bluuebunny/crossref_metadata_2025 huggingface dataset:
An Analysis of Dasatinib Treatment Patterns in Patients with Chronic Myeloid Leukemia after Experiencing Pleural Effusion during Dasatinib Therapy
Authors: McBride Ali , Brokars John , Reddy Sheila Reiss , Chang Eunice , Tarbox Marian H. , LeBlanc Thomas W.
Published: April 2023

Introduction: Treatment with dasatinib for chronic myeloid leukemia (CML) has been associated with development of pleural effusion; however, data regarding its optimal management are limited. We examined treatment patterns and healthcare resource utilization (HCRU) and costs among patients with CML treated with dasatinib who experienced a subsequent pleural effusion. Methods: Adults with CML and ≥1 pharmacy claim for dasatinib in 2015–2018 who experienced pleural effusion after dasatinib were identified using data from claims databases. Results: Overall, 123 patients were eligible. After 1 year, of the 38.2% of patients with a dose modification, 72.3% did not switch treatment; among these patients, 70.6% continued treatment. Among patients with a stable dose after pleural effusion (61.8%), 57.9% later switched to another TKI. The mean (SD) duration of dasatinib treatment after pleural effusion was 262.0 (124.0) days for patients with a dose modification versus 149.1 (155.2) days for those with a stable dose (p < 0.001). HCRU and costs were similar between groups. Conclusion: Dasatinib dose modification after pleural effusion was not always required; however, patients with dose modifications continued therapy for a longer duration with a lower rate of switching to another TKI versus patients who remained on a stable dose.
Achieving Equity in Hospital Performance Assessments Using Composite Race-Specific Measures of Risk-Standardized Readmission and Mortality Rates for Heart Failure
Authors: Mentias Amgad , Peterson Eric D. , Keshvani Neil , Kumbhani Dharam J. , Yancy Clyde W. , Morris Alanna A. , Allen Larry A. , Girotra Saket , Fonarow Gregg C. , Starling Randall C. , Alvarez Paulino , Desai Milind Y. , Cram Peter , Pandey Ambarish
Published: April 2023

Background:

The contemporary measures of hospital performance for heart failure hospitalization and 30-day risk-standardized readmission rate (RSRR) and risk-standardized mortality rate (RSMR) are estimated using the same risk adjustment model and overall event rate for all patients. Thus, these measures are mainly driven by the care quality and outcomes for the majority racial and ethnic group, and may not adequately represent the hospital performance for patients of Black and other races.

Methods:

Fee-for-service Medicare beneficiaries from January 2014 to December 2019 hospitalized with heart failure were identified. Hospital-level 30-day RSRR and RSMR were estimated using the traditional race-agnostic models and the race-specific approach. The composite race-specific performance metric was calculated as the average of the RSRR/RMSR measures derived separately for each race and ethnicity group. Correlation and concordance in hospital performance for all patients and patients of Black and other races were assessed using the composite race-specific and race-agnostic metrics.

Results:

The study included 1 903 232 patients (75.7% White [n=1 439 958]; 14.5% Black [n=276 684]; and 9.8% other races [n=186 590]) with heart failure from 1860 hospitals. There was a modest correlation between hospital-level 30-day performance metrics for patients of White versus Black race (Pearson correlation coefficient: RSRR=0.42; RSMR=0.26). Compared with the race-agnostic RSRR and RSMR, composite race-specific metrics for all patients demonstrated stronger correlation with RSRR (correlation coefficient: 0.60 versus 0.74) and RSMR (correlation coefficient: 0.44 versus 0.51) for Black patients. Concordance in hospital performance for all patients and patients of Black race was also higher with race-specific (versus race-agnostic) metrics (RSRR=64% versus 53% concordantly high-performing; 61% versus 51% concordantly low-performing). Race-specific RSRR and RSMR metrics (versus race-agnostic) led to reclassification in performance ranking of 35.8% and 39.2% of hospitals, respectively, with better 30-day and 1-year outcomes for patients of all race groups at hospitals reclassified as high-performing.

Conclusions:

Among patients hospitalized with heart failure, race-specific 30-day RSMR and RSRR are more equitable in representing hospital performance for patients of Black and other races.
Preeclampsia Prevention by Timed Birth at Term
Authors: Magee Laura A. , Wright David , Syngelaki Argyro , von Dadelszen Peter , Akolekar Ranjit , Wright Alan , Nicolaides Kypros H.
Published: April 2023

Background:

Most preeclampsia occurs at term. There are no effective preventative strategies. We aimed to identify the optimal preeclampsia screening and timing of birth strategy for prevention of term preeclampsia.

Methods:

This secondary analysis was of data from a prospective nonintervention cohort study of singleton pregnancies delivering at ≥24 weeks, without major anomalies, at 2 United Kingdom maternity hospitals. At routine visits at 11 to 13 weeks’ (57 131 pregnancies screened, 1138 term preeclampsia developed) or 35 to 36 weeks’ gestation (29 035 pregnancies screened, 619 term preeclampsia), with patient-specific preeclampsia risks determined by: United Kingdom National Institute for Health and Care Excellence guidance, and the Fetal Medicine Foundation competing-risks model. For each screening strategy, timing of birth for term preeclampsia prevention was evaluated at gestational time points that were fixed (37, 38, 39, 40 weeks) or dependent on preeclampsia risk by the competing-risks model at 35 to 36 weeks. Main outcomes were proportion of term preeclampsia prevented, and number-needed-to-deliver to prevent one term preeclampsia case.

Results:

The proportion of term preeclampsia prevented was the highest, and number-needed-to-deliver lowest, for preeclampsia screening at 35 to 36 (rather than 11–13) weeks. For delivery at 37 weeks, fewer cases of preeclampsia were prevented for National Institute for Health and Care Excellence (28.8%) than the competing-risks model (59.8%), and the number-needed-to-deliver was higher (16.4 versus 6.9, respectively). The risk-stratified approach (at 35–36 weeks) had similar preeclampsia prevention (by 57.2%) and number-needed-to-deliver (8.4), but fewer women would be induced at 37 weeks (1.2% versus 8.8%).

Conclusions:

Risk-stratified timing of birth at term may more than halve the risk of term preeclampsia.
Generalization Analysis of Pairwise Learning for Ranking With Deep Neural Networks
Authors: Huang Shuo , Zhou Junyu , Feng Han , Zhou Ding-Xuan
Published: April 2023

Pairwise learning is widely employed in ranking, similarity and metric learning, area under the ROC curve (AUC) maximization, and many other learning tasks involving sample pairs. Pairwise learning with deep neural networks was considered for ranking, but enough theoretical understanding about this topic is lacking. In this letter, we apply symmetric deep neural networks to pairwise learning for ranking with a hinge loss ϕh and carry out generalization analysis for this algorithm. A key step in our analysis is to characterize a function that minimizes the risk. This motivates us to first find the minimizer of ϕh-risk and then design our two-part deep neural networks with shared weights, which induces the antisymmetric property of the networks. We present convergence rates of the approximation error in terms of function smoothness and a noise condition and give an excess generalization error bound by means of properties of the hypothesis space generated by deep neural networks. Our analysis is based on tools from U-statistics and approximation theory.
Sensitivity to Control Signals in Triphasic Rhythmic Neural Systems: A Comparative Mechanistic Analysis via Infinitesimal Local Timing Response Curves
Authors: Yu Zhuojun , Rubin Jonathan E. , Thomas Peter J.
Published: April 2023

Similar activity patterns may arise from model neural networks with distinct coupling properties and individual unit dynamics. These similar patterns may, however, respond differently to parameter variations and specifically to tuning of inputs that represent control signals. In this work, we analyze the responses resulting from modulation of a localized input in each of three classes of model neural networks that have been recognized in the literature for their capacity to produce robust three-phase rhythms: coupled fast-slow oscillators, near-heteroclinic oscillators, and threshold-linear networks. Triphasic rhythms, in which each phase consists of a prolonged activation of a corresponding subgroup of neurons followed by a fast transition to another phase, represent a fundamental activity pattern observed across a range of central pattern generators underlying behaviors critical to survival, including respiration, locomotion, and feeding. To perform our analysis, we extend the recently developed local timing response curve (lTRC), which allows us to characterize the timing effects due to perturbations, and we complement our lTRC approach with model-specific dynamical systems analysis. Interestingly, we observe disparate effects of similar perturbations across distinct model classes. Thus, this work provides an analytical framework for studying control of oscillations in nonlinear dynamical systems and may help guide model selection in future efforts to study systems exhibiting triphasic rhythmic activity.
Visualizing the Pandemic: How the Front Pages of Local and National U.S. Media Used Images to Cover the Coronavirus Pandemic
Authors: Paul Newly
Published: April 2023

This study explored how The New York Times and the Dallas Morning News used visuals on their front pages to frame the coronavirus pandemic in 2020 and 2021. Findings indicated that the Times was more likely to publish COVID-related images on the front page, use the threat frame in its images, and use photographs taken by staff photojournalists than sourced from wire services or freelancers. The two newspapers were equally likely to give prominence to COVID-related photos on their front pages, by publishing them above the fold. The implications of these trends are discussed.
Delayed Cholecystectomy Management for Mirizzi Syndrome
Authors: Favors Lauren , Parker Mitchell , Koontz Curt , Koontz Olivia
Published: April 2023

Mirizzi syndrome is defined as a common hepatic duct obstruction from a cystic duct stone, which results in a severe inflammatory reaction that distorts biliary anatomy and makes surgical intervention challenging. Most case reports describe an open subtotal cholecystectomy as the most common surgical technique with few reports detailing successful laparoscopic interventions. This case involves an 11-year-old African American female who presented with right upper quadrant abdominal pain and imaging consistent with Mirizzi syndrome. She was taken for a laparoscopic cholecystectomy that was quickly aborted due to extensive inflammation. She subsequently underwent endoscopic decompression of her biliary tree by gastroenterology. She returned to the operating room six weeks later for a successful interval cholecystectomy. This case illustrates a unique report of delayed cholecystectomy for management of Mirizzi syndrome, which highlights a potential management strategy that avoids technically difficult laparoscopic cholecystectomy in the acute inflammatory period.
The Impact of a Job Crafting Intervention on Wellbeing in Health Care Leaders
Authors: Zmijewski Polina , Lindeman Brenessa , Rogers David A
Published: April 2023

Background

Job Crafting is a strategy undertaken by highly motivated individuals to modify their own work. Educating individuals about the benefits of this approach has recently been explored in other professions as a wellbeing intervention.

Objective

We aimed to demonstrate that a Job Crafting intervention for health care leaders would result in improved wellbeing, lower burnout, and enhanced job resources.

Methods

Fourteen health care leaders across 6 departments at one academic medical center participated in a two-part workshop on Job Crafting between January 1, 2019 and December 31, 2020. Participants completed electronic surveys before and 4-6 weeks after the sessions. Pre- and post-intervention scores were compared using Wilcoxon signed rank sum tests.

Results

Eighty-six percent of participants stated the sessions were useful and applicable to their jobs, with 93% stating they were a valuable use of time and would recommend sessions to others. Participant Job Crafting behaviors increased following the intervention, with 46% increasing structural and social resources ( P = .03) and 85% decreasing Hindrance Demands ( P = .02). Increased meaning in work was identified by 38% post-intervention ( P = .04). No statistically significant differences were identified in Distress Scores at high risk for burnout pre- and post-intervention (86% for both), but 30% of participants had an absolute improvement (decrease) in their Distress Score.

Conclusions

A Job Crafting intervention was associated with high rates of satisfaction among participants and was successful in increasing Job Crafting behaviors and perceptions of meaningful work, but did not result in a change in risk for burnout in the short follow-up period.
Tracheostomy in Critically Ill COVID-19 Patients on Extracorporeal Membrane Oxygenation: A Single-Center Experience
Authors: Staibano Phillip , Khattak Shahzaib , Amin Faizan , Engels Paul T. , Sommer Doron D.
Published: April 2023

Objectives:

Novel coronavirus-19 (COVID-19) has led to over 6 million fatalities globally. An estimated 75% of COVID-19 patients who require critical care admission develop acute respiratory distress syndrome (ARDS) needing invasive mechanical ventilation (IMV) and/or extracorporeal membrane oxygenation (ECMO). Due to prolonged ventilation requirements, these patients often also require tracheostomy. We performed a review of clinical outcomes in COVID-19 patients on ECMO at a high-volume tertiary care center in Hamilton, Ontario, Canada.

Methodology:

We performed a retrospective case series, including 24 adult patients diagnosed with COVID-19 who required IMV, veno-venous (ECMO), and tracheostomy. All patients were included from April to December 2021. We extracted demographic and clinical variables pertaining to the tracheostomy procedure and ECMO therapy. We performed descriptive statistical analyses. This study was approved by the Hamilton Integrated Research Ethics Board (14217-C).

Results:

We included 24 consecutive patients with COVID-19 who required tracheostomy while undergoing ECMO therapy. The mean age was 49.4 years [standard deviation (SD): 7.33], the majority of patients were male (75%), with mean body mass index of 32 (SD: 8.81). Overall mortality rate was 33.3%. Percutaneous tracheostomy was performed most frequently (83.3%) and, similar to open tracheostomy, was associated with a low rate of perioperative bleeding complications. Within surviving patients, the mean time to IMV weaning and decannulation was 60.2 (SD: 24.6) and 49.4 days (SD: 21.8), respectively.

Conclusion:

Percutaneous tracheostomy appears to be safe in COVID-19 patients on ECMO and holding anticoagulation 24 hours prior to and after tracheostomy may limit bleeding events in these patients.
Children With Disabilities and Their Mothers During the COVID-19 Pandemic Difficulties Experienced
Authors: Çelik Melike Yavaş
Published: April 2023

The aim of this study was to determine the difficulties experienced by disabled children and their mothers due to the necessity of being at home during the coronavirus 2019 (COVID-19) process. The research is a qualitatively prepared phenomenological-type descriptive study. “Content analysis” was used in the analysis of the interview questions. Semi-structured interview technique was used as the data collection method. It was determined that the disabled child lost the skills he learned during the COVID-19 process; his health was adversely affected; there were disruptions in the education process; behavioral problems began; and he experienced social isolation. As a result, it can be said that both children with disabilities and mothers who care for them try to cope with many difficulties during the COVID-19 process and they are left alone and do not receive support during this process.
Understanding components and predictors of delay of first treatment for mental health problems: A hospital-based study in China
Authors: Xie Guanqing , Zhou Wei , Xiao Shuiyuan , Wang Yao
Published: April 2023

Background:

Understanding components and predictors of delay of first treatment for mental health problems are crucial to inform interventions for earlier treatment. However, Chinese-context knowledge of this theme is still limited.

Methods:

We conducted an inpatient survey among 206 patients with various mental disorders in China. Delay of first utilization of mental healthcare (Delay-Total) and its two components of help-seeking delay (Delay-H) and referral delay (Delay-R) were assessed in terms of occurrence and duration. Binary logistic regression was performed to test predictors of Delay-Total, Delay-H and Delay-R, and multiple linear regression was used to test predictors of delay durations.

Results:

Overall, 66.0% patients experienced Delay-Total, with a duration range of 0 to 353 months; 49.5% patients had Delay-H (duration range = 0–207 months) and 29.6% with Delay-R (duration range = 0–323 months). Multivariate logistic regression analysis found that the diagnosis of severe mental disorders was a consistent predictor for a reduced chance of Delay-Total, Delay-H and Delay-R. Multiple linear regression analysis demonstrated that younger age of disorder onset and disorder onset before 2016 were significantly associated with longer delay.

Conclusions:

Delay of first treatment for mental health problems is still common in China. However, the development of mental health policy and services promotes shorter treatment delay. The diagnosis of common mental disorders and younger age of onset are risk factors of the occurrence and duration of delay, respectively. Thus, education of the public and non-mental-healthcare professionals are needed for better disorder recognition and more efforts should be inputted to support youngsters’ utilization of mental healthcare.
Hussle and Motivate: An Afrocentric Understanding of Constitutive Rhetoric Toward Economic Empowerment in Nipsey Hussle’s Victory Lap Album
Authors: Smith Damariyé L.
Published: April 2023

This essay examines the rhetorical strategies of the late Nipsey Hussle regarding the intersection of cultural rhetoric, identity, economic success, and financial literacy. Using what I call Afrocentric constitutive rhetoric as a methodological lens, I argue that Nipsey empowers his listeners toward an identity of economic success, specifically for marginalized communities, underscoring the ontological capacity of Hip-Hop rhetoric. To support this claim, I analyze select lyrics from Nipsey’s Grammy-nominated album, Victory Lap, released in 2018. Further, I illuminate the culturally distinct qualities of Nipsey’s rhetoric by coupling theorizations of Afrocentricity and constitutive rhetoric and its impact on identity formation for his listeners. Finally, I maintain that a cultural approach to constitutive rhetoric positions scholars to better understand the nuance of culturally specific rhetorical productions related to identity and economic empowerment.
Four-Year College Completion Rates: What Accounts for the Variation?
Authors: Tesfamariam Biniam , Alamo-Pastrana Carlos , Bradley Elizabeth H.
Published: April 2023

Higher education has been touted as critical to social mobility, even greater longevity; however, these benefits accrue with degree completion, and many students who begin college never earn a degree. Using the most recent Integrated Postsecondary Education Data System (IPEDS), we sought to understand variation in college completion rates and test hypotheses related to a set of institutional factors potentially associated with higher completion rates. Our findings suggest that greater attention to low-resource institutions is paramount if higher education is to fulfill the aspiration of promoting social mobility and equity. Several policy interventions could be used to combat ongoing disparities.
Evaluating and developing sealants for the prevention of pulmonary air leakage: A systematic review of animal models
Authors: Hermans Bob P. , Poos Steven E.M. , van Dort Daniël I.M. , Evers Jort , Li Wilson W.L. , van der Heijden Erik H.F.M. , Verhagen Ad F.T.M. , van Goor Harry , ten Broek Richard P.G.
Published: April 2023

Sealants may provide a solution for pulmonary air leakage (PAL), but their clinical application is debatable. For sealant comparison, standardized animal models are lacking. This systematic review aims to assess methodology and quality of animal models for PAL and sealant evaluation. All animal models investigating lung sealing devices (e.g., staplers, glues, energy devices) to prevent or treat PAL were retrieved systematically from Embase, Pubmed and Web of science. Methodological study characteristics, risk of bias, reporting quality and publication bias were assessed. A total of 71 studies were included ( N  =  75 experiments, N  =  1659 animals). Six different species and 18 strains were described; 92% of experiments used healthy animals, disease models were used in only six studies. Lesions to produce PAL were heterogenous, and only 11 studies used a previously reported technique, encompassing N  =  5 unique lesions. Clinically relevant outcomes were used in the minority of studies (imaging 16%, air leak 10.7%, air leak duration 4%). Reporting quality was poor, but revealed an upward trend per decade. Overall, high risk of bias was present, and only 18.7% used a negative control group. All but one study without control groups claimed positive outcomes (95.8%), in contrast to 84.3% using positive or negative control groups, which also concluded equivocal, adverse or inconclusive outcomes. In conclusion, animal studies evaluating sealants for prevention of PAL are heterogenous and of poor reporting quality. Using negative control groups, disease models and quantifiable outcomes seem important to increase validity and relevance. Further research is needed to reach consensus for model development and standardization.
The Associations Between Death Anxiety, Supernatural Beliefs, Caring for Loved Ones and Attachments
Authors: Rezapour Mahdi , Ferraro F. Richard
Published: April 2023

Despite extensive efforts in a better understanding of associations between death anxiety and various factors, efforts studying the complex associations across those variables are still limited. This study was conducted to better understand the possible complexity between death anxiety and myriad of factors, by first extracting the most important features, and then assessing the complexity of variables by checking all pairwise interaction terms. We found most of associated factors of death anxiety are related to the concept of attachment or caring for loved ones. Ill-effect attachment with positive associations with death anxiety included factors such as attachment to the physical side of oneself, being alone before death, and the possibility of death being the end of us. On the other hand, supernatural conceptions of worldviews such as believing in God, believing that the soul is separate from body, and being religious buffer against the death anxiety.
Recent research progress of conductive polymer-based supercapacitor electrode materials
Authors: Duan Haojie , Liu Yuanjun , Zhao Xiaoming
Published: April 2023

With the serious impact of fossil fuels on the environment and the rapid development of the global economy, the development of clean and usable energy storage devices has become one of the most important themes of sustainable development in the world today. Supercapacitors, known as ultracapacitors, have been supposed to be one of the most promising candidates to meet the requirements of human sustainable development, due to their advantages such as high capacity, high power density, high charging/discharging speed, long cycle life, and low processing cost. However, the low energy density of supercapacitors limits their large-scale application. Therefore, it is of great significance to develop high energy density supercapacitors and use them as power sources for practical devices. Conductive polymer-based electrode materials have unique advantages such as high theoretical capacitance, good conductivity, and good flexibility, and have high potential in supercapacitors. The research on conductive polymer-based electrode materials has promoted the rapid development of the field of supercapacitors. This review summarizes recent research progress on conductive polymers (including polypyrrole, polyaniline, and polythiophene), conductive polymer-based binary composites, and conductive polymer-based ternary and quaternary composites for supercapacitor electrodes. Furthermore, a summary of the use of conductive polymer-based textiles and fibers for flexible supercapacitors is also presented, along with the current challenges and future perspectives for conductive polymer-based supercapacitors.
Restoring Balance—A Woman’s Expressions of Lived Experience of Everyday Life During a Period of Aging: A Case Study
Authors: Norell Pejner Margaretha , Karlsson Staffan
Published: April 2023

Bereaved older people face stressors from the changes in roles associated with the death of a spouse. To illustrate the lived experience of everyday life during a period of aging after a woman’s loss of her spouse. One woman born in 1918 was followed between 74 and 80 years of age after her husband died. Data consisted of daily diary. The text from the diaries were analyzed with a phenomenological hermeneutical approach. Everyday life after becoming a widow is characterized by balancing between personal resources to manage everyday life and vulnerability. In health and social care, it is important to identify experiences of vulnerability because these are associated with poor health.
Understanding the Decision to Officially Report Sexual Assaults in Prison
Authors: Butler H. Daniel , Bouffard Jeffrey A. , Beatty Jennifer K. , Bouffard Leana A.
Published: April 2023

Most studies of crime reporting examine decisions to report to the police in community settings. While informative, this focus leaves a gap in identifying the correlates of official reporting behaviors among incarcerated individuals. This is noteworthy considering the passage of the Prison Rape Elimination Act mandating states collect and report data on sexual assaults in confinement facilities. To address these concerns, this study provides one of the first multivariable examinations of decisions to officially report sexual assaults to correctional staff. This study also examines the correlates of official reporting across perpetrator type (another incarcerated individual or correctional staff member) and the correlates for not reporting a sexual assault (embarrassment, fear of reprisal, and belief no investigation will take place). The findings indicate most sexual assaults are not reported, and few in-prison experiences or incident characteristics explain the decision to officially report or the reasons for not reporting.
Estimator-based event-triggered leader–following consensus of multiagent systems under denial-of-service attacks
Authors: Zhu Panming , Chen Guangdeng , Lin Guohuai , Chadli Mohammed
Published: April 2023

The leader–following consensus issue is investigated for multiagent systems under external disturbances and denial-of-service (DoS) attacks. DoS attacks are considered to be designed according to an unknown attack strategy and would block the communication network. First, a novel triggering mechanism is designed to save communication resources during normal communication periods by event-triggered strategy and to detect the end of attack periods by time-triggered strategy. Then, a set of estimators is constructed to predict the states of the agent itself and its neighbors when the attack occurs. The estimators do not contain the control signals, which only correct the prediction when the actual system states are received. As a result, a distributed switching controller is designed that includes event-triggered states during normal communication periods and predicted states during attack periods. Finally, the proposed secure control protocol is proven to ensure that the system states are eventually consensus and the Zeno behavior is not exhibited. Moreover, a simulation example is given to illustrate the effectiveness of the presented strategy.
Validation of the prognostic scoring system for in-hospital mortality prediction in cardiogenic shock patients requiring veno-arterial extracorporeal membrane oxygenation
Authors: Cheewatanakornkul Sirichai , Duangpakdee Pongsanae , Khwannimit Bodin , Bhurayanontachai Rungsun , Geater Sarayut Lucien , Geater Alan Frederick
Published: April 2023

Background

A few prognostic scoring systems have been developed for predicting mortality in patients with cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO), albeit with variations in performance. This study aimed to assess and compare various mortality prediction models in a cohort of patients receiving VA-ECMO following cardiogenic shock or arrest.

Methods

We retrospectively analyzed 77 patients with cardiogenic shock who were placed on VA-ECMO support between March 2014 and August 2021. The APACHE II, SAPS II, SAVE, Modified SAVE, ENCOURAGE, and ECMO-ACCEPTS scores were calculated for each patient to predict the in-hospital mortality.

Results

Fifty-six (72.7%) patients died. All prediction model scores, except the ECMO-ACCEPTS, differed significantly between non-survivors and survivors as follows: ENCOURAGE, 23 versus 16 ( p < 0.001); SAVE, −6 versus −3 ( p = 0.008); Modified SAVE, −5 versus 0 ( p = 0.005); APACHE II, 32 versus 22 ( p = 0.009); and SAPS II, 67 versus 49 ( p = 0.002). The ENCOURAGE score demonstrated the best discriminatory ability with an area under the receiver–operating characteristic curve of 0.81 (95% confidence interval: 0.7–0.81). All prognostic scoring systems possessed limited calibration ability. However, the SAPS II, SAVE, and ENCOURAGE scores had lower Akaike and Bayesian information criteria values, which were consistent with the results of the Hosmer–Lemeshow C statistic test, indicating better performance than the other scores.

Conclusions

The ENCOURAGE score can help predict in-hospital mortality in all subsets of VA-ECMO patients, even though it was originally designed to predict intensive care unit mortality in the post-acute myocardial infarction setting.
Narratives of Post-Truth: Lyotard and the Epistemic Fragmentation of Society
Authors: Baier Christian
Published: April 2023

In recent years, the post-truth phenomenon has dominated public and political discourse. This article offers a functional analysis of its mechanisms based on the category of narrative. After providing a brief definition of post-truth as a conceptual foundation, I trace the meaning of the term ‘narrative’ in the works of Jean-François Lyotard, focusing on the elusive category of small narrative. Utilizing terms and concepts of contemporary narrative theory, I propose a general definition of cultural narrative and reconceptualize Lyotard’s petit récit as a particular case of this superordinate category. Drawing on Lyotard’s phrase linguistics as set out in The Differend, I develop the category of epistemic sphere to analyze Donald Trump’s MAGA movement as an example of post-truth politics, the rise of populism and the epistemic fragmentation of society.
The value of PET/CT for the diagnosis and evaluation of immunotherapy in occult primary renal cell carcinoma: a case report
Authors: Jiang Ting , Zheng Hongjuan , Dong Ke , Guanghua Wen , Zhou Shishi , Li Chenghui , Dong Mengjie , Fu Jianfei
Published: April 2023

Skin and soft tissue diffusion metastasis (also known as occult cancer) is rare in renal cell carcinoma (RCC). Here, we report an extremely rare case of a 67-year-old male patient with occult primary RCC who developed metastases to the gums, skin, and diffuse soft tissue. The primary renal lesion was missed by computed tomography (CT), ultrasound, and 18F-fluorodeoxyglucose positron emission tomography (PET)/CT, and the diagnosis was confirmed by biopsy of gums and subcutaneous nodules. Subsequent enhanced CT revealed a lesion in the left kidney. The patient had progression-free survival of 16 months after treatment with axitinib and pembrolizumab. Pseudoprogression and tumor heterogeneity pose major challenges in the evaluation of immunotherapy. PET/CT is indispensable especially for cases with multiple metastases, widespread distribution of lesions, and major heterogeneity. In this case, the total lesion glycolysis was calculated by PET/CT and was used to evaluate systemic tumor load before and after immunotherapy, which was calculated as the product of the metabolic tumor volume and the mean standardized uptake value of the target lesion, which increased the accuracy of assessing diffuse lesions. Total lesion glycolysis can be used as a new method to quantitatively evaluate the efficacy of immunotherapy.
Correlation of signal transducer and activator of transcription-3 and β-catenin expression in laryngeal squamous cell carcinoma
Authors: Sun Yajing , Lu Xiuying , Li Hui , Li Xiaoming
Published: April 2023

Objective

The specific roles of phosphorylated signal transducer and activator of transcription-3 (p-STAT3) and β-Catenin in laryngeal squamous cell carcinoma (LSCC) remain unclear.

Methods

In this study, the correlations between p-STAT3, β-Catenin, and clinicopathological characteristics were investigated using tissues and clinical data from 124 LSCC cases. Immunohistochemistry and immunofluorescence assays were used to examine p-STAT3 and β-Catenin expression and localization in these samples. Kaplan–Meier survival and Cox regression analyses were performed to evaluate the prognostic significance of these proteins. LSCC cell lines were treated with a STAT3 inhibitor (dihydroartemisinin) or activator (interleukin-6) to explore the mechanism of p-STAT3 and β-Catenin.

Results

There was an inverse correlation between p-STAT3 and β-Catenin expression in the LSCC samples. Patients with high p-STAT3 and low β-Catenin expression levels had significantly worse overall survival. Multivariate Cox regression analysis revealed that lymph node metastasis and β-Catenin expression were both independently correlated with unfavorable overall survival. Cell treatment with the p-STAT3 inhibitor inhibited the nuclear accumulation of β-Catenin, while p-STAT3 activator treatment could promote β-Catenin translocation to the nucleus.

Conclusion

Overall, our data indicate that p-STAT3 expression is associated with LSCC by promoting β-Catenin degradation.
Everyday Sadism as a Predictor of Rape Myth Acceptance and Perception of Harassment
Authors: Saravia Lalinde Ivonne Alicia , Longpré Nicholas , de Roos Melissa
Published: April 2023

The #MeToo movement has stressed the need to understand why individuals who witness sexual violence may or may not take action. However, prevention programs usually fail to address the association between personality traits and attitudes, perception, and behavior in the context of sexual violence. To improve prevention programs’ effectiveness, it is vital to understand how personality traits might interfere with willingness to engage in bystander intervention. This study aims to explore the relationships between Everyday Sadism, perception of harassment, Rape Myths and gender in a sample of 177 participants recruited online. Analyses revealed significant gender differences, with men endorsing more Rape Myths, perceiving less harassment, and being more sadistic. Gender and everyday sadism emerged as significant predictors of perception of harassment. In the case of Rape Myths, age emerged as an additional predictor. These results have several implications, ranging from expanding our knowledge of the influence of everyday sadism on factors known to modulate bystander behaviors as well as informing and shaping the development of prevention programs.
A non-intrusive reduced-order model for wind farm wake analysis based on SPOD-DNN
Authors: Guo Zhaoliang , Xu Li , Zhou Guanhao , Zhang Kaijun
Published: April 2023

Wind farm wake modeling is of great significance for wind turbine layout optimization design and yaw control strategy. In this work, we combine deep neural network (DNN) with spectral proper orthogonal decomposition (SPOD) to discover dynamic characteristics of wake under different inflow conditions. Then an assessment of the proposed SPOD-DNN surrogate modeling method of parameterized fluid is performed by comparing the predicted results. Meanwhile, we demonstrate the robustness of the SPOD-DNN through a comparison with POD-DNN, where SPOD produces fewer modes than POD but can achieve the same cumulative contribution rate and wake prediction accuracy. In the end, the method is developed to predict the wake of single wind turbine in untrained inflow condition and Wake of six wind turbines with different yaw angles. The results reveals that the model has good generalization performance and can robustly reconstruct the wake of multiple wind turbines in different directions.
Adaptation of adult right ventricular scoring systems to pediatric patients undergoing continuous LVAD implantation: Feasible or not?
Authors: Kocabeyoglu Sinan Sabit , Kervan Umit , Sert Dogan Emre , Karahan Mehmet , Kavurt Ahmet Vedat , Koca Serhat
Published: April 2023

Purpose:

The aim of this study is to investigate the efficacy of adaptation of right ventricular (RV) risk scores used in adult patients to pediatric age group undergoing LVAD implantation.

Methods:

Twenty-two pediatric patients who underwent LVAD implantation were retrospectively reviewed from January 2014 to September 2018. Preoperative patient characteristics, hemodynamic parameters, and echocardiographic data were collected. Adult RV risk scores were calculated for all patients. Effects of all the parameters on RV function were also investigated. Study endpoints were RVF and in-hospital mortality.

Results:

Eleven (50%) of 22 patients were male. The mean age of the patients was 13.4 ± 3.8 years. The mean body surface area of the patients was 1.4 ± 0.4 m2. In five patients BiVAD implantation was performed. Of these five BiVAD patients two underwent successful heart transplant; two weaned from temporary RVAD and last patient died due to multi-organ failure. Four patients showed signs of early RVF; one patient was transplanted successfully while on medical support. Three patients developing RVF did not respond medical therapy necessitating ECMO and died in the early postoperative period. All risk scores and potential predictive factors were evaluated individually and in combination of several parameters. No significant predictor for RVF in pediatric patients that underwent LVAD implantation was found ( p > 0.05).

Conclusion:

Neither an adult risk score nor a predictive factor was successful in predicting RVF, alone or in combination due to limited number of patients and events. Large further investigations are needed to identify the predictors or scoring system in pediatric population.
Event-triggered H∞ control of semi-active quasi-zero stiffness air suspension system for commercial vehicles
Authors: Jiang Xinwei , Xu Xing , Liang Cong , Wang Feng
Published: April 2023

In this paper, an event-triggered [Formula: see text] control strategy is proposed for a novel quasi-zero stiffness semi-active air suspension (QZS-AS) system. The QZS-AS system consists of a quasi-zero isolator and magnetorheological dampers. The quasi-zero stiffness structure is composed of an air spring and a pneumatic actuator-cylinder. Compared with normal air suspension system, QZS-AS can achieve much lower natural frequency and better vibration isolation performance. In order to further enhance the vibration isolation performance of the QZS-AS system, semi-active robust control for nonlinear QZS-AS system is performed by adjusting the current of the magnetorheological damper. An event-triggered damping controller is introduced in the QZS-AS system to save the communication resources. Model-in-the-loop test and hardware-in-the-loop (HiL) test are conducted to verify the performance of proposed strategy. It is demonstrated that the event-triggered [Formula: see text] control is able to provide a similar performance as traditional time-triggered [Formula: see text] control while saving about 50% of the communication resources.
Method of predicting valve seal leakage considering deflection of the spool
Authors: Guo Fei , Xiang Chong , Chen Qiyao , Zheng Maoqi , Yu Wujiang , Wang Yuming
Published: April 2023

The small angular deflection of the spool under the action of non-equilibrium force is a main reason for valve seal failure. In the present study, a prediction model of the valve seal leakage was established considering the sectional shape and channel height of the leakage channel. The effect of spool deflection on the leakage rate was analyzed quantitatively from the results of three-dimensional finite element mechanical analysis. The microscale leakage channel of a contact deformation surface was then generated through the reconstruction of the rough surface with nanoscale precision, deterministic rough-peak contact analysis, and lattice leakage theory. The results showed that the spool deflection was the key factor affecting the leakage rate. The leakage rate was measured on a self-built experimental platform, and the experimental results verified the accuracy of the theoretical calculations.
Multi-objective parametric optimization of AWJM process using Taguchi-based GRA and DEAR methodology
Authors: Pathapalli Venkateshwar Reddy , Pittam Srinivasa Rao , Sarila Venukumar , Burragalla Dhanraj , Gagandeep Arora
Published: April 2023

Abrasive waterjet machining (AWJM) is a well-known non-traditional cutting process that is widely used to shape materials such as metals, ceramics, alloys, and composites. AWJM was utilized to manufacture titanium alloy in this study, with influencing parameters such as standoff distance (SOD), abrasive flow rate (AFR), and traverse speed (TS) being varied. Material removal rate (MRR) and surface roughness (SR) have been used to quantify the impact of these variables on machining quality. The effects of process factors on output responses were investigated using a Taguchi study approach with an L9 factorial design. SOD of 1 mm, AFR of 300 g/min, and TS of 519 m/s yield the best combination for greater MRR. A combination of SOD of 3 mm, AFR of 400 g/min, and TS of 519 m/s yields the best SR results. Simultaneous optimization of both outputs was also carried out using Taguchi-based Grey relational analysis (GRA) and data envelopment analysis-based ranking (DEAR) methodologies. PCA is utilized for considering the weights of responses and the correlation among them. Both methods obtained similar results, but there is a difference in the middle rankings in the nine experimental trials. Validation trials were run on the acquired combination of parameters, and the error was found to be within acceptable bounds.
The effect of fiber stacking sequence on mechanical and morphological behavior of paddy straw/pineapple leaf fiber-reinforced ortho-laminated polyester hybrid composites
Authors: Sathiyamurthy S , Vinoth V , Ananthi N , Devi P
Published: April 2023

The contemporary agricultural natural fiber is effectively used for fabricating composites because of its economical, ample availability, and biodegradability. In this way, the potential material for the reinforcement of hybrid (paddy straw and pineapple leaf) fiber- and ortho-laminated polyester composites was conducted. This research article is focused on the hybridization of untreated, treated, and paddy pulp fiber-reinforced polyester composite laminates. The unidirectional paddy straw fiber and pineapple leaf fiber (PALF) were used in the fabrication process of laminate using a compression molding machine with the mold dimensions of 300 × 300 × 5 mm is used and the investigation of mechanical (tensile, flexural, impact, hardness, shear) behaviors are conducted in the samples as per the standard. Five samples were prepared by varying the fiber content in the matrix in which sample S1 pure polyester plate without any addition of reinforcement. Out of these five samples, sample 4 (S4) produced better tensile, flexural, impact, hardness, and shear values of 28 MPa, 61 MPa, 3.46 Joules, 64 HR L, and 68.7 MPa, respectively. Comparing the laminate samples of S1 and S4 there is a 35.2% increase in the tensile value of S4, similarly, other values also resulted in better hikes. In addition to that, the water absorption properties of the laminate were also evaluated and fiber breakage, fiber pullout, fiber orientation, crack propagation, and voids on the fractured specimens were identified with help of a scanning electron microscope (SEM). Overall, the fabricated hybrid composite laminates were lightweight and has good fiber-matrix bonding with improved mechanical and morphological properties for commercial and home need applications.
Analyzing the geometrical errors of silicon nitride-titanium nitride on performing electric discharge machining using response surface methodology
Authors: Lakshmanan Selvarajan , Rajendran Rajavel , Shanmugakani Senthil Kumar , Krishnamoorthy Venkataramanan
Published: April 2023

Ceramic materials that find their applications in die extrusion and the balls used in bearings have a longer service life compared to that of traditional materials. Since ceramic materials are having high hardness properties, they cannot be machined traditionally, because traditional machining processes rely on the relative hardness of the tool material to the workpiece material. However, electric discharge machining aids in the machining of ceramic composites with good surface integrity performed by the copper electrodes. As a result, Spark Erosion Machining was used to investigate the geometrical tolerance of Si3N4-TiN composites. Electric discharge machining parameters range over five levels, like current from 2 to 6 A, voltage from 30 to 50 V, dielectric pressure (kg/cm2) from 16 to 24 kg/cm2, pulse on time (µs) from 15 to 19 μs, and pulse off time (µs) from 7 to 11 μs have been analyzed through an L25 orthogonal array. Main effect plots and two-dimensional and three-dimensional interaction plots have been drawn to investigate the effect of the input parameter on the output parameters like circularity, cylindricity, perpendicularity, runout, top radial overcut, and bottom radial overcut. The grey relational analysis is employed in finding the significant parameters through analysis of variance, and for each model, the regression coefficient is found. The optimal input parameters for the desired output parameters are found to be a current of 5.855 A; pulse-on time of 16.55 µs; pulse-off time of 7.22 µs; dielectric pressure of 16.32 kg/cm2; and a voltage of 40.3729 V. This research will help to enhance the geometric accuracy and precision of machined holes in Si3N4-TiN composites. The results are finally estimated using a residual data analysis, which shows that spark erosion can be improved.