bluuebunny/crossref_metadata_2025 huggingface dataset:
A Generalized Ordered Logit Model to Accommodate Multiple Rating Scales
Authors: Gangl Markus
Published: August 2023

Rating scales are ubiquitous in the social sciences, yet may present practical difficulties when response formats change over time or vary across surveys. To allow researchers to pool rating data across alternative question formats, the article provides a generalization of the ordered logit model that accommodates multiple scale formats in the measurement of a single rating construct. The resulting multiscale ordered logit model shares the interpretation as well as the proportional odds (or parallel lines) assumption with the standard ordered logit model. A further extension to relax the proportional odds assumption in the multiscale context is proposed, and the substitution of the logit with other convenient link functions is equally straightforward. The utility of the model is illustrated from an empirical analysis of the determinants of respondents’ confidence in democratic institutions that combines data from the European Social Survey, the General Social Survey, and the European and World Values Survey series.
Each step time-limited iterative learning control for a cushion robot with motion velocity constraints
Authors: Shan Rui , Sun Ping , Wang Shuoyu , Chang Hongbin
Published: August 2023

An each step time-limited iterative learning control model was developed for a cushion robot with velocity constraints. A predictive modeling method was proposed to solve the velocity mutation problem by employing a kinematic model to constrain the velocity inputs, which can then constrain the robot’s actual velocity. Furthermore, a tracking error system was established that used constrained motion velocity and a dynamic model. A new iterative controller with each step time-limited learning was built to reduce the transient adjustment time. Simulation results and comparative analyses revealed that the proposed control method quickly stabilizes the system and ensures that the human–robot system operates at a safe velocity.
Risk factors, lab parameters, angiographic characteristics and outcomes of coronary artery disease in young South Asian patients: a systematic review
Authors: Agrawal Anushka , Lamichhane Pratik , Eghbali Mason , Xavier Roshni , Cook Daniel Elkin , Elsherbiny Reem Maged , Jhajj Loveleen Kaur , Khanal Rajaram
Published: August 2023

This systematic review provides a qualitative summary of the risk factors, angiographic characteristics, treatment, and complications of young South Asians with coronary artery disease (CAD). PubMed, Embase, and Google Scholar were searched to identify research articles published between 1 January 2010 and 13 November 2022. Studies in patients aged 18 to 45 years that were conducted in South Asian countries, were published in the English language, and included information on patients’ clinical profiles and at least two risk factors for young CAD were included in the review. Smoking, dyslipidemia, high body mass index, increased high-sensitivity C-reactive protein, and hyperhomocysteinemia were observed in high proportions in young patients with CAD. Single-vessel disease was more common than multi-vessel disease in young CAD. The complications of CAD such as arrhythmias, cardiogenic shock, and heart failure were also commonly observed in young patients. Large-scale health promotion activities that curb modifiable risk factors such as smoking, obesity, and a sedentary lifestyle should be conducted in South Asian countries.
A systematic review and meta-analysis for human epidermal growth factor receptor 2 on upper tract urothelial carcinoma patients
Authors: Ye Jianjun , Liao Xinyang , Qiu Yu , Wei Qiang , Bao Yige
Published: August 2023

Objective:

The expression and significance of human epidermal growth factor receptor 2 (Her2) in upper tract urothelial carcinoma (UTUC) remains controversial. Thus, we aimed to systemically review the Her2 expression in UTUC patients and its relationship with pathological characters and clinical outcomes with meta-analysis.

Materials and methods:

A systematically computerized search in PubMed, Scopus, Embase and Cochrane was conducted. From a total of 454 related articles, 35 articles were finally reviewed and 16 papers were chosen for further analysis. Pathological characters included tumor stage, grade, lymph node metastasis (LNM) and lymphovascular invasion (LVI). The clinical outcomes included overall survival (OS), recurrence-free survival (RFS), cancer specific survival (CSS), metastatic-free survival (MFS) and progression-free survival (PFS). RevMan software was used for meta-analyses.

Results:

In total 16 studies from 1994 to 2020 were chosen, 14 studies used immunohistochemistry to assess the expression of Her2 and 5 studies used in situ hybridization, with a positive rate of 0 to 74.0% and 7.2 to 18.1%, respectively. Her2-positive was significantly associated with stage (pooled HR 1.86; 95 % CI 1.43–2.42), grade (pooled HR 2.81; 95 % CI 1.01–7.85) and LNM (pooled HR 1.93; 95 % CI 1.18–3.15). However, there was no statistically relationship between Her2-positive with LVI (pooled HR 1.48; 95 % CI 0.64–3.46) and RFS (pooled HR 1.41; 95 % CI 0.98–1.83).

Conclusions:

This review indicated that UTUC patients with Her2-positive tended to develop higher stage and grade tumors and LNM. The Her2 expression in UTUC patients deserves further investigation in the future.
Impact of anti-CGRP monoclonal antibodies on migraine attack accompanying symptoms: A real-world evidence study
Authors: Alpuente Alicia , Torre-Sune Anna , Caronna Edoardo , Gine-Cipres Eulalia , Torres-Ferrús Marta , Pozo-Rosich Patricia
Published: August 2023

Background

Clinical trials on anti-calcitonin gene-related peptide monoclonal antibodies poorly investigated their impact on migraine accompanying symptoms.

Objective

To evaluate the impact of basal accompanying symptoms on anti-CGRP monoclonal antibodies treatment response and their evolution after six months of treatment in migraine patients.

Methods

Patients with migraine diagnosis seen in the Headache Clinic and treated with erenumab, galcanezumab or fremanezumab were prospectively recruited. They completed a daily eDiary which provided data on headache frequency and the following accompanying symptoms of each day: photophobia, phonophobia, nausea, dizziness, and aura. Patients were classified as responders or non-responders based on 50% or greater reduction in headache days per month at month 6 (≥50% response rate). Accompanying symptoms ratios based on headache days per month were assessed per patient at baseline and after three and six months. Comparisons for basal characteristics, basal accompanying symptoms ratios and their evolution after six months between responders and non-responders were performed.

Results

One hundred and fifty-eight patients were included, 44% (69/158) showed ≥50% response rate after six months. A significant reduction in headache days per month in both groups was found at month 6 (−9.4 days/month in ≥50% response rate group; p < 0.001, −2.2 days/month in <50% response rate group; p = 0.004). Additionally, significant decreases in photophobia (−19.5%, p < 0.001), phonophobia (−12.1%, p = 0.010) and aura ratios (−25.1%, p = 0.008) were found in ≥50% response rate group. No statistically significant reductions were found in nausea and dizziness in any group since their reduction was correlated with the decrease in headache days per month. Higher photophobia ratios at baseline were predictive of an increased response between months 3 and 6 (Incidence Risk Ratio = 0.928, p = 0.040).

Conclusions

The days per month with photophobia, phonophobia and aura decreased at a higher rate than headache days per month after six months in the ≥50% response group. Higher photophobia ratios were associated with higher response rates between three and six months. It could indicate an involvement of peripheral CGRP in photophobia as well as a central modulation of migraine through these treatments which mainly act on the periphery.
Identifying the Nature of Travel by Different Transport Modes as Consummatory or Instrumental
Authors: Fu Xue-mei
Published: August 2023

Attitudes are crucial in understanding people’s travel behavior. In this paper, affective and cognitive components are simultaneously considered, where affective attitude refers to feelings and emotions that are evoked from traveling by particular mode, and the cognitive component of an attitude contains the attributes and beliefs associated with that mode. Based on a mobility survey for the Longitudinal Internet Studies for the Social Sciences (LISS) panel, this study endeavors to identify the relative importance of attitude components on travel behavior related to car, public transport, and bike, based on which the nature of mode-specific travel behavior could be determined. Being confined to the psychosocial sphere, the target mode-specific travel behavior will be defined as instrumental if a comparatively strong impact from cognitive attitude is observed and as consummatory if affective attitude has a larger influence on travel behavior. The identified behavioral nature is further examined across people with diverse characteristics. The dominant role of affective attitude suggests car travel behavior to be highly consummatory, which applies for most groups. Public transport travel is performed as an instrumental behavior basically determined by cognitive attitude, and this outcome considerably varies across population groups. Travel by bike is carried out by all the groups firmly as consummatory, and the negative effect of cognitive attitude on bike travel basically reflects people’s motivation to fulfill social desirability, which leads to a behavioral violation. The analysis offers a further understanding of travel behavior, which might provide useful implications for transportation administration.
Deicing Facility Capacity and Delay Estimation Using ASDE-X Data: Chicago O’Hare Simulation Case Study
Authors: Alsalous Osama , Hotle Susan
Published: August 2023

The main 34 airports in the United States reported 1,792,877 aircraft-minutes of departure delay related to ice and snow conditions in 2019 alone. This delay includes deicing aircraft at a centralized deicing facility, increasing the taxi-out phase. In this study, Airport surface detection equipment, Model X (ASDE-X) data at Chicago O’Hare International Airport (ORD) are used to extract deicing times based on aircraft movements within the centralized deicing facility. Airline-related information is parsed as individual lanes of the deicing facility are controlled by the airlines, determining which lanes a flight can use. The extracted deicing time for each aircraft type is then used to develop a simulation model evaluating the efficiency of the centralized deicing facility. Different queueing scenarios are tested for operational performance improvements. Our results show that if all deicing pads were open to all flights, removing airline control, a first come first served (FCFS) strategy with the pads having individual queues could save 25.1% of the aircraft-minutes spent in the deicing system compared with the currently implemented queueing process (baseline scenario). Removing airline control using a FCFS with a combined queue approach reduced aircraft-minutes by 17.8%. Assigning flights to lanes based on their mean deicing time (slow, medium, and fast groups) increased aircraft-minutes by 1.3% on average. This is the first study in the literature to use ASDE-X data from an airport located in the United States to provide data-driven deicing facility capacities and queueing recommendations.
Comprehensive study of anxiety and depression in females with urinary incontinence
Authors: Sarkar Debansu , Tandon Mrinal , Pal Dilip Kumar
Published: August 2023

Background:

Anxiety and depression are commonly seen with urinary incontinence (UI) and its association is strongest for urgency and mixed UI. It affects the quality of life and functional status.

Aims:

To assess the prevalence and severity of anxiety and depression in SUI (Stress urinary incontinence) and UUI/MUI (Urge or mixed urinary incontinence), to assess the severity of SUI and UUI/MUI and its association with anxiety and depression and to identify various factors associated with anxiety and depression.

Materials and methods:

An observational study using various tools as history regarding urinary incontinence, history of other prior events which can lead to anxiety or depression, age, educational level, BMI (Body mass index), HADS scale (Hospital anxiety and depression scale) for anxiety and depression and ICIQ-UI-SF score (International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form).

Results:

The Prevalence of anxiety and depression in UUI/MUI was higher. More women were overweight (BMI > 25) in the UUI/MUI group. Higher prevalence of anxiety and depression in the very severe urinary incontinence group. No association of the level of education with anxiety and depression in women with urinary incontinence.

Conclusion:

Anxiety and depression are more in UUI/MUI patients compared to SUI. In obese ladies, UUI is more prevalent compared to SUI. Anxiety and depression are more with increasing severity of incontinence. Anxiety and depression have no association with the educational status of the patients.
Spiritual Gifts and ‘Communal Competence’: Charismata in Conversation with Self-Determination Theory
Authors: Nicol Charissa
Published: August 2023

Deci and Ryan’s Basic Human Needs Theory (BHNT) claims that thriving is contingent upon the satisfaction of our fundamental psychological needs for autonomy, competence, and relatedness. This article considers how BHNT might complement a theological understanding of flourishing with particular reference to competence, and vice versa. By perceiving charismata as spiritual competencies with a mix of natural and supernatural qualities, it is possible to utilise insights from BHNT to identify circumstances that can support or thwart their cultivation. Whilst spiritual gifts are uniquely and diversely manifest in the individuals comprising the church community, they operate collectively since the Spirit instigates and enables them for a common purpose. Thus, as the sum of its interdependent parts, the church has a Spirit gifted ‘communal competence’ that is maximised in submission to, and unity with, others and God.
Major Determinants of Bank Profitability in India: A Machine Learning Approach
Authors: Rai Pratibha , Mohapatra Bibhuti Bhusan , Meitei A. Jiran , Jain Vanita
Published: August 2023

From reforms and fin-tech revolutions to macro-economic shocks, the Indian banking sector has witnessed rapid changes over the last two decades, which has significant implications for banks’ profitability. Viewing bank profitability from three different dimensions, Net Interest Margins (NIM), Return on Assets (RoA) and Return on Equity (RoE), this study has explored the key determinants with the help of machine learning algorithms. It has used a pooled data set of domestic and commercial banks covering 2005–2021. As a dependent variable, profitability by each measure (NIM, RoA and RoE) is reclassified into three categories, above average, average and below average, based on their quartiles. Twenty-one explanatory variables comprising bank-specific, macroeconomic and policy variables are chosen after due validation using feature selection methodology and multicollinearity check. The random forest (RF) classification algorithm is executed using the CARET package in R. The results obtained from feature selection are corroborated with the RF classification findings. The results are robust and give clear-cut visibility of unique and common factors influencing three profitability measures at varying levels. The classification estimates suggest that the bank-specific variables are major determinants of NIM, while macroeconomic and policy variables are the key determinants of RoA and RoE. Further, the results also suggest that the ratio of non-performing assets to total assets and business per employee are two such bank-specific determinants that play an important role in all three dimensions of profitability. Thus, recapitalization and automation will play an important role in bank profitability.
Augmenting the Theory of Planned Behaviour and Trust in Driving the Funder’s Intention to Donate: The Moderating Role of Herding Bias
Authors: Vijaya Vijaya , Yadav Ajit , Mathur Himendu Prakash
Published: August 2023

The current digital trend is to source funds for commercial or non-commercial purposes using online crowdfunding. In this study, we apply the theory of planned behaviour to study its effect on the funder’s intention to donate. We explore the impact of attitude, subjective norms and perceived behavioural control on a funder’s donation intention. We also study the effect of trust on a funder’s intention to donate moderated by herding bias. The study conducted a survey on Indian crowdfunders using a 5-point Likert Scale through a structured questionnaire. Structural equation modelling was used to analyse the results. The findings of the study reveal that all the identified constructs, namely attitude, subjective norms, perceived behavioural control and trust, significantly affect the funder’s intention to donate in donation crowdfunding campaigns. Moreover, herding bias significantly and positively moderates the relationship between trust and the funder’s intention to donate.
The Impact of Integrated Palliative Care on Survival in Idiopathic Pulmonary Fibrosis: A Retrospective Multicenter Comparison
Authors: Lu-Song Jenny , Bakal Jeffrey A. , Younus Sarah , Moran-Mendoza Onofre , Harle Ingrid , Morales Michelle , Rippon Naomi , Barratt Shaney L. , Adamali Huzaifa , Kalluri Meena
Published: August 2023

Background: Early and integrated palliative care is recommended for patients with idiopathic pulmonary fibrosis. Unfortunately, palliative care delivery remains poor due to various barriers in practice. This study describes various palliative care delivery models in a real-world cohort of patients with idiopathic pulmonary fibrosis, examines the predictors of survival in this cohort of patients, and explores the impact of palliative care on survival. Design: Charts were reviewed retrospectively and analyzed. The primary outcome was survival during a 4-year follow-up period. Two multivariable models were created to examine the impact of therapeutic strategies including palliative intervention on survival. Results: 298 patients with idiopathic pulmonary fibrosis were enrolled from 3 interstitial lung disease clinics with different palliative care models in Edmonton, Canada; Bristol, UK; and Kingston, Canada. 200 (67%) patients received palliative care and 119 (40%) died during follow up. Primary palliative care models (Edmonton and Bristol) delivered palliative care to 96% and 100% respectively compared 21% in the referral model (Queens). Palliative care [adjusted hazard ratio (aHR) .28 (.12-.65)] along with the use of antifibrotics [aHR .56 (.37-.84)], and body mass index >30 [aHR .47 (.37-.85)] reduced the risk of death in our idiopathic pulmonary fibrosis cohort. Opioid use was associated with worse survival [aHR 2.11 (1.30-23.43)]. Conclusions: Both palliative care and antifibrotic use were associated with survival benefit in this cohort of patients with idiopathic pulmonary fibrosis after adjusting for covariates. The benefit was seen despite differences in disease severity and different palliative care delivery models.
Bending performance and failure mechanism of 3D-printed hybrid geometry honeycombs with various poisson’s ratios
Authors: Montazeri Amin , Hasani Amirhosein , Safarabadi Majid
Published: August 2023

By utilizing 3D printing technology, experimental three-point bending (TPB) tests, and finite element analysis, six honeycomb structures with a variety of overall Poisson’s ratios (PR) are studied and compared in terms of bending properties and failure mechanisms. Four novel honeycombs that are designed by hybridizing hexagonal and re-entrant units outperform benchmark conventional honeycombs in terms of load-carrying capacity. Architected hybrid geometry honeycombs with zero PR show excellent specific energy absorption capability in comparison to benchmark honeycombs, absorbing approximately 136.9% and 475.1% more energy under TPB. 3D-printed honeycombs consisting of hexagonal units face layer separation damage mode under bending, while honeycombs with re-entrant cells in their lattice fail with joint shear due to the angle of their struts towards loadings. Designing honeycombs with a hybrid geometry lattice can enhance the load-carrying capacity, specific energy absorption, flexibility, and flexural modulus of the structure under bending. Due to their superior performance, the proposed architected hybrid geometry honeycombs with various Poisson’s ratios own promising applications in automotive, protective, and construction industries.
“Chameleonization” in the Folds of Culture: A Comparative Analysis of Cross-Cultural Qualitative Fieldwork
Authors: Dai Yuanyuan
Published: August 2023

This paper argues against a prevailing culture-free tendency in cross-cultural qualitative research that has been normalized by conventional qualitative research methodology to propose “ chameleonization,” a culturally sensitive research process. First, I delineate the paradoxes encountered in comparative research of Sino-U.S. university partnerships by comparing five fieldwork elements: research ethics, access to fields, informed consent, informants’ recruitment, and interview environment and process. The comparison reveals that the seemingly “golden” rule of Western-centered qualitative research and procedure were both disturbing and paralyzing in non-Western fields. Subsequently, this work deciphers these paradoxes with Hofstede's cultural dimension theory as a main analytical framework, supplemented by theories from cultural theorists in the two cultures. These paradoxes can be resolved through a chameleonization process through which researchers attune to a postmodern cross-culturalness by navigating the “folds of culture,” as characterized by their cross-cultural qualitative fields. Tentative strategies for applying chameleonization to activate, solidify, and extend a “folding-unfolding-refolding” process are then proposed, followed by a discussion on the approach’s potential limitations.
A Chronological Analysis of Intellectual Demands in the Turkish Writing Curricula
Authors: Tavsanli Omer Faruk , Soysal Yilmaz , Kaldirim Abdullah
Published: August 2023

The purpose of the study was to critically evaluate the updated Turkish writing curricula to decide whether they permit teachers to design higher intellectually demanding teaching sequences. This study was designed as a qualitative inquiry through a document analysis to estimate the pedagogically oriented intellectual demands of the curricular objectives in the writing field. A total of 935 writing objectives were deeply analyzed, and the generic picture displays that the objectives at the understand level dramatically dominate (65.2%) the elementary and middle school writing instruction. About one out of four objectives in the curricula were observed at the remember level showing that from elementary to middle school, the writing curricula’s intellectual capacities stay at the bottom. None of the writing objectives was evaluated at the apply (0.09%) or create (0%) levels. Only 8.46% of all objectives might be used to design and conduct an instructional sequence demanding higher intellectual processing, such as at the analyze level. Teachers could translate only 2.14% of all objectives into instructional episodes to require intellectual processes at the evaluate level. Recommendations are offered to teachers, curriculum developers, and educational policymakers.
“Racism Masked as Safety Concerns”: The Experiences of Residents of Color With Racialized Coveillance in a Predominantly White Neighborhood
Authors: Lowe Maria R. , Romero Luis A. , Carrola Madeline
Published: August 2023

Prior studies have focused on ways that White residents in predominantly White neighborhoods monitor their community for suspicious people and how these practices are racialized. However, only limited attention has been given to how residents of color in such neighborhoods experience these surveillance efforts. In this article, we explore how mostly White neighbors conduct on-the-ground monitoring of people of color in their daily lives, a process that we call “racialized coveillance.” Using data from neighborhood digital platforms, neighborhood materials, and 24 interviews with residents of color of an affluent, predominantly White community, we find that residents’ racialized coveillance sometimes misidentifies residents of color as suspicious outsiders. These efforts take the form of posts uploaded to the neighborhood’s social media sites, calls to the police, and in-person encounters. Such practices occur regularly and affect residents of color to varying degrees with Black male residents bearing the brunt of such efforts. As a result, we argue that racialized coveillance creates hostile territories for some residents of color in predominantly White neighborhoods, which contributes to the reproduction of these settings as White spaces.
Behavioral Outcomes of a Pragmatic Early Childhood Caries Management Trial
Authors: Lumsden C.L. , Edelstein B.L. , Leu C.S. , Zhang J. , Levine J. , Andrews H.
Published: August 2023

Objectives:

To evaluate a preventative behavioral intervention for managing early childhood caries (ECC) in a cohort of high-risk children.

Methods:

This pragmatic trial of the MySmileBuddy Program (MSB) evaluated preventive behavioral outcomes in a 1-y community health worker–delivered intervention to prevent ECC progression. Pre-/postintervention surveys assessed parent-reported child engagement in therapeutic toothbrushing (i.e., adult-assisted brushing with fluoridated toothpaste twice daily) and caries-related dietary behaviors and barriers. Generalized linear model with identity link for continuous variables and logit link for dichotomous outcomes evaluated pre-/postintervention comparisons and generalized estimating equations accounted for within-participant correlation (α = 0.05).

Results:

Among 1,130 children with postintervention data, the average age was 3.97 y, 99% were Medicaid insured, and 88% were Hispanic. Most parents (95%) were mothers/grandmothers, married or in a committed partnership (75%), unemployed (62%), and with modest education (80% high school degree or less). The odds of reported therapeutic brushing nearly doubled ( n = 864; odds ratio [OR] = 1.79, 95% confidence interval [CI] = 1.46, 2.20, P < 0.001); day and night bottle/sippy cup frequencies dropped 0.29 units ( n = 871; 95% CI = −0.37, −0.33, P < 0.001) and 0.22 units ( n = 1,130; 95% CI = −0.30, −0.15, P < 0.001); nighttime breastfeeding reduced 0.15 units ( n = 870; 95% CI = −0.21, −0.10, P < 0.001); sharing utensils reduced 0.30 units ( n = 572; 95% CI = −0.39, −0.21, P < 0.001); not using sugary foods to calm child improved 0.37 units ( n = 664; 95% CI = 0.31, 0.44, P < 0.001); odds of eating meals and snacks at a table increased ( n = 572; OR = 1.57, 95% CI = 1.28, 1.93, P < 0.001; n = 572; OR = 1.80, 95% CI = 1.50, 2.15, P < 0.001) respectively; and reducing barriers to behaviors improved 0.38 units for toothbrushing ( n = 666; 95% CI = 0.31, 0.44, P < 0.001) and 0.33 units for diet ( n = 668; 95% CI = 0.29, 0.38, P < 0.001).

Conclusion:

Despite limitations inherent to pragmatic trials, significant behavioral changes suggest that MSB yielded an important salutary impact. Forthcoming mediation analyses will explore causal pathways. Findings support integration of MSB’s behavior change program in caries management initiatives.

Knowledge Transfer Statement:

The results of this study can be used by clinicians, public health leaders, and researchers to inform the development and implementation of community-based, preventative behaviorally focused early childhood caries prevention programs. Study findings may enhance the understanding of the impact of behavioral interventions that engage parents of young children and could lead to more effective prevention for populations at high-risk of caries.
Arivu’s Dalit Rap: Cultural Resilience and Harnessing Hip-Hop for Cultural Assertion
Authors: Jose Jomal , Yeldho Joe Varghese
Published: August 2023

The emergent pan-Indian phenomenon of Dalit rap is championed by Arivu and other Dalit rappers, such as Ginni Mahi, Sumeet Samos, Duleshwar Tandi and Vedan. They draw from the wellspring of Dalit musical traditions. These musicians are successors to pioneers who utilized music and poetry in the anti-caste struggle such as Jyotirao Phule, Savitribai Phule, Poykayil Appachan, Bhimrao Kardak, Gaddar and Vilas Ghogre. Arivu’s music utilizes the cultural capital that developed as forms of self-expression and those sustained as cultural labour in the Dalit communities for political activism, sensitization of the public sphere and asserting the Dalit identity. He reimagines art that had been deemed symbols of denigration by the dominant savarna sensibility as those of pride and protest. His lyrics and music generate a discourse of resistance that alters the equations of the casteist public sphere through wider acceptance via new media. Arivu engages in contemporary sociopolitical commentary through rap infused with the stylistics of folk forms such as oppari and gaana. He integrates hip-hop aesthetics and Dalit aesthetics to cure cultural amnesia, challenge epistemic injustice, expose cultural appropriation and assert the Dalit identity. Arivu employs hip-hop in building counter-narratives of Dalit pride, Dalit environmentalism, historical injustice and social justice.
Use of Intraoperative Technology to Perform a Cam Resection During Hip Arthroscopy for Femoroacetabular Impingement Syndrome
Authors: Allahabadi Sachin , Fenn Thomas W. , Chapman Reagan , Nho Shane J.
Published: August 2023

Background:

The learning curve for the surgical treatment of cam deformities in femoroacetabular impingement syndrome (FAIS) presents a challenge for young or inexperienced surgeons, with the leading cause of failed hip arthroscopy being incomplete resection. Historically, alpha angle measurements are typically used perioperatively to both diagnose cam deformity and evaluate the adequacy of cam resection. The computer-assisted Styker HipCheck system offers the surgeon real-time alpha angle measurements, assisting with the execution of cam resection.

Indications:

The indication for use is any hip arthroscopic procedure for femoroacetabular impingement requiring osteochondroplasty of cam deformity. Advantages of the HipCheck system include shortened operative time; reduced risk of inadequate or over-resection; accelerated learning curve; no requirement of preoperative computed tomographic imaging or pre-planning; being noninvasive, portable, and not requiring additional instruments; increased patient and surgeon satisfaction; and allowance of repeated quantitative and visual assessment, which is particularly beneficial for more difficult regions, such as posteromedial and posterolateral, to view the femoral head/neck.

Technique Description:

Briefly, after intra-articular procedures are complete, the peripheral compartment is accessed. We prefer a T-type capsulotomy. Next, the cam deformity is registered on Stryker HipCheck software, automatically calculating alpha angles as the hip is dynamically moved through 6 registered positions. A standard cam resection is then performed. Once complete, the hip is dynamically assessed and again registered with the HipCheck system in the same 6 positions to ensure adequate resection has been performed.

Results:

When comparing patients with FAIS undergoing computer-guided resection or standard resection, both surgical interventions demonstrated successful reduction in alpha angle and no difference in degree of resection. In addition, the various computer-guided views exhibited good correlations to clinical radiographs.

Discussion:

The HipCheck intraoperative system allows the surgeon to evaluate the adequacy of cam resection through the use of automated alpha angles. Furthermore, the system offers instantaneous feedback of cam resection at any desired position of the hip. This intraoperative technology may offer less experienced surgeons an aid when performing hip arthroscopy for cam resection in the setting of femoroacetabular impingement.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Towards niche market for shared mobility: Identifying heterogeneity of potential early adopters to use shared electric bikes in a Chinese mega city
Authors: Wu Jiangyue , Lei Shuyu , Zhou Jiangping , Wang Xue , Tao Zhuolin
Published: August 2023

Shared mobility endures the pandemic, legislative upheaval, and points to a sizable potential market with wider range of shared services. As the shared mobility segment worldwide continually increases, a noticeable trend towards segmentation of shared mobility services, namely, the niche market, is gaining attention. However, the majority of scholarship has mainly focused on early adopters’ transition from conventional transportation modes to shared mobility, with little attention given to the shift towards specialized and niche shared mobility services. To address such gap, this study aims to explore the heterogeneous characteristics of potential early adopters of shared electric bikes among different transportation groups in the existing market. The questionnaire targets 1,034 citizens living in Shenzhen, a mega city in China, from March to April in 2020, before the official launch of the shared electric bikes scheme in the city. Both binary logistic models and text sentiment analysis have been conducted to present a comprehensive analytical framework to understand the group-sensitive identification of potential early adopters. Results reveal that age, car ownership, commute time, and confidence level on the potential scheme are four significant variables to explain all respondents’ willingness to adopt shared electric bikes, regardless of their existing dominant transport mode. However, when it comes to subgroups with different travel preferences, the profile of potential early adopters vary distinctly. Specifically, younger public transport users are interested in adopting shared electric bikes but have price concerns; gender is the most significant variable to predict private vehicle user’s adopt willingness, and female user show strong concerns on safety issue; users who primarily walk or cycle can benefit from shared electric bikes to travel longer distances, and lastly, there are no significant variables to predict electric bike users’ intention to switch from self-owned bikes to shared programmes. Overall, an analytical framework is presented in the study to comprehend the diverse features of prospective early adopters who may utilize shared electric bikes from different transportation groups, and a collection of development strategies for operators is proposed.
The Association Between Common Bile Duct Diameter and the Severity of Coronary Artery Atherosclerosis, Based on Calcium Score
Authors: Kheiridoost Langroudi Fatemeh , Faghihi Langroudi Taraneh , Akhoundi Neda , Siami Alireza
Published: August 2023

Objective:

The aim was to assess the relationship between the coronary calcium score and the common bile duct (CBD) diameter, to determine whether the increase in CBD diameter in patients without hepatobiliary disease could represent cardiovascular disease, or the extent of atherosclerosis in coronary arteries.

Materials and Methods:

The study cohort consisted of 103 patients referred for computed tomographic angiography (CTA) for coronary artery assessment. None of the patients had a gallbladder, biliary, or pancreatic disease or surgery history. The Agatston score determined the rates of arterial calcification. The diameter of the CBD was measured for a sonogram.

Results:

There was a statistically significant relatively strong correlation between calcium score and CBD diameter ( r = 0.44, P = .001), independent of baseline variables, such as demographics and cardiovascular risk profiles. In the multivariable regression model, advanced age (beta = 0.825, P = .005), history of hypertension (beta = 0.591, P = .034), and history of coronary stenting (beta = 1.339, P = .001) were shown to be the main determinants of CBD dilatation.

Conclusion:

A statistically significant correlation existed between the CBD diameter and calcium score, within the coronary arteries and this could represent a shared pathophysiology between CBD dilatation and the severity of coronary atherosclerosis.
Point of Care Ultrasonographic Life Support in Emergency (PULSE)—a quasi-experimental study
Authors: Ali Noman , Chhotani Abdul Ahad , Iqbal Sannia Perwaiz , Soomar Salman Muhammad , Raheem Ahmed , Waheed Shahan
Published: August 2023

Background

Many physicians use point-of-care ultrasound (PoCUS) in their clinical practice to improve their diagnostic capabilities, accuracy, and timeliness. Over the last two decades, the use of PoCUS in the emergency room has dramatically increased. This study aimed to determine emergency physicians’ retention of knowledge and skills after a brief training workshop on a focused ultrasound-guided approach to a patient presenting with undifferentiated shock, shortness of breath, and cardiac arrest in the emergency department of a tertiary care hospital. The secondary aim was to deliver the PoCUS-guided algorithmic approach to manage a patient presenting with undifferentiated shock, respiratory distress, and cardiac arrest in the emergency department.

Methods

A quasi-experimental study was conducted with a single-day Point of Care Ultrasonographic Life Support in Emergency (PULSE) training workshop in October 2021 at the Aga Khan University Hospital, Karachi, Pakistan. A total of 32 participants attended the course, including twenty-one junior residents (PGY 1 and 2) and medical officers with experience of fewer than two years working in different emergency departments of urban tertiary care hospitals across Karachi, Pakistan. Pre- and post-assessment tools comprised a written examination, evaluating participants' knowledge and skills in ultrasound image acquisition and interpretation. Cronbach's alpha was used to calculate the validity of the tool. Results obtained before and after the training session were compared by the McNemar’s test. A p value of ≤ 0.05 was considered significant.

Results

There was a significant improvement in response to each question pre to post-test after completion of the course (Table 1). The significant change can be seen in questions 7, 8, 13, and 15, with a percentage change of 33.3, 80.9, 42.9, and 47.7. There was a significant improvement in the understanding and knowledge of participants after the training. The scores in the post-test were high compared to the pre-test in each category, i.e., respiratory distress (p < 0.017), cardiac arrest (p < 0.041), basic ultrasound knowledge (p < 0.001), and undifferentiated shock (p < 0.001).

Conclusion

All participants showed improvement in their knowledge and confidence regarding using PoCUS in life-threatening conditions. Through this study, we have also developed an algorithmic approach to managing undifferentiated shock, respiratory failure, and cardiac arrest. Future studies must assess the effectiveness and feasibility of incorporating these algorithms into clinical practice.
Vidarabine, an anti-herpes agent, improves Porphyromonas gingivalis lipopolysaccharide-induced cardiac dysfunction in mice
Authors: Tsunoda Michinori , Matsuo Ichiro , Ohnuki Yoshiki , Suita Kenji , Ishikawa Misao , Mitsubayashi Takao , Ito Aiko , Mototani Yasumasa , Kiyomoto Kenichi , Morii Akinaka , Nariyama Megumi , Hayakawa Yoshio , Gomi Kazuhiro , Okumura Satoshi
Published: August 2023

In this work, we examined the involvement of type 5 adenylyl cyclase (AC5) in cardiac dysfunction induced in mice given Porphyromonas gingivalis lipopolysaccharide (PG-LPS) at a dose equivalent to the circulating levels in periodontitis (PD) patients. Cardiac function was significantly decreased in mice given PG-LPS compared to the control, but treatment for 1 week with the AC5 inhibitor vidarabine ameliorated the dysfunction. Cardiac fibrosis and myocyte apoptosis were significantly increased in the PG-LPS group, but vidarabine blocked these changes. The PG-LPS-induced cardiac dysfunction was associated with activation of cyclic AMP/Ca2+-calmodulin-dependent protein kinase II signaling and increased phospholamban phosphorylation at threonine 17. These results suggest that pharmacological AC5 inhibition may be a promising approach to treat PD-associated cardiovascular disease.
Brachytherapy for targeting the immune system in cervical cancer patients
Authors: Linares Isabel , Berenguer Frances Miguel Ángel , Cañas Rut , Najjari Dina , Gutiérrez Cristina , Marín Susanna , Comas Silvia , Guedea Ferran , Pujol Monica
Published: August 2023

Background

New combinations based on standard therapeutic modalities and immunotherapy require understanding the immunomodulatory properties of traditional treatments. The objective was to evaluate the impact of brachytherapy (BT) on the immune system of cervical cancer and to identify the best modality, High-dose-rate brachytherapy (HDR-BT) vs. Pulsed-dose-rate (PDR-BT), to target it.

Methods

Nineteen patients enrolled in a prospective study received chemoradiation (CRT) and subsequently HDR-BT or PDR-BT. Peripheral blood samples were obtained for immunophenotyping analysis by flow-cytometry before CRT, BT, and two and four weeks after BT. The Friedman one-way ANOVA, Conover post hoc test, and the Wilcoxon signed-rank test were used to compare changes in cell populations at different periods, perform multiple pairwise comparisons and assess differences between treatment groups (PDR and HDR).

Results

Natural killer cells (NKs) were the best target for BT. Patients receiving HDR-BT achieved significantly higher values ​​and longer time of the CD56dimCD16 + NK cells with greater cytotoxic capacity than the PDR-BT group, which presented their highest elevation of CD56-CD16 + NK cells. Furthermore, both BT modalities were associated with an increase in myeloid-derived suppressor cells (MDSCs), related to a worse clinical prognosis. However, there was a decrease in the percentage of CD4 + CD25 + Foxp3 + CD45RA + regulatory T cells (Tregs) in patients receiving HDR-BT, although there were no significant differences between BT.

Conclusions

Immune biomarkers are important predictive determinants in cervical cancer. Higher cytotoxic NK cells and a trend toward lower values of Tregs might support the use of HDR-BT to the detriment of PDR-BT and help develop effective combinations with immunotherapy.
Obesogenic diet and metabolic syndrome among adolescents in India: data-driven cluster analysis
Authors: Kirti Kirti , Singh Shri Kant
Published: August 2023

Background

Metabolic syndrome is on the rise in India and is primarily linked to obesogenic dietary habits. The synergy of both is a prominent risk factor for cardiovascular diseases (CVDs). Hence, the present study aims to unveil clusters at high risk of metabolic syndrome and ascertain cluster characteristics based on dietary patterns among adolescents aged 10–19 years.

Data and methods

The study utilizes secondary data, i.e., Comprehensive National Nutrition Survey conducted in 2016-18. The study sample includes children and adolescents aged 10–19 years. An unsupervised learning algorithm was used to ascertain possible clusters in the data based on individuals’ dietary patterns. The k-means were used to cluster the data according to their dietary patterns. To determine the number of clusters elbow method was used, and appropriate validation indices were also obtained for the final k. Further, to ascertain the distribution of the obesogenic dietary patterns and metabolic conditions in each cluster was analysed. Bivariate descriptive analysis was used to draw further inferences.

Results

The k-means clusters identified five optimum clusters based on 12,318 adolescents (6333 males (mean age:14.2 ± 2.8) and 5985 females (mean age:14.3 ± 2.8)) 17 dietary patterns. Clusters were named based on how prudent these were in terms of consuming a healthy diet. Cluster phenotypic characteristics were defined as follows: a cluster of obesogenic diets (24%) constituted the highest proportion of the total sample and was significantly suffering from obesity (p < 0.001), and greater proportions of lipid anomalies (p = 0.51) and hypertension (p = 0.44) but not statistically significant. In contrast, 21% of the sample comprised a plant-based diet cluster and suffered from all deficiencies but folate (p = 0.625), zinc (p = 0.132), and greater proportion from obesity (p = 0.19; not significant), and diabetes (p < 0.001). A cluster of “convenient” (20%) mainly suffered from lipid anomalies (p = 0.00), diabetes (p = 0.03), and a greater proportion from hypertension (p = 0.56) with deficiencies of all the essential vitamins and minerals but significantly from vitamin A (p < 0.001), folate (p < 0.001), and iron (p = 0.017). Lastly, the cluster of those who follow a “Western diet” (17%) was found to have lipid anomalies (p = 0.003), diabetes (p = 0.016), greater proportion of vitamin B12 (p = 0.136), D (p = 0.002), folate (p < 0.001), and iron deficiencies (p = 0.013).

Conclusions and relevance

Adolescents in India show a strong association between obesogenic diet and metabolic syndrome. Therefore, the burden of metabolic syndrome at early ages can be prevented by controlling obesogenic dietary practices and addressing micronutrient deficiencies. This may be done by targeted health promotional campaigns in schools and college-going populations in India.
Methodological issues of the electronic health records’ use in the context of epidemiological investigations, in light of missing data: a review of the recent literature
Authors: Tsiampalis Thomas , Panagiotakos Demosthenes
Published: August 2023

Background

Electronic health records (EHRs) are widely accepted to enhance the health care quality, patient monitoring, and early prevention of various diseases, even when there is incomplete or missing information in them.

Aim

The present review sought to investigate the impact of EHR implementation on healthcare quality and medical decision in the context of epidemiological investigations, considering missing or incomplete data.

Methods

Google scholar, Medline (via PubMed) and Scopus databases were searched for studies investigating the impact of EHR implementation on healthcare quality and medical decision, as well as for studies investigating the way of dealing with missing data, and their impact on medical decision and the development process of prediction models. Electronic searches were carried out up to 2022.

Results

EHRs were shown that they constitute an increasingly important tool for both physicians, decision makers and patients, which can improve national healthcare systems both for the convenience of patients and doctors, while they improve the quality of health care as well as they can also be used in order to save money. As far as the missing data handling techniques is concerned, several investigators have already tried to propose the best possible methodology, yet there is no wide consensus and acceptance in the scientific community, while there are also crucial gaps which should be addressed.

Conclusions

Through the present thorough investigation, the importance of the EHRs’ implementation in clinical practice was established, while at the same time the gap of knowledge regarding the missing data handling techniques was also pointed out.