Reinforced Research Articles

Unsteady MHD flow of tangent hyperbolic ternary hybrid nanofluid in a darcy-forchheimer porous medium over a permeable stretching sheet with variable thermal conductivity

Background This research investigates the unsteady magnetohydrodynamic (MHD) flow, heat, and mass transfer of tangent hyperbolic ternary hybrid nanofluids over a permeable stretching sheet. The study considers three types of nanoparticles—aluminum oxide (Al₂O₃), copper (Cu), and titanium oxide (TiO₂)—dispersed in a base fluid of ethylene glycol (C₂H₆O₂). This ternary hybrid nanofluid (Al₂O₃–Cu–TiO₂/C₂H₆O₂) has potential applications in cooling systems, biomedical uses for targeted drug delivery and hyperthermia treatments, heat exchangers, and polymer processing techniques like extrusion and casting. Methods The study examines the effects of various parameters, including the Weissenberg number, power law index, nanoparticle volume fraction, viscous dissipation, magnetic field, heat generation, nonlinear thermal radiation, temperature ratio, Joule heating, Brownian motion, thermophoresis, porous permeability, variable thermal conductivity, Eckert number, Prandtl number, Schmidt number, chemical reaction, velocity ratio, Forchheimer number, and unsteady parameters. The governing equations are transformed into similarity equations using appropriate transformations and solved numerically with the MATLAB BVP5C package. The results are validated against data from published articles to ensure reproducibility. Results The findings reveal that an increase in the Weissenberg and Forchheimer numbers reduces the velocity profile, while the temperature distribution increases. The variable thermal conductivity parameter (Γ) leads to a higher temperature profile, indicating improved heat transfer. Higher nanoparticle concentrations in the nanofluids and hybrid nanofluids result in enhanced skin friction, Nusselt number, and Sherwood number. Ternary hybrid nanofluids show the most significant improvement in heat transfer and thermal conductivity. Conclusions Ternary hybrid nanofluids significantly enhance heat and mass transfer, showing potential for applications in cooling systems, drug delivery, and polymer processing. The numerical results are consistent with previous research, confirming the reliability and reproducibility of the findings

Charpy Impact Test Result Comparison on Reinforcing Materials used in Continuous Filament 3D Printing

With the growing industrial demand for materials that can withstand dynamic loads, composite 3D printing, particularly utilizing continuous fiber reinforcements, presents a promising solution. This study investigates the toughness of three fiber-reinforced materials, namely carbon fiber, Kelvar, and fiberglass, by conducting Charpy impact tests. The results reveal that fiber-reinforced 3D materials significantly outperform standard 3D printed components, with fiberglass showing the highest toughness. These findings demonstrate that fiber-reinforced 3D printed materials offer a viable alternative for applications requiring high toughness and dynamic resistance.

Comparing Equivalence‐Based Instruction to a PowerPoint Video Lecture to Teach Differential Reinforcement Descriptors to College Students

ABSTRACTDifferential reinforcement (DR) procedures involve systematically arranging the environment to increase the future frequency of socially important behaviors while minimizing or eliminating problem behaviors. The purpose of the present study was to compare the effects of computerized stimulus equivalence‐based instruction (EBI) to a pre‐recorded voiceover PowerPoint lecture to teach definitions and examples of differential reinforcement procedures to college students. The three classes comprised textual stimuli characterizing differential reinforcement of other (DRO), alternative (DRA), and incompatible (DRI) behavior. Each class contained three members: name, definition, and short vignette examples. To program for generalization, two vignette exemplars were used during training while a third exemplar was used to assess stimulus generalization. We used a between‐subjects group design to compare pretest and posttest performances of EBI and lecture participants across (a) computer match‐to‐sample (MTS), (b) card sorting, and (c) written tests (fill‐in and multiple‐choice), with the latter two used to determine the degree to which class‐consistent responding generalized from selection‐based responding to other response topographies (i.e., sorting and writing). Results demonstrated that EBI produced greater score increases than lecture for MTS and card sorting tests, but increases were comparable for the two groups for both fill‐in and multiple‐choice written tests. Another posttest at 1 week showed maintenance of performance gains. Implications for using EBI to teach behavior analytic content are discussed.

The Effects of a DRO and Self-Monitoring Program on Prisoners in an Italian Prison

Abstract This study examined the effectiveness of differential reinforcement of other behavior and self-monitoring in reducing challenging behavior among sixteen male inmates in an Italian prison. A multiple baseline design across groups was used to evaluate changes in property destruction, self-injury, and aggression. Results indicated a substantial reduction in these targeted behaviors across all participants. Social validity measures indicated improved inmate perception of their quality of life and interactions with others in the prison.

Experimental and 1D Modeling Analysis of Thermoelectric Generation to Improve the Performance of Compressed Natural Gas Heavy-Duty Engines Used in Commercial 22-Ton Trucks

<div>A significant amount of chemical fuel energy in internal combustion engines is wasted through exhaust heat. Waste heat recovery (WHR) systems can transform the heat into electrical energy using thermoelectric generators (TEG). This work utilizes a 1D CFD model to demonstrate the potential of TEG-WHR in improving the thermal efficiency of mass-production, compressed natural gas (CNG) engines used in commercial 22-ton heavy-duty trucks. First, the TEG with heat exchanger experiments are performed to measure thermal and electrical performance data under different fin pitches and inlet gas conditions (Re number, temperature, gas flow rate). These data are used to develop and validate a TEG model, which considers user-defined functions of heat transfer and flow friction coefficients to reproduce measured thermal/electrical characteristics of the integrated TEG with its heat exchanger. The engine experiments are conducted based on the speed–torque map (51 test conditions) of the JE05 heavy-duty cycle using the turbocharged engine equipped with a multi-port injection system. The engine model is calibrated and validated against test data under base conditions (using production valve timings), optimal variable valve actuation (VVA), and variable compression ratio (VCR). Finally, the high-fidelity engine and TEG models are integrated to predict the electrical power generated by a compact TEG-WHR (three-layer, size: 1.3 × A4-paper). The integrated model considers a tradeoff between TEG-generated power and engine pumping loss. Simulation results show that the compact TEG can generate effective 20–701 W electrical powers, translating to about 0.03–1.07% brake thermal efficiency improvement.</div>

The Influence of Fashion Creep on Dress Etiquette: Is Your Organization Marked Safe?

As consumers navigate a world increasingly influenced by digital media, globalization, and progressive social norms, their fashion choices often serve as a form of personal expression and identity. Though individuals are encouraged to exercise freedom of expression, certain espoused fashion statements in public settings challenge socially acceptable societal norms and business etiquette. Thus, business etiquette and historical trends are marked “unsafe” from the ever-changing fashion industry trends. Evolutions in fashion and variations in cultural trends continue to challenge traditional dress norms in the workplace, formal public establishments, and classrooms across America. If inconsistent with organizational norms, these changes influence unfavorable perceptions of constituents and the respective organizations. Managing these impressions becomes critical for decision-makers desiring to protect an organization’s reputation and brand image. This paper explores the underlying dynamics shaping dressing norms, the paradigm shift, influences on professional attire, and outcomes associated with style selections. To embrace the changes and protect company images, we recommend continuous evaluation and reinforcement of dress code policies. We examine External Conformity Theory and Impression.

Analytical Model of Temperature-Induced Deformation for Tunable Thermal Expansion Metamaterial

Tunable thermal expansion metamaterials exhibit superior shock absorption performance in the field of high-precision equipment, but the applications are currently restricted by the unclear quantitative relationship of temperature-induced deformation. Herein, this work leverages the virtual work principle and the deformation geometric relationship to establish a generic temperature-induced deformation control model for bi-materials by utilizing the key variable coverage ratio under the condition of no deformation in the vertical direction. The feasible region regarding flexibility for the internal serpentine unit and lattice structure with different coverage ratios is given. The combination of the finite element and experimental methods is adopted to examine temperature-induced deformation, which presents tunable thermal expansion performances associated with the coverage ratio and temperature. This work, based on the established deformation coordination relationship of dual-material temperature-sensitive metamaterials, achieves temperature-induced deformation control and provides a reference for structural design adaptable in various working conditions such as vibration isolation and vibration reduction in complex engineering such as aerospace and so on. By strategically designing the coverage of the two structures within the specified range to maintain equivalent flexibility, the ultimate deformation of the serpentine unit is reduced by one-half due to deformation induced by temperature variations.

Baseline Fasting Glucose Level, Age, Sex, and Body Mass Index and the Development of Diabetes in US Adults

Understanding the interplay between diabetes risk factors and diabetes development is important to develop individual, practice, and population-level prevention strategies. To evaluate the progression from normal and impaired fasting glucose levels to diabetes among adults. This retrospective community-based cohort study used data from the Rochester Epidemiology Project, in Olmsted County, Minnesota, on 44 992 individuals with at least 2 fasting plasma glucose (FPG) measurements from January 1, 2005, to December 31, 2017. People who met criteria for diabetes on or before their first FPG measurement were excluded. Data were electronically retrieved in December 2019 with analyses finalized in November 2024. The exposure was baseline FPG level, with covariates including the following measures that are consistently recorded in the electronic health record: body mass index (BMI), age, and sex. The cumulative probability of freedom from diabetes was estimated and presented graphically using a Kaplan-Meier curve. Multivariable Cox proportional hazards regression modeling was used to estimate the partial hazard ratios (HRs) for variables of interest. Diabetes was defined as an FPG level greater than 125 mg/dL. A total of 44 992 individuals (mean [SD] age at baseline, 43.7 [11.8] years; 26 025 women [57.8%]) were included. The baseline mean (SD) BMI was 28.9 (6.6). Over a median follow-up of 6.8 years (IQR, 3.6-9.7 years), 3879 individuals (8.6%) developed diabetes. The Kaplan-Meier 10-year cumulative risk of incident diabetes was 12.8% (95% CI, 12.4%-13.2%). All initial FPG levels outside a range of 80 to 94 mg/dL were associated with increased risk for diabetes (ie, FPG <70 mg/dL: HR, 3.49 [95% CI, 2.19-5.57]; FPG 120-125 mg/dL: HR, 12.47 [10.84-14.34]). Other independent risk factors were male sex (HR, 1.31 [95% CI, 1.22-1.40]), older age (≥60 years: HR, 1.97 [95% CI, 1.71-2.28]), and any abnormal category of BMI, including underweight (BMI <18.5: HR, 2.42 [95% CI, 1.77-3.29]; BMI ≥40: HR, 4.03 [95% CI, 3.56-4.56]). There was a significant additive association of variables, particularly FPG level and BMI. For instance, a woman aged 55 to 59 years with a BMI of 18.5 to 24.9 and an FPG level of 95 to 99 mg/dL had an estimated 10-year diabetes risk of 7.0%. However, an almost doubling of risk to 13.0% was observed if the BMI was 30.0 to 34.9, and risk more than doubled again to 28.0% if FPG level also increased to 105 to 109 mg/dL. A nomogram was generated to facilitate individual classification into one of four 10-year risk categories. This retrospective cohort study of 44 992 individuals suggests that FPG level, age, BMI, and male sex were all associated with development of diabetes, with significant interaction between these variables. These data contribute to understanding the clinical course of diabetes and highlight the substantial individual variation in diabetes risk according to commonly measured clinical variables. The findings facilitate lifestyle and pharmacologic interventions to treat those at highest risk of diabetes to reduce future morbidity and mortality. Further work is needed to validate this risk categorization tool for different populations.

Does amplitude compression help or hinder attentional neural speech tracking?

Amplitude compression is an indispensable feature of contemporary audio production and especially relevant in modern hearing aids. The cortical fate of amplitude-compressed speech signals is not well-studied, however, and may yield undesired side effects: We hypothesize that compressing the amplitude envelope of continuous speech reduces neural tracking. Yet, leveraging such a 'compression side effect' on unwanted, distracting sounds could potentially support attentive listening if effectively reducing their neural tracking. In this study, we examined 24 young normal-hearing (NH) individuals, 19 older hearing-impaired (HI) individuals, and 12 older normal-hearing individuals. Participants were instructed to focus on one of two competing talkers while ignoring the other. Envelope compression (1:8 ratio, loudness-matched) was applied to one or both streams containing short speech repeats. Electroencephalography (EEG) allowed us to quantify the cortical response function and degree of speech tracking. With compression applied to the attended target stream, HI participants showed reduced behavioural accuracy, and compressed speech yielded generally lowered metrics of neural tracking. Importantly, we found that compressing the ignored stream resulted in a stronger neural representation of the uncompressed target speech. Our results imply that intelligent compression algorithms, with variable compression ratios applied to separated sources, could help individuals with hearing loss suppress distraction in complex multi-talker environments.Significant statement Amplitude compression, integral in contemporary audio production and hearing aids, poses an underexplored cortical challenge. Compressing the amplitude envelope of continuous speech is hypothesized to diminish neural tracking. Yet, capitalizing on this 'compression side effect' for distracting sounds might enhance attentive listening. Studying normal-hearing (NH), older hearing-impaired (HI), and older normal hearing individuals in dual-talker scenarios, we applied envelope compression to speech streams. Both NH and HI participants showed diminished neural tracking with compression on the speech streams. Despite weaker tracking of a compressed distractor, HI individuals exhibited stronger neural representation of the concurrent target. This suggests that adaptive compression algorithms, employing variable ratios for distinct sources, could aid individuals with hearing loss in suppressing distractions in complex multi-talker environments.

Bioequivalence and Food Effect Assessment Between 2 Oral Tablet Formulations of Rivaroxaban 20mg in Healthy Chinese Subjects.

To evaluate the bioequivalence and safety of oral rivaroxaban tablets between a test formulation and a reference formulation in healthy Chinese subjects, a randomized, open, 2-formulation, 4-cycle, complete repeat crossover study was conducted under both fasting and fed states. Thirty-six healthy participants were enrolled separately for the fasting and fed groups, and each subject received a single oral dose of 20mg of the test or reference formulation of rivaroxaban tablets per cycle. Blood samples were collected at specified intervals, and rivaroxaban was analyzed using liquid chromatography-tandem mass spectrometry. Under fasting and fed conditions, the 90% confidence intervals (CIs) for the geometric mean ratios of the maximum concentration (Cmax), the area under the plasma concentration-time curve from time 0 to the last measurable time point (AUC0-t), and the area under the curve extrapolated to infinity from time 0 (AUC0-∞) all fell within the 80%-125% CI, and the upper limit of the 90% CIs for the test-to-reference ratio of the within-subject variability was <2.5. This indicated that the test formulation of rivaroxaban is bioequivalent to the reference formulation. Compared to the fasted state, the Cmax, AUC0-t, and AUC0-∞ of rivaroxaban increased significantly by factors of 2, 1.6, and 1.5, respectively, following oral administration of 20mg of rivaroxaban in the fed state. This suggests that a high-fat diet significantly enhances the exposure to rivaroxaban. No serious adverse events were reported under fasting or fed conditions.

The Effect of Variable Ratios of Na2O/K2O Oxides in Glazes Containing BaO, ZnO, and ZrO2: Structural Analysis, Characteristic Temperatures, and Surface Properties

In this paper, the glazes of a multicomponent system (SiO2-Al2O3-CaO-MgO-Na2O-K2O-BaO-ZnO-ZrO2) were examined. This work focuses on five glazes and the difference between them as the molar ratio of the alkali oxides Na2O/K2O. Analysis of fired glazes focused on changes in phase composition (qualitative and quantitative) microstructure performed during observations made by scanning electron microscopy (SEM). The changing molar ratios were also studied in the structure analysis based on the result of data obtained by middle infrared (MIR) and Raman spectroscopy. The characteristic temperatures of the analyzed glazes were also designated using high-stage microscopy. Surface properties such as the color and roughness of the fired glazes were measured by means of a spectrometer and confocal microscopy as well. The amount and type of crystalline phases with the molar ratio of alkali oxides in the analyzed glazes were changed. In the glazes, the crystalline phase of a solid solution of plagioclase was obtained. The results obtained indicate that glazes with a predominant potassium oxide are characterized by lower characteristic temperatures and greater surface smoothness. Structure analysis indicates a different role for the five-molar ratio of Na2O/K2O.

Advanced design strategies and applications for enhanced higher-order multisegment denatured pascal curve gears

The existing Pascal curve gears suffer from limited flexibility in pitch curves and restricted changes in transmission ratios. This has impeded the application in a range of mechanical systems that require more adaptable gear solutions. For this, a design procedure for higher-order multisegment denatured Pascal curve gear is proposed. This innovative design offers greater flexibility in pitch curves and allows for a broader range of transmission ratios. The analysis of the transmission ratio confirms the theoretical predictions and highlights the effectiveness of the proposed gear design in achieving variable transmission ratios. The transmission mechanism of the higher-order multisegment denatured Pascal curve gear is analyzed and the unified mathematical expression of the families of Pascal curve gear is derived. The non-circular gears with free-form pitch curves can be obtained from higher-order multi-segment denatured Pascal curves by adjusting design parameters to unify different types of pitch curves. This approach provides significant flexibility in achieving specific transmission characteristics. Then the transmission characteristics are discussed. To further validate the design, the visual analysis and design software of the higher-order multisegment denatured Pascal curve gear is compiled based on Visual Basic, and is verified with the example. The novelty Pascal curve gears is applied to drive the differential velocity vane pump. The displacement, instantaneous flow rate, and pulsation rate of the differential velocity vane pump are calculated. The novelty drive mechanism could meet the requirements and have good performance. The application shows that the higher-order multisegment denatured Pascal curve gear is feasible in practice.

All-mirror wavefront division interferometer for Fourier transform spectrometry across multiple spectral ranges.

We report on the design of an all-mirror wavefront-division interferometer capable of spectroscopic studies across multiple spectral ranges-from the plasma frequencies of metals to terahertz wavelengths and beyond. The proposed method leverages the properties of laser sources with high spatial coherence. A theoretical framework for the interferometer scheme is presented, along with an analytical solution for determining the far-field interference pattern, which is validated through both optical propagation simulations and experimental results. The practical implementation of the spectrometer, using cost-effective off-the-shelf components (knife-edge prisms for separation and recombination), is demonstrated. The system features ultra-broad optical bandwidth, high throughput, simple architecture, dispersion-free operation, and variable arm split ratio. These unique attributes make our approach a prospective alternative to standard Fourier transform spectrometer schemes, specifically tailored to laser-based scenarios. Further, the employed design inherently enables the measurement of the sample's dispersion. In the experimental section, we demonstrate the feasibility of spectroscopic measurements by coupling the system with a supercontinuum source with more than an octave-spanning range (1.5µm - 4.4µm). As a proof-of-concept, an experimental demonstration is provided for various applied spectroscopic studies: transmission measurements of polymers (polypropylene) and gas (methane), as well as reflectance measurements of dried pharmaceuticals (insulin products on a metal surface).

Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study

Abstract Background Effective crisis management in operating rooms (ORs) is crucial for patient safety. Despite their benefits, adherence to OR crisis checklists is often limited, highlighting the need for innovative solutions. Objective The objective of this study was to evaluate the efficacy of augmented reality (AR)-enhanced checklists in improving protocol adherence, compared to traditional paper checklists and no checklist scenarios during simulated OR crises. Methods This study was a randomized comparative efficacy study comparing the utility of AR checklists, paper checklists, and no checklist scenarios using 4 validated and simulated OR crises scenarios: asystolic cardiac arrest, air embolism, unexplained hypotension/hypoxia, and malignant hyperthermia. The study took place in a simulated OR setting and had applicability to the standard procedures in ORs, critical care units, and urgent care scenarios in the emergency department. To form the 24 OR teams, 50 professionals including 24 anesthesiologists, 24 nurses, 1 surgeon, and 1 scrub nurse from two academic hospitals were included. The primary outcome measured was the failure to adhere (FTA) rate for critical actions during simulated OR crises. Adherence was determined using retrospective video analysis involving 595 key processes evaluated across 24 surgical teams. Interrater reliability was assessed using a Cohen κ. Secondary outcomes included checklist usability and cognitive load, as measured by the low-frequency to high-frequency (LF/HF) ratio of the heart rate variability. Results The AR checklist group showed a significantly lower FTA rate (mean 15.1%, SD 5.77%) compared to the paper checklist (mean 8.32%, SD 5.65%; t23=−2.08; P=.048) and the no checklist groups (mean 29.81%, SD 5.59%; t23=−6.47; P&lt;.001). The AR checklist also resulted in a higher LF/HF ratio for anesthesiologists (F2,46=4.88; P=.02), showing a potential increase in the level of cognitive load. Survey data indicated positive receptions for both AR and paper checklists. Conclusions These results suggest that AR checklists could offer a viable method for enhancing adherence to critical care protocols. Although, further research is needed to fully assess their impact on clinical outcomes and to address any associated increase in cognitive load.

Managing disruptive behaviors at school: a meta-analysis of strategies using differential reinforcement for all

Disruptive behaviors are a source of concern in schools. Differential reinforcement strategies are often recommended to reduce their emergence by withholding access to their reinforcer while reinforcing appropriate behaviors. Differential Reinforcement for All (DR-All) refers to using a differential reinforcement strategy in the same way for all the students in a class, which would be even beneficial if applied consistently throughout the school year. This meta-analysis includes 16 single-case studies conducted in regular primary schools. The results revealed an effect of the DR-All strategy on the reduction of disruptive behaviors. They also showed a large effect size heterogeneity across studies, partly explained by several moderators. DR-All points to an effective way to reduce disruption in regular classroom situations.

A 15 YEAR PERFORMANCE AND EVALUATION OF CRCP EXPERIMENTAL ROAD

This study presents a comprehensive 15-year evaluation of the Continuously Reinforced Concrete Pavement (CRCP) implemented in the Nakayama Bypass on National Highway Route 112. Spearheaded by a collaborative effort from The Nippon Road Co., Ltd., the Tohoku Regional Construction Bureau, Road Management Technology Center, Tohoku Branch, and Rainbow Consultants Co., Ltd., the research aims to assess the long-term performance, durability, and maintenance requirements of CRCP under various traffic and environmental conditions. The methodology encompasses detailed inspections and performance analyses, including pavement condition surveys, crack mapping, deflection measurements, and structural integrity assessments. This longitudinal study also integrates advanced evaluation techniques to understand the CRCP's behavior over its service life, focusing on crack propagation, load transfer efficiency, and overall pavement stability. Results indicate that CRCP, with its design and construction innovations, exhibits superior durability and performance compared to traditional pavement types. Notably, the CRCP section demonstrated remarkable resistance to traffic-induced stresses and environmental impacts, showcasing minimal maintenance needs over the 15-year period. The study also highlights the importance of initial quality control and precise construction practices as key factors contributing to the pavement's longevity and reduced lifecycle costs. Conclusively, the findings advocate for the broader adoption of CRCP in road infrastructure, emphasizing its cost-effectiveness and sustainability benefits. This research contributes valuable insights into pavement engineering, offering a robust evidence base for future CRCP projects and innovations in pavement technology. (Abstract generated by AI tool ChatGPT 4)

Reducing Plate Waste in Latvian Schools: Evaluating Interventions to Promote Sustainable Food Consumption Practices.

Food waste (FW) threatens food security, environmental sustainability, and economic efficiency, with about one-third of global food production lost or wasted. Schools play a crucial role in addressing FW, representing lost resources and missed educational opportunities. The present research assessed three interventions to reduce plate waste (PW) in Rezekne City schools, namely (S1) a plate waste tracker, (S2) an awareness and educational campaign, and (S3) organizational changes, including larger plates, extended lunch breaks, and teacher supervision. Implemented in three schools with a fourth as a control, PW was measured at three intervals, at pre-intervention, short-term, and long-term post-intervention. The PW data analysis utilized two models (day view and class view) and a Wilcoxon signed-rank test. While the plate waste tracker initially reduced PW, sustained impact required continuous reinforcement. The awareness and educational campaign alone proved insufficient, highlighting the need for complex strategies. The organizational changes unexpectedly increased PW, underscoring FW's complexity. The research has concluded that reducing FW requires tailored and multi-faceted approaches. According to the MOA framework, the school catering model in Rezekne City lacks essential "Opportunities" for effective FW reduction, as students have limited flexibility in portion sizes and food choices, which hinders the interventions' effectiveness. Future research should explore adaptable FW-reducing interventions suited to specific school contexts.

The influence of anterior chamber depth on the calculation of piggyback intraocular lenses.

Demonstrate the variability of the spherical and toric ratios between the refraction at the intraocular lens (IOL) plane and the refraction at the spectacle plane when the sphere and the cylinder power of toric piggyback IOLs are calculated. Also, a comparison of the results of piggyback power calculation with variable ratios, to the power calculation performed by a major manufacturer online calculator using a fixed ratio. Experimental study with theoretical eye models. Private practice, Buenos Aires Argentina. Schematic eyes with different values of pseudophakic anterior chamber depth (ACD), refractive cylinder and sphere were used to calculate the exact toric and spherical power of the IOL needed to achieve emmetropia. The toric ratio could range between 0.88 and 1.6, while the spherical ratio between 1.01 and 1.61. Therefore, using fixed ratios can lead to errors in IOL power calculation up to 1 diopter. The most likely errors are undercorrection in eyes with deep ACD and low amounts of sphere and astigmatism and overcorrections in eyes with shallow ACD and high preoperative sphere and/or cylinder. Manufacturers that calculate the power of piggyback IOLs with a fixed ratio of toricity and sphere should develop calculators that change this ratio according to the preoperatively measured variables. An excel file with the calculator used is provided.

Stroke Triage Alpha Rescue Score (STARS): Prehospital phone-based tool to identify cerebral large vessel occlusion.

Prehospital identification of stroke patients with large vessel occlusion (LVO) is crucial to optimize transport to an endovascular thrombectomy (EVT)-capable center. Existing scores require medical or paramedical expertise and specific teachings. We aimed to validate a simple prehospital phone-based score for LVO identification. First, the Stroke Triage Alpha Rescue Score (STARS) was designed among a retrospective cohort of 3452 stroke alerts from the Emergency Medical Dispatch Centers (EMDC) registry. Phone-based neurological assessment, characteristics, final diagnosis, and brain imaging were analyzed. The items weighting was based on odds ratios (ORs) of significant variables after multivariate analysis. Secondly, STARS was assessed by dispatchers for all suspected strokes in a prospective cohort. Receiver operating curve (ROC) and predictive performances were calculated for the external validation. In the retrospective cohort, the best balance between specificity and sensitivity was obtained with a combination of six items (presence or absence of: upper, lower limbs motor deficits, language impairment, facial palsy, consciousness disorder, smoking). Each item value was determined according to their respective OR to obtain a total STARS between 0 and 13, with the most favorable cut-off higher or equal to 7 points. Then, STARS was prospectively assessed in 799 stroke alerts between March 2021 and March 2022. LVO was finally detected in 63 of 653 patients (9.6%). The area under the ROC was 0.83 [95% CI: 0.78; 0.88]. STARS≥7 had 0.83 accuracy, 0.65 sensitivity, and 0.85 specificity for detecting LVO. STARS is a simple and accurate phone-based score, without specific teaching, to detect LVO in prehospital network. STARS correctly classified 83% of stroke alerts and could be useful to identify patients with LVO eligible for EVT.

Is there a relationship between rapid weight changes and self-reported injury in combat sports athletes? A 14-month study of 24 combat sports events.

To explore the potential association between rapid weight changes and self-reported injury status (presence or absence of injury) 7 days following competitive events among male and female combat sports competitors. A 14-month study of 24 events. A weight management questionnaire was completed 1-day post-competition, and an injury questionnaire was completed 7 days post-competition. These online questionnaires provided data on body mass and injury status. Mixed effects logistic regression models were used to analyse the odds ratios of rapid weight change variables and their impact on athletes' self-reporting as injured or non-injured. There were 172 responses (155 athletes) to both questionnaires (37 females (24 %) and 118 males (76 %)); 88 athletes (51 %) reported no injury, and 84 (49 %) reported injury. Rapid weight loss 7 days (RWL -7 days) and 24 h (RWL -24 h) before weigh-ins was 4.9 % ± 3.4 % and 2.6 % ± 2.1 % for females, and 6.1 % ± 3.2 % and 3.0 % ± 1.9 % for males. Mixed effects logistic regression models returned the highest odds ratio for male RWL -24 h (odds ratio: 1.20, 95 % confidence interval: 1.00-1.43, p = 0.044). This indicates that for a 1 % increase in male RWL -24 h before official weigh-ins, the likelihood of reporting an injury increases by a factor of 1.2. Male RWL -24 h before weigh-ins is associated with reporting an injury at 7 days post-competition. Therefore, athletes and coaches should carefully consider and aim to limit pre-competition rapid weight loss to minimise the likelihood of injury.