bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the experiences of social workers in working with children suspected to have fetal alcohol spectrum disorders
Authors: Gilbert David J , Mukherjee Raja AS , Kassam Nisha , Cook Penny A
Published: July 2021

Fetal alcohol spectrum disorder (FASD) is one outcome from prenatal alcohol exposure. Social workers are likely to encounter children with the condition, due to the greater likelihood of prenatal alcohol exposure among children in social services settings. This study explores the experiences of social workers in working with children suspected of having FASD and the support offered to social workers, the children and their families. Semi-structured interviews followed by qualitative framework analysis were conducted with seven child and family social workers along with one child protection solicitor who had experience of handling FASD cases. The two main themes that emerged from the data were a lack of knowledge about FASD and the paucity of diagnosis. Lack of knowledge among the social workers was linked to difficulty in managing children suspected to have the condition, feelings of frustration and normalisation of challenging behaviours. The paucity of diagnosis led to an under-emphasis of FASD in assessments, a dearth of specialist services and confusion about its specific effects in contexts of multiple substance misuse and harmful socio-environmental factors. The need for increased FASD awareness within social services and the development of FASD-targeted support for children and families is highlighted. Social workers would benefit from the inclusion of FASD-focused training in their curricula and professional development plans. Improving the diagnostic capacities of health institutions would address the paucity of diagnosis and raise the profile of FASD, especially in the social services setting.
Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow
Authors: Macri Francesco , Niu Bonnie T. , Erdelyi Shannon , Mayo John R. , Khosa Faisal , Nicolaou Savvas , Brubacher Jeffrey R.
Published: July 2021

Purpose:

Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital.

Methods:

Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint.

Results:

During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern.

Conclusions:

At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.
Intensive Care Unit Volume of Sepsis Patients Does Not Affect Mortality: Results of a Nationwide Retrospective Analysis
Authors: Naar Leon , Hechi Majed W. El , Gallastegi Ander Dorken , Renne B. Christian , Fawley Jason , Parks Jonathan J. , Mendoza April E. , Saillant Noelle N. , Velmahos George C. , Kaafarani Haytham M. A. , Lee Jarone
Published: July 2021

Background:

There is little research evaluating outcomes from sepsis in intensive care units (ICUs) with lower sepsis patient volumes as compared to ICUs with higher sepsis patient volumes. Our objective was to compare the outcomes of septic patients admitted to ICUs with different sepsis patient volumes.

Materials and Methods:

We included all patients from the eICU-CRD database admitted for the management of sepsis with blood lactate ≥ 2mmol/L within 24 hours of admission. Our primary outcome was ICU mortality. Secondary outcomes included hospital mortality, 30-day ventilator free days, and initiation of renal replacement therapy (RRT). ICUs were grouped in quartiles based on the number of septic patients treated at each unit.

Results:

10,716 patients were included in our analysis; 272 (2.5%) in low sepsis volume ICUs, 1,078 (10.1%) in medium-low sepsis volume ICUs, 2,608 (24.3%) in medium-high sepsis volume ICUs, and 6,758 (63.1%) in high sepsis volume ICUs. On multivariable analyses, no significant differences were documented regarding ICU and hospital mortality, and ventilator days in patients treated in lower versus higher sepsis volume ICUs. Patients treated at lower sepsis volume ICUs had lower rates of RRT initiation as compared to high volume units (medium-high vs. high: OR = 0.78, 95%CI = 0.66-0.91, P-value = 0.002 and medium-low vs. high: OR = 0.57, 95%CI = 0.44-0.73, P-value < 0.001).

Conclusion:

The previously described volume-outcome association in septic patients was not identified in an intensive care setting.
Utilization of Airway Pressure Release Ventilation as a Rescue Strategy in COVID-19 Patients: A Retrospective Analysis
Authors: Mahmoud Omar , Patadia Deep , Salonia James
Published: July 2021

Background:

Airway Pressure Release Ventilation (APRV) is a pressure controlled intermittent mandatory mode of ventilation characterized by prolonged inspiratory time and high mean airway pressure. Several studies have demonstrated that APRV can improve oxygenation and lung recruitment in patients with Acute Respiratory Distress Syndrome (ARDS). Although most patients with COVID-19 meet the Berlin criteria for ARDS, hypoxic respiratory failure due to COVID-19 may differ from traditional ARDS as patients often present with severe, refractory hypoxemia and significant variation in respiratory system compliance. To date, no studies investigating APRV in this patient population have been published. The aim of this study was to evaluate the effectiveness of APRV as a rescue mode of ventilation in critically ill patients diagnosed with COVID-19 and refractory hypoxemia.

Methods:

We conducted a retrospective analysis of patients admitted with COVID-19 requiring invasive mechanical ventilation who were treated with a trial of APRV for refractory hypoxemia. PaO2/FIO2 (P/F ratio), ventilatory ratio and ventilation outputs before and during APRV were compared.

Results:

APRV significantly improved the P/F ratio and decreased FIO2 requirements. PaCO2 and ventilatory ratio were also improved. There was an increase in tidal volume per predicted body weight during APRV and a decrease in total minute ventilation. On multivariate analysis, higher inspiratory to expiratory ratio (I: E) and airway pressure were associated with greater improvement in P/F ratio.

Conclusions:

APRV may improve oxygenation, alveolar ventilation and CO2 clearance in patients with COVID-19 and refractory hypoxemia. These effects are more pronounced with higher airway pressure and inspiratory time.
The Role of Discrimination Experiences in Postrape Adjustment Among Racial and Ethnic Minority Women
Authors: Walsh Kate , Gilmore Amanda K. , Barr Simone C. , Frazier Patricia , Ledray Linda , Acierno Ron , Ruggiero Kenneth J. , Kilpatrick Dean G. , Resnick Heidi S.
Published: July 2021

Although recent studies have linked discrimination frequency among Black and Latinx individuals to PTSD symptom severity, to our knowledge, these associations have yet to be examined among a diverse sample of recent rape survivors. The current secondary analysis of existing data examined the role of discrimination experiences in post-traumatic stress disorder (PTSD) symptoms, depression, and alcohol and drug problems among a racially and ethnically diverse sample of recent rape survivors. Participants were 139 Black (48.2%; n = 67), American Indian (18.7%; n = 26), Hispanic (15.1%; n = 21), and mixed race (17.3%; n = 24) girls and women age 15 or older who presented to the emergency department (ED) for a sexual assault forensic medical exam. They were randomly assigned to one of three intervention conditions, and completed a six-month postrape follow-up, including questions about mental health, substance use problems, and discrimination experiences. Regression analyses revealed that Black women experienced discrimination in significantly more situations and with greater frequency compared to American Indian and Hispanic women. Discrimination frequency was positively associated with PTSD and depression symptoms even after controlling for age, education, race, and intervention condition, but was not associated with alcohol or drug problems. Findings highlight the importance of attending to the heterogeneous experiences of discrimination among racial and ethnic minority women. Future work should adapt evidence-based early interventions to be maximally effective at combating both racial and sexual trauma exposures.
Sexual Re-Assault among College Women Differs Based on Sexual Refusal Assertiveness and Assertive Resistance Strategy Intentions
Authors: Oesterle Daniel W. , Jarnecke Amber M. , Gilmore Amanda K.
Published: July 2021

Sexual assault and sexual re-assault are common problems on college campuses for women, and experiencing an initial assault dramatically increases risk for experiencing sexual re-assault. Low use of sexual refusal assertiveness and assertive resistance strategy intentions has been found to predict initial victimization, yet few studies to date look collectively at the associations of sexual refusal assertiveness and assertive resistance strategy intentions to sexual re-assault. The current study examined both sexual refusal assertiveness and assertive resistance strategy intentions as potential moderators of sexual re-assault among college women. It was hypothesized that the association between sexual assault severity before college and sexual assault severity since college would be stronger among those with low sexual refusal assertiveness compared to those with high sexual refusal assertiveness (Hypothesis 1). it was also hypothesized that the association between sexual assault severity before college and sexual assault severity since college would be stronger among those who endorsed assertive resistance strategy intentions (Hypothesis 2). Participants (N = 623) included college women at a large, public university within the northwestern region of the United States, who completed a web-based survey. Results revealed that the association between sexual assault severity before college and sexual assault severity since college was significant among those with lower levels of sexual refusal assertiveness (t = 91.42, p < 0 .001). Results also revealed that the association between sexual assault severity before college and sexual assault severity since college was stronger among those who endorsed non-assertive resistance strategy intentions to a potential sexual assault scenario (t = 25.09, p < 0.001). These findings provide insight into risk for sexual re-assault, wherein risk reduction programmatic efforts may be targeted towards women entering college with a sexual assault history to increase their use of sexual refusal assertiveness and assertive resistance strategy intentions.
An Apocalypse Converted: William Stringfellow and Catholic Social Teaching on Climate Breakdown
Authors: Hargaden Kevin
Published: July 2021

In Laudato Si’, Pope Francis advances the concept of integral ecology to connect the environmental crisis with a range of social crises afflicting our societies. This concept is grounded in a theological commitment, but directed towards its political effects. Those two trajectories are represented by the encyclical’s articulation of a spiritual awakening described as an ecological conversion and its repeated calls to dialogue. Francis is not unaware of the risk that a naïve engagement in dialogue could stifle serious mitigation of the crises we face. Yet, even with many dire warnings about outcomes, much of the contemporary discourse around the climate and biodiversity crisis runs the risk of underestimating the nature of the problem. Apocalyptic theology, specifically in the work of William Stringfellow, is proposed as a valuable interlocutor at this point. Stringfellow’s account of the Christian life as a battle with the forces of Death allows Christians to name that which we are converted from in an ecological conversion, strengthening the grounds upon which dialogue is engaged.
A review on powertrain subsystems and charging technology in battery electric vehicles: Current and future trends
Authors: Wagh Kunal , Dhatrak Pankaj
Published: July 2021

The transport industry is a major contributor to both local pollution and greenhouse gas emissions (GHGs). The key challenge today is to mitigate the adverse impacts on the environment caused by road transportation. The volatile market prices and diminishing supplies of fuel have led to an unprecedented interest in battery electric vehicles (BEVs). In addition, improvements in motor efficiencies and significant advances in battery technology have made it easier for BEVs to compete with internal combustion engine (ICE) vehicles. This paper describes and assesses the latest technologies in different elements of the BEV: powertrain architectures, propulsion and regeneration systems, energy storage systems and charging techniques. The current and future trends of these technologies have been reviewed in detail. Finally, the key issue of electric vehicle component recycling (battery, motor and power electronics) has been discussed. Global emission regulations are pushing the industry towards zero or ultra-low emission vehicles. Thus, by 2025, most cars must have a considerable level of powertrain electrification. As the market share of electric vehicles increases, clear trends have emerged in the development of powertrain systems. However, some significant barriers must be overcome before appreciable market penetration can be achieved. The objective of the current study is to review and provide a complete picture of the current BEV technology and a framework to assist future research in the sector.
Multiple drug allergy syndrome in pregnancy: Lessons for sexual health physicians
Authors: Mohamed Buhary Thajunnisha , McGregor Alastair , McSorley John , Friday Dawn
Published: July 2021

Co-existence of multiple drug allergies and pregnancy often results in vexing dilemmas for physicians. A 21-year-old pregnant woman presented with asymptomatic cervicitis with dual infection with Chlamydia trachomatis and Neisseria gonorrhoeae during her third trimester. She reported a history of generalised rash with mucous membrane involvement following use of both macrolides and penicillins. Her gonococcal infection was successfully treated with a single dose of intramuscular gentamicin and chlamydial infection with oral clindamycin and rifampicin.
Impact of unequal censoring and insufficient follow-up on comparing survival outcomes: Applications to clinical studies
Authors: Srivastava Deo Kumar , George E Olusegun , Lu Zhaohua , Rai Shesh N
Published: July 2021

Clinical trials with survival endpoints are typically designed to enroll patients for a specified number of years, (usually 2–3 years) with another specified duration of follow-up (usually 2–3 years). Under this scheme, patients who are alive or free of the event of interest at the termination of the study are censored. Consequently, a patient may be censored due to insufficient follow-up duration or due to being lost to follow-up. Potentially, this process could lead to unequal censoring in the treatment arms and lead to inaccurate and adverse conclusions about treatment effects. In this article, using extensive simulation studies, we assess the impact of such censorings on statistical procedures (the generalized logrank tests) for comparing two survival distributions and illustrate our observations by revisiting Mukherjee et al.’s 1 findings of cardiovascular events in patients who took Rofecoxib (Vioxx).
Statistical methods for analysis of combined biomarker data from multiple nested case–control studies
Authors: Cheng Chao , Sloan Abigail , Wang Molin
Published: July 2021

By combining data across multiple studies, researchers increase sample size, statistical power, and precision for pooled analyses of biomarker–disease associations. However, researchers must adjust for between-study variability in biomarker measurements. Previous research often treats the biomarker measurements from a reference laboratory as a gold standard, even though those measurements are certainly not equal to their true values. This paper addresses measurement error and bias arising from both the reference and study-specific laboratories. We develop two calibration methods, the exact calibration method and approximate calibration method, for pooling biomarker data drawn from nested or matched case–control studies, where the calibration subset is obtained by randomly selecting controls from each contributing study. Simulation studies are conducted to evaluate the empirical performance of the proposed methods. We apply the proposed methods to a pooling project of nested case–control studies to evaluate the association between circulating 25-hydroxyvitamin D (25(OH)D) and colorectal cancer risk.
Macroeconomic Factors and Initial Public Offerings in Brazil
Authors: de Lima Amorim Daniel Penido , de Camargos Marcos Antônio , Ferreira Cristiano Mendonça Barbosa Lima
Published: July 2021

The strategy of going public plays a relevant role in business growth. Macroeconomic conditions are decisive for initial public offerings (IPOs). In this study, we analyzed the impact of macroeconomic factors on IPOs in the Brazilian stock market, considering the period from 2007 to 2018. We used autoregressive distributed lag (ARDL) models to analyze the existence of cointegration between the variables and the long-run effects. The estimated models considered the effects on the proceeds or the number of IPO, which can be related to interest rates, stock market returns, economic activity, and economic uncertainty. Our results indicate that economic activity and uncertainty have long-run effects on both the proceeds and the number of IPOs. There is also evidence that the interest rate has a long-run relationship with the IPO proceeds. In addition, we tested the causal relationships between macroeconomic factors and the IPO variables. For this purpose, we adopted a Granger causality test. We highlight that uncertainty precedes the IPO proceeds. Expectations about macroeconomic conditions are relevant for the decision to go public. Our evidence can provide guidance for stakeholders and policymakers.
Nexus Between Discount Rate and Industrial Performance
Authors: Khan Ajab
Published: July 2021

This study investigates the short-run responses and long-run performances of seven industries’ stock indices with discount rate changes in the firms listed in the Pakistan Stock Exchange (PSE) between 2009 and 2018.

The results indicate that short-run returns react positively to discount rate reduction, excluding the oil industry and vice versa. Therefore, long-term performance responds favourably with a reduction in the discount rate. Discount rate changes affect the apparel industry the most, while the oil industry is the least on the list.

This study serves potential investors for their returns against investment among these industries. Furthermore, it works as a guideline for regulators and policymakers to manage fluctuations for a stable capital market.
An Examination of the Factor Structure of the Multidimensional Psychological Flexibility Inventory
Authors: Thomas Kelsey N. , Bardeen Joseph R. , Witte Tracy K. , Rogers Travis A. , Benfer Natasha , Clauss Kate
Published: July 2021

The Multidimensional Psychological Flexibility Inventory (MPFI), a 60-item self-report measure, assesses the Acceptance and Commitment Therapy Hexaflex. The factor structure of the MPFI was examined in this study. In a community sample of adults ( N = 827), four models (correlated six-factor, one-factor, higher order, and bifactor) were tested for each of the constructs of interest (i.e., psychological flexibility and psychological inflexibility). All models, with the exception of the one-factor, provided adequate fit to the data. Differences between the three adequate fitting models were trivial in magnitude. Additional statistical indices from the bifactor models indicated that the general factors accounted for the large majority of reliable variance. The majority of the domain-specific factors evidenced redundancy with their respective general factors. Results from a series of structural regressions indicated that the domain-specific factors did not provide additional incremental utility above and beyond the general factors in predicting two relevant clinical constructs (i.e., health anxiety and depression). These results provide support for the use of the MPFI Flexibility and Inflexibility total scores, but not subscale scores. The MPFI may require further refinement to either greatly reduce the length of the measure, or to ensure that subscales have incremental utility.
How to Discriminate Lung Cancer From Benign Pulmonary Nodules and Masses? Usefulness of Diffusion-Weighted Magnetic Resonance Imaging With Apparent Diffusion Coefficient and Inside/Wall Apparent Diffusion Coefficient Ratio
Authors: Usuda Katsuo , Iwai Shun , Yamagata Aika , Iijima Yoshihito , Motono Nozomu , Doai Mariko , Matoba Munetaka , Hirata Keiya , Uramoto Hidetaka
Published: July 2021

Background:

Although diffusion-weighted imaging (DWI) is useful for differential diagnosis between lung cancers and benign pulmonary nodules and masses (BPNMs), it is difficult to differentiate pulmonary abscesses from lung cancers because pulmonary abscesses show restricted diffusion. With this research we will present how to assess the total apparent diffusion coefficient (ADC) and inside/wall ADC ratio for these pulmonary nodules and masses (PNMs).

Methods:

The pulmonary lesions were divided into next 3 groups. There were 40 lung cancers, 41 inflammatory benign PNMs (mycobacteria disease 13, pneumonia 12, pulmonary abscess 10, other 6) and 7 noninflammatory benign PNMs. Definitions were as follows: wall ADC = ADC value in outer one-third of the lesion; inside ADC = ADC value in central two-thirds of the lesion: inside/wall ADC ratio = ratio of inside ADC/wall ADC.

Results:

Mean total ADC (1.26 ± 0.32 × 10−3 mm2/s) of the lung cancers was remarkably lower than that (1.53 ± 0.53) of the BPNMs. The mean total ADC values were 1.26 ± 0.32 in lung cancer, 1.45 ± 0.47 in inflammatory BPNM and 2.04 ± 0.63 in noninflammatory BPNM, and there were significant differences among them. The mean inside ADC value (1.33 ± 0.32) of the lung cancers was remarkably higher than that (0.94 ± 0.42) of the pulmonary abscesses. The mean inside/wall ADC ratio (1.20 ± 0.28) of the lung cancers was remarkably higher than that (0.74 ± 0.14) of the pulmonary abscesses.

Conclusions:

Although ADC of DWI could differentiate lung cancer from BPNM, the inside/wall ADC ratio of DWI is efficient for differentiation between lung cancer and lung abscess. The inside/wall ADC ratio of DWI strengthens a weak point of DWI.
The State of The Art on Acetylcholinesterase Inhibitors in the Treatment of Alzheimer’s Disease
Authors: Vecchio Immacolata , Sorrentino Luca , Paoletti Annamaria , Marra Rosario , Arbitrio Mariamena
Published: July 2021

Alzheimer’s disease (AD) is a chronic disabling disease that affects the central nervous system. The main consequences of AD include the decline of cognitive functions and language disorders. One of the causes leading to AD is the decrease of neurotransmitter acetylcholine (ACh) levels in the brain, in part due to a higher activity of acetylcholinesterase (AChE), the enzyme responsible for its degradation. Many acetylcholinesterase inhibitors (AChEIs), both natural and synthetic, have been developed and used through the years to counteract the progression of the disease. The first of such drugs approved for a therapeutic use was tacrine, that binds through a reversible bond to the enzyme. However, tacrine has since been withdrawn because of its adverse effects. Currently, donepezil and galantamine are very promising AChEIs with clinical benefits. Moreover, rivastigmine is considered a pseudo-irreversible compound with anti-AChE action, providing similar effects at the clinical level. The purpose of this review is to provide an overview of what has been published over the last decade on the effectiveness of AChEIs in AD, analysing the most relevant issues under the clinical and methodological profiles and the consequent possible welfare effects for the whole world. Furthermore, novel drugs and possible therapeutic approaches are also discussed.
Development of in-use engine speed/torque heat maps across multiple heavy-duty commercial vehicle vocations
Authors: Zhang Chen , Kelly Kenneth , Kotz Andrew , Miller Eric
Published: July 2021

The U.S. Department of Energy (DOE) established the SuperTruck program with the goal of achieving brake thermal efficiency (BTE) greater than or equal to 55% as demonstrated in an operational heavy-duty (HD) diesel engine at a 65-miles-per-hour (mph) cruise point. Beyond the line-haul application, HD engines operate in a wide range of speed and torque conditions that are unlikely to yield the same efficiency under real-world operation. Thereby, the in-use engine heat maps described in this paper are a valuable tool to illustrate whether the engine-efficiency “sweet spot” matches the most frequent operating conditions. In this study, NREL developed engine heat maps to quantify the important operating points for various vocations using our Fleet DNA database of commercial fleet vehicle operations data. These heat maps clearly show that high-frequency operating points vary significantly according to vehicle vocation, while only a few of them match the sweet spot. Beyond the illustration, engine in-use heat maps can also be leveraged to build up reduced-order engine-efficiency models, needed by many rapid powertrain simulations. As case studies, nine reduced-order models – including line-haul truck, transfer truck, transit bus, transit bus with compressed natural gas (CNG) engine, drayage, refuse pickup, local delivery, utility truck, and school bus with CNG engine – using a trust-region reflective algorithm to fit the on-road data extracted based on the engine in-use heat maps.
Digital mapping as feminist method: critical reflections
Authors: Fileborn Bianca
Published: July 2021

Digital maps have been taken up as a productive tool in both activism and academic research. However, there has been less consideration of their use as a research method in qualitative social sciences research. This paper aims to contribute towards scholarship on qualitative research by providing a critical reflection on the use of digital mapping as a research method in a feminist research project on street-based harassment in Australia. Drawing on practices of reflexivity, as well as comments made by participants across 46 qualitative interviews, I consider how digital mapping can be used to facilitate feminist research, arguing that it represents a generative instrument which lends itself to the development of in-depth insights from participants. Yet, mapping also delimits the epistemological possibilities of qualitative research, and I consider how this method simultaneously constrains what can be known about street harassment.
Making ‘meanwhile. . .’: representing queer African youth through spontaneous collaborative graphic autoethnography
Authors: Meer Talia , Müller Alex
Published: July 2021

We present a participatory creative research project about the embodied experience of queer African youth, which brought together queer young people, academics and artists from Southern and East Africa (as the Qintu Collab) to produce popular media. We describe objectives and process and argue that this work can best be understood as collaborative graphic autoethnography. By working together, the Collab produced the anthology Meanwhile. . .: Graphic Short Stories About Everyday Queer Life in Southern and East Africa, that challenges dominant representations of African queerness, including pathologising public health discourses and heteronationalist political propaganda. This work also dialogically generated socially experienced embodied knowledge about the wellbeing, relationships, fears and aspirations of young queer people. Such collaboration pushes the boundaries of collaborative, autoethnographic and visual methods. Examining our experience shows the co-constructed nature of knowledge and reveals the considerable power of comics as analytical texts, and as basis for further analysis.
Ring the Bell for Sickle Cell: Encouraging Advocacy in an Underserved Community
Authors: Bloom Ellen M. , Hampton Kisha C. , Blackwell Kimber , Gibson Gary A. , Roberson Christopher , Meier Emily Riehm
Published: July 2021

Sickle cell disease (SCD) was once a disease of childhood because of a limited life expectancy. Due to medical advances, it is now common for people with SCD to live into adulthood. Funding and resources for adults with SCD, however, remain limited. Adult patients would benefit from increased access to medical care, mental health care services, and workforce development. The Indiana Sickle Cell Consortium, a group of medical providers and community-based organizations, worked closely with people living with SCD and their family members to create a campaign advocating for state funding for programs for adults with SCD. This campaign culminated with the passage of a bill that provides $250,000 in funding for program development for adults with SCD. The bill also directs the Indiana Department of Health to carry out a needs assessment for people with SCD in Indiana. However, continued efforts are needed to reduce health disparities for people with SCD. The Indiana Sickle Cell Consortium will continue advocacy efforts in future legislative cycles and bring attention to the health inequities that affect people with SCD.
HIV-Related Stigma Moderates the Relation Between Perceived Susceptibility and HIV Testing Intention Among Heterosexual (but Not Sexual Minority) College Students
Authors: Berger Alyssa , James Tyler G. , Ryan Sadie J.
Published: July 2021

HIV-related stigma remains a considerable barrier to engaging at-risk populations in HIV testing and prevention programs. We assessed the moderating role of HIV-related stigma on the relation between perceived susceptibility to HIV and HIV testing intention among college students. We hypothesized that the moderating role of HIV-related stigma would be differential between heterosexual and sexual minority college students. We administered a survey focused on HIV-related knowledge, attitudes, and behaviors in spring 2016 ( N = 2,159). We used multigroup path analysis to analyze the hypothesized moderation. HIV-related stigma moderated the relation between perceived susceptibility and testing intention for heterosexual but not sexual minority college students. Specifically, higher HIV-related stigma decreased the association between perceived susceptibility and testing intention. These results demonstrate the importance of priority population segmentation for HIV testing campaigns.
A statistical analysis on the influence of process and solution properties on centrifugally spun nanofiber morphology
Authors: Atıcı Bülin , Ünlü Cüneyt H , Yanilmaz Meltem
Published: July 2021

Centrifugal spinning is a fast and safe nanofiber production technique and polyacrylonitrile (PAN) nanofibers have been widely studied for many applications including energy storage, filtration, sensors, and biomedical applications. Nanofiber morphology, specific surface area, porosity and average fiber diameter are important to determine the performance of nanofibers in these fields. In centrifugal spinning, nanofiber morphology and average fiber diameter are influenced by solution properties and process parameters including rotational speed, feeding rate, collector distance, and nozzle diameter. In this study, the effect of solution concentration, rotational speed, feeding rate, collector distance and nozzle diameter on average fiber diameter and fiber morphology were studied and statistical analysis was performed to determine the main factors. Optimum solution and process parameters were determined as well. Increased average fiber diameter was seen with increasing polymer concentration and nanofibers produced at 4000 rpm with the feeding rate of 60 ml/h had the lowest average fiber diameter for all studied nozzle sizes (0.3 mm, 0.5 mm and 0.8 mm). 8 wt. % PAN solution was centrifugally spun with the rotational speed of 4000 rpm, feeding rate of 60 ml/h, collector distance of 20 cm and nozzle diameter of 0.3 mm and bead free nanofibers with the average fiber diameter of 680 ± 87 nm was observed.
‘Speaking the Data’: Renegotiating the Digitally-Mediated Body Through Performative Embodied Praxis, Sound and Rhythmic Affect
Authors: Hughes Kathryn Lawson
Published: July 2021

This article explores an alternative autoethnographic methodological approach, using embodied praxis and sound, for critically re-thinking contemporary subjective health practices of digital ‘self-tracking’; popularized in recent years through the rise in wearable biometric fitness devices, and online socio-cultural movements such as the Quantified Self and Strava platforms, which enable subjects to “share” their quantifiable body-data metrics. Through a performative praxis case study titled Speaking the Data (2017), the author renegotiates the “voice” of subjective agency within the quantitative data-discourse, “speaking the data” that her body is producing in “real-time” on a digital smart-bike machine. This embodied renegotiation, recorded using a sound “data-stream,” produces an alternative subjective data-set which is extended to the reader, who is invited to become “listener” in the theoretical/experiential praxis space. The sound “data-stream” thus proffers an affective expansion to our perceptions of what “body-data” can be, extending the possibilities for the digitally mediated body beyond biometric forms of quantification, through other sensorial registers of embodiment, using sound, rhythmic affect and lived experience.
Use of Augmented Reality to Train Sensemaking in High-Stakes Medical Environments
Authors: Sushereba Christen E. , Militello Laura G. , Wolf Steve , Patterson Emily S.
Published: July 2021

We present a framework for using augmented reality (AR) to train sensemaking skills in combat medics and civilian emergency medical personnel. AR and other extended reality technologies create engaging training environments, but their effectiveness on training outcomes is not yet clear. One benefit of AR is that it can enhance simulation training with realism and context that naturalistic decision-making (NDM) models emphasize. We describe four key elements of sensemaking that leverage the strengths of AR: perceptual skills, assessment skills, mental models, and generating/evaluating hypotheses. We discuss how AR can be used to train each of these four elements, along with design implications. A focus on naturalistic tasks and environments while designing AR-based simulation training will likely lead to training that is not only engaging but also effective.
Ecological Design of an Augmentative and Alternative Communication Device Interface
Authors: Shea Kaela , St-Cyr Olivier , Chau Tom
Published: July 2021

Autism spectrum disorder, cerebral palsy, brain stem stroke, and neurological injury are examples of conditions that may limit vocal communication. Augmentative and alternative communication (AAC) systems can provide a communication pathway to users who experience such complex communication needs, facilitating their societal participation and supporting some ability to direct their own care. We adapted the cognitive work analysis (CWA) framework to a linguistic domain for insights into an AAC design that best supports users’ communication. First, we applied the work domain analysis (WDA) to a popular commercial AAC system, Proloquo2Go. Data were gathered from guided AAC system use, domain experts, and the syntactic rules of the English language. The WDA exposed unmet needs in the commercial system. We then applied worker competency analysis to consider different approaches to present information and support user actions. The design included graphic forms and process views, and their integration into viewports and the workspace. Our novel application of CWA uncovered new considerations in AAC interface design and presents a nascent area of investigation, namely, AAC displays that more effectively support users’ goals. Future investigation will evaluate the mental workload of this AAC interface compared to that of current commercially available systems.
Irradiated Cereal and Abject Meat: Food as Satire and Warning in the Fallout Series
Authors: Stang Sarah
Published: July 2021

This article is a close reading of food and beverages in Bethesda’s acclaimed post-apocalyptic science fiction video game series, Fallout. Through a discussion of the visual design, narrative positioning, and in-game function of food and beverage consumption, this article demonstrates how Fallout uses food to critique the unchecked technological development, rampant consumerism, and environmental devastation of post-war American atomic culture. Specifically, pre-packaged, pre-apocalypse food is presented as a focal point for satire, while the irradiated meat harvested from the mutated creatures that populate this post-apocalyptic world is presented as abject and ambiguous. In this sense, food in the Fallout series, as in much science fiction media, can reinforce or challenge ideologies, beliefs, and cultural norms by evoking real-world anxieties.
An equivalent mechanical model investigating endplates deflection for PEM fuel cell stack
Authors: Zhang Zhiming , Shang Yapeng , Zhang Tong
Published: July 2021

The aim of this study is to obtain the deflection curve equations of endplates with one to five clamping belts which allows investigating endplates deflection for uniform contact pressure distribution. Based on an equivalent mechanical model for a large fuel cell stack, the effects of the thicknesses of endplates, numbers, and positions of clamping belts are discussed, and the optimal thickness of endplate with different clamping belts is obtained, and moreover the optimal position of intermediate and outer clamping belts on the endplates. Finally, a three-dimensional finite element analysis (FEA) of a fuel cell stack clamping with steel belts and nonlinear contact elements is compared to what the equivalent mechanical beam model predicts. The result of this study shows that the equivalent mechanical model gives good prediction accuracy for the deflection behavior of endplates and the clamping force of the fuel cell stack, which is effective and helpful for the design of a large fuel cell stack assembly.
Numerical study of the switching mechanism of a jet valve using the meshless method
Authors: Zhang Jun , Wang Yuanding , Tan Junjie , Zhu Guiping , Liu Jing
Published: July 2021

This study numerically investigates fluid dynamics of a jet flow at supersonic speed. The meshless method and the overlapping point cloud method are used to handle the moving boundary problems. The interaction between the jet flow and a moving ball-shaped plug is numerically solved, which has been rarely done in the published literature. The switching mechanism of a novel designed jet valve in an attitude and orbit control system (AOCS) is analyzed. It is found out that applied pressure to the control inlets of the jet valve must be high enough in order to successfully drive the plug to move and subsequently change the force direction acting on the jet valve. Then the switching mechanism of AOCS can be triggered. The initial fluid condition also plays a vital role and it significantly influences the response time of the switch. This study explores the underlying physics of the jet flow on its deflection, wall attachment, and interaction with the ball-shaped plug. It contributes to the optimization design of the jet valve in the AOCS with a fast and efficient response.
The impact of the COVID-19 pandemic on hospitalizations and plasmapheresis therapy in multiple sclerosis and neuromyelitis optica spectrum disorder: a nationwide analysis from Germany
Authors: Richter Daniel , Faissner Simon , Bartig Dirk , Tönges Lars , Hellwig Kerstin , Ayzenberg Ilya , Krogias Christos , Gold Ralf
Published: July 2021

Background:

Many countries worldwide reported side effects of the coronavirus disease 2019 (COVID-19) pandemic that have influenced the care of patients with other diseases in both acute and elective settings. Patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) represent the major patient population suffering from an autoimmune inflammatory demyelinating disease of the central nervous system. We aimed to analyze MS and NMOSD hospitalizations, the application of plasmapheresis therapy, and the dynamic during different periods of the COVID-19 pandemic in Germany.

Methods:

We conducted a nationwide retrospective cross-sectional study using the administrative database of all hospitalized patients with the main diagnosis of MS and NMOSD, including the information on the application of plasmapheresis therapy. We included full-year data from 1463 hospitals of all MS and NMOSD patients hospitalized in 2019 and 2020 in Germany ( n = 87,453). We compared case numbers and plasmapheresis therapy rates of the different pandemic periods in 2020 with the corresponding periods in 2019.

Results:

We observed a substantial decline of MS and NMOSD patients’ hospitalizations during the different pandemic periods, with the most remarkable decline during the first wave of the pandemic (First diagnosis of MS: −16.8%; relapsing-remitting MS: −34.0%; secondary progressive MS: −48.9%; primary progressive MS: −43.8%; NMOSD: −19.2%). Treatment rates with plasmapheresis increased for MS and NMOSD patients in 2020 compared to 2019 (1.8% versus 1.6%, p = 0.003; 14.0% versus 9.3%, p < 0.001), with a substantial increase during the first wave of the pandemic, especially in NMOSD patients (19.7% versus 8.4%, p < 0.001).

Conclusion:

There was a marked decline of MS and NMOSD patients’ hospitalizations during the different pandemic periods in 2020, with the most substantial reduction during the pandemic’s first wave and in progressive MS patients. MS and NMOSD patients who needed rescue relapse treatment continued to receive plasmapheresis therapy in Germany.
Facility location selection for the furniture industry of Bangladesh: Comparative AHP and FAHP analysis
Authors: Suman Md Nazmul Hasan , MD Sarfaraj Nagib , Chyon Fuad Ahmed , Fahim Md Rafiul Islam
Published: July 2021

The furniture industry is growing to a great extent in Bangladesh. Many market researchers believe that the industry has enormous potentiality. However, the expansion of this industry may face complexities within a few years. Due to the wrong selection of facilities, many organizations failed to earn profit as expected. It also needs a large investment. Selecting a suitable place for a new facility is going to be the biggest question of upcoming years. This study aimed to analyze Bangladesh’s furniture industry, address the facility location problem, and provide a constructive solution to the decision-makers. In this study, seven criteria were considered: availability of raw materials, transportations, skilled labor, proximity to customers, energy availability, economic zone facility, and environmental impact, and five ideal locations or alternatives: Khulna, Chattogram, Bogura, Gazipur, and Manikganj. Thirty-four experts took part in the survey to analyze the significant criteria for selecting a furniture industry’s facility location and alternatives or potential locations for the facility. The Analytical Hierarchy Process (AHP) and Fuzzy AHP methods (FAHP), two MCDM techniques, were used to analyze the data set. A sensitivity analysis was done to determine the model’s robustness for any critical changes in the real world. The result showed that ‘energy availability is the most significant criterion to select a facility location for the furniture industry, where it got 35.1% criteria weight in AHP and 33.9% in FAHP. ‘Chattogram’ was selected as the most suitable place containing 33.74% normalized weight in AHP and 33.81% normalized weight in FAHP.
Airbnb’s Success: Does It Depend on Who Is Measuring?
Authors: Agarwal Vinod , Koch James V. , McNab Robert M.
Published: July 2021

Because individual listing data for Airbnb typically are not publicly available, private companies have emerged to estimate the performance of Airbnb listings. The implicit assumption of a growing number of academics, policymakers, and consultants is that Airdna’s performance measures are directly comparable with those of STR. We argue that Airdna’s measures of Occupancy, Average Daily Rate (ADR), and Revenue per Available Room (RevPAR) do not conform to industry standards and exhibit significant bias. We expand available evidence by explicitly quantifying the sources and magnitude of the biases for Airdna’s performance measures for Airbnb listings. Using Airdna’s individual listing data for Virginia between the first quarter of 2015 and the 4th quarter of 2019, we find, on average, Airdna’s performance measures for Occupancy, ADR, and RevPAR were biased upward by 60 percent, 78 percent, and 179 percent, respectively.