bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilizing artificial intelligence to develop an advanced compressor airfoil family for industrial, aero-derivative, and heavy-duty gas turbines
Authors: Shahrabi Farahani Alireza , Mohammadi Esmaeil , Alizadeh Mohammad
Published: March 2023

This paper describes the procedure for developing a new airfoil family. This airfoil family applies to heavy-duty, industrial, and aero-derivative gas turbine compressors ranging from subsonic to transonic flow regimes. The airfoil family is generated by filling a database with optimized airfoil geometries. This database is structured in six dimensions, called design space parameters, including inlet Mach number, inlet flow angle, outlet flow angle, axial velocity density ratio, maximum thickness to chord ratio, and solidity. This six-dimensional space includes all compressor blades used in stationary gas turbine compressors. Each set of these design space parameters is related to an optimal geometry produced by the optimization system. The optimization system includes a parametrized airfoil generator, an accurate, fast blade-to-blade flow solver, and an evolutionary optimization algorithm. Airfoils of different stationary gas turbine compressor types are investigated to cover the required design space. Four hundred thirty airfoils, denoted as reference airfoils, are used to define design space borders. Comparing the newly optimized airfoils with reference airfoils revealed superior performance throughout the entire design space. They incorporate these optimized airfoils into a surrogate model, resulting in a fast, optimized airfoil generator (airfoil family). The transonic rotor of the existing multistage compressor has been redesigned according to the developed airfoil family. 3D computational fluid dynamics showed a 2% efficiency improvement for optimized blade row over the original design. Integrating this airfoil family and a streamline curvature code as part of a compressor design system is the main application of this advanced airfoil family.
Assessing sustainable development with the forces of technological innovation, entrepreneurial activity and energy consumption: Insight from asymmetric and bootstrap causality methods
Authors: Hussain Sadam , Udemba Edmund Ntom , Emir Firat , Khan Nazakat-Ullah , Chammam Wathek , Riahi Anis
Published: March 2023

This is a sustainable study of China amidst high carbon emissions. China has experienced tremendous increase in its economic operations and development which involve the excessive utilization of fossil fuel energy sources. This has put China in the list of nations that contribute towards global warming via carbon emission. On this note, data from China over the period 2002Q1–2019Q4 is analyzed, using multiple techniques (nonlinear autoregressive distributed lag-NARDL, fully modified ordinary least square-FMOLS, and bootstrap approach of Granger causality) for clear insight into China's sustainable development. Relevant instruments (technological innovation, entrepreneurial activities, economic growth proxied by GDP, fossil fuel energy consumption, and FDI) are used to measure China's economic and environmental performance to determine the level of sustainable development of the country. NARDL and FMOLS results reveal that technological innovation and entrepreneurial activity mitigate carbon emissions, while fossil fuels and economic growth induce China's carbon emissions. Also, findings from the bootstrap approach affirm the NARDL and FMOLS outcomes, with both two-way and one-way nexus established among the selected variables. Policies targeting the reduction of fossil fuel consumption in China despite the technological innovations and entrepreneurial activities are thus recommended.
Phytolith analyses of tropical plants and topsoil from western Peninsular Malaysia and their implications for paleoenvironmental reconstruction
Authors: Dai Lu , Bai Yu , Foong Swee Yeok , Cheng Zhongjing
Published: March 2023

The underrepresentation of many important rainforest species in pollen records still hinders accurate paleovegetation reconstructions in tropical Southeast Asia. In this study, we conducted a modern phytolith study of 141 plant and 15 surface soil samples around the forests of Jerai Hill in western Peninsular Malaysia to evaluate the potential of phytolith assemblages as a proxy for indicating tropical vegetation types. In the plant samples, including many Dipterocarpaceae species, tracheary annulate/helical phytoliths occur most commonly, followed by silicified epidermis, silicified stomata, elongate entire, sclereid, trichomes, irregular. A few diagnostic phytoliths with unique morphological features are found in dicotyledonous trees, palms, and ferns, such as spheroid ornate (sph_orn) and spheroid echinate (sph_ech). In contrast, the phytolith assemblage of surface sediment is dominated by sph_orn, sph_ech, and spheroid psilate. This suggests that similar to pollen, the contribution from dominating forest vegetation rich in Dipterocarpaceae species is obscure in phytolith deposits. However, phytolith analysis highlights the representation of monocotyledons and a few dicotyledonous trees. The more sensitive indication of Poaceae short-cell phytoliths than pollen for parent plants implies that their ratio to forest indicator phytoliths might be a valuable proxy of landscape openness. Additionally, the statistical analysis confirms that phytolith assemblages in the heath forest are slightly different from those in the lowland dipterocarp forest, exhibiting their potential to indicate various vegetation types.
The Effect of Women’s Empowerment on Intimate Partner Violence and Child Nutrition Outcomes in India, Nepal, and Pakistan
Authors: Inamdar Vedika , Tagat Anirudh , Parekh Aneree
Published: March 2023

Women’s empowerment is often defined to include aspects of agency, autonomy and choice, which in turn has consequences for facing intimate partner violence (IPV) and the ability of a woman to fulfil childcare responsibilities. This suggests that empowerment is directly and indirectly (via IPV) associated with child nutrition outcomes (CNOs), especially in South Asian countries where gendered norms may place the onus of childcare on mothers. We explore the interplay between empowerment, IPV and CNOs using nationally representative datasets from three South Asian countries—India, Nepal and Pakistan. We use a multivariate probit approach to investigate the direct and indirect effect of women’s empowerment and autonomy on child malnourishment (stunting, wasting and underweight). Across all countries, we find a strong statistically significant effect of improvements in decision-making power on increased likelihood of facing certain types of IPV. We also find a strong negative relationship between facing less severe violence in particular and CNOs across all countries, indicating that such violence experienced by mothers was detrimental to CNOs. Increasing women’s decision-making power within the household can help ameliorate adverse CNOs, and in India particularly, this increase in decision-making autonomy reduced the incidence of stunting and underweight children. The study concludes with limitations and directions for future work.
Hospice Patients’ End-of-Life Dreams and Visions: A Systematic Review of Qualitative Studies
Authors: Rabitti Elisa , Cavuto Silvio , Díaz Crescitelli Matías Eduardo , Bassi Maria Chiara , Ghirotto Luca
Published: March 2023

When conscious, about 50% to 60% of hospice patients report a “visitation” by someone who is not there while they dream or are awake: a phenomenon known as End-of-Life Dreams and Visions (ELDVs). Since the dying process is frequently complicated by delirium, ELDVs risk being misidentified as such by professionals and caregivers. To observe these phenomena from patients’ perspectives, we conducted a systematic review to aggregate and synthesize the findings from the qualitative studies about ELDVs of patients assisted in hospices to indicate future directions for research and care. MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Scopus, and Web of Science databases were searched, yielding 293 documents after duplicates were removed. Six qualitative articles reporting on five unique studies conducted in hospice settings were included in the meta-synthesis. We generated three main categories: i) typologies of ELDVs reported, ii) emotional consequences, and iii) intersubjective meaning-making. The ELDVs reported were experiences that remained intimate and unsocialized and thus preventing participants from defining a shared sense in their relationships. Training healthcare professionals to recognize ELDVs and take advantage of them in the care relationship is desirable. We also encourage the patient’s family members to listen and understand ELDVs when they occur actively. For caregivers to know how to interpret these phenomena may provide them with additional strategies for supporting, reassuring, and strengthening their relationships with their loved ones. The review allowed us to inform healthcare professionals and caregivers about how to help patients share their emotional and identity-related experiences and meaning-making in end-of-life.
Seasonal, Geographic, and Ethnic Influence on the Prevalence of Orofacial Clefts in Kuwait: A Nationwide Study
Authors: Alkharafi Lateefa , Mokhtar Ashraf , Burezq Hisham , Almerjan Deemah , Dashti Ghaidaa , Almutalaqem Reem , Alshammari Aminah , Alhasawi Saud , Alqatami Fawzi , Geevarghese Amrita
Published: March 2023

Objective

Accurate nationwide epidemiological evidence is vital to study the seasonal, geographic, and ethnic influence on the trends of orofacial cleft prevalence in Kuwait.

Design

Data obtained from the National Center for Health Information and Ministry of Health Hospital digital records were reviewed retrospectively to identify patients with orofacial clefts (OFC) using the ICD-10 diagnostic codes. The Jonckheere-Terpstra test was used to assess the trend of birth prevalence across the different years. The associations of types of OFC with ethnic and geographic influences were tested with chi-square or Fisher's exact tests, while the strength of that association was tested with multi-nominal logistic regression.

Results

Birth prevalence in Kuwait ranged from 0.75–2.55 per 1000 live births (0.73- 2.73 among Kuwaitis, 0.60–3.27 among non-Kuwaitis), with no statistically significant change observed during the past 28 years. The risk of unilateral cleft lip and palate was eight times higher during summer compared to Autumn, while the risk of cleft lip and palate remained lower during winter. Jahra (OR-7.76, CI- 1.51–39.80), Farwaneya (OR-6.65, CI- 1.34–33.06), and Hawalli (OR-6.72, CI- 1.26–35.98) governorates had higher odds of bilateral cleft lip when compared to Mubarak Alkabeer.

Conclusions

The study outcome is an indicator to improve patient care and customize healthcare infrastructure in the Ministry of Health. It also provides insight to develop projections of future needs. Future studies should focus on understanding the factors that might be a potential contributor to the seasonal change observed in the prevalence of OFC.
The Medication Possession Ratio as a Predictor of Longitudinal HIV-1 Viral Suppression
Authors: Rathbun R. Chris , Lewis Michelle M. , Yuet Wei Cheng , Woo Sukyung , Miller Jamie L. , Skrepnek Grant H.
Published: March 2023

Background:

Antiretroviral adherence is essential to achieve viral suppression and limit HIV-related morbidity and mortality; however, antiretroviral adherence thresholds to achieve viral suppression in clinical practice have not been fully characterized using administrative claims data.

Objective:

The purpose of this study was to assess the relationship between medication adherence and viral suppression among adult persons with HIV/AIDS (PWH) receiving antiretroviral therapy (ART) for ≥6 months.

Methods:

This historical cohort, real-world investigation assessed maintenance of viral load suppression and viral load area-under-the-curve (vAUC) in PWH ≥18 years of age based on ART adherence. A marginal effects model was used to determine the predicted probabilities of final plasma HIV-1 RNA <50 copies/mL or vAUC <1,000 copy-days/mL according to the medication possession ratio (MPR), estimated using a Jackknife model variance estimator and a delta-method for marginal effects standard error. Tests for statistical significance used a Šidák method to correct for multiple comparisons.

Results:

The mean MPR for ART was 86.7% (95% CI: 85.0%–88.4%) for the 372 PWH included in the study. The marginal effects analysis indicated that an MPR ≥82% was associated with a predicted probability of viral suppression <50 copies/mL ( P < 0.05). Significant predicted probabilities for vAUC <1,000 copy-days/mL were observed with an MPR ≥90% ( P < 0.05).

Conclusion and Relevance:

Medication possession ratio as a proxy for drug exposure was significantly and consistently associated with viral suppression using a longitudinal measure of HIV viremia. These findings can aid clinicians in the clinical management of PWH and inform future studies of adherence-viral suppression relationships with contemporary antiretroviral regimens.
Therapeutic Options for Adult Patients With Persistent Methicillin-Susceptible Staphylococcus aureus Bacteremia: A Narrative Review
Authors: Chastain Daniel B. , Covert Kelly L. , Tu Patrick J. , McDougal Steven , White Bryan P. , Cluck David
Published: March 2023

Objective:

To compare the efficacy of antimicrobial therapies used in the management of persistent methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia.

Data Sources:

A literature search using the PubMed database (inception to December 2022) was conducted using the search terms “ Staphylococcus aureus bacteremia,” “methicillin-susceptible Staphylococcus aureus bacteremia,” “persistent methicillin-susceptible Staphylococcus aureus bacteremia,” and “refractory methicillin-susceptible Staphylococcus aureus bacteremia .” In addition, therapeutic agents which could be used as treatment for MSSA including “nafcillin,” “oxacillin,” “cefazolin,” “ceftaroline,” “gentamicin,” “rifampin,” and “daptomycin” were also combined with the aforementioned search terms to capture data using these agents.

Study Selection/Data Extraction:

Clinical data were limited to those published in the English language. Articles and abstracts were considered for inclusion in addition to ongoing trials identified through ClinicalTrials.gov.

Data Synthesis:

A total of 78 articles were reviewed including 17 in vitro or animal model studies and 39 studies including patient data. The remaining 22 articles included guidelines, review articles, and editorials. Recent data evaluating use of dual β-lactam regimens for persistent MSSA bacteremia were limited to 8 case reports or case series.

Relevance to Patient Care and Clinical Practice:

At present, there is little guidance on how to best manage patients with persistent MSSA bacteremia. This narrative review collates the available data to assist clinicians in selecting the best possible antimicrobial regimen when facing this clinical conundrum.

Conclusions:

Modification of antimicrobial therapy, in conjunction with source control and infectious diseases consultation, may all be necessary to sterilize blood cultures in patients with persistent MSSA bacteremia.
Investigation on the tunable bi-stable clustered energy conversion inspired dynamic vibration absorbers: A theoretical study
Authors: Huang Xingbao , Zhang Xiao , Yang Bintang
Published: March 2023

This paper introduces an energy conversion inspired vibration control methodology and presents a representative prototype of tunable bi-stable energy converters. This work is concerned on improving energy conversion and absorption performance of tunable bi-stable clustered energy conversion inspired dynamic vibration absorbers (EC-DVAs). The deterministic parametric analysis of the energy transfer performance of clustered EC-DVAs is conducted. The nonlinear energy capture behaviors including transient energy transfer and snap-through motions are studied. It can be uniformly understood that the excellent energy transfer and conversion efficiency can be achieved by modulating the length ratio from 0.6 to 0.8. It is found that clustered EC-DVAs with four uniform cells and constant length ratio σ = 0.8 can obtain significant energy conversion and targeted energy transfer performance without requiring tedious active regulation when the system is subjected to wide-amplitude impulsive scenarios. Therefore, the proposed tunable bi-stable system composed of clustered EC-DVAs with state-of-the-art adaptive control strategies is a potential alternative for energy reuse and vibration suppression of mechanical components exposed to kaleidoscopic impulses.
Development and Validation of the Self-management of Dementia by Family Carers (SMDFC) Scale
Authors: Shehadeh Anas , Hunter Sharyn , Jeong Sarah
Published: March 2023

To develop and validate a scale, the Self-management of Dementia by Family Carers (SMDFC), mixed-methods were used. First, the domains of the SMDFC Scale were identified through a systematic literature review and interviews with expert professionals and carers. Then, the following psychometrics were performed: content and face validity, internal consistency, test-retest reliability, and construct validity. The final scale had 36 items grouped into 6 factors. The internal consistency and test-retest reliability coefficients were excellent. This scale can be used to determine carers’ ability to assist the person living with dementia to self-manage this condition in clinical practice and research.
Teacher Reports of Secondary Writing Instruction with Deaf Students
Authors: Wolbers Kimberly , Dostal Hannah , Holcomb Leala
Published: March 2023

Since students’ writing skills are largely shaped by the quality of instruction they receive, we can learn from what teachers report about their beliefs and approaches to the teaching and learning of writing. This study explores the state of writing instruction at secondary levels with deaf and hard of hearing (DHH) students through a mixed-methods approach using a sequential explanatory design. Two hundred and twenty-two teachers responded to a survey about writing instruction, and 10 teachers participated in follow-up focus groups. The findings indicate that the primary difference between the hearing middle and high school student population and the DHH population is experiences of language deprivation, which impact the preparedness of teachers of DHH students, as well as the time and focus of their writing instruction. Teachers reported that American Sign Language/English bilingual instruction was the greatest area of need in research.
Adult ADHD Diagnosis, Symptoms of Impulsivity, and Emotional Dysregulation in a Clinical Sample of Outpatients Consulting for a Behavioral Addiction
Authors: El Archi Sarah , Barrault Servane , Garcia Manuel , Branger Stéphanie , Maugé Damien , Ballon Nicolas , Brunault Paul
Published: March 2023

Objective:

This study aimed to investigate ADHD in adult outpatients seeking treatment for a behavioral addiction and to identify the specificity of psychopathological features if the behavioral addiction cooccurs with adult ADHD.

Method:

Sixty-five outpatients consulting for a behavioral addiction were assessed for ADHD (DIVA-5), addictive disorder (alcohol, tobacco, cannabis, gambling, gaming, food, and sex), impulsivity (UPPS-P), and emotion dysregulation (DERS-36).

Results:

In our sample of outpatients seeking treatment for a behavioral addiction, adult ADHD was independently associated with higher compulsive sexual behavior disorder severity, “sensation seeking,” “positive urgency,” difficulties in “goal-directed behavior,” “impulse control,” and use of “emotion regulation strategies” in the context of intense emotions. A 29% of the sample was diagnosed for adult ADHD.

Conclusion:

The association of adult ADHD with specific dimensions of impulsivity and emotion dysregulation, pave the way for future clinical and research perspectives.
A Case of Infective Endocarditis Treated With Homeopathy Medicine
Authors: Chabanov D , Tsintzas D , Vithoulkas G
Published: March 2023

Infective endocarditis is a deadly disease, associated with high mortality and morbidity. We present a case of a 14-year-old boy with antibiotic-resistant infective endocarditis who was treated with classical homeopathy. The case is analyzed according to the general reactivity of the organism and the Levels of Health theory.
The Rotting City: Surrealist Arts of Noticing the Urban Anthropocene
Authors: Wilson Japhy
Published: March 2023

This article develops a surrealist approach to researching and writing about the urban Anthropocene, as a critical contribution to existing literatures on “arts of noticing” and “staying with the trouble.” Drawing on psychogeographical explorations of the city of Iquitos in the Peruvian Amazon and distancing itself from conventional modes of academic writing, the article presents a montage of surrealist images of this (post)apocalyptic metropolis. Iquitos emerges as a palimpsest of the wreckage of repeated resource booms, strewn with the ruins of a stillborn modernity and incubating an uncanny fusion of apocalyptic and utopian elements observable in the everyday practices of its subaltern inhabitants. Just as Paris was the capital of the 19th century for Walter Benjamin’s Arcades Project, so the interpretation of Iquitos as an extreme metaphor for our combined and uneven apocalypse designates it as the capital of the Anthropocene.
Rite and Stone: Religious Belonging and Urban Space in Global Perspective
Authors: Burchardt Marian , Martínez-Ariño Julia , Griera Mar , Bramadat Paul
Published: March 2023

Over long periods, interdisciplinary debates in urban studies on the relationships between religion and urban space were influenced by mainstream versions of modernization theory. These were based on the binary of urban modernity and nonurban (religious) tradition. However, historical urban research has shown that cities were also more often sites of religious innovation. Inspired by Jennifer Robinson’s understanding of cities as “ordinary” sites of sociality, with this special issue we contribute to this vibrant debate on religion and urbanism. The articles in it examine the role of places of worship as spatial and urban projects and address the following questions: How do religious actors become spatial entrepreneurs whose spatial projects shape cities? Which religiously motivated social and material forms emerge in cities? What are the practices and regimes that contribute to the spatialization of religion? How does the nature of places of worship alter and adapt to rapidly changing urban environments? And what are the consequences of religious buildings and other material forms for the social reality of cities? We argue that in contrast to former periods, when religious buildings were considered and constructed as authoritative buildings, these buildings are now much more fluid. Broad social transformations profoundly changed the roles played by and the social meanings attributed to them. Religious buildings and informal religious sites are not mere static architectural structures but bring with them a wide variety of spatial, economic, political, affective, and spiritual investments which make their construction, presence, and transformation a slippery object for urban planning logics and experts.
Reforming the UK Furniture and Furnishings (Fire) (Safety) Regulations 1988
Authors: Page Jamie , Whaley Paul , Čavoški Aleksandra
Published: March 2023

This paper discusses the need for wider reform of UK chemicals policy following exit of the UK from the EU, focusing on chemical flame retardants as an example. Exposure to these chemicals presents a range of human environmental health issues and reveals important limitations in the UK’s approach to reconciling fire safety with environmental and public health protections. Key strategic issues that would advance evidence-informed policy in this area are identified.
Combining a Direct and Indirect Training Approach for Cross-Domain Competences: The Case of the Course “Pedagogy for Psychotherapists”
Authors: Udvardi-Lakos Nina , Weirich Marlene , Lützenburger Kim , Asbrand Julia , Renkl Alexander
Published: March 2023

In psychology programs, students should acquire both domain-specific knowledge and cross-domain competences important for later practice (e.g., multiple document literacy). Typically, such competences are trained directly in courses explicitly devoted to them or indirectly in courses on psychological topics that require them without systematically teaching and training them (e.g., when reading multiple texts about a topic). To exploit the advantages of both direct and indirect training approaches, we combined them in a new psychology course in which students were taught domain-specific knowledge on pedagogy and psychotherapy, and they were trained in the competence facets of (a) epistemic beliefs, (b) multiple document literacy, and (c) argumentative thinking. The direct training took a tried-and-tested example-based learning approach. A central element of the indirect training consisted of course assessments requiring the application of these three competences to the contents about pedagogy and psychotherapy. The combined training approach led to significant increases in declarative knowledge, advanced epistemic beliefs, and greater self-efficacy in implementing strategies relating to multiple document literacy and argumentative thinking. This approach can be adapted to accommodate different psychological content areas or different cross-domain competences.
The Effect of Priming Structural Fairness on Inequality Beliefs and Preferences
Authors: Lendway Paul , Huber Gregory A.
Published: March 2023

Experimental research on pay inequality attitudes often provides information about pay inequality with the expectation that greater awareness of pay differences will increase the belief that pay inequality is unfair, thereby strengthening support for policies addressing pay inequality. Less explored is whether providing information about why pay inequality might be justified may lower support for addressing pay inequality or counteract the effect of providing information about such inequality. This paper finds that providing static information about pay differences across the income distribution generally does not affect support for policies addressing pay inequality. However, providing information about pay inequality followed by a labor economics argument in support of pay differences (priming structural fairness) generally decreases support for such policies. One mechanism through which this effect may operate is by increasing the belief that differences in pay are justified.
Decreased Resting-State Alpha Self-Synchronization in Depressive Disorder
Authors: Mohammadi Yousef , Kafraj Mohadeseh Shafiei , Graversen Carina , Moradi Mohammad Hassan
Published: March 2023

Background. Depression disorder has been associated with altered oscillatory brain activity. The common methods to quantify oscillatory activity are Fourier and wavelet transforms. Both methods have difficulties distinguishing synchronized oscillatory activity from nonrhythmic and large-amplitude artifacts. Here we proposed a method called self-synchronization index (SSI) to quantify synchronized oscillatory activities in neural data. The method considers temporal characteristics of neural oscillations, amplitude, and cycles, to estimate the synchronization value for a specific frequency band. Method. The recorded electroencephalography (EEG) data of 45 depressed and 55 healthy individuals were used. The SSI method was applied to each EEG electrode filtered in the alpha frequency band (8-13 Hz). The multiple linear regression model was used to predict depression severity (Beck Depression Inventory-II scores) using alpha SSI values. Results. Patients with severe depression showed a lower alpha SSI than those with moderate depression and healthy controls in all brain regions. Moreover, the alpha SSI values negatively correlated with depression severity in all brain regions. The regression model showed a significant performance of depression severity prediction using alpha SSI. Conclusion. The findings support the SSI measure as a powerful tool for quantifying synchronous oscillatory activity. The data examined in this article support the idea that there is a strong link between the synchronization of alpha oscillatory neural activities and the level of depression. These findings yielded an objective and quantitative depression severity prediction.
Risks of Chronic Preoperative Opioid Use on Distal Radius Surgery Outcomes
Authors: Newton William N. , Sossamon Jake A. , Pire Jonathan R. , Daley Dane N.
Published: March 2023

Background:

The purpose of this study was to determine the influence of chronic preoperative opioid use on complications, reoperation rates, and postoperative opioid use among patients undergoing open reduction and internal fixation (ORIF) of distal radius fractures.

Methods:

A retrospective review of 111 patients who underwent ORIF of a distal radius fracture from 2019 to 2021 at an academic medical center by the same fellowship-trained orthopedic hand surgeon was conducted. Patient demographics, medical comorbidities, perioperative details, surgical complications, and patient-reported outcome measures were analyzed. The SCRIPTS database was used to obtain opioid prescription data.

Results:

A total of 10 patients (9.01%) were identified as preoperative chronic opioid users. This group was not associated with risk of increased complication. However, they were more likely to continue using narcotics at 90 and 180 days postoperatively. Patients with a history of substance use were at an increased risk of hardware complications and prolonged postoperative pain. In addition, these patients were more likely to receive narcotics at 90 and 180 days, and to have more refills postoperatively.

Conclusion:

Patients with preoperative opioid use are not at an increased risk of surgical complication following ORIF of distal radius fractures. However, they are at an increased risk of prolonged postoperative opioid use. Patients with a known history of substance use were at an increased risk of hardware complications, prolonged pain, and increased postoperative opioid use. Surgeons should consider these associations to better manage individual patients in the postoperative period.
Heart rate and heart rate variability during diagnostic and interventional neuroendovascular procedures
Authors: Essibayi Muhammed Amir , Toma Aureliana , Mowrey Wenzhu , Qin Jiyue , Hamad Mousa , Ryvlin Jessica , Holland Ryan , Fluss Rose , Altschul Dorothea , Lin Li-Mei , Altschul David J
Published: March 2023

Introduction

Heart rate variability (HRV) reflects the activity of the autonomic nervous system (ANS) and can be used as a potential predictor of stress-related cardiovascular diseases. This study aimed to assess whether physical and mental strain during the performance of cerebral endovascular procedure influence time-domain HRV parameters in operating surgeon.

Materials and Methods

Heart rate (HR) and HRV metrics were measured using a HR sensor chest strap before, during, and after neuroendovascular interventions performed by a single neurosurgeon. Three consecutive data series were reported by recording time domain: before procedure, during and after performing endovascular procedures. HR and HRV parameters were recorded during diagnostic and interventional neuroendovascular procedures. HR and HRV measures were analyzed by procedure type and recording time domain.

Results

HRV measures of a single endovascular neurosurgeon were recorded during 50 procedures. The median intraprocedural HRV score was the lowest and the median HR was the highest (HRV: 52, HR: 89 bpm) compared to preprocedural (HRV: 59, HR: 70 bpm) and postprocedural cardiovascular measures (HRV: 53, HR: 79, bpm, p < 0.001). On univariate linear regression, a negative association of interventional procedures with lower intraprocedural (β = −0.905, p = 0.001) and postprocedural (β = −1.12, p < 0.001) HRV scores compared to the diagnostic procedures was noted.

Conclusions

HRV is a reliable tool to measure cardiovascular and mental stress. Interventional neuro-endovascular procedures seem to negatively impact the cardiovascular measures of neurointerventionalists. Further longitudinal studies utilizing HRV are warranted to address their long-term effects on the mental health of physicians.
Role of spleen density in predicting postoperative complications in patients with acute mesenteric ischemia
Authors: He Qi-Na , Chen Lang , Hu Han-Yu , Yang Zhe , Huang Jing-Yong , Miao Shou-Liang , Chen Fan-Feng
Published: March 2023

Background

Acute mesenteric ischemia (AMI) is a life-threatening surgical emergency with a poor prognosis. This study assessed the association of diffuse reduction of spleen density (DROSD) with postoperative complications and identified risk factors for adverse outcomes in AMI patients after surgery.

Methods

Patients who were diagnosed with AMI and underwent surgical operations between April 2006 and July 2021 were enrolled. Spleen density was assessed using preoperative non-enhanced computed tomography. The lowest quartile of spleen density in all patients was regarded as the cutoff value for DROSD. Univariate and multivariate analyses were performed to determine the risk factors related to postoperative outcomes after surgery.

Results

According to the diagnostic cutoff, patients with a spleen density ≤49.07 HU were defined as DROSD. In a cohort of 97 patients, 34.0% developed complications within 30 days of surgery. The multivariate analysis illustrated that DROSD was an independent risk factor for prognostic outcomes in AMI patients after surgery.

Conclusion

Patients with low spleen density were prone to postoperative complications. As an imaging method, preoperative assessment of spleen density is a novel predictor that can be used clinically to identify high-risk AMI patients with poor prognosis.
Anaesthetic peripheral nerve blocks for a total knee replacement revision due to infection in a patient with symptomatic chronic coronary syndrome: A case report
Authors: Pires Marta R , Rodrigues Diana S , Segura-Grau Elena
Published: March 2023

This report aims to describe the perioperative management of a high-risk cardiovascular patient proposed for urgent total knee replacement revision. We discuss the use of peripheral nerve blocks and its impact on haemodynamic stability and clinical outcomes, including major cardiovascular adverse events and myocardial injury after non-cardiac surgery.
How cosmetic apps fragmentise and metricise the female face: A multimodal critical discourse analysis
Authors: Eriksson Göran , Kenalemang Lame Maatla
Published: March 2023

In the present time, we see a rapid development of so-called cosmetic apps promoted by prominent cosmetic companies. Although there is an emerging market for male consumers, these apps are marketed as technological innovations designed to analyse, rate and evaluate mainly women’s facial appearances through the submission of a selfie. Based on the results generated from the selfie, personalised solutions are offered in the form of recommended products to supposedly help women improve their appearances. Drawing on a critical feminist approach and using multimodal critical discourse analysis (MCDA), the aim of this article is to study how these evaluations are semiotically reproduced and presented to the users. The paper examines in detail how apps convey the evaluation process and transform a selfie into measures, presented through diagrams and charts, that is, how the female face is fragmented and metricised. Coming with affordances of being systematic, exact and scientific, these infographics assign the facial evaluations with meaning. A key argument is that these cosmetic apps are changing the way women are implied to consider and control their (facial) appearance. Following neoliberal notions, the apps put strong pressure on women to take the responsibility to engage in intensive forms of aesthetic labour and to consume the ‘right’ products to appear as the best versions of themselves.
Late poor outcomes of Clostridioides difficile infections in oncological patients: A multicentre cohort study
Authors: Calbo Esther , Hernández Sergi , Sopena Nieves , Castellá Laia , Lopez-Contreras Joaquín , Cuquet Jordi , López-Sánchez Maria , Pérez Rafel , Gudiol Carlota , Coloma Ana , Marimón Mariló , Espinach Joan , Andres Marta , Martos Purificación , Carvalho Rodrigues Gonçalo , Limón Enric
Published: March 2023

Background

Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce.

Aim/Objective

The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up.

Methods

A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case.

Findings/results

The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08–2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04).

Discussion

Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence
Short-term fasting and fasting mimicking diets combined with chemotherapy: a narrative review
Authors: Kikomeko Joachim , Schutte Tim , van Velzen Merel J.M. , Seefat Rianne , van Laarhoven Hanneke W.M.
Published: March 2023

Many patients with cancer search for and use alternative and complementary treatments, aiming to improve the effectiveness of their anticancer treatment and a reduction in treatment-associated side effects. Short-term fasting (STF) and fasting mimicking diets (FMDs) are among the most commonly used dietary interventions. In recent years, different trials have reported the promising results of dietary interventions in combination with chemotherapy, in terms of slowing down tumor growth and reduction in chemotherapy-related side effects. In this narrative review, we identify and describe the current evidence about feasibility and effects of STF and FMDs in cancer patients receiving chemotherapy. The studies that examined the effects of STF when combined with chemotherapy suggest potential benefits regarding reduction in side effects and improved quality of life. We also conclude with a list of well-designed studies that are still recruiting patients, examining the long-term effects of STF.
Eurasia in Russian and Chinese Political Expertise: A Comparative Analysis
Authors: Novikov Dmitrii , Bocharova Alexandra
Published: March 2023

Since Russia and China are both leading states on the Eurasian continent, the dynamism of their relations to a large extent dominates the dynamics of geopolitical processes in the region. The growing and escalating stand-off with the West in both countries, notably due to the recent developments in Ukraine, appears likely to further the rapprochement between Moscow and Beijing on many issues of strategic interaction. The relevant question in that context is whether the Russian and Chinese perceptions of Eurasia, of Eurasian regionalism, are truly compatible. In the past few years, Russia has made considerable attempts to foster its vision of an external international order on the continent, including the popularisation and substantiation of Eurasia as a concept with regard to its geopolitical surroundings. One of the main consumers of these ideas was supposed to be China. Have Russian endeavours accomplished their goals? In seeking to provide an appropriate response to this question, the authors have focused on an analysis of both states’ expert and academic discourse on Eurasia and Eurasian regionalism. This article conceptualises Eurasia as a social construct, an element of foreign policy discourse that is intended to be mirrored in academic and expert discourse. A comparative analysis of Russian and Chinese discourses should ascertain – albeit at least in part – the extent to which Beijing has embraced Moscow’s ideas on the development of Eurasian regionalism and the proximity of Russian and Chinese approaches to the international order of the continent or a particular part of it.
Implementation and Evaluation of an Automated Text Message–Based Diabetes Prevention Program for Adults With Pre-diabetes
Authors: Arora Sanjay , Lam Chun Nok , Burner Elizabeth , Menchine Michael
Published: March 2023

Background:

Despite the efficacy of diabetes prevention programs, only an estimated 5% of people with pre-diabetes actually participate. Mobile health (mHealth) holds promise to engage patients with pre-diabetes into lifestyle modification programs by decreasing the referral burden, centralizing remote enrollment, removing the physical requirement of a brick-and-mortar location, lowering operating costs through automation, and reducing time and transportation barriers.

Methods:

Non-randomized implementation study enrolling patients with pre-diabetes from a large health care organization. Patients were exposed to a text message–based program combining live human coaching guidance and support with automated scheduled, interactive, data-driven, and on-demand messages. The primary analysis examined predicted weight outcomes at 6 and 12 months. Secondary outcomes included predicted changes in HbA1c and minutes of exercise at 6 and 12 months.

Results:

Of the 163 participants included in the primary analysis, participants had a mean predicted weight loss of 5.5% at six months ( P < .001) and of 4.3% at 12 months ( P < .001). We observed a decrease in predicted HbA1c from 6.1 at baseline to 5.8 at 6 and 12 months ( P < .001). Activity minutes were statistically similar from a baseline of 155.5 minutes to 146.0 minutes ( P = .567) and 142.1 minutes ( P = .522) at 6 and 12 months, respectively, for the overall cohort.

Conclusions:

In this real-world implementation of the myAgileLife Diabetes Prevention Program among patients with pre-diabetes, we observed significant decreases in weight and HbA1c at 6 and 12 months. mHealth may represent an effective and easily scalable potential solution to deliver impactful diabetes prevention curricula to large numbers of patients.
Adding Nocturnal Advanced Practice Providers to an Academic Inpatient Neurology Service Improves Residents’ Educational Experience
Authors: Yu Andrew T. , Jepsen Nicole , Prasad Sashank , Klein Joshua P. , Doughty Christopher
Published: March 2023

Background and Objectives: In the inpatient academic medical center, increased demand for clinical services often equates to an increased workload for trainees, which could have a positive or negative impact on their educational experience. In 2020, our academic medical center hired Advanced Practice Providers (APPs) to provide continuous additional overnight coverage for our neurology ward teaching service. We hypothesized that adding APPs and reducing overnight clinical workload for residents would have a positive impact on resident education. Methods: We performed a mixed-methods, prospective study that included needs-assessments by residents, semi-structured interviews with both residents and APPs, and surveys to residents and nursing staff. In addition, we collected quantitative data such as hours of sleep, number of admissions, and number of pages to capture the impact of APPs on resident overnight shifts. Results: The addition of APPs overnight increased the median hours of sleep overnight from 1 hour to 3 hours ( P < .001) and decreased the median number of pages overnight from 31.5 to 17 ( P < .001). The median number of patients the resident was responsible for cross-covering overnight decreased from 24 patients to 14 patients ( P < .001). The majority of resident responses (94%) agreed that the addition of APPs benefited their education by reducing workload and increasing time allotted to reading and formulating plans for overnight admissions. 88% of residents agreed that the addition of APPs improved quality of life and reduced risk of burnout. Conclusion: Advanced Practice Providers significantly reduced resident workload, leading residents to report improvements in the educational experience overnight and reduced perceived risk of burnout.
Rash, Facial Droop, and Multifocal Intracranial Stenosis Due to Varicella Zoster Virus Vasculitis
Authors: Bilodeau Philippe-Antoine , Aghajan Yasmin , Izzy Saef
Published: March 2023

Background: This is a case of multifocal intracranial stenosis in a 74 year old male ultimately discovered to be due to Varicella Zoster Virus infection. Purpose: We highlight the importance of a broad differential diagnosis, even when the most likely etiology of intracranial stenosis is atherosclerosis. Our paper reviews the differential diagnosis as well as “red flags” for intracranial vasculopathy. Even though intracranial atherosclerotic disease is the most common cause of vasculopathy, infectious or inflammatory vasculitis should be considered on the differential. Conclusions: Before considering bypass surgery or other invasive neurosurgical procedures, ensure reversible causes of vasculopathy have been ruled out. The presence of cranial neuropathies, rash, and/or elevated inflammatory markers should be red flags for vasculitis in patients presenting with stroke.
Some Macrophages With High Expression of CHOP Undergo Necroptosis in Chronic Rhinosinusitis
Authors: Li Min , Fu Ziming , Qi Chenglin , Wang Qinying , Xie Hui , Li Huabin
Published: March 2023

Background

Endoplasmic reticulum stress (ER stress) is activated in chronic sinusitis with nasal polyps (CRSwNP) and leads to increased expression of C/EBP homologous protein (CHOP). However, the role of CHOP in the pathogenesis of CRSwNP remains unclear.

Methods

CHOP expression was detected by immunohistochemistry staining in nasal mucosa of control and CRSwNP patients. Co-localization of CHOP and cleaved caspase3, p-MLKL, and CD68 was detected by immunofluorescence staining in CRSwNP patients. TNFα, IFNγ, IL1β, LPS, and tunicamycin were added to primary dispersed nasal polyp cells (DNPCs) to explore their roles in cell death. Western blot, CCK8 assay, and flow cytometry were employed to detect cell death.

Results

CHOP was specifically activated in CRSwNP compared to controls. It was mainly macrophages that highly expressed CHOP, some of which underwent apoptosis and the other underwent necroptosis. IL1β induced increased CHOP and apoptosis, and a slight p-MLKL. In addition, ER stress could also promote p-MLKL expression. Whereas classical TNFα plus IFNγ and LPS did not induce increased necroptosis in DNPCs.

Conclusion

IL1β induced the apoptotic pathway and minor necroptosis. And ER stress also plays a role in the occurrence of necroptosis in CRSwNP.