bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Imperial Germany's Push to the Persian Gulf and Indian Ocean: A Strategic Imperative of Weltpolitik’
Authors: Overlack Peter
Published: March 2024

With the extension of the Berlin-Baghdad Railway and Germany's search first for naval coaling and later for radio station locations, the strategic usefulness of footholds in the Persian Gulf region came to the fore. Reliable communication with the African colonies and warships of the East Asian Cruiser Squadron in the expanse of the Indian Ocean was essential. With the allied Ottoman Empire regional expansion aimed to create a wedge to split the British Empire. Disruptive activities in Persia and Afghanistan aimed to pressure India and distract Britain. This places German strategy in the region in a significant world-political context leading up to the First World War.
Classifications of Trauma Exposure and Their Associations With 3-Year Follow-up Psychological Symptoms Among Korean Victims of Disaster: A Latent Class Analysis
Authors: Lee Hyunyup , Kang Sungrok
Published: March 2024

This study aimed to classify patterns of trauma exposure among disaster victims using latent class analysis (LCA) and to examine group differences in post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms over three years. Data were obtained from a 3-year panel survey of Korean disaster victims (male = 461, female = 513) who responded to four types of trauma experiences: threatened death, injury or disease, witnessing injury or death, and loss of family or relatives in 2017. The LCA yielded three classes: the low-threat (66.1%), life-threat (29.4%), and multi-threat (4.5%) groups. One-way analysis of variance showed that the multi-threat group had the highest levels of PTSD, depressive, and anxiety symptoms in 2017, 2018, and 2019. Post-traumatic stress disorder symptoms significantly decreased between 2017 and 2018 in the life-threat and multi-threat groups. However, there were no differences between 2018 and 2019 in any groups. These results highlight the importance of early intervention during the proximal period after trauma, particularly in individuals exposed to multiple types of traumatic experiences.
ChatGPT in private practice: The opportunities and pitfalls of novel technology
Authors: Lehman Kirk , Aroney Emeil , Wu Isabella
Published: March 2024

Objective

This article explores the transformative impact of OpenAI and ChatGPT on Australian medical practitioners, particularly psychiatrists in the private practice setting. It delves into the extensive benefits and limitations associated with integrating ChatGPT into medical practice, summarising current policies and scrutinising medicolegal implications.

Conclusion

A careful assessment is imperative to determine whether the benefits of AI integration outweigh the associated risks. Practitioners are urged to review AI-generated content to ensure its accuracy, recognising that liability likely resides with them rather than with AI platforms, despite the lack of case law specific to negligence and AI in the Australian context at present. It is important to employ measures that ensure patient confidentiality is not breached and practitioners are encouraged to seek counsel from their professional indemnity insurer. There is considerable potential for future development of specialised AI software tailored specifically for the medical profession, making the use of AI more suitable for the medical field in the Australian legal landscape. Moving forward, it is essential to embrace technology and actively address its challenges rather than dismissing AI integration into medical practice. It is becoming increasingly essential that both the psychiatric community, medical community at large and policy makers develop comprehensive guidelines to fill existing policy gaps and adapt to the evolving landscape of AI technologies in healthcare.
Martial races as clubs? The institutional logic of the martial race system of British India
Authors: Miller Charles
Published: March 2024

Military institutions can be seen as a solution to a type of principal-agent problem, in which a government principal contracts with a military agent to produce violence on their behalf. Absent extensive monitoring, low effort should be expected from the military agent. This should especially be the case for a mercenary force which cannot rely on patriotism or ideology. Yet the mercenary army of the British-ruled India consistently produced high and dedicated performance. In this paper, I argue that the otherwise curious institution of recruiting predominantly from the so-called ‘martial races’ helps to explain this puzzle. Drawing on Iannaccone’s club goods model, I argue that the martial race recruitment system represented an effective solution to the principal-agent problem by allowing the British to benefit from a repeat business arrangement with a small number of ethno-religious groups whose costly in-group prohibitions and poor outside options helped both to screen out potential shirkers and deter poor performance on the battlefield.
Eyeing Risks: A Critical Analysis of the Use of Periorbital Steroids in Fronto-orbital Advancement
Authors: Cho Daniel Y. , Blum Jessica D. , Kurnik Nicole , Swanson Jordan W. , Susarla Srinivas M. , Taylor Jesse A. , Hopper Richard A. , Bartlett Scott , Birgfeld Craig B.
Published: March 2024

Objective

To evaluate the outcomes associated with two techniques of periorbital steroid administration in bilateral fronto-orbital advancement (FOA).

Design

Multi-institutional retrospective chart review

Setting

Two high volume, tertiary US craniofacial centers

Patients, Participants

Patients who underwent FOA between 2012 and 2021

Interventions

Patients were divided into three cohorts based on method of steroid administration. Groups GEL and INJ represent those who received steroids in the form of triamcinolone soaked gelfoam or direct injection of dilute triamcinolone to the frontal/periorbital region, respectively. Group NON did not receive any periorbital steroids.

Main Outcome Measure(s)

Peri-operative outcomes including hospital length of stay and complications were evaluated based on method of periorbital steroid administration. Variables predictive of infectious complications were assessed using stepwise logistic regression.

Results

Four hundred and twelve patients were included in our sample (INJ:249, GEL:87, NON:76). Patients in the INJ group had a higher ASA class ( P < .001) while patients in the NON group were significantly more likely to be syndromic ( P < .001) and have multisuture craniosynostosis ( P < .001). Rate of infectious complications for each cohort were NON: 2.6%, INJ: 4.4%, and GEL: 10.3%. There was no significant difference between groups in hospital length of stay ( P = .654) or rate of post-operative infectious complications ( P = .061). Increased ASA class ( P = .021), increased length of stay ( P = .016), and increased intraoperative narcotics ( P = .011) were independent predictors of infectious complications.

Conclusions

We identified a dose-dependent relationship between periorbital steroids and rate of postoperative infections, with key contributions from ASA class, hospital length of stay, and dose of intraoperative narcotics.
Robust dynamic surface control of series elastic actuators based on reduced-order extended state observer
Authors: Yin Changwei , Du Fuxin , Zhang Yang , Chen Chao , Song Rui , Li Yibin
Published: March 2024

The compliance of series elastic actuators (SEAs) is significant for ensuring safe human–machine interaction. However, in practical applications, the SEA is inevitably encountered with unknown disturbances, such as parameter uncertainties, unmodeled dynamics, and environmental interferences. In this paper, a robust dynamic surface control scheme is presented to address the high-precision trajectory tracking problem of the SEA. Firstly, a reduced-order extended state observer (RESO) with only link-side position measurements is designed to estimate the unknown lumped disturbance and unmeasurable system states. Based on the estimated values from the RESO, a robust dynamic surface controller is proposed for the trajectory tracking of the SEA. Additionally, the finite-time filter is introduced to overcome the “explosion of complexity” in the backstepping controller, and the filtering error in the dynamic surface controller is reduced compared with the conventional first- and second-order filters. The stability of the closed-loop system is guaranteed by the Lyapunov theory. Finally, the effectiveness and superiority of the proposed control algorithm are verified through simulations and experiments.
Comparison of analgesic efficacy of tramadol, morphine and methadone in cats undergoing ovariohysterectomy
Authors: Goich Mariela , Bascuñán Alejandra , Faúndez Patricio , Siel Daniela
Published: March 2024

Objectives

The aim of this study was to compare the analgesic efficacy and the effect on physiological variables and behavior of the use of tramadol, methadone and morphine as preoperative analgesia in healthy cats undergoing elective ovariohysterectomy.

Methods

Cats undergoing ovariohysterectomy were randomly assigned to receive one of the following premedication treatments intramuscularly: methadone (0.2 mg/kg; n = 10); morphine (0.2 mg/kg; n = 10); or tramadol (3 mg/kg; n = 10). Induction of anesthesia was done with propofol, and maintenance of anesthesia was done with isoflurane. Intraoperative heart rate, arterial blood pressure, respiratory rate, end-tidal isoflurane concentration and frequency of rescue analgesia (fentanyl 2.5 µg/kg) were compared between groups. Postoperative analgesia was assessed using the UNESP-Botucatu Multidimensional Composite Pain Scale, and perioperative serum glucose, cortisol concentrations and postoperative rescue analgesia were evaluated.

Results

Intraoperative rescue analgesia was required in 76.5% of cats at some time during surgery, and 27% of cats required postoperative rescue analgesia up to 6 h after extubation. There were no significant differences between groups with respect to intraoperative and postoperative rescue analgesia, pain scale scores and end-tidal isoflurane concentrations. In the immediate postoperative period, after extubation, most of the patients presented with hypothermia; however, 1–6 h postoperatively, hyperthermia was observed in most of the patients, and was most common in the tramadol group.

Conclusions and clinical relevance

Under the conditions of this study, methadone, morphine and tramadol produced satisfactory postoperative analgesia in most of the cats undergoing ovariohysterectomy, and the effects lasted up to 6 h postoperatively. Intraoperative analgesia was not sufficient in most cases. Significant cardiovascular or respiratory effects contraindicating the use of these drugs were not found. Postanesthetic hyperthermia occurred with all opioids studied and was more frequent in the tramadol group.
Comparison of Doppler ultrasonic sphygmomanometry, oscillometry and high-definition oscillometry for non-invasive blood pressure measurement in conscious cats
Authors: Knies Marieke , Teske Erik , Kooistra Hans
Published: March 2024

Objectives

Systemic arterial hypertension is a common occurrence and can have serious adverse consequences in cats. Therefore, measuring blood pressure is very important. There are many indirect blood pressure measurement devices available. This study compared Doppler, oscillometric (petMAP Graphic II, SunTech Vet20, the Cardell Insight-X0000) and high-definition oscillometry devices for the non-invasive measurement of blood pressure in conscious cats.

Methods

In this prospective study, blood pressure was measured in 32 cats using the different devices according to the recommendations of the American College of Veterinary Internal Medicine Consensus Statement. Blood pressures (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP]), time to complete measurements, number of attempts needed, coefficient of variation (CV) between the blood pressure measurements of the different devices, ease of completing measurements and apparent stress level of the cat were assessed.

Results

There was a significant difference between devices in the time taken to obtain blood pressure readings and the number of attempts necessary to obtain six reliable measurements. The CV of the Doppler device was significantly smaller than that of the rest of the devices, but there were no other differences between the devices. The mean SBP, DBP and MAP measured by the petMAP device were significantly higher than the measurements from the other devices. The perceived ease of measurement was not significantly different between the various machines. The perceived level of stress of measurement with the Doppler device was significantly higher compared with the other devices but did not lead to an increased SBP.

Conclusions and relevance

Using a Doppler device to measure blood pressure in conscious cats is fast, relatively easy and gives reliable results. A disadvantage is that the Doppler device can only measure SBP, while oscillometric devices also provide DBP and MAP. However, in veterinary medicine, systolic hypertension is considered the most relevant.
Incidental AVF creation during unrelated hospitalization is associated with worse outcomes compared with outpatient AVF creation
Authors: Hafeez Muhammad Saad , Abdul-Malak Othman M , Reitz Katherine M , Go Catherine , Eslami Mohammad H , Chaer Rabih A , Yuo Theodore H
Published: March 2024

Introduction:

Arteriovenous fistula (AVF) creation during an inpatient hospitalization is often performed for patient convenience and to ensure compliance. We sought to evaluate whether this approach has comparable outcomes to outpatient AVF creation.

Methods:

We identified patients undergoing index AVF creation from the United States Renal Data System dataset (2012–2017). Patients were grouped into outpatient and inpatient. Outpatient included patients that were operated in either an outpatient setting, ambulatory surgical center or were admitted inpatient on the day of AVF creation. Inpatient included only patients with claims for an inpatient visit before access creation. Multiple safety outcomes were compared between groups using unadjusted and adjusted logistic regression methods generating odds ratios and 95% confidence intervals (95% CI). One-year maturation rates were compared using competing-risks regression methods generating sub-hazard ratios (sHR) and 95% CI. Outcomes were also compared after 1:1 propensity score matching.

Results:

We identified 68,872 patients undergoing AVF creation, 4855 (7.1%) of which were created during inpatient hospitalization. Patients in the inpatient group were older (65.8 ± 13.8 vs 65.2 ± 13.8, p = 0.002), more likely to be of Black race (28.1% vs 26.8%, p = 0.02), and have cardiovascular comorbidities (all p < 0.05). Patients in the inpatient groups were more likely to be dialyzed at for-profit (88.1% vs 85.9%, p < 0.01) and freestanding (94.8% vs 92.9%, p < 0.01) dialysis centers. On both unadjusted and adjusted analysis, inpatient group was more likely to experience 30-day adverse events (e.g. pneumonia, COPD exacerbation, stroke, myocardial infarction), any complication, and all-cause mortality. On competing risks analysis, successful two-needle cannulation at 1 year was significantly less likely in the inpatient group (68.1% vs 76.8%, p < 0.01; sHR = 0.68 [95% CI, 0.65–0.71], p < 0.01). These trends were robust on 1:1 propensity matching.

Conclusion:

Incidental AVF creation in hospitalized patients is associated with worse outcomes, ranging from mortality to postoperative complications to fistula maturation, compared with outpatient AVF creation.
Cardiac Morbidity and Mortality in Patients with Sarcoma: A Population-Based Study
Authors: Alanazi Rakan , Aljizeeri Ahmed , Alsaileek Ahmed , Alrashid Azzam , Alolayan Ashwaq , Alkaiyat Mohammad , Alenazy Basel , Shehata Hussam , Alqahtani Joud , Ardah Husam , Alshammari Kanan
Published: March 2024

Background:

Soft tissue sarcoma (STS) is a rare malignancy that affects soft tissues. It encompasses various subtypes and requires different treatment strategies. Doxorubicin is a commonly used anthracycline in the management of localized and metastatic STS. However, high doses of doxorubicin are associated with cardiotoxicity, which can significantly impact patients’ long-term outcomes. This study aimed to evaluate doxorubicin’s effect on cardiac function in patients with sarcoma and to correlate the frequency of cardiotoxicity with potential risk factors.

Methods:

A retrospective analysis was conducted on patients with sarcoma who were treated with doxorubicin between 2016 and 2022 at King Abdulaziz Medical City in Saudi Arabia. Patient demographic information, comorbidities, cardiac measurements, laboratory values, systemic therapy, and treatment outcomes were collected from electronic medical records. A statistical analysis was performed to assess the association between cardiotoxicity and various factors.

Results:

A total of 133 patients were included in the study, with a median age of 30 years. Cardiotoxicity was observed in 9% of the patients. Female patients had a significantly higher risk of developing cardiotoxicity. Patients with a higher Eastern Cooperative Oncology Group (ECOG) performance status and lower troponin I levels also had an increased risk of cardiotoxicity. However, there was no significant association between cardiotoxicity and the number of chemotherapy cycles, total cumulative dose of doxorubicin, or history of radiation. Furthermore, patients with cardiotoxicity had a higher risk of mortality. The overall survival of the patients was 18 months.

Conclusion:

Doxorubicin-associated cardiotoxicity is a concern for patients with sarcoma. Female patients and patients with a higher ECOG performance status are at an increased risk of developing cardiotoxicity. Careful monitoring and risk assessment are crucial for mitigating the adverse effects of doxorubicin treatment in patients with sarcoma. Future studies are warranted to validate these findings and explore preventive strategies for doxorubicin-induced cardiotoxicity in patients with sarcoma.
Schumacher against globalism and ecomodernism: Ecology, subsidiarity and the politics of scale
Authors: Quilley Stephen
Published: March 2024

E. F. Schumacher’s Small is Beautiful is one of the most succinct elaborations of Catholic social teaching (CST) and ‘distributism’ – construed as an alternative to both capitalism and socialism. Extending the logic of Polanyi, both market and state, and their right- and left-wing ideological expressions, are shown to be contending forms of collectivism – in that both aggregate the agency of disembedded ‘billiard ball’ individuals. Schumacher’s socio-economic vision is rooted in Livelihood and is orthogonal to both left and right, creating an opportunity for an alternative to modernity involving patterns of embedded production, consumption and reproduction (family, household and place-bound community). ‘Smallness’ and ‘localness’ speak to forms of embedded social capital that are ‘sticky’, viscous and relational, more ascriptive and less fluid. But for precisely this reason, the political agenda implicit in Schumacher’s vision is not only post-liberal, but explicitly both covenantal and Christian. It requires the ontology of sovereign, self-actualizing individuals to be reconnected and constrained through a transcendent relationality with God. Small is Beautiful is shown to be diametrically opposed to the eco-modernist, gnostic and sometimes even transhumanist worldview of global environmentalism.
Stress-strain behaviour of carbon fibre reinforced polymer-confined concrete containing macro fibres recycled from waste glass fibre reinforced polymer
Authors: Zou Qi-Qi , Fu Bing , Chen Jian-Fei , Teng Jin-Guang
Published: March 2024

Glass fibre-reinforced polymer (GFRP) wastes may be mechanically processed into small strips called “macro fibres,” which were used as short reinforcement fibres to produce macro fibre reinforced concrete (MFRC). The addition of such macro fibres into concrete has proven to be effective in enhancing the flexural strength and toughness of concrete, but it also slightly reduces the compressive strength of concrete. This paper presents a study on the behaviour of CFRP-confined MFRC. A total of 84 CFRP-confined MFRC cylinders were prepared and tested in axial compression. The test parameters included the CFRP confinement stiffness, macro fibre content, and fibre length. The test results show that the compressive strength and ultimate axial strain can be significantly enhanced through the use of CFRP confinement. The ultimate axial strain of CFRP-confined concrete with macro fibres is slightly higher than that without macro fibres. The test results were compared with two well-known stress-strain models for FRP-confined concrete, including Teng et al.’s design-oriented model and Jiang and Teng’s analysis-oriented model. A comparative analysis showed that both models slightly underestimate the compressive strength and slightly overestimate the ultimate axial strain for CFRP-confined MFRC.
Investments in Innovations and Market Structure: A Semi-parametric Approach
Authors: Singh Sukhdeep
Published: March 2024

The economic literature suggests that there is an inverted-U type of relationship between innovation and product market competition. Existing empirical studies assume a quadratic functional form while estimating the relationship between the two variables. Using data on the Indian manufacturing industry, this article contributes by using a semi-parametric approach to test the ‘Inverted-U’ hypothesis without assuming a priori functional form. The estimation results suggest that the functional form of the relationship is contingent upon the choice of product market competition indicator in the model. When product market competition is defined as overall price competition, the empirical evidence confirms the inverted-U hypothesis. This implies that both escape competition and the Schumpeterian effect are observed as price competition increases. However, when product market competition is defined as domestic competition, only the escape competition effect is observed.

JEL Codes: L10, L60, O30, O33, F10
Distinction and alternative tech: Exploring the techno-critical disposition
Authors: Stevenson Michael , Valente Pinto Carolina
Published: March 2024

How should we understand alternative social media and open-source technologies that seek to challenge the dominance of Big Tech? Are these ethical substitutes for monopolistic platforms and technological infrastructures, or “alternative” in the sense we might talk of alternative forms of culture? Here we offer new perspective on these questions by conceptualizing alternative tech through Bourdieu’s theories of cultural production and distinctive consumption. Building on the work of Holm, Coleman and others, we explore the “techno-critical disposition” through a case study of A Traversal Network of Feminist Servers (ATNOFS), arguing this is manifested primarily as “critical craftiness,” or hacker aesthetics in a critical register. Finally, we consider how ATNOFS represents a “distinctive” path to the wider adoption of alternative platforms, as well as how the techno-critical disposition may be reconfiguring legitimacy in the broader field of technology production.
Prediction of 6-DOF motion response of semi-submersible floating wind turbine in extreme sea conditions using OVMD-FE-PSO-LSTM methodology
Authors: Huang Jiarui , Song Lei , Yang Zhuoyi , Wu Qilong , Jiang Xiaochen , Wang Cheng
Published: March 2024

The motion response of offshore floating wind turbines significantly influences their structural integrity, power generation efficiency, operational complexity, safety, and stability. Therefore, predicting the motion response of offshore floating wind turbines is of paramount importance. In engineering practice, especially in extreme marine environments, the motion of wind turbines becomes more complex, making accurate prediction more challenging. In this era of rapid development in deep learning technology, some solutions have emerged for this problem. In this paper, we propose a hybrid model, namely the OVMD-FE-PSO-LSTM model. We begin by conducting numerical simulations of a 5 MW-OC4 semi-submersible floating wind turbine in extreme sea conditions, obtaining motion data for the turbine’s six degrees of freedom. We then decompose the initial motion data using an optimized traditional VMD method, assess the modal complexity with the FE method, combine modal components with similar complexity to reduce computational load, and make predictions using the PSO-LSTM model. Finally, we analyze and compare the predictive results of different models. The results demonstrate that the proposed hybrid model outperforms other comparative models in terms of accuracy, providing new insights into the prediction of the motion response of offshore floating wind turbines.
Exploring the development of heterogeneous contracting capabilities: The role of organizational design
Authors: Hallberg Niklas L
Published: March 2024

Previous research on learning to contract and contracting capabilities suggests that firms in interorganizational relationships adopt contractual designs that economize on transaction costs, and over time learn to govern their relationships in a more efficient manner by incrementally aligning contractual terms with transaction attributes based on new experiences made in their relationships. We augment the learning to contract literature by highlighting the role of organizational design as a factor that may impact contractual learning and the development of heterogeneous contracting capabilities. Specifically, we suggest that the level of specialization and structural integration across the firm’s technical, commercial, and legal functions may affect the effectiveness of contractual learning and the type of learning likely to occur. We also outline boundary conditions for our model in terms of potential interactions between the contractual environment, organizational design, and contractual learning.
The impact on thirty day readmissions for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease admitted to an observation unit versus an inpatient medical unit: A retrospective observational study
Authors: Bell Jacob , Lim Steven , Mikami Takahisa , Bahk Jeeyune , Argiro Stephen , Steiger David
Published: March 2024

Objectives

We aimed to evaluate the utility of an Observation Unit (OU) in management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and to identify the clinical characteristics of patients readmitted within 30-days for AECOPD following index admission to the OU or inpatient floor from the OU.

Methods

This is a retrospective observational study of patients admitted from January to December 2017 for AECOPD to an OU in an urban-based tertiary care hospital. Primary outcome was rate of 30-day readmission after admission for AECOPD for patients discharged from the OU versus inpatient service after failing OU management. Regression analyses were used to define risk factors.

Results

163 OU encounters from 92 unique patients were included. There was a lower readmission rate (33%) for patients converted from OU to inpatient care versus patients readmitted after direct discharge from the OU (44%). Patients with 30-day readmissions were more likely to be undomiciled, with history of congestive heart failure (CHF), pulmonary embolism (PE), or had previous admissions for AECOPD. Patients with >6 annual OU visits for AECOPD had higher rates of substance abuse, psychiatric diagnosis, and prior PE; when these patients were excluded, the 30-day readmission rate decreased to 13.5%.

Conclusion

Patients admitted for AECOPD with a history of PE, CHF, prior AECOPD admissions, and socioeconomic deprivation are at higher risk of readmission and should be prioritized for direct inpatient admission. Further prospective studies should be conducted to determine the clinical impact of this approach on readmission rates.
Covered endovascular reconstruction of the aortic bifurcation: A versatile technique with many potential applications
Authors: Lioupis Christos , Francoeur Luc , Prasad Vikash
Published: March 2024

We present our experience with using the bifurcated covered endovascular reconstruction technique in two unusual conditions. One patient with a traumatic “seat belt” aortic injury and a second patient with a bleeding aorto-enteric fistula were successfully treated with the CERAB technique. We discuss potential benefits of the technique outside the usual pattern of chronic atherosclerotic aortoiliac disease.
Single nucleotide polymorphisms in the Dicer gene modify the risk of systemic lupus erythematosus
Authors: Zhang Jingjing , Zhao Yufei , Wang Song , Zhang Shasha , Zhang Xiaoyun , Peng Chenxing , Liu Qingyi
Published: March 2024

Objective

MicroRNA-related single-nucleotide polymorphisms (miR-SNPs) can alter microRNA (miRNA) expression profiles, thereby influencing the risk of rheumatic diseases. Herrin a case control study, six miR-SNPs in miRNA processing machinery genes, namely RAN (rs14035), XPO5 (rs11077), Dicer (rs3742330), GEMIN3 (rs197412), GEMIN4 (rs2740348), and TNRC6B (rs9623117), were genotyped to assess their correlation with the risk of systemic lupus erythematosus (SLE).

Methods

We included 119 patients with SLE and 130 healthy controls. The genotypes of the six miR-SNPs were determined using polymerase chain reaction (PCR). Serum cytokine levels were assessed using a cytometric bead array, and fluorescent probe technology was used to determine plasma reactive oxygen species (ROS) levels.

Results

The AA genotype of Dicer was correlated with a 0.566-fold decreased risk of SLE compared with that of the AG + GG genotype (odds ratio, 0.566; 95% CI, 0.342–0.935; p = .026), and the rs3742330 A allele was associated with a significantly decreased risk of SLE ( p = .035) compared with that of the rs3742330G allele. Additionally, AA genotype carriers exhibited lower levels of interleukin-6 (IL-6) in the blood ( p = .013). Subsequent analysis revealed increased ROS production in patients with SLE than that in the controls (621.042 ± 425.285 vs 499.966 ± 302.273, p = .011).

Conclusion

Our findings suggest that ROS generation participates in SLE pathogenesis. The identification of Dicer gene SNP rs3742330 as a potential modifier of SLE risk via mediating IL-6 overproduction suggests a potential avenue for targeted interventions to manage SLE and its associated immune dysregulation.
The adaptable coach – a critical review of the practical implications for traditional and constraints-led approaches in sport coaching
Authors: Lindsay Riki , Spittle Michael
Published: March 2024

Coaches are faced with navigating a complex and dynamic environment that requires the wise and measured management of numerous competing factors. Traditional and contemporary approaches are often contrasted, with traditional approaches thought to be beneficial for outcomes like speed of skill acquisition but criticised for being overly prescriptive, and contemporary approaches praised for facilitating individualised learning and transferrable skillsets. We contend that the task for coaches is not deciding which approach is “better” and strictly conforming to one approach, rather it is determining which approach or learning principles best suit the athlete's learning requirements. Coaching is not an exact science, it is an art, in which skilled coaches need to be open, adaptable, and flexible in their approach, constantly considering the complexities of the wider coaching process. In this article, we discuss how coaching practices have the potential to be enhanced by integrating key principles from both traditional and contemporary (CLA) approaches to adapt practice to the emerging situation and meet the skill development needs of their athletes while considering the intricacies and subtleties that typify real-world coaching environments.
Carboxylated cellulose nanofibrils based on banana rachis as additive in oil-based emulsion coolant for effective flank wear reduction in lathe operation
Authors: Mushi Ngesa Ezekiel , Temu George Gasper , Msuya Neema
Published: March 2024

Nitro-oxidized carboxylated cellulose nanofibrils (NOCNFs) from the banana rachis are employed in oil-emulsion coolant as an additive. The concentrations of NOCNF were 0.1, 0.2, 0.3 wt. %. The cutting parameters include the spindle speeds and depth of cut. The temperature and wear reduction were significant. The temperature at the tool flank decreased from 119°C to 76°C, corresponding to an 11% reduction in wear at the depth of cut co. 2 mm and spindle speed of 1330 rpm. The viscosity of the nanofluid and the corrosion of the low-carbon mild steel specimen are discussed. Arguably, a stable NOCNF nanofluid suspension is good against wear even at elevated temperatures. Interestingly, these results occurred at a lower NOCNF concentration co. 0.3% wt. compared to 1–2 wt. % from Al2O3 nanoparticles in literature. In this paper, banana rachis nanofibrils are attractive for developing of effective and environmentally friendly additives from biomass.
An investigation on using artificial intelligence models to predict crater wear of tungsten carbide tool
Authors: Gabsi Abd El Hedi , Mathlouthi Safa , Ben Aissa Chokri
Published: March 2024

In this study, artificial intelligence (AI) tools were utilised to predict and analyse the progression of crater wear in cutting tools made of tungsten carbide during machining of aluminium 7075 alloy with a CNC lathe. The study investigated the impact of corner radius, feed rate, cutting speeds, and cut depth on the wear of the tools. Thirty experiments were conducted, with 24 used for training 11 independent AI models and the remaining 6 used for testing. This study stands out for its novelty as it pioneers the evaluation of 11 distinct AI models for the prediction of tool wear. With a high level of accuracy and a lower average deviation, the most effective model identified in this study was the gradient boosting model. By integrating AI algorithms into manufacturing processes, the monitoring of tool wear becomes more efficient, leading to reduce experiments, minimise testing costs, predict tool life, prevent failures, and boost productivity.
Evolutionary relationship between antimitochondrial antibody positivity and primary biliary cholangitis in Taiwan: a 16-year hospital cohort study
Authors: Chang Ming-Ling , Cheng Jur-Shan , Le Puo-Hsien , Chen Wei-Ting , Ku Hsin-Ping , Chien Rong-Nan
Published: March 2024

Background:

How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis–endemic areas is unknown.

Objectives:

We aimed to investigate this evolution in Taiwan.

Design/methods:

A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN.

Results:

AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/105 versus 11.61/105, p = 0.0002), but their incidence was comparable (0.99/105 versus 1.12/105, p = 0.36). The former group had a borderline significantly lower mean age (56.59 years versus 58.10 years, p = 0.06) and a lower female-to-male ratio (2.85:1 versus 5.44:1, p < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, p < 0.01; incidence change: −9.2%, p < 0.01) and PBC patients (prevalence change: 14.6%, p < 0.01; incidence change: −4.7%, p  < 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% versus 4.3%, p = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% versus 15.60%, p < 0.01).

Conclusion:

PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.
Time to Confirmed Neuroinfectious Diagnoses: Diagnostic Testing and Resource Allocation
Authors: Dugue Rachelle , Kim Carla , Boruah Abhilasha , Harrigan Eileen , Sun Yifei , Thakur Kiran T.
Published: March 2024

Background and Objectives

In a retrospective study evaluating the diagnostic approach of definitive neurological infections at a tertiary referral center, we assessed the time to diagnosis from presentation, number of diagnostic tests ordered, and modality of etiologic diagnosis.

Methods

A total of 111 confirmed clinical cases of neurological infections from 2010-2018 were reviewed. Definitive neuroinfectious diagnoses were defined by positive cerebrospinal (CSF) polymerase chain reaction (PCR)/antigen, CSF culture, CSF antibody, serology, or pathology tests.

Results

An etiologic diagnosis was determined at an average (SD) of 3.1 (5.9) days after presentation with an average (SD) of 27.7 (15.6) diagnostic tests ordered per workup. Viral neuro-infections were associated with lower intensive care unit (ICU) admission rates, shorter length of hospitalization, and fewer diagnostic tests ordered, as well as shorter time to definitive diagnosis ( P < .05). Longer hospitalizations were associated with immunosuppression status regardless of infectious etiology ( P < .001).

Discussion

Given the high morbidity and mortality of neuroinfectious disease, specifically meningitis and encephalitis, efficient diagnostic testing is imperative to facilitate the most appropriate clinical course of action with special attention to the specific patient population.
Comparison of dynamic susceptibility contrast (DSC) using gadolinium and iron-based contrast agents in high-grade glioma at high-field MRI
Authors: Wongsawaeng Doonyaporn , Schwartz Daniel , Li Xin , Muldoon Leslie L , Stoller Jared , Stateler Cooper , Holland Samantha , Szidonya Laszlo , Rooney William D , Wyatt Cory , Ambady Prakash , Fu Rongwei , Neuwelt Edward A , Barajas Ramon F
Published: March 2024

Purpose

To compare DSC-MRI using Gadolinium (GBCA) and Ferumoxytol (FBCA) in high-grade glioma at 3T and 7T MRI field strengths. We hypothesized that using FBCA at 7T would enhance the performance of DSC, as measured by contrast-to-noise ratio (CNR).

Methods

Ten patients (13 lesions) were assigned to 3T (6 patients, 6 lesions) or 7T (4 patients, 7 lesions). All lesions received 0.1 mmol/kg of GBCA on day 1. Ten lesions (4 at 3T and 6 at 7T) received a lower dose (0.6 mg/kg) of FBCA, followed by a higher dose (1.0-1.2 mg/kg), while 3 lesions (2 at 3T and 1 at 7T) received only a higher dose on Day 2. CBV maps with leakage correction for GBCA but not for FBCA were generated. The CNR and normalized CBV (nCBV) were analyzed on enhancing and non-enhancing high T2W lesions.

Results

Regardless of FBCA dose, GBCA showed higher CNR than FBCA at 7T, which was significant for high-dose FBCA ( p < .05). Comparable CNR between GBCA and high-dose FBCA was observed at 3T. There was a trend toward higher CNR for FBCA at 3T than 7T. GBCA also showed nCBV twice that of FBCA at both MRI field strengths with significance at 7T.

Conclusion

GBCA demonstrated higher image conspicuity, as measured by CNR, than FBCA on 7T. The stronger T2* weighting realized with higher magnetic field strength, combined with FBCA, likely results in more signal loss rather than enhanced performance on DSC. However, at clinical 3T, both GBCA and FBCA, particularly a dosage of 1.0–1.2 mg/kg (optimal for perfusion imaging), yielded comparable CNR.
Study protocol for a three-arm randomized controlled trial investigating the effectiveness, cost-utility, and physiological effects of a fully self-guided digital Acceptance and Commitment Therapy for Spanish patients with fibromyalgia
Authors: Gallego Ana , Serrat Mayte , Royuela-Colomer Estíbaliz , Sanabria-Mazo Juan P , Borràs Xavier , Esteve Montserrat , Grasa Mar , Rosa Araceli , Rozadilla-Sacanell Antoni , Almirall Miriam , D’Amico Francesco , Dai Yifei , Rosenbluth Michael J. , McCracken Lance M. , Navarrete Jaime , Feliu-Soler Albert , Luciano Juan V
Published: March 2024

Objective

Fibromyalgia (FM) is a prevalent pain syndrome with significant healthcare and societal costs. The aim of the SMART-FM-SP study is to determine the effectiveness, cost-utility, and physiological effects in patients with FM of a digital intervention (STANZA®) currently marketed in the United States, which delivers smartphone-based, fully self-guided Acceptance and Commitment Therapy (Digital ACT) for treating FM-related symptoms.

Methods

A single-site, parallel-group, superiority, randomized controlled trial (RCT) will be conducted, including a total of 360 adults diagnosed with FM. Individuals will be randomly allocated (1:1:1) to treatment as usual (TAU), to TAU plus 12 weeks of treatment with Digital ACT, or to TAU plus 12 weeks of treatment with digital symptom tracking (i.e. FibroST). Participants will be assessed at baseline, post-treatment, and 6-month follow-up. An intention-to-treat analysis using linear mixed models will be computed to analyze the effects of Digital ACT on functional impairment (primary outcome), as measured by the Fibromyalgia Impact Questionnaire Revised at 6 months from the inception of the treatment. Secondary outcomes include impression of change, symptoms of distress, pain catastrophising, quality of life, cost-utility, and selected biomarkers (cortisol and cortisone, immune-inflammatory markers, and FKBP5 gene polymorphisms). The role of ACT-related processes of change will be tested with path analyses.

Conclusions

This study is the first RCT that tests Digital ACT for Spanish patients with FM. Results will be important not only for patients and clinicians, but also for policy makers by examining the cost-utility of the app in a public healthcare context.
Barriers and challenges to telemedicine usage among the elderly population in Israel in light of the COVID-19 era: A qualitative study
Authors: Haimi Motti , Goren Uri , Grossman Zachi
Published: March 2024

Background

Although there may still be many challenges to its adoption, telemedicine is becoming more and more popular for helping elderly people preserve their independence and continue to live in their own homes. We intended to investigate the challenges and barriers (if any) experienced by the elderly population when using telemedicine services in Israel.

Methods

Fourteen elderly people were recruited for the study and interviewed in person using a semistructured interview protocol, using a qualitative technique. Participants’ replies were evaluated and analyzed thematically. The participants were questioned regarding their usage of telehealth services, the benefits they perceive in them, any potential difficulties or hurdles to use, and suggestions they had for making these services more readily available and simpler to use for the elderly.

Results

Most participants recognized the advantages of telehealth services, particularly for the elderly population during pandemics and normal times. However, most of them also expressed various challenges that face the elderly population in using these services. Many participants were concerned that the quality of telemedicine sessions may not be good enough compared to in-person sessions, and expressed a lack of confidence in telemedicine services, and frustration from the absence of in-person interaction and communication. Many participants highlighted the technological challenges in the use of computers and applications in general and in the context of healthcare, in particular, in addition to physiological and literacy difficulties. Finally, the participants suggested several ways to increase the accessibility and usage of telemedicine solutions by elderly people.

Conclusions

A proactive approach to identifying and resolving telehealth barriers can maximize virtual interactions for the older population and alleviate care inequities. In addition to identifying barriers that impede older patients from using telemedicine, there is a need to increase awareness of the availability, benefits, and uses of each telehealth service in comparison to in-person consultations.
A Qualitative Analysis of Knowledge Levels, Perceived Susceptibility, and Perceived Severity Surrounding Anal Cancer and Human Papillomavirus
Authors: Jovanov Adriana , Parks Ashley , Jovanov Cynthia , Mdluli Xolani
Published: March 2024

Introduction:

When examining health literacy and disease specific knowledge levels across ethnicities and communities, ethnic minority groups are known to be at a higher risk of being below the average health literacy threshold which is a factor linked to poor health status and higher mortality rates. This study examined disease specific knowledge levels, perceived severity, and perceived susceptibility surrounding anal cancer and HPV-related screening behaviors.

Methods:

The following research questions were explored: (1) “What are the common themes and/or beliefs when asked about anal cancer, HPV, and preventive screening?” and (2) “What are the common themes and beliefs surrounding the severity and susceptibility of contracting anal cancer?”. This study utilized a cross-sectional design to survey 26 individuals regarding their knowledge level and perspectives regarding anal cancer and HPV. An 8-question survey was developed de novo based on an application of the Health Belief Model (HBM) elements. This study employed thematic analysis to explore critical themes to construct a model to understand knowledge levels, attitudes, and risk perceptions regarding anal cancer and intention to participate in preventive screenings. The fundamental attitudes and themes related to anal cancer risk and intention to participate in preventative screenings were elicited using a qualitative descriptive technique. Coded data was utilized to analyze themes based on (1) knowledge and (2) perceived risk, both severity and susceptibility.

Results:

Overall, the findings indicate very low levels of knowledge regarding screening, anal cancer, and HPV across all genders. The low levels of anal cancer and HPV knowledge were seen in 13 coded segments (50% of surveys) which showed no familiarity with or comprehension of HPV, and 4 coded segments indicated no familiarity with anal cancer. In addition, 15 respondents (57%) had low or no preventive or screening-related knowledge. While some respondents (46%) illustrated high perceived severity for anal cancer, only 23% indicated high perceived susceptibility for anal cancer.

Conclusion:

The results from this study may be used to inform practitioners, providers, and policymakers in developing interventions addressing low levels of understanding and disease specific knowledge surrounding anal cancer in support of creating a standardized health screening procedure.