bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Load of Drivers in Entrance Zone of Road Tunnel Based on TOPSIS Improved Factor Analysis Method
Authors: Liang Bo , Qin Can , Niu Jia’an , Xiao Jinghang , Wen Sen
Published: September 2023

To quantify and analyze the psychological reactions of drivers at the entrance zone of a road tunnel, drivers’ physiological data (pupil area, saccade range, saccade speed, heart rate, and breathing rate) were collected using the eye-tracking system in a real driving environment. A psychological load model was developed to quantify the multiple psychological indicators and analyze the change of psychological load at different times and locations based on the TOPSIS (technique for order preference by similarity to an ideal solution) improved factor analysis method. Sensitivity analysis was used to explore the effect of psychological indicators on psychological load. Results of tests conducted at different times of day (12:00, 15:00, and 18:00) show that psychological loads increase slowly to 0.52, 0.38, and 0.23, respectively, when outside the tunnel entrance (from −100 m to −50 m), increase dramatically to a maximum value (1, 0.84, and 0.71) when approaching the tunnel entrance (from −50 m to 0 m), and decrease dramatically to 0.61, 0.58, and 0.41 when first entering the tunnel (from 0 m to 50 m), and then decrease slightly to 0.20, 0.13, and 0.12 when driving inside the tunnel (from 50 m to 200 m). The result also shows that the proportions of saccade speed, pupil area, and saccade range are larger than heart rate and breathing rate. Moreover, the psychological loads of drivers are considerably lower at 18:00 than at 15:00 and 12:00, and the psychological loads near the entrance are considerably larger than inside or outside the entrance.
Comparative Assessment of Exclusive Breastfeeding Rates From 24-Hour Recall and Since Birth Methods in Southwestern Pennsylvania Using Ecological Momentary Assessment
Authors: Isiguzo Chinwoke , Documet Patricia , Demirci Jill R. , Youk Ada , Mendez Gabriella , Davis Esa M. , Mendez Dara D.
Published: September 2023

Background:

Accurate measurement of exclusive breastfeeding is important in maternal and child health research. Exclusive breastfeeding is often measured using the 24-hour recall or the since birth method for the first 6 months. These methods can produce different estimates, introducing problems in interpreting breastfeeding behavior and making accurate comparisons across settings or countries.

Research Aim:

Our aim was to compare the exclusive breastfeeding rates between the 24-hour recall and since birth methods among a diverse cohort of birthing people using the ecological momentary assessments method. In addition, we compared the exclusive breastfeeding rates between the two methods across race and other maternal characteristics.

Methods:

This study is a secondary analysis using data from the Postpartum Mothers Mobile Study (PMOMS), a prospective longitudinal study which recruited participants during pregnancy and followed them for 12 months after delivery. Participants completed surveys in real-time via ecological momentary assessment. Individual exclusive breastfeeding rates from months 1–6 were computed using 24-hour recall and since birth methods for 284 participants. We calculated the percentage point difference between the two methods across child age and maternal characteristics. We used a two-sample test of proportions to determine if the differences observed in the proportions were significant.

Results:

Exclusive breastfeeding rates from the 24-hour recall were higher than the since birth rates across all ages and maternal characteristics. The difference between the two methods at 3 months was 25.7 percentage points and at 6 months was a 17.2 percentage points. Irrespective of the method used to measure exclusive breastfeeding, White participants had higher exclusive breastfeeding rates than Black participants.

Conclusion:

The 24-hour recall and the since birth methods of assessing exclusive breastfeeding provided substantially different estimates. These findings highlight the importance of specificity in measuring and reporting exclusive breastfeeding.
Pipeline reliability assessment and predictive maintenance considering multi-crack dependent degradation
Authors: Zheng Yujia , Dong Zengshou , Zhang Xiaohong , Shi Hui
Published: September 2023

Cracks due to corrosion are one of the main reasons for natural-gas pipeline leaks. Making the reliability assessment, prediction, and maintenance decision of pipelines based on measurable crack data is a central issue at present. The failure of pipelines is usually a result of the cumulative impact of multiple cracks. The interaction between adjacent cracks accelerates crack propagation, and greatly affects the degradation mechanism of pipelines. In this study, the reliability prediction and maintenance decisions were studied by considering the dependent degradation between multiple cracks in pipelines. Firstly, the initiation and propagation of pipeline cracks were modeled using a non-homogeneous Poisson process and a Gamma process, respectively. The interaction between cracks was defined to be a function of the random crack distance, which could be reflected by the change of shape parameters in the Gamma process. Secondly, the pipeline’s failure was defined as the competitive failure of the number of cracks, the maximum crack depth, and the total crack depth. The reliability prediction model of a pipeline under this failure mode was determined. A non-periodic combined maintenance policy considering both the pipeline condition and its predictive reliability was then proposed, and an optimal predictive maintenance decision model was constructed to minimize the long-term average cost rate. Finally, the effectiveness of the proposed model and policy was verified by a numerical experiment and a crack dataset of a transnational pipeline.
Compilation of load spectrum of CNC machine tools reliability test program based on Weibull kernel function
Authors: He Jialong , Zhang Wei , Li Guofa , Wang Jili , Zhang Jiancheng
Published: September 2023

The load spectrum is the foundational data for reliability tests that simulate actual working conditions. Determining typical working conditions and accurate load extrapolation are the key to the load spectrum. This paper proposes a method for compiling the load spectrum of a reliability test program of CNC machine tools based on Weibull kernel function. The aforementioned method aims to address the issues commonly encountered in the load spectrum, such as complex factors that affect typical working conditions, heterogeneous load data of working conditions, and reliance on assumption distribution during load extrapolation. The method involves a determination process for typical working conditions using the Weibull kernel function and a non-parametric load extrapolation method based on kernel function. Firstly, this paper proposes a kernel density estimation method based on Weibull kernel function to address the issues of probability density contribution value deviation caused by the inconsistency between the conventional kernel function symmetry and the off-peak characteristic of load. The approach is based on the physical meaning and generalization of the Weibull distribution parameters and is used to determine the typical working conditions of CNC machine tools. Secondly, this paper proposes a nonparametric rainflow extrapolation method for cutting loads of CNC machine tools based on two-dimensional kernel density estimation. The approach takes advantage of the nonparametric rainflow extrapolation method and considers the characteristics of the cutting load. And the load spectrum of the three-dimensional cutting force of the CNC machine tool is constructed using the mean-range probability density distribution of the cutting load. Finally, the reliability test program loading spectrum of CNC machine tools is determined using the Conover ratio coefficient. Through case analysis, it can be known that the nuclear density estimation method proposed in this paper can improve the compilation accuracy of the load spectrum and has practical application significance.
Use of the best-worst method to evaluate determinants affecting cost reduction of heat exchanger components in the Chinese automotive industry
Authors: Ding Ji-Feng , Kang Cathay Kuo-Tai
Published: September 2023

As China is a major automobile manufacturing and consumption country, cost reduction is an important indicator for the operation of the automobile industry. There are many automobile-related components and parts, and each component is important to the full functionality of the automobile. This article focuses on automobiles’ heat exchanger components (HECs) because they have important connections with the engine, transmission, body, and hydraulic systems of automobiles. Since the HECs are important functional parts of automobiles, it is worthwhile to investigate the determinants affecting the cost reduction of HECs in the automobile industry. Hence, the main purpose of this article is to evaluate the determinants affecting the cost reduction of HECs in the Chinese automotive industry using the best-worst method (BWM). Firstly, based on the literature and the opinions of industry and expert interviews, five evaluation dimensions and 20 evaluation factors were developed. Secondly, an empirical survey was conducted using the BWM and expert questionnaires. Finally, the study’s results revealed that: (1) “Research and development” is the most critical evaluation dimension that affects the cost reduction of HECs in the Chinese automotive industry; (2) The determinants affecting the cost reduction of HECs in the Chinese automotive industry were “value analysis/value engineering,”“production system optimization,”“developing industry standards,”“lightweighting,”“synchronous new product development,” and “waste reduction.” The empirical findings showed that the first three determinants were particularly important in the decision-making factors of cost reduction. In addition, this article discusses and suggests these determinants as a reference for future cost reduction evaluation of HECs in the Chinese automotive industry.
Variable selection using inverse probability of censoring weighting
Authors: Kojima Masahiro
Published: September 2023

In this article, we propose two variable selection methods for adjusting the censoring information for survival times, such as the restricted mean survival time. To adjust for the influence of censoring, we consider an inverse probability of censoring weighted for subjects with events. We derive a least absolute shrinkage and selection operator (lasso)-type variable selection method, which considers an inverse weighting for of the squared losses, and an information criterion-type variable selection method, which applies an inverse weighting of the survival probability to the power of each density function in the likelihood function. We prove the consistency of the inverse probability of censoring weighted lasso estimator and the maximum inverse probability of censoring weighted likelihood estimator. The performance of the inverse probability of censoring weighted lasso and inverse probability of censoring weighted information criterion are evaluated via a simulation study with six scenarios, and then their variable selection ability is demonstrated using data from two clinical studies. The results confirm that inverse probability of censoring weighted lasso and the inverse probability of censoring weighted likelihood function produce good estimation accuracy and consistent variable selection. We conclude that our two proposed methods are useful variable selection tools for adjusting the censoring information for survival time analyses.
The heterogeneous effect of European Union Cohesion Policy on regional well-being
Authors: Calegari Elena , Ferrara Antonella Rita , Freo Marzia , Reggiani Aura
Published: September 2023

This study contributes to understanding the multidimensional effects of the European Union Cohesion Policy and highlights the importance of considering a wider range of well-being indicators when evaluating regional policies. The Extended Regional Development Index is an index of regional well-being that measures a broader set of regional outcomes. We examine the effects of Cohesion Policy on the Extended Regional Development Index in European Union-27 regions from 2007 to 2013, analysing the distributional effects on different quantiles of the index. Our findings highlight the Cohesion Policy’s role in supporting regional well-being and individual income levels during the double recession of 2008 and 2011. Moreover, the policy contributes to a process of convergence between regions, especially in light of increased disparities due to the European Union’s eastern enlargement.
Promoting Healthy Relationships in Foster Care—“If I Had Seen What a Healthy Relationship Looks Like, that Would Have Changed My Perspective”
Authors: Ball Barbara , Hoefer Sharon , Ding Xiao , Sevillano Lalaine , Faulkner Monica
Published: September 2023

High levels of intimate partner violence among youth and young adults with history in foster care can perpetuate the cycle of violence and abuse. It is therefore important to understand how the experience of growing up in foster care impacts youths’ understanding and formation of intimate relationships. This qualitative study centered the perspectives of young adults and investigated what they learned about relationships through interactions with foster caregivers and child welfare professionals. We conducted semi-structured interviews with 27 young adults and used Consensual Qualitative Research methods to identify critical experiences in foster care and formulate strategies for promoting healthy relationships.
Justice-Involved, Sexually Victimized Women's Perspectives on the Acceptability of Receiving Trauma-Focused Therapy in Prison
Authors: Fradley Marley F. , Kathryn Allison M. , Steely Smith Mollee K. , Bossard MeeSoh , Zielinski Melissa J.
Published: September 2023

Incarcerated women report high rates of sexual victimization. Interviews with 63 previously incarcerated women survivors of sexual violence explored perceptions toward receiving trauma-focused therapy while incarcerated and postrelease trauma-focused therapy utilization. Nearly all participants (97%) recommended that trauma-focused therapy be available to incarcerated women. Most believed that prisons are acceptable places to receive trauma-focused therapy, without qualification (65%); some reported mixed feelings or indicated acceptability but identified factors that would increase acceptability (33%). Notably, most were currently experiencing trauma-related symptoms, but few had attended trauma-focused therapy following release. Findings indicate that access to prison-based trauma-focused therapy is necessary and acceptable.
Navigating the Field While Black: A Critical Race Analysis of Peer and Elder Advice to and From Black Evaluators
Authors: Avent Cherie M. , Reid Aileen , Moller J.R. , Adetogun Adeyemo , Hooks Singletary Brianna , Boyce Ayesha S.
Published: September 2023

The field of evaluation has experienced greater professionalization in the areas of evaluator education and training. Growth in these areas included sensitivity to issues of diversity, with efforts to attract and retain evaluators of color. Currently, there is limited scholarship on navigating a world with more opportunity but still dealing with being Black. Motivated by our identities as Black evaluators, we explored the education, training and socialization concerns experienced by Black evaluators and the advice they would offer. Through content analysis of semi-structured interviews and the utilization of Critical Race Theory as a framework, we garnered advice to and from Black evaluators on how to (a) navigate the politics in evaluation; (b) engage in reflection and reflexivity; (c) network and collaborate; (d) mentor and bring others along the way; and (e) develop as a professional evaluator. We offer a synthesis of these findings in the discussion and articulate further implications.
Toward culturally sustaining supervision practices in mathematics education: what do Pasifika research students value most about their supervisors?
Authors: Tupouniua John Griffith
Published: September 2023

Disrupting forms of exclusion in higher education requires culturally sustaining practices. However, in some areas of higher education, the notion of culturally sustaining practice remains unexplored. The present study addresses this disparity by exploring the concept of culturally sustaining supervision in the specific case of Pasifika research students in mathematics education. In particular, this case study examines what a group of 22 Pasifika research students in mathematics education valued most about their respective supervisors. Using talanoa (respectful and free-flowing conversation and discussion) to gather data, three characteristics of supervisors that the participants valued most were identified via thematic analysis: (a) being available and accessible; (b) developing the student’s confidence; and (c) providing support beyond the thesis. The characteristics are discussed with respect to the Pacific concept of vā (relationships), which refers to the intricate relational and spatial realm in which connections among people exist and evolve.
Evaluating the comparability of patient-level social risk data extracted from electronic health records: A systematic scoping review
Authors: Linfield Gaia H , Patel Shyam , Ko Hee Joo , Lacar Benjamin , Gottlieb Laura M , Adler-Milstein Julia , Singh Nina V , Pantell Matthew S , De Marchis Emilia H
Published: September 2023

Objective: To evaluate how and from where social risk data are extracted from EHRs for research purposes, and how observed differences may impact study generalizability. Methods: Systematic scoping review of peer-reviewed literature that used patient-level EHR data to assess 1 ± 6 social risk domains: housing, transportation, food, utilities, safety, social support/isolation. Results: 111/9022 identified articles met inclusion criteria. By domain, social support/isolation was most often included ( N = 68/111), predominantly defined by marital/partner status ( N = 48/68) and extracted from structured sociodemographic data ( N = 45/48). Housing risk was defined primarily by homelessness ( N = 39/49). Structured housing data was extracted most from billing codes and screening tools ( N = 15/30, 13/30, respectively). Across domains, data were predominantly sourced from structured fields ( N = 89/111) versus unstructured free text ( N = 32/111). Conclusion: We identified wide variability in how social domains are defined and extracted from EHRs for research. More consistency, particularly in how domains are operationalized, would enable greater insights across studies.
A robust multi-scale learning network with quasi-hyperbolic momentum-based Adam optimizer for bearing intelligent fault diagnosis under sample imbalance scenarios and strong noise environment
Authors: Ye Maoyou , Yan Xiaoan , Chen Ning , Liu Ying
Published: September 2023

Due to adverse working conditions of rotating machinery in actual engineering, bearing fault data are more difficult to acquire compared to normal data. That said, the real collected bearing vibration data are usually characterized by imbalance. Meanwhile, fault information of the raw collected bearing vibration data is effortlessly drowned out by strong noises, which indicates that it is awkward to efficiently recognize bearing fault states via using traditional fault diagnosis methods under this background. To overcome these problems, this research proposes an individual approach formally intituled as robust multi-scale learning network (RMSLN) with quasi-hyperbolic momentum-based Adam (QHAdam) optimizer for bearing fault diagnosis, which mainly includes convolution-pooling operation, multi-scale branch, and classification layer. Within the proposed method, the channel attention mechanism based on squeezed excitation network is embedded into the multi-scale branch in the form of residual connections, which not only reinforce important information and weaken noise interference, but also capture fault features more comprehensively and enhance the discrimination of fault states with fewer samples. Additionally, in the training process, QHAdam optimizer is introduced to tightly control the loss of RMSLN to enable a faster and smoother convergence. Two groups of experimental bearing data are studied to support the availability of presented approach, and several traditional fault diagnosis methods and representative imbalance fault diagnosis approaches are compared in four evaluation metrics (accuracy, macro-precision, macro-recall, and macro-F1 score) to highlight the advantages of the presented method.
Exploring the Use of AI in Qualitative Analysis: A Comparative Study of Guaranteed Income Data
Authors: Hamilton Leah , Elliott Desha , Quick Aaron , Smith Simone , Choplin Victoria
Published: September 2023

This study explores the potential of the AI chatbot ChatGPT to supplement human-centered tasks such as qualitative research analysis. The study compares the emergent themes in human and AI-generated qualitative analyses of interviews with guaranteed income pilot recipients. The results reveal that there are similarities and differences between human and AI-generated analyses, with the human coders recognizing some themes that ChatGPT did not and vice versa. The study concludes that AI like ChatGPT provides a powerful tool to supplement complex human-centered tasks, and predicts that such tools will become an additional tool to facilitate research tasks. Future research could explore feeding raw interview transcripts into ChatGPT and incorporating AI-generated themes into triangulation discussions to help identify oversights, alternative frames, and personal biases.
Impact on diabetes outcomes and team skills of integrating dietetic services into interprofessional education and teamwork in primary care
Authors: Rowe Gina C , McShane Phyllis , Brennan Congdon Heather , Pittman Joan , Rios Judith
Published: September 2023

Objectives

Diabetes is a complex disease requiring daily self-management of diet and activity, yet many patients do not receive recommended self-management education, medical nutrition therapy, or team-based care that includes registered dietitian nutritionists (RDNs). Such service deficits contribute to challenges in meeting combined diabetes care goals. We evaluated the impact of adding RDN-supervised dietetic interns to an established primary care interprofessional education/teamwork model on patients’ clinical outcomes and health professions students’ team skills.

Methods

Electronic health records were retrospectively analyzed to evaluate the impact of interprofessional care teams including dietetic practitioners on patient outcomes and compare these changes to outcomes achieved with the previous model without such participation. Pre-test/post-test surveys were used to evaluate health professions students’ self-reported changes in team skills.

Results

Patient outcomes for glycemic control, systolic blood pressure, triglycerides, and depression improved significantly, and emergency department visits decreased by 79% after interprofessional care. Average hemoglobin A1c levels decreased from 11.6% to 8.3% ( p < .001), an additional 1.1% reduction over previous results, following incorporation of dietetic practitioners. Students reported increased team skills after interprofessional care participation.

Discussion

Health professions and dietetic program faculty should collaborate to develop interprofessional best practice primary care models for patients with diabetes.
A study of the adaptation processes of individuals with intellectual disabilities and their mothers to COVID-19 restrictions
Authors: Süngü Büşra , Özer Dilara , Has Beyza , Balta Irem Afitap
Published: September 2023

In this study, it was aimed to examine the adaptation processes of individuals with intellectual disabilities and their mothers to COVID-19 restrictions. The research was designed in qualitative research method and focus group interview technique was used. The mothers of individuals with intellectual disabilities constitute the participant group of the study. A semi-structured interview form consisting of eight questions prepared by the researchers was used as a data collection tool. Data were collected through two focus group interviews via Zoom link. The data obtained were analyzed by content analysis method. As a result of the research, four themes were reached: “Life Before the Pandemic”, “Encountering the Pandemic”, “Effects of the Pandemic”, and “Facilitation in the Adaptation Process to the Pandemic”. As a result, although COVID-19 restrictions led to the regression of some skills of individuals with intellectual disabilities, it created an opportunity for them to develop new interests. In addition, although there were supports that facilitated the pandemic process, it was determined that mothers needed even more psychological support during this period.
Influence of fuselage arm cross-section on the aerodynamic and aeroacoustic performance of quadcopter unmanned aerial vehicles: A numerical investigation
Authors: Jizhou Liu , Ming Li , Kaimin Yang , Lei Gao
Published: September 2023

This paper investigates the influence of the fuselage arm cross-section shape on the aerodynamic and aeroacoustic performance of quadcopter Unmanned Aerial Vehicles in hover state by numerical simulation. The unsteady simulations of the flow field around one generic two-blade rotor and one fuselage arm are conducted by the Reynolds Averaged Navier-Stokes solver with the [Formula: see text] SST turbulence model. The total thrust forces and the sound pressure level spectra of five fuselage arm cross-section shapes with the same cross-section area are simulated and compared. Results show that the fuselage arm with a square cross-section has the highest aerodynamic performances for all the tested speeds of rotation. The fuselage arm with a circular cross-section ranks second in aerodynamic performance. However, it has the best aeroacoustic performance. The other three tested cross-section shapes show less thrust forces and higher sound pressure levels at the blade passing frequencies than the circular cross-section, which are not optimal neither aerodynamically nor aeroacoustically.
Teachers’ perceptions of the influence of leaders’ behaviours on school culture: Exploring paradigm RePaDO
Authors: Thompson Canute S
Published: September 2023

This study examines perspectives of seven Jamaican primary school teachers on the degree to which their principals’ leadership behaviours include emphasizes recognition, promotes participation in decision-making, takes account of their diverse skills, and demonstrates openness to criticism. The study further explores whether teachers consider the principal’s behaviour as contributing to the culture of the school. The study found that teachers value expressions of recognition and opportunities to participate in decision-making. The study also found that while teachers are consulted, they are of the view that their contributions are not sufficiently considered. Instructively, all respondents held the view that while all members of staff were responsible for shaping the culture of the school, the principal had a leading role to play. The findings of the study suggest the need for post-training executive coaching component be implemented which would involve periodic structured conversations about growth, leadership, interpersonal relationships, and culture leadership, among other issues. This mechanism would allow the principal to reflect critically on how he/she in shaping the culture of the school. This coaching exercise would have an even greater impact if it were reinforced by confidential 360° performance reviews focussing on various aspects of cultural leadership.
The efficacy of tranexamic acid in primary anatomic and reverse total shoulder arthroplasty: A systematic review and meta-analysis of level I randomized controlled trials
Authors: Berk Alexander N , Hysong Alexander A , Kahan Joseph B , Ifarraguerri Anna M , Trofa David P , Hamid Nady , Rao Allison J , Saltzman Bryan M
Published: September 2023

Purpose

The purpose of this study was to systematically review the available level I evidence regarding the impact of tranexamic acid (TXA) on early postoperative outcomes in patients undergoing anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).

Methods

A systematic review of the literature through April 2023 was performed to identify level I RCTs examining the use of TXA at the time of primary TSA or RTSA.

Results

Among 5 included studies, a total of 435 patients (219 TXA, 216 control) were identified. Superior hematologic outcomes were observed among the TXA cohort, including lower 24-hour drain output (MD −112.70 mL: p < 0.001), lower pre- to postoperative change in hemoglobin (MD: −0.68 g/dL, p < 0.001), and less total perioperative blood loss (MD: −249.56 mL, p < 0.001). Postoperative Visual Analog Scale for pain (VAS-pain) scores were lower in the TXA group, but not significantly (MD: −0.46, p = 0.17). Postoperative blood transfusion was required in 3/219 TXA patients (1.4%) and 7/216 control patients (3.2%) (RR: 0.40, p = 0.16).

Conclusion

Perioperative TXA reduces drain output and total blood loss without increasing the risk of adverse events. TXA was not shown to decrease postoperative transfusion rates when compared to placebo controls.

Level of Evidence

Level I, meta-analysis.
Investigation of Morphometric Factors Associated With Adolescent ACL Rupture
Authors: Akcaalan Serhat , Kavaklilar Abdurrahim , Caglar Ceyhun , Ugurlu Mahmut , Dogan Metin , Akkaya Mustafa
Published: September 2023

Background:

There are no definitive anatomic morphometric risk factors for adolescent anterior cruciate ligament (ACL) injury.

Purpose:

To compare the parameters used to define the tibial and femoral morphometric structure of the knee between adolescent patients with and without ACL rupture.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Included were magnetic resonance imaging (MRI) scans and radiographs of 115 patients aged 10 to 17 years who were evaluated for ACL rupture at a single institution between February 1, 2019, and January 31, 2022. Images from 115 patients with intact MRI scans were included as controls. We investigated the following imaging parameters: tibial slope (on lateral radiograph), lateral condylar height, tibial sulcus height, medial condylar height, condylar width, intercondylar notch with, intercondylar notch angle, notch index, eminence width, tibial plateau width, eminence width/tibial plateau width, medial/lateral/overall eminence height, medial plateau depth, and 2 different eminence angles. Parameters were compared between groups using the chi-square, Fisher exact, Student t, or Mann-Whitney U test, as appropriate. Receiver operating characteristic analysis was conducted for cutoff values of significant parameters.

Results:

There were no significant differences in age, sex, or side affected between groups. Only the medial plateau depth was found to be statistically significant between the ACL rupture and ACL intact groups (2.6 vs 2.2 mm; P = .015). A statistically significant cutoff value could not be obtained for the medial plateau depth.

Conclusion:

Medial plateau depth was found to be significantly greater in adolescent patients with ACL rupture compared with ACL-intact controls.
Nutrition-Related Experiences of Women With Perinatal Depression During the COVID-19 Pandemic: A Qualitative Study
Authors: Stott Dahlia , Klobodu Cynthia , Chiarello Lisa A , Posmontier Bobbie , Egohail Mona , Geller Pamela A , Andrews Horowitz June , Milliron Brandy-Joe
Published: September 2023

Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to the COVID-19 pandemic: (1) Adaptations in shopping and cooking behaviors; (2) increases in stress and declines in respite; (3) declines in support and increases in isolation; and (4) low levels of breastfeeding guidance. Our findings confirm the importance of resilience among women with perinatal depression and future research is needed to elucidate the mechanisms connecting resilience and dietary behaviors.
Reflux Disease Questionnaire Scoring and Utilization: A Scoping Review
Authors: Reddy Alexander T. , Posner Shai , Harbrecht Matthew , Koutlas Nicholas , Reichstein Jonathan , Cantrell Sarah , Leiman David A.
Published: September 2023

Background:

The RDQ was developed to assist in diagnosing GERD, but is now widely used in multiple contexts and validated in several languages. However, there is no standard RDQ scoring rubric, making comparisons between its uses challenging. Therefore, we performed a scoping review to explore the current applications and scoring cutoffs of the RDQ.

Methods:

The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science electronic databases were systematically searched from January 2001 to January 2021 by a medical librarian using controlled vocabulary terms and keywords to identify experimental and observational study designs.

Results:

The search strategy yielded 5707 studies and 116 met inclusion criteria yielding a total patient population of 115 064. Studies utilized the RDQ to establish a GERD diagnosis (n = 52, 45%), report the prevalence of GERD symptoms within a specific population (n = 21, 18%), and assess the effect of an intervention on symptoms (n = 43, 37%). There was variability between the scoring threshold used for diagnosing GERD, with total GERD domain score ≥12 being the most commonly used (n = 16, 14%).

Conclusions:

The RDQ was designed as an aid for diagnosing GERD, but scoring methods and thresholds vary and the RDQ now is used to describe the prevalence of GERD symptoms and to assess symptom response to intervention. Based on the current review, the use of RDQ appears best suited for comparing diagnostic or treatment cohorts in which symptoms are evaluated. Interpretation of RDQ findings outside of a study-specific context is limited without accepted scoring standards.
European Respiratory Society short guidelines for the use of as-needed ICS/formoterol in mild asthma
Authors: Papi Alberto , Ferreira Diogenes S. , Agache Ioana , Baraldi Eugenio , Beasley Richard , Brusselle Guy , Coleman Courtney , Gaga Mina , Gotera Rivera Carolina Maria , Melén Erik , Pavord Ian D. , Peñate Gómez Deborah , Schuermans Daniel , Spanevello Antonio , Tonia Thomy , Schleich Florence
Published: September 2023

Recent clinical trials of as-needed fixed-dose combination of inhaled corticosteroid (ICS)/formoterol have provided new evidence that may warrant a reconsideration of current practice. A Task Force was set up by the European Respiratory Society to provide evidence-based recommendations on the use of as-needed ICS/formoterol as treatment for mild asthma. The Task Force defined two questions that were assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. The Task Force utilised the outcomes to develop recommendations for a pragmatic guideline for everyday clinical practice. The Task Force suggests that adults with mild asthma use as-needed ICS/formoterol instead of regular ICS maintenance treatment plus as-needed short-acting β2-antagonist (SABA) and that adolescents with mild asthma use either as-needed ICS/formoterol or ICS maintenance treatment plus as-needed SABA (conditional recommendation; low certainty of evidence). The recommendation for adults places a relatively higher value on the reduction of systemic corticosteroid use and the outcomes related to exacerbations, and a relatively lower value on the small differences in asthma control. Either treatment option is suggested for adolescent patients as the balance is very close and data more limited. The Task Force recommends that adult and adolescent patients with mild asthma use as-needed ICS/formoterol instead of as-needed SABA (strong recommendation; low certainty of evidence). This recommendation is based on the benefit of as-needed ICS/formoterol in mild asthma on several outcomes and the risks related to as-needed SABA in the absence of anti-inflammatory treatment. The implementation of this recommendation is hampered in countries (including European Union countries) where as-needed ICS/formoterol is not approved for mild asthma.
Sensory interventions to relieve dyspnoea in critically ill mechanically ventilated patients
Authors: Bureau Côme , Niérat Marie-Cécile , Decavèle Maxens , Rivals Isabelle , Dangers Laurence , Beurton Alexandra , Virolle Sara , Deleris Robin , Delemazure Julie , Mayaux Julien , Morélot-Panzini Capucine , Dres Martin , Similowski Thomas , Demoule Alexandre
Published: September 2023

Background

In critically ill patients receiving mechanical ventilation, dyspnoea is frequent, severe and associated with an increased risk of neuropsychological sequelae. We evaluated the efficacy of sensory interventions targeting the brain rather than the respiratory system to relieve dyspnoea in mechanically ventilated patients.

Methods

Patients receiving mechanical ventilation for ≥48 h and reporting dyspnoea (unidimensional dyspnoea visual analogue scale (Dyspnoea-VAS)) first underwent increased pressure support and then, in random order, auditory stimulation (relaxing musicversuspink noise) and air flux stimulation (facialversuslower limb). Treatment responses were assessed using Dyspnoea-VAS, the Multidimensional Dyspnea Profile and measures of the neural drive to breathe (airway occlusion pressure (P0.1) and electromyography of inspiratory muscles).

Results

We included 46 patients (tracheotomy or intubation n=37; noninvasive ventilation n=9). Increasing pressure support decreased Dyspnoea-VAS by median 40 mm (p<0.001). Exposure to music decreased Dyspnoea-VAS compared with exposure to pink noise by median 40 mm (p<0.001). Exposure to facial air flux decreased Dyspnoea-VAS compared with limb air flux by median 30 mm (p<0.001). Increasing pressure support, but not music exposure and facial air flux, reducedP0.1by median 3.3 cmH2O (p<0.001).

Conclusions

In mechanically ventilated patients, sensory interventions can modulate the processing of respiratory signals by the brain irrespective of the intensity of the neural drive to breathe. It should therefore be possible to alleviate dyspnoea without resorting to pharmacological interventions or having to infringe the constraints of mechanical ventilation lung protection strategies by increasing ventilatory support.
MRI pulmonary artery flow detects lung vascular pathology in preterms with lung disease
Authors: Häfner Friederike , Kindt Alida , Strobl Kathrin , Förster Kai , Heydarian Motaharehsadat , Gonzalez Erika , Schubert Benjamin , Kraus Yvonne , Dalla Pozza Robert , Flemmer Andreas W. , Ertl-Wagner Birgit , Dietrich Olaf , Stoecklein Sophia , Tello Khodr , Hilgendorff Anne
Published: September 2023

Background

Pulmonary vascular disease (PVD) affects the majority of preterm neonates with bronchopulmonary dysplasia (BPD) and significantly determines long-term mortality through undetected progression into pulmonary hypertension. Our objectives were to associate characteristics of pulmonary artery (PA) flow and cardiac function with BPD-associated PVD near term using advanced magnetic resonance imaging (MRI) for improved risk stratification.

Methods

Preterms <32 weeks postmenstrual age (PMA) with/without BPD were clinically monitored including standard echocardiography and prospectively enrolled for 3 T MRI in spontaneous sleep near term (AIRR (Attention to Infants at Respiratory Risks) study). Semi-manual PA flow quantification (phase-contrast MRI; no BPD n=28, mild BPD n=35 and moderate/severe BPD n=25) was complemented by cardiac function assessment (cine MRI).

Results

We identified abnormalities in PA flow and cardiac function,i.e.increased net forward volume right/left ratio, decreased mean relative area change and pathological right end-diastolic volume, to sensitively detect BPD-associated PVD while correcting for PMA (leave-one-out area under the curve 0.88, sensitivity 0.80 and specificity 0.81). We linked these changes to increased right ventricular (RV) afterload (RV–arterial coupling (p=0.02), PA mid-systolic notching (t2; p=0.015) and cardiac index (p=1.67×10−8)) and correlated echocardiographic findings. Identified in moderate/severe BPD, we successfully applied the PA flow model in heterogeneous mild BPD cases, demonstrating strong correlation of PVD probability with indicators of BPD severity,i.e.duration of mechanical ventilation (rs=0.63, p=2.20×10−4) and oxygen supplementation (rs=0.60, p=6.00×10−4).

Conclusions

Abnormalities in MRI PA flow and cardiac function exhibit significant, synergistic potential to detect BPD-associated PVD, advancing the possibilities of risk-adapted monitoring.
Direct versus indirect epiglottis elevation in cervical spine movement during videolaryngoscopic intubation under manual in-line stabilization: a randomized controlled trial
Authors: Choi Seungeun , Lee Dong Ju , Shin Kyung Won , Kim Yoon Jung , Park Hee-Pyoung , Oh Hyongmin
Published: September 2023

Background

During videolaryngoscopic intubation, direct epiglottis elevation provides a higher percentage of glottic opening score than indirect epiglottis elevation. In this randomized controlled trial, we compared cervical spine movement during videolaryngoscopic intubation under manual in-line stabilization between the two glottis exposure methods.

Methods

Videolaryngoscopic intubation under manual in-line stabilization was performed using C-MAC® D-blade: direct (n = 51) and indirect (n = 51) epiglottis elevation groups. The percentage of glottic opening score was set equally at 50% during videolaryngoscopic intubation in both groups. The primary outcome measure was cervical spine movement during videolaryngoscopic intubation at the occiput–C1, C1–C2, and C2–C5. The secondary outcome measures included intubation performance (intubation success rate and intubation time).

Results

Cervical spine movement during videolaryngoscopic intubation was significantly smaller at the occiput–C1 in the direct epiglottis elevation group than in the indirect epiglottis elevation group (mean [standard deviation] 3.9 [4.0] vs. 5.8 [3.4] °, P = 0.011), whereas it was not significantly different at the C1–C2 and C2–C5 between the two groups. All intubations were successful on the first attempt, achieving a percentage of glottic opening score of 50% in both groups. Intubation time was longer in the direct epiglottis elevation group (median [interquartile range] 29.0 [24.0–35.0] vs. 22.0 [18.0–27.0] s, P < 0.001).

Conclusions

When performing videolaryngoscopic intubation under manual in-line stabilization, direct epiglottis elevation can be more beneficial than indirect epiglottis elevation in reducing cervical spine movement during videolaryngoscopic intubation at the occiput–C1.

Trial registration

Clinical Research Information Service (number: KCT0006239, date: 10/06/2021).
Mobilizing morality: how caregivers in Vietnam handle the challenges of daily diabetes care
Authors: Huyen Dieu Bui Thi , Thi Ai Nguyen , Kim Dung Vu Thi , Le Minh Hieu , Gammeltoft Tine , Vestergaard Amalie Rørholm
Published: September 2023

Background

As a chronic disease, type 2 diabetes (T2D) often involves long-term care obligations for patients’ family members. Understanding the socially and culturally specific challenges that family caregivers face and how they cope with them is crucial in developing targeted and effective interventions to support both caregivers and patients with T2D. This research examined family caregiving for people with T2D living in rural northern Vietnam. Although there is a growing literature on family support in Vietnam, little is known about the personal experiences of family caregivers for people with T2D. This paper seeks to fill this gap revealing some of the challenges and coping strategies of family caregivers to people with T2D.

Methods

This qualitative study is based on ethnographic research using primarily semi-structured interviews with 21 caregivers to a person with T2D in Vietnam. The research was conducted in 2022 by a Vietnamese-Danish research team. Each interview was voice-recorded, transcribed verbatim and thematically coded.

Results

Four major challenges emerged from the analysis: physical health concerns, psychological exhaustion, economic burdens, and lack of support. Caregivers expressed motivation to overcome these challenges as they felt a deep sense of responsibility towards their family member with diabetes. The primary caregiver’s sense of responsibility toward their family would often cause them not to share the burdens from caregiving with other family members to avoid burdening them as well. However, negative experiences from caregiving were decreased and positive feelings increased in the instances where caregiving was shared between multiple family members.

Conclusion

While family members expressed motivation to take care of the patient because of moral obligations, some caregivers, specifically primary caregivers, did not want to burden other family members with care tasks and were reluctant to ask for assistance. For families who did share the caregiving tasks among several family members, some of the negative sentiments associated with caregiving were diminished. Having multiple members of a family forming a caregiving community thus motivated people in handling care challenges.