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Abstract Background Engaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders’ experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use. Methods Semi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study. Results Twenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1) overcoming barriers to engagement, 2) consumer-initiated engagement; 3) breadth vs depth of engagement, 4) organisational transparency vs control and 5) users causing harm. Conclusions Social media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.

Developing a new and efficient catalytic route for the production of alkanes by upgrading the aqueous phenolic biofuels still remains a challenge. Here, we designed and synthesized a bifunctional catalyst that uses natural montmorillonite (MMT) as support and combines metal active sites and Brӧnsted acid sites in the MMT via ion exchange and reduction roasting process. The catalytic activity of the as-synthesized Pd-MMT (H+) was evaluated by the hydrodeoxygenation (HDO) of a series of lignin-derived phenolic compounds in water. Our model reaction study reveals that the HDO of phenol undergoes an initial hydrogenation of aromatic rings to produce cyclohexanol and cyclohexanone, followed by the dehydration of cyclohexanol to provide intermediate cyclohexene and a final hydrogenation of cyclohexene to create a cyclohexane product. The combination of high metal catalytic activity and Brӧnsted acidity in Pd-MMT (H+) synergistically accelerated the HDO of phenol. Furthermore, good catalytic activity and recycling ability were also observed for other lignin-derived phenolic compounds.

Objective Pediatric patients can be significantly impacted emotionally by exposure to acute trauma which may negatively impact long-term functioning and lead to an increase in overall distress. This study reports on the incidence of acute stress disorder among pediatric trauma patients in a hospital setting in the southeastern region of the USA.Methods Pediatric patient mental health assessments were conducted using the Childhood Stress Disorders Checklist- Short Form (CSDC-SF) as part of a new integrated behavioral health standard of care within the Trauma Services Division of a level 1 pediatric hospital. Mental health consultations occurred at bedside on inpatient hospital admission into trauma services, or at the outpatient hospital clinic after discharge for injuries treated in the emergency department.Results Associations among type of trauma, child age, and sex were explored in a sample of 617 children (58.9% male) aged 2–18 years (Mage=10.27). The sample was primarily ethnic minorities (56.1% black/African-American, 5% Hispanic/Latinx). Fifteen per cent or more of trauma reports were for burns (26%), motor vehicle accident (22.7%), and recreational sports or leisure activity-related injury (17.5%). Sixty-four per cent of children scored ≥1 on the CSDC-SF, indicating symptoms consistent with acute stress disorder. Higher scores were associated with female sex, age, and injury type.Level of evidence Level IV study provides evidence of the link between traumatic injury and mental health symptoms in a pediatric population. Findings highlight the critical need for mental health screening and provision of integrated mental health counseling services at time of acute pediatric trauma.

Taiwan’s unique circumstance as a contested state makes it imperative for the country to increase international support for and awareness of its embattled democracy at the hands of the authoritarian government in Beijing through positive public visibility. #TaiwanCanHelp, while perhaps similar to other forms of hashtag activism, is also very different because it also encompasses digitalization of diplomacy, in which the Taiwanese government seeks to raise international awareness of its struggle and gain goodwill through its medical equipment donations. The social influence of #TaiwanCanHelp has not been measured and examined extensively. Evaluation of hashtag use at a holistic level is imperative to the understanding of the extent of resonance across social media. This study explores the dynamics of the #TaiwanCanHelp hashtag on Twitter by quantifying the public response and uncovering the public opinions around #TaiwanCanHelp. A mixed-methods methodology incorporating time-series analysis, sentiment analysis, spatial analysis, and word clouds has been adopted. Our results reveal that #TaiwanCanHelp has resonated beyond Taiwan and received positive responses from diverse users across the globe. Our findings also suggest that the prominence of #TaiwanCanHelp rides on real-life events and is a successful attempt by the Taiwan government in generating international interest through digitalization of diplomacy to advance Taiwan’s interests.

There has been no consensus on the neural dissociation between emotion-label and emotion-laden words, which remains one of the major concerns in affective neurolinguistics. The current study adopted dot-probe tasks to investigate the valence effect on attentional bias toward Chinese emotion-label and emotion-laden words. Behavioral data showed that emotional word type and valence interacted in attentional bias scores with an attentional bias toward positive emotion-laden words rather than positive emotion-label words and that this bias was derived from the disengagement difficulty in positive emotion-laden words. In addition, an attentional bias toward negative emotion-label words relative to positive emotion-label words was observed. The event-related potential (ERP) data demonstrated an interaction between emotional word type, valence, and hemisphere. A significant hemisphere effect was observed during the processing of positive emotion-laden word pairs rather than positive emotion-label, negative emotion-label, and negative emotion-laden word pairs, with positive emotion-laden word pairs eliciting an enhanced P1 in the right hemisphere as compared to the left hemisphere. Our results found a dynamic attentional bias toward positive emotion-laden words; individuals allocated more attention to positive emotion-laden words in the early processing stage and had difficulty disengaging attention from them in the late processing stage.

The vertebral body’s Hounsfield unit (HU) value can credibly reflect patients’ bone mineral density (BMD). Given that poor bone-screw integration initially triggers screw loosening and regional differences in BMD and strength in the vertebral body exist, HU in screw holding planes should better predict screw loosening. According to the stress shielding effect, the stress distribution changes in the fixation segment with BMD reduction should be related to screw loosening, but this has not been identified. We retrospectively collected the radiographic and demographic data of 56 patients treated by single-level oblique lumbar interbody fusion (OLIF) with anterior lateral single rod (ALSR) screw fixation. BMD was identified by measuring HU values in vertebral bodies and screw holding planes. Regression analyses identified independent risk factors for cranial and caudal screw loosening separately. Meanwhile, OLIF with ALSR fixation was numerically simulated; the elastic modulus of bony structures was adjusted to simulate different grades of BMD reduction. Stress distribution changes were judged by computing stress distribution in screws, bone-screw interfaces, and cancellous bones in the fixation segment. The results showed that HU reduction in vertebral bodies and screw holding planes were independent risk factors for screw loosening. The predictive performance of screw holding plane HU is better than the mean HU of vertebral bodies. Cranial screws suffer a higher risk of screw loosening, but HU was not significantly different between cranial and caudal sides. The poor BMD led to stress concentrations on both the screw and bone-screw interfaces. Biomechanical deterioration was more severe in the cranial screws than in the caudal screws. Additionally, lower stress can also be observed in fixation segments’ cancellous bone. Therefore, a higher proportion of ALSR load transmission triggers stress concentration on the screw and bone-screw interfaces in patients with poor BMD. This, together with decreased bony strength in the screw holding position, contributes to screw loosening in osteoporotic patients biomechanically. The trajectory optimization of ALSR screws based on preoperative HU measurement and regular anti-osteoporosis therapy may effectively reduce the risk of screw loosening.

ObjectiveMotility compensation increases the risk of adjacent segment diseases (ASDs). Previous studies have demonstrated that patients with ASD have a poor bone mineral density (BMD), and changes in BMD affect the biomechanical environment of bones and tissues, possibly leading to an increase in ASD incidence. However, whether poor BMD increases the risk of ASD by aggravating the motility compensation of the adjacent segment remains unclear. The present study aimed to clarify this relationship in oblique lumbar interbody fusion (OLIF) models with different BMDs and additional fixation methods.MethodsStand-alone (S-A) OLIF and OLIF fixed with bilateral pedicle screws (BPS) were simulated in the L4–L5 segment of our well-validated lumbosacral model. Range of motions (ROMs) and stiffness in the surgical segment and at the cranial and caudal sides’ adjacent segments were computed under flexion, extension, and unilateral bending and axial rotation loading conditions.ResultsUnder most loading conditions, the motility compensation of both cranial and caudal segments adjacent to the OLIF segment steeply aggravated with BMD reduction in S-A and BPS OLIF models. More severe motility compensation of the adjacent segment was observed in BPS models than in S-A models. Correspondingly, the surgical segment's stiffness of S-A models was apparently lower than that of BPS models (S-A models showed higher ROMs and lower stiffness in the surgical segment).ConclusionPoor BMD aggravates the motility compensation of adjacent segments after both S-A OLIF and OLIF with BPS fixation. This variation may cause a higher risk of ASD in OLIF patients with poor BMD. S-A OLIF cannot provide instant postoperative stability; therefore, the daily motions of patients with S-A OLIF should be restricted before ideal interbody fusion to avoid surgical segment complications.

Phosphorus (P) accumulation in rice–wheat rotation fields around the Yangtze River delta have been enriched during the last decades. To protect the environment and save P resources, we conducted field experiments to optimize the P application scheme. First, one field experiment was designed as a series of P fertilizer application doses of 0–100 kg P2O5 hm−2. Grain yield and P uptake by crops were analyzed to calculate P surplus and P use efficiency. Soil P fractions were extracted and tested. According to the P balance, we optimized fertilization by reducing the chemical P amount, which was used by local farmers; furthermore, we substituted chemical P with organic fertilizer. To verify these management strategies, another field experiment was conducted with five treatments: no N, P, or K fertilizer (CK); only no P fertilizer (NK); farmers’ fertilization of P (90 kg P2O5 hm−2) (FFP); reducing 20% P (FFP-20%P); and reducing 20% P and replacing 20% P by manure (FFPM-36%P). The grain yield was enhanced by increased P fertilizer and reached a constant level after 75 kg P2O5 hm−2. Moreover, the annual P surplus was balanced around the input of 150 kg P2O5 hm−2. Accordingly, by optimizing fertilization (FFP-20%P) and further replacing manure (FFPM-36%P), we also achieved crop yield equivalent to that of FFP treatment (90 kg P2O5 hm−2). Thus, the 72–75 kg P2O5 hm−2 application rate is a threshold for the production of rice and wheat and P balance. Total P content in soil was enhanced by increased input of P fertilizer and mainly divided into labile Pi and middle stable Pi fractions. Soil Olsen-P content increased by P fertilization accordingly, while the content of organic P and stable P content was relatively constant. Reducing P fertilizer by 20% had similar results for soil P fractions when compared with farmers’ P fertilization treatment. Therefore, reducing at least 20% current input of P by farmers (annual 180 kg P2O5 hm−2) according to the balance of P surplus in rice and wheat rotation systems is an imperative measure to guarantee crop production with enhanced P use efficiency, and meanwhile, it can alleviate environmental risk.

Apical periodontitis is the inflammation and destruction of periradicular tissues, mediated by microbial factors originating from the infected pulp space. This bacteria-mediated inflammatory disease is known to interfere with root development in immature permanent teeth. Current research on interventions in immature teeth has been dedicated to facilitating the continuation of root development as well as regenerating the dentin–pulp complex, but the fundamental knowledge on the cellular interactions and the role of periapical mediators in apical periodontitis in immature roots that govern the disease process and post-treatment healing is limited. The limitations in 2D monolayer cell culture have a substantial role in the existing limitations of understanding cell-to-cell interactions in the pulpal and periapical tissues. Three-dimensional (3D) tissue constructs with two or more different cell populations are a better physiological representation of in vivo environment. These systems allow the high-throughput testing of multi-cell interactions and can be applied to study the interactions between stem cells and immune cells, including the role of mediators/cytokines in simulated environments. Well-designed 3D models are critical for understanding cellular functions and interactions in disease and healing processes for future therapeutic optimization in regenerative endodontics. This narrative review covers the fundamentals of (1) the disease process of apical periodontitis; (2) the influence and challenges of regeneration in immature roots; (3) the introduction of and crosstalk between mesenchymal stem cells and macrophages; (4) 3D cell culture techniques and their applications for studying cellular interactions in the pulpal and periapical tissues; (5) current investigations on cellular interactions in regenerative endodontics; and, lastly, (6) the dental–pulp organoid developed for regenerative endodontics.

Stereotactic ablative radiotherapy (SABR) may improve survival in patients with inoperable pulmonary oligometastases. However, the impact of pulmonary oligometastatic status after systemic therapy on SABR outcomes remains unclear. Hence, we investigated the outcomes of SABR in 45 patients with 77 lung tumors and the prognostic value of pulmonary oligoprogression. Eligibility criteria were pulmonary oligometastases (defined as ≤5 metastatic lung tumors), controlled extrapulmonary disease (EPD) after front-line systemic therapy, SABR as primary local treatment for inoperable pulmonary metastases, and consecutive imaging follow-up. Oligometastatic lung tumor was classified into controlled or oligoprogressive status. Overall survival (OS), in-field progression-free survival (IFPFS), out-field progression-free survival (OFPFS), and prognostic variables were evaluated. With 21.8 months median follow-up, the median OS, IFPFS, and OFPFS were 28.3, not reached, and 6.5 months, respectively. Two-year OS, IFPFS, and OFPFS rates were 56.0%, 74.2%, and 17.3%, respectively. Oligoprogressive status (p = 0.003), disease-free interval < 24 months (p = 0.041), and biologically effective dose (BED10) < 100 Gy (p = 0.006) were independently associated with inferior OS. BED10 ≥ 100 Gy (p = 0.029) was independently correlated with longer IFPFS. Oligoprogressive status (p = 0.017) and EPD (p = 0.019) were significantly associated with inferior OFPFS. Grade ≥ 2 radiation pneumonitis occurred in four (8.9%) patients. Conclusively, SABR with BED10 ≥ 100 Gy could provide substantial in-field tumor control and longer OS for systemic therapy respondents with inoperable pulmonary oligometastases. Oligoprogressive lung tumors exhibited a higher risk of out-field treatment failure and shorter OS. Hence, systemic therapy should be tailored for patients with oligoprogression to reduce the risk of out-field treatment failure. However, in the absence of effective systemic therapy, SABR is a reasonable alternative to reduce resistant tumor burden.

In this paper, we present a novel and unified model for studying the vibration of cylindrical shells based on the three-dimensional (3D) elastic theory and the Carrera Unified Formulation. Our approach represents a significant advancement in the field, as it enables us to accurately predict the vibrational behavior of cylindrical shells under arbitrary boundary conditions. To accomplish this, we expand the axial, circumferential, and radial displacements of the shell using Chebyshev polynomials and Taylor series, thereby reducing the dimensionality of the expansion and ensuring the precision and rigor of our results. In addition, we introduce three groups of artificial boundary surface springs to simulate the general end boundary conditions of the cylindrical shell and coupling springs to strongly couple the two surfaces of the cylindrical shell φ = 0 and φ = 2π to ensure continuity of displacements on these faces. Using the energy function of the entire cylindrical shell model, we obtain the characteristic equation of the system by finding the partial derivatives of the unknown coefficients of displacement in the energy function. By solving this equation, we can directly obtain the vibration characteristics of the cylindrical shell. We demonstrate the convergence, accuracy, and reliability of our approach by comparing our computational results with existing results in the literature and finite element results. Finally, we present simulation results of the frequency features of cylindrical shells with various geometrical and boundary parameters in the form of tables and figures. Overall, we believe that our novel approach has the potential to greatly enhance our understanding of cylindrical shells and pave the way for further advancements in the field of structural engineering. Our comprehensive model and simulation results contribute to the ongoing efforts to develop efficient and reliable techniques for analyzing the vibrational behavior of cylindrical shells.

This study proposed an all-fiber Fabry–Perot interferometer (FPI) strain sensor with two miniature bubble cavities. The device was fabricated by writing two axial, mutually close short-line structures via femtosecond laser pulse illumination to induce a refractive index modified area in the core of a single-mode fiber (SMF). Subsequently, the gap between the two short lines was discharged with a fusion splicer, resulting in the formation of two adjacent bubbles simultaneously in a standard SMF. When measured directly, the strain sensitivity of dual air cavities is 2.4 pm/με, the same as that of a single bubble. The measurement range for a single bubble is 802.14 µε, while the measurement range for a double bubble is 1734.15 µε. Analysis of the envelope shows that the device possesses a strain sensitivity of up to 32.3 pm/με, which is 13.5 times higher than that of a single air cavity. Moreover, with a maximum temperature sensitivity of only 0.91 pm/°C, the temperature cross sensitivity could be neglected. As the device is based on the internal structure inside the optical fiber, its robustness could be guarantee. The device is simple to prepare, highly sensitive, and has wide application prospects in the field of strain measurement.

This study proposes a high-efficiency method using a co-prime circular microphone array (CPCMA) for the bearing fault diagnosis, and discusses the acoustic characteristics of three fault-type signals at different rotation speeds. Due to the close positions of various bearing components, radiation sounds are seriously mixed, and it is challenging to separate the fault features. Direction-of-arrival (DOA) estimation can be used to suppress noise and directionally enhance sound sources of interest; however, classical array configurations usually require a large number of microphones to achieve high accuracy. To address this, a CPCMA is introduced to raise the array’s degrees of freedom in order to reduce the dependence on the microphone numbers and computation complexity. The estimation of signal parameters via rotational invariance techniques (ESPRIT) applied to a CPCMA can quickly figure out the DOA estimation without any prior knowledge. By using the techniques above, a sound source motion-tracking diagnosis method is proposed according to the movement characteristics of impact sound sources for each fault type. Additionally, more precise frequency spectra are obtained, which are used in combination to determine the fault types and locations.