bluuebunny/crossref_metadata_2025 huggingface dataset:
Journeys towards accessing an autism diagnosis and associated support: A survey of families of autistic children in Ecuador
Authors: Buffle Paulina , Cavadini Thalia , Ortega María de Lourdes , Armijos Cristina , Soto Patricia , Gentaz Edouard , Crane Laura
Published: September 2024

There has been limited research on families of autistic children in Ecuador, especially in relation to their experiences of accessing a diagnosis and associated support. In this study, we surveyed 767 families about their diagnostic and post-diagnostic journeys. Of these, 651 families had children who had received a formal autism diagnosis. In this group, we found that families usually suspected that their children may be developing atypically when they were between 6 and 48 months of age; families typically consulted a professional shortly after noticing signs of atypical development (e.g. within 6 months); most children received a diagnosis before the age of 48 months; and families typically reported consulting four or more different professionals to attain a diagnosis for their children. Families’ feelings and thoughts related to the diagnostic and post-diagnostic journey were often negative and were underpinned by concerns around a lack of information and services. We conclude with recommendations for optimal diagnostic and post-diagnostic support for autistic children and their families in Ecuador.

Lay abstract

There has been much research about the experiences of families of autistic children as they navigate the process of accessing a diagnosis and associated support. However, most of this work has been conducted in Europe, the United States, and Australia. In this study, we examined the experiences of 767 families in Ecuador via an in-depth survey. Of the families we surveyed, 651 had children whose journeys resulted in them receiving a formal autism diagnosis. Most families realized that their children might have developmental differences when they were between the ages of 6 and 48 months, after which they tended to seek support from a professional fairly quickly (i.e. within 6 months). Most families consulted with several different professionals before they accessed a diagnosis for their children, with children tending to receive a diagnosis before the age of 48 months. Families often reported negative emotions around their children’s diagnostic and post-diagnostic journeys, which were commonly related to the lack of information and services available to them. We hope that through gaining a greater understanding of the experiences of families of autistic children in Ecuador, these findings can be used to inform public policies that lead to the development of supports and services that better meet the needs of autistic people and their families in this context.
Practices for promoting a child’s best interests in paediatric rehabilitation – Perspectives of professionals and parents
Authors: Vänskä Nea , Sipari Salla , Haataja Leena
Published: September 2024

Practices for promoting a child’s best interests in rehabilitation are not sufficiently understood. This study describes the practices from the perspectives of professionals and parents of children with disabilities. We conducted 11 interviews: 5 in focus groups with professionals ( n = 27 [69%]), 3 with parents ( n = 9 [23%]), and 3 individual interviews of paediatric neurologists ( n = 3 [8%]). We used a qualitative approach, which included inductive content analysis, to examine the transcribed interview data. The practices for promoting a child’s best interests consisted of collective framing of child-specific rehabilitation, fostering a fulfilling daily life for the child, and ensuring appropriate rehabilitation. This was enhanced by using child-specific practices and comprehensively understanding the child’s rehabilitation in everyday life but was hindered by the absence of an established process and guidelines. The results highlighted substantial challenges in collaboration aligned with the child’s best interests, enabling the child’s active participation, and addressing the individual needs of the child and family. Promoting best interests through family–professional partnerships by using a systemic and ecological approach could guide the rehabilitation process and ensure the child’s right to participate.
Spine injuries among severely injured trauma patients: A retrospective single-center cohort study
Authors: Lassila Henri , Heinänen Mikko , Serlo Joni , Brinck Tuomas
Published: September 2024

Backgrounds and aims:

We aimed to determine the incidence and severity of spine injuries among severely injured trauma patients (Injury Severity Score (ISS)/New Injury Severity Score (NISS) > 15) treated in a single tertiary trauma center over 15 years. We also wanted to compare the demographics between patients with and without spine injuries and to determine the mortality of spine-injury patients.

Methods:

Data from the years 2006–2020 from the Helsinki Trauma Registry (HTR), a local trauma registry of the trauma unit of the Helsinki University Hospital (HUH), were reviewed. We divided patients into two groups, namely those with traumatic spine injury (TSI) and those without traumatic spine injury (N-TSI). TSI patients were further subdivided into groups according to the level of injury (cervical, thoracolumbar, or multilevel) and the presence of neurological symptoms.

Results:

We included 2529 patients: 1336 (53%) had a TSI and 1193 (47%) had N-TSI. TSI patients were injured more frequently by a high-fall mechanism (37% vs 21%, p < 0.001). Among TSI patients, 38% of high-fall injuries were self-inflicted. High falls, young age, and female gender were overrepresented in spine-injury patients with a self-inflicted injury mechanism. Cervical spine-injury patients were mostly elderly persons injured by a low-energy mechanism.

Conclusions:

Unlike other severely injured trauma patients, severely injured trauma patients with spine injuries are more frequently injured by a high-fall mechanism and self-injury.
Integral transformation for nonlinear oscillators
Authors: Dong Xue-Chen , Ou Qiu-Yu , Wu Yi-Han , Yu Jiahui
Published: September 2024

This paper introduces a generalized integral transform that encompasses the Laplace, Fourier, and numerous contemporary integral transforms as particular instances, while preserving their defining characteristics. Secondly, we propose the application of the generalized integral transform in the variational iteration method for the straightforward identification of the Lagrange multiplier, thus enabling the resolution of nonlinear oscillator problems. Finally, we present a series of illustrative examples to demonstrate the efficacy of this approach.
Tracing structural racism in Swedish policing: Laws, practices, and technologies of criminalized difference
Authors: Nafstad Ida , Parsa Amin
Published: September 2024

In 2008, the Swedish legislature removed any references to race and racial difference, formalizing a post-racial discourse. This has resulted in both the near impossibility of proving discrimination based on racialized difference, and a formal denial of racial discrimination as a social and structural problem. This article attempts to circumscribe these difficulties by suggesting an approach for tracing structural racism in Swedish policing. We argue that a claim of structural racism in policing cannot be studied by counting self-proclaimed racist officers or through individual experiences, for race is a structure in and of itself. Instead, we claim that structural racism can methodologically be studied through a combined reading of relevant (a) laws, (b) practices, and (c) technologies of policing, since these habitually produce racialized outcomes even in the absence of direct references to race or ethnicity. Reflecting this tripartite approach to the study of structural racism, we analyze data gathered from these three specific sites. We argue that developments in criminal policies and policing practices reproduce and reinforce structural racism as part of the wider penal structure, leading to a reproduction of the targets of punitive policies and police control in the intersection of class, place, race, and ethnicity.
Writing experiences in early childhood classrooms where children made higher language gains
Authors: Gabas Clariebelle , Schachter Rachel E , Bosire Jamlick PO
Published: September 2024

Although early writing is considered an essential pathway to language and literacy development for preschool-age children (i.e., 3- to 5-years-old), it tends to receive less priority when compared to reading in early childhood (EC) education. To bolster teachers’ early writing practices, researchers have closely examined the nature of the writing instruction and experiences that occur in EC classrooms. In this multiple methods study, we capitalized on a purposeful sample of 30 classrooms where children demonstrated higher language gains to examine and describe how early writing experiences were implemented in these contexts. Using deductive and inductive approaches, we explored various characteristics of writing events that occurred, including the grouping format, activity setting, instructional foci, and teachers’ supportive strategies to understand how these characteristics worked together to shape teacher-child writing interactions. We found that the written product and instructional foci were linked to teachers’ use of specific strategies, which ultimately shaped children’s participation in writing, particularly children’s engagement with different components of writing (i.e., handwriting, spelling, and composing). Findings of this study provide important insight into the dynamic interplay of environmental, instructional, and interactional factors that shape writing instruction and experiences in EC classrooms.
Geo-mapping atmospheric corrosion in Mauritius
Authors: Seechurn Yashwantraj , Wharton Julian A , Surnam Baboo Yashwansingh R
Published: September 2024

The complexity of atmospheric corrosion prediction in Mauritius, due to the influence of trade winds and mountainous landscapes, presents a hurdle in building a more resilient infrastructural system. In the absence of a corrosion map, the corrosion rate at a specific location is difficult to estimate. To achieve the UN Sustainable Development Goal 9 (Industry, Innovation and Infrastructure), an attempt is made to map the corrosivity of the whole country through regression modelling techniques and consideration of the factors affecting corrosion behaviour in the region. Previous field tests have recently been complemented with additional outdoor exposures to give a whole picture of the corrosivity of the Mauritian atmosphere. In this study, the relevant environmental data and known corrosion rates of carbon steel in specific locations are used to develop a corrosion map of the island as a vector data model depicting zones of specific ISO 9223 corrosivity categories.
Physician-Modified and In Situ Fenestrated Stent Grafts in Zone 0 for Aortic Arch Pathology After Ascending Aortic Replacement
Authors: Xie Yi , Yang Peng , Lu Chen , Liu Yu , Wang Haiyue , Zhang Yu , Hu Jia
Published: September 2024

Background:

We sought to describe our experience and outcomes of a zone 0 landing physician-modified aortic stent for the treatment of aortic arch pathologies late after open ascending aortic replacement.

Methods:

This study included consecutive patients with aortic arch diseases treated with total endovascular repair using different techniques. The indication for endovascular repair was agreed on in a multidisciplinary discussion. Study end points were technical success, early and late outcomes.

Results:

From November 2018 to May 2022, 16 consecutive patients underwent total endovascular repair of aortic arch pathologies. Median time for surgery was 4.8 hours (range, 2.6–6.6 hours). All the new-onset aortic arch pathologies were successfully treated. The 30-day mortality rate was 0%. Two patients had endoleak. The median length of postoperative stay was 4 days (range, 3–6 days). During follow-up, 1 patient underwent reintervention for type II endoleak. There were no conversions to retrograde dissection, aortic rupture and stroke.

Conclusions:

Our experience of using different total endovascular techniques for selective patients with arch pathologies who may be unfit or too risky for reopen surgery revealed favorable initial results. In addition, these techniques are promising options for urgent arch pathologies without availability of custom-manufactured devices. Durability concerns will need to be assessed in additional studies with long-term follow-up.

Clinical Impact

The use of physician-modified and in situ fenestrated stent grafts in zone 0 landing for aortic arch pathologies in patients with prior open ascending aortic replacement is effective in endovascular therapy. This innovation enables clinicians to offer an alternative option to high-risk patients, potentially reducing morbidity and mortality. It underscores the feasibility of tailored endovascular therapy in complex aortic diseases, where customized devices may not be available.
Teratogenicity Rates in Nearly 10 000 Offsprings of Antiseizure Medication-Exposed Pregnancies
Authors: Kobayashi Eliane
Published: September 2024

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When Non-Promising Findings Also Go From Aquarium to Bedside: The Importance of Rigorous Preclinical Analyses of ASM Candidates
Authors: Eyal Sara
Published: September 2024

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Epilepsy After Traumatic Brain Injury: A Triple Threat to the Brain—Carpe Diem or Carpe Dementia?
Authors: Zawar Ifrah
Published: September 2024

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Frontal Lobe Epilepsy: Bermuda's Triangle
Authors: Alonso Vanegas Mario Arturo , Arrotta Kayela , Davis Kathryn , Jobst Barbara C. , Kotagal Prakash , Poduri Annapurna , Valencia Ignacio
Published: September 2024

Despite great progress in imaging, genetics, surgery, and therapeutics, frontal lobe epilepsy (FLE) continues to be a challenge for neurologists and epileptologists. This manuscript summarizes the latest advancements in FLE discussed at the 2023 Epilepsy Specialist Symposium during the American Epilepsy Society Annual meeting. Correlation between stereoelectroencephalography and clinical symptoms has reinvigorated symptomatology literature in FLE, allowing for more precise aura anatomical localization. Neuropsychological assessments permit the identification of different FLE cognitive phenotypes, with language being the most prominent domain-specific impairment. These tests can help develop psychotherapeutic and cognitive support systems for these patients. Genetic and molecular studies have uncovered specific genes associated with FLE susceptibility, offering prospects for targeted therapies. Advanced neuroimaging techniques such as high field magnetic resonance imaging (MRI), functional MRI (fMRI), magnetoencephalography and colocalization of multiple imaging techniques have led to more precise localization of the epileptogenic zone providing insights into the dynamic neural networks underlying frontal lobe seizures. This has facilitated guided therapeutic surgical interventions that can be employed around the world, expanding access of these technologies to multiple populations. Despite many advances, prognosis of FLE remains poor for some patients. The biggest determinant for poor prognosis continues to be nonlesional FLE. Newer technological advancements aim to pass these barriers and offer FLE patients a better quality of life with lower seizure burden and higher cognitive outcomes.
Adapt or Die: Seizures Weaken Chemosensory Responses of Retrotrapezoid Nucleus Neurons to Hypercapnia
Authors: Glasscock Edward
Published: September 2024

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Pubic Hair Removal Practices and Motivations Among a Nationally Representative Sample of U.S. Men
Authors: Walsh-Buhi Eric R. , Javidi Hannah , Walsh-Buhi Margaret L. , Herbenick Debby , Houghton Rebecca F.
Published: September 2024

Understanding current pubic hair removal (PHR) practices is vital for public health, given the prevalence among U.S. adults. This study updates the understanding of PHR practices, motivations, and correlates in a nationally representative sample of adult men. In April 2023, through a probability-based internet panel survey (Ipsos KnowledgePanel®), we found that nearly half (46.7%) of respondents reported lifetime PHR, with 29.2% reporting PHR in the past 30 days. Statistically significant differences were observed in sexual orientation, age, socioeconomic status, sexual activity, and social media use. A higher proportion of Gay and Bisexual men (GBM) reported lifetime PHR (76.5%) compared with heterosexual men (44.6%), with GBM having nearly 3 times greater odds of reporting lifetime PHR (OR = 2.891, 95%CI [1.2, 6.7]). Being sexually active in the past month statistically significantly predicted both lifetime PHR (OR = 1.884, 95%CI [1.2, 2.9]) and past 30-day PHR (OR = 2.849, 95%CI [1.8, 4.6]). Age also emerged as a significant predictor, as men aged 25 to 34 years (OR = 2.275, 95%CI [1.0, 5.0]) and 45 to 54 years (OR = 2.493, 95%CI [1.1, 5.6]) had higher odds of reporting lifetime PHR compared with those aged 18 to 24 years. This study provides valuable insights and updated national data on the prevalence, methods, and frequency of PHR among men in the United States. Given the correlations between PHR practices and factors such as sexual orientation, sexual activity, and age, these findings can equip educators and health care providers with data to foster better health outcomes through acknowledging and addressing the interplay between individual choices and broader social and cultural factors.
Incidental Triangular Fibrocartilage Complex Changes on Wrist MRI
Authors: Fones Lilah , Kasper Alexis , Milano Molly , Ilyas Asif M.
Published: September 2024

Background:

Triangular fibrocartilage complex (TFCC) changes on wrist magnetic resonance imaging (MRI) may occur in patients without corresponding symptoms and examination consistent with TFCC pathology. This study aims to define the rate of asymptomatic TFCC changes in patients undergoing wrist MRI for indications other than ulnar-sided wrist pain and to compare this with the rate in ulnar-sided wrist pain patients.

Methods:

Patients who underwent wrist MRI at a single large orthopedic practice over a 2-year period were identified by Current Procedural Terminology (CPT) code 73221. Patients with an associated diagnosis, including “hand,” “wrist,” “radius,” “radial,” “scaphoid,” “navicular,” or “De Quervain,” were retrospectively reviewed for demographics, symptoms, examination, trauma, and MRI findings. Patients with ulnar-sided wrist pain were used as the comparison group.

Results:

Wrist MRIs were available for 132 patients, with 92 in the primary cohort and 40 forming the comparison group. The MRI indications included wrist pain (other than ulnar-sided; 64%), hand/thumb pain (21%), mass (12%), and numbness/tingling (2%). The TFCC MRI changes were seen in 44% of the patients and abnormal TFCC was positively associated with age. In contrast, 80% of the 40 patients with ulnar-sided wrist pain had abnormal TFCC on MRI.

Conclusions:

There is a high rate of abnormal TFCC identified on MRI in patients without corresponding ulnar-sided wrist symptoms. This highlights the importance of not treating MRI imaging in isolation without correlating with the patient’s symptoms while also preparing patients for a high likelihood of asymptomatic TFCC changes on routine wrist MRI.

Level of Evidence:

Retrospective case series; Level IV
Assessing the Impact of Nicotine Dependence on 90-Day Major Complications and 2-Year Hardware Outcomes in Open Reduction and Internal Fixation of the Distal Radius Fracture
Authors: Lawand Jad J. , Obias Isabel B. , Tansey Patrick J. , Faillace John J.
Published: September 2024

Background:

This study aims to assess the impact of nicotine dependence on both 90-day major postoperative outcomes and 2-year implant-related outcomes in patients undergoing open reduction internal fixation (ORIF) for distal radius fractures.

Methods:

We queried TriNetX, a national research database that provides real-time access to deidentified medical records, for patients of all ages who underwent an ORIF of the distal radius (Current Procedural Technology codes 25607, 25608, 25609) between 2001 and 2021. Patients were categorized by nicotine dependence history (International Classification of Diseases, Tenth Revision code: F17), with groups 1:1 propensity matched for age, sex, race, ethnicity, body mass index, type 2 diabetes, hypertension, cerebrovascular disease, and chronic obstructive pulmonary disease. The primary analysis examined major postoperative complications within 90 days, while the secondary analysis assessed hardware-related issues within 2 years. Risk ratios and 95% confidence intervals were generated for each outcome.

Results:

Of 62 137 patients treated with distal radius ORIF, 7764 had nicotine dependence, and 54 373 did not. Each group comprised 7591 patients after 1:1 matching. Nicotine dependence was associated with increased risk of skin infections, sepsis, and wound disruption in the 90-day postoperative period ( P < .001). Within the 2-year postoperative period, nicotine dependence was associated with increased risk of mechanical complication of internal fixation device ( P < .001), nonunion ( P < .01), and surgical intervention for nonunion ( P = .009).

Conclusions:

Nicotine dependence is associated with increased risk of infection, sepsis, wound disruption within 90 days, and hardware complication, nonunion, and nonunion repair at 2 years. These data emphasize the importance of nicotine counseling by treating surgeons.
Rupture of the Fibro-Osseous Septum of the Second Extensor Compartment as the Cause of True Dorsal Trigger Wrist: Case Report
Authors: Holc Fernando , Bronenberg Victorica Pedro , O. Abrego Mariano , Azulay Guillermo , L. Gallucci Gerardo , Boretto Jorge G.
Published: September 2024

This article presents a case of a dorsal trigger wrist, which was brought on by a rupture of the fibro-osseous septum of the second extensor compartment. This situation is highly uncommon and has not been previously documented. The septum, which divides the extensor carpi radialis brevis and the extensor carpi radialis longus on the second extensor compartment, is present in almost 45% of the population. The patient underwent surgical reconstruction of the septum, and a complete resolution of symptoms was achieved.
Ferroptosis-Associated Extracellular Matrix Remodeling in Radiation-Induced Lung Fibrosis Progression
Authors: Yan Xinyu , Yang Peixuan , Yang Chen , Wang Yinghui , Feng Zhijun , Liu Ting , Li Yani , Zhou Cheng , Li Minying
Published: September 2024

Background: Radiation-induced lung fibrosis (RILF) is a life-threatening complication of thoracic radiotherapy. Ferroptosis, a recently discovered type of cell death, is believed to contribute to RILF, though the associated mechanisms are unknown. This study aimed to investigate the potential mechanism of ferroptosis in RILF and examine the contribution of different cell types to ferroptosis during RILF progression. Methods: Histopathological changes in RILF lung tissue were assessed through H&E and Masson staining. IHC staining investigated ferroptosis markers (GPX4, ACSL4, NCOA4). Ferroptosis-related genes (FRG) and pathway scores were derived from RILF transcriptome microarray data. The sc-RNAseq analysis detected FRG score dynamics across cell types, validated by IF staining for PDGFR-α and ACSL4. Results: ACSL4 and NCOA4 protein levels were significantly higher and GPX4 lower in IR than control. FRG scores were positively correlated with fibrosis-related pathway scores in the RILF transcriptome data. FRG and ECM scores were concurrently upregulated in myofibroblasts. Enhanced co-staining of PDGFR-α and ACSL4 were observed in the fibrotic areas of RILF lungs. Conclusions: Our research indicated that in RILF, fibroblasts undergoing ferroptosis may release increased levels of ECM, potentially accelerating the progression of lung fibrosis. This finding presents ferroptosis as a potential therapeutic target in RILF.
Advancing readiness for change in substance use for people with substance use disorders using the Kawa model based intervention program: A quasi-experimental study
Authors: Hsiao Han-Yi , Wang Tsui-Ying , Lee Chun-Hung , Lu Young-Chin , Huang Yu-Chen , Chien Ying-Chun , Potenza Marc N. , Lin Chung-Ying
Published: September 2024

Background

Substance use disorders (SUDs) may cause severe social and health problems. Therefore, providing adequate treatments for people with SUDs to change their drug use behaviors is important. This study examined the effectiveness of Kawa Model based therapy among people with SUDs in Taiwan.

Methods

Participants were recruited from people with SUDs who violated the Controlled Drugs Act in Taiwan were mandated to abstinence services by law from January 2016 through October 2021 in Southern Taiwan. Each participant selected a 2-hour for 4 times or 8-hour for one day compulsory treatments and received either the Kawa model based treatment ( n = 55; 9 women; mean ± SD age = 36.73 ± 10.42 years) or psychoeducation courses ( n = 42; 8 women; mean ± SD age = 27.57 ± 5.78 years), respectively. Stages of change was assessed using the University of Rhode Island Change Assessment before and after treatments.

Results

There were no significant differences in the stages of change scores at baselines between the 2 groups ( p = .06–0.20). After treatments, participants who received the Kawa Model based treatment had higher scores in specific stages of change than did those who received the psychoeducation course in the domains of ‘contemplation’ ( p = .001), ‘action’ ( p = .001), and ‘readiness’ ( p = .002).

Conclusion

The present study demonstrated initial and preliminary findings that the Kawa Model based therapy may improve readiness for changing drug use behaviors in people with SUDs.
Characteristics of middle cerebral artery aneurysms treated endovascularly in a clip-favored institution
Authors: Kiyofuji Satoshi , Koizumi Satoshi , Kin Taichi , Miyawaki Satoru , Hongo Hiroki , Umekawa Motoyuki , Saito Nobuhito
Published: September 2024

Background

The emergence of flow disruptors has brought a dynamic transition in the selection of treatment for middle cerebral artery (MCA) aneurysms, and the number of MCA aneurysms clipped is acceleratingly decreasing. Still, retreatment after endovascular treatment is still a dilemma, which may necessitate surgical clipping. It is all the more important to elucidate characteristics of MCA aneurysms that make clipping unfavorable. Thus, the practical characteristics of MCA aneurysms treated endovascularly in a clip-favored institution before the usage of flow disruption devices were investigated.

Methods

This is a retrospective, single-center observational study. The clinical and imaging characteristics of treated MCA aneurysms from January 2012 to May 2022 were analyzed.

Results

A total of 83 aneurysms were included; 70 aneurysms (84%) were clipped, and 13 (16%) were treated endovascularly. Eighteen aneurysms (22%) were ruptured (clipping, 12; endovascular, 6). The reasons for an endovascular treatment were as follows: distal (3); subacutely ruptured with burdens of spasm (2); multiple aneurysms (6: another clipped in 3, coiled in 1, and conservatively managed in 2); no access to the operating room due to COVID-19 (1); and retreatment after coiling (1). Endovascular group aneurysms were smaller (maximum diameter 5.2 vs 7.3 mm, p < 0.01, as well as dome, neck, and height) without differences in the dome/neck and aspect (height/neck) ratios. In a subgroup analysis of 78 MCA bifurcation aneurysms, the endovascular group was still smaller (dome 4.4 vs 5.8 mm, p = 0.025; neck 2.8 vs 3.9, p = 0.03).

Conclusion

In a limited series from a clip-favored institution before the flow disruption era, factors guided to endovascular treatments on MCA aneurysms were rather anatomical and clinical factors such as distal location, subacutely ruptured, multiple, or retreatment after coiling, than morphological factors such as dome/neck and aspect ratios albeit smaller size.
Utilizing a portable magnetic resonance imaging (MRI) in the setting of an acute ischemic stroke in a patient with a cardiac implantable electronic device
Authors: Patel Mayur S. , Mannix Nicholas , Carfora Arianna , Nimjee Shahid M.
Published: September 2024

Background

Cardiac implantable electronic device (CIED) generally excludes patients from undergoing fixed, high-field magnetic resonance imaging (MRI). Acute ischemic stroke patients undergo MRI as a standard part of an assessment of infarct burden. The use of a portable MRI scanner may be useful in patients who have contraindications to high-field MRI. We present the first case of a patient with a CIED who required an endovascular thrombectomy (EVT) for large vessel occlusion. She underwent a low-field MRI in the operating room with the Hyperfine portable system.

Case

The patient is an 80-year-old female status post-CIED, on Eliquis who presented with an acute ischemic stroke. Her National Institutes of Health Stroke Scale (NIHSS) of 8. Imaging demonstrated a left M2 occlusion on computed tomography angiogram (CTA) of the head and neck. No lytics were used due to concomitant gastrointestinal bleed. While, admitted, her NIHSS increased to 15. A subsequent CTA demonstrated a left internal carotid artery terminus and M1 occlusion. She underwent EVT with thrombolysis in cerebral infarction (TICI) 3 revascularization. An MRI was performed intraoperatively using a Hyperfine system, which is a low-field, portable MRI, to assess infarct volume.

Conclusion

Hyperfine Swoop brain MRI may be safe for use in patients with contraindications to high-field MRI scans. Continued technological refinement will improve the quality of diffusion-weighted imaging. Larger studies will be required to generalize Hyperfine MRI-based imaging for patients with devices that exclude them from high-field imaging.
New fault bearing system for proactive detection in induction machines based on variable projection method: A comparative study
Authors: Dore Pascal , Chakkor Saad , El Oualkadi Ahmed , Baghouri Mostafa
Published: September 2024

Nowadays, when it comes to bearing faults monitoring, several solutions and implementations are in vogue due to the interest they arouse. It can be seen both in the types of hardware solutions used and, in the signal-processing algorithms and techniques employed. However, for a fault such as the bearing fault, which accounts for 41% of all faults in these systems and is also the source of the majority of other faults, it appears that the approaches used until now are insufficient for containing this fault and the losses it generates. The aim of this work is to present a new system dedicated exclusively to bearings, while also conducting a comparative study of the various algorithms currently used for mechanical fault detection, based on the mathematical model of the stator current signal used in the MCSA method, which is very close to the induced current signal. At the end, results of all simulations demonstrated that, in addition to the ESPRIT-TLS method, which is currently the best in terms of accuracy, the Varpro method could be a promising alternative.
Research on prediction and optimization of low-frequency noise in loader cabs
Authors: Fan Qinhong , Li Haolin , Dong Hongquan
Published: September 2024

Low-frequency noise caused by structural vibration has a significant impact on the comfort of wheel loader drivers. To reduce the adverse effects of vibration noise on drivers and improve their comfort, this study proposes a low-noise structural optimization method based on an approximate model. To accurately obtain the vibration noise data of the wheel loader’s driver cab, a designed experiment was conducted to collect vibration and internal noise data under specific working conditions. The frequency response method and panel acoustic contribution analysis method were used to analyze the structural vibration characteristics and acoustic response characteristics of the driver cab, respectively. The panels that have a significant impact on the vibration noise of the driver cab were identified, and their thicknesses were defined as design variables to establish an optimization model. Meanwhile, a response surface method was used to construct an approximate model, and the NSGA-II algorithm (Non-dominated Sorting Genetic Algorithm-II) was used to solve the optimization model and obtain the optimized driver cab structure. The results show that the maximum noise peak (117 Hz) of the loader cab was successfully reduced by 2.9 dB after optimization. This result demonstrates the effectiveness and feasibility of the proposed method.
Lightweight intelligent fault diagnosis method based on a multi-stage pruning distillation interleaving network
Authors: Ren Linlin , Li Xiaoming , Ma Hongbo , Zhang Guowei , Huang Song , Chen Ke , Wang Xiaoqing , Yue Weijie
Published: September 2024

Edge computing, a key technology in the Internet of Things, can help integrate real-time fault diagnosis into industrial applications. Lightweight and compression technologies are essential for deploying high-precision deep learning methods on resource-constrained edge computing systems. However, modeling accuracy is severely compromised by existing methods. To overcome this limitation, a new multi-stage pruning and distillation architecture was proposed in this study to compress a depthwise separable convolutional network for intelligent fault diagnosis of bearings in edge computing systems. The model was implemented on an NVIDIA Jetson Nano and verified using two bearing fault datasets. The results show that the proposed method can significantly reduce the calculation and reasoning time of the model and maintain high accuracy. The proposed method exhibits remarkable effectiveness, requires minimal memory, provides fast inference speeds, and is suitable for use in edge devices with less configuration.
Mitigating HV battery malfunctions in a 48 V P0 mild hybrid system: A novel voltage control strategy
Authors: Shang Ming , Zhang Zhendong , Yin Congbo
Published: September 2024

When the HV battery of a hybrid electric vehicle encounters severe faults, the 12 V battery can easily become depleted, forcing the vehicle to shut down. To address this issue, this paper proposes a novel voltage control strategy specifically tailored for a 48 V P0 mild hybrid system in a MHEV. The strategy comprises two main components. The first component is a dual closed-loop control strategy with weak magnetic control for the MCU, ensuring a stable voltage output from the BSG in generator mode across a wide speed range. The second component is a hierarchical control-based voltage control strategy for the HCU. In this context, the HCU serves as the central controller, coordinating with the BMS, MCU, DC/DC, and ECU to harmonize the voltage control mode of the hybrid system. The effectiveness of this strategy has been confirmed through bench and vehicle tests. Test results indicate that the strategy enables the hybrid system to maintain acceptable HV bus voltage fluctuations and provides effective hardware protection under various scenarios. The strategy guarantees that the vehicle can continue operating after a severe fault in the 48 V battery, thereby enhancing the robustness of the hybrid electric vehicle system.
Time-dependent Casson fluid flow over a vertical Riga plate subjected to slip conditions and thermal radiation: Aspects of Buongiorno’s model
Authors: Mahmood Zafar , Rehman Mujeeb Ur , Rafique Khadija , Adnan  , Khan Umar , Jubair Sidra , Ismail Emad AA , Awwad Fuad A
Published: September 2024

The study focuses on a vertical Riga surface-induced mixed convective, unsteady stagnation point flow of Casson fluid. This flow exhibits nonlinearity due to thermal radiation, chemical processes, Brownian motion, thermophoresis, Maxwell slip velocity, and Smoluchowski slip temperature conditions. The study’s goal is to improve thermal efficiency. By using suitable similarity variables, the partial differential equations are transformed into ordinary differential equations. Subsequently, these equations are resolved using the bvp4c function in MATLAB. The numerical findings for concentration, shear stress, Nusselt number, Sherwood number, velocity, and temperature distribution are shown graphically. When the values of the Casson parameter increase, the velocity profile was also increased while the concentration and temperature profiles decreased. The unsteadiness parameter increase was followed by a rise in the skin friction and a decrease in the profiles of Nusselt number and Sherwood number. Profiles of skin friction, Nusselt number, and Sherwood number were raised with the increased values of the modified Hartmann number. Increasing parameter values of Brownian motion result in a decrease of the Nusselt number profile, while the Sherwood number profile increases. On the other hand, as the thermophoresis parameter increase, the profiles of the Nusselt number and Sherwood number decrease. This study will aid in the improvement of the understanding of fluid dynamics and nanotechnology and, eventually, the creation of more effective and sustainable engineering-based solutions. When we compared our results to those of other studies in the literature, we discovered that they were quite consistent.
A comparative analysis of Newtonian heating and convective conditions for double stratified magnetized second grade nanofluid
Authors: Anwar Muhammad Imran , Shehzad Sabir Ali , Ali Mohsin , Fatima Hafiza Noor
Published: September 2024

A detailed examination of the effects of double stratification on the magnetized second grade nanofluid created by a stretching sheet within the porous medium has been carried out in this study. The CBC (convective boundary conditions) and NH (Newtonian heating) conditions are utilized for the analysis. The relevant similarity transformations are defined in order to transform the governing nonlinear PDEs into dimensionless ODEs. The transformed equations are numerically treated with bvp4c in Matlab software package. The computations are expressed in tabular and graphical forms. The flow parameters involved in the modeling are demonstrated on temperature, velocity, and concentration of nanofluid. The calculations of Nusselt number [Formula: see text], Sherwood number [Formula: see text] and skin-friction coefficient [Formula: see text] against the distinct values ofconstraints for general, CBC and NH are expressed to examine the flow situation. The numeric computations are matched with the literature published earlier for particular cases which shows the validity of current computations. It is noted that the skin friction is decreasing with an increment in second grade parameter. Flow velocity is increased by rising the second grade parameter.
Exploring the moderating role of health-promoting behaviours and self-compassion on the relationship between clinical decision-making and nurses’ well-being
Authors: Miley Molly , Mantzios Michail , Egan Helen , Connabeer Kathrina
Published: September 2024

Background:

Clinical decision-making is an essential part of the nursing role and has implications for both patient care and nurses’ well-being.

Aim:

This study aimed to explore the relationship between nurses’ perceptions of clinical decision-making ability and moral distress across a nursing population, and the potential link to self-compassion and health-promoting behaviours.

Methods:

A self-report questionnaire was distributed to a sample of nurses ( N = 152) from April to September 2022. The survey explored nurses’ perceptions of clinical decision-making ability, moral distress, physical activity, grazing, stress-eating, burnout and self-compassion.

Results:

Perceived clinical decision-making ability was associated with moral distress experience, and both self-compassion and grazing moderated this relationship, independently.

Conclusion:

Findings highlight the link between nurses’ perceptions of clinical decision-making ability and moral distress experience. Both eating behaviours and self-compassion influence the relationship between these two factors and identify potential areas that may support (and hinder) nurses’ well-being through clinical decision-making. These findings reinforce the importance of healthy eating habits and being self-compassionate to prevent moral distress arising as a result of clinical decision-making.
Lymph node ratio as an indicator of nodal status in the assessment of survival and recurrence in vulvar cancer: A cohort study
Authors: Mansouri Houyem , Zemni Ines , Sakhri Saida , Ayadi Mohamed Ali , Boujelbene Nadia , Ben Dhiab Tarek
Published: September 2024

Background:

Inguinal lymph node (LN) metastasis and particularly the number of metastatic lymph nodes (NMLN) represent a determinant prognostic factor in vulvar squamous cell carcinoma (VSCC). However, the NMLN may be related to the number of removed LNs. Therefore, the lymph node ratio (LNR) reflects not only the burden of LN involvement but also the quality and extent of lymphadenectomy.

Objectives:

To investigate the value of the LNR and the count of LN on overall survival (OS) and recurrence-free survival (RFS).

Design:

This study is a retrospective, longitudinal, institution-based study.

Methods:

This study included 192 patients treated for VSCC at the Salah Azaiez Institute between 1994 and 2022. Clinical, pathological, and evolutionary data were reported. Survival curves were generated by the Kaplan–Meier method, and predictive factors of outcome were analyzed using Cox proportional hazards models.

Results:

Surgery consisted of a radical vulvectomy, hemivulvectomy, and pelvic exenteration in, respectively, 96.4%, 2.1%, and 1.6% of cases followed by adjuvant radiotherapy in 38.5% of cases. LN dissection was bilateral in 88.5% of cases. LNR = 0, LNR = 0–0.2, and LNR ⩾0.2 were recorded in, respectively, 64.7%, 22.1%, and 13.2% of cases. With a mean follow-up time of 35 ± 42.06 months, the 5-year OS was 52.5% and the 5-year RFS was 55.8%. On multivariate analysis, the independent prognostic factors of OS were the LNR (hazard ratio (HR) = 5.702; 95% confidence interval (CI) = 2.282–14.245; p < 0.0001), Federation of Gynecology and Obstetrics (FIGO) stage (HR = 2.089; 95% CI = 1.028–4.277; p = 0.042), and free margins (HR = 2.247; 95% CI = 1.215–4.155; p = 0.01). Recurrences were recorded in 37.5% of cases. Independent prognostic factors of RFS were the LNR (HR = 2.911; 95% CI = 1.468–5.779; p = 0.002), FIGO stage (HR = 1.835; 95% CI = 1.071–3.141; p = 0.027), and free margins (HR = 2.091; 95% CI = 1.286–3.999; p = 0.003).

Conclusion:

Surgical margin, FIGO stage, and LNR represent the independent prognostic factors of survival and LNR showed superior prognostic predictive accuracy compared with the revised 2021 FIGO staging system for predicting OS and RFS in VSCC.
Media memory activism in post-conflict Bosnia-Herzegovina
Authors: Labonté Véronique
Published: September 2024

Taking Bosnia-Herzegovina as a case study, this article examines how memory activists, acting at the meso-level, use digital media to implement various counter-memory strategies in relation to the war of 1992–1995. A variety of practices at the margins of official historical discourses, which are still dominated by victimization and hatred, are examined and examples from both the literature and original empirical data are used to show how, in an extremely tense political climate, memory activists can use diverse strategies and tools to allow new representations of the past to circulate, bringing about mnemonic change. I suggest that memory activists in BiH, although operating in a public sphere governed by ethnonationalist divisions and political parallelism, use digital media as an arena, space, or repository for counter-memory narratives. Supported by thematic analysis, this interdisciplinary research paper responds to a need for contemporary empirical research on media memory activism and opens new perspectives for future interdisciplinary studies of these issues in other divided societies.
Expected outcome for reconstructive hand surgery after spinal cord injuries related to level of injury and sex
Authors: Ramström Therese , Bunketorp Käll Lina , Dunn Jennifer , Reinholdt Carina , Wangdell Johanna
Published: September 2024

This retrospective, multicentre study maps grip strength and grasp ability after tendon transfer surgery in patients with tetraplegia. Data were analysed in the whole group and in subgroups stratified into the International Classification for Surgery of the Hand in Tetraplegia (ICSHT) and sex. In total, 200 arms (143 patients) had tendon transfer surgery to restore grip and pinch function, 74% were men, 42% were ICSHT group ≤3 and 58% ICSHT were group ≥4. The one-year outcome across all participants for grip strength was 5.2 kg, pinch strength 2.1 kg and a score of 108 for the Grasp and Release test. Men had significantly higher grip and pinch strength compared to women, while there was no significant difference with respect to grasp ability. ICSHT group ≥4 had significantly higher grip strength and grasp ability compared to ICSHT group ≤3, whereas no significant difference in pinch strength between ICSHT groups was seen.

Level of evidence: III
Single versus double fascicular transfer for brachial plexus injuries: a systematic review and meta-analysis with meta-regression
Authors: Shekouhi Ramin , Ahmed Syeda Hoorulain , Mattia Alexzandra , Husseiny Yousef , Gerhold Cameron , Chim Harvey
Published: September 2024

The primary objective of this review was to assess whether double fascicular transfer has superior outcomes compared with single fascicular transfer for reanimation of elbow flexion. In total, 58 studies including 1388 patients (mean age 29 years [SD 8]) were included. Subgroup analysis comparing the severity of brachial plexus injury (C5-C6, C5-C7, C5-C8) showed no significant difference in the recovery of MRC grade 3 and 4. The aggregated mean Disabilities of Arm, Shoulder and Hand score was 38 for the single fascicular transfer group and 27 for the double fascicular transfer group. Meta-regression controlling for level of injury showed that double fascicular transfer and C5-C6 injury were significant predictors of achieving MRC grade 3, while double fascicular transfer and shorter duration of surgical delay were significant predictors of achieving MRC grade 4. When controlling for the level of injury, double fascicular transfer is associated with a greater likelihood of achieving MRC grade 3 and 4 compared to single fascicular transfer. Overall donor site morbidity was not significantly different between single fascicular transfer and double fascicular transfer.
Radiography versus computed tomography for osseous staging of Kienböck’s disease
Authors: Hesse Nina , Kalb Karl-Heinz , Stohldreier Yannick , Gildein Hannah , van Schoonhoven Jörg , Schmitt Rainer
Published: September 2024

This retrospective study compared the diagnostic accuracy of conventional radiography (CR) and computed tomography (CT) in classifying Kienböck’s disease (KD) according to Lichtman staging. Besides age, cartilage condition and vascularity, bone morphology is important in choosing the most appropriate treatment in KD. In 278 patients, two musculoskeletal radiologists performed a consensus reading of 281 lunate necroses according to the Lichtman classification, based on CR and CT. Stage IIIc was most common in CR (43%) and CT (61%), followed by stage IIIa for CR (25%) and stage IV for CT (15%). In 67%, KD was classified as the same in both modalities. The KD stage had to be upgraded in CT in 34% of cases, notably with stage IIIa progressing to IIIc in 24 out of 69 patients and stage IIIb to IIIc in 23 out of 38 cases. Overall, the Lichtman score was significantly higher on CT. The findings suggest that CT is better than CR in accurately determining the stage of KD stage, indicating a potential shift towards more surgical salvage procedures.

Level of evidence: III