bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of laser micro-drilling machinability and performance optimization of polymer nanocomposites reinforced with different carbon allotropes
Authors: Mishra Lipsamayee , Mahapatra Trupti Ranjan , Mishra Debadutta , Parimanik Soumya Ranjan
Published: March 2023

The comparative assessment of the laser micro-drilling machinability of polymer matrix nanocomposites dispersed with conducting fillers of different carbon allotropes (carbon nanotube (CNT), graphite, and carbon black (CB)) to produce minimum taper and heat-affected zone (HAZ) has been first time reported in this article. The required composite specimens are synthesized via ultrasonicator-assisted compression molding method and characterized for their thermal, electrical, and mechanical properties. The central composite design-based response surface methodology (CRSM) is implemented for the planification of experimentation using a pulsed Nd:YAG laser and subsequent higher-order regression modeling of the desired performance indicators. The contemporary accelerated particle swarm optimization (APSO) technique and metaheuristic whale optimization algorithm (WOA) have been utilized to define optimum controllable process parameters (pulse frequency, cutting speed, lamp current, and air pressure) and the assortment of optimum conditions are justified by performing confirmatory tests. CNT-reinforced composite material exhibits superior tensile, hardness, and thermal properties whereas graphite-based polymer composite show good electrical conductivity. The most minor taper and HAZ values are observed in the laser micro-drilling of epoxy-based CNT and CB materials, respectively. The two swarm-based algorithms predict more accurate results for the desired output responses than the statistical CRSM, with the least errors compared to the values attained by the WOA. Optimal taper (with CNT/epoxy composite at 30 m/s cutting speed, 22.6 amp lamp current, 3 kHz pulse frequency, and 1 kg/cm2 air pressure) and HAZ (with CB/epoxy composite at 30 m/s cutting speed, 22.97 amp lamp current, 3 kHz pulse frequency, and 5 kg/cm2 air pressure) values obtained in the confirmatory test showed 15% and 12% errors, respectively, as compared to the predicted data in WOA.
A Qualitative Study on Challenges Faced by Postnatal Mothers
Authors: Sabitha Nayak , Kumar Shetty Prasanna
Published: March 2023

The core variable arrived at were Challenges of postnatal motherhood phenomenon from mothers’ perspective, eight essential themes were developed, and they were as follows: ‘Contented with the birth experience; A wider perspective of womanhood’. ‘Coming up with physiological and emotional challenges; a note worthy experience’. ‘Being happy with the gender of the baby; A God given gift’. ‘Glad to be a mother with a good family support’. ‘Happy to receive the intended care in the hospital; a boon to every mother’. ‘Ready to face challenges; marital perspective’. ‘Newborn care; a tender loving care of womanhood’. ‘Joyous moment to be with the newborn but unhappy due to physical and psychological alteration’.

Interpretation and Conclusion

The findings of the study throw light on various challenges faced by mothers and their coping strategies. In this study majority of the mothers had least to moderately expressed challenges and highly expressed challenges were minimal. This could be hypothesised that the study participants were from a rural setting where most of the mothers are unemployed and most of the mothers have a good support system which helps them to face challenges positively. Nevertheless, literature shows that Emotional challenges, Breastfeeding challenges and newborn care challenges are faced globally which can be addressed by creating awareness programmes. This can be achieved through nurse-led clinics on childbirth education in the OBG and Paediatric units with Mathr Shiksha Abhiyaan which will benefit most of the Pregnant and lactating mothers coming to OPD.
The Court of Justice in JY v. Wiener Landesregierung: Could we expect more?
Authors: Bellenghi Guido
Published: March 2023

The ruling of the Grand Chamber of the Court of Justice in Case C-118/20 JY v. Wiener Landesregierung EU:C:2022:34 follows the judgments in Rottmann and Tjebbes. These cases concern the relationship between EU law and national citizenship. In particular, they deal with the compatibility of national authorities’ decisions on loss of nationality with the proportionality principle. The JY v. Wiener Landesregierung case highlights the contradictory nature of nationality law, which cannot be fully understood from a purely domestic perspective and yet remains within the sphere of Member States’ competences. Overall, the decision of the CJEU in JY v. Wiener Landesregierung leaves a bittersweet taste in EU lawyers’ mouths. On the one hand, the Court appears to implicitly make clear its aversion for certain national practices. In doing so, it ensures, in the case in question, a higher degree of protection of EU law-derived rights. On the other hand, the ruling does not adequately ensure sufficient safeguards for similar future cases. Finally, the Court seems to have missed a significant opportunity provided by the principle of mutual trust.
Causal Variations at IRF6 Gene Identified in Van der Woude Syndrome Pedigrees
Authors: Yang Cheng-Wei , Yin Bin , Shi Jia-Yu , Shi Bing , Jia Zhong-Lin
Published: March 2023

The purpose of this study is to analyze the clinical characteristics of patients with Van der Woude syndrome (VWS) and to detect variations in each patient. Finally, the combination of genotype and phenotype can make a clear diagnosis of VWS patients with different phenotype penetrance.

Five Chinese VWS pedigree were enrolled. Whole exome sequencing of the proband was performed, and the potential pathogenic variation was further verified by Sanger sequencing in the patient and their parents. The human mutant IRF6 coding sequence was generated from the human full-length IRF6 plasmid by site-directed mutagenesis and cloned into the GV658 vector, RT-qPCR and Western blot were used to detect the expression of IRF6.

We found one de novo nonsense variation (p. Gln118Ter) and three novel missense variations (p. Gly301Glu, p. Gly267Ala, and p. Glu404Gly) co-segregated with VWS. RT-qPCR analysis revealed that p. Glu404Gly significantly reduced the expression level of IRF6 mRNA. Western blot of cell lysates confirmed that IRF6 p. Glu404Gly abundance levels were lower than those for IRF6 wild type.

This discovery of the novel variation ( IRF6 p. Glu404Gly) expands the spectrum of known variations in VWS in Chinese humans. Genetic results combined with clinical phenotypes and differential diagnosis points from other diseases can make a definitive diagnosis and provide genetic counseling for families.
High-Density IgG4+ Plasma Cells Infiltration Is Associated With Fibroplasia in Fibrostenotic Crohn's Disease
Authors: Escobar David , Bushara Omar , Sun Leyu , Liao Jie , Yang Guang-Yu
Published: March 2023

Transmural fibrosis and stricture formation are key pathogenic processes for Crohn's disease that underlies clinical refractoriness, resulting in severe morbidity. The mechanisms for fibroplasia in Crohn's are not fully elucidated. In this study, we identified a cohort of refractory Crohn's disease with surgically resected bowel specimens including cases with bowel stricture and age-/sex-matched refractory disease without bowel stricture. Via immunohistochemistry, density and distribution of IgG4+ plasma cells in resected cases were analyzed. The histologic severity of fibrosis and association with gross evidence of stricture formation and IgG4+ plasma cells were comprehensively analyzed. Our results showed that density of IgG4+ plasma cells/high-power field (IgG4+ PCs/HPF) was significantly associated with increasing histologic fibrosis score (15 IgG4+ PCs/HPF in specimens with fibrosis score 0 vs 31 IgG4+ PC/HPF in fibrosis score 2 and 3, P = .039). Patients with gross evidence of stricture had significantly higher fibrosis scores compared to those without gross evidence of stricture ( P = .044). There was a trend that mean IgG4+ plasma cell count was higher in Crohn's disease with gross stricture formation ( P = .26), although it did not reach statistical significance (likely due to multiple pathogenesis events involved in bowel stricture formation besides IgG4+ plasma cells; such as transmural fibrosis, muscular hypertrophy, transmural ulcer/scar formation, and muscular–neural dysfunction). Our findings indicate IgG4+ plasma cells are associated with increasing histologic fibrosis in Crohn's. Further research is needed to establish a role for IgG4+ plasma cells in fibroplasia with an eye toward potential medical therapies targeting IgG4+ plasma cells to prevent transmural fibrosis.
Mental Health and Well-being Measures for Mean Comparison and Screening in Adolescents: An Assessment of Unidimensionality and Sex and Age Measurement Invariance
Authors: Black Louise , Humphrey Neil , Panayiotou Margarita , Marquez Jose
Published: March 2023

Adolescence is a period of increased vulnerability for low well-being and mental health problems, particularly for girls and older adolescents. Accurate measurement via brief self-report is therefore vital to understanding prevalence, group trends, screening efforts, and response to intervention. We drew on data from the #BeeWell study ( N = 37,149, aged 12–15) to consider whether sum-scoring, mean comparisons, and deployment for screening were likely to show bias for eight such measures. Evidence for unidimensionality, considering dynamic fit confirmatory factor models, exploratory graph analysis, and bifactor modeling, was found for five measures. Of these five, most showed a degree of non-invariance across sex and age likely incompatible with mean comparison. Effects on selection were minimal, except sensitivity was substantially lower in boys for the internalizing symptoms measure. Measure-specific insights are discussed, as are general issues highlighted by our analysis, such as item reversals and measurement invariance.
Mammographic Density Reduction is Associated to the Prognosis in Asian Breast Cancer Patients Receiving Hormone Therapy
Authors: Shia Wei-Chung , Lin Li-Sheng , Wu Hwa-Koon , Chen Chih-Jung , Chen Dar-Ren
Published: March 2023

Introduction

Using mammographic density as a significant biomarker for predicting prognosis in adjuvant hormone therapy patients is controversial due to the conflicting results of recent studies. This study aimed to evaluate hormone therapy-induced mammographic density reduction and its association with prognosis in Taiwanese patients .

Methods

In this retrospective study, 1941 patients with breast cancer were screened, and 399 patients with estrogen receptor -positive breast cancer who received adjuvant hormone therapy were enrolled. The mammographic density was measured using a fully automatic estimation procedure based on full-field digital mammography. The prognosis included relapse and metastasis during treatment follow-up. The Kaplan-Meier method and Cox proportional hazards model were used for disease-free survival analysis.

Results

A mammographic density reduction rate >20.8%, measured preoperatively and after receiving hormone therapy from 12-18 months, was a significant threshold for predicting prognosis in patients with breast cancer. The disease-free survival rate was significantly higher in patients whose mammographic density reduction rate was >20.8% (P = .048).

Conclusion

This study’s findings could help estimate the prognosis for patients with breast cancer and may improve the quality of adjuvant hormone therapy after enlarging the study cohort in the future.
Resilience and Challenges Among Women With Histories of Addiction and Victimization Newly Admitted to a Sober Living Home: A Brief Report
Authors: Edwards Katie M. , Siller Laura
Published: March 2023

This study examined strengths (i.e., empowerment, purpose) and challenges (i.e., depressive and posttraumatic stress disorder symptomatology, financial and housing worries) experienced by women ( N = 44) with histories of addiction and victimization newly admitted to a sober living home (SLH). Women had moderate to high levels of both strengths and challenges. In general, strengths and challenges were inversely related (e.g., higher purpose was related to lower depression), and challenges were positively related (e.g., higher financial worries were related to higher posttraumatic stress symptoms). The findings remind us that women entering SLHs have myriad needs and that comprehensive services drawing upon women's resilience are needed.
Disruptive Technologies and Innovation in Hospitality: A Computer-Assisted Qualitative Data Analysis Approach
Authors: Lee Minwoo , Sisson Annamarie D. , Costa Rui , Bai Billy
Published: March 2023

As emerging digital technologies have been used for disruptive innovation and business models, an essential component for hospitality researchers and practitioners is to determine the role of disruptive technologies and innovation in hospitality businesses. This study synthesizes prior research on disruptive innovation and identifies disruptive technologies in the hospitality context. A thematic analysis was performed through a computer-assisted qualitative data analysis approach using 23 publicly traded hospitality companies. Results reveal that disruptive technology and innovation are among the most critical strategic aspects in contemporary hospitality firms. This study provides contributions to hospitality researchers and practitioners to implement disruptive technologies for superior business performance. This study is among the first to introduce and synthesize disruptive technologies and innovation in the hospitality context.
Association between vitamin D and myopia in adolescents and young adults: Evidence of national cross-sectional study
Authors: Zhang Rui-Heng , Yang Qiong , Dong Li , Li Yi-Fan , Zhou Wen-Da , Wu Hao-Tian , Li He-Yan , Shao Lei , Zhang Chuan , Wang Ya-Xing , Wei Wen Bin
Published: March 2023

Purpose

Studies have indicated that the observed association between vitamin D and myopia was confounded by time spent outdoors. This study aimed to elucidate this association using a national cross-sectional dataset.

Methods

Participants with 12 to 25 years who participated in non-cycloplegic vision exam from National Health and Nutrition Examination Survey (NHANES) 2001 to 2008 were included in the present study. Myopia was defined as spherical equivalent of any eyes ≤ −0.5 diopters (D).

Results

7,657 participants were included. The weighted proportion of emmetropes, mild myopia, moderate myopia, and high myopia were 45.5%, 39.1%, 11.6%, and 3.8%, respectively. After adjusting for age, gender, ethnicity, TV/computer usage, and stratified by education attainment, every 10 nmol/L increment of serum 25(OH)D concentration was associated with a reduced risk of myopia (odds ratio [OR] = 0.96, 95% confidence interval [95%CI] 0.93–0.99 for any myopia; OR = 0.96, 95%CI 0.93–1.00 for mild myopia; OR = 0.99, 95%CI 0.97–1.01 for moderate myopia; OR = 0.89, 95%CI 0.84–0.95 for high myopia). Serum 25(OH)D level was closely correlated with time spent outdoors. After categorizing time spent outdoors into quarters (low, low-medium, medium-high, and high), every 1 quarter increment of time spent outdoors was associated with 2.49 nmol/L higher serum 25(OH)D concentration. After adjusting for time spent outdoors, serum 25(OH)D level did not show significant association with myopia (OR = 1.01, 95%CI 0.94–1.06 for 10 nmol/L increment).

Conclusions

The association between high serum vitamin D and reduced risk of myopia is confounded by longer time spent outdoors. Evidence from the present study does not support that there is a direct association between serum vitamin D level with myopia.
Pharmacophore-Aided Virtual Screening and Molecular Dynamics Simulation Identifies TrkB Agonists for Treatment of CDKL5-Deficiency Disorders
Authors: Ademuwagun Ibitayo Abigail , Oduselu Gbolahan Oladipupo , Rotimi Solomon Oladapo , Adebiyi Ezekiel
Published: March 2023

Therapeutic intervention in cyclin-dependent kinase-like 5 (CDKL5) deficiency disorders (CDDs) has remained a concern over the years. Recent advances into the mechanistic interplay of signalling pathways has revealed the role of deficient tropomyosin receptor kinase B (TrkB)/phospholipase C γ1 signalling cascade in CDD. Novel findings showed that in vivo administration of a TrkB agonist, 7,8-dihydroxyflavone (7,8-DHF), resulted in a remarkable reversal in the molecular pathologic mechanisms underlying CDD. Owing to this discovery, this study aimed to identify more potent TrkB agonists than 7,8-DHF that could serve as alternatives or combinatorial drugs towards effective management of CDD. Using pharmacophore modelling and multiple database screening, we identified 691 compounds with identical pharmacophore features with 7,8-DHF. Virtual screening of these ligands resulted in identification of at least 6 compounds with better binding affinities than 7,8-DHF. The in silico pharmacokinetic and ADMET studies of the compounds also indicated better drug-like qualities than those of 7,8-DHF. Postdocking analyses and molecular dynamics simulations of the best hits, 6-hydroxy-10-(2-oxo-1-azatricyclo[7.3.1.05,13]trideca-3,5(13),6,8-tetraen-3-yl)-8-oxa-13,14,16-triazatetracyclo[7.7.0.02,7.011,15]hexadeca-1,3,6,9,11,15-hexaen-5-one (PubChem: 91637738) and 6-hydroxy-10-(8-methyl-2-oxo-1H-quinolin-3-yl)-8-oxa-13,14,16-triazatetracyclo[7.7.0.02,7.011,15]hexadeca-1,3,6,9,11,15-hexaen-5-one (PubChem ID: 91641310), revealed unique ligand interactions, validating the docking findings. We hereby recommend experimental validation of the best hits in CDKL5 knock out models before consideration as drugs in CDD management.
Engender(ing) immigrant space: A praxis through collaborative storytelling and interactive documentary
Authors: Akram Sana
Published: March 2023

Immigrant space – a place of convergence of multiple movements – engenders through rhythms of the everyday and an art of inhabitation of its people. It comprises stories of resilience that must be amplified and celebrated, especially when they are at a threat of erasure on account of systemic and structural violence, and/or a lack of concerted effort to document them. Little Pakistan is one such immigrant space inhabited by Pakistani Americans in Brooklyn, New York City. In this article, I propose a framework titled ‘Engender(ing)’ for a rediscovery of meanings vested in immigrant space, explaining its emergence and expansion across forms, delimitations and associations. The framework is then applied through a confluence of collaborative storytelling and interactive documentary. The outcome, Little Pakistan – Future Histories, is an interactive documentary project presented as a case study, with people – artist, community, publics – assuming the role of ‘innovators of meanings’ to rediscover Little Pakistan as an ‘ensemble of meanings’. I infer that this framework and its praxis offer promise for future collaborative new media documentary practice and research in the context of other immigrant enclaves, neighborhoods and similarly structured spaces.
‘It’s a generational thing, really’. Understandings of sexual rights in a digital age
Authors: Spišák Sanna
Published: March 2023

Deriving from a large-scale research project on intimacy in data-driven culture in Finland, I build on a sub-study examining Finland’s presumed sexual digital divide between generations. I analysed in-depth, semi-structured research discussions with six social media users who actively participated in the online discussion following the posting of a video on TikTok by the National Board of Investigation on the potential risks and dangers of sending nude images online. I wanted to know why this particular ‘awareness-raising video’ gained so much negative feedback from its young audiences on TikTok and other social media platforms. By using the idea of ‘generational sexualities’, I focus on the shared social imaginary the research participants seem to have on the sexual and digital divide between generations. As a result of my analysis, I propose that the idea of a generational gap regarding the digital modes of sexual engagement is a culturally and socially shared narrative contributing to a disconnective effect between the generations in sexual matters. Furthermore, the analysis of my research materials reveals that young people’s ‘full sexual rights’ operate as a specific generational narrative that organises and structures my research participants’ perspectives of what is inclusive and socially just sexual education. The educational efforts must go beyond risk and harm as ‘no-sexting’ educational materials may contribute to sexual discrimination and marginalisation, increase social inequality and negatively impact young people’s sexual wellbeing.
Decoupling mechanism of industry carbon emissions, carbon intensity and economic growth in Pakistan
Authors: Amir Iqbal , Tang Xuan , Jahangir Sayeda , Yang Yuqing , Rasool Samma Faiz
Published: March 2023

The study examined the decoupling relationship between industry carbon emissions and economic growth using the most current updated data. We collected data from the industry sector of Pakistan from 1991 to 2018. This study used two techniques, Tapio’s elasticity and fluctuation index, to test the decoupling relationship and the relationship’s stability between industry carbon emissions and economic growth. First, we analyzed the decoupling relationship between industry carbon emissions and economic growth in Pakistan using Tapio’s decoupling model, decoupling the elasticity of technology, scale and structure. Second, the decoupling volatility index was used to determine the stability of the technology, scale and structure elasticity. The Tapio decoupling elasticity technique results confirmed the significant relationship between industry CO2 emissions, economic growth and added value comes out to be a simple feature of each stage and undergoes expansive negative and strong decoupling processes. The outcomes of elastically decoupled volatility indexes suggest that three out of four indices are high, indicating unstable decoupling conditions. This study concludes that growth and volatility were the crucial characteristics of industrial carbon emissions during 1991–2018. Hence, the industry’s carbon emissions were increased from 16.67 million tons in 1991 to 55.70 million tons in 2018, an average yearly growth of 4.56%.
How supranational institutions benefit from crises: Member states’ solidarity and the EU's image during the COVID-19 pandemic
Authors: Papageorgiou Achillefs , Immonen Waltteri
Published: March 2023

In this article, we demonstrate how solidarity between member states can have a positive effect on the image of the EU, even if the latter's actions in handling a crisis such as the COVID-19 pandemic are deemed unsatisfactory. Employing data from a special Eurobarometer survey enriched with data from the Oxford's COVID-19 government response tracker, we show that European citizens who are more satisfied with interstate solidarity have to a greater extent a positive image of the EU compared to citizens who are less satisfied. We also show that this effect is further pronounced in the case of EU citizens who are less satisfied with institutional solidarity, which is the solidarity going from EU institutions to the member states.
Low-velocity impact performance of ultra-high molecular weight polyethylene/aramid-polyester core-spun yarn hybrid composites
Authors: Guo Weinan , Chang Hao , Ni Jiahuan , Zhu Kai , Gao Bo , Yang Dan , Gao Yantao
Published: March 2023

The impact resistant composite has excellent energy absorption efficiency, but the structure and material selection of the composite have great influence on its energy absorption. In order to explore the effect of structure on the energy absorption of Ultra-high molecular weight polyethylene (UHMWPE) composites and the application potential of new aramid core-spun yarn and new polyester core-spun yarn in impact resistant composites. The UHMWPE composites with different fiber orientations and stacking sequences structure, as well as the new hybrid composites containing aramid core-spun yarn and polyester core-spun yarn were tested by low-velocity impact test and scanning electron microscope (SEM) observation. The differences of energy absorption of UHMWPE composites with different structures and the advantages of the new hybrid composites were analyzed. The results show that the energy absorption of the 45°/0°/90°/−45° UHMWPE composite is 15% and 86% higher than that of the 0°/90°/0°/90°UHMWPE composite and the 0°/90°/45°/−45° UHMWPE composite, respectively, which is the best structure among the three composites. The energy absorption performance of the composites introduced with aramid core-spun yarn and polyester core-spun yarn were improved by 223% and 202%, respectively, so that the energy absorption performance was significantly improved by new yarns.
Therapist-Assisted Internet-Delivered Cognitive Behavioral Therapy for Insomnia: A Case Report
Authors: Landy Meredith S. H. , Newman Leorra , Carney Alison E. , Donkin Victoria , Nicholls Jocelyn , Krol Sonia A. , Farvolden Peter
Published: March 2023

Despite its well-documented efficacy, few clinicians are trained to deliver Cognitive Behavioral Therapy for Insomnia (CBT-I), and it remains an inaccessible treatment. Therapist-Assisted Internet-Delivered Cognitive Behavioral Therapy for Insomnia (TAI-CBT-I) holds promise for overcoming barriers to accessing this evidence-based treatment. However, to date, there have been no case reports published that describe how to deliver TAI-CBT-I. This case report fills in this gap by illustrating the application and utility of such a treatment on an asynchronous platform. We report on a course of TAI-CBT-I for a 34-year-old Caribbean Canadian male who presented with chronic insomnia characterized by difficulty falling and staying asleep, night awakenings, and reduced helpfulness from medication. Self-report measures of sleep, depression, functioning and ability, and therapist satisfaction were administered throughout treatment, post-discharge, and at follow-up. Improvement was noted across all measures. This case report demonstrates that TAI-CBT-I can be an effective treatment for chronic insomnia and showcases how to deliver it.
Aisle Inequality
Authors: Mayorga Sarah , Underhill Megan R. , Crosser Lauren
Published: March 2023

When a simple trip to the grocery store is anything but, the reality of unequal choices forces us to rethink the American notion that consumption is freedom.
How We Define Mass Shootings Shapes What We Can Learn about Them
Authors: Brazzell Melanie , Tober Tara Leigh , Bridges Tristan
Published: March 2023

Melanie Brazzell, Tara Leigh Tober, and Tristan Bridges on counting consequences.
American Racism
Authors: Tavory Iddo
Published: March 2023

Iddo Tavory on The Making of White American Identity and On Critical Race Theory.
A Promise of Care
Authors: Thrasher Steven W.
Published: March 2023

Steven W. Thrasher on the body public.
Ultrasound-Tomographic Image Fusion – A Novel Tool for Follow up After Acute Complicated Appendicitis
Authors: Saukhat Olga , Mushailov Avital , Kleinbaum Yeruham , Barash Yiftach , Klang Eyal , Nachmany Ido , Horesh Nir
Published: March 2023

Background

Computerized tomography (CT) is an integral part of the follow-up and decision-making process in complicated acute appendicitis (AA) treated non-operatively. However, repeated CT scans are costly and cause radiation exposure. Ultrasound-tomographic image fusion is a novel tool that integrates CT images to an Ultrasound (US) machine, thus allowing accurate assessment of the healing process compared to CT on presentation. In this study, we aimed to assess the feasibility of US-CT fusion as part of the management of appendicitis.

Materials and Methods

We retrospectively collected data of consecutive patients with complicated AA managed non-operatively and followed up with US Fusion for clinical decision-making. Patients demographics, clinical data, and follow-up outcomes were extracted and analyzed.

Results

Overall, 19 patients were included. An index Fusion US was conducted in 13 patients (68.4%) during admission, while the rest were performed as part of an ambulatory follow-up. Nine patients (47.3%) had more than 1 US Fusion performed as part of their follow-up, and 3 patients underwent a third US Fusion. Eventually, 5 patients (26.3%) underwent elective interval appendectomy based on the outcomes of the US Fusion, due to a non-resolution of imaging findings and ongoing symptoms. In 10 patients (52.6%), there was no evidence of an abscess in the repeated US Fusion, while in 3 patients (15.8%), it significantly diminished to less than 1 cm in diameter.

Conclusion

Ultrasound-tomographic image fusion is feasible and can play a significant role in the decision-making process for the management of complicated AA.
Fatigue experimental study on full-scale large sectional model of orthotropic steel deck of urban rail bridge
Authors: Zeng Yong , Qiu Zhou , Yang Changchun , Haozheng Su , Xiang Zhongfu , Zhou Jianting
Published: March 2023

The fatigue problem of orthotropic steel bridge decks of urban rail transit steel bridges has gradually become one of the hot research topics. And it is also a key problem that restricts the further development of rail transit steel bridges. In this paper, the orthotropic steel bridge deck structure of a long-span urban rail transit cable-stayed bridge is studied. Based on the segmental finite element model and full-scale model, the fatigue details of the joint weld between an orthotropic steel bridge deck and U-rib were studied theoretically and experimentally. The theoretical model of the segment is analyzed to obtain the hot spot stress characteristics. On this basis, the full-scale model fatigue test and the fatigue performance evaluation are completed based on the S-N curve. The results show that the fatigue performance of the bridge deck and U-rib joints of the orthotropic steel bridge deck structure model meets the design requirements and has a certain safety reserve. The joint fatigue details of the bridge deck, the U-rib joint weld, and the diaphragm plate are the sensitive areas that are most likely to occur fatigue failure first and need to be paid attention to in the later bridge maintenance and inspection.
Carotid stenting: Does stent design matter?
Authors: Shahat Mohamed , Cieri Enrico , Rocha-Neves Joao , SA Khairy
Published: March 2023

Background

Carotid artery stenting (CAS) is considered an important tool in carotid revascularization. Carotid artery stenting is usually performed by using self-expandable stent with different designs. The stent design influences many physical characteristics. Also, it may affect the complication rate with special relevance to perioperative stroke, hemodynamic instability, and late restenosis.

Methods

This study comprised all consecutive patients who underwent carotid artery stenting for atherosclerotic carotid stenosis from March 2014 to May 2021. Both symptomatic patient and asymptomatic patients were included. Patients with a symptomatic carotid stenosis of ≥50% or asymptomatic carotid stenosis of ≥60% were selected for carotid artery stenting . Patients with fibromuscular dysplasia and acute or unstable plaque were not included. Variables of clinical relevance were tested in multivariable analysis using binary logistic regression model.

Results

A total of 728 patients were enrolled. The majority of this cohort was asymptomatic (578/728, 79.4%), while 150/728 (20.6%) were symptomatic. The mean degree of carotid stenosis was 77.82 ± 4.73%, with a mean plaque length of 1.76 ± 0.55 cm. A total of 277 (38%) patients were treated with Xact® Carotid Stent System. Successful carotid artery stenting was achieved in 698 (96%) of patients. Of these patients, stroke rate in symptomatic patients was nine (5.8%), while in asymptomatic patients was 20 (3.4%). In a multivariable analysis, the open-cell carotid stent was not associated with a differential risk for combined acute and sub-acute neurologic complications as compared with closed-cell stents. Patients treated with open cell stents had a significantly lower rate of procedural hypotension ( P 0.0188) at bivariate analysis.

Conclusion

Carotid artery stenting is considered a safe alternative to CEA that can be used in selected average surgical risk patient. Different stent designs can affect the rate of major adverse events in carotid artery stenting patients, but further studies are necessary with avoiding different bias to study the effect of different stent designs.
Adults’ Visual Cue Preferences and Wayfinding Abilities in Healthcare Centers
Authors: Asli Afsaneh Alizadeh , Moshfeghifar Samaneh , Mousighichi Pouya , Samimi Paniz Mousavi
Published: March 2023

Objectives:

Physical and visual elements that help people find their way around an environment are called visual cues (VCs). The current study aims to evaluate adults’ wayfinding abilities (navigation, orientation, spatial anxiety, and distance estimation) and VC (navigational color coding) preferences in terms of color and position; additionally, investigates their differences in adults’ life span phases (young adults, early middle-aged adults, and late middle-aged adults).

Background:

Wayfinding in complex environments such as healthcare centers has been challenging for most people. Although VCs are being used increasingly to facilitate wayfinding, considering people’s preferences regarding VCs, especially navigational color coding, are neglected.

Methods:

Obtained data from a survey of 375 healthcare center visitors with textual and photo questionnaires were analyzed by descriptive statics and one-way analysis of variance.

Results:

Young adults preferred VCs with “mixed colors and positioned in the middle of the floor,” early middle-aged adults preferred “warm color VCs in the middle of the wall,” and late middle-aged adults preferred “warm color VCs at the bottom of the wall.” Additionally, the results demonstrated that with aging, navigation and distance estimation abilities deteriorate, and spatial anxiety increases.

Conclusions:

The outcomes of the present study increase our knowledge regarding the impact of adults’ life span phases on their wayfinding abilities and VC preferences and offer suggestions for architects and healthcare center stakeholders to provide environments that improve adults’ wayfinding.
Associations of Surgical Team Communication With the Layout of Physical Space: A Network Analysis of the Operating Room in a Military Medical Center
Authors: Kabo Felichism W. , Stucky Christopher H. , De Jong Marla J.
Published: March 2023

Aim:

To examine how the spatial topology of the operating room (OR) within the medical center impacts surgical team communication.

Background:

Understanding the complex association between surgical team communication and the OR’s spatial network location is critical to patient safety. Effective surgical communication is associated with fewer adverse events and medical errors.

Methods:

We employed a cross-sectional, quantitative, case study, and network-centric study design. We studied the population of 204 clinicians in a large military medical center (36 perioperative nurses, 34 surgical technicians, 62 anesthesia providers, and 72 surgeons), focusing on surgical teams with cases completed within duty hours. Data were collected from December 2020 to June 2021 using an electronic survey. Spatial network analysis was done using electronic floor plans. Statistical analysis was done with descriptive statistics and linear regressions. The outcomes were general and task-specific communication, and team-level variables were aggregated from scores for all team members. Spatial effects were assessed with network centrality (degree, Laplacian, and betweenness).

Results:

The individual-level survey response rate was 77% (157 of 204). Data were collected on 137 surgical teams. On a 5-point scale, general and task-specific communication ranged from 3.4 to 5.0 and 3.5 to 5.0, respectively (for both, median = 4.7). Team size ranged from 4 to 6 individuals (median = 4). Surgical suites with higher network centralities were associated with significantly lower communication scores.

Conclusions:

The OR’s spatial network location has important impacts on surgical team communication. Our findings have design and workflow implications for ORs and even surgical care in combat zones.
Correlation of Arthroscopic Grading and Optical Coherence Tomography as Markers of Early Repair and Predictors of Later Healing Evident on MRI and Histomorphometric Assessment of Cartilage Defects Implanted with Chondrocytes Overexpressing IGF-I
Authors: Ciamillo Sarah A. , Pownder Sarah L. , Potter Hollis G. , Stefanovski Darko , Nixon Alan J. , Ortved Kyla F.
Published: March 2023

Objective

Injury of articular cartilage is common, and due to the poor intrinsic capabilities of chondrocytes, it can precipitate joint degradation and osteoarthritis (OA). Implantation of autologous chondrocytes into cartilaginous defects has been used to bolster repair. Accurate assessment of the quality of repair tissue remains challenging. This study aimed to investigate the utility of noninvasive imaging modalities, including arthroscopic grading and optical coherence tomography (OCT) for assessment of early cartilage repair (8 weeks), and MRI to determine long-term healing (8 months).

Design

Large (15 mm diameter), full-thickness chondral defects were created on both lateral trochlear ridges of the femur in 24 horses. Defects were implanted with autologous chondrocytes transduced with rAAV5-IGF-I, autologous chondrocytes transduced with rAAV5-GFP, naïve autologous chondrocytes, or autologous fibrin. Healing was evaluated at 8 weeks post-implantation using arthroscopy and OCT, and at 8 months post-implantation using MRI, gross pathology, and histopathology.

Results

OCT and arthroscopic scoring of short-term repair tissue were significantly correlated. Arthroscopy was also correlated with later gross pathology and histopathology of repair tissue at 8 months post-implantation, while OCT was not correlated. MRI was not correlated with any other assessment variable.

Conclusions

This study indicated that arthroscopic inspection and manual probing to develop an early repair score may be a better predictor of long-term cartilage repair quality following autologous chondrocyte implantation. Furthermore, qualitative MRI may not provide additional discriminatory information when assessing mature repair tissue, at least in this equine model of cartilage repair.
Revision Arthroscopic Labral Repair Using All-Suture Anchors in Patients With Subcritical Glenoid Bone Loss After Failed Bankart Repair: Clinical Outcomes at 2-Year Follow-up
Authors: Lee Jae-Hoo , Shin Sang-Jin
Published: March 2023

Background:

All-suture anchors have been used for primary arthroscopic Bankart repair because of their ability to minimize initial bone loss.

Purpose:

To evaluate the clinical efficacy of using all-suture anchors in revision arthroscopic labral repair after failed Bankart repair.

Study Design:

Case series; Level of evidence, 4.

Methods:

Enrolled in this study were 28 patients who underwent revision arthroscopic labral repair with all-suture anchors after a failed primary arthroscopic Bankart repair. Revision surgery was determined for patients who had a frank redislocation history with subcritical glenoid bone loss (<15%), nonengaged Hill-Sachs lesion, or off-track lesion. Minimum 2-year postoperative outcomes were evaluated using shoulder range of motion (ROM), the Rowe score, the American Shoulder and Elbow Surgeons (ASES) score, apprehension, and the redislocation rate. Postoperative shoulder anteroposterior radiographs were assessed to evaluate arthritic changes in the glenohumeral joint.

Results:

The mean patient age was 28.1 ± 6.5 years, and the mean time between primary Bankart repair and revision surgery was 5.4 ± 4.1 years. Compared with the number of suture anchors used in the primary operation, significantly more all-suture anchors were inserted in the revision surgery (3.1 ± 0.5 vs 5.8 ± 1.3, P < .001). During the mean follow-up period of 31.8 ± 10.1 months, 3 patients (10.7%) required reoperation because of traumatic redislocation and symptomatic instability. Of patients with symptoms that did not require reoperation, 2 patients (7.1%) had subjective instability with apprehension depending on the arm position. There was no significant change between preoperative and postoperative ROM. However, ASES (preoperative: 61.2 ± 13.3 to postoperative: 81.4 ± 10.4, P < .01) and Rowe (preoperative: 48.7 ± 9.3 to postoperative: 81.7 ± 13.2, P < .01) scores were significantly improved after revision surgery. Eight patients (28.6%) showed arthritic changes in the glenohumeral joint on final plain anteroposterior radiographs.

Conclusion:

Revision arthroscopic labral repair using all-suture anchors demonstrated satisfactory 2-year clinical outcomes in terms of functional improvement. Postoperative stability was obtained in 82% of patients without recurrent shoulder instability after failed arthroscopic Bankart repair.
Tracking CSR Communication Research Within the Chinese Context: A Systematic Literature Review
Authors: Dong Chuqing , Song Baobao , Cheng Yang , Zheng Qi
Published: March 2023

Considering the globalization of corporate social responsibility (CSR), China has become an important and distinctive market for CSR practice and research. Communication, as a fast-growing subfield of CSR research, has made substantial contributions to the theorization of CSR yet has been dominated by Western contexts. To provide a contextualized view of CSR communication, this study systematically examined the 88 articles of CSR communication research published in peer-reviewed journals with a focus on the Chinese context. Findings revealed the unique characteristics of Chinese CSR and the status of Chinese CSR communication literature in terms of publication trend, authorship/institution, RQ/Hypothesis, research topics, research context, theoretical frameworks, and methodological approaches. In addition, this study identified gaps in the current Chinese CSR communication research. It offered directions for future development regarding strengthening conceptual development, innovating methodological approaches, and expanding research topics and scopes.
Racial and Socioeconomic Characteristics Associated with the use of Telehealth Services Among Adults With Ambulatory Sensitive Conditions
Authors: Chumbler Neale R. , Chen Ming , Harrison Austin , Surbhi Satya
Published: March 2023

Introduction

The COVID-19 pandemic led to a major transition for patients from routine ambulatory-care-based in-person primary care visits to telehealth visits to manage chronic diseases. However, it remains unclear the extent to which individuals access telehealth services and whether such utilization varies along neighborhood characteristics, especially among racial minorities. This study aims to examine the association of outpatient telehealth utilization with sociodemographic, clinical, and neighborhood characteristics among adults with ambulatory care sensitive conditions (ACSCs) during the COVID-19 pandemic.

Methods

We included adults treated for an ACSC between March 5, 2020, and December 31, 2020, at a single ambulatory-care-based healthcare system, which serves a large population of low-income patients in the South region of the United States (i.e., Memphis, TN, Metropolitan Statistical Area). Telehealth utilization was defined by outpatient procedural codes and providers’ notes on the type of visits. Generalized linear mixed models were used to examine the association of sociodemographic, clinical, and neighborhood factors with telehealth utilization in the overall cohort and the racial subpopulations.

Results

Among the 13,962 adults with ACSCs, 8583 (62.5%) used outpatient telehealth services. Patients who were older, female, with mental disorders, and who had more comorbidities had higher rates of telehealth services ( p < .05). Controlling for covariates, we observed 75.2% and 23.1% increased use of telehealth services among Hispanics and other race groups, respectively, compared to Whites. Patients who commuted more than 30 minutes to health facilities were slightly less likely to use telehealth services [OR: 0.994 (0.991,0.998)]. Racial minorities (Blacks and Hispanics) with mental disorders were more likely to use telehealth service when compared to Whites.

Discussion

We found that among patients being treated for ACSCs, the use of telehealth services was highly prevalent in Hispanic patients in general and were more pronounced among both Hispanics and Black patients who have mental disorders.
Sex and gender differences in acute stroke care: metrics, access to treatment and outcome. A territorial analysis of the Stroke Code System of Catalonia
Authors: Silva Yolanda , Sánchez-Cirera Laura , Terceño Mikel , Dorado Laura , Valls Adrián , Martínez Marina , Abilleira Sònia , Rubiera Marta , Quesada Helena , Llull Laura , Rodríguez-Campello Ana , Martí-Fàbregas Joan , Seró Laia , Purroy Francisco , Payo Iago , García Sònia , Cánovas David , Krupinski Jurek , Mas Natalia , Palomeras Ernest , Cocho Dolores , Font Maria Àngels , Catena Esther , Puiggròs Elsa , Pedroza Claudia , Marín Gemma , Carrión Dolors , Costa Xavier , Almendros Mari Cruz , Torres Ivan , Colom Carla , Velasquez John Alejandro , Diaz Gloria , Jiménez Xavier , Subirats Teresa , Deulofeu Anna , Hidalgo Verónica , Salvat-Plana Mercè , Pérez de la Ossa Natalia
Published: March 2023

Introduction:

Previous studies have reported differences in the management and outcome of women stroke patients in comparison with men. We aim to analyze sex and gender differences in the medical assistance, access to treatment and outcome of acute stroke patients in Catalonia.

Patients and methods:

Data were obtained from a prospective population-based registry of stroke code activations in Catalonia (CICAT) from January/2016 to December/2019. The registry includes demographic data, stroke severity, stroke subtype, reperfusion therapy, and time workflow. Centralized clinical outcome at 90 days was assessed in patients receiving reperfusion therapy.

Results:

A total of 23,371 stroke code activations were registered (54% men, 46% women). No differences in prehospital time metrics were observed. Women more frequently had a final diagnosis of stroke mimic, were older and had a previous worse functional situation. Among ischemic stroke patients, women had higher stroke severity and more frequently presented proximal large vessel occlusion. Women received more frequently reperfusion therapy (48.2% vs 43.1%, p < 0.001). Women tended to present a worse outcome at 90 days, especially for the group receiving only IVT (good outcome 56.7% vs 63.8%; p < 0.001), but not for the group of patients treated with IVT + MT or MT alone, although sex was not independently associated with clinical outcome in logistic regression analysis (OR 1.07; 95% CI, 0.94–1.23; p = 0.27) nor in the analysis after matching using the propensity score (OR 1.09; 95% CI, 0.97–1.22).

Discussion and conclusion:

We found some differences by sex in that acute stroke was more frequent in older women and the stroke severity was higher. We found no differences in medical assistance times, access to reperfusion treatment and early complications. Worse clinical outcome at 90 days in women was conditioned by stroke severity and older age, but not by sex itself.