bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Intervention Approaches of Emotion Regulation and Learning Strategies on Students’ Learning and Mental Health
Authors: Charbonnier Elodie , Le Vigouroux Sarah , Puechlong Cécile , Montalescot Lucile , Goncalves Aurélie , Baussard Louise , Gisclard Beatrice , Philippe Antony G. , Lespiau Florence
Published: March 2023

University students are a vulnerable population, and many recent studies show that anxiety, depressive symptoms, and academic burnout have been on the increase since the beginning of the COVID-19 pandemic. These findings point to a need for interventions to reduce these difficulties. The purpose of the present study was to assess the effects of 2 formats of an innovative program on students’ mental health (anxiety, depressive symptoms, and academic burnout), intolerance of uncertainty, learned helplessness, and learning. Our sample was composed of 105 university students, recruited on a voluntary basis. They were divided into 3 groups: online intervention group (n = 36), face-to-face intervention group (n = 32), and control group (n = 37). The following variables were measured through online questionnaires: anxiety and depressive symptoms, academic burnout, intolerance of uncertainty, learned helplessness, perceived social support, learning strategies, and beliefs. There were 2 assessments 10 weeks apart (ie, before and after the program in the case of the 2 intervention groups). We performed nonparametric analyses to run comparisons between the 2 assessment timepoints in each group. Results showed that participants in the 2 intervention groups had lower levels of learned helplessness and intolerance of uncertainty at the end of the program. Furthermore, participants in the face-to-face group reported higher levels of perceived social support, academic self-efficacy, and help-seeking strategies. The present study highlighted the benefits of our innovative program, especially its face-to-face format.

Clinical Trial - ID: NCT04978194.
Venoarterial extracorporeal membrane oxygenation for “protected” catheter-based embolectomy in high-risk/massive pulmonary embolism
Authors: Brewer Joseph M , Sparling Jeffrey , Maybauer Marc O
Published: March 2023

High-risk/massive pulmonary embolism (PE) has a high mortality rate, especially when cardiac arrest occurs. Venoarterial (V-A) extracorporeal membrane oxygenation (ECMO) can rapidly restore and maintain circulation while a decision regarding further care or performance of other interventions takes place. Catheter-based embolectomy (CBE) is a technology that allows for percutaneous access, clot removal, and potential resolution of shock while avoiding sternotomy required for traditional pulmonary embolectomy. Rapid placement of V-A ECMO in patients with high-risk/massive PE prior to CBE may confer circulatory protection before, during, and after the procedure.
Improving venous symptoms in C0s-C1s patients after multicomponent diosmin-based preparation: Initial experience
Authors: Greco Michele , Bissacco Daniele
Published: March 2023

The use of drug therapies in patients with chronic venous disease (CVD) remains a topic of debate regarding safety, compliance, and effectiveness. Although the beneficial effects of molecules like diosmin have been established in patients with chronic venous insufficiency (CVI) of C3–C6 classes, the evidence for its use in C0–C1 patients is not well documented. This report aims to describe and analyze the positive impact of a new diosmin-based drug therapy on a population of C0–C1 patients in terms of relief of venous symptoms.
Thermoelastic stress mitigation and weight reduction of functionally graded multilayer nonuniform thickness disc
Authors: Eldeeb AM , Shabana YM , Elsawaf A
Published: March 2023

In this paper, the particle swarm optimization method is used to reduce the weight of a multilayer rotating nonuniform thickness disc along with alleviation of the maximum tangential stress and the maximum tangential stress-jump at the interfaces. The proposed disc is made of functionally graded material and is subjected to both mechanical pressure and thermal loads. It is divided into several layers with each one having its unique volume fraction. These volume fractions are considered the design variables of the optimization problem along with two geometrical parameters related to the disc thickness. The equilibrium equation in polar coordinates are solved using the finite difference method. A punch of optimization results is calculated and discussed. It is concluded that the range of design variables’ variation widens by considering more layers. Finally, there is no potential disc configuration or geometry is found dominant to enhance the design parameters concurrently. Therefore, performing similar optimization analyses is compulsory to obtain an efficient and durable structure.
Frailty and Redemptive Flourishing: Learning Through Lived Experience
Authors: Trentham John David
Published: March 2023

This article presents an extended meditation exercise on Christian learning through the lived experience of frailty. It was composed at various points of calendar distance from the author's experience of sudden cardiac arrest. The structure of the meditation conforms to a catechetical–doctrinal framework, appealing to didache, didaskalia, and didasko. An original poem by Dan Haase is referenced and included in the appendix.
Kenaf fiber reinforced chemically functionalized styrene-acrylonitrile composites
Authors: Tamta Nisha , Palsule Sanjay
Published: March 2023

In view of no reports on natural fiber reinforced functionalized styrene acrylonitrile composites, this study develops kenaf fiber (KNF) reinforced chemically functionalized styrene acrylonitrile (CF-SAN) composites (KNF/CF-SAN) by extrusion and injection molding. The selected CF-SAN matrix is a chemically functionalized random ter-polymer, with high (10 ± 2%) maleic anhydride functionality and requires higher processing temperature. With respect to CF-SAN, the 10/90, 20/80 and 30/70 KNF/CF-SAN composites show 25%, 46% and 75% higher tensile modulus, 23%, 55% and 78% higher tensile strength, 34%, 66% and 104% higher flexural modulus and 48%, 87% and 125% higher flexural strength. Relative to the dry matrix, the water absorbed composites show higher properties, but relative to the respective dry composites, the water absorbed composites have at least 7% lower tensile strength and at least 20% lower tensile modulus, flexural modulus and flexural strength. SEM and FTIR (ATR-IR) establish that hydrogen bonding and esterification by Palsule process impart CF-SAN/KNF adhesion and bonding in the composites. The composites show thermal stability between KNF reinforcement and CF-SAN matrix upto 295°C.
Slacktivism
Authors: Ginzburg Boris
Published: March 2023

Many countries have introduced e-government petitioning systems, in which a petition that gathers a certain quota of signatures triggers some political outcome. This paper models citizens who choose whether to sign such a petition. Citizens are imperfectly informed about the petition’s chance of bringing change. The number of citizens is large, while the cost of signing is positive but low. I show that a petition that can bring change succeeds by a strictly positive margin. Hence, a citizen signing the petition is almost surely not pivotal. On the other hand, a petition that cannot bring change still gathers the required number of signatures when citizens are not very well informed, implying a failure of information aggregation.
Surface defect and chatter monitoring in robotic drilling CFRP composites using acoustic emission technique
Authors: Li Maojun , Jiang Xiaoyang , Huang Dingxiao
Published: March 2023

Robotic machining is feasible for cutting composites in the field of aviation manufacturing with the benefit of high flexibility and applicability. Riveting is widely used as an important joining technique of aircraft structures requiring hole making on CFRP composites. However, due to the inhomogeneous and anisotropy characteristics of CFRP composites and the weak rigidity of robot, surface damage, and chatter are prone to occur during robotic drilling process, which significantly affect geometrical accuracy of assembled structure. In this work, robotic drilling trials on CFRP composites with different parameters (spindle speed: 3000–15000 rpm, feed rate: 0.01–0.10 mm/rev) were conducted to understand the formation mechanisms of surface damage, as well as the relationship between acoustic emission (AE) signals and defect characteristics. The root mean square (RMS), fast Fourier transform and short-time Fourier transform were successfully used for processing AE signals. The occurrence of entry burr and exit burr were investigated based on different fiber cutting angle and corresponding fiber fracture mechanisms. Drilling status and detailed mechanisms of indentation during robotic drilling were identified/monitored by processing AE signals in the time domain, frequency domain, and time-frequency domain analysis. Matrix cracking, delamination and fiber failure during robotic drilling process was highly related with AE frequency of 0–129, 133–203 and 221–346 kHz, respectively.
Simulation of the performance of continuous solar-powered adsorption refrigeration system for optimal use in Zaria, Nigeria
Authors: Sowunmi Adetunji Rasheed , Folayan Clement Olaloye , Anafi Fatai Olukayode , Ajayi Olusegun Ayoola , Omisanya Nua Olarewaju , Edet Albright Abu , Oyedeji Ayodeji Nathaniel , Salami Kazeem Adeniyi
Published: March 2023

Cooling without electricity is the reason for solar adorption refrigeration systems. The epileptic power supply, especially in developing countries, makes solar refrigeration a very attractive option. This is coupled with the abundance of solar energy, making it a favourable alternative power source amongst other power mixes. This article introduces a solar adsorption refrigerator that continually generates cooling using solar energy as a standalone. Thus, this study aims to simulate and analyse the feasibility of refrigeration from a system that uses a blend of zeolite-based adsorbents and water (H2O) as adsorbate pairs via four solar concentrating collectors, two for adsorption and two for desorption using TRNSYS 16.0 simulation software. Unlike the conventional refrigeration system, the compressor was replaced with a solar concentrating collector while other components, such as the condenser, evaporator, and throttling valves, remained. The findings demonstrate that the technology delivered continuous cooling, and due to the comparatively intense beam radiation during the middle of the day, the cooling rate increased.
Exploring hydrogen fuel cell and battery freight locomotive options using train dynamics simulation
Authors: Cole Colin , Sun Yan , Wu Qing , Spiryagin Maksym
Published: March 2023

As efforts are being made to quickly adopt zero carbon technologies and replace fossil fuel powered trains, the design requirements are explored using train dynamics simulations to establish energy needs. The test case was a freight train of 3030 gross tonnes consisting of two locomotives and thirty wagons operating on a relatively flat coastal rail route. Then, assuming rapid deployment of existing and near market technologies, speculative locomotive designs are proposed for both battery only and hydrogen-battery systems. Batteries were assumed as rack mounted systems and hydrogen assumed at 250 bar gaseous. The results showed that full recovery of dynamic braking required only a very small amount of storage to capture and allow re-use, requiring a battery of only 6% of the trip total of recovered energy. The haulage task was found to require traction energy of 10.7 MWh per locomotive but reduced to a net requirement of 7.6 MWh per locomotive with recovery of dynamic braking energy. The large mass of batteries needed for the operating trip, however, limits the practical operating range. The results showed that, although hydrogen storage and equipment occupy considerable space and the containment systems have large mass, the space and mass requirements for a hydrogen system in this case study could be as low as half that required for batteries, while higher pressure or cryogenic approaches to hydrogen storage will allow the scaling for longer range.
Nonlinear aeroelastic stability analysis of a folding wing by using geometrically exact fully intrinsic beam equations
Authors: Moravej Barzani Sayed Hossein , Shahverdi Hossein
Published: March 2023

In this paper, the aeroelastic instability of folding wings by using the geometrically exact fully intrinsic beam equations is investigated. The important advantages of these equations in comparison with other structural beam equations are complete modeling without simplifying assumptions in large deformations, low-order nonlinearities, and thus less complexity. For the first time, folding angles have been implemented in the geometrically exact fully intrinsic beam equations and hence this is the main novelty of this study. The applied aerodynamic loads in an incompressible flow regime are determined using Peter’s unsteady aerodynamic model. In order to check the stability of the system, first the resulting non-linear partial differential equations are discretized by employing the central finite difference method, and then linearized about the nonlinear steady-state condition. By obtaining the eigenvalues of the linearized system, the stability of the wing is evaluated. Furthermore, investigation of the effects of some important parameters such as stiffness ratio and length ratio on the flutter speed of the folding wing for various folding angles, is another achievement of this study. It is observed that the geometrically exact fully intrinsic beam equations can model the folding angles for the aeroelastic analysis more accurately and the capabilities of these equations became more specific.
Book review: Dhananjay Tripathi (eds.), Re-Imagining Border Studies in South Asia
Authors: Deka Kaustabh
Published: March 2023

Dhananjay Tripathi (eds.), Re-Imagining Border Studies in South Asia. Routledge Taylor & Francis Group, 2021, pp. 264 (hardback), ISBN 9780367337186.
Association of Talar Neck Fractures With Body Extension and Risk of Avascular Necrosis
Authors: Mechas Charles A. , Aneja Arun , Nazal Mark R. , Pectol Richard W. , Sneed Chandler R. , Foster Jeffrey A. , Kinchelow Daria L. , Kavolus Matthew W. , Landy David C. , Srinath Arjun , Moghadamian Eric S.
Published: March 2023

Background:

The objective of this study was to determine whether talar neck fractures with proximal extension (TNPE) into the talar body are associated with higher rates of avascular necrosis (AVN) compared to isolated talar neck (TN) fractures.

Methods:

A retrospective review of patients sustaining talar neck fractures at a level I trauma center from 2008 to 2016 was performed. Demographic and clinical data were collected from the electronic medical record. Fractures were characterized as TN or TNPE based on initial radiographs. TNPE was defined as a fracture that originates on the talar neck and extends proximal to a line subtended from the junction of the neck and the articular cartilage dorsal to the anterior portion of the lateral process of the talus. Fractures were classified according to the modified Hawkins classification for analysis. The primary outcome was the development of AVN. Secondary outcomes included nonunion and collapse. These were measured on postoperative radiographs.

Results:

There were 137 fractures in 130 patients, with 80 (58%) fractures in the TN group and 57 (42%) in the TNPE group. Median follow-up was 10 months (interquartile range, 6-18 months). The TNPE group was more likely to develop AVN as compared to the TN group (49% vs 19%, P < .001). Similarly, the TNPE group had a higher rate of collapse (14% vs 4%, P = .03) and nonunion (26% vs 9%, P = .01). Even after adjusting for open fracture, Hawkins fracture type, smoking, and diabetes, AVN still remained significant for the TNPE group as compared to the TN group with an odds ratio of 3.47 (95% CI, 1.51-7.99).

Conclusion:

We found a higher rate of AVN, subsequent collapse, and nonunion in patients with TNPE compared to isolated TN fractures.

Level of Evidence:

Level III, retrospective cohort study.
Association of Dopamine Transporter Gene (DAT1) 40 bp 3′ UTR VNTR Polymorphism (rs28363170) and Cannabis Use Disorder
Authors: Olasore Holiness SA , Osuntoki Akinniyi A , Magbagbeola Olubunmi A , Awesu Abdur-Rasheed B , Olashore Anthony A
Published: March 2023

Introduction:

Cannabis remains the most widely used illicit drug among Nigerians, often associated with psychiatric disorders. Since genetic predisposition has been implicated in substance use disorders, we, therefore, aimed at finding out the relationship between dopamine transporter gene (DAT1) polymorphism and cannabis use disorder.

Methods:

We recruited 104 patients from a tertiary psychiatric facility in Lagos, Nigeria, who were diagnosed with cannabis use disorder according to ICD-10 and 96 non-smokers as a comparative group. The smokers were screened with Cannabis Use Disorder Identification Test (CUDIT), and cannabis dependence was assessed with the Severity of Dependence Scale (SDS). Genotyping was carried out for the 40 bp 3′ UTR VNTR of the DAT1 (rs28363170).

Results:

The frequencies of 9R/9R, 9R/10R, 10R/10R among non-smokers and smokers were 14 (14.3%), 25 (26.2%), 57 (59.5%) and 17 (16.3%), 54 (51.9%), 33 (31.7%) respectively. The genotype distribution was in Hardy Weinberg equilibrium (HWE) only in the smokers’ population (χ² = 1.896, P = .166). Individuals with the 10R allele were almost twice as likely as the 9R carriers to smoke cannabis (OR = 1.915, 95% CI: 1.225-2.995). However, this polymorphism was not associated with the quantity of cannabis smoked, age at onset of smoking, CUDIT, and SDS scores.

Conclusion:

The DAT VNTR polymorphism was associated with cannabis smoking but not cannabis use disorder.
Finite Element Model-Computed Mechanical Behavior of Femurs with Metastatic Disease Varies Between Physiologic and Idealized Loading Simulations
Authors: Johnson Joshua E , Brouillette Marc J , Miller Benjamin J , Goetz Jessica E
Published: March 2023

Background and objectives:

Femurs affected by metastatic bone disease (MBD) frequently undergo surgery to prevent impending pathologic fractures due to clinician-perceived increases in fracture risk. Finite element (FE) models can provide more objective assessments of fracture risk. However, FE models of femurs with MBD have implemented strain- and strength-based estimates of fracture risk under a wide variety of loading configurations, and “physiologic” loading models typically simulate a single abductor force. Due to these variations, it is currently difficult to interpret mechanical fracture risk results across studies of femoral MBD. Our aims were to evaluate (1) differences in mechanical behavior between idealized loading configurations and those incorporating physiologic muscle forces, and (2) differences in the rankings of mechanical behavior between different loading configurations, in FE simulations to predict fracture risk in femurs with MBD.

Methods:

We evaluated 9 different patient-specific FE loading simulations for a cohort of 54 MBD femurs: strain outcome simulations—physiologic (normal walking [NW], stair ascent [SA], stumbling), and joint contact only (NW contact force, excluding muscle forces); strength outcome simulations—physiologic (NW, SA), joint contact only, offset torsion, and sideways fall. Tensile principal strain and femur strength were compared between simulations using statistical analyses.

Results:

Tensile principal strain was 26% higher ( R2 = 0.719, P < .001) and femur strength was 4% lower ( R2 = 0.984, P < .001) in simulations excluding physiologic muscle forces. Rankings of the mechanical predictions were correlated between the strain outcome simulations (ρ = 0.723 to 0.990, P < .001), and between strength outcome simulations (ρ = 0.524 to 0.984, P < .001).

Conclusions:

Overall, simulations incorporating physiologic muscle forces affected local strain outcomes more than global strength outcomes. Absolute values of strain and strength computed using idealized (no muscle forces) and physiologic loading configurations should be used within the appropriate context when interpreting fracture risk in femurs with MBD.
Cues facilitate foreign language vocabulary learning from instructional videos: Behavioral and neural evidence
Authors: Pi Zhongling , Liu Caixia , Wang Luchun , Yang Jiumin , Li Xiying
Published: March 2023

Vocabulary learning is basic for mastering a foreign language. Many students learn foreign language (FL) vocabulary via instructional videos outside of traditional classrooms, as there is no limit to time or space. Cues (e.g. coloring, highlighting, arrows, and text) are design features in instructional videos that not only guide learners’ attention, but also facilitate the organization and integration of information. However, little is known about how visual cues and text cues influence FL vocabulary learning from instructional videos. In Experiment 1, we tested the effects of synonym text cues presented before the instructional video and visual cues during the video. Effects were measured in terms of participants’ judgments of learning and objective measures of learning performance (indicated by accuracy on immediate and delayed tests). Learners showed highest accuracy in the text cues condition, followed by the visual cues condition, and finally the no cues condition. In Experiment 2, we tested the neural oscillatory correlates of cues in FL vocabulary instructional videos based on electroencephalogram (EEG) evidence of frontal theta and frontal-parietal alpha power. Compared to visual cues during the video, text cues before the video elicited higher frontal theta power, suggesting higher working memory processing, at the early stage of learning from instructional videos. The results of this study have implications for designing effective FL vocabulary instructional videos with cues.
Addressing the Gap Between Academic Research and Grassroots Public Health Practice: Supporting Policy, Systems, and Environmental Changes in Rural Communities
Authors: Gabbert Kerry Darr , Tompkins Nancy O’Hara , Murphy Emily
Published: March 2023

Public health practice continues to expand beyond traditional partners to increase reach and impact in communities. This is particularly important in rural communities, who face inequities in the social determinants of health and increased chronic disease burden. However, the capacity for non-traditional community organizations to understand and implement public health work varies widely. Promoting policy, systems, and environmental change strategies (PSE’s) is a promising method to support public health in rural communities, due to their variety, flexibility, and potential impact.

Using a mixed methods approach to data analysis, we explore the barriers, challenges, and lessons learned from efforts in two rural Appalachian counties to stimulate use of PSE strategies through micro-funding. Several significant barriers were identified: challenges with evaluation and reporting, and lack of understanding and limited utilization of PSE strategies. Successful approaches to overcome these barriers included (1) changing reporting processes to reduce reliance on technology and shift reporting burden from community partners to researchers, (2) adapting data collection to capitalize on strengths of project partners, and (3) abandoning scientific language to embrace more common terminology used in communities. Policy changes were the least utilized strategy. This strategy may be less relevant in rural grassroots organizations with a small staff. Additional research into barriers to policy change is recommended. Enhanced training and support for grassroots, local-level PSE interventions could expand public health promotion in rural areas, reducing rural health disparities.
A Community Profile of Walking and Cycling for Exercise or Transportation in a Rural County in the Southeastern United States
Authors: Fitzhugh Eugene C. , Jarvandi Soghra , Franck Karen L. , Elizer Amy
Published: March 2023

People living in rural areas of the United States, especially in the southern region, are much less likely to walk or cycle for leisure time or transportation. The purpose of this study is to provide a more detailed community-level estimate of walking and cycling behaviors and attitudes among adults living in a rural county (Hardeman County, TN) participating in a High Obesity Program (HOP) from the Centers for Disease Control and Prevention. Telephone interviews and online surveys regarding walking and cycling behaviors, attitudes, and perceptions of the built environment were completed by 634 adults. Questions originated from the 2002 National Survey of Bicyclist and Pedestrian Attitudes and Behavior. Respondents were classified as walkers, cyclists, or both. Chi-square and logistic regression were used for data analysis. Of adults in this county, 67.2% were walkers and 16.2% cyclists. Both forms of active living tended to decrease with age, especially after 50 years. Walking was associated with younger ages, 2-person households, positive perceived health, and a feeling that walking was good for them. Cycling was only associated with age. Most people felt that their communities were safe places to walk or bike. Walking was most often done on roads or road shoulder. Social support and intrinsic motivators may also play a role in walking and bicycling in rural areas. Interventions that promote walking and cycling in rural areas should provide a means for social support, creating activity-friendly routes perceived to be safe, and enhanced destinations for places to be physically active.
The Great Australian TV Delay: Disruption, Online Piracy and Netflix
Authors: Vettoretto Ren , Moore Christopher
Published: March 2023

Netflix’s arrival in Australia in 2015, almost a decade after its start as a streaming media platform, helped to close the cultural and technological gap in televisual content legitimately available to the national audience. Australians, eager for international content unavailable locally, had turned to Internet piracy, dramatically changing traditional national televisual consumption practices. Although commonly described as “disruptive,” Netflix’s arrival in Australia, according to its users, was mostly stabilizing and not as transformative to their viewing practices as it may seem. By drawing on in-depth interviews with Australian Netflix users, we provide an account of its early integration into the Australian media landscape. The methodology provides a new model for examining the experience of users engaging with technologies labeled as “disruptive.” The Disruption-Experience (D-E) model is a means for exploring participants’ experiences and accounting for ways that new technologies can reinforce, undermine and dramatically shift user thoughts, feelings and practices. In applying this model to the experiences of Australian Netflix users, we discovered that Netflix concretized—but did not necessarily create—a new set of expectations about agency, accessibility, and temporality that has not previously been accounted for. This is an important discovery at a time of rapid proliferation and adoption of streaming video-on-demand (SVOD) services in Australia, as the competing costs and demands of multiple services could mean a return to the once-prodigious levels of illegal and unauthorized access to television content.
Onset of an Active Charcot Foot in a Person with Longstanding Type 1 Diabetes and Normal Vibration Perception Threshold—A Case Report
Authors: Petrova Nina L. , Banatwalla Rumaisa , Hunt Katharine F. , Ahluwalia Raju , Elias David A. , Bates Maureen , Vas Prashanth R. J.
Published: March 2023

Charcot neuro-osteoarthropathy (CNO), or Charcot foot, is a disabling complication of diabetes, which is poorly understood and frequently overlooked. We describe an atypical presentation of an active Charcot foot in a woman with a long-standing type 1 diabetes who did not exhibit loss of protective sensation (sensate to a 10-gram monofilament) or loss of vibration sensation. These standard measures of large nerve fibre function ruled out “classical” neuropathy. However, additional testing showed reduced sweat gland function most likely related to degeneration of c-fibres (small fibre neuropathy). This case raises the awareness that in addition to the “textbook” description, in diabetes, Charcot foot can develop in individuals with “minimal” or “no signs” of clinical neuropathy. The onset of active Charcot foot should be suspected in every person with diabetes and history of trauma even when foot and ankle x-rays are normal. Offloading should be initiated until the diagnosis is proven otherwise.
Optimising the delivery of breast cancer risk assessment for women aged 30–39 years: A qualitative study of women’s views
Authors: Hindmarch Sarah , Gorman Louise , Hawkes Rhiannon E , Howell Sacha J , French David P
Published: March 2023

Background:

Identifying women aged 30–39 years at increased risk of developing breast cancer could allow them to consider screening and preventive strategies. Research is underway to determine the feasibility of offering breast cancer risk assessment to this age group. However, it is unclear how best to deliver and communicate risk estimates to these women, in order to avoid potential harms such as undue anxiety and increase benefits such as informed decision-making.

Objectives:

This study aimed to investigate women’s views on, and requirements for, this proposed novel approach to risk assessment.

Design:

A cross-sectional qualitative design was used.

Methods:

Thirty-seven women aged 30–39 years with no family history or personal history of breast cancer participated in seven focus groups (n = 29) and eight individual interviews. Data were analysed thematically using a framework approach.

Results:

Four themes were developed. Acceptability of risk assessment service concerns the positive views women have towards the prospect of participating in breast cancer risk assessment. Promoting engagement with the service describes the difficulties women in this age group experience in relation to healthcare access, including mental load and a lack of cultural awareness, and the implications of this for service design and delivery. Impact of receiving risk results focuses on the anticipated impacts of receiving different risk outcomes, namely, complacency towards breast awareness behaviours following low-risk results, an absence of reassurance following average-risk results and anxiety for high-risk results. Women’s information requirements highlights women’s desire to be fully informed at invite including understanding why the service is needed. In addition, women wanted risk feedback to focus on plans for management.

Conclusion:

The idea of breast cancer risk assessment was received favourably among this age group, providing that a risk management plan and support from healthcare professionals is available. Determinants of acceptability of a new service included minimising effort required to engage with service, co-development of invitation and risk feedback materials and the importance of educational campaigning about the potential benefits of participation in risk assessment.
Perspectives of Singaporean Chinese patients with mild dementia and their family caregivers towards end-of-life care: Results from a qualitative study
Authors: Seow Dennis , Pang Amanda , Ho Suzanna , Malhotra Chetna
Published: March 2023

Background

Currently, there is little understanding of how patients with dementia and their caregivers view end-of-life (EOL) care. We thus aimed to study and understand the perception of EOL care by patients with mild dementia and their family caregivers.

Methods

We conducted qualitative in-depth interviews with 25 patients with mild dementia and their family caregivers belonging to Chinese ethnicity in Singapore. Patients’ and family caregivers’ understanding of illness, patients’ preferences for EOL care and caregiver concerns for the patients were discussed. Thematic analysis was conducted on the transcribed results of the interviews.

Results

We identified three main themes of person-centred EOL care: planning for cognitive decline and death, supporting patients to die peacefully at home, and supporting family caregivers to cope with patient’s condition. Most patients wanted to die peacefully and be cared for at their home. However, they were reluctant to initiate discussions regarding their future health care and seemed to be in denial that they may decline cognitively in future. Caregiver burden was noticeable for all family caregivers interviewed.

Conclusion

. Results highlight three important components that would enhance the delivery of patient-centred EOL care in patients with mild dementia. Strategies based on these components can enable family caregivers and health care providers to plan for and provide patient-centred EOL care concordant with patients’ wishes.
Community pharmacists’ measurement of health-related quality of life for breast cancer with positive hormone receptors: A prospective observational study
Authors: Ichimura Takenori , Nomura Hisanaga , Shimizu Hisanori
Published: March 2023

Objectives:

Many patients with hormone-receptor positive breast cancer undergo prolonged treatment. However, the long-term patient quality of life assessment has not been examined. Using community pharmacists’ assistance is one method for assessing long-term quality of life. Thus, this study aimed to understand the ongoing health-related quality of life and quality-adjusted life year among breast cancer patients so that community pharmacists may contribute to their pharmacotherapy.

Methods:

We conducted a prospective observational study with 22 breast cancer patients who had health-related quality of life at the initial measurement and 6 months later.

Results:

Regarding the health-related quality of life, quality-adjusted life year concerning all patients was 0.890 (95% confidence interval: 0.846–0.935). Quality-adjusted life year concerning those younger than 65 years was 0.907 (95% confidence interval: 0.841–0.973), and that for individuals older than 65 years was 0.874 (95% confidence interval: 0.804–0.943). The adjuvant chemotherapy group had a lower health-related quality of life at the initial measurement (0.887; 95% confidence interval: 0.833–0.941) but showed a higher quality of life 6 months later (0.951; 95% confidence interval: 0894–1.010). Quality-adjusted life year for individuals regarding adjuvant chemotherapy was 0.919 (95% confidence interval: 0.874–0.964). In contrast, the life-prolonged group had a higher health-related quality of life at the initial measurement, which was lower 6 months later.

Conclusions:

As a result of measuring quality of life using the EuroQol 5-dimensions-5-levels, this study revealed a decline in health-related quality of life in patients undergoing hormonal therapy for breast cancer. The study is expected to assist community pharmacists in managing outpatients.
“S.O.S. time!” Paradoxes of digital time experience among emerging adults
Authors: Ayadi Nawel , Djelassi Souad
Published: March 2023

The concept of time is revisited through the lens of the digital revolution. Our research aims to explore the relationship between emerging adults’ experience and perception of time and their use of digital technologies including the Internet, social networks, mobile apps, entertainment platforms, and instant messaging. A qualitative approach using a sample of 22 French emerging adults identified four perceptual dimensions of time – spiritual, organizational, evaluative, and affective. Our results show that emerging adults’ digital experience of time is characterized by three temporal paradoxes – (de)consumption of time, (de)regulation, and emotional ambivalence related to time.
Drivers of SME Growth: Quantile Regression Evidence From Developing Countries
Authors: Erdogan Aysa Ipek
Published: March 2023

This study explores the determinants of firm growth rate for small and medium-sized enterprises (SMEs) in different quantiles of the conditional growth rate distribution using data from World Bank Enterprise Surveys (WBES) covering 80 developing and emerging markets. It contributes to the literature by providing evidence of the effects of insufficiently investigated factors on firm growth. It also examines the impacts on firm growth of certain factors for which there is conflicting empirical evidence. Our quantile regression results show that firm age is negatively associated with firm growth rate throughout the entire distribution, except the lower tail. Firm size has a negative effect on growth rate in the upper tail of the distribution. We also find that the industry experience of the top manager positively impacts the growth rate only in the upper-middle range of the distribution. Product innovation positively affects firm growth rate from the lower-middle range to the highest quantile of the growth distribution. Additionally, we provide evidence that process innovation has a positive relationship with growth in the middle quantiles. SMEs that see access to financing as a more severe obstacle to their operations have lower growth rates throughout almost the entire growth distribution.
Impact of Celebrity, Micro-Celebrity, and Virtual Influencers on Chinese Gen Z’s Purchase Intention Through Social Media
Authors: Chiu Candy Lim , Ho Han-Chiang
Published: March 2023

Social media advertising strategies, including using traditional celebrity endorsers and micro-celebrity influencers, are prevalent marketing tools. However, the trend of using virtual influencers to endorse products is a novel potential way to attract young consumers. This present study aims to analyze the influence of the three types of endorsers (traditional celebrity, micro-celebrity, and virtual influencers) source credibility (i.e., physical attractiveness, expertise, and trustworthiness) on the purchase intention of the Chinese Generation Z, under varying levels of product involvement, through the mediating effect of emotional attachment. The Hayes Process Macro was used as a statistical analysis tool for our research propositions. Overall, our findings highlight the effectiveness of attachment theory in social media endorsement advertisements. Furthermore, these findings can guide marketers, who desire to respond to the purchase trends of Generation Z, to adjust their marketing strategies accordingly.
Incidence Rates and Pathology Types of Boxing-Specific Injuries: A Systematic Review and Meta-analysis of Epidemiology Studies in the 21st Century
Authors: Mao Yunhe , Zhao Dongmei , Li Jian , Fu Weili
Published: March 2023

Background:

To the best of our knowledge, an evidence-based investigation into 21st-century boxing-specific injury rates and types has yet to be performed.

Purpose:

To provide an overview and quantitative synthesis of the incidence rates (IRs) and pathological categorizations of boxing-specific injuries in the 21st century.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched literature published from January 2000 to November 2021 in PubMed and the Cochrane Library systematically for qualifying epidemiology studies of organized boxing activities across the world. Two independent reviewers completed the literature review, data extraction, and quality assessment. The IRs of injuries per 1000 boxers (IRN), per 1000 competition exposures (IRE), and per 1000 minutes of competition (IRC) or training (IRT) were subsequently calculated. Single-arm meta-analyses were performed for the subgroups of different types of boxing. Sample size weighted means were calculated using a random-effects model in all studies with 95% CIs.

Results:

Out of an initial 9584 articles, 14 studies were included, with most (11/14) having a moderate level of quality. The pooled IRN in overall injuries was 223.9 (95% CI, 157.5-290.4), the IRE was 233.3 (95% CI, 161.3-305.2), and the IRC was 13.0 (95% CI, 8.9-17.1). In professional boxing, the IRN (399.8), IRE (379.8), and IRC (23.9) were all significantly higher than in the amateur and female groups. The IRE (76.6 vs 250.6; P < .000) and IRC (9.2 vs 15.4; P < .000) in amateur boxing were significantly lower in studies between 2010 and 2019 than in earlier studies. For pathology categorization, the pooled frequencies were 12.3% (95% CI, 8.7%-15.9%) for concussion, 21.4% (95% CI, 14.1%-28.6%) for skin laceration, 30.2% (95% CI, 22.1%-38.2%) for soft tissue contusion, 15.3% (95% CI, 7.7%-22.9%) for sprain and muscle/ligament injury, and 11.4% (95% CI, 2.7%-20.1%) for fracture.

Conclusion:

IRs of injury remain high in professional boxing, although they have decreased in the past 10 years in amateur boxing. Soft tissue contusion was the most common injury type. Better exposure measurements and epidemiologic indicators should be applied in future studies.

Registration:

CRD42021289993 (PROSPERO).
Dementia During the COVID-19 Pandemic: Experiences From Clinicians, Patients, and Caregivers in Switzerland
Authors: Neumann Eileen , Ballmer Lisa , Studhalter Olivia , Schmid Nicole , Jung Hans H.
Published: March 2023

Background: The COVID-19 pandemic had a significant impact on the Swiss health care system, affecting especially vulnerable people, such as patients suffering from dementia. The purpose of this study was to investigate the challenges experienced by dementia patients, their carers, and clinicians during the pandemic in Switzerland. Methods: An online survey was sent to all memory clinics in the German speaking part of Switzerland. Patients diagnosed with dementia and their carers were recruited for semi-structured telephone interviews at the memory clinic of the University Hospital Zurich. Results: A total of 28 clinicians, 17 carers, and seven patients participated in this study. According to the clinicians, all aspects of clinical work were affected by the pandemic. Carers did not perceive a significant role of the pandemic in the disease progression of the patients, despite many challenges faced. Patients described a high level of conscientiousness during the pandemic. Recommendations for future scenarios were provided from all groups. Conclusion: In order to increase the systemic resilience of the Swiss health care system, it is important to consider the experiences and recommendations of vulnerable groups and health care professionals for future public health measures and policies.
New Method of Tibio-calcaneal-Navicular Arthrodesis After Talectomy
Authors: Ali-Zade Chingiz , Aliyev Huseyn , Alizada Farhad
Published: March 2023

Background:

After astragalectomy, patients still have a shortening of the limb, which can require various reconstructive manipulations. We have developed a simple and versatile tibio-calcaneal-navicular arthrodesis (TCNA) technique to reduce limb shortening.

Methods:

The main difference from the standard method of arthrodesis between the tibia and calcaneus is that in our method after astragalectomy, the tibia rests with the anterior edge against the os navicularis, and the posterior edge against the calcaneus. We have observed 14 patients (2 were female, 12 were male) operated by a new method of tibio-calcaneal-navicular arthrodesis (TCNA) from 2003 to 2020 years with various forms of osteomyelitis, fractures, and septic necrosis of the talus. The average age of the patients was 42.2 (ranged 20-75) years. Observation results will be assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score 1-1.5 years after surgery and treatment time in the Ilizarov apparatus.

Results:

In all patients, the wounds healed by primary intention. The average time of immobilization in the apparatus was 4.9 (ranged 3.5-6) months. The average limb shortening 2.0 ± 0.5 cm. AOFAS ankle-hindfoot score (n = 14) in all patients came up to 77.9 ± 6.8 (min 68, max 86) SD 12.8. Nonunion was noted in the region of the anterior edge of the tibia in 1 patient (7.1%), and in another patient a painless nonunion was formed (7.1%). Patients wore ordinary footwear without arch supporter and with heels up to 2 cm.

Conclusion:

Good and satisfactory results were obtained in all patients. The new TCNA method allows restoring the supporting ability of a limb, reduces shortening, and improves the quality of life for patients.

Level of Evidence:

Level IV, case series, low-quality cohort or case- control studies.
Risk-targeted hazard for seismic design in New Zealand considering individual and societal risk targets
Authors: Horspool Nick , Hulsey Anne , Elwood Kenneth , Gerstenberger Matthew
Published: March 2023

The promotion of risk-targeted hazard as the basis of seismic design internationally has increased over the past decade. Risk-targeted hazard estimates are derived through convolution of hazard curves with representative fragility functions and provide a means to target uniform risk across a region. Using risk targets also enables performance objectives of building codes that are consistent with other life risks and can include societal input into the expected performance of structures. Current design procedures using a uniform-hazard spectrum are unable to provide equal risk across the country due to variation in the shapes of hazard curves in different locations and uncertainty in structural response. In this article a framework is proposed, which can be used with national seismic hazard models, to produce risk-targeted hazard spectra for seismic design. This study extends the risk-targeted hazard framework through full quantification of epistemic uncertainty in seismic hazard and includes multiple risk targets for individual and societal risk at the building and city scales. The article describes a framework that can be used to adjust current seismic design force levels in New Zealand standards to target uniform seismic risk for buildings considering both the performance of individual buildings and the performance of cities.
Sparse clusterability: testing for cluster structure in high dimensions
Authors: Laborde Jose , Stewart Paul A. , Chen Zhihua , Chen Yian A. , Brownstein Naomi C.
Published: March 2023

Background

Cluster analysis is utilized frequently in scientific theory and applications to separate data into groups. A key assumption in many clustering algorithms is that the data was generated from a population consisting of multiple distinct clusters. Clusterability testing allows users to question the inherent assumption of latent cluster structure, a theoretical requirement for meaningful results in cluster analysis.

Results

This paper proposes methods for clusterability testing designed for high-dimensional data by utilizing sparse principal component analysis. Type I error and power of the clusterability tests are evaluated using simulated data with different types of cluster structure in high dimensions. Empirical performance of the new methods is evaluated and compared with prior methods on gene expression, microarray, and shotgun proteomics data. Our methods had reasonably low Type I error and maintained power for many datasets with a variety of structures and dimensions. Cluster structure was not detectable in other datasets with spatially close clusters.

Conclusion

This is the first analysis of clusterability testing on both simulated and real-world high-dimensional data.