bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthesis and application of a halogen-free epoxy resin flame retardant curing agent
Authors: Liu Hengyang , Liang Bing , Long Jiapeng 
Published: August 2023

In this study, the intermediate of SPDPC flame retardant curing agent was successfully synthesized through the reaction between phosphorus oxychloride and pentaerythritol under the catalysis of 4-dimethylaminopyridine. Using 1,2-propylenediamine and the prepared SPDPC, a novel phosphorus and nitrogen flame retardant curing agent named poly1,2-propylenediamine pentaerythritol diphosphate (PDS) was successfully synthesized. The target product was subjected to characterization using infrared spectroscopy, mass spectrometry, hydrogen NMR spectroscopy and thermogravimetric analysis. The molecular structure of the product was determined and its decomposition temperature curve obtained, leading to the conclusion that it could be cured at high temperatures. DDS was selected as the curing agent for epoxy E-51, the specific curing conditions were obtained by DSC test. Subsequently, E-51, DDS and PDS were mixed for high temperature curing resulting in obtaining test spline of PDS-E-51 flame retardant composite material. Then, the flame retardancy and mechanical properties of the spline were tested. It was observed that pure EP cured by DDS had an LOI of only 19.5%, indicating its flammability. However, upon addition of PDS as a flame retardant, the LOI significantly increased with 20 parts resulting in an LOI of 29.7%. The addition of 25 parts results in an increase in limiting oxygen index to 30.3%, while the tensile strength and impact strength are measured at 38.27 MPa and 5.087 kJ/m2 respectively. The CCT test shows that the addition of PDS can significantly reduce the HHR and THR of the system. CCT digital photos show that the addition of PDS can make the combustion residue of the system expand obviously, showing a good expansion and flame retardant effect. TG-FTIR gas phase infrared absorption indicates that the addition of PDS can reduce the concentration of combustible gas in the combustion process. Test results indicate that the mechanical properties of PDS-E-51 flame retardant composites experience a certain degree of decline, but with increasing amounts of PDS curing agent added, their flame retardancy is significantly enhanced.
The Role of Reflection in Learning with Simulation Games – A Multi-Method Quasi Experimental Research
Authors: Alf Tobias , de Wijse Marieke , Trautwein Friedrich 
Published: August 2023

Introduction The role of reflection in experience-based learning is discussed widely. This paper researches the effects of a reflection assignment as part of debriefing with qualitative and quantitative methodology in five simulation game-based seminars. Research Design and Methods The intervention (reflection assignment) used in this study consists of three reflective questions that are discussed in groups. We aim to find out the effects of adding this intervention to the regular in-between-debriefings (three times during the whole seminar). The methodological setup is quasi-experimental and so, consisted of a test group and a control group. Two different types of simulation games were used, one a general management game and the other a change management game. Data used in this study is gathered from three different sources: First, we used in-game-performance data from both games. Second, we used two types of questionnaires to evaluate game experience and self-reported learning (MEEGA+ and ZMS inventory). Third, the reflection notes from the treatment-teams were used for qualitative analysis. Results In several dimensions (game-success, game-experience and self-reported learning) significant differences were found between treatment and non-treatment students. Qualitative data show a deep level of reflection for treatment teams differentiating for the two simulation games evaluated. Discussion Supported by the qualitative reflection data we assume that the better results for treatment-students are routed in the repetitive reflection. The permanent circular reflection helps treatment students to understand the games better and gain deeper insights.
Does tele-exercise training for tetraplegia meet the spinal cord injury-specific physical activity guidelines? A 7-month longitudinal study
Authors: Gomes Costa Rodrigo Rodrigues , Dorneles Jefferson Rodrigues , Veloso João Henrique Carneiro Leão , Gonçalves Carlos Wellington Passos , Ribeiro Neto Frederico 
Published: August 2023

Introduction Tele-exercise, defined as an intervention that offers physical training provided remotely, represents an alternative for remote care during social isolation and the absence of in-person interventions, considering the difficulties of regular exercise engagement in tetraplegia. The current study aimed to examine whether tele-exercise training in individuals with tetraplegia meets the recommendations proposed by the spinal cord injury (SCI)-specific guidelines, and the adherence. Methods Twenty SCI tetraplegia performed tele-exercise training. The weekly training load of the tele-exercise training during the 27 weeks was compared to the estimated training load of SCI-specific guidelines: TW vigorous guideline: vigorous intensity of guideline proposed for Tweedy et al.; MG vigorous guideline: vigorous intensity of guideline proposed for Martin Ginis et al.; MG moderate guideline: moderate intensity of guideline proposed for Martin Ginis et al. Adherence was obtained weekly during 27 weeks. Results The tele-exercise training load was 22.0% higher than the MG moderate guideline and 21.6% and 47.7% lower than the MG vigorous and TW vigorous guidelines, respectively. The tele-exercise training loads for men and women were, respectively, 2.3% and 35.0% higher than the MG moderate guideline; 34.0% and 13.2% lower than the MG vigorous guideline; and 56.1% and 42.1% lower than the TW vigorous guideline. Adherence was 45.1%. Conclusion The tele-exercise training in men and women with tetraplegia for 7 months met the moderate intensity of recommendation proposed by one SCI exercise guideline. The adherence was 45.1%, with higher values for men compared to women. This finding shows that tele-exercise training may be an alternative exercise training intervention for tetraplegia and prompts reflexion on the inclusion of tele-exercise training in SCI exercise guidelines.
Feasibility and initial psychometric properties of the observe, reflect, improve children’s learning tool (ORICL) for early childhood services: A tool for building capacity in infant and toddler educators
Authors: Williams Kate E. , Janus Magdalena , Harrison Linda J. , Wong Sandie , Elwick Sheena , McFarland Laura 
Published: August 2023

Child observation is a critical component of quality pedagogy in early childhood education and care (ECEC). The ORICL (Observe, Reflect, Improve Children’s Learning) tool was co-designed by ECEC researchers, policymakers, leaders, and practitioners to support this work. Educators rate the experiences of individual children, and responses of educators and peers on 118 items across five domains. In this study of the utility of ORICL, the tool was used by 21 educators across 12 ECEC services for a total of 66 children. Descriptive statistical analyses were used to determine how educators used the full range of the ORICL rating scale, and the psychometric properties of the tool were explored. Findings suggest that the ORICL items can be readily observed and rated by educators for children aged under 3 years, the rating scale is appropriate, and there is early evidence to support the domain structure of the tool.
Two-year real-world outcome data from a single tertiary centre shows reduced ustekinumab persistence in a non-bio-naïve Crohn’s disease cohort with penetrating disease, -ostomies and sarcopenia
Authors: Inniss Saskia , Fragkos Konstantinos C. , Whitley Lisa , Wimpory Rachel , Rebello Eleanor , Lisboa Ana , Khetan Tanvi , Hassan Jasmine , Simpson Kate , Bhagwanani Anisha , Vega Roser , Parisi Ioanna , Harrow Paul , Seward Edward , McCartney Sara , Bloom Stuart , Smith Andrew M. , Plumb Andrew , Rahman Farooq Z. 
Published: August 2023

Background: Ustekinumab was approved in 2016 for the treatment of moderate–severe Crohn’s disease (CD). Clinical trials and real-world studies have suggested ustekinumab to be a safe and effective treatment; however, studies to date infrequently use imaging techniques to predict response to biologics in CD. Objectives: We assessed the 2-year real-world effectiveness and safety of ustekinumab in a tertiary CD cohort with the use of novel imaging techniques. Design: Retrospective cohort study. Methods: Retrospective data were collected between 2016 and 2021. Study end points included ustekinumab persistence, biological and/or clinical response and remission at 12, 18 and 24 months. Statistical analysis included demographic and inferential analyses. Results: In all, 131 CD patients [57.3% female, median age of 26.0 (21.0–37.0)] were included. Patients were non-bio naïve, and the majority received ustekinumab as third- or fourth-line treatment. At 24 months, 61.0% (80/131) persisted with ustekinumab [52.7% (69/131) steroid free]. Clinical response was reported in 55.2% (37/67), clinical remission in 85.7% (57/67), biological response in 46.8% (22/47) and biological remission in 31.9% (15/47) of patients at 24 months. The low outcome numbers were attributable to missing data. Improvements in routine disease markers, including C-reactive protein and Harvey–Bradshaw Index, were also reflected in magnetic resonance imaging-derived disease scores. The presence of penetrating CD, an -ostomy and sarcopenia were all predictors of poorer ustekinumab outcomes ( p < 0.05). Conclusion: Ustekinumab is effective in non-bio-naïve CD patients with non-stricturing, non-penetrating disease with an unremarkable safety profile but may be less effective in those with penetrating disease, -ostomies and sarcopenia.
Feasibility and acceptability to use a smartphone-based manikin for daily longitudinal self-reporting of chronic pain
Authors: Ali Syed Mustafa , Selby David A , Bourke Darryl , Bravo Santisteban Ramiro D , Chiarotto Alessandro , Firth Jill , James Ben , Parker Ben , Dixon William G , van der Veer Sabine N 
Published: August 2023

Background As management of chronic pain continues to be suboptimal, there is a need for tools that support frequent, longitudinal pain self-reporting to improve our understanding of pain. This study aimed to assess the feasibility and acceptability of daily pain self-reporting using a smartphone-based pain manikin. Methods For this prospective feasibility study, we recruited adults with lived experience of painful musculoskeletal condition. They were asked to complete daily pain self-reports via an app for 30 days. We assessed feasibility by calculating pain report completion levels, and investigated differences in completion levels between subgroups. We assessed acceptability via an end-of-study questionnaire, which we analysed descriptively. Results Of the 104 participants, the majority were female ( n = 87; 84%), aged 45-64 ( n = 59; 57%), and of white ethnic background ( n = 89; 86%). The mean completion levels was 21 (± 7.7) pain self-reports. People who were not working (odds ratio (OR) = 1.84; 95% confidence interval (CI), 1.52-2.23) were more likely, and people living in less deprived areas (OR = 0.77; 95% CI, 0.62-0.97) and of non-white ethnicity (OR = 0.45; 95% CI, 0.36-0.57) were less likely to complete pain self-reports than their employed, more deprived and white counterparts, respectively. Of the 96 participants completing the end-of-study questionnaire, almost all participants agreed that it was easy to complete a pain drawing ( n = 89; 93%). Conclusion It is feasible and acceptable to self–report pain using a smartphone–based manikin over a month. For its wider adoption for pain self–reporting, the feasibility and acceptability should be further explored among people with diverse socio–economic and ethnic backgrounds.
Modeling the intention and usage of medicine vending machine: Using partial least squares-structural equation modelling and necessary condition analysis
Authors: Yang Qing , Al Mamun Abdullah , Gao Jingzu , Makhbul Zafir Khan Mohamed 
Published: August 2023

Objective This study aimed to investigate the factors influencing the intention to use and actual usage of medicine vending machines (MVMs) in China and to close the existing literature gap by examining the relationship between perceived convenience (PC), perceived trust, performance expectancy, effort expectancy, and social influence, on the intention to use MVM in a comprehensive manner. The impact of facilitating conditions on MVM adoption was also examined. Finally, customer age was tested as a moderator. Methods This was a cross-sectional study that used data collected through a self-administered questionnaire. A combination of partial least squares-structural equation modeling (PLS-SEM) and necessary condition analysis (NCA) technique was used to analyze and discuss the 308 valid questionnaires, test the hypotheses, and conduct an in-depth analysis. Results The results showed that PC, perceived trust, and performance expectancy were significantly related to the intention to use MVM. Effort expectancy was a non-significant predictor of intention to use MVM. Social influence was a significant negative predictor of the intention to use MVM. More importantly, performance expectancy was found to be a necessary factor for MVM intention, providing new marketing ideas for MVM owners. Age had a significant moderating effect on the facilitating conditions and intention to use vending machines. The relatively young population is more conscious of the facilitating conditions. Conclusions The findings of this study are of considerable importance as a guide for the main user group of vending machines. The combined analysis and discussion of PLS-SEM and NCA provide a sound theoretical basis for the practical implications of this study. In the future, we will attempt to use this technique in other areas of study. In terms of theoretical implications, this study provides technical references for future research.
Interobserver Agreement and Satisfaction With the use of Telemedicine for Evaluating low Back Pain: A Primary, Observational, Cross-Sectional, Analytical Study
Authors: Dias Jair Moreira , Mendes Adriano Fernando , Pestana de Aguiar Eduardo , Silveira Luan Costa , Noel Dias Maria Fernanda , Barbosa Raposo Nádia Rezende 
Published: August 2023

Study design A primary, observational, cross-sectional, analytical study. Objective The development of a framework for systematic telemedicine (TM) for orthopedic physicians in frequent clinical care may increase agreement in diagnosis and satisfaction among users of TM. Therefore, this study aimed to estimate the agreement in the diagnosis of low back pain (LBP) between TM, systematized by a self-completed digital questionnaire, and face-to-face (FF) care in patients with LBP. Methods This study included adults up to 75 years of age with LBP for more than 6 weeks. They were evaluated at 2 independent time points (TM and FF) by different orthopedists with 3 different levels of expertise. Professionals evaluated the sample without prior knowledge of the diagnosis, and each orthopedist provided a diagnosis. Diagnostic agreement was the primary outcome. Secondary outcomes were the duration of the visit and satisfaction among healthcare professionals. Results A total of 168 participants were eligible, of whom 126 sought care through TM and 122 sought FF care (mean age, 47 years [range, 18-75 years]; 66.4% women). The agreement among professionals regarding the diagnosis was moderate (kappa = .585, P = .001). TM was faster than FF (11.9 minutes (standard deviation = 4.1) vs 18.6 (SD = 6.9), P < .001). Professional satisfaction was higher among spine specialists than among orthopedic residents and orthopedists who were not specialists in spine surgery. Conclusion Agreement in diagnosis was moderate for TM, with a 30% shorter visit duration than FF. Satisfaction varied by professional expertise and was higher among spine specialists than among professionals with other expertise.
Predicting the Risk of Injuries Through Assessments of Asymmetric Lower Limb Functional Performance: A Prospective Study of 415 Youth Taekwondo Athletes
Authors: Guan Yanfei , Bredin Shannon S.D. , Taunton Jack , Jiang Qinxian , Wu Nana , Warburton Darren E.R. 
Published: August 2023

Background: The impact of interlimb asymmetries on sport injuries is unclear because of inconsistent findings, and there is a lack of research on youth athletes and the sport of taekwondo. Purpose: To examine the effects of functional interlimb asymmetries on noncontact lower limb injuries in youth athletes. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 415 taekwondo athletes (318 boys and 97 girls) aged 6 to 17 years underwent baseline testing to determine interlimb asymmetries through the single-leg countermovement jump (CMJ), hop, and triple hop tests as well as the Star Excursion Balance Test. The athletes were then evaluated for 12 months to observe the occurrence of noncontact lower limb injuries. Results: During the study, 98 athletes (70 boys and 28 girls) sustained at least 1 noncontact lower limb injury. Athletes with higher interlimb asymmetries in single-leg CMJ height showed a significantly increased risk of noncontact lower limb injuries (boys: odds ratio [OR], 1.053 [95% CI, 1.027-1.080], P < .001; girls: OR, 1.070 [95% CI, 1.016-1.128], P = .011). Asymmetry in single-leg CMJ height of ≥15.28% was found to be the cutoff point for predicting noncontact lower limb injuries in boys (OR, 4.652 [95% CI, 2.577-8.398]; P < .001). Conclusion: This study highlights the utility of interlimb asymmetries in unilateral jump performance as a tool for assessing the risk of noncontact lower limb injuries in youth taekwondo athletes of both sexes. A proper evaluation of interlimb asymmetries may improve prevention strategies for youth athletes.
Midterm Clinical Outcomes After Arthroscopic Rotator Cuff Repair in Olympic Volleyball Players: Return to Sports and Return to Performance
Authors: Porcellini Giuseppe , Ziroglu Nezih , De Santis Elisa , Micheloni Gian Mario , Tarallo Luigi , Giorgini Andrea 
Published: August 2023

Background: The decision-making process and predicting the time to return to sport (RTS) and return to performance (RTP) after arthroscopic rotator cuff repair (ARCR) in elite volleyball players are difficult issues to address, even among experienced shoulder surgeons. Purpose/Hypothesis: The purpose of the study was to evaluate the results in Olympic-level volleyball players treated with arthroscopic supraspinatus repair and to report the RTS and the RTP. It was hypothesized that these athletes had higher RTS and faster RTP. Study Design: Case series; Level of evidence, 4. Methods: This study included 17 elite volleyball athletes (11 male, 6 female; mean age, 26.2 years) who underwent ARCR for partial- and full-thickness supraspinatus tears that did not improve despite nonoperative treatment. The clinical results were evaluated at 12 months postoperatively. The authors compared the athletes’ preoperative, 6-month, and 12-month Kerlan-Jobe Orthopaedic Clinic (KJOC) scores and the visual analog scale (VAS) for pain after competition and conducted 6- and 12-month isometric strength analyses. The athletes’ RTS and RTP times were recorded. Results: All tears were on the dominant side (15 right, 2 left), and 82% were partial tears (14 partial thickness, 3 full thickness). The mean time from the onset of symptoms to surgery was 11.3 ± 6.7 months. While the mean Kerlan-Jobe Orthopaedic Clinic score was 31 preoperatively, it was 89 after 6 months ( P < .001 vs preoperative) and 96 after 12 months ( P = .003 vs 6 months). The mean VAS for pain was 7.9 preoperatively, 0.4 at 6 months ( P < .001 vs preoperative), and 0.1 at 12 months ( P = .02 vs 6 months). All athletes were able to reach their preinjury level, with RTS at a mean of 6.9 months and RTP at a mean of 12.4 months. Conclusion: ARCR appears to be an effective option for Olympic-level volleyball players who do not benefit from nonoperative treatment. All athletes returned to their preinjury level of sports. The surgeon and athlete can plan surgical decision-making and timing based on the mean RTS time of 6.9 months and mean RTP time of 12.4 months.
LepR+ niche cell–derived AREG compromises hematopoietic stem cell maintenance under conditions of DNA repair deficiency and aging
Authors: Wu Limei , Lin Qiqi , Chatla Srinivas , Amarachintha Surya , Wilson Andrew F. , Atale Neha , Gao Zhenxia J. , Joseph Jonathan , Wolff Emily V. , Du Wei 
Published: August 2023

Abstract
The cross talk between extrinsic niche-derived and intrinsic hematopoietic stem cell (HSC) factors controlling HSC maintenance remains elusive. Here, we demonstrated that amphiregulin (AREG) from bone marrow (BM) leptin receptor (LepR+) niche cells is an important factor that mediates the cross talk between the BM niche and HSCs in stem cell maintenance. Mice deficient of the DNA repair gene Brca2, specifically in LepR+ cells (LepR-Cre;Brca2fl/fl), exhibited increased frequencies of total and myeloid-biased HSCs. Furthermore, HSCs from LepR-Cre;Brca2fl/fl mice showed compromised repopulation, increased expansion of donor-derived, myeloid-biased HSCs, and increased myeloid output. Brca2-deficient BM LepR+ cells exhibited persistent DNA damage–inducible overproduction of AREG. Ex vivo treatment of wild-type HSCs or systemic treatment of C57BL/6 mice with recombinant AREG impaired repopulation, leading to HSC exhaustion. Conversely, inhibition of AREG by an anti–AREG-neutralizing antibody or deletion of the Areg gene in LepR-Cre;Brca2fl/fl mice rescued HSC defects caused by AREG. Mechanistically, AREG activated the phosphoinositide 3-kinases (PI3K)/AKT/mammalian target of rapamycin (mTOR) pathway, promoted HSC cycling, and compromised HSC quiescence. Finally, we demonstrated that BM LepR+ niche cells from other DNA repair–deficient and aged mice also showed persistent DNA damage–associated overexpression of AREG, which exerts similar negative effects on HSC maintenance. Therefore, we identified an important factor that regulates HSCs function under conditions of DNA repair deficiency and aging.