bluuebunny/crossref_metadata_2025 huggingface dataset:
A Pediatric Lateral Submental Mass: A Rare Presentation of Dermoid Cyst
Authors: Sauer Adam , Abrol Anish , Cabrera Claudia I. , Shah Jay
Published: May 2021

Dermoid cysts are benign cutaneous neoplasms that contain germ cells from the ectoderm and mesoderm. Approximately 70% are diagnosed during childhood before the age of 5. Although they can present throughout the body, the prevalence is 7% for those arising from the head and neck. These lesions present primarily as midline masses and are classified as sublingual, submental, or overlapping depending on their relationship with the muscles of the floor of mouth. A 10-year-old female presented with a 2-week history of right submental swelling. She denied pain, dysphagia, odynophagia, or respiratory distress. Physical examination showed nontender fullness of the submental region without erythema or induration and no palpable cervical lymphadenopathy. Ultrasound showed an oval-shaped cystic mass measuring 4.8 × 4.0 × 2.6 cm. After a course of clindamycin, a computed tomography was obtained which showed a right 4.5 × 4.0 × 2.6 cm fluid filled lesion, within the right lateral floor of mouth. Intraoral resection was performed and the mass was freed from the geniohyoid and mylohyoid. Histopathology was consistent with a dermoid cyst. Submental masses have a broad differential, but rarely are they dermoid cysts if they arise lateral to the midline. With appropriate diagnosis and total surgical excision, patients and their families can be reassured in similar cases.
Contrast-Enhanced Ultrasound Imaging of Uterine Disorders: A Systematic Review
Authors: Stoelinga Barbara , Juffermans Lynda , Dooper Anniek , de Lange Marleen , Hehenkamp Wouter , Van den Bosch Thierry , Huirne Judith
Published: May 2021

Uterine disorders are often presented with overlapping symptoms. The microvasculature holds specific information important for diagnosing uterine disorders. Conventional sonography is an established diagnostic technique in gynecology, but is limited by its inability to image the microvasculature. Contrast-enhanced ultrasound (CEUS), is capable of imaging the microvasculature by means of intravascular contrast agents; that is, gas-filled microbubbles. We provide a literature overview on the use of CEUS in diagnosing myometrial and endometrial disorders, that is, fibroids, adenomyosis, leiomyosarcomas and endometrial carcinomas, as well as for monitoring and enhancing the effectiveness of minimally invasive therapies. A systematic literature search with quality assessment was performed until December 2020. In total 34 studies were included, published between 2007 and 2020.The results entail a description of contrast-enhancement patterns obtained from healthy tissue and from malignant and benign tissue; providing a first base for potential diagnostic differentiation in gynecology. In addition it is also possible to determine the degree of myometrial invasion in case of endometrial carcinoma using CEUS. The effectiveness of minimally invasive therapies for uterine disorders can safely and accurately be assessed with CEUS. In conclusion, the abovementioned applications of CEUS are promising and it is worth further exploring its full potential for gynecology by designing innovative and methodologically high-quality clinical studies.
Impact of postoperative hypothermia on outcomes after off-pump coronary artery bypass grafting
Authors: Ntinopoulos Vasileios , Papadopoulos Nestoras , Haeussler Achim , Odavic Dragan , Fodor Patricia , Dzemali Omer
Published: May 2021

Background

Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery.

Methods

A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007–2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching.

Results

Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups.

Conclusions

Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.
Traumatic brachial artery injury successfully treated with a stent-graft: A case report
Authors: Kawatani Yohei , Mochizuki Takeshi , Hori Takaki
Published: May 2021

There are few reports on brachial artery injury treated with stent-grafts. A 69-year-old man presented with a crush injury to the left upper arm. Enhanced computed tomography revealed left humerus fracture and disruption of the blood flow of the brachial artery along with paresis of the forearm. Following external fixation of the fracture, we performed endovascular therapy for brachial artery injury. Using real-time ultrasound imaging guidance, the injured lesion was crossed by the wire, and Viabahn endoprosthesis was placed in the left brachial artery. Hemostasis was achieved, and blood flow to the forearm was restored. Subsequently, the paresis improved.
Optimising risk factors for atrial fibrillation post-cardiac surgery
Authors: Goulden Christopher J , Hagana Arwa , Ulucay Edagul , Zaman Sadia , Ahmed Amna , Harky Amer
Published: May 2021

Postoperative atrial fibrillation (POAF) is an ongoing complication following cardiac surgery, with an incidence of 15%–60%. It is associated with substantial mortality and morbidity, as well increased hospital stays and healthcare costs. The pathogenesis is not fully understood, but the literature suggests that POAF occurs when transient, postoperative triggers act on vulnerable atrial tissue produced by preoperative, procedure-induced and postoperative processes such as inflammation, oxidative stress, autonomic dysfunction and electrophysiological remodelling of the atrial tissues. This sets the stage for arrhythmogenic mechanisms, such as ectopic firing secondary to triggered activity and re-entry mechanisms generating POAF. Preoperative factors include advanced age, sex, ethnicity, cardiovascular risk factors, preoperative drugs, electrocardiogram and echocardiogram abnormalities. Procedural factors include: the use of cardiopulmonary bypass and aortic cross clamp, type of cardiac surgery, use of hypothermia, left ventricular venting, bicaval cannulation and exclusion of the left atrial appendage. Postoperative factors include postoperative drugs, electrolyte and fluid balance and infection. This review explores the pathogenesis of POAF and the contribution of these perioperative factors in the development of POAF. Patients can be risk stratified for targeted treatment and prophylaxis, and how these factors can be attenuated to improve POAF outcomes following cardiac surgery.
Venoarterial extracorporeal membrane oxygenation for cardiogenic shock after coronary endarterectomy
Authors: Li Bo , Wang Liangshan , Gu Chengxiong
Published: May 2021

Background:

Clinical outcomes of cardiogenic shock patients who were supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary endarterectomy (CE) have not yet been reported. We conducted a retrospective observational study to evaluate the short-term outcomes of patients supported with VA-ECMO after CE.

Methods:

Patients ( n = 32) who received VA-ECMO refractory cardiogenic shock after CE between January 2011 and December 2020 at the Beijing Anzhen Hospital were reviewed retrospectively. Multivariable logistic regression analysis was used to identify factors independently associated with in-hospital mortality.

Results:

Twenty patients (63%) could be weaned from VA-ECMO, and 12 patients (38%) survived to hospital discharge. The median (interquartile range [IQR]) time on VA-ECMO support was 4 (3–6) days. The median (IQR) length of ICU stay and hospital stay were 9 (5–13) and 20 (15–27) days, respectively. Neurological complications were observed in 4 (13%) of the patients. ECMO-related complications occurred in 9 (28%) of the patients. SAVE score was identified as an independent protective factor for in-hospital mortality (OR, 0.70; 95% CI, 0.54–0.91; p = 0.009). The area under the receiver operating characteristic curve for SAVE score was 0.83 (95% CI, 0.67–0.98). SOFA score (0.78; 95% CI, 0.62–0.94) and EuroSCORE (0.79; 95% CI, 0.62–0.97) also exhibited good performances.

Conclusions:

VA-ECMO is an acceptable technique for the treatment of cardiogenic shock in patients undergoing CE. SAVE score might be a useful tool to predict survival for these patients. Prospective studies are needed to assess long-term outcomes of hospital survivors.
Altered cerebellar-cortical resting-state functional connectivity in cannabis users
Authors: Schnakenberg Martin Ashley M , Kim Dae-Jin , Newman Sharlene D , Cheng Hu , Hetrick William P , Mackie Ken , O’Donnell Brian F
Published: May 2021

Background:

Cannabis use has been associated with abnormalities in cerebellar mediated motor and non-motor (i.e. cognition and personality) phenomena. Since the cerebellum is a region with high cannabinoid type 1 receptor density, these impairments may reflect alterations of signaling between the cerebellum and other brain regions.

Aims:

We hypothesized that cerebellar-cortical resting-state functional connectivity (rsFC) would be altered in cannabis users, relative to their non-using peers. It was also hypothesized that differences in rsFC would be associated with cannabis use features, such as age of initiation and lifetime use.

Methods:

Cerebellar-cortical and subcortical rsFCs were computed between 28 cerebellar lobules, defined by a spatially unbiased atlas template of the cerebellum, and individual voxels in the cerebral regions, in 41 regular cannabis users (20 female) and healthy non-using peers ( N = 31; 18 female). We also investigated associations between rsFC and cannabis use features (e.g. lifetime cannabis use and age of initiation).

Results:

Cannabis users demonstrated hyperconnectivity between the anterior cerebellar regions (i.e. lobule I-IV) with the posterior cingulate cortex, and hypoconnectivity between the rest of the cerebellum (i.e. Crus I and II, lobule VIIb, VIIIa, VIIIb, IX, and X) and the cortex. No associations were observed between features of cannabis use and rsFC.

Conclusions:

Cannabis use was associated with altered patterns of rsFC from the cerebellum to the cerebral cortex which may have a downstream impact on behavior and cognition.
Public Administration Scholarship: Revisiting the Applied Function
Authors: Goodsell Charles T.
Published: May 2021

Public Administration is reaffirmed as an applied field of practice rather than a traditional academic discipline. Hence, scholarly research in it should not merely expand an extant body of knowledge, but also support, encourage, and refine its linked professional practice out in the nation and world. The author tests this idea on his own books, with mixed results.
Efficacy and tolerability of chemosaturation in patients with hepatic metastases from uveal melanoma
Authors: Estler Arne , Artzner Christoph , Bitzer Michael , Nikolaou Konstantin , Hoffmann Rüdiger , Hepp Tobias , Hagen Florian , Eigentler Thomas , Forschner Andrea , Grözinger Gerd
Published: May 2021

Background

Patients with hepatic metastatic uveal melanoma still have a poor outcome.

Purpose

To evaluate overall survival (OS), progression-free survival (PFS), and response predictors in these patients treated with chemosaturation by percutaneous hepatic perfusion with melphalan (CS-PHP).

Material and Methods

Between June 2015 and March 2020, a total of 29 patients (median age 69.7 years; age range 30–81 years; 60% women; median BMI 25.7 kg/m2; range 18.7–35.3kg/m2; 1–6 procedures per patient) were treated with 53 CS-PHPs. All patients received cross-sectional imaging for initial and follow-up examinations. Baseline tumor load, extrahepatic tumor load, tumor response, PFS, and OS were assessed. Non-parametric statistics were used.

Results

After the initial CS-PHP, a partial response was observed in 11 patients (41%), stable disease in 12 patients (44%) and progressive disease in 4 patients (15%); two patients died before the response was evaluated. After initial CS-PHP, median OS was 12.9 ± 7.4 months and median PFS was 7.1 ± 7.4 months. OS after one year was 50%. After the second CS-PHP, median PFS was 7.9 ± 5.7 months. Seven patients had a liver tumor burden >25%, associated with a significantly shorter OS (6.0 ± 2.4 vs. 14.1 ± 12.7 months; P = 0.008). At the time of first CS-PHP, 41% (12/29) of the patients had extrahepatic metastases that did not affect OS (11.1 ± 8.4 months vs. 12.9 ± 13.6 months; P = 0.66).

Conclusion

CS-PHP is a safe and effective treatment for the hepatic metastatic uveal melanoma, especially for patients with a hepatic tumor burden <25%.
Treatment of nonunion after femoral neck fracture with valgus intertrochanteric osteotomy: a case report with 18-year follow-up
Authors: Zhou Qi-Jia , Peng Xiao-Qiang , Fei Zheng-Guo , Zhu Xiao-Hu , Sun Chun-Guang
Published: May 2021

We herein report the long-term effect of valgus intertrochanteric osteotomy for nonunion after femoral neck fracture. In this report, we describe our experience using valgus intertrochanteric osteotomy to treat nonunion after femoral neck fracture in a 20-year-old woman. The patient was discharged from the hospital 10 days after the operation, the internal fixation device was removed 1 year after the operation, and the patient was then followed up for 18 years. Valgus intertrochanteric osteotomy can effectively treat nonunion after adductive femoral neck fracture.
Diagnosis and treatment of pleomorphic rhabdomyosarcoma of the uterus: a rare case report and review of the literature
Authors: Li Zi-Jun , Li Cheng-Lie , Wang Wei , Fu Xiao-Ying , Zhen Ya-Qin
Published: May 2021

Pleomorphic rhabdomyosarcomas of the uterus (PRMSu) is a rare malignant tumor of the female genital tract. Accurate diagnosis and effective treatment of PRMSu are important. We report an 81-year-old woman who was diagnosed with PRMSu. She had an extremely unusual presentation of secondary dyspnea because of an extremely large uterus (26.0 cm). Pelvic magnetic resonance imaging showed rare severe enlargement and intrauterine filling with tumor tissue, and she was initially diagnosed with uterine leiomyosarcoma. The patient underwent hysterectomy, as well as bilateral salpingo-oophorectomy and omentectomy, and was finally confirmed as having PRMSu by histopathology combined with immunohistochemistry. We performed a systematic review of the literature between 1982 and 2020 and focused on different treatment strategies and prognosis of PRMSu. A retrospective review of 28 cases was conducted and survival analysis was estimated by using the Kaplan–Meier method. We found that the accuracy of diagnosis of PRMSu completely depends on histopathology and immunohistochemistry because of no special clinical symptoms, no sensitive tumor markers, and no special imaging findings. Although there is no standardized approach for treating this rare disease, the treatment strategy of a surgical operation combined with adjuvant chemotherapy appears to be the best choice.
Autoimmune pancreatitis with pancreatic calculi and pseudocyst: a case report
Authors: Cui Xiaobing , Xu Wen , Zhang Yingchun , Wang Fang , Guo Pei , Gong Wei
Published: May 2021

Autoimmune pancreatitis (AIP) is a unique form of pancreatitis often associated with infiltration of immunoglobulin G4-positive cells, a swollen pancreas, and diffuse narrowing of the pancreatic ducts. Unlike acute pancreatitis, AIP is rarely complicated with pseudocysts. Pancreatic calculi, a feature of ordinary chronic pancreatitis, are unusual during short-term follow-up in patients with AIP. We herein describe a 46-year-old man who initially presented with a submucosal tumor of the stomach. The patient was finally diagnosed with AIP accompanied by a pancreatic tail pseudocyst located in the gastric wall and pancreatic calculi by endoscopic ultrasonography-guided fine-needle aspiration. He underwent endoscopic retrograde cholangiopancreatography, pancreatic duct stent placement, and steroid treatment and achieved good clinical and laboratory responses. Although AIP is a common autoimmune disease that responds well to steroids, pseudocysts and pancreatic calculi are rare manifestations of AIP and should be given special attention, especially in patients with disease relapse.
Risk factors for delayed radiographic resolution in children with refractory Mycoplasma pneumoniae pneumonia
Authors: Yan Qiuli , Niu Wensi , Jiang Wujun , Hao Chuangli , Chen Meiyuan , Hua Jun
Published: May 2021

Objective

To determine the risk factors for delayed radiographic resolution in children with refractory Mycoplasma pneumoniae pneumonia (RMPP) and explore the most suitable time for interventional bronchoscopy.

Methods

This retrospective study involved 142 children with RMPP who were admitted to our hospital from 1 January 2015 to 31 December 2017. They were divided into a common resolution group and a delayed resolution group based on their chest radiograph series.

Results

Among the 142 patients, 67 showed common resolution on chest radiographs and 75 showed delayed resolution. Independent risk factors for delayed resolution were a clinical course of ≥11.5 days before the performance of interventional bronchoscopy, mucus plug formation, corticosteroid resistance, and atelectasis. When bronchoscopy was performed before the disease had been present for <11.5 days, the length of hospitalization, total fever duration, and duration of time until disappearance of coughing were shorter than those in children who underwent bronchoscopy after the disease had been present for ≥11.5 days.

Conclusions

Corticosteroid resistance, the time to interventional bronchoscopy, atelectasis, and mucus plug formation were associated with delayed resolution on chest radiographs. Performance of interventional bronchoscopy before the clinical course has reached 11.5 days may help alleviate clinical symptoms and improve radiographic resolution.
Systemic immune-inflammation index as a promising predictor of mortality in patients with acute coronary syndrome: a real-world study
Authors: Su Gaofan , Zhang Ying , Xiao Ruyi , Zhang Tingting , Gong Binbin
Published: May 2021

Objective

Prognostic indicators in acute coronary syndrome (ACS) would aid in decision-making and identifying high-risk patients. The systemic immune-inflammation index (SII) has good prognostic value in many diseases; however, its use has not been reported for ACS. We aimed to determine the associations between the SII and outcomes in patients with ACS, with adjustment for confounders.

Methods

In this retrospective cohort study, we used the MIMIC-III (Multiparameter Intelligent Monitoring in Intensive Care) database and the eICU Collaborative Research Database. The primary outcome was 30-day mortality. Cox regression analysis was performed to determine the relationship between the SII and patient outcomes, and we conducted subgroup analysis and smooth curve fitting.

Results

We identified 4699 patients with ACS: 1741 women and 2949 men, mean age 82.8±29.7 years, and mean SII 72.58±12.9. For 30-day all-cause mortality, the unadjusted hazard ratio (HR) (95% confidence interval [CI]) of SII <69.4 and SII >88.8 were 1.25 (1.04, 1.50) and 1.38 (1.15, 1.65), respectively. With SII >88.8, this association remained significant after adjustment for numerous potential confounders: HR 1.27 (1.06, 1.52). A similar relationship was observed for 90-day and 1-year all-cause mortality.

Conclusions

SII is a promising prognostic indicator for unselected patients with ACS. This finding needs to be confirmed in prospective studies.
Different disease characteristics in young patients with colorectal cancer: a large retrospective study in a city in Romania
Authors: Gheju Adelina , Jurescu Aura , Tăban Sorina , Al-Jobory Diana , Lazăr Fulger , Dema Alis
Published: May 2021

Objective

In 2018, colorectal cancer (CRC) was the second most frequent malignancy in Romania after lung cancer. Although CRC is typically encountered in patients >50 years old, CRC's global incidence among younger adults has been increasing. We aimed to compare the disease characteristics of patients with CRC aged ≤50 years with those >50 years old.

Methods

We retrospectively evaluated data from patients with CRC who underwent standard surgery at “Pius Brinzeu” Emergency County Hospital, Timisoara, Romania. Patients were divided into two groups: Group 1 (patients ≤50 years old) and Group 2 (patients >50 years old). Six parameters were analyzed (sex, residence location, age, tumor localization, microscopic findings, pathological staging).

Results

Data on age-related CRC were available for 1380 patients treated from January 2012 to December 2018. Group 1 included 120 patients while group 2 included 1260 patients. Significantly more Group 1 patients presented with advanced CRC compared with Group 2 patients (94.2% vs. 87.4%). Furthermore, CRC in younger adults was more likely to be diagnosed at an advanced stage.

Conclusions

Monitoring the CRC incidence in younger adults is essential to assess whether screening practices require changes and to raise awareness among clinicians of the increasing CRC incidence among younger patients.
Improving Interstate Freeway Travel Time Reliability Analysis by Clustering Travel Time Distributions
Authors: Zhang Xiaoxiao , Zhao Mo , Appiah Justice , Fontaine Michael D.
Published: May 2021

Travel time reliability quantifies variability in travel times and has become a critical aspect for evaluating transportation network performance. The empirical travel time cumulative distribution function (CDF) has been used as a tool to preserve inherent information on the variability and distribution of travel times. With advances in data collection technology, probe vehicle data has been frequently used to measure highway system performance. One challenge with using CDFs when handling large amounts of probe vehicle data is deciding how many different CDFs are necessary to fully characterize experienced travel times. This paper explores statistical methods for clustering CDFs of travel times at segment level into an optimal number of homogeneous clusters that retain all relevant distributional information. Two clustering methods were tested, one based on classic hierarchical clustering and the other used model-based functional data clustering, to find out their performance on clustering distributions using travel time data from Interstate 64 in Virginia. Freeway segments and those within interchange areas were clustered separately. To find the proper data format as clustering input, both scaled and original travel times were considered. In addition, a non-data-driven method based on geometric features was included for comparison. The results showed that for freeway segments, clustering using travel times and the Anderson–Darling dissimilarity matrix and Ward’s linkage had the best performance. For interchange segments, model-based clustering provided the best clusters. By clustering segments into homogenous groups, the results of this study could improve the efficiency of further travel time reliability modeling.
Eco-Drive Technology, Human Factors, and Environmental and Economic Benefits
Authors: Khan Ata M. , Kent Greg , Choudhry Omar
Published: May 2021

The objective of eco-drive technology is to reduce fuel consumption and resulting emissions using advances in communication and traffic control technologies with capability to support infrastructure-to-vehicle connection in a signalized network. On the human factors side, there is growing interest across the world in advising drivers to take eco-drive actions by effectively using the green phase of the signal cycle time to save fuel and reduce emissions. This paper describes a large-scale real-world research project in Ottawa (Ontario, Canada) on this subject. The technology and methods that support the green light optimized speed advisory (GLOSA) system were refined and all 1,178 traffic signals in the city were equipped to connect with a fleet of vehicles. Field study data were analyzed for speed trajectories, fuel consumption, and GLOSA compliance. Greenhouse emissions and fuel cost changes were computed. An anonymous questionnaire study investigated driver perception of the usefulness of the signal data displayed on an in-vehicle unit as advice on driving adjustment decisions made under prevailing traffic conditions. The over 65% compliance with GLOSA and the results of the driver questionnaire were mutually consistent. The fuel saving amounted to 7.6% but was adjusted to 5% because of uncertainties in daily vehicle travel. The reduction in carbon dioxide equivalent and fuel cost reported in the paper are based on a 5% adjustment. These results can be used for cost–benefit studies. Also, simulation-based research projects can verify their findings with the real-world experience reported in this paper.
Implementation Sequence Optimization for Dedicated Bus Lane Projects
Authors: Bayrak Murat , Guler S. Ilgin , Schonfeld Paul
Published: May 2021

Transportation projects are often implemented in phases, and the total project duration can span years. Optimization of the sequence in which transportation projects are implemented can decrease the severity of disruptions caused by construction, reduce the total cost of projects, and increase the present value of the benefits of the project. This paper presents a method for optimizing the sequence and location of dedicated bus lane implementations. The proposed method is based on a bi-level optimization framework. The lower level simulates the traffic using a link transmission model to evaluate car and bus delays, while the upper level optimizes the locations of bus lanes and/or the implementation sequence of a given bus lane configuration. If the budget or other resource constraints are binding, the optimized sequence uniquely determines the optimal schedule. The solution method is evaluated for a test network, and an analysis of sensitivity to different demand patterns and different bus lane configurations is conducted. First, the optimized locations for bus lane implementation are determined for an illustrative test network. Results suggest that, when considering the implementation sequence for the optimized set of bus lane locations, the sequence of implementation does not yield significant benefits. However, if bus lanes are implemented on every possible link, the results suggest that prioritizing the implementation of bus lanes on peripheral links would reduce the total cost the most. These locations coincide with the set of optimized locations for bus lane implementation. Further tests considering non-uniform demand patterns also confirm these findings.
The Mobilization for Spatial Justice in Divided Societies: Urban Commons, Trust Reconstruction, and Socialist Memory in Bosnia and Herzegovina
Authors: Milan Chiara
Published: May 2021

The article contributes to the urban studies literature and the study of social movements in divided societies by disclosing the distinctive features and mobilizing potential that the notion of urban commons retains in a war-torn society with a socialist legacy. Specifically, it investigates how urban space and urban commons are reclaimed in a post-conflict and post-socialist country such as Bosnia and Herzegovina. By using Sarajevo as a case study, the article explores several grassroots initiatives undertaken by local urban activists to reappropriate cultural buildings and public space in the city. The study discloses that in a post-conflict and post-socialist society urban commons can bear a unifying potential as acts of commoning favor trust reconstruction processes and strengthen community ties. While the erosion of social ties and the legacy of the war might not encourage mobilization for the commons, the reference to socialist-era practices and language can represent a vantage point to advocate in favor of collective governance. Throughout their actions, urban activists instrumentally referred to the historical experience of socialism to develop a discourse that resonates with the domestic cultural environment. The article points also to a generational difference amongst activists in their references to Yugoslav state socialism. While long-time activists strove to critically reappraise it, the younger ones born in the immediate post-war period appear to hold a more superficial and ambivalent historical knowledge of the socialist heritage, to which they had only partial access and no lived experience.
Differentiated European Integration of Ukraine in Comparative Perspective
Authors: Duleba Alexander
Published: May 2021

This article offers a comparative analysis of Ukraine’s Association Agreement against the backdrop of other agreements of the EU with third countries that facilitate their partial integration into the EU’s common space of four freedoms, albeit without institutional membership (EEA Agreement of Norway, Iceland, and Liechtenstein; EU–Swiss Bilaterals, and Turkey’s Customs Union). In addition, this analysis includes the Stabilisation and Association Agreements of the Western Balkan countries and the former Europe Agreements of the Central European countries. The research draws on concepts of differentiated integration and external governance of the EU. The analysis is built along two dimensions: identification of the regulatory boundary (policy-taking: scope of transposition of the EU acquis, legal quality of transposition, and the type of supervision mechanism) and organizational boundary (policy-shaping: inclusion in the EU institutions). The analysis concludes that Ukraine’s Association Agreement compared with other EU integration agreements with third countries includes the largest structural asymmetry, that is, a biggest gap between the largest volume of acquis, which Ukraine has to incorporate into its national legislation on one hand, and the lowest level of institutional involvement of Ukraine in policy-shaping within the EU on the other.
Vulnerable Research: Competencies for Trauma and Justice-Informed Ethnography
Authors: Winfield Taylor Paige
Published: May 2021

Ethnographers often work with individuals who are physically, psychologically, spiritually, and/or structurally vulnerable. The article introduces six competencies for ethnographers to be trained in and assessed on to ensure their research is trauma and justice-informed. The author builds from her own research experiences, current methodological approaches to qualitative inquiry, and an integration of sociology and psychology to detail these competencies and provide tools for training and assessment. The competencies include the following: (a) self-awareness; (b) participant-centered approach; (c) recognition of social location; (d) attention to trauma; (e) knowledge of professional limits; and (f) effective boundaries and self-care. The six competencies and Action-reflection course outlined in the article are designed to support researchers in attending to how their personal histories, embodied states, and power dynamics shape the research endeavor, as well as, learn skills for healthy boundary-keeping, risk assessment, and steps to minimize participant (re)traumatization. Although these competencies are essential for work with disempowered populations, they are beneficial for all qualitative researchers to ensure both personal and participant safety.
Plasma β-Amyloid in Mild Behavioural Impairment – Neuropsychiatric Symptoms on the Alzheimer’s Continuum
Authors: Miao Ruxin , Chen Hung-Yu , Gill Sascha , Naude James , Smith Eric E. , Ismail Zahinoor ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: May 2021

Introduction:

Simple markers are required to recognize older adults at higher risk for neurodegenerative disease. Mild behavioural impairment (MBI) and plasma β-amyloid (Aβ) have been independently implicated in the development of incident cognitive decline and dementia. Here we studied the associations between MBI and plasma Aβ42/Aβ40.

Methods:

Participants with normal cognition (n = 86) or mild cognitive impairment (n = 53) were selected from the Alzheimer’s Disease Neuroimaging Initiative. MBI scores were derived from Neuropsychiatric Inventory items. Plasma Aβ42/Aβ40 ratios were assayed using mass spectrometry. Linear regressions were fitted to assess the association between MBI total score as well as MBI domain scores with plasma Aβ42/Aβ40.

Results:

Lower plasma Aβ42/Aβ40 was associated with higher MBI total score ( p = 0.04) and greater affective dysregulation ( p = 0.04), but not with impaired drive/motivation ( p = 0.095) or impulse dyscontrol ( p = 0.29) MBI domains.

Conclusion:

In persons with normal cognition or mild cognitive impairment, MBI was associated with low plasma Aβ42/Aβ40. Incorporating MBI into case detection may help capture preclinical and prodromal Alzheimer’s disease.
Damsels in distress: Discourses of entrepreneurship in management textbooks
Authors: Richard Tasha , Deal Nicholous M , Mills Albert J
Published: May 2021

The purpose of this study is to provide insight into the discursive foundations of entrepreneurial identity for women in Canada by examining the social positions, representations and spaces they take in introductory business textbooks. We ask three questions: (1) What issues of power and discourses related to gender are subsumed in Canadian textbooks? (2) In what way is gender represented in texts of entrepreneurship in Canadian management education? (3) How are women portrayed in entrepreneurship texts? The data that we draw upon comes from 13 Canadian management textbooks that have been used in introductory business courses to teach students about the functions of business. By narrowing in on content in entrepreneurship education, we use poststructural feminism as a lens to interrogate gendered discourses that influence what and how students are taught about the ideals of entrepreneurship in undergraduate business programs in Canada. Our findings suggest that the entrepreneurship texts studied were overly gendered in masculine terms, serving to privilege the experience of male business while simultaneously marginalizing the representation of women entrepreneurs. We argue that marginalizing women in textbooks may form barriers to their interest and participation in entrepreneurial pursuits, and thereby call on scholars and practitioners to reconsider the importance of equality in materials used in the classroom.
A modified design for hydraulic engine mount to improve its vibrational performance
Authors: Fallahi Farzad , Shabani Rasoul , Rezazadeh Ghader , Tariverdilo Saeid
Published: May 2021

Recently, hydraulic engine mounts have been used widely as an effective vibration isolator in automotive engines. They consist of two fluid chambers connected by an inertia track path and a decoupler mechanism with a floating plate. An ideal hydraulic mount should have high stiffness and damping at low frequencies and at high frequencies should act as a good isolator. Despite their acceptable performance, there are some drawbacks including switching, nonlinear behavior of the decoupler plate at low frequencies, and occurrence of the resonance due to the passage of the fluid through the decoupler in the high-frequency range. This paper proposes a new decoupler mechanism where the floating decoupler plate is replaced with a membrane where its tension could be controlled considering the operational frequency. Considering the discrete model of the operating fluid and the continuous model of the membrane, governing equations of the system are derived. By increasing the membrane tension at low frequencies, it is shown that the desired dynamic stiffness and damping can be achieved and the nonlinear switching behavior is eliminated. At the same time, by decreasing the membrane tension at high frequencies, it is shown that there is a significant increase in system compliance, resulting in better isolation. Results also show that the membrane replacement also eliminates the fluid resonances at high frequencies. Finally, the two-objective optimization method of the genetic algorithm is employed to find the optimal values of the membrane tension and the mount parameters. The results show that the proposed mechanism can be used as a suitable alternative to the conventional hydraulic mounts.
Hydraulic pump fault diagnosis based on chaotic characteristics of speed signals under non-stationary conditions
Authors: Liu Jia-Min , Gu Li-Chen , Geng Bao-Long , Shi Yuan
Published: May 2021

Pumps are vital components in hydraulic equipment, and their malfunction is directly related to the normal operation of the whole system. The hydraulic system is accompanied by the conversion of multi-domain energy during operation. In particular, it exhibits non-stationarity and nonlinearity under variable operating conditions, which brings difficulties to fault diagnosis. In this paper, the instantaneous angular speed (IAS) signal obtained by the equal-angle measurement is studied to diagnose pump faults under non-stationary conditions. For this purpose, a synchroextracting normal S transform method is proposed to extract the time-frequency feature components properly. Then, the extracted signal is reconstructed into a high-dimensional phase space based on the improved C-C method. On this basis, the quantitative analysis indicators of pump state are obtained by the G-P algorithm and small-data method, including correlation dimension, Kolmogorov entropy, and largest Lyapunov exponent. Pump faults can be classified in a chaotic space by using these sensitive features. The results show that the proposed method is capable of diagnosing different states of pumps and robust to the variation of load values.
Fatigue level detection using multivariate autoregressive exogenous nonlinear modeling based on driver body pressure distribution
Authors: Parsa Mehdi Jamshidi , Javadi Mehrdad , Mazinan Amir Hooshang
Published: May 2021

Prolonged driving causes symptoms of fatigue in drivers and changes their physical condition during driving. The purpose of this paper is to use a force measurement system located in the driver’s seat by force-sensitive resistance pressure sensors in order to record the received information to predict fatigue by learning regression-based models. This system is designed with 16 FSR (Force Sensing Resistor) sensors mounted on the seat and its backrest that records the driver’s body’s data, based on the force exerted by the driver on the seat in standard mode and during driving at various times. Fatigue level prediction is based on the trained nonlinear autoregressive exogenous model. In this procedure, models based on multivariate regression are first trained, and then correctness is checked. In this paper, the fatigue index is divided into five parts from 0 to 100 included fully conscious, slightly tired, moderately tired, very tired, and extremely tired, so the criterion for diagnosis is crossing the 75% of fatigue index and entering the extremely tired range. The results show that nonlinear models based on exogenous autoregressive have better performance than the linear mode, and even in the nonlinear model of NARX neural network, the fatigue of one step ahead is well predictable. A flopped state will be predictable when the body is immersed in the seat due to fatigue, so is far from the standard sitting position and will be in the extremely tired warning range.
Impact of climatic conditions on the parameters of failure flow of military vehicles
Authors: Dobrzinskij Nikolaj , Fedaravicius Algimantas , Pilkauskas Kestutis , Slizys Egidijus
Published: May 2021

Relevance of the article is based on participation of armed forces in various operations and exercises, where reliability of machinery is one of the most important factors. Transportation of soldiers as well as completion of variety of tasks is ensured by properly functioning technical equipment. Reliability of military vehicles – armoured SISU E13TP Finnish built and HMMWV M1025 USA built were selected as the object of the article. Impact of climatic conditions on reliability of the vehicles exploited in southwestern part of the Atlantic continental forest area is researched by a case study of the vehicles exploitation under conditions of the climate of Lithuania. Reliability of military vehicles depends on a number of factors such as properties of the vehicles and external conditions of their operation. Their systems and mechanisms are influenced by a number of factors that cause different failures. Climatic conditions represent one of the factors of operating load which is directly dependent on the climate zone. Therefore, assessment of the reliability is started with the analysis of climatic factors affecting operating conditions of the vehicles. Relationship between the impact of climatic factors and failure flow of the vehicles is presented and discussed.
Attenuation of leakage flow using axially nonuniform tip clearance in high loading transonic compressor rotor
Authors: Cui Weiwei , Liu Fusong , Wang Xinglu , Yao Fei
Published: May 2021

Several linearly nonuniform clearances have been designed to explore a novel strategy for attenuation of leakage flow in tip region of high loading transonic rotor and the effects of axially nonuniform clearance on detailed tip flow structure and stable operating range of rotor have been discussed as well. The results showed that the tip flow characteristic of rotor is affected mainly by the combined effects of two parts of low-velocity flow, which are produced by interaction of leakage flow with passage shock and boundary layer separation near suction side, respectively. However, the stall margin of rotor and isentropic efficiency near tip region is dominated significantly by the former part, and the local changes of size and shape of tip clearance have a large influence on it. Once the strength of leakage flow decreases due to clearance size variation, the boundary layer separation near suction side of blade tip worsens gradually and increases additional aerodynamic losses in passage. Both the mass flow rate and mixing losses of the tip leakage flow can be reduced due to a smaller size of clearance existing in front part of clearance of rotor with a linearly divergent clearance shape, and the area of low-velocity region near pressure side has reduced accordingly. By contrast, a linearly convergent shape of tip clearance can increase both the area of low-velocity region and the mixing loss of leakage flow as a result of a larger size of clearance existing over the front part of blade tip of rotor. Eventually, a divergent shape of tip clearance with a reasonable minimum size near leading edge of blade tip is preferred for transonic rotor in consideration of the benefit in stall margin improvement with nearly no penalty in efficiency.
High dynamic range and high dispersion stability of a magnetorheological grease damper for semi-active vibration suppression
Authors: Shiraishi Toshihiko , Nagamatsu Shuto , Misaki Hirotaka
Published: May 2021

In this study, the dynamic range and dispersion stability of a shear-type magnetorheological (MR) grease damper were experimentally investigated as important characteristics affecting the performance of semi-active vibration suppression. Furthermore, the damper was applied to the semi-active vibration suppression of a small single-degree-of-freedom model structure subjected to seismic excitation. The performance test results of the damper indicated that it has a dynamic range of 157 times, which is much higher than that of conventional MR dampers. Also, because of the high dispersion stability of MR grease, the results showed that its performance can be kept for 9 days longer in comparison with a similar damper using MR fluid. Moreover, the structural vibration suppression test results demonstrated that the damper can suppress vibration response over a wide frequency range by applying skyhook-based control, which can take full advantage of the damper’s high dynamic range.
Challenges and Opportunities of Providing Pediatric Funeral Services: A National Survey of Funeral Professionals
Authors: James Kristin , Hawley Betsy , McCoy Carrie R. , Lindley Lisa C.
Published: May 2021

Background:

Funeral professionals offer a unique opportunity to support, educate, and advocate for grieving families after the death of a child. From the initial point of contact to the burial, funeral professionals shape the final moments and memories of a family and a community. And yet, little is known about the needs of funeral professionals to provide high quality services when a child dies.

Objectives:

To conduct a needs assessment among funeral professionals in conducting funeral services for children.

Methods:

Active National Funeral Directors Association members were surveyed on their experience and needs in providing pediatric funeral services. The survey contained 41 questions about experience, skills, and knowledge in providing pediatric funerals. The survey included multiple choice, yes/no, and open-ended questions. Descriptive statistics were generated from the survey items and comments/open-ended questions were coded and assessed for themes.

Results:

More than 200 responses were received. The respondents conducted 43 pediatric funeral services in a 5-year period (approx. 8 services/year). The top 5 self-identified training needs included grieving parents, grieving siblings, memorials, comforting the community, and outreach. Themes from the open-ended questions were (a) maintaining professionalism, (b) managing emotions and experiences, (c) assessing family dynamics, (d) managing professional skills, and (e) building collaborative networks.

Conclusions:

Specific training needs were identified that will inform the development of targeted training for funeral professionals to improve their skills and knowledge of pediatric funeral services.
Asian Pacific Americans Living with HIV Who Were Smuggled Immigrants: A Qualitative Study
Authors: Huang Feifei , Chen Wei-Ti , Shiu Cheng-Shi , Sun Wenxiu , Radaza Abigail , Toma Lance , Luu Binh Vinh , Ah-Yune Judy
Published: May 2021

Migrant smuggling is a humanitarian crisis that impacts public health. A limited number of studies have focused on the links between migrant smuggling and its impact on the risk of infectious diseases, including HIV, for those smuggled. To explore these links, we conducted in-depth interviews with 11 Asian and Pacific Americans (APA) living with HIV in New York and Los Angeles. Qualitative content analysis revealed that smuggled immigrants described their experience as one with opportunity and danger. Smuggled immigrants, who aimed to achieve their American dream, were influenced by hometown pioneers who successfully journeyed to the United States and by the prospect of gaining legal status through immigration policy similar to the 1986 amnesty. Unfortunately, the long and dangerous journey exposed the immigrants to health problems, including risk for HIV. Thus, health care providers for immigrants should assess their migration routes and screen for infectious diseases.