bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vinyl-ester nanocomposites based on a binary-solvent system for well-exfoliated graphene and enhanced performance
Authors: Mirzapour Miraidin , Robert Mathieu , Benmokrane Brahim 
Published: February 2024

This paper introduces a green approach for preparing well-dispersed graphene nanoplates (GNPs) in vinyl-ester (VE) resin. The GNPs were exfoliated in a novel binary-solvent system comprised of a water and ethanol mixture (S nanocomposites). Water and ethanol were considered poor solvents for graphene, but a combination of them could be an ideal solvent mixture. TEM images of the S nanocomposites revealed well-exfoliated graphene sheets with a few wrinkles. Hence, the effective surface areas of the GNPs considerably increased, playing a vital role in enhancing the performance of the nanocomposites. With the incorporation of just 0.4 wt% of exfoliated GNPs (S2 nanocomposite) in the VE, the tensile strength, and toughness enhanced by 51%, and 63%, respectively. Fractography analysis indicated smooth fracture surfaces of pure resin changed to very rough surface structures for the S2 nanocomposite. The viscoelastic properties of the specimens indicated that directly loading GNPs into the resin decreased the glass transition temperature (Tg) of the VE resin. In contrast, the samples prepared by liquid-phase exfoliation enhanced the Tg of the VE. Lastly, the barrier properties of the S2 nanocomposite revealed that its water absorption decreased by 26% compared to the pure resin.
Educational Attainment and Perceived Need for Future ADL Assistance
Authors: Finan Julia M. , Landes Scott D. 
Published: February 2024

The current study examined whether educational attainment was associated with perceived need of assistance with future activities of daily living (ADL) among middle-aged and early older-aged adults in the United States. Data for 54,946 adults aged 40–65 years from the 2011–2014 National Health Interview Survey (NHIS) were analyzed using ordered logistic regression. Adults with more education will on average need less ADL assistance than adults with less education. Paradoxically, this study found that higher levels of formal education were associated with perceiving more need for future ADL assistance. This association was also found to vary between males and females. Building knowledge of long-term care planning into existing public educational structures and providing this knowledge to adults no longer involved in the formal educational system through medical providers may lead to better anticipation of future care needs.
Phenotypic and genotypic characterization of Neisseria gonorrhoeae isolates among individuals at high risk for sexually transmitted diseases in Zurich, Switzerland
Authors: Jünger Christian , Imkamp Frank , Balakrishna Suraj , Gysin Marina , Haldimann Klara , Brugger Silvio D , Scheier Thomas C , Hampel Benjamin , Hobbie Sven N , Günthard Huldrych F , Braun Dominique L 
Published: February 2024

Background While ceftriaxone resistance remains scarce in Switzerland, global Neisseria gonorrhoeae (NG) antimicrobial resistance poses an urgent threat. This study describes clinical characteristics in MSM (men who have sex with men) diagnosed with NG infection and analyses NG resistance by phenotypic and genotypic means. Methods Data of MSM enrolled in three clinical cohorts with a positive polymerase chain reaction test (PCR) for NG were analysed between January 2019 and December 2021 and linked with antibiotic susceptibility testing. Bacterial isolates were subjected to whole genome sequencing (WGS). Results Of 142 participants, 141 (99%) were MSM and 118 (84%) living with HIV. Participants were treated with ceftriaxone ( N = 79), azithromycin ( N = 2), or a combination of both ( N = 61). No clinical or microbiological failures were observed. From 182 positive PCR samples taken, 23 were available for detailed analysis. Based on minimal inhibitory concentrations (MICs), all isolates were susceptible to ceftriaxone, gentamicin, cefixime, cefpodoxime, ertapenem, zoliflodacin, and spectinomycin. Resistance to azithromycin, tetracyclines and ciprofloxacin was observed in 10 (43%), 23 (100%) and 11 (48%) of the cases, respectively. Analysis of WGS data revealed combinations of resistance determinants that matched with the corresponding phenotypic resistance pattern of each isolate. Conclusion Among the MSM diagnosed with NG mainly acquired in Switzerland, ceftriaxone MICs were low for a subset of bacterial isolates studied and no treatment failures were observed. For azithromycin, high occurrences of in vitro resistance were found. Gentamicin, cefixime, cefpodoxime, ertapenem, spectinomycin, and zoliflodacin displayed excellent in vitro activity against the 23 isolates underscoring their potential as alternative agents to ceftriaxone.
Improving awareness and uptake of pre-exposure HIV prophylaxis amongst service users accessing Sexual Health London, a regional online postal sexually transmitted infection testing health service
Authors: Caoimhe Curran , Spate Jonathan , Day Sara 
Published: February 2024

Background The UK pledged commitment to the global strategy of zero new HIV infections and HIV-related deaths by 2030. PrEP was commissioned in England in 2020 and is fundamental to achieving these targets, yet awareness and uptake are suboptimal in certain populations. Method Sexual Health London (SHL) incorporated questions on its e-triage questionnaire estimating need for PrEP amongst online service users. Two types of signposting messaging were shown to users directing them to more detailed online content: PrEP-discussion (potential need) and PrEP-eligible (assumed need). The effectiveness of this signposting was evaluated by reviewing demographics and triage responses in returning users. Results 426,149 SHL users requested STI screening between 1.7.21-31.10.22. 16% (69,867/426,149) and 32.2% (137,489/426,149) of individuals received PrEP-eligible and PrEP-discussion signposting. The PrEP-eligible cohort were: 41.0% gay/bisexual or other men who have sex with men (GBMSM), 16.3% heterosexual males, 33.1% heterosexual females, and 60.6% were of white ethnicity. The PrEP-discussion cohort were: 9.3% GBMSM, 34.3%% heterosexual males, 45.5% heterosexual females and 63.7% of white ethnicity. 50.4% (35,190/69,867) and 41.3% (56,808/137,489) of the PrEP-eligible and PrEP discussion cohorts ordered a subsequent SHL STI testing kit, during which 10.0% (3510/35,190) and 5.9% (3364/56,808) reported taking PrEP. Of those who denied taking PrEP, 59% (18,702/31,680) and 61.0% (32,559/53,444) triggered PrEP signposting again. 95.4% of PrEP starters were GBMSM (6562/6874) and 1.4% (97/6874) heterosexual males/females. Conclusion The e-service demonstrated feasibility in estimating PrEP need and signposting service users. Up to 16% of returning users subsequently commenced PrEP. This highlights significant missed opportunities for the remaining online users, who continue to report HIV acquisition risk(s). Further efforts regionally/nationally to optimise uptake of PrEP, particularly among under-represented groups are warranted.
Do benzodiazepines reduce the efficacy of transcranial magnetic stimulation?
Authors: Tran Lana , Hahn Lisa , Gill Shane , Ng Felicity , Clarke Patrick , Paterson Tom , Galletly Cherrie 
Published: February 2024

Objective To investigate the effect of concomitant use of benzodiazepines on the efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant major depressive disorder (TR-MDD). Methods This is a retrospective study comparing rTMS treatment outcomes between patients taking benzodiazepines ( n = 59) and those who were not ( n = 136). Participants completed the HAM-A, HAM-D17, MADRS and ZUNG at baseline and at the end of treatment. Results Patients taking benzodiazepines during rTMS treatment did not show any difference in partial response, response or remission rates compared to patients not treated with benzodiazepines. There was a significant decrease ( p < .0001) in depression and anxiety scores from baseline to post-treatment among both groups. Conclusions Concomitant benzodiazepine treatment had no effect on the efficacy of rTMS treatment of TRD, contrary to previous research.
Vibration isolation characteristics of a novel composite flexible vibration-damping foundation
Authors: Qin Yuxuan , Pang Fuzhen , Tang Yang , Lin Yaotao , Zhang Hang , Li Haichao 
Published: February 2024

To address the challenge of low-frequency vibration in ships, we introduce a vibration isolation technique and a composite flexible vibration-damping foundation grounded in the principles of impedance equalization and the off-plane attenuation properties of surface waves. We utilize a fluid-structural coupling finite element method and experimental validation to analyze the effect of various properties of the liquid layer of the base. The results indicate that the composite foundation offers superior vibration isolation compared to traditional foundations across a frequency range of 10–500 Hz. Enhancements in the liquid’s viscosity and an increased layer thickness are found to significantly bolster the foundation’s ability to isolate vibrations. The relationship between liquid density and the vibration isolation performance of the base is not entirely positive. An increase in liquid density does provide some improvement to the vibration isolation performance at higher frequencies. Additionally, the presence of multiple liquid sacs within the foundation has a minimal influence on low-frequency isolation but proves to be increasingly beneficial at higher frequencies. Through this study, we aim to provide fresh perspectives and solutions for the attenuation and management of low-frequency vibrations in ships.
What happens when private general practitioners receive incentivisation offers from pharmaceutical sales representatives? A qualitative study in Pakistan
Authors: Noor Muhammad Naveed , Rahman-Shepherd Afifah , Khan Sabeen Sharif , Hasan Rumina , Siddiqui Amna Rehana , Azam Iqbal , Bhutto Faiza , Isani Afshan Khurshid , Siddiqi Sameen , Khan Robyna Irshad , Shakoor Sadia , Khan Mishal 
Published: February 2024

Objectives Pharmaceutical incentivisation of physicians for profit maximisation is a well-documented health system challenge. This study examined general practitioners’ (GPs) reactions to pharmaceutical incentivisation offers in one region in Pakistan. Methods We used the Standardised Pharmaceutical Sales Representative (SPSR) method and qualitative interviews with GPs. SPSRs were field researchers representing mock pharmaceutical companies who recorded their observations of 267 GPs’ responses to pharmaceutical incentivisation offers. We triangulated SPSR data using qualitative interviews with a subset of the same GPs to gather information about how they interpreted different interaction outcomes. Results We found four major outcomes for GPs being offered incentives by pharmaceutical companies for prescribing medications. GPs might agree to make incentivisation deals, reject incentivisation offers, disallow PSRs to access them, or remain indeterminate with no clear indication of acceptance or rejection of incentivisation offers. GPs rejecting SPSRs’ incentivisation offers indicated having active commitments to other pharmaceutical companies, not being able to work with unheard-of companies, and asking SPSRs to return later. Conclusions The GP-pharmaceutical sales representative interaction that centres on profit-maximisation is complex as offers to engage in prescribing for mutual financial benefit are not taken up immediately. The SPSR method helps understand the extent of distortion of practices impacted by incentivisation. Such an understanding can support the development of strategies to control unethical behaviours.
Assessment of dementia knowledge in Indian speech-language pathology students
Authors: Chandrashekar Pooja , Nagaraj Hema 
Published: February 2024

Objectives Speech-language pathologists (SLPs) have a crucial role in assisting individuals with dementia due to the communication and swallowing challenges associated with the disease. As the number of dementia cases rises in India at an increasing rate, investigating the level of dementia knowledge of SLP students can offer insight into the preparedness of the healthcare system to meet this emerging demand. Method A cross-sectional survey was conducted on SLP students pursuing their final year undergraduate, postgraduate and doctoral degrees from four universities across India. Dementia knowledge was assessed using the Dementia Knowledge Assessment Scale (DKAS) and information about previous dementia exposure (both formal and informal) was collected. The collected data were analysed using quantitative methods. Results A total of 220 students (64.70% response rate) completed the survey. Overall dementia knowledge was inadequate with an average score of 22.08 ± 10.06. Previous dementia exposure among the students was also found to be low and did not affect dementia knowledge scores. Discussion Despite the fundamental role SLPs play in the care of individuals with dementia, the lack of knowledge in this area emphasizes the need for enhancing dementia training programs through educational curricula and clinical placements.
Middle-phalanx-base radiographic morphology and its clinical implications
Authors: Tay Poi Hoon , Lim Zhixue , Cheah Andre Eu Jin 
Published: February 2024

The aim of this study was to establish normative values for the teardrop angle at the base of the middle phalanx. Our results showed a consistent mean teardrop angle in the range of 50°–51°, with no statistically significant difference observed between digits. Level of evidence: III
Diagnostic and treatment recommendations for recurrent or persistent symptoms after trapeziectomy: a Delphi study
Authors: Herren Daniel B. , Boeckstyns Michel , Chung Kevin C. , Farnebo Simon , Hagert Elisabet , Tang Jin Bo , Verstreken Frederik ,   the FaiTh study group, Marks Miriam 
Published: February 2024

The aim of this Delphi study was to provide a diagnostic and treatment algorithm for patients with persistent or recurrent symptoms after trapeziometacarpal joint resection arthroplasty. Three Delphi rounds were conducted in which surveys were sent to 182 experienced hand surgeons worldwide. Responses were received from 140 participants. A consensus threshold was set at 67% agreement. Diagnostic tools and treatment approaches for six common revision scenarios achieved consensus. Radiographs are appropriate as primary (97%) and CT scans as secondary (76%) diagnostic tools. For scaphometacarpal impingement, 67% of respondents agreed that revision interposition is appropriate, with 93% recommending autologous tendon for the interposition. Additional suspension was considered appropriate by 68% of the participants. The diagnostic and treatment algorithm can help the surgeon to identify the reason for persistent symptoms after trapeziometacarpal joint resection arthroplasty and to choose an appropriate treatment strategy. Level of evidence: V
The Influence of Psychosocial Factors on Patients Undergoing Anterior Cruciate Ligament Reconstruction
Authors: Momaya Amit M. , Wood Audria S. , Benson Elizabeth M. , Kwapisz Adam L. 
Published: February 2024

Context: Anterior cruciate ligament (ACL) injuries greatly impact patients in terms of future performance, reduced physical activity and athletic participation, and overall economic burden. Decades of research have investigated how to improve ACL reconstruction (ACLR) outcomes. Recently, there has been growing interest to understand the effects of psychosocial factors on patient outcomes. Study Design: Clinical review. Evidence Acquisition: A search of the PubMed database was performed in March 2023. Articles were reviewed by at least 2 authors to determine relevance. We highlighted publications of the past 5 years while incorporating previous pertinent studies. Level of Evidence: Level 5. Results: There is no standardization of psychosocial factors regarding ACLR. As such, there is a lack of consensus regarding which psychosocial measures to use and when. There is a need for clarification of the complex relationship between psychosocial factors and physical function. Despite this, psychosocial factors have the potential to help predict patients who are more likely to return to sport: (1) desire/motivation to return; (2) lower levels of kinesiophobia; (3) higher levels of self-efficacy, confidence, and subjective knee function; (4) risk acceptance; and (5) social support. However, there are no standardized interventions to improve psychosocial factors after ACLR. Conclusion: Psychosocial factors affect outcomes after ACLR. However, the interplay between psychosocial factors and physical function is complex. There is emerging evidence that testing and interventions may improve ACLR outcomes. There is a lack of standardized interventions to determine or improve psychosocial factors after ACLR. Further research is needed to identify psychosocial factors and to develop standardized interventions for clinicians to implement to improve clinical outcomes.
Telemedicine in the age of the pandemics: The prospects of web-based remote patient monitoring systems for orthopaedic ambulatory care management in the developing economies
Authors: Onyeabor Uchechukwu Solomon , Okenwa Wilfred Okwudili , Onwuasoigwe Okechukwu , Lasebikan Omolade Ayoola , Schaaf Thorsten , Pinkwart Niels , Balzer Felix 
Published: February 2024

Objective The goal of this research was to demonstrate the efficacy of telemedicine via design, implementation and evaluation of a web-based remote patient monitoring system (WB-RPMS) across the tertiary/university teaching hospitals in a developing country Nigeria, as a tool to continue to expand access to an affordable and resilient tertiary healthcare system through the challenging times of the COVID-19 pandemic or any future disruptions. Methods This research employed an agile and human-centred design thinking philosophy, which saw the researchers iteratively collaborate with clinicians across the system development value chain. It also employed qualitative and quantitative research methods for new system evaluations. After the system's development, a 20-patient sample was randomly selected from members of the National Youth Service Corp to evaluate the WB-RPMS Patient Portal for usability and user experience through a survey based on the system usability scale. Again, the COREQ standards for reporting research result were adopted for this study. Results The evaluation of the WB-RPMS Patient Portal by a select patient sample showed that 95.0% of the respondents believed that they would like to use the system frequently. It was also discovered that 90.0% of all respondents also indicated that they found the Patient Portal to be simple; 85.0% of the respondents believed and indicated that the WB-RPMS Patient Portal was easy to use. Conclusions The result of the usability evaluation of the developed WB-RPMS Patient Portal showed that it was well received by the select patient sample and by the clinicians who participated in the development process. In fact, the performance of the system shows that it has the potential to remotely support and sustain improved access to affordable healthcare for outpatients in developing countries even during times of uncertainties and disruptions as recently occasioned by COVID-19 pandemic.
Internet hospital response to the COVID-19 pandemic in a tertiary hospital in China: Perspectives based on a mixed-methods
Authors: Wu Xiaolong , Kuang Yulin , Guo Yonglin , Wu Ji , Xiao Li 
Published: February 2024

Objective This study aimed to summarize the characteristics of the Internet hospital services of the Seventh Affiliated Hospital of Sun Yat-sen University (SAHSYSU), describe diagnosis and treatment patterns in each department, determine SAHSYSU Internet hospital's role in pandemic control, and explore development strategies in non-pandemic situations. Methods Mixed-methods was used in this study. Qualitative organizational behavior analysis was conducted on hospital meeting records and semi-structured interview records to determine the research analysis indicators. We quantitatively analyzed online consultation record data of SAHSYSU Internet hospital from January to December 2020, and conduct classification analysis on departmental case studies using K-means clustering algorithm. Results 29,944 patient data items were retrieved. Internet hospital services synchronized with COVID-19 pandemic development in China and Guangdong province. The service volume peaked during the period of January to March, which coincided with the height of the pandemic. Out of the total visits, 58.90% were conducted during office hours while 41.10% were conducted during non-office hours. The majority of the patients came from Guangdong (19.67%) and Hubei (9.09%) provinces. The cluster analysis identified three clusters, each with different change rates and magnitudes of change for various departments. Conclusion Internet hospitals complemented conventional medical services, providing crucial medical care during the COVID-19 pandemic. Internet hospitals are the future trend of medical services and should be improved based on each department's treatment characteristics.
Long-Term Functional Outcomes and Athletic Ability in Shoulder Sports After Anatomic Coracoclavicular Ligament Reconstruction for Chronic Type 3 and 5 Acromioclavicular Joint Injuries
Authors: Muench Lukas N. , Berthold Daniel P. , Rupp Marco-Christopher , Dorsey Caitlin G. , Hawthorne Benjamin , Trudeau Maxwell T. , Wolf John D. , Wellington Ian , Mazzocca Augustus D. 
Published: February 2024

Background: Promising short- and midterm outcomes have been seen after anatomic coracoclavicular ligament reconstruction (ACCR) for chronic acromioclavicular joint (ACJ) injuries. Purpose/Hypothesis: To evaluate long-term outcomes and shoulder-related athletic ability in patients after ACCR for chronic type 3 and 5 ACJ injuries. It was hypothesized that these patients would maintain significant functional improvement and sufficient shoulder-sport ability at a long-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: Included were 19 patients (mean age, 45.9 ± 11.2 years) who underwent ACCR for type 3 or 5 ACJ injuries between January 2003 and August 2014. Functional outcome measures included the American Shoulder and Elbow Surgeons (ASES), Rowe, Constant-Murley, Simple Shoulder Test (SST), and Single Assessment Numeric Evaluation (SANE) scores as well as the visual analog scale (VAS) for pain, which were collected preoperatively and at the final follow-up. Postoperative shoulder-dependent athletic ability was assessed using the Athletic Shoulder Outcome Scoring System (ASOSS). Shoulder activity level was evaluated using the Shoulder Activity Scale (SAS), while the Subjective Patient Outcome for Return to Sports (SPORTS) score was collected to assess the patients’ ability to return to their preinjury sporting activity. Results: The mean follow-up time was 10.1 ± 3.8 years (range, 6.1-18.8 years). Patients achieved significant pre- to postoperative improvements on the ASES (from 54.2 ± 22.6 to 83.5 ± 23.1), Rowe (from 66.6 ± 18.1 to 85.3 ± 19), Constant-Murley (from 64.6 ± 20.9 to 80.2 ± 22.7), SST (from 7.2 ± 3.4 to 10.5 ± 2.7), SANE (from 30.1 ± 23.2 to 83.6 ± 26.3), and VAS pain scores (from 4.7 ± 2.7 to 1.8 ± 2.8) ( P < .001 for all), with no significant differences between type 3 and 5 injuries. At the final follow-up, patients achieved an ASOSS of 80.6 ± 32, SAS level of 11.6 ± 5.1, and SPORTS score of 7.3 ± 4.1, with no significant differences between type 3 and 5 injuries. Four patients (21.1%) had postoperative complications. Conclusion: Patients undergoing ACCR using free tendon allografts for chronic type 3 and 5 ACJ injuries maintained significant improvements in functional outcomes at the long-term follow-up and achieved favorable postoperative shoulder-sport ability, activity, and return to preinjury sports participation.