bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Urine Drug Testing to Estimate the Prevalence of Drug Use
Authors: Han Benjamin H. , Mello Elizabeth , Tuazon Ellenie , Paone Denise
Published: October 2020

Objectives

Estimating the prevalence of drug use in the general population is important given its potential health consequences but is challenging. Self-reported surveys on drug use have inherent limitations that underestimate drug use. We evaluated the performance of linking urine drug testing with a local, representative health examination survey in estimating the prevalence of drug use in New York City (NYC).

Methods

We used urine drug testing from the NYC Health and Nutrition Examination Survey (NYC HANES) to estimate the prevalence of drug use (benzodiazepines, cocaine, heroin, and opioid analgesics) among the study sample and compare the findings with self-reported responses to questions about past–12-month drug use from the same survey.

Results

Of 1527 respondents to NYC HANES, urine drug testing was performed on 1297 (84.9%) participants who provided urine and consented to future studies. Self-reported responses gave past–12-month weighted estimates for heroin, cocaine, or any prescription drug misuse of 13.8% (95% CI, 11.6%-16.3%), for prescription drug misuse of 9.9% (95% CI, 8.1%-12.1%), and for heroin or cocaine use of 6.1% (95% CI, 4.7%-7.9%). Urine drug testing gave past–12-month weighted estimates for any drug use of 4.3% (95% CI, 3.0%-6.0%), for use of any prescription drug of 2.8% (95% CI, 1.9%-4.1%), and for heroin or cocaine use of 2.0% (95% CI, 1.2%-3.6%).

Conclusion

Urine drug testing provided underestimates for the prevalence of drug use at a population level compared with self-report. Researchers should use other methods to estimate the prevalence of drug use on a population level.
The Effects of Case-Based Teaching in Nursing Skill Education: Cases Do Matter
Authors: Liu Lanfang , Li Mengqian , Zheng Qiaoling , Jiang Hua
Published: October 2020

Nursing skill education plays a very important part for the nursing education. It’s necessary to analyze the role of the case-based teaching (CBT) in nursing skill education, to provide insights into the nursing education. The sophomore nursing students who received nursing skill teaching from September 2019 to January 2020 were selected. The students either underwent traditional teaching (control group) or CBT (CBT group) intervention. The objective structure clinical examination (OSCE), autonomous learning ability, questionnaire for effects evaluation of CBT, and student’s satisfaction level on CBT were analyzed. A total of 146 participants were included. There were no significant differences in the gender, age and the final exam score as freshman between 2 groups (all P > .05). The OSCE scores and autonomous learning ability in CBT group were significantly higher than that of control group (all P < .05). The most students favored the use of CBT, and most students were satisfied with CBT. CBT is beneficial to improve the nursing skill and comprehensive ability of students, and it’s conducive to increase the interest of students, which merits application in nursing education.
Interpersonal Connectivity Work: Being there with and for geographically distant others
Authors: Hafermalz Ella , Riemer Kai
Published: October 2020

In this paper we ask how interpersonal connectivity can be achieved at a geographic distance. This is in contrast with extant literature that focuses on states of connectivity rather than the work needed to achieve it. We draw on phenomenological ideas of embodiment, presence and distance, in combination with empirical material from an extreme remote work context – telenursing in Australia. The nurses we interviewed triage patients entirely by telephone. We argue that even with low social and technical connectivity, interpersonal connectivity is achievable through skilful work with technology. We explore the work that goes into ‘being there with and for distant others’ by combining the phenomenological concepts of ‘maximal grip’ and ‘intentional arc’ with empirical examples. We propose that interpersonal connectivity is oriented empathetically towards both the other person and agentically towards the joint situation. We thereby develop a conceptual model of interpersonal connectivity work, which argues that distributed workers need to skilfully balance the dualities of freedom/control and nearness/farness to achieve interpersonal connectivity. Achieving and maintaining interpersonal connectivity is an important skill, particularly for leaders who operate in work contexts that are increasingly distributed, flexible and temporary.
Assessing the Impact of Off-the-Job and On-the-Job Training on Employment Outcomes: A Counterfactual Evaluation of the PIPOL Program
Authors: Pastore Francesco , Pompili Marco
Published: October 2020

Background:

This article studies the effect of PIPOL, an integrated program of active labor policies launched by the Friuli Venezia Giulia, an Italian region, in 2014.

Objectives:

To understand the impact of training in a classroom setting (off-the-job) and work-related training (on-the-job) on employment integration of benefit recipients.

Research design:

We adopt a counterfactual approach by comparing a target group (treated) against a control group (19,899) extracted by means of propensity score matching and Mahalanobis distance matching among subjects who, while registered in the program over the years 2014–2016, had never benefited from it. The selection of about 7,175 recipients in the program and in each type of intervention was random. Subjects: About 30,000 job seekers made up of 3,911 interns, 2,945 trainees, and 319 recipients of training and internship within PIPOL. Target: Young people, Not in Education Employment or Trainings, and over 30s.

Measures:

We look at different outcomes: employment tout court and employment in open-ended contracts.

Results:

The overall net impact of PIPOL was equal to +5 pp on average. Specifically, impact results were classroom training none, internship sizable (+14.1 pp), and training combined with an internship, quite sizable (+9.6 pp). Furthermore, training to gain a qualification was the most effective (+6.4 pp) among those receiving combined training and internship. Internship also increased the chance to find permanent employment (+3 pp). Among recipients, women, immigrants, and low-skilled recipients registered the most sizable impact on finding employment and training in manufacturing and construction was more effective than elsewhere.

Conclusions:

Italian young people have ever-increasing academic attainment but, due to the sequential nature of the education system, little work-related competences. This could explain the greater success of internships on classroom training.
Reporting Microaggressions: Kinship Carers’ Complaints about Identity Slights
Authors: Wilkes Julie , Speer Susan A.
Published: October 2020

The psychological concept of “microaggression” has refocused interest on what counts as prejudicial action. It redirects attention from standard socio-cognitive explanations of overt prejudice among social groups toward recipients’ perspectives of largely unwitting and subtle everyday racism. Microaggression studies define common implicit identity challenges faced by minority groups, including kinship carers. However, criticisms of the “microaggressions program” raise difficulties inherent in establishing prejudicial action from accounts of necessarily ambiguous actions, and contend that reliance on self-reporting inevitably lacks validity. This conversation analytic (CA) study offers a complementary approach: from videos of ten kinship carer support groups it shows how participants construct accountabilities for prejudicial actions in their retrospective reports of questions, challenges and suspicions in ways that build these actions as microaggressive. It addresses methodological shortcomings in microaggression studies, and extends CA research on accountability in offense construction, and on prejudicial social actions that are contested and difficult to analyze.
In the shadow of threatening norms: How students with visual impairment contest and reproduce institutional positions
Authors: Bödicker Anne , Akbaba Yalız
Published: October 2020

This article focuses on semi-narrative guided interviews with students with visual impairment (VI) who attend a state-approved special school for students with VI at the time of the interview, although they had different previous experiences in both segregated and inclusive schools. We are conducting a qualitative analysis from the perspective of teenagers concerning how they negotiate institutional ascriptions of (dis)abilities. We have selected interview sequences of two young people: (a) Kai: self-confidence and internalized self-doubt and (b) Felix: between fighting and claiming ableist divides. Our analyses reveal the different ways of how Kai and Felix each contest the ableist divide they constantly have to cope with. Kai does so by sticking to her self-concept and ambitious life plans; Felix does so by ridiculing how the institution ascribes neediness to students.
Ruta N, an island of innovation in Medellín’s downtown
Authors: Arenas Lehyton , Atienza Miguel , Vergara Perucich José Francisco
Published: October 2020

This article discusses the contribution of innovation centres in nearby neighbourhoods based on primary data. This paper involves the study of the case of Ruta N in Medellín to expose the relationship between a consolidated neighbourhood and new innovation facilities. Ruta N was founded after the implementation of a city-level policy for innovation intended to secure the economic growth of a former deprived area of the city. This innovation attracted local and international creative entrepreneurs to Medellín’s downtown but with inconsistent results. The analysis revealed that Ruta N rarely interacts with the nearby neighbourhood, thus restricting its potential to contribute to the community. Instead, it is perceived that Ruta N takes advantage of the neighbourhood to meet the needs of Ruta N users, not the other way around. As a result, community members argue that Ruta N could promote potential conflicts in the area.
Supporting the survivors: Experiences and perceptions of peer support offered to UK terrorist survivors
Authors: Rew Nichola Emma Jalfon
Published: October 2020

Recent terror incidents in the UK, including the targeting of concert attendees in Manchester, to individuals socialising and working in central London, highlight the public’s vulnerability and that attacks can be indiscriminate, resulting in any individual becoming a victim to this fearful crime. As a consequence of these and other attacks, including those overseas, media reporting within the UK has increasingly focused on the inadequate levels of support offered to survivors from official agencies. However, little evaluation has been conducted regarding the benefits of support networks and online support groups created directly by those individuals affected by terror attacks.

Quantitative research findings obtained through a self-administered online questionnaire, completed by 81 survivors of terrorist attacks who are members of different peer support networks in the UK, endorsed that while victims feel that adequate professional support is lacking, significant positive experiences have been achieved through peer support, particularly through the internet. This first independent academic study found that it was these methods of support that had the most resonance with individuals and offers several recommendations, based on findings, which could enhance and improve support for survivors of terrorism in the future.
Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis
Authors: Thombs Brett D. , Levis Brooke , Lyubenova Anita , Neupane Dipika , Negeri Zelalem , Wu Yin , Sun Ying , He Chen , Krishnan Ankur , Vigod Simone N. , Bhandari Parash Mani , Imran Mahrukh , Rice Danielle B. , Azar Marleine , Chiovitti Matthew J. , Saadat Nazanin , Riehm Kira E. , Boruff Jill T. , Cuijpers Pim , Gilbody Simon , Ioannidis John P. A. , Kloda Lorie A. , Patten Scott B. , Shrier Ian , Ziegelstein Roy C. , Comeau Liane , Mitchell Nicholas D. , Tonelli Marcello , Barnes Jacqueline , Beck Cheryl Tatano , Bindt Carola , Figueiredo Barbara , Helle Nadine , Howard Louise M. , Kohlhoff Jane , Kozinszky Zoltán , Leonardou Angeliki A. , Radoš Sandra Nakić , Quispel Chantal , Rochat Tamsen J. , Stein Alan , Stewart Robert C. , Tadinac Meri , Tandon S. Darius , Tendais Iva , Töreki Annamária , Tran Thach D. , Trevillion Kylee , Turner Katherine , Vega-Dienstmaier Johann M. , Benedetti Andrea
Published: October 2020

Objective:

The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported “feelings consistent with postpartum depression” based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).

Methods:

We searched Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and the Web of Science Core Collection through June 2016 for studies with data sets with item response data to calculate EPDS-5 scores and that used the SCID to ascertain depression status. We conducted an individual participant data meta-analysis to estimate pooled percentage of EPDS-5 ≥7, pooled SCID major depression prevalence, and the pooled difference in prevalence.

Results:

A total of 3,958 participants from 19 primary studies were included. Pooled prevalence of SCID major depression was 9.2% (95% confidence interval [CI] 6.0% to 13.7%), pooled percentage of participants with EPDS-5 ≥7 was 16.2% (95% CI 10.7% to 23.8%), and pooled difference was 8.0% (95% CI 2.9% to 13.2%). In the 19 included studies, mean and median ratios of EPDS-5 to SCID prevalence were 2.1 and 1.4 times.

Conclusions:

Prevalence estimated based on EPDS-5 ≥7 appears to be substantially higher than the prevalence of major depression. Validated diagnostic interviews should be used to establish prevalence.
Situating Adult Learning and Education in Refugee Livelihood Adaptation and Progression Toward Self-Reliance: The Case of Refugees in the Kyaka II Settlement in Southwestern Uganda
Authors: Awidi Salome Joy , Quan-Baffour Kofi
Published: October 2020

Livelihood adaptation in refugee camps is often fragile and inherently problematic owing to their physical characteristics and policy restrictions. The Uganda refugee policy applauded as progressive exhibits internal contradictions which influence livelihoods. The purpose of this study is to explore the significant role of adult education in livelihood adaptation. The study used qualitative research methods of interviews and focus group discussions. Purposive sampling technique was used in selecting 70 participants from eight Common Interest Groups, of both refugees and Ugandan nationals. The findings indicate that access to agriculture extension education and financial literacy facilitates the acquisition of relevant skillsets for adaptation. The study concludes that adult education provides immediate, relevant skillsets for adaptation.
Novel Neurotechnological Interventions for Pediatric Drug-Resistant Epilepsy: Physician Perspectives
Authors: McDonald Patrick J. , Hrincu Viorica , Connolly Mary B. , Harrison Mark J. , Ibrahim George M. , Naftel Robert P. , Chiong Winston , Udwadia Farhad , Illes Judy
Published: October 2020

This qualitative study investigated factors that guide physicians’ choices for minimally invasive and neuromodulatory interventions as alternatives to conventional surgery or medical management for pediatric drug-resistant epilepsy. North American physicians were recruited to one of 4 focus groups at national conferences. Discussions were analyzed using qualitative content analysis. A pragmatic neuroethics framework was applied to interpret results. Discussions revealed 2 major thematic branches: (1) clinical decision making and (2) ethical considerations. Under clinical decision making, physicians emphasized scientific evidence and patient candidacy when assessing neurotechnologies for patients. Ongoing seizures without intervention was important for safety and neurodevelopment. Under ethical considerations, resource allocation, among other financial considerations for technology adoption, were considerable sources of pressure on decision making. Access to neurotechnology was a salient theme differentiating Canadian and American contexts. When assessing novel neurotechnological interventions for pediatric drug-resistant epilepsy, physicians balance clinical and ethical factors to guide decision making and best practice.
A Comprehensive Review of Neurologic Manifestations of COVID-19 and Management of Pre-existing Neurologic Disorders in Children
Authors: Kim Yunsung , Walser Sarah A. , Asghar Sheila J. , Jain Rohit , Mainali Gayatra , Kumar Ashutosh
Published: October 2020

Since the first reports of SARS-CoV-2 infection from China, multiple studies have been published regarding the epidemiologic aspects of COVID-19 including clinical manifestations and outcomes. The majority of these studies have focused on respiratory complications. However, recent findings have highlighted the systemic effects of the virus, including its potential impact on the nervous system. Similar to SARS-CoV-1, cellular entry of SARS-CoV-2 depends on the expression of ACE2, a receptor that is abundantly expressed in the nervous system. Neurologic manifestations in adults include cerebrovascular insults, encephalitis or encephalopathy, and neuromuscular disorders. However, the presence of these neurologic findings in the pediatric population is unclear. In this review, the potential neurotropism of SARS-CoV-2, known neurologic manifestations of COVID-19 in children, and management of preexisting pediatric neurologic conditions during the COVID-19 pandemic are discussed.
Impact of Fluid Balance on Mortality Is Mediated by Fluid Accumulation Index in Sepsis: A Cohort Study
Authors: Shen Yanfei , Huang Xinmei , Cai Guolong , Xu Qianghong , Hu Caibao , Ma Chunfang , Yan Jing
Published: October 2020

Fluid balance (FB) is associated with poor sepsis outcomes; however, it cannot accurately reflect the dynamic fluid accumulation status. Here, we explored a new index, the FB to fluid intake ratio (FB/FI), for evaluating dynamic fluid accumulation in sepsis. FB/FI values within 48 hours were recorded. Their association with in-hospital mortality was investigated using logistic regression and mediation analyses of data from 7,839 patients. In extended logistic models, a linear association was found between FB and mortality (odds ratio [OR]: 1.05-1.08, p < 0.001). However, this association became non-significant after the adjustment of FB/FI (OR: 1.00, 95% confidence interval [CI]: 0.98-1.02). For FB/FI and mortality, a cut-off value of 0.25 was defined. In the spline function logistic model, FB/FI > 0.25 was significantly associated with increased mortality (OR: 4.46, 95% CI: 2.92-6.80), whereas FB/FI ≤ 0.25 was not. For the FB/FI > 0.25 subgroup, mediation analysis was used to clarify the relationship between FB, FB/FI, and mortality. We observed that the direct effect of FB was non-significant (adjusted coefficient: −0.001, 95% CI: −0.005 to 0.002) while the indirect effect was significant (adjusted coefficient: 0.009, 95% CI: 0.006-0.011). In the FB/FI ≤ 0.25 subgroup, both the FB volume (0.9 ± 0.7 vs. −2.0 ± 1.9, p < 0.001) and the FB/FI ratio (0.14 ± 0.07 vs. −0.77 ± 1.60, p < 0.001) were significantly higher in patients with FB > 0 than those with FB ≤ 0. However, both the crude and adjusted comparisons of hospital mortality were non-significant. Similar associations were observed in septic shock patients. FB/FI > 0.25 is a significant risk factor for mortality in sepsis, while FB/FI ≤ 0.25 is not. The association between FB and mortality is completely mediated by this new fluid accumulation index. More comprehensive indices are required for evaluating dynamic fluid status in sepsis.
Evidence-Based Management of the Critically Ill Adult With SARS-CoV-2 Infection
Authors: Chivukula Raghu R. , Maley Jason H. , Dudzinski David M. , Hibbert Kathryn , Hardin C. Corey
Published: October 2020

Human infection by the novel viral pathogen SARS-CoV-2 results in a clinical syndrome termed Coronavirus Disease 2019 (COVID-19). Although the majority of COVID-19 cases are self-limiting, a substantial minority of patients develop disease severe enough to require intensive care. Features of critical illness associated with COVID-19 include hypoxemic respiratory failure, acute respiratory distress syndrome (ARDS), shock, and multiple organ dysfunction syndrome (MODS). In most (but not all) respects critically ill patients with COVID-19 resemble critically ill patients with ARDS due to other causes and are optimally managed with standard, evidence-based critical care protocols. However, there is naturally an intense interest in developing specific therapies for severe COVID-19. Here we synthesize the rapidly expanding literature around the pathophysiology, clinical presentation, and management of COVID-19 with a focus on those points most relevant for intensivists tasked with caring for these patients. We specifically highlight evidence-based approaches that we believe should guide the identification, triage, respiratory support, and general ICU care of critically ill patients infected with SARS-CoV-2. In addition, in light of the pressing need and growing enthusiasm for targeted COVID-19 therapies, we review the biological basis, plausibility, and clinical evidence underlying these novel treatment approaches.
Intimate Partner Violence Among Women of Reproductive Age in Nicaragua: Results From a Nationwide Survey
Authors: Hernández-Vásquez Akram , Chévez-Ramírez Tatiana , Rojas-Roque Carlos
Published: October 2020

This article aims to identify the factors associated with intimate partner violence (IPV) using data from the latest available nationwide survey in Nicaragua. A secondary analysis of the 2011–2012 Nicaraguan Demography and Health Survey (ENDESA 2011–2012) was conducted. A total of 12,605 women aged 15–49 years who had reported being married or united were included. IPV (yes/no) was defined as the outcome variable, and it was considered if a woman suffered verbal, psychological, physical, or sexual violence during the previous 12 months. Crude and adjusted odds ratios with 95% CI were calculated using a bivariate and multivariate logistic regression model. A p value <.05 was considered statistically significant and did not correct p values for multiple testing. The overall prevalence of IPV was 17.5%. Women living in urban setting (AOR: 1.51, 95% CI: 1.26–1.80), women who self-identify as native (AOR: 1.34, 95% CI: 1.34–1.61) or women who have a history of abuse as a child (AOR: 1.96, 95% CI: 1.69–2.27) were more likely to suffer IPV compared to their counterparts. Age was found to be a protective factor for IPV. Variables such as educational level and wealth index, do not report any association with IPV. Our findings shows that IPV in Nicaragua continues to be a frequent event. The results provide evidence of drivers for IPV at a national level. These findings are useful for the design of intervention policies and strategies for the prevention of IPV.
Why Do School Staff Sometimes Fail to Report Potential Victimization Cases? A Mixed-methods Study
Authors: Greco Ana M. , Pérez Eva Gómez , Pereda Noemí , Guilera Georgina , González Iriana Santos
Published: October 2020

Schools are in a position to connect children and adolescents suspected of being victims of violence with an external source of support by making referrals to external agencies. However, several studies have identified obstacles that hinder early reporting among school staff members. Very few studies have applied a mixed-method approach to try to understand this sensitive issue. The current study used this approach to analyze to what extent the students suspected of being victimized match the ones reported by active school staff members in Spain ( n = 453, 83.5% females, age: M = 42.23, SD = 9.46). We classified the reasons given for not reporting the potential victimization cases encountered and made comparisons to determine whether there were differences in the level of knowledge, or in the sociodemographic characteristics, of respondents who gave different reasons for not reporting. Although 73.5% of school staff members had detected at least one potential case, 40.8% of them referred it to an external agency. The most common reasons for lack of reporting included deciding not to do so once concerns had been shared within the school and believing that one must be certain or that only serious violence should be reported. The findings of this study may help to further understand the decisions not to report certain suspicions of potential victimization cases to external agencies by school staff. There is an urgent need to raise awareness about the duty to report these concerns to external agencies, even in the absence of agreement from the school management team. Members of school staff need to be strongly encouraged to become familiar with the existing protocols.
Measuring Perceived Benefits and Costs of New Technology Adoption in the Chinese Textile and Apparel Industry
Authors: Wang Baolu , Ha-Brookshire Jung E. , Bonifay Wesley
Published: October 2020

The textile and apparel industry have been fundamentally changed due to technology development. However, developing countries, such as China, are falling behind for adopting new technologies. The literature suggests firm managers’ perceived benefits and costs of new technology are key variables for their motivation to adopt new technology. However, no reliable and valid scales existed to measure these constructs within the developing country context—specifically in China. Thus, the study aimed to develop scales for measuring Chinese textile and apparel firm managers’ perceived benefits and costs of new technology adoption, using the psychometric method of item response theory. After item generation, item bank development, and psychometric evaluation tested by 599 Chinese textile and apparel firm managers, the two scales were created. These scales provide an opportunity to measure Chinese textile and apparel firm managers’ perceived benefits and costs of new technology adoption, offering tools for additional technology adoption motivation research.
Translating CDSMP to the Workplace: Results of the Live Healthy Work Healthy Program
Authors: Wilson Mark G. , DeJoy David M. , Vandenberg Robert J. , Padilla Heather M. , Haynes Nicholas J. , Zuercher Heather , Corso Phaedra , Lorig Kate , Smith Matthew L.
Published: October 2020

Purpose:

Report the results of a randomized, controlled trial of Live Healthy, Work Healthy (LHWH), a worksite translation of the Chronic Disease Self-Management Program (CDSMP).

Design:

14 worksites were randomly assigned to LHWH, standard CDSMP (usual care) or no-intervention (control) group.

Setting:

The diverse set of work organizations centered around a rural community in SE US.

Subjects:

411 participants completed baseline data with 359 being included in the final analyses.

Intervention:

LHWH had been adapted to fit the unique characteristics of work organizations. This translated program consists of 15 sessions over 8 weeks and was facilitated by trained lay leaders.

Measures:

The primary outcomes including health risk, patient-provider communication, quality of life, medical adherence and work performance were collected pretest, posttest (6 mos.) and follow-up (12 mos.).

Analysis:

Analyses were conducted using latent change score models in a structural equation modeling framework.

Results:

79% of participants reported at least one chronic condition with an average of 2.7 chronic conditions reported. Results indicated that LHWH program demonstrated positive changes in a most outcomes including significant exercise (uΔ = 0.89, p < .01), chronic disease self-efficacy (uΔ = 0.63, p < .05), fatigue (uΔ = −1.45, p < .05), stress (uΔ = −0.98, p < .01) and mentally unhealthy days (uΔ = −3.47, p < .001).

Conclusions:

The translation of LHWH is an effective, low cost, embeddable program that has the potential to improve the health and work life of employees.
Blades optimal design of squirrel cage fan based on Hicks-Henne function
Authors: Zhou Huaxin , Zhou Shuiqing , Gao Zengliang , Dong Haobing , Yang Ke
Published: October 2020

The traditional single-arc blade used in the squirrel cage fan is simple in structure and cannot meet relevant parameterized design requirements. In order to improve the aerodynamic performance of single-arc blades of squirrel cage fans an improved Hicks-Henne function was used in this study to parameterize the blade expression in a Q35 single-suction squirrel cage fan. The AE criterion was used to optimize the Latin hypercube design, a Co-Kriging agent model was established with High and low confidence samples, and the NSGA-II algorithm was combined with the flow rate and total pressure efficiency as a multi-objective optimization goal. A set of optimal blade parameters was selected under the premise that the flow meets the design requirements. The optimized fan's total pressure and total pressure efficiency were improved at each working point. At the design working point, the fan's total pressure increased by about 23Pa, the effective air volume increased by 1.18m³/min, and the total pressure efficiency improved by 3.31%.
Effects of angle formation between melted zone and friction direction on thermal fatigue and wear resistance of truck drum brake
Authors: Yu Dahui , Zhou Ti , Zhou Hong , Xu Yao , Zhang Peng , Yan Yuying
Published: October 2020

The failure of grey cast iron drum brake is mainly caused by thermal fatigue crack running through the top along the axial direction, which has the characteristics of regional failure. By using the advantages of laser fabrication technology, the single models with five different angles combined with the anti-crack ring were designed. The optical microscope, scanning electron microscope and X-ray diffraction were used to characterize the microstructure and phase of the drum brake material grey cast iron and the bionic coupling unit. Both single models and double combination models were tested for thermal fatigue and wear after thermal fatigue, respectively. The effects of angle on the thermal fatigue and wear resistance of the bionic coupling models were investigated. Experimental results show that the microstructure of the unit was better than that of the base grey cast iron due to the appearance of ledeburite, martensite and residual austenite after laser treatment. Besides, thermal fatigue crack has a great influence on wear performance. The thermal fatigue crack and wear loss weight are the least in the model with anti-crack ring + 45°angle, the main crack length is the shortest. The service life of the drum brake with the double combination bionic coupling model is increased by 50% compared with that of the untreated drum brake in bench test.
Entrance length effects on the flow features of rectangular liquid jets
Authors: Aliyoldashi MH , Tadjfar M , Jaberi A
Published: October 2020

An experimental study was carried out to investigate the effects of entrance length on the main characteristics of rectangular liquid jets discharged into the stagnant atmosphere. Six rectangular nozzles, all with the same aspect ratio of 3 but with different entrance length ratios ranging from 3.3 to 60 were constructed. The physics of the fluid flows was visualized by the aid of backlight shadowgraph technique and high speed photography. Flow visualizations revealed that in the mid-range of Weber numbers, the perturbations induced over the liquid surface remarkably depended on the entrance length ratio. Moreover, the characteristics of the axis-switching instability of rectangular liquid jets were measured. It was found that axis-switching wavelength was independent of the entrance length, while the amplitude of axis-switching was directly influenced. For entrance length ratios smaller than 10, the amplitude was increased with increase of entrance length, whereas for entrance length ratios higher than 10, this trend was reversed. Measurements of breakup length also showed that the transition of flow regimes was not perceptibly affected by the entrance length.
Colonic cryptococcosis as a rare presentation in HIV infection: a case report and review of the literature
Authors: Quincho-Lopez Alvaro , Montenegro-Idrogo Juan , Verona-Rubio Rogger Oscar
Published: October 2020

Colonic cryptococcal infection is unusual in people living with HIV (PLWH) and even more so without concomitant neurological compromise. Published case reports describe diarrhea and other intestinal manifestations that are often confused with systemic tuberculosis infection. We describe an Peruvian woman living with HIV on antiretroviral therapy who presented hypotensive with a 6-month history of fever and epigastric pain, in addition to episodes of sporadic diarrhea. Due to the suspicion of systemic tuberculosis, antituberculosis treatment was started. Days later, without clinical improvement, colonoscopy revealed ulcers in the transverse colon. Histopathological examination of biopsied tissue was compatible with Cryptococcus spp. She received antifungal therapy with amphotericin B and fluconazole. Despite the treatment, the patient died six days later from multiple organ failure.
Alpha-lipoic acid alleviates colistin nephrotoxicity in rats
Authors: Oktan Mehmet Asi , Heybeli Cihan , Ural Cemre , Kocak Ayse , Bilici Gokcen , Cavdar Zahide , Ozbal Seda , Arslan Sevki , Yilmaz Osman , Cavdar Caner
Published: October 2020

Colistin methanesulfonate (CMS), a clinical form of colistin, is widely used as a last-line treatment for multidrug-resistant (MDR) gram-negative bacterial infections in critically ill patients presenting a considerably high mortality rate. However, nephrotoxicity is considered to be a critical adverse effect that limits CMS’s clinical use. Alpha-lipoic acid (ALA) is a strong antioxidant that is effective in preventing nephrotoxicity in many models. The aim of this study was to investigate ALA’s ability to protect against nephrotoxicity induced by colistin in rats. Male Wistar albino rats were randomly divided into four groups. Group 1 was the control group (Control; n = 6), in which isotonic saline was administered to the rats. Group 2 was the ALA group (ALA; n = 6) in which rats received 100 mg/kg ALA. Groups 3 was the CMS (CMS; n = 7) in which 450.000 IU/kg/day of CMS was administered to the rats. Groups 4 was the CMS + ALA group (n = 6), in which rats were injected with 100 mg/kg of ALA 30 min before administration of CMS. All injections were performed intraperitoneally at 1, 4, 7, and 10 days. Urine was collected by using a metabolic cage for 24 h after each administration. The rats were euthanized under ether anesthesia after 24 h of the last administration. Blood and kidney samples then were collected for histological and biochemical analysis. ALA pretreatment could reverse the effects of colistin-induced nephrotoxicity, partly through its suppressing effect on Nox4 and caspase-3, which in turn results in its antioxidant and antiapoptotic effect. Therefore, ALA may be an effective strategy for the management of colistin nephrotoxicity.
Governing border security infrastructures: Maintaining large-scale information systems
Authors: Glouftsios Georgios
Published: October 2020

This article explores the maintenance of large-scale information systems that are used for, among other purposes, border security in the European Union. My argument is that information systems do not always operate according to their design scripts. They materialize as unruly, unstable and failing infrastructures that are governed through maintenance in order to correct any identified functional anomalies and address potential future failures by adapting them to emerging technologies and the service needs of end-users (e.g. border guards, police). To conceptualize the maintenance labour through which information systems are governed, I synthesize ideas developed in Michel Foucault’s work on biopolitics and governmentality with contributions that explore the agentic forces and proclivities of technoscientific matter. By unearthing the very mechanics of maintenance processes, I make two contributions to the literature that interrogates the digitization and smartening of border security. First, I demonstrate that attending to maintenance permits a more complete understanding of the agency of information systems. Second, I broaden the research agenda that explores border security as practice by directing attention towards the often invisible, but politically significant, labour of maintainers who, by rendering information systems functional, sustain the power to govern international mobility by digital means.
The Impact of CEOs’ Characteristics on Corporate Leverage: Indian Scenario
Authors: Kaur Rupinder , Singh Balwinder
Published: October 2020

Ever since the prominent work by Modigliani and Miller (1958), much research has been undertaken in trying to identify the factors affecting the capital structure. Lately, behavioural finance has begun to take hold of a more prominent position in trying to explain aspects of finance which traditional research has failed to clarify. In fact, a growing body of empirical evidence suggests that manager-specific characteristics significantly influence firms' financing decisions. The limited work carried out in lower-middle income countries drives us to thoroughly investigate the role played by CEOs’ characteristics in determining corporate financing decisions.

Employing a sample of 307 non-financial firms listed in Nifty 500 index, the panel regression results indicate that CEO tenure is significantly and positively associated to firm’s leverage for the possible reason that a long tenure of CEO reflects strong networks and alliances with important stakeholders that allow the CEO to compose, foster, and support risky initiatives like raising debt. Further, the level of leverage is higher at organizations where CEOs are younger on account of the fact that career and financial securities are imperative to a greater extent for older executives; therefore they may evade risky engagements that may interfere with their securities. The results also display that CEO share ownership has a significantly negative relationship to leverage because these executives have a large share of their personal wealth capitalized in the firm in the shape of firm-specific human capital and common stock holdings. This makes managerial insiders unwilling to use the optimum amount of debt funding for the firm for the reason that additional bankruptcy risk associated with higher levels of debt may arise.

The findings thus put forward that recurrent job changes among the senior officials should be discouraged because the subsequent short-term focus and dearth of firm-specific knowledge might promote risk evasion. It shows that elder executives desire a more conservative capital structure whereas younger executives endeavour to take more risk. So, there is a need to bring diversification in the management so as to take advantage from the skills and services of the young. The inverse association between CEO share ownership and firm leverage specifies that board of directors and the shareholders should be stringent in checking managers to make sure they perform as per the interests of shareholders. It seems that while making capital structure decisions risk seeking behaviour favouring high corporate leverage is important and should be encouraged.
Implicit Knowledge in the Context of Education for Sustainable Development: Students’ Orientations Towards Sustainability-Related Topics
Authors: Holfelder Anne-Katrin
Published: October 2020

This study argues from a sociology of knowledge perspective which considers implicit knowledge as the basis for orientation towards a certain topic. Reconstructing this type of knowledge can help to better understand the learner’s perspective. Implicit knowledge originates from shared experiences. It therefore indirectly provides information about the experiences of learners. In this study, implicit knowledge (orientations) regarding sustainability-related topics was reconstructed from open group discussions with upper secondary-level students from Germany. Three main orientations are presented in this article: the orientation based on a predetermined future of the world, the orientation based on conformity and the orientation based on knowledge and awareness. The findings are discussed with regard to the shared experiences of the students and in terms of their implications for the practice and theory of education for sustainable development.
Analytical performance and method comparison of a quantitative point-of-care immunoassay for measurement of bile acids in cats and dogs
Authors: Weiler Kristina , Kleber Katharina , Zielinsky Sabine , Moritz Andreas , Bauer Natali
Published: October 2020

Point-of-care analyzers (POCAs) for quantitative assessment of bile acids (BAs) are scarce in veterinary medicine. We evaluated the Fuji Dri-Chem Immuno AU10V analyzer and v-BA test kit (Fujifilm) for detection of feline and canine total serum BA concentration. Results were compared with a 5th-generation assay as reference method and a 3rd-generation assay, both run on a bench-top analyzer. Analytical performance was assessed at 3 different concentration ranges, and with interferences. For method comparison, samples of 60 healthy and diseased cats and 64 dogs were included. Linearity was demonstrated for a BA concentration up to 130 µmol/L in cats ( r = 0.99) and 110 µmol/L in dogs ( r = 0.99). The analyzer showed high precision near the lower limit of quantification of 2 µmol/L reported by the manufacturer. Intra- and inter-assay coefficients of variation were < 5% for both species and all concentrations. Interferences were observed for bilirubin (800 mg/L) and lipid (4 g/L). There was excellent correlation with the reference method for feline ( rs = 0.98) and canine samples ( rs = 0.97), with proportional biases of 6.7% and −1.3%, respectively. However, a large bias (44.1%) was noted when the POCA was compared to the 3rd-generation assay. Total observed error was less than total allowable error at the 3 concentrations. The POCA reliably detected feline and canine BA in clinically relevant concentrations.
A low-cost and efficient d33-mode piezoelectric tuned mass damper with simultaneously optimized electrical and mechanical tuning
Authors: Lai Yong-An , Kim Jin-Yeon , Yang Chuang-Sheng Walter , Chung Lap-Loi
Published: October 2020

This paper proposes a low-cost and efficient piezoelectric tuned mass damper (Piezo-TMD) for structural vibration reduction and energy harvesting. The Piezo-TMD consists of not only a proof mass, piezoelectric materials deforming in the d33 mode, and an electrical resistance, but also a spring and an inductor which enable the mechanical frequency and electrical frequency of the Piezo-TMD to be tuned to the structural resonance frequency. The equations of motion of a structure with the Piezo-TMD are derived, and an optimal design procedure for the Piezo-TMD is proposed to achieve a simultaneous maximum vibration reduction and energy harvesting. The performance of the Piezo-TMD is compared with that of a conventional optimal TMD installed in a footbridge under a pedestrian loading. The simulation results show that the Piezo-TMD performs better than the optimal conventional TMD in terms of vibration reduction while efficiently converting the absorbed mechanical energy to electricity with a high energy harvesting ratio. The innovative development of simultaneously tuning the mechanical and electrical systems leads to a much lower number of PZT stacks (saving 88% of piezoelectric materials in an illustrated case). The parametric study shows that the Piezo-TMD achieves the best performance when the optimal values for the spring stiffness, resistance, inductance, and the number of piezoelectric stacks are adopted from the proposed optimal design. If the selected spring stiffness and inductance are uncertain in a range between 0.94-1.07 times the optimal values, the vibration reduction performance of the Piezo-TMD remains similar, and the energy harvesting performance reduces less than 5%, as compared to the optimal performance. The effect of the number of piezoelectric stacks was also investigated. An insufficient number of piezoelectric stacks reduces the Piezo-TMD performance, and an excessive stack number does not improve the Piezo-TMD performance but increases the Piezo-TMD cost. Finally, the proposed Piezo-TMD employs inductance to significantly reduce the PZT stack number, thereby significantly reducing the cost of Piezo-TMDs.
Too Much Too Late? Chemotherapy Administration at the End of Life: A Retrospective Observational Study
Authors: Wilkerson David H. , Santos Jennifer L. , Tan Xiyan , Gomez Teny Henry
Published: October 2020

Purpose:

Cancer treatment for those nearing death has become increasingly aggressive over time despite evidence that less aggressive approaches are associated with better quality of life and sometimes longer survival. Chemotherapy administration in the last 14 days of life is one of the proposed benchmarks for quality of cancer care. The purpose of our study is to evaluate factors associated with aggressive cancer treatment in patients who died within 2 weeks of receiving chemotherapy.

Methods:

This retrospective cohort study evaluated adult patients who died between 1 February 2018 and 1 March 2019 after receiving cancer treatment in the preceding 14 days at the Prisma Health Cancer Institute. This project was approved by our institutional review board. Data was obtained by review of electronic medical records and analyzed using commercial software.

Results:

We identified 92 patients who met inclusion criteria for the study. Of those who were staged, 57% had metastatic disease. A majority received treatments with only palliative intent (54%). These patients overwhelmingly died in the hospital (62%). Few had documented advanced directives (28%) or dedicated palliative care for longer than 1 week (28%). Overall, this cohort reflects a rate of 11.7% of patients who received cancer treatment during the study time period.

Significance of Results:

Patients receiving aggressive cancer treatment at the end of life elucidate significant gaps in quality cancer care, particularly the early involvement of dedicated palliative care. Systematic review helped identify multiple gaps and assisted in implementing interventions to improve this outcome.