Permanent Changes Research Articles

Modeling Drug Responses and Evolutionary Dynamics using Patient-Derived Xenografts Reveals Precision Medicine Strategies for Triple Negative Breast Cancer.

The inter- and intra-tumor heterogeneity of triple negative breast cancers (TNBC), which is reflected in diverse drug responses, interplays with tumor evolution. Here, we developed a preclinical experimental and analytical framework using treatment-naive TNBC patient-derived tumor xenografts (PDTX) to test their predictive value in personalized cancer treatment approaches. Patients and their matched PDTX exhibited concordant drug responses to neoadjuvant therapy using two trial designs and dosing schedules. This platform enabled analysis of non-genetic mechanisms involved in relapse dynamics. Treatment resulted in permanent phenotypic changes with functional and therapeutic consequences. High throughput drug screening methods in ex vivo patient derived tumor xenograft cells (PDTCs) revealed patient-specific drug response changes dependent on first-line therapy. This was validated in vivo, as exemplified by a change in olaparib sensitivity in tumors previously treated with clinically relevant cycles of standard-of-care chemotherapy. In summary, PDTXs provide a robust tool to test patient drug responses and therapeutic regimens and to model evolutionary trajectories. However, high inter-model variability and permanent non-genomic transcriptional changes constrain their use for personalized cancer therapy. This work highlights important considerations associated with preclinical drug response modeling and potential uses of the platform to identify efficacious and preferential sequential therapeutic regimens.

Serum integrin accumulation during asthma exacerbation: The role of matrix metalloproteinases.

The inflammation caused by asthma exacerbation can lead to permanent changes in the airways and loss of lung function. Integrins are membrane receptors that interact with components of the extracellular matrix and cell adhesion molecules. It is known that these receptors can be found in soluble form in some conditions such as asthma, but it is unknown if exacerbation during asthma leads to soluble integrins. Our results indicated that asthma patients showed higher levels of soluble α1, α2, and β2 integrin subunits in their serum compared to controls, as confirmed by both ELISA and western blot. During asthma exacerbation, the levels of α2 and β2 integrin subunits increased even more compared to non-exacerbation and controls, while the α1 integrin subunit decreased. Western blot analysis identified two β2 integrin subunits, one at 75 kDa and another at 120 kDa; the 120 kDa subunit increased during asthma exacerbation. The activity of matrix metalloproteinase 9 (MMP9) increased during exacerbation, while MMP2 remained unchanged. Lower forced expiratory volume in 1 second (FEV1) values were associated with higher expression levels of α2, β1, and β2 integrin subunits. Active and latent MMP9 were correlated with the levels of the β2 integrin subunit, which means that at low levels of active and latent MMP9, there are lower levels of β2 integrin subunit. In conclusion, asthma exacerbation leads to the presence of soluble integrins, particularly the β2 subunit, most likely due to MMP9-induced proteolytic cleavage.

Finnish translation and linguistic validation of the FACE-Q Head and Neck Cancer Module.

Head and neck cancer (HNC) and its treatment can result in permanent changes to a patient's appearance, speaking, eating, and psychosocial well-being. To better assess the impact of the disease on HNC patients, the FACE-Q Head and Neck Cancer Module, a health-related quality-of-life instrument, was developed. The aim of this study was to produce and linguistically validate a Finnish version of the module. The module was translated into Finnish following the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. A total of 51 patients who had undergone tumour resection and reconstruction of the oral cavity, tonsil, or tongue area between 2019 and 2021 were approached for a pilot study. They completed the translated module and provided feedback on any linguistic issues. Adjustments were made based on the pilot study comments. The FACE-Q Head and Neck Cancer Module translated well into Finnish. Twenty-one (41%) patients participated in the survey, 12 men (57%) and nine women (43%) with a median age of 66 years (range 48-89 years). The median time since surgery was 3 years (range 1-4 years). Based on the feedback from the pilot study participants, one word was changed, and one question was rewritten. Otherwise, no deficiencies were identified in the language of the module. In summary, this study produced a linguistically valid Finnish version of the FACE-Q Head and Neck Cancer Module, enabling its application in evaluating the health-related quality-of-life among Finnish HNC patients who have undergone reconstructive surgery.

Higher education for sustainable development in the digital era: Mapping the bibliometric analysis

Modern higher education institutions in developed countries are becoming active agents of permanent societal changes. The aim of the study is to map the scientific landscape on the topic of higher education for sustainable development in the context of digitalization. In the research process, bibliometric analysis, an in-built Scopus instrument, and VOSviewer were used. The findings proved that the severe restrictions faced by universities during the COVID-19 pandemic became a powerful impulse to intensify the attention of scientists to the mentioned topic. Visualization maps of keywords and scientific publications showed the existing interdisciplinary nature and the main thematic directions of research on higher education for sustainable development in the digital era. They demonstrated a direct connection between the basic principles of the sustainable development concept, sustainable development goals, higher education, universities, digitization, and digital technologies. The largest number of works on the specified subject belong to scientists from China, Spain, the Czech Republic, Germany, and Ukraine. The study concluded that future publications in the analyzed field would cover the effectiveness of digital technologies in higher education, the development of competencies for the digital economy, inclusiveness, cybersecurity, as well as ethical aspects of the use of technologies to achieve the global sustainable development goals. AcknowledgmentThis analysis is carried out within the framework of the scientific project “Model of the Post-War Recovery of Border Universities of Ukraine in the Digitalization Era Under the Sustainable Development Concept” with the support of the Ministry of Education and Science of Ukraine (Order No 1190 dated 30.12.2022).

Extrusion of High-density Porous Polyethylene Implants in the Nose.

Few alloplastic implant materials have been successfully used in nasal reconstruction. The high-density porous polyethylene (HDPE) implant is the most widely accepted alloplastic material for reconstructing the nasal structure. Some authors suggest that the problems associated with using grafts and biocompatible materials are often due to errors on the part of the surgeon or the technique used. This study aims to report several cases of complications related to using HDPEs in the nose. A total of 23 patients who reacted negatively to alloplastic implants were treated. The removal of HDPE is complex due to the formation of connective tissue within it. These complications can cause permanent atrophic changes to the skin of the nose. Most of the patients presented with extrusion of their HDPE implants in the nasal columella region. All patients underwent implant removal, cleaning, disinfection, and secondary rhinoplasty. Surgeons must be able to recognize these possible complications and manage them successfully. Even today, many professionals use alloplastic grafts for reconstruction and esthetics of the nasal region. The potential for permanent damage to the skin and soft tissues, as well as complications such as infection and extrusion of the implant, makes the use of autogenous tissue preferable over alloplastic implants. Early detection and immediate treatment of complications are essential to minimize the severity of the deformity.

Experimental Study on the Effect of Calcium Aluminate Cement Addition on the Drying and Physical Properties of Refractory Castables Containing Colloidal Silica.

Colloidal silica-bonded castables offer several advantages compared to traditional calcium aluminate cement (CAC)-bonded castables, including lower torque values during mixing, superior drying properties, and a lower CaO content. Nevertheless, information on the combination of CAC and colloidal silica is limited, and the effect of CAC additions on the drying properties of colloidal silica-bonded castables remains unknown. In this study, these drying properties were measured by rapidly heating 400 kg samples to 500 °C and assessing the resulting damage to each sample. Additionally, the physical and chemical properties of small-scale samples were analyzed to evaluate the impact of CAC addition. The analyzed properties included cold crushing strength (CCS), density, permanent linear change (PLC) and weight loss. The microstructure of the samples was investigated by FESEM and EDS. The results indicate that adding 1.5 wt.% increased the cold crushing strength at 20 °C, while lower CAC amounts had no noticeable effect. A mullite phase was observed in the sample without CAC, and correspondingly, anorthite was found in those with CAC additions. The samples exhibited significant differences in the drying tests, with the degrees of damage increasing with the CAC addition.

Higher education and the new role of the teacher: the relevance of soft skills to enhance the professional identity

Introduction: The labor market is defined today by permanent changes that are transforming the curricula in Higher Education Institutions (HEIs). HEI professors are becoming teacher-mentors who focus on improving students' perception of professional identity. Four European universities created the “Teach-BEASTs – Teaching to BE Aware STudents (Teach-BEASTs)”, an Erasmus+ program focused on this redefinition of the role of the teacher. The objectives are to demonstrate the practical value of transferred knowledge and skills in STEM subjects. Methodology: is based on a solid literature review of the article's theoretical framework and key concepts. On the other hand, it focuses on the analysis of the role of academic teachers, professors, officials in charge of academic career directions and the educational process, as well as deans and directors. Results and discussion: focus on Career Awareness Pills, which are modules that encourage students to reflect on the material covered from the perspective of their interests, passions, aptitudes, and the market value of the skills and information obtained that will be examined and constitute the core of the methodology. Conclusions: the first conclusions corroborate the objectives, specifically highlighting the value of activities to develop social skills or interpersonal skills.

Long-term immunological changes after corrective cardiacsurgery.

Infants with congenital heart disease (CHD) often undergo thymectomy during corrective cardiac surgery (CCS). The long-term immunological effects remain controversial, with concerns regarding increased susceptibility to infections, allergies, autoimmunity due to compromised immune tolerance mechanisms. This study aims to elucidate the long-term immunological effects of early thymectomy. We enrolled 22 patients who underwent thymectomy in infancy and were followed up in the Pediatric Allergy and Immunology Clinic at Marmara University. We performed demographic characteristics and detailed immunological evaluation, including immunoglobulins, vaccine responses, lymphocyte subset analyses, upregulation, proliferation of T cells and T-cell receptor excision circles (TRECs). Sixteen patients had a history of infection, including six serious infections, all in the first year. Lymphopenia was observed in 27% of patients, with a significant decrease in naive CD4+ and recent thymic emigrant T cells counts and an increase in the proportion of memory T-cells, indicating premature immune senescence. Low levels of IgG, IgA and IgM were found in 36%, 40% and 22% of patients respectively. Vaccine responses were positive in 90% of patients. TREC levels were low in all 10 patients analysed. Seven of nine patients had normal proliferation. Twenty-two percent of patients had allergic disease, and autoimmunity was not observed. Early thymectomy leads to permanent immunological changes that are indicative of early immunosenescence. It is recommended to preserve thymic tissue during surgery and requires long-term follow-up in terms of findings such as allergy and autoimmunity as well as infections due to impaired immune tolerance mechanisms.

In development intervention, professionals aim to enhance working practices and interaction

Abstract Background The social services and healthcare professions are experiencing a global labor shortage. Enhancing the appeal and retention requires the development of work and processes through community-level interventions that reduce workload and bolster resources. Further research into such interventions is necessary. This study focuses on a systematic community-based practice development model (Breakthrough Collaboratives) to evaluate the change in alignment with the development intervention’s objectives and the prerequisites for change. The evaluation will utilize the process evaluation model for well-being at work projects and health promotion interventions. Methods This qualitative process evaluation employs a multi-case study approach to depict the changes occurring during the development intervention. It assesses the development processes of fifteen workplaces across Finland. The research material includes recorded group discussions from the initial workshop, where professionals establish goals and development targets for their work. The qualitative data are analyzed using content analysis. The analysis is guided by questions such as: What goals and development objectives do participants set for their work? What workplace-specific characteristics inform these objectives? Results Preliminary findings indicate that the work units’ development objectives concentrate on updating the unit’s common rules, enhancing the induction process for new employees, improving work behavior, and refining meeting practices. Workplace-specific characteristics differ based on the work unit’s sector, the level of trust among professionals, and their willingness to critically evaluate management. Additionally, competence and professionalism emerge as prominent themes in group discussions. Conclusions In a workplace development intervention, professionals aim to enhance common working practices and interaction, with the goal of improving well-being at work. Key messages • Enhancing operational practices and promoting positive interpersonal conduct among colleagues constitutes a pivotal goal in advancing social and health care work units. • The Community based intervention provides workplaces with concrete models to support co-creation and permanent changes in working practices.

Noise inequalities and cardiovascular diseases in Bulgaria

Abstract Background Social determinants of health in the physical environment are among the social determinants that greatly impact population health. At very high levels, noise can cause permanent changes in a person’s psyche but, even at lower levels, it can cause stress and disorders. Global burden of diseases studies arrange noise on the second position among the environmental risk factors, related to sleep disturbance, cardiovascular effects etc. The study aims to analyse noise pollution in Bulgaria and measure its association with cardiovascular diseases. Methods National Statistical Institute and Eurostat data were used to analyse the noise pollution in Bulgaria. The 28 regions were compared according to the proportion of surveyed points above permissible limits and the death rates due to CVD, /2022/. Data were statistically processed with SPSS v.26. To establish the correlation, the Pearson coefficient was used. Results Data provided by Eurostat reveal that 9% of the total population suffers from noise but there is a very positive trend - from 17.7% /in 2005/ to 8.7% /in 2023/. The share of surveyed points above permissible limits shows a continuing trend of maintaining a high percentage - 71.80% /2011/ and 68.62%/2022/. The district comparison shows significant variations - Blagoevgrad -17.65% and Silistra, Kyustendil and Razgrad with shares above 80%. The study found that almost all districts with the highest share of surveyed points above permissible limits have higher levels of death rate due to CVD. The results of statistical data analysis show that there is a positive moderate linear correlation between the share of surveyed points above permissible limits and the death rate due to CVD - Pearson coefficient 0.423 (p = 0.025). Conclusions The study found a moderate correlation between noise pollution and the death rate due to cardiovascular disease. CVD have a multifactorial genesis, but reducing noise in urban areas would help prevent these diseases. Key messages • As a result of the performed analysis, it can be concluded that the investigated indicators determining the degree of discomfort during the daily period remained high in Bulgaria. • The established health inequalities between regions and the increasing mortality from CVD are one of the factors for the deteriorating level of public health in Bulgaria.

Psychometric testing of the continence and mobility in older adults knowledge quiz

AbstractWhat are the psychometric properties of the Continence and Mobility in Older Adults Knowledge Quiz? Our previous research revealed gaps in practicing and student nurses' knowledge of mobility and continence in older people. To address this gap, we developed a self‐directed e‐learning module on continence and mobility to enhance student nurses knowledge. The module provided education about continence, mobility, and the links between them. Since we were unable to locate a continence and mobility measure that captured both lower urinary track symptoms and elements of mobility, we developed a continence and mobility knowledge quiz. For researchers and educators to be able to use this quiz with confidence, psychometric testing of our continence and mobility knowledge quiz was required. When caring for older people, two geriatric challenges—continence and mobility—are often linked and viewed as indicators of frailty. Functional changes related to continence and/or mobility can indicate an acute illness in older persons and, if left untreated, can result in permanent changes managing continence needs. Continence care is often viewed negatively and is not prioritized by nurses. We employed stages in development of the Continence and Mobility Knowledge Quiz. In stage one, we developed 18 item true/false items from the literature with the guidance of a continence expert. In stage two, we tested the Quiz with nursing students from three universities in Canada. In stage three, (the current stage) we assessed the validity of the scale using a factor analysis and a reliability analysis (via standardized Cronbach's alpha). From our sample of 420, factor analysis indicated a two‐factor model (as suggested by Kaiser's rule), explained 22% of the variation in responses to the assessment items. We recommend removing item 7 as it does not contribute to the internal consistency of the tool. Cronbach's alpha after removing 7 is 0.65, indicating satisfactory reliability. To our knowledge, this is the first validated tool for measuring nurse knowledge about continence and mobility that addresses both a range of lower urinary tract symptoms and elements of mobility in older adults.

Implications of Long-Term Double Eyelid Tape Use.

The widespread adoption of double eyelid tapes (DET) to achieve thedesired double eyelid aesthetic has prompted investigations into their long-term effects. Given the delicate and complex anatomy of the eyelid, concerns have emerged about the impact of DETs on eyelid structure and the outcomes of subsequent surgical procedures. A cohort of 267 outpatients from our department was recruited between January 2022 and January 2024 to participate in a survey assessing the usage of double eyelid tape (DET). Eyelid laxity was subsequently tested in all outpatients using the Vertical Lid Pull and Parallel Lid Pull methods. Among all participants, 33 underwent double eyelid surgery, with 22 having a history of excessive DET usage and 11 with no DET usage. Post-operative outcomes, including operation duration, satisfaction levels, and complications were recorded. Additionally excised eyelid skin tissues during surgery underwent Masson's staining and EVG staining to analyze collagen and elastic fibers. Among surveyed outpatients (mean age: 23.79 ± 3.71years, 99.63% female, mean BMI: 21.56 ± 1.75kg/m2), 56.55% had oculopathy with ametropia being predominant (53.93%). Hooded eyelids were the most prevalent congenital condition (62.54%). Nearly half (49.44%) used Double Eyelid Tapes (DET) for 1-2years, with 70.04% experiencing discomfort and 70.79% reporting permanent eyelid shape change. Lid pull measurements showed no significant difference in vertical pulls between DET users and non-users, but parallel pulls varied significantly (p<0.05). Complications like asymmetry, numbness, and hypertrophic scars were exclusive to DET users. Physician evaluations favored non-DET users significantly (p<0.05). Histological analysis revealed an interesting finding that individuals using DET have higher collagen levels and notable changes in skin structure when compared to non-users. Prolonged use of double eyelid tape (DET) may result in eyelid laxity, impacting ocular health and complicating blepharoplasty procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Changes in Auditory Performance Following a Virtual Reality Music Concert.

The purpose of this study was to evaluate threshold and suprathreshold auditory risk from a newly popular platform of music concert entertainment; virtual reality (VR) headsets. Recreational noise exposure to music is the primary source of hearing hazard in young-adults, with noise doses of in-person concert venues and music festivals well in excess of the recommended daily exposure recommendation from the National Institute for Occupational Safety and Health. While research on the relationship between personal music players and noise-induced hearing loss risk is abundant, no study has yet evaluated noise-induced hearing loss risk from VR headsets, which are newest to the commercial market at this time. Thirty-one young-adult participants (18 to 25 years) with normal-hearing sensitivity (0 to 16 dB HL) experienced a VR music concert and participated in three data collection timepoints: Session A preexposure, Session A post-exposure, and Session B post-exposure. Participants underwent baseline testing for audiometry (0.25 to 20 kHz), distortion product otoacoustic emission testing (1 to 10 kHz), and Words-in-Noise testing. Participants then wore a commercially available VR headset (Meta Quest 2) and experienced a freely available online VR music concert (via the video-sharing website "YouTube"). The VR music concert duration was 90 min set to maximum volume, which yielded an average sound level equivalent of 78.7 dBA, max sound level of 88.2 dBA, and LC peak sound level of 98.6 dBA. Post-exposure testing was conducted immediately at the conclusion of the VR concert, and again within 24 hr to 1 week after the exposure. Participants also answered a questionnaire that estimated noise exposure history (National Acoustics Laboratory "Noise Calculator"). Post-exposure deficit was not observed in DPOAEs or Words-in-Noise score (p's > 0.05). However, statistically significant temporary post-exposure deficit was observed in audiometry at 4, 8, and 12.5 kHz (p's < 0.05) (mean differences: 2 to 3 dB HL). Twenty-four hours and 1-week post-exposure measurements revealed no permanent changes from baseline measurements (p's > 0.05) aside from one spurious difference at 12.5 kHz. Males tended to exhibit a significantly higher noise history score on average than females. The primary, secondary, and tertiary sources of noise hazard history in this young-adult cohort included amplified music. These preliminary data suggest that VR music concerts-which are likely to produce a substantially lower noise dose than in-person music concerts-may still be capable of producing at least slight, temporary threshold shifts on the order of 2 to 3 dB HL. Future research should include VR headsets in personal music player risk assessment, as the VR music concert platform is increasing rapidly in popularity among young-adults.

Epigenetic programming of obesity in early life through modulation of the kynurenine pathway.

Childhood obesity is a global health concern that has its origins before birth. Although genetics plays a crucial role, increasing evidence suggests that epigenetic modifications during fetal life could also influence its incidence. In this model, during the fetal period, interactions between genetic makeup, intrauterine factors, and environmental conditions, increase the risk of childhood obesity. This is in accordance with the Developmental Origins of Health and Disease (DOHaD) hypothesis, in which specific intrauterine environments can have long-lasting effects on the immune system's essential functions during crucial stages of fetal growth, resulting in permanent changes to the immune function of the offspring. Consequently, dysfunction can consequently make the offspring more prone to inflammatory and immune-related disorders later in life. In this review, we examine how maternal inflammation could influence the risk of childhood obesity. We propose that during pregnancy, modification of the expression of critical genes in metabolic and signaling pathways, such as the kynurenine (Kyn) pathway, occurs due to increased levels of maternal inflammation. We also propose that such expression differences are mediated by epigenetic changes. Furthermore, we also hypothesize that the Kyn pathway produces metabolites that have immunoregulatory effects and may play a crucial role in regulating inflammation during pregnancy. As a result, interventions aimed at improving maternal inflammation may be able to help alleviate the risk of childhood obesity.

The Transition to Adulthood: A Qualitative Study of Autism Spectrum Disorder From Military and Veteran Parents and Military-Dependent Young Adults.

Given the unique experiences of military service members and their families, military-dependent young adults (18-25 years old) with autism spectrum disorder (ASD) and their military or veteran families experience unique barriers to accessing quality mental health care during the transition to adulthood. In fact, developing services to address ASD challenges for military families is a burgeoning area of interest for the department of defense. However, there is a limited knowledge on the specific needs of military families as the young adult's transition outside of high school and lose supports. The present study conducted 3 focus groups with 16 military and veteran parents, and 3 focus groups with 10 military-dependent young adults to evaluate the needs of military-dependent young adults (17-25 years old) with ASD and military/veteran parents with a young adult with ASD. Parents reported several key topics, including barriers to services (e.g., permanent change of station, recently moving to a state and lacking awareness of the available resources), defining adulthood in terms working in a cohesive family structure, and therapy recommendations for parents and young adults with ASD transitioning to adulthood. Young adults provided key information, including describing experiences with having a parent in the military, difficulty accessing services during the transition to adulthood, and recommendations on therapy for military-dependent young adults with ASD. Military and veteran families with autistic dependents lack access to important mental-health resources. When developing programs for military families and military-dependent autistic young adults, mental health providers should consider the frequent relocations, lack of access to important transition resources, and common military values. The presence of advocates at military bases should be encouraged to help military families navigate autism services in their local community.

An elastoplastic beam bond model for DEM simulation of deformable materials and breakage behaviors

AbstractIn modern chemical engineering production, numerous elastoplastic materials, often formed into agglomerates, frequently undergo plastic deformation and rupture. Understanding how these materials behave under different conditions is crucial for improving manufacturing processes and material design. In this work, an elastoplastic beam bond model for discrete element method (DEM) simulation was developed, in which a yield criterion is introduced into Timoshenko beam bond method. The model can simulate not just the initial elastic (stretchy) behavior of the materials but also their plastic (permanent) deformation behaviors. The model was applied to central collision of two agglomerates, agglomerate uniaxial compression, and agglomerate‐wall impact cases. It is shown that the updated model could predict the behavior of materials that undergo permanent changes under stress, compared to previous models that only considered elastic behaviors. This could enable more accurate simulations of particulate materials and aid in better process design.

A parallel investigation of trauma exposure, maladaptive appraisals and posttraumatic stress reactions in two groups of trauma-exposed adolescents

ABSTRACT Background: Maladaptive appraisals, such as thoughts about experiencing a permanent and disturbing change and about being a fragile person in a scary world, are associated with posttraumatic stress reactions (PTSR) for trauma-exposed children and adolescents. Less is known about what puts young people at risk for developing such appraisals, and the differential relationship between the types of appraisals and PTSR. Objective: The primary aim was to examine the role of age, gender and exposure to potentially traumatizing events (PTEs) for the levels of maladaptive appraisals. The secondary aim was to investigate the association between the levels of maladaptive appraisals (appraisals of a permanent change and appraisals about a scary world) and PTSR. Methods: We investigated these aims in two samples: survivors after the terror attack at Utøya island in Norway in 2011 (N = 165, mean age 17.65, SD = 1.19) and adolescents referred to treatment after mainly interpersonal trauma (N = 152, mean age 15.08, SD = 2.18). The aims were investigated using linear regression and partial correlation. Results: In the terror-exposed sample, female gender was significantly associated with higher levels of scary-world appraisals, witnessing or learning that someone close were exposed to physical violence was significantly associated with more permanent-change appraisals, and a higher number of PTEs was significantly associated with higher levels of both types of appraisals. For the clinical sample, we found no significant associations between exposure to PTEs, gender, age, and the level of maladaptive appraisals. Both types of maladaptive appraisals were highly associated with PTSR in both samples, and there was no significant difference in the strength of the associations between the types of appraisals and PTSR. Conclusions: The results have implications for identifying adolescents at risk for developing harmful maladaptive appraisals. Both scary-world appraisals and permanent-change appraisals were strongly associated with PTSR in both groups of trauma-exposed adolescents.

Evaluation of Concrete Fatigue Damage with Elastic Wave-based Measurement Techniques

Fatigue damage is a progressive and permanent change in the internal material structure due to cyclic loading. The cyclic loads can be due to wind, waves, temperature variation, and traffic loads. Each cyclic load application introduces micro-damages that accumulate to induce failure. Detecting these micro-damages requires sensitive measuring techniques. Hence this research compares the sensitivity of different measuring techniques applied to fatigue experiments of concrete. The applied NDT are the passive acoustic emission technique (AET) and active ultrasonic measurements. In addition, linear variable differential transformers (LVDTs) are applied as a reference measurement. Accordingly in this research, cylindrical concrete samples are subjected to monotonic and cyclic Brazilian splitting tests. The cylinders are 100 mm in diameter and 150 mm in length. The cyclic load is applied to these samples with a loading frequency of 5 Hz. During the tests, the damage evolution is monitored with AET, ultrasonic measurements and LVDTs. There are eight AE sensors attached to the sample. The two LVDTs are positioned at the center of the sample's front and back side. Besides passively monitoring the acoustic emissions, the AET sensors are also used to do active ultrasonic measurements. The research reports the comparison conducted on the deformations and cracks measured with the LVDTs, the damage growth identified with the AET, and the change in the ultrasonic pulse velocity measurements. In addition, the study also presents the damage analysis capacity of the methods across different types of loading: monotonic, constant amplitude, and stepped fatigue loading. The comparison shows that combination of AET and ultrasonic velocity measurement is a sensitive indicator for damage growth.

A national cross-sectional survey on community spinal cord injury individuals profiles, health-related quality of life and support services in China: implications for healthcare and rehabilitation

BackgroundSpinal cord injury (SCI) results in severe, permanent functional changes and has become a global health priority due to its high incidence, cost, and disability rate. Current national epidemiological data on SCI in China are limited and outdated. This study aimed to provide a comprehensive, national cross-sectional investigation of SCI epidemiology in China.MethodsThis cross-sectional study included 3055 SCI participants aged 8 to 78 years, conducted from May to September 2023. Data collected encompassed demographic characteristics, employment status, etiology, years lived with disability (YLD), family structure, caregiving status, income, health insurance, paralysis type, and health-related quality of life (HRQoL). Descriptive statistics analyses were used to assess demographic and injury characteristics. Group differences were assessed using t-tests, one-way ANOVA and Chi-square tests. Significant factors were examined using multivariate regression analysis.ResultsThe majority (88.9%) of respondents were aged 15 to 59 years, with a male-to-female ratio of 2.36:1. Car accidents caused 45.4% of tetraplegia cases, falls caused 35.9% of paraplegia cases, and myelitis was the leading cause of non-traumatic SCI. Among paraplegia participants, 65.5% had complete SCI, while 53.1% of tetraplegia participants had incomplete SCI. Functional improvement was reported by 9.58% of participants. Half (50.3%) of the respondents were unemployed, and 75% had incomes below the national average. HRQoL was significantly lower in the SCI population compared to controls, mainly influenced by injury site, income, age and etiology (p < 0.05).ConclusionsSCI participants in China exhibit low HRQoL and reemployment rates. Accessible community and vocational rehabilitation programs, alongside robust public medical services, are essential for enhancing reemployment and HRQoL among SCI participants, reducing the overall disease burden.

Structural health monitoring of scarf bonded repaired glass/epoxy laminates interleaved with carbon non-woven veil

Bonded repair patches/joints often introduce vulnerabilities in composite laminates, making them prime candidates for structural health monitoring (SHM). In this study, stepped-scarf bonded joints were manufactured using glass fibre-reinforced epoxy laminates as representative repair patches, and a novel SHM approach through the electrical resistance change method was applied. To establish an electrically conductive path within the stepped-scarf joint, non-woven carbon fibre veils with areal weights of 10 g/m² and 20 g/m² were interlaid along the stepped bondline. Two types of tensile tests were performed. In the first set of tests, the stepped-scarf joints underwent monotonic quasi-static tensile loading until the bondline was completely fractured (catastrophic failure) and the change in electrical resistance was continuously monitored. The failure stress of the joint with a 10 g/ m² carbon veil was only marginally decreased (∼2 %) in comparison with that of the joints without a carbon veil, while the failure stress of the joint with a 20 g/m² carbon non-woven veil was considerably decreased (by ∼9 %). However, the joints with 10 g/m² and 20 g/m² carbon veils exhibited a significant change in electrical resistance (∼200 % and ∼1000 %, up to full failure, respectively). Simultaneously, the change in electrical resistance was used for the detection of damage initiation and progression, supported by digital images taken during the tests. In the second set of tests, the joints were subjected to a cyclic tensile loading/unloading regime and the change in electrical resistance was monitored. A significant amount of permanent change in resistance during the unloading phases (up to 120 % in the bondline with a 20 g/m² veil) was observed, providing insights into the laminate and bondline damage evolution. In addition, thermal images obtained with the joule heating method in the cyclic tensile tests were used to confirm the damage detected with the electrical resistance change method. Moreover, the micrographs from the fracture surfaces indicated that the variations in electrical resistance change are largely caused by damage occurring within or near the carbon veils. In conclusion, the results demonstrate that the presented SHM approach, which incorporates carbon non-woven fibre veils within non-conductive laminate composites, holds promise for monitoring damage initiation and propagation in repaired composite laminates as well as adhesively bonded composite laminate joints, without adversely influencing the structural integrity of the bondline.