bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the influence of ship waves on the dynamic response of floating tidal current power generation device
Authors: Hua Ai , Feng Yin , Gong Xiwu
Published: June 2024

To study the influence of ship traveling waves on the hydrodynamic performance between the carrier platform and the turbine, the computational fluid dynamics method and the DFBI motion module of STAR CCM+ software were adopted. Under the condition of the coupling of the ship traveling wave and wave current generated at different speeds, the overall motion response of the power plant is simulated. What’s more, the influence of different wave conditions on the heave, pitch, and roll of the carrier platform and the energy efficiency of the turbine is analyzed. The results show that the ship speed has little effect on the carrier heave motion, but the maximum value of the carrier pitch motion increases with the increase in the ship speed. The value of turbine energy acquisition efficiency always decreases with decreasing lateral spacing and increases with decreasing speed. This paper has a certain reference value for the engineering application of floating tidal current power generation equipment.
Research on short-term load forecasting based on clustering and deep learning
Authors: Li Feige , He Guangshen , Wang Ye , Luan Zhongyu , Xue Yongzhong , Yang Zhaojie
Published: June 2024

In power systems, power load forecasting is essential to ensure the reliability and efficiency of power supply. Since power load is affected by many factors, including weather, seasonality, and social activities, its patterns and changes are complex and diverse, and traditional forecasting methods may make it difficult to meet demand. In this background, this study combines the K-means clustering algorithm and deep learning model. First, through K-means clustering, we grouped historical load data, dates, and temperatures to identify different load patterns. This grouping helps adapt to different load changes, thereby improving the adaptability of the forecast. Then, a deep learning model is applied, combining a convolutional neural network (CNN) and a two-layer bidirectionally gated recurrent unit (BIGRU). These two models are used to deal with spatiotemporal characteristics and sequence dependence in load data respectively. CNN is used to capture the spatial features in the load data, while BIGRU processes the time series information in the data to effectively capture the complex dynamic nature of the load. K-means clustering information is entered as additional data into the CNN and BIGRU models. The experimental results of the study show that by fully considering different load patterns and data characteristics. Reducing load demand and providing more reliable short-term load forecasts improve the efficiency of the power supply, reduce energy waste, and reduce the burden on the power system.
Study the optimization of offshore floating PV power systems and its application
Authors: Chen Qian , Zhang Yi , Wang Rui
Published: June 2024

In recent years, the application of solar photovoltaic (PV) has been developing rapidly with a large amount of PV power stations built and operating. However, the land resources for PV power plants are relatively limited. Offshore PV power plants are expected to become an alternative means to solve such problems. In this paper, the PVsyst and AQWA are used to comprehensively simulate the power generation performance of floating PV power stations and thin-film PV power stations under offshore conditions, and the factors affecting the performance of floating PV systems are studied. By establishing the nonlinear regression numerical models, the relationship between the factors is compared by path analysis. The results show that the swing angle has the greatest influence on the system performance. The above work provides certain guidelines for the development and construction of offshore PV systems.
Comparison of two state evaluation methods for wind power generation equipment
Authors: Zhang Wei , Wu Zhiqiang , Li Qiang , Wen Aijun , Bao Beifang , Liu Zesan , Yan Yurong
Published: June 2024

The existing intelligent warning system achieved intelligent warning through state prediction, state evaluation, and fault localization. This article proposed and compared two state evaluation methods based on adjustable smoothing parameters and sliding window similarity. Actual wind turbine data was used as training data for the multivariate state prediction model, and the predicted data was used as input for the two state judgment methods. It was concluded that the sliding window similarity method has advantages in early warning accuracy, timeliness, and simplicity. Finally, the influence of sliding window parameters on early warning sensitivity was analyzed and discussed.
The orbital angular momentum of radiation from relativistic electrons in the laser wave field with linear polarization
Authors: Bogdanov O.V. , Bragin S.V.
Published: June 2024

The paper reports the results of calculations of the generation of twisted photons by relativistic electrons in the laser wave field with linear polarization. It is shown that in this case the probability of radiation of twisted photons obeys the selection rule that n + m is an even number. The radiation of the probability of detecting a twisted photon is numerically investigated depending on various parameters: photon energy, helicity and the cone opening of the twisted photon. In general, the radiation of twisted photons by electrons in the laser wave field with linear polarization is a mixture of twisted photons at the total angular momentum of the photons; however, we have found conditions when generation of twisted photons will be an almost pure source of twisted photons.
Performance assessment of a newly developed non-invasive 2D beam profile monitor for high-intensity accelerators
Authors: Rosily Sherry , M Hari Prasad , Dikshit Biswaranjan , Krishnagopal Srinivas , Kumar Rajesh
Published: June 2024

In high-intensity accelerators, minimizing beam loss is
paramount to avoid damages and activation of accelerator
components. To achieve this, a reliable beam profile monitor is
essential for assessing the beam center and spread. Additionally,
the beam profile can be used to steer the beam during regular
operation, thus reducing beam loss. In cases of irregular events,
the monitor can initiate beam profile recording to identify and
address any issues promptly. In this manuscript, we present a
detailed description of a non-invasive 2D beam profile monitor,
focusing on its components, operation, and most importantly, its
reliability and failure modes. From operation experience, failure
modes of the system and its effects were identified. Fault tree
analysis was carried out. Failure rate of sheet generator was
estimated using response surface method. Failure rates of components
were used to estimate the failure rate of the system. From the
target reliability, the required maximum repair time of the system
was calculated.
Performance of the CERN Proton Synchrotron internal dump: numerical simulation studies and comparison with beam measurements
Authors: Niang S. , Pugnat T. , Domange D. , Esposito L.S. , Giovannozzi M. , Gnacadja E. , Hernalsteens C. , Huschauer A. , Tesse R.
Published: June 2024

In the framework of the LHC Injector Upgrade project, a new
internal dump for the CERN Proton Synchrotron (PS) ring has been
designed, installed, and successfully commissioned. This device is
designed to move rapidly into the beam and stop charged particles
over several thousand turns to provide protection to PS hardware
against beam-induced damage. Due to its design, the internal dump
absorbs only a fraction of the secondary particles shower produced
by the beam particles that impinge on it. The performance of the
dump should ensure efficient use throughout the PS energy range,
i.e. from injection at 2 GeV (kinetic energy) to flat top at
26 GeV (total energy). This paper presents comprehensive numerical
simulations that combine advanced beam dynamics and beam-matter
interaction codes to analyse the behaviour of stopped or scattered
particles. Based on the impacts computed by multi-turn beam dynamics
simulations, detailed shower simulations with FLUKA were
performed to assess the impact of the radiation field on downstream
equipment, with a particular emphasis on the dose measured by Beam
Loss Monitors. The results of these numerical simulations are
compared with the data collected during the routine operation of the
PS and its internal dump.
Exhaled breath analysis for the discrimination of asthma and chronic obstructive pulmonary disease
Authors: Li Lan , Chen Haibin , Shi Jinying , Chai Shukun , Yan Li , Meng Deyang , Cai Zhigang , Guan Jitao , Xin Yunwei , Zhang Xu , Sun Wuzhuang , Lu Xi , He Mengqi , Li Qingyun , Yan Xixin
Published: June 2024

Chronic obstructive pulmonary disease (COPD) and asthma are the most common chronic respiratory diseases. In middle-aged and elderly patients, it is difficult to distinguish between COPD and asthma based on clinical symptoms and pulmonary function examinations in clinical practice. Thus, an accurate and reliable inspection method is required. In this study, we aimed to identify breath biomarkers and evaluate the accuracy of breathomics-based methods for discriminating between COPD and asthma. In this multi-center cross-sectional study, exhaled breath samples were collected from 89 patients with COPD and 73 with asthma and detected on a high-pressure photon ionization time-of-flight mass spectrometry (HPPI-TOFMS) platform from 20 October 2022, to 20 May 2023, in four hospitals. Data analysis was performed from 15 June 2023 to 16 August 2023. The sensitivity, specificity, and accuracy were calculated to assess the overall performance of the volatile organic component (VOC)-based COPD and asthma discrimination models. Potential VOC markers related to COPD and asthma were also analyzed. The age of all participants ranged from to 18–86 years, and 54 (33.3%) were men. The age [median (minimum, maximum)] of COPD and asthma participants were 66.0 (46.0, 86.0), and 44.0 (17.0, 80.0). The male and female ratio of COPD and asthma participants were 14/75 and 40/33, respectively. Based on breathomics feature selection, ten VOCs were identified as COPD and asthma discrimination biomarkers via breath testing. The joint panel of these ten VOCs achieved an area under the curve of 0.843, sensitivity of 75.9%, specificity of 87.5%, and accuracy of 80.0% in COPD and asthma discrimination. Furthermore, the VOCs detected in the breath samples were closely related to the clinical characteristics of COPD and asthma. The VOC-based COPD and asthma discrimination model showed good accuracy, providing a new strategy for clinical diagnosis. Breathomics-based methods may play an important role in the diagnosis of COPD and asthma.
Inverse designed WS2 planar chiral metasurface with geometric phase
Authors: Jo Jaegang , Lee Sangbin , Bae Munseong , Nelson Damian , Crozier Kenneth B , Yu Nanfang , Chung Haejun , Kim Sejeong
Published: June 2024

Increasing attention is being paid to chiral metasurfaces due to their ability to selectively manipulate right-hand circularly polarized light or left-hand circularly polarized light. The thin nature of metasurfaces, however, poses a challenge in creating a device with effective phase modulation. Plasmonic chiral metasurfaces have attempted to address this issue by increasing light–matter interaction, but they suffer from metallic loss. Dielectric metasurfaces made from high-index materials enable phase modulation while being thin. Very few materials, however, have high refractive index and low loss at visible wavelengths. Recently, some 2D materials have been shown to exhibit high refractive index and low loss in the visible wavelengths, positioning them as promising platforms for meta-optics. This study introduces and details a planar chiral metasurface with a geometric phase composed of WS2 meta-units. By employing adjoint optimization techniques, we achieved broadband circular dichroism (

>

0.5 in the wavelength range of 653–796 nm) and a high extinction ratio (19.6 dB at λ = 675 nm).
Phylogeny and evolution of streptophyte algae
Authors: Bierenbroodspot Maaike J , Pröschold Thomas , Fürst-Jansen Janine M R , de Vries Sophie , Irisarri Iker , Darienko Tatyana , de Vries Jan
Published: June 2024

The Streptophyta emerged about a billion years ago. Nowadays, this branch of the green lineage is most famous for one of its clades, the land plants (Embryophyta). Although Embryophyta make up the major share of species numbers in Streptophyta, there is a diversity of probably >5000 species of streptophyte algae that form a paraphyletic grade next to land plants. Here, we focus on the deep divergences that gave rise to the diversity of streptophytes, hence particularly on the streptophyte algae. Phylogenomic efforts have not only clarified the position of streptophyte algae relative to land plants, but recent efforts have also begun to unravel the relationships and major radiations within streptophyte algal diversity. We illustrate how new phylogenomic perspectives have changed our view on the evolutionary emergence of key traits, such as intricate signalling networks that are intertwined with multicellular growth and the chemodiverse hotbed from which they emerged. These traits are key for the biology of land plants but were bequeathed from their algal progenitors.
Care Partners’ Engagement in Preventing Falls for Community-Dwelling Older People With Dementia
Authors: Zhou Yuanjin , Berridge Clara , Hooyman Nancy , Mroz Tracy M , Sadak Tatiana , Choi Seung W , Phelan Elizabeth A
Published: June 2024

Background and Objectives

Little is known about how to prevent falls in community-dwelling older people with dementia. Although their care partners adopt various behaviors to prevent their falls, it is unclear if these behaviors reduce falls for those with different levels of fall risk.

Research Design and Methods

Linking the 2015 and 2016 National Health and Aging Trends Study and the 2015 National Study of Caregiving (NSOC), we identified 390 community-dwelling older people with dementia with 607 care partners. We selected 26 NSOC items representing fall risk management (FRM) behaviors. We examined the prevalence and dimensionality of these behaviors and investigated associations between care partners’ behaviors in 2015 (T1) and older people’s falls in 2016 (T2) stratified by their fall incidence at T1, adjusting for covariates.

Results

Five domains of FRM were identified: mobility and safety assistance, medical service coordination, health management, social service coordination, and accommodation. For those who did not fall at T1, mobility and safety assistance and social service coordination were each associated with an increased risk of falling at T2 (adjusted incidence rate ratio [aIRR] = 1.39, 95% confidence interval [CI] = 1.06–1.83, p = .019, aIRR = 1.25, 95% CI = 1.01–1.55, p = .043). For those who had fallen at T1, social service coordination was associated with a decreased risk of falling at T2 (aIRR = 0.83, 95% CI = 0.73–0.94, p = .004).

Discussion and Implications

The different impacts of dementia care partners’ FRM behaviors emphasize the need to address specific behaviors when involving care partners in preventing falls for older people with dementia at varying levels of fall risk.
Post-Treatment Displacement of Facial Soft Tissue Fillers—A Retrospective Ultrasound-based Investigation of 382 Zygomatic Regions
Authors: Schelke Leonie , Lowrey Nicola , Mojallal Ali , Rowland-Warmann MJ , Wortsman Ximena , Sigrist Rosa M. , Velthuis Peter J. , Cotofana Sebastian
Published: June 2024

BACKGROUND

Clinical and ultrasound experience has revealed that after soft tissue injections of the lateral cheek, the filler may displace from the zygoma to the caudal temporal area.

OBJECTIVE

To obtain more data to provide insight into product distribution when soft tissue fillers are injected in the zygomatic region.

METHODS

Two hundred patients were examined with facial ultrasound imaging of the zygomatic and temporal region. Inclusion criteria were simply a positive response on the screening questionnaire as to whether or not they had filler injections placed in their lateral cheek. Control injections were also performed to the zygomatic regions of a body donor and in 10 patients ultrasound-guided.

RESULTS

A correlation was found between the layers in which filler was detected on the zygoma and where it was ultimately found in the temples. Four different redistribution patterns were observed: (1) migration of filler within the superficial muscular aponeurotic system (SMAS) on the zygoma into the superficial temporal fascia. Migration of filler from the lateral suborbicularis oculi fat to (2) the deep interfacial plane of the temple or (3) to the superficial temporal fat pad; (4) migration from the supraperiosteal layer of the zygoma to the superficial temporal fat pad. Body donor and patients: filler deposits injected on the zygoma were witnessed to shift during injection into the caudal part of the temple.

CONCLUSION

Soft tissue filler aliquots may be redistributed into the temples after injections of the lateral side of the zygomatic arch. The displacement follows a distinct pattern depending on the initial layer of injection.
Three-point Method Nerve Block for Relieving Pain of Microbotox Injection in Middle and Upper Face
Authors: Liu Bing , Su Xueshang , Chai Hongli , Chen Qi , Hu Jintian , Wang Yongqian
Published: June 2024

Background:

With the popularity of microbotox, pain caused by multiple microdroplets and subcutaneous injection of botulinum toxin is increasing. This study presents a new, refined, three-point nerve block technique that provides effective pain relief during minimally invasive injection therapy targeting the middle and upper face.

Methods:

Fifty volunteers underwent facial ultrasonography to measure the locations of the supraorbital and infraorbital foramen. Following microdrop Botox injection of the middle and upper face, 100 patients underwent a self-controlled study to analyze whether a three-point nerve block surpasses topical anesthesia for reducing injection pain. The visual analog scale pain score, the time of the three-point method and botulinum toxin injection, and side effects were recorded.

Results:

Among the volunteers, the location of the supraorbital and infraorbital foramen showed no statistical difference between the left and right sides. For the 100 patients (13 men, 87 women) who underwent the three-point nerve block, the visual analog scale pain scores on the experimental side were significantly lower than those on the control side, except in the frontotemporal region (2.46 ± 0.50, 2.42 ± 0.47, P > 0.05). The duration of the unilateral three-point nerve block was 74.8 ± 5.64 seconds. The total injection time was 189.86 ± 26.79 seconds (range 148–286 s).

Conclusions:

The three-point method exerted prominent analgesic effects during middle and upper facial treatments, with benefits including a precise block region, high satisfaction, and simple operation technique. Therefore, clinicians can easily master and apply this method.
Reconstruction of Long Tibial Defect Using Free Osteocutaneos Fibular Flap in a Sub-Saharan Africa Setting
Authors: Gebremariyam Zenebe Teklu , Lorenzo Andres Rodriguez , Dibisa Firisa Tolosa , Gonfa Metekiya Ararso
Published: June 2024

Tibial defects present a formidable reconstructive challenge, particularly in resource-limited settings such as Sub-Saharan Africa. The application of free osteocutaneous fibular flaps has emerged as a versatile and reliable technique for addressing these complex cases. However, the specific considerations and outcomes associated with this approach in Sub-Saharan Africa remain underexplored. This case report presents a detailed account of a patient with a long tibial defect managed using a free osteocutaneous fibular flap in Jimma University Medical Center, Ethiopia. The surgical intervention resulted in successful reconstruction of the tibial defect, with satisfactory functional outcomes observed during the follow-up period. The use of a free fibular flap for addressing bone defects is proposed as an economically viable single-stage procedure, requiring less patient compliance. Studies on this technique in Sub-Saharan Africa are limited, but outcomes have shown comparability to those in more developed countries.
Use of Dermal Substitute Matrices for Coverage of Exposed Limb Vascular Repairs: A Literature Review
Authors: Makkawi Kareem W. , Beaineh Paul T. , Habr Natasha T. , Ibrahim Amir E.
Published: June 2024

Background:

Prompt coverage of vascular repairs in the extremities is needed to protect from desiccation and trauma. In the absence of local soft tissues to provide early coverage pending demarcation of the tissues and the zone of injury, there is no clear data in the literature on the ideal coverage method. This article is the first to review the use of dermal substitutes for temporary coverage of extremity vascular repairs pending definitive coverage.

Methods:

We conducted a review of the literature to identify previous articles indexed in PubMed and Ovid using these search terms: [(skin) OR (artificial skin) OR (Integra) OR (dermal substitute) OR (dermal substitute matrix) OR (dermal regeneration) OR (dermal regeneration matrix) OR (dermal regeneration template)] AND [(bypass) OR (graft) OR (vascular surgery) OR (revascularization) OR (salvage) OR (limb salvage) OR (vascular repair) OR (artery repair) OR (arterial repair)] AND [(limb) OR (extremity) OR (leg) OR (arm) OR (vascular injury) OR (amputation)].

Results:

Of the 32 articles retrieved for initial review, five case reports with six patients of dermal substitute use for direct coverage of extremity repairs were identified. In all cases, the dermal substitute was able to provide stable coverage pending definitive coverage or was allowed to heal secondarily.

Conclusions:

Dermal substitute matrices are a potential means of temporary coverage of exposed extremity vascular repairs when there is a paucity of local soft tissues pending more definitive coverage.
Strategies to Improve Resident Wellness in Plastic Surgery Training
Authors: Koljonen Jessie L. , Ruffolo Alexis M. , Neumeister Michael W. , Sommer Nicole Z.
Published: June 2024

Residency is known to be a challenging time in a surgeon’s career. Surgical residents must learn the breadth of their field and develop technical skills while maintaining relationships and well-being outside their training. High burnout rates are well documented among all medical specialties, particularly during residency. Proven strategies in medical education that help decrease burnout and improve resident well-being, while maintaining quality patient care, have been reported in the medical education literature. However, little has been published specific to plastic surgery training programs. We discuss strategies that can be implemented into the curricula and workflow at plastic surgery residency programs to maximize resident well-being. We advocate for a multifaceted approach that includes a night float system, day call, integrating advanced practice providers to offload noneducational resident tasks, and establishing a wellness program. It is our hope that these strategies may serve as a guide for plastic surgery residency programs to promote general wellness and prevent burnout among trainees.
Donor Limb Functional Restoration via a Novel Clinical Care Pathway following Fibula Free Flap Harvest for Head and Neck Reconstruction
Authors: Halfpap Joshua P. , Hammer Daniel A. , Kingsbury Trevor D. , Ortiz-Pomales Yan T. , O’Reilly Eamon B. , Pontillo Marisa
Published: June 2024

Patients undergoing head and neck skeletal reconstruction (HNR) often require free tissue transfer from the extremities to ensure proper restoration of form and function. This requires a team-based, highly reliable medical system centered around the patient needs. Surgical intervention across multiple sites and harvesting of donor tissue results in short- and long-term physical impairments. There is a paucity of research objectively measuring impairments resulting from the graft donor site. There is a lack of research that objectively measures impairments and protocols for the management of these patients postoperatively. Patients undergo little, if any, formal approach to dealing with the vast impairments, which are sequelae to this surgery. This leads to large discrepancies in proposed functional progressions, return to duty timelines, and utilization of rehabilitative resources. At a major military medical center, an innovative clinical care pathway for patients undergoing HNR using free tissue transfer was implemented using a multidisciplinary model that focuses on early engagement with rehabilitation. This model, paired with a single surgery, will attempt to return service members to duty months earlier than the traditional approach. This report describes the conceptual framework and implementation of a new criteria-based, multidisciplinary clinical care pathway for HNR patients. The collaboration amongst the multidisciplinary care team has optimized the holistic health of the patient and communication with their support network, yielding faster return to normalization of daily life activities. The long-term goal is to further develop and formalize this pathway to best serve this patient population.
Aggregatibacter Aphrophilus as a Rare Cause of Endogenous Endophthalmitis
Authors: Kanda Pushpinder , Kundapur Deeksha , Chen Henry , Dollin Michael
Published: June 2024

Purpose:

To describe a rare case of endogenous endophthalmitis caused by Aggregatibacter aphrophilus (A. aphrophilus) in context of all previously reported cases of endophthalmitis caused by this organism.

Methods:

A 59-year-old male with no history of ocular trauma or surgery presented with a red, painful right eye with light perception vision. Examination showed a hypopyon, dense fibrin reaction, and cells in the anterior chamber. B-scan ultrasound showed evidence of vitritis. Broad investigations were initiated for both inflammatory and infectious etiologies.

Results:

The patient was diagnosed with presumed endogenous bacterial endophthalmitis as the blood cultures was positive for A. aphrophilus and vitreous cultures were negative for growth. The patient was promptly treated with intravitreal and systemic antibiotics and later underwent pars plana vitrectomy. The final visual acuity was 20/50. The patient had a prosthetic aortic valve and careful investigations had ruled out endocarditis.

Conclusions:

This case emphasizes the importance of early recognition, investigation, and intervention for A. aphrophilus endophthalmitis including the role of therapeutic vitrectomy. While early presentation can mimic ocular inflammatory diseases, infection from under-recognized causative organisms like A. aphrophilus, should be ruled out. Systemic and intraocular antibiotics should be started promptly in order to provide the best visual prognosis.
Social support and the association between post-traumatic stress disorder and risk for long-term prescription opioid use
Authors: Sullivan Mark D. , Wilson Lauren , Amick Matthew , Miller-Matero Lisa R. , Chrusciel Timothy , Salas Joanne , Zabel Celeste , Lustman Patrick J. , Ahmedani Brian , Carpenter Ryan W. , Scherrer Jeffrey F.
Published: June 2024

Post-traumatic stress disorder (PTSD) is common in patients with chronic pain, adversely affects chronic pain outcomes, and is associated with opioid use and adverse opioid outcomes. Social support is a robust predictor of PTSD incidence and course as well as chronic pain outcome. We determined whether the association between PTSD and persistent opioid use was modified by emotional support in a cohort of patients receiving opioids for noncancer pain. Eligible participants were ≥18 years and had completed a new period of prescription opioid use lasting 30 to 90 days. Bivariate associations between cohort characteristics and each key variable was assessed using χ2 tests for categorical variables and t-tests for continuous variables. Interaction between PTSD and emotional support was assessed by a priori stratification on low vs high emotional support. Participants (n = 808) were 53.6 (SD ± 11.6) years of age, 69.8% female, 69.6% White, and 26.4% African American. Overall, 17.2% had probable PTSD. High emotional support was significantly (P < 0.0001) more common among those without probable PTSD. Prescription opioid use at 6-month follow-up was significantly (P = 0.0368) more common among patients with vs without probable PTSD. In fully adjusted models, PTSD was no longer associated with opioid use at 6-month follow-up among participants with high emotional support. Among those with lower emotional support, PTSD was significantly associated with opioid use at 6-month follow-up in unadjusted (odds ratio = 2.40; 95% confidence interval: 1.24-4.64) and adjusted models (odds ratio = 2.39; 95% confidence interval: 1.14-4.99). Results point to the hypothesis that improvement of emotional support in vulnerable patients with chronic pain and PTSD may help reduce sustained opioid use.
Psychometric Testing of the Thai Version of Self-Care of Chronic Illness Inventory Version 4c in Patients With Stroke
Authors: Srisomthrong Kannika , Suwanno Jom , Klinjun Nuntaporn , Suwanno Juk , Kelly Matthew
Published: June 2024

Background

Self-Care of Chronic Illness Inventory version 4c is a non–disease-specific self-care measure used in individuals with multiple chronic conditions. This instrument may be applied to patients with specific diseases such as stroke.

Objective

The aim of this study was to evaluate the psychometric properties of the Thai version of the Self-Care of Chronic Illness Inventory version 4c in patients with stroke.

Methods

This multicenter, cross-sectional study adhered to the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) guidelines and enrolled patients with stroke from 16 primary care centers in southern Thailand. Structural validity was assessed using confirmatory factor analysis, internal consistency reliability using Cronbach α coefficient and global reliability index, and test-retest reliability using intraclass correlation coefficients.

Results

The final analysis included a total of 350 participants. Confirmatory factor analysis supported the 2-factor Self-Care Maintenance scale structure, although the item allocation to the dimensions differed from that of the original model. The Self-Care Monitoring scale demonstrated a 1-factor structure with permitted residual covariance. The Self-Care Management scale maintained a 2-factor structure, similar to that of the original model. Simultaneous confirmatory factor analysis of the combined items supported the general model with the 3 scales. The Self-Care Maintenance scale exhibited marginally adequate α (0.68) and ω (0.66) coefficients, and an adequate composite reliability index (0.79). The other 2 scales demonstrated adequate α (range, 0.79–0.86), ω (range, 0.75–0.86), and composite reliability (range, 0.83–0.86) indices. Intraclass correlation coefficients showed adequate test-retest reliability for all scales (range, 0.76–0.90).

Conclusions

The generic self-care measure, Self-Care of Chronic Illness Inventory version 4c, demonstrated strong psychometric properties in patients with stroke. This instrument may be a valuable tool for assessing stroke self-care in Thailand.
Assessing Krenning’s score on 68Ga-DOTATATE PET-CT and miPSMA score on 68Ga-PSMA-11 PET-CT in TENIS: a comparison with FDG PET/CT and examining the feasibility of targeted radionuclide therapy
Authors: Sonavane Sunita , Salvi Omkar , Asopa Ramesh V. , Basu Sandip
Published: June 2024

Objectives

The objective of this study was to assess receptor expression in metastatic differentiated thyroid carcinoma patients with progressive elevated thyroglobulin and negative iodine scintigraphy, we used 68Ga-DOTATATE [Gallium-68 1,4,7,10‐tetraazacyclododecane‐1,4,7,10‐tetraacetic acid (DOTA)–octreotate (DOTATATE)] (Krenning’s score) and 68Ga-PSMA-11 (Gallium-68 prostate‐specific membrane antigen‐11) PET-computed tomography (CT) [molecular imaging prostate‐specific membrane antigen (miPSMA) score]. Patients with Krenning’s score 3 and above and miPSMA score 2 and above were considered to determine the incidence of patients, who would qualify for treatment with 177Lu-DOTATATE/PSMA [Lutetium-177 1,4,7,10‐tetraazacyclododecane‐1,4,7,10‐tetraacetic acid (DOTA)–octreotate (DOTATATE)/prostate‐specific membrane antigen]-based therapy. In addition, we compared 68Ga-DOTATATE and 68Ga-PSMA-11 PET-CT with 2-deoxy-2-[F-18]fluoroglucose (18F-FDG) PET-CT (using maximum standardized uptake value).

Materials and methods

A total of 74 patients with histopathologically proven metastatic differentiated thyroid carcinoma with thyroglobulin elevation and negative iodine scintigraphy syndrome were studied retrospectively. They all had 18F-FDG, 68Ga-DOTATATE, and 68Ga-PSMA-11 PET-CT scans available for undertaking this analysis. The lesions detected by 68Ga-DOTATATE and 68Ga-PSMA-11 were evaluated using Krenning’s and miPSMA scores. In addition, quantitative comparisons of maximum standardized uptake values for 68Ga-DOTATATE and 68Ga-PSMA-11, as well as with 18F-FDG, were conducted.

Results

Patient-wise analysis revealed positivity rates of 40.5% for 68Ga-DOTATATE, 41.89% for 68Ga-PSMA-11, and 75.67% for 18F-FDG. Among the 74 patients, 14 (18.91%) were deemed eligible for 177Lu-DOTATATE/PSMA-617 therapy based on Krenning’s score of 3 and above both/either miPSMA score of 2 and above on 68Ga-DOTATATE or 68Ga-PSMA-11 PET-CT. Within this subgroup, seven out of 74 patients (9.45%) were eligible for 177Lu-DOTATATE therapy, and nine out of 74 patients (12.16%) were eligible for 177Lu-PSMA-targeted therapy. Four patients were eligible for both therapies.

Conclusion

Among thyroglobulin elevation and negative iodine scintigraphy patient’s subgroup, 9.45% could qualify for 177Lu-DOTATATE and 12.16% for 177Lu-PSMA-617. Four were eligible for both therapies. Given the lack of effective therapies, this subset of patients warrants consideration for radionuclide therapy exploration.
Successful Treatment of Refractory or Relapsed Hepatoblastoma With Autologous Hematopoietic Stem Cell Transplantation in Children
Authors: Kim Bo Kyung , Choi Jung Yoon , Hong Kyung Taek , Park Hyun Jin , Kang Hyoung Jin
Published: June 2024

Background:

The standard-risk hepatoblastoma has a good prognosis in children; however, refractory or relapsed (R/R) hepatoblastoma has a poor prognosis and high mortality rate. This study aimed to demonstrate the efficacy of high-dose chemotherapy and autologous hematopoietic stem cell transplantation (HSCT) rescue in pediatric patients with R/R hepatoblastoma.

Methods:

We retrospectively analyzed 6 pediatric patients with R/R hepatoblastoma who underwent autologous HSCT. The MEC conditioning regimen was used for all patients, comprising melphalan 140 mg/m2/day intravenously (IV) on day 7 and 70 mg/m2 on day 6, etoposide 200 mg/m2 IV on days 5 to 8, and carboplatin 400 mg/m2 IV on days 5 to 8. One patient received a TopoThioCarbo regimen, comprising topotecan 2 mg/m2/day IV on days 4 to 8, thiotepa 300 mg/m2/day IV on days 6 to 8, and carboplatin 500 mg/m2/day IV on days 3 to 5, as the conditioning regimen for the first transplantation. This was followed by salvage chemotherapy for relapse, and the second transplantation was performed using MEC as the conditioning regimen.

Results:

We report the retrospective results of 6 patients with a median age of 1.8 (range 0.4 to 10.2) years who had R/R hepatoblastoma and underwent autologous HSCT. The median follow-up period was 58 (range 28 to 113) months after diagnosis. The median stage at diagnosis was 2.0 (range 2 to 4). Two patients had lung metastases during diagnosis. The median initial alpha-fetoprotein level was 292,888 (range 28,831 to 2,406,942) ng/mL, and the median number of chemotherapy lines before autologous HSCT was 3.5 (range 2 to 7). The disease status before HSCT was complete remission (CR) for all patients. The engraftment rate was 100%. No treatment-related mortality was reported. The 3-year event-free survival and overall survival rates were 83.3% and 100%, respectively. One patient relapsed after the second HSCT and achieved CR after salvage chemotherapy.

Conclusion:

This study suggests autologous HSCT as an effective treatment in pediatric patients with R/R hepatoblastoma. Nevertheless, future large-scale prospective studies are warranted.
Effect of Spirituality on Psychological Resilience and Hope in Patient-Family Caregiver Dyads Experiencing Gynecological Cancer
Authors: Yildiz Tulay , Uslu-Sahan Fatma
Published: June 2024

Background

Women experiencing gynecological cancer (GCPs) and family caregivers (FCGs) use spirituality to cope with cancer. However, the dual relationship between the impact of spirituality on psychological resilience and hope among both GCPs and FCGs has not yet been explored.

Objective

To examine the interdependent relationship between spirituality, psychological resilience, and hope of women with gynecological cancer and their FCGs at the dyadic level.

Methods

In this cross-sectional study, 107 dyads were recruited from the gynecological oncology departments of 2 university hospitals in Ankara, Turkey. The GCPs and FCGs completed a Patient/Family Caregiver Information Form, Spiritual Well-being Scale, Connor-Davidson Resilience Scale, and Dispositional Hope Scale. Data were analyzed using descriptive statistics and Pearson’s correlations. This study used the Actor-Partner Interdependence Model.

Results

Spirituality of both GCPs and FCGs had a significant positive effect on their psychological resilience (B= 0.918,P< .001;B= 0.435,P< .001, respectively) and hope (B= 0.350,P< .001;B= 0.246,P< .001, respectively). However, the spirituality of GCPs and FCGs did not have a partner effect on psychological resilience (B= −0.150,P< .052;B= −0.150,P= .052, respectively) and hope (B= −0.012,P= .810;B= 0.073,P= .157, respectively).

Conclusions

Spirituality of GCPs and their FCGs positively affected their psychological resilience and hope, but the effect on each other was limited.

Implications for Practice

Health professionals, especially nurses, should focus on tailoring spiritual care interventions to the unique needs of each individual within the GCP and FCG dyads. Personalized approaches that recognize and address the specific spiritual concerns of patients and caregivers may be more effective in promoting psychological resilience and hope.
The Forensic Perspective of Infectious Endocarditis
Authors: Krywanczyk Alison , Gilson Thomas
Published: June 2024

Increasing rates of infectious endocarditis (IE) are well-described in the United States and worldwide, yet forensic literature regarding IE is sparse. Autopsy databases may help identify subsets of patients at increased risk of mortality. We reviewed all deaths due to IE in our office between 2010 and 2022 (with full autopsy performed) and found 29. The average age was 44 years. Manners of death included natural (69%), accident (28%), and homicide (3%). For all accidental deaths, acute intoxication was included in either part I or II. The aortic valve was most affected (62%), followed by tricuspid (28%) and mitral (24%). Seventy-six percent of affected valves were native, and 24% were prosthetic. Common risk factors included intravenous drug use (48%) and chronic ethanolism (21%). No sustained increase in deaths due to IE was identified. These data show marked differences from clinical literature, including a lower average age and higher incidence of substance use disorders, and it is unlikely selection bias is the sole reason. There was inconsistency in death certification, most notably by not including pertinent IE risk factors. Improving consistency and quality of IE death certification will aid in detecting regional trends and assist multi-institutional collaboration efforts.
Perforation of the Heart During Elective Removal of an Inferior Vena Cava Filter
Authors: Desai Sapna P. , Yu Christine Z. , Evangelista Frank , Gill James R.
Published: June 2024

A common treatment for venous thromboembolic disease in patients with contraindications to anticoagulation includes placement of an inferior vena cava (IVC) filter. Temporary filters are available to avoid the risk of long-term permanent placement. A woman in her 60s with a history of uterine serous carcinoma presented to the emergency department with cardiac arrest following elective attempted IVC filter removal. Three months prior, a temporary filter was placed because anticoagulation medication was stopped in preparation for a hysterectomy. During the IVC retrieval procedure, which was performed using an intravascular approach from the right jugular vein, the filter was tilted, requiring the use of a different retrieval sheath. During catheter reentry, the patient complained of discomfort in the chest and neck, after which she became hypotensive, lost consciousness, and died. Autopsy revealed 2 cardiac perforations, one in each ventricle. Approximately 600 mL of liquid and clotted blood was within the tense pericardial sac. An IVC filter was found in place, with no adjacent hemorrhage.

To our knowledge, this is the first reported fatality due to cardiac perforation by an access sheath during intravascular removal of an IVC filter. This instance also documents the time course of the cardiac perforations to the resultant loss of consciousness.
Change in Nutrition and Physical Activity Practices in Early Childcare and Education Settings in Illinois During the COVID-19 Pandemic
Authors: Schermbeck Rebecca M. , Lin Yu Chen , Leider Julien , Simon Janna , Chriqui Jamie
Published: June 2024

Context:

For many young children, early childcare and education (ECE) programs are the only source of nutritious meals and physical activity (PA); however, the COVID-19 pandemic led to program closures, restrictions, and changed practices.

Objective:

To examine changes in nutrition and PA-related best practices in ECE settings in Illinois from 2019, just prior to the pandemic, as compared to 2022. We also examined how changes over time varied by program type (ie, centers vs homes), Child and Adult Care Food Program (CACFP) status, and/or Head Start/Early Head Start status.

Design:

The study design is a repeated cross-sectional survey administered in December 2019 and October 2022.

Setting:

State of Illinois.

Participants:

A total of 888 and 1162 ECE providers completed initial and follow-up surveys, respectively.

Intervention:

NA

Main Outcome Measure:

Provider report of meeting 14 nutrition and 9 PA-related best practices.

Results:

Overall, 9 nutrition-related best practices were maintained and 5 declined over time. Centers, CACFP, and Head Start providers reported significant declines in meeting nutrition-related practices over time. A total of 8 PA-related best practices were maintained and 1 declined over time. Centers reported a significant decline in 5 of the PA-related best practices over time, and these declines were significantly different than in homes over time. Similarly, Head Start programs reported a decline in 4 PA-related best practices over time, and the change was significantly different from non-Head Start programs in 3 of the 4 practices.

Conclusion:

The findings of this study should be considered a new baseline for ECE nutrition and PA-related best practices in Illinois and should serve as a wake-up call for advocates nationwide with regard to the provision of nutrition and PA-related best practices in centers and by CACFP and Head Start providers postpandemic.
Choice of antiretroviral therapy has low impact on weight gain
Authors: Drechsler Henning , Ayers Colby , Oboho Ikwo , Enwerem Ngozi , Hanna John , Clark Christopher , Kitchell Ellen , Jain Mamta , Luque Amneris , Bedimo Roger
Published: June 2024

Objective:

Antiretroviral therapy (ART) containing integrase inhibitors (INSTIs) and/or tenofovir alafenamide (TAF) has been associated with greater weight gain. Yet few studies have delineated between exposure to ‘anchor’ drugs [protease inhibitors (PI), nonnucleoside reverse transcriptase inhibitors (NNRTI) or INSTIs] and exposure to nucleoside reverse transcriptase inhibitors (NRTIs).

Design:

In this cohort of antiretroviral drug-naive patients who initiated ART from 2008–2022, we analyzed BMI gain for eight contemporary ‘anchor’ drugs and three contemporary NRTIs during the first 3 years of ART. We censored patients if they stopped, switched, or added another antiretroviral drug to their regimen.

Methods:

We used generalized estimating equations (GEE) to assess the association between BMI gain and choice of ART and a nonlinear mixed model for the marginal coefficients of determination. We adjusted for time, baseline demographic and HIV-characteristics, and time-updated HIV and substance use-related variables.

Results:

The median BMI gain in 4 194 patients over 3 years was + 1.9 kg/m2 [interquartile range (IQR) 0.1–4.1]. Most patients were black (55%) and men (77%). Multivariable modeling from 20 528 BMI measurements revealed that the type of ART accounted for just 9% of the predicted BMI change. Only efavirenz (EFV) and tenofovir disoproxil fumarate (TDF) were independently associated with (lower) weight gain but no differences were observed between INSTIs, PIs, and rilpivirine, or between TAF and abacavir.

Conclusion:

The choice of initial ART had little impact on weight gain. INSTIs or TAF were not independently associated with weight change after ART initiation, but EFV and TDF were.
Public-private mix in health systems and repercussions for health inequalities in Latin American countries: a scoping review protocol
Authors: dos Anjos Eduarda Ferreira , de Oliveira Suelen Carlos , Mendoza-Ruiz Adriana , del Pilar Flores-Quispe Maria , Mendes Pereira Adelyne Maria , Kendall Carl , Sansigolo Kerr Ligia Regina Franco , Ortelan Naiá , Pinto Junior Elzo Pereira , Romero Natalia , Leyland Alastair , Barreto Mauricio Lima , Machado Cristiani Vieira
Published: June 2024

Introduction

Health system models in Latin American countries express differences in the state’s role in regulating, financing and providing health services, as well as in the coexistence of different care arrangements involving public and private entities. This scoping review will seek to identify evidence on how the different public-private configurations of health systems influence health inequalities in Latin America.

Methods and Analysis

This protocol will be guided by the scoping review methodology developed by the Joanna Briggs Institute. The results will be presented according to the PRISMA-ScR protocol. Searches will be carried out on the Scielo, Lilacs, Embase, Pubmed, Web of Science and Scopus databases. The inclusion criteria will be publications whose central theme is the public-private mix of health systems in Latin America between January 2000 and March 2024. Exclusion criteria will be clinical trials, incomplete studies or in the design phase, duplicate publications, pre-print studies and gray literature (interim reports, unpublished texts, dissertations, and theses. The steps for carrying out the scope review will: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarizing, and reporting the results. Two independent reviewers will select the articles. The results will be described, analyzed, and categorized through narrative synthesis, correlating with the research objectives and questions.

Expected results

It is hoped that this scoping protocol will provide a comprehensive framework for investigating the gaps in the current literature on the public-private mix in Latin America and the effects on health inequalities.

Link to the protocol record in the Open Science Framework (OSF)

https://osf.io/rkzx3/?view_only=4594a2c52f2d47128d805fdd9dd1359b.