bluuebunny/crossref_metadata_2025 huggingface dataset:
Reviewing the manufacturing challenges and scientific debates: Insights into the antibacterial capabilities and potential applications of PLA/ZnO nanocomposites
Authors: Dejene Bekinew Kitaw
Published: November 2024

The growing demand for antibacterial materials, particularly for biomedical and packaging applications, has prompted significant interest in biodegradable alternatives to traditional plastics. Among these, poly(lactic acid) (PLA) is a biocompatible and biodegradable polymer that is increasingly being recognized as a promising matrix material for the development of functional nanocomposites. Notably, the incorporation of zinc oxide (ZnO) nanoparticles into PLA matrices enhances their antibacterial functionality, providing effective solutions against both Gram-positive and Gram-negative bacteria. However, challenges persist in manufacturing PLA/ZnO nanocomposites, including achieving uniform nanoparticle dispersion, ensuring interfacial compatibility, and addressing scalability issues for industrial applications. Moreover, ongoing scientific debates regarding the exact antibacterial mechanisms of ZnO, such as reactive oxygen species (ROS) generation, physical disruption of bacterial membranes, and zinc ion release, complicate the efforts to optimize these materials. This review summarizes the current state of research on PLA/ZnO nanocomposites, exploring both the manufacturing challenges and the scientific discussions regarding their antibacterial mechanisms. Consequently, by identifying unresolved questions and consolidating existing knowledge, this review provides valuable insights for researchers and engineers seeking to advance the development of effective antibacterial materials, ultimately contributing to solutions to global health and environmental challenges.
Structural design and motion characteristics analysis of dual-mode active swing arm tracked robot
Authors: Zhang Yuanxun , Cheng Zhen , Wang Jianqin , Wang Lei , Sun Fengwei
Published: November 2024

Focusing on the demand for complex terrain traversal capability of mobile robots, this paper presents a mobile and creep dual-mode tracked robot configuration with capability of autonomous extrication, in response to solving the problem of tracked robots trapped due to insufficient obstacle-crossing capability. Based on the geometrical characteristics of parallelogram and its dynamic computation on the ground, a topological configuration of mobile tracked mechanism with the ability of creep is studied. An integrated structural design method of mobile chassis that integrates the swing arm and the tracked mechanism is proposed and a dual-mode active swing arm tracked robot structural model is established. The mobile and creep characteristics of the dual-mode active swing arm tracked robot are revealed through comparative simulations in multiple working conditions; Through the prototype tests in such typical working conditions as climbing, turning and obstacle-crossing, the feasibility of creep for the robot is verified and it is proved that the obstacle-crossing ability can be effectively improved. The research results provide theoretical support for improving the adaptability and possibility of mobile robots in complex terrain.
WOB fuzzy control and experimental study on horizontal well experimental setup
Authors: Kuang Yuchun , Zhang Tao , He Jingbin , Lin Wei , Yang Bo , Han Yiwei , Long Wei , Yang Qiling
Published: November 2024

This paper developed a horizontal drillstring-wellbore-bit experimental setup based on the similarity of physical behaviors. A data acquisition and control system was established to achieve real-time control over the Rotations Per Minute (RPM) and Rate of Penetration (ROP). Combining experts’ experience and practical drilling experiments, a constant Weight on Bit (WOB) fuzzy controller was designed for rock-breaking experiment. To validate the reliability of the control system, control tests were conducted with different WOB settings at varying RPM. The results indicated that the WOB control error was within 60 N, with an error rate below 3%. Rock drilling experiments were conducted on different rocks. In sandstone drilling experiments, as WOB increased from 600N to 900 N, the ROP, Torque on Bit (TOB), and Stick-slip Vibration Intensity (SSVI) increased significantly, reaching 114.12, 3.6, and 2.97 times of the original values, respectively. When the RPM increased from 21 to 30 RPM, TOB, SSVI, and ROP changed to 1.43, 0.89, and 3.84 times of the original values. The increase in ROP during sandstone drilling was evident, suggesting a moderate increase in drilling parameters, with caution against stick-slip vibrations, which can be mitigated by increasing RPM. In limestone drilling experiments, as WOB increased from 900 to 3300 N, TOB, SSVI, and ROP increased by 2.45, 3.17, and 56.34 times, respectively. When RPM was increased from 45 to 63 RPM, TOB, SSVI, and ROP changed by 0.88, 0.74, and 1.68 times, respectively. Under conditions of high WOB and RPM, the limestone drilling speed increased more significantly.
Disaster preparedness at the University of Dar es Salaam Library, Tanzania
Authors: Mkhai Emmanuel M , Kassim Mohamed
Published: November 2024

Disaster management is important for sustainable access of library resources. This article presents a study that has assessed disaster preparedness at the University of Dar es Salaam library in Tanzania. The study employed a case study research design with both qualitative and quantitative approaches to collect and analyze data. The study’s findings indicate that a majority of the participants were aware of potential disasters that could adversely affect the library’s resources. However, the research suggests that despite this knowledge, most respondents were not familiar with the crucial factors involved in effectively managing such disasters. Additionally, the findings reveal that many participants lack the necessary knowledge and skills to handle these situations. Along with the inadequate disaster management equipment and other challenges like a lack of training on disaster management, the library’s resources are at risk if a disaster were to occur. Overall, the study’s findings demonstrate that the library is not adequately prepared to handle potential disasters, which could potentially impact its ability to provide services to its users. Therefore, it is crucial for the library to allocate sufficient resources for effective disaster management to ensure the sustainable provision of services to its users.
Ethical climate and turnover intention among nurses: A scoping review
Authors: Ammari Nada , Gantare Abdellah
Published: November 2024

Introduction

Nursing shortages and turnover pose significant challenges for health organizations worldwide, driven by various organizational and individual factors. Ethical climate has emerged as a critical aspect influencing nurses' well-being and retention within healthcare settings, reflecting organizational practices with moral implications. Understanding the relationship between ethical climate and turnover intention among nurses is paramount for practitioners, managers, and policymakers.

Aim

This review aimed to examine evidence and synthesize findings from prior studies on the association between ethical climate and turnover intention among nurses and identify key variables influencing its dynamics.

Methods

A scoping review methodology was employed, encompassing studies retrieved up to February 2024 from major scientific databases, including PUBMED/MEDLINE, WEB OF SCIENCE, SCOPUS, and SCIENCE DIRECT. This study was conducted following ethical considerations and sound scientific guidelines.

Results

Sixteen articles meeting the inclusion criteria were identified. Overall, a significant association between ethical climate and turnover intention was observed, with theoretical underpinnings demonstrated. Key variables frequently linked to both ethical climate and turnover intention included organizational commitment, job satisfaction, and moral distress, while organizational commitment, organizational cynicism, and organizational trust emerged as mediators.

Conclusion

Despite demonstrating a clear association, results underscore the necessity for replication studies, qualitative and longitudinal approaches, and standardized measurement. Enhancing the ethical climate through regular assessments, education, and interprofessional collaboration can improve retention. Future research should focus on theory building, ethical management and leadership, associated factors analysis, and intervention studies to develop comprehensive models and effective strategies for improving the ethical climate and reducing nurse turnover.
Women’s Empowerment and Son Preference: The Case of India
Authors: Das Senjuti Ghosh , Bagli Supravat
Published: November 2024

The purpose of this article is to explore the changing patterns of women’s empowerment and son preference at the Indian sub-national level. We have measured the state-level degree of women’s empowerment and son preference for two different periods, that is, 2015–2016 and 2019–2020 using the fourth and fifth rounds state-level National Family Health Survey data. The sample of the study consists of women who can potentially have son preference. The study has examined whether the mean level of women’s empowerment and son preference has changed significantly between the two concerned time periods. The categorisation and cluster analysis of the states is done based on the degree of women’s empowerment and son preference. To explore the degree of association between son preference and women’s empowerment and its indicators, a correlation matrix is formed. No significant increase in the mean level of son preference is found whereas the average value of the degree of women’s empowerment increased significantly in 2019–2020 compared to 2015–2016. Further, the states categorised as having comparatively strong women’s empowerment do not necessarily have a comparatively low level of son preference. No significant association between women’s empowerment and son preference is explored through the correlation matrix as well. Thus, the study leads to the conclusion that son preference in India has no significant association with women’s empowerment.
The Economics of Education: A Panel Data Analysis of the Impact of Gendered Human Capital on Output Growth in India
Authors: Rani Geeta , Baliyan Kavita
Published: November 2024

Using panel regressions, this article investigates to what extent a reduction in gender inequality in education may increase growth of output at sub-national level in India. The article finds a considerable impact of gender inequality on economic growth which is robust. Point estimates suggest that 0.58% of the growth rate is accounted for by a better gender ratio in education attainment. Given the assumption that the distribution of innate abilities among males and females is equal, it is observed that under-addressed issue of gender equity has resulted in educational inequality and further to the adverse selection of a less efficient pool of labour having a negative impact on economic growth through lowering the average quality of human capital. Gender equality is an outcome-based achievement depending upon the successful accessibility of opportunities by females thereby the issue of gender equity becomes the precondition for gender equality.
Examining Family Testimonials for the Reauthorization of the Individuals With Disabilities Education Act
Authors: Hardy Abby , Fulton Kelly , Kim Julianna , Li Chak , Cheung W. Catherine , Burke Meghan M. , Rossetti Zach
Published: November 2024

In the last reauthorization of the Individuals with Disabilities Education Act (IDEA), families of individuals with disabilities provided less than 4% of the public comments. Given that families are equal partners in the decision-making process for students with disabilities, it is critical to understand their suggestions for IDEA. To this end, we analyzed the testimonials of 65 families of individuals with disabilities. Specifically, after completing a civic engagement program, participants provided video, audio, and/or written testimonials focused on their suggestions for the next IDEA reauthorization. Participants suggested strengthening existing IDEA provisions, increasing federal funding of special education, addressing personnel issues in special education, improving accountability, and increasing family knowledge and empowerment. Participants’ suggestions were further analyzed by examining patterns within the data; families of children with (vs. without) autism were significantly more likely to request that the next IDEA reauthorization increases knowledge and empowerment. Implications for future research and policy are discussed.
On linear heat equation via conformable derivative approach
Authors: Nemri Akram
Published: November 2024

The aim of this work is to establish in great detail the conformable Fourier analysis related to the cosine. We define and analyze the properties of the even conformable translation and the convolution. By adopting the approximation of the identity approach, we study the conformable cosine Fourier transform and its inverse formula. The second theme of this paper is an application of the Fourier analysis developed earlier. We extend the heat representation theory inaugurated by P.C. Rosenbloom and D.V. Widder to the conformable analysis. We construct the solution source and the heat polynomials and constitute with the associated functions a biorthogonal system. We conclude by solving the analytic Cauchy problem related to the conformable heat equation.
Effectiveness and sustainability of a multidisciplinary care model for patients with hemodialysis access dysfunction
Authors: Gan Chye Chung , Pang Suh Chien , Tan Ru Yu , Tng Alvin Ren Kwang , Tan Chee Wooi , Lim Lydia Wei Wei , Tay Hsien Ts’ung , Zhuang Kun Da , Ng Li Choo , Tay Kiang Hiong , Chong Tze Tec , Tan Chieh Suai
Published: November 2024

Background:

A multidisciplinary care model involving the interventional radiologist, vascular surgeon, interventional nephrologist, renal advanced nurse practitioner, and renal coordinators was implemented to improve the care for the patient admitted with dysfunctional hemodialysis access. This study aims to evaluate the effectiveness and sustainability of this multidisciplinary care model.

Method:

A dedicated interventional nephrology suite was established to perform endovascular procedures for patients admitted with hemodialysis access dysfunction via the emergency department of the hospital. We retrospectively collected data from electronic medical records 1-year before and after the implementation (April 2015). Outcome measures include waiting time for intervention, length of stays (LOS), number of dialysis catheter insertions before the intervention, number of inpatient dialysis required, and success rates of the interventions. The waiting time for intervention and LOS was tracked over the next 3 years to determine the sustainability of the care model.

Results:

Eight hundred eighty-one endovascular interventions (314 angioplasties, 567 thrombolysis) were performed on 554 patients. Post-implementation, a greater proportion of intervention was performed within 24 h (238 (50.2%) vs 70 (17.2%), p < 0.001) with lesser proportion of patients requiring bridging hemodialysis via temporary catheter, 156 (32.9%) versus 215 (52.8%), p < 0.001. A shorter median LOS and days-to-intervention were reported, 3 (IQR 2–6) versus 5 days (IQR 3–8), p < 0.001 and 1 (IQR 1–2) versus 3 days (IQR 2–4), p < 0.001 respectively. Less hemodialysis session/patient required, 2 (IQR 1–3) versus 3 (IQR 2–4), p < 0.001. The procedural success rate was greater, 440 (92.8%) versus 355 (87.2%), p = 0.020. Three years following implementation, the proportion of patients who received intervention within 24 h and were discharged within 48 h was reported to be persistently greater, 43% versus 13%, p < 0.001, and 27% versus 6%, p < 0.001 respectively.

Discussion:

This multi-disciplinary collaboration demonstrated a sustainable care model in improving the delivery of healthcare services for patients with dysfunctional hemodialysis access.
Effect of virtual reality video application on fistula puncture-associated pain in patients undergoing hemodialysis: Assessor-blinded randomized trial
Authors: Ersoy Nese Altınok , Kesik Gülşah , Dede Fatih
Published: November 2024

Objective:

To elucidate the effect of virtual reality video application on fistula puncture-associated pain in patients undergoing hemodialysis.

Design:

Attention controlled and assessor-blinded randomized trial.

Materials and methods:

Attention controlled and assessor-blinded randomized trial was conducted 28 patients at the hemodialysis center of City Hospital. The patients in the intervention group ( n = 14) participated in 12 hemodialysis sessions with virtual reality video application under the researcher’s supervision. The patients in the control group ( n = 14) received a 6-min training session on diet compliance. The Sociodemographic Form and Visual Analog Scale were used to collect data in person at various time points: baseline (t0), during the 1st to 12th hemodialysis sessions (t1–t12), and 1 week after implementation (t13).

Results:

Virtual reality video application helped in effectively decreasing pain over time, as revealed by significant differences in the measurements at t1–t12 and t13 ( p < 0.05). Time-based variations in within-group differences revealed that the median fistula puncture-associated pain values were significantly higher at baseline and t13 measurements in the intervention group ( p < 0.05). In contrast, no significant differences were observed in the median fistula puncture-associated pain values in the control group ( p < 0.05).

Conclusion:

In patients undergoing hemodialysis, the application of virtual reality helps decrease fistula puncture-associated pain values. Advances in technology, particularly virtual reality, may play a vital role in shaping the future of healthcare.
A Fuzzy Bi-objective Mathematical Model for Perishable Medical Goods Supply Chain Network Considering Crisis Situations: An Empirical Study
Authors: Shahrabadi Fereshteh , Kia Hamidreza , Heidari Ali , Khalilzadeh Mohammad
Published: November 2024

In case of crisis, the salvation of injuries depends on the timely provision of medical goods, relief supplies, and equipment. The aim of this study is to present a mathematical model for the supply chain network of perishable medical goods in crisis situation considering the uncertain environment. In this paper, a three-level supply chain including suppliers, intermediate warehouses, and final customers is developed for perishable medical items. The uncertainty of customer demand for service and the spent time in the intermediate warehouses are considered using the exponential distribution functions. Also, it is assumed that the life-cycle of perishable medical goods follow the Weibull distribution function. The model attempts to minimize the total costs of the supply chain and total presence time of perishable items in the whole chain. The LP-Metric method is employed for solving small-sized problems. Due to the NP-Hardness of the problem, the modified Multi-objective Particle Swarm Optimization (MOPSO) and Non-dominated Sorting Genetic Algorithm (NSGA-II) are utilized as 2 well-known and efficient meta-heuristic algorithms for solving large-sized problems. The findings indicate that the meta-heuristic algorithms are efficient in achieving close to the optimal solution for large-size problems in a reasonable time. Also, the results demonstrate that NSGA-II outperforms MOPSO in terms of the high quality solution. Finally, the applicability of the model to real-world problems is demonstrated using a real case study. This paper can assist the planners and decision-makers of perishable drugs supply chain networks in crisis conditions with on-time supplying and distributing the required emergency items.
On Mechanical Behavior and Characterization of Soft Tissues
Authors: Chavan Radhika , Kamble Nitin , Kuthe Chetan , Sarnobat Sandeep
Published: November 2024

The growth and advancements done in solid mechanics and metallurgy have come up with various characterization techniques that help in prediction of elastic properties of different types of materials—isotropic, anisotropic, transverse isotropic, etc. Soft tissues which refer to fibrous tissues, fat, blood vessels, muscles and other tissues that support the body were found to have some control over its mechanical properties. This mechanical behavior of soft tissues has recently shifted the attention of many researchers to develop methods to characterize and describe the mechanical response of soft tissues. The paper discusses the biomechanical nature of soft tissues and the work done to characterize their elastic properties. The paper gives a review of the behavior and characteristics of soft tissues extracted from various experimental tests employed in their characterization. Soft tissues exhibit complex behavior and various complexities are involved in their experimental testing due to their small size and fragile nature. The paper focuses on the conventionally used tensile and compression tests and the difficulties encountered in soft tissue characterization. It also describes the utility of ultrasound technique which is a non-destructive method to characterize soft tissues. Tensile and compression test used to characterize materials are destructive in nature. Ultrasound technique can provide a better way to characterize material in a non-destructive manner
Experimental and statistical investigation on temperature gradient of CFST truss chords
Authors: Yan Xinkai , Liu Yongjian , Liu Jiang , Zhang Guojing , Wang Zhuang
Published: November 2024

Due to mutual shading occlusion among staggered components, the solar temperature fields of CFST truss are complex, and the temperature actions of the truss chords differ from that of single-tube members, posing challenges in the calculation and assessment of thermal effects. This study proposed a temperature action mode tailored to independent thermal effects of CFST truss. Experimental testing over 1 year was conducted on a CFST truss specimen, with temperature gradients of chords analyzed using an extreme value statistical method and various machine learning algorithms. Structural parameters affecting temperature gradients were also examined through numerical simulation. The findings were applied to assess thermal responses in a real bridge scenario. Significant differences in the temperature gradients were observed between upper and lower chords, with the upper chords showing larger vertical temperature difference and the lower chords exhibiting slightly larger lateral temperature difference. A linear relationship in the temperature actions across different chords was notable. Bending effects induced by temperature gradients in chords may equal or surpass those caused by vehicle loads, necessitating careful consideration in CFST bridge design. The proposed extreme value statistical method for bridge temperatures, based on fourth-order linear moments, effectively determined optimal thresholds and probability distributions, demonstrating excellent performance when applied to tested data. Advanced machine leaning-based predictive models for bridge temperatures offer enhanced flexibility and accuracy compared to traditional predictive formulas.
Participatory developed school-based interventions targeting physical activity and sedentary behaviour among children and adolescents: A scoping review
Authors: Van Oeckel Veerle , Vandendriessche Anneke , Deforche Benedicte , Altenburg Teatske , Koobasi Muguet , Pauwels Nele S. , Verloigne Maïté
Published: November 2024

Aims:

A significant number of children and adolescents are insufficiently physically active and have a sedentary lifestyle, which is associated with adverse health outcomes, necessitating effective interventions. Using a participatory approach, which engages youth in intervention development, may enhance intervention effectiveness, as such interventions are believed to be more tailored to the needs of the target group. This scoping review aimed to provide an overview of the results of process and effect evaluations of studies that developed school-based physical activity and/or sedentary behaviour interventions using a participatory approach among children and adolescents.

Methods:

Six databases (MEDLINE, Embase, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus and SPORTDiscus) were searched. Studies were included when they evaluated the participatory process, intervention implementation or health-related intervention effects. A quality assessment was completed using two QualSyst checklists. Extracted data included characteristics of studies, interventions, and participatory processes; characteristics of participants from whom data were collected; outcomes measured and measurement methods used; and key findings.

Results:

Twenty-five papers, covering 18 original studies, were included. Studies suggested that participatory processes were generally perceived positively, resulting in pupils feeling empowered, experiencing ownership and gaining certain skills. Participatory developed interventions also seemed to be generally well received, although the intervention dose delivered and intervention reach seemed to vary between studies. Finally, studies generally tended to report no effects on health.

Conclusions:

Although a participatory approach could be promising in empowering pupils and promoting intervention acceptance, apparent differences in intervention implementation and limited effectiveness highlight the need to enhance participatory processes and intervention effectiveness.
Sedimentary relations: cultures of access and the matter of shallow seabed coring
Authors: Hine Amelia , Brinkhoff Thorsten , Bolta Anna Pasco , Peters Kimberley , Sammler Katherine G , Tietje Kristin
Published: November 2024

Contemporary cultural geographies have increasingly addressed subterranean and deep spaces through questions of access to earthly materials and the politics of resource extraction. This article engages with these themes through an investigation into the ‘doings’ or practices of seabed access. It does so by following the embodied and material experiences of two human geographers, an artist, a scientific coordinator and a microbiologist, who together undertook a day trip to learn shallow sediment coring in the Wadden Sea mudflats of Northern Germany. Stemming from a research project concerned with the accessibility of the seabed in international waters (how society can access its ‘common heritage’), we examine how taking samples from even the most accessible type of seabed – a shallow coastal mudflat within national waters that is not covered by seawater during low tide – presents a myriad of considerations, challenges and complications. We argue these are vital in examining the cultures of access – the embodied and material limits that define and shape participation in environments in which you and I have rights. These considerations, challenges and complications ranged from physical strength and balance requirements to an understanding of tidal movements, access to simple but specific equipment, appropriate clothing and private transport. We use ethnographic reflections and our photographic engagements to consider sedimentary relations: how we can and do relate to the seabed.
School Transportation as Social Capital: Suburban School Leaders at the Wheel of Equitable Access
Authors: Preis Deirdra
Published: November 2024

The roots of opportunity gaps in suburban schools often lie hidden in widely-accepted operational practices. Despite the importance of the informal curriculum to social capital development, suburban leaders sometimes underestimate how transportation restrictions can bar access to resources that are critical to advancing their Black, Brown, and lower-income students. This case illuminates how racism, classism, and housing segregation worked synergistically to create marginalizing transportation conditions in a majority-White suburban high school, and how the social-emotional impact ultimately led to the exclusionary discipline of two students. It addresses how race-neutral policies and deficit cultures contribute to unjust treatment of minoritized students, and underscores the need for suburban leaders to become racially literate and advocate for practices that ensure equitable access to capital-building resources for every student.
Results of Vertical Infra-Axillary Thoracotomy for Total Repair of Tetralogy of Fallot
Authors: Do Tien Anh , Luong Bao Tuan , Nguyen Tran Thuy , Nguyen Phong Ba , Luong Huyen Nhu Thi , Nguyen Viet Bang , Le Minh Ngoc , Nguyen Duong Ha Thai , Le Thanh Ngoc
Published: November 2024

Objective:

To demonstrate the efficacy of minimally invasive surgery via a vertical infra-axillary incision for complete tetralogy of Fallot (TOF) correction.

Methods:

In a study conducted from April to October 2023, 33 patients with TOF underwent total repair using this approach. On average, the patient age was 5.94 ± 2.68 months, weight was 6.49 ± 0.97 kg, and mean z-score index for the pulmonary valve annulus was –1.38 ± 0.92. Results also highlighted abnormal coronary artery pathways in 18.2% of cases, including 1 patient with dextrocardia and situs inversus.

Results:

The average incision length was 4.01 ± 0.6 cm, with bypass and clamping times of 95.42 ± 33.19 min and 69.24 ± 28.15 min, respectively. Preservation of the pulmonary valve annulus was achieved in 67% of patients. No postoperative deaths occurred, and there were no significant ventilation differences between groups. After surgery, no severe pulmonary valve regurgitation was observed, with patients remaining in excellent condition throughout the 7-month follow-up. The pulmonary valve pressure gradient after the procedure was 23.97 ± 10.65 mm Hg, and no heart failure cases were reported per the Ross classification at the latest follow-up.

Conclusions:

The vertical infra-axillary incision approach for total TOF repair is safe, effective, and cosmetically advantageous.
Minimally Invasive Video-Assisted Surgery for Concomitant Ascending Aorta and Aortic Valve Replacement via Right Infra-Axillary Thoracotomy
Authors: Wang Shuwei , Luo Chentao , Zhou Bing , Hu Zhibin , Liu Zhifang , Han Erlei , Wu Changhao , Mei Fuyang , Lu Xiaofeng , Chen Weikang , Dong Zhiqiang , Cui Yong
Published: November 2024

Objective:

This study aims to assess the safety, efficacy, and esthetic outcomes of an innovative 4 cm right infra-axillary incision approach for concomitant ascending aorta and aortic valve replacement (AAR and AVR), with a specific focus on achieving optimal surgical outcomes while ensuring minimal visible scarring.

Methods:

We retrospectively examined all elective cases of concomitant AAR and AVR surgery performed at our institution from July 2021 to June 2023. Exclusions encompassed emergency surgery, acute type A aortic dissection, active aortic valve endocarditis, redo cardiac surgery, the necessity for concurrent mitral valve replacement, or left ventricular assist device implantation. We collected and analyzed perioperative data for the patients.

Results:

The study comprised 24 consecutive patients. Cardiopulmonary bypass time and aortic cross-clamp time averaged 215.0 (interquartile range [IQR], 38.0) and 158.0 (IQR, 37.0) min, respectively. No instances of reoperation due to postoperative bleeding or need for permanent pacemaker implantation were recorded. Initial 24-h postoperative drainage volume averaged 186.9 ± 76.9 mL. Average follow-up duration was 21.7 ± 6.2 months (range, 5 to 30 months). Throughout short-term follow-up, no occurrences of valve dysfunction, paravalvular leak, cardiovascular events necessitating readmission, or mortality were observed.

Conclusions:

The right infra-axillary incision approach effectively yields secure, successful, and cosmetically pleasing outcomes for concomitant AAR and AVR. Further research and comparisons are warranted to validate these findings.
5-years patency results of Zilver PTX on the femoro-popliteal arterial segment: A Northern Sydney experience
Authors: Saricilar Erin C , Anning Naomi , Gatmaitan Raleene , Patel Kiraati , Fisher Charles , Puttaswamy Vikram
Published: November 2024

Background

The burden of peripheral arterial disease is increasing. Treatment of femoro-popliteal lesions remains challenging despite novel endovascular devices. Drug-eluting stents suppress post-treatment inflammation and reducing neo-intimal hyperplasia to reduce in-stent restenosis.

Methods

A multi-centre retrospective 5-years longitudinal study was undertaken to evaluate freedom from clinically driven target limb revascularisation (FF CD-TLR) and patency of Zilver PTX stents in treating symptomatic femoro-popliteal stenotic lesions. Kaplan–Meier survival curves were used to demonstrate FF CD-TLR, primary, primary assisted and secondary patency.

Results

There were 148 patients and 183 lesions treated with a mean age of 80.3 years and 52% males. The all-cause 5-years mortality was 25%. FF CD-TLR yearly patencies to 5 years were 81%, 67%, 62%, 57% and 52%, respectively, with significantly poorer outcomes for in-stent restenosis, longer stent lengths and lesions at the femoro-popliteal junction. Primary patencies were 63%, 47%, 40%, 34% and 24%, assisted primary patencies were 90%, 75%, 68%, 59% and 48% and secondary patencies were 96%, 94%, 94%, 92% and 92%. Major adverse limb events were 5% at 1-year and cumulative at 5-years was 16%.

Discussion

The clinical outcomes in this study population are comparable to recent publications with smaller cohorts. Our study confirms Zilver PTX has very good primary patency over 5 years with no discernible effect on all-cause mortality in an elderly cohort with particularly long treated lesions. Our results are similar to those seen in younger patients with shorter lesions. Nonetheless, longer lesions required more reinterventions to maintain patency.

Conclusion

Zilver PTX is a safe and durable drug-eluting stent when utilised in the management of femoro-popliteal stenotic lesions with good long-term patency and limited need for re-intervention.
Round table discussion. The management of proximal scaphoid nonunion
Authors: Liu Bo , Caloia Martín , HO Pak-Cheong , Mathoulin Christophe , Wolfe Scott
Published: November 2024

The management of scaphoid nonunion, although relatively common, continues to pose challenges, especially if complicated by avascular necrosis of the proximal pole, humpback or dorsal intercalated segment instability deformities, and early scaphoid nonunion advanced collapse. In this round table article, four surgeons were asked to answer key questions on a clinical example of a proximal scaphoid nonunion to outline their approach and rationale in their preferred treatment choices. The current panel of experts leans towards arthroscopic methods of treatment and most agree that arthroscopic bone grafting has become an important and revolutionary treatment option, which has yielded excellent results. However, both open and arthroscopic grafting are validated methods of treatment and which is to be performed is largely based on the surgeon’s preference.
Buddy taping after reduction of displaced extra-articular phalangeal finger fractures in children: a randomized controlled trial
Authors: Weber Daniel M. , Luckert Christian , Kalisch Markus , Subotic Ulrike , Weil Robert , Seiler Michelle
Published: November 2024

In this randomized controlled trial, we assessed the non-inferiority of buddy taping to splinting after reduction of displaced extra-articular proximal and middle phalangeal finger fractures in children. The primary outcome was the rate of secondary fracture displacements; the secondary outcomes were patient comfort, analgesic efficacy and total range of active motion 6 months after injury. Eighty-one patients participated: 43 with taping and 38 with splinting. Secondary displacement occurred in eight patients: five in the splinting group and three in the taping group. Risk difference was below the predefined non-inferiority of 10%. Patient comfort was significantly higher in the taping group, with no group differences for other parameters. Our previous study recommended taping for undisplaced finger fractures in children. With the current data, we recommend taping these finger fractures irrespective of displacement or need for reduction. We are encouraged to propose taping as an alternative to splinting for increased patient comfort, lower cost, and shorter application time.

Level of evidence: I
A Cross-Cultural Investigation of Prejudice Against Transgender People
Authors: Napier Jaime L.
Published: November 2024

The current research offers a cross-cultural examination of transgender prejudice, with a particular focus on the role of gender. Analyses of a survey conducted in 23 countries (with N’s ranging from 485 to 1,098) representing both Western and non-Western societies showed that there is greater bias toward transgender women (vs. men) overall, among both male and female participants. These differences were small and not reliable in most Western countries, whereas participants in China, Russia, South Korea, and Türkiye made greater distinctions. Men (vs. women) and conservatives reported higher prejudice, and this was more pronounced in Western (vs. non-Western) countries. Religiosity was associated with anti-transgender prejudice in Western (but not non-Western) countries, but this was completely accounted for by anti-gay attitudes. Finally, anti-gay and anti-transgender prejudice were strongly related to each other across samples, and the denial of gender identity predicted anti-transgender prejudice over and above anti-gay prejudice.
From Microaggressions to Viral Trends: A Qualitative Examination of Black Emerging Adults’ Experiences With Online Racial Discrimination
Authors: Banks Jasmine , Ward L. Monique
Published: November 2024

This study examines how Black emerging adults experience and perceive online racial discrimination. We systematically analyzed responses from 260 Black college students (aged 18-29) at a predominantly White institution in the Midwest, collected during the fall 2020 semester. Utilizing a two-step approach, we identified emerging themes in their experiences, then examined these themes through the lens of the Taxonomy of Online Racism (TOR), allowing us to understand how different manifestations of ORD intersect and relate. Content analysis revealed eleven forms of ORD, with Microaggressions ( n = 67), Encounters with Content Related to Police Violence Against Black Individuals ( n = 46), and Exposure to Anti-Black Lives Matter Sentiments ( n = 44) being the most prevalent. We also find that ORD is a complex phenomenon, shaped by factors such as current events and individual interpretations, which can differ from established definitions in research and policy.
Incident dementia in ischaemic stroke patients with early cardiac complications: A propensity-score matched cohort study
Authors: Bucci Tommaso , Choi Sylvia E , Tsang Christopher TW , Yiu Kai-Hang , Buckley Benjamin JR , Pignatelli Pasquale , Scheitz Jan F , Lip Gregory YH , Abdul-Rahim Azmil H
Published: November 2024

Introduction:

The risk of dementia in patients with stroke-heart syndrome (SHS) remains unexplored.

Patients and methods:

Retrospective analysis using the TriNetX network, including patients with ischaemic stroke from 2010 to 2020. These patients were categorised into two groups: those with SHS (heart failure, myocardial infarction, ventricular fibrillation, or Takotsubo cardiomyopathy within 30 days post-stroke) and those without SHS. The primary outcome was the 1-year risk of dementia (vascular dementia, dementia in other disease, unspecified dementia, or Alzheimer’s disease). The secondary outcome was the 1-year risk of all-cause death. Cox regression analysis after 1:1 propensity score matching (PSM) was performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the outcomes.

Results:

We included 52,971 patients with SHS (66.6 ± 14.6 years, 42.2% females) and 854,232 patients without SHS (64.7 ± 15.4 years, 48.2% females). Following PSM, 52,970 well-balanced patients were considered in each group. Patients with SHS had a higher risk of incident dementia compared to those without SHS (HR 1.28, 95%CI 1.20–1.36). The risk was the highest during the first 31 days of follow-up (HR 1.51, 95%CI 1.31–1.74) and was mainly driven by vascular and mixed forms. The increased risk of dementia in patients with SHS, was independent of oral anticoagulant use, sex and age but it was the highest in those aged <75 years compared to ⩾75 years.

Discussion and conclusion:

SHS is associated with increased risk of dementia. Future studies are needed to develop innovative strategies for preventing complications associated with stroke-heart syndrome and improving the long-term prognosis of these patients.
Design optimization of ceramic membrane filters based on a response surface method
Authors: Owusu Sekyere Augustine , Baidoo Martina Francisca , Ohemeng-Boahen Godfred , Essandoh Helen MK
Published: November 2024

Ceramic membrane filters fabricated from local raw materials are excellent for municipal wastewater treatment. This paper studied the fabrication of ceramic membranes using Response Surface Methodology (RSM). It also looked at the influence of clay, palm kernel shell ash, kaolin, and starch on the properties of ceramic membrane filters. Optimal test conditions and procedures were determined by selecting a fitting model based on experimental data. The Box–Behnken design (BBD) was chosen for its ability to reduce the number of experimental trials, thus making it cost-effective. The BBD design was executed using Design-Expert 13 software (Stat-Ease, Inc., Minneapolis, MN, USA), requiring 29 experimental runs. According to the study, responses such as porosity, flow rate, thickness, and density were used in the model. The fabrication of the 29 ceramic membranes includes formulation, shaping (slip casting method), drying, and sintering. Based on RSM, an optimum ceramic membrane design was proposed: Kaolin = 413 g, Clay = 180 g, Starch 147 g, Palm Kernel shell ash = 13 g. Compared with the test results, this combination possesses favorable and reliable accuracy. The addition of kaolin played a role in creating a porous framework within the ceramic membrane. Clay serves as a binding agent, aiding the consolidation of ceramic particles within the membrane matrix. Starch served as a pore-forming agent during the fabrication process. From the study, the palm kernel shell ash served as a binder and a reinforcing agent, bolstering mechanical strength and structural robustness.
Aligning our actions with our words: A systematic review of gender and racial diversity in surgical subspecialties
Authors: Lewis Joshua E , Pride Lornee C , Luk Hannah G , Oyejide Kafayat , Wilson Isha M , Tawiah Winston E , Watkins Cale M , Lee Wei-Chen
Published: November 2024

Introduction:

Persistent racial and gender disparities are prevalent within the higher education and medical training system, notably seen in the underrepresentation of Hispanic or Latinos, Black Americans, and female surgeons compared to their respective population proportions. This study aims to quantify publications addressing ethnic or gender diversity across various surgical specialties, analyze publication trends, and explore specific topics within medical literature.

Database:

The Database includes PubMed, Google Scholar, and Scopus

Methods:

Employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we conducted a systematic literature review utilizing the PubMed, Google Scholar, and Scopus databases. A broad inclusion criterion for both ethnic and gender diversity of plastic surgery, neurosurgery, otolaryngology, dermatology, orthopedic surgery, and gender surgery was utilized. The literature was selected between 2014 and 2024. In the content of our study, diversity in articles was defined as any article that focused on addressing gender or racial/ethnicity in the subspecialty.

Results:

Of 1529 initially screened articles, 346 were included. Orthopedic surgery had the most diversity publications (n = 86), followed by general surgery (n = 67) and plastic surgery (n = 51). Significant increases in diversity publications were observed across all specialties. Orthopedic surgery showed the highest growth (+0.17 publications/year, p < 0.001), followed by plastic surgery (+0.12, p = 0.002) and general surgery (+0.11, p = 0.003). Race/ethnicity was the primary focus (51.4%), with fewer articles on gender (19.7%) or both (28.9%). Diversity topics included demographics, pipeline/recruitment, application process, training experience, leadership, and workplace treatment.

Conclusion:

These insights underscore the importance of continued efforts to promote diversity within surgical specialties to enhance patient care and outcomes. Further research and initiatives are needed to ensure equitable representation in surgical fields. Addressing diversity issues in surgical specialties is essential for improving healthcare outcomes and reducing disparities.
CUDASW++4.0: ultra-fast GPU-based Smith–Waterman protein sequence database search
Authors: Schmidt Bertil , Kallenborn Felix , Chacon Alejandro , Hundt Christian
Published: November 2024

Background

The maximal sensitivity for local pairwise alignment makes the Smith-Waterman algorithm a popular choice for protein sequence database search. However, its quadratic time complexity makes it compute-intensive. Unfortunately, current state-of-the-art software tools are not able to leverage the massively parallel processing capabilities of modern GPUs with close-to-peak performance. This motivates the need for more efficient implementations.

Results

CUDASW++4.0 is a fast software tool for scanning protein sequence databases with the Smith-Waterman algorithm on CUDA-enabled GPUs. Our approach achieves high efficiency for dynamic programming-based alignment computation by minimizing memory accesses and instructions. We provide both efficient matrix tiling, and sequence database partitioning schemes, and exploit next generation floating point arithmetic and novel DPX instructions. This leads to close-to-peak performance on modern GPU generations (Ampere, Ada, Hopper) with throughput rates of up to 1.94 TCUPS, 5.01 TCUPS, 5.71 TCUPS on an A100, L40S, and H100, respectively. Evaluation on the Swiss-Prot, UniRef50, and TrEMBL databases shows that CUDASW++4.0 gains over an order-of-magnitude performance improvements over previous GPU-based approaches (CUDASW++3.0, ADEPT, SW#DB). In addition, our algorithm demonstrates significant speedups over top-performing CPU-based tools (BLASTP, SWIPE, SWIMM2.0), can exploit multi-GPU nodes with linear scaling, and features an impressive energy efficiency of up to 15.7 GCUPS/Watt.

Conclusion

CUDASW++4.0 changes the standing of GPUs in protein sequence database search with Smith-Waterman alignment by providing close-to-peak performance on modern GPUs. It is freely available at https://github.com/asbschmidt/CUDASW4.