bluuebunny/crossref_metadata_2025 huggingface dataset:
Feline eosinophilic sclerosing fibroplasia associated with T-/natural killer-cell lymphoma
Authors: Klang Andrea , Bertram Christof A. , Donovan Taryn A. , Craig Linden E. , Walter Ingrid , Wolfesberger Birgitt , Degasperi Brigitte , Baszler Elisabeth , Rütgen Barbara C. , Hammer Sabine E. , Fuchs-Baumgartinger Andrea
Published: September 2024

Feline eosinophilic sclerosing fibroplasia (FESF) is a proliferative, inflammatory disease of the gastrointestinal tract and other sites, uncommonly diagnosed in the cat. This entity of uncertain etiology typically presents as a progressive mass lesion, mimicking a neoplastic process. In this case series, we present 17 cases of FESF associated with intralesional lymphoma. Histologic and immunohistochemical characterization of this unique lymphoma revealed that the neoplastic lymphocytes were immunopositive for CD56 and/ or CD3, suggesting a natural killer cell, natural killer T-cell, or T-cell origin. This case series represents the first description of this lymphoma subtype, for which the term eosinophilic sclerosing lymphoma is proposed.
Natural Versus Board Standards: Similarity or Differences? Evaluation of Plaster Models of Nonorthodontic Optimal Occlusion Using ABO Criteria
Authors: Shivapuja Prasanna-Kumar , Smith Late Robert T. , Krishnaswamy Nathamuni Rengarajan
Published: September 2024

Aim

The main aim of the study was to evaluate tooth position in plaster models of nonorthodontic subjects that have optimal occlusion, using the American Board of Orthodontics (ABO) criteria and comparing it to ABO standards.

Methods

Forty nonorthodontic subjects with optimal occlusion were evaluated for teeth positioning with ABO measurement criteria, using the ABO gauge. These measurements were compared to the ABO standards. On the panoramic radiographs of these subjects, distances between the roots of teeth were measured using the digital ruler in Quick CephR. Lateral cephalograms were scanned and digitized into Quick CephR systems to evaluate the skeletal anteroposterior and vertical relationship. Means and standard deviations were calculated for all the variables and compared to ABO standards. Correlations were obtained between attrition and overjet. Correlations were also studied between anteroposterior skeletal relation, vertical skeletal relation, and teeth positioning. In subjects that had accurate age records, the relationship between age and change in buccolingual inclination was evaluated.

Results

A significant difference in the mean values for inclination of maxillary and mandibular first bicuspids, second bicuspids, first molars, and second molars as compared to the board criteria was observed. Accuracy of panoramic radiograph to measure root proximity, especially in the cuspid region, is questionable. There was a positive correlation between overjet at the cuspid region and attrition. There was a minimal correlation between age and buccolingual inclination of teeth, indicating only a trend for mandibular second bicuspid to upright with age.

Conclusion

The ABO criteria and standards used to evaluate finished orthodontic cases are consistent with naturally occurring optimal dentitions, except for buccolingual inclination of posterior teeth in both maxillary and mandibular arches.
Enhancing wind turbine load response tool through geometric non-linearities correction: Case study on DEFlex and design load comparison
Authors: Barlas Emre , Gözcü Ozan
Published: September 2024

This paper introduces a rapid correction technique applied in DEFlex, Ørsted’s in-house aero-servo-hydro-elastic solver for offshore wind turbines. The technique addresses geometric non-linearities from large wind turbine blade deflections, focusing specifically on correcting the angle of attack for torsional deflections. To assess the implementation, comparisons were made with the literature and HAWC2, using the IEA 15-MW wind turbine blade subjected to static and simplified dynamic loading. Additionally, simulations of normal operation scenarios, both with and without turbulence, were performed on a real wind turbine exceeding 10 MW rated power. The results were compared with Siemens Gamesa Renewable Energys tool BHawC, which utilizes a co-rotational formulation for capturing large blade deflections. The findings reveal that coupling DEFlex with the correction method accurately captures the angle of attack dynamics and significantly improves the agreement of fatigue loads.
Intubation and Mechanical Ventilation in Patients with Acute Pulmonary Embolism: A Scoping Review
Authors: Lee Eun Sang , Baltsen Cecilie Dahl , Stubblefield William B. , Granfeldt Asger , Andersen Asger , Stannek Karsten , Dudzinski David M. , Kabrhel Christopher , Lyhne Mads Dam
Published: September 2024

Objectives

High-risk acute pulmonary embolism (PE) is associated with significant mortality and may require emergency endotracheal intubation and mechanical ventilation. Intubation and ventilation are thought to exacerbate cardiorespiratory instability. Our purpose was to conduct a systematic literature review to identify studies investigating peri-intubation events in acute PE.

Methods

A systematic search of Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library was performed. Results were screened by two independent observers. Studies reporting on intubation and positive pressure ventilation in acute PE patients were included. The primary outcome was adverse events during the peri-intubation period. Data was synthesized and an assessment of risk of bias was conducted. The review was registered on PROSPERO (CRD42023444483).

Results

4100 unique articles were screened. Three retrospective studies comprising 104 patients with acute PE met criteria and were included. Peri-intubation, hemodynamic collapse was observed in 19%-28% of cases. Patients with hemodynamic collapse exhibited higher rates of echocardiographic RV dysfunction.

Conclusions

Peri-intubation adverse events are common in patients with acute PE. Current evidence is limited and highlights the need for further research to optimize management of respiratory failure in acute PE and patient selection for intubation to improve patient outcomes.
Examining Well-Being and Healthy Lifestyle Interventions among Nursing Students Worldwide: A Scoping Review
Authors: Gipson Christine S. , Deal Belinda , Skinner Michael
Published: September 2024

Purpose: The purpose of this scoping review was to identify intervention studies related to well-being and healthy lifestyles in nursing students to identify research gaps in the literature for future research. Methods: The review followed the Joanna Briggs Institute (JBI), JBI Manual for Evidence Synthesis, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. Five databases were searched to retrieve the articles assessed by this review: APA PsycINFO, CINAHL Complete, PubMed, Scopus, and Web of Science. Inclusion criteria included articles with a sample population of nursing students; addressed the well-being, wellness, health, or healthy lifestyle(s) of nursing students; tested an intervention(s), lifestyle change, behavioral change interventions, or behavior change technique. Findings: Twenty-four articles were included for analysis. Three categories of interventions were found: interventions related to (1) educational and curricular strategies, (2) psychological related interventions, and (3) supportive environments. Conclusion: This review adds to the literature by identifying future interventions that can increase the well-being of nursing students. The ability to cope with the stressors of school and competing demands is essential to meet academic requirements and goals. Therefore, understanding how to address nursing student well-being is vital to the future of the nursing profession.
Crossers in a Segmented Labour Market: Occupational Advancement and Wage Changes from Semi-Skilled and Unskilled Jobs
Authors: Wotschack Philip , Samtleben Claire
Published: September 2024

How the upward mobility chances of workers in unskilled or semi-skilled jobs are shaped by influences at the organisational and sectoral level remains an open question. This article aims to close this research gap by examining the role of internal labour market characteristics in the promotion prospects and wage increases of workers in semi-skilled and unskilled positions. The hypotheses are derived from dual and segmented labour market theory. Regression analyses based on linked-employer-employee-data (LIAB), covering 44,024 workers in semi-skilled and unskilled positions from 2005 to 2010, underline the importance of the internal labour market. A considerable share of workers moved to skilled positions through company change. For the workers who stayed with the company, career advancements were associated with regular training investments and formalised regulations at the company level. Collective agreements, in contrast, were associated with lower chances of upward mobility, but higher wages.
Synthesis of a single-degree-of-freedom noncircular pulley-five-bar finger rehabilitation mechanism considering force transfer performance
Authors: Chen Jianneng , Yao Kun , Yu Chennan , Xu Yuanxiang , Zhou Shuyu , Ye Jun
Published: September 2024

Currently, most of the finger rehabilitation mechanisms achieve the desired motion by scale synthesis or using multi-degree-of-freedom (DOF) mechanisms, which cannot simultaneously achieve the requirements of posture and trajectory for finger rehabilitation. Aiming to solve this problem, this study proposes a single-DOF noncircular pulley-five-bar finger rehabilitation mechanism, obtains the pose requirements of finger movement and extracts four important poses. The solution domain of the five-bar mechanism with four poses was solved using the solution-region synthesis method, and the noncircular pulley was used to constrain two rods, making it a single-DOF mechanism. According to the requirements of the finger rehabilitation mechanism and considering the force transmission characteristics of the mechanism, the mechanism parameter optimization model is established, and the optimal parameters are optimized. The calculation model of noncircular pulley transmission is established, and the profile of noncircular pulley is solved according to the obtained rod rotation angle relationship. A finger rehabilitation device was developed, and an experimental study was performed. It was found that the device passed four poses, and the actual trajectory was consistent with the target trajectory. It is confirmed that the single-DOF noncircular pulley-five-bar finger rehabilitation mechanism proposed is effective, and solution method are correct.
A tail probability density distribution model of stress amplitude under band-limited stochastic vibration loadings
Authors: Zhu Yuhao , Li Piao
Published: September 2024

Resonance of engineering structures under stochastic vibration loadings is a primary cause of fatigue failure. Considering that cyclic loadings below the fatigue limit of the material contribute little to fatigue damage, the portion of the stress amplitude distribution that exceeds the fatigue limit is in focus in this paper, and a tail probability density distribution model of stress amplitude under band-limited stochastic vibration loadings is proposed. First, the response stress power spectral density functions under band-limited loadings are simulated by using the normal distribution and the Weibull distribution, respectively, and then the frequency domain signals are converted into time domain signals by adopting the inverse fast Fourier transform method. A two-parameter Weibull model of tail probability density distribution of stress amplitude is proposed, and the relationship between model parameters and power spectral moment parameters is given. Finally, the comparative analysis of the model accuracy and the vibration fatigue test of aluminum alloy notch specimen are carried out. It is demonstrated that the fatigue life predicted by the presented model is highly coincident with the results of tests and the time domain method.
Emergency Management Simulation of an Unexpected Opioid Overdose in a Rural Setting: An Innovative Use of Drone Technologies
Authors: Niles Lauren L. , Sullivan Veronica , Amiri Azita
Published: September 2024

Background

The utilization of unmanned aircraft systems (UAS) in healthcare presents an innovative and effective approach for the delivery of emergency medical supplies to rural communities. Providing healthcare students with opportunities to work with UAS prepares them to embrace novel technologies in their future careers. Caring for individuals living in rural communities and those with substance abuse disorders are critical components of current healthcare education.

Intervention

This simulation ready-to-use describes an innovative simulation learning exercise (SLE) developed using UAS technologies to address an unexpected opioid overdose in a rural setting.

Methods

Students received pre-simulation instruction on the concepts of addiction, emergency management of an opioid overdose, and rural healthcare. Students participated in an unfolding, two-part SLE.

Results

The first scenario simulated emergency management of the opioid overdose in which a UAS delivered rescue medications. This was followed by a second scenario simulating continuing care after initial stabilization. Debriefing of the simulation and reflection activities were completed.

Discussion

The integration of UAS in healthcare education provides a valuable opportunity for students to increase their knowledge of innovative technologies. The UAS provides educators with a novel resource to expand simulation experiences, increase student engagement, and promote knowledge retention of difficult concepts. Instructions for implementation and educational resources provided in the Appendix.
Lockdown Stories: A Qualitative Assessment and Comprehensive Taxonomy of Career Resources
Authors: Rochat Shékina , Arnoux-Nicolas Caroline , Borgen William A.
Published: September 2024

Career resources are receiving increasing attention in the context of career development. This paper utilizes M. E. Ford’s (1992) ten components of effective functioning to provide a comprehensive typology of factors likely to act as career resources and test this proposition in a context of career shock with a narrative design. In the weeks following the first COVID-19 lockdown, 42 participants were asked to complete a questionnaire about their well-being, perceived employability, and emotional anticipation of their career future, as well as to write three stories about their experience with the lockdown. M. E. Ford’s categories were used to identify and code the resources and obstacles mentioned in the stories. Results show the relevance of such a taxonomy to classify both career resources and obstacles. Additionally, the type of story (general story, positive or negative story) in which career resources and obstacles were mentioned played a significant role in their association with the quantitative measures. Conceptual and practical implications are discussed.
Preferred Leadership Behavior in the Serbian Setting: A Cross-Regional Perspective
Authors: Stošić Panić Danijela , Simić Ivana
Published: September 2024

The aim of the study is to identify the relationship between national culture and preferred leadership behavior in the Republic of Serbia. Using the Value Survey Module 2008 (VSM08) and the Leader Behavior Description Questionnaire XII (LBDQXII), the research is conducted on a sample of 344 employees in Serbian business organizations. The results show that the national culture in Serbia is homogeneous, but that two Serbian first-level regions according to the Nomenclature of Territorial Units for Statistics (NUTS1) exhibit some differences in preferences for leader behavior and in correlation patterns between cultural values and aspects of preferred leadership behavior. This study fills a gap in researching the relationship between national culture and preferred leadership behavior in Serbia. Moreover, the results provide a basis for aligning actual with the preferred leadership behavior, so that the organizational goals can be achieved more efficiently. Despite the significant contributions, the study is not without limitations, primarily related to the sample size.
A Tossed Salad: Heterogeneity of Societal Culture and Preferred Leader Behavior in the Russian Federation
Authors: Littrell Romie F. , Ljubica Jasenko
Published: September 2024

In this study, we examine societal-cultural values and employee preferences for explicit leader behaviors and their relationships in the Russian Federation. Our analyses of data obtained from samples in two large regions (Siberia and Western Russia); indicate the heterogeneity, that is, differences of the traditional, Slavophile-Orthodox, and Western-like characteristics therein. In doing so, we contribute to the literature on culturally contingent business leadership in Russia, by providing a basis for and stimulating research to enlarge and systematize the literature and construct useful practical recommendations.
Opening the Black Box: Editorial to the “Culture and Leadership in Slavic Nations” Special Issue in the Cross-Cultural Research Journal
Authors: Ljubica Jasenko , Littrell Romie F.
Published: September 2024

This Special Issue is an installment of the series of studies carried out by the Centre for Cross Cultural Comparisons ([ https://crossculturalcentre.homestead.com/ ]( https://crossculturalcentre.homestead.com/ )), an international voluntary association of researchers, students and practitioners interested in the global study of culture and leadership. This Consortium investigates the relationships among preferred leader behavior dimensions and societal cultural values of employed businesspeople across the globe, with the intent of improving managerial leadership practice in businesses.
Science, Not Scientists: Reflections on Science, Culture, and Their Mediators
Authors: Taragin-Zeller Lea , Peterson Hannah
Published: September 2024

In this commentary, we lay out a research agenda for studying religion and science communication that moves beyond theological and moral tensions to include embodied knowledge practices and orientation toward particular vocational futures. Based on findings from a case study of a National Geographic Kids magazine tailored for Orthodox Jews, we argue that diversifying science communication includes navigating embodied knowledge practices and competing “imagined futures” regarding science-related vocations. Advancing recent conversations at the nexus of religion and science communication, our case study highlights the generative possibilities that arise when centering religion amid other processes of science communication diversification.
Risk Prediction Models for Preoperative Deep Vein Thrombosis in Older Patients with Hip Fracture: A Systematic Review and Meta-Analysis
Authors: Guo Huali , Xu Kuankuan , Deng Fangfang , Chen Qingqing , Liang Jie , Zhang Kun
Published: September 2024

Objective

To systematically assess the risk prediction models for preoperative deep vein thrombosis in older patients with hip fractures.

Method

We searched four databases for literature through November 17, 2023. We included patients aged ≥60 with hip fractures and considered English-language case-control or cohort studies that focused on developing and/or validating risk prediction models for DVT in this population. Excluded were studies that solely analyzed risk factors without constructing a prediction model, had fewer than 2 predictive variables, or were not available in full-text or were duplicate publications. The Predictive Model Bias Risk Assessment tool was utilized to evaluate risk of bias. The area under the curve (AUC) values were meta-analyzed using R Studio software. The I2 index and Cochrane q test were employed to assess heterogeneity. Additionally, sensitivity analysis was performed by systematically removing individual studies to explore the sources of heterogeneity.

Results

A total of 1880 studies were gathered. Out of these, seven studies were included, encompassing 8 models. The most commonly utilized factors in the models were D-dimer and the time from injury to admission. The pooled AUC value for the validation of 8 models was 0.84 (95% confidence interval: 0.80-0.87), indicating robust model performance.

Conclusion

Current risk prediction models for preoperative DVT in elderly hip fracture patients are still in the developmental phase. Future research should focus on developing new models with larger sample sizes, robust study designs, and multicenter external validation.
In Defense of Democratic Qualitative Research Teams: A Bourdieusian Approach to Critical Reflexivity
Authors: Case Collin , Cumbass Kanler , Stich Amy E.
Published: September 2024

In this article, we provide a critical reflexive tool developed to interrogate hierarchical research team structures. As members of a qualitative research team working on a large-scale federally funded project, we aim to provide guidance for scholars interested in working against established hierarchies toward more democratic team practices. Our approach is guided by critical scholarship that employs Bourdieu’s conceptualization of reflexivity to move beyond individual-level positionality, toward the critical analysis of the larger academic field and intellectual bias produced through the neoliberal academic field. Though some have argued for the need to preserve hierarchy, we stand in defense of democratic teams.
Effects of Chronotherapeutic Interventions in Adults With ADHD and Delayed Sleep Phase Syndrome (DSPS) on Regulation of Appetite and Glucose Metabolism
Authors: van Andel Emma , Vogel Suzan W. N. , Bijlenga Denise , Kalsbeek Andries , Beekman Aartjan T. F. , Kooij J. J. Sandra
Published: September 2024

Background: ADHD is highly comorbid with Delayed Sleep Phase Syndrome (DSPS). Both are associated with obesity and diabetes, which can be caused by long-term dysregulations of appetite and glucose metabolism. This study explores hormones involved in these processes and the effects of chronotherapeutic interventions in a small sample of adults with ADHD and DSPS. Methods: Exploratory, secondary analysis of data from the PhASE study, a three-armed randomized clinical trial, are presented, including 37 adults (18–53 years) with ADHD and DSPS receiving three weeks of 0.5 mg/day (1) placebo, (2) melatonin, or (3) melatonin plus 30 minutes of bright light therapy (BLT). Leptin (appetite-suppressing), ghrelin (appetite-stimulating), insulin, insulin-like growth factor-1 (IGF-1), and glucose were measured from blood collected at 08:00 hours. Salivary cortisol was collected during the first 30 minutes after awakening and self-reported appetite was assessed. Results: Baseline leptin and IGF-1 levels were higher than reference ranges, and ghrelin and cortisol levels were lower, while insulin and glucose were normal. Melatonin treatment decreased leptin and insulin. Other outcomes remained unchanged and melatonin + BLT had no effects. Conclusion: Due to the small sample size and exploratory nature of the study, results should be interpreted with caution. Overall, these results show no strong indications for dysregulation of appetite and glucose metabolism to suggest high risk of obesity and diabetes in this small sample of adults with ADHD and DSPS. However, baseline appetite was suppressed, likely because measurements took place in the early morning which could be considered the biological night for this study population. Melatonin treatment seemed to cause subtle changes in appetite-regulating hormones suggesting increased appetite. Chronotherapeutic treatment may affect appetite-regulating hormones by advancing the biological rhythm and/or altering eating behaviors, but this remains to be investigated in larger samples using detailed food diaries.
Examining the effect of nudging on college students’ behavioral engagement and willingness to participate in online courses
Authors: Guo Xiaoli , Li Rui , Ren Zhihong , Zhu Xu
Published: September 2024

Nudging is a subtle behavioral intervention that has been successful in various domains such as healthy eating and energy conservation, yet its application in mental health remains underexplored. This study examines the effect of nudging to increase engagement with online mental health resources in a university setting. We assigned 2539 first-year undergraduate and graduate students in China to either a nudging group, which received course information augmented with behavioral cues (including framing effects and social norms), or a control group, which received only basic course information. Outcomes measured included self-reported willingness to enroll, willingness to recommend enrollment, and actual enrollment actions. Results indicated that students in the nudging group demonstrated significantly higher engagement levels than those in the control group across all metrics. These findings suggest the potential of nudging strategies to effectively enhance college students’ participation in online mental health education.
Identifying children at risk in Swedish Child Health Services
Authors: Wennergren Mattias , Fäldt Anna
Published: September 2024

Background:

Child Health Services plays an important role in identifying at-risk children and intervening early to break negative trends in child health. Sociodemographic risk factors can impact the workload of Child Health Services and affect the possibilities of providing the national child healthcare programme.

Aims:

This study aims to present the sociodemographic characteristics of families who are registered within the Child Health Services, as defined by the Child adjusted Care Need Index.

Methods:

By collecting personal identification numbers from children six years or younger registered at a child healthcare centre, and combining this with their caregiver’s sociodemographic background, this study was able to create a sociodemographic index for each child healthcare centre in Sweden.

Results:

The study included 687,543 children and 1,335,540 caregivers from 981 child healthcare centres in Sweden. Approximately 21% of all children in the study population had a caregiver born in Southern or Eastern Europe outside the European Union, or in Africa, Asia, or South America, 7% had single parents, 17% had at least one unemployed caregiver, and 9% had at least one caregiver who had not completed high school. The average input values and the average index values varied widely both between and within the regions.

Conclusions:

This study displays a large variation in sociodemographics for child healthcare centres both within and between regions. Since several regions and national agencies in Sweden use the Child adjusted Care Need Index, it is necessary to keep the dispersion in mind.
The Untold Story: Early and Mid-Term Results of Subintimal Angioplasty in Superficial Femoral Artery Versus Popliteal Artery Chronic Total Occlusion
Authors: Shahat Mohammed , Ali Sahar H. , Hussein Ahmed N. , Taha Ashraf G. , Taha Mohamed A. H.
Published: September 2024

Objectives:

This study aims to compare the immediate and mid-term outcomes of subintimal angioplasty (SIA) of chronic total occlusions (CTOs) of superficial femoral artery (SFA) versus popliteal artery (PA) and to identify possible predictors of loss of limb-based patency (LBP).

Methods:

This is a retrospective analysis of chronic lower-limb ischemia (CLI) patients (Rutherford classes 3–6) presenting with CTO of SFA or PA treated by SIA and selective stenting in the period 2018 to 2021. Immediate outcomes were compared between the SFA and PA groups, including technical success, perioperative complications, and 30-day major amputation and mortality rates. Mid-term outcomes for technically successful procedures included limb-based patency (LBP), wound healing rate, amputation-free survival (AFS), and major adverse limb events (MALEs).

Results:

A total of 450 CLI patients underwent SIA of CTO at the SFA (n=260, 57.8%) and the PA (n=190, 42.2%). The indication for revascularization was chronic limb-threatening ischemia in 80.8% of SFA group and 84.2% of PA group. Technical success rate was higher in the PA group compared to the SFA group (96.3% vs 91.2%; p=0.03). The 30-day amputation rates were comparable between the SFA and PA groups (7.7% vs 6.8%, p=0.7, respectively). No perioperative mortality or systemic major complications occurred in the present study. Kaplan-Meier estimate of the 1-year rates were significantly better for SFA group regarding LBP (82% for SFA group vs 43% for PA group, p=0.006), AFS (88% vs 64%, p=0.02), and wound healing (79% vs 58%, p=0.027), respectively. The number of runoff vessels was the only factor associated with loss of LBP (hazard ratio [HR], 0.055; 95% confidence interval [CI]: 0.001–3.020, p=0.039).

Conclusions:

Subintimal angioplasty is an effective and safe endovascular treatment option of CTO at SFA and PA with satisfactory immediate outcomes. The mid-term outcomes, however, are better for SFA lesions in terms of improved LBP, AFS, and wound healing rates.

Clinical Impact:

Subintimal angioplasty is a valuable tool in the armamentarium of endovascular surgeons, as re-entry devices aren’t always widely accessible. This study aims to assess the technical outcomes of peripheral vascular interventions for infrainguinal chronic total occlusions and identify possible predictors for successful subintimal angioplasty .Subintimal angioplasty is an effective treatment option for infrainguinal CTO with difference in result of immediate outcomes in popliteal lesions and SFA lesions
A methodology for predicting and optimizing the lubrication of an off-road machine transmission
Authors: Magri Luca , Marani Pietro , Massarotti Giorgio Paolo , Ferrari Cristian
Published: September 2024

This article presents an analysis method based on lumped-parameters (LP) and computational fluid dynamics (CFD) to evaluate the behavior and calibrate the lubrication (LUB) circuit in an agricultural dual-clutch transmission. Gearbox LUB is crucial because it affects reliability, life, and transmission efficiency. The transmission’s hydraulic circuit consists of the higher pressure power transmission control and actuation circuit and the low pressure LUB circuit. The former was analyzed with LP approach, instead the latter was modeled with CFD approach due to its geometric complexity. The results will be contextualized by commenting on the advantages and limitations of LP and CFD analysis, finally outlining a mixed analysis methodology. The simulations are solved for different engine speed. The results are used to calibrate a comprehensive LP model (model) and to optimize the LUB circuit by adjusting some critical design parameters. As an experimental approach, simplified tests are usually performed ignoring the action of the centrifugal force, which has a great impact on the flow regime inside the LUB ducts. This work aims to develop a methodology for analyzing LUB in all parts of the gearbox, which can help designers test various combinations within industrial timeframes and obtain reliable and the most efficient configuration.
Understanding global citizenship education in the classroom: A case study of teaching practices
Authors: Barry Maria , Waldron Fionnuala , Bryan Audrey
Published: September 2024

The complexity of supporting teachers for Global Citizenship Education (GCE) in formal education contexts is widely recognised. Informed by classroom practice, this article documents a case study of three teachers to interrogate GCE pedagogy, and to contribute new insights to inform support for teachers. Previous research identifies factors that influence GCE teaching and learning, specifically teacher values, GCE orientations, and cultural and structural tensions. However, further insights drawn directly from teacher practice are required to understand more fully these complex and dynamic processes. Based on a qualitative study of upper secondary classroom practice, we analyse distinctive aspects of GCE and illustrate how and why GCE manifests differently across various classroom settings. Specifically, we consider the role of teacher’s ideological stances regarding the participatory nature of GCE and, consider how teachers can move from traditional, teacher-led approaches to more empowering experiences for students.
Liquid Chromatography-Mass Spectrometry analysis of some early green dyes
Authors: Plater Michael John , Raab Andrea , Hartmann Horst
Published: September 2024

Five historical green dyes from the Historische Farbstoffsammlung, Technical University of Dresden, have been analysed by liquid chromatography – mass spectrometry (LC-MS). The dyes were determined to be formed by the alkylation of either crystal violet or rosaniline and contained both doubly and singly charged ions. One sample had a spread of higher molecular weight doubly charged ions reminiscent of the alkylation of a Hofmann violet. Malachite green was the dye present in one sample.
Endoscopic retrograde appendicitis therapy
Authors: Zhang Anding , Fan Na , Zhang Xinhui , Guo Hongwei , Zhou Ying , Zeng Lingchao , Lin Yan , Jiang Xun
Published: September 2024

Endoscopic retrograde appendicitis therapy (ERAT) is a novel and minimally invasive technological alternative for the management of acute or chronic appendicitis. Through endoscopic appendiceal intubation, obstructions such as appendiceal feces and parasites within the appendiceal lumen can be effectively eliminated, leading to patient recovery. Additionally, in cases where the orifices are swollen or complicated appendicitis is present, a stent may be inserted following appendiceal flushing. Due to the utilization of endoscopy for accessing the orifices of the appendix in order to alleviate appendiceal obstruction, patients were able to avoid undergoing appendectomy and experienced a reduced likelihood of recurrence when compared to antibiotic therapy. Additionally, the ERAT provided alternative options for individuals with appendicitis and comorbidities. Recent advancements in techniques, such as the “mother–baby” endoscopic system and the use of microbubble contrast agents, have expanded the range of indications and the eligible patient populations. The objective of this review is to present a comprehensive overview of the development, procedural aspects, therapeutic principles, treatment efficacy, therapeutic applications, and potential complications associated with ERAT.
The ‘vulnerable nerve’; surgically acquired neuropathy in distal humeral surgery patients and the role of a tourniquet
Authors: Williams Mark G , Donoghue Sophie J , Thomas Ellen , Evans Jonathan P , Thomas William , Smith Christopher
Published: September 2024

Background

The complication of neuropathy is high in patients undergoing distal humerus surgery. Tourniquets (TQs) are typically used but can lead to nerve injury.

Methods

We present a comparative study of a pre-intervention group ( n = 38) and a post-intervention group ( n = 38) undergoing distal humerus surgery between November 2020 and July 2023. The intervention included TQ discontinuation and the introduction of intravenous tranexamic acid at induction. Our analysis encompasses patient, anaesthetic, and surgical variables, as well as the rates and severity of neuropathy.

Results

Post-intervention, the rate of surgically acquired or deterioration in nerve injury improved from 15.8% ( n = 6) to 2.6% ( n = 1). Pre-intervention, the mean TQ duration was significantly longer for patients with post-operative neuropathy versus those without (120 min, SD = 29 vs. 88 min, SD = 38, p = 0.032). Surgery duration was not significantly longer without a TQ but was associated with a greater reduction in haemoglobin (12.7 g/L, SD = 10.9 vs. 25.2 g/L, SD = 15.5, p = 0.03).

Discussion

Trauma patients have a high risk of acquiring a nerve injury following elbow surgery or deterioration of a pre-surgical nerve injury, which emphasises the concept of vulnerable nerves. The cessation of using a TQ was associated with a lower nerve injury rate, with no cases of major nerve injury and no significant increase in surgical time.
Is revision to anatomic shoulder arthroplasty still an option? A systematic review
Authors: Gulzar Musab , Welp Kathryn M , Chang Michelle J , Woodmass Jarret M , Worden Jacob A , Cooke Hayden L , Chopra Krishna N , Gottschalk Michael B , Wagner Eric R
Published: September 2024

Background

With the historical complications when using total shoulder arthroplasty (TSA) to revise failed arthroplasties, and the success of the reverse prosthesis in the revision setting, the question arises whether revision to TSA is still a reasonable option? This systematic review examines revision to TSA and the factors associated with outcomes.

Methods

A systematic review was performed for studies of TSA used to revise a failed hemiarthroplasty or TSA. The primary outcome was implant failure leading to a repeat revision arthroplasty. Secondary outcomes included visual analog scale (VAS) pain scores, shoulder motion and other clinical outcomes of shoulder function. Data were pooled to generate representative frequency-weighted means.

Results

Thirteen studies were included, totaling 312 shoulders. Etiologies for revision included glenoid arthrosis (62%), glenoid component failure (36%), and other (2%). Of which, 39% of cases experienced complications and 12% required another arthroplasty revision. Secondary outcomes such as VAS pain, Constant, ASES and UCLA score improved, but none were statistically significant. Unsatisfactory outcomes were higher among patients with glenoid bone loss, instability, and soft tissue deficiencies.

Discussion

Revision to anatomic TSA can be an acceptable option in certain patients. However, the high rate of complications and glenoid loosening, makes this a limited approach for a revision to anatomic TSA procedure.
Myxedema ascites? A rare presentation of ascites in severe hypothyroidism: A case report and review
Authors: Konar Kylie Divashnee , Pillay Somasundram , Sookdev Nishan
Published: September 2024

Ascites represents an infrequent sequela of hypothyroidism, manifesting in fewer than 4% of affected individuals. Herein, we delineate a case characterized by profound hypothyroidism accompanied by substantial ascites, further complicated by cardiac insufficiency. A 29-year-old female, previously diagnosed with postradiation hypothyroidism subsequent to a diagnosis of Grave’s disease 11 years prior, presented with exacerbating dyspnoea, abdominal distension, and orthopnea. In January 2024, she was admitted with massive ascites, exhibiting clinical manifestations of both hypothyroidism and cardiac failure. Thyroid function tests were markedly abnormal, with a thyroid-stimulating hormone level of 77.65 mIU/L, triiodothyronine at 2.2 nmol/L, and thyroxine levels below 3.2 pmol/L. Echocardiographic evaluation revealed dilated cardiomyopathy with a significantly reduced systolic (ejection fraction of 25.9%) and diastolic function (E/A ratio of 0.87). Analysis of the ascitic fluid demonstrated a serum-ascites albumin gradient exceeding 1.1 g/L (3 g/L). Ultrasonography of the abdomen ruled out portal hypertension, while computed tomography of the abdomen confirmed extensive ascites without evidence of malignancy. Under the supervision of a specialist, the patient was administered a high dosage of levothyroxine (300 mcg), leading to a significant amelioration in both thyroid function parameters and her ascites. Subsequent thyroid function tests demonstrated a decrease in thyroid-stimulating hormone levels to 11.7 mIU/L and an increase in thyroxine levels to 15.6 pmol/L, indicating a positive response to the thyroid hormone replacement therapy. Subsequent echocardiographic assessment showed improvement in the ejection fraction to 26.9% and diastolic function (E/A ratio of 1.27). Myxedema ascites, though infrequent, is readily amenable to treatment. The serum-ascites albumin gradient exceeding 1.1 g/L may be indicative of hypothyroidism-associated ascites, although the paucity of studies renders it uncertain whether this is a characteristic feature. Further investigation into the etiology, diagnostic criteria, and management strategies for ascites in the context of hypothyroidism is warranted.
Duodeno-duodenal intussusception due to gastrointestinal stromal tumor: A case report
Authors: Khaoula Boumeriem , Iliass Bourekba , Insumbo Paulino , Ittimade Nassar , Kaoutar Imrani , Nabil Moatassim Billah
Published: September 2024

Gastrointestinal stromal tumors, previously referred to as leiomyomas and leiomyosarcomas, are one of the most common mesenchymal tumors of the gastrointestinal tract, predominantly located in the stomach (60%–70%), followed by the small intestine (20%–30%). They manifest at any age but more commonly in patients older than 50 years. Patients with gastrointestinal stromal tumors usually have vague and nonspecific symptoms. The diagnosis is sometimes challenging requiring multiple imaging modalities, including computed tomography and magnetic resonance imaging, used for diagnosis, staging, and surveillance. Treatment involves surgery and targeted therapy. Serious complications have been reported such as intussusception which is exceptionally rare due to the extraluminal growth pattern tendency of gastrointestinal stromal tumors. We present the case of a 77-year-old female with duodeno-duodenal intussusception secondary to a gastrointestinal stromal tumor. This case report contributes valuable insight into the diverse presentation and complications of gastrointestinal stromal tumors.
Diagnostic and management challenges of a rare case of caesarean scar pregnancy in a low-resource setting: a case report
Authors: Nwankwo Malarchy E , Egeonu Richard O , Ikeotuonye Arinze C , Eleje George U , Okafor Chisolum O , Ikpeze Golibe C , Ugadu Samuel N , Agbanu Chimezie M , Nwankwo Adamalarchy F , Okafor Chigozie G
Published: September 2024

Caesarean scar pregnancy is a rare type of ectopic pregnancy with the potential for catastrophic outcomes. A high index of suspicion is required for prompt diagnosis and intervention to improve outcomes. This report describes a rare case of Caesarean scar pregnancy, which was initially misdiagnosed as a threatened miscarriage and cervical ectopic pregnancy. A 35-year-old multiparous lady with two previous caesarean sections presented to the Gynaecology Unit of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nigeria, at an estimated gestational age of 10 weeks, with recurrent vaginal bleeding of eight weeks’ duration. She was referred to our facility from a private hospital, where she had first been managed as a case of threatened miscarriage and later as a cervical ectopic pregnancy. The transvaginal ultrasound in our facility was in keeping with a viable Caesarean scar pregnancy. The urine pregnancy test was positive, and the quantitative serum beta human chorionic gonadotropin was 75.6 mIU/ml. She had initial medical treatment with a combination of systemic multidose and intrauterine sac methotrexate and, subsequently, hysterotomy. Following systemic and local methotrexate, there was the demise of the foetus, which was evacuated at hysterotomy, and the uterine scar defect was repaired. She was discharged home in stable clinical condition one week after surgery. Her serum beta human chorionic gonadotropin dropped to 51.6 mIU/mL two weeks post-hysterotomy, and her urine pregnancy test became negative three weeks later. Though rare, caesarean scar pregnancy should be considered a differential diagnosis in reproductive-aged women with a previous caesarean section who present with vaginal bleeding in the first trimester.
Destructive foreign body granuloma: A case report
Authors: Wongwan Pithiwat , Prakairungthong Sarun , Atipas Suvajana , Thongyai Kanthong , Limviriyakul Siriporn , Suvarnsit Kanokrat
Published: September 2024

External auditory canal polyps are predominantly inflammatory processes but occasionally indicate more severe pathology. Prolonged conservative management may postpone accurate diagnosis and appropriate therapeutic intervention. This case report presents a 37-year-old woman, previously healthy with a normal ear, who underwent a right myringotomy with the insertion of a pressure-equalizing tube in one hospital after an upper respiratory tract infection. However, due to the pandemic era, she lost follow-up for 2 years and subsequently presented to another hospital with worsening hearing and persistent otorrhea. The attending physician found a large polypoid lesion occupying her right external ear canal. A computerized tomography scan revealed an irregular enhancement mass involving the right ear canal, the middle ear cavity, and mastoid air cells with multiple destruction of the skull base and intracranial involvement in the right middle cranial fossa. The possibility of malignancy was raised, prompting the patient to seek evaluation in a third hospital. A right tympanomastoidectomy was performed, and during a posterior tympanotomy, a pressure-equalizing tube was discovered in her middle ear. The pathological results confirmed the presence of foreign body granuloma. Following surgery, the patient’s otorrhea improved.
An exploration of medical professionals’ attitudes, perceived knowledge and concerns around medical cannabis in the United Kingdom
Authors: Heeg Hallie , Morari Ana , Lynskey Michael , Turner John JD
Published: September 2024

Background

In the UK, there are over 40,000 specialist clinicians who are eligible to prescribe cannabis-based medical products (CBMPs); however, only approximately 100 actively do so (0.25%). Since the legalization of medical cannabis in the UK in 2018, there has been a limited number of prescriptions issued by the National Health Service (NHS). Availability through private healthcare is rising, with current estimates suggesting that 25,000–30,000 patients are accessing medical cannabis though private clinics.

Objective

The objectives of this study were (1) to assess attitudes, perceived knowledge and concerns around medical cannabis among medical/health care professionals (HCPs) in the UK, and (2) to examine differences between professionals who had previously undertaken training on medical cannabis and those who had not.

Methods

Using a quantitative cross-sectional survey design, a questionnaire was presented to participants to explore their personal and professional perspectives towards medical cannabis. Questions addressed HCPs’ perceived knowledge, confidence and concerns about medical cannabis prescribing, alongside their personal experiences and attitudes toward legalization.

Results

A total of 72 HCPs completed the survey, of which 55.6% had received training in medical cannabis. HCPs trained in medical cannabis reported a statistically significant higher perceived knowledge of medical cannabis, greater confidence in prescribing and increased recognition of its value as a medicine compared to their non-trained colleagues ( p < 0.05 for all comparisons). Notably, trained individuals were significantly less concerned that use of medical cannabis lacks sufficient evidence of efficacy ( X2(1) = 8.74, ( p = 0.003). Barriers to prescription and cost of medical cannabis were the most endorsed concerns among both HCP groups.

Conclusions

The study found that undergoing medical cannabis training is associated with less hesitancy in prescribing CBMPs and increased confidence in its medicinal value.