bluuebunny/crossref_metadata_2025 huggingface dataset:
Psoriasis-Arthritis: Update der EULAR-Empfehlungen
Authors: Aringer Martin
Published: July 2024

Objective: New modes of action and more data on the efficacy and safety of existing drugs in psoriatic arthritis (PsA) required an update of the EULAR 2019 recommendations for the pharmacological treatment of PsA. Methods: Following EULAR standardised operating procedures, the process included a systematic literature review and a consensus meeting of 36 international experts in April 2023. Levels of evidence and grades of recommendations were determined. Results: The updated recommendations comprise 7 overarching principles and 11 recommendations, and provide a treatment strategy for pharmacological therapies. Non-steroidal anti-inflammatory drugs should be used in monotherapy only for mild PsA and in the short term; oral glucocorticoids are not recommended. In patients with peripheral arthritis, rapid initiation of conventional synthetic disease-modifying antirheumatic drugs is recommended and methotrexate preferred. If the treatment target is not achieved with this strategy, a biological disease-modifying antirheumatic drug (bDMARD) should be initiated, without preference among modes of action. Relevant skin psoriasis should orient towards bDMARDs targeting interleukin (IL)-23p40, IL-23p19, IL-17A and IL-17A/F inhibitors. In case of predominant axial or entheseal disease, an algorithm is also proposed. Use of Janus kinase inhibitors is proposed primarily after bDMARD failure, taking relevant risk factors into account, or in case bDMARDs are not an appropriate choice. Inflammatory bowel disease and uveitis, if present, should influence drug choices, with monoclonal tumour necrosis factor inhibitors proposed. Drug switches and tapering in sustained remission are also addressed. Conclusion: These updated recommendations integrate all currently available drugs in a practical and progressive approach, which will be helpful in the pharmacological management of PsA.
Psoriasis: Sind Geschlechtsunterschiede bedeutsam?
Authors: Sticherling Michael
Published: July 2024

Background: Psoriasis is a common chronic inflammatory skin disease with an exceptionally high burden for women. Objective: Sex-dependent differences in disease manifestation, severity, treatment choices, subjective disease perception, and the impact on quality of life and risk factors are described and comprehensively discussed. Methods: A literature search was conducted using MEDLINE (PubMed) and the Cochrane Library for systematic reviews to investigate the challenges in treating women with psoriasis.
Geschlechtsspezifische Unterschiede in Diagnostik und Therapie entzündlich-rheumatischer Erkrankungen
Authors: Albrecht Katinka , Strangfeld Anja
Published: July 2024

Hintergrund: Geschlechtsunterschiede in Diagnostik und Therapie verschiedenster Erkrankungen werden zunehmend erforscht mit dem Ziel, Therapiestrategien zu optimieren und den individuellen Behandlungserfolg zu verbessern. Method: ik: In dieser Arbeit wird die bestehende Literatur zu geschlechtsspezifischen Unterschieden bei entzündlich-rheumatischen Erkrankungen zusammengefasst. Ergebnisse: Viele, aber nicht alle entzündlich-rheumatischen Erkrankungen treten häufiger bei Frauen als bei Männern auf. Frauen haben oft eine längere Beschwerdedauer bis zur Diagnosestellung als Männer, was durch unterschiedliche klinische und radiologische Erscheinungsbilder verursacht sein kann. Frauen haben krankheitsübergreifend häufiger niedrigere Remissions- und Therapieansprechraten in Bezug auf die antirheumatische Medikation als Männer, auch Therapieabbrüche sind bei Frauen häufiger als bei Männern. Ob Frauen vermehrt Anti-drug-Antikörper gegen biologische Antirheumatika entwickeln, ist noch unklar. Bei Januskinaseinhibitoren gibt es bislang keine Hinweise auf ein unterschiedliches Therapieansprechen. Schlussfolgerung: Ob auch in der Rheumatologie individuelle Dosierungsschemata und geschlechtsangepasste Therapieziele nötig sind, kann aus der bisherigen Evidenz nicht abgeleitet werden.
Family History of Stroke Is Associated with Large- and Small-Vessel Etiology: A Systematic Review and Meta-Analysis
Authors: Błaż Michał , Sarzyńska-Długosz Iwona
Published: July 2024

Background: Several studies have investigated the association between family history of stroke (FHS) and stroke etiology, recurrence, or mortality; however, the results have been discrepant. We conducted a systematic review with meta-analysis to further evaluate the associations. Materials and Methods: We searched Scopus database using the term “family history” AND “stroke” up to December 2023 to identify observational studies and systematic reviews reporting both the prevalence of FHS and the rates of stroke etiology or recurrence or mortality. Case reports, series, and narrative reviews were excluded. We used odds ratio (OR) as a common measure of association and I2 to determine heterogeneity of effects across studies. Results: We have identified 22 articles (130,999 patients, 53% female), which met the prespecified inclusion criteria. After pooling the results, FHS was associated with large-vessel (OR, 1.24, 95% CI [1.07–1.44]), as well as small-vessel (OR, 1.17, 95% CI [1.05–1.31]), but not cardioembolic stroke etiology (OR, 0.74, 95% CI [0.60–0.90]). There was no relationship between FHS and stroke recurrence (OR, 1.16, 96% CI [0.84–1.61]), nor mortality (0.94, 95% CI [0.63–1.41]). Conclusions: FHS is associated with large- and small-vessel stroke etiology, but not stroke recurrence or mortality. These findings might be useful to physicians caring for stroke patients in their everyday practice.
North American Fetal Therapy Network: Maternal Outcomes in Fetal Aqueductal Stenosis
Authors: Emery Stephen P. , Lopa Samia , Peterson Erika , Miller Jena L. , Treadwell Marjorie C. , Gebb Juliana , Galan Henry , Bergh Eric P. , Criebaum Amanda , McLennan Amelia , Lillegard Joseph B. , Blumenfeld Yair J. , Turan Ozhan M. , Streitman David C.
Published: July 2024

Introduction: Fetal aqueductal stenosis (AS) affects approximately 1:1,000 pregnancies. Obstruction of cerebral spinal fluid circulation occurs at the aqueduct of Sylvius, leading to progressive hydrocephalus and macrocephaly, which often necessitates cesarean section (CS). The purpose of this study was to describe maternal outcomes associated with fetal AS. Methods: This study is conducted through the North American Fetal Therapy Network (NAFTNet). Subjects with a prenatal diagnosis of severe fetal central nervous system ventriculomegaly were recruited and followed longitudinally. Maternal events around the delivery of fetuses with AS were recorded and analyzed. Results: Thirty-seven subjects with fetal AS confirmed by neonatal neuroimaging were analyzed. The average gestational age at delivery was 36.7 weeks. Overall, 86% were delivered by CS, and 62% of these were elective. Ninety-one percent of CSs were performed through a Pfannenstiel abdominal incision. A classical uterine incision was required in 13% of cesarean deliveries. The peripartum complication rate was 27%. Conclusion: Women carrying a fetus with AS were at risk for preterm birth, cesarean delivery, a classical uterine incision, and peripartum complications. These data highlight the maternal morbidity associated with fetal AS and the potential benefit of in utero therapy not only for neonatal outcomes but also for maternal outcomes.
Predictive Value of the sFlt-1/PlGF Ratio and Interleukin-6 for the Presence of Placental Lesions in Spontaneous Preterm Labor with Intact Membranes with Delivery within 7 Days
Authors: Kacerovsky Marian , Hornychova Helena , Holeckova Magdalena , Pavlikova Ladislava , Rezabkova Chloubova Jitka , Jacobsson Bo , Musilova Ivana
Published: July 2024

Introduction: The aim of the study was to identify predictive values of the soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio and interleukin (IL)-6, assessed with a clinically available method in a large-volume biochemistry laboratory, in maternal blood, amniotic fluid, and umbilical cord blood for the presence of the placental lesions consistent with maternal vascular malperfusion (MVM) and acute histological chorioamnionitis (HCA), respectively. Methods: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays. Results: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL. Conclusion: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days.
Real world treatment of hypertension on hemodialyses-data from large Polish database
Authors: Symonides Bartosz , Zaborska-Dworak Maria , Lewandowski Jacek , Marcinkowski Wojciech , Zawierucha Jacek , Prystacki Tomasz , Malyszko Jolanta
Published: July 2024

Introduction: The prevalence of hypertension among patients with end stage kidney disease (ESKD) undergoing hemodialysis (HD) ranges from 72-88% depending on applied diagnostic criteria and chosen method of blood pressure measurement. Despite the guidelines recommending the widespread use of renin angiotensin system blockers (RASB) in patients with kidney disease, their utilization in patients on HD may be suboptimal, especially in patients with preserved diuresis. This hesitance often steams from concern is often due to fear of a decrease in eGFR and a subsequent decrease in diuresis.

The aim of this study was to compare clinical characteristics, blood pressure, safety, and hemodialysis adequacy indices in hypertensive HD patients on multiple antihypertensive drug regimens, including diuretic treated with RASB (RASB group) or without RASB (no-RASB) with preserved residual diuresis.
We sought to examine the real life use of RASB in hemodialysis patients in relation to their clinical characteristics, blood pressure, safety, and hemodialysis adequacy.

Methods: From a database of 5879 patients receiving hemodialysis (mean age 65.2±14.2 yrs., 60% of males) of the largest provider of HD in the country, we selected the subgroup treated with at least three antihypertensive medications including diuretics. We compared patients treated with RASB to counterparts without RASB (no-RASB).

Results: RASB group has similar age and gender proportions as well as BMI and bioimpedance,compared to counterparts. However, dry body mass was significantly lower in the RASB group (78.1±18.3 kg vs. 80.0±18.2 kg, p<0.017). Prevalence of diabetes mellitus was similar in both groups, but RASB-treated patients have cardiovascular diseases more frequently (70.1% vs. 60.8%; p<0.001). Systolic blood pressure and the number of antihypertensive drugs used were significantly higher in RASB patients than in counterparts (146±16 mmHg vs. 144±15 mmHg; p<0.001 and 4.1±0.9 vs. 3.5±0.5; p<0001 respectively). RASB-treated patients have significantly longer dialysis vintage (52.7±44.4 months vs. 40.2±40.9 months; p<0.001) and dialysis time (722±87.1 min./week vs. 713±93.4 min./week;p<0.017) than counterparts. Serum potassium was slightly but significantly higher in RASB (5.3±0.8 mmol/L vs. 5.1±0.7 mmol/L;p<0.01).

Conclusions: In the real world setting, RASB can be safely used in HD patients treated with diuretics with preserved residual diuresis. Given that many HD patients present numerous multimorbidities, RASB should not only be considered as an additional hypotensive drug in poorly controlled hypertension but also in other compelling indications in HD patients. The tendency toward hyperkalemia in HD patients could be effectively managed with appropriate diet and HD prescription adjustments.
Plain Chest Film Versus Computed Tomography of the Chest as the Initial Imaging Modality for Blunt Thoracic Injury
Authors: L’Huillier Joseph C. , Carroll Hannah L. , Zhao Jane Y. , Jalal Kabir , Yu Jihnhee , Guo Weidun A.
Published: July 2024

Background

While chest X-ray (CXR) is an efficient tool for expeditious detection of life-threatening injury, chest computed tomography (CCT) is more sensitive albeit with added time, cost, and radiation. Thus far, there is limited evidence and lack of consensus on the best imaging practices. We sought to determine the association between imaging modality and outcomes in isolated blunt thoracic trauma.

Methods

The 2017-2020 TQIP database was queried for adult patients who sustained isolated blunt chest trauma and underwent chest imaging within 24 hours of admission. Patients who underwent CCT were 2:1 propensity-score-matched to those who underwent CXR. The primary outcome was mortality, and the secondary outcomes were hospital and ICU length of stay (LOS), ICU admission, need for and days requiring mechanical ventilation, complications, and discharge location.

Results

Propensity score matching yielded 17 716 patients with CCT and 8861 with CXR. While bivariate analysis showed lower 24-hr (CCT .2% vs CXR .4%, P = .0015) and in-hospital mortality (CCT 1.2% vs CXR 1.5%, P = .0454) in the CCT group, there was no difference in survival probability between groups ( P = .1045). A higher percentage of CCT patients were admitted to the ICU (CCT 26.9% vs CXR 21.9%, P < .0001) and discharged to rehab (CCT .8% vs CXR .5%, P = .0178).

Discussion

CT offers no survival benefit over CXR in isolated blunt thoracic trauma. While CCT should be considered if clinically unclear, CXR likely suffices as an initial screening tool. These findings facilitate optimal resource allocation in constrained environments.
Safety Study of Percutaneous Gastroscopic Gastrostomy in Patients After Ventriculoperitoneal Shunt
Authors: Wang Dexian , Peng Run , Huang Yebin , Zhou Jun , Long Zhihua , Wang Jianjun , Zhang Dejian
Published: July 2024

Objective

To evaluate the safety study of percutaneous gastroscopic gastrostomy in patients after ventriculoperitoneal shunt.

Methods

We conducted a retrospective analysis of neurosurgical patients who underwent VPS and PEG at our hospital between January 2012 and November 2023. Patients were divided into 2 groups: VPS group and VPS followed by PEG gruop. Patients received routine antibiotic prophylaxis before the procedure, continued for 48 hours. Follow-up included monitoring immediate complications, particularly wound infection, intracranial infection, neurologic status deterioration, and shunt dysfunction. Routine follow-up visits were conducted post-discharge.

Results

In the VPS group (n = 778), the incidence of intracranial infection was 3.08%. Among patients with PEG after VPS, the time interval between procedures ranged from 13 to 685 days. The mean follow-up period was 22 (1-77) months, with no deaths or further complications.

Conclusion

Performing PEG more than 13 days after VPS does not significantly increase the risk of intracranial infections or PEG-associated infections, making it a relatively safe procedure.
The Relationship Between Negative Urgency and Anxiety and Worry in American College Students
Authors: Fensken Michael , Forzano Lori-Ann B. , Soda Lauren
Published: July 2024

The primary objective was to assess the degree to which intolerance of uncertainty accounts for the association between negative urgency and anxiety and worry. The sample included 389 American college students from a state college in the Northeastern United States. Hayes’ PROCESS v4.1 (2022) macro was used to investigate the mediating effects of intolerance of uncertainty on the relationship between negative urgency and worry and anxiety. A direct effect of negative urgency on worry was found and a mediating effect of intolerance of uncertainty was observed. A direct effect of negative urgency on state anxiety was found, and a mediating effect of intolerance of uncertainty was observed. The study advances support for the mediatory role of intolerance of uncertainty between negative urgency and anxiety and worry in American college students.
A case report of primary Kaposiform hemangioendothelioma of the humerus
Authors: Wang Ye , He Zhenqi , Hao Hua
Published: July 2024

To examine the clinicopathological and immunohistochemical features of Kaposiform hemangioendothelioma (KHE) and discuss its differential diagnosis and prognosis. A patient with KHE was examined; the patient’s clinical and histopathological features were observed, and the expression levels of CD31, CD34, ERG, D2-40, SMA, GLUT-1, and LANA-1 were assessed. The patient was a four-year-old child with primary KHE of the humerus. She was admitted to the hospital because of pain in the right elbow joint and limited movement for more than 2 years. Imaging revealed Langerhans cell histiocytosis. The child was not diagnosed with Kasabach-Merritt phenomenon (KMP). The tumor consists of multiple hemangiomatous nodules with infiltrative growth separated by fibrous connective tissue. The proliferating hemangiomatoid nodules consisted of crisscrossing short spindle-shaped cell bundles and erythrocyte-containing lacunar or crescentic vessels. Immunohistochemical staining showed that the tumor cells diffusely expressed CD31, CD34, ERG, and other vascular endothelium-derived markers; further, the tumor cells expressed neither GLUT-1 nor LANA-1. The patient’s general condition improved after surgical resection. There was no tumor recurrence after more than 8 months of follow-up. Primary KHE of the humerus is a rare vasculogenic tumor. It presents with morphological features that require an accurate differential diagnosis.
Characteristics and Factors Associated With Nonoperative Management and Hospital Outcomes After Hip Fractures Among Community-Dwelling Older Adults: Retrospective Analysis
Authors: Lee Se Won , Holt Jonathan , Joung Keong M. , Ayutyanont Napatkamon
Published: July 2024

Nonoperative treatment is used at varying rates among older adults with hip fractures despite the high mortality. This retrospective analysis of 7803 patients 65 and older admitted with hip fractures is to estimate the odds of nonoperative treatment and in-hospital mortality after hip fractures among community-dwelling older adults. 13.6% underwent nonoperative treatment. Compared to the group with operative treatment, the nonoperative group had a higher in-hospital mortality rate (6.51% vs. 1.32%, p < .0001). Male sex, nondisplaced fracture, and comorbidities of acute myocardial infarction, congestive heart failure, cerebrovascular disorder, dementia, and liver disease were associated with an increased likelihood of nonoperative treatment. Nonoperative treatment, advanced age, use of osteoporosis pharmacotherapy, multiple medical comorbidities, and hospital-acquired complications were associated with increased in-hospital mortality. Specific characteristics were associated with nonoperative management and in-hospital mortality among older adults with hip fractures. Additional research is necessary to improve the care of this vulnerable population.
Shaping the future of healthcare in British Columbia: Establishing provincial clinical governance for responsible deployment of artificial intelligence tools
Authors: Arnaout Angel , Gill Prabjot , Virani Alice , Flatt Alexandra , Prodan-Balla Natasha , Byres David , Stowe Megan , Saremi Alireza , Coss Michael , Tatto Michael , Tuason May , Malovec Shannon , Virani Sean
Published: July 2024

As healthcare embraces the transformative potential of Artificial Intelligence (AI), it is imperative to safeguard patient and provider safety, equity, and trust in the healthcare system. This article outlines the approach taken by the British Columbia (BC) Provincial Health Services Authority (PHSA) to establish clinical governance for the responsible deployment of AI tools in healthcare. Leveraging its province-wide mandate and expertise, PHSA establishes the infrastructure and processes to proactively and systematically intake, assess, prioritize, and evaluate AI tools. PHSA proposes a coordinated approach in AI tool deployment in collaboration with regional health authorities to prevent duplication of efforts and ensure equitable access to existing and emerging AI tools across the province of BC, incorporating principles of anti-Indigenous racism, cultural safety, and humility. The proposed governance structure underscores the identification of clinical needs, proactive ethics review, rigorous risk assessment, data validation, transparent communication, provider training, and ongoing evaluation to ensure success.
Intelligent packaging films based on two-dimensional nanomaterials for food safety and quality monitoring: Future insights and roadblocks
Authors: Moustafa Hesham , Hemida Mohamed H , Nour Mohamed A , Abou-Kandil Ahmed I
Published: July 2024

More than 1.3 billion tons of foodstuffs are wasted each year because of their storage, handling, transportation or sale, resulting in the world suffering from famine and food shortages. This means that huge amounts of the resources utilized in food production are wasted. Greenhouse gas emissions caused by food degradation that gets wasted results in serious environmental and human health impacts. Food losses could be caused by microbes, temperature, humidity, UV-lights, or other factors related to the current pandemics, that have serious jeopardy impacts on the food security and the environment. Thus, smart packaging-based 2D-nanomaterials (2DMs) including sensors and pH-responsive tags have developed for achieving the quality and prolong the shelf-life of foodstuffs. Because they are capable to detect, sense, record internal or external changes in the product’s area. They also can give a prompt message or color changing to the producer or consumer to decide about the shelf lives and expiration dates for consuming the foodstuffs without deteriorating food and packaging. This study reviews the recent advancements in 2DMs regarding preparation, characterization, and applications including active/intelligent food packaging industries. Facile and green functionalization of 2DMs-based graphene oxide (GO) by folic acid or natural dyes enabling them be used in several sensor/artificial intelligence disciplines are discussed. Future insights on the challenges towards the potential outbreak prevention in foodstuffs and their control in long-term use and risk management of these materials are also discussed.
Impact of Clinical Pharmacists in the Inflammatory Bowel Disease Clinic
Authors: Lopez Ashley , Snider Melissa , McFerran Allison , Holland Ariel , Bagnola Aaron , Mellet John , Li Junan , Butnariu Madalina
Published: July 2024

Background: Limited evidence exists regarding pharmacist involvement and impact in inflammatory bowel disease (IBD) interdisciplinary clinic care models. The purpose is to describe pharmacist utilization in an interdisciplinary IBD clinic and evaluate clinical impact on patient quality of life. Methods: This was a retrospective cohort study comparing outcomes in patients with Crohn’s disease initiated on therapy when the implementation of pharmacy services began (Early Phase) to the expansion of pharmacy services (Recent Phase). The primary outcome compared the proportion of patients referred to a pharmacist and those achieving a Harvey-Bradshaw Index (HBI) reduction of ≥3 points after therapy initiation. Results: 50 patients were included in the Early Phase and 43 patients in the Recent Phase. Utilization in pharmacy referrals increased from 48% (n = 24) in the Early Phase to 72% (n = 31) in the Recent Phase ( P = 0.03). The proportion of patients achieving a HBI reduction of ≥3 points increased from 35% (n = 14) in the Early Phase to 51% (n = 18) in the Recent Phase ( P = 0.23). Results also found a greater proportion of patients remaining steroid free in the Recent Phase compared to the Early Phase (50% vs 63%; P = 0.01) and C-reactive protein (CRP) improved significantly in the Recent Phase (−11) compared to (−3) in the Early Phase ( P = 0.006). Conclusion: The utilization of pharmacists in an interdisciplinary IBD clinic increased and showed to impact patient care through improving symptom relief as seen by the achievement rate of the HBI score reduction, reducing steroid use after therapy initiation, and making clinically significant interventions.
Breaking barriers for breaking ground: A categorisation of public sector challenges to smart city project implementation
Authors: Akgün Emine Zehra , Gerli Paolo , Mora Luca , McTigue Clare
Published: July 2024

Smart city technologies provide promising solutions for local governments to tackling societal challenges and enhancing public service provision. The global embrace of these digital innovations represents a new era in public sector advancements. However, it has also brought to light difficulties that existing public sector innovation (PSI) theories struggle to address. One key issue is the lack of comprehensive knowledge regarding the most critical barriers to implementing smart city projects and their intensity. We address this knowledge gap with a systematic literature review within the smart city domain, focusing on literature reporting on the barriers that local governments commonly encounter. This effort has culminated in the development of a conceptual framework that categorize smart city project barriers, forming a taxonomy that builds on and expand the most recent development in the PSI literature. This study contributes to PSI theory refinement by offering a more nuanced understanding of the barriers that local governments might experience when attempting to sustain digital innovation efforts. Moreover, this insight into PSI dynamics is a valuable resource for local governments as they seek to devise realistic mitigation strategies tailored to local development needs.
Research on the traction characteristic evaluation of urban rail vehicles based on entropy weight TOPSIS
Authors: Zhu Aihua , Long Dongping , Du Cong , Yang Jianwei , Zhang Fan
Published: July 2024

This paper aims to investigate the influence of different speed at the end of the constant power section of the traction characteristic curve (TCC) on the vehicle dynamic performance and evaluate the TCC. A dynamics co-simulation model is developed in SIMPACK and MATLAB for dynamic analysis of the urban rail vehicle (URV) under different traction characteristics. Then it is used to investigate how acceleration distance and vehicle dynamic performance varies with the speed at the end of the constant power section of the TCC under different starting torques. Moreover, the entropy weight TOPSIS method which is widely used to solve the multi-objective decision-making problem is chosen to evaluate the traction characteristics based on various dynamic performance indexes over 25 test sections and acceleration distance. The results show that under traction conditions, the starting torque has effects on the lateral and vertical accelerations of car body, lateral and vertical wheel-rail contact forces, derailment coefficient and wheel unloading factor. The higher the torque, the greater the value of each index, that means the poorer the vehicle ride characteristics and running safety. For a given starting torque, the dynamic performance indexes increase with the increase of the speed at the end of the constant power section from 50 km/h to 80 km/h during the vehicle speed-up process. The maximum growth rate of the lateral and vertical accelerations of car body, lateral and vertical wheel-rail contact forces are 17%, 8%, 8% and 2%, respectively, when the speed at the end of the constant power section increases from 50 km/h to 80 km/h. Last, the comprehensive evaluation of traction characteristics using entropy-weight TOPSIS method reveals when the starting torque is 800 [Formula: see text], 1000 [Formula: see text], 1200 [Formula: see text] and 1400 [Formula: see text], the corresponding optimal speed at the end of the constant power section is 80 km/h, 80 km/h, 70 km/h and 50 km/h, respectively. The result of the study can provide theoretical support for traction characteristic design and traction control for URVs.
Analysis of the dynamic contact behaviour of high-speed train transmission gear excited by wheel defects
Authors: Dou Shuo , Liu Wenpeng
Published: July 2024

Studies on wheel flatness and polygonal wear have demonstrated that wheel defects cause severe impact forces at the wheel–rail interfaces. This study investigated the dynamic contact mechanical behaviour of high–speed train transmission gears when subjected to wheel defects. First, a train-track coupling dynamics model was established, considering the localized contact characteristics of transmission gears. This model was developed using the slice method and the Hertz contact model, exploring the spatial coupling effects between the gear contact interface and the train–track interface. Subsequently, the dynamic model was employed to extract essential contact mechanical parameters of the transmission gear under the influence of wheel defects, including gear meshing load, gear contact stress, and sliding velocity. Furthermore, an analysis was conducted to uncover and elucidate the mechanism by which wheel flatness and polygonal wear impact the dynamic contact behaviour of the transmission gear. This study underscores the importance of considering wheel defects when assessing the contact fatigue and wear performance of high-speed train transmission gears.
Association between CD4 lymphocyte count and the incidence of comorbidities in Human immunodeficiency virus positive patients with virological suppression after antiretroviral treatment
Authors: Galeano Adriana C , Rincón-Rodríguez CJ , Gil Fabián , Valderrama-Beltrán S
Published: July 2024

Background

The incidence of comorbidities is higher in HIV-positive patients than in the general population due to factors, such as HIV-related chronic inflammation. There is no consensus on whether a low CD4 lymphocyte count after virological suppression at long-term follow-up increases the risk of comorbidities. This study evaluates the association between CD4 lymphocyte count and the incidence of comorbidities during the first 5 years of virological suppression after highly active antiretroviral treatment.

Methods

We conducted a cohort study of HIV-positive adults who achieved virological suppression in an HIV program between 2002 and 2016 in Colombia. A generalized equation estimation model was used to estimate the association between CD4 lymphocyte count and the incidence of comorbidities.

Results

A follow-up period of at least 1 year was completed in 921 HIV-positive patients with virological suppression. We found 71 comorbidities during a maximum of 5 years of follow-up; 41 (59%) were AIDS-defining comorbidities and 19 (46%) of them occurred during the first semester. Thirty cases of non-AIDS- defining comorbidities were diagnosed. We did not find any association between CD4 lymphocyte count and the incidence of comorbidities (OR 0.92, CI 95% 0.45 -1.91 for CD4 201-499 cells/µL vs CD4 ≤200 cells/µL, and OR 0.55, 95% CI 0.21-1.44 for CD4 ≥500 cells/µL vs CD4 ≤200 cells/µL).

Conclusion

No association was found between CD4 lymphocyte count and the incidence of AIDS-defining or non-AIDS-defining comorbidities in patients with virological suppression. Further studies are needed to assess the risk of comorbidities in this population to design interventions aimed at improving their prognosis.
Introducing geological wonder: Planetary thinking as a disruption of narcissism
Authors: Bendik-Keymer Jeremy , Pedersen Stefan
Published: July 2024

Since its origin in 15th century European imperialism, the globe has been an object of conquest involving regimes of territorial exclusion and various forms of land abstraction now known as nationalism, colonialism, capitalism, and industrialism. Coming to think like the Earth system and generating politics grounded in it could pose a welcome disruption of these systematically controlling orders only if such planetary thinking is grounded in a nondominating orientation. We propose that this grounding be geological wonder, the open consideration of Earth as a system exceeding human narcissism. Following Dipesh Chakrabarty's distinction between the globe and the planet, we articulate planetarism in an emerging cosmology decentering human life while emphasizing human limits. Globality, by contrast, is a modern, narcissistic formation that geological wonder unsettles. We draw on Martha C. Nussbaum's politics of wonder to articulate a postglobal, disruptive virtue.
Hashtag capitalism: An introduction
Authors: Kamalnath Akshaya
Published: July 2024

This article aims to introduce the phenomenon of ‘hashtag capitalism’ – that is, the ability of shareholders, employees, customers and even members of society to leverage social media in a way that influences corporate behaviour. While it is a positive development that, via social media, members of society are engaging with and influencing corporate decision-making, there are also concerns that some individuals are able to influence the financial decisions and opinions of others, and that such individuals might need to be held accountable. The article describes the different developments that have created the perfect storm to give rise to hashtag capitalism and argues that there is an urgent need for corporate law and regulation to reckon with this phenomenon, to ensure that we are able to retain the benefits while effectively addressing the risks involved.
A Participatory Evaluation of an Urban Garden Project in Ecuador: Exploring Factors That Impact the Recovery of People With Severe Mental Health Problems
Authors: Zamora-Moncayo Emilia C. , Herrera Bernarda , Larrieta June , DuBois Aimée , Miguel Esponda Georgina
Published: July 2024

For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors ( family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.
Tumor Budding in Invasive Breast Carcinoma, No Special Type: Association With Pathological Prognostic Factors and Comparison of 2 Different Scoring Systems
Authors: Sivamayuran Vinothika , Wijesinghe Harshima Disvini , Constantine Roshana , Lokuhetty Menaka Dilani Samarawickrama
Published: July 2024

Introduction. In contrast to colorectal carcinoma, the significance of tumor budding in breast carcinoma is not established. The X20 objective which is used to assess tumor budding in colorectal carcinoma, is not widely available in countries with limited resources. This study aimed to determine the prevalence of tumor budding and its associations with pathological prognostic factors in invasive breast carcinoma-no special type (IBC-NST), and to assess the correlation between the tumor budding observed using ×20 and ×40 objectives. Methods. A total of 349 excision specimens of IBC-NST were studied. Tumor budding was defined as a single cell/cluster of up to 4 cells at the invasive front and was assessed in hotspots at the advancing edge of the tumor using ×20 and ×40 objectives. Tumor budding was categorized into low (<5/0.785 mm2), intermediate (5-9/0.785 mm2), and high budding (≥10/0.785 mm2) for ×20 objective and low (≤4/0.196 mm2) and high (≥5/0.196 mm2) for ×40 objective based on the number of buds per hotspot. The association between tumor budding and prognostic factors was analyzed with Mann-Whitney U test, Kruskal-Wallis test, χ2 test, and logistic regression. Correlation between tumor budding in ×20 and ×40 objectives was analyzed with Pearson correlation test. Results. The prevalence of tumor budding was 72.5%. There was a significant correlation between the number of buddings observed in ×40 objective and ×20 objective (0.958). High tumor budding observed in both objectives was significantly associated with size ( P < .001), lymphovascular invasion ( P < .001), perineural invasion ( P < .001), lymph node status ( P < .001), number of lymph nodes ( P < .001), T stage ( P < .001), and N stage ( P < .001) on univariate analysis, but only lymph node positivity ( P < .001) showed significant association on multivariate analysis. Conclusion. Tumor budding assessed with ×20 and ×40 objectives showed a significant correlation and was significantly associated lymph node metastasis on multivariate analysis.
Reliability of an Expanded Non-alcoholic Steatohepatitis Grading and Staging System for Assessment of Disease Activity and Fibrosis
Authors: Loh Jiezhen Tracy , Salomao Marcela , Moreira Roger , Pai Rish
Published: July 2024

The nonalcoholic steatohepatitis clinical research network (NASH-CRN) system is commonly used for histologic assessment of disease activity and fibrosis in NASH. Despite this, the system does not fully capture the range of disease activity and fibrosis. As such, an expanded NAS (E-NAS) grading and staging system with a calculated E-NAS index was developed by our group. In this follow up study, we aim to revalidate the E-NAS system and compare its reliability to existing systems. Hematoxylin and eosin and trichrome stained sections from 40 liver biopsies were reviewed digitally by four hepatopathologists and assessed using the NASH-CRN and E-NAS systems as well as a modified Ishak fibrosis stage. The pathologist's gestalt impression of disease activity and fibrosis was scored on a Visual Analogue Scale (VAS), which ranged from 0 (no activity/fibrosis) to 100 (the worst activity/fibrosis ever seen). Inter-rater reliability was assessed, and Spearman correlation coefficients were calculated. The E-NAS index had higher inter-rater agreement versus the NAS score (ICC 0.70 vs 0.61). The inter-rater agreement for ballooning in the E-NAS system was also higher at 0.67 compared to the NAS (ICC 0.60). ICCs for fibrosis were comparable between all the systems assessed (0.78 to 0.88). Finally, the calculated E-NAS index was higher with increasing stage of fibrosis compared to the NAS suggesting that it associates better with fibrosis. In summary, the E-NAS system demonstrates substantial inter-rater reliability as well as improved correlation with disease activity VAS and fibrosis compared to the NAS score.
Security and heritage in the making of urban futures: A new research avenue
Authors: Lazzaretti Vera
Published: July 2024

Heritage and security are distinct research topics in anthropology, but some of their connections have been unpacked, particularly in scholarship about heritage during conflicts and peace building. This article, however, brings them analytically together to understand how they entangle to shape cities and their futures. In scrutinising overlooked similarities between heritage and security, my longitudinal ethnography in Banaras (Varanasi) suggests that both intersect productively in anticipating and making urban futures. I argue that a Hindu majoritarian urban future—as materialised in the walls, signboards and checkpoints of the Prime Minister’s flagship Kashi Vishvanath Dham and Corridor—unfolded precisely through security and heritage. This future seems to be, at least partially, shared by those who are excluded from it. Bridging the largely disconnected anthropological scholarship on heritage and security, this article offers a first ethnographically-grounded theorisation of security and heritage as cross-fertilising urban processes that make futures.
Universities in global transformation: Re-thinking curriculum integration and collaboration to co-create our future
Authors: Piazza Roberta , Castiglione Giovanni , Guevara Jose Roberto
Published: July 2024

University-based curriculum development often involves adding new content. This ‘just add’ approach has also been applied to integrating the UN SDGs into curricula, reducing them to a checklist rather than embracing their holistic and transformative aims. This is particularly concerning for SDG 4 and SDG 4.7, which require deep, cross-cutting understanding for educational transformation towards a more equitable and sustainable world. In this short reflection paper, colleagues from the University of Catania and RMIT University reflect on integrating SDGs into university curricula, emphasizing collaboration to transform education. They explore the context within universities, the commitment, and challenges in preparing students to understand the complex world through the SDGs’ vision. The authors discuss SDGs and Education for Sustainable Development (ESD) as frameworks guiding successful SDG integration. Using climate change education as an example, they highlight the need for coordinated actions across multiple scales, aligning with transformative learning principles. The authors argue that SDGs offer an opportunity for transformative processes requiring effective collaboration among colleagues and students. They call for university leadership to support ongoing staff capacity building, resource collaborative, and cross-disciplinary teaching and learning projects and promote self-reflexivity on universities’ roles in addressing global challenges.
Race or Place: Partisanship Among Black Rural Voters
Authors: Newby Kara
Published: July 2024

Rural voters are often portrayed as a monolith of White and conservative, although 22% of the rural population are non-White. Rural minorities, specifically Black rural voters, intersect two potentially competing identities informing political partisanship. First, place: there is a growing geographic schism between rural and urban voters, with rural voters aligning more closely with the Republican party. Second, race: there is a political gap between White and Black voters, with Black voters aligning more closely with the Democratic party. Using data from the 2019 and 2020 ANES Studies I investigate the effects of these intersecting identities on political identification accounting for rural resentment. Rural resentment, or feelings of a loss of political power to urban areas, is found among both White and Black rural voters. For Black rural voters, a strong race identity can buffer the effects of rural resentment, keeping them from pushing toward the Republican party.
Diabetic Foot Osteomyelitis in Patients with and without Peripheral Arterial Disease: Two Different Diseases?
Authors: Meloni Marco , Bellizzi Ermanno , Andreadi Aikaterini , Di Venanzio Michela , Mazzeo Luca , Giurato Laura , Bellia Alfonso , Uccioli Luigi , Lauro Davide
Published: July 2024

The aim of the current study was to evaluate the outcomes of patients with diabetic foot osteomyelitis (DFO), comparing subjects with and without peripheral arterial disease (PAD). The study is a prospective study including a population of patients affected by a DFO located in the forefoot. All patients were managed by a surgical conservative approach defined by the removal of the infected bone, in association with the antibiotic therapy. Patients were divided into two groups: those with PAD (neuro-ischaemic DFO) and those without (neuropathic DFO). After 1 year of follow-up, the following outcome were evaluated and compared between groups: healing, healing time, minor amputation, major amputation, hospitalization, need for surgical re-intervention. Overall, 166 patients were included, 87(52.4%) of them had neuro-ischaemic DFO and 79 (47.6%) neuropathic DFO. Patients with neuro-ischaemic DFO in comparison to neuropathic DFO were older (72.5 ± 9 vs 64.1 ± 15.5 years, P < .0001), had longer diabetes duration (21.8 ± 5.6 vs 16.4 ± 7.6 years, P < .0001), higher rate of dialysis (13.8 vs 1.3%, P = .001) and ischaemic heart disease (79.3 vs 12.7%, P < .0001). Outcomes for neuro-ischaemic DFO and neuropathic DFO were: healing (96.5 vs 97.5%, P = .7), healing time (7.8 ± 6.2 vs 5.7 ± 3.7 weeks, P = .01), minor amputation (16.1 vs 3.8%, P = .006), major amputation (0 vs 0%, ns), hospitalization (90.8 vs 51.9%, P < .0001), surgical re-intervention (14.9 vs 8.8%, P = .004) respectively. In addition, PAD resulted in an independent predictor of minor amputation, hospitalization, and surgical re-intervention. DFO in patients with PAD was characterized by longer healing time, more cases of minor amputation, hospitalization, and surgical re-intervention. PAD independently predicted the risk of minor amputation, hospitalization, and surgical re-intervention, while it was not associated with the healing rate.
“You Don’t Want Us to Solve This”: Agenda Setting in the Federal Hearings on Name, Image, and Likeness
Authors: Harry Molly
Published: July 2024

From 2020 to 2024, the United States Congress held 11 hearings pertaining to name, image, and likeness (NIL). Various stakeholder groups have participated in these hearings including Congress and those looking to “maintain” or “disrupt” college sport and the National Collegiate Athletic Association (NCAA). Despite the significance of NIL to college athletics, limited research has examined these hearings and the messages communicated within them. Thus, critical discourse analysis and agenda setting theory were used to shed light on the language surrounding NIL through the Congressional hearings. Findings demonstrate the aforementioned groups’—Congress, “Maintainers,” and “Disruptors”—used narrative framing and topic selection, resulting in conflicting agendas and mixed messaging. Implications include improved communicative and political strategies for NIL stakeholders, enhanced NIL education for college athletes, and the extension of agenda setting theory to sport communication.