bluuebunny/crossref_metadata_2025 huggingface dataset:
Using THz waves to diagnose debonding defects in a heat-resistant structure
Authors: Jang Hye-Lim , Kim Semo , Han Dae-Hyun , Kang Lae-Hyong
Published: March 2023

This study proposes a method for finding defects in heat-resistant structures without causing any damage to them, by utilizing THz waves. THz waves, also called Terahertz waves, are a portion of the electromagnetic spectrum with a frequency range of 0.1 to 10 THz, which lies between the microwave and infrared frequencies. These waves have unique properties that make them useful for nondestructive testing of various materials such as plastics, composites, and heat-resistant materials. The proposed method involves mounting a THz wave scanner on a multi-axis stage and using it to detect defects in conical- and cylindrical-shaped heat-resistant structures. Once the scan angle and height are set, the scan path is automatically calculated, and the THz wave scanner follows this path to perform the scan. As an initial step, the time taken for the THz wave to penetrate the heat-resistant structure and reach the adhesive layer was calculated. The time windowed data corresponding to the adhesive layer was then examined. Signal processing was applied to remove noise from the data to achieve more precise defect visualization. The THz signal to which the signal processing was applied was then reconstructed into a three-dimensional matrix, and the result corresponding to the adhesive layer was visualized in the same shape as the planar figure of the actual specimen. Those areas of the visualized image reflecting characteristics that deviated from those associated with a normal signal were identified as suffering from debonding defects. We performed a visual inspection of the adhesive layer of the actual heat-resistant structure and compared it to the images obtained by our method. There was a notable agreement between the two, thereby confirming that the technique presented in this paper is a viable means of inspecting heat-resistant structures for debonding defects.
A rapid 2D-FDTD method for damage detection in stiffened plate using time-reversed Lamb wave
Authors: Yu Sunquan , Fan Chengguang , Zhao Yong
Published: March 2023

This study proposes an improved two-dimensional finite-difference time-domain method (2D-FDTD) to simulate the propagation of guided waves in three-dimensional (3D) stiffened plates, which can greatly reduce the calculation amount and accelerate the simulation process. This method can be used for damage-detection imaging based on time-reversal with wavefield reconstruction (TR-RW) as a quick numerical simulation of wavefield is available. First, the piezoelectric wafer active sensors excite and collect Lamb wave signals in the damaged stiffening plate, after which these signals are reversed in the time domain. Second, the TR signals are again triggered by each sensor in turn on the reconstructed numerical model of the tested structure with 2D-FDTD. Third, the wavefield animation is obtained through simulation. Finally, the energy of the wavefield can be focused in certain areas, indicating the location of the damage. As an example, TR-RW, combined with 2D-FDTD method, is adopted to detect damage in an integral grid-stiffened plate, showing that the proposed 2D method can decrease the calculation time from dozens of minutes in the 3D model to dozens of seconds, which is of great significance for damage-detection applications. Furthermore, compared with the virtual TR method, the combined TR-RW and 2D-FDTD method can overcome the multipath effect and improve the damage location accuracy of stiffened structures.
Machine tool chattering monitoring by Chen-Lee chaotic system-based deep convolutional generative adversarial nets
Authors: Kuo Ping-Huan , Luan Po-Chien , Tseng Yung-Ruen , Yau Her-Terng
Published: March 2023

Chatter has a direct effect on the precision and life of machine tools and its detection is a crucial issue in all metal machining processes. Traditional methods focus on how to extract discriminative features to help identify chatter. In this study, an effective procedure for chatter data preprocessing is proposed that can improve neural network learning results from data of extremely low quantity. Different Computer numerical control (CNC) machines, cutting tools, operation conditions as well as workpiece material, and shapes all generate different dynamic behavior . Therefore, the same cutting conditions are processed in different CNCs, some will produce chatter, and some will not. In order to collect chatter signals of different cutting environments, the cost of materials and time is relatively high. Cutting chatter also leads to tool wear, which also increases the cost of data collection. This makes the use of CNCs for large-scale chatter testing experiments impractical. However, a way of producing accurate chatter test results from rather sparse data is needed. The solution to this practical problem involved an innovative data preprocessing and training strategy combined with a modified convolutional neural network and a deep convolutional generative adversarial net. Through the characteristics of a chaotic attractor, the variability of chatter data can be minimized. Moreover, the characteristics of a chaotic attractor are utilized where the chaotic system, very sensitive to the input, can distinguish data with chatter and without chatter to improve chatter detection and classification. Convolutional neural networks can be effective chatter classifiers, and adversarial networks can act as generators that produce more data. Original training data are collected and preprocessed by the Chen-Lee chaotic error mapping. Experimental results indicated that the generative adversarial network (GAN) model could generate better training data than the traditional data augmentation method. The convolutional neural networks were trained using augmented data produced by the generator network. The adversarial training process used these data to create the generator and the generator could produce enough data to compensate for the lack of training data. The experimental results are compared without a data generator and data augmentation. Using only 60 original data, the proposed method has an accuracy of 95.3% on leave-one-out cross-validation over 10 runs and surpassed other methods and models. The forged data are also compared with original training data as well as data produced by augmentation. The distribution shows that forged data have similar quality and characteristics to the original data. The proposed training strategy provides a high-quality deep learning chatter detection model.
Distinctions With a Difference: Illiberalism and Authoritarianism in Scholarly Study
Authors: Waller Julian G
Published: March 2023

Comparative social science concepts such as “illiberalism” and “authoritarianism” are increasingly common terms of art used in academic and policy debates, yet usage patterns and their substantive meaning vary widely across publications and authors. This article presents parsimonious “best-use” conceptualizations of both constructs, underlining the limitations of current, often widely disparate practices. In doing so, it outlines the reasons why this state of affairs is analytically unnecessary, leading to both conceptual stretching and terminological confusion. Illiberalism can most fruitfully be conceptualized positively and ideationally, capturing a distinct form of ideological reaction against hegemonic liberalism, experienced largely over the last several decades, with a variety of case-specific elements. This definition sits in partial contradistinction with other, sometimes-associated concepts such as anti-liberalism, populism, or conservatism and is not associated with regime-type definitionally. Authoritarianism, meanwhile, is most parsimoniously treated as a residual categorization of political regime vis-a-vis the concept of electoral democracy, which accords with the goals for which most scholars deploy it.
Evaluation of Eculizumab Use in Renal Transplant Recipients
Authors: Norville Kathryn , Stephen Jenise , Mead-Harvey Carolyn , Corey Rebecca , Votruba Cassandra
Published: March 2023

Introduction: Eculizumab is a monoclonal antibody that binds to complement protein C5, inhibiting complement-mediated thrombotic microangiopathy. It is approved for several indications including atypical hemolytic uremic syndrome. Additionally, eculizumab is used off-label for antibody-mediated rejection and C3 glomerulopathy in renal transplant recipients. Due to limited data available, the purpose of this study was to describe the use of eculizumab treatment in renal transplant recipients. Design: This retrospective single-center study evaluated the safety and efficacy of eculizumab for on- and off-label indications in renal transplant recipients. Adult renal transplant recipients receiving at least 1 dose of eculizumab posttransplant between October 2018 and September 2021 were included. The primary outcome evaluated was graft failure in patients treated with eculizumab. Results: Forty-seven patients were included in analysis. The median age at eculizumab initiation was 51 years [IQR 38-60], with 55% being female. Indications for eculizumab included atypical hemolytic uremic syndrome/thrombotic microangiopathy (63.8%), antibody-mediated rejection (27.7%), C3 glomerulopathy (4.3%), and other (4.3%). Graft failure occurred in 10 patients (21.3%) with a median of 2.4 weeks [IQR 0.5-23.3] from transplant to graft failure. At last follow-up (median 56.1 weeks), 44 (93.6%) patients were alive. After eculizumab initiation, renal function improved at 1 week, 1 month, and last follow-up. Conclusion: Eculizumab treatment demonstrated a benefit on graft and patient survival compared to reported incidence in thrombotic microangiopathy and antibody-mediated rejection. Due to the small sample size and retrospective design, further research is warranted to confirm these results.
The Applicability of Photovoice in Pseudo-total Institutions – Methodological Insights From an Exploratory Study on Physical Activity in Nursing Homes
Authors: Frahsa Annika , Trüb Dorothée , Thiel Ansgar
Published: March 2023

Photovoice helps participants express their perspectives through photography. As a setting for Photovoice, nursing homes represent challenging, yet promising, contexts partly characterized by elements of Goffman’s concept of “total institutions” and more fully characterized as Heinzelmann’s “pseudo-total institutions.” We analyzed Photovoice’s applicability in nursing homes within the context of physical activity promotion research. Our results indicate Photovoice (1) helps overcome fear and builds trust between researchers and participants, (2) requires certain ethical considerations, (3) addresses technical alienation, (4) determines what is relevant from participants’ point of view, and (5) points out the invisibility of significant others. Further, we provide insights for (6) making Photovoice research a priority in organizational routines, (7) contextualizing photographs, and (8) adjusting for COVID19-related methodological challenges. We also discuss our insights for potential adaptations to ensure participant privacy and safety when using Photovoice in pseudo-total institutions, such as nursing homes. Photovoice reveals activity-promoting and activity-impeding factors possibly unrecognized with other research methods, as well as differences in stakeholder perspectives about physical activity.
Under the Yoke of Ottoman Domination: Slavery and Central European Philhellenism During the Greek War of Independence
Authors: Mapes Christopher
Published: March 2023

Slavery remained a problem for Central Europeans after the defeat of Napoleon. Concerns over White, Christian enslavement animated German-speaking European responses to the Greek Independence movement. As most antislavery advocates turned their attention to the increasing volume of the slaves traded between Africa and the New World, as well as the persistence and entrenchment of New World slavery, Central Europeans turned their attention to the Christian, Greek subjects of the Ottoman Empire. The so-called ‘Barbary Problem’ ( Barbareskenfrage) became enmeshed with the Eastern Question as Greeks revolted in Ottoman lands. Central Europeans had long viewed the domination of Christians in Islamic North Africa as the central problem of slavery until increased German migration and involvement in the New World brought new tensions to the ideas surrounding slavery. Greek insurrectionists against the Ottoman Empire breathed new life into older ideas about Christians enslaved in Islamic portions of Europe and Africa. Greek Independence gave Germans a bête noir closer to Europe than that of slavery in the Americas. Much of this interest owes to an enduring German philhellenic tradition which has been seldom analysed. Indeed, as Sue Marchand has written ‘the obsession of the Schillerian German literary and scholarly elite with the ancient Greeks has become an accepted-if severely underanlaysed-cliché’. This paper uses archival documents to shed more light on how Central Europeans’ interest and participation in the Greek War of Independence helped to revive old ideas about Christian enslavement at a time when New World slavery became the central concern of a broader European humanitarian protest against servitude.
Peripheral nerve sheath tumour mimicking deep calf thrombus: An incidental finding during lower limb venous Doppler ultrasound
Authors: Ilounoh Christopher Ekene , Eteng Rajuno Ernest , Bukenya Samuel Lincoln
Published: March 2023

Introduction:

Peripheral nerve sheath tumours are neurogenic neoplasms that arise from the nerve sheath which are not within the central nervous system. While most of these lesions may be benign, some of them may undergo malignant transformation, establishing why it is imperative for ultrasound practitioners to familiarise themselves with ultrasound presentations of this lesion to facilitate early and effective diagnosis, which would in turn positively impact patient management.

Case report:

We present an incidental finding of a thrombus-mimicking peripheral nerve sheath tumour in a female patient who came to the ultrasound department for a left leg deep vein thrombosis scan.

Discussion:

This case study demonstrates a peripheral nerve sheath tumour which by virtue of its location (very closely adjacent the deep calf veins) and appearance (incompressible, heterogeneous, minimal colour flow), mimicked a deep calf vein thrombus on ultrasound. Careful surveillance of the area on ultrasound revealed the lesion was distinct from the calf vasculature, and further imaging was advised. A magnetic resonance imaging was conducted confirming the diagnosis of a peripheral nerve sheath tumour.

Conclusion:

In addition to assessing the lower limb venous system during deep venous thrombosis scans, sonographers should be mindful that other soft tissue lesions such as peripheral nerve sheath tumour may be present with symptoms that mimic those of a thrombotic leg, and therefore check to exclude or confirm the presence of any adjacent soft tissue lesions, especially at the symptomatic site indicated by the patient.
Effect of the golden points and non-golden points on performance parameters in professional padel
Authors: Escudero-Tena Adrián , Galatti Larissa , Sánchez-Alcaraz Bernardino J , Muñoz Diego , Ibáñez Sergio J
Published: March 2023

Since the 2020 season the World Padel Tour (WPT) has incorporated the golden point rule, which consists of playing a point to decide the game when the score is deuce (40–40). The objective of this study was to analyze the characteristics of the golden points and the rest of the points in men's and women's professional padel, as well as to identify the differences between both types of points. A sample of 2752 points (1431 men's and 1321 women's) was used from 394 games identified and finished with a golden point, corresponding to 69 matches played in the 2021 season of the WPT circuit. The variables recorded were the type of point (golden points and non-golden points), player serving, tactical service position, number of net exchanges, effectiveness of the partner serving and effectiveness of the last shot through systematic observation. The results indicate that during the golden points in men's padel, the Australian position is usually used more, while in women's padel the Australian position is more common when the player on the right serves and the traditional one when the player on the left serves. In addition, both in men and women, the most common serves are those directed towards the side wall. On the other hand, except for the errors in women's padel during the golden points, the winning shots are made in areas close to the net and the errors in areas at the back of the court.
Reliability analysis of bathtub-shaped distribution using empirical Bayesian and E-Bayesian estimations under progressive Type-II censoring
Authors: Shi Weihua , Gui Wenhao
Published: March 2023

This paper investigates the performance of empirical Bayesian and E-Bayesian estimation of the bathtub-shaped distribution based on the progressive Type-II censored samples. These two estimations overcome the selection of hyperparameters in the Bayesian method. The empirical Bayesian analysis employs the classical approach to determine the hyperparameters. The E-Bayesian estimation uses the prior distribution of hyperparameters to derive the expectation of Bayesian estimates. The estimates of parameters are derived under the squared error loss and LINEX loss functions. The extensive simulations show the results of the empirical Bayesian estimates and the E-Bayesain estimates. Further, the empirical Bayesian estimation is also presented to analyze the parameters of bathtub-shaped distribution based on the general progressive Type-II censored samples. The two datasets from the electromechanical field and medical survival analysis are analyzed using the empirical Bayesian and E-Bayesian methods.
Revisiting the use of hedges and boosters in scientific research articles in Morocco: Caution that does not exclude conviction
Authors: Mifdal Mohamed , Lewis Marilyn
Published: March 2023

The ways in which researchers present the results of their research and make claims about them are determined by the conventions of academic writing held by the scientific community. This article examines the use of hedges and boosters in the published articles of PhD students in a Moroccan university, and to what extent these students are conscious of their semantic and pragmatic meanings and use them adequately following established conventions. Textual analysis was implemented to study the use of these discourse markers in the published articles. We additionally carried out qualitative and quantitative research in the form of questionnaires and semi-structured interviews to gain a better understanding of hedge and booster use. While the students may use hedges in contexts in which the results are deemed uncertain and unsatisfactory, expressing conviction through boosters is a common practice. These results indicate a lack of appropriate adherence to academic conventions and that cultural influences and other contextual variables are in play. Thus, revising textbooks and methodologies in Moroccan universities based on scientific data and conventions is required.
Beyond Blood Glucose and Blood Pressure Control in Type 2 Diabetes: Alternative Management Strategies to Prevent the Development and Progression of CKD
Authors: Wright Wendy L. , Urquhart Scott , Brunton Stephen
Published: March 2023

Chronic kidney disease associated with Type 2 diabetes is linked to significant increase in morbidity, reduced quality of life, and early death. Current guidelines recommend targets for the management of hyperglycemia, hypertension, and dyslipidemia but there remains a residual risk of chronic kidney disease progression and adverse cardiovascular outcomes in patients with Type 2 diabetes. The 2022 consensus report from the American Diabetes Association and Kidney Disease: Improving Global Outcomes support the use of sodium–glucose co-transporter 2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists to improve kidney and cardiovascular outcomes. Coordination between those working in the primary care setting and those in endocrinology and nephrology clinics may optimize the prevention of chronic kidney disease progression in patients with Type 2 diabetes. Nurse practitioners, physician assistants, and primary care physicians play an important role in making timely patient referrals to kidney specialists. This article explores the use of novel therapies capable of reducing the risk of cardiovascular disease and chronic kidney disease progression beyond what can be achieved with control of blood glucose, blood pressure, and lipid levels. It also discusses the importance of monitoring at-risk patients to facilitate early diagnosis and initiation of effective kidney-protective therapy.

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Impact of TP53 on outcome of patients with myelofibrosis undergoing hematopoietic stem cell transplantation
Authors: Gagelmann Nico , Badbaran Anita , Salit Rachel B , Schroeder Thomas , Gurnari Carmelo , Pagliuca Simona , Panagiota Victoria , Rautenberg Christina , Cassinat Bruno , Thol Felicitas R. , Wolschke Christine , Robin Marie , Heuser Michael , Rubio Marie-Thérèse , Maciejewski Jaroslaw P. , Reinhardt Hans Christian , Scott Bart L , Kröger Nicolaus
Published: March 2023

TP53 mutations (TP53MT) have been associated with poor outcomes in various hematologic malignancies, but no data exist on its role in patients with myelofibrosis undergoing hematopoietic stem cell transplantation (HSCT). Here, we took advantage of a large international multicenter cohort to evaluate the role of TP53MTin this setting. Among 349 included patients, 49 (13%) had detectable TP53MT, of whom 30 showed a multi-hit configuration. Median variant allele frequency was 20.3%. Cytogenetic risk was favorable (71%), unfavorable (23%), and very high (6%), with complex karyotype present in 36 patients (10%). Median survival of TP53MT patients was 1.5 years vs 13.5 years for the TP53WT group (P<0.001). Outcome was driven by multi-hit TP53MT constellation (P<0.001), showing 6-year survival of 56% for single-hit vs 25% for multi-hit TP53MT carriers vs 64% for TP53WT. Outcome was independent of current transplant-specific risk factors and conditioning intensity. Similarly, cumulative incidence of relapse was 17% for single-hit vs 52% for multi-hit vs 21% for TP53WT. Ten patients with TP53MT (20%) presented as leukemic transformation vs only 7 (2%) in the TP53WT group (P<0.001). Out of the 10 patients with TP53MT, 8 showed multi-hit constellation. Median time to leukemic transformation was shorter for multi-and single-hit TP53MT (0.7 and 0.5 years, respectively) vs 2.5 years for TP53WT. In summary, multi-hit TP53MT represents a very high-risk group in myelofibrosis patients undergoing HSCT, whereas single-hit TP53MTalone showed similar outcome to non-mutated patients, informing prognostication for survival and relapse together with current transplant-specific tools.
Influence of a guideline or an additional rapid strep test on antibiotic prescriptions for sore throat: the cluster randomized controlled trial of HALS (Hals und Antibiotika Leitlinien Strategien)
Authors: Wächtler Hannelore , Kaduszkiewicz Hanna , Kuhnert Oskar , Malottki Karolina Agata , Maaß Sonja , Hedderich Jürgen , Wiese Birgitt , Donner-Banzhoff Norbert , Hansmann-Wiest Julia
Published: March 2023

Background

Pharyngitis due to Group A beta-hemolytic streptococci (GAS) is seen as the main indication for antibiotics for sore throat. In primary care settings prescription rates are much higher than the prevalence of GAS. Recommendations in international guidelines differ considerably. A German guideline suggested to consider antibiotics for patients with Centor or McIsaac scores ≥ 3, first choice being penicillin V for 7 days, and recommended analgesics for all. We investigated, if the implementation of this guideline lowers the antibiotic prescription rate, and if a rapid antigen detection strep-test (RADT) in patients with scores ≥ 3 lowers the rate further.

Methods

HALS was an open pragmatic parallel group three-arm cluster-randomized controlled trial. Primary care practices in Northern Germany were randomized into three groups: Guideline (GL-group), modified guideline with a RADT for scores ≥ 3 (GL-RADT-group) or usual care (UC-group). All practices were visited and instructed by the study team (outreach visits) and supplied with material according to their group. The practices were asked to recruit 11 consecutive patients ≥ 2 years with an acute sore throat and being at least moderately impaired. A study throat swab for GAS was taken in every patient. The antibiotic prescription rate at the first consultation was the primary outcome.

Results

From October 2010 to March 2012, 68 general practitioners in 61 practices recruited 520 patients, 516 could be analyzed for the primary endpoint. Antibiotic prescription rates did not differ between groups (p = 0.162) and were about three times higher than the GAS rate: GL-group 97/187 patients (52%; GAS = 16%), GL-RADT-group 74/172 (43%; GAS = 16%) and UC-group 68/157 (43%; GAS = 14%). In the GL-RADT-group 55% of patients had scores ≥ 3 compared to 35% in GL-group (p < 0.001). After adjustment, in the GL-RADT-group the OR was 0.23 for getting an antibiotic compared to the GL-group (p = 0.010), even though 35 of 90 patients with a negative Strep-test got an antibiotic in the GL-RADT-group. The prescription rates per practice covered the full range from 0 to 100% in all groups.

Conclusion

The scores proposed in the implemented guideline seem inappropriate to lower antibiotic prescriptions for sore throat, but better adherence of practitioners to negative RADTs should lead to fewer prescriptions.

Trial registration

DRKS00013018, retrospectively registered 28.11.2017.
Nonagenarians admission and prognosis in a tertiary center intensive coronary care unit – a prospective study
Authors: Bruoha Sharon , Maller Tomer , Loutati Ranel , Perel Nimrod , Tabi Meir , Taha Louay , Yosefy Chaim , Jafari Jamal , Braver Omri , Amsalem Itshak , Hitter Rafael , Manassra Mohamed , Levy Nir , Abu-Alkean Ismael , Hamyil Kamal , Steinmetz Yoed , Karameh Hani , Karmi Mohamed , Marmor David , Wolak Arik , Glikson Michael , Asher Elad
Published: March 2023

Background

With increasing life expectancy, the prevalence of nonagenarians with cardiovascular disease is steadily growing. However, this population is underrepresented in randomized trials and thus poorly defined, with little quality evidence to support and guide optimal management. The aim of the present study was to evaluate the clinical management, therapeutic approach, and outcomes of nonagenarians admitted to a tertiary care center intensive coronary care unit (ICCU).

Methods

We prospectively collected all patients admitted to a tertiary care center ICCU between July 2019 – July 2022 and compared nonagenarians to all other patients. The primary outcome was in-hospital mortality.

Results

A total of 3807 patients were included in the study. Of them 178 (4.7%) were nonagenarians and 93 (52%) females. Each year the prevalence of nonagenarians has increased from 4.0% to 2019, to 4.2% in 2020, 4.6% in 2021 and 5.3% in 2022. Admission causes differed between groups, including a lower rate of acute coronary syndromes (27% vs. 48.6%, p < 0.001) and a higher rate of septic shock (4.5% vs. 1.2%, p < 0.001) in nonagenarians. Nonagenarians had more comorbidities, such as hypertension, renal failure, and atrial fibrillation (82% vs. 59.6%, 23% vs. 12.9%, 30.3% vs. 14.4% p < 0.001, respectively). Coronary intervention was the main treatment approach, although an invasive strategy was less frequent in nonagenarians in comparison to younger subjects. In-hospital mortality rate was 2-fold higher in the nonagenarians (5.6% vs. 2.5%, p = 0.025).

Conclusion

With increasing life expectancy, the prevalence of nonagenarians in ICCU’s is expected to increase. Although nonagenarian patients had more comorbidities and higher in-hospital mortality, they generally have good outcomes after admission to the ICCU. Hence, further studies to create evidence-based practices and to support and guide optimal management in these patients are warranted.
How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect: a mixed methods process evaluation embedded in a randomised controlled trial
Authors: Bunn Christopher , Palmer Victoria , Chng Nai Rui , Andersen Eivind , Gray Cindy M. , Hunt Kate , Jelsma Judith G. M. , Morgan Heather , der Sanden Maria Nijhuis-van , Pereira Hugo V. , Philpott Matthew , Roberts Glyn C. , Rooksby John , Røynesdal Øystein B. , Silva Marlene N. , Sørensen Marit , Teixeira Pedro J. , van Achterberg Theo , van de Glind Irene , van Mechelen Willem , van Nassau Femke , van der Ploeg Hidde P. , Wyke Sally
Published: March 2023

Background

A randomised trial of European Fans in Training (EuroFIT), a 12-week healthy lifestyle program delivered in 15 professional football clubs in the Netherlands, Norway, Portugal, and the United Kingdom, successfully increased physical activity and improved diet but did not reduce sedentary time. To guide future implementation, this paper investigates how those effects were achieved. We ask: 1) how was EuroFIT implemented? 2) what were the processes through which outcomes were achieved?

Methods

We analysed qualitative data implementation notes, observations of 29 of 180 weekly EuroFIT deliveries, semi-structured interviews with 16 coaches and 15 club representatives, and 30 focus group discussions with participants (15 post-program and 15 after 12 months). We descriptively analysed quantitative data on recruitment, attendance at sessions and logs of use of the technologies and survey data on the views of participants at baseline, post program and after 12 months. We used a triangulation protocol to investigate agreement between data from difference sources, organised around meeting 15 objectives within the two research questions.

Results

We successfully recruited clubs, coaches and men to EuroFIT though the draw of the football club seemed stronger in the UK and Portugal. Advertising that emphasized getting fitter, club-based deliveries, and not ‘standing out’ worked and attendance and fidelity were good, so that coaches in all countries were able to deliver EuroFIT flexibly as intended. Coaches in all 15 clubs facilitated the use of behaviour change techniques and interaction between men, which together enhanced motivation. Participants found it harder to change sedentary time than physical activity and diet. Fitting changes into daily routines, planning for setbacks and recognising the personal benefit of behaviour change were important to maintain changes. Bespoke technologies were valued, but technological hitches frustrated participants.

Conclusion

EuroFIT was delivered as planned by trained club coaches working flexibly in all countries. It worked as expected to attract men and support initiation and maintenance of changes in physical activity and diet but the use of bespoke, unstable, technologies was frustrating. Future deliveries should eliminate the focus on sedentary time and should use only proven technologies to support self-monitoring and social interaction.

Trial registration

ISRCTN81935608, registered 16/06/2015.
Early-induced diabetic obese rat MACAPOS 2
Authors: Ngakou Mukam Joseph , Mvongo Clémence , Nkoubat Sandrine , Fankem Gaëtan Olivier , Mfopa Adamou , Noubissi Paul Aimé , Fokam Tagne Michel Archange , Kamgang René , Essame Oyono Jean-Louis
Published: March 2023

Background

Diabetes mellitus is a metabolic disease characterized by an abnormally high blood glucose level. Glucose intolerance and insulin resistance are two characteristics that promote the onset and development of type 2 diabetes. The aim of this study was to create a diabetic rat model from obese rat MACAPOS 2.

Methods

A group of rats was subjected to a high-fat diet (HFD) compared to a control group (NC) which received a normal diet. After 16 weeks of HFD, Lee index was calculated, obese rats were subjected to an oral glucose tolerance test (OGTT) and insulin tolerance test (ITT). One group of HFD rats (HFDZ) received streptozotocin 22.5 mg/kg (iv). One week later, weight gain, water and food intakes, urine volume and fasting blood glucose levels were evaluated. Animals were also subjected to glucose tolerance and insulin tolerance tests.

Results

After 16 weeks of HFD, rats became obese, glucose intolerant and resistant to insulin. The body weight of rats was significantly high (+ 26.23%) compared to normal rats, glycemia remained significantly high (+ 45.46%, P < 0.01) two hours after administration of glucose in high-fat diet rats, water intake and urine volume were comparable to those of NC. In HFD, the streptozotocin injected after one week (HFDZ), amplified glucose intolerance. During ITT, glycemia remained significantly (P < 0.01) high from 15 min; and did not vary during the 60 min of ITT. The fasting glycemia one week after streptozotocin injection was significantly high (288 mg/dL) compared to HFD (114 mg/dL), associated whit a significant (P < 0.01) increase in water intake and 24 h urine volume.

Conclusion

These results showed that MACAPOS 2 associated with a low dose of streptozotocin (22.5 mg/dL) early leads to the diabetes in obese albinos Wistar rats and could be a real model to study the type 2 diabetes mellitus.
Learning experiences of first year graduate entry nursing students in New Zealand and Australia: a qualitative case study
Authors: Winnington Rhona , Shannon Kay , Turner Rosemary , Jarden Rebecca , McClunie-Trust Patricia , Jones Virginia , Merrick Eamon , Donaldson Andrea , Macdiarmid Rachel
Published: March 2023

Background

Graduate entry nursing programmes provide students with an accelerated pathway to becoming a registered nurse. Motivations for study, together with commonly shared characteristics of students enrolling in such programmes is becoming well documented, however, their experiences of studying for a professional qualification in this manner is less understood. As a means of maintaining the relevance of these fast-tracked programmes in the future, an understanding of graduate entry nursing students’ experiences of academic teaching and clinical placements is imperative.

Objective

To explore the academic and clinical experiences of students enrolled in the first year of graduate entry nursing programmes in New Zealand and Australia.

Methods

A qualitative case study approach was taken. Here we report the experiences of nine students enrolled in their first year of a two-year graduate entry nursing programme during 2020. Semi-structured interviews were used for data collection and analysed using Braun and Clarke’s thematic analysis.

Findings

Three overarching themes were developed—affirmation, reflections on expectations and clinical experiences.

Conclusion

This study highlights the experiences of first year graduate entry nursing students, with many experiencing affirmation that their altruistic career visions came to fruition. The findings indicate that these graduate-entry nursing students interviewed for this study tended to be flexible and adaptable in their approach to study as a means of meeting the challenges of the programme, all of which are key characteristics for a registered nurse; with personal growth and the development of the self, providing preparation for their second year of study.
Clinical characteristics, management, and outcomes of pulmonary valve myxoma: systematic review of published case reports
Authors: Saputra Pandit Bagus Tri , Jannah Ayik Rochyatul , Rofananda Ihsan Fahmi , Al-Farabi Makhyan Jibril , Wungu Citrawati Dyah Kencono , Susilo Hendri , Alsagaff Mochamad Yusuf , Gusnanto Arief , Oktaviono Yudi Her
Published: March 2023

Background

Cardiac myxoma is the most common type of primary cardiac tumor, with the majority located in the atrial wall. The tumor is attached to valvular structures in a few cases, of which the pulmonary valve is the least affected. Pulmonary valve myxoma may have different clinical manifestations from the more common cardiac myxomas because of its vital position. A misdiagnosis of these types of cardiac myxoma may be detrimental to the care and well-being of patients. Therefore, this systematic review aims to define the clinical characteristics of pulmonary valve myxoma and how this differs from a more common cardiac myxoma.

Methods

Employed literature was obtained from PubMed, ScienceDirect, Scopus, Springer, and ProQuest without a publication year limit on August 23, 2022. The keyword was “pulmonary valve myxoma.” Inclusion criteria were as follows: (1) case report or series, (2) available individual patient data, and (3) myxoma that is attached to pulmonary valve structures with no evidence of metastasis. Non-English language or nonhuman subject studies were excluded. Johanna Briggs Institute checklists were used for the risk of bias assessment. Data are presented descriptively.

Results

This review included 9 case reports from 2237 articles. All cases show a low risk of bias. Pulmonary valve myxoma is dominated by males (5:4), and the patient’s median age is 57 years with a bimodal distribution in pediatric and geriatric populations. The clinical manifestation of pulmonary valve myxoma is often unspecified or asymptomatic. However, systolic murmur in the pulmonary valve area is heard in 67% of cases. Echocardiography remains the diagnostic modality of choice in the majority of cases. Tumor attached to the pulmonary cusps or annulus and extended to adjacent tissues in all cases. Therefore, valve replacement or adjacent tissue reconstructions are required in 77% of cases. The recurrence and mortality are considerably high, with 33% and 22% cases, respectively.

Conclusions

Pulmonary valve myxoma is more common in males with a bimodal age distribution, and its outcomes seem worse than usual cardiac myxomas. Increasing awareness of its clinical symptoms, early diagnosis, and complete myxoma resection before the presence of congestive heart failure symptoms are important in achieving excellent outcomes. A firm embolization blockade is needed to prevent myxoma recurrence.
Evaluation of the clinical efficacy of vaginal treatment options for persistent high-risk human papillomavirus infection after excisional treatment of cervical high-grade squamous intraepithelial lesions: a systematic review and Bayesian network meta-analysis
Authors: Tang Yiqian , Tong Qing , Dai Ning , Xu Cai
Published: March 2023

Background

To evaluate the clinical efficacy of different vaginal administration on cervical persistent high-risk human papillomavirus (HR-HPV) infection after excisional treatment for high-grade squamous intraepithelial lesions (HSIL).

Methods

Six databases (PubMed, EmBase, Cochrane Central, China Knowledge Network database, China Biomedical Literature Service, and WanFang database) were searched to collect randomized controlled trials (RCTs) of various types of vaginal administration compared to no treatment on persistent HR-HPV infection after HSIL excisional treatment, and comprehensive analysis of the clearance of different drugs on HR-HPV was performed using Bayesian reticulation meta-analysis.

Results

The study analyzed the efficacy of eight interventions, including Interferon, Baofukang, Paiteling, Bletilla striata Sanhuang Powder, Lactobacilli vaginal capsules, Fuanning + Interferon, Interferon + Lactobacilli vaginal capsules, and Interferon + Baofukang, on the clearance of HR-HPV after excisional treatment through pooling and analyzing data from 52 RCTs. The results of the study demonstrated that Interferon + Lactobacilli vaginal capsules [OR 16.0 (95% CIs 8.1–32.0)], Interferon + Fuanning [OR 16.0 (95% CIs 1.1–52.0)], and Interferon + Baofukang [OR 14.0 (95% CIs 6.8–28.0)] were all found to significantly improve postoperative HR-HPV clearance rates when compared to no treatment. Furthermore, when studies with high-risk bias were excluded, Interferon + Lactobacilli vaginal capsules [OR 8.6 (95% CIs 4.7–19.0)] and Interferon + Baofukang [OR 22.0 (95% CIs 8.7–59.0)] were still found to be positively associated with increased postoperative HR-HPV clearance rate. Additionally, the study´s results also indicate that Interferon + Baofukang was effective in enhancing the postoperative HR-HPV clearance rates, mainly when the studies were restricted to a follow-up period of at least 12 months [OR 9.6 (95% CIs 2.9–34.0)]. However, it is important to note that the majority of the trials (29 out of 52, 51.6%) were rated as moderate to high risk of bias, and the certainty of the evidence was moderate to very low.

Conclusion

The application of various forms of vaginal administration, except for individual use of Lactobacilli vaginal capsules, is more efficacious than no treatment in patients with cervical persistent HR-HPV infection after excisional treatment. However, all of the estimates of the effect size for change in the efficiency of HR-HPV clearance are uncertain. Our confidence in effect estimates and ranking of treatments is low, which needs larger, more rigorous, and longer follow-up RCTs to resolve.
Residual β-cell function in Brazilian Type 1 diabetes after 3 years of diagnosis: prevalence and association with low presence of nephropathy
Authors: Gabbay Monica A. L. , Crispim Felipe , Dib Sergio A.
Published: March 2023

Background

Persistence of β cell-function in Type 1 diabetes (T1D) is associated with glycaemia stability and lower prevalence of microvascular complications. We aimed to assess the prevalence of residual C- peptide secretion in long-term Brazilian childhood onset T1D receiving usual diabetes care and its association to clinical, metabolic variables and microvascular complications.

Methods

A cross-sectional observational study with 138 T1D adults with ≥ 3 years from the diagnosis by routine diabetes care. Clinical, metabolic variables and microvascular complications were compared between positive ultra-sensitive fasting serum C-peptide (FCP +) and negative (FCP-) participants.

Results

T1D studied had ≥ 3 yrs. of diagnosis and 60% had FCP > 1.15 pmol/L. FCP + T1D were older at diagnosis (10 vs 8 y.o; p = 0.03) and had less duration of diabetes (11 vs 15 y.o; p = 0.002). There was no association between the FCP + and other clinical and metabolic variable but there was inversely association with microalbuminuria (28.6% vs 13.4%, p = 0.03), regardless of HbA1c. FCP > 47 pmol/L were associated with nephropathy protection but were not related to others microvascular complications.

Conclusion

Residual insulin secretion is present in 60% of T1D with ≥ 3 years of diagnosis in routine diabetes care. FCP + was positively associated with age of diagnosis and negatively with duration of disease and microalbuminuria, regardless of HbA1c.
HbA1c is a predictive factor of severe coronary stenosis and major adverse cardiovascular events in patients with both type 2 diabetes and coronary heart disease
Authors: Jiao Xiaojuan , Zhang Qin , Peng Ping , Shen Yunfeng
Published: March 2023

Background

Coronary heart disease (CHD) is not only a macrovascular complication of type 2 diabetes mellitus (T2DM). Cardiovascular disease (CVD) is one of the leading causes of mortality among individuals with T2DM. Reducing the risk of adverse cardiovascular events (MACE) is crucial for the management of patients with CHD. This study aimed to investigate the effect of glycemic control on CHD severity and 3-point MACE (3p-MACE) risk in patients with T2DM and CHD.

Methods

681 patients with both T2DM and CHD throughout October 2017 and October 2021 who were hospitalized in the second affiliated hospital of Nanchang university were included. A total of 300 patients were eventually enrolled in this retrospective cohort research. The severity of CHD in these patients was assessed, and the primary outcome during follow-up was recorded, with the primary result being the 3-point major adverse cardiovascular event (3p-MACE). The correlation between baseline glycated hemoglobin A1c (b-HbA1c) and the severity of CHD was evaluated by logistic regression analysis. The effect of b-HbA1c and follow-up HbA1c (f-HbA1c) levels on the risk of 3p-MACE were investigated by cox regression analysis.

Results

b-HbA1c was positively correlated with the severity of CHD (r = 0.207, p = 0.001), and patients with b-HbA1c > 9% were more likely to have severe CHD. The HRs for b-HbA1c and f-HbA1c on the risk of 3p-MACE were 1.24 (95% CI 0.94–1.64, p = 0.123) and 1.32 (95% CI 1.02–1.72, p = 0.036), respectively. Patients with f-HbA1c   ≥8.6% had a higher risk of 3p-MACE than f-HbA1c < 8.6% (HR = 1.79, 95% CI 1.16–2.79, p = 0.009).

Conclusion

In patients with both T2DM and CHD, b-HbA1c was an independent predictive factor of severe CHD. f-HbA1c was an independent predictive factor of 3p-MACE. Having the f-HbA1c below 8.6% significantly reduced the risk of 3p-MACE.
Prognostic significance of non-infarcted myocardium correlated with microvascular impairment evaluated dynamically by native T1 mapping
Authors: Chen Bing-Hua , An Dong-Aolei , Wu Chong-Wen , Yue Ting , Bautista Matthew , Ouchi Erika , Xu Jian-Rong , Hu Jiani , Zhou Yan , Pu Jun , Wu Lian-Ming
Published: March 2023

Objectives

This study aimed to investigate the influence of microvascular impairment on myocardial characteristic alterations in remote myocardium at multiple time points, and its prognostic significance after acute ST-segment elevation myocardial infarction (STEMI).

Methods

Patients were enrolled prospectively and performed CMR at baseline, 30 days, and 6 months. The primary endpoint was major adverse cardiac events (MACE): death, myocardial reinfarction, malignant arrhythmia, and hospitalization for heart failure. Cox proportional hazards regression modeling was analyzed to estimate the correlation between T1 mapping of remote myocardium and MACE in patients with and without microvascular obstruction (MVO).

Results

A total of 135 patients (mean age 60.72 years; 12.70% female, median follow-up 510 days) were included, of whom 86 (63.70%) had MVO and 26 (19.26%) with MACE occurred in patients. Native T1 values of remote myocardium changed dynamically. At 1 week and 30 days, T1 values of remote myocardium in the group with MVO were higher than those without MVO (p = 0.030 and p = 0.001, respectively). In multivariable cox regression analysis of 135 patients, native1w T1 (HR 1.03, 95%CI 1.01–1.04, p = 0.002), native30D T1 (HR 1.05, 95%CI 1.03–1.07, p < 0.001) and LGE (HR 1.10, 95%CI 1.05–1.15, p < 0.001) were joint independent predictors of MACE. In multivariable cox regression analysis of 86 patients with MVO, native30D T1 (HR 1.05, 95%CI 1.04–1.07, p < 0.001) and LGE (HR 1.10, 95%CI 1.05–1.15, p < 0.001) were joint independent predictors of MACE.

Conclusions

The evolution of native T1 in remote myocardium was associated with the extent of microvascular impairment after reperfusion injury. In patients with MVO, native30D T1 and LGE were joint independent predictors of MACE.
Project-based entrepreneurial learning (PBEL): a blended model for startup creations at higher education institutions
Authors: Santoso R. Tri Priyono Budi , Priyanto Sony Heru , Junaedi I. Wayan Ruspendi , Santoso Donald Samuel Slamet , Sunaryanto Lasmono Tri
Published: March 2023

This research aims to describe the dynamics of applying project-based entrepreneurial learning (PBEL) in creating startups at higher education institutions. Action research was used for eight participants as the research method by applying the PBEL model in the form of a narrative method. The results revealed that all university students can produce products, starting from prototypes until business products. The PBEL model drives successful startups. For the more effective startups, the PBEL model needs to add network marketing and funding to be applied. Future research is expected to address questions from the results of this study.