bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of biomechanical compliance on control performance of a magnetorheological sliding seat system
Authors: Mao Min , Choi Young T , Wereley Norman M , Browne Alan L , Johnson Nancy L
Published: April 2023

We investigate the feasibility of a sliding seat with a magnetorheological (MR) energy absorber (MREA) to minimize loads transmitted to a payload in a ground vehicle for frontal impact speeds ranging as high as 7 m/s (15.7 mph). The crash pulse for a given impact speed was assumed to be a rectangular deceleration pulse having a prescribed magnitude and duration. The control objective is to bring the seat system to rest using the available stroke, while accommodating changes in impact velocity and occupant mass ranging from a 5th percentile female to a 95th percentile male. The seat system was first treated as a single-degree-of-freedom (SDOF) rigid occupant (RO) model, and two control algorithms are developed: (1) constant Bingham number control and (2) constant force control. To explore the effects of occupant compliance on the adaptive seat system performance, a multi-degree-of-freedom (MDOF) compliant occupant (CO) model was integrated with the seat mass and the same control algorithms were used. Simulation results showed that the designed adaptive controllers successfully controlled load-stroke profiles to bring the seat system to rest in the available stroke and reduced occupant decelerations. Analysis showed extensive coupling between the seat structures and occupant biodynamic response.
Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth
Authors: Langton Calvin M. , Betteridge Mackenzie , Worling James R.
Published: April 2023

The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher and lower likelihoods of violent and any reoffending at opposite ends of their trichotomous ratings. Summing items weighted using their promotive and risk odds ratios produced statistically significant improvements in predictive accuracy, improvements found also with a cross-validation sample of 171 justice-involved youth. The nature of strengths and implications for the development of SPJ tools and training in their use were discussed.
Risk of Prescription Opioid Exposure in Children and Adolescents With Attention Deficit Hyperactivity Disorder: A Nationwide Longitudinal Study
Authors: Hsu Ju-Wei , Tsai Shih-Jen , Bai Ya-Mei , Huang Kai-Lin , Su Tung-Ping , Chen Tzeng-Ji , Chen Mu-Hong
Published: April 2023

Background:

US studies suggest a positive association between attention deficit–hyperactivity disorder (ADHD) and the risk of exposure to prescription opioids. However, whether this association holds in Asian countries remains unclear.

Methods:

In total, 91,518 children and adolescents with ADHD and 91,518 age- and sex-matched controls were enrolled for the period of 2001 to 2009; they were followed up until the end of 2011 to determine whether they had used prescription opioids.

Results:

Children (hazard ratio [HR]: 5.83) and adolescents (HR: 3.44) with ADHD had a higher likelihood of receiving opioid prescriptions than did their matched controls. Furthermore, patients with ADHD had greater likelihoods of cumulative exposure to opioids of >14 (HR: 5.93) and >30 days (HR: 6.07).

Discussion:

Owing to the evidence of a significant link between opioid prescription use and eventual abuse, close monitoring for prescription opioid use is necessary for at-risk children and adolescents with ADHD.
Abacavir safety and effectiveness in young infants with HIV in South African observational cohorts
Authors: de Waal Reneé , Rabie Helena , Technau Karl-Günter , Eley Brian , Sipambo Nosisa , Cotton Mark , Boulle Andrew , Wood Robin , Tanser Frank , Fatti Geoffrey , Egger Matthias , Davies Mary-Ann ,   and International epidemiology Databases to Evaluate AIDS (IeDEA) Southern Africa
Published: April 2023

Background

WHO guidelines recommend abacavir in first-line antiretroviral treatment for children and neonates. However, there is no approved dose <3 months of age, and data in neonates are limited.

Methods

We included infants who initiated ART aged <3 months, between 2006 and 2019, in nine South African cohorts. In those who received abacavir or zidovudine, we described antiretroviral discontinuation rates; and 6- and 12-month viral suppression (<400 copies/mL). We compared infants aged <28 and ≥28 days, those weighing <3 and ≥3 kg.

Results

Overall 837/1643 infants (51%) received abacavir and 443 (27%) received zidovudine. Median (interquartile range, IQR) age was 52 days (23–71), CD4 percentage was 27.9 (19.2–38.0), and weight was 4.0 kg (3.0–4.7) at ART initiation. In those with ≥1 month’s follow-up, 100/718 (14%) infants discontinued abacavir, at a median of 17.5 months (IQR 6.5–39.5). Abacavir discontinuations did not differ by age or weight category ( p = 0.4 and 0.2, respectively); and were less frequent than zidovudine discontinuations (adjusted hazard ratio 0.14, 95% confidence interval 0.10–0.20). Viral suppression at 12 months occurred in 43/79 (54%) and 130/250 (52%) of those who started abacavir aged <28 and ≥28 days, respectively ( p = 0.8); 11/19 (58%) and 31/60 (52%) in those who weighed <3 and ≥3 kg, respectively ( p = 0.6); and 174/329 (53%) in those on abacavir versus 77/138 (56%) in those on zidovudine (adjusted odds ratio 1.8, 95% confidence interval 1.0–3.2).

Conclusion

Our data suggest that abacavir may be used safely in infants <28 days old or who weigh <3 kg.
The Black pill pipeline: A process-tracing analysis of the Incel’s continuum of violent radicalization
Authors: Green Robert , Fowler Kurt , Palombi Allan
Published: April 2023

Incels represent a subculture born on the Internet and unified by their inability to establish and maintain sexual relationships with women. When new members enter, they are placed at the beginning of a subcultural process that uses their shared experience to introduce them to increasingly radical viewpoints. In order to analyze Incel subculture, this research uses a purposive sample of on-line discussion boards of Incel culture and traces the subcultural process of radicalization. Findings suggest that Incels use a series of increasingly radical “pills” to denote their position within the subculture and move new and prospective members along an ever increasing pipeline of extremism resulting in both advocating for and approval of violence.
Reorienting curriculum materials as agents of restorative justice in early literacy classrooms
Authors: Ferguson Daniel E , Dernikos Bessie P
Published: April 2023

Amidst numerous curricular reforms across the USA that censor reading materials and promote standardized literacy policies, the authors ask in this article: What rights do early childhood teachers and students have in curriculum-making, and to the very materiality of their own classrooms? More broadly, they wonder: How do material regulations in US schools impact the curricular work of restorative justice in early literacy classrooms? The authors examine one curriculum material used in classrooms across the USA, using theories of materiality to explain its orientation, disorientation, and reorientation within discourses around anti-critical race theory and pro-“science of reading” legislation. Moreover, they aim to explore the potentialities of curricula as agents of restorative justice and, consequently, the threats to justice from the disorientations expressed around specific curriculum materials.
Correlation between heat transfer and flow in an internal combustion engine evaluated with a MEMS sensor
Authors: Dejima Kazuhito , Nakabeppu Osamu
Published: April 2023

Understanding heat transfer is important for developing high-performance internal combustion engines, but heat transfer mechanisms have not yet been elucidated. The objective of this study is to clarify the correlation between flow and heat transfer in an engine. Local instantaneous heat flux and advection speed adjacent to a wall were measured using a resistance-type three-point heat flux sensor to achieve this purpose. Furthermore, local instantaneous Nusselt and Reynolds numbers were calculated based on the measured heat flux and the advection speed using two characteristic lengths: (1) bore diameter and (2) penetration depth. Consequently, it was found that the ensemble-averaged Nusselt numbers varied exponentially as a function of the ensemble-averaged Reynolds numbers in both models, and good correlation equations could be derived. The penetration-depth model reproduced the experimental values more precisely. On the other hand, the Reynolds number index of the bore-diameter model corresponds with the heat transfer on the rear wall of a cylinder installed in a flow. This suggests an analogy between the engine and rear wall of a cylinder. Additionally, the impacts of each heat transfer factor were evaluated. As a result, it was found that a dominant factor until the heat flux peak is the temperature difference between the gas and wall. However, its effect becomes small after the heat flux peak, and it was found that the density and advection speed mainly affect the heat flux decrease.
Influence of geometrical design on the cooling process of double annular turbine section
Authors: Pařez Jan , Tater Adam , Kovář Patrik , Mačák Pavel , Vampola Tomáš
Published: April 2023

The article describes the issue of gas turbine cooling after operation. Due to natural convection, an asymmetric temperature distribution occurs in the double annulus, which has a significant effect on the thermal bow of the rotor. At the same time, the desire to minimize radial clearances as this brings the advantage of higher engine efficiency is nowadays essential. On the other hand, it also requires the ability to understand and predict the cooling transient to avoid critical failures during engine restart. Based on a real engine, an experimental facility was designed to represent a simplified double annulus flow path in a section of the turbine flow path. Experimental measurements were performed and a computational model of natural convective flow during gas turbine cooling was developed. The time dependence of the temperature fields was observed and compared with computational model. Furthermore, the dependence of the temperature differences between the upper and lower double annulus was presented. The computational study is carried out with different geometrical setups, which were also validated by experimental measurements. It is shown that the thermal gradient of the rotor due to natural convection can be significantly affected by the choice of geometry and other constraints in this region. The results of the study showed several options to mitigate the rotor bow of a gas turbine. The applicability of the results may have a significant influence on the design and development of gas turbines nowadays.
What makes adults choose to learn: Factors that stimulate or prevent adults from learning
Authors: Broek Simon , Linden Josje van der , Kuijpers Maria Anna Catharina Theresia , Semeijn Judith Hilde
Published: April 2023

Adult learning policies need to be based on an understanding of the inequalities in the uptake and benefits of learning and why adults might not participate. This needs to go beyond a mere insight in barriers that, once removed, do no longer provide a reason for adults not to participate. This article aims to delph deeper in understanding what makes adults choose to learn. It starts by applying a capability approach perspective to adult learning to evaluate whether adults have freedom to value learning and, whether they can effectively turn this freedom into learning. This conceptual framing puts certain concepts in the spotlight, namely, ‘agency’, ‘conversion factors’ and ‘benefits of learning’, which were further explored through a narrative literature review analysing 109 articles. This resulted in an exploration of these concepts and their interplay feeding into a conceptual model, opening new perspectives for evaluating whether adults have equal opportunities to value adult learning and turn their willingness into actual learning. This model supports future empirical studies aimed to understand participation and non-participation of adults in learning that can in turn feed policy makers with better insights and tools to develop interventions actually provide the right encouragements for adults to learn.
A High-Quality Nomogram for Predicting Lung Metastasis in Newly Diagnosed Stage IV Thyroid Cancer: A Population-Based Study
Authors: Wang WenYi , Liu JiaJing , Xu XiaoFan , Huo LiQun , Wang XuLin , Gu Jun
Published: April 2023

Introduction: Lung metastasis (LM) implies a very dismal event in patients with thyroid cancer. We aimed to construct a nomogram to predict LM for newly diagnosed stage IV thyroid cancer. Methods: A total of 1407 stage IV thyroid cancer patients were gathered from the surveillance, epidemiology, and end results (SEER) database. Pearson's Chi-squared test or Fisher's exact test was used to identify LM-related factors, and logistic regression analysis was employed to identify independent risk parameters of LM, which were included to establish a nomogram model by R software. The discriminative ability and predictive accuracy of the nomogram were assessed using the area under the curve (AUC) and calibration plots. Cox regression analysis and Kaplan–Meier analysis were applied to evaluate the clinical utility of this model. A simulation trial was conducted to verify the health economic value of this nomogram in predicting TCLM. Results: Five variables were found to be independent risk predictors of LM, including grade, histology, N stage, bone metastasis, and liver metastasis. The results of the AUC and calibration curves demonstrated that the nomogram exhibited outstanding performance for predicting the risk of LM patients both internally and externally. The LM prediction risk was an independent prognostic factor for stage IV thyroid cancer patients [ P = .009, hazard ratio (HR): 1.812, 95% CI: 1.163-2.824]. Conclusion: We successfully developed a predictive model for stage IV thyroid cancer, which provides important information for identifying patients at high risk of LM and implementing early preventive interventions to improve their outcomes.
Hormonal contraceptive use, menstrual cycle characteristics and training/nutrition related profiles of elite, sub-elite and amateur athletes and exercisers: One size is unlikely to fit all
Authors: Langan-Evans Carl , Hearris Mark A , McQuilliam Stephen , Burke Louise M , Stellingwerff Trent , Elliott-Sale Kirsty J , Morton James P
Published: April 2023

The aim of the present study was to simultaneously audit hormonal contraceptive (HC) use, menstrual cycle characteristics and training/nutrition related profiles in pre-menopausal women from varying athletic and exercise backgrounds. Elite ( n = 51), sub-elite ( n = 118) and amateur ( n = 392) female athletes and exercisers were examined via an anonymous quantitative/qualitative survey tool. All analyses for ratio data were conducted utilising one- and two-way ANOVA/ANCOVA and odds ratio models, with ordinal data analysed via Pearson's Chi-squared tests. HC use was similar across elite, sub-elite and amateurs (34–44%). Menstrual cycle length was not different ( P = 0.08) between competitive levels (28 ± 13 days), but 66% of respondents reported cycle variability (10 ± 11 days). Training profiles were not different based on contraceptive status ( P > 0.05) yet were across competitive groups ( P < 0.05). Daily meal/snack intakes were not different between contraceptive status ( P > 0.05), though elite and sub-elite groups reported a higher daily meal consumption compared to amateurs ( P < 0.01). Forty percent of all respondents skipped meals, attributed to lack of time, schedule and alterations in appetite, with reported changes in taste preferences during pre-menses (14–35%) and menses (15–25%) towards sweet foods (60%), with cravings for chocolate and other confectionary (25%). Prevalence of dietary supplement use was not influenced by contraceptive status ( P = 0.31), though elites (76%) reported higher use ( P = 0.04) than amateurs (63%). Data demonstrates that in female athletes and exercisers, competitive level appears to affect simple markers of training and nutrition practice, yet contraceptive status does not.
Low acromial insufficiency fracture rate in reverse shoulder arthroplasty with distal clavicle excision
Authors: Chen Raymond E , Vaughan Alayna , Santoro Adam J , Namdari Surena , Williams Gerald R
Published: April 2023

Background

This study investigated the rate of acromial insufficiency fractures (AIF) in patients undergoing reverse shoulder arthroplasty (RSA) with concomitant distal clavicle excision (DCE).

Methods

Patients who underwent primary RSA with DCE by a single surgeon from 2010 to 2021 were identified. Exclusion criteria included revision RSA, RSA for fracture, or cases utilizing an augmented baseplate or bone graft. AIF was defined as a radiographically proven acromion or scapular spine fracture. Pain without an identifiable fracture on imaging was defined as an acromial insufficiency reaction. Patient demographics, implant information, and radiograph measurements were compared between patients with and without acromial pathology.

Results

One hundred and seventy-five patients were included. Mean age was 72.8 years, and 67% of patients were female. There were 3/174 acromial insufficiency fractures (1.7%). AIF occurred at a mean of 9.3 months after surgery. Twelve patients had insufficiency reactions (6.9%). Patients with acromial pathology were more likely to be female ( p = .003) and have a diagnosis of osteoporosis ( p = .047) and inflammatory arthritis ( p = .049). There was no significant difference between groups in terms of other factors.

Conclusion

The AIF rate in patients who underwent RSA with DCE was 1.7%. These findings suggest that DCE in the setting of RSA may have a protective role against AIF.
Targeting Creativity Through Sentiment Analysis: A Survey on Bucharest City Tourism
Authors: Surugiu Camelia , Surugiu Marius-Răzvan , Grădinaru Cătălin
Published: April 2023

This study investigates the sentiments of Bucharest city visitors resulting from their interaction with various attractions perceived as being “creative.” The online reviews displayed on TripAdvisor were collected as a database for our research, covering the July 2016 to July 2022 period. The data were processed using R software and NVivo software intended for text analysis and the investigation of the sentiments’ distribution. The findings suggest that creative offer spurs positive and very positive sentiments among travelers. Tourists experienced joy and trust during their tourism products and services consumption. The creative products are encountered especially in restaurants and escape rooms and are less correlated with heritage, arts, museums, or architecture. These findings are very useful for local entrepreneurs, local authorities, and policymakers in order to find solutions to include more creative products and services in the city tourism offer. Even if the present research is limited to Bucharest city, a future investigation could address the creativity dimensions of other destinations in Romania and abroad, highlighting the specific tourist attractions that boost various sentiment types among tourists.
The Effect of Tang Forte (Royal Jelly) Capsule on Hypoglycemia and Clinical Course in COVID-19 Patients Under Corticosteroid Therapy
Authors: Pourfard Hamidreza , Ahmadi Ali , Habibi Zahra , Asadi-Samani Majid , Shahinfard Najmeh , Soleimani Akbar
Published: April 2023

Corticosteroids improve the complications of Covid-19 but may cause some side effects such as hyperglycemia. Royal jelly is one of the bee products that exert anti-inflammatory, insulin-like, and hypoglycemic activities. The present study was conducted to investigate the effect of royal jelly capsules on blood sugar and the clinical course of Covid-19 in the patients receiving corticosteroid therapy. In this clinical trial, 72 Covid-19 patients with positive reverse transcription polymerase chain reaction (RT-PCR) test and pulmonary involvement hospitalized in Shahrekord Hajar Hospital were enrolled and randomized into two groups: treatment (receiving corticosteroids and Royal Jelly 1000 mg capsules daily for 7 days) and placebo (given corticosteroids and placebo). Laboratory tests, blood sugar, and clinical courses were determined and compared. Data was analyzed using SPSS version 16. On day 7 after the onset of the intervention, the dosage and frequency of insulin, FBS level, and required corticosteroid showed a decrease in both groups but the inter-group difference was not significant ( P > .05). As well, the Spo2 level indicated a non-significant increase and hospital stay length indicated a non-significant decrease in the intervention group ( P > .05). Among the symptoms, only headache, cough, and dyspnea indicated an improvement in the intervention group ( P < .05). Overall, the results indicated the short-term consumption of royal jelly could not significantly improve blood sugar and the clinical course of Covid-19; however, it could significantly improve headache, cough, and dyspnea in the patients.
The Clay Minerals Group (CMG): 1947–2022
Authors: Kemp Simon J.
Published: April 2023

The Clay Minerals Group (CMG), the first of the Special Interest Groups of the Mineralogical Society of the UK and Ireland, was inaugurated in January 1947. The CMG, together with its Belgian equivalent (originally the Comité Belge pour l'Etude des Argiles, later the Belgian Clay Group, now defunct), formed the world's first organizations dedicated to clay mineral research. The CMG celebrated its 75th anniversary in 2022. The Group's aims are to stimulate interest in clay mineralogy, to facilitate an exchange of information between members by providing facilities for reading and discussing papers on research on clay minerals (and allied topics) and to expedite their publication and to encourage practical applications of such research, and these have remained reassuringly the same throughout its history. A founder and active member of both the European Clay Groups Association and the Association Internationale Pour L'Etude des Argiles, the CMG has promoted clay science through the publication of the highly regarded journal Clay Minerals and a series of influential book titles, organizing international and national scientific conferences and meetings, the George Brown Lecture series, providing bursaries and grants to assist researchers and hosting the Images of Clay archive. The initial and sustained success of the CMG has been largely due to the labours of many officers and committee members, some of whom have been recognized for their science and service with awards from the Mineralogical Society of the UK and Ireland and elsewhere. By maintaining this effort, the evident, continuing demand for clay mineral research to assist with changing societal needs should ensure the relevance and health of the CMG for the foreseeable future.
Principles of patient partnership: integrating patient perspectives into ERS Clinical Research Collaborations
Authors: Coleman Courtney , Fulton Olivia , Boyd Jeanette , Williams Clare , Powell Zena , Brightling Christopher E. , van den Berge Maarten , Siddiqui Salman , Powell Pippa
Published: April 2023

Patient and public involvement in research is increasingly considered a cornerstone of good research practice, and the research community recognises people with lived experience as valuable stakeholders within the research process. European Respiratory Society (ERS) strongly encourages patient input into its research programme and scientific activities, working in partnership with the European Lung Foundation (ELF) to facilitate this. Based on the ERS and ELF experience and best practice in the field of patient and public involvement, we developed a set of principles to which future ERS and ELF collaborations should adhere. These principles provide guidance on how to address key challenges when planning and conducting patient and public involvement in order to develop successful partnerships with patients and drive forward patient-centred research.
Exploring caregivers’ perceptions of community-based service requirements of patients with spinal cord injury: a qualitative study
Authors: Galehdar Nasrin , Heydari Heshmatolah
Published: April 2023

Background

The incidence of spinal cord injury is increasing worldwide. Patients with spinal cord injury and their families face many difficulties during the disease course. Caregivers are more involved with these patients than anyone else, so recognizing patients’ care requirements based on caregivers’ opinions can facilitate care provision to these people. The purpose of this study was to explore caregivers’ perceptions of the community-based services requirements of patients with spinal cord injury.

Methods

This qualitative research was conducted in Iran from Apr 2021 to Dec 2022 using the conventional content analysis method. The participants in the study included family caregivers and providers of home care services to patients with spinal cord injury, who were selected by purposeful sampling. Data were collected by conducting 14 face-to-face interviews and analyzed based on the method proposed by Lundman and Graneheim.

Results

Data analysis led to the extraction of 815 primary codes, which were organized into two themes: community reintegration (with two categories, including the need to provide a suitable social platform and lifelong care) and palliative care (with two categories, including family conference and survival management).

Conclusion

Social facilities and infrastructure should be modified in a way that patients with spinal cord injury can appropriately benefit from community-based care services and an independent satisfactory life. Palliative care should be continuously provided from the time of lesion development until the patient’s death.
Point-of-care laboratory testing in primary care: utilization, limitations and perspectives of general practitioners in Germany
Authors: Matthes Anni , Wolf Florian , Schmiemann Guido , Gágyor Ildikó , Bleidorn Jutta , Markwart Robby
Published: April 2023

Background

Due to their fast turnaround time and user-friendliness, point-of-care tests (POCTs) possess a great potential in primary care. The purpose of the study was to assess general practitioners’ (GPs) perspectives on POCT use in German primary care, including utilization, limitations and requirements.

Methods

We conducted a cross-sectional survey study among GPs in Germany (federal states of Thuringia, Bremen and Bavaria (Lower Franconia), study period: 04/22–06/2022).

Results

From 2,014 GPs reached, 292 participated in our study (response rate: 14.5%). The median number of POCTs used per GP was 7.0 (IQR: 5.0–8.0). Six POCTs are used by the majority of surveyed GPs (> 50%): urine dipstick tests (99%), glucose (urine [91%] and plasma [69%]), SARS-CoV-2 (80%), urine microalbumin (77%), troponin I/T (74%) and prothrombin time / international normalized ratio (65%). The number of utilized POCTs did not differ between GP practice type (p = 0.307) and population size of GP practice location (p = 0.099). The great majority of participating German GPs (93%) rated POCTs as useful diagnostic tools in the GP practice. GPs ranked immediate decisions on patient management and the increase in diagnostic certainty as the most important reasons for performing POCTs. The most frequently reported limitations of POCT use in the GP practice were economic aspects (high costs and inadequate reimbursement), concerns regarding diagnostic accuracy, and difficulties to integrate POCT-testing into practice routines (e.g. time and personnel expenses).

Conclusion

Although participating German GPs generally perceive POCTs as useful diagnostic tools and numerous POCTs are available, several test-related and contextual factors contribute to the relatively low utilization of POCTs in primary care.
Optimized design of surgical steps in pars plana vitrectomy for macular hole retinal detachment in pathological myopia decreases rate of iatrogenic retinal break and shortens length of operation
Authors: Zhu Ying , Xu Huizhuo , Wang Xianggui
Published: April 2023

Background

To investigate the effect of surgical steps optimization in pars plana vitrectomy (PPV) with internal limiting membrane (ILM) flap for macular hole retinal detachment (MHRD) in pathological myopia.

Methods

A retrospective, consecutive, nonrandomized comparative study. High myopic eyes diagnosed with MHRD receiving PPV with ILM flap from March 2019 to June 2020 in Department of Ophthalmology, Xiangya Hospital, Central South University were included in the study. Patients were included into two groups based on different design of surgical steps. In the routine group, extension of posterior vitreous detachment (PVD) towards periphery was performed right after induction of PVD. In the experiment group, the retina was reattached with drainage of subretinal fluid through macular hole before peripheral vitreous was dealt with. Complete ophthalmic examinations were performed before and after surgery. The follow-up time was at least 6 months. The rate of iatrogenic retinal break and length of operation were compared between the two groups.

Results

Thirty-one eyes from 31 patients were included in the study with 15 in the experiment group and 16 in the routine group. Demographics showed no statistically significant difference between the two groups. Post-op BCVA, rate of macular hole closure and rate of retinal reattachment were similar in the two groups. The rate of iatrogenic retinal break in the experiment group was significantly lower than that in the routine group (6.7% vs. 37.5%, P < 0.05). The average length of operation was 78.6 ± 18.8 min in the routine group and 64.0 ± 12.1 min in the experiment group (P < 0.05).

Conclusions

Optimized design of surgical steps in PPV for MHRD could effectively decrease the rate of iatrogenic retinal tear and shorten the length of operation.
Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study
Authors: Peñataro Yori Pablo , Paredes Olórtegui Maribel , Schiaffino Francesca , Colston Josh M. , Pinedo Vasquez Tackeshy , Garcia Bardales Paul F. , Shapiama Lopez Valentino , Zegarra Paredes Loyda Fiorella , Perez Karin , Curico Greisi , Flynn Thomas , Zhang Jixian , Ramal Asayag Cesar , Meza Sanchez Graciela , Silva Delgado Hermann , Casapia Morales Martin , Casanova Wilma , Jiu Bruce , Oberhelman Richard , Munayco Escate Cesar , Silver Rachel , Henao Olga , Cooper Kerry K. , Liu Jie , Houpt Eric R. , Kosek Margaret N.
Published: April 2023

Background

The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity. We then designed a study that would delineate background levels of transmission in the community in the absence of symptoms to provide corrected estimates of attribution for the principal determinants of AFI.

Methods

A case-control study of acute febrile illness in patients ten years or older seeking health care in Iquitos, Loreto, Peru, was planned. Upon enrollment, we will obtain blood, saliva, and mid-turbinate nasal swabs at enrollment with a follow-up visit on day 21–28 following enrollment to attain vital status and convalescent saliva and blood samples, as well as a questionnaire including clinical, socio-demographic, occupational, travel, and animal contact information for each participant. Whole blood samples are to be simultaneously tested for 32 pathogens using TaqMan array cards. Mid-turbinate samples will be tested for SARS-CoV-2, Influenza A and Influenza B. Conditional logistic regression models will be fitted treating case/control status as the outcome and with pathogen-specific sample positivity as predictors to attain estimates of attributable pathogen fractions for AFI.

Discussion

The modular PCR platforms will allow for reporting of all primary results of respiratory samples within 72 h and blood samples within one week, allowing for results to influence local medical practice and enable timely public health responses. The inclusion of controls will allow for a more accurate estimate of the importance of specific prevalent pathogens as a cause of acute illness.

Study Registration

Project 1791, Registro de Proyectos de Investigación en Salud Pública (PRISA), Instituto Nacional de Salud, Perú.
Efficacy of personalized exercise program on physical function in elderly patients with rheumatoid arthritis at high risk for sarcopenia: study protocol for a randomized controlled trial
Authors: Onishi Akira , Torii Mie , Hidaka Yu , Uozumi Ryuji , Oshima Yohei , Tanaka Hiroki , Onizawa Hideo , Fujii Takayuki , Murata Koichi , Murakami Kosaku , Tanaka Masao , Matsuda Shuichi , Morinobu Akio , Arai Hidenori , Hashimoto Motomu
Published: April 2023

Background

Patients with rheumatoid arthritis (RA) are prone to muscle atrophy due to inflammatory cytokines and corticosteroid use and immobility due to joint pain and deformity. Although resistance training is effective and safe in reversing muscle atrophy in RA, some patients are unable to perform a conventional high-load exercise program due to disease-related limitations. This study aims to examine the efficacy of individualized exercise therapy on physical function in elderly patients with RA who are at a high risk for sarcopenia.

Methods

This study is a single-center, parallel-group, two-arm, healthcare provider- and outcome assessor-blinded, superiority randomized controlled trial with a 1:1 allocation ratio. A total of 160 participants with RA between 60 and 85 years of age with a positive screening test for sarcopenia will be included. The intervention group will receive nutritional guidance and a four-month individualized exercise program in addition to the usual treatment. The control group will receive nutritional guidance in addition to the usual care. The primary endpoint will be physical function assessed using the Short Physical Performance Battery (SPPB) at 4 months. The data on outcome measures will be collected at baseline and at the two- and four-month follow-ups. Linear mixed-effects models for repeated measures will be conducted using the modified intention-to-treat analysis population.

Discussion

This study will provide evidence on whether a personalized exercise program can improve physical function and quality of life in elderly patients with RA. Some limitations include limited generalizability due to the single-center study and lack of blinding of the patients to the intervention assignment because of the nature of the exercise. Physical therapists may use this knowledge in their daily practice to improve RA treatment. Tailored exercise may enhance the health outcomes of the RA population and contribute to a reduction in healthcare costs.

Trial registration

The study protocol was retrospectively registered at the University hospital Medical Information Network-Clinical Trial Repository (UMIN-CTR) (registration number: UMIN000044930, https://www.umin.ac.jp/ctr/index-j.htm) on January 4, 2022.
Contributions of age, gender, body mass index, and normalized arch height to hallux valgus: a decision tree approach
Authors: Jung Do-Young , Jung Sung-hoon , Gwak Gyeong-tae
Published: April 2023

Background

Hallux valgus (HV) is a common toe deformity with various contributory factors. The interactions between intrinsic risk factors of HV, such as arch height, sex, age, and body mass index (BMI) should be considered. The present study aimed to establish a predictive model for HV using intrinsic factors, such as sex, age, BMI, and arch height based on decision tree (DT) model.

Methods

This is retrospective study. The study data were based on the fifth Size Korea survey, of the Korea Technology Standard Institute. Among 5,185 patients, 645 were excluded due to unsuitable age or missing data, and 4,540 (males = 2,236 and females = 2,304) were selected for inclusion in the study. Seven variables (i.e., sex, age, BMI, and four normalized arch height variables) were used to develop the prediction model for the presence of HV using a DT model.

Results

The DT model correctly classified 68.79% (95% confidence interval [CI] = 67.25–70.29%) of the training data set (3,633 cases). The predicted presence of HV based on the DT was verified against the testing data set (907 cases) and showed an accuracy of 69.57% (95% CI = 66.46–72.55%).

Conclusions

The DT model predicted the presence of HV on the basis of sex, age, and normalized arch height. According to our model, women aged over 50 years and those with lower normalized arch height were at high risk of HV.
Surgery-related disseminated intravascular coagulation predicts postoperative complications
Authors: Imaoka Yuki , Ohira Masahiro , Imaoka Kouki , Bekki Tomoaki , Nakano Ryosuke , Kuroda Shintaro , Tahara Hiroyuki , Ide Kentaro , Kobayashi Tsuyoshi , Tanaka Yuka , Ohdan Hideki
Published: April 2023

Purpose

The rate of postoperative morbidity, including infectious complications, is still high after major hepatobiliary pancreatic (HBP) surgery. Although surgery-related disseminated intravascular coagulation (DIC) occurs in some cases, its significance has not been elucidated in HBP surgery. This study aimed to evaluate the influence of surgery-related DIC on the complication severity after HBP surgery.

Methods

We analyzed the records of 100 patients with hepatectomy in two or more segments, hepatectomy with biliary tract reconstruction, and pancreaticoduodenectomy. The baseline characteristics and complications were compared between patients with and without surgery-related DIC on postoperative day 1 (POD1) after HBP surgery between 2010 and 2018. Complication severity was assessed using the Comprehensive Complication Index (CCI).

Results

The DIC group (surgery-related DIC on POD1) had predictive factors, such as larger bleeding volume and higher liver enzyme levels. The DIC group exhibited significantly elevated rates of surgical site infection, sepsis, prolonged intensive care unit stay, more frequent blood transfusions, and higher CCI. Furthermore, compared with and without adjustment of DIC, odds ratio (OR) of AST level and operation time for  the risk of high CCI decreased (OR of AST level: 1.25 to 1.19 and OR of operation time: 1.30 to 1.23) and the significant differences had vanished.

Conclusions

Surgery-related DIC on POD1 could be a partial mediator between AST level, operation time and higher CCI. The prevention or proper management of surgery-related DIC on POD1 can be an important target to reduce the severity of postoperative complications.
Predictive factors on postoperative venous thromboembolism after minimally invasive colorectal cancer surgery: a retrospective observational study
Authors: Wu Dabin , Gu Haitao , Tang Yunhao , Peng Linglong , Liu Hang , Jiang Yahui , Xu Zhiquan , Wei Qi , Wang Yaxu
Published: April 2023

Background

Venous thromboembolism (VTE) is a serious and preventable postoperative complication. However, the predictive significance of perioperative biochemical parameters for VTE after minimally invasive colorectal cancer surgery remains unclear.

Methods

A total of 149 patients undergoing minimally invasive colorectal cancer surgery were collected between October 2021 and October 2022. Biochemical parameters related to preoperative and postoperative day 1, day 3, and day 5 were collected, including D-Dimer, mean platelet volume (MPV), and maximum amplitude (MA) of thromboelastography (TEG). Receiver operating characteristic (ROC) curves were used to explore the predictive powers of meaningful biochemical parameters for postoperative VTE, and calibration curves were used to assess predictive accuracy.

Results

The overall cumulative incidence of VTE was 8.1% (12/149). The preoperative and postoperative day 3 D-Dimer, postoperative day 3, and day 5 MPV, and postoperative day 1, day 3, and day 5 TEG-MA was significantly higher in the VTE group than in the non-VTE group (P < 0.05). The results of both the ROC curve and the calibration curve indicated that these meaningful D-Dimer, MPV, and TEG-MA had moderate discrimination and consistency for postoperative VTE.

Conclusions

D-Dimer, MPV, and TEG-MA may predict postoperative VTE in patients undergoing minimally invasive surgery for colorectal cancer at specific times in the perioperative period.
Sexual and reproductive health and gender-based violence among female migrants in Morocco: a cross sectional survey
Authors: Acharai Laila , Khalis Mohamed , Bouaddi Oumnia , Krisht Ghida , Elomrani Sanae , Yahyane Abdelhakim , Assarag Bouchra
Published: April 2023

Background

Over the past decade, Morocco has increasingly become the chosen destination for a growing number of migrants from neighbouring countries and especially from Sub-Saharan Africa. The aim of this study is to describe the sexual and reproductive health (SRH), as well as sexual and gender-based violence (SGBV) among female migrants in Morocco.

Methods

This is a descriptive cross-sectional study conducted between July and December 2021. Female migrants were recruited from one university maternity hospital and two primary healthcare centres in Rabat. Data were collected using a structured face-to-face questionnaire, which included information about sociodemographic characteristics, SRH, history of SGBV and its impact, as well as the utilization of preventive and supportive SGBV services.

Results

A total of 151 participants were included in this study. The majority of participants (60.9%) were aged 18 to 34 years old and 83.3% were single. Many participants (62.1%) did not use contraceptives. More than half (56%) of the participants who were pregnant at the time of the study were receiving pre-natal care. About 29.9% of interviewed participants reported experiencing female genital mutilation, and a significant majority (87.4%) experienced SGBV at least once during their lifetimes, while 76.2% experienced SGBV during migration. The most commonly reported form of violence was verbal abuse (75.8%). Among the victims of SGBV, a minority have visited a health facility (7%) or filed a complaint (9%) in the aftermath of violence.

Conclusion

Overall, our findings showed low contraception coverage, moderate access to prenatal care, high prevalence of SGBV, and low utilization of preventive and supportive SGBV services among migrant women in Morocco. Further studies are needed to understand the contextual barriers to access, and utilization of SRH care and additional efforts should be undertaken to strengthen SGBV prevention and support systems.
Trends and factors associated with HIV testing among women aged 15–49 years in Belize: an analysis using the Multiple Indicator Cluster Survey 2006, 2011, and 2015–2016
Authors: Leonardo Naudia L. , Chien Li-Yin
Published: April 2023

Background

Belize has one of the highest human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome prevalence rates in Central America, with women of reproductive age being particularly vulnerable to HIV. Therefore, this study examined the factors associated with HIV testing among women of reproductive age in Belize and trends in HIV testing in 2006, 2011, and 2015–2016.

Methods

Cross-sectional data were analyzed using three Belize Multiple Indicator Cluster Surveys. The number of participants were 1,675, 4,096, and 4,699 women aged 15–49 years in 2006, 2011, and 2015–2016, respectively. We used variance-weighted least-squares regression to estimate annual changes. Multivariate logistic regression analysis was performed to evaluate the associated factors. Analyses were conducted using Stata version 15, and weights were applied for generalization to the population.

Results

HIV testing rates increased from 47.7% in 2006 to 66.5% in 2015, with an average annual change of 0.082 (95% confidence interval: 0.07–0.09). Logistic regression models showed that women aged 15–24 years were less likely to have been tested for HIV compared to women aged 25–34 years. Women from the Mayan ethnic group were less likely to have been tested than those from other ethnic groups. Compared to women who spoke Spanish, those who spoke English/Creole were more likely to have been tested for HIV; additionally, those who spoke minority languages were less likely to have been tested. Being married and having given birth were associated with increased odds of HIV testing. Living in rural areas and households with the poorest wealth indices were associated with decreased odds of being tested for HIV. Women with good HIV knowledge and accepting attitudes towards people living with HIV were more likely to be tested.

Conclusions

From 2006 to 2015, HIV testing in women of reproductive age showed an increasing trend in Belize. We recommend interventions to expand HIV testing for women of reproductive age in Belize, particularly those aged 15–24 years, speaking minority languages, living in rural areas, and having a low socioeconomic status.
“Value my culture, value me”: a case for culturally relevant mentoring in medical education and academic medicine
Authors: Sotto-Santiago Sylk , Mac Jacqueline , Genao Inginia
Published: April 2023

Introduction

Mentoring programs are one mechanism used to increase diversity and participation of historically underrepresented groups in academic medicine. However, more knowledge is needed about the mentoring experiences and how culturally relevant concepts and perspectives may influence diverse students, trainees, and faculty success. This case study utilized the Culturally Engaging Campus Environments (CECE) model which examines the experiences of students in higher education. We used this model to examine the mentoring experiences of Black and Latine faculty and offer practical implications for the medical education continuum.

Methods

Our research approach is best understood through qualitative inquiry stemming from a single-case study which allowed for in-depth understanding of the contexts informing the phenomenon. Phenomenology is well positioned to contribute to understanding science and health professions. Selection criteria included individuals who self-identified as Black or Latine; inclusive of all faculty ranks and tracks. This analysis focuses on 8 semi-structured interviews, averaging 3 h in length.

Results

Findings centered on the area of cultural relevance, and participant narratives revealed the connection of mentoring with cultural familiarity, culturally relevant knowledge, cultural service and engagement, and cultural validation.

Conclusion

The use of cultural relevance indicators can inform the creation and evolution of mentoring programs towards holistic support of historically underrepresented trainees and faculty. Implications also focus on the development of mentors and championing the incorporation of cultural humility in the mentoring process. The implications in praxis offers the possibility for a new framework for culturally relevant mentoring (CRM). Through this framework we aim to enhance and facilitate inclusive learning environments and career development.