bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Secondary Aromatic Diamines in Rigid Isocyanurate-Based Foams
Authors: Scott R.V. , House D.W. , Gattuso M.J. , Ashida K. , Frisch K.C. , Klempner D. , Mahdi S. , Parekh C.
Published: September 2023

Commercial isocyanurate foams are generally modified with urethane groups. Other groups, such as amide, imide, carbodiimide, or oxazolidone linkages, have been used to modify such foams in order to improve physical properties (brittleness, friability). In the present work, urea modification was studied through the addition of a secondary aromatic diamine. The urea modification was studied in urethane-polyisocyanurate foams as well as foams in which the aromatic secondary diamine was the only source of active hydrogen. Exceptions were those foams in which water was used as the blowing agent. High isocyanate indices were employed so that the latter foams contained only urea and isocyanurate linkages. These foams were modified in the above manner in an effort to create a highly fire-resistant foam since the thermal stability and the rigidity of urea groups are known to be higher than that of urethane groups.

The introduction of the aromatic secondary diamine into rigid foams has been shown to result in significantly improved compressive strength values, especially perpendicular to foam rise. This has led to the improvement of the isotropy of the foams. This improvement was verified by optical microscopy studies of the cell structure. These studies indicate that the incorporation of the additive resulted in much smaller cells with less elongation in the rise direction. As a result of the finer cells, slightly lower k-factors were obtained. This observation was true for freshly made foam samples as well as for samples aged at —20°C and 70°C. The dimensional stabilities of the aged samples were also consistent with these observations in that the addition of the aromatic diamine resulted in improved stabilities.
The Effect of Polymer Structure on the Gas Permeability of Model Polyurethanes
Authors: Kaplan W.A. , Tabor R.L.
Published: September 2023

In the face of impending CFC elimination, a large variety of low-boiling alternate blowing agents have come under scrutiny for use in rigid foam insulation applications. The permeability of both the alternate blowing agent and atmospheric gases through the rigid foam thermoset polymer contributes to the rate at which the k-factor of the resulting foam deteriorates.

In this study, a compression moulding method for synthesizing polymer films from polyurethane formulation components (a variety of diols with pure and polymeric methylenediphenyl diisocyanate) was developed and utilised to produce films containing distinct structural features. The permeabilities of the films to oxygen and carbon dioxide were then determined using a diffusion cell combined with either an infrared or coulombic detector. The effects on permeability of structural features such as diol molecular weight, alkylene oxide repeat unit, and isocyanate functionality are presented. Structural features determined to promote improved barrier performance in polymer films have been incorporated into a fully formulated foam system. Foam permeability and k-factor ageing comparisons were then made which demonstrate the improved foam barrier performance. The resulting structure/permeability correlations derived from these experiments will be useful in designing rigid foam polymers for use in alternate blowing agent applications.
The Arrested Diffusion Phenomenon in Dense Polyethylene Foams
Authors: Briscoe B.J. , Chaudhary B.I. , Sawas T.
Published: September 2023

The diffusion of gases from a polymeric matrix containing a dispersed and non-interconnected gaseous phase at a pressure higher than the ambient pressure is studied. Specifically, a dense polyethylene foam, manufactured from LDPE which is expanded using high pressure nitrogen, is characterised in terms of its mass and density changes as a function of time and its behaviour at triaxial (hydrostatic) compression. This material was found to be degassing when stored at ambient conditions of temperature and pressure but this process occurs, apparently, at a slow rate and is accompanied by a volume contraction of the material leading to an increase of its apparent density. At the same time, a decrease in the compressibility of the foam was observed with lapsed storage time, indicating a decrease in the void volume it contained. A model was used to simulate the mass transport process of the gas and the volume relaxation of the solid. The model, although a first order approximation of the phenomena taking place, provides results which are qualitatively consistent with the experimental data and predicts the mass loss rate of the foam reasonably well. The model indicates that introduction of voids in a solid reduces the apparent diffusion coefficient of a gas in the solid. This is due to a pneumatic “buffer action” of its voids which becomes more pronounced as the volume of the latter increases. An extension of the model is used to quantitatively rationalise the triaxial compressibility of the same foams as a function of their history.
Large Scale Energy Recovery Trials on Polyurethane, PET, Acrylic and Nylon
Authors: Soderberg D.J. , Lenton R.A. , Boylett A.R. , Hicks D.A.
Published: September 2023

The use of plastics as an energy source has been demonstrated on a commercial scale at a plastics manufacturing site. This paper covers the preparation and use of pre and post consumer plastics as supplementary fuels within a circulating fluidised bed boiler specially designed for co-combustion with coal. Full emissions data on the 15% mixtures of individual plastics with coal are presented together with calculations of thermal efficiencies. Measurements by an independent body confirm that the co-combustion of coal and plastic reduce some emissions relative to coal alone. Thermal efficiencies of around 80% were achieved during operation, and this heat was used effectively during the production of plastics.
Educational Programming Environments for Enhancing Conceptual Design in the Object-Oriented Paradigm: A Systematic Mapping Study
Authors: Tsichouridis Alexandros , Xinogalos Stelios , Ampatzoglou Apostolos
Published: September 2023

Teaching and learning programming, and especially Object-Oriented Programming (OOP), is a complicated and challenging task. Students have to comprehend various OOP concepts and utilize them for designing object-oriented programs. Various types of educational programming environments, such as microworlds and educational games, have been devised for supporting novices mainly in comprehending OOP concepts. However, such environments do not usually support students in the conceptual design of object-oriented programs of a considerable length and complexity. In this paper, we focus on a systematic mapping study (SMS) of educational programming environments for enhancing the conceptual design in OOP, which relies on modularity, abstraction and encapsulation. The research questions investigate the intended learning outcomes, the empirical evidence on the effectiveness, and the teaching/learning technologies used by educational programming environments for enhancing the conceptual design in OOP. The findings can support instructors in selecting appropriate tools for their courses and researchers in the field of educational programming environments for OOP.
Integrating Rogoff's Sociocultural Development Theories for Effective Faith Transmission in Confessional Anglican Churches: A Case Study of Sydney Diocese
Authors: Beilharz Tim
Published: September 2023

This article suggests an integration of Barbara Rogoff's sociocultural development theories into Christian faith transmission. Drawing from Confessional Anglican Churches in Sydney, it examines prevailing models of children's ministry influenced by Western schooling principles. Highlighting Rogoff's intent community participation and cultural learning theories, it argues for their applicability in fostering meaningful children's ministry practices among children and the alignment with Confessional Anglican theology. It concludes with suggestions for application in children's ministry practice.
In Love With a Trauma Survivor: When a History of Childhood Abuse Interferes With Relationship Satisfaction Among Couples
Authors: Finzi-Dottan Ricky , Gewirtz-Meydan Ateret
Published: September 2023

To date, the majority of research examining the effect of childhood abuse on relational aspects in adulthood is almost exclusively based on intraindividual data. The current study explores a moderating-mediating model from a dyadic perspective, examining the mediating effect that perceived intimacy has on the associations between concern couple caregiving and relationship satisfaction. It further investigates whether these mediation paths are moderated by a history of childhood abuse (physical/emotional/sexual). A total of 143 nonclinical couples ( n = 286) in enduring relationships were recruited. A moderated mediation actor–partner interdependence model (moderated mediation actor-partner interdependence model (APIM)) comprised of three segments, was conducted. Results indicated that intimacy mediated the link between concern caregiving and relationship satisfaction on the actor’s level, with effects applying equally to both husbands and wives. A higher level of intimacy among husbands and wives alike is linked, in turn, with higher relationship satisfaction. The path between actors’ concern caregiving and their level of intimacy was moderated by the actors’ childhood emotional and physical abuse; specifically, concern caregiving exerts greater effect on intimacy among participants who experienced high levels of emotional abuse, or low levels of physical abuse. Our findings highlight how different types of childhood abuse affect adult romantic relationships differently.
Comparison of Community Pharmacist and Non-Community Pharmacist Perceptions of a Community Pharmacy Specialty Board Certification
Authors: Wollen Joshua , Lieu Han H. , Yu Sydney , White Julia C. , Davis Shantera Rayford
Published: September 2023

Background: Pharmacy board certification provides pharmacists with formal recognition of their careers and their involvement in direct and comprehensive patient care. Credentialing as a board-certified pharmacist demonstrates that the pharmacist has specialized expertise and is able to provide advanced level patient care in a specific pharmacy practice specialty. There is currently not a community pharmacy board certification available in the United States. With the expanding role and clinical expectations of community pharmacists nationwide, perspectives regarding the utility of a community pharmacy specialty board certification are necessary. Methods: A cross-sectional survey with demographic and perception questions (5-point Likert scale) was distributed electronically via Qualtrics. A random sample of pharmacists registered in Rhode Island, Ohio, and Nebraska were selected and surveyed. Results: 53 survey responses were collected. There was a statistically significant difference in board certification history ( P = .001) and history of post-graduate training ( P < .001) between community pharmacists and non-community pharmacists. Community pharmacists were more likely to simultaneously see community pharmacists as general practitioners ( P = .030) and as pharmacy practice specialists ( P = .001). Non-community pharmacists were more likely to be familiar with current maintenance requirements for pharmacy board certifications ( P < .001) and to feel that a board certification is an appropriate indicator of experience in a pharmacy specialty area ( P = .016). Conclusion: Views regarding community pharmacy and board certification differed between community and non-community pharmacists. There was not a statistically significant difference in the perceived value of community pharmacy board certification between community and non-community pharmacist.
‘Am I Too Straight for the Gay People, Am I Too Gay for the Straight People?’: A Qualitative Analysis of How Young Bisexual Women Navigate Self-presentation on Dating Apps
Authors: Hackett Charlotte , Gerodetti Natalia
Published: September 2023

Many young people with marginalized sexual identities still experience discrimination and discomfort when searching for relationships on digital networks. Young bisexual women who are searching for/confirming their identities consistently face ‘binegativity’, typified by marginalization, hypersexualization, and erasure, despite some positive affordances of online connecting. Based on a small-scale qualitative study with young women aged 18–24, this article considers the ways in which young bisexual women construct and navigate their online dating profiles. Drawing on Goffman’s ideas of self-presentation and an examination of how visual clues are supported by verbal statements, this article argues that bisexual young women’s engagement with dating apps requires identity modulation and produces ambivalent affective formations. Their experiences of digital networked spaces are simultaneously shaped by a search for identity, agency, pleasures as well as frustrations and hateful messaging.
Bedside placement of tunneled femorally inserted central catheters in pediatric patients on extracorporeal life support: A case series and discussion
Authors: Weber Mark D , Conlon Thomas , Connelly James , Himebauch Adam S
Published: September 2023

Background:

Pediatric patients requiring extracorporeal life support (ECLS) often need central venous access for extended periods of time. In this population, the placement of an upper extremity peripherally inserted central catheter (PICC) can be challenging due to the location and size of the venous ECLS cannula. Bedside placement of a tunneled femorally inserted central catheters (T-FICC) can be a viable alternative to a traditional PICC.

Methods:

In this case series we present five children who were on ECLS and had a T-FICC placed at the bedside.

Results:

In this series of five patients we successfully placed T-FICCs while the patients were on ECLS. The T-FICCs dwelled from 15 to 182 days. There were no events of central line associated blood stream infections or deep vein thrombosis. There was only one unintentional line dislodgement noted.

Conclusion:

The use of T-FICCs placed at the bedside is a safe and reliable alternative for secure long-term venous access in children who are on ECLS.
The Value of Neoadjuvant Anthracycline-Based Regimens for HER2-Positive Breast Cancer: A Systematic Review and Meta-analysis Including 1366 Patients
Authors: Ding Yuqin , Ding Kaijing , He Xiangming , Mo Wenju , Liang Chenlu , Gong Lijie , Huang Yuting , Ding Xiaowen
Published: September 2023

Background:

The standard recommendation for neoadjuvant therapy for human epidermal growth factor receptor-2 (HER2)-positive breast cancer patients is trastuzumab in combination with chemotherapy, but there is no current standard recommendation for appropriate chemotherapy regimens. This meta-analysis evaluated the efficacy and cardiac safety of the concurrent use of anti-HER2 targeted drugs and anthracycline-based neoadjuvant chemotherapy (NAC) for HER2-positive breast cancers.

Methods:

The pooled odds ratio (OR) rate for pathologic complete response (pCR), the pooled hazard ratio (HR) of overall survival (OS), and the left ventricular ejection fraction (LVEF) decline events were all calculated. Differences in efficacy, prognosis, and cardiac safety were compared between patients receiving an anthracycline-containing regimen (AB) and those treated with non-anthracycline-based (nAB) NAC.

Results:

A total of 1366 patients in 4 prospective and 3 retrospective studies were included in the meta-analysis. The pooled OR for pCR rate was 0.73 with a 95% confidence interval (CI) of 0.43 to 1.24 ( P = .246). Subgroup analysis of low tumor burden cases showed no improvement in pCR rate for patients in the AB group compared with nAB, with the pooled OR rate being 0.73 with a 95% CI of 0.37 to 1.44 ( P= .357). The 3-year OS rate was 95.63% and 95.54% in the AB and nAB groups, respectively, with no statistical difference ( P= .157). There was a significant increase in the rate of LVEF decline of 19.07% in the AB group compared with 13.33% for the nAB group, with an HR of 1.62 and a 95% CI of 1.11 to 2.36 ( P = .013).

Conclusions:

The addition of anthracyclines did not improve pCR rates and survival after neoadjuvant and the increased cardiotoxicity of anthracyclines further limited their application. This study showed that it was feasible to use anti-HER2 drugs without anthracyclines in neoadjuvant therapy for HER2-positive breast cancer patients.
Windfall money and outbound tourism: A natural experiment from lottery winnings
Authors: Boto-García David , Muñiz-Fernández Alvaro , Pérez Levi
Published: September 2023

Income is a relevant factor for explaining outbound tourism demand. However, when working with regional- or country-level data, it is difficult to disentangle the role of income in stimulating tourism travelling from other factors that correlate with greater income levels. This paper exploits a natural experiment from Spanish Christmas Lottery to estimate the causal effect of income shocks on outbound tourism. We leverage the staggered and quasi-random assignment of lottery winnings across Spanish regions to estimate the elasticity of outbound annual trips and expenditure to windfall gains. Using difference-in-differences with the amount of lottery prizes as an indicator of treatment intensity, we show that lottery winnings per capita increase both the annual number of tourism trips and expenditure per capita. This effect operates during the first 2 years following the draw, which is likely explained by bandwagon and income multiplier effects.
Schools and Wastewater Surveillance: Practical Implications for an Emerging Technology to Impact Child Health
Authors: Johnson Gwendolyn , Espàrza Angelina , Stevenson Elizabeth , Stadler Lauren , Ensor Kathy , Williams Stephen , Sheth Komal , Johnson Catherine , Hopkins Loren
Published: September 2023

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a public health tool that supplements traditional surveillance methods used to detect the prevalence of the SARS-CoV-2 virus in communities. In May 2020, the Houston Health Department (HHD) partnered with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. The HHD subsequently launched a program to conduct targeted wastewater sampling at 52 school sites located in a large, urban school district in Houston. Data generated by this program are shared with school district officials and nurses from participating schools. Although initial feedback from these stakeholders indicated that they considered the wastewater data valuable, the emergency nature of the pandemic prevented a systematic evaluation of the program. To address this gap in knowledge, the HHD and Rice University conducted a study to determine how wastewater data are used to make decisions about COVID-19 prevention and mitigation practices in schools. Our findings indicate that maximizing the utility of wastewater data in the school context will require the development of communication strategies and education efforts tailored to the needs of specific audiences and improving collaboration between local health departments, school districts, and school nurses.
Novel Percutaneous Mechanical Thrombectomy Device for Treating Upper Extremity Deep Vein Thrombosis in Patient With Paget-Schroetter Syndrome
Authors: Patel Mitul S.
Published: September 2023

Paget-Schroetter Syndrome (PSS) is a form of upper extremity deep vein thrombosis (DVT) caused by the external compression of the subclavian vein at the thoracic outlet. Here we describe a complex PSS case in a 43-year-old female who experienced multiple recurrent DVTs and a right-sided hemothorax following two continuous aspiration thrombectomy procedures and a first rib resection. Rapid and complete symptom resolution was achieved with the InThrill Thrombectomy System (Inari Medical), a novel, thrombolytic-free, percutaneous mechanical thrombectomy device that removed all recurrent acute and subacute thrombus in a single session without significant blood loss.
Impact of COVID-19 on Depression, Anxiety, Stress, Coping, and Grief in Pre-Health Professional Students in Lima, Peru
Authors: Horton Abby Grammer , Chalco Eduardo Franco , Cuellar Matthew , Paredes Gladys Ivonne Moran , Cuellar Norma
Published: September 2023

Introduction: Peru had the world's highest death rate of COVID-19 with 213,000+ deaths and counting (Beaubien, 2021). Hospitalization and care for COVID-19 patients with limited resources has added stress to the shortage of frontline workers and resulted in students filling in the gap in acute care clinical settings. The purpose of this study was to examine the impact of COVID-19 on mental health (e.g., depression, anxiety, stress, and coping) and grief on undergraduate nursing and pharmacy students in Lima, Peru. Methods: This was a quantitative, descriptive study that examined students’ self-report of mental health and grief at baseline during data collection. Results: Significant findings were reported in coping based on death of family member of COVID-19 ( p = .02). Anxiety was positively correlated with grief (Rho = 0.35, p < .001), stress (Rho = 0.53, p < .001), and depression (Rho = 0.76, p < .001). Grief was positively correlated with stress (Rho = 0.25, p < .001) and depression (Rho = 0.39, p < .001). Finally, stress was positively correlated with depression (Rho = 0.51, p < .001). Discussion: This is the first study to explore nursing and pharmacy students’ perceptions on how the COVID-19 pandemic impacted their mental health.
Impact of hydrogen direct injection on engine combustion and emissions in a GDI engine
Authors: Wang Lei , Li Haiyu , Huang Zhaoming , Wang Li , Chen Weiguo
Published: September 2023

The combustion and emission characteristics of a hydrogen engine were investigated through experimental analysis using a GDI engine. To enable hydrogen in-cylinder direct injection, a specialized hydrogen gas injector was employed. A comparative analysis of the combustion performance between gasoline and hydrogen fuels in a spark-ignited engine was conducted. Additionally, the study experimentally explored the thermal efficiency and emission reduction potential of hydrogen engines in lean combustion modes. The results indicated a significant improvement in the combustion rate when hydrogen fuel was utilized in the spark-ignited engine. However, the effective thermal efficiency was found to be lower than that of gasoline fuel due to the delayed MBF50 under stoichiometric conditions. Furthermore, when compared to gasoline fuel, the reduction of CO and THC emissions was accompanied by an increase in NOx emissions. Nevertheless, optimizing the air dilution ratio in hydrogen engines led to an improvement in the effective thermal efficiency. Specifically, under medium load conditions, a Lambda value of 2.7 resulted in an effective thermal efficiency of 43.5%. Additionally, under ultra-lean conditions (Lambda > 2.3), NOx emissions could be reduced to below 50 ppm, reaching as low as 44 ppm. This study highlights the potential of improving combustion efficiency and reducing emissions by utilizing hydrogen fuel, particularly in lean combustion modes. It contributes to the continuous development of hydrogen engine technology and promotes the implementation of cleaner and more efficient energy solutions.
Higher perceived stress during the COVID-19 pandemic increased menstrual dysregulation and menopause symptoms
Authors: Garcia de leon Romina , Baaske Alexandra , Albert Arianne Y. , Booth Amy , Racey C. Sarai , Gordon Shanlea , Smith Laurie W. , Gottschlich Anna , Sadarangani Manish , Kaida Angela , Ogilvie Gina S. , Brotto Lori A. , Galea Liisa A.M.
Published: September 2023

Background:

The increased stress the world experienced with the coronavirus disease (COVID-19) pandemic affected mental health, disproportionately affecting females. However, how perceived stress in the first year affected menstrual and menopausal symptoms has not yet been investigated.

Objectives:

This study evaluates the effect that the first year of the COVID-19 pandemic had on female reproductive and mental health.

Methods:

Residents in British Columbia, Canada, were surveyed online as part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex. A subgroup of participants (n = 4171), who were assigned female sex at birth (age 25–69 years) and were surveyed within the first 6–12 months of the pandemic (August 2020–February 2021), prior to the widespread rollout of vaccines, was retrospectively asked if they noticed changes in their menstrual or menopausal symptoms, and completing validated measures of stress, depression and anxiety.

Design:

This is a population-based online retrospective survey.

Results:

We found that 27.8% reported menstrual cycle disturbances and 6.7% reported increased menopause symptoms. Those who scored higher on perceived stress, depression and anxiety scales were more likely to report reproductive cycle disturbances. Free-text responses revealed that reasons for disturbances were perceived to be related to the pandemic.

Conclusion:

The COVID-19 pandemic has highlighted the need to research female-specific health issues, such as menstruation. Our data indicate that in the first year of the pandemic, almost one-third of the menstruating population reported disturbances in their cycle, which was related to percieved stress, depression and anxiety scores.
Political Viewpoint Diversity in the News: Market and Ownership Conditions for a Pluralistic Media System
Authors: Garz Marcel , Ots Mart , Sjøvaag Helle
Published: September 2023

The assumption that ownership has an effect on the diversity of news is based on the forms of control that ownership allows and the market conditions in which ownership is exercised. In this study, we perform a large-scale analysis of the Swedish newspaper market, surveying 130 newspapers and parliamentary speeches over a period of six years (2014–2019), to substantiate to what extent market and for-profit ownership forms impact political viewpoint diversity. Our analysis shows that newspapers with market leadership and chain ownership offer more political viewpoint diversity than number two and single-owned papers. In contrast, the ownership forms surveyed here (private, foundation, and publicly traded ownerships) display little effect on newspapers’ internal diversity. We also find that a greater number of papers in a local market does not imply more external diversity in that market. The analysis thus offers some nuance to the notion that ownership form and market pluralism are prerequisites for viewpoint diversity, highlighting instead the importance of scale effects for pluralistic media systems.
Experimenting With International Curricula in Shanghai: Policies, Practice, and a Network Ethnography Analysis
Authors: Jin (金津) Jin , Chen (陈佳颖) Jiaying
Published: September 2023

Purpose

Drawing on a study of international schools in Shanghai, this study explores how external experiences and curricula are mobilized as policy tools to inspire local educational innovations and how these experiences are enacted differently by schools.

Design/Approach/Methods

Based on a review of policy documents and interviews with school principals, senior management stakeholders, and teachers, this study identifies and compares the typologies of international schools in policy design and practice. Then, by deploying the network ethnography method following three key nodes, this study offers some explanations for the gaps between policy design and enactments.

Findings

This study demonstrates the complex relations, interests, and struggles involved in constructing and shaping the meanings of international curricula within local education. The findings show the autonomy of policy networks and the difficulties of ‘steering’ them in a clear-cut way.

Originality/Value

This study is one of the earliest attempts, if not the first, to experiment with the method of network ethnography in the context of China. These findings offer a nuanced account of the complex relations and ad hocery involved in policy learning.
On the diversity of scientific culture and the tradition of postpartum confinement in China
Authors: Zhang Meifang
Published: September 2023

This paper observes the practice of postpartum confinement by urban women in China with high educational levels from the perspective of cognitive conception and behavioural practice. It reveals the cognitive conflict and self-adjustment in these women between ‘modern health notions’ and ‘traditional medical practices’, and analyses the rationality of the long-standing presence of and local differences in the practice as a traditional postpartum nursing behaviour for Chinese women. Moreover, this paper emphasizes the important value of postpartum confinement as a kind of local knowledge and holds that adhering to and advocating the locality and diversification of knowledge, including scientific knowledge, is conducive to the long-term coexistence and sustainable development of different knowledge traditions.
Pre-Hospital and Post-Hospital Quality of Care in Traumatic Spinal Column and Cord Injuries in Iran
Authors: Zeinaddini-Meymand Arman , Baigi Vali , Mousavi-Nasab Mohammad Mehdi , Shool Sina , Sadeghi-Naini Mohsen , Azadmanjir Zahra , Jazayeri Seyed Behnam , Berchi Kankam Samuel , Dashtkoohi Mohammad , Shakeri Aidin , Fakharian Esmail , Kouchakinejad-Eramsadati Leila , Pirnejad Habibollah , Sadeghi-Bazargani Homayoun , Bagheri Laleh , Pourandish Yasaman , Amiri Malihe , Pour-Rashidi Ahmad , Harrop James , Rahimi-Movaghar Vafa
Published: September 2023

Study design

A retrospective study.

Objectives

The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs).

Methods

The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and follow-ups of patients with SCI evaluated the QoC in the post-hospital phase.

Results

In the pre-hospital phase, cervical collars and immobilization were implemented in 46.4% and 48.5% of the cases, respectively. Transport time from the scene to the hospital was documented as <1 hour and <8 hours in 33.4% and 93.9% of the patients, respectively. Post-hospital indicators in patients with SCI revealed a first-year mortality rate of 12.5% (20/160), a high incidence of secondary complications, reduced access to electrical wheelchairs (4.2%) and modified cars (7.7%), and low employment rate (21.4%).

Conclusion

These findings revealed a significant delay in transport time to the first care facilities, low use of immobilization equipment indicating low pre-hospital QoC. Further, the high incidence of secondary complications, low employment rate, and low access to electrical wheelchairs and modified cars indicate lower post-hospital QoC in patients with SCI. These findings imply the need for further planning to improve the QoC for patients with TSC/SCIs.
The Prevalence of Asymptomatic Cervical Spinal Cord Compression in Individuals Presenting With Symptomatic Lumbar Spinal Stenosis: A Meta-Analysis
Authors: Farahbakhsh Farzin , Khosravi Sepehr , Baigi Vali , Pourghahramani Koltapeh Masoud , Khayyamfar Amirmahdi , Eskandari Zahra , Ghodsi Zahra , Harrop James , Rahimi-Movaghar Vafa
Published: September 2023

Study Design

Systematic review and meta-analysis.

Objective

The aim of this study was to determine the prevalence of asymptomatic cervical spinal cord compression (CSCC) in individuals with lumbar spinal stenosis (LSS).

Methods

A systematic electronic search was conducted in Medline, EMBASE, Scopus, and Web of Science without language restriction, with no starting date limit to June 8, 2023, to define the prevalence of asymptomatic CSCC in symptomatic LSS patients. Asymptomatic CSCC was defined based on radiographic studies. All types of studies were included in the review. Meta-analysis was performed on the reported prevalence of asymptomatic CSCC in LSS.

Results

The database search yielded 10,272 articles. After a full-text review, five studies were included in the final review, comprising a total of 1043 cases. Two studies had a low risk for bias, two moderate, and one estimated to be high risk. The range of prevalence of asymptomatic CSCC in LSS in the five included studies was between 24% and 61%. Meta-analysis on the reported prevalence of asymptomatic CSCC patients with symptomatic LSS demonstrated that the random pooled prevalence was 35% (95% CI: 23 to 48).

Conclusions

Asymptomatic CSCC appears to occur in a high number of patients, with this study noting its presence in one-third of patients with LSS. Based on these findings, we strongly recommend that spine surgeons exercise particular caution during the positioning of patients who are undergoing surgery for lumbar stenosis. Furthermore, it is imperative to monitor individuals with symptomatic LSS closely for any potential signs of emerging myelopathy.
Expression of Customer (Dis)satisfaction in Online Restaurant Reviews: The Relationship Between Adversative Connective Constructions and Star Ratings
Authors: Baker Matthew J. , Hashimoto Brett
Published: September 2023

Online restaurant reviews contain expressions of customer expectations in prose as well as in star ratings that indicate overall customer satisfaction. In prose, one way customers communicate that expectations are or are not met is through a grammatical construction called adversative connectives (ACs) (i.e., constituents such as but, although, however, and even though). In the present study, we examine the relationship between star ratings and customers’ use of ACs by employing a combination of content analysis, mixed-effects models, and thematic analysis in a corpus of nearly 35,000 online reviews for restaurants located in the United States. The results reveal an important way customers communicate their (dis)satisfaction online. Specifically, the statistical modeling indicates that the ACs used and the content they emphasize have a significant relationship with star ratings. Restaurant owners can use these findings to focus on the most important information in customer reviews, especially when they are sifting through many reviews or through reviews for which no summative rating is provided.
Debut crimes and chronic offenders in Queensland
Authors: Townsley Michael , Hutchins Benjamin
Published: September 2023

We investigate whether the type of crime committed early in an individual's career has a bearing on patterns of subsequent offending (the so-called debut hypothesis) in an Australian setting. Police-recorded crime data from 2008 to 2020 were used and partitioned into cohorts based on the year of the first offence. We computed, for each cohort, the rate at which individuals progressed to established criminal careers conditioned by their first recorded offence. Individuals who commit burglary, vehicle theft, or robbery as their first recorded offence were observed to become chronic offenders at higher rates than those who commit other types of first offences. We also demonstrated that this relationship exists for other dimensions of the criminal career and is time stable. The policy implications of our findings suggest that a combination of opportunity reduction and diversionary policies has the potential to substantially reduce the prospects of chronic criminal careers and their societal impact.
Clinical characteristics of chylothorax: results from the International Collaborative Effusion database
Authors: Porcel José M. , Bielsa Silvia , Civit Carmen , Aujayeb Avinash , Janssen Julius , Bodtger Uffe , Fjaellegaard Katrine , Petersen Jesper Koefod , Welch Hugh , Symonds Jenny , Mitchell Michael A. , Grabczak Elżbieta Magdalena , Ellayeh Mohamed , Addala Dinesh , Wrightson John M. , Rahman Najib M. , Munavvar Mohammed , Koegelenberg Coenraad F.N. , Labarca Gonzalo , Mei Federico , Maskell Nick , Bhatnagar Rahul
Published: September 2023

Background

Chylothorax is an uncommon medical condition for which limited data are available regarding the contemporary aetiology, management and outcomes. The goal of this study was to better define these poorly characterised features.

Methods

The medical records of adult patients diagnosed with chylothorax at 12 centres across Europe, America and South Africa from 2009–2021 were retrospectively reviewed. Descriptive and inferential statistics were performed.

Results

77 patients (median age 69 years, male to female ratio 1.5) were included. Subacute dyspnoea was the most typical presenting symptom (66%). The commonest cause of chylothorax was malignancy (68.8%), with lymphoma accounting for 62% of these cases. Other aetiologies were trauma (13%), inflammatory/miscellaneous conditions (11.7%) and idiopathic cases (6.5%). At the initial thoracentesis, the pleural fluid appeared milky in 73%, was exudative in 89% and exhibited triglyceride concentrations >100 mg·dL−1in 88%. Lymphangiography/lymphoscintigraphy were rarely ordered (3%), and demonstration of chylomicrons in pleural fluid was never ascertained. 67% of patients required interventional pleural procedures. Dietary measures were infrequently followed (36%). No patient underwent thoracic duct ligation or embolisation. Morbidity included infections (18%), and thrombosis in malignant aetiologies (16%). The 1-year mortality was 47%. Pleural fluid protein >3.5 mg·dL−1(sub-distribution hazard ratio (SHR) 4.346) or lactate dehydrogenase <500 U·L−1(SHR 10.21) increased the likelihood of effusion resolution. Pleural fluid protein ≤3.5 mg·dL−1(HR 4.047), bilateral effusions (HR 2.749) and a history of respiratory disease (HR 2.428) negatively influenced survival.

Conclusion

Chylothoraces have a poor prognosis and most require pleural interventions. Despite the standard recommendations, lymphatic imaging is seldom used, nor are dietary restrictions followed.
Influence of ethnicity on adherence to nonsurgical interventions for COPD: a scoping review
Authors: Alamer Sarah , Robinson-Barella Anna , Nazar Hamde , Husband Andy
Published: September 2023

Objective:

Poor therapeutic adherence and the contributing factors have been extensively researched in several chronic diseases, including COPD. However, the influence of ethnicity on adherence to nonsurgical treatment interventions for COPD (e.g.smoking cessation and pulmonary rehabilitation) is not well understood. This scoping review was performed to better understand variations in adherence among people from minority ethnic communities diagnosed with COPD.

Method:

This scoping review was designed based on the refined frameworks of Arksey and O'Malley, developed by JBI (Joanna Briggs Institute). Systematic searches were performed across three databases: CINHAL (EBSCO), MEDLINE (Ovid) and Embase (Ovid).

Results:

Out of 3654 identified records, 37 studies were deemed eligible for inclusion; these were conducted in various countries and involved populations of diverse ethnic groups diagnosed with COPD. The included studies considered provision and/or adherence to medication (n=8, 21.6%), smoking cessation (n=11, 29.7%), influenza vaccinations (n=7, 18.9%), pulmonary rehabilitation (n=11, 29.7%) and oxygen therapy (n=2, 5.4%). Outcomes varied widely between studies within a single intervention (e.g.initiation, adherence and completion of pulmonary rehabilitation programme). However, most of the included studies suggested the presence of inequalities linked to ethnicity across interventions.

Conclusion:

This review indicated the presence of poor adherence to nonsurgical interventions among people from minority ethnic backgrounds living with COPD. However, due to the heterogeneity in population groups considered and compared within the individual studies, it is challenging to identify and understand the key inequalities influencing adherence to nonsurgical interventions. Further research is needed to better explore this.
Disruption of the Novel Small Protein RBR7 Leads to Enhanced Plant Resistance to Blast Disease
Authors: Shi Hui , Xiong Qing , Zhao Zhangjie , Zhou Lian , Yin Junjie , Lu Xiang , Chen Xuewei , Wang Jing
Published: September 2023

Plant disease is a threat to global food security. Breeding crops carrying broad-spectrum resistance loci is an effective way to control infectious disease. Disease-resistant mutants are valuable resources for deciphering the underlying mechanisms of plant immunity and could provide genetic loci to generate disease-resistant crops. Here, we identified a rice mutant, rbr7 (rice blast resistance 7), that confers resistance against different strains of Magnaporthe oryzae. Disease-mimicking necrotic lesions started to appear on the leaves of rbr7 four weeks after sowing. Histochemical analysis revealed reactive oxygen species accumulation and cell death accompanied by spontaneous lesion formation in rbr7. Map-based cloning and bulk segregation analysis showed a 2855 bp fragment deletion on chromosome 5, leading to the disruption of the LOC_Os05g28480-coding protein. Transgenic rbr7 complementation plants showed compromised resistance to rice blast, indicating that LOC_Os05g28480, or Rbr7, regulates the rice immune response. Rbr7 encodes a small protein of unknown function with 85 amino acids. Transcriptomic analysis revealed that disruption of RBR7 led to the upregulation of genes responding to salicylic acid, systemic acquired resistance and pathogenesis-related genes. Taken together, our findings reveal insights into a novel small protein involved in regulating plant resistance to rice blast and provide a potential target for crop breeding.
TIPred: a novel stacked ensemble approach for the accelerated discovery of tyrosinase inhibitory peptides
Authors: Charoenkwan Phasit , Kongsompong Sasikarn , Schaduangrat Nalini , Chumnanpuen Pramote , Shoombuatong Watshara
Published: September 2023

Background

Tyrosinase is an enzyme involved in melanin production in the skin. Several hyperpigmentation disorders involve the overproduction of melanin and instability of tyrosinase activity resulting in darker, discolored patches on the skin. Therefore, discovering tyrosinase inhibitory peptides (TIPs) is of great significance for basic research and clinical treatments. However, the identification of TIPs using experimental methods is generally cost-ineffective and time-consuming.

Results

Herein, a stacked ensemble learning approach, called TIPred, is proposed for the accurate and quick identification of TIPs by using sequence information. TIPred explored a comprehensive set of various baseline models derived from well-known machine learning (ML) algorithms and heterogeneous feature encoding schemes from multiple perspectives, such as chemical structure properties, physicochemical properties, and composition information. Subsequently, 130 baseline models were trained and optimized to create new probabilistic features. Finally, the feature selection approach was utilized to determine the optimal feature vector for developing TIPred. Both tenfold cross-validation and independent test methods were employed to assess the predictive capability of TIPred by using the stacking strategy. Experimental results showed that TIPred significantly outperformed the state-of-the-art method in terms of the independent test, with an accuracy of 0.923, MCC of 0.757 and an AUC of 0.977.

Conclusions

The proposed TIPred approach could be a valuable tool for rapidly discovering novel TIPs and effectively identifying potential TIP candidates for follow-up experimental validation. Moreover, an online webserver of TIPred is publicly available at http://pmlabstack.pythonanywhere.com/TIPred.
Multidrug-resistant bacterial infection in adult patients following cardiac surgery: clinical characteristics and risk factors
Authors: Ren Jianwei , Duan Shengchen , Wu Yuanxing , Wen Mingxiu , Zhang Jianye , Liu Yulei , Zhu Guangfa
Published: September 2023

Background

The prevalence of infections with multidrug-resistant organism (MDRO) pose great challenges for anti-infective therapy. Previous research on MDRO infections after cardiac surgery was limited. Therefore, understanding and mastering the clinical characteristics and risk predictors of MDRO infection after cardiac surgery is of great significance for standardized management of perioperative patients.

Methods

The medical records of adult patients with MDRO infection after cardiac surgery from January 2018 to October 2021 were collected, and patients were divided into MDR infection group (n = 176) and non-MDR infection group (n = 233). Univariate and multivariate regression analysis of variables was performed to determine the risk predictors of MDRO infection.

Results

The incidence of MDRO infection was 8.6%. Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa were the most common, accounting for 37.3%, 23.5% and 18.0%, respectively. The main infection type were lower respiratory tract infection (LTRI = 29.0%). Univariate analysis showed that underwent coronary artery bypass graft (CABG) (P = 0.001) and secondary operation (P = 0.008), pre-infection exposure to vancomycin (P < 0.001) and linezolid (P = 0.002), combination antibiotics (P < 0.001), four antibiotics in combination (P = 0.005), glucocorticoid use (P = 0.029), preoperative hypoalbuminemia (P = 0.003) were risk factors for post-operative MDRO infection. Multivariate regression analysis showed that underwent CABG (OR = 1.228, 95%CI = 1.056∽1.427, P = 0.008), secondary operation (OR = 1.910, 95%CI = 1.131∽3.425, P = 0.015) and pre-infection exposure to linezolid (OR = 3.704, 95%CI = 1.291∽10.629, P = 0.005) were independent risk predictors for MDRO infection. The risk of MDRO infection increased with the length of stay in the ICU (P < 0.001) and the length of stay before diagnosis of infection (P = 0.003), and the difference was statistically significant. Meanwhile, the length of stay after infection (P = 0.005) and the total length of hospital stay (P < 0.001) were significantly longer in the MDRO infection group, and the all-cause mortality was numerically higher in the MDRO infection group (31.3% versus 23.2%).

Conclusions

The morbidity and mortality of MDRO infection was high in adult cardiac surgery, and many risk factors influence the occurrence of MDRO infection. In the future, clinicians should focus on high-risk patients, strengthen multidisciplinary collaboration on infection prevention and control measures, reduce the morbidity and mortality of MDRO infection, and improve the prognosis of in-hospital patients.