bluuebunny/crossref_metadata_2025 huggingface dataset:
Project-Based Learning in a Mechanical Engineering Course: A new proposal based on student's views
Authors: Barbosa Flavia V , Lobarinhas Pedro AM , Teixeira Senhorinha FCF , Teixeira José CF
Published: February 2022

The evolution of learning in higher education is nowadays evident. Several discussions and studies have been performed about new methodologies that can disrupt the way the classes are taught in universities. In this context, Project-Based Learning (PBL) is the most emphasized.

In the Mechanical Engineering course at the University of Minho (UM), the Integration Project (IP) courses apply a PBL methodology, being these classes the differentiating element of the Integrated Master in Mechanical Engineering (IMME) compared with other Portuguese universities. However, even if the innovative aspect of this approach is recognized nationally, the opinions between students and Professors, about the structure and organization of this class, are still divided. In that sense, this work presents a new proposal for the IP courses in which the opinion of students and successful models implemented in international universities are considered. This study analyses the best PBL methodologies implemented in Engineering courses and presents a PBL model actually implemented at the IMME. This information is combined with the student's views obtained from a survey conducted at the Department of Mechanical Engineering (DEM), regarding the actual PBL model. Through this study, a new proposal for the IP courses is presented. This proposal intends to provide an effective answer to the necessity of the students, using successful tools and methodologies to improve the teaching and learning process in the IMME course.

Through this proposal, it is expected to increase the learning process and motivation of the students making them better prepared for a productive profession.
Attitudes and use patterns for mobile technology and upper extremity home exercises in stroke survivors in the United States
Authors: Kim Hayejin , Kim Grace J
Published: February 2022

Introduction

The use of mobile technology (MT) in home-based occupational therapy is expected to continue growing. This study describes daily use patterns for MT and upper extremity (UE) home exercise programs (HEPs) for community-dwelling stroke survivors in the United States.

Method

Cross-sectional survey. Data were analyzed using descriptive statistics and bivariate comparisons.

Results

N = 61 (30 stroke and 31 controls). Individuals with stroke had similar levels of knowledge, skill, and use of MT compared with non-disabled age-matched adults. Stroke participants used MT more frequently for information searching, social media, and reminders compared to control participants. Stroke participants were motivated to improve UE function (93.3%) and reported a need for additional HEP training (56.7%). Perceived facilitators to improve UE use included talking to peers (73.3%), getting more information (73.3%), and talking to a therapist (63.3%).

Conclusions

MT may have multiple potential benefits when integrated into occupational therapy practice including supporting instrumental ADLs, facilitating social connection, and increasing adherence to UE HEPs. Future work should focus on maximizing adherence and providing performance feedback through the use of social media to promote peer support and consistent remote communication using text messaging, phone calls, or video calls to deliver information and reminders on exercises.
Post-Truth as an Epistemic Crisis: The Need for Rationality, Autonomy, and Pluralism
Authors: Hoggan-Kloubert Tetyana , Hoggan Chad
Published: February 2022

Contemporary society is experiencing an epistemic crisis, evidenced by such “post-truth” phenomena as “alternative facts.” Traditional notions related to knowledge and Truth have been under continual, partly justifiable, attack under the eclectic banner of postmodernism, and alternative epistemic foundations (essential for democracy to function) have not been provided. Drawing on the European and North American literature of political theory, philosophy, and adult education, this article offers an update and defense of three core epistemic concepts: rationality, autonomy, and pluralism. To address the epistemic crisis, adult education needs to develop epistemically responsible learners, promote diverse public learning spaces (agoras), and teach learners how to engage in meaningful dialogue outside of their own echo chambers.
Taking a Critical Look at Adolescent Research on Black Girls and Women: A Systematic Review
Authors: Agger Charlotte A. , Roby ReAnna S. , Nicolai Korinthia D. , Koenka Alison C. , Miles Monica L.
Published: February 2022

In the field of adolescent development, the language, theoretical frameworks, methods for collecting and analyzing data, and ways of interpretation that researchers use may advance notions of white supremacy and perpetuate racist ideas. Understanding how researchers study Black girls and women, in particular, is a critical step in working toward the production of science and knowledge that promotes an anti-racist and anti-sexist agenda and centers the voices of historically marginalized adolescents. Accordingly, we engaged in a systematic review (k = 48) with the goal of taking a critical look at how researchers study Black girls and women. Our synthesis of empirical articles from four prominent adolescent research journals published between 2010 and 2020 revealed themes related to (a) a dearth of critical theoretical frameworks, (b) a lack of acknowledgment of the intersectional experiences of Black girls and women, (c) differences in how researchers incorporate ethnic/racial information, (d) the use of a deficit perspective, and (e) the dominance of quantitative designs. We discuss these themes and conclude with recommendations for incorporating critical frameworks and more varied methodologies, issuing a call for adolescent development scholars to take a deeper, asset-based, and more critical approach to studying Black girls and their development.
What do Teachers do to Show They Care? Learning From the Voices of Early Adolescents
Authors: Whitehead Jenna , Schonert-Reichl Kimberly A. , Oberle Eva , Boyd Lara
Published: February 2022

This mixed methods study examined how middle school students (ages 11–13) in middle-class neighborhoods in Western Canada characterized a caring teacher. Specifically, qualitative content analysis was conducted on 199 sixth and seventh grade students’ written responses to the question “What are three things that teachers do to show they care?” Guided by recent work in the area of mindfulness in teaching, we identified 19 themes: one was categorized as General Teaching (e.g., “They teach”), and 18 that were grouped into one of three thematic categories associated with mindful teaching: Calm (e.g., calm/not reactive), Clear (e.g., democratic communication), and Kind (e.g., empathy). In their descriptions of caring teachers, almost all students (97.5%) used Kind themes, while many used Clear themes (41%); with fewer students using Calm (13.6%) or General Teaching (10.6%) themes. Chi square analyses revealed that girls were more likely to mention Clear themes compared to boys, while boys were more likely to use the specific themes of nurturance and helpfulness. Additional demographic differences were also explored. This research adds to the growing body of studies aimed at elucidating the role of mindful teaching in caring student-teacher relationships, particularly from the perspectives of early adolescents.
Family Sex Trafficking Among the Bedia Caste of India: Defying the Dominant Human Trafficking Discourse
Authors: Dalla Rochelle L. , Roselius Kaitlin , Erwin Sarah , Peter Jessie , Panchal Trupti Jhaveri , Ranjan Ramani , Mischra Mrinalini , Sahu Sagar
Published: February 2022

Largely characterized as an urban issue, empirical studies of minor sex trafficking in rural communities—including India, a global hotspot for child sex trafficking—are exceptionally uncommon. Yet, the commercial sexual exploitation of children thrives in many rural Indian villages, fueled by caste discrimination, family tradition, and poverty. In response, this study aimed to investigate minor sex trafficking among a particular culturally unique and geographically isolated population, in relation to the dominant human trafficking literature. In-depth interviews were conducted with 31 female members of the Bedia caste—a unique population whose primary form of income is derived from participation in the rural sex trade. Framed by the social theory of intersectionality, we sought to (1) identify vulnerabilities for commercial sex industry entry among Bedia youth and (2) examine the cultural context of the commercial sex industry among the Bedia, with particular attention to the dominant victim/perpetrator paradigms. Implications for continued research, practice, and policy are included.
Multifaceted Intergroup Relations in an American Town—Immigrant Intrusion, Symbiosis, and Invisibility
Authors: Lemekh Halyna
Published: February 2022

Based on ethnographic fieldwork, this article explores the intricate relationships between three major ethno-racial groups residing in a suburban town in the New York metropolitan area. At the present time, the prosperous Korean ethnoburb is gentrified by Korean immigrants, triggering the displacement of the old-timers, referred to as the “White exodus” in this research. Granted that the cheap labor is in high demand in the rejuvenating neighborhood, the town has become a magnet for Guatemalan immigrants who have established their own ethnic islet in the vicinity. While the relationships between the Asian immigrants and the White old-timers generated by invasion-succession trends are full of resentment, the work-related interactions between the Asian and Hispanic (mostly Guatemalan) immigrants can be described as immigrant symbiosis. Both groups are aware of explicit exploitation, but they need and rely on each other to attain their own “American dream.”
Efficacy and Safety of Immediate-Release Nifedipine in Critically Ill Patients
Authors: Seto Stephanie L. , Barra Megan E. , Hamidi Arzo , Sin Jonathan H. , Devine Lauren T.
Published: February 2022

Background: Immediate-release nifedipine (IRN) is a calcium channel blocker with potent vasodilatory and antihypertensive properties. Safety concerns led to a black box warning for increased risk of myocardial infarction, stroke, and arrhythmias. Objective: The aim of this study was to evaluate the safety and efficacy of IRN for acute blood pressure lowering in critically ill patients. Methods: A retrospective, single-center study was performed in critically ill patients who received at least one dose of IRN. The primary endpoint was the change in systolic blood pressure (SBP) measured at baseline and 1 hour after first administration of IRN. Secondary outcomes included clinically significant hypotension, defined as an absolute reduction in SBP ≥ 15% or vasopressor initiation within 1 hour after administration; incidence of arrhythmias, stroke, or myocardial injury; and time to transition off antihypertensive infusions. Results: IRN resulted in a median [interquartile range] SBP change of −10 [−21 to −1] mmHg between baseline 142 mmHg [124-155] and 1 h post-administration 127 mmHg [114-144]; P < .001. Twenty-seven percent of patients experienced clinically significant hypotension, with hypotension observed in 24% and vasopressors initiated in 4% of patients. Sixteen percent of patients experienced new-onset arrhythmia and 18% experienced myocardial injury following IRN during hospitalization. Median time to transition off intravenous (IV) continuous infusion antihypertensives was 8.5 [0-31.5] hours. Conclusion: IRN led to a reduction in SBP which may have been associated with clinically significant hypotension and need for vasopressor support. Further studies with direct comparisons to alternatives are needed to determine the true association of adverse events with IRN.
Nondestructive inspection of gas turbine blades by active thermography using different fluids
Authors: Mohammadian Milad , Akbari Davood , Farahani Mohammadreza , Faraji Kalajahi Pouya
Published: February 2022

Presence of defects in the gas turbine blades’ affects the blade performance and reduces the blade life. One of the common defects in the internal cooling passages of a gas turbine blade, is residual ceramic created in the blade production stage. This types of defects, can be beneficially detected by using active thermography. In this paper, nondestructive testing of internal cooling passages of a gas turbine blade is conducted by active thermography method using different types of excitations. Carbon dioxide (CO2), hot air, and water-vapor were selected as excitation sources. Inspection with water-vapor stimulations were performed at three different pressures flow rates. Results indicated that the IR thermography tests with water-vapor excitation, provide higher detectability compared to the other methods. However, internal passages were revealed by all of the pre-mentioned excitation methods. Residual ceramic in internal passages of the blade were clearly revealed by application of hot air and water-vapor. Results also indicated that application of the maximum pressure and flow rate, offer a better detectability and visibility. Some surface defects on the gas turbine blades were also been detected by application of water-vapor excitation.
Wind turbine wake calculation model with exponential reciprocal attenuation
Authors: Ren Jianhua , Niu Wang , Liu HongYu
Published: February 2022

This paper studies the general wind turbine wake mathematical model—Jensen model based on some famous wind tunnel experimental data. Based on the study of the initial Jensen wake model equation, the improved semi empirical Jensen model equation was studied in this paper considering the factors of wind turbine wake attenuation in the distance. According to the form of exponential reciprocal attenuation, the model was modified again. Corresponding Jensen exponential reciprocal attenuation wake model was obtained. The simulations and contrast experiments were carried out in the advanced calculation tool. Corresponding comparison experiments of various wake equations were carried out. The theoretical and experimental results show that Jensen exponent reciprocal attenuation wake model can accurately calculate the variation of general wind turbine wake. Its development and application have important theoretical significance and practical value for wind energy utilization.
Population aging redefines the economic growth-carbon emissions nexus, energy consumption-carbon emissions nexus - Evidence from 36 OECD countries
Authors: Wang Qiang , Yang Ting , Li Rongrong , Wang Lili
Published: February 2022

This work aims to analyze the impact of population aging on the relationship between economic growth and carbon emissions, and the relationship between energy consumption and carbon emissions. To this end, based on the panel data of 36 OECD countries from 1996 to 2016, the panel threshold regression model was developed. In the model, per capita carbon emissions are the explained variables, economic development (per capita GDP) and per capita energy consumption are the core explanatory variables of the two models respectively, population aging is the threshold variable, population size, technological innovation level, the degree of urbanization, industrial structure and energy intensity are control variables. The empirical results show that there is a population aging threshold effect between per capita GDP and per capita carbon emissions, and between per capita energy consumption and per capita carbon emissions. This means that population aging is an important factor that affects the relationship between economic growth and carbon emissions, as well as energy consumption and carbon emissions. Although economic growth and carbon emissions, energy consumption and carbon emissions were coupled, the coupling state decline when the population aging crosses the threshold value. This indicates that the population aging contributes to the decoupling of the economic growth and carbon emissions, and the decoupling of energy consumption and carbon emissions. Finally, on the basis of the proposed model, a robust analysis of the variable of trade openness was conducted to prove the validity of this research.
Care provided by nurses to patients with juvenile systemic lupus erythematosus
Authors: Costa Andrea A , Robba Hingrid CS , Silva Clovis A , Ferreira Juliana Caires OA
Published: February 2022

Objectives

To describe the care provided by Brazilian nurses to patients with Juvenile Systemic Lupus Erythematosus (JSLE) using a self-administered questionnaire and to evaluate the possible association of demographic data and knowledge of the disease with availability of tools for diagnosis and treatment in Brazilian pediatric services.

Method

This is a cross-sectional observational descriptive study that analyzed the care provided by Brazilian nurses to patients with JSLE based on the answers to a self-administered questionnaire. Questions included demographics of professionals, nursing consultation, usage of tools to assess disease activity, diagnostic criteria, general care, available practices, transition program, and practices needed for better care.

Results

A total of 111/373 (29.4%) questionnaires were completed, most professionals were female (90.1%). Hospitalization (45.9%) and poor medication adherence (27.9%) were the most reported problems, and lack of knowledge about the institutional transition process to adult care was mentioned by half of the professionals (50.5%). Comparisons of professionals on expected care of patients regarding the type of service, hospitalized patient care, and care provided to patients with JSLE did not reveal statistically significant differences ( p > 0.05). Nurses who care for patients with JSLE are more likely to work in a public setting (14.5% vs. 36.8%, p = 0.048) and less likely to verify vaccination records (0.12.9% vs. 36.8%, p = 0.038). Nurses who worked in the inpatient setting with patients with JSLE were less likely to address pain concerns (11.7% vs. 61.6%, p < 0.0001) compared to nurses who didn’t work with JSLE patients. However, they were more likely to discuss sunscreen use (54.9% vs. 25%, p < 0.05) and be part of a multi-disciplinary team (84.3 vs. 50%, p < 0.0001).

Conclusions

This study demonstrates that the care provided by nurses to patients with JSLE does not consider all the resources available to assess the disease and occurs differently in the inpatient versus outpatient settings. Future research should address this gap in care. Lack of JSLE awareness was commonly reported among professionals, confirming the need for greater knowledge about JSLE, its treatment, and ways to improve adherence.
Governance and Management of a Savings and Credit Cooperative: The Successful Example of a Haitian SACCO
Authors: Messabia Nabil , Beauvoir Edouich , Kooli Chokri
Published: February 2022

This research aims to understand the different success factors of a savings and credit cooperative (SACCO) through the study of the managerial dimensions and its style of governance. Semi-directed interviews were conducted with three directors who are founding members of the Haitian ‘MEN ALE MEN VINI (MAMEV)’ cooperative. NVIVO version 11 software was used as a tool for coding and data analysis. The interviews concluded that the success of the cooperative is linked to the personal attributes of the various directors, effective management, good governance and an efficient decision-making system. This research also showed that the success of cooperatives is partly related to the notoriety, leadership, willingness and level of commitment of its directors. It is also related to the good governance manifested in the participatory management and decision-making, the transparency of the organization and the quality of the work of the cooperatives. Also, the research has shown that anchoring the cooperative in the community, bringing the population closer to the cooperative and offering services adapted to the community’s needs have a positive influence on the membership and make the cooperative more sustainable. Finally, the research showed that the adoption of an effective governance mode helped to ensure the sustainability, viability, modernity, efficiency and social, financial and economic soundness of the cooperative. The experience of this SACCO not only helped the members to counteract the myth of incapacity that prevailed in Haitian community at the time but also improved the living conditions of the members as well as those of community members. The research provides a novel contribution to the resilient and sustainable model of governing and managing SACCOs. It also presents a new model of the Success Keys of SACCOs.
Cariprazine: A new partial dopamine agonist with a familiar profile
Authors: Hope Judy , Keks Nicholas A
Published: February 2022

Objective

Cariprazine is the third partial dopamine agonist now available in Australia. This paper will review the properties, evidence and likely clinical place of cariprazine.

Conclusion

Cariprazine is a partial agonist with high affinity at dopamine D2 and D3 receptors, partial agonism at 5HT1a receptors, moderate 5HT2a and H1 antagonism and no anticholinergic activity. It is rapidly absorbed, is unaffected by food, achieves a peak plasma level in 4–8 hours and has high bioavailability. The half-life of cariprazine and its metabolites is long (7–8 days); steady state occurs in 4–8 weeks. It is hepatically metabolized via 3A4 cytochrome enzymes. Cariprazine is an effective antipsychotic in acute schizophrenia in both short and longer placebo-controlled studies. Cariprazine appears to have small advantages in negative symptoms of schizophrenia. While not approved for bipolar disorder, cariprazine is effective in mania and mixed states but requires doses higher than current maximums recommended. Cariprazine causes more akathisia than aripiprazole or brexpiprazole but is less prone to insomnia, weight gain and sedation. Risks for hyperprolactinaemia and QTc prolongation are low. Cariprazine is another ‘metabolically-friendly’ antipsychotic for schizophrenia, with advantages for those with negative symptoms, mood symptoms or problems with adherence.
Ill-defined: Concepts of mental health and illness are becoming broader, looser, and more benign
Authors: Jackson Henry J. , Haslam Nick
Published: February 2022

Objectives

We argue that mental health-related concepts have become degraded within professional circles and in the wider community. We identify three trends: concept creep, the rise of broad umbrella concepts (e.g. distress and trauma), and the conflation of mental health with well-being, which marginalises serious mental illness. We speculate on the causes of these trends, including cultural shifts towards greater sensitivity to harm and the rise of wellness industries. Contributing factors within psychiatry include overdiagnosis, dimensional models and transdiagnostic perspectives.

Conclusions

These trends may lead to inflated demands on services from those at the milder end of the psychopathological spectrum. We set out seven measures that mental health professionals can take to resist trends towards broad concepts of mental illness and limit some of their adverse consequences.
Theory analysis method for the effect of temperature and electrostrictive on the actuation stability of dielectric elastomers
Authors: Du Xiaozhen , Guo Yue , Hao Zhenfu , Cai Xing , Yu Hong
Published: February 2022

Dielectric elastomer (DE) as an electroactive soft material can produce large deformation induced by voltage. Usually, the deformation is limited by various failure modes, which affect the stability of the DE electrical actuation. The previous researches have demonstrated temperature affection on the dielectric constant of DE. In this paper, the mathematical calculation theory for the various unstable DE failure is deduced with the thermoelastic model. The numerical model and analysis result discussed the effects of temperature and electrostriction coefficient on the instability phenomena of DE. The nominal stress deformation changes with the nominal electric displacement on the DE material at different temperatures. The stable working range area encircles by the curves of electromechanical instability (EMI), tension loss ( s = 0), electrical breakdown (EB), and tension rupture (λ = λR). The results show that the increase of temperature can improve the nominal stress and the nominal electric field of the actuator, which consequently enhances the stability of DE. Simultaneously, the stability of DE can also be improved when the electrostriction coefficient becomes smaller within a certain range. These conclusions have implications for improving the stability of DE electro-deformation.
Racial Disparities in Social Workers’ Licensing Rates
Authors: Kim Joy Jeounghee
Published: February 2022

Objectives

This study aimed at examining how racial disparities in social workers’ licensing rates are explained by the major sources of the disparities: racial differences in educational eligibilities, the field of practice, and demographic vulnerabilities of social workers.

Methods

Drawing a nationally representative sample of 3990 social workers from the Current Population Survey, this study tested how the probabilities of their licensing were explained by the major sources of racial disparities.

Results

For master’s level social workers, African American–White differences in the field of practice and the type of employers explained away the disparity in required licensing rates. The Hispanic–White and other race–White disparities were largely due to non-White social workers’ limited educational eligibilities and the states of residence that might have imposed varying occupational regulations.

Conclusions

As licensing disparities reflect socioeconomic injustice that confronts many non-White social workers, they call for more purposeful research and interventions within the profession.
“It’s Hard, but We Could Kind of Laugh About It”: Exploring the Role of Humor in Brain Cancer Caregiving
Authors: Heinsch Milena , Cootes Hannah , Wells Hannah , Tickner Campbell , Sampson Dara , Kay-Lambkin Frances
Published: February 2022

Research exploring the benefits of humor for caregivers is limited and, to date, no qualitative studies have explored the role of humor in brain cancer caregiving. To address this gap, we analyzed transcripts from twenty-one in-depth telephone interviews conducted with brain cancer caregivers from a strengths perspective. Thematic analysis using Braun and Clarke’s method revealed that humor functions as (1) an innate element of the self and relationship, (2) an expression of mutual connection and understanding, (3) a way of managing difficult or awkward moments, (4) a form of avoidance or a welcome distraction, and may be (5) helpful, or unhelpful, depending on where someone is in the brain cancer trajectory. Findings suggest that humor represents an important yet complex individual and family strength for health service providers to identify and build upon.
Parental Perceptions of Cerebral Palsy and Expectations of the Operation Outcomes in Greece and in Italy
Authors: Tsibidaki Assimina
Published: February 2022

Children with cerebral palsy (CP) are often hospitalized and have long stays, as they need surgeries and operations. The perioperative period can be perplexing for the people involved. This study investigates parents’ perceptions of CP and expectations of operation and surgery outcomes in Greece and in Italy during this crucial perioperative period. A total of 120 married parents participated in the study: 60 mothers and 60 fathers who had a biological child with CP. All children had operable CP and were under continuous medical/surgical treatment. Semi-structured interviews were used for data collection. Parents expressed diverse perceptions of CP whilst they had almost the same perceptions of it in both countries. They mainly represented CP as a medical problem affecting the whole family, including the child. Parent's expectations on orthopaedic surgeries concerned improving the child's quality of life, the level of its functional impairment and the rehabilitation of its movement and gait. There were no statistically significant differences as regards country of origin and parents’ gender on perceptions of CP and expectations of operation and surgery outcomes. This study suggests that parents outline a variety of perceptions of the condition of CP and of expectations concerning operation and surgery outcomes.
Low Mean Platelet Volume is Associated with Deep Vein Thrombosis in Older Patients with Hip Fracture
Authors: Wang Zhicong , Chen Xi , Wu Jijun , Zhou Qing , Liu Hailong , Wu Yuxuan , Liu Shuping , Liu Yuehong
Published: February 2022

This study aimed to explore the association between mean platelet volume (MPV) and preoperative deep vein thrombosis (DVT) in older patients with hip fracture. A total of 352 consecutive older patients with hip fracture were included from January 2014 to December 2020. MPV values were measured on admission, and color Doppler ultrasonography was performed for DVT screening before the planned surgery. The receiver operating characteristic (ROC) curve was used to establish the optimal cut-off value for the prediction of DVT. Univariate and multivariate logistic regression analysis were used to examine the association between factors and DVT. The overall prevalence of preoperative DVT was 15.1%, and patients with DVT had a lower value of MPV than non-DVT patients (11.6 ± 1.2 fL vs 12.3 ± 1.4 fL, P < .01). The cut-off point according to the ROC curve for MPV was 13.3 fL, and multivariate logistic regression analysis showed that MPV level < 13.3 fL was significantly associated with an increased risk of DVT (OR = 4.857, 95% CI: 1.091-21.617, P = .038), and with every 1.0 fL decrease in MPV, the risk increased by 27.7% (OR = 1.277, 95% CI: 1.001-1.629, P = .047). Our findings indicate that a low MPV level is associated with DVT in older patients with hip fracture. As MPV is a simple indicator that can be calculated from the blood routine test, it may be a potential biomarker of DVT with the combination of other tests, further studies are needed to confirm these results.
Evaluation of a pediatric pre-chemotherapy rapid hydration protocol: A quality assurance project
Authors: McKinnon Krista , Tran Tracey , Lewis Victor
Published: February 2022

Introduction

Intravenous hydration may be utilized to prevent nephrotoxicity and facilitate drug elimination in patients receiving high-dose chemotherapy. Prolonged hydration protocols may lead to delayed initiation and completion of therapy, lengthening hospital admissions. Rapid hydration protocols have been implemented to reduce the time required for patients to meet parameters for chemotherapy administration. This study aims to evaluate a rapid hydration protocol implemented at the Alberta Children's Hospital (ACH).

Methods

Starting January 2018 through May 2018, data was prospectively collected for pediatric oncology acute care and ambulatory patients at ACH receiving methotrexate (MTX), cisplatin, cyclophosphamide, or ifosfamide. The primary outcome was the time to achieve pre-determined urine parameters prior to chemotherapy administration. Secondary outcomes included the proportion of cycles that achieved urine parameters and the efficacy of each rapid hydration step.

Results

A total of 22 cycles were included, 13 for MTX and 9 for non-MTX chemotherapy. Median time to meet all urine parameters was 120 min (range 30–600 min). Two cycles (15%) failed rapid hydration in the MTX group, while no cycles required further hydration in the non-MTX group. Adverse events potentially attributable to hydration were mild and did not require intervention.

Conclusion

The ACH rapid hydration protocol resulted in reduced time to meet target urine parameters. The results of this quality assurance review support the continued use of rapid hydration prior to chemotherapy administration.
The religious component of uncertainty avoidance in the child-rearing practices in Kerala, India
Authors: James Joanna , Thomas Tissy Mariam , Muraleedharan Arya
Published: February 2022

The degree to which individuals of a society are uncomfortable with unpredictability and ambiguity is expressed by the Uncertainty Avoidance dimension of Geert Hofstede. Many studies have explored Uncertainty avoidance in terms of factors such as religion, law, and technology. The present study focuses on religion as it is the most explored research area while studying uncertainty avoidance of a culture. Based on this premise, we sought to understand the religious component of uncertainty avoidance in child-rearing practices in Kerala. A total of six participants were interviewed for this study from various districts in Kerala. Parents having children in the age group of 15 to 18 were chosen based on the nature of the study. Data collection was carried out through the interview method using a semi-structured interview schedule consisting of 21 questions developed based on the objectives of the present study. Because participants were not available due to the current Covid-19 circumstances, data were acquired and recorded over the phone. The collected data were transcribed, and thematic analysis was performed. The study’s major themes include a sense of belonging as a Keralite imprinted by Kerala’s rich culture, confidence in religion and overcoming uncertainty, and non-religious aspects of uncertainty. Thus the present study explored the nature and concept of uncertainty avoidance and how religion has been interwoven into child-rearing methods across Kerala.
The experience of receiving a diagnosis of depression in adolescence: A pilot qualitative study in Brazil
Authors: Viduani Anna , Benetti Silvia , Petresco Sandra , Piccin Jader , Velazquez Bruna , Fisher Helen L , Mondelli Valeria , Kohrt Brandon A , Kieling Christian
Published: February 2022

Receiving a diagnosis of depression can have an important impact on the lives of adolescents. However, there is limited information about how youth tackle, attribute meaning to and understand mental health diagnoses. The aim of this study was to explore adolescents’ initial reactions after receiving a clinical diagnosis of Major Depressive Disorder in the context of a neurobiological study of depression in Brazil. Using a qualitative design, eight Brazilian adolescents were interviewed twice: immediately after a psychiatric assessment and neuroimaging study, in which they were given a diagnosis of depression, and in a follow-up visit 2 weeks later. Interviews were designed to explore the subjective experience of receiving the diagnosis and the impacts of depression on adolescents’ lives. Framework Analysis was used to analyze the accounts. Diagnosis was perceived as a reification of an abnormal status, highlighting the role of stigma and the process of disclosing the diagnosis to others. Adolescents reported the multiple sensemaking processes that occurred when they received a diagnosis of depression, and most struggled with the idea that negative emotions would equate their experience with a disorder. The results show that future efforts could enhance clinical assessment processes with adolescents by exploring adolescents’ reactions to diagnosis, as well as the support networks available to them, resulting in increased help-seeking behaviors, and diminished social and personal stigma.
Fuzzy-based escape route fire-vulnerability assessment model for indoor built environment
Authors: Kızılkaya Öksüz Nilüfer , Tanyer Ali Murat , Pekeriçli Mehmet Koray
Published: February 2022

Fire safety evaluation is rarely involved in the iterative building design process except for legislative approval phases compared to other building objectives. However, regardless of architectural design priorities, all buildings should have adequate fire protection. This research develops a fire vulnerability assessment model based on the impact of architects on fire protection and effects of building design characteristics on fire safety. Inherent to the uncertain nature of fire safety evaluation practice, this study proposes a fuzzy vulnerability decision-making methodology to detect and visualize escape route vulnerabilities, which have the highest impact on the interoperability of fire safety and architectural design practices. The model was validated in an opera house building since the assembly occupancies have specific importance due to the significant number of fire causalities. The escape routes of the case study building were evaluated for materials’ fire reaction, route flow, route equipment, means of egress, dimensions and layout input variables. The output vulnerability levels were discussed to enhance the understanding of critical building design factors that contribute to fire vulnerability. The results confirm that the model is fairly effective in the detection and visualization of vulnerability sources by reducing communication time delays and preventing human-induced mistakes.
Uncertainty analysis of mechanical behavior of natural fiber composites
Authors: Ravandi Mohammad , Noorian Mohammad , Banu Mihaela
Published: February 2022

The natural origin of the fibers combined with random production flaws results in significant uncertainties in the properties of natural fiber-reinforced composites. A probabilistic assessment can help to characterize the uncertainties and evaluate the reliability of natural fiber composites, enabling their use in engineering designs. To this end, this study aims to analyze the uncertainties in the tensile strength and frequency response of a unidirectional flax/epoxy composite due to the actual variability of various input parameters, including the fiber material properties and manufacturing flaws. Based on the available data in the literature, the non-deterministic input variables were divided into normal and uniform variables using a statistical test. A computationally efficient response surface approach based on the polynomial chaos expansion was proposed to conduct the uncertainty analysis with multi-type uncertain variables. Moreover, the results were validated by experimental measurements and compared with the direct Monte Carlo simulation to demonstrate the accuracy and efficiency of the surrogate model.
Role of water micro-explosion on fuel droplet size distribution, engine performance, and emissions in a water-diesel emulsified engine: A comprehensive numerical investigation
Authors: Rostampour Arman , Shojaeefard Mohammad Hassan , Molaeimanesh Gholam Reza
Published: February 2022

The global warming crisis and strict regulations have pushed the automotive industry into technological change, but it will take time, so finding quick solutions can be very helpful. Using water in diesel emulsion is one of the low-cost and fast solutions to reduce pollution and improve the performance of diesel engines. In this study, the effects of adding water to diesel fuel and the phenomena that occur when water enters the combustion chamber are investigated. For this purpose, a simulation of a four-cylinder diesel engine has been used with different content of water in diesel (0% or pure diesel, 5%, 10%, 15%, and 20%). The simulations are performed in Converge CFD using dynamic mesh and adaptive mesh refinement. The results showed that the use of water in diesel leads to an improvement of about 10% in engine indicated power and a simultaneous reduction in soot and NOx by 10 and 30%, respectively. The simulation results showed that water droplet micro-explosions accelerated the fuel droplet breakup process and reduced the combustion duration by 10%–30%.
Commons, Communes, and Freedom
Authors: Frye Harrison
Published: February 2022

Private property rights involve coercion against non-owners in their enforcement. As critics of private property point out, this coercion involves a restriction on freedom. Sometimes, such critics suggest that collective property expands rights of access, and therefore expands freedom relative to private property. Does this follow? This paper argues no. To make this argument, I look at two particular forms of collective property: open-access commons and closed-access communes. Both may give rise to potential threats to freedom. This does not mean that collective property never expands freedom relative to private property. It only means we cannot infer from the fact that collective property rules extend rights of access that collective property expands freedom. The upshot is a need to pay more attention to how different property rights work in practice.
Impact of COVID-19 Pandemic on Men Who Have Sex With Men That Practice Chemsex in France: Results From the National ERAS Web Survey
Authors: Roux Perrine , Donadille Cécile , Girard Gabriel , Spire Bruno , Protière Christel , Velter Annie
Published: February 2022

Chemsex—the use of drugs in a sexual context—has been associated with more at-risk sexual practices and substance-related complications in men who have sex with men (MSM). To date, no study has focused on the impact of France’s first coronavirus disease 2019 (COVID-19)-related lockdown on the mental health and drug/alcohol use of MSM who practice chemsex. We implemented a web-based survey of 9,488 MSM living in France in June 2020 (after the country’s first COVID-19 lockdown). Specifically, we first compared the subpopulation of MSM who self-reported practicing chemsex during their most recent sexual intercourse (defined as “chemsexers”) with other MSM, using five outcomes: increased 1/tobacco use, 2/alcohol use, and 3/other psychoactive drug use. 4/using psychotropic medication during the lockdown, and finally 5/psychological distress. We then analyzed the outcomes’ associations with the main explanatory variable “chemsexer,” after adjusting for all relevant variables. Among 7,195 MSM who had sexual intercourse with a man during the previous 6 months, 359 participants (5%) were identified as “chemsexers.” Multivariable analyses showed that during the first lockdown period, chemsexers were significantly more likely than non-chemsexers to have increased their use of tobacco, alcohol, and other psychoactive substances. Chemsexers were also more likely to have used psychotropic medication and to have experienced psychological distress during the previous month. Given the ongoing COVID-19 pandemic in France and worldwide, this finding highlights the need to develop psychosocial interventions and harm reduction services for MSM chemsexers, potentially via mobile health.
Estimation of associations between MMP9 gene polymorphisms and breast cancer: Evidence from a meta-analysis
Authors: Yan Cunye , Sun Chenyu , Lu Dengwei , Zhao Tianming , Ding Xiuxiu , Zamir Irma , Tang Mi , Shao Cong , Zhang Fan
Published: February 2022

Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases, which play critical roles in cancer progression and metastasis. In recent years, many researchers have been studying the relationship between MMP9 and breast cancer. However, it still remains indecisive. Therefore, we conducted a meta-analysis to draw more accurate conclusions. A total of 21 relevant documents were retrieved, including 25 case-control studies. We quantitatively analyzed the data obtained. To clarify the relationship between MMP9 polymorphism and breast cancer susceptibility under different conditions, we also made a further subgroup analysis for each locus. In summary, we discovered that MMP9 rs3918242 rendered an increased risk for breast cancer, especially among Iranians and Indians. MMP9 rs3787268 could be a protective factor. MMP9 rs17576 and MMP9 rs2250889 have no association with breast cancer risk.
Management of acute exacerbation of chronic obstructive pulmonary disease under a tiered medical system in China
Authors: Liu Xiaojing , Du Chunling , Hu Fuying , Zhao Yunfeng , Zhou Jintao , Wang Qian , Mu Yutong , Lu Jinchang , Gao Lei , Cui Bo , Ma Yuan , Sun Tieying , Qian Feng , Chen Zhihong
Published: February 2022

Background:

The Chinese government has promoted the ‘tiered medical services’ policy in which diseases are classified by severity, mode of onset and difficulty of treatment since 2015 to optimize medical resources. We evaluated the diagnosis and treatment of acute exacerbation (AE) of chronic obstructive pulmonary disease (AECOPD) under the tiered system.

Methods:

We conducted a cross-sectional study. COPD characteristics and treatments were compared among hospitals in different tiers. Associations were examined by univariate and multivariable logistic regression analysis. In addition, multivariate logistic regression was performed to identify the possible influencing factors of antibiotics, glucocorticoids and anticoagulant usages.

Results:

Eligible COPD patients ( n = 432) were consecutively recruited from eight hospitals in different tiers in China. Patients in the countryside preferred the community hospitals, whereas patients in cities preferred second-tier and teaching hospitals when they suffer from AECOPD. It indicates most COPD patients are likely to treat their disease locally. The severity of COPD AE increased with tiers of hospitals ( p < 0.001). However, our results clearly show that most community hospitals can only deal with mild exacerbation of COPD. Approximately 90% of AE patients received antibiotics. We speculated that antibiotics abuse might exist in the three tiers of hospitals. Multivariate analysis demonstrated that long-term antibiotics usage (⩾14 days) was associated with moderate exacerbation [odds ratio (OR): 5.295, 95% confidence intervals (CI) 2.248–12.473, p < 0.001], radiographic progression (OR: 2.176, 95% CI: 1.047–4.522, p = 0.037), positive sputum etiology (OR: 3.073, 95% CI: 1.477–6.394, p = 0.003) and increased white blood cells (OR: 2.470, 95% CI: 1.190–5.126, p = 0.015). The proportion of glucocorticoids increased with the hospital hierarchy (18.6% versus 45.6% versus 69.2%, p < 0.001). The proportions of severe cases in the second-tier hospitals were 26.9%; however, non-invasive positive pressure ventilation (NPPV) rate was only 14.7%. Anticoagulant is not commonly used in AECOPD, and the community hospitals had the lowest proportion of anticoagulation regimen (1.7% versus 14.3% versus 20.5%, p = 0.002).

Conclusions:

The ‘tiered medical services’ policy in AECOPD management has been unsatisfactory in the past years. Irrational treatment strategies in different hospitals were still found when comparing with international guideline. Further reform of the policy is still needed to optimize the management of AECOPD in China.