bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence, Characteristics and Factors Associated with Adverse Drug Reactions Among Hospitalized Patients
Authors: MT Madhushika , SS Jayasinghe , PLGC Liyanage , TGHK Sumanathilaka
Published: February 2024

Objectives: This study aimed to describe the prevalence and characteristics of ADRs and to identify the factors associated with ADRs among hospitalized patients. Methodology: A descriptive cross-sectional study was conducted over a 6 month period at Teaching Hospital Karapitiya (THK), Sri Lanka. A total of 2000 patients, who were admitted consecutively for any type of treatment during the study period were enrolled. The factors associated with ADRs were evaluated using logistic regression models, using ADR occurrence as the outcome. Results: A total of 123 ADRs were found from the sample. The prevalence of ADRs among hospitalized patients was 6.2%. (95% CI 5.1-7.2). ADRs were reported in 62 males (50.4%). The median (IQR) age of ADR occurrence was 52 (35-67) years. The most prevalent type of ADR was Type A (n = 62, 50.4%) and out of the total ADRs, 74 were moderately severe reactions (60.2%). Antibiotics (n = 29, 23.5%) were the most common causative agent for ADRs, followed by anticoagulants (n = 10, 8.1%). The multivariate logistic regression model showed that the number of prescribed drugs ( P = .011), ADR history ( P = 0 0.01) and diabetes mellitus ( P = .003) were significantly associated with the occurrence of ADRs. Age ( P = .21), gender ( P = .31), ethnicity ( P = .14), and other concomitant illnesses (Hypertension P = .66, Ischemic Heart Disease P = .25, etc.) did not associated with the occurrence of ADRs. Conclusion: According to this study the prevalence of ADRs was significant among inward patients in the Teaching Hospital, Karapitiya. The number of prescribed drugs, ADR history and diabetes mellitus were significantly correlated with the occurrence of ADRs. The results of the study can be used to guide healthcare professionals to revise the medication list frequently and monitor the patients who are at risk for developing ADRs.
Cable ties in forensic practice
Authors: Byard Roger W
Published: February 2024

Cable or zip ties are mass produced inexpensive nylon fasteners, which have a locking mechanism to prevent them from being loosened. Their use in medicolegal cases is infrequent, being involved in situations of neck compression or restraint. The Forensic Science SA Pathology Database (in Adelaide, Australia) and search engines PubMed, Google Scholar and Google were examined for cases where cable ties were documented as either causing death or being potentially lethal, being a contributor to death, or having been used for restraint purposes. Neck compression resulting in ligature strangulation was found in cases of homicide and suicide in adults. Accidental neck compression was rarely reported in children. Cases of restraint again occurred in both homicides and suicides, with nonlethal wrist restraint being used by law enforcement officers in lieu of traditional handcuffs. Cable ties may also be used to fasten ligatures to suspension points in case of hanging. Despite their ready availability, cable ties are only relatively rarely involved in medicolegal cases. More traditional forms of manual or ligature neck compression are still favoured possibly because they require less dexterity.
Perspectives on family resilience in the face of unemployment: a case study on unemployed City of Johannesburg families
Authors: Monakedi Lesiba , Nel Lindi
Published: February 2024

Unemployment is a global phenomenon that is affecting many individuals and families negatively, in particular, their functioning, well-being, and coping mechanisms. Unemployment is thus regarded as a risk factor that places many families in adverse situations. While literature extensively describes family resilience in the face of diverse adversities, little research documents family resilience in the face of unemployment, especially in South Africa. It is within this context that we set out to explore the adversity of unemployment from a resilience perspective with the intention to unmask the embedded protective processes in affected families. This was approached through the loose application of Walsh’s family resilience perspective as a theoretical lens. In-depth, semi-structured interviews were conducted with nine participants who were regarded as breadwinners or key family providers. Each participant engaged in two interviews that were four months apart to allow for reflection and member checking. Data were analysed through a hybrid process that incorporated both the inductive and the deductive logic of thematic analysis. Participants described several key protective processes, which aligned with what Walsh proposed. The practice of communicating, the ability to connect, and the use of spirituality were identified as particularly useful. Overall, the findings imply that despite the experienced adverse conditions of unemployment, South African families demonstrate thriving potential.
Women’s social resilience in the context of male out-migration in Dehradun district, India
Authors: Cagliani Federica , Mazzucato Valentina , Fourie Elsje
Published: February 2024

It is widely acknowledged that migration impacts men and women differently. Most prior research has looked at these effects on the migrants themselves, while those who remain in their places of origin have received less scholarly attention. This article investigates how male labor migration from the Dehradun district of India affects the wives who stay behind. It adopts a social resilience perspective by focusing on the opportunities and vulnerabilities that women face once their husbands migrate. Our findings identify four factors that shape these women’s resilience as well as four domains of resilience. While women with strong support networks and higher social statuses tend to experience a greater sense of resilience when their husbands migrate, their personal circumstances nevertheless interact in nuanced and sometimes surprising ways. We argue that stay-behind wives are neither particularly vulnerable nor emancipated but can occupy myriad positions along this spectrum.
Fault severity identification of planetary gearbox based on refined composite multiscale diversity entropy
Authors: Chen Gaige , Lu Taiwu , Wang Xianzhi , Wei Yu , Ma Hongbo
Published: February 2024

Planetary gearbox is a key component in modern industry. A sudden failure may cause disastrous consequences. Thus, accurately acquiring the fault severity can be of importance. Diversity entropy emerges as a promising feature extraction tool for monitoring the health condition. However, the original diversity entropy has the defect that the data length of multiple time series will shorten at deep scales, resulting in unstable complexity estimation at high scale. To overcome this defect, a new feature extraction method has been proposed named refined composite multiscale diversity entropy (RCMDE). The proposed RCMDE method combines moving average windows under each scale factor and the refined state probability to improve the statistical reliability, which allows the diversity entropy to explore more refined fault information hidden at deeper scales. The simulation and experiment results proved that the proposed method has the highest diagnostic accuracy with the best stability in fault severity identification of planetary gearbox.
A Comparison of Single-Case Effect Measures Using Check-In Check-Out Data
Authors: Peart Allison M. , Drevon Daniel D. , Jasper Andrea D.
Published: February 2024

There are numerous effect measures researchers can select when conducting a meta-analysis of single-case experimental design research. These effect measures model different characteristics of the data, so it is possible that a researcher’s choice of an effect measure could lead to different conclusions about the same intervention. The current study investigated the impact of effect measure selection on conclusions about the effectiveness of check-in check-out (CICO), a commonly used intervention within School-Wide Positive Behavior Interventions and Supports. Using a multilevel meta-analysis of seven different effect measures across 95 cases in 22 studies, findings suggested that all effect measures indicated statistically significant results of CICO in improving student behavior. However, the magnitude of the effects varied when comparing the results to interpretive guidelines, suggesting that the selection of effect measures may impact conclusions regarding the extent to which an intervention is effective. Implications, limitations, and future directions are discussed.
Comparison of different porcine models simulating myocardial cold ischemia of pediatric donor hearts
Authors: Stukov Yuriy , Bleiweis Mark S , Wilson Laura , Peek Giles J , March Keith , Richards Elaine M , Staples Edward D , Jacobs Jeffrey P
Published: February 2024

Background

Our team previously identified a stem cell-derived cardioprotective additive that can be added to standard cardioplegia to extend myocardial viability during prolonged myocardial cold ischemic time (CIT) in rodent models. The purpose of this study was to utilize a porcine model to compare in-vivo versus ex-vivo porcine simulation of CIT that accompanies cardiac transplantation in humans, in order to determine an optimal method for translation of our studies to larger animals.

Methods

Eight 39–55 kg Yorkshire X pigs were randomly assigned to either in-vivo or ex-vivo simulation. After administration of general anesthesia and endotracheal intubation, baseline measurement of left ventricular performance was obtained via transesophageal echocardiography (TEE). After midline sternotomy and heparin administration, the aorta was cross-clamped and two liters of HTK-Custodiol were introduced via the aortic root. The in-vivo method utilized cold ischemic heart storage in the chest cavity while supporting the experimental animal with cardiopulmonary bypass (CPB). The ex-vivo method involved standard cardiac procurement, cold ischemic storage outside of the body, and subsequent cardiac reperfusion utilizing cardiac reanimation in a Langendorff heart perfusion mode. After CIT, measurements of post-ischemic left ventricular performance were obtained via echocardiography. Results are presented as: Mean ± Standard Deviation (Median, Minimum–Maximum).

Results

Weight (kilograms) was similar in the in-vivo group and the ex-vivo group: 44 ± 1.8 (44, 42–46) versus 44 ± 5.1 (43.5, 39–51), respectively. Cold ischemic time (minutes) was longer in the ex-vivo group: 360 ± 0 (360, 360–360) versus 141 ± 26.7 (149, 102–163). Temperature (degrees Celsius) was colder in the ex-vivo group: 8 ± 0 (8, 8–8) versus 16.5 ± 4.2 (16, 12–16). In the in-vivo group, baseline ejection fraction and ejection fraction after CIT were: 48.25% ± 14.95% (48.5%, 33%–63%) and 41.25% ± 22.32% (41.5%, 20%–62%), respectively. In the ex-vivo group, baseline ejection fraction and ejection fraction after CIT were: 56.4% ± 5.9% (57%, 50%–67%) and 60.4% ± 7.7% (61.5%, 51.9%–67%), respectively.

Conclusion

The ex-vivo technique is suitable to evaluate cardioplegia additives that may substantially extend myocardial tolerance to cold ischemia.
High-resolution climate change during the Marine Isotope Stage 3 revealed by Zhouqu loess in the eastern margin of the Tibetan Plateau
Authors: Chen Zixuan , Li Qiong , Li Pushuang , Zhou Jiantao , Su Yating , Liu Weiming , Luo Yuanlong , Wen Chen , Xu Xuechao , Yang Shengli
Published: February 2024

A consensus has not yet been reached on effects of climate change and driving mechanisms between the Tibetan Plateau (TP) and adjacent monsoonal areas during the Marine Isotope Stage 3 (MIS 3). Loess–paleosol sequences from the TP provide valuable information about the MIS 3 environmental history. Detailed color index and a diffuse reflectance spectral (DRS) analysis of Zhouqu (ZQ) loess from the Western Qinling Mountains were conducted to investigate climate change on the eastern margin of the TP during the MIS 3. Our results show that the variations in color index and iron oxide content in ZQ loess are mainly caused by the pedogenesis and climate conditions. The lightness (L*) value and hematite (Hm) content were used to reconstruct the precipitation history and temperature changes, respectively. The reconstructed records revealed that climate change during the MIS 3 was characterized by high frequency and large amplitude, with millennial-scale changes superimposed on orbital-scale changes. Warm–humid climate occurred in the late MIS 3, while the early climate of MIS 3 was relatively cold–dry. The Indian summer monsoon (ISM) and temperature variations during the MIS 3 mainly occurred due to obliquity and precession. The North Atlantic cooling led to the southward movement of the Intertropical Convergence Zone, and the downstream cooling of the atmosphere by the westerly jet could result in events on a millennial-scale in the eastern margin of the TP. The interhemispheric forcing may play an important role in driving the strong summer monsoon in the late MIS 3.
Engineering design and the impact of digital technology from computer-aided engineering to industrial metaverses: A perspective
Authors: Patterson Eann A.
Published: February 2024

Digital technology for engineering design is evolving from computer-aided engineering tools via digital twins to industrial metaverses. These advances are resolving many of the challenges associated with implementing concurrent design and enabling larger design domains to be considered and designs to be developed, reviewed and demonstrated more rapidly and with a wider range of stakeholders. However, the new technology is also creating new challenges associated with confidence in digital representations and with methods of working with a rapidly evolving design. These challenges need to be addressed so that radical new designs of complex systems can be produced quickly to support society in addressing the evolving crisis of climate change.
Development of Aggregate Dielectric Constant Database Protocol for Asphalt Concrete Density Prediction
Authors: Abufares Lama , Al-Qadi Imad L.
Published: February 2024

Contractors are paid incentives/disincentives based on achieved in situ asphalt concrete (AC) density. Ground-penetrating radar (GPR) has been proven feasible for predicting in situ density of AC pavements using various empirical and fundamental approaches. However, to use fundamental equations for density prediction, aggregate dielectric constant must be known beforehand. Destructive cores are usually extracted from the pavement to back-calculate the aggregate dielectric constant. This cancels out the non-destructive benefit of the GPR technology. In this study, GPR is used to quantify the dielectric constant of 10 different aggregates commonly used in AC mixes in Illinois, U.S. The sampled aggregates included limestone, dolomite, trap rock, granite, and crushed gravel. The purpose was to initiate an aggregate dielectric constant database that would help predict AC density nondestructively and accurately. By using the aggregate database, GPR would help contractors estimate achieved density in real-time without prior calibration. This technology would save energy, time, and cost. Simulations using gprMax and a sensitivity analysis are presented to illustrate the effect of aggregate dielectric constant on AC bulk dielectric constant and, consequently, on AC density predicted by the Al-Qadi Lahouar Leng model. A new procedure to determine the aggregate dielectric constant using the electromagnetic mixing theory is detailed. Advanced chemical tests confirmed that the aggregate dielectric constant is a function of its elemental/mineral compositions. Finally, laboratory and field data were used to validate AC density prediction using the aggregate database. The establishment of an aggregate dielectric constant database would improve the accuracy of GPR in nondestructive AC density prediction.
A futures study of life satisfaction among Iranian students
Authors: Saeedy Sina
Published: February 2024

Both anecdotal and empirical evidence strongly suggest that the current circumstances are leaving the younger generation in Iran dissatisfied. In light of that, this article embarks on a comprehensive exploration of this predicament through a mixed methods design. The focal point of this investigation rests on a selected cohort of graduate students from the University of Tehran. The administered questionnaire survey, encompassing a sample of 237 students, revealed a significant deficit in both their present and future life satisfaction measures. To delve deeper into the origins of this issue, a series of 32 in-depth interviews were conducted, providing invaluable insights. This qualitative phase was accompanied by a Thematic Analysis and the application of the Causal Layered Analysis methodology. The research findings uncovered an intricate web of factors contributing to youth discontentment. While systemic factors like injustice, corruption, and lack of civil liberties play a significant role, there are deeper layers at play. These include ideological conflicts between the younger generation and the government, the pervasive escalation of social comparison bias, and the spread of loss of meaning in life among the youth. Moreover, this study sheds light on their deepest level of perception and illuminates how they are unable to nurture a positive perspective on their life and society.
Learning About Resilience from Rural Interprofessional Healthcare Teams: Insights from the “First Wave” of COVID-19
Authors: Coady Maureen
Published: February 2024

Building resilience is a key concern for adult educators today as we face unprecedented global challenges such as the coronavirus disease-19 (COVID-19). Nowhere is this more apparent than in educational initiatives with health professionals who experience many stressors in their work, now amplified by the pandemic. This paper reports the results of focus groups with three interprofessional primary healthcare teams in rural Nova Scotia, Canada, in the fall of 2021. The aim was to learn about their lived experience during the first year of the pandemic, as a basis for considering how resilience could be nurtured and supported in rural team-based collaborative practices settings. Findings reveal that, while each collaborative team experienced recognized COVID-19 workplace stressors, they leveraged a store of collective resilience to navigate the pandemic. The trust, sense of purpose, and shared problem-solving skills they derived from working in collaborative structures over time enabled them to regain equilibrium and to adapt to new norms, and to transform thier practices. The study highlights the power of collaborative learning to strengthen overall ability for resilient performance, and the adaptive capacity that is required to deliver and sustain quality healthcare. The study highlights the need for continuing professional education that values naturally occurring practice-based learning. Adult educators are well positioned to support health professionals and health systems to nurture and support resilient action. They bring an understanding of effective collaborative tools and processes that foster dialogue and collective awareness that leads to a shared identity and understanding. As this study reveals, it is this shared identity and capacity arising within a group that enables them to draw on their collective sources of support to deal with adversity.
Culture, Cultural Competence, and Clinical Care
Authors: Cassidy Tanya M.
Published: February 2024

Culture competence is a concept that can be traced back to health care considerations in the 1960s and 1970s, and in particular to nursing education. Critics of the concept have argued that this was not simple a listing of cultural facts, behaviors, and practices, but instead follow a more ethnographic understanding of culture. In this article, I recognize that culture is not simply about the other, but something we all possess, and is also always changing throughout our lives. Understanding and respecting diversity and culture is key to improving services, including lactation support.
Proportional control of a parallel robogami delta mechanism with embedded 2D printed angle sensor feedback
Authors: Türkmen Dila , Kalafat Merve Acer
Published: February 2024

Robogami structures are employed for many purposes, including miniature parallel manipulators. Parallel manipulators require accurate joint position feedback, underlining the open problem in robogami structures for providing sophisticated feedback with 2D, fully embeddable, down-scalable, flexible sensors. Existing studies include only on-off control applications, excluding any parallel mechanism implementations and continuous proportional control signals. We implement silver inkjet printed angle sensors for the first time into a robogami structure and use this class of sensors for control. For the first time, a parallel manipulator is controlled with a 2D sensor, and printed sensors are tested for continuous control. Performances are analyzed with set-point and tracking control tasks using a paper Delta mechanism, compared with on-off control and encoder feedback control cases for better evaluation. A detailed comparison with the existing studies both for robogami parallel mechanisms and other sensor-embedded flexible hinges is provided. Encoder-like control performances are achieved in a wide range of the joint space and down to ~1 mm. RMS task space accuracy is recorded. Sources and potential improvements for the less accurate regions are stated. We conclude that printed sensors are promising for parallel mechanisms and continuous signal control applications.
Symmetric laminates for enhanced tire durability: A numerical study on belt edge separation
Authors: Yadav Ankush , Gandecha Ankur , Mahajan Jitendra
Published: February 2024

Tire failure due to belt edge separation is a common issue caused by various factors such as adhesion loss, high heat generation, and interlaminar shear. This research paper focuses on studying the phenomenon of belt edge separation in tires by investigating the effect of belt lay arrangement on this failure mode. The study examines two types of belt arrangements, namely Symmetric and Asymmetric, in both four belt and three belt package configurations, using advanced finite element analysis (FEA) techniques. MSC-MARC commercial Finite Element software is employed to conduct FE analysis on an 11R22.5 tire model under steady-state rolling conditions. Through numerical simulations, the study reveals that the symmetric belt arrangement, irrespective of the belt package configuration (four belt or three belt), minimizes strain energy density, principal strains, and principal stresses in the belt edge region compared to the asymmetric arrangement. Interestingly, the asymmetric arrangement is commonly used by tire companies for Truck Bus Radial (TBR) tires. Based on the findings of numerical simulations, this research paper proposes a new three belt package configuration that effectively utilizes the symmetric belt lay arrangement as a potential solution to reduce belt edge separation in TBR tires.
Epidemiology studies on effects of lithium salts in pregnancy are confounded by the inability to control for other potentially teratogenic factors
Authors: Smith Carr J. , Payne Victoria M.
Published: February 2024

Introduction

In bipolar women who took lithium during pregnancy, several epidemiology studies have reported small increases in a rare fetal cardiac defect termed Ebstein’s anomaly.

Methods

Behavioral, environmental, and lifestyle-associated risk factors associated with bipolar disorder and health insurance status were determined from an Internet search. The search was conducted from October 1, 2023, through October 14, 2023. The search terms employed included the following: bipolar, bipolar disorder, mood disorders, pregnancy, congenital heart defects, Ebstein’s anomaly, diabetes, hypertension, Medicaid, Medicaid patients, alcohol use, cigarette smoking, marijuana, cocaine, methamphetamine, narcotics, nutrition, diet, obesity, body mass index, environment, environmental exposures, poverty, socioeconomic status, divorce, unemployment, and income. No quotes, special fields, truncations, etc., were used in the searches. No filters of any kind were used in the searches.

Results

Women who remain on lithium in the United States throughout their pregnancy are likely to be experiencing mania symptoms and/or suicidal ideation refractory to other drugs. Pregnant women administered the highest doses of lithium salts would be expected to have been insufficiently responsive to lower doses. Any small increases in the retrospectively determined risk of fetal cardiac anomalies in bipolar women taking lithium salts cannot be disentangled from potential developmental effects resulting from very high rates of cigarette smoking, poor diet, alcohol abuse, ingestion of illegal drugs like cocaine or opioids, marijuana smoking, obesity, and poverty.

Conclusions

The small risks in fetal cardiac abnormalities reported in the epidemiology literature do not establish a causal association for lithium salts and Ebstein’s anomaly.
Superparamagnetic Iron Oxide Nanoparticle Implantation and Magnetic Field Exposure Modulate Bone Microarchitecture Following Spinal Cord Injury in Adult Male Rats
Authors: Chakraborty Arpita , Porwal Konica , Raman Srishty , Chandra Yadav Subhash , Vishnubhatla Sreenivas , Kochhar Kanwal Preet , Jain Suman
Published: February 2024

Background: Osteoporosis is one of the detrimental effects of spinal cord injury (SCI), leading to bone loss. It has already been established that superparamagnetic nanoparticles when exposed to an external magnetic field (MF) show strong magnetisation and promote locomotor recovery.

Purpose: The aim of the present study is to explore the role of magnetised nanoparticles in ameliorating SCI-induced osteoporosis.

Methods: The rats were divided into Sham, SCI, SCI+MF, SCI+V, SCI+NP and SCI+NP+MF groups. A complete transection was performed at the T13 level, followed by iron oxide nanoparticle implantation along with MF exposure for 7 or 14 days.

Results: A significant increase in locomotor score was evident at day 5 in all groups except in the SCI+V group, and at day 7, all groups showed a significant increase in Basso, Beattie and Bresnahan score as compared to the pre-surgery score at week 1 of the study period. A significant decrease in bone volume/total volume ratio and trabecular thickness and increase in trabecular separation were observed in all groups as compared to Sham. A significant increase in trabecular thickness in the SCI+NP+MF group as compared to the SCI+MF group was observed after one week. After two weeks, the SCI+MF group showed a significant increase in locomotor scores at days 5 and 13 as compared to the SCI, SCI+V and SCI+NP groups. Bone loss was significantly observed in all groups except SCI+MF, as compared to Sham. Cortical bone showed no significant change at both time points. On histopathological examination of the spinal cord, we observed significant improvement in lesion volume in SCI+MF and SCI+NP+MF groups after one week, whereas only the SCI+NP+MF group showed a significant decrease after two weeks.

Conclusion: Electromagnetic field stimulation partially restored bone architecture after superparamagnetic nanoparticle implantation, which may be due to reduced lesion volume and improved locomotor behaviour.
The Future of Research in an Artificial Intelligence-Driven World
Authors: Kulkarni Mukta , Mantere Saku , Vaara Eero , van den Broek Elmira , Pachidi Stella , Glaser Vern L. , Gehman Joel , Petriglieri Gianpiero , Lindebaum Dirk , Cameron Lindsey D. , Rahman Hatim A. , Islam Gazi , Greenwood Michelle
Published: February 2024

Current and future developments in artificial intelligence (AI) systems have the capacity to revolutionize the research process for better or worse. On the one hand, AI systems can serve as collaborators as they help streamline and conduct our research. On the other hand, such systems can also become our adversaries when they impoverish our ability to learn as theorists, or when they lead us astray through inaccurate, biased, or fake information. No matter which angle is considered, and whether we like it or not, AI systems are here to stay. In this curated discussion, we raise questions about human centrality and agency in the research process, and about the multiple philosophical and practical challenges we are facing now and ones we will face in the future.
A Feminist Critical Analysis of Public Toilets and Gender: A Systematic Review
Authors: Lewkowitz Shawna , Gilliland Jason
Published: February 2024

This systematic review explores how the provision and experience of public toilets in urban spaces are gendered in North America, Europe, Australia, and New Zealand. A search of 4 bibliographic databases resulted in 19 articles for inclusion. Data were analyzed using a feminist critical perspective and the United Nations (UN) framework on standards to assess the provision of sanitation in public spaces. The framework criteria include availability; accessibility; affordability; quality and safety; and acceptability, privacy, and dignity. This review demonstrates that more public toilets that consider the needs of all genders are needed, and it offers guidance to policymakers, planners, and funders on what to consider when planning and building them.
Methylphenidate and Sleep Difficulties in Children and Adolescents With ADHD: Results From the 2-Year Naturalistic Pharmacovigilance ADDUCE Study
Authors: Häge Alexander , Man Kenneth K. C. , Inglis Sarah K. , Buitelaar Jan , Carucci Sara , Danckaerts Marina , Dittmann Ralf W. , Falissard Bruno , Garas Peter , Hollis Chris , Konrad Kerstin , Kovshoff Hanna , Liddle Elizabeth , McCarthy Suzanne , Neubert Antje , Nagy Peter , Rosenthal Eric , Sonuga-Barke Edmund J. S. , Zuddas Alessandro , Wong Ian C. K. , Coghill David , Banaschewski Tobias
Published: February 2024

Objective:

Short-term RCTs have demonstrated that MPH-treatment significantly reduces ADHD-symptoms, but is also associated with adverse events, including sleep problems. However, data on long-term effects of MPH on sleep remain limited.

Methods:

We performed a 2-year naturalistic prospective pharmacovigilance multicentre study. Participants were recruited into three groups: ADHD patients intending to start MPH-treatment (MPH-group), those not intending to use ADHD-medication (no-MPH-group), and a non-ADHD control-group. Sleep problems were assessed with the Children’s-Sleep-Habits-Questionnaire (CSHQ).

Results:

1,410 participants were enrolled. Baseline mean CSHQ-total-sleep-scores could be considered clinically significant for the MPH-group and the no-MPH-group, but not for controls. The only group to show a significant increase in any aspect of sleep from baseline to 24-months was the control-group. Comparing the MPH- to the no-MPH-group no differences in total-sleep-score changes were found.

Conclusion:

Our findings support that sleep-problems are common in ADHD, but don’t suggest significant negative long-term effects of MPH on sleep.
Democracy as a floating signifier: The struggle for legitimation of programming in Swedish schools
Authors: Raptopoulou Anthemis , Munhall Brendan
Published: February 2024

The concept of democracy is a central component in education policy at all levels, yet its meaning can be interpreted in a number of ways. This paper examines how democracy is conceptualised and utilised as a legitimising force driving education policy reform. More specifically, attention is given to the use of democracy in the process of promoting programming’s inclusion in the Swedish compulsory curriculum. A number of mass-media articles published in Swedish are analysed using the concept of floating signifiers. The context of Sweden is of particular interest, since the notion of democracy has been a driving force in Swedish society for the legitimisation of education policy changes. In this paper, we chose to approach the link between democracy and education from a critical perspective and ask how the concept of democracy is being utilized as a part of political struggles to hegemonize and legitimize educational changes. It is argued that democracy, as a floating signifier, was central to the discursive production of the educational agenda of programming and its legitimisation. This article aims to function as a critique of the promotion of programming in education as a means to democracy.
An Examination of How Participation in Basic Instruction Program (BIP) Courses May Influence College Student Retention Rates
Authors: Naeger Dylan , Greenwell Chris , Hums Mary
Published: February 2024

The purpose of this study was to determine how enrollment in a basic instruction program (BIP) course may affect undergraduate student retention rates. This study examined whether enrollment in BIP courses influenced student retention of all first-time, full-time, baccalaureate degree-seeking students enrolled at a public research university during the years of 2014 and 2015 ( N = 5,565). A significant finding showed students enrolled in BIP courses during their first or second year had 1.65 greater odds of being retained after the second year. Additionally, students enrolled in BIP courses during their second year had 3.22 greater odds of second year retention. For each additional BIP course enrolled, students had 1.39 greater odds of being retained after the second year. While most institutions no longer require BIP enrollment, the findings in the current study demonstrate an association between BIP enrollment and greater odds of student retention.
Case-to-Condition Ratios in Qualitative Comparative Analysis: Adding Cases Instead of Removing Conditions
Authors: Glaesser Judith
Published: February 2024

In qualitative comparative analysis, as with all methods, there is a question about how many cases are needed to make an analysis robust. In deciding on the number of cases, a key consideration is the number of conditions to be analyzed. I suggest that adding cases is preferable to dropping conditions if there are too many conditions relative to the number of cases. I first consider the relationship of low n and limited diversity, followed by an exploration of two scenarios: (1) cases in the study are the universe; (2) more cases could exist. I suggest that a simple rule or benchmark on how many cases to include in relation to the number of conditions is unlikely to be helpful since this depends at least in part on the goals and circumstances of the research. Finally, this issue is not confined to QCA but affects all types of research.
Systematic Review and Meta-analysis of Fenestrated and Chimney/Snorkel Techniques for Endovascular Repair of Juxtarenal Aortic Aneurysms
Authors: Baldeh Tejan , Reilly Tomás , Mansoor Tayyaub , Feeney Gerard , Medani Mekki , Moloney Michael A. , Kavanagh Eamon G.
Published: February 2024

Objectives:

Comparative effectiveness of fenestrated endovascular aneurysm repair (FEVAR) and chimney graft endovascular aneurysm repair (ChEVAR) for juxtarenal aortic aneurysms (JAAs) remains unclear. Our objective was to identify and analyze the current body of evidence comparing the effectiveness of both techniques for JAA.

Methods:

We performed a systematic review and meta-analysis comparing the effectiveness of FEVAR and ChEVAR for JAA repair. We searched MEDLINE, EMBASE, and Cochrane Register for Controlled Trials from January 1, 1990, for randomized and non-randomized studies assessing outcomes of FEVAR and ChEVAR for JAA repair. Screening, data extraction, risk of bias assessment, and GRADE (Grading of Recommendations, Assessments, Development, and Evaluations) certainty of evidence were performed in duplicate. Data were pooled statistically where possible.

Results:

Nine retrospective cohort studies comparing the use of FEVAR and ChEVAR for juxtarenal aneurysm were included for meta-analysis. The FEVAR and ChEVAR arms of the meta-analysis consisted of 726 participants and 518 participants, respectively. There were 598 (86.8%) and 332 (81.6%) men in each arm. The mean diameter was larger in the ChEVAR arm (59 mm vs 52.5 mm). Both techniques had similar rates of postoperative 30-day mortality, 3.38% (8/237) versus 3.52% (8/227), acute kidney injury, 16.76% (31/185) versus 17.31% (18/104), and major adverse cardiac events, 7.30% (46/630) versus 6.60% (22/333). The meta-analysis supported the use of FEVAR for most outcomes, with significant advantage for technical success (odds ratio [OR]: 3.24, 95% CI: 1.24–8.42) and avoidance of type 1 endoleak (OR: 5.76, 95% CI: 1.94–17.08), but a disadvantage for spinal cord ischemia (OR: 10.21, 95% CI: 1.21–86.11), which had a very low number of events. The quality of evidence was “moderate” for most outcomes.

Conclusion:

Both endovascular techniques had good safety profiles. The evidence does not support superiority of either FEVAR or ChEVAR for JAA.

Clinical Impact:

While lack of equipoise has hampered the design of randomised trials of open versus endovascular repair of juxtarenal aortic aneurysms, concern about the durability of endovascular repair highlights the need for stronger evidence of the comparative efficacy of endovascular techniques. This review performed meta-analysis and evidence appraisal of recent data from large observational studies comparing fenestrated and chimney techniques, using a comprehensive outcome set. Superiority of either intervention could not be established due to differences in participants’ baseline risk in each study arm. However, data suggests that both techniques are safe and suitable for use when indicated.
Targeting Receptor Tyrosine Kinases as a Novel Strategy for the Treatment of Triple-Negative Breast Cancer
Authors: Jaradat Sara K. , Ayoub Nehad M. , Al Sharie Ahmed H. , Aldaod Julia M.
Published: February 2024

Triple-negative breast cancer (TNBC) comprises a group of aggressive and heterogeneous breast carcinoma. Chemotherapy is the mainstay for the treatment of triple-negative tumors. Nevertheless, the success of chemotherapeutic treatments is limited by their toxicity and development of acquired resistance leading to therapeutic failure and tumor relapse. Hence, there is an urgent need to explore novel targeted therapies for TNBC. Receptor tyrosine kinases (RTKs) are a family of transmembrane receptors that are key regulators of intracellular signaling pathways controlling cell proliferation, differentiation, survival, and motility. Aberrant activity and/or expression of several types of RTKs have been strongly connected to tumorigenesis. RTKs are frequently overexpressed and/or deregulated in triple-negative breast tumors and are further associated with tumor progression and reduced survival in patients. Therefore, targeting RTKs could be an appealing therapeutic strategy for the treatment of TNBC. This review summarizes the current evidence regarding the antitumor activity of RTK inhibitors in preclinical models of TNBC. The review also provides insights into the clinical trials evaluating the use of RTK inhibitors for the treatment of patients with TNBC.
Diabetic Foot Screening Guidelines and the Role of Artificial Intelligence: Time to Turn the Tide!
Authors: Formosa Cynthia , Chockalingam Nachiappan , Papanas Nikolaos , Gatt Alfred
Published: February 2024

Despite medical and technological advancements, foot amputations continue to rise. Thus, the effort of diabetic foot management should be toward prevention and early diagnosis. Healthcare professionals need to be trained, equipped, and supported with adequate resources to be able to identify and deliver appropriate foot care. Every effort should be made to minimize the impact of complications and to ensure prompt access to care for everyone. Artificial intelligence and smart technology could provide a significant opportunity to improve efficiency in diabetes care, which may reduce diabetic foot complications. The possible potential of the new technologies which are emerging together with their current developing applications for diabetic foot care are suggested. A call for immediate change in diabetes foot screening guidelines is imperative to save limbs and lives.
Compression of the Ulnar Nerve by the Arcade of Struthers: Look and You Shall Find
Authors: Elmaraghi Shady , Taylor Ruby , Tung Isaac , Patterson Megan M. , Mackinnon Susan E.
Published: February 2024

Background:

The arcade of Struthers was first proposed by Kane et al in 1973. Clinical investigations of this structure have been limited to small case series, focusing on the arcade as an isolated cause of compressive ulnar neuropathy. The purpose of our study was to investigate the incidence of this structure in patients undergoing ulnar nerve transposition.

Methods:

A retrospective chart review of prospectively maintained data in a single surgeon’s practice was performed. Records of patients undergoing surgery for compressive ulnar neuropathy at the cubital tunnel were evaluated for documentation of a compressive arcade of Struthers. In addition, a scoping review of the literature was undertaken to better characterize current understanding of this structure and its recognition in clinical practice.

Results:

A total of 197 patients underwent ulnar nerve transposition. The overall incidence of a compressive arcade of Struthers was noted to be 67 out of 197 (34%). All patients with a compressive arcade were noted to have an internal brachial ligament running below the nerve. Patients undergoing revision surgery were found to have a compressive arcade 51% of the time (20/39), whereas 30% of patients undergoing primary surgery were found to have a compressive arcade (47/158). Only 12 clinical studies examining the arcade of Struthers have been published in the last 20 years, the majority being single case reports.

Conclusions:

Compression of the ulnar nerve by the arcade of Struthers is a common finding and can contribute to compressive ulnar neuropathy at the elbow both in primary and revision cases.
Thoracic aortic aneurysms, a single center’s 10-years experience and analysis of outcomes
Authors: Baldaia Leonor , Duque Mariana , Silva Miguel , Silva Eduardo , Nunes Celso , Constâncio Vânia , Orelhas Luís , Fonseca Manuel , Antunes Luís F.
Published: February 2024

Introduction

Thoracic aortic aneurysms (TAAs) are an increasingly prevalent pathology with significant associated morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) is the primary line of treatment. The purpose of this study was to analyse a single center’s experience in the treatment of TAAs and identify possible risk factors for worse outcomes.

Methods

A retrospective review of our institutional database was done to identify all patients treated for TAAs in a 10-year period, from 1 January 2012 to 31 December 2022. Data were extracted from patients’ medical records. Primary outcome was all-cause mortality and secondary outcomes were procedure related morbidity (vascular access complications, medullary ischaemia, stroke, endoleaks, migration, aneurysm sac enlargement >5 mm) and need for reintervention at 1-, 6- and 12-month follow-up. A descriptive and inferential analysis of the data was performed. Statistical analyses were conducted using the IBM Statistical Package for Social Sciences (SPSS) software.

Results

We identified 34 patients treated for TAAs in this period. Mean age was 68 years [47–87] and 79.4% of patients were male. Mean aneurysm diameter was 63 mm [35–100], 55.9% fusiform and 44.1% saccular. The majority (91.2%) were located at the descending thoracic aorta and 3 (8.8%) of them extended to the aortic arch. The most common aetiology was degenerative in 22 patients (64.7%), followed by aortic dissection in 8 patients (23.5%). Elective surgery was performed in 19 (61.3%) patients and 12 (38.7%) had urgent repair. TEVAR was the treatment of choice in 24 (77.4%) patients, and the remaining 7 (22.6%) were treated with hybrid surgery. Mean length of hospital stay was 10 days [2–80] (6 days for elective repair versus 16 days for urgent repair, p = .016). Follow-up period ranged from 1 month to 10 years. At 1 year follow-up, all-cause mortality was 15%, morbidity was 30% (with 6 (22%) patients having a type Ia endoleak) and need for reintervention was 22%. Aneurysm diameter was a significant risk factor for procedure related morbidity (median diameter of 73.5 mm versus 56.0 mm in patients with no morbidity; p = .027). The presence of type Ia endoleak was significantly associated with higher reintervention rates ( p = .001), but not with higher mortality rates ( p = .515). Age, female sex, aetiology and urgent repair weren’t associated with any significant differences in the outcomes.

Conclusions

TEVAR proved to be effective in the treatment of TAAs, with good outcomes at short and mid-term follow-up. TAAs should be diagnosed earlier and be promptly treated when meeting criteria to prevent worse outcomes.
Building middle leading practice through pedagogy-focused professional development
Authors: Harris Jess , Jaremus Felicia , Gore Jennifer
Published: February 2024

School middle leaders (MLs) play a pivotal role in improving student outcomes through leading teaching and learning. However, MLs face considerable challenges in driving school improvement, including comparatively few opportunities for targeted professional development (PD). In this paper, we explore the impact of a pedagogy-focused, collaborative approach to PD, known as Quality Teaching Rounds (QTR), for middle leading practice. Twenty-two post-QTR interviews with MLs, principals and classroom teachers at nine primary schools in NSW, Australia, were thematically analysed using Kemmis's theory of practice architectures. We found that QTR positively impacted middle leading by: (1) building agreement about good pedagogical practice; (2) enhancing pedagogy through a process of reciprocal lesson observation; and (3) building collegial culture by flattening power hierarchies. We argue that it is critical to offer MLs powerful forms of collaborative PD if they are to enact the transformative potential of their role in driving pedagogical improvement.
Middle Class African American Parents’ Aspirations for Rigor and Reading Curriculum During the Pandemic Era in Detroit Schools
Authors: Hill K. Dara
Published: February 2024

This community-based research study examined the perspectives of African American parents of middle-class economic status who participated in a social network pertaining to school choice decisions during the pandemic era of virtual schooling. Their residency and school choices emerged against the grain of urban schools that have racially charged histories and decades of residential mobility trends. I examined parents’ aspirations for academic rigor and perspectives of literacy practices at select schools as well as public school district official perspectives of supporting the enrollment process and attracting families to the district. Parent interview and survey data revealed confidence in public, private, and charter school selections prior to enrolling, but uncertainty with the virtual literacy curriculum once enrolled in school. School district official interviews revealed enhanced awareness of parents’ concerns surrounding school choice and need to be proactive to the needs of middle-class families.
Performing Up to Par: Hospitality Firms After ASU 2016-02
Authors: Jang Youngki , Liu Crocker H. , Weinbaum David , Yehuda Nir
Published: February 2024

Relative to sales, the average operating lease commitments of hospitality firms are 4 times larger than those of other publicly traded firms. In response to the recently enacted accounting standards update No. 2016-02 (ASU 2016-02) that requires lessees to recognize operating leases on their balance sheet, hospitality firms decreased their use of operating leases, switching to shorter-term off-balance sheet leases. We find that this change did not have negative consequences on firm performance, shareholders, or employees. The only significant effect we do find is an improvement in credit ratings for firms that reduced operating leases in response to the new standard. Our findings are inconsistent with the concerns some hospitality managers and academics expressed prior to the introduction of the standard.