bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-Thinking the “Invisible Child” Constitutions
Authors: Couzens Meda
Published: June 2024

Recent attempts to systematise the constitutional protection of children’s rights by creating constitutional typologies have been a useful first step in theorising this growing field. These efforts have focused on the wording of constitutions rather than their application, while forms of constitutional protection that are less textually explicit and more difficult to detect have received limited attention. By exploring the constitutional protection of children’s rights in France, this article demonstrates that some constitutions poor in explicit provisions on children’s rights can provide valuable protection through their general provisions. The article further argues that constitutional typologies of children’s rights protection should be expanded to encompass non-liberal constitutions.
Religious Women in Africa
Authors: Almeida João Miguel
Published: June 2024

This paper sets out not only to explain how the Servants of Our Lady of Fatima became a missionary congregation in Mozambique in the late Portuguese colonial period (1972–1975) but also to detail the impacts of their activities in the post-colonial period in Mozambique. This process highlights the pastoral and theological approaches of the Servants. The missionary women were empowered during the early years of independence. This historical context was marked by changes in the ecclesiastic structures and pastoral approaches as well as changes in church-state relation during the transition of Mozambique to independence and the “sixteen years war” (1977–1992).
The Founding of the Baikaryū
Authors: Mross Michaela
Published: June 2024

This article explores the founding of the Baikaryū, the Sōtō school’s lineage of goeika hymn chanting. In the 1920s, Buddhist reformers in other schools developed lineages of singing goeika and in this process standardized the performance practice. Seeing the great popularity of goeika hymn chanting, Sōtō clerics created their goeika lineage in the 1950s, strongly influenced by the Shingon goeika lineages. I examine the background that led to the founding of the Baikaryū. Why did Sōtō clerics decide to create a new goeika lineage? What were their models? And what steps did they take? Throughout this article, I demonstrate that music played a vital role in fostering lay engagement in Sōtō Zen, as well as in other traditional Buddhist schools, in the twentieth century as clerics felt the need to employ new hymns and songs that sound—and “feel”—fresh to lay people.
1. Human Evolutionary Demography
Authors: Sear Rebecca , Burger Oskar , Lee Ronald
Published: June 2024

Human evolutionary demography combines research in evolutionary biology with the study of human demographic patterns and behaviors. Evolutionary biology and demography share many conceptual features that give rise to a natural complementarity, such as a focus on the population as a unit of study and emphasis on aggregate processes that have implications for individuals. They also have distinct strengths that further this natural partnership. Evolutionary approaches are often top-down and theory driven, while demographic ones are more often bottom-up and driven by data and robust estimation procedures. We suggest that human evolutionary demography reflects these areas of overlap and complementary strengths while emphasizing at least two main objectives: understanding the role of evolutionary processes in shaping population-level demographic patterns (e.g., the evolution of age-specific patterns of mortality or fertility), and using an evolutionary approach to understand contemporary variation between individuals in demographic patterns (e.g., how and why does fertility respond to environmental influences, and vary between and within populations?).

Evolutionary demography is also inherently interdisciplinary. Interdisciplinary approaches are vital to furthering our understanding of the complex processes underlying demographic patterns, in part because such approaches can be a disruptive force challenging researchers to question assumptions and see the world differently.

The papers in this volume demonstrate that integration of demography and evolutionary sciences strengthens both. This recognition by an ever-growing number of researchers has resulted in such a successful body of research that we are now able to showcase this field with this collection of papers, illustrating the vibrancy and diversity of research in human evolutionary demography.
18. Sociality, Food Sharing, and the Evolution of Life Histories
Authors: Lee Ronald , Boe Carl
Published: June 2024

Life history theory has focused on the life cycle tradeoffs faced by individuals who are constrained by the energy they can forage for themselves at each age. However, humans are deeply social and adults transfer food to children for many years, freeing them from this energy constraint but also bringing the risk that parental death could entail the death of all dependent offspring. Multiple simultaneously dependent offspring also bring a family life cycle squeeze in which dependency ratio doubles. Food sharing and alloparenting ameliorate both problems, providing life insurance and smoothing the life cycle squeeze, while permitting humans to rely on food resources that would be too uncertain for isolated individuals. Food sharing and intergenerational transfers in turn affect the way natural selection shapes life histories. We use microsimulations to study evolution of life histories. Births inherit the mother’s genome subject to mutations. Individuals live under different social arrangements and forage with productivity depending on population density. Natural selection on life histories occurs. We examine the way the size and relatedness of sharing group arrangements alter the evolution of life history traits through mutation and natural selection. We consider which social arrangements, with their corresponding evolved life histories, are most successful in a group competition where all face the same density constraint. There is a tradeoff between costs and benefits of sharing. We find that intermediate levels are most successful, unless childhood conditions strongly influence later life productivity.
26. Historical Family Reconstitution Databases in the Study of Kinship Influences on Demographic Outcomes
Authors: Willführ Kai P. , Fox Jonathan F. , Voland Eckart
Published: June 2024

Human life histories and demographic outcomes are impacted by kin behaviour in diverse ways, and human evolutionary theory is essential to understanding how environmental context and kin relationship moderate this behaviour in cooperative versus competitive directions. However, kin presence is simultaneously correlated with behavioural and non-behavioural factors such as risk of infection or familial wealth. As such, it can be hard to disentangle evolutionary effects from other factors correlated within a family. In this chapter we discuss how historical family reconstitution databases have assisted in the investigation of kin effects and their advantages in disentangling these behavioural kin effects from non-behavioural accompanying factors. A variety of family reconstitution studies exist across varying geographic and cultural contexts, and their application to kinship research has resulted in varying findings. This highlights how kin impacts differ depending on circumstance. We describe several family reconstitution studies and discuss the importance of evolutionary theory in understanding kin effects across different populations.
30. The Biodemography of Human Health in Contemporary Non-industrial Populations
Authors: Gurven Michael , Kaplan Hillard , Trumble Benjamin , Stieglitz Jonathan
Published: June 2024

The life history of human hunter-gatherers is characterized by an extended post-reproductive lifespan, prolonged juvenile growth, high fertility with multiple dependents and biparental care, and extensive intra- and inter-generational resource and information transfer. Long-term, indepth study of contemporary non-industrial populations offers important glimpses into how these traits operate, and insights into how they may have evolved. The Tsimane Health and Life History Project is a large-scale bio-behavioral study of the human life course designed to help understand the bidirectional connections between life history, health and social behavior in a high fertility, kin-based population lacking amenities of modern urban life. It seeks to document the epidemiology of health and mortality across the lifespan, and to understand how growth and investment, social structure, sharing networks and behavior impact health and aging. It focuses on how pathogen burden influences health and well-being during development and adulthood, and addresses how modernization affects health and sociality. We reflect on the implications of current findings and highlight the need for more joint ethnographic and biomedical studies of subsistence populations to address unresolved questions not only in evolutionary anthropology or biodemography, but in public health, epidemiology, gerontology and medicine.
Comparative Analysis of Nebulized Versus Intravenous Fentanyl for Pain Control After Tonsillectomy: A Double-Blind, Randomized, Controlled Trial
Authors: Pantabtim Chanitda , Chumpathong Saowapark , Vichitvejpaisal Phongthara , Limsettho Wilawan , Mangmeesri Peerachatra
Published: June 2024

Objectives:

Effective posttonsillectomy analgesia is crucial for patient comfort and recovery. Fentanyl, notable for its potency, rapid action, and lipophilicity, has been successfully used in various procedures through multiple administration routes. However, the use of its nebulized form for posttonsillectomy pain has not been extensively explored. This study sought to compare the analgesic efficacy, onset time, and complications between nebulized and intravenous fentanyl in posttonsillectomy patients.

Methods and Methods:

In this randomized controlled trial, adult patients who underwent tonsillectomy were assigned to either an intravenous fentanyl group (1 mcg/kg) or a nebulized fentanyl group (4 mcg/kg). In both groups, fentanyl was administered when pain scores exceeded three. Pain levels were monitored every 5 minutes until they fell below four. The study also recorded the duration until the next analgesia request and noted complications (such as respiratory depression, bradycardia, chest tightness, drowsiness, nausea, pruritus, sweating, and flushing) within 24 hours. Patient exclusions were based on predetermined criteria.

Results:

From an initial cohort of 59 patients, 22 in the intravenous group and 27 in the nebulizer group were eligible for analysis after applying the exclusion criteria. The nebulizer group exhibited a significantly prolonged period before the next analgesia request, with a median of 683.5 minutes (interquartile range 260-1440), in contrast to the 326.7 minutes (145.0-504.7) observed in the intravenous group ( P = .009). The time to achieve a pain score less than 4 and the incidence of side effects did not differ significantly between the groups.

Conclusion:

Nebulized fentanyl provided a longer duration of analgesia than intravenous fentanyl in posttonsillectomy pain management, with similar onset times and side effect profiles. These findings underscore the potential of nebulized fentanyl as an effective alternative for pain control in posttonsillectomy patients.
Brute forcing on secured shell servers emphasising the role of cyber forensics – a quali-quantitative study
Authors: Raj Atul , Chauhan Mohit , Chhoker Virender Kumar , Rani Mukta , Singh Bajrang Kumar , D’Souza Roshan , Bodwal Jatin
Published: June 2024

Background

Increasing numbers of cyber attacks threaten us personally and professionally. Cyber crimes include obtaining sensitive information (medical or financial) but may extend to organising heinous crimes including murders and aggravated sexual assaults. A major vector of cyber crimes is brute force attacks on secured shell servers.

Aim of study

This research highlights the prevalence of the intensity of brute force attacks on secured shell servers via quali-quantitative analysis of cyber attacks.

Methodology

The brute force attacks were recorded over a period of 20 days with the help of logs taken from five dedicated servers installed in a production environment.

Results

There were a minimum of 6470 and maximum of 22,715 attacks on a server per day. The total number of attacks on all the servers during the study period was 1,065,920. The brute force attacks were mainly targeted at the service network accounts.

Conclusion

Growth of the field of cyber forensics is the optimal solution to prevent the malicious use of internet services and the commissioning of crimes by this means.
The importance of ankel-brachial index in prediction vascular complications in transradial access procedures
Authors: Li Chuanwei , Zhang Wen , Xiao Jun , Zeng Chunyu , Xu Chunmei
Published: June 2024

Objective

The study aimed to explore the predictors of vascular complications (VCs) associated with transradial access, as the occurrence and severity of these complications were found to be significantly lower compared to femoral access. However, it is important to note that the occurrence of these complications still has a negative impact on clinical outcomes. Nevertheless, there is limited available data on the predictors of complications specifically related to radial access.

Methods

A retrospective case-control study was conducted on individuals who underwent percutaneous coronary diagnostic or therapeutic procedures at Daping Hospital, following the inclusion and exclusion criteria. The study compared demographic characteristics, VC types, ankle brachial index (ABI), and severity of coronary artery stenosis between the two groups.

Results

We enrolled 300 subjects with VCs and 300 age- and sex-matched subjects without VCs as controls. There were no differences in the baseline characteristics or comorbidities between the groups. Compared to the control group, the VC group has a higher portion of left radial access (6.0%) and previous radial artery puncture history (29.7% vs. 18.3%, p<0.001). The ABI was significantly lower than the non-VC group (1.17  ±  0.17 vs. 1.23 ± 0.14, p<0.001). In the multivariate logistic regression analysis, several factors were found to be independently associated with the occurrence of VC. These factors include ABI (OR=0.060, 95% CI: 0.014–0.249, p<0.001), the procedure being performed by junior operators (OR=1.892, 95% CI: 1.314–2.745, p<0.001), and previous access on the same radial artery (OR=1.795, 95% CI: 1.190–2.707, p<0.01).

Conclusions

Patients who exhibit a lower ABI and have a history of prior radial access procedures may be at an increased risk of developing radial access VC. Therefore, it is recommended to routinely measure ABI prior to these procedures, as it may serve as a predictive tool for assessing the risk of VC.
Artificial intelligence iterative reconstruction in abdominal CT of patients with irregular arm positioning: a case-by-case evaluation
Authors: Li Jin , Meng Ting , Zhang Guozhi , Yu Xiang , Lu Zhihua , Zhang Weiguo
Published: June 2024

Background

Streak artifacts induced by irregular arm positioning have been an issue in diagnosing the abdomen.

Purpose

To illustrate the risk of misdiagnosis in abdominal computed tomography (CT) of patients with irregular arm positioning through a case-by-case evaluation and to test if it can be solved by the artificial intelligence iterative reconstruction (AIIR) algorithm.

Material and Methods

By reviewing 5220 cases of chest and thoracoabdominal CT, 64 patients with irregular arm positioning were enrolled, whose image data were reconstructed using AIIR in addition to routine hybrid iterative reconstruction (HIR). Lesion detection for livers, spleens, kidneys, gallbladders, and pancreas on AIIR images, performed by two radiologists, was compared with those on HIR images. Discrepancies arising from AIIR images included both cases with additional abnormalities and those with corrections made on previous detections. For cases with discrepancies, artifact scores for organs where discrepancies were found, and contrast-to-noise ratios (CNRs) of cysts with discrepancies were compared between two image sets.

Results

Additional abnormalities were detected for 15 cases: additional liver cirrhosis (n=2); additional gallbladder stone (n=1); additional cholecystitis (n=1), additional spleen nodule (n=1); additional kidney cysts (n=8); additional liver cysts (3); and additional spleen cyst (n=1). A spleen contusion was corrected for one case. All involved artifact scores were improved on AIIR images. CNRs of involved liver, kidney, and spleen cysts were improved by up to 539.7%, 538.5%, and 245.5%, respectively.

Conclusion

Irregular arm positioning may induce a variety of misdiagnoses in abdominal CT, which is almost totally avoidable by the AIIR algorithm.
Sonic gravimeter for determining the acceleration of gravity: A laboratory experiment for undergraduate students
Authors: Bernal Eduardo , Martínez-Gutiérrez Daniel , Valera Benjamin , Sánchez Salvador , Posadas David , Ascanio Gabriel
Published: June 2024

This paper deals with the measurement of the acceleration of gravity as part of an Experimental Physics Laboratory experiment for undergraduate students. The acceleration of gravity (g) has been commonly determined measuring the travel time of a body by means of a simple pendulum or objects in free fall. However, the use of mechanical or electronic chronometers as well as other devices may generate experimental errors. A prototype for determining such a parameter has been developed. Its operating principle is based on the uniformly accelerated rectilinear motion through the free fall of two bodies. The proposed prototype allows recording the sound caused by the impact of two bodies (steel balls) when falling on a solid surface. The analysis of the signal produced by the sound is made using MATLAB. When graphing the signal, the student can observe two peaks generated by the sound of the impact of each ball when impacting the metal surface for the first time. Knowing the height and sample time, the student can calculate the acceleration of gravity experimentally. Results obtained with the device described have been compared with the theoretical ones.
Effect of Medial Patellofemoral Complex Reconstruction Technique on Patellofemoral Contact Pressure, Contact Area, and Kinematics
Authors: White Alexander E. , James Evan W. , Jahandar Amirhossein , Jones Ruth H. , Fabricant Peter D.
Published: June 2024

Background:

Medial patellofemoral ligament (MPFL) reconstruction is considered by many to be the gold standard to treat lateral patellar instability; however, some investigators have reported good clinical results after isolated medial quadriceps tendon–femoral ligament (MQTFL) reconstruction or a combined MPFL/MQTFL reconstruction. A handful of studies have preliminarily investigated the biomechanical consequences of these various medial patellar stabilizing procedures. Despite this, no existing study has included multiple medial patellofemoral complex (MPFC) reconstructions and assessment of lateral patellar translation at distinct flexion angles.

Hypothesis:

Combined MPFL/MQTFL reconstruction would restore patellofemoral contact areas, forces, and kinematics closest to the native state compared with isolated reconstruction of the MPFL or MQTFL alone.

Study Design:

Controlled laboratory study.

Methods:

Ten adult cadaveric knee specimens were prepared and analyzed under 5 different conditions: (1) intact state, (2) transected MPFC, (3) isolated MPFL reconstruction, (4) isolated MQTFL reconstruction, and (5) combined MPFL/MQTFL reconstruction. Patellar tilt, lateral patellar translation, patellofemoral contact forces, and patellofemoral contact areas were measured in each condition from 0° to 80° through simulated knee flexion using a custom servohydraulic load frame with pressure sensor technology and a motion capture system for kinematic data acquisition.

Results:

The isolated MPFL, isolated MQTFL, and combined MPFL/MQTFL reconstruction conditions produced significantly less lateral patellar tilt compared with the transected MPFC state ( P < .05). No statistically significant differences were found when each reconstruction technique was compared with the intact state in patellar tilt, lateral patellar translation, contact forces, and contact areas.

Conclusion:

All 3 reconstruction techniques (isolated MPFL reconstruction, isolated MQTFL reconstruction, and combined MPFL/MQTFL reconstruction) restored native knee kinematics, contact forces, and contact areas without overconstraint.

Clinical Relevance:

Isolated MPFL reconstruction, isolated MQTFL reconstruction, and combined MPFL/MQTFL reconstruction all restore patellofemoral stability comparable with the intact MPFC state without the overconstraint that could be concerning for increasing risk of patellofemoral arthritis.
Capacity to Consent to Treatment of Substance Use Disorders at Ontario's Consent and Capacity Board: A Review of Past Reported Decisions
Authors: Hauck Tanya S. , Goud Rachel , Warner Michele , Franchuk Susan , Zaheer Juveria , Stergiopoulos Vicky , Tang Victor M. , Buckley Leslie
Published: June 2024

Capacity to consent to treatment of substance use disorders at Ontario's Consent and Capacity Board: A review of past reported decisions

Plain Language Summary Title

An Ontario review of legal cases which have considered patients' ability to consent to substance use treatments
A Mixed-Methods Investigation of Adolescents’ Beliefs About the Causes of Depression
Authors: Ahuvia Isaac L. , Chen Sharon , Gordon Lucy H. , Fox Kathryn R. , Schleider Jessica L.
Published: June 2024

The goal of the present study was to better understand adolescents’ beliefs about what causes depression and how these beliefs relate to other clinical constructs. This study explored the causal beliefs about depression held by a diverse sample of U.S. adolescents with elevated depression symptoms ( N = 281; 55% White non-Hispanic; 53% cisgender girl; 78% LGBQ*). Qualitative methods were used to identify causal beliefs from open-ended survey responses. Quantitative methods compared the perceived causes of one’s own depression versus others’ depression, compared causal beliefs across groups, and measured the association between causal beliefs and additional clinical constructs. The most common causal beliefs were dysfunctional home and family relationships (52%) and stress from school (42%). Several causal beliefs were expressed more in regards to one’s own depression than others’ depression (e.g., adverse childhood events, 11% vs. 3%, p = .004) and vice versa (e.g., social media use, 12% vs. 2%, p < .001). Few significant relationships emerged between causal beliefs and demographic and clinical variables. Adolescents’ causal beliefs about depression are diverse and multifaceted, and their causal beliefs endorsed about their own depression differ substantially from those endorsed about depression generally. However, associations between adolescents’ causal beliefs and clinical variables appear limited.
Hybrid Pedagogical Intervention can Decrease Impulsivity and Antisocial Behavior and Improve Motor and Cognitive Functions Among Iranian Adolescent
Authors: Shariati Sharif , Nazari Shahram , Norouzi Seyed Hossini Rasool , Manzano-Sánchez David , Norouzi Ebrahim
Published: June 2024

The present study aimed to investigate the impact of a hybrid pedagogical model consisting of Teaching Games for Understanding (TGFU) and Teaching for Personal and Social Responsibility (TPSR) on the impulsivity, antisocial behaviors, and cognitive function of adolescent students. The study involved 60 male adolescent school students with an average age of 13.32 ± 1.65 years. The research was conducted in four stages: pre-test, teaching game and responsibility through table tennis sessions, post-test, and follow-up. The results of rANOVA indicated a significant decrease in impulsivity and antisocial behaviors from the beginning to the end of the intervention, along with an improvement in responsibility, cognitive, and motor function. Notably, the hybrid pedagogical model participants reported lower scores for impulsivity and antisocial behavior and higher scores for cognitive and motor function than their counterparts in the control group. The findings of the present study provide evidence for the effectiveness of hybrid pedagogical model in adolescent school students and physical education settings. These results suggest that hybrid pedagogical model can be a valuable addition to standard interventions such as psychotherapy, for reducing psychological problems and impulsivity in adolescent students.
Investigating drilling characteristics of stir-squeeze cast Al6082 composites reinforced with MWCNTs
Authors: Baghel Madhusudan , Krishna Chimata Murali , Kumar Ashish , Namdev Anurag
Published: June 2024

Objective of current study is to examine the machining characteristics of Al6082 composites embedded with multi-walled carbon nanotubes (MWCNTs). Herein, chemical vapor deposition (CVD) technique was used to develop MWCNTs. Stir-squeeze casting method was used to develop 0.3 wt.%−1.2 wt.% MWCNTs/Al6082 composites. Morphology of MWCNTs was analyzed by field emission scanning electron microscopy (FESEM). FESEM analysis was performed for as-cast nanocomposites which showed uniform spreading of MWCNTs up to 0.9 wt.% and beyond that clusters of MWCNTs were observed. Hardness and tensile strength of nanocomposites were also measured to observe the impact of addition of MWCNTs. Al6082 composites reinforced with 0.9 wt.% of MWCNTs showed highest hardness and tensile strength. It is important to examine the drilling characteristics as CNT in tube form may become constraint if they are not uniformly distributed and may obstruct tool movement. CNC electric discharge machining (EDM) and CNC milling machine were used to perform the drilling operation on nanocomposites with varying cutting parameters. It was noticed that inclusion of MWCNTs enhanced material removal rate (MRR) and surface finish of composites owing to enhanced brittleness. Strong interfacial bonding between MWCNTs and Al6082 matrix reduced the delamination during drilling operation.
Triggers and Regulation: Qualitative Experiences of Anger and Aggression Among Youth
Authors: Farley Tatjana M. , McWey Lenore M.
Published: June 2024

Anger and aggression are among the most clinically pervasive symptoms of people with complex trauma histories, however, there is little agreement about how anger and aggression are defined, triggers to anger and aggression, and how anger and aggression are regulated. Plus, limited research exists from youths’ perspectives. Using a developmental trauma framework as a guide, a phenomenological qualitative study was conducted to understand youths’ experiences of anger and aggression with a sample of youth with low and higher levels of risk exposure. Resulting themes points to youths’ perceptions of triggers, regulation, purposes, and usefulness of anger and aggression. While there were similarities across groups, there were notable differences in how youth described triggers and the regulation of anger and aggression. Findings point to the importance of considering the adaptive functioning of anger and aggression in the context of youth’ lives.
Characteristics of Patients Not Receiving Chemical Thromboprophylaxis Following Foot and Ankle Surgery: Data From the Multicenter, Prospective UK Foot and Ankle Thrombo-Embolism Audit (UK-FATE)
Authors: Malhotra Karan , Houchen-Wolloff Linzy , Mason Lyndon , Mangwani Jitendra ,   UK-FATE Collaborative
Published: June 2024

Background:

Although the rate of venous thromboembolism (VTE) after foot and ankle surgery is low, multiple factors influence risk for individual patients. Furthermore, there are no clear guidelines on which patients may benefit from chemical thromboprophylaxis. Our aim was to assess patients not treated with chemical thromboprophylaxis after foot and ankle surgery, and to report on their specific patient and surgical risk factors for VTE.

Methods:

This was a multicenter, prospective, national audit of patients undergoing foot and ankle surgery (including Achilles tendon ruptures) from 68 participating UK centers. The study was conducted between June 1, 2022, and November 30, 2022, with a further 3-month follow-up. Following data cleansing, 3309 patients were included who did not receive postoperative thromboprophylaxis.

Results:

Most patients were elective cases (2589 patients, 78.24%) with ASA grade I or II (2679 patients, 80.96%), fully weightbearing postoperatively (2752 patients, 83.17%), and either without ankle splintage, or splinted in a plantigrade boot (2797 patients, 84.53%). The VTE rate was 0.30% overall (11 cases), with no VTE-related mortality. No single demographic, surgical, or postoperative factor was associated with reduced risk of VTE. However, patients who had elective or trauma surgery not involving the ankle, who were ASA grade I or II and who were weightbearing immediately postoperatively (without splinting or in a plantigrade boot) had a VTE rate of 0.05% (1 of 1819 patients), compared with 0.67% (10 of 1490 patients, P = .002).

Conclusion:

Patients not receiving chemical thromboprophylaxis had a low incidence of symptomatic VTE, although they do represent a curated group considered lower risk. Within this group we describe characteristics associated with a substantially lower risk of VTE. All patients should be assessed on an individual basis, and further work is required to substantiate our findings.
Resonance frequency tracking control of a three-degree-of-freedom acoustic resonance system
Authors: Wu Junjie , Zhan Xiaobin , Shi Tielin
Published: June 2024

Resonance can enhance energy conversion and transmission efficiency in mechanical systems. However, maintaining effective resonant behavior by tracking the resonant frequency can be challenging due to load fluctuations. This study introduces a software-based phase-locked loop (SPLL) control method for three-degree-of-freedom acoustic resonant systems (3DOFARS). Initially, the dynamic equation governing the behavior of 3DOFARS is provided, followed by a frequency domain analysis based on the amplitude-phase frequency characteristic curve. Subsequently, the SPLL control method is developed by considering the phase relationship between the system’s excitation signal and response signal, and a control model is then established using Simulink. For the step, slope, and sinusoidal disturbances with specific amplitude and frequency variations, the SPLL control method can track the excitation frequency to the resonant frequency in real time. Among these disturbances, step disturbances pose a greater risk of system instability compared to slope and sinusoidal disturbances. Finally, simulation verification and statistical analysis are carried out by introducing quality interferences of varying types, amplitudes, and frequencies to assess the SPLL control method’s impact on different interferences. Under stable conditions, the SPLL method has better control capabilities against low-frequency interference and better robustness against high-frequency interference. In comparison to conventional methods, the SPLL control method effectively maintains real-time tracking of the excitation frequency to the resonant frequency while upholding process flow integrity.
Space, affect and contagious bodies: Representing HIV in 1990s Czech cinema
Authors: Antalóczy Fanni
Published: June 2024

Wiktor Grodecki’s trilogy – Not Angels But Angels (1994), Body Without Soul (1996) and Mandragora (1996) – depict the Czech queer sex industry of the 1990s. This article examines the films’ representational attitudes to queerness and contagion at the intersection of cultural geography, body studies and affect theory. The films equate queer with contagion. Queer practices question the definition of sexual orientations; spaces used for sex lose the dichotomy of public and private, and sexuality is reduced to bodily functions. Queer bodies are represented as endangered and dangerous at the same time: the virus they might be carrying and transmitting is present as a constant, invisible threat. The possible contagion of the bodies disrupts the borders of normativity and inscribes them with stigma, resulting in shame and fear as the dominant affects inscribed on spaces and experienced in/on bodies.
Educating Families on Urgent Maternal Warning Signs: Learning From a Pilot to Improve Training and Tools for Maternal and Child Home Visiting Programs
Authors: Stierman Elizabeth K. , Watts Thomasina , Lawson Shari M. , Bruce Teneele M. , Reed-Vance Maxine , Bower Kelly M. , Creanga Andreea A. , Callaghan-Koru Jennifer A.
Published: June 2024

Early recognition of the warning signs of pregnancy-related complications and provision of timely, quality care could prevent many maternal deaths. We piloted a maternal warning signs education intervention with five Maryland-based maternal, infant, and early childhood home visiting programs serving populations disproportionately affected by adverse maternal outcomes. The intervention included a 1.5-hr online training for home visitors, monthly collaborative calls with program managers, and a client education toolkit with a 3-min video, illustrated handout of 15 urgent maternal warning signs, magnet with the same, and discussion guide for home visitor–client interactions. A mixed-methods formative evaluation assessed the acceptability, feasibility, and utilization of different components of the intervention. Home visiting program staff reported that the materials were highly acceptable and easily understood by diverse client populations. They valued the illustrations, simple language, and translation of materials in multiple languages. Program managers found implementation a relatively simple process, feasible for in-person and remote visits. Despite positive reception, not all components of the toolkit were used consistently. Program managers and staff also identified the need for more guidance and tools to help clients communicate with health care providers and advocate for their health care needs. Feedback from pilot sites was used to adapt the training and tools, including adding content on patient self-advocacy. Home visiting programs have a unique ability to engage families during pregnancy and the postpartum period. This pilot offers lessons learned on strategies and tools that home visiting programs can use to improve early recognition and care-seeking for urgent maternal warning signs.
Efficient diagnosis leads to better care: streamlining epilepsy diagnosis pathways
Authors: Aungaroon Gewalin
Published: June 2024

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The Best Things Happen When You Least Expect Them: Responsive Neurostimulation During Low-Risk Brain States is Associated with Improved Long-Term Seizure Suppression
Authors: Philipsberg Paul A. , Shuman Tristan
Published: June 2024

[Box: see text]
Impact and determinants of door in–door out time for stroke thrombectomy transfers in a large hub-and-spoke network
Authors: Ahmed Rashid A. , Withers James R. , McIntyre Joyce A. , Leslie-Mazwi Thabele M. , Das Alvin S. , Dmytriw Adam A. , Hirsch Joshua A. , Rabinov James D. , Doron Omer , Stapleton Christopher J. , Patel Aman B. , Singhal Aneesh B. , Rost Natalia S. , Regenhardt Robert W.
Published: June 2024

Introduction

The mantra “time is brain” cannot be overstated for patients suffering from acute ischemic stroke. This is especially true for those with large vessel occlusions (LVOs) requiring transfer to an endovascular thrombectomy (EVT) capable center. We sought to evaluate the spoke hospital door in–door out (DIDO) times for patients transferred to our hub center for EVT.

Methods

Individuals who first presented with LVO to a spoke hospital and were then transferred to the hub for EVT were retrospectively identified from a prospectively maintained database from January 2019 to November 2022. DIDO was defined as the time between spoke hospital door in arrival and door out exit. Baseline characteristics, treatments, and outcomes were compared, dichotomizing DIDO at 90 minutes based in the American Heart Association goal for DIDO ≤90 minutes for 50% of transfers. Multivariable regression analyses were performed for determinants of the 90-day ordinal modified Rankin Scale (mRS) and DIDO.

Results

We identified 194 patients transferred for EVT with available DIDO. The median age was 67 years (IQR 57–80), and 46% were female. The median National Institutes of Health Stroke Scale (NIHSS) was 16 (10–20), 50% were treated with intravenous thrombolysis at a spoke, and TICI 2B-3 reperfusion was achieved in 87% at the hub. The median DIDO was 120 minutes (97–149), with DIDO ≤90 minutes achieved in 18%. DIDO was a significant determinant of 90-day ordinal mRS ( B = 0.007, 95% CI = 0.001–0.012, p = 0.013), even when accounting for the last known well-to-spoke door in, spoke door out-to-hub arrival, hub arrival-to-puncture, puncture-to-first pass, age, NIHSS, intravenous thrombolysis, TICI 2B-3, and symptomatic intracranial hemorrhage. Importantly, determinants of DIDO included Black race or Hispanic ethnicity ( B = 0.918, 95% CI = 0.010–1.826, p = 0.048), atrial fibrillation or heart failure ( B = 0.793, 95% CI = 0.257–1.329, p = 0.004), and basilar LVO location ( B = 2.528, 95% CI = 1.154–3.901, p < 0.001).

Conclusion

Spoke DIDO was the most important period of time for long-term outcomes of LVO stroke patients treated with EVT. Targets were identified to reduce DIDO and improve patient outcomes.
Successful maintenance of a sustained molecular response in CML patients receiving low-dose tyrosine kinase inhibitors
Authors: Li Yan , Kuang Pu , Zhu Huanling , Pan Ling , Dong Tian , Lin Ting , Chen Yu , Yang Yunfan
Published: June 2024

Background:

The development of tyrosine kinase inhibitor (TKI) therapy has positively impacted the survival rates of patients with chronic myeloid leukemia (CML). It is common in medical practice to adjust the dosage of TKI downward because of TKI-associated adverse events, financial burden, comorbidity, or an attempt at treatment-free remission.

Objectives:

This investigation sought to explore the feasibility of employing a reduced dosage of TKI for treating CML.

Design:

This was a retrospective study.

Methods:

Patients with CML in its chronic phase who had been on a reduced dose of TKI for a minimum of 3 months for various reasons in a practical clinical environment, irrespective of molecular response, were included. Regular molecular monitoring was performed, and changes in adverse events were recorded after dose reduction.

Results:

This research included a total of 144 participants. Upon reducing the dosage, 136 of 144 patients achieved major molecular response or deeper, and 132 of 144 achieved molecular response 4 (MR4). Following a median observation period of 16 months, the calculated 1- and 2-year survival rates free from MR4 failure were estimated to be 96.5% (95% CI: 90.8–98.7) and 90.5% (95% CI: 81.3–95.3), respectively. MR4 failure-free survival was better in patients with longer MR4 durations (⩾34 months) before dose reduction ( p = 0.02). The median interval from dose reduction to MR4 loss was 15 months. Improved TKI-associated adverse events after dose reduction were observed in 61.3% of patients.

Conclusion:

Lowering the TKI dose can effectively preserve a deep molecular response over time while relieving adverse events caused by TKIs.
A retrospective pharmacovigilance study of post-marketing safety concerns with cefuroxime
Authors: Jiang Cheng , Zheng Xiaoxiao , Li Ping , Qian Jiancheng , Li Qin
Published: June 2024

Background:

Cefuroxime has played a crucial role in the prevention and treatment of bacterial infections. However, the differences in adverse events across formulations and routes remain unclear.

Objectives:

This study aimed to investigate the post-marketing safety of cefuroxime, particularly concerning formulations and routes.

Design:

A retrospective pharmacovigilance study of cefuroxime was conducted using the data from Food and Drug Administration Adverse Event Reporting System database.

Methods:

The clinical characteristics and concomitant drugs reported with cefuroxime were investigated. Adverse event signals of cefuroxime were identified based on four disproportionality algorithms. The signal differences of cefuroxime across formulations and routes were further examined.

Results:

A total of 1810 adverse event reports associated with cefuroxime were identified, and 181 cefuroxime-associated signals were detected. Compared with tablets, injections were more likely to cause preferred terms ‘blood pressure decreased’ and ‘anaphylactic shock’. In addition, system organ class ‘eye disorders’ significantly increased when cefuroxime was administered intraocularly, underscoring the importance of exercising caution regarding ocular toxicity.

Conclusion:

The adverse events associated with cefuroxime were significantly different across formulations and routes, which deserve special attention in clinical use.
Supporting visually impaired students in virtual learning environments in Ghana
Authors: Amponsah Samuel , van Wyk Michael Moose , Thomas Michael
Published: June 2024

Distance education (DE) has been in existence in Ghana for almost three decades guided by the philosophy of making quality education more accessible and relevant to all students. In line with best practices across the globe, Ghanaian institutions providing DE have been integrating digital technologies to augment traditional forms of delivery over the last decade. However, specific gaps have been identified in the provision for students with special educational needs and disabilities (SEND). To address this, the current study involves a multi-site exploratory case study using Accessibility4Equity principles to explore the challenges that distance providers face when enrolling visually impaired students (VIS). Fourteen participants comprising eight DE administrators and six IT personnel from four DE public higher educational institutions in Ghana were selected for this study. Findings identified several key themes, including access and equity, participation and imperatives for the inclusion of VIS. Based on this novel research approach, several implications emerged to drive the agenda for strategies to admit VIS into DE programmes in Ghana. Arising from this, recommendations suggest that future research is needed to address the gaps in the Accessibility4Equity supportive framework for VIS in virtual learning spaces.
Evaluation of health factors on artificial intelligence and the internet of things-based older adults healthcare programmes
Authors: Kim Jong In , Kim Gukbin
Published: June 2024

Objective

This study evaluates Artificial intelligence and the Internet of Things-based older adults' healthcare programmes (AI·IoT-OAHPs), which offer non-face-to-face and face-to-face health management to older adults for health promotion.

Methods

The study involved 146 participants, adults over 60 who had registered in AI·IoT-OAHPs. This study assessed the health factors as the outcome of pre- and post-health screening and health management through AI·IoT-OAHPs for six months.

Results

Preand post-health screening and management through AI·IoT-OAHPs were evaluated as significant outcomes in 14 health factors. Notably, the benefits of post-cognitive function showed a twofold increase in older female adults through AI·IoT-OAHPs. Adults over 70 showed a fourfold increase in post-walking days, a threefold in post-dietary practice, and a twofold in post-cognitive function in the post-effects compared with pre via AI·IoT-OAHPs.

Conclusions

AI·IoT-OAHPs seem to be an effective program in the realm of face-to-face and non-face-to-face AI·IoT-based older adults' healthcare initiatives in the era of COVID-19. Consequently, the study suggests that AI·IoT-OAHPs contribute to the upgrade in health promotion of older adults. In future studies, the effectiveness of AI·IoT-OAHPs can be evaluated as a continuous project every year in the short term and every two years in the long term.
Effects of an Experiential Learning Curriculum on Systems-Thinking
Authors: Kovaric Kelly , Gingell Gareth
Published: June 2024

Introduction

Though health systems science (HSS) is referred to as the third pillar of medical education along with the pillars of basic science and clinical care, the effects of learning theories used to teach components of HSS including quality improvement/ patient safety (QI/PS), are poorly understood. Experiential learning theory is often referenced in QI/ PS education but its effects on QI/PS education are not well-described.

Objective

To examine the effects of teaching QI using experiential learning theory on resident systems-thinking.

Methods

Data was gathered from 30 resident participants in a 3-h QI workshop designed using experiential learning theory. Using a mixed-methods design, aspects of learner systems-thinking were analyzed both before and after the workshop. Learners were asked about their confidence in systems-thinking behaviors, and their QI plans were evaluated qualitatively for themes as well as quantitatively via the QIKAT-R.

Results

There was a significant increase in self-reported confidence in systems-thinking behaviors post-workshop. Odds ratio of the QI aim statement focusing on the systems-level of the problem after the workshop was 41.4 with a 95% CI of 8.9142 to 192.2721, p-value .0001. Thematic analysis of QI plans revealed a change in residents’ thinking about healthcare problems. They shifted from attributing problems to individual actors to thinking about the problem as lying in the interaction between systems.

Conclusion

Experiential learning theory can be an effective framework for QI to transform learners into systems-thinkers.
Computed tomography perfusion as an early predictor of malignant cerebral infarction
Authors: Rodríguez-Vázquez Alejandro , Laredo Carlos , Reyes Luis , Dolz Guillem , Doncel-Moriano Antonio , Llansó Laura , Rudilosso Salvatore , Llull Laura , Renú Arturo , Amaro Sergio , Torné Ramón , Urra Xabier , Chamorro Ángel
Published: June 2024

Introduction:

Malignant middle cerebral artery infarction (MCI) needs rapid intervention. This study aimed to enhance the prediction of MCI using computed tomography perfusion (CTP) with varied quantitative benchmarks.

Materials and Methods:

We retrospectively analyzed 253 patients from a single-center registry presenting with acute, severe, proximal large vessel occlusion studied with whole-brain CTP imaging at hospital arrival within the first 24 h of symptoms-onset. MCI was defined by clinical and imaging criteria, including decreased level of consciousness, anisocoria, death due to cerebral edema, or need for decompressive craniectomy, together with midline shift ⩾6 mm, or infarction of more than 50% of the MCA territory. The predictive accuracy of baseline ASPECTS and CTP quantifications for MCI was assessed by receiver operating characteristic (ROC) area under the curve (AUC) while F-score was calculated as an indicator of precision and sensitivity.

Results:

Sixty-three out of 253 patients (25%) fulfilled MCI criteria and had worse clinical and imaging results than the non-MCI group. The capacity to predict MCI was lower for baseline ASPECTS (AUC 0.83, F-score 0.52, Youden’s index 6), than with perfusion-based measures: relative cerebral blood volume threshold <40% (AUC 0.87, F-score 0.71, Youden’s index 34 mL) or relative cerebral blood flow threshold <35% (AUC 0.87, F-score 0.62, Youden’s index 67 mL). CTP based on rCBV measurements identified twice as many MCI as baseline CT ASPECTS.

Discussion and conclusion:

CTP-based quantifications may offer enhanced predictive capabilities for MCI compared to non-contrast baseline CT ASPECTS, potentially improving the monitoring of severe ischemic stroke patients at risk of life-threatening edema and its treatment.