bluuebunny/crossref_metadata_2025 huggingface dataset:
Venous and Arterial Thromboembolism in Patients with Metastatic Lung Cancer
Authors: Qin Ya , Zhang Lingfei , Liang Xiao , Sun Xia , Wang Nanyao , Yuan Ming , Wang Qiong , Wu Dan
Published: February 2023

Lung cancer is the leading cause of cancer-related mortality worldwide with an increasing incidence in many countries. There were few studies on arterial and venous thromboembolism (ATE/VTE) in patients with metastatic lung cancer. Our study focused on the clinical characteristics of stage IV lung cancer patients with ATE or VTE to further explore the risk factors and prognosis. Patients diagnosed with metastatic lung cancer were enrolled from January 2011 to June 2019 at a tertiary hospital in Jiangyin, China. Log-rank test was used to reveal the survival for patients with ATE or VTE. Univariable analysis and multivariable logistic regression were used to study the risk factors for ATE. A total of 587 patients were enrolled in our study, including 52 patients with VTE and 48 with ATE. ATE occurred earlier than VTE. Patients with ATE had a worse prognosis. Multivariable logistic regression revealed that older age and a history of hypertension were independent risk factors for ATE. Patients with metastatic lung cancer were at high risk of VTE and ATE. ATE occurred earlier and was associated with a worse prognosis. Attention should be paid to metastatic lung cancer patients who may develop thromboembolism, especially ATE.
Technology Talent Development: Beyond an Hour of Code
Authors: Hebda Maryann R.
Published: February 2023

As technologically gifted students apply their abilities to computer science, they naturally flow through the talent development stages of potential, competency, and expertise. Processes that have always been important for gifted students to learn as they develop potential are embedded in learning code, which engages the beginning programmer in rich and complex authentic projects (Housand et al., 2017). As stakeholders present opportunities for open-ended, creative processes and products, the Computer Science Teachers Association (CSTA; 2017) and International Society for Technology in Education (ISTE; 2016) Standards can form guidelines for gifted students to self-direct their education through technology. Learning to code results in both cognitive and psychosocial skill development, including creative and critical thinking, logical and systematic reasoning, positive risk-taking and processing of feedback, perseverance through challenges, social skills, and collaboration.
Ready Coder One: Collaborative Game Design-Based Learning on Gifted Fourth Graders’ 21st Century Skills
Authors: O’Grady-Jones Mary , Grant Michael M.
Published: February 2023

The purpose of this research was to describe the impact of digital game building on fourth grade gifted and talented students’ problem-solving, creativity, and collaboration skills. Increasingly, there has been a call to involve students in real-world experiences through projects that explore authentic issues using technology. Game design-based learning with its unique set of affordances may offer a path to integrating technology, computer science education, creativity, and problem-solving. Increasingly, the ability to create rather than just consume technology has gained attention linking creativity and collaboration to using coding language. In this study, data collection included student reflection journals, classroom observations, classroom video recordings, a focus group interview, and students’ games. Participants came from two GT classes ( n = 45). Qualitative analysis identified five themes: overcoming challenges of group work, developing a culture of collaboration, creating narrative, and connecting science, problem-solving in Scratch’s coding environment, and reflecting on learning. Findings indicated involving gifted students in game design-based learning in science had a positive impact on student perceptions of problem-solving, creativity, and collaboration.
The Rurality of Intimate Partner Femicide: Examining Risk Factors in Queensland
Authors: McLachlan Freya
Published: February 2023

While violence against women and domestic violence can be seen throughout Australia, emerging evidence suggests that intimate partner femicide (IPF) is more common in rural spaces than urban ones. This study examined 100 IPF cases to determine the rate of femicide and frequency of common risk factors in rural areas of Queensland, Australia. The study also explored how victims accessed services and the characteristics of rural IPF and male offenders. Findings indicated that IPF is more common in rural areas and associated risk factors are similar between urban and rural cases. Rural IPF was more likely to occur during a current relationship and offenders were found to be less likely to conceal their actions. These differences suggest that the physical and social isolation of rural spaces may facilitate higher rates IPF. Implications discuss the need for rural-focused policies and responses.
Cost-effectiveness of pembrolizumab in first-line for microsatellite-instability-high or mismatch-repair-deficient metastatic colorectal cancerF
Authors: Giuliani Jacopo , Mandara Marta , Mantoan Beatrice , Ferrario Lucrezia , Mangiola Daniela , Napoli Giuseppe , Muraro Marco , Fiorica Francesco
Published: February 2023

The aim of this paper was to assess the cost-effectiveness of pembrolizumab in first-line for microsatellite-instability-high or mismatch-repair-deficient metastatic colorectal cancer. We have considered the pivotal phase III randomized controlled trial of pembrolizumab in first-line for microsatellite-instability-high mismatch-repair-deficient metastatic colorectal cancer. The last available update of each trial was considered as the original source. Incremental cost-effectiveness ratio was calculated as the ratio between the difference of the costs in the intervention and in the control groups (pharmacy costs) and the difference between the effect in the intervention and in the control groups (progression-free survival). The costs of drugs are at the Pharmacy of the Mater Salutis Hospital of Legnago (VR, Italy) and are expressed in euros (€). Three hundred and seven patients were considered in the pivotal phase III randomized controlled trial. Pembrolizumab obtained a cost per month progression-free survival gained ranged from 6471 € towards mFOLFOX (5-FU, oxaliplatin and leucovorin) plus cetuximab to 7886 € towards mFOLFOX. To sum up, combining pharmacological costs of drugs with the measure of efficacy represented by progression-free survival, at the actual prize pembrolizumab cannot be considered cost-effectiveness for first-line treatment for microsatellite-instability-high mismatch-repair-deficient metastatic colorectal cancer. A reduction in pharmacological costs is mandatory.
Understanding and Influencing Perceptions about Marine Protected Areas Through an Aquarium Exhibit: A Multi-phase Case Study from South Africa
Authors: Mann-Lang Judy B. , Naidoo Thashnee , Francolini Elizabeth , Mann Bruce Q , Sink Kerry , Bodenstaff Colette
Published: February 2023

Visitors to Marine Protected Areas (MPAs) provide income and can help MPAs achieve their objectives, thereby contributing to the maintenance and restoration of ocean health. However, MPAs are less well known than terrestrial protected areas. Based at the uShaka Sea World aquarium in South Africa, this multi-phase case study sought to describe visitors’ knowledge of MPAs; use the information to design a new temporary interpretive exhibit on MPAs and then use timing and tracking to assess visitors’ engagement with the exhibit and a free response postcard system to assess the influence of the exhibit on visitors’ perceptions of MPAs. Initial survey results showed that visitors had little knowledge of MPAs. Assessment after installation revealed some surprising levels of engagement and the free response postcards showed positive perceptions and a deeper understanding of MPAs. The results provide recommendations to enhance communication and engagement strategies both in aquariums and MPAs.
Association of Meteorological Factors With COVID-19 During Harmattan in Nigeria
Authors: Ogaugwu Christian , Mmaduakor Chika , Adewale Oloruntobi
Published: February 2023

Harmattan is a season of dry, cold, dusty wind, and haze that is peculiar to West Africa. This season and COVID-19 share common conditions such as malaise and respiratory issues like as runny nose, cough and sneezing, and raise a question of a possible relationship that begs to be answered. This study investigated whether the meteorological factors of humidity and wind speed during harmattan have association with COVID-19 incidence and mortality in the 2 major COVID-19 epicenters of Lagos state and the Federal Capital Territory (FCT) in southern and northern geopolitical regions of Nigeria respectively. Data used were from March, 2020 to February, 2022, which corresponded to the period of 2 years after the first case of COVID-19 was detected in Nigeria. Correlation analysis was performed using incidence or mortality data on COVID-19 over the duration of 2 years and during the harmattan periods, as well as the humidity and wind speed data for the corresponding periods. Our results showed that there was no significant correlation between the humidity or wind speed and COVID-19 daily incidence or mortality during the harmattan and non-harmattan periods in Lagos state. In the FCT however, there was a significant positive correlation between humidity and COVID-19 incidence, as well as a negative correlation between wind speed and COVID-19 incidence. No significant correlation existed between humidity or wind speed and daily mortality. Taken together, the findings of this study show that weather components of the harmattan season have association with COVID-19 incidence but not mortality, and the association could vary depending on location.
Creating Time for LGBT+ Disabled Youth: Co-production Outside Chrononormativity
Authors: Humphrey Harvey , Coleman-Fountain Edmund
Published: February 2023

This article explores how ‘chrononormative’ constructions of time shape research and offers an approach to co-production and research involvement that draws on insights from trans, queer, and disability studies. The article presents early reflections on an NIHR School for Social Care–funded research study, approved prior to but developed under the context of the Covid-19 pandemic, investigating personal support, sexuality, and gender in young disabled adults’ lives. This project has been supported by a Participatory Advisory Group (PAG) of LGBT+ young disabled adults and we reflect on how engagement with the PAG has shaped our understanding of debates around time and involvement in co-production discourse. Our engagement with trans, queer, and disability theory allows us to think about the constraints on time that such involvement has pushed against as we have sought to account for the diverse needs of the body-minds of the PAG in pandemic times. We suggest that this may speak to opening up the diversity and accessibility of co-production across other research contexts and intend this piece to encourage these conversations. The article thus offers a critical exploration of themes of time, embodiment, and identity in the way in which co-production is enacted in funded research.
Cross-section behaviour of cold-formed high strength steel irregular hexagonal hollow section stub columns under combined compression and bending
Authors: Liu Jun-zhi , Chan Tak-Ming , Young Ben
Published: February 2023

Cross-section behaviour for cold-formed high strength steel (HSS) irregular hexagonal hollow section (IHexHS) stub columns under combined compression and bending is studied and presented in this paper. Finite element models were developed and validated using the existing experimental data collated from the previous research. Upon the validated finite element models, extensive parametric studies were subsequently carried out to generate more numerical data covering a wider range of cross-section dimensions, steel grades and load combinations from pure compression to pure bending. The obtained numerical results were utilised to assess the accuracy and the applicability of the current design codes, such as Eurocode of EN 1993-1-12 (EC3) and the North American code of ANSI/AISC 360-16 (AISC) for cold-formed HSS IHexHS stub columns under combined loading. It was demonstrated that the existing design codes can be safely applied and can be extended for cold-formed HSS IHexHS stub columns design under combined loading. In cross-sectional resistance predictions, conservative results were provided from the existing design codes. The over-predictions were primarily due to the neglect of the strain hardening and plate element interaction. The end points used in the interaction curves of EC3 and AISC adopt an idealised elastic-plastic material model to derive the corresponding resistance in cross-sectional level. The employment of Continuous Strength Method (CSM) leads to improved accuracy in cross-sectional resistance prediction with updated end points in the interaction curve. More consistent and reliable predictions were revealed by carrying out reliability analysis in accordance with EN 1990.
Axial compression performance of concrete filled double skin (SHS outer and CHS inner) steel tubular columns strengthened by CFRP
Authors: Wan Jun , Wang Caisen , Liang Jiongfeng , Lin Siqi
Published: February 2023

This paper reports the compressive behavior of concrete-filled double skin steel tubular (CFDST) columns strengthened by CFRP under axial loading. The outer skin was made of square hollow sections (SHS), while the inner skin was made of circular hollow sections (CHS). Twelve CFDST columns strengthened by CFRP and three CFDST columns were tested. The failure mode, load-displacement relationship, axial load-carrying capacity and initial stiffness are given and analyzed. The results showed that the CFDST columns strengthened by CFRP have better mechanical properties than the column without CFRP reinforcement (i.e. the CFDST columns). The CFDST columns strengthened by CFRP eventually failed due to CFRP rupture or buckling of the external steel tube near the end and cracked concrete damage from the outer steel tube. The stiffness and axial load bearing capacity of the column can be improved as the number of CFRP layers increases. A simplified design formula of CFDST columns strengthened by CFRP is proposed, which is in good agreement with the experimental results.
Concrete clouds: Bunkers, data, preparedness
Authors: Taylor ARE
Published: February 2023

As visions of the end-times accelerate under neoliberal capitalism, corporations and governments are moving their valuable digital data into that most iconic end-of-the-world architecture: the nuclear bunker. This article traces the rise of the bunker as a prominent architectural form for the industrial storage of data. In doing so, it introduces the concept of ‘data preparedness’ to explore one way that data centres and cloud back-up providers strategically position themselves and their clients in imaginative relation to threatening futures. Rebranded as an ‘ultra-secure’ data centre, the bunker is no longer orientated towards the omnipresent threat of nuclear terror that structured everyday life during the Cold War. Rather, the bunkered data centre promises preparedness for an existential threat that lurks behind the screens of daily life in the digital world: the unending prospect of data loss or IT system failure.
Study on nonlinear dynamic characteristics of power six-branch herringbone gear transmission system with 3D modification
Authors: Li Zhibin , Wang Sanmin
Published: February 2023

The power six-branch herringbone gear transmission system has the advantages of large power transmission and transmission ratio. Because of its multi-way transmission and over-constraint structure, to prevent loaded tooth interference, there are large backlashes between teeth. The system shows complex nonlinear dynamic characteristics under the influence of backlashes, which seriously affects meshing performance. The modification technology can effectively improve gear meshing performance. Hence, on the basis of optimizing meshing performance of the active pair of the six-branch herringbone gear transmission system, this article will combine 3D modification with system nonlinear vibration characteristics and propose an analysis method of the system nonlinear vibration characteristics under 3D modification to reduce vibration and noise. First, the 3D modified tooth surface equation is determined by forming grinding, the loaded transmission error (LTE) of the system's active pair is obtained by tooth contact analysis (TCA) and loaded tooth contact analysis (LTCA) technology, and the optimal modification parameters are obtained by Ant Lion Optimizer (ALO) with the minimum error amplitude as optimization objective. Then, the time-varying meshing stiffness of system under the optimal modification is calculated, and the pure torsional nonlinear dynamic model with backlashes, meshing stiffness, and static transmission error (STE) is established. Finally, the global vibration characteristics in parameter field are studied through time domain and bifurcation diagram of system. Results show that the 3D modification can eliminate edge contact of tooth and improve tooth contact performance. With the increase of input power, the root mean square (RMS) values of acceleration increase and the RMS values and jump decrease after 3D modification. With the increase of input speed, the RMS curves appear multiple resonance peaks and jumps at low input speed. After 3D modification, the RMS, jump, and resonance peak values decrease. Compared with level І, the backlashes and STEs of level II and phase difference ϛsII have great influence on system dynamic characteristics and easily make system in chaotic motion, while the 3D modification reduces their influence and makes system motion periodic.
Climate obligations and social norms
Authors: Collins Stephanie
Published: February 2023

Many governments are failing to act sufficiently strongly on climate change. Given this, what should motivated affluent individuals in high-consumption societies do? This paper argues that social norms are a particularly valuable target for individual climate action. Within norm-promotion, the paper makes the case for a focus on anti-fossil fuel norms specifically. Section 1 outlines gaps in the existing literature on individuals’ climate change obligations. Section 2 characterises social norms. Section 3 provides seven reasons why social norms are a particularly worthy target for individual climate actors. Section 4 asks which social norms individuals should emphasise, arguing that anti-fossil fuel norms have advantages over emissions reduction and offsetting norms. Section 5 outlines the pathways and mechanisms individuals might exploit to promote anti-fossil fuel norms.
Some notes on the necessity of autonomous educational practice and two concerns
Authors: Säfström Carl Anders
Published: February 2023

This article suggests a sophistical autonomous practice in response to Platonian Aristotelian philosophy’s domination over education. It shows the dangers of empty education in which education is reduced to schooling the perfect citizen in the image of a perfect state. An example is given in which schooling in empty education is reduced to a tool for authoritarian capitalism inscribed in the formation of the State to increase profit while undermining a democratic society. Instead, this article claims that education was introduced by the Sophists as verification of equality and will show how education works counter to anti-educational and anti-democratic tendencies of Platonian/Aristotelian discourses on education and schooling. The article identifies and develops a practice of ignorance of inequality as such inequality is inscribed in machine schooling and offers a sophistical practice instead. The article concludes by highlighting an autonomous tradition of educational practice making practice, as evident once Platonian and Aristotelian philosophy is refuted as saying anything meaningful about education.
Effect of Partial Foot Amputation Level on Gait Independence in Patients With Chronic Lower Extremity Wounds: A Retrospective Analysis of a Japanese Multicenter Database
Authors: Sonoda Yuma , Maeshige Noriaki , Uemura Mikiko , Imaoka Shinsuke , Kawabe Nobuhide , Hayashi Hisae , Fujii Miki , Tsuji Yoriko , Furukawa Masahide , Kohzuki Masahiro , Terashi Hiroto
Published: February 2023

Partial foot amputation (PFA) is generally planned to minimize the amputation level; nonetheless, the effect of PFA levels on gait independence in amputees remains unclear. This study aimed to investigate the impact of PFA levels of the forefoot on gait independence in patients with chronic lower extremity (LE) wounds. This multicenter retrospective cohort study included 232 hospitalized Japanese patients treated and rehabilitated for chronic LE wounds. A multivariate analysis based on PFA levels was conducted for gait independence at discharge, with age and comorbidities as independent variables. Patients with Lisfranc amputation had significantly less independent gait than patients with more distal amputation and those without amputation (<22% vs >40%; P = .027; Fisher's exact test). Logistic regression analysis revealed that Lisfranc amputation (odds ratio [OR]: 0.257, P = .047), age (OR: 0.559, P = .043), and chronic limb-threatening ischemia (OR: 0.450, P = .010) were independent factors associated with gait independence. Additionally, the regression model confirmed discrimination performance using the C index (0.691, P < .001) with receiver operating characteristic analysis. In patients with chronic LE wounds undergoing PFA, Lisfranc amputation was negatively associated with gait independence.
Analysing Adolescent Education and Health Trajectories in Crisis Contexts: Examples From a Multi-Year Longitudinal Cross-Country Study
Authors: Devonald Megan , Jones Nicola
Published: February 2023

Qualitative longitudinal research is a useful method for studying adolescent development, not least because the dimension of temporality in the analysis of longitudinal studies can help researchers understand the complexity of transitions during this unique and dynamic life stage. The Gender and Adolescence: Global Evidence programme is a multi-year cross-country longitudinal study of adolescents in low- and middle-income countries. This article presents the methodological opportunities and challenges involved in analyzing such datasets, and seeks to offer insights for researchers undertaking qualitative longitudinal research. To ensure that both breadth and depth of such data are accurately represented in the analysis, a range of analytical approaches can be used. In this article, we provide key examples of how this data has been analyzed across a cohort of adolescent participants, exploring changes both pre- and post-Covid-19 including interactions with critical health and education services, and within individual life histories, exploring individual adolescent trajectories over multiple time points. Furthermore, we highlight how including caregivers’ and key informants’ perspectives can enhance triangulation of results. We show the importance of using a range of different approaches when analyzing a qualitative longitudinal dataset.
Developing a clinical academic career pathway in a Community and Mental Health NHS Trust
Authors: Bernhardt Lizelle , Baillon Sarah , Corr Susan M , de Vries Kay
Published: February 2023

Background:

Despite growing evidence of the impact that clinical academic (CA) staff have on patient care and clinical practice, there are disproportionately low numbers of nurses, allied health professionals (AHPs) and other healthcare professionals in CA joint roles, compared to their medical colleagues.

Aim:

To describe the initial development of a CA career pathway for nurses, AHPs and other healthcare professionals in a Community and Mental Health NHS Trust.

Methods:

Kotter’s 8-Step Change Model was used to expand opportunities and research culture across an NHS Trust.

Results:

A variety of capacity and capability initiatives at different academic levels were created to support CA development and to complement those available externally. These opportunities were underpinned by a research and development strategy, senior leadership buy-in, manager and clinical staff support, and targeted organisation-wide communication.

Conclusion:

The ongoing development of innovative CA opportunities in the Trust, alongside greater support for staff interested in pursuing CA careers, has resulted in a growing number of individuals successful in developing as CAs. This has led to a growth in research culture in the organisation and a greater understanding of what CA staff can bring to patient care, the clinical service and the wider organisation.
Cardiovascular disease and bone health in aging female rheumatic disease populations: A review
Authors: Cabling Marven G , Sandhu Vaneet K , Downey Christina D , Torralba Karina D
Published: February 2023

Rheumatic diseases cover a wide spectrum of conditions, including primary and secondary degenerative joint diseases and autoimmune inflammatory rheumatic diseases. The risks of cardiovascular disease and osteoporosis and resultant fractures in aging female rheumatic disease populations, especially those with autoimmune rheumatic diseases, are increased. Changes in the immune system in aging populations need to be considered especially among patients with autoimmune rheumatic diseases. Immunosenescence is closely aligned to reduced adaptive immunity and increased non-specific innate immunity leading to chronic inflammation of inflammaging. The effective use of disease-modifying antirheumatic drugs to control autoimmune rheumatic diseases may also mitigate factors leading to cardiovascular disease and osteoporosis. Rheumatic diseases, which largely manifest as arthritis, predispose patients to premature joint degeneration and poor bone health and therefore have a higher risk of developing end-stage arthritis requiring joint arthroplasties sooner or more often than other patients without rheumatic disease.
Music, Resilience and ‘Soundscaping’: Some Reflections on the War in Ukraine
Authors: Clark Janine Natalya
Published: February 2023

There exists a rich corpus of literature exploring some of the diverse roles – positive and negative – that music can play in war. This interdisciplinary article makes a novel contribution to this literature, and to research on the sociology of music more broadly, through its particular emphasis on resilience. Scholarship on resilience has increasingly moved beyond person-centred, psychology-based approaches towards more complex relational and multi-systemic framings that situate the concept in the interactions between individuals and their social ecologies (environments). However, it has given little attention to the sensory dimensions of these ecologies, including their acoustic dimensions. Focusing on the war in Ukraine and drawing primarily on media sources (including several online videos) to develop its analysis, the article argues that music can be a form and expression of resilience (and resistance) in war situations that directly acts on the acoustic ecology – a concept that to date has mainly been discussed within ecology and conservation research. Specifically, the article frames music as a form of ‘soundscaping’, in the sense of an active aligning of sound and wellbeing.
The influence of partial union on the mechanical strength of scaphoid fractures: a finite element study
Authors: Rothenfluh Esin , Jain Sambhav , Guggenberger Roman , Taylor William R. , Hosseini Nasab Seyyed Hamed
Published: February 2023

Assessment of scaphoid fracture union on computed tomography scans is not currently standardized. We investigated the extent of scaphoid waist fracture union required to withstand physiological loads in a finite element model, based on a high-resolution CT scan of a cadaveric forearm. For simulations, the scaphoid waist was partially fused at the radial and ulnar sides. A physiological load of 100 N was transmitted to the scaphoid and the minimal amount of union to maintain biomechanical stability was recorded. The orientation of the fracture plane was varied to analyse the effect on biomechanical stability. The results indicate that the scaphoid is more prone to re-fracture when healing occurs on the ulnar side, where at least 60% union is required. Union occurring from the radial side can withstand loads with as little as 25% union. In fractures more parallel to the radial axis, the scaphoid seems less resistant on the radial side, as at least 50% union is required. A quantitative CT scan analysis with the proposed cut-off values and a consistently applied clinical examination will guide the clinician as to whether mid-waist scaphoid fractures can be considered as truly united.
Subpectoral proximal humeral anatomy: Guidance to decrease risk of fracture following subpectoral biceps tenodesis
Authors: Wang Hanbin , Huddleston Hailey P , Kurtzman Joey S , Gedailovich Samuel , Deegan Liam , Aibinder William R
Published: February 2023

Background

Biceps tenodesis is used for a variety of shoulder and biceps pathologies. Humeral fracture is a significant complication of this procedure. This cadaveric anatomy study sought to determine the cortical thickness of the humeral proximal shaft to identify the optimal technique to decrease unicortical drilling and reduce the risk of fracture.

Methods

A computed tomography (CT) of eight cadaveric humeral specimens was obtained with a metallic marker placed at the site of subpectoral tenodesis. These scans were examined to define the cortical thickness of the subpectoral region of the humerus and determine angular safe zones for reaming.

Results

At the standard point of a subpectoral tenodesis, a mean angle relative to the coronal plane of 29.2° medially and 21.6° laterally from the deepest portion of the bicipital groove avoided unicortical drilling with a 7 mm reamer. These values varied slightly 1 cm proximal and distal to this level. The thickest regions of cortex in the subpectoral humerus correspond to the ridges of the bicipital groove.

Discussion

To avoid unicortical tunnels, surgeons should limit deviation from the perpendicular approach to no more than 23° relative to the coronal plane medially and 11° relative to the coronal plane laterally.
Exploring attitudes of healthcare professionals towards those with fibromyalgia: A Q-methodological approach
Authors: Scott Laura , Dolan Eamon , Baker Nita , Melia Yvonne
Published: February 2023

Fibromyalgia remains a difficult condition to diagnose and treat. Research suggests that this leads to frustrating experiences for service users and healthcare professionals. This has led to negative healthcare professional attitudes towards working with those with fibromyalgia. The research to date reports negative attitudes and predominantly investigates attitudes of primary care physicians. This study explores the attitudes of a range of healthcare professionals towards those diagnosed with fibromyalgia. Using Q-methodology, 27 healthcare professionals completed a sorting task and questionnaire to prioritise statements relating to a range of different attitudes towards service users. All participants significantly loaded onto three factors that explained a total of 64% of the data variance. Factor 1 reflected the attitude ‘Service users with fibromyalgia are no different to other service users and I enjoy working with them’. Factor 2 reflected the attitude ‘Service users with fibromyalgia are inaccurate informants of their own condition due to lack of understanding of their condition and are not likely to engage in treatments’. Factor 3 reflected the attitude ‘Service users with fibromyalgia are trustworthy with a lot of clinical problems [but I lack confidence in specialist skills to support them]’. Contrary to the current literature, there appears to be supportive attitudes from healthcare professionals towards service users diagnosed with fibromyalgia. Increased specialised training, clinical exposure to working with fibromyalgia and reflective practice spaces were identified as elements that could improve healthcare professional attitudes.
The development of a smartphone app to enhance post-traumatic stress disorder treatment in high-risk workers
Authors: Deady Mark , Collins Daniel , Gayed Aimee , Harvey Samuel B , Bryant Richard
Published: February 2023

Objective

Post-traumatic stress disorder (PTSD) is highly prevalent in certain populations. However, evidence indicates that many individuals do not respond to treatment. Digital supports hold promise for increasing service provision and engagement but there is a lack of evidence on blended care options and still less research guiding the development of such tools. This study details the development and overarching framework used to build a smartphone app to support PTSD treatment.

Methods

The app was developed in line with the Integrate, Design, Assess, and Share (IDEAS) framework for the development of digital health interventions and involved clinicians (n=3), frontline worker clients (n=5) and trauma-exposed frontline workers (n=19). Integrated iterative rounds of testing were conducted via in-depth interviews, surveys, prototype testing and workshops, alongside app and content development.

Results

Clinicians and frontline workers both expressed a clear preference for the app to augment but not replace face-to-face therapy, with the aim of increasing between-session support, and facilitating homework completion. Content was adapted for app delivery from manualised therapy (trauma-focused cognitive behavioural therapy (CBT). Prototype versions of the app were well received, with both clinicians and clients reporting the app was easy to use, understandable, appropriate and highly recommendable. System Usability Scale (SUS) scores were on average in the excellent range (82/100).

Conclusions

This is one of the first studies to document the development of a blended care app designed specifically to augment clinical care for PTSD, and the first within a frontline worker population. Through a systematic framework with active end user consultation, a highly usable app was built to undergo subsequent evaluation.
Willingness and preparedness to work during the first wave of the COVID-19 pandemic: A cross-sectional survey among registered nurses in a Danish university hospital
Authors: Kusk Kathrine Hoffmann , Laugesen Britt , Jørgensen Lone , Albrechtsen Maja Thomsen , Grøkjær Mette , Cusack Lynette , Pedersen Birgith , Lerbæk Birgitte , Haslund-Thomsen Helle , Thorup Charlotte Brun , Jacobsen Sara , Bundgaard Karin , Voldbjerg Siri Lygum , Nielsen Marie Germund
Published: February 2023

Nurses are imperative for healthcare systems’ ability to effectively function during pandemics, yet multiple factors may affect their willingness and preparedness to work. The aim of the present cross-sectional survey was to identify factors associated with registered nurses’ (RN) willingness and preparedness to work during the novel coronavirus disease (COVID-19) pandemic. The study was reported following the STROBE guidelines. A total of 358 nurses completed a self-administered online questionnaire. The participants were a part of a COVID-19 task force at a Danish university hospital during spring 2020. The results showed that the majority of RNs felt a professional obligation to engage in clinical work during the pandemic; however, their willingness and preparedness to work were affected by multiple factors, such as being relocated voluntarily, being prepared for the task and feeling safe. This study highlights that these factors are essential for the hospital management and nurse leaders to take responsibility for.
Structural Changes in Human Mobility Under the Zero-COVID Strategy in China
Authors: Mu Xiaoyan , Zhang Xiaohu , Yeh Anthony Gar-On , Yu Yang , Wang Jiejing
Published: February 2023

Over the past two years, China has wrested domestic control of the COVID-19 pandemic through non-pharmaceutical interventions. However, the extent to which the pandemic has changed people’s travel behavior in the new normal under the zero-COVID policy is not yet clear. This study investigates the profound effects of the zero-COVID strategy on human mobility in 365 Chinese cities over time. Our results suggest the following: (1) Even between city pairs with no local cases, intercity mobility decreased by an average of 16%, whereas intra-city mobility increased by 9% compared with the pre-pandemic baseline. Long-distance travel decreased substantially, while trips below 100 km increased slightly. These new trends indicate a localized pattern which is presumably caused by the wide adoption of teleworking and virtual classes, as well as concerns about the safety and availability of public transportation. (2) Containment measures caused a considerably acute decline in intercity short-distance trips but exerted a markedly lasting effect on long-distance trips. (3) Cities with lower levels of urbanization, smaller population sizes, less labor force, and lower GDP and GDP per capita experienced greater reductions in mobility, which may be due to their insufficient management capabilities. (4) The Chinese government has adopted adaptive measures to contain outbreaks. Stricter and more timely responses led to faster recoveries in the second half of 2021 compared with the first half. Inter- and intra-city mobility decreased by 41% and 26%, respectively, within the first 2 weeks of an outbreak, and it took 6-7 weeks to return to pre-outbreak levels.
Do Patients With Functional Hallux Limitus Have a Low-Lying or Bulky FHL Muscle Belly?
Authors: Sockalingam Navindravadhanam , Reymond Nils , Rybnikov Alexey , Dubois-Ferriere Victor , Assal Mathieu
Published: February 2023

Background:

Functional hallux limitus (FHLim) refers to a limitation of hallux dorsiflexion when the first metatarsal head is under load, whereas physiologic dorsiflexion is measured in the unloaded condition. Limited excursion of the flexor hallucis longus (FHL) in the retrotalar pulley has been identified as a possible cause of FHLim. A low-lying or bulky FHL muscle belly could be the cause of this limitation. However, to date, there are no published data regarding the association between clinical and anatomical findings. The purpose of this anatomical study is to correlate the presence of FHLim and objective morphologic findings through magnetic resonance imaging (MRI).

Methods:

Twenty-six patients (27 feet) were included in this observational study. They were divided into 2 groups, based on positive and negative Stretch Tests. In both groups, we measured on MRI the distance from the most inferior part of the FHL muscle belly and the retrotalar pulley as well as the cross-sectional area of the muscle belly 20, 30, and 40 mm proximal to the retrotalar pulley.

Results:

Eighteen patients had a positive Stretch Test and 9 patients had a negative Stretch Test. The mean distance between the most inferior part of the FHL muscle belly and the retrotalar pulley was 6.0 ± 6.4 mm for the positive group and 11.8 ± 9.4 mm for the negative group ( P = .039). The mean cross section of the muscle measured at 20, 30, and 40 mm from the pulley were 190 ± 90, 300 ± 112, and 395 ± 123 mm2 for the positive group and 98 ± 44, 206 ± 72, and 294 ± 61mm2 for the negative group ( P values .005, .019, and .017).

Conclusion:

Based on these findings, we can conclude that patients with FHLim do have a low-lying FHL muscle belly causing limited excursion in the retrotalar pulley. However, the mean volume of the muscle belly was comparable in both groups, and therefore bulkiness was not found to be a contributing factor.

Level of Evidence:

Level III, observational study.
Gender Differences and Hiatal Hernias
Authors: Wilkerson Jordan A. , Fatima Hala , Ceppa DuyKhanh P.
Published: February 2023

Hiatal hernias are a common problem, affecting ~25% of the population. While data on sex-related or gender-related issues affecting hiatal hernias are rare, a clear distinction between men and women in pathophysiology and presentation exists, and these differences ought to be considered in the management of patients. We present a brief review of the established data on gender differences in hiatal hernias.
The Impact of Gastroparesis on Antireflux Surgery
Authors: Black Kimberly Grant , Maclellan William Cameron
Published: February 2023

Foregut surgeons will encounter gastroparesis in patients with gastroesophageal reflux disease and prior gastresophageal operations. Clues in the history and diagnostic studies at first consultation will inform surgical decision making. Stepwise progression through multiple treatments may be required for patients to achieve symptom relief from post-surgical gastroparesis. Endoscopic pyloromyotomy and robotic-assisted pyloroplasty are safe, effective and definitive procedures for post-surgical gastroparesis.
Research on the technology of flame spraying aluminum coating for composite material
Authors: Guo Qiang , Zhu Junjun , Li Chao , Tang Peng , Wen Chen , Liu Lan , Wang Tianze , Hu Yeqin , Zhao Yingnan , Zhao Ming , Feng Yulong , Xu Hengyuan , Liu Hai
Published: February 2023

Aluminum coating was prepared on composite material surface by using oxygen-acetylene flame spraying technology. The H01-103H sealants were used to seal the thermal sprayed aluminum coatings. The characteristics of the aluminum coatings with and without H01-103H sealant, including surface morphologies, phase composition, and bonding strength, were investigated by means of SEM, EDS, and mechanical testing machine. Thermal shock experiment and low temperature cooling test were also used to examine the thermal shock resistance and frost resistance of the Al coatings. Electrical conductivity and electromagnetic shielding properties were then tested according to four-probe measurement principle and GJB 5239-2004, respectively. The results showed that the bond strength was 7.36 MPa and the surface porosity was about 5.21% for Al coating without H01-103H sealant, in addition, the H01-103H sealants could fill into the pores, reducing the porosity and increasing the bond strength of the coating. Furthermore, the main component of the coating was Al, the oxygen content was only 1.43%. Flame sprayed aluminum coating, with surface electrical resistance 0.89 mΩ and 5–18 GHz electromagnetic shielding effectiveness above 35 dB, was an ideal candidate for electromagnetic shielding utilization. The Al coating remained intact, compact, no cracks, peeling, layering under 50–200°C and −30°C, which showed good thermal shock resistance and frost resistance.
Dual targeting of protein translation and nuclear protein export results in enhanced antimyeloma effects
Authors: Li Shirong , Fu Jing , Walker Christopher J. , Yang Jun , Bhutani Divaya , Chakraborty Rajshekhar , Mamillapalli Niha , Mapara Markus Y. , Landesman Yosef , Lentzsch Suzanne
Published: February 2023

Selinexor (KPT-330) is a small molecule inhibitor of XPO1, which mediates the transport of tumor suppressor proteins, oncogene messenger RNAs, and other proteins involved in governing cell growthfrom the cell nucleus to the cytoplasm. It is overexpressed in many cancer types. Because eukaryotic translation initiator factor 4E (eIF4E) plays a critical role in protein translation in cancer cells in multiple myeloma (MM), we evaluated the effectiveness of combined inhibition of protein translation and nuclear export in MM. Selinexor, an inhibitor of nuclear protein export, dose-dependently decreased eIF4E, IKZF1, and c-MYC protein levels. Using a doxycycline-inducible–pLKO-Tet-On vector, knockdown of eIF4E significantly enhanced the antiproliferative effects of selinexor, sensitized resistant MM cells to selinexor, and increased apoptosis in MM cells. Immunofluorescent analysis of MM cells showed that the combined treatment increased the localization of residual eIF4E to the nucleus compared with selinexor-only treatment. The overexpression of eIF4E at least partially rescued the effects of selinexor in MM cells by reducing G1 cell cycle arrest and increasing the selinexor-IC50 10-fold. Moreover, the combination of selinexor with pharmacologic inhibitors of protein translation showed synergistic anti-MM effects. These results suggest a synergistic anti-MM effect of selinexor combined with eIF4E inhibitors in vitro. Our work provides a better understanding of the potential mechanism of resistance to selinexor and a rationale for combining selinexor with eIF4E inhibitors for the treatment of MM.
Inhibition of miR-101-3p prevents human aortic valve interstitial cell calcification through regulation of CDH11/SOX9 expression
Authors: Chen Jianglei , Lin Yi , Sun Zhongjie
Published: February 2023

Background

Calcific aortic valve disease (CAVD) is the second leading cause of adult heart diseases. The purpose of this study is to investigate whether miR-101-3p plays a role in the human aortic valve interstitial cells (HAVICs) calcification and the underlying mechanisms.

Methods

Small RNA deep sequencing and qPCR analysis were used to determine changes in microRNA expression in calcified human aortic valves.

Results

The data showed that miR-101-3p levels were increased in the calcified human aortic valves. Using cultured primary HAVICs, we demonstrated that the miR-101-3p mimic promoted calcification and upregulated the osteogenesis pathway, while anti-miR-101-3p inhibited osteogenic differentiation and prevented calcification in HAVICs treated with the osteogenic conditioned medium. Mechanistically, miR-101-3p directly targeted cadherin-11 (CDH11) and Sry-related high-mobility-group box 9 (SOX9), key factors in the regulation of chondrogenesis and osteogenesis. Both CDH11 and SOX9 expressions were downregulated in the calcified human HAVICs. Inhibition of miR-101-3p restored expression of CDH11, SOX9 and ASPN and prevented osteogenesis in HAVICs under the calcific condition.

Conclusion

miR-101-3p plays an important role in HAVIC calcification through regulation of CDH11/SOX9 expression. The finding is important as it reveals that miR-1013p may be a potential therapeutic target for calcific aortic valve disease.
Numerical Visualization of Grease Flow in a Gearbox
Authors: Liu Hua , Dangl Florian , Lohner Thomas , Stahl Karsten
Published: February 2023

Lubricating greases are widely used in e.g. open gear drives and gearboxes with difficult sealing conditions. The efficiency and heat balance of grease-lubricated gearboxes depend strongly on the lubrication mechanisms channeling and circulating, for which the grease flow is causal. The computational fluid dynamics opens up the possibility to visualize and understand the grease flow in gearboxes in more detail. In this study, a single-stage gearbox lubricated with an NLGI 1-2 grease was modeled by the finite-volume method to numerically investigate the fluid flow. Results show that the rotating gears influence the grease sump only locally around the gears. For a low grease fill volume, the rotation of the gears is widely separated from the grease sump. For a high grease fill volume, a pronounced gear-grease interaction results in a circulating grease flow around the gears. The simulated grease distributions show good accordance with high-speed camera recordings.