bluuebunny/crossref_metadata_2025 huggingface dataset:
What is military labour? War, logistics, and the Mughals in early modern South Asia
Authors: Nath Pratyay
Published: January 2021

The category of ‘military labour’ has traditionally been used to designate ‘combat labour’ – the labour of soldiers. Focusing on the case of early modern South Asia, the present essay argues that this equivalence is misplaced and that it is a product of a distorted view of war defined primarily in terms of combat. The essay discusses the roles played by the logistical workforce of Mughal armies in conducting military campaigns and facilitating imperial expansion. It calls for broadening the category of ‘military labour’ to include all types of labour rendered consciously towards the fulfilment of military objectives.
Letting the affordances fool around: architectural space from the users’ point of view
Authors: Baggs Edward , Sailer Kerstin
Published: January 2021

Erik Rietveld’s lecture describes the creation of architectural works from the point of view of the architects. We are curious about architectural space as a living system: what happens once the architects have left? We introduce the space syntax notion of virtual community, and suggest that this is compatible with Rietveld’s distinction between the field and the landscape of affordances.
Vibration bandgap of a locally resonant beam considering horizontal springs
Authors: Bao Huihuang , Wu Chuanyu , Zheng Wenguang , Yan Bo
Published: January 2021

Structural vibrations could seriously affect the working performance and even cause fatal hazards to host structures. To reduce low frequency vibrations, a locally resonant metamaterial beam coupled by horizontal springs is proposed. The dynamic model of the metamaterial beam is established with the finite element method. The frequency response function of the metamaterial beam is derived, and the bandgap of the locally resonant beam is obtained. The effects of the number of locally resonator units, damping, mass, and stiffness of the vertical spring and horizontal spring are analyzed. The results show that with the increase of the number of units, damping ratio, mass, and stiffness, the bandgap changes significantly, resulting in the enhanced vibration suppress performance in the low-frequency region ( f < 200 Hz). The resonator with the horizontal spring is conducive to suppress vibrations of the beam.
Formulation of goat’s milk yogurt with fig powder: Aromatic profile, physicochemical and microbiological characteristics
Authors: Mahmoudi Souhila , Barrocas Dias Cristina , Manhita Ana , Boutoumi Hocine , Charif Rahma
Published: January 2021

Fig ( Ficus carica L.) is an excellent source of sugars, dietary fibers, minerals, vitamins, organic acids and phytochemicals. The aim of the present work was to investigate the effect of fig powder supplement, as a natural sweetener and flavoring agent, on the physicochemical, microbiological and sensory characteristics of goat’s milk yogurt. It aimed also to determine antioxidant capacity and volatile profile using gas chromatography/mass spectrometry (GC/MS) analysis. Pyrolysis-GC/MS (Py-GC/MS) was also used for the characterization of fig powder. Fig powder exhibited an important antioxidant activity against DPPH. Radical (IC50 = 1.92 ± 0.05 mg per mL). Volatile compounds, from several classes (acids, alcohols, aldehydes, esters, triterpenoids and others) were identified in fig powder. Py-GC/MS data revealed that degradation of fig powder macromolecules leaded to the formation of several aromatic and volatile compounds such as fatty acids, ketones, aromatic phenols, lactones among others. The addition of fig powder increased significantly (p < 0.05) the titrable acidity, the total solids, the carbohydrate content, and the total lactic acid bacteria count of yogurts. Likewise, fig powder supplement improved yogurt taste, texture and aroma and covered the unpleasant flavor of goat’s milk. Thus, fig powder is a natural sweetener and flavoring agent that can be used to formulate a new stirred goat’s yogurt of good quality.
Will blockchain shift Online Travel Agencies toward growth or to an end?
Authors: Ampountolas Apostolos , Chiffer Elizabeth
Published: January 2021

The hospitality industry is one of the fastest-growing sectors globally. With the emergence of different distribution platforms, customers can obtain real-time price changes, availability, and promotions. Looking to the future, traditional online travel agencies will have to undergo a utility shift in order to adapt to new technology. Therefore, blockchain technology has the potential to revolutionize distribution channels’ operational processes. This article aims to introduce blockchain’s immense potential and initiate two research propositions for further study.
Who cares? At what price? The hidden costs of socially engaged arts labour and the moral failure of cultural policy
Authors: Belfiore Eleonora
Published: January 2021

In the broader context of research into cultural labour, this article focuses analytical attention on working conditions within socially engaged arts practice, which have been under-researched to date. In particular, the article aims to uncover the unacknowledged costs shouldered by socially engaged practitioners working on publicly subsidised participatory projects. On the basis of the analysis of qualitative interviews with socially engaged artists and creative professionals, the article calls for an explicit effort to bring our public cultural institutions to task in relation to what Mark Banks calls ‘creative justice’. This entails highlighting the mechanisms of systemic exploitation of artists within current funding practices and the ways in which project-based funding rarely incorporates, as a matter of course, provisions to ensure the fulfilment of duties of care towards both artists and participating communities. The article draws on feminist ethics of care to advance a first intervention towards developing fresh thinking on the moral economy of the subsidised arts sector; it does this by starting from an acknowledgement that the normative environments of contemporary arts funding point to a clear moral failure of cultural policy.
A comparison of COVID-19 epidemiological indicators in Sweden, Norway, Denmark, and Finland
Authors: Yarmol-Matusiak Erica A. , Cipriano Lauren E. , Stranges Saverio
Published: January 2021

Aims: To compare the early impact of COVID-19 infections and mortality from February to July 2020 across the Nordic nations of Sweden, Norway, Denmark, and Finland through available public data sources and conduct a descriptive analysis of the potential factors that drove different epidemiological outcomes, with a focus on Sweden’s response. Methods: COVID-19 cases, deaths, tests, case age distribution, and the difference between 2020 all-cause mortality and the average mortality of the previous 5 years were compared across nations. Patterns in cell phone mobility data, testing strategies, and seniors’ care home deaths were also compared. Data for each nation were based on publicly available sources as of July 31, 2020. Results: Compared with its Nordic peers, Sweden had a higher incidence rate across all ages, a higher COVID-19-related death rate only partially explained by population demographics, a higher death rate in seniors’ care, and higher all-cause mortality. Sweden had approximately half as much mobility change as its Nordic neighbours until April and followed similar rates as its neighbours from April to July. Denmark led its Nordic peers in testing rates, while Sweden had the highest cumulative test-positivity rate continuously from mid-March. Conclusions: COVID-19 pushed Sweden’s health system to its capacity, exposed systemic weaknesses in the seniors’ care system, and revealed challenges with implementing effective contact tracing and testing strategies while experiencing a high case burden. Looser government restrictions at the beginning of the outbreak are likely to have played a role in the impact of COVID-19 in Sweden. In an effort to improve epidemic control, Sweden has increased testing rates, implemented more restrictive prevention measures, and increased their intensive care unit bed capacity.
National identity profiles and support for the European Union
Authors: Aichholzer Julian , Kritzinger Sylvia , Plescia Carolina
Published: January 2021

Scholars have long recognized that national identity-related factors are among the strongest predictors of citizens’ attitudes toward the European Union. But while some find that they reinforce support for the European Union, other scholars show that national identity undermines its support. In this article, we aim to disentangle this puzzle by studying how the national identity profiles of European citizens relate to support for the European Union across individuals and member states. To this end, we employ data from the International Social Survey Program 2013, by far the most extensive collection of survey questions on national identity, and the technique of latent class analysis. Our results show which specific configurations of national identity entail support, ambivalence or rejection of the European Union, their antecedents, and their variation across countries.
Social work indigenization in Mainland China: Towards a state-led decolonizing framework
Authors: Lin Shen (Lamson)
Published: January 2021

The tension between indigenizing versus internationalizing social work knowledge, resulting from local-specific sensitivity, has been a contemporary dispute in the Global South where there are diverse geo-historical backgrounds. This is the case in China, where the mainstream international narrative surrounding social work development has been configured by the normative values and knowledge of a Euromodern origin. Such misrepresentation rarely reflects indigenous voices from the local social work academy. Informed by Foucault’s thesis of power/knowledge, this article first compares the model of state social work in China and the world. Then, as a decolonizing project, a narrative review of 26 Chinese language articles was conducted.

Findings

Distinctive service and policy practices in the Chinese traditional helping system were identified to illustrate how western social work was ethnocentrically repositioned in the “post-socialist” China. These initiatives include micro-level “Civil Affairs” services, meso-level “mass work” practice, and macro-level “Minsheng” State and crossregional Pairing Aid Programs, which are rooted in the cultural (Confucianism), economical (socialist market economy), and political (Marxism) ecosystem in China.

Applications

Through an indigenized epistemological stance, a state-led anti-colonial framework is presented to unveil the making of social work indigenization and social welfare development that de-centers Eurocentric hegemony. To reorient social work knowledge apart from persistent neo-colonialism in the form of academic imperialism, social work development should be tailored into a locally responsive and geopolitically appropriate models in the non-western world.
Multiculturalism beyond citizenship: The inclusion of non-citizens
Authors: Teo Terri-Anne
Published: January 2021

This article questions multiculturalism’s reliance on citizenship as a default condition of inclusion. While agreeing with multiculturalists that there are groups within the citizenry who are excluded from citizenship rights on the basis of their cultural background, this article highlights the misrecognition of non-citizens that is yet unaccounted for by Anglophone theories of multiculturalism where eligibility to multicultural rights-claiming hinges on the condition of formal citizenship. The status of non-citizenship affects conceptions of ‘difference’ where representations of cultural ‘otherness’ are compounded by the ‘foreignness’ of non-citizens. Frameworks of multicultural citizenship entail recognition through group-specific rights, but only for citizens, in so doing excluding the needs and rights of non-citizens. The assumption made by multiculturalists is that citizenship is a condition of multicultural rights and/or recognition despite scenarios where non-citizens may not desire the citizenship of their host country, or the idea of ‘belonging’ it is attached to. Appealing to multiculturalist principles and the neo-republican notion of non-domination, I argue that multiculturalism as a theory can challenge the limitations of citizenship by expanding its compass to include non-citizens as multicultural subjects.
Care-full research ethics in multispecies relations on dairy farms
Authors: Lonkila Annika
Published: January 2021

Although ethical questions are at the core of more-than-human geographies, more attention needs to be paid on researchers’ ethical responsibilities to more-than-human research subjects in social scientific research. In this paper I critically analyze my empirical work on Finnish dairy farms from the perspective of multispecies research ethics. I suggest that the concept of care is useful in understanding more-than-human research ethics. Attending to the needs of others can work as a starting point for making difficult ethical decisions in the field. However, in contested moments, different needs are often in conflict. Here, situated ethical responses might be needed in relation to the practices of fieldwork, for example to avoid causing harm to research subjects. Importantly, researchers have to care for their research subjects also through their analysis; addressing the questions related to research ethics also in terms of knowledge politics. When the ethics of care is complemented with the notion of ethics of exclusion, it has potential to tease out broader responsibilities both in interactions and knowledge about other animals and more-than-human research settings.
Current Fertility Status Does Not Predict Sociosexual Attitudes and Desires in Normally Ovulating Women
Authors: Thomas Andrew G. , Armstrong Stephanie L. , Stewart-Williams Steve , Jones Benedict C.
Published: January 2021

Previous research has found that women at peak fertility show greater interest in extra-pair sex. However, recent replications have failed to detect this effect. In this study, we add to this ongoing debate by testing whether sociosexuality (the willingness to have sex in the absence of commitment) is higher in women who are at peak fertility. A sample of normally ovulating women ( N = 773) completed a measure of sociosexuality and had their current fertility status estimated using the backward counting method. Contrary to our hypothesis, current fertility was unrelated to sociosexual attitudes and desires, even when relationship status was included as a moderator. These findings raise further doubts about the association between fertility and desire for extra-pair sex.
A proposed wavy shield for suppression of supersonic jet noise utilizing reflections
Authors: Mankbadi Reda R , Salehian Saman
Published: January 2021

In this work we propose replacing the conventional flat-surface airframe that shields the engine by a wavy surface. The basic principle is to design a wavy pattern to reflect the incoming near-field flow and acoustic perturbations into waves of a particular dominant frequency. The reflected waves will then excite the corresponding frequency of the large-scale structure in the initial region of the jet’s shear layer. By designing the frequency of the reflected waves to be the harmonic of the fundamental frequency that corresponds to the radiated peak noise, the two frequency-modes interact nonlinearly. With the appropriate phase difference, the harmonic dampens the fundamental as it extracts energy from it to amplify. The outcome is a reduction in the peak noise. To evaluate this concept, we conducted Detached Eddy Simulations for a rectangular supersonic jet with and without the wavy shield and verified our numerical results with experimental data for a free jet, as well as, for a jet with an adjacent flat surface. Results show that the proposed wavy surface reduces the jet noise as compared to that of the corresponding flat surface by as much as 4 dB.
Getting a Foot IN the Door: GABAergic INterneuron-Specific Enhancers
Authors: Goldberg Ethan M.
Published: January 2021

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Intraneural Synovial Sarcoma of the Median Nerve in a 15-Year-Old Male: A Case Report and Review of Literature
Authors: Samia Arthur , Scarcella Joshua , Zeri Richard , Guo Yifan
Published: January 2021

There have been 8 synovial sarcomas of the median nerve reported. We report a case of a 15-year-old male with synovial sarcoma of the right-hand median nerve. Patient presented with a 2-month history of enlarging mass at the base of the right thenar eminence associated with numbness in the median nerve distribution. Physical examination revealed a soft mass over the thenar eminence and paresthesia in the median nerve distribution. He underwent excision of the tumor, which revealed a well-encapsulated lesion encompassing the median nerve, involving the first, second, and radial aspect of the third web space as well as recurrent branches of the median nerve. Following excision of the tumor, a thorough metastatic workup was negative for metastatic disease. He was staged as III, T2b, N0, M0—poorly differentiated monophasic synovial sarcoma of the right median nerve. Postoperatively the patient was started on chemotherapy and radiation. Intraneural synovial sarcoma is extremely rare. Our case is the youngest with the longest follow-up. He is currently at a status of 3 years posttreatment with no signs of recurrence and excellent use of his right hand. This case is of particular interest due to the rarity of the disease along with this being the best outcome reported in the literature to-date.
Lifting the curse of knowing: How feedback improves perspective-taking
Authors: Damen Debby , van Amelsvoort Marije , van der Wijst Per , Pollmann Monique , Krahmer Emiel
Published: January 2021

People are likely to use their own knowledge as a frame of reference when they try to assess another person’s perspective. Due to this egocentric anchoring, people often overestimate the extent to which others share their point of view. This study investigated which type of feedback (if any) stimulates perceivers to make estimations of another person’s perspective that are less biased by egocentric knowledge. We allocated participants to one of the three feedback conditions (no feedback, accuracy feedback, narrative feedback). Findings showed that participants who were given feedback adjusted their perspective-judgement more than those who did not receive feedback. They also showed less egocentric projection on future assessments. Participants adjusted their perspective within the same trial to the same degree for both feedback types. However, participants’ egocentric bias was only reduced when they received narrative feedback and not when they received accuracy feedback about their performance. Implications of these findings for theories of perspective-taking are discussed.
Relation between physical activity and cerebral small vessel disease: A nine-year prospective cohort study
Authors: Landman Thijs RJ , Thijssen Dick HJ , Tuladhar Anil M , de Leeuw Frank-Erik
Published: January 2021

Background and aims

Given the unexplored potential of physical activity to reduce the progression of cerebral small vessel disease (cSVD, the purpose of this study was to prospectively (across nine-year follow-up) examine the relation between (baseline) physical activity and the (clinical and imaging) consequences of the whole spectrum of cerebral small vessel disease.

Methods

Five hundred and three patients with cerebral small vessel disease from the RUNDMC study were followed for nine years. Physical activity was assessed using a questionnaire in 2006, 2011, and 2015. Clinical events (i.e. all-cause mortality, cerebrovascular events (by stroke subtype)) were collected with a structured questionnaire. Patients underwent magnetic resonance imaging scanning for the assessment of magnetic resonance imaging markers of cerebral small vessel disease (i.e. white matter hyperintensities, lacunes, and microbleeds) and microstructural integrity of the white matter at three timepoints.

Results

The mean age at baseline was 66 (SD 9.0) years; 44% were women. A higher baseline physical activity level was independently associated with a lower all-cause mortality (HR: 0.69, 95%CI: 0.49–0.98, p = 0.03) and incidence of cerebrovascular disease (HR: 0.58, 95%CI: 0.36–0.96, p = 0.03). However, we found no relation between physical activity and incident lacunar stroke or progression of magnetic resonance imaging markers of cerebral small vessel disease.

Conclusions

Whilst regular physical activity was not related to the progression of magnetic resonance imaging markers of cerebral small vessel disease across a nine-year follow-up, results from our study prove that high levels of physical activity in patients with cerebral small vessel disease are associated with a lower all-cause mortality and lower incidence of cerebrovascular events.
External validation of two prediction tools for patients at risk for recurrent Clostridioides difficile infection
Authors: van Rossen Tessel M. , van Dijk Laura J. , Heymans Martijn W. , Dekkers Olaf M. , Vandenbroucke-Grauls Christina M. J. E. , van Beurden Yvette H.
Published: January 2021

Background:

One in four patients with primary Clostridioides difficile infection (CDI) develops recurrent CDI (rCDI). With every recurrence, the chance of a subsequent CDI episode increases. Early identification of patients at risk for rCDI might help doctors to guide treatment. The aim of this study was to externally validate published clinical prediction tools for rCDI.

Methods:

The validation cohort consisted of 129 patients, diagnosed with CDI between 2018 and 2020. rCDI risk scores were calculated for each individual patient in the validation cohort using the scoring tools described in the derivation studies. Per score value, we compared the average predicted risk of rCDI with the observed number of rCDI cases. Discrimination was assessed by calculating the area under the receiver operating characteristic curve (AUC).

Results:

Two prediction tools were selected for validation (Cobo 2018 and Larrainzar-Coghen 2016). The two derivation studies used different definitions for rCDI. Using Cobo’s definition, rCDI occurred in 34 patients (26%) of the validation cohort: using the definition of Larrainzar-Coghen, we observed 19 recurrences (15%). The performance of both prediction tools was poor when applied to our validation cohort. The estimated AUC was 0.43 [95% confidence interval (CI); 0.32–0.54] for Cobo’s tool and 0.42 (95% CI; 0.28–0.56) for Larrainzar-Coghen’s tool.

Conclusion:

Performance of both prediction tools was disappointing in the external validation cohort. Currently identified clinical risk factors may not be sufficient for accurate prediction of rCDI.
Self-Worth and Self-Knowledge in Iranian Patients Seeking Cosmetic Surgery: A Comparative Study
Authors: Valikhani Ahmad , Sattarian Rafat , Rahmanian Mahdieh , Moustafa Ahmed A. , McKinlay Audrey
Published: January 2021

Prior research has reported a psychological impairment in patients seeking cosmetic surgery. However, the role of other variables such as contingencies of self-worth and self-knowledge has been ignored. Hence, the aim of this study was to examine new psychological structures, contingencies of self-worth, and self-knowledge among patients seeking cosmetic surgery. Eighty patients (47 female and 33 male; mean age = 28.98, SD = 8.32; 40 seeking cosmetic surgery and 40 seeking surgical treatment) were randomly recruited from the Shahid Motahhari clinic in Shiraz, Iran. The patients completed the Contingencies of Self-Worth Scale, Integrative Self-Knowledge Scale, Subjective Vitality Scale, and Depression Anxiety Stress Scale-21. The results showed that, compared to the surgical treatment group, self-worth in patients seeking cosmetic surgery was found to depend on their appearance and the approval of others. Further, the self-knowledge in patients seeking cosmetic surgery was lower than that of patients seeking surgical treatment. In addition, there were no significant differences between the two groups in vitality, depression, anxiety, and stress. It can be concluded that patients seeking cosmetic surgery have lower self-knowledge and their self-esteem depends on their appearance and the approval of others.
Clinical Decision Support for Diabetes Care in the Hospital: A Time for Change Toward Improvement of Management and Outcomes
Authors: Pichardo-Lowden Ariana R.
Published: January 2021

The increasing prevalence of diabetes permeates hospitals and dysglycemia is associated with poor clinical and economic outcomes. Despite endorsed guidelines, barriers to optimal management and gaps in care prevail. Providers’ limitations on knowledge, attitudes, and decision-making about hospital diabetes management are common. This adds to the complexity of dispersed glucose and insulin dosing data within medical records. This creates a dichotomy as safe and effective care are key objectives of healthcare organizations. This perspective highlights evidence of the benefits of clinical decision support (CDS) in hospital glycemic management. It elaborates on barriers CDS can help resolve, and factors driving its success. CDS represents a resource to individualize care and improve outcomes. It can help overcome a multifactorial problem impacting patients’ lives on a daily basis.
Friedrich Engels on state socialism
Authors: Pateman Joe
Published: January 2021

In the ideological legacy of Friedrich Engels, the critique of ‘state socialism’ has a prominent, if overlooked, place. According to this conception, the essence of socialism is that the existing state intervenes in the capitalist economy and society with reforms to benefit the working class. The first section of this article outlines Engels’ critique of state socialism. It mentions how left geographers have approached his remarks on the trend, specifically in regard to the housing question, nationalisation and liberal democracy. The second part highlights the contemporary significance of Engels’ conception of proletarian emancipation – as contained in his critique of state socialism. Engels’ remarks can help clarify the objective conditions for socialism, conditions that some left geographers continue to ignore. It brings Engels insights to bear upon the Syriza Party in Greece, Corbynism in the UK, Bernie Sanders in the USA and the ‘Pink Tide’ in Latin America.
Similarity Predicts Cross-National Social Preferences
Authors: Froehlich L. , Dorrough A. R. , Glöckner A. , Stürmer S.
Published: January 2021

Humans are not purely selfish money maximizers. Most individuals take into account consequences for others in their decisions, reflecting social preferences. In a large-scale study ( N = 2,889) involving population-representative samples from 10 nations, we investigated social preferences toward different national out-groups. Social preferences varied systematically depending on the other person’s nationality. Individuals showed higher social preferences toward others from nations rated similar to their own nation in terms of the stereotype content dimensions of agency, conservative/progressive beliefs, and communion (ABC) and, to a lesser extent, the Hofstede cultural dimensions. Similarity according to the ABC stereotypes more strongly predicted out-group-specific social preferences than similarity according to the Hofstede cultural dimensions. The effects of similarity on social preferences increased with identification with the national in-group. Results support self-categorization theory, but not social identity theory, indicating that perceptions of similarity influence interaction behavior between individuals from different nations.
Transcirculation microballoon-assisted coil embolization for dorsal pancreatic artery aneurysm due to celiac artery dissection: A case report
Authors: Takara Yuki , Yunaiyama Daisuke , Saguchi Toru , Shirota Natsuhiko , Yamada Takafumi , Akasaka Junetsu , Saito Kazuhiro
Published: January 2021

The dorsal pancreatic artery is a part of peripancreatic arcade connecting celiac artery to transpancreatic artery. A dorsal pancreatic artery aneurysm derived from dissection of celiac artery is a rare pathology, and it sometimes requires ingenious strategy in an endovascular surgery. Hereby, we report a case of a patient who underwent coil embolization for dorsal pancreatic artery aneurysm due to celiac artery dissection by applying transcirculation approach of a balloon catheter through the peripancreatic arcade, which was successfully achieved.
Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years
Authors: Kokame Gregg T. , Tanji Tarin T. , Omizo Jase N.
Published: January 2021

Purpose:

We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures.

Methods:

A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation.

Results:

The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage.

Conclusions:

Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.
Nudging in Singapore: Current Implementation in Three Key Areas
Authors: Detenber Benjamin H.
Published: January 2021

The city state of Singapore has a long history of social engineering efforts, yet only recently have social scientists and civil servants started to use behavioural insights (BI) to create ‘nudges’ and integrate them into the daily lives of citizens. Colloquially known as a nanny state for its extensive social programmes and sometimes heavy-handed approach to guiding social behaviour, Singapore is often regarded favourably by its neighbours in terms of its cleanliness, efficiency, and productivity. Yet how it manages its populace and the restrictions it imposes on unwanted behaviours are sometimes viewed sceptically by others in Asia and the West. Thus, many in the Singapore Civil Service have come to see nudging as a less coercive way to promote social welfare and well-being. This article reviews some of the latest actions in three areas: finance, health, and the environment. In discussing the range of nudging practices, their effectiveness will be assessed and some of the implications for society and individuals will be addressed. To the extent that Singapore can be considered a bellwether or harbinger, its use of nudges may offer a glimpse of what lies ahead for other countries in the region.

JEL codes: E70, O35
Improvement of the polyurethane spring isolation device for HV post insulators and its evaluation by fragility curves
Authors: Gökçe Tansu , Orakdöğen Engin , Yüksel Ercan
Published: January 2021

A novel seismic base isolation system has been developed for high-voltage (HV) porcelain post insulators. The seismic isolation device consists of two steel plates, four polyurethane springs, and a steel rod, which are low-cost components compared to the post insulators. Two alternative designs of the device are experimentally and numerically assessed in this article. A simple and robust numerical model consisting of linear line elements and nonlinear springs was generated, and subsequently validated using the experimental results. Incremental dynamic analyses (IDAs) were then performed to obtain fragility curves. Ten historical earthquake profiles, scaled to intensities between 0.1 and 2.0 g, were then applied to the numerical models. The fragility curves, generated according to the latest version of IEEE-693, demonstrate that the seismic isolation devices are highly effective in diminishing the base moment of the porcelain insulator. It should be noted that relatively large displacements at the top of the pole must be accounted for by ensuring adequate slackness in the flexible conductors.
Sirenomelia With Anhydramnios: A Clue From the Movements of Fetal Limbs
Authors: Chauhan Rahul Dev , Sahoo Ipsita , Mathur Yashvir
Published: January 2021

Sirenomelia is a rare, lethal congenital malformation of the fetus, typically characterized by the fusion of lower limbs and additional malformations involving the lumbosacral spine and urogenital and gastrointestinal tracts. We report a case of sirenomelia with anhydramnios detected during anomaly scan where the fetus had normal morphology of long bones of the lower limbs. There were associated abnormalities of the lumbosacral spine (caudal dysgenesis). The abortus had fused lower limbs, absent external genitalia and anal orifice, single umbilical artery, and Potter facies. We also highlight the interesting diagnostic challenges faced by us during this antenatal ultrasound. To our knowledge, this is the first case report of sirenomelia where the synchronous movement of lower limbs was a clue that led to the timely antenatal detection of this rare entity. This ultimately helped in perinatal counseling of parents to decide on termination of pregnancy.
Continuity in general practice and hospitalization patterns: an observational study
Authors: Wensing Michel , Szecsenyi Joachim , Laux Gunter
Published: January 2021

Background

High continuity of care is a key feature of strong general practice. This study aimed to assess the effect of a programme for enhancing strong general practice care on the continuity of care in Germany. The second aim was to assess the effect of continuity of care on hospitalization patterns.

Methods

We performed an observational study in Germany, involving patients who received a strong general practice care programme (n=1.037.075) and patients who did not receive this programme (n=723.127) in the year 2017. We extracted data from a health insurance database. The cohorts were compared with respect to three measures of continuity of care (Usual Provider Index, Herfindahl Index, and the Sequential Continuity Index), adjusted for patient characteristics. The effects of continuity in general practice on the rates of hospitalization, rehospitalization, and avoidable hospitalization were examined in multiple regression analyses.

Results

Compared to the control cohort, continuity in general practice was higher in patients who received the programme (continuity measures were 12.47 to 23.76% higher, P< 0.0001). Higher continuity of care was independently associated with lowered risk of hospitalization, rehospitalization, and avoidable hospitalization (relative risk reductions between 2.45 and 9.74%, P< 0.0001). Higher age, female sex, higher morbidity (Charlson-index), and home-dwelling status (not nursing home) were associated with higher rates of hospitalization.

Conclusion

Higher continuity of care may be one of the mechanisms underlying lower hospitalization rates in patients who received strong general practice care, but further research is needed to examine the causality underlying the associations.
Effect of a sports mouthguard on the functional range of motion of the spine and the upper body posture in taekwondo
Authors: Ohlendorf Daniela , Romdhane Mara , Lehmann Christoph , Lehmann Sebastian , Kopp Stefan , Maurer-Grubinger Christian , Oremek Gerhard , Groneberg David A. , Wanke Eileen M.
Published: January 2021

Background

The aim is to investigate to what extent the different oral protections compared to the habitual occlusion affect the upper body posture in statics and during taekwondo-specific movement.

Methods

12 Taekwondoka (5 f/7 m) of German national team were measured by using a 3d back scanner and an ultrasonic distance measuring (upright stand, taekwondo attack and defense movement, two taekwondo specific combinations) in habitual occlusion, with a custom-made and ready-made mouth protection

Results

There are no significant changes in the upper body posture (p ≥ 0.05). Depending on the dynamic measurements, different significant reactions of the spinal position were found while wearing the custom made mouthguard or the ready-made mouthguard according to the conducted movement.

Conclusion

The measured changes in dynamic movements are not clinical relevant. Based on the positive responses from the participants, the custom-made mouth protection can be recommended combined with an individual analysis.
Exome sequencing enables diagnosis of X-linked hypohidrotic ectodermal dysplasia in patient with eosinophilic esophagitis and severe atopy
Authors: Modi Bhavi P. , Del Bel Kate L. , Lin Susan , Sharma Mehul , Richmond Phillip A. , van Karnebeek Clara D. M. , Chan Edmond S. , Avinashi Vishal , Rehmus Wingfield E. , Biggs Catherine M. , Wasserman Wyeth W. , Turvey Stuart E.
Published: January 2021

X-linked hypohidrotic ectodermal dysplasia (XLHED) is the most common form of ectodermal dysplasia. Clinical and genetic heterogeneity between different ectodermal dysplasia types and evidence of incomplete penetrance and variable expressivity increase the potential for misdiagnosis. We describe a family with X-linked hypohidrotic ectodermal dysplasia (XLHED) presenting with variable expressivity of symptoms between affected siblings. In addition to the classical signs of hypohidrosis, hypotrichosis and hypodontia, the index patient—a 5 year old boy, also presented with a severe atopy phenotype that was not observed in the other two affected brothers. Exome sequencing in the index and the mother identified a pathogenic nonsense variant in EDA (NM_001399.4: c.766 C>T; p. Gln256Ter). This study highlights how exome sequencing was crucial in establishing a precise molecular diagnosis of XLHED by enabling us to rule out other differential diagnoses including NEMO deficiency syndrome, that was initially presented as a clinical diagnosis to the family.
Clinical and immunologic characteristics of Japanese patients with anti-glomerular basement membrane disease: case reports and literature review
Authors: Shimamura Yoshinosuke , Maeda Takuto , Abe Koki , Ogawa Yayoi , Takizawa Hideki
Published: January 2021

Background

Clinical studies of anti-glomerular basement membrane (GBM) disease were limited because of the low incidence. We aimed to report the characteristics, treatments, and outcomes of patients with anti-GBM disease at a tertiary reference medical center in Japan and review the literature of mortality in patients with anti-GBM disease.

Case presentation

Case 1 was a 72-year-old Japanese man that was referred with worsening of the serum creatinine (from 1.1 to 27.3 mg/dL). Anti-GBM disease was confirmed by renal biopsy, and treatments with oral prednisolone and plasmapheresis were initiated. Although his anti-GBM antibody decreased (from 476 to 18 units/mL) after the treatments, the patient died from lung abscess. Case 2 was a 32-year-old Japanese man that presented with fever and macroscopic hematuria. At presentation, his serum creatinine was 4.2 mg/dL, and anti-GBM antibody was 265 units/mL. Renal biopsy confirmed the diagnosis of anti-GBM disease, and intensive treatments with plasmapheresis and methyl prednisolone were started, followed by oral prednisolone. Living-donor kidney transplantation was performed because his anti-GBM antibody had remained undetectable for 1 year after diagnosis. In the main text, clinicopathological characteristics of 12 patients with anti-GBM disease at our institution were summarized.

Conclusions

We found that the 1-year survival rate of patients with anti-GBM disease was 88% in our cohort, which was comparable to previous studies. Multicenter, nationwide studies are expected to evaluate prognosis of Japanese patients with this rare entity.
Temporary central venous catheter at hemodialysis initiation and reasons for use: a cross-sectional study
Authors: Nakaya Izaya , Goto Taijiro , Nakamura Yuki , Yoshikawa Kazuhiro , Oyama Junji , Tamayama Yoshihiko , Morooka Mizuho , Ito Sadatoshi , Ishioka Hirotaka , Matsuura Yuki , Soma Jun
Published: January 2021

Background

Creating permanent vascular access (VA) is recommended before hemodialysis initiation in patients with end-stage renal disease (ESRD). Although many patients are still introduced to hemodialysis with temporary central venous catheters (CVCs), the reasons for their use remain unclear. We aimed to clarify the characteristics of Japanese patients introduced to hemodialysis using temporary CVCs, the reasons for their use, and whether this rate can be reduced in the future.

Methods

We conducted this cross-sectional study in an acute care general hospital in Japan. We enrolled 393 patients aged ≥ 18 years who received a permanent VA creation for initiating hemodialysis. We classified participants into the temporary CVC group or the permanent VA group according to the VA type at hemodialysis initiation and compared their backgrounds. We identified why permanent VA could not be used at hemodialysis initiation for patients in the temporary CVC group.

Results

Of the 393 patients, 137 (35%) initiated hemodialysis with a temporary CVC, and arteriovenous fistulas (AVFs) were created as the first VA in all patients during hospitalization following hemodialysis initiation. The remaining 256 patients (65%) initiated hemodialysis via AVF cannulation. The duration of predialysis nephrology care was significantly shorter in the temporary CVC group than that in the permanent VA group. The median time from AVF creation to the first successful cannulation was also shorter in the temporary CVC group (8 vs. 66 days, P < 0.001), but the estimated glomerular filtration rate values at hemodialysis initiation did not differ. Reasons for temporary CVC use were varied and complex. Problems on the part of healthcare providers, patient behavioral issues, and characteristics of causative kidney disease itself were underlying reasons. Delayed referral to a nephrologist was less frequent than expected (16%) and the most commonly reported reason (20%) was that a nephrologist was unable to predict the timing of hemodialysis initiation.

Conclusions

Patients with ESRD should be referred to a nephrologist earlier for AVF creation. However, given the already relatively high rate of hemodialysis initiation with permanent VA in Japan, we considered it surprisingly difficult to further reduce the temporary CVC usage rate in Japan.
The efficacy of ultrasound-guided multifidus cervicis plane block versus greater occipital nerve block for cervicogenic headache
Authors: Mohamed Zenat Eldadamony , Zarad Carmen Ali , Flifel Mohamed E. , Abou Elmaaty Ali A.
Published: January 2021

Introduction

Traditionally, non-invasive and invasive techniques were used for the treatment of cervicogenic headache (CH). Greater occipital nerve block is the most frequent peripheral nerve block invasive technique used for the management of cervicogenic headache. The purpose of this prospective, double-blinded study was to compare the efficacy of two different techniques: multifidus cervicis plane block and greater occipital nerve block in the treatment of refractory cervicogenic headache by using ultrasound.

Methods

Sixty patients with cervicogenic headache were recruited and diagnosed according to the ICHD-III beta version. The patients were divided into two groups, one group was for greater occipital nerve block and the other group was for multifidus cervicis plane block with ultrasound-guided.

Results

Visual analog scale (VAS) was 2.09% in the multifidus cervicis plane block (MCPB) group and was 2.22% in the greater occipital nerve block (GONB) group with a median reduction of − 4.33 and − 3.048, respectively, at 2-week visits with a statistically significant difference better in the MCPB group (P< 0.001). At 4 weeks visits, VAS scale was better in the MCPB group than in the GONB group (3.79 and 4.44, respectively) with a median reduction in VAS scale (− 3.27 and − 3.095, respectively) and statistically significant differences between both groups (P= 0.020).

Conclusion

Both the ultrasound-guided multifidus cervicis plane block and greater occipital nerve block are effective as intervention techniques in the treatment of refractory cervicogenic headache. These techniques are simple, safe, more reliable with less side effects, and often reduce the requirements of analgesic drugs.
The periodic rotary motions of a rigid body in a new domain of angular velocity
Authors: Ismail A. I.
Published: January 2021

In the previous works, the limiting case for the motion of a rigid body about a fixed point in a Newtonian force field, which comes from a gravity center lies on Z-axis, is solved. The authors apply the small parameter technique which is achieved giving the body a sufficiently large angular velocity component ro about the fixed z-axis of the body. The periodic solutions of motion are obtained in neighborhood ro tends to $$\infty$$
∞
. In our work, we aim to find periodic solutions to the problem of motion in the neighborhood of r0 tends to $$0$$

0

. So, we give a new assumption that: ro is sufficiently small. Under this assumption, we must achieve a large parameter and search for another technique for solving this problem. This technique is named; a large parameter technique instead of the small one well known previously. We see the advantage of the new technique which appears in saving high energy used to begin the motion and give the solution of the problem in another domain. The obtained solutions by the new technique depend on ro. We consider that the center of mass of this body does not necessarily coincide with the fixed point O. We reduce the six nonlinear differential equations of the body and their three first integrals to a quasilinear autonomous system of two degrees of freedom and one first integral. We solve the rational case when the frequencies of the generating system are rational except $$(\,\omega = \,1,\,2,1/2,3,1/3, \ldots )$$

(

ω
=

1
,

2
,
1
/
2
,
3
,
1
/
3
,
…
)

under the condition $$\gamma^{\prime\prime}_{0} = \cos \theta_{o} \approx 0$$

γ
0
″

=
cos

θ
o

≈
0

. We use the fourth-order Runge–Kutta method to find the periodic solutions in the closed interval of the time t and to compare the analytical method with the numerical one.
Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 patients—a case series
Authors: Agrawal Akshat , Sen Kamal Kumar , Satapathy Gitanjali , Sethi Humsheer Singh , Sharawat Ajay , Reddy Dwarampudi Sindhu
Published: January 2021

Background

Spontaneous pneumomediastinum, pneumothorax and spontaneous subcutaneous emphysema are rare entities. A rising trend in the setting of COVID-19 even in patients who are not put on invasive ventilation can suggest an alternative aetiology.

Case presentation

We describe four cases which presented with suspected symptoms of COVID-19 and were diagnosed with pneumomediastinum, pneumothorax, and subcutaneous emphysema which would have been missed if not for computed tomography scan performed at the time of admission. Three of these cases had no prior history of any iatrogenic intervention, and the fourth person developing pneumothorax and subcutaneous emphysema after intubation.

Conclusions

Pneumomediastinum, pneumothorax and subcutaneous emphysema can be noted as a complication of COVID-19 itself as well as the complication of management of COVID-19.