bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of premarital genetic counseling for couples at risk of hemoglobinopathies in Kingdom of Bahrain
Authors: Bahram Samya , Haji Aalaa , Abdulwahab Hawra , Mohsen Hanan , Alnashaba Tahera , Al-Aradi Zainab , Mandeel Mohamed
Published: April 2023

Objectives

Hemoglobinopathies are the commonest inherited blood disorders and form a serious burden worldwide, affecting communities, patient quality of life and healthcare resources. The Kingdom of Bahrain has issued a law obligating couples to undergo premarital screening to detect those at risk of having children affected with these disorders. The aim of this study was to analyze the marital decisions of couples at risk for hemoglobinopathies and follow up the outcomes.

Methods

A retrospective study was conducted on couples at risk for hemoglobinopathies identified during the premarital screening program at local health centers in the Kingdom of Bahrain and referred to the genetics department in the Salmaniya Medical Complex for genetic counselling in 2018–2020.

Results

A total of 189 couples were found to be at risk for hemoglobinopathies, of whom 159 completed the survey. Of these, 107 (67%) decided to proceed with their marriage and 26 couples achieved pregnancy. Out of 24 at-risk pregnancies with known outcome, 83.3% were spontaneous whereas only 16.7% underwent in-vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD). Eight out of 20 infants born to couples after spontaneous conception were affected. A positive attitude toward IVF with PGD was held by 60% of at-risk couples.

Conclusions

Despite undergoing premarital screening and genetic counselling, a large percentage of at-risk couples proceeded with their marriage. Most of them justified their decision due to the availability of advanced methods that aid in the prevention of having an affected child. However, the cost of such intervention was a major barrier for the majority of couples.
A clean and civil city: Local associations and the moral bordering of Parisian public space
Authors: Benjamin Carrie Ann
Published: April 2023

For years, city officials in Paris have tried to reduce ‘incivility’ to maintain public order and security. While civility is being used by the city to enforce a respect for others through a respect for public space, it is also being used to claim moral authority and legitimacy by groups who already enjoy a privileged access to these spaces. Although some of these groups may seek to bring their neighbours into an imagined moral community through ‘awareness raising’, others attempt a revanchist approach to push the ‘uncivil’ and ‘undeserving’ further outside the borders of this community. This article argues that in combatting incivility and bad behaviour, local associations attempt to establish a spatial and moral community that legitimises their vision of appropriate consumption and use of public space and excludes already-marginalised publics from its borders.
A Descriptive Study to Assess Level of Stress, Anxiety, and Pain Among Hospitalized Children Admitted in the Pediatric Surgery Unit of APC, PGIMER, Chandigarh 2020−2022
Authors: Praveen Shama , Sharma Sunita , Peters Nitin James
Published: April 2023

Background

Hospitalization is stressful for children. Hospitalized children suffer from stress due to the negative change in their life. Children facing medical procedures often experience pain and anxiety. Physical, psychological, social, cultural, and environmental factors all influence child behavior, which is especially challenging for children as compared to adults. Both pharmacological and non-pharmacological approaches can be used to manage distress among children. There are several ways to reduce stress, anxiety, and pain among hospitalized children. Puzzles, books, comics, crossword, video games, televisions, toys, phone, and so on. all are effective ways through which child can be engaged.

Aim

To assess the level of stress, anxiety, and pain among hospitalized children admitted in the Pediatric Surgery Unit, APC, PGIMER, Chandigarh, India.

Methods

A descriptive study was conducted on 60 hospitalized children. Purposive sampling was used to recruit the sample. The data were collected through interview schedule consisting of socio-demographic profile, clinical profile, and questionnaire on stress, anxiety and pain.

Results

The findings of the study revealed that all the children were having moderate stress, whereas majority of the children (91.7%) were having moderate anxiety, and only 8.3% of the children were having severe anxiety. During the assessment it was also found that almost 55% were having pain score 4, that is, Hurts little bit as assessed by Wong baker face pain scale.

Conclusion

Children who were being hospitalized were having varied degrees of stress, anxiety, and pain. Therefore, some diversional therapy should be planned to reduce their distress.
Beyond corporate financialization: From global value chains to the conundrum of intangible investments
Authors: Liagouras George
Published: April 2023

The article presents a constructive critique of the ‘financialization of the firm’ hypothesis. Without calling into question the idea that financialization has been a major structural change over the last four decades, it argues that the financialization of the firm argument has been pushed too far, especially regarding its ‘crowding-out’ and ‘drain’ effects on investment. Instead, the capacity of finance to accelerate the process of ‘creative destruction’ through the reallocation of capital has not been sufficiently taken into consideration. Consequently, the corporate financialization approaches tend to underestimate other structural changes in business organization, like the associated rise of Global Value Chains (GVCs) and intangible investments, both conceptualized by the ‘smiling curve’ notion. These secular changes challenge the categories of investment and capital we inherited from industrial capitalism. It remains, however, that we do not know how to measure intangible investment.
Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review
Authors: Van Riper Marcia , Cosgrove Bethany , Fleming Louise
Published: April 2023

Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.
Identifying Mental Health Profiles Among Adolescents Who Experienced a Recent Parental Deployment or Military-Related Family Separation
Authors: Lucier-Greer Mallory , O’Neal Catherine Walker , Mancini Jay A.
Published: April 2023

Accessing two independent samples of adolescents in military families in the United States who recently experienced parental separation ( N = 573; N = 186), this study sought to identify adolescent mental health profiles indexed on multiple indicators. In other words, we asked how military adolescents fare after parental separation in terms of mental health indicators. Proximal family processes (family cohesion, conflict, and marital adjustment) were also examined in relation to mental health profiles as well as core adolescent outcomes, self-rated health, and school enjoyment. In both samples, three profiles emerged identifying similar structures of mental health profiles. Two-thirds of adolescents were in the lowest risk mental health group. Poor family cohesion and greater conflict were associated with the moderate and highest risk groups. The lowest risk group reported better health and greater school enjoyment. Family nurses and other health care professionals are encouraged to inquire about military connectedness, structural changes occurring within the family system, and family processes in relation to adolescent well-being.
The Relevance of Thrombo-Inflammatory Biomarkers and Their Relationship with Circulating Glycosaminoglycans in End-Stage Renal Disease Patients
Authors: Allen Madeline , Bansal Vinod , Siddiqui Fakiha , Hoppensteadt Debra , Krupa Emily , Fareed Jawed , Kantarcioglu Bulent
Published: April 2023

En-stage renal disease (ESRD) is a growing public health problem. The atherosclerotic cardiovascular complications are the leading causes of mortality and morbidity in the ESRD. In this study, we sought to quantify the levels of thrombo-inflammatory biomarkers in an ESRD patients in comparison to healthy controls to determine their relevance in thrombo-inflammation and adverse outcomes. The levels of D-Dimer, C-reactive protein (CRP), plasminogen activator inhibitor 1 (PAI-1) antigen, functional PAI-1, thrombin activatable fibrinolysis inhibitor, tissue plasminogen activator, von Willebrand factor, and anti-PF4 IgG and microparticle (MP) activity were quantified by using commercially available ELISA immunoassays for each of the ESRD ( n = 73) and control plasma samples ( n = 10). The levels of endogenous glycosaminoglycans (GAGs) were quantified by utilizing a Heparin Red Probe (Redprobes UG, Germany). The collected data were analyzed to demonstrate the relationship between various parameters. All the tested biomarkers were increased in ESRD patients in comparison to healthy controls ( p < 0.05). These biomarkers have shown significant correlations within each other except for anti-PF4 Ig G and MPs. The CRP levels were significantly higher in patients who had coronary artery disease (CAD) ( p < 0.05), but there was no significant difference in other biomarkers according to the cardiovascular outcomes. In the multivariate analysis, the CRP (odds ratio: 1.19; 95% confidence interval: 1.01–1.41; p: 0.03) value was an independent predictor of CAD. In this study, we demonstrated increased levels of 10 different biomarkers in ESRD patients. The CRP levels can be a good predictor of CAD in ESRD patients.
Profile of Solid Tumor Patients Complicated With Venous Thromboembolism: A 10-Year Retrospective Cross-Sectional Study Based on 1482 Cases
Authors: Li Huimin , Tian Yu , Niu Haiwen , He Lili , Cao Guolei , Zhang Changxi , Kaiweisierkezi Kaiseer , Luo Qin
Published: April 2023

The aim of this single-centre 10-year retrospective observational study was to evaluate the profile of Chinese cancerous patients complicated with venous thromboembolism (VTE) based on demographic features, clinical characteristics, and medication exposure. Consecutive 1482 patients with solid tumor complicated with VTE at a tertiary center between 2012 and 2021 were retrospectively enrolled. Data were collected on demographics, comorbidities, discharge diagnoses, laboratory examination data, treatment details, and imaging description of the lesion. The overall incidence of clinical VTE was 1.35% in hospitalized patients with cancer in our center. Lung cancer was the most frequent tumor subtype for developing VTE events, accounting for 24.83% of all cases. Over half of the patients (66.60%) were observed to have an increased risk of VTE within the first 6 months of cancer diagnosis. Close to half of the patients (46.49%) had received chemotherapy within 6 months prior to the diagnosis of VTE. The frequency of massive ascites group (＞2000 mL) in gynecological patients with VTE was significantly larger than that of nonmassive ascites group (≤2000 mL) ( P < .001). Patients with ovarian, vulvar, lung cancers were considered at high risk for VTE. The assessment and monitoring of VTE in patients with cancer within the first 6 months of cancer diagnosis should be strengthened. VTE occurrence was closely related to advanced age and stage, adenocarcinoma, obesity and noval anticancer therapies in patients with cancer. Early detection of VTE-related examination may lead to earlier intervention for patients with gynecological tumors with preoperative massive ascites.
Percutaneous arteriovenous fistula creation in the management of severe Hemophilia A and end-stage kidney disease needing hemodialysis access, and beyond
Authors: Parkash Shanti , Pena Camilo , Cepak Joshua , Kimberly Robison , Zachariah Mareena , Li Wei
Published: April 2023

With the contemporary KDOQI, a patient-focused approach in vascular access care is emphasized more than ever when planning RRT. Nevertheless, functional vascular access continues to be the Achilles’ heel for successful hemodialysis in specific patient sub-groups, such as the Hemophilia-A population. The newer percutaneous endovascular approach is a safer alternative when conventional surgical AVF poses high bleeding risks perioperatively, which subsequently prevents ESKD patients to have desired permanent dialysis access. This article presents the case of a 45-year-old male with severe Hemophilia-A, who has been dialysis-dependent due to diabetic kidney disease and hypertension. Due to the severity of his progressively worsening bleeding disorder, his previous surgeries to treat other comorbidities have been complicated and involved challenging peri-operative treatment courses that include blood and factor VIII infusions, bleeding wounds, along with prolonged hospital stays. With the fear of bleeding diathesis, a conventional surgical AVF was not pursued, which has left him with a prolonged tunneled CVC while not being considered a candidate for peritoneal dialysis. We offered the patient a left arm percutaneous endovascular AVF creation with the WavelinQ™ 4F Endo-AVF system as an alternative option for his permanent hemodialysis access. An Endo-AVF was created bloodlessly between the left radial artery and lateral radial vein percutaneously with only two 4-French accesses at left wrist. The patient has been receiving full sessions of hemodialysis with expected flow rates and free of the CVC since. Likely the first case of such utilization reported, the utilization of percutaneous Endo-AVF for this patient has suggested not only that the endovascularly created AVF offers a good alternative dialysis access for hemophilia A patient populations, but also due to this technology’s unique features, it can be potentially employed in other situations, such as needs for reliable and chronic venous accesses and blood product exchanges.
Do live-stream telemedicine follow-up appointments for a Ponseti-treated clubfoot caseload compare favourably with a face-to-face review? Observed clinical outcomes and treatment provision during the COVID-19 pandemic
Authors: Douglas Christine , Simmonds Jane , Kedroff Louise , Tennant Sally
Published: April 2023

Introduction

Restrictions on face-to-face (F2F) healthcare services during the recent COVID-19 pandemic necessitated novel provision of care for Ponseti-treated clubfoot patients. This retrospective review compares the effectiveness of telemedicine (TM) using live-stream videoconferencing compared to conventional F2F review, in two cohorts of 78 patients attending routine follow-up, during Ponseti-treated clubfoot bracing in their first 5 years.

Methods

Rates of compliance, recurrence of deformity, and type of intervention provided were compared between cohorts. The TM cohort was re-evaluated F2F as part of routine follow-up care. Attendance rates were compared between cohorts and with an equivalent time period the previous year.

Results

There was no significant difference in the rate of compliance between cohorts (77% in the TM group, 74% in the F2F group), or in the rate of recurrence. Subsequent F2F review of the TM cohort showed that compliance had improved in some patients, indicating successful TM intervention. There were no missed cases of recurrence. TM follow-up appointments offered similar rates of management of skin problems, brace adjustment, and provision of exercises. At least one element of intervention was provided in 64% of the TM group, and 72% of the F2F group. TM connection was successful in 74% of booked appointments. The number of patients attending was similar to F2F bookings one year prior.

Discussion

The use of TM for routine follow-up of Ponseti-treated clubfoot patients can be as clinically effective as F2F assessment, and has potential for integration into routine follow-up care.
Evaluating robustness of a generalized linear model when applied to electronic health record data accessed using an Open API
Authors: Sharma Priya , Haaland Perry , Krishnamurthy Ashok , Lan Bo , Schmitt Patrick L , Sinha Meghamala , Xu Hao , Fecho Karamarie
Published: April 2023

The Integrated Clinical and Environmental Exposures Service (ICEES) provides open regulatory-compliant access to clinical data, including electronic health record data, that have been integrated with environmental exposures data. While ICEES has been validated in the context of an asthma use case and several other use cases, the regulatory constraints on the ICEES open application programming interface (OpenAPI) result in data loss when using the service for multivariate analysis. In this study, we investigated the robustness of the ICEES OpenAPI through a comparative analysis, in which we applied a generalized linear model (GLM) to the OpenAPI data and the constraint-free source data to examine factors predictive of asthma exacerbations. Consistent with previous studies, we found that the main predictors identified by both analyses were sex, prednisone, race, obesity, and airborne particulate exposure. Comparison of GLM model fit revealed that data loss impacts model quality, but only with select interaction terms. We conclude that the ICEES OpenAPI supports multivariate analysis, albeit with potential data loss that users should be aware of.
Social, seamless, just, and open: Advancing mobile communication research
Authors: Cumiskey Kathleen M , Humphreys Lee
Published: April 2023

Through integrating the research featured in this issue, this article describes generative areas for future research and the means to advance the impact of our field. Reflective practices related to field building and knowledge access for which Rich Ling helped to lay the groundwork are highlighted. Ling’s work in mobile media and telecommunications has influenced the theoretical, methodological, and empirical opportunities for mobile communication research. Four themes for future mobile communication research have emerged: social, seamless, just, and open. These themes align with the work featured in this issue and with Ling’s promotion of practices that enhance our field to develop relevancy, integrity, and ecological validity. This article places special focus on global and social justice as leading to a better understanding of mobile communication in the world.
The smartphone as a tool for mobile communication research: Assessing mobile campaign perceptions and effects with experience sampling
Authors: Otto Lukas P , Kruikemeier Sanne
Published: April 2023

Mobile communication differs from other forms of mediated communication in terms of connectedness, dynamics, omnipresence, and interactivity. Consequently, it can be difficult for scholars to investigate mobile communication using traditional research methods. The main goal of this article is to show how the mobile experience sampling method (MESM), in combination with data donations, can be useful for addressing the challenges of mobile communication research. We explicate the design using an experience-sampling study that was conducted on mobile campaigning during the Dutch 2021 national election. Using this case, we discuss how MESM can be extended and combined with other data sources, such as tracking data, GPS, and sensory data, to address the challenges of mobile communication effects research and facilitate future studies.
Probably not a game: Playing with the AI in the ritual of taking pictures on the mobile phone
Authors: Neumayer Christina , Sicart Miguel
Published: April 2023

This research explores mediated ritual interactions in the form of pictures taken using a mobile device in tandem with two critical designs: Probably Not and World to GIF. We take our point of departure in Rich Ling’s understanding of mobile interaction as a ritual of social cohesion and social bonding to explore sociotechnical interactions with mobile technology. By means of playful critical interaction design methods, we explore how deviance from the ritual of mediated interaction through taking pictures on the mobile phone may enhance our understanding of artificial agents. Building upon Ling’s work, we mobilize the ritual aspect of mobile communication to open possibilities for imagining alternatives of seeing the world through artificial intelligence. We conclude by arguing that playful designs in mobile communication research may allow us to disassemble and reassemble mobile apps which enables critical reflection on the role of artificial agents in mobile rituals.
“A friend who knows what they’re talking about”: Extending source credibility theory to analyze the wellness influencer industry on Instagram
Authors: Wellman Mariah L
Published: April 2023

While many scholars have explored the norms central to the success of social media influencers, credibility is a necessary attribute of creator presentation that remains underexplored. This essay argues for the application and extension of source credibility theory (SCT) to unpack how credibility manifests within the wellness influencer industry on Instagram. SCT originally included three constructs: expertise, trustworthiness, and attractiveness. I extend this theoretical framework by considering a fourth construct: positionality. When applied with the additional construct, SCT can help explain how influencers build and maintain credibility over time, especially within the wellness industry, where some influencers do not have more traditional forms of expertise like degrees and certifications in a health-related field. Through in-depth interviews with wellness influencers across the United States, I detail how credibility is operationalized within the wellness industry on Instagram and utilized to build relationships with followers and grow successful businesses.
Sensemaking and public intimacy on TikTok: How viral videos influence interpersonal relationships offline
Authors: Mendelson Emily A
Published: April 2023

Digital communication technologies transform social relationships by networking strangers into mediated intimate publics. Guided by the question of what happens when displays of public intimacy go viral, I analyze communicative methods within intimate publics on TikTok through an exploratory, qualitative case study of the viral “couch guy” meme. Results indicate that users on TikTok participate in intimate publics through the uploading of original content, duplication and replication of content, commenting, and lurking. Utilizing sensemaking as an analytic, first, I demonstrate how TikTok’s platform affordances transform displays of public intimacy into public extimacy, transforming TikTok into a space where social scripts and relationship expectations are negotiated. Second, I offer a preliminary organizational structure of communicative actions within the “couch guy” public on TikTok. Overall, this article concludes that participation in mediated publics has the potential to influence interpersonal relationships offline.
Experimental and numerical investigation of thermal fatigue life in wedge specimens made of Ni-resist D5S cast iron
Authors: Ktari Ahmed , Mellouli Dhouha , Kôster Alain , Haddar Nader , Toure Alexandra Marie-Louise , Remy Luc
Published: April 2023

Thermal fatigue experiments were performed on a single-edge wedge specimen of Ni-resist D5S cast iron to reproduce the conditions to which exhaust manifolds are subjected during service. The leading edge temperature was cycled between 20°C and 850°C, and the temperature distribution on the specimen surface was measured with thermocouples during thermal cycling. Due to the complexity of the loads, a uncoupled thermomechanical computation of the problem was performed using the three-dimensional finite element code ABAQUS to evaluate the temperature, stress and strain distribution over a thermal fatigue specimen. The heat fluxes and forced convection coefficients generated by the thermal fatigue benchmark were optimized in both heating and cooling phases by reverse engineering to reproduce the experimental temperature-time profiles measured by thermocouples on the surface of the specimen. Then, an elastic-viscoplastic tow-layer model was used to simulate the mechanical behavior of the studied material. It was found that the maximum stress value was located in the center of the specimen at the edge of the wedge. This result was confirmed by experimental observations. The crack initiation zone is located in the edge zone and the direction of crack propagation is perpendicular to the edge line toward the thick part of the specimen. The saturation of the main crack propagation near the uniform specimen zone was mainly explained by the rapid decrease of the energy dissipated per cycle.
A blind spot in AI-powered logo makers: visual design principles
Authors: Bertão Renato Antonio , Yeoun Myeong-Heum , Joo Jaewoo
Published: April 2023

Artificial intelligence is already embedded in several digital tools used across design disciplines. Although it offers advantages in automating and facilitating design tasks, this technology has constraints to empowering practitioners. AI systems steadily incorporate machine learning to deliver meaningful designs but fail in critical dimensions such as creativity. Moreover, the intensive use of AI features to provide a design solution – so-called AI design – challenges the boundaries of the design field and designers’ roles. AI-powered logo makers exemplify a horizon where non-designers can access design tools to create a personal or business visual identity. However, in the current context, these online businesses are limited to randomize layout solutions lacking the visual properties a logo requires. This article reports mixed-method research focusing on AI-powered logo makers’ processes and outcomes. We investigated their capability to deliver consistent logo designs and to what extent their algorithms address logo design principles. Initially, our study identified representative visual principles in logo design-related literature. After probing AI-powered logo makers’ features that enable logo creation, we conducted an exploratory experiment to obtain solutions. Finally, we invited logo design experts to evaluate whether three visual principles (proportion, balance and unity) were incorporated into the layouts. The assessment’s results suggest that these AI design tools must calibrate the algorithms to provide solutions that meet expected logo design standards. Even focusing on a particular AI tool and a few visual principles, our research contributes to initial directions for developing algorithms that embody the complex aspects of visual design syntax.
Cultural stories: Curriculum design learnings from an arts-based Australian university project in Timor-Leste
Authors: Mathews Rachel A , Stevens Kym , Meijer George
Published: April 2023

This paper investigates the preparation of Australian undergraduate university arts students for a life challenging arts-teaching and creative experience in Timor-Leste. It explores university teaching practice and how we may achieve better student experiences in preparation for their futures as teaching artists. This narrative inquiry research hears the voices of the students through their individual, personal stories. The emerging teaching artists articulate challenges, identify shifts in beliefs and values, and confirm skills that are transferable to cultural arts teaching contexts in the future. In all, the research has resulted in 46 recommendations, some minor, and some requiring more significant structural changes that affect course delivery. For the purposes of this paper, we reflect on and discuss three of the major findings and recommendations in the pedagogical, cultural, and artistic areas of the project implementation. As such, this paper represents a reflective analysis of some of the findings regarding curriculum design within this project.
Potentialising the potential: Dream of everything you can become, and become everything you dream of
Authors: Andersen Niels Åkerstrøm , Knudsen Hanne , Sandager Jette
Published: April 2023

In education, the child is often observed as a potential to be shaped and realised. In this article, we analyse the educational program, First Lego League. Surprisingly, its aim is not simply to realise a potential, but to potentialise the child to become unlimited potential. Children should become ‘a force for change’, and they are told that ‘you can be anything, just do it!’. To implement this program, First Lego League develops a transition medium that consists of non-representative, presentational symbols such as play, fun, innovation, dance and discovery. Such a program does not come without costs. Our analysis reveals how negativity is negated, knowledge is devalued and the children’s selfnarratives are decoupled. This could result in children being confronted with paradoxical demands, which are difficult to navigate. Analytically, the article draws on Niklas Luhmann’s systems theory and in particular his concepts of form and medium.
Flexible, monolithic piezoelectric sensors for large-area structural impact monitoring via MUSIC-assisted machine learning
Authors: Zhu Chen , Xu Zhangyu , Hou Chao , Lv Xiaodong , Jiang Shan , Ye Dong , Huang YongAn
Published: April 2023

Aircraft smart skin requires the integration of large-scale, ultrathin, and high-sensitive sensor network on the surface for structural health monitoring (SHM). However, it is fairly difficult to fabricate such large-area flexible sensor networks with low cost and high reliability. Although flexible and monolithic sensors are easy to be fabricated, their applications in large-area impact monitoring have yet to be developed and revealed. In this study, an impact monitoring and localization technology based on monolithic small-area sensors is proposed for large-area structures. The pivotal principle lies in the combination of the flexible piezoelectric sensor array and the Multiple Signal Classification (MUSIC)-assisted Artificial Intelligence Network (ANN) algorithm, where the key sorted feature matrix from the output signals to ANN can be captured by the MUSIC algorithm to achieve the spatial location estimation. The results show that the flexible piezoelectric sensors demonstrate excellent performance to monitor structural impacts in a region of more than 7500% of its area. Secondly, excellent conformation between the sensors and complex surfaces is achieved by the ultrathin thickness almost without affecting the surficial flow field. The overall recognition accuracy and robustness of impact location of machine learning is greatly increased by the integration of MUSIC algorithm, which is immune to the shape, material, thickness, or opening holes of the structure. Except for the impact location, impact energy, impact frequency, impact hardness and other structural health parameters can also be monitored. Therefore, a great prospect in the integrated monitoring of the aircraft’s structural and environmental parameters is expected.
TSCK guided parameter convex optimization tunable Q-factor wavelet transform and its application in wheelset bearing fault diagnosis
Authors: Zhang Xiong , Wu Wenbo , Li Jialu , Wan Shuting
Published: April 2023

Wheelset bearing is a typical vulnerable structural component in high-speed trains and heavy haul vehicles. In addition to the typical nonlinear and nonstationary characteristics, the vibration signal of wheelset bearing also contains track subgrade vibration and transmission path coupling interference components. To solve this problem, this paper proposes a new feature extraction method for wheelset bearing faults. This method constructs the Teager energy spectrum correlation kurtosis, which is purposely sensitive to periodic fault impulse components, as the objective function. The Q-factor and redundancy of tunable Q-factor wavelet transform are selected by using the parameter convex optimization method, which makes the signal decomposition have better sparsity, so as to extract fault information accurately. Simulated analysis, experimental signal analysis of QPZZ-II test-bed, and experimental signal analysis of wheelset bearing test-bed show that the proposed method can suppress the influence of nonperiodic transient impulse components, harmonic components, and noise components in the signal and accurately extract the periodic impact characteristics of bearings.
An Intervention Program for Families of Adults on the Autism Spectrum: A Case Study
Authors: Tagavi Daina M. , Stobbe Gary A. , Bearss Karen
Published: April 2023

Caregivers of adults on the autism spectrum report having limited access to resources that aid in supporting their child and helping them lead more independent lives. There is a need for interventions designed to teach caregivers strategies that address challenging behaviors, as well as promote independence. Using a case study design, we evaluated the preliminary feasibility and acceptability of Research Units in Behavioral Intervention (RUBI) with caregivers of three adults on the autism spectrum. Outcomes support preliminary feasibility and acceptability, as indicated by low attrition (0%) and high adherence to the RUBI manual (mean adherence = 91%). Following intervention, all adults on the autism spectrum demonstrated decreased levels of challenging behaviors and increased independence. The results of this study provide insight on next steps for investigation, including avenues for RUBI adaptation when delivered to adults on the autism spectrum and their families.
Mollusks from Arctic Region at the National Museum of Natural Sciences Collections (MNCN-CSIC, Madrid, Spain)
Authors: Bragado Álvarez Mª Dolores , de Andrés Cobeta Javier
Published: April 2023

The Mollusca Collection of the National Museum of Natural Sciences (MNCN, CSIC, Madrid) contains some specimens from the Arctic Circle, exactly thirty-eight lots including historical collections, which may provide insights to climate change research. Some of these collections refer to those of the Head of the Scientific Commission of the Pacific, the mariner and naturalist Patricio Paz y Membiela (accessioned in 1873), and the malacologists Joaquín González Hidalgo and Florentino Azpeitia (accessioned in 1913 and 1934 respectively). Recently there has been a donation from the collector and diplomat Javier Conde de Saro which was accessioned in the MNCN in 2011 and a collection of the curator of the Mollusca Collection, Rafael Araujo, of 2010. These specimens belong to twenty-six species (fifteen marine and three freshwater gastropods; six marine and one freshwater bivalves; and one polyplacophoran) from places such as Kola Peninsula, Greenland, and Novaya Zembla; and Russian Arctic waters. All of these specimens have been databased and are an important contribution to global research as mollusk are heavily affected by temperature changes and ocean acidification.
Thrombectomy for a basilar artery occlusion in a 2-year-old child: A focus on anatomical and technical aspects
Authors: Radu Răzvan Alexandru , Costalat Vincent , Machi Paolo , Derraz Imad , Dargazanli Cyril , Meyer Pierre , Cagnazzo Federico
Published: April 2023

Endovascular treatment (EVT) for large vessel, acute ischemic stroke in children remains a subject of debate, with evidence for its benefits derived from case series and individual case reports. At present, guidelines are cautious in recommending EVT for children under 5 years of age, mainly due to a lack of data and incomplete cerebral and femoral vessel development. However, based on the small number of cases reported in the literature, EVT appears to be safe and effective for pediatric use and arterial diameters can accommodate currently available devices. Available evidence shows that in patients with a normal arterial development, a 6-Fr femoral approach can be safely used by 2 years of age. We describe the case of a 2-year-old child who benefited from late-window EVT for a basilar occlusion. The procedure was safely performed using a 6-Fr femoral introducer, a 6-Fr guide catheter, and a 5-Fr aspiration catheter. We discuss also normal cerebral and femoral vessel development, providing descriptive tables of compatibility between femoral and cerebral arterial diameters by age groups and currently available endovascular devices.
Investigation and control of the ticking noise of the full floating piston pin
Authors: Li Zhibo , He Xiping , Yang Yi , Liu Qiang
Published: April 2023

The focus of this work is to investigate the ticking noise produced by the vibro-impacts between piston pin and connecting rod small head bearing. Numerical calculation and experimental verification methods were adopted and a novel method to control this intermittent noise was proposed. The dynamic model of crankshaft connecting rod piston with full floating piston pin was established and the essence of piston pin ticking was analyzed. The occurrence time of the ticking corresponded to the crankshaft angle when the resultant force of piston pin passed through the 0 axis. At the moment of impact, the peak hydraulic pressure of lubricating oil was found to be proportional to the impact strength. In order to suppress this noise, the oil groove on the bearing was designed considering the minimum oil film. After adding the oil groove, the impact intensity was significantly reduced and the noise was even eliminated. The calculated results were in good agreement with the experimental tests, and the research of this work provided a reference for controlling the ticking noise of piston pin.
The effect of patient empowerment on patient activation level: A review of individuals with cardiovascular diseases
Authors: Düzel Barış , Saygili Meltem , Özer Özlem , Zubaroğlu Yanardağ Melek
Published: April 2023

Objectives

The aim of this study is to examine the effect of patient empowerment on patient activation level in individuals with cardiovascular diseases.

Methods

The population of the study is adult individuals receiving inpatient treatment in the Cardiology clinic of a city hospital operating in Turkey. In the study, convenience sampling method was applied, and a questionnaire was conducted from 543 patients.

Results

As a result of the analyses made in the study, positive and low correlations were detected between the patient empowerment scale sub-dimensions and the patient activation level. According to regression analysis results, it was identified that the patient empowerment sub-dimensions together accounted for 6.4% of the total variance on the patient activation level, and the increase in the ‘knowledge and understanding’ levels of the patients statistically increased their perceptions of the patient activation level.

Discussion

The results show that by providing patient empowerment in individuals with chronic diseases, their active participation can be increased in the treatment processes and consequently in the chronic disease management.
The dialectics of leadership identity construction: Case studies from Indigenous women leaders
Authors: de Santibañes Mariana , Ospina Sonia M , Lee Seulki , Santamaria Angela , Evans Michelle M , Muelas Dunen , Guerrero Nazareth
Published: April 2023

Challenging oversimplified models, the leader identity literature calls for new perspectives of leadership identity construction (LIC). Using a collective leadership lens and narrative methods, this collaborative study explores how Indigenous women’s leadership identities develop within a contest for power and voice. Observations, interviews, and micro-ethnographies helped identify how history, community dynamics and cultural contradictions influence LIC. We find the LIC process to unfold as a dialectical spiral, informed by contradictions experienced when enacting social identities in various spheres of influence. This highlights the intersectionality of salient identities when theorizing LIC, and suggests that minoritized leaders can resignify and ultimately, capitalize on their multiple identities to strengthen their leadership.
Working with adults with intellectual challenges to enhance their employability skills
Authors: Krishnan S. Rama Gokula , Meena B. Preethi
Published: April 2023

The employability of the intellectually challenged has received little attention in the past. In order to fill this research gap, the present study was undertaken. The study is centered on the experiences of six intellectually challenged individuals who received employability training at a non-governmental organization. A focus group discussion along with a case study was conducted. The researchers employed the Rigorous and Accelerated Data Reduction (RADaR) technique to analyze the data from the focus group discussion. Results from both the focus group discussion and the case study revealed that the training program has had a significant impact on the lives of the participants and has aided them in becoming economically empowered and independent.
‘There’s a perfect way to do things, and there’s a real way to do things’: Attitudes, beliefs and practices of strength and conditioning coaches in elite international women's rugby union
Authors: Nolan David , Horgan Peter , MacNamara Aine , Egan Brendan
Published: April 2023

Optimal physical performance is a product of specific and tailored training. There are well-established sex differences in anatomical, physiological, and performance factors between biological males and females, which may have implications for physical preparation. A potential knowledge gap exists in relation to sex-specific differences in physical preparation because practitioners largely rely upon empirical evidence collected in male subjects for reference when devising interventions for female athletes. Therefore, this study explored the attitudes, beliefs and practices of strength and conditioning coaches ( n = 8; M/F, 6/2) in elite level (international) women's rugby union using semi-structured interviews (mean ± standard deviation duration 59 ± 15 minutes). The interviews explored differences in coaching elite female rugby players compared to males, with specific focus on training methodologies and understanding of pertinent aspects of female physiology. Reflexive thematic analysis was utilised to generate a rich qualitative dataset. Analysis resulted in the identification of higher-order themes: developmental stage of women's rugby, physical preparation, and education. Additional subthemes were created to facilitate organisation and presentation of data. The majority of coaches consider sex-specificity when devising physical preparation interventions as a function of training experience, rather than physiological between-sex differences, yet there were conflicting, and often erroneous understanding of female-specific considerations. To the authors knowledge, this is the first study to investigate attitudes, beliefs, and practices in elite level strength and conditioning coaches regarding sex-specific differences, and as such, illustrates the current understanding and opinions of practitioners in international level women's rugby union.
Computerized adaptive testing for the patient evaluation measure (PEM) in patients undergoing cubital tunnel syndrome surgery
Authors: Teunissen Joris S. , Hovius Steven E. R. , Ulrich Dietmar J. O. , Issa Fadi , Rodrigues Jeremy N. , Harrison Conrad J.
Published: April 2023

In outcome measures, item response theory (IRT) validation can deliver interval-scaled high-quality measurement that can be harnessed using computerized adaptive tests (CATs) to pose fewer questions to patients. We aimed to develop a CAT by developing an IRT model for the Patient Evaluation Measure (PEM) for patients undergoing cubital tunnel syndrome (CuTS) surgery. Nine hundred and seventy-nine completed PEM responses of patients with CuTS in the United Kingdom Hand Registry were used to develop and calibrate the CAT. Its performance was then evaluated in a simulated cohort of 1000 patients. The CAT reduced the original PEM length from ten to a median of two questions (range two to four), while preserving a high level of precision (median standard error of measurement of 0.27). The mean error between the CAT score and full-length score was 0.08%. A Bland–Altman analysis showed good agreement with no signs of bias. The CAT version of the PEM can substantially reduce patient burden while enhancing construct validity by harnessing IRT for patients undergoing CuTS surgery.
Rehabilitation following flexor tendon injury in Zone 2: a randomized controlled study
Authors: Renberg Markus , Turesson Christina , Borén Linda , Nyman Erika , Farnebo Simon
Published: April 2023

The aim of this study was to compare an early active motion (EAM) regimen to a modified Kleinert passive motion therapy in Zone 2 flexor tendon injuries with regards to range of motion (ROM), grip strength and patient-reported outcome measures (PROMs). Seventy-two patients were included. At 3 months postoperatively, we found no difference in total active motion (TAM) between the EAM and the Kleinert groups (median 195.5°, range 115°–273° versus median 191.5°, range 113°–260°), but a significantly better grip strength (median 76%, range 44%–99% versus median 54%, range 19%–101%; p <  0.0005) in the EAM group. Disabilities of the Arm, Shoulder and Hand (DASH) score as well as patient-reported weakness, cold intolerance and problems in daily activities also favoured the EAM group. At 12 months postoperatively, there was no difference in TAM, grip strength or any of the PROMs used. We conclude that EAM leads to a quicker recovery in terms of grip strength and PROMs, but that both regimens lead to similar results at 12 months.

Level of evidence: I
Oxygen insufflation through the bronchoscope channel for sedation-induced hypoxia: safe and effective
Authors: Abouzgheib Wissam , Miller Henry , Bartter Thaddeus
Published: April 2023

Objectives:

To evaluate both efficacy and safety parameters for insufflation through the bronchoscope as a method of recovery from sedation-induced hypoxia. To explore parameters applicable to use in human beings using an animal model.

Materials and methods:

Two adult pigs were sedated enough to depress respiratory drive. The effects of insufflation at 15 l/min (the upper limits of flow that might be used clinically) were then evaluated. Pressure and volume responses to bronchoscopy during intubation and without an endotracheal tube in place were recorded. Several assays were performed for each scenario, with each animal acting as its own control. Recovery from hypoxemia using insufflation was compared with recovery using mechanical ventilation.

Results:

Insufflation was effective, with rapid increases in fraction of inspired oxygen (FIO2), saturation, and partial pressure of arterial oxygen (PaO2). The rate of recovery using insufflation was faster than that from institution of mechanical ventilation. Insufflation in an intubated animal with cuff inflated led to a rapid and dangerous rise in pressure. With balloon deflated, there were no adverse pressure consequences from insufflation via the endotracheal tube at a rate of 15 l/min.

Conclusion:

Insufflation through the bronchoscope for episodes of sedation-induced hypoxia should be safe and effective as long as not delivered within a closed system.