bluuebunny/crossref_metadata_2025 huggingface dataset:
Vibration-based structural damage detection using 1-D convolutional neural network and transfer learning
Authors: Teng Shuai , Chen Gongfa , Yan Zhaocheng , Cheng Li , Bassir David
Published: December 2022

This paper presents a novel vibration-based structural damage detection approach by using a one-dimensional convolutional neural network (1-D CNN) and transfer learning (TL). The CNN can effectively extract structural damage information from the vibration signals. However, the CNN training needs enough samples, while some damage samples (scenarios) obtained from real structures are limited, which will compromise the CNN ability to detect structural damage. As a solution, the numerical models have potential to provide sufficient CNN training samples; meanwhile, the state-of-the-art TL technique can significantly shorten the network training time and improve the accuracy. Therefore, this paper proposes a new method to detect the damage of a bridge model. The 1-D CNN is firstly trained with the samples of the single damage scenarios of the numerical bridge model. And then it is transferred to the complex scenarios of multi-damage (double or triple simultaneously), random size structures, and experimental model. The results demonstrate that: with the TL, the accuracy of damage detection is increased by about 47% at most, and the convergence speed is increased by at least 50%; in particular, the TL can inhibit over-fitting, and for the real bridge case, the accuracy also increased by 44.4%. It is demonstrated that: the TL can effectively improve the damage detection accuracy and convergence effect, and the application of this method to the random size structures also proves its generalization.
The relationship of light exposure to sleep outcomes among office workers. Part 2: Comparison of days with and without social constraints
Authors: Beute F , Lowden A , Aries MBC
Published: December 2022

Social constraints posed by work schedules influence sleep duration and timing. Everyday light exposure can help (or hinder) sleep outcomes. This study investigated the differences in the relationship between light exposure and sleep outcomes on days with and without social constraints using ambulatory assessment for 4–6 weeks for 15 office employees. The effects of light on sleep were investigated for both clock time and wake time (related to individual sleep times). Participants were exposed to more light during the morning and afternoon on workdays, and sleep times were later on days without social constraints. The relationship between light exposure and sleep was more pronounced, or sometimes even only present, for days without social constraints. In addition, no differences were found between clock time and wake time, which underlines the complexity of the relationship between everyday light exposure and sleep. Despite increased light exposure during workdays, the effects of light on sleep were more pronounced on days without social constraints. It may signal that office workers need a more substantial circadian stimulus (i.e. higher light exposure) for light to influence sleep outcomes on days with social constraints.
Three woven structures of reduced graphene oxide conductive silk fabrics prepared by two different methods for electrical setting and sensing
Authors: Chen Kun , Xu Jingying , Zheng Yiqian , Li Jialin , Hong Xinghua
Published: December 2022

Silk is widely used in flexible electronic equipment and intelligent textiles because of its well mechanical properties and bio-compatibility. Reduced graphene oxide is a two-dimensional carbon material with honeycomb lattice structure atoms and excellent electrical conductivity, which can give fabric a significant electrical conductivity. Herein, three types of RGO/Silk woven fabrics (satin, twill, and backed weaves) and two coating methods (screen printing and impregnating) were provided to explore the electrical properties, pressure sensing property and influence mechanism of silk surface characteristics. The results show the best preparation process of these two methods is five finishing times and 2 h reduction time. And the RGO/silk fabrics obtained by screen printing and impregnation have similar resistivity, but the RGO/silk fabrics obtained by screen printing provide better washing resistance. After nine washing cycles, the resistance of RGO/silk fabrics prepared by screen printing is 2 kΩ less than that obtained by impregnation. In addition, under the two methods, backed weave fabric shows the best conductivity, followed by twill and satin weave. Moreover, the RGO/Silk fabric sensor responds well to human motion, like finger bending and hand-holding objects. This work provides a train of thought and method for flexible conductive silk fabric.
The Orc—Playing the “Wholly Other”: Investigations of Kant's Sublime and The Technological Sublime in Blizzard Entertainment's Massive Multiplayer Online Game World of Warcraft
Authors: Kampmann Walther Bo , Juel Larsen Lasse
Published: December 2022

While the complicated scheme of the philosophical sublime may at first hand seem mere platitude when brought to life in computer games, this article claims that the action/adventure game World of Warcraft wedges open a space in which to operate the sublime and navigate radically “other” subjectivities. The hypothesis is that the assembly of fantastic elements in World of Warcraft duplicates the Kantian sublime while at the same time commenting upon and even radicalizing it. The Romantic tradition of the sublime as it unfolds in Immanuel Kant's third Critique is outlined followed by an attempt to topologize elements of the fantastic in Blizzard's game design philosophy leading to a clarification of what we call “the knotted point of play” where game object, game interaction, and game subject intervene. Finally, we explore how the notion of the technological sublime relates to World of Warcraft and beyond.
Brain aneurysm rupture during mechanical thrombectomy for large vessel occlusion: Technical case series and complication avoidance strategies
Authors: Benalia Victor HC , Cortez Gustavo M , Monteiro Andre , Siddiqui Adnan , Aghaebrahim Amin , Sauvageau Eric , Hanel Ricardo A
Published: December 2022

Endovascular therapy became the mainstream treatment for patients with acute stroke due to emergent large vessel occlusion (LVO). With increasing number of interventions, it is not uncommon for incidental vascular pathologies to be found during mechanical thrombectomy. Overall, intracranial aneurysms can occur in up to 4% of the population, but previous studies suggest a slightly higher prevalence of intracranial aneurysms in stroke patients as they may share common risk factors. We report on three patients with acute stroke secondary to LVO undergoing mechanical thrombectomy with brain aneurysms incidentally discovered and discuss the potential implications and technical considerations of performing revascularization in these scenarios. In the first case, a patient treated with stent-retriever and aspiration developed a carotid-cavernous fistula without clinical repercussion. The second case illustrates an internal carotid artery posterior communicating segment aneurysm rupture with a massive subarachnoid hemorrhage. The third case exemplifies an unruptured middle cerebral artery bifurcation aneurysm related to an M2 occlusion managed with a different strategy, avoiding aneurysm rupture. Intraprocedural aneurysm rupture is a potential complication during mechanical thrombectomy, especially when anatomical challenges are present. Interventionalists should be aware of the potential risk and constraints in this setting in order to mitigate adverse events.
Vessel wall imaging and quantitative flow assessment in arteriovenous malformations: A feasibility study
Authors: McGuire Laura Stone , Rizko Mark , Brunozzi Denise , Charbel Fady T , Alaraj Ali
Published: December 2022

Introduction

Cerebral arteriovenous malformations (AVMs) carry a rupture rate of 2–3% per year. Several architectural factors may influence rupture rate, and a recently theorized model of AVMs describes the influence of vessel wall inflammation. A novel imaging modality, vessel wall imaging (VWI), has been developed to view inflammatory processes in vessel wall foci but has not yet been examined in AVMs, which is the aim of this study.

Methods

This retrospective review studies prospectively collected data on patients with ruptured and unruptured AVMs between 2019 and 2021. Inclusion criteria included adult patients (≥18 years) with radiographically diagnosed AVM who underwent VWI. Charts were reviewed for medical history, clinical presentation, hospital course, discharge condition, and follow-up. Angioarchitectural features, blood flow, and VWI were compared in patients with and without hemorrhagic patients.

Results

Nine patients underwent VWI, mean age 37.7 ± 9.9 years. Four presented with hemorrhage (44.4%). Seven (77.7%) received glue embolization and 6 (66.7%) underwent surgical resection. All patients (4/4) with a history of hypertension presented with hemorrhage ( p = 0.0027). Size and Spetzler-Martin grade were not associated with hemorrhage ( p = 0.47, p = 0.59). Net AVM flow was higher in patients presenting with hemorrhage, although nonsignificant ( p = 0.19). With VWI, 3 (75%) hemorrhagic AVMs showed visible nidus and draining veins, and all three demonstrated positive post-contrast wall enhancement in at least one of their draining veins; conversely, of fivenonhemorrhagic AVMs, only 2 (40%) demonstrated post-contrast wall enhancement in any draining vein ( p = 0.090).

Conclusion

This pilot study successfully demonstrated capture of venous walls in AVMs using VWI. In this study, draining vein enhancement occurred more often in hemorrhagic AVM and in those with higher venous volumetric flow.
Obstacle avoidance planning of autonomous vehicles using deep reinforcement learning
Authors: Qian Yubin , Feng Song , Hu Wenhao , Wang Wanqiu
Published: December 2022

Obstacle avoidance path planning in a dynamic circumstance is one of the fundamental problems of autonomous vehicles, counting optional maneuvers: emergency braking and active steering. This paper proposes emergency obstacle avoidance planning based on deep reinforcement learning (DRL), considering safety and comfort. Firstly, the vehicle emergency braking and lane change processes are analyzed in detail. A graded hazard index is defined to indicate the degree of the potential risk of the current vehicle movement. The longitudinal distance and lateral waypoint models are established, including the comfort deceleration and stability coefficient considerations. Simultaneously, a fuzzy PID controller is installed to track to satisfy the stability and feasibility of the path. Then, this paper proposes a DRL process to determine the obstacle avoidance plan. Mainly, multi-reward functions are designed for different collisions, corresponding penalties for longitudinal rear-end collisions, and lane-changing side collisions based on the safety distance, comfort reward, and safety reward. Apply a special DRL method-DQN to release the planning program. The difference is that the long and short-term memory (LSTM) layer is utilized to solve incomplete observations and improve the efficiency and stability of the algorithm in a dynamic environment. Once the policy is practiced, the vehicle can automatically perform the best obstacle avoidance maneuver in an emergency, improving driving safety. Finally, this paper builds a simulated environment in CARLA and is trained to evaluate the effectiveness of the proposed algorithm. The collision rate, safety distance difference, and total reward index indicate that the collision avoidance path is generated safely, and the lateral acceleration and longitudinal velocity satisfy the comfort requirements. Besides, the method proposed in this paper is compared with traditional DRL, which proves the beneficial performance in safety and efficiency.
Research on neural network model reference adaptive disturbance rejection control of digital hydraulic cylinder
Authors: Jiang Shouling , Wang Hui , Zhao Guochao
Published: December 2022

The nonlinear factors in the digital hydraulic cylinder will reduce the accuracy of the control system. In order to improve the control accuracy of the control system, in this paper, a model reference adaptive disturbance rejection control method based on neural network is proposed. Firstly, the dead zone model is used to replace the nonlinear link in the feedback mechanism. A detailed mathematical model of digital hydraulic cylinder is established and the nonlinear hydraulic spring force is also considered, and a complete nonlinear state space model of digital hydraulic cylinder is derived based on LuGre friction model. Then the reference model is designed. By introducing ESO (extended state observer), the uncertainties and external disturbances of the controlled object are all equivalent to a total disturbance. The RBF (Radial Basis Function) network is used to approximate the unknown function FZ, the neural model reference adaptive disturbance rejection composite controller is designed by using Lyapunov direct method and Barbalat lemma. Finally, the simulation verification is carried out by using MATLAB. The simulation results show that the control strategy can effectively improve the response characteristics of the system, reduce the steady-state error of the system, and improve the robustness of the system.
Exploring determinants of international transfers of women soccer players in Portuguese football
Authors: Mourao Paulo
Published: December 2022

In this pioneering work, we reflect on transfers in women's football. For this purpose, we collected all transfers from the two seasons with the most records in Portugal (the 2019/2020 and 2020/2021 seasons). The four dimensions associated with individual and prestige characteristics conducive to changing clubs, as well as 14 variables, were tested. For treating the problem of the endogeneity of some variables, we used a probit model with instrumental variables. The results obtained showed that high values of “goals per match” increase the probability of a player having an international transfer. Other determinants, such as the position of the transferring club or the player's field position, are also discussed in detail.
Interventions for non-alcoholic liver disease: a gut microbial metabolites perspective
Authors: Guo Jin , Shi Chun-Xia , Zhang Qing-Qi , Deng Wei , Zhang Lu-Yi , Chen Qian , Zhang Dan-Mei , Gong Zuo-Jiong
Published: December 2022

Over the past two decades, non-alcoholic fatty liver disease (NAFLD) has become a leading burden of hepatocellular carcinoma and liver transplantation. Although the exact pathogenesis of NAFLD has not been fully elucidated, recent hypotheses placed more emphasis on the crucial role of the gut microbiome and its derivatives. Reportedly, microbial metabolites such as short-chain fatty acids, amino acid metabolites (indole and its derivatives), bile acids (BAs), trimethylamine N-oxide (TMAO), and endogenous ethanol exhibit sophisticated bioactive properties. These molecules regulate host lipid, glucose, and BAs metabolic homeostasis via modulating nutrient absorption, energy expenditure, inflammation, and the neuroendocrine axis. Consequently, a broad range of research has studied the therapeutic effects of microbiota-derived metabolites. In this review, we explore the interaction of microbial products and NAFLD. We also discuss the regulatory role of existing NAFLD therapies on metabolite levels and investigate the potential of targeting those metabolites to relieve NAFLD.
Midline submuscular penile prosthesis reservoir placement for patients with bilateral inaccessible inguinal rings: technique and outcomes
Authors: Zisman Ariel , Razdan Shirin , Siegal Alexandra , Sljivich Michaela , Bieber Christine , Ho Patrick , Valenzuela Robert
Published: December 2022

Introduction:

One of the most challenging aspects of inflatable penile prosthesis (IPP) surgery is reservoir placement. The traditional space of Retzius (SOR) is not suitable for all patients. For example, radical cystectomy or prostatectomy may alter the anatomical SOR. Hence, traditional placement of the reservoir in this space increases the risk of bowel or vascular injury. Also, patients with bilateral inguinal hernias repaired with mesh, or those with previous reservoirs that have been retained, are not eligible for a Retzius reservoir. Our study reports on the use of midline sub-rectus muscle placement of a penile prosthesis reservoir in these patients as an alternative to high submuscular placement commonly used.

Methods:

A retrospective chart review of male patients who underwent IPP surgery between June 2017 and 2021 was conducted. Patients were divided into two groups based on the location of the reservoir: SOR versus Midline Submuscular Reservoir (MSMR). Complication rates were compared, including herniated reservoirs, infections, bowel injuries, and vascular injuries.

Results:

Our cohort included 461 patients who underwent IPP surgery between June 2017 and 2021 in one tertiary center. SOR was used in 89% of patients and MSMR in 11% of patients ( n = 413 and 48, respectively). Median follow-up for all patients was 28 months. The mean age was 67 ± 8 years. There was no statistically significant difference between the two groups regarding age or comorbidities (BMI, diabetes mellitus, hypertension, hyperlipidemia, and coronary artery disease). The complication rate was low in both the SOR and MSMR groups, with device malfunction being the most common (2% versus 4%, respectively; p = 0.32). The infection rate was 0.5% in the SOR group with no infections in the MSMR group (NS). There was only one case of herniation requiring surgical revision in the SOR group and no cases of bowel or vascular injury.

Conclusion:

Placement of a penile prosthesis reservoir within a midline rectus submuscular space is a safe and effective technique when the SOR is compromised by previous surgery or bilateral inguinal canals are not accessible.
Tumor glycolytic profiling through 18F-FDG PET/CT predicts immune checkpoint inhibitor efficacy in advanced NSCLC
Authors: Silva Saulo Brito , Wanderley Carlos Wagner S. , Gomes Marin José Flavio , Macedo Mariana Petaccia de , do Nascimento Ellen Caroline Toledo , Antonacio Fernanda Frozoni , Figueiredo Caroline Sales , Trinconi Cunha Mateus , Cunha Fernando Q. , Castro Junior Gilberto de
Published: December 2022

Background:

A significant proportion of patients with non-small-cell lung cancer (NSCLC) do not respond to immune checkpoint inhibitors (ICIs). Since metabolic reprogramming with increased glycolysis is a hallmark of cancer and is involved in immune evasion, we used 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) to evaluate the baseline glycolytic parameters of patients with advanced NSCLC submitted to ICIs, and assessed their predictive value.

Methods:

18F-FDG PET/CT results in the 3 months before ICIs treatment were included. Maximum standardized uptake values, whole metabolic tumor volume (wMTV), and whole-body total lesion glycolysis (wTLG) were evaluated. Cutoff values for high or low glycolytic categories were determined using receiver-operating characteristic curves. Progression-free survival (PFS) and overall survival (OS) were evaluated. Patients with a complete response and a matching group with resistance to ICIs underwent immunohistochemistry analysis. An unsupervised k-means clustering model integrating programmed cell death ligand 1 (PD-L1) expression, glycolytic parameters, and ICIs therapy was performed.

Results:

In all, 98 patients were included. Lower baseline 18F-FDG PET/CT parameters were associated with responses to ICIs. Patients with low wMTV or wTLG had improved PFS and OS. High wTLG, strong tumor expression of glucose transporter-1, and lack of responses were significantly associated. Patients with low glycolytic parameters benefited from ICIs, regardless of chemotherapy. Conversely, those with high parameters benefited from the addition of chemotherapy. Patients with higher wTLG and lower PD-L1 were associated with progression and worse survival to ICIs monotherapy.

Conclusions:

Glycolytic metabolic profiles established through baseline 18F-FDG PET/CT are useful biomarkers for evaluating ICI therapy in advanced NSCLC.
Social Assistance Expansion and Political Inclusion in Latin America
Authors: Barrientos Armando
Published: December 2022

Has social assistance expansion contributed to political inclusion in Latin America? The current literature favours a “policy exchange” approach, hypothesising that social assistance is an electoral asset exploited by governing coalitions. The findings from this literature are mixed. The article proposes an alternative approach emphasising political inclusion. In unequal societies where economic cooperation is regulated by institutions generating inequality and disadvantage, social assistance contributes to the political inclusion of disadvantaged groups. Analysis of Latin American Public Opinion Project data for 2010 to 2019 data finds support for this hypothesis.
Impact of Job Risks on Job Performance and Propensity to Quit Journalism Among Television Camerapersons Covering Conflicts in Nigeria
Authors: Gever Verlumun Celestine , Talabi Felix Olajide , Okunade Joshua Kayode , Aiyesimoju Ayodeji Boluwatife , Sanusi Bernice , Bello Samson Adedapo , Apuke Oberiri Destiny
Published: December 2022

This study examined the impact of job risks on job performance and the propensity to quit journalism among 576 TV camerapersons covering insecurity in Nigeria. The result of the study showed a significant main effect of job risks on job performance, F(2,548) = 241.016, p = .001, eta squared, ηp2 = .468. Also, career longevity significantly affects the relationship between job risks and performance, F(1,548) = 28.372, p = .001. Despite attaining statistical significance, the degree of the relationship was low, ηp2 = .049. A significant statistical relationship exists between job risks and the propensity to quit journalism among TV camerapersons. A further breakdown of the result showed that the more educated, the more propensity to quit journalism and vice versa. Finally, expected rewards such as career advancement, finance, commendations, and passion for journalism are why TV camerapersons have continued to cover security issues despite the known risks involved.
Fatal Post COVID mRNA-Vaccine Associated Cerebral Ischemia
Authors: McMillan Nadia , Rosenberg Harry J. , Anderson Matthew P. , Pal Pankaj , Stephenson Kathryn , Fehnel Corey R.
Published: December 2022

Background

Venous thromboses have been linked to several COVID-19 vaccines, but there is limited information on the Moderna vaccine’s effect on the risk of arterial thrombosis. Here we describe a case of post-Moderna COVID-19 vaccination arterial infarct with vaccine-associated diffuse cortical edema that was complicated by refractory intracranial hypertension.

Case Summary

24 hrs after receiving her first dose of the Moderna COVID-19 vaccine, a 30-year-old female developed severe headache. Three weeks later she was admitted with subacute headache and confusion. Imaging initially showed scattered cortical thrombosis with an elevated opening pressure on lumbar puncture. An external ventricular drain was placed, but she continued to have elevated intracranial pressure. Ultimately, she required a hemicraniectomy, but intractable cerebral edema resulted in her death. Pathology was consistent with thrombosis and associated inflammatory response.

Conclusion

Though correlational, her medical team surmised that the mRNA vaccine may have contributed to this presentation. The side effects of COVID-19 infection and vaccination are still incompletely understood. Though complications are rare, clinicians should be aware of presentations like this one.
Early Mobilization Post Acute Stroke Thrombolysis and/or Thrombectomy Survey
Authors: Silver Brian , Demers-Peel Meaghan , Alexandrov Anne W. , Selim Magdy H. , Bernhardt Julie
Published: December 2022

Background

We sought to determine mobilization practices following emergency stroke therapy in centers across the United States.

Methods

We surveyed hospitals in the NIH StrokeNet regarding mobilization practices following acute stroke thrombolysis and/or thrombectomy. An anonymous survey was sent out to all StrokeNet sites Survey questions included stroke center designation, location of admission, whether a formal bed rest protocol was in place, minimum bed rest period required, which person first mobilized the patient.

Results

48 centers responded to the survey including 45 Comprehensive Stroke Centers and 3 Primary Stroke Centers. Most patients were admitted to a neuro-intensive care unit (54%), others to a general medical/surgical ICU, stroke ward, or combination. 60% of respondents indicated that a formal bed rest policy was in place. Minimum bed rest requirements after thrombolysis alone ranged from 0 to 24 hours (35% with a 24-hour bed rest protocol, 19% with no minimum, 13% with a 12-hour minimum, 4% with an 8-hour minimum, 4% with a 6-hour minimum, and 6% with a variable rest period). Similar variations were reported in patients undergoing thrombectomy with ranges from 0 to 24 hours bed rest. First mobilization was by a nurse 52% of the time and by a physical therapist 48% of the time.

Conclusions

Mobilization practices following emergency ischemic stroke reperfusion treatments vary significantly across stroke centers. Mobilization of patients is performed primarily by nurses and therapists. Further study regarding an optimal approach for mobilization following acute ischemic stroke thrombolysis and/or thrombectomy is warranted.
Giant Cell Arteritis Presenting With Multiple Cranial Neuropathies – Case Report
Authors: Ye Jessica J. , Bouffard Marc A. , Brooks Earllondra , Hung Yin P. , Kimchi Eyal Y.
Published: December 2022

Background: Vision loss accounts for most ophthalmic presentations of giant cell arteritis (GCA), but an important minority of patients present with diplopia and other cranial neuropathies.

Case study: Here we present the case of an 84-year-old woman with a prior history of multiple cancers who was admitted to our hospital after developing double vision. She was found to have mydriasis, ptosis, and ophthalmoplegia in the right eye (OD) consistent with a combined R CNIII/CNVI neuropathy, as well as highly elevated inflammatory markers. Given her cancer history, the patient was initially worked up for various neoplastic, paraneoplastic, inflammatory, and infectious causes of multiple cranial neuropathies; however, as these results were negative, GCA became a more likely contender as a possible rare cause of multiple cranial neuropathies. The patient underwent temporal artery biopsy which showed pathology consistent with giant cell arteritis, and she was treated with steroids with eventual improvement in ophthalmoplegia and ptosis.

Conclusions: This case illustrates the importance of recognizing GCA as a rare possible cause of multiple cranial neuropathies, including the indispensable role of temporal artery biopsy.
The role of CAR-T cell therapy as second line in diffuse large B-cell lymphoma
Authors: Albanyan Omar , Chavez Julio , Munoz Javier
Published: December 2022

For approximately three decades, autologous hematopoietic cell transplantation (auto-HCT) has been the standard of care for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) after frontline therapy. This approach is limited due to the intensity of chemotherapy and the proportion of patients who relapse after auto-HCT. Since the approval of anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy and novel agents, the treatment paradigm for DLBCL has changed remarkably. Anti-CD19 CAR-T therapy was first approved for relapsed DLBCL after two or more previous lines of therapy with long-lasting responses, with over 50% of patients still alive at 5-year follow-up. Here, we discuss recent randomized phase 3 clinical trials using axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel in the second-line therapy setting compared with the standard of care in transplant-eligible patients who have DLBCL R/R within 12 months of completing chemo-immunotherapy, potentially changing the treatment algorithm for DLBCL.
Caregiving for older people living with chronic pain: analysis of the English longitudinal study of ageing and health survey for England
Authors: Smith Toby , Mansfield Michael , Hanson Sarah , Welsh Allie , Khoury Reema , Clark Allan , Dures Emma , Adams Jo
Published: December 2022

Background

Chronic pain is a disabling condition. Many people with chronic pain seek informal support for everyday activities of daily living (ADL). However, there remains uncertainty on the type of people with chronic pain who access this support, what types of support they need and who provides such support. The purpose of this analysis was to answer these uncertainties.

Methods

Data from the Health Survey for England (HSE) and English Longitudinal Study of Ageing (ELSA) were accessed. People who reported chronic pain (moderate or above for minimum of 12 months) were identified. From these cohorts, we determined if individuals self-reported receiving informal care. Data on caregiver profiles and caregiving activities were reported through descriptive statistics. Logistic regression analyses were performed to compare health status outcomes between people with pain who received and who did not receive informal care.

Results

2178 people with chronic pain from the ELSA cohort and 571 from the HSE cohort were analysed. People who received care were frequently female, older aged with several medical morbidities including musculoskeletal diseases such as arthritis. People with chronic pain received informal care for several diverse tasks. Most frequently these related to instrumental activities of daily living (IADL) such as shopping and housework. They were most frequently provided by partners or their children. Although they reported greater disability and symptoms ( p < 0.001), people who received care did not report differences in health status, loneliness or wellbeing ( p = 0.27; p = 0.46).

Conclusions

Whilst it may be possible to characterise people living in chronic pain who receive informal care, there is some uncertainty on the impact of informal caregiving on their health and wellbeing. Consideration should now be made on how best to support both care recipients and informal caregivers, to ensure their health and quality of life is promoted whilst living with chronic pain.
Sero-prevalence and associated factors of hepatitis B virus among pregnant women in Hawassa city public hospitals, Southern Ethiopia: Cross-sectional study design
Authors: Kassaw Birku , Abera Netsanet , Legesse Tegene , Workineh Alemu , Ambaw Gizachew
Published: December 2022

Objective:

This study aimed to determine the prevalence and identify associated factors of hepatitis B virus infection among pregnant women attending antenatal care (ANC) follow-up.

Methods:

An institution-based cross-sectional study was conducted from March 04 to April 03, 2020. A total of 381 women were selected using systematic random sampling after every two consecutive women. Structured and interviewer administered questionnaire was used to collect the data. A 2 ml of venous blood sample was drawn from each participant. The plasma was separated from the collected blood samples and was analyzed using a rapid hepatitis B surface antigen (HBsAg) kit to determine hepatitis sero status. Data were entered into the EPI-Data version 3.1, then exported to the statistical package for social sciences version 25 software and analyzed. Multivariable logistic regression was performed to identify independent predictors of HBsAg B seroprevalence at a p-value <0.05.

Results:

The prevalence of HBsAg sero-positivity among pregnant women was 6.6%, 95% CI (4.2, 8.9). History of hosptal admission (adjusted odds ratio (AOR) = 4.11; 95% CI = 1.33–12.71), surgical history (AOR = 6.8; 95% CI = 1.93–23.93), history dental procedures (AOR = 4.93; 95% CI = 1.31–18.53), and body tatoo practices (AOR = 6.822; 95% CI = 1.89–24.69) were found to be associated with HBsAg sero-positivity.

Conclusion:

This study found that HBsAg sero positivity among pregnant women in the study area was in intermediate edemicity. Factors such as history of hospital admission, history of surgery, history of dental procedures, and body tattoo practices were found to be associated with HBsAg sero-positivity. The government of Ethiopia should strengthen screening of all pregnant women for HBV as a part of routine ANC in ANC clinics and treating if they are positive to prevent mother to child transmission.
Satisfaction with comprehensive emergency obstetric and newborn care services and associated factors among clients in University of Gondar Specialized Hospital, Northwest Ethiopia: A cross-sectional study
Authors: Tiruneh Misganaw Guadie , Kebede Adane , Geberu Demiss Mulatu , Feleke Sefineh Fenta
Published: December 2022

Objective:

Emergency obstetric and newborn care services treat 70–80% of maternal deaths. This study aimed to assess satisfaction with comprehensive emergency obstetric and newborn care (CEmONC) services and associated factors among clients in the University of Gondar Specialized Hospital.

Methods:

Institution-based cross-sectional study was conducted on 404 participants using a systematic random sampling method. The study was conducted from March 5 to May 5, 2020, using interviewer-administered structured questionnaires. Binary logistic regression was used to find the association between independent variables and client satisfaction. The level of statistical significance was declared at a p value less than 0.05.

Results:

The overall clients’ satisfaction with CEmONC services was 65.1% (95% confidence interval (CI): 60.9–69.8). Clients’ satisfaction was affected by women who had antenatal care (ANC) of three visits (adjusted odds ratio (AOR): 6.5; 95%, CI: 2.04–20.8), women waited less than 15 min (AOR: 4.15, 95% CI: 1.9–9.06), mothers stayed ⩽1 day (AOR: 0.28, 95% CI: 0.09–0.9) and 2–3 days (AOR: 0.98, 95% CI: 0.1–0.69), obtaining a welcoming environment (AOR: 4.6, 95% CI: 2.15–9.88), and getting providers explanation of examinations (AOR: 3.3, 95% CI: 1.97–5.52).

Conclusion:

The observed clients’ satisfaction with CEmONC services was suboptimal. Having ANC of three visits, waiting less than 15 min, duration of stay, obtaining a welcoming environment, and an explanation of providers’ examination were the identified factors of client’s satisfaction. Therefore, hospital managers and health professionals should work on the identified factors to increase the client’s satisfaction with these services.
Chorea hyperglycemia basal ganglia syndrome: A case report from Nepal
Authors: Bhandari Samikchhya Keshary , Kharel Himal , Gajurel Bikram Prasad , Karn Ragesh , Rajbhandari Reema , Gautam Niraj , Shrestha Ashish , Ojha Rajeev
Published: December 2022

A rare case of chorea hyperglycemic basal ganglia syndrome in a 56-year-old woman who presented with left-sided hemichorea in the setting of uncontrolled, non-ketotic, type II diabetes mellitus is reported. Early blood glucose control could lead to complete resolution of symptoms. Despite an excellent prognosis, delayed recognition and management can lead to prolong disability due to movement disorder.
Neurofibromatosis type 1 in Syrian older patient presented with gastric outlet obstruction
Authors: Almousa Maher , Albeiruti Ahmad , Aljomaa Mohammad , Aleter Assem , Jarad Youssef
Published: December 2022

Neurofibromatosis type 1 is an autosomal dominant disorder with cutaneous features and multiple tumors that involve different organs. Gastrointestinal stromal tumors are non-epithelial tumors associated with neurofibromatosis type 1 and arise from the gastrointestinal tract. Patients with gastrointestinal stromal tumor present most commonly with anemia due to overt or occult bleeding and in rare cases diagnosis might be delayed so patients present with gastrointestinal tract obstruction. Here, we report a rare case of an older patient with neurofibromatosis type 1, who was undiagnosed and presented with acute abdomen due to gastric outlet obstruction. It was caused by progressive gastrointestinal stromal tumor in the antrum of the stomach. Gastrointestinal stromal tumors should be considered in the differential diagnosis of gastric outlet obstruction, especially in patients with neurofibromatosis type 1.
Management of scleroderma renal crisis with left ventricular diastolic dysfunction in a resource-limited setting: A rare case report
Authors: Asfaw Yonathan Aliye , Huang Helen , Anand Ayush , Taimur Muhammad , Khan Asad Ali , Shah Sangam , Poudel Sujan , Michel Jack , Michel George
Published: December 2022

Scleroderma renal crisis with left ventricular diastolic dysfunction can lead to significant mortality. We presented the case of a 32-year-old female with anuria for 2 days. On further inquiry, she had joint pain, difficulty turning her head sidewise, and associated difficulty in finger movement. Also, hyperpigmentation with superimposed hypopigmentation was reported, which reduced during her pregnancy and worsened post-partum. Her family history suggested similar complaints in her mother. In addition, she had a blurring of vision. She had hypertension, microangiopathic hemolytic anemia, deranged renal function, and retinopathy on ophthalmologic examination. Radiological investigations revealed pulmonary edema, pleural effusion, and left ventricular diastolic dysfunction. Hence, a diagnosis of scleroderma renal crisis complicated by left ventricular diastolic dysfunction was made. She was managed conservatively using anti-hypertensive medications and hemodialysis, which resulted in gradual improvement. Our case highlighted the management approach to this rare presentation with anti-hypertensives and hemodialysis in a resource-limited setting.
The Concentration-after-Personalisation Index (CAPI): Governing effects of personalisation using the example of targeted online advertising
Authors: Laux Johann , Stephany Fabian , Russell Chris , Wachter Sandra , Mittelstadt Brent
Published: December 2022

Firms are increasingly personalising their offers and services, leading to an ever finer-grained segmentation of consumers online. Targeted online advertising and online price discrimination are salient examples of this development. While personalisation's overall effects on consumer welfare are expectably ambiguous, it can lead to concentration in the distribution of advertising and commercial offers. Constellations are possible in which a market is generally open to competition, but the targeted consumer is only made aware of one possible seller. For the consumer, such a market could effectively resemble a monopoly. We call such extreme cases ‘targeting pockets’. Competition-law metrics such as the Herfindahl–Hirschman Index and traditional means of public oversight of adverts would not detect this concentration. We, therefore, suggest a novel metric, the Concentration-after-Personalisation Index (CAPI). The CAPI treats every consumer as a separate ‘market’, computes a measure of concentration for personalised adverts and offers for each individual consumer separately, and then averages the result to measure the exposure experienced by an average consumer. We demonstrate how the CAPI can serve as a monitoring tool for regulators and auditors and thus help to enforce existing consumer law as well as proposed new regulations such as the European Union's Digital Services Act and its Artificial Intelligence Act. We further show how adding noise via randomly distributed non-personalised adverts can dilute the potential harm of overly concentrated personalisation. We demonstrate how the CAPI can identify the optimal degree of added noise, balancing the protection of consumer choice with the economic interests of advertisers.
Quality of the Indian clinical practice guidelines for the management of cardiovascular conditions
Authors: Dhurjati Rupasvi , Sagar Vidya , Kanukula Raju , Rehana Nusrath , Mohanan Padinhare P , Huffman Mark D. , Bhaumik Soumyadeep , Salam Abdul
Published: December 2022

To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from inception until August 2020, to identify Indian CPGs for the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures. Quality of the each included CPG was assessed using the AGREE II tool by four reviewers in duplicate, independently. Each AGREE II domain score and overall quality score was considered low (≤40%), moderate (40.1%-59.9%), and high (≥60%). Of the 23 CPGs included, six (26%) were reported to be adapted from other CPGs. Fourteen (61%) CPGs were produced by medical associations, six (26%) by individual authors and three (13%) by government agencies. Based on the AGREE II overall quality score, two (9%) CPGs were of high quality, four (17%) and seventeen (74%) CPGs were of moderate and low quality, respectively. Except for scope and purpose, and clarity of presentation all other domains were rated low. The quality of most Indian CPGs for managing CVD conditions assessed using the AGREE II tool was moderate-to-low. Combined efforts from different stakeholders are needed to develop, disseminate and implement high-quality CPGs while identifying and addressing barriers to their uptake to optimize patient care and improve outcomes.
Challenges on the European Union-China cooperation in higher education from ‘people-to-people dialogue’ perspective: The case of health-related joint projects
Authors: Santiago Anabela , Rodrigues Carlos , Diogo Sara , da Silva Jorge Tavares
Published: December 2022

The European Union (EU) and People’s Republic of China have a tradition of cooperation in Higher Education (HE) that has been increasingly developed since the Chinese reform of economic opening. From 2012 onwards, when the EU-China High-Level People-to-people Dialogue was established as the third pillar of a Comprehensive Strategic Partnership between both parties, this cooperation in HE was enhanced, particularly in terms of people mobility (students, teachers and researchers). Along with this, globalization and the need for global governance responses in terms of global issues like climate changes, water and food security, pandemics and other health issues lead us to reflect about the role of academic and scientific cooperation - in the domain of HE and research cooperation-in the lens of this People-to-People approach. By means of a literature review grounded on different sources of documents (scientific articles; policy briefs; joint statements and educational programs) and their content analysis, the aim of this paper is to trace a brief state-of-the-art of the EU-China relations in the field of HE and research to analyze if there are effective EU-China partnerships in HE as a whole, and in health scientific joint research projects in particular, by mapping health-related projects involving the EU’s and PRC’s academic and research institutions, as well as their goals.
Localization and Likelihood of Chondral and Osteochondral Lesions After Patellar Dislocation in Surgically Treated Children and Adolescents
Authors: Jungesblut Wibke , Rupprecht Martin , Schroeder Malte , Krajewski Kara Leigh , Stuecker Ralf , Berger-Groch Josephine , Strahl Andre , Hubert Jan , Jungesblut Oliver D.
Published: December 2022

Background:

Patellar dislocation is a common injury in children and adolescents. There is a lack of information about concomitant osteochondral lesions in these patients.

Hypothesis:

We hypothesized that the likelihood of chondral or osteochondral lesions would increase with each prior patellar dislocation and that the appearance of lesions in surgically treated children and adolescents would be influenced by age, sex, injury mechanism, and body mass index (BMI).

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Inclusion criteria were (1) age <18 years, (2) surgical treatment with diagnostic arthroscopy of the knee including description of chondral and osteochondral lesions, and (3) maximum time period between the last patellar dislocation and presentation in our department of 6 weeks and maximum of 4 weeks between presentation and surgery. A total of 153 children (173 knees) with a mean age of 13.0 ± 2.1 years were included. All surgical reports and intraoperative arthroscopic imaging were analyzed retrospectively for the location and severity of lesions. The likelihood of lesions was calculated with multiple stepwise regression models regarding injury mechanism, number of dislocations, sex, age, physeal closure, and BMI.

Results:

The regression model to predict femoral lesions was statistically significant (χ2[5] = 26.55; P < .001) and identified male sex, BMI ≥25, traumatic injury mechanism, and physeal closure as independent factors associated with the appearance of femoral lesions. The second regression model predicting the appearance of patellar lesions was also statistically significant (χ2[4] = 26.07; P < .001) and identified the traumatic injury mechanism as a single independent predictor for patellar lesions.

Conclusion:

BMI ≥25, male sex, and physeal closure were factors significantly associated with femoral chondral and osteochondral lesions in our cohort. In case of traumatic lateral patellar dislocation (LPD), the likelihood of patellar and femoral chondral and osteochondral lesions is significantly higher than in nontraumatic LPD. Early magnetic resonance imaging and surgical treatment should be considered in obese patients, male patients, and patients with physeal closure and after traumatic LPD.
Healthcare Professionals’ Perspective on Palliative Care in Intensive Care Settings: An Interpretive Descriptive Study
Authors: Alshehri Hanan Hamdan , Wolf Axel , Öhlén Joakim , Olausson Sepideh
Published: December 2022

There is a growing need to integrate palliative care into intensive care units and to develop appropriate knowledge translation strategies. However, multiple challenges persist in attempts to achieve this objective. In this study, we aimed to explore intensive care professionals’ perspectives on providing palliative and end-of-life care within an intensive care context. We used an interpretive description approach and interviewed 36 intensive care professionals at four hospitals in Saudi Arabia. Our findings reflect a discourse about end-of-life care driven by a do-not-resuscitate classification and challenges associated with family involvement in care goals. We provide key insights of importance for the development of strategies for the integration and knowledge translation of palliative care into intensive care contexts.
Achalasia Treatment: From the Whale Bone to POEM
Authors: Schlottmann Francisco , Herbella Fernando A. M. , Patti Marco G.
Published: December 2022

Achalasia treatment started with forceful dilatation of the cardia with the aid of whale bones in the 17th century. In the following 3 centuries, treatment alternated between endoscopic and surgical therapy with advances in both fields. Surgery evolved from cardioplasties to cardiomytomy, from open approach to minimally invasive, from the thoracic route to the abdomen, from human hands to robotic arms. Endoscopic therapy evolved from dilatation with whale bones to pneumatic balloons, from botulinum toxin injection to peroral endoscopic myotomy.