bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Intralymphatic Immunotherapy in Allergic Rhinitis Patients: A Systematic Review and Meta-analysis
Authors: Jiang Sijie , Xie Shaobing , Tang Qingping , Zhang Hua , Xie Zhihai , Zhang Junyi , Jiang Weihong
Published: May 2023

Background. Intralymphatic immunotherapy (ILIT) is short-course administration of allergen-specific immunotherapy (AIT). This study is aimed at assessing the clinical efficacy and safety of ILIT in patients with allergic rhinitis (AR). Methods. MEDLINE, PUBMED, and Cochrane Library were used to conduct electronic searches for clinical trials comparing ILIT and placebo in patients with AR. The final search took place on August 24, 2022. Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. The outcomes included combined symptom and medication scores (CSMS), visual analog scale (VAS), allergic rhinoconjunctivitis quality of life (RQLQ), Skin-prick test (SPT), and adverse events (AEs). Data were synthesized as mean difference (MD)/standard mean difference (SMD) or risk difference (RD) and 95% confidence interval (CI). Results. Thirteen studies (454 participants) were included in this study. The ILIT group had better clinical improvement on the CSMS (random effects model, SMD-0.85, 95% CI [-1.58, -0.11],

P
=
0.02

) and RQLQ (fixed-effects model, MD-0.42, 95% CI [0.69, 0.15],

P
=
0.003

) than the placebo group. The booster injection was beneficial for CSMS (

P
<
0.0001

), and the 4-week injection interval was superior to the 2-week injection period for improving VAS (

P
<
0.0001

). Local swelling or erythema was the main AE following injection (random effects model, RD 0.16, 95% CI [0.05, 0.27],

P
=
0.005

). Discussion. For individuals with AR, ILIT is safe and effective. ILIT alleviates clinical symptoms and reduces pharmaceutical consumption without causing severe AEs. However, the validity of this study is compromised by the substantial heterogeneity and risk of bias in the included researches. RegistrationCRD42022355329.
Efficient Artificial Neural Network for Smart Grid Stability Prediction
Authors: Mohsen Saeed , Bajaj Mohit , Kotb Hossam , Pushkarna Mukesh , Alphonse Sadam , Ghoneim Sherif S. M.
Published: May 2023

According to the stability process of smart grids, which starts by gathering information of consumers, and then evaluating this information based on specifications of a power supply, and finally, information of a price is sent to the consumers as a report about the utilization. From this perspective, this process is too much time consuming, thus it should predict a smart grid stability via artificial intelligence (e.g., neural networks). Recent advances in the accuracy of neural network have effective solutions to solving the smart grid stability prediction issues, but it remains necessary to develop high performance neural networks that give higher accuracy. In this paper, an artificial neural network (ANN) is proposed to predict a smart grid stability for Decentral Smart Grid Control (DSGC) systems. This neural network is applied to a dataset aggregated from simulations of grid stability, executed on a four-node network with star topology, and engaged in two classes of grid stability–stable and unstable. Keras framework is used to train the proposed neural network, and a hyperparameter tuning method is utilized to achieve high accuracy. Receiver operating characteristic (ROC) curves and confusion matrices are experimentally utilized to evaluate the performance of the proposed neural network. The neural network provides high performance, with a testing loss rate of 0.0619, and a testing accuracy of 97.36%. The weighted average recall, precision, and F1-score for the proposed neural network are 98.02%, 98.03%, and 98.02%, respectively, while the area under the ROC curves (AUCs) is 100%. This neural network with the utilized dataset indeed provides an accurate and quick approach of predicting grid stability to analyze DSGC systems.
Transcriptomic and Proteomic of Gastrocnemius Muscle in Peripheral Artery Disease
Authors: Ferrucci Luigi , Candia Julián , Ubaida-Mohien Ceereena , Lyashkov Alexey , Banskota Nirad , Leeuwenburgh Christiaan , Wohlgemuth Stephanie , Guralnik Jack M. , Kaileh Mary , Zhang Dongxue , Sufit Robert , De Supriyo , Gorospe Myriam , Munk Rachel , Peterson Charlotte A. , McDermott Mary M.
Published: May 2023

Background:

Few effective therapies exist to improve lower extremity muscle pathology and mobility loss due to peripheral artery disease (PAD), in part because mechanisms associated with functional impairment remain unclear.

Methods:

To better understand mechanisms of muscle impairment in PAD, we performed in-depth transcriptomic and proteomic analyses on gastrocnemius muscle biopsies from 31 PAD participants (mean age, 69.9 years) and 29 age- and sex-matched non-PAD controls (mean age, 70.0 years) free of diabetes or limb-threatening ischemia.

Results:

Transcriptomic and proteomic analyses suggested activation of hypoxia-compensatory mechanisms in PAD muscle, including inflammation, fibrosis, apoptosis, angiogenesis, unfolded protein response, and nerve and muscle repair. Stoichiometric proportions of mitochondrial respiratory proteins were aberrant in PAD compared to non-PAD, suggesting that respiratory proteins not in complete functional units are not removed by mitophagy, likely contributing to abnormal mitochondrial activity. Supporting this hypothesis, greater mitochondrial respiratory protein abundance was significantly associated with greater complex II and complex IV respiratory activity in non-PAD but not in PAD. Rate-limiting glycolytic enzymes, such as hexokinase and pyruvate kinase, were less abundant in muscle of people with PAD compared with non-PAD participants, suggesting diminished glucose metabolism.

Conclusions:

In PAD muscle, hypoxia induces accumulation of mitochondria respiratory proteins, reduced activity of rate-limiting glycolytic enzymes, and an enhanced integrated stress response that modulates protein translation. These mechanisms may serve as targets for disease modification.
Interobserver Agreement on Intracranial Hemorrhage on Magnetic Resonance Imaging in Patients With Ischemic Stroke
Authors: van der Ende Nadinda A.M. , Luijten Sven P.R. , Kluijtmans Leo , Postma Alida A. , Cornelissen Sandra A. , van Hattem Antonius M.G. , Lycklama à Nijeholt Geert J. , Bokkers Reinoud P.H. , Thomassen Lars , Waje-Andreassen Ulrike , Logallo Nicola , Bracard Serge , Gory Benjamin , Roozenbeek Bob , Dippel Diederik W.J. , van der Lugt Aad
Published: May 2023

Background:

The Heidelberg Bleeding Classification, developed for computed tomography, is also frequently used to classify intracranial hemorrhage (ICH) on magnetic resonance imaging. Additionally, the presence of any ICH is frequently used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. We assessed the interobserver agreement on the presence of any ICH and the type of ICH according to the Heidelberg Bleeding Classification on magnetic resonance imaging in patients treated with reperfusion therapy.

Methods:

We used 300 magnetic resonance imaging scans including susceptibility-weighted imaging or T2*-weighted gradient echo imaging of ischemic stroke patients within 1 week after reperfusion therapy. Six observers, blinded to clinical characteristics except for suspected location of the infarction, independently rated ICH according to the Heidelberg Bleeding Classification in random pairs. Percent agreement and Cohen’s kappa (κ) were estimated for the presence of any ICH (yes/no), and for agreement on the Heidelberg Bleeding Classification class 1 and 2. For the Heidelberg Bleeding Classification class 1 and 2, weighted κ was estimated to take the degree of disagreement into account.

Results:

In 297 of 300 scans, the quality of scans was sufficient to score ICH. Observers agreed on the presence or absence of any ICH in 264 of 297 scans (88.9%; κ 0.78 [95% CI, 0.71–0.85]). There was agreement on the Heidelberg Bleeding Classification class 1 and 2 and no ICH in class 1 and 2 in 226 of 297 scans (76.1%; κ 0.63 [95% CI, 0.56–0.69]; weighted κ 0.90 [95% CI, 0.87–0.93]).

Conclusions:

The presence of any ICH can be reliably scored on magnetic resonance imaging and can, therefore, be used as (safety) outcome measure in clinical stroke trials that evaluate acute interventions. Agreement of ICH types according to the Heidelberg Bleeding Classification is substantial and disagreements are small.
Naturalistic Causal Probing for Morpho-Syntax
Authors: Amini Afra , Pimentel Tiago , Meister Clara , Cotterell Ryan
Published: May 2023

Probing has become a go-to methodology for interpreting and analyzing deep neural models in natural language processing. However, there is still a lack of understanding of the limitations and weaknesses of various types of probes. In this work, we suggest a strategy for input-level intervention on naturalistic sentences. Using our approach, we intervene on the morpho-syntactic features of a sentence, while keeping the rest of the sentence unchanged. Such an intervention allows us to causally probe pre-trained models. We apply our naturalistic causal probing framework to analyze the effects of grammatical gender and number on contextualized representations extracted from three pre-trained models in Spanish, the multilingual versions of BERT, RoBERTa, and GPT-2. Our experiments suggest that naturalistic interventions lead to stable estimates of the causal effects of various linguistic properties. Moreover, our experiments demonstrate the importance of naturalistic causal probing when analyzing pre-trained models.

https://github.com/rycolab/naturalistic-causal-probing
Revision of the genus Pollanisus Walker, 1854(Lepidoptera: Zygaenidae: Procridinae)
Authors: MOLLET BERNARD , TARMANN GERHARD M.
Published: May 2023

The genus Pollanisus is endemic for Australia. Its revision is mainly based on head studies and includes 21 known species and 7 new species, Pollanisus jumbun sp. n., Pollanisus yugambeh sp. n., Pollanisus horakae sp. n., Pollanisus worimi sp. n., Pollanisus kalliesi sp. n., Pollanisus jirrbal sp. n. and Pollanisus nocturna sp. n. Moreover, two species, Pollanisus eumetopus syn. n. and Pollanisus eungellae syn. n., are synonymized with Pollanisus acharon (Fabricius, 1775). The status of 8 unnamed species (Tarmann, 2004) is discussed. New data on the phenology and bionomics are provided. New host plants in the genus Hibbertia (Dilleniaceae) are reported.
Changes in Relative Humidity Profiles over Earth’s Oceans in a Warming Climate: A Satellite-Data-Based Inference
Authors: Abraham Carsten , Goldblatt Colin
Published: May 2023

Recently, we presented a classification of “primitive” relative humidity (RH) profiles into eight distinct clusters over Earth’s oceans, based on about 18 years (2003–20) of observations from the AIRS on NASA’s Aqua satellite. Here we investigate the seasonal variability and decadal trends, both in the vertical structure of these RH profiles, and in their associated area of occurrence. Since vertical structures (except in the marine boundary layer) of each RH class are generally robust across all seasons and change only weakly in a warming climate, seasonal or decadal changes to their occurrence areas shift patterns of global moisture distribution. Globally, the marine boundary layer exhibits nonlinear moistening effects after about 2010, the end of the warming hiatus. Annual time series of ocean areas dominated by RH classes have linear trends, which are positive only for the most moist and driest RH classes (in terms of the free troposphere) associated with deep convection and large-scale subsidence favoring conditions for low-level stratocumulus clouds, respectively. Based on estimated linear trends of RH-class occurrences and sea surface temperatures, we infer projected linear responses of RH in a warming climate. Ocean areas dominated by most moist and driest RH classes (in terms of the free atmosphere) are estimated to increase by about 1% and 2%, respectively (corresponding to about 2.5% K−1 and 4.5% K−1, respectively). The averaged global and tropical RH structure remain almost constant in a warming climate. While this is consistent with other studies, our results show how increases in most moist and dry areas compensate each other, indicating possible increases in the frequency or persistence of future extreme events.
Resident Experiences in Pathways to Health for Cleveland Refugees: A Pilot Study
Authors: Cater Mackenzie , Kuruvilla Rebecca , Lee Jenny , Alibeji Naba , Wilaisakditipakorn Tanaporn Jasmine , Clark Marie
Published: May 2023

Refugee families often report discomfort with navigating the United States health care system, while medical trainees feel unprepared to meet the needs of refugee families. Pediatric residents partnered with a local refugee resettlement organization to create and deliver a user-friendly health care navigation curriculum to newly arrived refugee families. Pediatric residents completed pre-intervention and post-intervention surveys to assess their comfort and interest in working with refugee populations. Residents reported high interest in working with refugees despite little direct experience working with this population. There was a significant increase in residents’ reported understanding of refugee health as a result of this intervention. Future research is needed to assess the efficacy of such curricula for both refugee families and pediatric residents.
Using Explicit Instruction and Virtual Manipulatives to Teach Measurement Concepts for Students With Autism Spectrum Disorder
Authors: Liu Di , Lory Catharine , Lei Qingli , Cai Weiwei , Mao Yiwen , Yang Xuan
Published: May 2023

Measurement concepts are an essential foundation for more advanced mathematical concepts. To address the challenges of students with autism spectrum disorder (ASD) in learning measurement concepts, this study investigated the effects of using a combination of explicit instruction and virtual manipulatives (VMs) to teach measurement concepts to students with ASD in China. Using a single-case multiple-probe across skills design, researchers examined whether the intervention could support the acquisition and maintenance of measurement concepts in students with ASD. Based on visual analysis, a functional relation was found between the independent variable (i.e., explicit instruction with VMs) and student performance on solving measurement concepts problems. Implications for practice and research are discussed.
Exploring the Dilemmas, Challenges, and Opportunities of Adolescent Fatherhood: An Exploratory Case Study
Authors: Makhavhu Eugene Musiiwa , Ramukumba Tendani Sara , Masala-Chokwe Mmajapi Elizabeth
Published: May 2023

Teenage pregnancy is a significant concern for society, and the effect on education is immense. In South Africa, policies were thus introduced allowing pregnant school-going children to continue attending class until the baby’s birth. However, research on adolescent pregnancy generally ignores teenage fathers and focuses mostly on teenage mothers. Parents of teenage girls are also encouraged to offer support to their children, but the same cannot be said about adolescent fathers. They confront numerous barriers in fulfilling their parenting roles. A qualitative exploratory study was conducted to explore adolescent fathers’ dilemmas, challenges, and opportunities. Interviews were conducted to collect data from 5 adolescent fathers in 1 township in South Africa. Findings indicate that adolescent fathers face various challenges and experience fatherhood differently. The phenomenon’s effects on education are immense and unavoidable, yet some opportunities accompany the fathering role. Adolescent fathers are exposed to several complex situations that impact their lives. To understand these, further research studies into adolescent fatherhood still need to be conducted, and reproductive health education efforts should equally be directed toward empowering boys to the same extent as girls.
Race Disparities in Hypertension Prevalence Among Older Men
Authors: Baxter Samuel L. K. , Zare Hossein , Thorpe Roland J.
Published: May 2023

This study aimed to examine whether hypertension prevalence varies by race/ethnicity and within age groups in a nationally representative sample of men in the United States. Hypertension was defined as blood pressure (BP) readings of 140 mm Hg and higher for systolic BP, 90 mm Hg and higher for diastolic BP, or self-reports of taking medication for hypertension. Modified Poisson models estimated prevalence ratios (PRs) and 95% confidence intervals (CI) for race and age group associations with hypertension. The prevalence of hypertension was 38% overall and 46% of the men were aged 50 and older. Analyses that focused on older men (50 years of age or older) found that non-Hispanic Black men had a higher prevalence of hypertension (PR  =  1.28, 95% CI: 1.19 − 1.37) compared to non-Hispanic White men. We suggest future research utilize life course perspectives to better identify which cumulative experiences impact hypertension disparities.
A Novel Indicator to Correct for Individual Reported Heterogeneity. An Application to Self-Evaluation of Later-Life Depression
Authors: Berretta Serena , Garbin Sara , Iannario Maria , Paccagnella Omar
Published: May 2023

Program evaluations often investigate complex or multi-dimensional constructs, such as individual opinions or attitudes, by means of ratings. A different interpretation of the same question may affect cross-country comparability, leading to the Differential Item Functioning problem. Anchoring vignettes were introduced in the literature as a way to adjust self-evaluations from this interpersonal incomparability. In this paper, we first introduce a new nonparametric solution to analyse anchoring vignette data, recoding a variable based on a rating scale to a new corrected-variable that guarantees comparability in any cross-country analysis. Then, we exploit the flexibility of a mixture model introduced to account for uncertainty in the response process (the CUP model) to test if the proposed solution is effectively able to remove this reported heterogeneity. This solution is easy to construct and has important advantages compared with the original nonparametric solution adopted with anchoring vignette data. The novel indicator is applied to investigate self-reported depression in an old population. Data that will be analysed come from the second wave of the Survey of Health, Ageing and Retirement in Europe, collected in 2006/2007. Results highlight the need of correcting for reported heterogeneity comparing individual self-evaluations. Once interpersonal incomparability resulting from the different uses of response scales is removed from the self-assessments, some estimates are reversed in magnitude and signs with respect to the analysis of the collected data.
Income Inequality, Economic Complexity, and Renewable Energy Impacts in Controlling Consumption-Based Carbon Emissions
Authors: Ulucak Recep , Danish  , Zhang Yaoqi , Chen Rui , Qiu Yiting
Published: May 2023

Although many studies have been conducted on the role of renewable energy in the environment, literature has ignored the potential role of socioeconomic indicators in renewable energy and pollution nexus. Also, critical questions arose with the critical factors, such as income inequality and economic complexity, have not been answered properly. This study explores the nexus between income inequality, economic complexity, renewable energy consumption, GDP per capita, and pollution and thus aims to reach efficient policy strategies by revealing empirical evidence. The study follows an environmental impact model structure and conducts the panel-corrected standard errors and fixed effect regression. BRICS countries (Brazil, Russia, India, China, and South Africa) are selected to conduct our research. Annual data covering the period 1990–2017 for the sample countries are employed. Consumption-based carbon dioxide emissions as an indicator of environmental pollution are used since income inequality makes more sense in terms of the consumption side of an economy and is more related to consumers rather than the production sector. The obtained results reveal that income inequality has a positive and significant impact on consumption-based carbon dioxide emissions. However, GDP per capita, renewable energy, and economic complexity reduce pollution. It is also observed that the interaction term of inequality and renewable energy decreases emissions. Findings confirm that socioeconomic indicators, such as economic complexity and income inequality with the interaction of renewable energy, are crucial factors in reducing emissions and designing a greener future.
The Effect of Nine-in-One-Drawing Therapy on Anxiety, Depression, and Psychological Resilience of Community Correction Objects
Authors: Liu Yang , Zhang Zili , Chen Feng
Published: May 2023

Investigate the effect of Nine-in-one-drawing therapy on anxiety, depression, and psychological resilience of community correction objects. Sixty cases of community correction objects with anxiety and depression were randomly divided into experimental group and control group, with 30 cases in each group. The conventional psychological correction methods was adopted in the control group and the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Connor-Davidson Resilience Scale (CD-RISC) was used to evaluate. In the experimental group, Nine-in-one-drawing therapy was adopted based on the correction items of the control group, and Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Connor-Davidson Resilience Scale was used before and after intervention in the two groups for evaluation. The intervention activities in the two groups were carried out five times separately, with a duration of about 1 hour and an interval of 3 days. After the intervention, the anxiety and depression scores of the community correction objects in the experimental group were significantly lower than those in the control group, and the psychological resilience scores were significantly higher than those in the control group (both p < .05). Nine-in-one-drawing therapy can reduce the anxiety and depression of community correction objects, and improve their psychological resilience.
Relations between Students’ Study Approaches, Perceptions of the Learning Environment, and Academic Achievement in Flipped Classroom Learning: Evidence from Self-Reported and Process Data
Authors: Han Feifei
Published: May 2023

This study examined the extent to which relations between students’ perceptions of the learning environment, academic achievement, and study approaches measured by both self-reported and process data were consistent amongst 323 engineering students in a flipped classroom course. A hierarchical cluster analysis on four self-reported scales identified deep and surface study approaches. Students reporting deep approaches obtained significantly better marks than those reporting surface approaches. An agglomerative sequence clustering on sequences of students’ online interactions found four observed study approaches: two focused on content and two focused on assessment. Students adopting content-focused approaches performed significantly better than those employing assessment-focused ones. Two cross-tabulations revealed consistency of relational patterns between perceptions of the learning environment and study approaches by self-reported or process data. Amongst students with better perceptions, a significantly higher proportion of them reported deep approaches than surface approaches. Amongst students using content-focused approaches, significantly higher proportions of them held positive perceptions than negative perceptions. The study results suggest to teachers that fostering a better learning environment, helping students understand how online and in-person components are integrated, and equipping them with knowledge and principles of flipped classroom learning would be useful to enhance students’ learning experiences in flipped classroom courses.
Effects of Etomidate on Postintubation Hypotension, Inflammatory Markers, and Mortality in Critically Ill Patients with COVID-19: An International, Multicenter, Retrospective Study
Authors: Leou Konstantinos , Mendez Dianelys , Horani George , Papagiannakis Nikolaos , Jiménez Sánchez Roberto , Mazzei Diana , Mora Isabel , Manickam Rajapriya , Tourlakopoulos Konstantinos , Garrido Peñalver José Francisco , Jiménez Medina David , Rodríguez Mulero María Dolores , Annousis Konstantinos , Laou Eleni , García de Guadiana-Romualdo Luis , Pantazopoulos Ioannis , Kaur Kunwar , Chalkias Athanasios ,   ETOCOVID Study group
Published: May 2023

Objective

To evaluate the association of etomidate with postintubation hypotension, inflammation, and mortality in critically ill patients with COVID-19.

Design

International, multicenter, retrospective study.

Participants

Critically ill patients hospitalized specifically for COVID-19 from three major academic institutions in the US and Europe.

Main Outcome and Measures

Patients were allocated into the etomidate (ET) group or another induction agent (OA) group. The primary outcome was postintubation hypotension. Secondary outcomes included postintubation inflammatory status, in-hospital mortality, and mortality at 30 days.

Results

171 patients with a median age of 68 (IQR 58-73) years were included (ET, n  =  98; OA, n  =  73). Etomidate was associated with lower postintubation mean arterial pressure [74.33 (64-85) mm Hg versus 81.84 (69.75–94.25) mm Hg, p  =  0.005] compared to other agents. No statistically significant differences were generally observed in inflammatory markers between the two groups at 7- and 14-days after admission to the intensive care unit. In-hospital mortality [77 (79%) versus 41 (56%), p  =  0.003] and mortality at 30-days [78 (80%) versus 43 (59%), p  =  0.006] were higher in the ET group. In multivariate logistic regression analysis, only etomidate (p  =  0.009) and postintubation mean arterial pressure (p < 0.001) had a statistically significant effect on mortality, in contrast to stress-dose steroids (p  =  0.301), after adjusting for creatinine (p  =  0.695), blood urea nitrogen (p  =  0.153), age (p  =  0.055), oxygen saturation of hemoglobin (SpO2) (p  =  0.941), and fraction of inspired oxygen (FiO2) (p  =  0.712).

Conclusions

Administration of a single-bolus dose of etomidate in critically ill patients with COVID-19 is associated with lower postintubation mean arterial pressure and higher in-hospital and 30-day mortality compared to other induction agents.
Performance of single slope solar still with various operation parameters—An experimental, statistical, and CFD simulation approach toward optimality
Authors: Prasad Rakesh , Singh Yashvir , Sharma Anuj Kumar , Sahu Rohit , Dwivedi Vijay Kumar , Kumar Sanjeev
Published: May 2023

Potable water is a basic need in various aspects of daily life. The conversion of brackish water to potable water through conventional sources is costly and environmental issues are associated. In this regard, solar energy is a preference over fossil fuel or another energy source because of its cost and environment. Therefore, solar still is very popular, but the performance still must be improved to meet our potable water demand. In the present work, the productivity of the still is tested with various operational parameters such as glass plate inclination 27°, 28°, and 29°, and basin heat absorption capacity was also observed with sand, clay sand, and granite for water yield. Water yielding is also affected by water depth in basing investigated as 2, 3, and 4 cm for productivity. Performance of still with various operation parameters was analyzed by using RSM (response surface methodology). The process optimization to get maximum output was analyzed through the RSM technique to save time and effort for experiments. After analysis, a better yield of 630 mL may be obtained with clay sand at 27° glass inclination and 2 cm water depth. The analyzed optimum parameters were validated through experimental data. This optimum condition was also verified by CFD analysis by using ANSYS Fluent v17, in which glass temperature ( TG) and water temperature ( Tw) variation was noted, and water yielding was found proportional to the heat transfer coefficient. The economy of the operation was calculated as 2.87 Rs/liter best price of yielded distilled water with clay sand.
Early Follow-up of Parents by a Specialized Cleft Nurse After the Birth of an Infant with Cleft lip and/or Palate
Authors: Lindberg Nina Ellefsen , Kynø Nina Margrete , Billaud Feragen Kristin , Pripp Are Hugo , Tønseth Kim Alexander
Published: May 2023

Objective

To document the impact of early follow-up by specialized cleft nurses (SCNs) to families of infants with cleft lip and/or cleft palate (CL/P).

Design

Prospective inclusion of a control group, which received standard care alone, followed by an intervention group, which in addition received early SCN follow-up.

Setting

The cleft lip and palate team at a University hospital.

Participants

70 families (69 mothers and 57 fathers); control group (n = 38); intervention group (n = 32).

Intervention

SCNs offered a consultation at the maternity ward and follow-ups by phone or face-to-face at one, three, eight weeks and six months after birth.

Outcome measures

Use of Internet-Questionnaire, Quality of discharge teaching scale (QDTS), Post discharge coping difficulty scale (PDCDS), Response on follow-up by health professionals.

Results

Infants in the intervention group were admitted less frequently to a Neonatal Intensive Care unit (NICU); 21.9% vs 51.4%, P = .012. Parents in the intervention group used internet for cleft-related reasons less frequently (74.6% vs 85.9%), P = .112 and the mothers benefitted less from cleft-related activity on the internet ( P = .013). The intervention group reported higher mean score for satisfaction with total cleft care ( P = .001). There were no significant group differences regarding mean total score for discharge teaching ( P = .315) and coping difficulties ( P = .919).

Conclusion

Early follow-up by a SCN with expertise in cleft care is highly valued by parents. Closer cooperation between the cleft team and health professionals at birth hospitals and Child health centers is necessary for optimal follow-up.
Composition of the gut microbiome, role of diet, lifestyle, and antioxidant therapies in diabetes mellitus and diabetic retinopathy
Authors: Oganov Anthony C , Seddon Ian , Zein Mike , Yazdanpanah Ghasem , Fonoudi Hossein , Jabbehdari Sayena
Published: May 2023

The gut microbiome is a complex ecosystem in the gastrointestinal tract composed of trillions of bacteria, viruses, fungi, and protozoa. Disruption of this delicate ecosystem, formally called “dysbiosis”, has been linked to a variety of metabolic and inflammatory pathologies. Several studies have focused on abnormal microbiome composition and correlated these findings with the development of type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR). However, given the complexity of this ecosystem, the current studies are narrow in design and present variable findings. Composition of the gut microbiome in patients with DR significantly differs from patients with diabetes without retinopathy as well as from healthy controls. Additionally, the gut microbiome has been shown to modify effects of medication, diet, exercise, and antioxidant use on the development and progression of DR. In this paper, we present a comprehensive review of literature on the effect of oxidative stress, antioxidant therapies, and dysbiosis on DR.
Structural and clinical changes in previously treated type 1 macular neovascularization in non-responder AMD eyes switched to brolucizumab
Authors: Pece Alfredo , Fossataro Federica , Maione Giulio , Liuzzi Raffaele
Published: May 2023

Purpose

To examine structural and clinical changes in previously treated type 1 macular neovascularization (MNV) in non-responder age-related macular degeneration (nAMD) eyes switched to brolucizumab. Subretinal hyper-reflective material (SHRM), intraretinal (IRF) and subretinal fluid (SRF) presence, fibrovascular-pigment epithelium detachment (PED) height and central macular thickness (CMT) variation were analyzed using optical coherence tomography (OCT).

Methods

In this prospective study all patients underwent a complete ophthalmological evaluation including structural OCT at baseline (T0), one month (T1), three (T2), four (T3) and six months after switching to brolucizumab treatment (T4). Non-responder criterion was the persistence of IRF and SRF. Moreover, CMT and BCVA had shown worsening or no improvement before switching to brolucizumab. Clinical function and structural activity biomarkers were measured at each visit and changes were analyzed. P value <0.05 was considered statistically significant.

Results

Twenty eyes of twenty patients were enrolled. All the structural variables examined during the follow-up showed significant reductions. Decreases in IRF, SRF and PED were already significant at T1 (p < 0.05). SHRM was significantly reduced at T2 (p < 0.05). Structural biomarkers were absent at T3. At T4, all biomarkers remained stable while SHRM was no longer detectable in 18 patients. Changes in visual acuity from baseline to T4 were not significant.

Conclusion

This short-term experience highlights that brolucizumab might be considered an effective treatment option in nAMD with type 1 MNV, as it can promote a reduction of structural activity biomarkers.
How to Overcome the Secretiveness of a Group: Opportunities of Online Interviews
Authors: Maia Inês
Published: May 2023

In a pandemic, qualitative methodologies and in-person interviews, the key to understanding the experiences lived by participants in social phenomena, proved to be ill-suited. As a result of the restrictions imposed during this period, the challenge was even more considerable in the research of groups and practices marked by secretiveness and self-closing, in that our presence in the field, always marked by hurdles, was impracticable. In this text, we propose a reflection on the experience of conducting online interviews with university students (Porto, Portugal) involved in praxe (hazing), a complex and multidimensional social phenomenon that profoundly shapes academic life in Portuguese universities. We will discuss the differences between holding in-person interviews before the pandemic and online interviews during the lockdown. We draw attention to practical, methodological, and ethical considerations in adapting research to an online context and conclude that, despite the challenges, online interviews opened up surprising opportunities for collecting these students’ experiences.
Impact of the COVID-19 pandemic on Swedish adults aged 77 years and older: Age differences in lifestyle changes
Authors: Augustsson Erika , Von Saenger Isabelle , Agahi Neda , Kåreholt Ingemar , Ericsson Malin
Published: May 2023

Aims:

This study aimed to describe the impact of the COVID-19 pandemic on lifestyle and social activities among older adults in Sweden, with a special focus on differences between the ‘younger old’ (aged 77–84) and ‘older old’ (aged 85–109).

Methods:

This study is based on a nationally representative sample of older adults (aged ⩾77 years) in Sweden (SWEOLD). Data were collected between May 2021 and April 2022, when many recommendations were removed but the virus was still classified as a public health disease. We studied occurrences and differences between the two age groups in several lifestyle factors and social activities.

Results:

The younger old displayed larger changes in lifestyles because of the pandemic than the older old. Most changes were found in social interactions with family.

Conclusions:

Our results highlight the large heterogeneity within the Swedish population aged ⩾77 years, and that the younger old experienced a bigger lifestyle change than the older old. Previous activity levels might be important to consider in order to understand how regulations may affect the older population. Finally, our findings indicate large age differences in Internet use, which require attention to prevent digital exclusion of an already vulnerable group.
Boys perpetrating sexual harassment on peer girls in secondary school: A focus group study about pupils’ experiences
Authors: Slaatten Hilde , Malterud Kirsti
Published: May 2023

Aims:

To explore experiences of sexual harassment of adolescent girls by peer boys during school hours.

Methods:

Focus group study with a convenience sample of six girls and 12 boys aged 13–15 years from two different lower secondary schools in Norway. Thematic analysis with Systematic Text Condensation was used with data from three focus group discussions, supported by theory about gender performativity.

Results:

Analysis demonstrated how girls experienced specific aspects of unwanted sexual attention perpetrated by male peers. When boys trivialized sexualized behaviour perceived as intimidating by girls, the behaviour was perceived as ‘normal’. Among the boys, sexual name-calling was only meant as a joke to put the girls in their place, while girls were silenced. In this way, patterns of gendered interaction contribute to performing and maintaining sexual harassment. Responses from co-pupils and teachers had strong impact on further harassment, contributing to either escalation or resistance. Signalling disapproval when being harassed was difficult when bystander behaviour was lacking or degrading. The participants wanted teachers to intervene in response to sexual harassment, emphasizing that being present or showing concern is not enough to stop the harassment. The lack of proactive responses from bystanders may also represent gender performativity, where invisibility contributes to social conventions such as normalization.

Conclusions:

Our analysis indicates a need for interventions targeting sexual harassment among pupils in Norwegian schools, with a special awareness of gendered performance. Both teachers and pupils would benefit from increased knowledge and skills in how to detect and stop unwanted sexual attention.
Co-addictive human–machine configurations: Relating critical design and algorithm studies to medical-psychiatric research on “problematic Internet use”
Authors: Helm Paula , Matzner Tobias
Published: May 2023

Next to popular term Internet addiction, problematic Internet use (PIU) has established itself as an umbrella term for all types of repetitive impairing behaviors associated with new media technologies. Yet, debates about categorization, prevention, and treatment are nowhere near settled. When it comes to classification, medical-psychiatric research has so far retained authority. Here, PIU is examined primarily at the level of the individual user, and it is at this level that solutions are sought. Complementing this, research from critical algorithm studies and technology ethics emphasize the design of many applications as problematic, while cautioning against a determinist view of technology making people addicted. Based on new materialist conceptions of responsibility, the article argues for integrating the different perspectives into a relational understanding of co-addictive human–machine configurations. The goal is to capture the interactive character of PIU, and to achieve a well-calibrated distribution of responsibilities in avoiding destructive habits.
Development of a novel real-time AE source localisation technique using ANN for health monitoring of rail section: an experimental study
Authors: Kundu Tamal , Pal Apurba , Roy Parikshit , Datta Aloke Kumar , Topdar Pijush
Published: May 2023

Almost all countries are using railways to transport passengers and freight. Due to heavy load and environmental exposure, these rail sections are prone to damage. Thus, structural health monitoring of the rail section is an essential topic of research to ensure safety and predict the remaining useful life of the track. Consequently, the detection and localisation of damages/cracks in rail section are crucial. It also helps in taking corrective action in time. In this context, the acoustic emission (AE) technique is found to be a powerful non-destructive testing technique which has great potential to localise cracks in rail sections. Actually, the initiation or growth of a damage/crack in a structure emits AE waves, which may be captured using AE sensors mounted on different locations of the structure. The damage itself acts as an AE source. Subsequently, in this study, a novel approach is developed to localise the AE source in a rail section using the artificial neural network (ANN). The ANN model is based on the experimental crack signals captured through a single AE sensor by placing it at different regions of the rail section. For each position of the sensor, cracks are simulated using pencil lead break at different locations along the length and depth of the rail section. It is observed that the developed ANN model predicts the location of the AE source with better accuracy in comparison to the existing localisation methods. The minimum error is found to be less than 1%. Therefore, it can be concluded that the developed ANN model is a suitable option for predicting potential crack locations during real-time monitoring of rail sections.
Parents as secondary patients: Towards a more family-centred approach to care
Authors: Eichinger Johanna , Elger Bernice , Yi Jiao Tian , Koné Insa , Shaw David Martin
Published: May 2023

The definition of ‘patient’ is commonly taken for granted and considered as obvious, but the term is rather underconceptualised in the literature. In this paper, it will be argued that the criterion of suffering can be considered a sufficient criterion for a parent to be considered a secondary patient when their seriously ill child is receiving medical care (i.e. not necessarily the parents themselves) – these parents are sufferers in virtue of the suffering of others. The nature of parental and child health and well-being is clearly relational and bidirectional, thus also a bidirectional and relational integration of parental and paediatric patient care is necessary. A genuine expansion of the concept ‘patient’ to parents, both practically and theoretically, can help to bring awareness to the closely intertwining, interacting and interdependent vulnerabilities of both parties, the potential conflicts of interests involved, and also to demand support and reduce hurdles, for example, in reimbursement by health insurers. Treating parents as patients will (1) help the affected child (the primary patient), as unhealthy and/or mentally unstable parents are likely to negatively influence a child's treatment and (2) prevent the parents (the secondary patients) from becoming primary patients themselves due to their suffering because of their child's illness.
Effects of Iliac Tortuosity Index on Fenestrated Endovascular Aortic Aneurysm Repair for Pararenal and Thoracoabdominal Aortic Aneurysms
Authors: Jordano Lia , Robinson Emilie C. , Mirza Aleem , Skeik Nedaa , Stanberry Larissa , Manunga Jesse
Published: May 2023

Purpose:

To evaluate the effect of iliac tortuosity on procedural metrics and outcomes of patients with complex aortic aneurysms (cAAs) undergoing repair with fenestrated/branched endografts (f/b-EVAR [endovascular aortic aneurysm repair]).

Material and Methods:

The study is a single-center, retrospective review of a prospectively maintained database of patients undergoing aneurysm repair using f/b-EVAR between the years 2013 and 2020 at our institution. Included patients had at least 1 preoperative computed tomography angiography (CTA) available for analysis. Iliac artery tortuosity index (TI) was calculated using centerline of flow imaging from a 3-dimensional work station based on the formula: (centerline iliac artery length / straight-line iliac artery length). The associations between iliac artery tortuosity and procedural metrics, including total operative time, fluoroscopy time, radiation dose, contrast volume, and estimated blood loss (EBL), were evaluated.

Results:

During this period, 219 patients with cAAs underwent f/b-EVAR at our institution. Ninety-one patients (74% men; mean age = 75.2±7.7 years) met criteria for inclusion into the study. In this group, there were 72 (79%) juxtarenal or paravisceral aneurysms and 18 (20%) thoracoabdominal aortic aneurysms and 5 patients (5.4%) with failed previous EVAR. The average aneurysm diameter was 60.1±0.74 mm. Overall, 270 vessels were targeted, and 267 (99%) were successfully incorporated, including 25 celiac arteries, 67 superior mesenteric arteries, and 175 renal arteries. The mean total operative time was 236±83 minutes, fluoroscopy time was 87±39 minutes, contrast volume was 81±47 mL, radiation dose 3246±2207 mGy, and EBL was 290±409 mL. The average left and right TIs for all patients were 1.5±0.3 and 1.4±0.3, respectively. On multivariable analysis, the interval estimates suggest positive association between TI and procedural metrics to a certain degree.

Conclusions:

In the current series, we found no definitive association between iliac artery TI and procedural metrics, including operative time, contrast used, EBL, fluoroscopy time, and dose in patients undergoing cAA repair using f/b-EVAR. However, there was a trend toward association between TI and all these metrics on multivariable analysis. This potential association needs to be evaluated in a larger series.

Clinical Impact

Iliac artery tortuosity should not exclude patients with complex aortic aneurysms from being offered fenestrated or branched stent graft repair. However, special considerations should be taken to mitigate the impact of access tortuosity on alignment of fenestrations with target vessels, including use of extra stiff wires, through and through access and delivering the fenestrated/branched device into another (larger) sheath such as a Gore DrySeal in patients with arteries large enough to accommodate such sheaths.
Potential Utility of Hand Acceleration Time in Quantifying the Degree of Malperfusion in Patients With Suspected Hemodialysis Access–Induced Distal Ischemia
Authors: Gruber Maxwell , Sommerset Jill , Hansen-Nyholm Cali , Feliciano Beejay , Vea Yolanda , Karmy-Jones Riyad
Published: May 2023

Steal phenomenon after upper extremity hemodialysis access is a clinical diagnosis and consists of signs and symptoms ranging from pain during dialysis to tissue loss. Duplex ultrasonography of the access site and limb arterial perfusion often serves as an adjunct to the diagnosis but can have limitations and there is no specific duplex measurement that indicates that an intervention will be a success. We have used hand acceleration time (HAT) to assess perfusion in a number of trauma and shock cases and hypothesized that this approach could also be beneficial in assessing patients with hemodialysis access–induced distal ischemia (HAIDI), both for identifying patients who are candidates for intervention and to measure whether the intervention will be successful. Specifically, we hypothesized that a HAT <100 ms is associated with normal hand perfusion. We performed a retrospective review of 4 patients with upper extremity arteriovenous fistulas who presented with pain and tissue loss involving the ipsilateral hand. In 2 cases, the tissue loss was not primarily due to steal (one due to skin slough from antibiotic reaction and the other due to focal calciphylaxis), and 2 patients had diffuse calcific disease of the forearm arteries. All 4 patients had antegrade flow in the forearm arteries and HAT >100 ms. One patient with soft tissue sloughing was managed with banding of the proximal fistula, and 3 had proximalization of the fistula. All 4 achieved HAT <100 ms and had resolution of symptoms. Hand acceleration time may be a valuable adjunct to determine whether intervention in the setting of hemodialysis access–induced distal ischemia HAIDI may assist with wound healing.