Investigation of Compression Strength of Bliss Style Corrugated Fiberboard Boxes

The global demand for corrugated fiberboard is projected to experience a significant upsurge in the near future. Based on the end-use, packaging for processed and fresh food categories accounted for approximately 39% of the overall consumption of corrugated fiberboard in 2015. With key advantages such as providing an uninterrupted bottom, laminated corners for higher stacking strength, increased material use efficiency, side cutout options for display at retail and a wide range of styles over other styles of containers, Bliss style boxes find prominence in the agriculture sector. While numerous predictive strength models associating corrugated fiberboard material specifications to the box compression strength (BCT), and ultimately the stacking strength of corrugated containers, have been developed over the past century, there is a considerable lack of studies that include Bliss style containers. The overall aim of this empirical study was to develop a mathematical relationship based on the simplified McKee formula towards predicting BCT of four styles of Bliss boxes. Effects of box styles, length of load-bearing walls and number of internal corners on the overall BCT were explored using data collected from lab-based testing. The proposed mathematical model includes a box design constant (k), edge crush test values, board thickness, and three lengths of load-bearing walls (total, single-wall, and double-wall) of the containers. The k-values for each bliss box design, explored through linear regression analyses, explain up to 98.1% of the differences in BCT between the styles. The proposed mathematical model can assist practitioners with accelerating packaging development cycle times and optimizing packaging designs

Referral trajectories in patients with vertigo, dizziness and balance disorders and their impact on health-related quality of life and functioning: results from the longitudinal multicenter study MobilE-TRA

BACKGROUND: Due to reported barriers in the management of patients with vertigo, dizziness and balance problems (VDB), referral trajectories starting from primary care might be determined by other factors than medical necessity. The objective of this paper was to examine the impact of disease-related and other determinants on referral trajectories of older patients with VDB and to investigate, how these trajectories affect the patients’ functioning and health-related quality of life (HRQoL). METHODS: Data originate from the longitudinal multicenter study MobilE-TRA, conducted in two German federal states. Referrals to neurologists or ear-nose-throat (ENT) specialists were considered. Referral patterns were visualized using a state sequence analysis. Predictors of referral trajectories were examined using a multinomial logistic regression model. Linear mixed models were calculated to assess the impact of referral patterns on the patients’ HRQoL and functioning. RESULTS: We identified three patterns of referral trajectories: primary care physician (PCP) only, PCP and neurologist, and PCP and ENT. Chances of referral to a neurologist were higher for patients with a neurological comorbidity (OR = 3.22, 95%-CI [1.003; 10.327]) and lower for patients from Saxony (OR = 0.08, 95%-CI [0.013; 0.419]). Patients with a PCP and neurologist referral pattern had a lower HRQoL and lower functioning at baseline assessment. Patients with unspecific diagnoses also had lower functioning. CONCLUSION: Referral trajectories were determined by present comorbidities and the regional healthcare characteristics. Referral trajectories affected patients’ HRQoL. Unspecific VDB diagnoses seem to increase the risk of ineffective management and consequently impaired functioning. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11060-8

Effects of a medical second opinion programme on patients' decision for or against knee arthroplasty and their satisfaction with the programme

BACKGROUND German social legislation gives patients the right to obtain a second opinion before elective surgery and defines quality criteria for reimbursement by statutory health insurances. However, the effects of second opinions before elective surgery are largely unknown. The aim of this study was to evaluate the effects of a second opinion programme in patients recommended for knee arthroplasty. METHODS The largest statutory health insurance funds in Bavaria offered patients who had been recommended to have knee arthroplasty the opportunity to partake in a second opinion programme which consisted of an in person presentation to an experienced knee surgeon. In this cohort study, consecutive patients from this second opinion programme who signed informed consent were included from 07/10/2016 to 14/02/2020. Data were collected before and after the second opinion visit. RESULTS A total of 141 (66%) of 215 patients who presented for a second opinion participated in the evaluation study. The second opinion physician recommended knee arthroplasty to 40% of the patients, later knee arthroplasty if the conditions worsened to 40%, and no knee arthroplasty to 20%. After receiving the second opinion 28 of 56 (41%) undecided patients preferred knee arthroplasty, 14 no knee arthroplasty, 14 remained undecided. Four of 46 patients with a preference for \textquotedblarthroplasty\textquotedbl changed their decision to \textquotedblno arthroplasty\textquotedbl, five of 35 patients from \textquotedblno arthroplasty\textquotedbl to \textquotedblarthroplasty\textquotedbl. The patients were more confident in their decision according to the decision confidence scale (before: 5.4 ± 3.0; after: 7.8 ± 2.5; p~< 0.001). They rated their satisfaction with the second opinion programme with a mean grade of 1.35 (± 0.60) (best:1; worst:6). Logistic regression analyses showed that the recommendation of the second opinion physician for joint arthroplasty was associated with the guideline criteria radiological severity of osteoarthritis (p~= 0.001) and knee-joint-specific quality of life (p~= 0.041). CONCLUSION The second opinion of an experienced knee surgeon frequently deviates from the initial recommendation for knee arthroplasty. The association of guideline criteria to the second recommendation suggests a high quality of the second opinion. From the patient perspective, the second opinion reduces uncertainties in their treatment decision

The Effect of the Nature and Perceived Validity of Zodiac Personality Predictions of on Logic Test Performance

This study investigated the effect of priming on puzzle performance in 49 students. Subjects were given fictitious Chinese Zodiac personality descriptions and asked to complete a Sudoku puzzle. Descriptions were manipulated based on nature (positive or negative) and perceived validity (valid or not valid) of description. Subjects read fictitious research statistics that either supported or refuted the validity Chinese Zodiac Animal Signs in order to manipulate perceived validity. It was hypothesized that participants who received the positive/valid horoscope and negative/invalid horoscope predictions would perform best. Findings supported previous literature that priming subjects to think a certain way can affect behavior (Gramzow, Johnson, &amp; Willard, 2014). Subjects primed to think positively about themselves performed better than those primed to think negatively about themselves. Additionally, perceived validity of horoscope predictions had no effect on performance. This study also discovered a marginally significant trend for participants to reject information that negatively affected their self-perceptions. This research expands upon existing knowledge on priming of positive or negative personality traits in order to fully understand its effect on performance

Patient trajectories and their impact on mobility, social participation and quality of life in patients with vertigo/dizziness/balance disorders and osteoarthritis (MobilE-TRA): Study protocol of an observational, practice-based cohort study

INTRODUCTION Mobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several shortcomings regarding mobility sustainment of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions and deficiencies in personalising care based on patients' needs and experiences. A tailored healthcare strategy targeted at mobility of older adults is still missing. OBJECTIVE The objective is to develop multiprofessional care pathways targeted at mobility sustainment and social participation in patients with vertigo/dizziness/balance disorders (VDB) and osteoarthritis (OA) . METHODS Data regarding quality of life, mobility limitation, pain, stiffness and physical function is collected in a longitudinal observational study between 2017 and 2019. General practitioners (GPs) recruit their patients with VDB or OA. Patients who visited their GP in the last quarter will be identified in the practice software based on VDB and OA-related International Classification of Diseases 10th Revision. Study material will be sent from the practice to patients by mail. Six months and 12 months after baseline, all patients will receive a mail directly from the study team containing the follow-up questionnaire. GPs fill out questionnaires regarding patient diagnostics, therapy and referrals. ETHICS AND DISSEMINATION The study was approved by the ethical committee of the Ludwig-Maximilians-Universität München and of the Technische Universität Dresden. Results will be published in scientific, peer-reviewed journals and at national and international conferences. Results will be disseminated via newsletters, the project website and a regional conference for representatives of local and national authorities

Long-term monitoring of SARS-CoV-2 seroprevalence and variants in Ethiopia provides prediction for immunity and cross-immunity

Under-reporting of COVID-19 and the limited information about circulating SARS-CoV-2 variants remain major challenges for many African countries. We analyzed SARS-CoV-2 infection dynamics in Addis Ababa and Jimma, Ethiopia, focusing on reinfection, immunity, and vaccination effects. We conducted an antibody serology study spanning August 2020 to July 2022 with five rounds of data collection across a population of 4723, sequenced PCR-test positive samples, used available test positivity rates, and constructed two mathematical models integrating this data. A multivariant model explores variant dynamics identifying wildtype, alpha, delta, and omicron BA.4/5 as key variants in the study population, and cross-immunity between variants, revealing risk reductions between 24% and 69%. An antibody-level model predicts slow decay leading to sustained high antibody levels. Retrospectively, increased early vaccination might have substantially reduced infections during the delta and omicron waves in the considered group of individuals, though further vaccination now seems less impactful