bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing vortex-induced vibration suppression in π-shaped girders using wind tunnel testing and CFD analysis
Authors: Liu Jun , Xian Bo , Li Feng , Tian Liyong , Qiu Enxi , Ni Zhifu
Published: November 2024

This investigation meticulously explores the vortex-induced vibration (VIV) characteristics in Π-shaped girders within long-span cable-stayed bridges, presenting novel VIV mitigation techniques. Employing detailed wind tunnel evaluations of a 1:50 scale model alongside computational fluid dynamics (CFD) analyses to model the two-dimensional flow around the girder, this study reveals the formation and shedding of vortices behind the railings and main steel girder, which significantly contribute to VIV in such structures. The introduction of horizontal splitter plates, one m in width, in conjunction with two-m-wide V-shaped guide vanes, was found to substantially reduce the VIV amplitude of the Π-shaped girder, minimizing vortex generation on the deck’s sides and dramatically reducing the maximum vertical VIV amplitude from 208.75 mm to only 5.56 mm. CFD simulations confirm the effectiveness of these measures in suppressing Karman vortex street formation, thereby significantly improving downstream airflow characteristics. These findings offer pivotal insights for the advancement of bridge design and the proactive management of VIV, showcasing the potential of integrated aerodynamic modifications to enhance structural resilience and performance.
Kenstituent power: an exploration of feminist constitutional change in Barbie
Authors: Houghton Ruth , Murray C. R. G. , O’Donoghue Aoife
Published: November 2024

Greta Gerwig’s Barbie explores the influence of childhood dream worlds and toys over adult life, and the singular importance of a toy which represents an empowered woman. But this story plays out against the backdrop of deep societal challenges. That the subject matter of the film is light does not detract from its cultural significance; it enhances its reach and thereby its influence. Constitutional change, property, dissent, inequality and revolution are not the B-plot of the film, they suffuse every scene and motivate its major characters. In this article we explore the significance of Barbie Land as a supposed embodiment of a feminist utopia and the extent to which Gerwig is confronting viewers with difficult questions about authority and just governance in the Real World.
‘I’m here to see my gynaecologist’: reproductive justice and the Deleuzian becoming of Barbie
Authors: Winters Della J. , Grimm Courtney A. , Bola Raveena
Published: November 2024

Rejecting critiques of the final line of Greta Gerwig's Barbie as a bioessentialist classification of gender, we engage with the Deleuzian concept of becoming to argue that this final line is not only gender inclusive but gender expansive, particularly within the current political moment. Challenging settled, hegemonic gender identities through the unsettled and dynamic possibilities of becoming, we explore how this dialogue can be interpreted as messaging to promote bodily autonomy for all by focusing on the essential role of reproductive and sexual health as necessary for liberation. Despite Barbie exemplifying white feminism and commodifying liberatory messages into a product, the audience and their connections with the film's messages generate the possibilities of liberating white feminism from its self-imposed limitations through becoming and deterritorialisation.
Antifibrotic drug treatment of patients with idiopathic pulmonary fibrosis in Sweden: A registry-based observational study
Authors: Carlson Lisa , Kalafatis Dimitrios , Pesonen Ida , Magnusson Jesper M , Skold Magnus
Published: November 2024

Objectives

Idiopathic pulmonary fibrosis (IPF) is characterized by progressive fibrosis of the lung parenchyma, resulting in respiratory failure. This study analysed differences in patient characteristics and antifibrotic treatment strategies during the first years after IPF diagnosis.

Methods

Data from patients with IPF was extracted from the Swedish IPF registry. Patients were defined as treated (either as fully- or reduced treated) or non-treated with antifibrotic drugs. Differences in clinical parameters and side effects were defined.

Results

Among 532 patients, 371 received treatment with antifibrotic drugs. Treated patients were younger, had worse lung function, higher body mass index (BMI), higher Gender-Age-Physiology stage, and were more often on oxygen treatment. Non-treated patients displayed a stable BMI, whereas patients treated with antifibrotics declined in BMI during follow-up. More than half (56%) of treated patients had reduced antifibrotic treatment. Sixty per cent reported side effects, with diarrhoea, nausea, and skin rash as the most common.

Conclusions

Patients prescribed antifibrotic treatment had more advanced disease compared to patients not prescribed antifibrotics. A considerable proportion of the patients had reduced treatment, probably due to more side effects in this group. This indicates that individuals starting treatment at IPF diagnosis are considered to be in greater need of antifibrotic drug treatment by the prescriber, compared to individuals with less severe disease.
Dynamic Morphology of Dilated Ascending Aorta and its Implications for Proximal Landing During Thoracic Endovascular Aortic Repair
Authors: Skrypnik Denis , Bischoff Moritz S. , Meisenbacher Katrin , Hagedorn Matthias , Kilian Samuel , Rengier Fabian , Andre Florian , Böckler Dittmar , Steen Henning
Published: November 2024

Introduction:

To improve the outcomes of thoracic endovascular aortic repair (TEVAR), we investigated the dynamic morphology of dilated and nondilated ascending aortas (AAs) to determine whether an appropriate proximal landing zone for TEVAR exists if the middle AA is dilated.

Materials and Methods:

Patients with dilated (diameter 40–50 mm) and nondilated (<40 mm) AAs underwent electrocardiogram-gated computed tomography angiography of the entire AA in the systolic and diastolic phases. For each plane of each AA segment, the maximal and minimal diameters in systole and diastole were recorded.

Results:

A total of 105 patients were enrolled (54% male; median age: 80 years [IQR 78–85]). A total of 35 patients were included in the dilated AA group (DG), and 70 patients were included in the nondilated AA group (n-DG). The aortic planes of the AA segment at the sinotubular junction (STJ) showed a more oval-shaped morphology compared with the distal planes of the same segment (the differences between the maximum and minimum diameters were 8.9% to 9.4% and 4.8% to 5.6%, respectively). If the mid-ascending aorta was dilated, the aortic segment at the STJ showed a more pronounced reversed-funnel 3D morphology, with a 14% (IQR 11%–19%) difference in diameters between the proximal and distal segmental planes shown in the n-DG and 18% (IQR 16%–22%, p<0.001) in the DG.

Conclusion:

If the middle AA is dilated, it is considered unsuitable to perform TEVAR using conventional endografts without additional proximal fixation in the aortic segment at the STJ due to its pronounced reversed-funnel segmental morphology. By contrast, the aortic segment at the brachiocephalic trunk seems to be promising for performing TEVAR using an endograft of the appropriate size and conformability. Moreover, endograft sizing using the average aortic diameter instead of the maximal AA diameter in an oval-shaped aortic plane morphology should be considered.

Clinical Impact

If the middle ascending aorta is dilated, it is considered unsuitable to perform TEVAR with a proximal landing in the aortic segment at the sinotubular junction due to its pronounced reversed-funnel segmental morphology and high risk of type Ia endoleak and endograft migration. By contrast, the aortic segment at the brachiocephalic trunk seems to be promising for performing TEVAR due to its moderate funnel morphology using an endograft of appropriate size and conformability.
TIPS, a Trick for Transcaval TEVAR Access
Authors: Kuypers Toon , Houthoofd Sabrina , Maleux Geert
Published: November 2024

Purpose:

We described an alternative access for thoracic endovascular aortic repair (TEVAR) deployment using a transjugular intrahepatic portosystemic shunt (TIPS) needle for gaining transcaval access to the abdominal aorta.

Case report:

A 63-year-old man presented with a penetrating atherosclerotic ulcer in the descending aorta. Traditional transfemoral and transaxillary access were not possible. A transcaval access was established using a TIPS needle to puncture from the caval vein to the aorta. Next, the access was gradually upsized until a 22 french large-bore transcaval access was achieved. Afterwards the thoracic endograft was positioned and deployed accustomed. The infrarenal aortocaval fistula was closed with a covered stent.

Conclusion:

When classic TEVAR access is not possible, transcaval access is a valuable and minimally invasive alternative access. We prefer the use of a TIPS needle for gaining access and use a covered stent for closing the aortic access site when possible instead of using electrified wires nor a transseptal occluder device. Preoperative planning remains key.

Clinical Impact

We discribe a transcaval access with a TIPS needle and closing of the aortocaval fistula with a covered stent. We are one of fiew reports of transcaval puncturing instead of using an electrified wire and the first using a TIPS needle for gaining transcaval access. We hope this case and our comments help other surgeons, radiologists and patients when they are in need of a transcaval access and contribute to a successful procedure.
Factors Associated With Adverse Outcomes Among Patients Undergoing Endovascular Revascularization for Iliac Artery Lesions TASC II A and B: A Single-Center Study
Authors: Nut Lam Van , Tin Le Duc , Duc Hoang , Abdalla Abdelrahman Sherif , Kwaah Patrick A. , Le Trang T.B. , Vy Tran Thi Thuy , Le Thoa , Minh Anh Pham , Kim Que Do , Huy Nguyen Tien
Published: November 2024

Purpose:

This prospective study from October 2016 to September 2020 aimed to identify the factors associated with non-revascularization and mortality rates in patients who underwent endovascular interventions for Trans-Atlantic Inter-Society Consensus (TASC) II A/B iliac artery occlusions at the Department of Vascular Surgery.

Methods:

Patients with TASC II A/B iliac artery occlusions who underwent endovascular intervention, including balloon angioplasty and stent placement, were included. The primary outcomes were factors associated with non-revascularization and mortality rate.

Results:

A total of 133 patients were enrolled in this study. Univariable analysis revealed significant associations between non-revascularization and diabetes (hazard ratio [HR]=2.61, 95% confidence interval [CI], p=0.03), chronic kidney disease (HR=16.2, 95% CI, p=0.01), and severe calcifications (HR=8.56, 95% CI, p<0.001). Subsequent multivariable analysis confirmed the significance of these factors, showing HRs of 3.04 (95% CI, p=0.02), 13.12 (95% CI, p=0.03), and 8.62 (95% CI, p<0.001), respectively. The overall mortality rate observed was 20.3%. Severe calcifications emerged as a significant risk factor for mortality in both univariable (HR=2.47, 95% CI, p=0.02) and multivariable (HR=3.01, 95% CI, p<0.001) analyses.

Conclusion:

Severe calcifications correlate with non-revascularization and mortality, while comorbidities like diabetes mellitus and chronic kidney disease are also associated with non-revascularization. Recognizing these identified factors holds substantial promise in enhancing patient selection and procedural approaches, potentially bolstering the success rates of endovascular interventions. However, further research aimed at comprehending the underlying mechanisms and devising strategies to mitigate these risks is imperative for continued improvement in patient outcomes.

Clinical Impact

The study provides valuable insights into patient selection and procedural planning for endovascular interventions in TASC II A/B iliac artery occlusions. Identifying severe calcifications, diabetes, and chronic kidney disease as key risk factors for non-revascularization and mortality equips clinicians with essential predictive tools, potentially improving outcomes by tailoring treatment approaches. The innovation lies in highlighting the impact of comorbidities and calcification severity, offering a pathway to refine patient eligibility criteria and optimize procedural decisions. This underscores the importance of further research to develop strategies that mitigate these risk factors and enhance intervention success rates.
Fault diagnosis of needle selector drive parts based on adaptive stochastic resonance with improved generative adversarial networks
Authors: Ru Xin , Jin Renjie , Peng Laihu , Qi Yubao , Hou Liangmei
Published: November 2024

Piezoelectric needle selectors, as key weaving components in the jacquard knitting process of knitting machinery, are widely used in textile equipment. Accurate diagnostic procedures for needle selector drive faults are crucial to ensure the normal operation of the equipment. However, traditional vibration diagnosis methods cannot detect weak periodic signals, resulting in low accuracy of monitoring results. To address this issue, this paper proposes an adaptive stochastic resonance (SR) method based on an improved generative adversarial network (IGAN). Firstly, in order to solve the problem of difficulty in obtaining stochastic resonance parameters, SR is combined with IGAN, and IGAN provides the optimal SR parameters. Secondly, a soft threshold residual attention mechanism and residual network were introduced in the GAN network, and multiple generators were utilized to alleviate the problem of model collapse, in order to adapt to the actual working environment. In addition, due to the large amount of data, it is recommended to use feature parameters for training to improve the efficiency of model training. Finally, through a typical vibration data, the influence of different parameter quantities on the training accuracy of the model was studied, and the superiority of the proposed model compared to other models and the stability of the model under different environmental influences were explored. The results show that this method can effectively detect weak periodic signals of the needle selection driver, effectively alleviate the problem of model collapse in different environments, and is superior to existing methods in terms of accuracy and stability.
The Infected Diabetic Foot: Does Negative Pressure Wound Therapy with Irrigation Reduce Bioburden and Improve Wound Healing?
Authors: Suludere Mehmet A. , Malone Matthew , Siah Michael C. , Tarricone Arthur , Coye Tyler L. , Najafi Bijan , Lavery Lawrence A.
Published: November 2024

The aim of this study was to compare the microbial loads of patients with diabetic foot infections treated with negative pressure wound therapy (NPWT) with and without irrigation with polyhexamethylene biguanide (NPWTi-P). This is a post hoc analysis of combined data of two randomized clinical trials. We evaluated people with diabetes treated with moderate and severe diabetic foot infections that required surgery. Tissue specimens were obtained after the initial surgery and following a second planned return to the operating room after 48–72 h of NPWT or NPWTi-P, prior to the second surgery. We used quantitative polymerase chain reaction (qPCR) to determine the total microbial loads (Log10 16S copies per gram of tissue). There was no difference in mean quantitative bacterial cultures among patients that received NPWT and NPWTi-P (before first surgery Log10: NPWT = 6.4 ± 1.8, NPWTi-P = 7.5 ± 1.7 vs before second surgery Log10: NPWT = 6.7 ± 1.8, NPWTi-P = 7.6 ± 1.9 p = .12). There was no difference in wound healing (59.5% vs 50.0%, p = .51) or time to heal (127 ± 109.3 vs 143 ± 95.9), p = .71). There were fewer re-infections in people that received traditional NPWT (28.6% vs 56.3%, p = .05).

Level of Clinical Evidence: Level 1.
“Brain propane’’: Propionate Fuels the Brain in Mice With Brain Energy Deficits
Authors: Neal Elliott S. , Borges Karin
Published: November 2024

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Navigating the Pandemic Through Technology: Colombian NGOs Promoting Peace During the COVID-19 Era
Authors: Guntrum Laura Gianna , Cerrillo Sofia , Reuter Christian
Published: November 2024

This article examines how Colombian NGOs use Information and Communication Technologies (ICTs) for peacebuilding attempts amid the COVID-19 pandemic. Drawing from 17 interviews with NGO members, the study underscores the pivotal role of digital peacebuilding in sustaining and expanding peace attempts, effective data management, and a broader engagement of target groups beyond in-person activities often associated with safety and financial concerns. The findings also identify prevailing challenges of incorporating ICTs in NGO's peacebuilding activities, ranging from privacy-related concerns to connectivity issues. The article points out the potential for NGOs to enhance interactivity, knowledge transfer, and diversity in their activities with ICTs, including IT security training and awareness campaigns on hate speech and propaganda. It also emphasizes the importance of developing risk reduction strategies tailored to the specific needs of different target groups.
Gameplay 2.0: Toward a New Theory
Authors: Juel Larsen Lasse , Kampmann Walther Bo
Published: November 2024

The aim of this article is to present an updated version of our previous theory of gameplay. “Gameplay” is a term often used without a clear definition or consistent application. In this article, we propose categorizing gameplay into three distinct yet interconnected layers: the first emphasizing temporality, the second highlighting spatiality, and the third pinpointing emotion as anchor point. Our model and understanding are influenced by the philosophy of phenomenology, particularly Husserl's objective examination of the first-person perspective in perceptual experience—a commendable approach for blending formalism with real-time experience without resorting to subjectivism or psychologism. We offer an analytical and methodological framework for understanding gameplay, relying on micro-tensions to elucidate gameplay as a structural entity as well as an experiential phenomenon. As we shall demonstrate, micro-tensions are present within each of the three layers, paving the way for the entirety of gameplay—referred to by gamers as “great gameplay.”
Endovascular abdominal aortic aneurysm repair (EVAR) outcomes of unibody and single/double docking limb endografts in Medicare beneficiaries between 2012 and 2018
Authors: Conrad Mark F. , Sood Ami , O’Brien Alex , Prasad Sapna , Zendejas Erik , Thompson Matt
Published: November 2024

Objective

The evaluation of perioperative and long term outcomes for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) using anatomic (unibody) and proximal neck fixated (docking limbs) endografts across consecutive time cohorts.

Design

This study compares the outcomes of EVAR in Medicare patients stratified by mode of fixation.

Methods

All patients who underwent EVAR between 2012 and 2018 were identified in the Medicare database. Anatomic fixation (AF) and proximal fixation (PF) grafts were differentiated using Current Procedural Terminology (CPT) codes. The AF population was divided into three-time cohorts based on iterative changes in graft design: Cohort 1: (01/01/2012–20/07/2014); Cohort 2: (21/07/2014–09/05/2016); and Cohort 3: (10/05/2016–31/12/2017). The PF cohort was similarly divided into these three periods. Outcomes were evaluated through 31/12/2020 and included all-cause mortality, aortic rupture, and aortic-related reintervention.

Results

32,031 patients underwent EVAR during the study period; 4729 were AF and 27,302 were PF. There were more women ( p < .001) and patients with peripheral vascular disease (PVD) ( p < .001) in the AF group. There were no group differences in perioperative outcomes. In Cohort 1, there was a higher rate of reintervention (11.9% vs 7.6%; p < .001) and aortic rupture (5.3% vs 4.0%; p = .019) in the AF group compared to the PF group. In Cohort 2, reintervention, aortic rupture, and reintervention rates were similar between the two groups (p = NS). In Cohort 3, the reintervention and aortic rupture rates were similar between the two groups (p = NS).

Conclusion

The higher rates of aortic rupture and reintervention seen in the AF group in Cohort 1 when compared with the PF group did not persist in Cohorts 2 and 3. This suggests that improvements in graft design may have led to durability which is similar to that of PF grafts. However, late aneurysm related complications are inherent risks after EVAR and long-term surveillance remains necessary.
Revisiting working memory 50 years after Baddeley and Hitch: A review of field-specific conceptualisations, use and misuse, and paths forward for studying children
Authors: Miller-Cotto Dana , Gordon Rebecca
Published: November 2024

As trained educational and developmental psychologists who study the role of working memory in educational outcomes, we know the various assumptions made about definitions and measurements of this cognitive ability. Considering the popularity of the Baddeley and Hitch working memory model in these fields, we raise challenges related to measurement, overlap with executive function, and adopting working memory measurement approaches from adult models. We propose that researchers consider how working memory tasks might tap multiple other abilities. This is problematic in the context of child cognitive development and in understanding which factors explain educational outcomes in children. We recommend giving greater attention to the central executive, acknowledging the overlap between the central executive and executive function in study design, and investigating a developmental model in the context of the broader abilities evoked in measurement. These recommendations may provide a fuller understanding of working memory’s mechanistic role in children’s learning and development and assist in developing reasonable adjustments for specific aspects of working memory for children who struggle.
An overview of cell salvage in orthopaedic hip and knee arthroplasty surgery
Authors: Patel Ravi , Golding Steven , Nandra Rajpal , Banerjee Robin
Published: November 2024

Blood management is a critical aspect of patient care during surgical procedures. In the United Kingdom, there is a growing recognition of the need to integrate intraoperative cell salvage into blood management protocols, especially for invasive surgeries where significant blood loss is anticipated. While donated blood (allogeneic blood) is traditionally used in such cases, it carries risks and potential complications. Consequently, intraoperative cell salvage presents itself as an appealing alternative, particularly in hip and knee arthroplasty procedures. Intraoperative cell salvage involves the collection and reinfusion of a patient’s own blood (autologous blood) lost during surgery. Studies have consistently shown that autologous blood collected via intraoperative cell salvage has fewer complications and greater benefits compared to donated blood. However, despite these advantages, the widespread adoption of intraoperative cell salvage in UK hospitals remains limited, primarily due to associated costs. While the integration of intraoperative cell salvage into blood management services may incur initial expenses, research suggests that it could ultimately prove to be cost-effective. This is because improved patient outcomes associated with intraoperative cell salvage may lead to reduced postoperative complications and shorter hospital stays. Thus, there is a growing imperative to overcome financial barriers and promote the implementation of intraopertive cell salvage as a standard practice in perioperative care across UK health care settings. The purpose of this scoping literature review is to consolidate the available information on the current use of intraoperative cell salvage and to identify intraoperative cell salvage techniques and devices described for use in an arthroplasty setting.
Staff satisfaction with reusable surgical drapes
Authors: Snow Hayden , Clarke Jessica , Taylor Kara , McGain Forbes
Published: November 2024

Background:

Reusable surgical textiles have substantial environmental benefits over single-use, disposable items. However, staff satisfaction with the performance of reusable textiles is unclear. During a trial period using reusable drapes, staff were surveyed regarding satisfaction with the products.

Results:

A total of 30 staff members responded to the survey. Overall, 90% of respondents were either satisfied/very satisfied (80%) or neutral (10%) when asked about their satisfaction with the reusable drapes, while 10% were unsatisfied/very unsatisfied; 87% of staff responded that reusable drapes were either as effective or more effective than disposable drapes. Reusable drapes showed very high levels of staff satisfaction in terms of durability (87%), fluid protection (70%) and provision of a sterile field (80%). There were no staff who did not support the ongoing use of reusable surgical drapes.

Conclusion:

There is extremely high staff satisfaction with reusable surgical drapes.
A call to action: Standardisation of intravaginal hygiene product reporting in preoperative evaluation
Authors: Reese Alyssa , Hobika Kathryn , Donnelly Katelyn , Richards Raymond , Evancho Peter , Eddib Abeer
Published: November 2024

Preoperative checklists have demonstrated efficacy in improving patient care in the surgical setting. While the assessment of perioperative risks through patient inquiry is extensive, the menstrual status of the patient is one question that is not frequently discussed. If a patient is menstruating during their surgical procedure, unknown use of an intravaginal menstrual hygiene product, such as a tampon or menstrual cup, places the patient at risk of infection. This review seeks to bring attention to these risks by exploring Boyer v. Morimoto, a case where a patient developed toxic shock syndrome after a tampon was left in after surgery. We conclude with recommendations for standardised documentation of intravaginal menstrual hygiene products, with the aim to minimise perioperative risks.
Intramedullary nailing for concomitant extra-articular ulnar head fractures in distal radial fractures
Authors: den Hengst Stella , Luan Anna , Hanel Douglas P. , Bhashyam Abhiram R.
Published: November 2024

Four adult female patients were treated with an intramedullary Steinmann pin for an unstable extra-articular distal ulnar fracture associated with a distal radial fracture treated with plate osteosynthesis. All showed good radiographic and functional outcomes. One patient required removal of the Steinmann pin.
Short delay to initiate plasma exchange or immunoadsorption as synergistic therapies for patients in the acute phase of anti-NMDAR encephalitis
Authors: Su Miao , Wu Zichao , Luo Qiuyan , Feng Huiyu , Zhou Hongyan
Published: November 2024

Background:

Combined first-line therapies have been frequently adopted for patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Plasma exchange (PE) or immunoadsorption (IA) was used as an add-on option following initial immunotherapies, including high-dose steroids and intravenous immunoglobulin (IVIG). However, whether a shorter delay of PE or IA can improve the early recovery prognosis of patients with anti-NMDAR encephalitis remains largely unknown.

Objective:

To compare short-term clinical improvement between patients with early and late initiation of PE or IA in anti-NMDAR encephalitis.

Design:

A retrospective study was conducted for patients admitted with anti-NMDAR encephalitis between January 2015 and December 2023 ( n = 29), including 21 patients who received PE or IA as synergistic therapies.

Methods:

The clinical prognosis was compared between the early PE/IA group and the late PE/IA group in the research. Primary outcome included changes in the Clinical Assessment Scale for Autoimmune Encephalitis (∆CASE) at 90 and 120 days after encephalitis onset. Secondary outcomes included changes in the modified Rankin scale (∆mRS) after 90 and 120 days from encephalitis onset, and the length of intensive care unit (ICU) stay for patients with severe anti-NMDAR encephalitis.

Results:

The ∆CASE scores after 90 and 120 days from encephalitis onset revealed a significant difference between patients with early and late initiation of PE or IA ( p ⩽ 0.05). A significant difference in the ∆mRS was also found between patients with early and late initiation of PE or IA in severe encephalitis ( p ⩽ 0.05). No significant difference was found in the length of ICU admission ( p = 0.101).

Conclusion:

Our findings emphasize the importance of considering PE or IA as early as feasible for patients with anti-NMDAR encephalitis, even when steroids and IVIG are in use.
Leadership capacity development in the Australian early childhood sector. Re-energising through mentoring
Authors: Hadley Fay , Andrews Rebecca , Waniganayake Manjula , Hay Iain , Jones Catherine , Liang Xinyun Meg
Published: November 2024

Mentoring is a leadership capacity development strategy for experienced early childhood teachers (ECTs). Being a well-trained mentor, who is supported to undertake the role can contribute to re-energising experienced ECTs and enhance the early childhood sector workforce. However, little is known about the benefits of outsourcing mentoring as most research refers to in-house mentoring. This paper reports on the mentors’ experience of a two-phase on-line mentoring program in Australia supporting new early childhood teachers. The study design was framed by the theory of Community of Practice involving academic mentors, experienced teacher mentors and novice teachers as mentees. Mentors’ reflections indicated that knowledge and skills accumulated during this program shifted their understanding of mentoring and contributed towards creating short and long-term service-level changes. This paper offers a provocation for new possibilities in mentoring in the early childhood sector.
Fenthion flea-killer: Unpredictable and dangerous
Authors: Rahalkar Kshitij , Ng Mingwei , Tan Elizabeth Ming Jing , Tan Boon Kiat Kenneth , Yao Yi Ju , Anantham Devanand , Ponampalam R
Published: November 2024

Introduction

This case of fenthion poisoning demonstrates the delayed, protracted and yet unpredictable nature of cholinergic effects which are unique to fenthion toxicity.

Case Presentation

A 36-year-old female presented to the emergency department with drowsiness and vomiting, 8 hours after an unknown pesticide ingestion. She had some cholinergic symptoms (miosis, incontinence, emesis) suspicious of organophosphate toxicity but was initially well with no bronchorrhea or bradycardia. During her admission, she developed increasing salivation and bronchorrhea resulting in respiratory failure requiring intubation 27 h’ post-ingestion. Possible aspiration pneumonitis was initially considered given the delayed nature of deterioration. However, blood toxicology results confirmed fenthion poisoning. Atropine and pralidoxime boluses were administered followed by continuous infusion. She was extubated after initial improvement and stabilization – only to require reintubation for recurring respiratory failure and seizures on Days 4 and 5, each time following apparent recovery. She was eventually weaned off mechanical ventilation only on Day 31.

Discussion and Conclusion

This case illustrates the importance of physician awareness to potentially innocuous presentations of fenthion poisoning as symptoms at the onset may appear benign and falsely reassuring. Serious toxic manifestations may be significantly delayed over a prolonged, waxing-and-waning clinical course because of the compound’s high lipid solubility and metabolism into potent secondary compounds.
A systematic review and meta-analysis of carfilzomib-associated thrombocytopenia as an adverse event in patients with multiple myeloma
Authors: Smrdel Lara , Locatelli Igor , Zver Samo , Gobec Martina
Published: November 2024

Background:

Carfilzomib is a second-generation proteasome inhibitor (PI) used for combination therapy with dexamethasone and/or lenalidomide in patients with relapsed or refractory multiple myeloma. Reports indicate that PIs have a unique toxicity profile that includes thrombocytopenia as a hematologic adverse event; however, its occurrence has not yet been quantified systematically.

Objectives:

The main objective of our systematic review and meta-analysis is to investigate the incidence of thrombocytopenia in patients with multiple myeloma after treatment with carfilzomib.

Design:

Selection of studies and meta-analysis of trials was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Data sources and methods:

Two investigators performed an independent literature search of PubMed, Web of Science, SciFinder, the Cochrane Central Register of Controlled Trials, as well as the US and EU clinical trials registries. The cumulative incidence and overall relative risk were calculated with the random effect model using RevMan and R statistical software.

Results:

The analysis included a total of 9237 patients, 2516 patients in single-arm studies and 6721 patients in randomized controlled trials (RCTs). A total of 47 studies were included; among these, 14 were RCTs. Analysis of currently available data showed that treatment with carfilzomib may increase the incidence of all-grade thrombocytopenia, and this correlated with the dose used. With supportive therapy alone, the incidence is 26%. The addition of carfilzomib to the treatment results in a 37% increase in incidence, whereas with bortezomib, the increase is slightly lower at 34%. Surprisingly, when treatment with carfilzomib and bortezomib was compared, bortezomib was found to be more likely to exacerbate high-grade thrombocytopenia (7%) than carfilzomib (3%).

Conclusion:

Clarification of these associations suggests that clinicians should be aware of the potential risk of high-grade thrombocytopenia occurring and monitor patients closely to take appropriate measures.

Trial registration:

Registered in PROSPERO under the number CRD42022314378.
Parkinson's disease detection from EEG signal employing autoencoder and RBFNN-based hybrid deep learning framework utilizing power spectral density
Authors: Jibon Ferdaus Anam , Tasbir Alif , Talukder Md. Alamin , Uddin Md. Ashraf , Rabbi Fazla , Uddin Md. Salam , Alanazi Fars K. , Kazi Mohsin
Published: November 2024

Objective

Early detection of Parkinson's disease (PD) is essential for halting its progression, yet challenges remain in leveraging deep learning for accurate identification. This study aims to overcome these obstacles by introducing a hybrid deep learning approach that enhances PD detection through a combination of autoencoder (AE) and radial basis function neural network (RBFNN).

Methods

The proposed method analyzes the power spectral density (PSD) of preprocessed electroencephalography (EEG) signals, with artifacts removed, to assess energy distribution across EEG sub-bands. AEs are employed to extract features from reconstructed signals, which are subsequently classified by an RBFNN. The approach is validated on UC SanDiego's EEG dataset, consisting of 31 subjects and 93 minutes of recordings.

Results

The hybrid model demonstrates promising performance, achieving a classification accuracy of 99%. The improved accuracy is attributed to advanced feature selection techniques, robust data preprocessing, and the integration of AEs with RBFNN, setting a new benchmark in PD detection frameworks.

Conclusion

This study highlights the efficacy of the hybrid deep learning framework in detecting PD, particularly emphasizing the importance of using multiple EEG channels and advanced preprocessing techniques. The results underscore the potential of this approach for practical clinical applications, offering a reliable solution for early and accurate PD detection.
Book review: Rachel Lawes, Using Semiotics in Marketing: How to Achieve Consumer Insight for Brand Growth and Profits
Authors: Nair Thejas C
Published: November 2024

Rachel Lawes, Using Semiotics in Marketing: How to Achieve Consumer Insight for Brand Growth and Profits, London: Kogan Page, 2020. 280 pp., £95.00 (Hardcover). ISBN: 978-1789662078.
Willingness to Pay for Community-based Health Insurance: A Systematic Review and Analysis of Factors Influencing Participation and Implications for Healthcare Financing
Authors: Bhojak Nimesh P. , Dodiya Shakti B. , Mathur Ashish , Momin Mohammadali K. , Patel Sureshbhai N.
Published: November 2024

Willingness to pay (WTP) for community-based health insurance (CBHI) is a crucial factor in understanding individuals’ attitudes and behaviours towards participating in insurance schemes. This article aims to examine the concept of WTP for CBHI and its implications for healthcare financing and accessibility. The research gives an organized and retrospective view of the antecedents, decisions and outcomes (ADO) of CBHI using a systematic review. The article also provides an overview of the theories, contexts and methods (TCM) employed to gain this understanding. The analysis concludes by identifying existing knowledge gaps and suggesting relevant ideas for future WTP and CBHI research. This article contributes to the existing body of knowledge on WTP for CBHI and provides insights for policymakers and researchers seeking to enhance the sustainability and effectiveness of CBHI programmes.
Economic and Performance Analysis of Achilles Tendon Rupture in the National Basketball Association
Authors: Meadows Kristopher , Ye Fei , Qiu Abram , Iyawe Osasu , Kenneth-Nwosa Kenneth
Published: November 2024

Background:

Achilles tendon ruptures are common and potentially career-ending injuries for National Basketball Association (NBA) players. Many studies have reviewed the impact of Achilles tendon ruptures on return to play (RTP) and performance, but there are no studies on their economic significance.

Purpose/Hypothesis:

This study aimed to analyze the economic and performance consequences of Achilles tendon ruptures usingthe cost of recovery (COR) for NBA franchises as well as preinjury salary/career success. It was hypothesized that players with higher preinjury salaries or performance would have an increased COR, higher rates of RTP, and more career success after their injury.

Study Design:

Descriptive epidemiology study.

Methods:

Publicly available data of NBA players who sustained an Achilles tendon rupture between 1990 and 2023 were analyzed. Data were retrospectively gathered by R software code to include players’ ages, positions, salaries, pre- and postinjury player efficiency rating, time missed after injury, and RTP. Performance impact was measured by advanced statistics: player efficiency rating, Win Shares per 48 Minutes, and Value Over Replacement Player. Two groups of 3 cohorts were created: All-Star, Starter, and Reserve versus group A (<$3,999,999), group B (≥$3,999,999 to ≤$8,999,999), and group C (>$8,999,999). Analysis of variance with post hoc Tukey tests for continuous data and Fisher exact tests for categorical data was used. Significance levels were set at P < .05.

Results:

A total of 37 players met the inclusion criteria and played between the years of 1992 through 2019. The mean COR that NBA teams faced was $4 million per player. The cumulative economic loss from Achilles tendon ruptures in the NBA between 1992 and 2019 was $117,578,851. Overall RTP was 78.38%, and 31.03% of players who returned to play were out of the NBA within 3 years. RTP to the highest playing level was highest in group B (45.5%), followed by group A (40%) then group C (12.5%). The COR of All-Star players, Starter players, and Reserve players averaged $5.7 million, $3.4 million, and $3 million, respectively.

Conclusion:

This study investigated the financial and performance implications of Achilles tendon ruptures among NBA athletes. Most players struggled to restore their preinjury performance, except for Reserve players. The findings provide valuable insights into the complexities of COR and postinjury performance.
Factors Affecting Outcomes and Complications of Primary Anterior Cruciate Ligament Reconstruction: A Retrospective Study of 110 Patients
Authors: Alkhatatba Mohammad , Atallah Micheal , Awad Baha’ , Araiqat Bashar , Aloqaily Ammar , Awad Hasan , Atallah Mathew , Ahmed Marwan
Published: November 2024

Background:

Anterior cruciate ligament injury poses a major effect on the quality of life of patients. Anterior cruciate ligament reconstruction (ACLR) remains the mainstay of treatment.

Purposes:

To (1) test for the correlation of patients’ characteristics such as body mass index (BMI), age, smoking status, and postoperative infrapatellar numbness with the subjective outcome of primary ACLR and (2) investigate whether postsurgical complications can be related to the studied patients’ characteristics.

Study Design:

Case series; Level of evidence, 4.

Methods:

Demographic data and operational notes from patients who underwent primary ACLR at the institute between 2011 and 2022 were extracted. Patients’ surgical outcomes were evaluated subjectively using the International Knee Documentation Committee (IKDC) score and the Knee injury and Osteoarthritis Outcome Score (KOOS). Pre- and postoperative scoring were completed at postoperative follow-up in December of 2022, patients completed both the IKDC and the KOOS questionnaires. Patients were asked to rate their knee function out of 10 before and after surgery. This rating was based on the patients’ self-assessment of their functional ability without the use of a formal instrument. Knee function was assigned as better, worse, or the same through a comparison of patients’ reported scores before and after surgery.

Results:

Male patients comprised 108 (98.2%) of the total cohort, the mean ± SD age at the time of surgery was 27.92 ± 7.39 years, and BMI was 26.54 ± 3.89. The mean follow-up time was 48.92 ± 27.99 months. Most patients did not need postsurgical intervention (n = 97; 88.2%), while 4 (3.6%), 7 (6.4%), and 2 (1.8%) needed revision, debridement, or both, respectively. The mean IKDC score and KOOS, respectively, were 74.37 ± 20.17 and 85.50 ± 14.83. Patients’ BMI had a significant effect on IKDC score (74.68 ± 20.0; P < .001), and infrapatellar numbness after surgery also affected patients’ IKDC score ( P = .002) and KOOS ( P = .043). The age at the time of ACLR was associated with contralateral leg surgery ( P = .017).

Conclusion:

This study showed that higher BMI and infrapatellar numbness negatively affect the subjective outcomes after primary ACLR. Older age at the time of primary ACLR was associated with a higher likelihood of surgery in the contralateral leg.
“Close to my Heart”: Teacher Educators Building Racial Literacies
Authors: Lammert Catherine , Tondreau Amy , Chen Xiufang , Hylton Rhonda , O’Brien Lisa , Yang Shuling
Published: November 2024

Although building preservice teachers’ racial literacy is a key goal to reducing racial inequity in K-12 settings, little attention has been paid to how literacy teacher educators are prepared to conduct this work. This is unsurprising given the neoliberal logic underpinning universities today. In this multiduo autoethnographic study, six literacy teacher educators utilized reflection on critical incidents to examine their own racial literacy development. By forming cross-racial pairs and utilizing a combination of writing and dialogue, these six participant/researchers interrogated their own views and experiences of race and racism. Findings suggest that the examination of critical incidents can support teacher educators’ racial literacy growth. Specifically, participants reflected on the vulnerability necessary to support preservice teachers’ racial literacy development and utilized ethnographic methods to build the practice of sharing about their own racial literacy learning. They also used critical incidents to come to a deeper understanding of the construct of racial literacy itself. These results imply that for professional organizations such as the Literacy Research Association to deliver on their espoused commitments to addressing ongoing institutional racism, they must intentionally create professional spaces for coreflection and dialog about racial literacy. Further, we consider the implications of this work for literacy doctoral programs and teacher educator preparation within contexts of college and university-based teacher education programs.
Pediatric asthma and COVID-19 vaccination: unveiling patterns of hesitancy and acceptance
Authors: Tavakol Marzieh , Gharagozlou Saber , Abbasi Mohammad , Zamani Zahra , Gharagozlou Mohammad
Published: November 2024

Background:

The global COVID-19 pandemic, declared in January 2020, necessitated urgent preventive measures, with vaccination as a key strategy. Despite progress in vaccine development and distribution, widespread hesitancy persists, impeding global disease control efforts. This study specifically explores COVID-19 vaccine hesitancy and acceptance among Iranian children with asthma, aiming to understand factors unique to this subgroup.

Method:

A cross-sectional investigation was carried out in an allergy clinic in Iran, including a total of 522 asthmatic children between the ages of 5 and 18 years. A comprehensive questionnaire, built upon previous studies, investigated the factors that influence vaccine hesitation and acceptance. Data pertaining to demographics, vaccination status, and factors influencing hesitancy or acceptance were collected.

Results:

Among the participants, 27.5% were administered the COVID-19 vaccine. Decisions were greatly influenced by family dynamics, with a notable association between parent and child vaccination. Children’s vaccination rates were associated with their age and the frequency of COVID-19 diagnosis among their parents. The primary factors motivating individuals to get vaccinated were safety concerns (67.1%) and a strong belief in the severity of COVID-19 (43.4%). On the other hand, vaccine hesitancy resulted from concerns about potential adverse effects (77%), lack of confidence (28.3%), and a belief that children who had already contracted COVID-19 did not require vaccination (22.5%).

Conclusion:

The study highlights COVID-19 vaccine hesitancy and acceptance among asthmatic children in Iran, emphasizing parental decision-making factors. Tailored interventions are required due to the lower vaccination rate in this specific group. Healthcare providers play a vital role in influencing opinions, urging actions against misinformation, enhancing vaccine understanding, and promoting positive attitudes.
Decision-making about climate change adaptation
Authors: Nalau Johanna
Published: November 2024

Decision-making about and for climate change adaptation has fascinated the field of adaptation science for decades. We now have a solid set of decision-support tools, frameworks and approaches available to support decision-makers. Yet, in this piece, I argue that the black box of decision-making requires unravelling for us to better understand what heuristics (rule of thumb) are used about climate adaptation and how these impact the very decisions made. I also point out areas in need of more research including a new focus on decision quality, artificial intelligence and data, and the role of imagination in driving climate adaptation decision-making.