bluuebunny/crossref_metadata_2025 huggingface dataset:
Unique granulated leucocytes in peripheral blood in yellow phosphorous poisoning: An interesting tool for monitoring therapeutic response
Authors: Gupta Rakesh Kumar , Kumar Verma Kartavya , Achari Rohini Rokkam
Published: January 2023

Yellow phosphorus is one of the most commonly used rodenticides in India for household pest control. It is available as pastes containing 2% to 5% of yellow phosphorus. Yellow phosphorous-containing rodenticides are easily available and account for one of the most common causes of suicidal poisoning in India. We describe a case of yellow phosphorus poisoning in a 17-years-old child who recovered from hepatic encephalopathy and showed unique peripheral smear findings in the form of spurious monocytosis and hypergranulosis of these granulocytes.
Survival impact of unexpected N2 in stage IIIB/N2 non-small cell lung cancer patients
Authors: Erdoğu Volkan , Çıtak Necati , Sezen Celal Buğra , Kizir Dilekhan , Tanrıkulu Gamze , Doğru Mustafa Vedat , Seyrek Yunus , Cansever Levent , Saydam Özkan , Metin Muzaffer
Published: January 2023

Background

We investigated the effect of unexpected N2 on survival in stage IIIB/N2 cases.

Methods

We retrospectively analyzed 1803 non-small cell lung cancer patients between 2010 and 2016. There were 89 patients (4.9%) with unexpected N2 (pathological (p) IIIB/N2 group), whereas 49 patients (2.7%) with cN2 (clinical (c) IIIB/N2 group). Although pIIIB/N2 group underwent surgery followed by adjuvant therapy, the cIIIB/N2 group of patients had multimodality treatment including induction chemotherapy ± radiotherapy followed by surgery.

Results

The five-year overall survival (OS) for all patients was 36.0% [median survival time (MST) 27.9 months], and disease-free survival (DFS) was 28.9% (MST, 18.2 months). The OS was 39.6% (MST: 34.4 months) and the median DFS time was 31.1% (Median: 23.1 months) in the pIIIB/N2 group, whereas it was 29.2% (MST: 23.0 months) for OS and 22% (median: 12.4 months) for DFS in the cIIIB/N2 group. There were no significant OS and DFS differences between the pIIIB/N2 group and the cIIIB/N2 group ( p = 0.124 and p = 0.168, respectively).

Conclusions

In stage IIIB/N2 cases, the fact that N2 could not be detected preoperatively with minimally invasive or invasive methods and was detected in the pathological examination after surgery does not provide a survival advantage.
Networked frame contestation from authoritarian to Western democracy – A case of China's (failed) Twiplomacy in contesting coronavirus narrative in the UK
Authors: Zeng Yuan
Published: January 2023

Transnational political communication today is being reconfigured by digital technologies and global power transition. Authoritarian state actors such as China are increasingly active on global social media platforms such as Twitter to directly advance their preferred frames with foreign publics in Western democracies, most notably in what could be called Chinese Twiplomacy contesting narrative globally over contentious issues. This paper problematises such Twiplomacy from authoritarians to Western democracies as ‘networked transnational frame contestation’, arguing that the political and cultural distance between the sending and target countries, the networked affordance of social media, and the national prism of the target countries, all contribute importantly to the complexity of such frame contestation. Through a case study on China's Twiplomacy in contesting coronavirus narrative in the UK, this paper further provides empirical evidence on how ‘networked transnational frame contestation’ works between politically and culturally distant countries. Using a mixed-method approach combining social network analysis and discourse analysis, this study finds that China's emotion-evoking discursive strategy draws traction but the authoritarian nature of the highly centralised networkedness and that of its discursive strategy, together with the strong cultural discordance with British publics, lead to networked recontextualisation of its intended frames in Britain. British publics, heavily relying on British political elites and press for foreign affairs, invoke shared cultural reference to recontextualise Chinese frames into culturally resonant counterframes. This study proposes a paradigm of ‘networkedness within cascades’ to understand frame contestation between politically and culturally distant countries.
Contributions of Science Fiction to Thinking up (Im)possible Future Societies: Medical Students’ Genetic Imaginary
Authors: Barbosa Miguel , Santos Ricardo R.
Published: January 2023

Science fiction has been an inexhaustible source for the creation of technoscientific imaginary that has marked certain historical periods and influenced the production of subjectivity. This imaginary evokes complex ontological, epistemological, political, social, environmental and existential questions on the present and the future. The aim of this study was to identify and characterize the cultural productions accessed by the public to form an opinion about the genetic manipulation of human beings. A survey about sources of information that influence opinions on the genetic manipulation of human beings was applied to 360 medical students (70.8% female). Movies were the most commonly mentioned source of information, followed by books, documentaries, news programs, television series, informational videos, soap operas and videogames. Science fiction was the most frequent genre and dystopian views of the future of humanity predominated.
Noradrenaline released from locus coeruleus axons contracts cerebral capillary pericytes via α2 adrenergic receptors
Authors: Korte Nils , James Greg , You Haoming , Hirunpattarasilp Chanawee , Christie Isabel , Sethi Huma , Attwell David
Published: January 2023

Noradrenaline (NA) release from locus coeruleus axons generates vascular contractile tone in arteriolar smooth muscle and contractile capillary pericytes. This tone allows neuronal activity to evoke vasodilation that increases local cerebral blood flow (CBF). Much of the vascular resistance within the brain is located in capillaries and locus coeruleus axons have NA release sites closer to pericytes than to arterioles. In acute brain slices, NA contracted pericytes but did not raise the pericyte cytoplasmic Ca2+ concentration, while the α1 agonist phenylephrine did not evoke contraction. Blocking α2 adrenergic receptors (α2Rs, which induce contraction by inhibiting cAMP production), greatly reduced the NA-evoked pericyte contraction, whereas stimulating α2Rs using xylazine (a sedative) or clonidine (an anti-hypertensive drug) evoked pericyte contraction. Noradrenaline-evoked pericyte contraction and capillary constriction are thus mediated via α2Rs. Consequently, α2Rs may not only modulate CBF in health and pathological conditions, but also contribute to CBF changes evoked by α2R ligands administered in research, veterinary and clinical settings.
Simulation training results in performance retention for the management of airway fires: A prospective observational study
Authors: Eidelman Pozin Inna , Zabida Amir , Friedman Zeev , Ivry Michal , Friedman Maria , Zahavi Guy , Yahav Shafir Dana D , Orkin Dina , Berkenstadt Haim
Published: January 2023

Given the severity of the consequences of operating room fires, it is recommended that every anaesthesiologist master fire safety protocols and periodically participate in operating room fire drills. The aim of the present study was to evaluate skill retention one year after an airway fire training programme. Anaesthesiology residents were evaluated using an airway fire simulation-based scenario one year after an educational programme that included a one-h long problem-based learning session, a simulation-based airway fire drill with debriefing, and a formal group discussion. The same simulation scenario was used for both the initial training and the one-year assessment. Thirty-eight anaesthesiology residents participated as pairs in the initial training programme. Of these, 36 participated in the evaluation a year later. Performance after one year was better than performance during the initial simulation. Time to removal of tracheal tube was 7.0 (4.0–12.8) s (median (interquartile range)) at the one-year assessment compared with 22.0 (18.5–52.5) s at the time of initial training ( P < 0.001). Performance improvement was also demonstrated by a higher incidence of performance of crucial action items (cessation of airway gases, removal of sponges and pouring of saline), as well as shorter duration of time necessary to perform these tasks. After controlling the fire, the time to re-establish ventilation by bag-mask ventilation or intubation was shorter at one year: 18.0 (11.0–29.0 ) s, compared with initial training 54.0 s (36.2–69.8) s ( P = 0.001). We conclude that skills are effectively retained for a year after an airway fire management training session.
The asymmetric and long-run effect of energy productivity on environmental degradation in the United Kingdom
Authors: Kirikkaleli Dervis , Sowah James K , Addai Kwaku
Published: January 2023

Energy efficiency offers a vast, low-cost energy resource for the economy, but only if the nation can craft a comprehensive and innovative approach to unlock it. One of the most viable options is to invest in energy productivity. This study examines the asymmetric and long-run effects of energy productivity on environmental degradation while controlling for renewable energy, economic growth, and financial development, utilizing the nonlinear autoregressive distributive lag model and other robust econometric techniques in the United Kingdom during the period 1990Q1–2020Q4. The United Kingdom is one of the world's wealthiest countries; its environment is being severely strained and is challenged in boasting massive investments to reduce CO2 emissions to 78% by 2035. Given the important scenarios for energy efficiency, this study outcome indicates that (a) energy productivity has been beneficial for reducing carbon emissions; (b) renewable energy sources significantly mitigate carbon emissions in the United Kingdom, and (c) economic growth and financial development cause to increase carbon emissions in the United Kingdom. Given the findings, some policy recommendations abound. The negative statistically significant coefficient of renewable energy is an indication that the expansion of renewable energy is essential to achieving clean and sustainable growth. Furthermore, policymakers should enact new environmental laws that prioritize R&D and embrace cleaner technologies.
Shared responsibility for decision-making in NICU: A scoping review
Authors: Pellikka Hanna-Kaisa , Axelin Anna , Sankilampi Ulla , Kangasniemi Mari
Published: January 2023

Background

Shared responsibility is an essential part of family-centred care and it characterizes the relationship between parents and healthcare professionals. Despite this, little is known about their shared responsibility for decision-making in neonatal intensive care units.

Aim

The aim of this scoping review was to identify previous studies on the subject and to summarize the knowledge that has been published so far.

Method

The review was conducted using electronic searches in the CINAHL, PubMed, Scopus and PsycINFO databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers that had been published in English from 2010 to September 2021. The data were selected based on inclusion and exclusion criteria and the findings were inductively summarized. We identified eight papers that met the inclusion criteria.

Ethical considerations:

The scoping review was conducted according to good scientific practice by respecting authorship and reporting the study processes accurately, honestly and transparently.

Results

The results showed that shared responsibility for decision-making was based on the parents’ intentions, but the degree to which they were willing to take responsibility varied. The facilitating and inhibiting factors for shared responsibility for decision-making were related to the communication between parents and professionals. The impact was related to the parents’ emotions.

Conclusion

It is essential that parents and professionals negotiate how both parties will contribute to their shared responsibility for decision-making. This will enable them to reach a mutual understanding of what is in the infants’ best interests and to mitigate the emotional burden of decisions in neonatal intensive care units. More research is needed to clarify the concept of shared responsibility for decision-making in this intensive care context.
Enhancing an online cognitive behavioural therapy intervention for depression: Harnessing the feedback of sexual and gender minority youth to help improve SPARX
Authors: Lucassen Mathijs FG , Stasiak Karolina , Fleming Theresa , Shepherd Matthew , Merry Sally N
Published: January 2023

Objective

SPARX is an online cognitive behavioural therapy self-help intervention for adolescent depression provided in serious game format. Since 2014, it has been freely available in Aotearoa New Zealand (NZ) due to funding from the NZ government. In 2020/21, feedback from sexual and gender minority youth (SGMY) was used to refine and update SPARX.

Method

Three online focus groups and follow-up email consultations involved 12 SGMY (16 to 25 years old) in NZ. A general inductive approach was used to analyse data.

Results

SGMY had specific needs as well as preferences and four themes were identified: attend to our contextual realities; portrayals of sexual and gender minority people in games; envisaged ideals for serious gaming and appraisals of SPARX. SGMY feedback was used to improve SPARX for this unique population, with the updates launched in October 2021.

Conclusions

SGMY are underserved in terms of their mental health needs. Refining or tailoring existing interventions proffers a potential way forward in terms of addressing these needs.
Psychometric Properties of the Brief Fatigue Inventory in Hemodialysis Patients during a Dialysis Day: A Preliminary Report
Authors: Debnath Subrata , Rueda Rain , Thomas Nimmy , Kottewar Saket , Grant Sheena , Lorenzo Carlos
Published: January 2023

The aim of this study was to evaluate the psychometric properties of the Brief Fatigue Inventory (BFI) in hemodialysis patients. During a dialysis day, patients completed both 9-item BFI and 21-item Beck Depression Inventory (BDI)-II questionnaires. The psychometric properties of the BFI were assessed in terms of reliability and validity. The BFI had an overall Cronbach’s coefficient alpha of .92. Inter-item correlation coefficients between BFI items ranged from .38 to. 81 (all p < .0001). Exploratory factor analysis revealed bidimensional factor structure of the BFI—fatigue “severity” and fatigue “interference” explaining 11.0% and 62.0% of the total variance in the data set, respectively. In criterion validity analysis, BFI composite score correlated significantly with the total BDI-II score—Pearson correlation coefficient .40 ( p < .0001). These preliminary results support the satisfactory psychometric properties of the BFI in assessing fatigue among hemodialysis patients during a dialysis day in a clinic setting.
Decision Support System and Web-Application Using Supervised Machine Learning Algorithms for Easy Cancer Classifications
Authors: Chandrashekar K , Setlur Anagha S , Sabhapathi C Adithya , Raiker Satyam Suresh , Singh Satyam , Niranjan Vidya
Published: January 2023

Using a decision support system (DSS) that classifies various cancers provides support to the clinicians/researchers to make better decisions that can aid in early cancer diagnosis, thereby reducing chances of incorrect disease diagnosis. Thus, this work aimed at designing a classification model that can predict accurately for 5 different cancer types comprising of 20 cancer exomes, using the mutations identified from whole exome cancer analysis. Initially, a basic model was designed using supervised machine learning classification algorithms such as K-nearest neighbor (KNN), support vector machine (SVM), decision tree, naïve bayes and random forest (RF), among which decision tree and random forest performed better in terms of preliminary model accuracy. However, output predictions were incorrect due to less training scores. Thus, 16 essential features were then selected for model improvement using 2 approaches. All imbalanced datasets were balanced using SMOTE. In the first approach, all features from 20 cancer exome datasets were trained and models were designed using decision tree and random forest. Balanced datasets for decision tree model showed an accuracy of 77%, while with the RF model, the accuracy improved to 82% where all 5 cancer types were predicted correctly. Area under the curve for RF model was closer to 1, than decision tree model. In the second approach, all 15 datasets were trained, while 5 were tested. However, only 2 cancer types were predicted correctly. To cross validate RF model, Matthew’s correlation co-efficient (MCC) test was performed. For method 1, the MCC test and MCC cross validation was found to be 0.7796 and 0.9356 respectively. Likewise, for second approach, MCC was observed to be 0.9365, corroborating the accuracy of the designed model. The model was successfully deployed using Streamlit as a web application for easy use. This study presents insights for allowing easy cancer classifications.
Process and Outcome of Community Engagement Event on Substance Use and Addiction Risks Facing Their Immigrant Communities in Regina, Saskatchewan
Authors: Maina Geoffrey , Mousavian Ghazal , Sherstobitoff Jordan , Kamrul Rejina , Twum-Antwi Barbara , Lewis Kennedy , Malonga Francia , Herzog Thea , Maroof Razawa , Okinyo-Owiti Denis
Published: January 2023

Canada is a significant destination for immigrants who are drawn from different ethnic and cultural backgrounds some of whom have a hidden risk for substance use disorders due to acculturation stress and are not screened for risks of substance use or addiction when considering medical admissibility. Not surprisingly, healthcare providers in Regina are reporting a noticeable increase in substance use among immigrants. These immigrants experience barriers in seeking substance use prevention and treatment services due to diverse challenges: stigma, shame, and lack of knowledge of existing services. Considering the discussed challenges and risks of substance use disorders in immigrant communities, creating a safe space for discussing these topics is urgent. To understand and address these challenges, a connection grant from the Saskatchewan Health Research Foundation (SHRF) to mobilize immigrant communities in Regina to explore substance use issues and their impact on the community was sought and received. Subsequently, a Zoom knowledge-sharing event brought settlement agency stakeholders together to deliberate issues on substance use and addiction faced by immigrants in Regina, Saskatchewan. The Zoom session included presentations on immigrants and substance use from the clinical, community, and lived experience perspectives of immigrants. Because of the challenges and risks, this community consultation process revealed that acculturation stress and the ease of obtaining socially acceptable substances fuel substance use and addiction among immigrants in Regina; this is further exacerbated by the lack of programming available to prevent and reduce the risks of substance use in this population. A team of knowledge keepers with lived experiences, service providers, and researchers was assembled to explore substance use and addiction among immigrants. This manuscript reports the process of community engagement to identify solutions to this budding issue. The strengths, challenges, and lessons learned are identified.
Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19: A Systematic Review, Meta-Analysis, and Trial Sequence Analysis
Authors: Shrestha Abhigan Babu , Pokharel Pashupati , Singh Harendra , Shrestha Sajina , Fioni
Published: January 2023

OBJECTIVE

This systematic review and meta-analysis aimed to find the association between serum Krebs von den Lungen-6 (KL-6) and the severity of Coronavirus disease 2019 (COVID-19) infection.

DATA SOURCES

Databases of Embase, PubMed, Web of Science, Science Direct, and Google Scholar were searched for studies reporting KL-6 levels in COVID-19 patients, published between January 2020 and September 30 2022.

DATA SYNTHESIS

For comparison between the groups, standard mean difference (SMD) and 95% confidence intervals (CI) were computed as the effect sizes. Sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were measured to assess the diagnostic power of KL-6. In addition, the summary receiver operating characteristics curve (sROC) was constructed to summarize the true positive (TP), and false positive (FP) rates. To validate the findings of meta-analysis, Trial Sequential Analysis (TSA) was conducted.

RESULTS

Altogether 497 severe COVID-19 patients and 934 non-severe (mild to moderate) COVID-19 patients were included. Pooling of 12 studies indicated that the serum KL-6 level had significant association with severity of COVID-19 infection: standard mean difference = 1.18 (95% CI: 0.93-1.43), p = 0.01; I2: 58.56%]. Pooled diagnostic parameters calculated from eight studies were: sensitivity 0.53 (95% CI: 0.47-0.59); specificity 0.90 (95% CI: 0.88-0.93); positive likelihood ratio 4.80 (95% CI: 3.53-6.53); negative likelihood ratio 0.46 (95% CI: 0.32-0.68); and area under curve: 0.8841. Additionally, TSA verified the adequacy of sample size and robustness of the meta-analysis.

CONCLUSION

Serum KL-6 level has a moderate degree of correlation with the severity of COVID-19 infection but has low sensitivity. So, it is not recommended as a screening test for severe COVID-19 infection.
Understanding Financial Toxicity in Patients with Head and Neck Cancer: A Systematic Review
Authors: Rosi-Schumacher Mattie , Patel Shivam , Phan Chandat , Goyal Neerav
Published: January 2023

Background:

Cancer treatment often results in financial burdens for patients including healthcare costs as well as treatment-induced disability leading to “financial toxicity” (FT) and decreased quality of life. The purpose of this review is to describe FT related to head and neck cancer (HNC) treatment, including quantifications of direct and indirect costs and descriptions of measurement tools.

Methods:

PubMed, Embase, Cochrane Library, and Web of Science databases were searched to identify articles published before April 2022. Full-text published studies were included if they assessed direct or indirect costs of HNC treatment; studies were excluded if they did not focus on HNC or financial burden. The risk of bias was assessed, and the results of the studies were synthesized.

Results:

Database searches yielded 530 unique studies, and 33 studies met the criteria for inclusion. Medical expenses for patients with HNC were higher than for patients with other cancers or controls in several studies. Major surgical procedures, neck dissection, free-flap reconstruction, and intensive care unit admission increased hospital costs. Trimodal therapy with surgery plus chemoradiation represented the most expensive treatment, and chemoradiation increased complication-related health care costs. In several studies, >50% of patients treated for HNC were disabled and did not return to work. One of the greatest contributors to the indirect cost of HNC treatment is the loss of lifetime wages. Patients with HNC are at risk for depression, anxiety, and social isolation, which are linked to a decreased quality of life and treatment non-adherence. The only tools used to assess FT in patients with HNC are the Comprehensive Score for financial Toxicity (COST) and the Financial Index of Toxicity (FIT).

Conclusion:

Financial toxicity is highly prevalent among patients with HNC. Further research is needed to validate the assessment tools for quantifying FT in HNC patients.
Reliability and validity of the Autism Screen for Kids and Youth
Authors: Lavi Rachelle , Stokes Mark A
Published: January 2023

Few instruments screen for autism spectrum disorder (ASD) among kindergarteners and older children. The Autism Screen for Kids and Youth (ASKY) is a 30-item parental questionnaire for 4- to 18-year-old children and adolescents available in Arabic, English, and Hebrew. We examined the sensitivity, specificity, and temporal stability of the Hebrew ASKY’s categorizations (“probable ASD” versus “probable non-ASD”) of 167 autistic and non-autistic 4- to 18-year olds. Algorithm-based categorization following The Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition ( DSM-5) rules demonstrated 91.8% sensitivity, 71.7% specificity, and excellent test–retest reliability (κ = 0.783, 95% confidence interval (CI) = 0.583–0.983, p < 0.001). Total score-based categorization using a cutoff of 9 demonstrated high receiver operating characteristics area under the curve (AUC = 0.874) and high sensitivity (93.4%), specificity (78.3%), internal consistency (Cronbach’s α = 0.954), and test–retest reliability (κscores = 0.674, κinstrument = 0.783). Discussing both categorization approaches, we show that the ASKY is a promising instrument for ASD screening of older children.

Lay Abstract

It is important that autistic children be diagnosed as early as possible so their needs can be met and their families can gain important insights into their behavior and interact with them appropriately. However, very few autism screening instruments are appropriate for children who have outgrown early childhood. The Autism Screen for Kids and Youth (ASKY) presents parents of children aged 4–18 years with 30 items that relate to autistic behaviors as defined by the current clinical diagnostic criteria for autism spectrum disorder ( DSM-5 ASD). We evaluated the Hebrew instrument’s performance on 167 autistic and non-autistic children and adolescents. We found that the ASKY algorithm correctly identified 92% of the autistic individuals as “probable ASD” and correctly identified 72% of the non-autistic individuals as “probable non-ASD,” with these classifications showing excellent stability over time. Using total questionnaire score instead of the algorithm improved the ASKY’s ability to correctly identify autistic individuals as “probable ASD” and non-autistic individuals as “probable non-ASD” to 93% and 78%, respectively. Overall, the ASKY is a promising instrument for ASD screening of older children.
A local modulation signal bispectrum for multiple amplitude and frequency modulation demodulation in gearbox fault diagnosis
Authors: Guo Junchao , He Qingbo , Yang Yang , Zhen Dong , Gu Fengshou , Ball Andrew D
Published: January 2023

This paper proposes a novel multiple amplitude modulation and frequency modulation (AM–FM) demodulation method based on local modulation signal bispectrum (LMSB), which can demodulate the fault features of different components from the gearbox signal with multi-mesh frequency bands and multi-modulation components. Firstly, the collected measurement signal is decomposed into a series of sub-band signals, and the generated sub-band signals are demodulated by modulation signal bispectrum (MSB), which realizes the simultaneous demodulation of multi-mesh frequency bands and multi-modulation components. Subsequently, each sub-band signal resulting from MSB demodulation is synchronously averaged to generate the LMSB, which removes random noise and interference frequencies from the sub-band signals. Finally, the periodic modulation intensity (PMI) is utilized to evaluate the ability of the LMSB to demodulate multi-component signals with AM–FM components. The effectiveness of LMSB in processing multi-component signals with AM–FM components is demonstrated by numerical simulation signals and experimental analysis. Analysis results demonstrate the superiority of LMSB in multiple AM–FM demodulation compared with MSB, envelope analysis (EA) and Teager energy operator (TEO). This research provides a novel perspective for gearbox fault detection.
Lightweight semantic segmentation of complex structural damage recognition for actual bridges
Authors: Xu Yang , Fan Yunlei , Li Hui
Published: January 2023

Although structural damage recognition has been extensively investigated using deep learning and computer vision (CV) techniques, the following limitations exist for real-world applications: (1) the accuracy heavily relies on a large volume of network parameters; (2) the sensitivity to tiny cracks is limited due to low contrast between microcrack and background pixels; (3) the robustness on complex cracks with various morphological features and surface disturbances is inadequate. To address these issues, this study proposes a lightweight, accurate, and robust semantic segmentation method of complex structural damage recognition for actual bridges. Firstly, a modified DeepLabv3+ model is established using the lightweight MobileNetV2 backbone and transposed convolutions to reduce parameter volume and enhance the recognition capability of local minor damages. Secondly, the depthwise separable convolution is utilized instead of the standard convolution to decouple the spatial and channel interactions of feature maps. Thirdly, a refined atrous spatial pyramid pooling (ASPP) module is constructed at the backbone end using multilevel dilated convolutions to expand the receptive fields. Finally, a piecewise synthetical loss function based on focal and dice losses is designed for different training stages. A total of 3226 actual crack images in different scales, resolutions, and scenes are utilized to verify the proposed method. The results show that the mean intersection-over-union for complex cracks in various real-world scenarios reaches 0.776 with significant reductions of 91.5% in parameter volume and 38.9% in recognition time. Comparative studies demonstrate the superiority of the proposed method over existing lightweight crack segmentation models based on SegNet and DenseNet. In addition, ablation experiments demonstrate the necessity and effectiveness of the MobileNetV2 backbone, refined ASPP module, and piecewise synthetical loss function. Moreover, the robustness and expandability of the proposed method on new structural damage categories (including concrete spalling, rebar exposure, and cable corrosion) are also verified.
Initial structural damage detection approach via FE-based data augmentation and class activation map
Authors: Jeong Inho , Kim Hyejin , Cho Haeseong , Park Hyungbum , Kim Taeseong
Published: January 2023

Damage is generally initiated locally and spread to the entire structure. To avoid the destruction of the entire structure, it is crucial to detect and act on damage at an early stage through the real-time monitoring of the entire structure. However, the attachment of the many sensors to obtain sufficient detection resolution could change the structural dynamic characteristics of the structure. To compensate for these shortcomings, research has been conducted on digital image correlation (DIC) as a non-contact method of displacement/strain measurement. In addition, the real-time monitoring of a structure using DIC equipment is relatively straightforward. The final goal of this study is to predict the location of damage using the displacement of the structure surface which can be via DIC. This paper introduces a method for monitoring damage locations using a class activation map (CAM) network. The feasibility of the proposed process using the finite element method for an example considering the experimental situation was confirmed. To generate training data, the finite element method was used to obtain the displacement and strain of a target structure. Herein, sub-structuring approach with data augmentation using Gaussian integration point interpolation were employed to obtain the benign performance of the proposed approach. Thus, the proposed CAM network could classify the presence or absence of damage by considering strain fields. Moreover, the relevant result of the CAM network is a CAM image, which indicates the location of the damage. Finally, this CAM network was applied to a tensile specimen example and show good performance in the classification and detection of damage locations.
Polarization, Media Professionalism, and Support for Press Freedoms in Sub-Saharan Africa: A Report on Early Results
Authors: VonDoepp Peter , Young Daniel J
Published: January 2023

This article reports on early results of a research project examining popular support for media freedoms in sub-Saharan Africa. Using data from the Afrobarometer surveys, as well as other sources, we specifically examine cross-national variation in support for media freedoms, seeking to account for the national-level factors that affect that variation. Our findings suggest the importance of two factors in particular. The first is the level of polarization in society. Using a novel measure of this factor, we find that higher levels of polarization are associated with lower levels of support for media freedoms. The second factor is the level of professionalism characterizing the media sector. We find that lower levels of media professionalism drive down support for media freedoms. Further research will explore these through the use of multilevel analysis that incorporates investigation of individual-level factors shaping support for media freedoms.
Efficacy and Safety of East Asian Herbal Medicine for Brain Metastases in Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis Protocol to Identify Specific Herbs
Authors: Xu Bowen , Ge Yuansha , Wang Heping , Zhang Xiaoxiao , Wu Jingyuan , Li Jie
Published: January 2023

Introduction:

Brain metastasis (BM) is a significant risk factor for survival and prognosis in non-small cell lung cancer (NSCLC). While surgical resection and radiotherapy are the primary treatment modalities, the overall prognosis in NSCLC patients with BM remains poor, and all therapies lead to adverse events. East Asian herbal medicine (EAHM) has broad prospects as an adjuvant treatment, but its efficacy and safety remain controversial. We propose to conduct a systematic review and meta-analysis to summarize the clinical efficacy and safety of EAHM for the treatment of NSCLC with BMs and to identify specific herbs that can improve the prognosis.

Methods:

The PubMed, EMBASE, CENTRAL, Web of Science, CBM, CNKI, Wanfang, VIP, Evidence Reports on Kampo Treatment, ICHUSHI, and Oriental Medicine Advanced Searching Integrated System databases will be searched from their inception to October 2022. Randomized controlled trials will be included. Two authors will evaluate the eligibility and quality of the included trials. The methodological quality will be assessed using the RoB 2 tool, and Stata 16 will be used for data synthesis. Publication bias will be assessed using funnel plots and Egger tests. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system will evaluate the quality of the synthesized evidence. Further sensitivity analyses will be performed to determine the efficacies of specific herbs in EAHM.

Discussion:

Given there are currently no systematic reviews and meta-analyses of the efficacy of EAHM as a treatment for NSCLC with BMs, a compilation and analysis of the available high-quality clinical research evidence are essential. The results will help establish guidelines for the application of specific herbs as a complementary alternative therapy for BMs in NSCLC. The findings will be published in a peer-reviewed journal.

PROSPERO registration number:

CRD42022300527.
Disability Research in Australia: Deciding to Be a Research Participant and the Experience of Participation
Authors: Slattery Maddy , Ehrlich Carolyn , Norwood Michael , Amsters Delena , Allen Gary
Published: January 2023

Little is known about why people with disability choose to take part in disability research and what their experience is like. Knowledge of this may help researchers and research ethics committees improve the empowered and ethical participation of people with disability in disability, healthcare, and human service focussed research. This cross-sectional mixed-methods study explored the perspectives and experiences of a group of Australian adults with disability regarding their involvement in research. Online surveys (N = 29) and follow-up interviews (N = 15) were conducted. The study found the decision to participate was a complex appraisal of benefit to self and others, research relevance, value, comfort, convenience, safety and risk. The attitudes and behaviours of researchers in cultivating trust by adopting an empathic approach to the conduct of disability research appear to be an important aspect of participant experience. Research ethics committees may benefit from knowledge of the ‘microethical’ moments that occur in such research.
Bullying and intellectual disability from the perspective of students
Authors: Llauradó Esther Vela , Estévez Ana López
Published: January 2023

Bullying has been a recurrent phenomenon throughout the history of education. Among those most vulnerable are those with intellectual disabilities who tend to suffer greater levels of victimisation. The purpose of this research is to analyse the prevalence of bullying of students with intellectual disability in ordinary schools compared to special education schools. The project used a nonexperimental, descriptive and correlational methodology with a sample of 99 students who completed the validated European Bellying Intervention Project Questionnaire measurement tool. The results show that the majority of students who were victimised by bullies left their ordinary school during secondary education. Within ordinary schools, students with disabilities are more likely to experience bullying in the role of victim while in special education schools the most frequent role is that of observer.
Atopic Dermatitis: Diagnosis, Disparity, and Management in Children of Color
Authors: Brar Kanwaljit K. , Singh Anne Marie , De Guzman Nancy , Aquino Marcella
Published: January 2023

Atopic dermatitis (AD), sometimes referred to as eczema, is the most common chronic skin condition in children. Children of color have a higher reported prevalence of AD compared with their White counterparts. The purpose of this article is to discuss the differences of AD in skin of color (SOC), including clinical findings and management, with an emphasis on early recognition to avoid more severe, persistent disease. School nurses are on the frontline for these students with their ability to guide families and help support students with AD in the school setting.
Treatment preferences in relation to fatigue of patients with relapsing multiple sclerosis: A discrete choice experiment
Authors: Tervonen Tommi , Fox Robert J , Brooks Anne , Sidorenko Tatiana , Boyanova Neli , Levitan Bennett , Hennessy Brian , Phillips-Beyer Andrea
Published: January 2023

Background

Treatment decisions for multiple sclerosis (MS) are influenced by many factors such as disease symptoms, comorbidities, and tolerability.

Objective

To determine how much relapsing MS patients were willing to accept the worsening of certain aspects of their MS in return for improvements in symptoms or treatment convenience.

Methods

A web-based discrete choice experiment (DCE) was conducted in patients with relapsing MS. Multinomial logit models were used to estimate relative attribute importance (RAI) and to quantify attribute trade-offs.

Results

The DCE was completed by 817 participants from the US, the UK, Poland, and Russia. The most valued attributes of MS therapy to participants were effects on physical fatigue (RAI = 22.3%), cognitive fatigue (RAI = 22.0%), relapses over 2 years (RAI = 20.7%), and MS progression (RAI = 18.4%). Participants would accept six additional relapses in 2 years and a decrease of 7 years in time to disease progression to improve either cognitive or physical fatigue from “quite a bit of difficulty” to “no difficulty.”

Conclusion

Patients strongly valued improving cognitive and physical fatigue and were willing to accept additional relapses or a shorter time to disease progression to have less fatigue. The impact of fatigue on MS patients’ quality of life should be considered in treatment decisions.
Isolated, Full-Thickness Proximal Rectus Femoris Injury in Competitive Athletes: A Systematic Review of Injury Characteristics and Return to Play
Authors: Knapik Derrick M. , Alter Thomas D. , Ganapathy Aravinda , Smith Matthew V. , Brophy Robert H. , Matava Matthew J.
Published: January 2023

Background:

Characteristics regarding mechanism of injury, management, and return-to-play (RTP) rate and timing are important when treating and counseling athletes with rectus femoris tears.

Purpose:

To systematically review the literature to better understand the prevalence, sporting activity, injury mechanisms, and treatment of patients with rectus femoris injury and to provide prognostic information regarding the rate and timing of RTP.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Following the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we queried PubMed/MEDLINE, Cochrane, OVID, EMBASE, and Google Scholar in March 2022 for studies reporting on athletes sustaining isolated, full-thickness tearing, or bony avulsion injuries to the proximal rectus femoris during sporting activity. Excluded were studies without evidence of full-thickness tearing or avulsion, with athletes sustaining concomitant injuries, or with injuries occurring from nonsporting activities. The percentage of athletes sustaining injuries was calculated based on sport, injury mechanism, and management (nonoperative versus operative).

Results:

Of 132 studies initially identified, 18 were included, comprising 132 athletes (mean age, 24.0 ± 5.4 years; range, 12-43 years). The most common sporting activities were soccer (70.5%) and rugby (15.2%). The most reported mechanisms of injury were kicking (47.6%) and excessive knee flexion/forced hip extension (42.9%). Avulsion injuries were reported in 86% (n = 114) of athletes. Nonoperative management was reported in 19.7% of athletes, with operative management performed in 80.3%. The mean follow-up time was 21.4 ± 11.4 months (range, 1.5-48 months). The RTP rate was 93.3% (n = 14) in nonoperatively treated and 100% (n = 106) in operatively treated athletes, and the mean RTP time was 11.7 weeks (range, 5.5-15.2 weeks) in nonoperatively treated and 22.1 weeks (range, 14.0-37.6 weeks) in operatively treated athletes. Complications were reported in 7.7% (2/26) of nonoperatively treated and 18% (n = 19/106) of operatively treated athletes.

Conclusion:

Full-thickness proximal rectus femoris injuries occurred most frequently in athletes participating in soccer and rugby secondary to explosive, eccentric contractions involved in kicking and sprinting. Operative management was performed in the majority of cases. Athletes who underwent operative repair had a 100% RTP rate versus 93.3% in athletes treated nonoperatively.
Determinants of Awareness of Clinical Practice Guidelines among Healthcare Users in Japan
Authors: Sato Yasuto , Okumura Akiko , Nohara Michiko , Fukuoka Toshio
Published: January 2023

Clinical practice guidelines (CPGs) are used by both healthcare users and providers, so their recognition is important. The present study's purpose was to clarify the features of healthcare users who are aware of the CPGs. A cross-sectional survey was conducted targeting Internet survey panels ( n = 6000). The study participants (age range, 20s to 60s) had no medical qualifications and had received medical care in the last 3 months. Multivariate logistic regression analysis was performed to clarify the factors related to the awareness of CPGs. When “I have seen the CPGs” was used as the objective variable, the odds ratios (ORs) were high for “e-health literacy/score 31–40” (OR = 8.72, 95% confidence interval [CI]: 6.51-11.68), “Sources of health information/healthcare workers and professionals” (OR = 2.61, 95% CI: 2.17-3.14), “Age/20s” (OR = 2.38, 95% CI: 1.74–3.23), and “I have been diagnosed and treated for a major illness” (OR = 2.01, 95% CI: 1.52–2.65). These results could be applied to aid the dissemination and utilization of CPGs among healthcare users.
Multi-criteria decision-making approach for optimal seismic/energy retrofitting of existing buildings
Authors: Caruso Martina , Pinho Rui , Bianchi Federica , Cavalieri Francesco , Lemmo Maria Teresa
Published: January 2023

Given the current climate emergency and the ambitious targets of carbon emissions reduction worldwide, retrofitting strategies on existing buildings are typically aimed at reducing their energy demand, decarbonizing the power supply, and addressing embodied carbon stored in construction materials. However, the contribution of potential earthquake-induced impacts has been traditionally not considered, while the consequences of several past events highlighted their relevant impact on the environment due to post-disaster rehabilitation activities. This study presents a multi-criteria decision-making approach for the identification of optimal renovation strategies for existing buildings, based on economic and environmental life cycle impacts (including both earthquake-induced losses and energy consumption), payback period of the retrofit investment and expected loss of life due to seismic hazard, through its application to a case-study building. Such parameters are thus suggested as meaningful decision-making variables for the choice of the best retrofitting strategy for a given building, that is the one that leads to an optimal balance between reduction of seismic vulnerability and increase of energy efficiency, based on the climatic conditions and the seismic hazard at the site of interest.
Response and failure mechanism of utility tunnel with flexible joints under reverse fault: An experimental, numerical, and analytical investigation
Authors: Wang Zhigang , Tao Lianjin , Shi Cheng , An Shao , Liu Jun
Published: January 2023

Severe seismic damage occurs to tunnels across or adjacent to the active faults in a high-intensity earthquake area. Therefore, investigating the response and failure mechanism of the utility tunnel structure with flexible joints across the reverse fault is of significant importance. This paper conducts a model test of 1:30, modelling reverse fault rupture with a 45° dip angle and a utility tunnel with flexible joints embedded in the sand layer. The results show that the lining structure in the hanging wall area appears to have longitudinal cracks, concrete falls off, and there is continuous dislocation. Then, a nonlinear three-dimensional finite element model (FEM) is adapted to reveal the utility tunnel response under reverse faulting and to simulate the model test. The numerical results show that the tensile failure area of the lining caused by reverse faulting is larger than the compression failure area. The damage distribution has regional characteristics, and especially the joint area is seriously damaged. The settlement profile of the tunnel under reverse fault can be fitted reasonably by a complementary error function. Finally, an analytical solution of the longitudinal response of the tunnel under reverse fault based on the double-parameter Pasternak model is derived. The analytical solution results show good agreement with the numerical and experimental results. The longitudinal response of the tunnel under reverse fault can be divided into two parts: the influence zone and the non-influenced zone. The flexible joints significantly reduce the damage degree and the damaged area of the tunnel caused by reverse fault dislocation.