elections in Lebanon, a country with a power-sharing, consociational, sect-based system that guarantees the representation of 18 legally recognized sects (i.e. religious confessions). Yet, only six women were elected. This article explores whether and how sectarianism trumps gender and support for female candidates in general in vote intention. In doing so, it addresses the interaction between sectarian/ethnic and gender voting in contexts where both identities intersect. This intersection emerges when vote intention is influenced by factors that stem from the patriarchal nature of society and structures of sectarianism, creating interdependent systems of disadvantage. Building on a countrywide pre-electoral survey on the attitudes of young voters in Lebanon, I test ethnic voting and gender-affinity theories and develop fine-grained conceptual links between gender and the wider norms of inclusion and exclusion under sectarian-based political systems in post-conflict countries.
Secondary and Tertiary Prevention for Adolescent Dating Violence: A Systematic Review
Authors: Camacho Soto Jeniffer Nicole , Exner-Cortens Deinera , McMorris Carly , Madigan Sheri
Published: July 2024

Adolescent dating violence (ADV) is a pervasive public health issue associated with numerous social, psychological, and physical health consequences. Thus, programs are often implemented to prevent ADV and promote healthy relationships. Although there is a growing body of literature on primary ADV prevention strategies (i.e., prevention), little is known about secondary (e.g., early intervention) and tertiary (e.g., manage and reduce impact once occurring) ADV prevention approaches. This systematic review, guided by Cochrane Review methodology, summarizes available evidence on secondary and tertiary ADV preventive interventions. The search had no date restriction and was conducted in eight databases in November 2022. Studies published in English and/or Spanish were included if they described the development, implementation, and/or evaluation of a secondary and/or tertiary preventive intervention for ADV. After screening the titles and abstracts of 3,645 articles, 31 articles were included in this study, reporting on 14 secondary, 3 primary/secondary, 6 secondary/tertiary, and 1 tertiary ADV preventive intervention. The included studies highlighted that available secondary ADV prevention strategies are quite effective in preventing ADV victimization and perpetration, and that the effects may be strongest for teens with a higher risk of being involved in an abusive relationship. The only included study that reported on a tertiary intervention was a program development study. Based on the lack of tertiary prevention strategies available for ADV, clinical interventions focusing on treating and reducing negative consequences after ADV are needed.
How the Police and Armed Forces Construct Gender on Social Media: A Comparison of El Salvador and Honduras
Authors: Fahlberg Anjuli , García Katherine , García Laura , Pérez Justin , Nadel Peter
Published: July 2024

Although social media is the new frontier for policing, little research has examined how state security forces construct gender online. To address this gap, we analyzed 315 TikTok videos posted by law enforcement agencies in El Salvador and Honduras. We find that gender is constructed by (1) showcasing (or not) female officers; (2) displaying masculinized and feminized policing practices; (3) advancing gendered ideas through editorial additions. We further find that gendered performances by police vary between the “iron-fist” regime of El Salvador and the “soft-touch” regime in Honduras, while the armed forces of both countries adopt more gender-neutral images.
The “good is up” metaphoric effects on recognition: True for source guessing but false for item memory
Authors: Jin Zixi , von Hecker Ulrich , Symeonidou Nikoletta , Liu Yi , Klauer Karl Christoph
Published: July 2024

The “good is up” metaphor, which links valence and verticality was found to influence affective judgement and to direct attention, but its effects on memory remain unclear with contradictory research findings. To provide a more accurate assessment of memory components involved in recognition, such as item memory and source-guessing biases, a standard source monitoring paradigm was applied in this research. A series of three experiments provided a conceptual replication and extension of Experiment 2 by Crawford et al., (2014) and yielded a consistent result pattern suggesting that the “good is up” metaphor biases participants’ guessing of source location. That is, when source memory failed, participants were more inclined to guess the “up” location versus “down” location for positive items (and vice versa for negative items). It did, however, not affect source memory or item memory for valenced stimuli learned from metaphor-congruent versus incongruent locations (i.e., no metaphor-(in)congruent effects in memory). We suggest that the “good is up” metaphor may affect cognitive processes in a more subtle way than originally suggested.
Increased metamemory accuracy with practice does not require practice with metamemory
Authors: West John T , Kuhns Jack M , Touron Dayna R , Mulligan Neil W
Published: July 2024

Given that learners do not always predict their future memory performance accurately, there is a need to better understand how metamemory accuracy can be improved. Prior research suggests that one way to improve is practice—participants tend to become better at predicting their future memory performance over the course of multi-trial learning experiments. However, it is currently unclear whether such improvements result from participants having practised making metamemory judgements or whether comparable improvements occur even in their absence. This issue was investigated in three multi-trial, cued recall experiments wherein participants either did or did not receive practice making judgements of learning. Metamemory accuracy increased across study blocks but did so equally for the two groups. These results indicate that increased metamemory accuracy with practice is not due to participants having practised explicit metamemory monitoring but instead due to other factors associated with multi-trial learning such as retrieval practice and the availability of prior test performance as a metamemory cue.
The impact of subtle contextual information on remembering to complete academic goals
Authors: Nuño Christopher O , Christopher Edward A , Shelton Jill Talley
Published: July 2024

Remembering to complete goals—termed prospective memory (PM)—is critical for success in everyday life, yet minimal empirical work has been dedicated to examining PM within an educational setting. The main goal of this study was to investigate students’ ability to complete numerous future-oriented academic intentions (PM tasks) while simultaneously paying attention to a lecture and to see if working memory (WM) capacity and adding subtle contextual information would support the students’ likelihood of completing their PM tasks. Participants took part in a 2-hr session of college course-like activities. Throughout the session, there was occasionally the opportunity to complete one of several naturalistic PM tasks. The following findings are based on the results of our Bayesian models. Providing subtle contextual clues about when PM tasks could be completed was found to likely increase performance. The number of PM intentions to be remembered (i.e., load) produced no discernable effect on ongoing task performance or PM performance. Furthermore, individual differences in WM capacity were likely to be predictive of a near-zero change in PM performance. The current findings hold meaningful implications for educators, wherein providing context, even at a subtle level, can enhance students’ ability to remember to complete tasks, without altering their ability to focus on the tasks at hand. Moreover, it appears that asking students to remember to complete multiple, prospective in-class tasks is not likely to hinder task completion or their ability to focus on other ongoing tasks.
PCSK9 Inhibitor with Statin Therapy for Intracranial Artery Stenosis ( PISTIAS): Rationale and design of a multicenter randomized controlled trial
Authors: Hu Xinzhi , Zhang Zongmuyu , Liu Caiyan , Li Mingli , Liu Yiyang , Cheng Anqi , Yu Qiuyu , Guo Haoyao , Zou Yinxi , Zhou Li , Wang Hebo , Song Bo , You Yong , Xia Jian , Zhang Jingfen , Ai Zhibing , Sun Qinjian , Han Ju , Liu Jing , Lu Baoquan , Deng Qiwen , Li Guanzeng , Wang Peng-fei , Li Xiangqing , An Yi , Wu Bo , Yan Zhongrui , Wang Yining , Xu Wei-Hai
Published: July 2024

Rationale:

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors enable an additional 54–75% reduction in low-density lipoprotein cholesterol (LDL-C) in statin-treated patients, demonstrating plaque regression in coronary artery disease. However, the impact of achieving an extremely low level of LDL-C with PCSK9 inhibitors (e.g. Evolocumab) on symptomatic intracranial atherosclerosis remains unexplored.

Aim and hypothesis:

To determine whether combining Evolocumab and statins achieves a more significant symptomatic intracranial plaque regression than statin therapy alone.

Sample size estimates:

With a sample size of 1000 subjects, a two-sided α of 0.05, and 20% lost to follow-up, the study will have 83.3% power to detect the difference in intracranial plaque burden.

Methods and design:

This is an investigator-initiated multicenter, randomized, open-label, outcome assessor-blinded trial, evaluating the impact of combining Evolocumab and statins on intracranial plaque burden assessed by high-resolution magnetic resonance imaging at baseline in patients undergoing a clinically indicated acute stroke or transient ischemic attack due to intracranial artery stenosis, and after 24 weeks of treatment. Subjects (n = 1000) were randomized 1:1 into two groups to receive either Evolocumab 140 mg every 2 weeks with statin therapy or statin therapy alone.

Study outcomes:

The primary endpoint is the change in intracranial plaque burden assessed by high-resolution magnetic resonance imaging, performed at baseline and at the end of the 24-week treatment period.

Discussion:

This trial will explore whether more significant intracranial plaque regression is achievable with the treatment of combining Evolocumab and statins, providing information about efficacy and safety data.

Trial registration number:

ChiCTR2300068868; https://www.chictr.org.cn/
The Mediating Role of Self-stigma of Seeking Help in the Relationship between Perceived Occupational Prestige and Mental Health: A Cross-Sectional Study on Medical Doctors
Authors: Thai Bui Thi Hong , Trang Nguyen Thi Nhu
Published: July 2024

Based on social identity theory, this study aimed at evaluating the effect of perceived occupational prestige and self-stigma of seeking help on mental health issues (depression, stress, and anxiety) among medical doctors. A self-administered questionnaire survey was conducted on 374 medical doctors working in Vietnam with convenient sampling strategies. The study employed the 22-item version of the Perception of Occupational Status Survey (POSS), the Self-stigma of Seeking Help Scale (SSOSH), and the 21-item version of the Depression-Anxiety-Stress Scale (DASS-21). Results showed that perceived occupational prestige had a negative association with mental health issues among medical doctors. Furthermore, results suggested that the relationship between perceived occupational prestige and mental health was mediated by self-stigma of seeking help. Self-stigma of seeking help increased the risk of mental health issues. However, medical doctors perceived high occupational prestige, which weakened self-stigma of seeking help, and therefore, it indirectly reduces the risk of mental health issues among medical doctors. The results hence provide empirical support for social identity hypothesis. Based on the results, the study also provides some practical suggestions for therapists working with healthcare professionals in intervening mental health issues.
Blast Performance of Polyurea-Coated Modular Structure Composed of Fiber-Reinforced Polymer and Foam Sandwich Panels
Authors: Saini Kusum , Matsagar Vasant Annasaheb
Published: July 2024

Lightweight modular structures have become a requirement in today’s world, especially for areas that are prone to occurrence of extreme events, such as earthquakes and blasts, and are situated in difficult terrains with challenging accessibility. Sandwiched composites can be one of the most suitable building units for construction of these structures due to their engineered mechanical and physical properties. Therefore, in this numerical study, performance assessment of a sandwich modular structure in the shape of a truncated cylinder is conducted under blast load. The sandwich modular structure is composed of flat and curved carbon fiber-reinforced polymer (CFRP) and extruded polystyrene (XPS) foam sandwich panels. A three-dimensional (3D) finite element (FE) model of the sandwich modular structure is developed considering the orthotropic behavior of CFRP facesheets and the crushing foam behavior is accounted for the XPS foam core in the FE modeling. The damage assessment in the CFRP facesheet is performed using Hashin’s damage criterion. Furthermore, the effect of polyurea with varying thicknesses on the blast-resistance of the structure is investigated. The polyurea is modeled as hyperelastic material using the Mooney-Rivlin model. The influence of polyurea positioning is studied when (a) applied externally to flat and curved walls of the structure directly exposed to the blast and (b) applied internally to flat and curved walls of the structure opposite to the exposure of the blast (rear face). It is observed that the flat walls of the structure are more vulnerable to the blast load than the curved walls of the structure. Moreover, a quadratic and linear reduction in the deflection of flat and curved walls with increasing thickness of polyurea coating is obtained, respectively. In addition, with increasing thickness of the additional polyurea coating, a logarithmic reduction in the kinetic energy of the sandwich modular structure is reported.
Oxaliplatin-associated shock in stage III colorectal cancer patients: real-world evidence in Taiwan
Authors: Wang Ling-Yi , Hsieh Hui-Hsia , Chu Sung-Chao , Chang Wei-Chuan , Kuo Yi-Ting , Wu Tien-Yuan
Published: July 2024

Background:

Oxaliplatin-associated shock (referred to as shock) is a rare but life-threatening adverse event.

Objectives:

This pioneering cohort study aimed to quantitatively investigate the association between oxaliplatin use and shock in patients with stage III colorectal cancer (CRC), identify potential independent risk factors for shock, and assess the cycle-to-shock during oxaliplatin treatment.

Design:

The study utilized a nested case–control (NCC) design to assess the association between oxaliplatin and shock and employed a case-crossover approach to address unmeasured confounders.

Methods:

All newly diagnosed stage III CRC patients were identified from the CRC Health Database (2012–2016). Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for oxaliplatin’s link to shock incidence.

Results:

Among 6932 oxaliplatin recipients, 331 suffered shock. In all, 3309 controls were selected via risk-set sampling for the shock cases. Oxaliplatin use is associated with a doubled risk of shock (adjusted OR: 2.08, 95% CI: 1.23–3.52). Two independent risk factors were male sex (adjusted OR: 1.33, 95% CI: 1.05–1.69) and heart diseases (adjusted OR: 1.65, 95% CI: 1.17–2.32). The case-crossover analysis revealed a more than fourfold risk (OR: 4.4, 95% CI: 1.67–11.62). In total, 22 of 331 shock cases were exposed to oxaliplatin within 2 days of shock onset, with a median cycle-to-shock time at the seventh cycle.

Conclusion:

Oxaliplatin use significantly increased shock risk in stage III CRC patients. Male sex and heart disease are two independent risk factors.
Interests and feelings of Spanish teachers on twitter during Covid-19
Authors: Gómez-Camacho Alejandro , Moreno-Fernandez Olga
Published: July 2024

The diffusion of Covid-19 imposed the confinement of the entire Spanish population between March and June 2020. An exploratory study of the evolution of teachers’ interests and feelings in social networks is carried out. For this purpose, three key periods have been differentiated: pre-pandemic (January 2018-February 2020), confinement and state of alarm (March 2020-May 2021), and post-pandemic (June 2021-March 2022). We analyzed 9462 tweets from faculty communities on Twitter using public data mining, sentiment analysis, and semantic content analysis. The results highlight a significant increase in teacher interventions on Twitter and an increase in emotional content during the confinement in both positive and negative sentiments, closely related to the use of emojis. During the pandemic period, new topics of interest appeared related to the evolution of COVID-19 in Spain and the safety of the return to the classroom. Topics dealing with digital tools and innovative methodologies appeared with different relevance in all the periods analyzed.
Catastrophic Case of West Nile Virus Rhombencephalitis in AIDS
Authors: Sharma Rupam , Salimi Elika , D’Assumpcao Carlos , Valdez Michael , Chaudhry Akriti , Heidari Arash , Kuran Rasha , Bhandohal Janpreet
Published: July 2024

West Nile Virus (WNV) belongs to the Flaviviridae family of viruses. It was first isolated and identified in 1937. Patients typically present with flu-like symptoms or are asymptomatic; however, neuroinvasive West Nile can lead to significant neurological impairment. Herein presented is a catastrophic case of WNV rhombencephalitis in a male patient newly diagnosed with AIDS. This report sheds light on the potential for severe neurological complications in co-infected patients and emphasizes the importance of early recognition.
Spatial politics and struggle for hegemony: The role of Komala in the revolutionary movement of Iranian Kurdistan
Authors: Saidi Hamed
Published: July 2024

The question of Kurds in Iran is a political as well as a regional issue. By applying the Gramscian spatial perspective, this paper examines how the socialist movement in Iranian Kurdistan has rethought and reshaped the collective identities of the Kurds through spatially collective mobilization. While “private spaces” were central for Komala as sites of group formation and political underground activities, after the fall of the Shah in 1979, the opening up of public spaces was of crucial importance for Komala to transform from a small organization to a social and influential current. The production and use of the public spaces enabled Komala to establish associational ties among subordinate social groups through strengthening a collective identity and political ideology. For Komala, the territoriality of the Kurdish region has been historically formed by class conflicts and class-relevant social relations in conjunction with the national question (self-determination for Kurdistan), and in relation to a specific spatial location in place, space, and scale.
Uncertain living: Pestering displaceability in a neighbourhood regeneration process
Authors: Zaban Hila
Published: July 2024

This paper examines the impact of top-down regeneration plans on residents, specifically focusing on the concept of ‘pestering displaceability’. Using a case study from Beersheba, Israel, it demonstrates how large-scale regeneration plans, while aiming to address housing needs and revitalize old quarters, can potentially displace residents, including homeowners. The concept of displaceability, as defined by Tzfadia and Yiftachel (2022), refers to the potential of being displaced and reflects the erosion of residents’ right to the city as a new order is imposed on their familiar environment. The central argument of the paper is that displaceability creates a sense of constant uncertainty—an urban state of mind characterized by a pestering nuisance—which individuals across different global contexts increasingly experience. Displaceability is not merely a mental condition of long-term anxiety. It is the new urban condition, a political condition manifested in a new and deteriorated form of urban citizenship. The study examines residents’ perceptions of potential displacement from their neighbourhood, which elicit both hopeful and fearful sentiments. Focusing on Beersheba’s Gimel neighbourhood, currently undergoing regeneration after a period of disinvestment, the research delves into the pre-gentrification era characterized by uncertainty regarding the process’s outcomes, including its speed, costs, and benefits. The paper documents this transformative phase using qualitative methods such as interviews and participant observation.
Minimally Invasive Surgery For Management of Bunionette Deformity (Tailor’s Bunion) Using Fifth Metatarsal Osteotomies: A Systematic Review and Meta-Analysis
Authors: Lewis Thomas L. , Lam Peter , Alkhalfan Yousif , Ray Robbie
Published: July 2024

Background:

There has been increasing interest in the use of percutaneous or minimally invasive osteotomy techniques for bunionette correction. The aim of this systematic review was to investigate the clinical and radiographic outcomes following percutaneous or minimally invasive surgery for bunionette deformity correction.

Methods:

A systematic review following PRISMA guidelines was undertaken. All clinical studies published in MEDLINE, Embase, PubMed, and the Cochrane Library Database from inception until December 2023 reporting on the use of percutaneous or minimally invasive osteotomy techniques for bunionette deformity correction were included. The primary outcome was radiographic deformity correction. A meta-analysis of clinical and radiographic outcomes was performed to assess the mean difference following surgery. Risk of bias was assessed using the ROBINS-I tool.

Results:

A total of 942 potential studies were identified, of which 18 were included encompassing 714 feet in 580 patients. There were no comparative studies identified. The majority of studies (n = 14/18) used an unfixed distal osteotomy technique. All studies showed a statistically significant improvement in clinical outcomes (American Orthopaedic Foot & Ankle Society ankle-hindfoot score and visual analog scale for pain) and radiologic outcomes (fourth-fifth intermetatarsal angle and fifth metatarsophalangeal angle). Complication rates ranged from 0% to 21.4%. The nonunion rate was 0% to 5.6%. Overall risk of bias was low to moderate. The most common complication was development of a hypertrophic callus that tended to resorb over time without needing further surgical intervention.

Conclusion:

The results of this systematic review must be considered in light of the methodologic limitations of the studies analyzed—including additional procedures performed at the same time as the bunionette correction, lack of comparative studies, and heterogeneity of the case series included. Despite these limitations, our review suggests that percutaneous techniques for bunionette deformity correction are generally clinically safe and associated with improvement in radiographic alignment and patient-reported outcome measures.
Arthroscopy-Assisted Open Fabella Excision With Medial Meniscus Revision Repair
Authors: Iwuoha Chukwuma T. , Tollefson Luke V. , Larson Joey , Kennedy Nicholas I. , LaPrade Robert F.
Published: July 2024

Background:

The fabella is a sesamoid bone that is a normal anatomic variant yet a rare cause of pathology in the posterolateral portion of the knee. The fabella can cause chronic knee pain in patients with knee osteoarthritis and athletes at all levels and in rare cases can cause neuropathy. Initially, treatment for a painful fabella includes conservative measures, with surgical intervention after conservative treatments have failed. This technique describes our arthroscopic-assisted fabella removal technique with a concomitant medial meniscus revision repair.

Indications:

The goal of treatment is to relieve pain and numbness. Conservative measures (i.e., nonsteroidal anti-inflammatory drugs [NSAIDs], range of motion exercises, heel cord stretching, etc.) are the initial step in treatment. Patients are treated surgically after conservative measures have failed. The surgical approach involves an open incision, arthroscopy, or a combination.

Technique Description:

With the patient in the supine position, a physical examination is performed under anesthesia to compare to validate clinical findings. An open lateral knee approach helps to locate the fabella which is grasped with an Alice clap. An arthroscopy is performed, and viewing posterolaterally will confirm that the fabella is within the grips of the Alice clamp. After repair of the meniscus, the surgical bed is repositioned to identify the fabella properly. Excision of the fabella is performed sharply from the lateral gastrocnemius tendon, and palpation is demonstrated to ensure complete removal. Caution is essential to avoid complications including damage to nearby anatomic structures, such as the lateral gastrocnemius tendon, and incomplete fabella removal.

Results:

A clinical study by Dekker et al reported that 80% of patients were able to return to full activities and postoperative patient-reported outcomes improved from preoperative to postoperative. Fabella excision is recommended for patients with fabella pain who do not respond to conservative treatment.

Discussion:

We describe a technique for removing the fabella with arthroscopic assistance. Patients who have not responded appropriately to conservative treatment for a painful fabella should consider surgical intervention. With the early initiation of rehabilitation, patients will have an increased likelihood of decreased pain, resolution of symptoms, and reduced knee stiffness.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.