bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of aerodynamic performance by applying the combination of lamellar and 3D wheel deflectors on the SUV model
Authors: Feng Jinyang , Duan Menghua , Qin Ling , Chen Yi , Huang Shunqiao , Wang Qingyang
Published: December 2023

In the developmental phase of an electric SUV model, optimizing the SUV model’s aerodynamic performance often involves the use of wheel deflectors to control airflow around the front wheels. While lamellar wheel deflectors are a common choice for reducing aerodynamic drag, the automotive industry is increasingly embracing 3D wheel deflectors to enhance drag reduction efforts. This study delves into the flow patterns surrounding the front wheels and the drag reduction mechanisms brought about by wheel deflectors. In this research, we harness the strengths of both lamellar and 3D wheel deflectors to introduce a more effective design approach. The conceived wheel deflectors aim to simultaneously decrease aerodynamic drag and lift, a dual-purpose strategy that extends the SUV’s range and optimizes its stability at high speeds. To validate these optimization effects, comprehensive Computational Fluid Dynamics (CFD) simulations and subsequent wind tunnel testing are conducted. The findings presented in this paper establish a crucial foundation for the design and optimization of wheel deflectors, contributing to advancements in the field.
AIDS-related gastrointestinal cytomegalovirus end-organ disease: A retrospective cohort study at a tertiary center in São Paulo, Brazil
Authors: Reis Schneider Gustavo Arthur , Bogoni Giuliane , Castanheira Nidyanara Francine , Lucas Júnior Rodovaldo Moraes , Vidal José Ernesto
Published: December 2023

Background

Current information about AIDS-related gastrointestinal cytomegalovirus end-organ disease (CMV-EOD) is scarce. The objectives of this study were to identify the prevalence and main features of gastrointestinal CMV-EOD in patients with advanced HIV disease.

Methods

Retrospective cohort study carried-out at a tertiary-care center in São Paulo, Brazil, from January to December 2019. We included hospitalized people living with HIV with gastrointestinal CMV-EOD, CD4 + count ≤100 cells/µL, and ≥ one quantitative detection of CMV DNA in plasma.

Results

Ten (3.8%) of 261 cases had gastrointestinal CMV-EOD. Nine (90%) cases were men, age median (IQR) was 44 (38–54) years, and CD4 + cell count median (IQR) was 6 (7–39) cells/µL. The 10 cases had positive quantitative detection of CMV DNA in plasma with median (IQR) of 572 (103–2 981) IU/mL. The main presenting condition was esophagitis ( n = 7, 2.7% cases). Eight (80%) cases received anti-CMV treatment, and one case died due to nosocomial pneumonia.

Conclusions

The prevalence of gastrointestinal CMV-EOD was 3.8%, similar to described in pre-combined antiretroviral therapy studies. Among cases with gastrointestinal CMV-EOD, all had positive quantitative detection of CMV-DNA in plasma but the values varied; esophagitis was the most common presentation, and all but one were discharged from the hospital.
Identifying and Analysing Iran Medical Tourism Development Barriers Using Fuzzy Cognitive Mapping
Authors: Shojaei Payam , Haqbin Arash , Saber Mostafa
Published: December 2023

The medical tourism industry has been observing significant developments in Iran. This country has been attracting tourists from countries in the Middle East and different regions of the world for a long time. However, nowadays, the Iran medical tourism industry faces serious barriers and challenges which deteriorate its participation in the global medical tourism market. The present article aims to investigate the barriers to the development of medical tourism in this country. In this regard, by reviewing the related literature and a weighted content validity ratio (CVR) analysis, 17 critical barriers were identified and finalised. Then, their casual relations were determined using a fuzzy cognitive mapping (FCM) methodology. The data gathered by a panel consisted of 10 experts in the field of medical tourism. The results show that five barriers, including managers’ lack of knowledge, lack of strategic planning, lack of cooperation and coordination, weak government support and lack of enabling tourism sector, are considered the most important. The findings of this research provide opportunities for practitioners and policymakers to concentrate on Iran’s medical tourism in order to overcome the barriers and consequently enhance the development of this lucrative industry.
Calycosin Protects against Focal Cerebral Ischemia/Reperfusion Injury via Inhibiting the HMGB1/TLR4/NF-κB Signaling Pathway
Authors: Wang Yong , Wang Shifeng , Zhang Peng , Xiao Shengjun , Shi Huizhong , Chen Zihan
Published: December 2023

Background

The rate of disability and mortality associated with cerebral ischemia/reperfusion injury (CIRI) is high due to limited treatment options, making it a major challenge to clinical management. Calycosin is a biologically active compound hostile to inflammatory, neuroprotective, and tumor effects. Whether calycosin has an ischemia/reperfusion effect or mechanism is unclear.

Materials and Methods

For in vivo experiments, we randomly divided rats into five groups: blank control group, middle cerebral artery occlusion/reperfusion (MCAO/R) surgical group, calycosin + MCAO/R group (5 mg/kg), calycosin + MCAO/R group (10 mg/kg), and calycosin + MCAO/R group (20 mg/kg). Molding of the middle cerebral artery was performed. Calycosin’s neuroprotective effects were evaluated using the neurological deficit score, brain edema rate, and cerebral infarct volume. For in vitro experiments, we divided PC12 cells into five groups: blank control group, oxygen and glucose deprivation/reperfusion (OGD/R) group, calycosin + OGD/R group (1 × 10−6 mol/L), calycosin + OGD/R group (4 × 10−6 mol/L), and calycosin + OGD/R group (16 × 10−6 mol/L). The optimal concentration of calycosin on PC12 cells was determined using the cell counting kit-8 (CCK-8) cell activity assay. The expression of nuclear factor kappa-B (NF-κB)-related factors was detected using real-time quantitative polymerase chain reaction and Western blotting.

Results

In rats, the MCAO/R model resulted in elevated neurological deficit scores, increased brain infarct volumes, and increased brain edema rates. The OGD/R model decreased rat adrenal pheochromocytoma (PC12) cell activity, and calycosin had a significant cerebral protective effect on PC12 cells under OGD/R conditions. In addition, calycosin can inhibit the activation of the NF-κB pathway, and its neuroprotective effect may be related to the NF-κB pathway.

Conclusion

Calycosin can reduce focal CIRI, and the neuroprotective effect of calycosin may be related to the inhibition of the high mobility group protein 1/toll-like receptor 4 (TLR4)/NF-κB signaling pathways.
Perceived Health Risks, Health Behaviors, and BMI Among Diverse Adults in Israel
Authors: Videl Hila , Levin Chedva , Azulay Chertok Ilana
Published: December 2023

Introduction:

Obesity is associated with an increased relative risk of COVID-19-related mortality. The interplay of culture and religion in the overweight/obesity context has been minimally examined. The purpose of this study was to examine the association between preventive health behaviors, sociodemographic factors, and obesity among religiously diverse adults in Israel.

Methods:

Using a quantitative cross-sectional design, an online survey was distributed to diverse adults in Israel during the pandemic using social media, email, and snowball methods.

Results:

Participants included 635 adults: 69.1% Jewish, 26.5% Muslim, and 4.4% “other.” Jewish adults scored lower than others on perceived personal risk ( p < .001), infection spread risk ( p < .001), and preventive behaviors engagement ( p < .005). Higher body mass index (BMI) predicted higher personal risk and higher likelihood of preventive behaviors engagement ( p < .001).

Discussion:

Results demonstrate the association between religion, health risk perceptions, and COVID-19-related health behaviors. Nurses should consider the influence of culture and religion on health practices and recommend relevant lifestyle modifications to reduce COVID-19 risks.
Analysis of clamped-clamped piezoelectric energy harvester under vortex induced vibration considering the stretching effect
Authors: Alimanesh Mobin , Zamanian Mehdi
Published: December 2023

This paper investigates the middle layer stretching effect on the dynamic behavior of an energy harvester clamped-clamped beam. Two foam cylinders that are attached together as a dumbbell are mounted on the middle part of the beam for vortex-induced vibrations. The piezoelectric patch collects the electrical energy produced by vortex induced vibration. In this analysis the coupled differential equations governing on the structure oscillation, harvested voltage and fluid lift force are established applying the Hamilton’s principle, Gauss law and wake oscillator model. The obtained differential equations are discretized using Galerkin method, and solved by both numerical and analytical perturbation methods. The results demonstrate that middle layer stretching effect has a significant effect on the lock-in domain, and the output electric voltage must be evaluated by considering this effect. It has been shown that for large values of cylinder diameter the difference between numerical and theoretical results increases due to increasing the middle layer stretching effect.
Feasible Adaptation of ESDM for Statewide Implementation: A Look at Potential Effects, Implementation Conditions, and Cost
Authors: Rooks-Ellis Deborah L. , Scheibel Gretchen , Mason Craig , Tu Shihfen
Published: December 2023

This article describes the development and use of a first of its kind statewide implementation of an adapted Early Start Denver Model (ESDM). Supported by a collaborative partnership between stakeholders that included families, state agencies, and a state university, the intervention was implemented within the existing framework of a northeastern state’s relationship-based Individuals with Disabilities Education Act (IDEA) Part C early intervention program. Participants were 194 families. The study examined the effectiveness and implementation costs of an adaptation of the ESDM using a coaching model to inform statewide implementation to improve outcomes for young children with autism spectrum disorder (ASD) in rural and low-resource states. Results indicated 194 children who received a monthly average of 10.90 hr of adapted ESDM for an average of 12 months demonstrated an improvement in the frequency of ASD symptomology for a total cost of US$2,511/child. Intervention intensity and child factors demonstrated varying influence on outcomes. This study contributes to the literature by demonstrating the potential for positive impact of an evidence-based practice scaled to a statewide model of early intervention for young children with ASD.
The Development and Validation of a Measure of Mental Health, Help-Seeking Beliefs in Arabic-Speaking Refugees
Authors: Mastrogiovanni Natalie , Byrow Yulisha , Nickerson Angela
Published: December 2023

Despite reporting elevated rates of posttraumatic stress disorder (PTSD), refugees are less likely than other groups to seek psychological treatment. Relatively little attention has been paid to the role of negative help-seeking beliefs in influencing treatment uptake. The current study sought to develop and psychometrically validate a novel measure indexing negative help-seeking beliefs for refugees (Help-Seeking Beliefs Scale [HSBS]). In this study, 262 Arabic-speaking refugee participants completed an online survey consisting of the HSBS along with measures indexing similar constructs (self-stigma of PTSD and help-seeking, perceived stigma, negative help-seeking attitudes, and help-seeking intentions). Factor analysis revealed a three-factor structure aligning with key themes identified in the literature: (a) Fear of Negative Consequences, (b) Inappropriateness, and (c) Perceived Necessity. The scale demonstrated excellent internal consistency, convergent validity, and predicted reduced help-seeking intentions. Results support the utility of a novel measure capturing a prominent help-seeking barrier in a population with high psychopathology and low treatment uptake.
Are Productive Scientists More Willing to Engage With the Public?
Authors: Bao Luye , Calice Mikhaila N. , Brossard Dominique , Scheufele Dietram A. , Markowitz Ezra M.
Published: December 2023

Scientists are increasingly expected to participate in public engagement around prominent science and technology issues. However, scientists remain concerned that public engagement takes time away from conducting research. Little is known about the relationship between scientists’ productivity and their willingness to participate in different types of public engagement. Using a census survey of scientists from 30 U.S. land-grant universities ( N = 5,208), we find that productive scientists are slightly more willing to participate in public scholarship than less productive scientists. In addition, social science consideration, institutional incentives, and self-efficacy are associated with a greater willingness to participate in public scholarship and informal science education.
Parameters optimum of multiple underframe suspended equipment on high-speed railway vehicle carbody vibration control by using an improved genetic algorithm
Authors: Wang Qunsheng , Zeng Jing , Mao Rancheng , Jiang Xuesong
Published: December 2023

Carbody vibration control and ride comfort improvement are important research parts of high-speed railway vehicle dynamic. The effectiveness of utilizing carbody underframe suspended equipment as dynamic vibration absorbers for carbody vibration suppression has been validated. While previous research has focused mainly on a single suspended equipment without considering its vibration tolerance, a balance must be struck between reducing carbody vibration and maintaining equipment performance. To address the challenging, a multi-objective and multi-parameter optimization method is employed, integrating an improved niche genetic algorithm (INGA) into the numerical simulation process. Considering carbody flexible and multi-suspended equipment, a rigid-flexible dynamics model of a high-speed railway vehicle is established and validated on a vehicle dynamics test rig. Based on the numerical analysis, the optimal parameter combination of the stiffness and the longitudinal installation position is obtained from an evaluation function that comprehensively assesses the vibration performance of both the vehicle carbody and the equipment. Comparative analysis between the results obtained from the optimal and primitive parameters demonstrates that the optimization process not only achieves significant improvements in carbody vibration reduction but also effectively controls equipment vibration within reasonable limits. The multi-objective and multi-parameter optimization method applied on carbody underframe suspended system proves to be valuable in improving the dynamic performance of high-speed railway vehicles.
Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes
Authors: Gruneir Andrea , Chamberlain Stephanie A. , Jensen Charlotte , Cummings Greta , Hoben Matthias , Boamah Sheila , Bosco Clarisse , Ekhlas Sadaf , Bolt Sascha R. , Rappon Tim , Berta Whitney B. , Squires Janet , Estabrooks Carole A.
Published: December 2023

While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014–2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work–life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.
Eclectic Auto-ethno-graphy?
Authors: Badley Graham Francis
Published: December 2023

In this article, I discuss auto-ethno-graphy, here deliberately hyphenated to stress the crucial, constituent elements of the admittedly blurred genre of autoethnographic inquiry. I do so mainly to rescue the genre from the accusation that it is not only blurred but also inevitably uncritical.
The Past and Future of Corporate Sustainability Research
Authors: Burbano Vanessa C. , Delmas Magali A. , Cobo Manuel Jesus
Published: December 2023

Despite the skyrocketing of corporate sustainability research in management, environmental grand challenges like climate change, persist. Given firms’ pivotal role in either improving or worsening these challenges, it is important to consider how corporate sustainability research can affect the resolution of these challenges. Understanding the historical evolution of the cognitive structure of the field facilitates the forecasting of the likely future path of sustainability research. Through the analysis of the co-occurrence of 25,701 keywords in 11,954 sustainability-related articles from 1994 to 2021, we identify and graphically illustrate how ideas in the field have been interconnected, evolved, and are trending. Unexpectedly, we observe that the environmental focus in the literature wanes despite heightened environmental salience. We suggest ways that the trajectory of sustainability research should change to improve our ability to help businesses address environmental challenges. These include reassessing the problem focus, recalibrating theoretical foundations, and reimagining methodologies.
Enhancing student writing with do-it-yourself corpora on a PhD pre-sessional programme
Authors: Therova Dana , McKay Andrew
Published: December 2023

As an effective writing course should focus on disciplines and their unique characteristics, practitioners of English for academic purposes (EAP) are often faced with the challenge of addressing the different needs of learners from various fields of study. This article reports on how a data-driven learning (DDL) approach can be applied to enhance student written production in a multidisciplinary classroom in a 10-week PhD pre-sessional programme at a British University. The participants were six international students who used a do-it-yourself (DIY) corpus in weekly DDL sessions to familiarize themselves with discipline-specific academic writing conventions and applying them in their writing. The effectiveness of this approach was investigated through a ‘talk around texts’ technique employed in semi-structured interviews with individual students and their supervisors on programme completion. The findings show that a DDL approach utilizing a DIY corpus has the potential of enhancing PhD student writing in a multidisciplinary classroom on a pre-sessional programme. This article suggests that DDL could be successfully implemented not only in PhD pre-sessional programmes, but also in wider EAP contexts.
School absenteeism in autistic children and adolescents: A scoping review
Authors: Nordin Viviann , Palmgren Maud , Lindbladh Anna , Bölte Sven , Jonsson Ulf
Published: December 2023

School absenteeism is a major societal problem, with a range of potential adverse long-term consequences. This scoping review aimed to provide a comprehensive overview of the research on school absenteeism in autistic children and adolescents, expose important gaps in the literature, and explore possibilities for future systematic reviews. Five relevant databases were searched systematically from inception to June 2023, yielding a total of 46 eligible reports from 42 separate studies. All studies were conducted in high-income countries, and most were published in the last decade. Three major themes emerged: occurrence, contextual factors, and interventions. The results of large-scale population-based studies clearly suggested that autistic children and adolescents were absent from school more often than their non-autistic peers, which partly was attributable to co-occurring conditions. Bullying also emerged as a potential risk factor. Only a few preliminary studies were available on targeted interventions, emphasizing the need for more robust studies. More research is also needed on the mechanisms leading to and maintaining school absenteeism in this group of learners. Overall, the diversity of research questions, methods, and definitions used in this body of research suggests that systematic reviews with narrow focus on a few key questions may still be premature.

Lay abstract

Autistic children and teenagers are, on average, absent from school more than their peers. The aim of this review was to provide an overview of the research on absence from school in autistic learners in primary and secondary school, to help guide future research. We sifted through 4632 reports and found 42 studies with a focus on school absence and autism. We looked at how, when, and where the studies were conducted. We also summarized the results and outlined how absence was measured in the studies. Absence from school may lead to problems later in life, like incomplete education and unemployment. It is therefore important to know how common this problem is among autistic learners, what the reasons may be, and what type of support they need. The studies were from high-income countries and were mainly published in the last 10 years. Studies based on school registers from the United States and the United Kingdom clearly showed that children and teenagers with autism had higher risk of school absence than those without autism. Absence was often linked to problems with mental health or additional neurodevelopmental conditions. Several studies also showed that absence in autistic children and adolescents was related to problems in school, like bullying or lack of knowledge about autism. Support programs were only evaluated in a few studies with a small number of study participants. We conclude that more research is needed to better understand why autistic learners are absent and what they need to thrive in school.
‘It’s like almost hypnotised people’: An exploration of vernacular discourses and social imaginaries of terrorism in the United Kingdom
Authors: Rodrigo-Jusué Itoiz
Published: December 2023

Despite recent calls for ‘ordinary’ citizens to become active and responsible as individuals in preventing and countering terrorism and radicalisation in the United Kingdom, little is yet known about how members of the general public make sense of political violence, or about how they think it should be dealt with. Using a bottom-up vernacular security studies approach, this article examines what lay citizens believe about the causes of terrorism and what responses they think are appropriate. Based on qualitative data from one-to-one interviews with members of the public and an analysis based on constructivist grounded theory methodology, the article discusses three key figures that emerged from interviewees’ accounts of terrorism: the vulnerable subject, the radicalised individual and the radicaliser. Overall, the results reveal that a radicalisation framework is dominant in participants’ discourses on terrorism. The article argues that the dominant imaginaries of terrorism identified in this research draw consent towards pre-emptive security practices such as the Prevent duty and de-radicalisation interventions. The discussion problematises the depoliticisation of political violence and the normalisation of illiberal security measures that this conceptualisation of terrorism entails, while stressing the discriminatory character of the social imaginaries of terrorism.
Economic Insecurity and the Rise of Anti-Immigrant Sentiments: The Role of Labor Market Risks and Welfare Deservingness Perception
Authors: Lee Jaewook
Published: December 2023

Globalization and technological advancements pose a threat of job loss for native-born citizens, potentially leading to blaming immigrants for economic hardship. This sentiment hinges on the perception that foreign-born residents are not contributing to the host society, often combined with discourse portraying immigrants as competitors regarding welfare benefits. Nevertheless, we have limited knowledge about how labor market risk to job loss is related to anti-immigrant sentiments in tandem with their assessment of the welfare state, such as the deservingness of beneficiaries. Drawing on the European Social Survey, this study examines the relationship between labor market risks, deservingness perception, and anti-immigrant attitudes. First, the extent to which individuals are exposed to job-displacing transformations is negatively associated with a perception of immigrants’ contribution to the host society. Second, in contrast, the perception that welfare recipients are deserving is positively associated with an attitude toward immigrant contribution. Third, the association between the labor market risks and the devaluation of immigrants’ contributions is stronger among individuals who emphasize the deservingness of beneficiaries. We argue that economic insecurity combined with frustration with the fairness of the social welfare system can drive anti-immigrant attitudes.
Digital Volunteers as Trusted Public Health Communicators
Authors: Dunn Silesky Melissa , Sittig Jennifer , Panchal Darshana , Bonnevie Erika
Published: December 2023

Background

Social media influencers are increasingly being positioned by health campaigns as trusted messengers who can share public health information with their communities. There is also an opportunity for campaigns to work with unpaid, digital volunteers (DVs) who want to use their platforms for good, despite not being compensated. DVs are a cost-effective way of supplementing an influencer-driven messaging campaign.

Evaluation Approach

Our influencer and DV network, El Beacon, aims to spread pro-COVID-19 vaccination messages on social media to the Hispanic community. Since 2021, 3,001 DVs have been recruited. Process metrics related to DVs are tracked using a variety of software including Facebook ads manager, Sprout Social, and Hubspot. Metrics received include the number of volunteer sign-ups, cost per lead generated, ad performance, organic and paid impressions and engagement of ads and El Beacon social content, newsletter open rates, newsletter clickthrough rates, and newsletter engagement.

Implications for practice

Understanding best practices for recruiting and retaining DVs for a public health campaign can help other practitioners optimize their experience working with DVs. Some of these best practices include: identify a specific DV target audience that will be most receptive to your message and best reached by your recruitment efforts, be responsive to what resonates with your DVs, be flexible in how you define “network engagement,” and use paid influencers to help build momentum.
Multimodal Prehabilitation for Patients Undergoing Endovascular Aortic Aneurysm Repair Surgery: A Feasibility Study
Authors: Coca-Martinez Miquel , St-Pierre Jade , Girsowicz Elie , Doonan Robert J. , Obrand Daniel I. , Bayne Jason P. , Steinmetz Oren K. , Mackenzie Kent S. , Carli Francesco , Martinez-Palli Graciela , Gill Heather L.
Published: December 2023

Background:

Elective treatment options for aortic abdominal aneurysms include open repair or the less-invasive endovascular aortic aneurysm repair (EVAR). Recovery from EVAR is generally considered easier and faster than open repair. Despite this, EVAR remains a major procedure, and average return to preoperative quality of life is at least 3 months. The purpose of this study is to determine the safety and feasibility of multimodal prehabilitation, a multidisciplinary preoperative optimization intervention, in patients undergoing EVAR and its impact on perioperative functional capacity and quality of life.

Methods:

Candidates for EVAR with an infra-renal abdominal aortic aneurysm <7.5cm were invited to participate in a 6-week multimodal prehabilitation program that included (1) supervised and home-based exercise, (2) nutritional support, (3) psychosocial support, and (4) smoking cessation. Functional capacity and quality of life were assessed at baseline, before surgery and 6 weeks postoperatively. Recruitment rate, safety, and compliance were also assessed.

Results:

A total of 24 patients were included, 17 males (70%) and 7 females (30%). No adverse events occurred during the program. Compliance to each component of the program (median [Q1-Q3]) was 66% [67] for supervised training, 100% [67] for home-based training, and 100% [100] for nutrition. The multimodal prehabilitation program elicited a significant increase in functional capacity and quality of life preoperatively.

Conclusion:

Multimodal prehabilitation for patients awaiting EVAR is feasible and safe. Multimodal prehabilitation improves both functional capacity and quality of life preoperatively. Further research is needed to assess the impact of multimodal prehabilitation on postoperative quality of life and functional capacity.

Clinical Impact

Multimodal prehabilitation is safe and feasible in patients awaiting endovascular aneurysm repair. The importance of this finding is that multimodal prehabilitation can be safely delivered preoperatively in patients awaiting EVAR. Although further research is needed, multimodal prehabilitation seems to improve preoperative functional capacity and quality of life. This could have an impact for the future implementation of prehabilitation interventions in order to increase functional reserve and quality of life preoperatively so that this high-risk population can cope better with the surgical stress and return to their normal life faster postoperatively.
2-Bromopalmitate inhibits malignant behaviors of HPSCC cells by hindering the membrane location of Ras protein
Authors: Wang Chen , Cui Zhao-Yang , Chang Hai-Yan , Wu Chang-Zhen , Yu Zhao-Yan , Wang Xiao-Ting , Liu Yi-Qing , Li Chang-Le , Du Xiang-Ge , Li Jian-Feng
Published: December 2023

Palmitoylation, which is mediated by protein acyltransferase (PAT) and performs important biological functions, is the only reversible lipid modification in organism. To study the effect of protein palmitoylation on hypopharyngeal squamous cell carcinoma (HPSCC), the expression levels of 23 PATs in tumor tissues of 8 HPSCC patients were determined, and high mRNA and protein levels of DHHC9 and DHHC15 were found. Subsequently, we investigated the effect of 2-bromopalmitate (2BP), a small-molecular inhibitor of protein palmitoylation, on the behavior of Fadu cells in vitro (50 μM) and in nude mouse xenograft models (50 μmol/kg), and found that 2BP suppressed the proliferation, invasion, and migration of Fadu cells without increasing cell apoptosis. Mechanistically, the effect of 2BP on the transduction of BMP, Wnt, Shh, and FGF signaling pathways was tested with qRT-PCR, and its drug target was explored with western blotting and acyl-biotinyl exchange assay. Our results showed that 2BP inhibited the transduction of the FGF/ERK signaling pathway. The palmitoylation level of Ras protein decreased after 2BP treatment, and its distribution in the cell membrane structure was reduced significantly. The findings of this work reveal that protein palmitoylation mediated by DHHC9 and DHHC15 may play important roles in the occurrence and development of HPSCC. 2BP is able to inhibit the malignant biological behaviors of HPSCC cells, possibly via hindering the palmitoylation and membrane location of Ras protein, which might, in turn, offer a low-toxicity anti-cancer drug for targeting the treatment of HPSCC.
Identifying appropriate scenario termination rules for squad-level simulations of warfighter lethality
Authors: Biggs Adam T , Hamilton Joseph A , Markwald Rachel R
Published: December 2023

Small arms combat simulations are emerging as a method to convert raw human performance metrics into quantifiable lethality outcomes. Specifically, speed and accuracy measures can be directly converted into a percentage chance of winning a gunfight using small arms combat modeling. Although the technique provides an opportunity to clearly communicate implications to a military audience, there are numerous assumptions to this modeling technique that require further exploration. One critical assumption involves the termination rule, or criterion to identify when the combat simulation should end. The termination rule must be clearly identified because it will impact the casualties inflicted and suffered by each side during simulation. Here, we discuss the implications of three broad categories of termination rules: (1) total victory, (2) retreat criteria, and (3) resource limitations. Each approach has different scenarios that might be more or less advantageous to use as a termination rule. Taken together, this information should help improve lethality modeling procedures using different simulation techniques to convert human performance metrics into quantifiable chances of winning a combat engagement.
Primary Arthrodesis of Non-thumb Metacarpophalangeal Joints of the Hand: Clinical and Patient-Reported Outcomes
Authors: Rode Matthew M. , Strother Courtney Carlson , Welling Benjamin D. , Rizzo Marco
Published: December 2023

Background:

Metacarpophalangeal (MCP) joint arthritis is common secondary to a variety of inflammatory, degenerative, and traumatic causes. Although MCP arthroplasty is more common for the second to fifth digits, primary arthrodesis can be used for high-demand patients with arthritis or unsalvageable fractures of the MCP joint. There has been limited recent studies on the outcomes of these patients.

Methods:

A retrospective review of 38 fingers in 27 patients with primary arthrodesis from 1990 to 2020 was conducted. The major outcomes were complications, reoperations, radiographic union, and time to union. Patient-reported outcomes including the Michigan Hand Outcomes Questionnaire and a questionnaire specific to the operative MCP joint were collected.

Results:

Rate of radiographic union was 84% including revisions. The average time to union was 3.6 months. Rates of complications, reoperation, and amputation were 26%, 16%, and 7%, respectively. Arthrodesis as part of emergent trauma reconstruction was significantly more likely to result in reoperation (50% vs 7%) and complication (63% vs 17%) than chronic arthritis. Patient-reported outcomes were fair to good with improvement in pain (79%), function (66%), and appearance (40%). Sixty-six percent (66%) of patients were satisfied with their surgery, and 73% would repeat the surgery.

Conclusion:

Arthrodesis for unsalvageable MCP fractures was associated with higher rates of reoperation and complication than inflammatory or degenerative arthritis. Excluding emergent trauma, MCP fusion was reliable with a reoperation rate of 7% and a modest complication rate of 17%. Patients rated reasonable levels of satisfaction and willingness to repeat the procedure despite complications.
The Use of a Novel Chimeric Flexor Carpi Ulnaris and Ulnar Artery Flap for Elbow Coverage
Authors: Shafarenko Mark S. , Baltzer Heather L.
Published: December 2023

Elbow defects have a number of etiologies and present a difficult task for the reconstructive surgeon. A number of reconstructive options have been previously reported. We describe a case of a 54-year-old woman with a recurrent elbow defect secondary to prior trauma, surgical fixation, and infection. This was successfully managed with a novel chimeric flexor capri ulnaris and ulnar artery flap for coverage of the defect, which has not been previously described. This may serve as a useful guide for surgeons moving forward.
A war foretold: How Western mainstream news media omitted NATO eastward expansion as a contributing factor to Russia’s 2022 invasion of the Ukraine
Authors: Zollmann Florian
Published: December 2023

This article assesses how Western mainstream news media framed causal factors of Russia’s 2022 invasion of the Ukraine. The article is based on a synthesis and integration of scholarly studies as well as a primary data analysis of Western mainstream newspaper reporting. The research firstly conducts an integrative literature review investigating how Western mainstream news media have reported on Russia and the new Cold War more broadly. Using this as a backdrop, a quantitative and qualitative content study investigates how causes of the 2022 invasion of Ukraine were framed in the US, the UK and the German press. To contextualize news media framing, the second section critically assesses the Western diplomatic and historical record of NATO expansion. The article identifies two competing explanatory frameworks: the dominant Western news media narrative assumes that Russia/Putin’s imperial ambitions and nefarious traits have caused the war, and a second narrative, advanced by several scholars, former diplomats and selected journalists, asserts that NATO’s eastward expansion created the context for Russia’s invasion. The article concludes that the second narrative has been de-emphasized in the news. Such framing is contrary to the historical and documentary record, and links to a marginalization of non-military solutions to solve the conflict.
Review of World Rugby’s Test Method 01 head injury criteria: Procedure analysis and optimisation
Authors: Colino E , Felipe JL , Douglas M , Harrison E , Webb C , del Corral J , Gallardo L , Garcia-Unanue J
Published: December 2023

Rugby is a close-contact sport in which players occasionally fall headfirst to the ground during scrums and tackles. Because head impacts represent an obvious threat to players’ integrity and safety, World Rugby, Rugby’s International Governing Body, developed a test method named Test Method 01 to evaluate the capacity of the playing surface to mitigate head impacts by determining the critical fall height (CFH). The aim of this study is to analyse World Rugby’s current Test Method 01 head injury criteria (HIC), which consider a field as unsafe if the CFH is below 1.3 m. To make this analysis, a pilot study was performed on seven artificial turf rugby fields. At each field, a three-drop procedure was performed to estimate the initial CFH (CFH0). Subsequently, the procedure was repeated on each surface at 50-mm intervals, from 0.6 m below to 0.6 m above CFH0. All possible combinations of four height–HIC data pairs with two height values below and above 1000 HIC were obtained. A comparison was performed between the linear adjustment, currently prescribed in Test Method 01 to calculate the CFH0, and the quadratic adjustment. In particular, the percentage of outliers obtained when applying both the linear and quadratic adjustment and the robustness of the regressions were investigated. The results show that the current Test Method 01 can be improved by applying two main modifications: first, replacing the linear adjustment with a quadratic adjustment, and second, adapting the current test restrictions by maintaining the maximum difference between the highest and the lowest drop heights in 1.00 m, increasing the minimum difference between consecutive drop heights from 0.15 to 0.20 m and removing the current prohibition on obtaining HIC values close to 1000.
Risk factors for interstitial lung disease in rheumatoid arthritis: a cohort study from the KOBIO registry
Authors: Min Hong Ki , Kim Se Hee , Lee Sang-Heon , Kim Hae-Rim
Published: December 2023

Background:

Interstitial lung disease (ILD) is a critical extra-articular manifestation of rheumatoid arthritis (RA). However, little is known about the risk factors of RA-ILD.

Objectives:

Here, we examined the effect of demographic, clinical, therapeutic, and environmental factors on the incidence of ILD in RA patients using the Korean College of Rheumatology Biologics and Targeted Therapy (KOBIO) registry.

Design:

We used data from the KOBIO registry, a multi-center, prospective, observational cohort that included RA patients in South Korea.

Methods:

RA patients who used biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) or conventional synthetic (cs)DMARDs, and were enrolled in the KOBIO registry, were examined. Demographic, clinical, and radiographic characteristics, as well as medications, were recorded at baseline and annually thereafter. Kaplan–Meier curves and the log-rank test were used to compare the incidence of ILD between RA patients taking different b/tsDMARDs. Hazard ratios (HRs) were calculated by Cox regression analyses.

Results:

In total, 2492 patients (1967 in the b/tsDMARDs group and 525 in the csDMARDs group) were analyzed. The b/tsDMARDs group showed longer disease duration, higher erythrocyte sedimentation rate/C-reactive protein, and higher disease activity score-28 (DAS28) than the csDMARDs group. The incidence of ILD was significantly higher in those taking tumor necrosis factor inhibitors and abatacept than in those taking csDMARDs (log ranked p < 0.001). Multivariate Cox regression analysis identified older age (HR = 1.057, p = 0.001), male sex (HR = 2.824, p = 0.007), time-averaged DAS28 (HR = 2.241, p < 0.001), and rheumatoid factor titer (HR = 1.009, p = 0.007) as having a significantly increased HR for ILD occurrence.

Conclusion:

ILD is a rare but critical extra-articular symptom of RA patients. Therefore, RA patients with the above risk factors should be monitored carefully for ILD development.
Fungal empyema thoracis, a rare but an emerging entity: a retrospective case series from Pakistan
Authors: Iqbal Nousheen , Ali Akbar Shoukat , Zahid Aqusa , Jabeen Kausar , Irfan Muhammad
Published: December 2023

Background and objective:

Fungal empyema is a rare entity which is associated with high mortality. It is mostly seen in immune-compromised hosts. However, there is limited data available on fungal empyema from developing countries regarding risk factors, treatment, and outcome. This study was conducted to determine the risk factors, clinical features, treatment, and outcome of fungal empyema.

Methods:

A retrospective observational study was performed on proven fungal empyema cases, admitted at Aga Khan University Hospital, Karachi, Pakistan during January 2018 to May 2021. We excluded all those patients with polymicrobial bacterial and fungal empyema or with negative pleural fluid cultures. A preformed questionnaire was filled out for each case.

Results:

A total of 26 patients were diagnosed with fungal empyema with a mean age of 43.6 ± 20.3 years. Of these, 16 (61.5%) patients were male. Diabetes mellitus was the most frequent comorbidity ( n = 11, 42.3%), followed by hypertension ( n = 9, 34.6%), malignancy ( n = 6, 23.1%), and asthma ( n = 1, 3.8%). Ten (38.5%) patients had multiple comorbidities. Candida spp. was isolated in 21 (80.8%) patients and Aspergillus spp. in 7 (26.9%) patients. Fusarium spp. was isolated from one (3.9%) patient. Video-assisted thoracoscopy surgery was done in 14 (53.8%) patients and 12 (46.1%) patients were managed with tube thoracostomy. Twenty-one (80.8%) patients received antifungal agents. Overall, in-hospital mortality was 38.5% ( n = 10) and all patients developed respiratory failure. Clinical improvement was seen in 16 (61.5%) patients.

Conclusion:

Our data suggest that fungal empyema has a poor outcome as almost one-third of our patients died. Early diagnosis and intervention can improve outcome.
Ultrasound and magnetic resonance imaging neurography assessment of diagnostic criteria in patients with carpal tunnel syndrome using electrophysiological tests as gold standard: A prospective study
Authors: Alkaphoury Mona Gamalludin , Dola Eman F
Published: December 2023

Objectives:

Evaluating peripheral neuropathy mainly relies on physical examination, patient history, and electrophysiological studies. High-resolution ultrasound is a fast, noninvasive modality for dynamic nerve assessment that enables the length of the nerve to be examined. Magnetic resonance imaging is preferred for examining deeper nerves with a high contrast resolution; its use shows excellent benefit in patients with atypical presentation, equivocal diagnosis, suspected secondary causes, and postsurgical relapse. We aimed to assess the measurements and criteria for both ultrasound and magnetic resonance neurography for the diagnosis of carpal tunnel syndrome, based mainly on the three measurements assessed by Buchberger et al.

Methods:

This prospective study was conducted to test diagnostic accuracy. Thirty-two patients who presented clinically with, and were diagnosed by electrophysiological tests as having, carpal tunnel syndrome participated. Superficial ultrasound of the wrist joint was performed on all participants, followed by magnetic resonance imaging within 1 week of ultrasonography.

Results:

The three main parameters of cross-sectional area measurement, distal nerve flattening, and flexor retinaculum bowing indices showed positive occurrences of 93.7%, 59.4%, and 59.4%, respectively; 90.6% of patients had decreased nerve echotexture. The diagnostic ability of magnetic resonance imaging was decreased when cross-sectional area measurements were used: positive results were achieved in 81.2% of patients, but the positive results showing the distal tunnel nerve increased flattening and bowed flexor retinaculum slightly decreased to 56.2% for each. A high T2 signal of the median nerve was observed in 90.6% of patients. In an agreement analysis, we found a statistically significant difference that supported the use of ultrasound as a primary diagnostic modality for carpal tunnel syndrome. However, magnetic resonance imaging improved tissue characterization and was a good diagnostic modality, with a statistically significant difference, for cases of secondary carpal tunnel syndrome, detection of the underlying entrapping cause, and early abnormality detection in the innervated muscle.

Conclusions:

Our results demonstrate that ultrasound examination can be used as the first imaging modality after physician evaluation, with results comparable to those of electrophysiological studies for evaluating carpal tunnel syndrome and determining its cause. Magnetic resonance neurography examination is the second step in detecting secondary causes in cases with suspected early muscle denervation changes that cannot be elicited by ultrasound or in cases with equivocal results.