Sleep and insulin sensitivity in adolescents at risk of type 2 diabetes: the Sleep Manipulation in Adolescents at Risk of Type 2 Diabetes randomized crossover study

STUDY OBJECTIVES

To investigate the effect of increasing sleep duration for 1 week, compared to a week of habitual and decreased sleep, on insulin sensitivity (IS) in adolescents at risk for type 2 diabetes (T2D).

METHODS

Adolescents, 13-18 years old, at risk for T2D, with obesity and other risk factors, were recruited for a randomized (1:1), open-label, sex-stratified crossover study, that manipulated time-in-bed to modify sleep duration (measured by actigraphy). Following a week of habitual (HB) sleep, time-in-bed was increased (IN) and decreased (DE) by 1 hour 30 min/night for 1 week, counterbalanced across participants (HBINDE or HBDEIN), and separated by a week of washout sleep. The main outcome measure was IS, obtained via 2-hour oral-glucose-tolerance-test conducted after each sleep week.

RESULTS

Of the 43 participants recruited, 36 (84%) completed all sleep interventions (52.8% female, age = 15.1 years, body mass index = 99.9th percentile, order: HBINDE = 18 and HBDEIN = 18). On average, during the HB week, participants slept 7 hours 31 min/night; sleep duration was 1 hour 02 min/night higher during the IN week and 1 hour 19 min/night lower during the DE week. We found a significant effect of sleep week on IS with a large effect size. Following the IN sleep week, IS was 20% higher compared to after the HB and DE sleep weeks, but there was no significant difference in IS following HB versus DE sleep weeks.

CONCLUSIONS

Whenever possible, clinicians should empower youth at risk of T2D to improve their sleep duration, since even a modest increase in sleep duration of 1 h/night for 1 week can have a positive impact on IS in this population.

CLINICAL TRIALS

Sleep Extension and IS in Adolescents, https://clinicaltrials.gov/study/NCT03754036, November 23rd, 2018.

TRIAL REGISTRATION

ClinicalTrials.gov (ID:NCT03754036).

A Concrete Core Void Imaging Approach and Parameter Analysis of Concrete-Filled Steel Tube Members Using Travel Time Tomography: Multi-Physics Simulations and Experimental Studies

Concrete-filled steel tube (CFST) members have been widely used in civil engineering due to their advanced mechanical properties. However, internal defects such as the concrete core voids and interface debonding in CFST structures are likely to weaken their load-carrying capacity and stiffness, which affects the safety and serviceability. Visualizing the inner defects of the concrete cores in CFST members is a critical requirement and a challenging task due to the obvious difference in the material mechanical parameters of the concrete core and steel tube in CFST members. In this study, a curved ray theory-based travel time tomography (TTT) with a least square iterative linear inversion algorithm is first introduced to quantitatively identify and visualize the sizes and positions of the concrete core voids in CFST members. Secondly, a numerical investigation of the influence of different parameters on the inversion algorithm for the defect imaging of CFST members, including the effects of the model weighting matrix, weighting factor and grid size on the void's imaging quality and accuracy, is carried out. Finally, an experimental study on six CFST specimens with mimicked concrete core void defects is performed in a laboratory and the mimicked defects are visualized. The results demonstrate that TTT can identify the sizes and positions of the concrete core void defects in CFST members efficiently with the use of optimal parameters.

Investigation of the possibility of using an augmented reality-based endotracheal aspiration simulation tool for nursing education

AIM

We developed an augmented reality technology-based endotracheal aspiration simulation tool (the AR tool) consisting of three modes: a mode for nursing students to learn endotracheal aspiration by themselves (learning mode); a mode for repeated practice (practice mode); and a mode for confirmation testing (test mode). This study aimed to compare the learning outcomes of the AR tool with traditional training mannequins and identify potential uses and improvements of the AR tool.

METHODS

We invited students, and faculty members from the three universities who agreed to cooperate in conducting this study. Fifty-four students and nine faculty members agreed to participate in this study. The students were divided into two groups. One group was to study with the AR tool and the other group was to study with the traditional half-body training mannequin for suction. The students in both groups were asked to demonstrate endotracheal aspiration on another full-body type training mannequin which could be used as a patient with a tracheostomy (Skill test). Group interviews with faculty members focused on the topic of the AR tool's potential use in nursing education and improvement needed.

RESULTS

There was little significant difference in the skill test results of endotracheal aspiration of students in both groups. The students and faculty members both expressed an interest in the AR tool. They said it was suitable for self-study of endotracheal aspiration.

CONCLUSIONS

This AR tool is an effective teaching tool for learning the sequence of endotracheal suctioning, although there are some areas that need improvement.

Protective effects of Azilsartan against cyclophosphamide-induced ovarian toxicity in rats model

Background

Cyclophosphamide (CP) is an effective alkylating anticancer agent that is widely used in cancer chemotherapy, and it can cause ototoxicity and infertility in women.

Objectives

So, this study aimed to evaluate the protective effects of Azilsartan (AZ) as an antioxidant and anti-inflammatory agent in a rat model of CP-induced ovarian toxicity.

Materials and Methods

After receiving the 28 female Wister rats, they were acclimatized in proper environmental conditions for a week and then randomly divided into four groups based on the study protocol. After 15 days of the experiment, they were sacrificed, and organs were collected for biomarker detection (Using the ELISA technique) and histopathological analysis.

Results

The level of IL-10 was significantly (P < 0.05) decreased in all treated groups compared to control hostile groups, while the TNF-α level was significantly (P < 0.05) increased in AZ (220.67 ± 7.88 ng/mL) and AZ + CP groups (221.78 ± 9.11 ng/mL) compared to control negative/CP groups. Regarding the oxidative biomarker level, a significant increase was only found in the AZ + CP group (176.02 ± 6.71 nmol/mL) compared to the control negative group. On the other hand, histopathological findings revealed that ovarian sections in animals that received a single dose of CP had severe ovarian atrophy with significant follicular regression and deterioration, as well as depletion of stromal supportive tissues.

Conclusions

Azilsartan drastically reduced CP-induced ovarian toxicity in vivo by enhancing oxidative stress and inhibiting inflammatory effects in ovarian cells.

Load-Carrying Capacity of Thin-Walled Composite Columns with Rectangular Cross-Section under Axial Compression

The aim of the current study was to determine the load capacity of composite columns subjected to axial compressive load. The subjects of the study were two types of columns with a rectangular cross-section, with different edge lengths. The tested columns had a closed cross-section. Four different fiber arrangements were analyzed for both cross-sections studied. The research was realized using interdisciplinary methods to determine the mechanism of damage to the composite material, with particular emphasis on damage initiation and propagation. Experimental tests were realized on a testing machine, the analysis was carried out with an acoustic emission system, and image analysis using visual assessment system of deflections of the walls of the structure. In addition, a number of numerical analyses were realized based on advanced modeling techniques for fiber-reinforced composites. A comparative analysis of both quantitative and qualitative results is presented for both analyses. The innovation of the presented research lies in the development of a custom method for modeling structures made of composite material with special emphasis on the failure phase. This will allow to accurately reflect the modeling of thin-walled structures with closed cross-section subjected to loading in a complex stress state.

Experimental investigation of tension-reducing effectiveness of keystone perforator island flap

Background and aim

Nowadays, the reconstruction of large and complex defects with keystone perforator island flaps (KPIF) has gained popularity in plastic and reconstructive surgery. The keystone perforator island flap was described as a curvilinear shaped trapezoidal design flap, with two V-Y advancement flaps end-to-side. It is a multiperforator advancement flap, based on multiple fasciocutaneous or musculocutaneous perforators, described by Behan in 2003. These flaps have a simple harvest technique, an easy-to-implement design, and they are time and cost-saving. Their blood supply lends a versatile and robust character, with less complications. Nonetheless, their biomechanical properties and effectiveness are unclear, the wound-closure tension-reducing effect is not well documented in existing literature. The present study aims to investigate the wound closure tension-reducing effect of type I, type IIA, type Sidney Melanoma Unit I (SMU) and type SMU II KPIFs. The main purpose of this study was to clarify the tension-reducing effect of the KPIF technique, which can contribute to the understanding of the biomechanical benefits of the KPIF.

Methods

This is an experimental, in vivo study, based on twelve white race porcine models (PIC-FII-377), as their anatomy and wound healing process is very similar to that of humans. In this study, 42 wounds that could not be closed by primary wound closure, known as 'unclosable' elliptical defects, were created in six different anatomical regions. The criteria used for not achieving primary wound closure were the breaking of 0 nylon suture or the edges of the wound. Each defect was closed with different types of keystone perforator island flap: type I, type IIA, type Sydney Melanoma Unit I and type Sydney Melanoma Unit II. Keystone perforator island flaps were used in 42 cases. Intraoperative tissue tension was measured by an AXIS FB50, 50 N force gauge tensiometer. In all cases a wide elliptical excision was performed for the primary defect. Before reconstruction, tissue tension was measured across the widest point of the elliptical primary defect. Skin incision was performed for the first flap, without division of deep fascia. After preparing first flap, tension was measured at the widest point of the wound. Furthermore, deep fascia for the second flap was divided, tissue tension across the widest point of the primary defect was measured. Finally, tension was measurement across the widest point of the donor-site after closure of the defect-side flap and V-Y closure of either end of keystone perforator island flap.

Results

In this study were included 12 porcine model (PIC-FII-377). A number of 42 keystone perforator island flaps were performed in this study, in six different anatomical regions, ranging between 3.3 x 12 cm and 16 x 30 cm. All elliptical defects were unclosable, with varying sizes ranging between 2 x 4 cm and 8 x 20 cm. The mean tension that was required to close all wounds with primary closure initially was 24.51 N 10.73 N. After using a type I KPIF a tension decrease of -7.04 N ± 4.93 N was seen, in the case of type IIA KPIF the tension decreased to -12.43 N± 5.63 N. Furthermore, after reconstruction with type SMU I KPIF the tension decreased to -7.38N ± 5.21N. After using a type SMU II KPIF a tension decrease of -10.52 N± 5.74 N was seen.

Conclusions

The main purpose of this study was to clarify the tension-reducing effect of the KPIF technique, which can contribute to the understanding of the biomechanical benefits of the KPIF. The outcomes of the present study suggest that type I, type IIA, type SMU I, and SMU II of keystone perforator island flaps have a significant tension-reducing effects, especially the technique that involves the division of the deep fascia. The results of this experimental research thoroughly explain the benefits of these flaps. The effectiveness of the flap and doubts on biomechanical properties have not been answered so far. It will encourage more plastic surgeons to use the flap, especially given its proven benefits.

Temporal evolution of postsurgical bone repair in a rabbit model: A [99mTc]Tc-MDP scintigraphic study

Bone regeneration is crucial for repairing bone tissue following various injuries. Research techniques that enable the study of metabolic changes in bone tissue under different conditions are important for understanding bone repair and remodeling. This study used bone scintigraphy to evaluate osteogenesis secondary to osteotomy in a preclinical model of New Zealand rabbits. For this purpose, we conducted a longitudinal, prospective, case-control study in which scintigraphic variables were measured in both the right forearm (case-operated) and the left forearm (control - non-operated). The study sample consisted of 10 rabbits subjected to osteotomy, followed by a 12-week postoperative evaluation period, divided into six imaging stages at 1, 2, 3, 4, 8, and 12 weeks. We observed that the operated forearm showed significantly higher external radiation than the control side, using the pinhole collimator, denoting an increase in the biodistribution and tropism of the radiopharmaceutical to the operated forearm. Among the three evaluated time points, osteoblastic activity was highest in the second week and presented a significant decline in the 8th and 12th weeks, denoting regeneration and resolution of the surgical injury; the control forearm was also influenced by the inactivity imposed by the operated forearm. This fact was notably evidenced by the reduction in the metabolic activity of osteoblasts in the left forearm. Our study suggested that bone scintigraphy was sensitive enough to semi-quantitatively differentiate the metabolic activity of osteoblasts in the operated forearm in the three temporal landmarks evaluated in the study.

Bromopyrene Symphony: Synthesis and Characterisation of Isomeric Derivatives at Non-K Region and Nodal Positions for Diverse Functionalisation Strategies

Pyrene, a renowned aromatic hydrocarbon, continues to captivate researchers due to its versatile properties and potential applications across various scientific domains. Among its derivatives, bromopyrenes stand out for their significance in synthetic chemistry, materials science, and environmental studies. The strategic functionalisation of pyrene at non-K region and nodal positions is crucial for expanding its utility, allowing for diverse functionalisation strategies. Bromo-substituted precursors serve as vital intermediates in synthetic routes; however, the substitution pattern of bromoderivatives significantly impacts their subsequent functionalisation and properties, posing challenges in synthesis and purification. Understanding the distinct electronic structure of pyrene is pivotal, dictating the preferential electrophilic aromatic substitution reactions at specific positions. Despite the wealth of literature, contradictions and complexities persist in synthesising suitably substituted bromopyrenes due to the unpredictable nature of substitution reactions. Building upon historical precedents, this study provides a comprehensive overview of bromine introduction in pyrene derivatives, offering optimised synthesis conditions based on laboratory research. Specifically, the synthesis of mono-, di-, tri-, and tetrabromopyrene isomers at non-K positions (1-, 3-, 6-, 8-) and nodal positions (2-, 7-) is systematically explored. By elucidating efficient synthetic methodologies and reaction conditions, this research contributes to advancing the synthesis and functionalisation strategies of pyrene derivatives, unlocking new possibilities for their utilisation in various fields.

Investigations of the migraine-provoking effect of levcromakalim in patients with migraine with aura

BACKGROUND/HYPOTHESIS

Experimental provocation studies have yielded important insights in migraine pathophysiology. Levcromakalim has been previously shown to induce migraine-like attacks with and without aura. In this study, we aim to further explore the migraine aura-inducing potential of levcromakalim.

METHODS

In a double-blind, randomized, placebo-controlled cross-over study, 27 adult participants with migraine with aura received intravenous infusions of levcromakalim and saline. Headache, aura and associated symptoms were evaluated for 24 hours following administration of the study drug. The primary endpoint was occurrence of migraine-like attacks with or without aura in the 24-hour observation period.

RESULTS

Thirteen participants developed migraine-like attacks on the active day only (P = 0.0098), and four participants developed aura on the active day only (P = 0.68). The median time to onset of migraine-like headache was three hours, and the median time to onset of aura was 27.5 minutes.

CONCLUSION/INTERPRETATION

Our findings affirm the potent migraine-inducing effect of levcromakalim. We observed a lower induction-rate of migraine aura than previously reported. Further studies are warranted to identify predictors of migraine aura following levcromakalim.

CLINICALTRIALS.GOV IDENTIFIER

NCT04905654.

N-of-1 Trials of Antimicrobial Stewardship Interventions to Optimize Antibiotic Prescribing for Upper Respiratory Tract Infection in Emergency Departments: Protocol for a Quasi-Experimental Study

BACKGROUND

Antimicrobial stewardship programs attempting to optimize antibiotic therapy and clinical outcomes mainly focus on inpatient and outpatient settings. The lack of antimicrobial stewardship program studies in the emergency department (ED) represents a gap in tackling the problem of antimicrobial resistance as EDs treat a substantial number of upper respiratory tract infection cases throughout the year.

OBJECTIVE

We intend to implement two evidence-based interventions: (1) patient education and (2) providing physician feedback on their prescribing rates. We will incorporate evidence from a literature review and contextualizing the interventions based on findings from a local qualitative study.

METHODS

Our study uses a quasi-experimental design to evaluate the effects of interventions over time in the EDs of 4 public hospitals in Singapore. We will include an initial control period of 18 months. In the next 6 months, we will randomize 2 EDs to receive 1 intervention (ie, patient education) and the other 2 EDs to receive the alternative intervention (ie, physician feedback). All EDs will receive the second intervention in the subsequent 6 months on top of the ongoing intervention. Data will be collected for another 6 months to assess the persistence of the intervention effects. The information leaflets will be handed to patients at the EDs before they consult with the physician, while feedback to individual physicians by senior doctors is in the form of electronic text messages. The feedback will contain the physicians' antibiotic prescribing rate compared with the departments' overall antibiotic prescribing rate and a bite-size message on good antibiotic prescribing practices.

RESULTS

We will analyze the data using segmented regression with difference-in-difference estimation to account for concurrent cluster comparisons.

CONCLUSIONS

Our proposed study assesses the effectiveness of evidence-based, context-specific interventions to optimize antibiotic prescribing in EDs. These interventions are aligned with Singapore's national effort to tackle antimicrobial resistance and can be scaled up if successful.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05451863; https://clinicaltrials.gov/study/NCT05451836.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50417.

The value of multimodal ultrasonography in the evaluation of late presenting testicular torsion in a rat experimental model

OBJECTIVE

To evaluate the value of multimodal ultrasonography (US) in a rat experimental torsion model after 6 h of torsion with different degrees.

METHODS

Twenty-one male rats were divided into three groups. Left testes of the rats were twisted around their vascular pedicle 360 degrees in group 1, 720 degrees in group 2, and 1080 degrees in group 3 and intact right testes of the rats were accepted as control group. Grey-scale US, superb microvascular imaging (SMI), colour Doppler ultrasonography (CDUS), strain elastography (SE), and two-dimensional (2-D) shear wave elastography (SWE) examinations were applied 6 h after torsion procedure and testes were removed for pathological evaluation.

RESULTS

Short-axis dimensions and volumes of the torsion side were higher than control testes. Lengths of the testes in the 3rd torsion group were smaller than the testes in groups 1 and 2 (P < 0.002). SMI was better than CDUS in recognizing blood flow in testicular tissue. Strain ratios were higher in group 1 and decreased with the increasing torsion degree. Emean and standard deviation (SD) measurements increased in the torsion side. Pathologically the mean testicular damage scores were statistically significant between torsion and control testes in all groups.

CONCLUSION

Our results showed that short-axis and volume measurements, SMI, 2D-SWE, and SE are effective in the evaluation and diagnosis of testicular torsion (TT).

ADVANCES IN KNOWLEDGE

Evaluation of affected testis and intact testis with multiparametric US in late presenting TT cases is more reliable than being dependent on a single sonographic modality.

Impact of fully online flipped classroom on academic achievement in undergraduate dental education: An experimental study

INTRODUCTION

The last two decades have seen a shift towards blended learning in education due to technological advancements. This study focuses on dental education, comparing two blended learning models -enriched virtual and fully online flipped classroom - in terms of academic achievement, aligning with the Association for Dental Education in Europe's competencies.

MATERIALS AND METHODS

The research was modelled in a quantitative design with a pre-post-test control group experimental design. The study was conducted at Ege University Faculty of Dentistry in Turkey for 4 weeks with the experimental (n = 44) and control (n = 39) groups divided into two groups by impartial assignment. To the experimental group, the theoretical part of the course was tried to be conveyed before each lesson with video lessons prepared with EdPuzzle containing reinforcement questions and a question set consisting of case questions. The practical learning objectives of the course were tried to be gained through the discussion of the previously presented case questions in the online synchronous course. As tools for collecting data, a unique academic achievement test, a course evaluation form and a semi-structured qualitative data collection form were used.

RESULTS

It was seen that the flipped classroom model had a more positive effect on students' academic achievement than the enriched virtual classroom model. The general satisfaction levels of the participants regarding these two models are also higher in favour of the flipped classroom model.

CONCLUSION

This study provides significant findings for educational institutions, policymakers and educators about the impact of fully online teaching methods on academic achievement. In this context, the flipped classroom method can be preferred both in cases where education is blocked and in dental education institutions that want to ensure digital transformation efficiently and partially remotely.

Medical, Surgical and Experimental Approaches to Acute Mesenteric Ischemia and Reperfusion

Background

Acute mesenteric ishemia(AMI) is a rare but very serious disease with high rate of mortality and morbidity. About 1-2% of all gastrointestinal disease is AMI. Mortality is about 60-80% and depends of time between starting of symptoms and establishing of diagnosis, type AMI, comorbidities. AMI is often in older population with coronary syndrom and atrial fibrilation. AMI may be occlusive(embolisatio arteriae mesentericae superior(AMS), or thrombosis of AMS, mesenterial vein thrombosis) and nonoclusive form(NOMI). NOMI is rising in critical ill patients in shock or sepsis. Pathophysiology of AMI is very complex and significant role in this proces has ischemia and also reperfusion. Reperfusion injury including oxidative stres, inflamation, infection. The best diagnostic approach is CT angiography but after high clinical suspicion on AMI. Patients have sudden, catastrophic abdominal pain, vomitus, bloody diarrhoea. Therapy is multidisciplinary-basic treatment(resuscitation with cristaloids, antibiotic, anticoagulans...), surgical treatment-resection necrotic segments of intestinum without anastomosis or endovascular treatment. In early phases conservative treatment is possible( vasodilatation, thrombolysis). In some countries there are Intestinal Stroke Centers (ISC) in which patients with AMI have better prognosis. Because of progressive nature of AMI( rapide worsening) rare are clinical study,but there are many experimental study on animal models. Most of experimental study investigate protective effects of some supstances on damage on intestinum and remote organs during ishemia and reperfusion.

Objective

To present literature data of clinical and experimental study, describe experiments on animal models and mention supstances whit promising results in protective strategies during AMI.

Methods

We analysed Pubmed by using mesh terms such as acute mesenteric ischemia, intestinal injury, reperfusion, experimental study, clinical and therapeutic approach. Results: Sudden abdominal pain resists on opioids analgetics, high rate of CRP, hyperlactatemia, increase of D dimer is enough for suspicion of AMI. Often is delayed in establishing of diagnosis of AMI. CT angiography has sensitivity of 94%. Pneumatosis is sign of necrosis of intestinal wall. Classical surgical approach is dominant, more than 70%,. Endovascular treatment became often last few years. Experimental studies investigate occlusion of AMS with atraumatic clamp, with schemia and reperfusion in different intervals Most animals models are on wistar male rats.

Conclusion

AMI has still high rate of mortality. Better diagnostic and therapeutic principles (shorter interval between appearance of symptoms and starting of therapy, multidisciplinary approach, higher percent of endovascular procedures), could decrease mortality. Experimental studies on animal models may be succesfull in development of new clinical, conservative approaches in the early phases of AMI in the future.

Histopathological and immunohistochemical investigation of the effect of Shilajit in rats with experimental spinal cord injury

BACKGROUND

This experimental study was designed to investigate the histopathological and immunohistochemical effects of Shilajit in rats with experimentally induced spinal cord injury (SCI).

METHODS

The rats were divided into three groups: Control group: The group in which spinal cord damage was created but no drug was administered. Low-dose group: This is the group in which intraperitoneal Shilajit is given at a dose of 150 mg/kg at the 1st h, 1st day, 2nd day, and 3rd day after spinal cord damage was induced. High-dose group: This is the group in which intraperitoneal Shilajit is given at a dose of 250 mg/kg at the 1st h, 1st day, 2nd day, and 3rd day after spinal cord damage was induced. Thin sections taken from the spinal cord after euthanasia were sent for histopathological and immunohistochemical examination.

RESULTS

Histopathological examination of the high-dose group showed lower amounts of morphological findings compared to the low-dose group and control group. While a significant CD68 immune reaction was observed in the control group of rats with spinal injury, the positive immune reaction was found to be significantly decreased in the Shilajit-applied groups.

CONCLUSION

It is thought that the use of Shilajit in SCI will reduce the effects of secondary damage in SCI and that its administra-tion to such patients will have positive effects on the results.

Understanding lifetime and dispersion of cough-emitted droplets in air

To understand the exact transmission routes of SARS-CoV-2 and to explore effects of time, space and indoor environment on the dynamics of droplets and aerosols, rigorous testing and observation must be conducted. In the current work, the spatial and temporal dispersions of aerosol droplets from a simulated cough were comprehensively examined over a long duration (70 min). An artificial cough generator was constructed to generate reliably repeatable respiratory ejecta. The measurements were performed at different locations in front (along the axial direction and off-axis) and behind the source in a sealed experimental enclosure. Aerosols of 0.3-10 µm (around 20% of the maximum nuclei count) were shown to persist for a very long time in a still environment, and this has a substantial implication for airborne disease transmission. The experiments demonstrated that a ventilation system could reduce the total aerosol volume and the droplet lifetime significantly. To explain the experimental observations in more detail and to understand the droplet in-air behaviour at various ambient temperatures and relative humidity, numerical simulations were performed using the Eulerian-Lagrangian approach. The simulations show that many of the small droplets remain suspended in the air over time instead of falling to the ground.

Pharmaceutical Interventions for Inpatients with Liver Cirrhosis and Liver Transplantation: A Systematic Review of Experimental Studies

Liver cirrhosis, which is considered one of the leading causes of death in the world, can lead to severe complications, and is often followed by a liver transplantation. These patients take an average of nine medications daily. If not managed adequately, it can be accompanied by serious drug-related problems. To reduce this risk, a clinical pharmacist may be included as part of the healthcare team to optimize medication therapy in this population. This study aimed to systematically identify the pharmaceutical interventions which reduced drug-related problems and improved medication therapy for adult hospitalized liver cirrhotic and liver transplant patients when compared to standard care. Three databases (PubMed, Embase, and CENTRAL) were systematically searched from the inception of each database to 25 October 2023, and interventional studies in the English language were included. The risk of bias was assessed according to RoB-I for the UBA study and RoB2 for the identified RCT. The detected interventions to reduce drug-related problems in liver cirrhotic and liver transplant patients were extracted and classified according to a "Hierarchy of Controls" model. Two studies from Germany and the USA met our inclusion criteria, respectively. In these studies, we identified two interventions that included education, expert consultation, and the monitoring of the immunosuppressive medications serum level. The main objective of the two included studies was improving patients' compliance through adherence. These pharmaceutical interventions identified were classified as administrative controls, which is one of the lowest levels in the "Hierarchy of Controls" with which to address a potential risk. Pharmaceutical interventions to optimize medication therapy were found to be rare in the examined population, and were limited to "administrative controls". These interventions were limited to transplant patients' education and the monitoring of the immunosuppressive medication serum levels. No interventional studies were found to have investigated pharmaceutical interventions in patients with liver cirrhosis. Especially regarding this patient group, future studies to reduce DRPs using pharmaceutical interventions are needed. This study received no external funding and its PROSPERO registration number is CRD42022309122.

In Vivo and In Vitro Characterization of the Recently Emergent PRRSV 1-4-4 L1C Variant (L1C.5) in Comparison with Other PRRSV-2 Lineage 1 Isolates

The recently emerged PRRSV 1-4-4 L1C variant (L1C.5) was in vivo and in vitro characterized in this study in comparison with three other contemporary 1-4-4 isolates (L1C.1, L1A, and L1H) and one 1-7-4 L1A isolate. Seventy-two 3-week-old PRRSV-naive pigs were divided into six groups with twelve pigs/group. Forty-eight pigs (eight/group) were for inoculation, and 24 pigs (four/group) served as contact pigs. Pigs in pen A of each room were inoculated with the corresponding virus or negative media. At two days post inoculation (DPI), contact pigs were added to pen B adjacent to pen A in each room. Pigs were necropsied at 10 and 28 DPI. Compared to other virus-inoculated groups, the L1C.5-inoculated pigs exhibited more severe anorexia and lethargy, higher mortality, a higher fraction of pigs with fever (>40 °C), higher average temperature at several DPIs, and higher viremia levels at 2 DPI. A higher percentage of the contact pigs in the L1C.5 group became viremic at two days post contact, implying the higher transmissibility of this virus strain. It was also found that some PRRSV isolates caused brain infection in inoculation pigs and/or contact pigs. The complete genome sequences and growth characteristics in ZMAC cells of five PRRSV-2 isolates were further compared. Collectively, this study confirms that the PRRSV 1-4-4 L1C variant (L1C.5) is highly virulent with potential higher transmissibility, but the genetic determinants of virulence remain to be elucidated.

Simulation and experimental study on the stability and comfortability of the wheelchair human system under uneven pavement

With the improvement in the level of science and technology and the improvement of people's living standards, the functions of traditional manual wheelchairs have been unable to meet people's living needs. Therefore, traditional wheelchairs have been gradually replaced by smart wheelchairs. Compared with traditional wheelchairs, smart wheelchairs have the characteristics of light operation and faster speed. However, when driving on some complex road surfaces, the vibration generated by the bumps of the motorcycle will cause damage to the human body, so wheelchairs with good electric power and stability can better meet the needs of people and make up for their travel needs. Based on the traditional vehicle stability analysis method, the mathematical theory of roll stability and pitch stability of the wheelchair-human system was established. We built a multi-body dynamics model with human skeleton and joint stiffness based on the multi-body dynamics method. The functioning of the wheelchair-human system was simulated and analyzed on the ditch, step, and combined road. The acceleration and Euler angle changes of the human head, chest, and wheelchair truss position were obtained, and the data results were analyzed to evaluate the stability and comfort of the system. Finally, a wheelchair test platform was built, and the road driving test was carried out according to the simulation conditions to obtain the system acceleration and angle data during the driving process. The simulation analysis was compared to verify the accuracy of the multi-body dynamics method, and the stability and comfort of the system were evaluated.

Comparative Evaluation of Two Paclitaxel-Coated Stents in an Experimental Setting

INTRODUCTION

Unlike paclitaxel-coated balloons, pre-clinical data comparing different paclitaxel-coated stents (PCSs) are weak. The study objective was to compare the features of the 2 main PCSs: Eluvia® (Boston Scientific, Marlborough, MA) versus ZilverPTX® (Cook Medical, Bloomington, IN).

METHOD

Analysis was carried out on 12 pigs divided into 2 groups: Eluvia® (n=6) and ZilverPTX® (n=6). The pigs received the PCS corresponding to their group in each external iliac artery and were paired one by one, to examine 6 different post-implantation timepoints: after 30 minutes, 6 hours, 24 hours, 3 days, 7 days, and 14 days. The paclitaxel concentration measurements and the histological analysis were carried out under blind testing on the plasma, arterial, lymph node, and muscle samples. A linear regression model and Wilcoxon Mann-Whitney test were used to study the variables.

RESULTS

The plasma paclitaxel rate decrease over 24 hours after PCS implantation was significantly different between the two groups, expressed by the correlation coefficient 0.19 (0.14-0.23; p<0.001) with an undetectable concentration at the 10th hour for Eluvia® versus 3 days for ZilverPTX®. Significantly higher paclitaxel concentrations with ZilverPTX® PCS were observed in muscle samples at each timepoint: extensor digitorum brevis 3.2 (1.17-5.23; p=0.005), biceps femoris 4.27 (2.27-6.26; p<0.001), semi-tendinosus 3.79 (1.85-5.73; p=0.001), tibialis anterior 3.0 (1.37-4.64; p=0.001), and in the femoral nodes 2.27±1.74 ng/g versus 0.14±0.13 ng/g (p<0.001). Histological analysis revealed a trend for more marked intimal inflammation in the arteries stented with ZilverPTX® (p=0.063), especially after the 7th and 14th days.

CONCLUSION

Such a difference in the concentration of paclitaxel in the plasma, muscles, and lymph nodes between the two stents was higher than expected based on differences in device design. The clinical consequences of these results remain to be elucidated, particularly regarding the concerning presence of paclitaxel in muscles and adjacent lymph nodes.

CLINICAL IMPACT

This experimental study compares 2 paclitaxel-coated stents. It demonstrates that differences in stent designs and drug features (coatings and concentrations) translate into differences in terms of concentrations of paclitaxel in the plasma, muscles, and lymph nodes. Our results favor the Eluvia® stent over the ZilverPTX® stent, although more studies are required to confirm this conclusion.

Medial Meniscus Posterior Root Repair Reduces but Does Not Avoid Histologic Progression of Osteoarthritis: Randomized In Vivo Experimental Study in a Rabbit Model

BACKGROUND

The optimal treatment option for meniscus root tears is still challenging, and whether the meniscus root repair ultimately can arrest or delay osteoarthritic changes is still a concern.

PURPOSE/HYPOTHESIS

The purpose of this study was 2-fold: (1) to describe and compare histopathologic findings of 3 different therapeutic options for medial meniscus posterior root tear: nonoperative management, partial meniscectomy, and meniscus root repair; and (2) to test the hypothesis that meniscus root tears treated nonoperatively predispose to a lower risk of osteoarthritic progression compared with partial meniscectomy.

STUDY DESIGN

Controlled laboratory study.

METHODS

Posteromedial meniscus root tears were carried out in 39 New Zealand White rabbits. Animals were randomly assigned into 3 experimental groups: partial meniscectomy after root tear (PM; n = 13), root tears treated conservatively (CT; n = 13), and transtibial root repair (RR; n = 13). Contralateral limbs were used as healthy controls. The animals were euthanized at 16 weeks postoperatively; tissue samples of femoral and tibial articular cartilage were collected and processed for macro- and microscopic assessment to detect signs of early osteoarthritis (OA). Each sample was histopathologically assessed using the Osteoarthritis Research Society International grading and staging system.

RESULTS

Osteoarthritic changes were the hallmark in all 3 experimental groups. The RR group had the lowest scores for cartilage damage (mean, 2.5; range, 2-3), and the PM group exhibited higher and more severe signs of OA (mean, 16; range, 9-16) compared with the CT group (mean, 5; range, 4-6). The between-group comparison revealed significant differences, as the PM group showed a significantly higher rate of macro- and microscopic osteoarthritic changes compared with the RR (P < .001) and CT (P < .001) groups. The weightbearing area of the medial femoral condyle was the most severely affected, and tidemark disruption was evident in all tissue samples.

CONCLUSION

Meniscus root repair cannot completely arrest the histopathologic progression of knee OA but leads to significantly less severe degenerative changes than partial meniscectomy and nonoperative treatment. Partial meniscectomy leads to the most severe osteoarthritic progression, while stable radial tears left in situ have lower progression compared with partial meniscectomy.

CLINICAL RELEVANCE

Histologic assessment is an essential tool and metric for guiding and understanding osteoarthritic features, providing insight into the disease development and progression. This study provides histopathologic evidence on osteoarthritic progression after medial meniscus posterior root repair. This knowledge can help to set more realistic expectations and can lead to the future development of augmented techniques.

The comparison of anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis

Various intestine anastomosis techniques have been studied and used, but which is best is still debated. In our center, double-layer full-thickness intestine anastomosis was still considered as standard. However, a single-layer extramucosal intestine anastomosis has shown favorable results. This study created an anastomotic model to compare the anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis.

METHODS

This experimental study was performed in 20 randomized healthy male pigs, to be included either in Group A (Single-layer extramucosal intestine anastomosis) or Group B (Double-layer full-thickness intestine anastomosis). Enterotomy followed by an end-to-end anastomosis suture was performed in the jejunum. Fourteen days after the operation, any anastomosis leakage and its location was documented. The anastomosis strength was evaluated using manometry. Data were compared between groups using the Mann-Whitney U and Fischer Exact test, considering a significance level of P<0.05.

RESULTS

The overall mean intraluminal anastomotic bursting pressure was 4,257±1,185. Group A had a higher intraluminal anastomotic bursting pressure but was not statistically significant compared to group B (4.726±0.952 vs. 3.787±1.252 kilopascals, P=0.063). One leakage (5%, antimesenteric area) occurred in Group A and three leakages (15%, antimesenteric and mesenteric area) occurred in Group B. However, statistical analysis with Fischer exact showed no significant difference of leakage rate between those groups (P=0.291).

CONCLUSIONS

The anastomosis strength and leakage did not differ significantly between the single-layer extramucosal intestine anastomosis group and the double-layer full-thickness anastomosis group. However, the location of leakage was most common in the antimesenteric area in the double-layer full-thickness anastomosis group.

Design of a High-Speed Rotary Ultrasonic Machining Machine Tool for Machining Microstructure of Brittle Materials

Aiming at the problems of low machining accuracy and more serious tool wear in the traditional diamond grinding machining (DGM) microstructure of hard and brittle materials, this paper proposes high-speed rotary ultrasonic machining (HRUM) technology and develops a HRUM machine tool. The hardware part of the machine tool mainly includes the spindle module, micro-motion system module, ultrasonic machining tank module, and data acquisition (DAQ) system module. The LabView-based controlled machining control system, including motion selection, initialization, coarse tool setting, constant force tool setting, control machining, and coordinate display module, is developed. Comparative experimental research of the HRUM and DGM of small holes in Al2O3 ceramics is carried out in the developed HRUM machine tool. The results demonstrate that HRUM effectively reduces axial cutting forces, reduces binder adhesion, and suppresses slippage while improving tool-cutting ability and extending tool life compared to DGM under the same machining parameters. This technology has essential research significance for the high-precision and efficient machining of microstructures in hard and brittle materials.

Underwater Undulating Propulsion Biomimetic Robots: A Review

The traditional propeller-based propulsion of underwater robots is inefficient and poorly adapted to practice. By contrast, underwater biomimetic robots show better stability and maneuverability in harsh marine environments. This is particularly true of undulating propulsion biomimetic robots. This paper classifies the existing underwater biomimetic robots and outlines their main contributions to the field. The propulsion mechanisms of underwater biomimetic undulating robots are summarized based on theoretical, numerical and experimental studies. Future perspectives on underwater biomimetic undulating robots are also presented, filling the gaps in the existing literature.

Eccentric Compression Properties of FRP-Concrete-Steel Double-Skin Square Tubular Columns

FRP (fiber-reinforced polymer)-concrete-steel double-skin square tubular (FCSST) columns are composed of an outside FRP tube, an inside steel tube and the concrete filled between them. Under the continuous constraint of the outside and inside tube, the strain, strength and ductility of concrete are improved significantly compared with those of traditionally reinforced concrete without lateral restraint. Additionally, the outside and inside tube not only function as the permanent formwork in casting but improve the bending and shear resistance of composite columns. Meanwhile, the hollow core also reduces the weight of the structure. Through the compressive testing of 19 FCSST columns subjected to eccentric load, this study focuses on the influence of eccentricity and layers of axial FRP cloth (away from the loading point) on the evolution of axial strain along the cross-section, axial bearing capacity, axial load-lateral deflection curve and other eccentric properties. The results can provide basis and reference for the design and construction of FCSST columns and are of great theoretical significance and practical value for the application of composite columns in the engineering of structures in a corrosive environment and other harsh conditions.

Guideline Implementation for Improved Asthma Management and Treatment Adherence in Children in Jordan

Asthma imposes a significant social burden on children, their families, and society at large. As a chronic health condition, effective management could greatly benefit from consistent adherence to guidelines. Despite this, minimal effort has been exerted to examine the impact of asthma management guidelines and adherence to treatment on children with asthma and the mothers caring for them. This study was designed to evaluate the influence of asthma management guidelines on the knowledge and treatment adherence among children with asthma and their mothers. A quasi-experimental design was utilized, and the study was conducted at two large hospitals in Jordan: Princess Rahma Hospital and King Hussein Medical Center. A purposive sample of children aged 6-12 years (n = 100) who were accompanied by their mothers (n = 100) were recruited for this study. Data were collected using a structured questionnaire and an observation checklist before and after the implementation of guidelines. Statistical analyses were performed using SPSS. The results revealed a statistically significant improvement in knowledge related to asthma among children and their mothers (p < 0.001). Additionally, a statistically significant difference was observed in the children's adherence to their treatment regimen before and after the implementation of asthma management guidelines (p < 0.001). Moreover, the improvements in knowledge and practice related to asthma were sustained in the follow-up assessments. In conclusion, the guidelines had a beneficial effect on the children's adherence to their treatment regimen both before and after their implementation. Thus, asthma patients should adhere to conventional guidelines at various health services to manage their condition effectively.

Mechanics Characteristics of a 3D Star-Shaped Negative Poisson's Ratio Composite Structure

A negative Poisson's ratio honeycomb material has the characteristics of anti-conventional deformation behavior and high impact resistance, which is a new lightweight microstructure material with broad application prospects. However, most of the current research is still at the microscopic level and two-dimensional level, and little research has been carried out for three-dimensional structures. Compared with the two-dimensional level, three-dimensional negative Poisson's ratio structural mechanics metamaterials have the advantages of a lighter mass, higher material utilization, and more stable mechanical properties, and they have great potential for development in the fields of aerospace, the defense industry, and vehicles and ships. This paper presents a novel 3D star-shaped negative Poisson's ratio cell and composite structure, inspired by the octagon-shaped 2D negative Poisson's ratio cell. The article carried out a model experimental study with the help of 3D printing technology and compared it with the numerical simulation results. The effects of structural form and material properties on the mechanical characteristics of 3D star-shaped negative Poisson's ratio composite structures were investigated through a parametric analysis system. The results show that the error of the equivalent elastic modulus and the equivalent Poisson's ratio of the 3D negative Poisson's ratio cell and the composite structure is within 5%. The authors found that the size of the cell structure is the main factor affecting the equivalent Poisson's ratio and the equivalent elastic modulus of the star-shaped 3D negative Poisson's ratio composite structure. Furthermore, among the eight real materials tested, rubber exhibited the best negative Poisson's ratio effect, while the copper alloy showed the best effect among the metal materials, with a Poisson's ratio between -0.058 to -0.050.

Shape Adjustment and Experimental Study of a Shape Memory Cable (SMC) Structure

Large deployable cable net antennas have attracted extensive attention worldwide because of their simple structure and high storage ratio. The cable net structure is affected by long exposure in a harsh space environment during satellite operation, resulting in large thermal deformation and stress relaxation, which leads to a degradation of antenna performance. To address the thermal deformation of the cable net structure, a shape memory cable (SMC) net structure model was proposed with surface accuracy as the research objective. Specifically, we aimed to utilize its phase transition characteristics to adjust the thermal deformation of cable net structure and improve its surface accuracy. A shape memory cable net structure model with a diameter of 2.2 m was built, and a normal temperature experiment and high- and low-temperature experiments were carried out. High- and low-temperature test refers to environmental simulation testing of shape memory cable net structures under high- and low-temperature conditions. This was done to determine whether the adjustment method for surface accuracy meets the requirements. The results showed that the shape memory alloy wire has a relatively stable ability to adjust the surface accuracy of the cable net structure at room temperature. During temperature cycling, the thermal deformation of the shape memory cable net structure is slight, and the surface accuracy is good. Compared with ordinary cable net structures, the shape memory cable net structure has improved surface accuracy by 44.4% and 45.2% at high and low temperatures, respectively. This proved the effectiveness of the method for adjusting surface accuracy. These experimental results offer guiding significance for engineering applications.

Hybrid Steel/NSM/GFRP System versus GFRP Wrapping for Upgrading RC Wall-like Columns

Reinforced concrete (RC) wall-like columns are commonly employed in structures in Saudi Arabia. These columns are preferred by architects owing to their minimum projection in the usable space. However, they often need strengthening due to several reasons, such as the addition of more stories and increasing the live load as a result of changing the usage of the building. This research aimed to obtain the best scheme for the axial strengthening of RC wall-like columns. The challenge in this research is to develop strengthening schemes for RC wall-like columns, which are favored by architects. Accordingly, these schemes were designed so that the dimensions of the column cross-section are not increased. In this regard, six wall-like columns were experimentally examined in the event of axial compression with zero eccentricity. Two specimens were not retrofitted to be used as control columns, whereas four specimens were retrofitted with four schemes. The first scheme incorporated traditional glass fiber-reinforced polymer (GFRP) wrapping, while the second one utilized GFRP wrapping combined with steel plates. The last two schemes involved the addition of near-surface mounted (NSM) steel bars combined with GFRP wrapping and steel plates. The strengthened specimens were compared with regard to axial stiffness, maximum load, and dissipated energy. Besides column testing, two analytical approaches were suggested for computing the axial capacity of tested columns. Moreover, finite element (FE) analysis was performed for evaluating the axial load versus displacement response of tested columns. As an outcome of the study, the best strengthening scheme was proposed to be used by practicing engineers for axial upgrading of wall-like columns.

Investigation of an Effective Anchoring Length of CFRP Tapes Used to Strengthen Steel Thin-Walled Beams with a Rectangular Cross-Section Subjected to Four-Point Bending

In order to design an optimal reinforcement of steel thin-walled beams with composite materials, it is worth analyzing two important, although often overlooked issues, which are the selection of the appropriate thickness of the adhesive layer and the effective anchoring length of the composite tape. This paper, which is part of a wider laboratory study devoted to the strengthening of thin-walled steel profiles, focuses on the second issue. The paper involves a description of laboratory four-point bending tests during which ten thin-walled steel beams made of a rectangular section with dimensions of 120 × 60 × 3 and a length of 3 m were tested. Two beams were taken as reference beams, and the other eight were reinforced using Sika CarboDur S512 carbon fiber composite tape, assuming four different effective anchorage lengths. The impact of the length of the anchoring of the composite tape on the value of the displacements and strains of the tested beams and on the value of the destructive load that caused tape detachment was analyzed. The following phase was numerical analyses carried out in the Abaqus program, which showed high consistency with the results of laboratory tests. In reference to the conducted tests, it was observed that the increase in the anchoring length of the composite tape has a slight impact on the change in the value of strains and displacements in the tested beams. Nevertheless, the increase in the effective anchorage length has a significant impact on the load value at which the composite tapes are detached from the surface of the steel thin-walled beam.

Corrosion-Effected Bond Behavior between PVA-Fiber-Reinforced Concrete and Steel Rebar under Chloride Environment

Corrosion-effected bond behavior between polyvinyl-alcohol-fiber-reinforced concrete and steel rebar under a chloride environment is the experimental subject studied in the present work. Twenty-four pull-out specimens are designed and subjected firstly to an accelerated corrosion test. The effects of polyvinyl alcohol fibers on the cracking behavior, chloride penetration of concrete members and the corrosion loss of steel rebars during the corrosion test are discussed. After this, these corroded specimens are subjected to a pull-out test. The failure mode, the bond-slip curves and the typical bond-stress values are measured during the test. The effects of polyvinyl alcohol fibers and corrosion loss on bond behavior between polyvinyl-alcohol-fiber-reinforced concrete and steel rebar are clarified. Results show that the polyvinyl-alcohol-fiber-reinforced concrete exhibits worse resistance to corrosion damage than plain concrete. The cracking width, chloride penetration depth in concrete and the corrosion loss of steel rebar are more serious for the specimens with more polyvinyl alcohol fibers. The polyvinyl alcohol fibers also negatively affect bonding in ascending branches for both the specimens, but improve the bonding in descending branches after peak stress in the case of splitting. In the present test, the bond strength of corrosive specimens is increased slightly and then decreases gradually with the deepening of corrosion loss. The failures of specimens change from pull-out to splitting-pull-out as the corrosion time exceeds 30 days. Compared with uncorroded specimens, the maximum degradation of bond strength is about 50.1% when the corrosion is increased from 0% to 15%.

Charring-induced morphological changes of Chinese "Five Grains": An experimental study

INTRODUCTION

Charring process affects the preservation potential of seeds, resulting in limited perceptions of crop assemblages recovered from archaeological layers. Therefore, the specifics of the charring process deserve further investigation. Colloquially referred to as the "Five Grains" (), bread wheat (Triticum aestivum), foxtail millet (Setaria italica), broomcorn millet (Panicum miliaceum), rice (Oryza sativa), and soybean (Glycine max) represent a set of four major cultivated cereals and a pulse constituting crucial staple food in Chinese history and the most frequently discovered crops at archaeological sites in China.

METHODS

This paper aims to understand the changes in size, volume, and weight loss of grains under variable aerobic charring conditions. The size and weight were measured for the untreated specimens and the specimens heated at different temperatures and over different time-periods.

RESULTS

We found that temperature and exposure time directly affected the grain size. Specifically, the grains of most species shrank at lower temperatures and expanded rapidly at higher temperatures.

DISCUSSION

Among the "Five Grains", soybean was the type least affected by charring, followed by wheat, rice, and millet. Volume and weight can be used as conversion factors to minimize the bias in quantitative representation due to varied charring preservation potential. For rice, wheat and soybean, the variation in volume is smaller. For millet, both volume and weight can be used as the control to understand the consequences of charring for the assemblage. Further experiments and comparisons of ancient samples are needed in future studies to investigate other factors that affect the preservation of charred plant remains.

Composition of yoga-philosophy based mental traits (Gunas) in major psychiatric disorders: A trans-diagnostic approach

Yoga philosophy includes the theory of Tri-guna (three mental traits): sattva (signifies a tendency to 'goodness'), rajas (tendency towards 'activity'), and tamas (tendency towards "inertia"). This cross-sectional study aimed to understand the differences in the expression of gunas in patients suffering from major psychiatric disorders (n = 113, 40 females) and age-gender-education-matched healthy controls (HCs; n = 113, 40 females). Patients were diagnosed by a psychiatrist using DSM 5 criteria and suffered from the following disorders: depression (n = 30), schizophrenia (SCZ; n = 28), obsessive-compulsive disorder (OCD; n = 23), anxiety (n = 16), and bipolar affective disorder (BPAD; n = 16). Tri-gunas were assessed using a validated tool (Vedic Personality Inventory) and symptoms were assessed using standard scales as per the diagnosis. Multi-variate analysis of variance (MANOVA) was used to assess the differences in guna scores between HCs and patients, and between patients with different diagnoses. A two-tailed Pearson correlation was performed between the gunas and psychometric scales. Results revealed that HCs had significantly higher sattva traits as compared to patients (except those with OCD). Each psychiatric diagnosis also showed a specific guna configuration: (1) Anxiety disorders and OCD: High sattva-rajas, low tamas; (2) Depression: High sattva-tamas, low rajas; (3) Psychotic disorders (SCZ/BPAD): High tamo-rajas, low sattva. Significant positive correlations were observed between rajas traits and anxiety/OC/positive psychotic symptoms, negative psychotic symptoms and tamas traits, and sattva traits and OC symptoms. This finding has clinical implications, both to develop ways of predicting outcomes of psychiatric disorders, as well as to develop psycho-therapeutic and lifestyle interventions targeting the gunas.

The effects of education on foot care behaviors and self-efficacy in type 2 diabetes patients

Background

Diabetic foot significantly affects the quality of life of patients with diabetes. It leads to loss of labor force, psychosocial trauma, and high treatment costs due to serious morbidity and mortality. Nurses have an important responsibility to improve the metabolic status of individuals with diabetes, to protect them from foot complications, and to teach patients foot care skills.

Aim

This study investigated the effects of education on type 2 diabetes patients regarding diabetic foot care and self-efficacy.

Materials and Methods

This quasi-experimental study was conducted from February to July 2016 in hospitals located in the city of Balıkesir in Turkey with type 2 diabetes patients who were admitted to the internal medicine clinic and monitored by the endocrinology and internal medicine outpatient clinics. G*power 3.1.9.2 software was used to calculate the sample size of 94 people with a 5% type 1 error, and 90% power. The study was carried out with stratified randomization, and a questionnaire was administered to the experimental and control groups. The experimental group received training, and both groups' scores on the Diabetic Foot Behavior Questionnaire [Appendix 1] and the Diabetic Foot Care Self-Efficacy Scale [Appendix 2] were compared after three months. The t-test, the paired t-test, and the Chi-square test were used.

Results

While the self-efficacy and the foot care behavior scores of the control group did not show any differences (P > 0.05), the experimental group's scores were significantly higher (P < 0.05). The control group's self-efficacy and foot care behavior scores on the pre-test and final test were similar, while the experimental group's scores increased (P < 0.05).

Conclusions

Starting from the diagnosis of diabetes, it is advisable to carry out foot assessments and to follow up with diabetics who received foot care education to increase their self-efficacy, to make foot care a habit, and to re-evaluate missing or incorrect practices during check-ups.

An experimental study of liquid micro-jets produced with a gas dynamic virtual nozzle under the influence of an electric field

The results of an experimental study of micro-jets produced with a gas dynamic virtual nozzle (GDVN) under the influence of an electric field are provided and discussed for the first time. The experimental study is performed with a 50% volume mixture of water and ethanol, and nitrogen focusing gas. The liquid sample and gas Reynolds numbers range from 0.09-5.4 and 0-190, respectively. The external electrode was positioned 400-500 μm downstream of the nozzle tip and an effect of electric potential between the electrode and the sample liquid from 0-7 kV was investigated. The jetting parametric space is examined as a function of operating gas and liquid flow rates, outlet chamber pressure, and an external electric field. The experimentally observed jet diameter, length and velocity ranged from 1-25 μm, 50-500 μm and 0.5-10 m/s, respectively. The jetting shape snapshots were processed automatically using purposely developed computer vision software. The velocity of the jet was calculated from the measured jet diameter and the sample flow rate. It is found that micro-jets accelerate in the direction of the applied electric field in the downstream direction at a constant acceleration as opposed to the standard GDVNs. New jetting modes were observed, where either the focusing gas or the electric forces dominate, encouraging further theoretical and numerical studies towards optimized system design. The study shows the potential to unlock a new generation of low background sample delivery for serial diffraction measurements of weakly scattering objects.

#SexyBodyPositive: When Sexualization Does Not Undermine Young Women's Body Image

Research suggests that exposure to social networking sites portraying a thin and often sexualized beauty ideal reduces young women's body satisfaction, while exposure to body-positive content improves it. However, it is unclear whether sexualization could impair the beneficial effects of body-positivity messages. Young Italian women were exposed to one of three experimental conditions showing sexualized beauty ideals, sexualized body positivity, or non-sexualized body positivity that appeared either on Instagram (Study 1, N = 356) or TikTok (Study 2, N = 316). Across the two studies, results showed that, regardless of sexualization, exposure to body positivity increased body satisfaction and positive mood compared with pre-exposure measures, while exposure to sexualized beauty ideals reduced it. Participants in the sexualized beauty ideal condition also engaged in upward appearance social comparison whereas body positivity elicited downward comparison. Problematic social networking sites' use moderated the effects of condition on body satisfaction, appearance social comparison, and positive mood, while downward comparison mediated the relation between condition and body satisfaction and positive mood. Our results highlight both beneficial and critical aspects of body positivity that should be taken into consideration when designing body image interventions and policymaking.

Clearance of Metal Particles After Percutaneous Nephrolithotomy with Trilogy Lithotripter

Purpose: To evaluate the clearance of metal particles produced and released in the pelvicaliceal system (PCS) during percutaneous nephrolithotomy (PCNL) with the use of the Swiss Lithoclast^® Trilogy dual-energy (EMS Urology, Nyon, Switzerland) lithotripter. Methods: An experimental in vivo study and a clinical investigation of case series were conducted. An in vivo porcine model with two pigs for lithotripsy (after inserting artificial stones into the collecting system) and two pigs for submucosal injection of metal particles (provided by the manufacturer of Trilogy) was conducted. Porcine kidney histology analysis for metal leftovers was conducted immediately or 2 weeks after the surgery. A prospective observational study design included 10 consecutive patients treated with conventional 30F PCNL or with 22F mini-PCNL technique. Only the patients with the confirmed metal particles in the PCS during the initial PCNL and the need for additional retrograde intrarenal surgery over a period of 2-4 weeks were selected. The presence of metal particles was evaluated during the second endoscopic surgery. Results: The generated metal particles during PCNL and the submucosally injected particles were not found macroscopically 2 weeks postoperatively in porcine models. No pathologic changes such as foreign body granuloma or inflammation were found. Similarly, no metal particles were observed during the second look endoscopy (n = 10). Conclusion: Metal particles observed endoscopically using the Trilogy lithotripter are cleared with no pathologic evidence of tissue damage from the metal particles 2 weeks after the procedure. Thus, the intraoperative release of any particle by the Trilogy lithotripter should not raise any safety concerns.

To be or not to be stressed: Designing autonomy to reduce stress at work

BACKGROUND

Many organizations are undertaking efforts to reduce the stress of (oftentimes overworked) employees. Information Technology (IT) (e.g., smartphones) has the potential to be a key instrument for reducing stress. One design-relevant factor considered to reduce stress is the concept of autonomy. Unfortunately, little research exists using autonomy as a characteristic of technology design.

OBJECTIVE

Against this background, this study aimed to investigate specific autonomy-related design options with the potential to prevent stress.

METHODS

In a factorial survey, this experimental study tested three design options in an overwork scenario: 1) autonomy (no intervention by design), 2) nudge ("nudging" by design), and 3) enforcement (hard stop by design). 51 participants (mean age 38 years, 50% women, mean work experience 18 years) from the Netherlands, United Kingdom, United States of America, and Germany participated in the experiment for 330 seconds on average. To test our hypothesis, we used a two-step approach. First, a multiple linear regression was applied. Second, we carried out a one-way ANCOVA comparing the effects of our design options.

RESULTS

Our results indicate that autonomy can be manipulated through technology design and is negatively correlated with stress. Additionally, the design options autonomy and nudge were associated with lower levels of perceived stress than was enforcement.

CONCLUSION

The study proposes a careful use of IT and policies that limit the perceived autonomy of employees. Overall, this study offers a set of design recommendations arguing that organizations should implement technology that helps employees prevent overwork and maintain their autonomy.

Experimental study of a heparin-coated venous stent fabricated by atomic layer deposition

OBJECTIVE

To evaluate the safety and efficacy of heparin-coated venous stents in animals.

METHODS

We used atomic layer deposition technology to obtain a heparin coating with good stability and then prepared a heparin-coated venous stent based on this technology. The experimental stents were prepared according to the diameter of the rabbit inferior vena cava and were divided into Ni-Ti alloy stent group, Ni-Ti-Al₂O₃ stent group and Ni-Ti-Al₂O₃-Heparin stent group. 3 days, 7 days and 14 days after stent implantation, the materials were collected, and the three groups of stents were observed by hard tissue section pathology, immunohistochemistry and scanning electron microscope to observe the differences in vascular wall inflammation, thrombosis, lumen stenosis and vascular intima regeneration.

RESULT AND CONCLUSION

The experiment confirmed the safety of the heparin-coated stent in vivo. Compared with the control group, the experimental group showed a high degree of vascular endothelialization and an intact neointimal structure 14 days after implantation. The long-term safety and biological effects of heparin-coated venous stents in animals require further study.

Microstructure-Based Computational Analysis of Deformation Stages of Rock-like Sandy-Cement Samples in Uniaxial Compression

This work presents a new finite-difference continuum damage mechanics approach for assessment of threshold stresses based on the mechanical response of a representative volume element of a sandy-cement rock-like material. An original experimental study allows validating the mathematical model. A new modification of the damage accumulation kinetic equation is proposed. Several approaches based on acoustic emission, instantaneous Poisson's ratio and reversal point method are employed to determine the threshold stresses. Relying on the numerical modeling of deformation and failure of model samples, the threshold stresses and the deformation stages are determined. The model predicts the crack initiation stress threshold with less than 10% error. The model prediction of the crack damage stress threshold corresponds to the upper boundary of the experimental range. The model predicts the peak stress threshold with less than 0.2% error in comparison with the average experimental peak stress. The results of numerical modeling are shown to correlate well with the available experimental and literature data and sufficiently complement them.

Kombuchas from Green and Black Tea Modulate the Gut Microbiota and Improve the Intestinal Health of Wistar Rats Fed a High-Fat High-Fructose Diet

The Western diet can negatively affect the gut microbiota and is associated with metabolic disorders. Kombucha, a tea fermented by a symbiotic culture of bacteria and yeast (SCOBY), is known for its bioactive properties and has become popular in the last years. In this study, we evaluated the effects of regular kombucha consumption on the gut microbiota and on outcomes related to the intestinal health of Wistar rats fed a high-fat high-fructose diet. After eight weeks receiving a standard diet (AIN-93M) (n = 10) or a high-fat and high-fructose diet (HFHF) (n = 30) to induce metabolic disorders, the animals were subdivided into four groups: AIN-93M (n = 10); HFHF (n = 10); GTK (HFHF + green tea kombucha (n = 10); and BTK (HFHF + black tea kombucha; n = 10) for 10 weeks. Although body composition did not differ among the groups, the HFHF diet was associated with metabolic alterations, and stimulated the growth of gram-negative bacteria such as Proteobacteria and Bacteroides. Kombucha ingestion could somewhat modulate the gut microbiota, attenuating the effects of a Western diet by increasing propionate production and favoring the growth of beneficial bacteria, such as Adlercreutzia in the GTK group. Our results suggest that regular kombucha consumption may be beneficial to intestinal health, which can be mostly attributed to its high content and diversity of phenolic compounds.

Curcumin-Added Whey Protein Positively Modulates Skeletal Muscle Inflammation and Oxidative Damage after Exhaustive Exercise

(1) Background: Exhaustive exercise can induce muscle damage. The consumption of nutritional compounds with the ability to positively influence the oxidative balance and an exacerbated inflammatory process has been previously studied. However, little is known about the nutritional value of curcumin (CCM) when mixed with whey protein concentrate (WPC). This study was developed to evaluate the effect of CCM-added WPC on inflammatory and oxidative process control and histopathological consequences in muscle tissue submitted to an exhaustive swimming test (ET). (2) Methods: 48 animals were randomly allocated to six groups (n = 8). An ET was performed 4 weeks after the start of the diet and animals were euthanized 24 h post ET. (3) Results: WPC + CCM and CCM groups reduced IL-6 and increased IL-10 expression in muscle tissue. CCM reduced carbonyl protein after ET compared to standard AIN-93M ET and WPC + CCM ET diets. Higher nitric oxide concentrations were observed in animals that consumed WPC + CCM and CCM. Consumption of WPC + CCM or isolated CCM reduced areas of inflammatory infiltrate and fibrotic tissue in the muscle. (4) Conclusions: WPC + CCM and isolated CCM contribute to the reduction in inflammation and oxidative damage caused by the exhaustive swimming test.

The Effect of Using Reactive Agility Exercises with the FITLIGHT Training System on the Speed of Visual Reaction Time and Dribbling Skill of Basketball Players

The study aimed to determine the effect of reactive agility with the FITLIGHT training system on the speed of the visual reaction time and dribbling skill of basketball players. Participants were divided into an experimental group (n = 10; age, 14.80 ± 0.79 years; height, 163.80 ± 3.46 cm; weight, 55.90 ± 0.99 kg; training, 4.50 ± 0.53 years) and a control group (n = 10; age, 14.60 ± 0.70 years; height, 163.30 ± 3.47 cm; weight, 56.10 ± 0.74 kg; training, 4.30 ± 0.48 years). Reactive agility was assessed through a modified t-test, visual reaction time was assessed using the Li Lafayette instrument Visual Reaction Time Apparatus 63014 response panel, and dribbling skills were assessed through dribbling testing. The results showed improved agility through the modified agility t-test (11%; p = 0.001), an increased speed of visual reaction time for both the right and left hands (23-31%), and improved dribbling skills (19%; p = 0.001) for the experimental group using the FITLIGHT reactive agility software. The results also showed increased skills of the experimental group when compared to the control group. Differences in variability emerged between 6 and 14.1% in favor of the experimental group. Therefore, the researchers recommended that attention should be paid to activating the role of the FITLIGHT reactive agility training to improve and develop the physical, visual, and skill capabilities of basketball players. The researchers propose that FITLIGHT can be effectively used in the basketball training process.

Experimental Study on Hot Spot Stresses of Curved Composite Twin-Girder Bridges

Curved composite twin-girder bridges are suitable for mountainous areas, due to their advantages of light self-weight, excellent mechanical performance, and fewer construction requirements. It has been found that many composite twin-girder bridges collapsed due to fatigue failure. However, the literature review showed no relevant studies on the fatigue performance of curved composite twin-girder bridges. Because of this, the specimen of 1:2 scale curved composite twin-girder bridge in accordance with the design scheme of Xizhen Bridge in China was designed and tested. Three possible fatigue details were selected: cruciform connections, transverse attachments, and transverse splices named Class I, Class II, and Class III. For the test data of nominal stress (NS), equations were proposed to convert the strain value into the internal force of the fatigue detail position. The stress caused by torsion accounts for 2.8% of the total stress, which is almost negligible. The fatigue evaluation process based on the hot spot stress (HSS) S-N curve method is presented. The HSS method is more conservative than the NS S-N curve method in predicting the fatigue life of complex structures with high-stress concentrations.

Experimental Study of Injection Molding Replicability for the Micro Embossment of the Ultrasonic Vibrator

It is challenging to fabricate micro features on an injection-molded polymer product. Ultrasonic vibration induced into micro-injection molding is helpful for flow of polymer melt. In this paper, a micro-injection mold integrated with ultrasonic vibration was designed and fabricated, and micro embossment was machined on the surface of the ultrasonic vibrator. Poly(methacrylic acid methyl ester) (PMMA) was used for injection molding experiments, with four ultrasonic power levels (0, 300, 600, and 900 W), three injection speed levels (60, 80, and 100 cm³/s), two injection pressure levels (60 and 90 MPa) and a mold temperature of 60 °C. It was found that ultrasonic vibration perpendicular to the middle surface of the cavity is beneficial in forming transverse microstructure, but is not conducive to generating longitudinal microstructure. Increase in injection pressure can improve molding qualities for both the longitudinal micro groove and the transverse micro groove. Increase in injection speed is not conducive to forming the longitudinal micro groove but benefits formation of the transverse micro groove. When ultrasonic vibration is applied at the injection and packing stages, molding quality of the longitudinal micro groove becomes worse, while that of the transverse micro groove becomes better.

Open science and public trust in science: Results from two studies

In two studies, we examined whether open science practices, such as making materials, data, and code of a study openly accessible, positively affect public trust in science. Furthermore, we investigated whether the potential trust-damaging effects of research being funded privately (e.g. by a commercial enterprise) may be buffered by such practices. After preregistering six hypotheses, we conducted a survey study (Study 1; N = 504) and an experimental study (Study 2; N = 588) in two German general population samples. In both studies, we found evidence for the positive effects of open science practices on trust, though it should be noted that in Study 2, results were more inconsistent. We did not however find evidence for the aforementioned buffering effect. We conclude that while open science practices may contribute to increasing trust in science, the importance of making use of open science practices visible should not be underestimated.

Open science and public trust in science: Results from two studies

In two studies, we examined whether open science practices, such as making materials, data, and code of a study openly accessible, positively affect public trust in science. Furthermore, we investigated whether the potential trust-damaging effects of research being funded privately (e.g. by a commercial enterprise) may be buffered by such practices. After preregistering six hypotheses, we conducted a survey study (Study 1; N = 504) and an experimental study (Study 2; N = 588) in two German general population samples. In both studies, we found evidence for the positive effects of open science practices on trust, though it should be noted that in Study 2, results were more inconsistent. We did not however find evidence for the aforementioned buffering effect. We conclude that while open science practices may contribute to increasing trust in science, the importance of making use of open science practices visible should not be underestimated.

Open science and public trust in science: Results from two studies

In two studies, we examined whether open science practices, such as making materials, data, and code of a study openly accessible, positively affect public trust in science. Furthermore, we investigated whether the potential trust-damaging effects of research being funded privately (e.g. by a commercial enterprise) may be buffered by such practices. After preregistering six hypotheses, we conducted a survey study (Study 1; N = 504) and an experimental study (Study 2; N = 588) in two German general population samples. In both studies, we found evidence for the positive effects of open science practices on trust, though it should be noted that in Study 2, results were more inconsistent. We did not however find evidence for the aforementioned buffering effect. We conclude that while open science practices may contribute to increasing trust in science, the importance of making use of open science practices visible should not be underestimated.

Open science and public trust in science: Results from two studies

In two studies, we examined whether open science practices, such as making materials, data, and code of a study openly accessible, positively affect public trust in science. Furthermore, we investigated whether the potential trust-damaging effects of research being funded privately (e.g. by a commercial enterprise) may be buffered by such practices. After preregistering six hypotheses, we conducted a survey study (Study 1; N = 504) and an experimental study (Study 2; N = 588) in two German general population samples. In both studies, we found evidence for the positive effects of open science practices on trust, though it should be noted that in Study 2, results were more inconsistent. We did not however find evidence for the aforementioned buffering effect. We conclude that while open science practices may contribute to increasing trust in science, the importance of making use of open science practices visible should not be underestimated.

Experimental Study on the Blast Resistance Performance of FRP Grid & Mortar Reinforced Concrete Arch Structure

In order to verify the feasibility of using FRP grid and mortar reinforcement technology to enhance the blast resistance of concrete arch structures, this paper designed and fabricated FRP grid and mortar reinforced concrete arch structures and conducted blast resistance tests in the field. A detailed design of anti-explosion scheme was carried out before the experiment. The tests were conducted to observe the structural cracking, concrete collapse, and reinforcement peeling of FRP grid and mortar reinforced concrete arch under the explosion. In order to compare the anti-explosion performance with the protective arch structures in other literature, the explosion of 2 kg TNT with a blast distance of 600 mm was selected. After the explosion, it was found that the blast resistance of the FRP grid and mortar reinforced concrete arch was significantly higher than that of the unreinforced arch, and the concrete arch reinforced with FRP grid and mortar has a better damage patterns and improved blast resistance performance than that of the FRP and steel plate reinforced arch. According to the research results, the FRP grid and mortar composite reinforcement technology can be used to enhance the blast resistance of arch structures in protection projects.