bluuebunny/crossref_metadata_2025 huggingface dataset:
Contact-initiated shared control strategies for four-arm supernumerary manipulation with foot interfaces
Authors: Amanhoud Walid , Hernandez Sanchez Jacob , Bouri Mohamed , Billard Aude
Published: June 2021

In industrial or surgical settings, to achieve many tasks successfully, at least two people are needed. To this end, robotic assistance could be used to enable a single person to perform such tasks alone, with the help of robots through direct, shared, or autonomous control. We are interested in four-arm manipulation scenarios, where both feet are used to control two robotic arms via bi-pedal haptic interfaces. The robotic arms complement the tasks of the biological arms, for instance, in supporting and moving an object while working on it (using both hands). To reduce fatigue, cognitive workload, and to ease the execution of the foot manipulation, we propose two types of assistance that can be enabled upon contact with the object (i.e., based on the interaction forces): autonomous-contact force generation and auto-coordination of the robotic arms. The latter relates to controlling both arms with a single foot, once the object is grasped. We designed four (shared) control strategies that are derived from the combinations (absence/presence) of both assistance modalities, and we compared them through a user study (with 12 participants) on a four-arm manipulation task. The results show that force assistance positively improves human–robot fluency in the four-arm task, the ease of use and usefulness; it also reduces the fatigue. Finally, to make the dual-assistance approach the preferred and most successful among the proposed control strategies, delegating the grasping force to the robotic arms is a crucial factor when controlling them both with a single foot.
Prediction of the number of metastatic axillary lymph nodes in breast cancer by radiomic signature based on dynamic contrast-enhanced MRI
Authors: Li Lan , Yu Tao , Sun Jianqing , Jiang Shixi , Liu Daihong , Wang Xiaoxia , Zhang Jiuquan
Published: June 2021

Background

The number of metastatic axillary lymph nodes (ALNs) play a crucial role in the staging, prognosis and therapy of patients with breast cancer.

Purpose

To predict the number of metastatic ALNs in breast cancer via radiomics.

Material and Methods

We enrolled 197 patients with breast cancer who underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). A total of 3386 radiomic features were extracted from the early- and delayed-phase subtraction images. To classify the number of metastatic ALNs, logistic regression was used to develop a radiomic signature and nomogram.

Results

The radiomic signature were constructed to distinguish the N0 group from the N+ (metastatic ALNs ≥ 1) group, which yielded area under the curve (AUC) values of 0.82 and 0.81 in the training and test group, respectively. Based on the radiomic signature and BI-RADS category, a nomogram was further developed and showed excellent predictive performance with AUC values of 0.85 and 0.89 in the training and test groups, respectively. Another radiomic signature was constructed to distinguish the N1 (1–3 ALNs) group from the N2–3 (≥4 metastatic ALNs) group and showed encouraging performance with AUC values of 0.94 and 0.84 in training and test group, respectively.

Conclusions

We developed a nomogram and a radiomic signature that can be used to predict ALN metastasis and distinguish the N1 from the N2-3 group. Both nomogram and radiomic signature may be potential tools to assist clinicians in assessing ALN metastasis in patients with breast cancer.
Management for traumatic hepatic injury diagnosed by contrast-enhanced ultrasonography in a patient with an occluded coeliac axis: a case report
Authors: Sul Young Hoon , Kim Yook
Published: June 2021

Transcatheter arterial embolization (TAE) is the standard of care for haemodynamically-stable patients with blunt hepatic injury but it is sometimes impossible due to unfavourable vascular anatomies. This case report describes a 43-year-old male patient with abdominal pain following a motorcycle accident. Based on computed tomography (CT) findings, he was diagnosed with high-grade hepatic injury with coeliac axis stenosis (CAS) due to compression by the median arcuate ligament, and an aberrant right hepatic artery. Contrast-enhanced ultrasonography (CEUS) demonstrated multiple high echogenic tubular and ovoid structures suggestive of active bleeding within the injured liver area. Angiography revealed unique interlobar and intrahepatic collateral vessels between the right and left hepatic arteries. Liver haemorrhages were also identified. Catheterization of the feeding arteries through the collateral pathway was unsuccessful, so a decision was made to cannulate the stenotic portion of the coeliac trunk with a 5-Fr Yashiro catheter. After several attempts, the microcatheter was successfully advanced coaxially into the common hepatic artery. Embolization was performed with a 1:2 mixture of N-butyl cyanoacrylate and iodized oil. Successful haemostasis was confirmed following TAE. CEUS helped clinicians identify active bleeding following traumatic solid organ injury. TAE was a safe and effective treatment strategy. Before performing TAE, attention should be given to the presence of CAS associated with compression by the median arcuate ligament.
Pseudoaneurysm as a rare complication in the treatment of superior mesenteric artery embolism via percutaneous mechanical thrombectomy: a case report
Authors: Yu Zuanbiao , Hu Jiangnan , Lang Dehai
Published: June 2021

Percutaneous mechanical thrombectomy is a safe and effective treatment for addressing thrombosis in various embolic diseases. In recent years, this approach has also been actively applied in the management of acute embolic occlusion of the superior mesenteric artery. A pseudoaneurysm as a complication of this operation is remarkably rare. This is the first case report of the diagnosis and treatment of a pseudoaneurysm that developed as a complication after the application of percutaneous mechanical thrombectomy via an AngioJet device for thrombolysis in the superior mesenteric artery.
Cefoperazone and sulbactam-related eosinophilic peritonitis: a case report and literature review
Authors: Wang Zi , Li Zhiying , Luo Suping , Yang Zhikai , Xing Ying , Pu Chengwei , Dong Jie
Published: June 2021

Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis that occurs because of an overreaction to constituents that are related to the catheter or tubing, peritoneal dialysate, pathogenic infection, or intraperitoneal drug use. EP caused by antibiotic use is rare. We present the case of a patient with cefoperazone and sulbactam-related EP. A 59-year-old woman who was undergoing peritoneal dialysis presented with peritonitis with abdominal pain and turbid peritoneal dialysis. Empiric intraperitoneal cefazolin in combination with cefoperazone and sulbactam was started after peritoneal dialysis effluent cultures were performed. Her peritonitis achieved remission in 2 days with the help of cephalosporin, but she developed EP 1 week later, when her dialysate eosinophil count peaked at 49% of the total dialysate white blood cells (absolute count, 110/mm3). We excluded other possible causes and speculated that cefoperazone and sulbactam was the probable cause of EP. The patient continued treatment with cefoperazone and sulbactam for 14 days. EP resolved within 48 hours after stopping cefoperazone and sulbactam. Thus, EP can be caused by cefoperazone and sulbactam use. Physicians should be able to distinguish antibiotic-related EP from refractory peritonitis to avoid technique failure.
Poor social support and loneliness in chronic headache: Prevalence and effect modifiers
Authors: Westergaard Maria Lurenda , Lau Cathrine Juel , Allesøe Karen , Andreasen Anne Helms , Jensen Rigmor Højland
Published: June 2021

Objective

To explore the prevalence of poor social support and loneliness among people with chronic headache, and how these might be effect modifiers in the relationships between chronic headache and stress, medication overuse, and self-rated health.

Background

Poor social support and loneliness are consistently linked to worse health outcomes. There are few epidemiologic studies on their effect on headache.

Methods

The Danish Capital Region Health Survey, a cross-sectional survey, was conducted in 2017. Participants were asked about headache, pain medication use, social support, loneliness, perceived stress, and self-rated health. Data were accessed from sociodemographic registers. Logistic regression analyses were performed to test for effect modification.

Results

The response rate was 52.6% (55,185 respondents) and was representative of the target population. People with chronic headache were more likely to report poor social support and loneliness compared to those without chronic headache ( p < 0.0001 for both). Odds ratios for the combination of chronic headache and poor social support were very high for stress (odds ratio 8.1), medication overuse (odds ratio 21.9), and poor self-rated health (odds ratio 10.2) compared to those without chronic headache and with good social support. Those who reported both chronic headache and loneliness had a very high odds ratio for stress (odds ratio 14.4), medication overuse (odds ratio 20.1), and poor self-rated health (odds ratio 15.9) compared to those without chronic headache and low loneliness score. When adjusted for sociodemographic factors, poor social support and loneliness were not significant effect modifiers in almost all these associations. Loneliness was a significant effect modifier in the association between chronic headache and medication overuse, but exerted greater effect among those who did not report they were lonely.

Conclusion

Poor social support and loneliness were prevalent among people with chronic headache. The combination of chronic headache and poor social support or loneliness showed higher odds ratios for stress, medication overuse, and poor self-rated health compared to those with good social support and low loneliness scores. The effect of loneliness in the relationship between chronic headache and medication overuse warrants further study.
Transformation of library and information management: Decolonization or Indigenization?
Authors: Lilley Spencer
Published: June 2021

This article considers how colonization has impacted on Indigenous knowledge systems. It discusses the issues that need to be addressed by institutions, library and information professionals, and professional associations to ensure that they are able to meet the needs of the Indigenous people in their communities. The article addresses why this transformation is required and outlines the issues that will need to be changed through a decolonization or indigenization process.
Challenges and opportunities for parliamentary libraries during COVID-19: A case study of the National Assembly of Quebec Library
Authors: Ménard Carolyne
Published: June 2021

Parliamentary libraries play a crucial role in providing information support to decision-makers around the world. These institutions have faced an unprecedented situation with the COVID-19 pandemic. Many have had to modify their practices considerably to keep serving their users. This article explores how the National Assembly of Quebec Library has responded to this issue and redefined its services during the pandemic. The author presents the challenges and opportunities met while adapting virtual services, redefining document handling and improving team communication, and foresees future obstacles for the institution. This case study shares best practices and the lessons learned in the hope of informing and advising similar institutions facing challenges during this pandemic.
Economic crises, civilian mobilization, and repression in developing states
Authors: Koren Ore , Mukherjee Bumba
Published: June 2021

Research on the causes of repression has had limited success in connecting economic crises to state-led violence. We develop an explanation for violent government repression in urban areas, which links the importance of urban infrastructure in enabling civilians to wage an effective opposition campaign with the stress caused by economic crisis, empirically validating the underlying mechanisms using disaggregated geospatial data. We then confirm the empirical expectation that governments will violently repress during times of economic crisis where the civilians’ capacity to wage a collective action campaign is high using a disaggregated global sample of urban areas within developing states.
The Extent to Which Ageism Has Affected Lifelong Learning Settings: Perspectives From Practitioners in Taiwan
Authors: Liu Yi-Hui , Chao Pei-Ju , Fried Juliet H. , Hsu Tsu-Hsuan
Published: June 2021

As of 2018, Taiwan had a population of approximately 23.5 million people, of which 14% had reached 65 years old. To promote healthy and active aging for Taiwanese older adults, the Lifelong Learning Act was amended in 2018 in order to support older adults in terms of their personal development and leisure opportunities. The primary goal of the study was to explore the attitudes toward older adults and ageist behaviors shown by Taiwanese lifelong learning practitioners, including faculty members, lecturers, and volunteers. The results showed that Taiwanese lifelong learning practitioners, especially faculty members, had a high level of benevolent ageist attitudes toward older adults. However, associations between demographic factors on ageist behaviors were inconsistent. The findings of the study provide suggestions and research directions for the purpose of building a better age discrimination-free lifelong learning environment for current and prospective older learners.
Multi-layered in vitro 3D-bone model via combination of osteogenic cell sheets with electrospun membrane interlayer
Authors: Tevlek Atakan , Aydin Halil Murat
Published: June 2021

In this study, it was aimed to present an approach for the development of multi-layered tissue engineering constructs by using cell sheet engineering. Briefly, MC3T3-E1 mouse pre-osteoblast cells were cultured in temperature-responsive plates (Nunc Upcell®) in the presence of osteogenic medium and the resulting cell sheets were laminated with electrospun poly(L-lactic acid) (PLLA) membranes to obtain viable three-dimensional, thick constructs. The constructs prepared without PLLA membranes were used as control. The cell viability and death in the resulting structures were investigated by microscopic and colorimetric methods. The in vitro performance of the structures was discussed comparatively. Alkaline phosphatase (ALP) activity, collagen and sulfated glycosaminoglycan (sGAG) content values were calculated. The presented approach shows potential for engineering applications of complex tissues with at least two or more microenvironments such as osteochondral, corneal or vascular tissues.
Asystole in 2 Pediatric Patients During Dexmedetomidine Infusion
Authors: Lichtsinn Katrin , Sehgal Ila , Wilson Alexandra
Published: June 2021

Introduction:

Bradycardia is a known side effect of dexmedetomidine. Reports of sinus pauses or asystole, however, are rare. We present 2 cases of pediatric patients who developed asystole on a dexmedetomidine infusion.

Summary of Cases:

An 8-week-old male with RSV bronchiolitis and acute hypoxemic respiratory failure was started on dexmedetomidine for sedation at 0.2 mcg/kg/h with a maximum dose of 0.7mcg/kg/h. On Hospital day (HD) 4, on dexmedetomidine at 0.7 mcg/kg/h, he developed intermittent episodes of bradycardia with heart rates in the 60 s. Echocardiogram on HD 6 showed normal function. On HD 7, he began having periods of asystole lasting up to 6 seconds. Dexmedetomidine was discontinued, with the resolution of episodes of asystole after 6 hours. A 27-month-old male with a congenital left diaphragmatic hernia and pulmonary hypertension who had been weaned off sildenafil 6 months earlier underwent re-repair of left diaphragmatic hernia. Postoperatively he remained intubated and paralyzed. Dexmedetomidine was started at 0.3 mcg/kg/h for sedation, with a maximum dose of 1.2 mcg/kg/h. An echocardiogram on HD 3 showed good function with mild to moderate pulmonary hypertension. That evening, with dexmedetomidine at 1.1 mcg/kg/h, he developed a 15 second period of asystole requiring CPR. Dexmedetomidine was discontinued, and he was started on a midazolam infusion with no further episodes.

Discussion:

Both cases occurred in patients without cardiac conduction defects or on negative chronotropic or sympatholytic medications that have been associated with dexmedetomidine-induced asystole. We hypothesize that both episodes of asystole were due to increased patient-related vagal tone exacerbated by dexmedetomidine.
Pharmacotherapy Considerations in Heart Failure with Mildly-Reduced Ejection Fraction
Authors: Baker Carrie , Perkins Scott L. , Schoenborn Erika , Biondi Nicholas L. , Bowers Riley D.
Published: June 2021

Heart failure with mildly reduced ejection fraction (HFmrEF) has been classified using various definitions since its first mention in the literature in 2014. This group was most recently defined in the Universal Definition and Classification of Heart Failure (HF) as HF with a left ventricular ejection fraction of 41% to 49%. An increasing emphasis has been placed on HFmrEF over the past several years, with many recent publications suggesting that common therapies used in HF with reduced ejection fraction provide benefit in this population as well. Patients with HFmrEF comprise approximately one-quarter of all patients with HF. The lack of authoritative guidance concerning pharmacotherapeutic approaches in these patients leaves a significant portion of HF patients without an evidence-based approach. Although it remains unclear if HFmrEF is simply a transitional state from preserved to reduced ejection fraction, or a distinct phenotype requiring medical optimization, there are clear cardiovascular benefits to managing this subset appropriately. This publication was created to help serve as a resource for clinicians on this evolving subset of HF and aid in preventing the progression of this disease state through improved therapy optimization. The objective of this article is to briefly discuss the epidemiology and pathophysiology of HFmrEF and review the pharmacology and clinical application of therapies for the management of HFmrEF.
On the use of ultrasonic guided waves for the health monitoring of rails
Authors: Masmoudi Mohamed , Yaacoubi Slah , Koabaz Mahmoud , Akrout Mabrouka , Skaiky Ahmad
Published: June 2021

This paper deals with the health monitoring of rails. Many nondestructive techniques have been applied to rule on the health of rails. Ultrasonic guided waves (UGWs) technique is one among them. The current study focuses on this technique. First, it describes several kinds of defects that can occur in rails. Then, it presents the principle, advantages and limitations of UGW technique. The paper gathers as exhaustive as possible the previous works in which the said technique was used as a tool to monitor the health of rails. The paper put special emphasis on the use of UGW in structural health monitoring (SHM) context. In order to better understand the benefit/need of this technique in this context, by especially the non-specialist reader, a background concerning SHM is provided.
Does a carbon emissions trading scheme spur urban green innovation? Evidence from a quasi-natural experiment in China
Authors: Li Chao , Li Xiangyou , Song Deyong , Tian Meng
Published: June 2021

Based on the panel data of 277 cities between 2003 and 2017 and a unique city-level dataset of green patent applications, this study employs the difference-in-differences (DID) method to evaluate the effect of China’s carbon emission trading scheme (ETS) pilots on urban green innovation. The findings indicate that China’s ETS pilots have a positive impact on urban green innovation, and that impact is more significant for municipalities than for prefecture-level cities. Furthermore, the impact on different categories of urban green innovation is heterogeneous. More specifically, China’s ETS pilots have significantly spurred urban green innovation that is closely related to energy conservation and emission reduction, including alternative energy production, transportation, energy conservation and so forth. Moreover, the facilitating effect of China’s ETS pilots on urban green innovation suffers from a lagging effect, which began to show a significant positive effect in 2016. Overall, this paper identifies the effect of China’s ETS pilots on urban green innovation, and suggests that the government should consider the heterogeneity of urban green innovation when designing national ETS policies.
When the Quest for the Best Pays Off: How Maximising Entrepreneurs Improve Performance by Creating Entrepreneurial and Market Oriented Businesses
Authors: Soltwisch Brandon William
Published: June 2021

New research in the behavioural sciences has identified that some individuals consistently strive to make the best choice through extensive information search (maximisers), while others are inclined to select options that are good enough (satisficers). The purpose of this study is to investigate how these decision-making styles impact the entrepreneurial process. It is predicted that maximising entrepreneurs will perform better in their entrepreneurial ventures than satisficing entrepreneurs. In order to achieve improved outcomes, it is expected that maximisers will apply their preference for information search to develop more entrepreneurially oriented and market-oriented businesses. Data gathered from a sample of 172 entrepreneurs in the United States indicate that entrepreneurs who maximise outperformed their satisficing counterparts. This relationship was mediated by both entrepreneurial orientation and market orientation, suggesting that maximising entrepreneurs are more likely than satisficers to adopt innovative and market driven approaches to improve entrepreneurial performance.
Stock Market Reaction on Green-Bond Issue: Evidence from Indian Green-Bond Issuers
Authors: Verma Rakesh Kumar , Bansal Rohit
Published: June 2021

Purpose:

A green bond is a financial instrument issued by governments, financial institutions and corporations to fund green projects, such as those involving renewable energy, green buildings, low carbon transport, etc. This study analyses the effect of green-bond issue announcement on the issuer’s stock price movement. It shows the reaction of the stock price after the issue of green bonds.

Methodology:

This study is based on secondary data. Green-bond issue dates have been collected from newspaper articles from different online sources, such as Business Standard, The Economic Times, Moneycontrol, etc. The closing prices of stocks have been taken from the NSE (National Stock Exchange of India Limited) website. An event window of 21 days has been fixed for the study, including the 10 days before and after the issue date. Data analysis is carried out through the event study method using the R software. Calculation of abnormal returns is done using three models: mean-adjusted returns model, market-adjusted returns model and risk-adjusted returns model.

Findings:

The results show that the issue of green bonds has a significant positive effect on the stock price. Returns increase after the green-bond issue announcement. Although the announcement day shows a negative return for all the samples taken for the study, the 10-day cumulative abnormal return (CAR) is positive. Thus, green-bond issues lead to positive sentiments among investors.

Research implications:

This research article will help the government issue more green bonds so that the proceeds can be utilized for green projects. The government should motivate corporations and financial institutions to issue more green bonds to help the economy grow. In India, very few organizations have issued a green bond. It will be beneficial if these players issue green bonds, as it will increase the firms’ value and boost returns to the investors.

Originality/value:

The effect of green-bond issue on stock returns has been analysed in some studies in developed countries. This is the first study to examine the impact of green-bond issue on stock returns in the Indian context, to the best of our knowledge.
Screening and Vaccination Against Measles and Varicella Among Health Care Workers: A Cost-effectiveness Analysis
Authors: Lee Ji-Suk , Jeong Oh , Yang Hyunju
Published: June 2021

The aim of this study was to examine the most cost-effective strategy of screening and vaccinating measles- and varicella-susceptible health care workers (HCWs). A retrospective cost-effectiveness analysis was conducted at a tertiary hospital in Korea with 300 HCWs who were at high risk of infection. Self-reported histories of vaccinations, infectious diseases, and contact with such cases were collected. Serological tests for immunoglobulin G titers of measles and varicella were performed. Data were analyzed using analysis of variance, Kruskal-Wallis test, χ2 test, and Fisher exact test. Seropositivity rates were 96.3% for measles and 95.7% for varicella. Four different strategies (cases) for vaccination were investigated. Considering the progressive decline in antibody concentrations and the false-positive responses in self-reported histories, case 3, which involved administering 2-dose vaccinations to susceptible HCWs demonstrated by antibody screening tests for both measles and varicella, was the most cost-effective strategy. Health care facilities should establish mandatory immunization policies that reduce the risk of transmission of vaccine-preventable diseases.
With(Out) a Little Help From My Friends? Reconciling Incongruous Findings on Stakeholder Management, Innovation, and Firm Performance
Authors: Haefner Naomi , Palmié Maximilian , Leppänen Petteri T.
Published: June 2021

Are stakeholder management and innovation substitutes or complements in affecting firm performance? Extant research provides support for both positions and thus leaves us with a puzzle. We conduct an exploratory fuzzy set qualitative comparative analysis (fsQCA) of 204 publicly listed European firms combining survey and archival data to formulate theory on how stakeholder management and innovation work (in)effectively together. Distinguishing between internal and external stakeholders and exploitative and exploratory innovation, we elaborate that managing for stakeholders and innovation can be both substitutes and complements depending on a set of contingencies. We discuss boundary conditions and implications for future research.
Health care Providers’ Perceptions About Overweight and Obesity Among People Living With Human Immunodeficiency Virus in Nigeria
Authors: Olawepo John O. , Pharr Jennifer R. , Kabir Raisa , Olutola Ayodotun
Published: June 2021

HIV infection was associated with significant weight loss before the advent of potent antiretroviral therapy (ART). Weight gain while on treatment was seen as a clinical indicator of treatment success. Perceptions of health care providers (HCPs) about obesity among people living with (PLHIV) were examined. We conducted 16 key informant interviews with HCPs in two states in southeastern Nigeria, which were then coded thematically. The respondents included seven physicians, four nurses, three adherence counselors, and two pharmacists. The analysis revealed three key themes: HCPs do not see excess weight gain as a problem; there are several challenges in managing obesity among PLHIV; and comorbidities play a role in the management of obesity among PLHIV. We conclude that obesity among PLHIV is an important clinical issue that HCPs need to address with the commencement of ART.
Alcohol Consumption During Pregnancy in Brazil: Elements of an Interpretive Approach
Authors: Martinelli Júlia Lustosa , Germano Carla Maria Ramos , de Avó Lucimar Retto da Silva , Fontanella Bruno José Barcellos , Melo Débora Gusmão
Published: June 2021

With this research, we aimed to raise elements to enhance the understanding of alcohol consumption among pregnant women in Brazil. Fourteen women identified as alcohol consumers during pregnancy were interviewed. Alcohol consumption during pregnancy seemed to be associated with three groups of interconnected issues: subjective and individual issues (such as expectations, motivations, and women’s difficulty in identifying their own consumption as risky); sociocultural and environmental issues (such as alcohol cultural value, easy access, and influence from relatives, friends, and partners); misinformation, inconsistent opinions publicized through media and lack of technically addressing the subject during prenatal care. Collective and individual health educative actions seem necessary to decrease alcohol consumption among Brazilian women with similar sociocultural characteristics. Media campaigns and explicit information about negative alcohol effects, articulated with individualized actions, such as a systematic approach of this theme during prenatal care, could allow earlier and more appropriate identification and intervention of women at risk.
Successfully Negotiating Life Challenges: Learnings From Adults With Cerebral Palsy
Authors: Gaskin Cadeyrn J. , Imms Christine , R. Dagley Gavin , Msall Michael E. , Reddihough Dinah
Published: June 2021

Despite facing multidimensional inequalities, some adults with cerebral palsy achieve positive social outcomes (e.g., independent living, employment, and romantic relationships). We interviewed 23 adults (aged 23–47 years) about how they successfully negotiated the challenges of adulthood. Common to all life situations was doing what others (people without cerebral palsy) do. Origins of success lay in their formative experiences (e.g., typical parental expectations with commensurate support and acceptance and supported involvement in school life). Their present functioning (e.g., positive self-concept, well-honed social skills, and physical fitness) combined with present contexts (e.g., expectations of involvement in adult activities and accessible and accommodating environments) enabled them to find ways of negotiating challenges. Finding a way included drawing on knowledge and skills, gravitating toward those who are comfortable with difference, maintaining function, and using natural and paid supports. The findings suggest multiple avenues for supporting people with cerebral palsy to achieve positive social outcomes.
Improvement in Total and Face-to-Face Provider Time in a Multidisciplinary Craniofacial Team Clinic: An Interventional Study
Authors: Wood Alexis C. , de Mitchell C. Alejandra Garcia , Kaushik Ruchi
Published: June 2021

Objective:

Identify factors contributing to time a family spends in a Multidisciplinary Craniofacial Team Clinic (MDCT) and implement an intervention to reduce this time.

Design:

Interventional: a restructuring of clinics to serve those patients requiring fewer provider encounters separately.

Setting:

An American Cleft Palate-Craniofacial Association-accredited MDCT in an academic children’s hospital.

Patients/Participants:

One hundred sixty-seven patients with craniofacial diagnoses.

Interventions:

Time data were tabulated over ∼2 years. Following 9 months of data collection, patients requiring fewer provider encounters were scheduled to a separate clinic serving children with craniosynostosis, and data were collected in the same fashion for another 14 months.

Main Outcome Measures:

Principal outcome measures included total visit time and proportion of the visit spent without a provider in the room before and after clinic restructuring.

Results:

The average time spent by family in a clinic session was 161.53 minutes, of which 64.3% was spent without a provider in the room. Prior to clinic restructuring, a greater number of provider encounters was inversely associated with percentage of time spent without a provider ( P < .001). Upon identifying this predictor, scheduling patients who needed fewer provider encounters to a Craniosynostosis Clinic session resulted in reduction in absolute and percentage of time spent without a provider ( P < .001).

Conclusions:

The number of provider encounters is a significant predictor of the proportion of a clinic visit spent without a provider. Clinic restructuring to remove patient visits that comprise fewer provider encounters resulted in a greater percentage of time spent with a provider in an MDCT.
Using Guided Practice for Students With EBD Within Explicit Instruction
Authors: Morris Jared R. , Dexter Douglas D. , Hunter William
Published: June 2021

Guided practice within explicit instruction has been shown to be an effective method for teaching academic and behavioral skills to students with emotional and behavioral disorders (EBD). The support provided through guided practice allows students to acquire new skills confidently and successfully. This article provides practitioners of students with and at risk for EBD steps for incorporating guided practice into their instructional routine.
Using the Self-Advocacy Strategy to Support Middle School Students With EBD
Authors: Balint-Langel Kinga , Riden Benjamin S.
Published: June 2021

Self-advocacy skills enable active student involvement in the Individualized Education Program (IEP) planning process. However, some students with emotional and behavioral disorders (EBD) lack appropriate self-advocacy skills and may require specific instruction in how to prepare for and participate in their own IEP. Special educators may have limited knowledge and skills to foster the self-advocacy skills of students with EBD. Therefore, this article focuses on a research-based strategy, the Self-Advocacy Strategy (SAS), that can be used by educators to effectively promote students’ self-advocacy skills. Research support and a detailed overview and guidelines on how educators can implement the SAS in their classrooms are included.
Studying nonlinear vibrations of composite conical panels with arbitrary-shaped cutout reinforced with graphene platelets based on higher-order shear deformation theory
Authors: Ansari Reza , Hassani Ramtin , Hasrati Emad , Rouhi Hessam
Published: June 2021

In this article, the vibrational behavior of conical panels in the nonlinear regime made of functionally graded graphene platelet–reinforced composite having a hole with various shapes is investigated in the context of higher-order shear deformation theory. To achieve this aim, a numerical approach is used based on the variational differential quadrature and finite element methods. The geometrical nonlinearity is captured using the von Karman hypothesis. Also, the modified Halpin–Tsai model and rule of mixture are applied to calculate the material properties of graphene platelet–reinforced composite for various functionally graded distribution patterns of graphene platelets. The governing equations are derived by a variational approach and represented in matrix-vector form for the computational purposes. Moreover, attributable to using higher-order shear deformation theory, a mixed formulation approach is presented to consider the continuity of first-order derivatives on the common boundaries of elements. In the numerical results, the nonlinear free vibration behaviors of functionally graded graphene platelet–reinforced composite conical panels including square/circular/elliptical hole and with crack are studied. The effects of boundary conditions, graphene platelet reinforcement, and other important parameters on the vibrational response of panels are comprehensively analyzed.
Evaluation of external contamination on the vial surfaces of some hazardous drugs that commonly used in Chinese hospitals and comparison between environmental contamination generated during robotic compounding by IV: Dispensing robot vs. manual compounding in biological safety cabinet
Authors: ML Hao , T Wang , JQ Zhu , YJ Song , TJ Gong , LK Zou , J Liu , JF Yan
Published: June 2021

Objectives

The aims of the study were to evaluate the external contamination of hazardous drug vials used in Chinese hospitals and to compare environmental contamination generated by a robotic intelligent dispensing system (WEINAS) and a manual compounding procedure using a biological safety cabinet (BSC).

Methods

Cyclophosphamide, fluorouracil, and gemcitabine were selected as the representative hazardous drugs to monitor surface contamination of vials. In the comparative analysis of environmental contamination from manual and robotic compounding, wipe samples were taken from infusion bags, gloves, and the different locations of the BSC and the WEINAS robotic system. In this study, high-performance liquid chromatography coupled with double mass spectrometer (HPLC-MS/MS) was employed for sample analysis.

Results

(1) External contamination was measured on vials of all three hazardous drugs. The contamination detected on fluorouracil vials was the highest with an average amount up to 904.33 ng/vial, followed by cyclophosphamide (43.51 ng/vial), and gemcitabine (unprotected vials of 5.92 ng/vial, protected vials of 0.66 ng/vial); (2) overall, the environmental contamination induced by WEINAS robotic compounding was significantly reduced compared to that by manual compounding inside the BSC. Particularly, compared with manual compounding, the surface contamination on the infusion bags during robotic compounding was nearly nine times lower for cyclophosphamide (10.62 ng/cm2 vs 90.43 ng/cm2), two times lower for fluorouracil (3.47 vs 7.52 ng/cm2), and more than 23 times lower for gemcitabine (2.61 ng/cm2 vs 62.28 ng/cm2).

Conclusions

The external contamination occurred extensively on some hazardous drug vials that commonly used in Chinese hospitals. Comparison analysis for both compounding procedures revealed that robotic compounding can remarkably reduce environmental contamination.
Effectiveness of the Weighted Blanket With Psychiatric Patients in the Emergency Department: A Pilot Study
Authors: Dickson Debra A. , Gantt Laura , Swanson Melvin
Published: June 2021

Background:

Restraint and seclusion continue to be used with patients demonstrating aggressive and violent behaviors while in the emergency department and as inpatients in behavioral health (BH) units. The use of sensory interventions such as the weighted blanket (WB) is garnering interest as alternatives to aid in managing anxiety, anger, and aggressive behaviors. Reports of the effectiveness of the WB have primarily been anecdotal, and results of research with children have been mixed. Only one study has been conducted with the WB with adults on an inpatient psychiatric unit.

Aims:

The aim of this pilot study was to assess the effectiveness of the WB by determining whether it decreases anxiety and/or anger in adult emergency department patients with preexisting psychiatric diagnoses.

Methods:

The study used a quasi-experimental, nonequivalent control group design with pre- and posttests for anxiety and anger. The intervention was a 15-pound WB. Participants ( N = 15) were in one of three groups, which included no weighted blanket (NWB), WB for 15 minutes, or WB for 30 minutes.

Results:

All three groups showed a decrease in anxiety and anger scores. However, participants in the WB groups had a greater decrease in anxiety and anger posttest scores.

Conclusions:

The small sample size in this study did not allow for the determination of any differences between groups on anxiety or anger scores that could be viewed as a significant finding.
Exploring ADHD Symptoms and Associated Impairment across Development
Authors: Niina Ayako , Eyre Olga , Wootton Robyn , Stergiakouli Evie , Thapar Anita , Riglin Lucy
Published: June 2021

Objective

ADHD symptoms typically decline with age, but less is known about whether the presentation of specific ADHD symptoms differs across development. This study aimed to examine the frequency and associated impairment of specific ADHD symptoms in childhood, adolescence, and young adulthood.

Method

A prospective, longitudinal cohort, the Avon Longitudinal Study of Parents and Children, was utilized ( N = 2,327). ADHD symptoms and impairment were assessed using the Development and Well Being Assessment at ages 7, 15, and 25.

Results

Specific ADHD symptom frequencies and their associated impairment varied across development for the majority of symptoms, although easily distracted was one of the most commonly reported symptoms at each age, and difficulty sustaining attention was consistently associated with high levels of impairment.

Conclusion

These findings suggest differences in the presentations of ADHD symptoms across development: current understanding of how ADHD presents in childhood/adolescence may not be generalizable to young adulthood.
Multiphysics coupling in the Exascale computing project
Authors: Evans Thomas M , White Julia C
Published: June 2021

Multiphysics coupling presents a significant challenge in terms of both computational accuracy and performance. Achieving high performance on coupled simulations can be particularly challenging in a high-performance computing context. The US Department of Energy Exascale Computing Project has the mission to prepare mission-relevant applications for the delivery of the exascale computers starting in 2023. Many of these applications require multiphysics coupling, and the implementations must be performant on exascale hardware. In this special issue we feature six articles performing advanced multiphysics coupling that span the computational science domains in the Exascale Computing Project.
Ocular ischemic manifestations in fibromuscular dysplasia
Authors: Artaechevarria-Artieda June , Cabrejas-Martinez Laura , Azpitarte Sánchez-Muros Claudia , Oses Lara Marta , Quiroga-Caneiro Elena , Alonso-Peralta Miguel Angel , Saez-Pinel Rafael , García-Torres Araceli , Navas-Vinagre Inmaculada
Published: June 2021

Purpose:

To report visual, clinical and radiological outcomes of three patients with fibromuscular dysplasia (FMD) that presented different ocular ischemic events, supported by different multimodal imaging.

Methods:

A retrospective study including patients who attended a tertiary referral hospital from July 2016 to June 2019 referring acute visual loss and later diagnosed of FMD. Ophthalmological examination included best corrected visual acuity (BCVA), biomicroscopy, fundoscopy, fluorescein angiography (FA), and macular and retinal nerve fiber layer spectral domain optic coherence tomography (SD-OCT). Patients were admitted by the Neurology service, completing the study with blood and cerebrospinal fluid (CSF) test, serology and cultures, cerebral magnetic resonance angiography (angioMRI), and arteriography.

Results:

Three patients were included; one male and second females. All referred unilateral acute visual loss, with BCVA of counting fingers or hand-motion. Relative afferent pupilar defect was present in all patients. Two patients associated neurological focal signs and one had chronic hypertension. Fundoscopy revealed hemorrhages and exudates in all patients, and the typical sign of “string-of-beads” in one. FA showed dye filling delay and macular and peripheral hypofluorescence. SD-OCT revealed acute and chronic retinal ischemic signs. Blood and CSF tests, serologies and cultures resulted negative. All presented cerebral vascular involvement, objectified in the cerebral angioMRI or arteriography.

Conclusions:

FMD should be considered in cases with unilateral sudden visual loss associated to neurological focal deficits in young patients. The typical “string-of-beads” image is rare in small arteries such as the retinal vasculature. When suspected, a complete ophthalmological examination and cerebral vascular imaging is essential to confirm the diagnosis.
Investigation on the drag effect of a rolling element confined in the cavity of a cylindrical roller bearing
Authors: Gao Wenjun , Zhang Shuo , Li Xiaohang , Liu Zhenxia
Published: June 2021

In cylindrical roller bearings, the drag effect may be induced by the rolling element translating in a fluid environment of the bearing cavity. In this article, the computational fluid dynamics method and experimental tests are employed to analyse its flow characteristics and pressure distribution. The results indicate that the pressure difference between the windward side and the leeward side of the cylinder is raised in view of it blocking the flow field. Four whirl vortexes are formed in four outlets of two wedge-shaped areas between the front part of the cylindrical surface and adjacent walls for the cylinder of L/ D = 1.5 at Re = 4.5 × 103. Vortex shedding is found in the direction of cylinder axis at Re = 4.5 × 104. The relationship between drag coefficient and Reynolds number is illustrated, obviously higher than that of the two-dimensional cylinder in open space.
The effects of web-based text structure strategy instruction on adult Chinese ELLs’ reading comprehension and reading strategy use
Authors: Xu Zhihong , Wijekumar Kausalai (Kay) , Wang Qing , Irey Robin , Liang Hua
Published: June 2021

Underdeveloped reading comprehension skills can limit academic success; a particular challenge for English language learners (ELLs). The current study investigated whether a web-based text structure strategy, delivered via the Intelligent Tutoring of Structure Strategy (ITSS) program to adult Chinese ELLs, improved students’ use of reading strategies and/or overall reading comprehension. Using a quasi-experimental nonequivalent control group design, 207 adult Chinese ELLs from four classes were assigned to intervention or control groups. The intervention group utilized the ITSS to support their English reading instruction, whereas the control group was exposed to only traditional instruction. Our results indicate that the ITSS intervention had a statistically significant positive effect on adult Chinese ELLs’ reading comprehension ( β = 3.07, p < 0.001) with Cohen’s d = 0.43, as measured by the College English Test-4 (CET-4). Furthermore, we found that Chinese ELLs reported using more higher-order reading strategies ( p < 0.01) after the intervention and there was no significant change of reported reading strategy usage for the control group from pretest and post-test. However, the current study did not provide evidence that the change in use of reading strategies mediated the relationship between the intervention/control condition and Chinese ELLs’ reading comprehension.
Providing vs. receiving peer feedback: Learners’ beliefs and experiences
Authors: Martin Ines A. , Sippel Lieselotte
Published: June 2021

This study used questionnaires eliciting quantitative and qualitative data to investigate (1) foreign language learners’ beliefs about peer feedback on pronunciation before and after a peer feedback intervention and (2) peer feedback providers’, peer feedback receivers’, and teacher feedback receivers’ experiences of the intervention. Participants included 127 first-year learners of German. They were assigned to a peer feedback provider group, a peer feedback receiver group, a teacher feedback receiver group, or a control group. After a general pronunciation training for the first three groups and a metacognitive instruction session for the first two groups, the peer feedback providers were instructed to give feedback on their peers’ pronunciation whereas the peer feedback receivers were asked to incorporate their peers’ feedback and the teacher feedback receivers were asked to incorporate feedback from their teachers. Quantitative and qualitative data from a pre- and post-intervention beliefs questionnaire revealed that while all groups held mostly positive beliefs about peer feedback before the intervention, only the peer feedback providers’ beliefs changed over time, specifically, their beliefs about peer feedback were significantly more positive after the intervention. Data from an exit questionnaire further indicated that the teacher feedback receivers found their feedback more useful than the peer feedback receivers. Moreover, while the peer feedback providers found correcting peers beneficial for their own language development, many of them felt uncomfortable giving feedback, whereas the peer feedback receivers did not feel uncomfortable receiving it. These findings suggest that peer feedback providers may need additional instruction to help them feel more comfortable correcting other learners.