bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal design of the vehicle mechatronic ISD suspension system using the structure-immittance approach
Authors: Shen Yujie , Hua Jie , Wu Bin , Chen Zhong , Xiong Xiaoxia , Chen Long
Published: July 2021

There are three types of two-terminal mechanical elements, namely the inerter, the spring, and the damper in the vehicle ISD suspension system, and how to design the suspension structure has drawn much attention in automotive engineering fields. Due to the advantage of using the external electrical network to simulate the corresponding mechanical impedance output, a ball-screw mechatronic inerter is adopted in the optimal design procedure in this paper. A half vehicle dynamic model considering the vehicle body vertical motion and pitch motion is established, and the optimal design methodology of the vehicle mechatronic ISD suspension is proposed by using the structure-immittance approach to ensure the simplicity of the suspension structures. The dynamic performance indexes constraints are taken into account, and the optimal structures are discussed in detail. Numerical simulations results show that, the dynamic performance indexes, namely the RMS (root-mean square) of the vehicle body vertical acceleration and the RMS of the pitch motion acceleration of the mechatronic ISD suspensions can be reduced by 31% and 35% without constraints, and 18% and 15% with constraints by comparing to the passive suspension system. The structure-immittance approach can be easily adopted in the vehicle suspension structural design, and the research fruits will provide a new thought for the application of the inerter element in automotive engineering.
Mycoplasma genitalium infection in women reporting dysuria: A pilot study and review of the literature
Authors: Olson Elizabeth , Gupta Kanupriya , Van Der Pol Barbara , Galbraith James W , Geisler William M
Published: July 2021

Mycoplasma genitalium (MG) infection, a sexually transmitted infection (STI), causes cervicitis and may cause reproductive sequelae and adverse pregnancy outcomes. Some MG-infected women report dysuria, a symptom frequently attributed to urinary tract infection (UTI). Given potential MG-associated morbidity and the likelihood that UTI treatment would be ineffective in eradicating MG, an improved understanding of MG infection frequency and clinical significance in young women reporting dysuria is needed. We conducted MG testing on stored urogenital specimens collected in a pilot study on frequency of STIs in young women presenting to an emergency department for dysuria evaluation and performed a literature review on MG infection frequency in women reporting dysuria. Among 25 women presenting for dysuria evaluation in our pilot study, 6 (24.0%) had MG detected and one-third had co-infection with chlamydia and one-third with trichomoniasis; half with MG detected did not receive an antibiotic with known efficacy against MG, while the other half received azithromycin. In five studies identified in the literature review, dysuria was reported by 7%–19% of women and MG detected in 5%–22%. MG infection is common in young women with dysuria and empiric UTI treatment may not be effective against MG. Studies evaluating the clinical significance of MG infection in women reporting dysuria are needed.
Modeling the probability of occurrence of events
Authors: Bottai Matteo , Discacciati Andrea , Santoni Giola
Published: July 2021

This paper introduces the event-probability function, a measure of occurrence of an event of interest over time, defined as the instantaneous probability of an event at a given time point conditional on having survived until that point. Unlike the hazard function, the event-probability function is a proper probability. This paper describes properties and interpretation of the event-probability function, presents its connection with other popular functions, such as the hazard and survival functions, proposes practical flexible proportional-odds models for estimating conditional event-probabilities given covariates with possibly censored and truncated observations, discusses the theoretical and computational aspects of parameter estimation, and applies the proposed models for assessing mortality in patients with metastatic renal carcinoma from a randomized clinical trial.
The Critical Role of Semantic Working Memory in Language Comprehension and Production
Authors: Martin Randi C.
Published: July 2021

Although research on the role of verbal working memory (WM) in language processing has focused on phonological maintenance, considerable evidence indicates that the maintenance of semantic information plays a more critical role. This article reviews studies of brain-damaged and healthy individuals demonstrating the contribution of semantic WM to language processing. On the sentence-comprehension side, semantic WM supports the retention of individual word meanings prior to their integration. It also serves to maintain semantic information in an activated state such that semantic interference between sentence constituents can be resolved. Phonological WM does not appear to support either of these functions, though it contributes to verbatim sentence recall. On the production side, evidence points to the phrase as the minimal scope of advance planning in sentence formulation, and to semantic WM as supporting the representation of the meanings of the content words within a phrase. Planning at the phonological level appears to have a very limited scope, making few demands on phonological WM. These findings imply that treatment of semantic but not phonological WM deficits should lead to improved sentence comprehension and production, and preliminary findings support that view.
Asymmetric cross-citations in private law: An empirical study of 28 supreme courts in the EU
Authors: D’Andrea Sabrina , Divissenko Nikita , Fanou Maria , Krisztián Anna , Kukavica Jaka , Potocka-Sionek Nastazja , Siems Mathias
Published: July 2021

Recent years have seen a growing volume of research on citations between courts from different countries. This article fills a gap in the current literature by presenting and analysing cross-citations between the highest domestic courts responsible for matters of private law in the EU from 2000 to 2018. It addresses two main questions: first, to what extent do judges cite foreign case law in their decisions? Second, what may explain the varying levels of engagement of supreme courts with foreign case law? Our findings offer a mixed result as to the nature and frequency of such cross-citations. Overall, we identify 2984 cross-citations; yet, only in few instances do we find a reciprocal relationship between the supreme courts of two countries, while more generally an asymmetric picture emerges. The article also discusses whether problems with the ease of access to court decisions may partly be responsible for limitations in the use of cross-citations.
Patterns of End-of-Life Care as Measured by Emergency Room Visits Among Cancer Patients in Puerto Rico
Authors: Ramos-Fernández María R. , Ortiz-Ortiz Karen J. , Torres-Cintrón Carlos R. , Tortolero-Luna Guillermo
Published: July 2021

Background:

Community palliative care (PC) services are scarce in Puerto Rico (PR). Patients with advanced cancer commonly visit the emergency department(ED) at the end of life (EoL). Recognition of patients with limited life expectancies and PC needs may improve the EoL trajectory of these patients. Our objective was to characterize ED visits of cancer patients at the EoL by examining the patterns of ED visits in PR using the PR Central Cancer Registry-Health Insurance Linkage Database (PRCCR-HILD).

Methods:

The cohort consisted of patients aged ≥18 years with a primary invasive that died between 2011- 2017, with a recorded date of death, and who had insurance claims during their last three months. EoL indicators were ED visits, ED death, and hospice care use.

Results:

The study cohort included 10,755 cancer patients. 49.6% had ≥1 ED visit, 20.3% had ≥2 ED visits, and 9.7% died in the ED. In the adjusted model, female patients (aOR 0.80; 95% CI 0.68-0.93; p-value < 0.01), patients aged ≥80 years (aOR 0.47; 95% CI 0.36-0.63; p-value < 0.01), being enrolled in Medicare (aOR 0.74; 95% CI 0.61-0.90; p-value < 0.01) or being enrolled in Medicaid/Medicare (aOR 0.76; 95% CI 0.62-0.93; p-value = 0.01) were less likely to have an ED visit the date of death. Patients with distant stage are more likely to have ED ≥ 2visits ( p-value < 0.05). Conclusions: ED visits at EoL can be interpreted as poor quality cancer care and awareness of the potential of ED-initiated PC is needed in PR.
The Effect of Labor Dance on Traumatic Childbirth Perception and Comfort: A Randomized Controlled Study
Authors: Akin Bihter , Yurteri Türkmen Hülya , Yalnız Dilcen Hacer , Sert Ebru
Published: July 2021

This study aims to evaluate the effect of labor dance on traumatic childbirth perception and comfort. This is a randomized controlled experimental study. The study was conducted with 120 primiparous pregnant women (60 in experiment group, 60 in control group). The pregnant women in the experiment group performed labor dance with the researcher midwife during the active phase of labor. The researcher implemented the Childbirth Comfort Questionnaire (CCQ) when the cervical dilation was 8 cm. The Postpartum Comfort Scale (PCS) and Traumatic Childbirth Perception Scale (TCPS) were implemented almost 2 hours after giving birth. The scores of the women in the experiment group in TCPS were significantly lower than those in the control group while their mean scores in CCQ and PCS were significantly higher. Labor dance contributed to the women’s more positive childbirth experiences, perceptions of childbirth as less traumatic, and increased their comfort levels.
Validation of chemotherapy drug vapor containment of an air cleaning closed-system drug transfer device
Authors: Levin Galit , Sessink Paul JM
Published: July 2021

Purpose

The purpose of this study was to test the efficacy of ChemfortTM, an air filtration closed-system drug transfer device to prevent release of chemotherapy drug vapors and aerosols under extreme conditions. The air cleaning system is based on the adsorption of drug vapors by an activated carbon filter in the Vial Adaptor before the air is released out of the drug vial. The functionality of the carbon filter was also tested at the end of device’s shelf life, and after a contact period with drug vapors for 7 days. Cyclophosphamide and 5-fluorouracil were the chemotherapy drugs tested.

Methods

The Vial Adaptor was attached to a drug vial and both were placed in a glass vessel. A needle was punctured through the vessel stopper and the Vial Adaptor septum to allow nitrogen gas to flow into the vial and to exit the vial via the air filter into the glass vessel which was connected to a cold trap. Potential contaminated surfaces in the trap system were wiped or rinsed to collect the escaped drug. Samples were analyzed using liquid chromatography tandem mass spectrometry.

Results

Cyclophosphamide and 5-fluorouracil were detected on most surfaces inside the trap system for all Vial Adaptors without an activated carbon filter. Contamination did not differ between the Vial Adaptors with and without membrane filter indicating no effect of the membrane filter. The results show no release of either drug for the Vial Adaptors with an activated carbon filter even after 3 years of simulated aging and 7 days of exposure to drug vapors.

Conclusions

Validation of air cleaning CSTDs is important to secure vapor and aerosol containment of chemotherapy and other hazardous drugs. The presented test method has proven to be appropriate for the validation of ChemfortTM Vial Adaptors. No release of cyclophosphamide and 5- fluorouracil was found even for Vial Adaptors after 3 years of simulated aging and 7 days of exposure to drug vapors.
Comparison of corneal astigmatism characteristics and prevalence of corneal astigmatism between Turkish individuals and Syrian refugees
Authors: Guven Soner
Published: July 2021

Purpose:

To compare the prevalence, magnitude and type of corneal astigmatism between Turkish individuals and Syrian refugees.

Material and methods:

Data of patients scheduled for cataract surgery between January 2019 and 2020 were reviewed. The patients were randomly stratified according to their ethnicity (Turkish individuals or Syrian refugees). Keratometry was performed with the keratometer of IOLMaster 500. Quantitative analysis was performed using the power vector method (J0 and J45). The association between age and astigmatism in the two groups was explored.

Results:

The study included 4085 eyes of 2049 patients (3962 eyes of Turkish individuals and 123 eyes of Syrian refugees). The mean magnitude of corneal astigmatism, J0, J45 and prevalence of against the rule (ATR) astigmatism and with the rule (WTR) astigmatism were 1.01 D, 0.06, 0.01 D, 37.6% and 43.7% in Turkish individuals and 1.13 D, −0.02, 0.07 D, 46.3% and 37.4% in Syrian refugees, respectively. There were no significant differences according to age, sex, right/left eyes, corneal astigmatism magnitude, keratometric values, J0 and J45 ( p > 0.05) between the two groups. Below 40 years of age, the mean corneal astigmatism magnitude in Syrian refugees was significantly higher than that in Turkish individuals ( p = 0.037). At all ages, ATR astigmatism prevalence was higher in Syrian refugees than in Turkish individuals. ATR astigmatic shift began at a younger age in Syrian refugees ( p = 0.037). Age- and sex-adjusted analysis showed that J0 was significantly lower in Syrian refugees than in Turkish individuals ( p = 0.013).

Conclusion:

The prevalence and magnitude of ATR astigmatism were higher and onset earlier in Syrian refugees than in Turkish individuals.
An investigation into the psychosocial impact of therapeutic recreation summer camp for youth with serious illness and disability
Authors: Yang Jacquelyn , Shafran Roz , Bennett Sophie , Jolly Allan
Published: July 2021

Objectives

This study aimed to evaluate the impact on emotional, social, physical and educational functioning of a therapeutic recreation camp provided by ‘Over The Wall’, a UK charity for children and young people with chronic illness or disability.

Method

Two hundred and sixty four people registered to attend camp were sent the Pediatric Quality of Life Inventory version Child Self-Report Scale before camp, immediately after camp, 1 month after camp and 3 months after camp.

Results

Of those invited to participate, 178 children completed the pre-camp survey (67% response rate). Of those, 105 completed both the post-camp 1 and pre-camp questionnaires (59% of pre-camp respondents), and 60 of those participants subsequently completed the 1-month post-camp questionnaire as well (34% of pre-camp respondents). Only 32 participants completed the 3-month follow-up data (18% of pre-camp respondents). Across the first three timepoints (pre-Camp, post-Camp and 1 month follow-up), a repeated measures ANOVA indicated a significant improvement in emotional and social functioning, but not physical or school functioning ( p < 0.05). Post-hoc analyses on pre-camp and post-camp scores revealed small-medium effect sizes of 0.317 and 0.272 for emotional and social functioning, respectively.

Discussion

The therapeutic recreation summer camp provided for children and young people with health challenges had a significant, positive impact on emotional and social functioning. Such camps can therefore be considered as having empirical support for their aims. Further work is warranted to increase the response rate to establish the longer term impact of the camps and the wider impact of the camps on the wider family.
The Closing Educational Gap in E-privacy Management in European Perspective
Authors: Maineri Angelica M , Achterberg Peter , Luijkx Ruud
Published: July 2021

Educational gaps are increasingly salient as skills and knowledge gain prominence in digital societies. E-privacy management, namely, the ability to control the flow of information about the self, is an important asset nowadays, since a skillful use of digital technologies enables full participation in social life and limits the exposure to unwarranted algorithmic processes. We investigate whether and why education affects e-privacy management, and whether the educational gaps vary following a country’s degree of digitalization. We empirically test two sets of mechanisms, one derived from the digital divide and diffusion of innovations theories and the other from the reflexive modernization theory. The study employs Eurobarometer 87.1 data ( N = 21,177), collected in 2017 among representative samples from 28 European countries, and uses multilevel linear regression model. Findings suggest that the years spent in education positively affect e-privacy management, and that this effect is largely mediated by digital skills and Internet use, and to a lesser extent by a reflexive mind-set. The educational gap in e-privacy management narrows in more digitalized countries.
Towards a coherent methodology for the documentation of small-scale multilingualism: Dealing with speech data
Authors: Di Carlo Pierpaolo , Ojong Diba Rachel A. , Good Jeff
Published: July 2021

Purpose:

To contribute to the establishment of a novel approach to language documentation that includes bilingual and multilingual speech data. This approach would open this domain of study to work by specialists of bilingualism and multilingualism.

Approach:

Within language documentation, the approach adopted in this paper exemplifies the “contemporary communicative ecology” mode of documentation. This radically differs from the “ancestral-code” mode of documentation that characterizes most language documentation corpora. Within the context of multilingualism studies, this paper advocates for the inclusion of a strong ethnographic component to research on multilingualism.

Data and Analysis:

The data presented comes from a context characterized by small-scale multilingualism, and the analyses provided are by and large focused on uncovering aspects of local metapragmatics.

Conclusions:

Conducting language documentation in contexts of small-scale multilingualism requires that the adequacy of a corpus is assessed with regard to sociolinguistic, rather than only structural linguistic, requirements. The notion of sociolinguistic adequacy is discussed in detail in analytical terms and illustrated through an example taken from ongoing research led by the authors.

Originality:

To date, there are no existing publications reviewing in the detail provided here how the documentation of multilingual speech in contexts of small-scale multilingualism should be structured. The contribution is highly original, in particular, for its theoretical grounding of the proposed approach.

Significance/Implications:

This article can serve as a reference for those interested in methodological and theoretical concerns relating to the practice of language documentation in contexts of small-scale multilingualism across the world. It may also help clarify ways for sociolinguists to engage more closely with work on language documentation, a domain that has thus far remained primarily informed by structural linguistic approaches.
In time, we will simply disappear: Racial demographic shift undermines privileged group members’ support for marginalized social groups via collective angst
Authors: Stefaniak Anna , Wohl Michael J. A.
Published: July 2021

The racial demographic shift occurring in many Western countries provides a unique context to study the reactions of a high-power group (White people) to the potential loss of their privileged position in society. Three experiments ( N = 77, N = 302, N = 555) conducted in Canada, the US, and the UK showed that White people who are reminded about the ongoing demographic changes and who see race relations as a zero-sum game whereby any gains by minorities must come at the expense of the majority, experience stronger collective angst and, to a lesser extent, fear (but not anger). In turn, collective angst, but not the other negative group-based emotions, fuels their motivation to protect the existing intergroup hierarchy by withdrawing support for progressive social movements and increases anti-immigration sentiments. Downregulating the existential threat experienced by White majorities in the face of a racial demographic shift may be one way to reduce acrimonious behavioral intentions aimed at preserving their place in the social hierarchy.
Risk perception in newspaper chains: Threats, uncertainties and corporate boundary work
Authors: Sjøvaag Helle , Owren Thomas
Published: July 2021

This article presents an analysis of risk perception among chain newspaper CEOs in Scandinavia. Based on in-depth, semi-structured interviews, the analysis finds that risk is perceived in relation to public trust, corporate expansion and contentious government regulation. We discuss these themes in relation to their uncertainty, and the potential gains and losses that accompany them. The aim of the study is to sharpen the distinction between risks, uncertainties and threats as they are mobilized in research on the news industries, contributing to the research on strategic media management at the firm level. The contribution of the study is furthermore to demonstrate how CEOs’ risk perception can be seen as boundary work performed at the corporate level.
The Psychological Impact of Slaughterhouse Employment: A Systematic Literature Review
Authors: Slade Jessica , Alleyne Emma
Published: July 2021

The role of a slaughterhouse worker (SHW) involves the authorized killing of living beings, yet there is limited understanding of the consequences this behavior has on their well-being. The purpose of this systematic review is to collate and evaluate the current literature on the psychological impact of slaughterhouse employment. Fourteen studies met the specific a priori inclusion criteria. The findings from this review were demarcated by the focus of studies: (1) the prevalence of mental health disorders, (2) the types of coping mechanisms used, and (3) the link between slaughterhouse employment and crime perpetration. It was found that SHWs have a higher prevalence rate of mental health issues, in particular depression and anxiety, in addition to violence-supportive attitudes. Furthermore, the workers employ a variety of both adaptive and maladaptive strategies to cope with the workplace environment and associated stressors. Finally, there is some evidence that slaughterhouse work is associated with increased crime levels. The research reviewed has shown a link between slaughterhouse work and antisocial behavior generally and sexual offending specifically. There was no support for such an association with violent crimes, however. Based on existing research, we suggest future directions for research (i.e., applying more methodological rigor) but highlight key findings for practitioners and policymakers that warrant attention.
Computer-Assisted Surgical Navigation for Primary and Metastatic Bone Malignancy of the Pelvis: Current Evidence and Future Directions
Authors: Christ Alexander B. , Hansen Derek G. , Healey John H. , Fabbri Nicola
Published: July 2021

Computer-assisted navigation and robotic surgery have gained popularity in the treatment of pelvic bone malignancies, given the complexity of the bony pelvis, the proximity of numerous vital structures, and the historical challenges of pelvic bone tumor surgery. Initial interest was on enhancing the accuracy in sarcoma resection by improving the quality of surgical margins and decreasing the incidence of local recurrences. Several studies have shown an association between intraoperative navigation and increased incidence of negative margin bone resection, but long-term outcomes of navigation in pelvic bone tumor resection have yet to be established. Historically, mechanical stabilization of pelvic bone metastases has been limited to Harrington-type total hip arthroplasty for disabling periacetabular disease, but more recently, computer-assisted surgery has been employed for minimally invasive percutaneous fixation and stabilization; although still in its incipient stages, this procedure is potentially appealing for treating patients with bone metastases to the pelvis. The authors review the literature on navigation for the treatment of primary and metastatic tumors of the pelvic bone and discuss the best practices and limitations of these techniques.
Examining the validity and reliability of the revised developmental work personality scale (RDWPS)-traditional Chinese version
Authors: Liu De-Chang , Strauser David , Pan Ay-Woan
Published: July 2021

Background

Work personality was found to relate to successful work adjustment, job readiness, work motivation and job maintenance. The revised developmental work personality scale (RDWPS) is a self-reported assessment to evaluate the work personality of the examinee which further psychometric study is required and needs to be applied to different culture. The aim of this study was to examine the theoretical structure, validity, and reliability of the traditional Chinese version of the RDWPS.

Methods

The subjects were 113 university students with no known physical or mental illness who aged between 19 and 22. Cluster analysis was used to examine the theoretical structure. Rasch analysis was applied to examine the psychometric properties.

Results

We dropped the unfit three items and found the 11 items of traditional Chinese version of the RDWPS was adequate to fit the theoretical construct. The results of the Rasch analysis showed that the 11 items with a three-point rating scale of the traditional Chinese version of the RDWPS had acceptable internal consistency (α = 0.76), moderate reliability, and met the criteria of unidimensionality.

Conclusions

The results of this study provided initial evidence that the traditional Chinese version of the RDWPS can be readily applied to research related to work behavior for those whose primary language is traditional Chinese, with adequate reliability and validity.
Differences of expected intervention effects between participant-led and facilitator-led preventive care services in Japan
Authors: Yun Shan , Takashima Risa , Yoshida Kazuki , Sawamura Daisuke , Inoue Takao , Sakai Shinya
Published: July 2021

Objective

To examine the effect of different management methods on the effectiveness of care preventive programmes for community-dwelling older adults.

Methods

This study comprised two facilitator-led (FL) and one participant-led (PL) preventive care classes in Japan. All participants received the intervention for approximately 12 weeks. Functional assessments, occupational dysfunctions, and subjective health were measured before and after the interventions. A two-way mixed design analysis of covariance (ANCOVA) was adopted to examine the effect of the interventions, adjusted for previous experiences with preventive care services. The level of significance was set at P < 0.05.

Results

Fourteen participants in the PL group (76.64 ± 6.48 years, 92.9% women) and 29 participants in the FL group (76.55 ± 5.75 years, 75.9% women) were included in the statistical analysis. ANCOVA showed significant group × time interaction effects in the Five Times Sit-to-Stand Test (FTSST), the Timed Up & Go (TUG), occupational deprivation of the Classification and Assessment of Occupational Dysfunction Scale, and self-rated health. Simple main effect tests showed that the TUG decreased significantly in the PL group, while occupational deprivation and self-rated health scores improved significantly. In contrast, FTSST scores significantly improved in the FL group.

Conclusion

PL-type management may be more appropriate for preventing social isolation and withdrawal, while FL-type management may be more appropriate for preventing physical frailty. Selecting not only adequate programmes but also an appropriate management type that matches the service purpose can help provide more effective care preventive services.
‘From Nazi Inferno to Soviet Hell’: Polish-Jewish children and youth and their trajectories of survival during and after World War II
Authors: Friedla Katharina
Published: July 2021

This article relates the experiences of Polish-Jewish children, born or raised in Germany, who survived the war in the Soviet hinterland, and validates that their traumatic wartime experiences had long-lasting consequences. Over the course of the years 1938 to 1945, as well as throughout the post-war decade, this group of children survived several fundamental, political transformations, which deeply affected and irrevocably changed their lives. These caesuras thrust them through a triad of transitions: as young deportees and refugees they ceased to be children; they were moved forcibly from one country to another; and the emotional pain and trauma they experienced during forced migrations. All of these children were refugees three or more times over: expelled from Germany to Poland, deported or sent to the interior of the Soviet Union, ‘repatriated’ from the USSR to Poland, they fled to Displaced Persons camps in Germany or Austria, and finally emigrated to Western countries. These extremely personal accounts of Polish-Jewish children experiences not only open a window into the past and help us to better understand the special plight of child victims and survivors, but they also allow us to reflect more deeply, thoughtfully, and comprehensively on the present-day issues of forced migration, displacement, and refugee crises.
Navigating the ethics of remote research data collection
Authors: Gelinas Luke , Morrell Walker , White Sarah A , Bierer Barbara E
Published: July 2021

COVID-19 has accelerated broad trends already in place toward remote research data collection and monitoring. This move implicates novel ethical and regulatory challenges which have not yet received due attention. Existing work is preliminary and does not seek to identify or grapple with the issues in a rigorous and sophisticated way. Here, we provide a framework for identifying and addressing challenges that we believe can help the research community realize the benefits of remote technologies while preserving ethical ideals and public trust. We organize issues into several distinct categories and provide points to consider in a table that can help facilitate ethical design and review of research studies using remote health instruments.
Persistent decline of hospitalizations for acute stroke and acute coronary syndrome during the second wave of the COVID-19 pandemic in Greece: collateral damage unaffected
Authors: Katsouras Christos , Tsivgoulis Georgios , Papafaklis Michail , Karapanayiotides Theodore , Alexopoulos Dimitrios , Ntais Evangelos , Papagiannopoulou Georgia , Koutroulou Ioanna , Ziakas Antonios , Sianos Georgios , Kouparanis Antonios , Trivilou Paraskevi , Ballas Christos , Samara Ioanna , Kosmidou Maria , Palaiodimou Lina , Grigoriadis Nikolaos , Michalis Lampros K. , Giannopoulos Sotirios
Published: July 2021

Background:

An alarming cerebro/cardiovascular collateral damage, reflected by a decline in admissions for acute stroke (AS) and acute coronary syndrome (ACS), was observed during the initial phase of the COVID-19 pandemic, thereby leading to a re-design of public campaigns. However, there are limited data regarding the AS and ACS hospitalization rates during the second wave of the pandemic, which was followed by re-imposition of lockdowns.

Methods:

We calculated the rate of AS and ACS hospitalizations from three representative tertiary care hospitals in Greece during a 2-month period (November–December 2020) of the second wave of the COVID-19 pandemic compared with the corresponding control period in 2019 from three representative tertiary care hospitals in Greece. This was a follow-up study with identical design to our previous report evaluating AS and ACS hospitalizations during the first wave of the pandemic (March–April 2020).

Results:

Compared with 2019, there was a 34% relative reduction of AS hospitalizations [incidence rate ratio (IRR): 0.66, 95% confidence interval (CI): 0.48–0.92, p = 0.013] and 33% relative reduction of ACS hospitalizations (IRR: 0.67, 95% CI: 0.54–0.83, p < 0.001) during the second wave of the COVID-19 pandemic. The relative reduction was smaller and did not reach the level of statistical significance for the respective syndromes (haemorrhagic stroke: IRR 0.87, 95% CI: 0.41–1.82, p = 0.71; ST-elevation myocardial infarction: IRR 0.81, 95% CI: 0.57–1.14, p = 0.22).

Conclusion:

AS and ACS hospitalizations were persistently reduced during the second wave of the COVID-19 pandemic compared with 2019 in Greece. This decline was similar to the observations during the first wave despite the large differences in the epidemiological COVID-19 burden. Lockdowns, a common characteristic in both waves, appear to have a detrimental indirect impact on cerebro/cardiovascular diseases in the general population.
Integrated Health Care and Value Co-Creation: A Beneficial Fusion to Improve Patient Outcomes and Service Efficacy
Authors: Davey Janet , Krisjanous Jayne
Published: July 2021

This conceptual article integrates value co-creation concepts with dimensions of integrated care demonstrating how a marketing framework and a framework originated in health can achieve a beneficial fusion to enhance health outcomes. Using midwifery health care services as the context, we contend that integrated care models focus only on co-production overlooking the complex, value co-creation potential of value-in-use for improved health outcomes. We add four new dimensions of value-in-use: client–provider shared principles, client agency, empowerment, and relationship equality. Adopting an interdisciplinary approach, a value co-creation perspective advances our understanding of the activities and processes of integrated care at the various levels in the patient’s lifeworld beyond the patient–carer interface. We argue that adding value-in-use dimensions to health care’s integrated care model adds conceptual clarity and will improve service delivery and patient health care outcomes.
How Team Emotions Impact Individual Employee Strain Before, During, and After a Stressful Event: A Latent Growth Curve Modeling Approach
Authors: Xu Shi (Tracy) , Martinez Larry R. , Van Hoof Hubert
Published: July 2021

Employee strain is a significant and costly issue for hospitality organizations. This study investigated the change trajectory of strain pre, during, and post a discrete stressful event and how cohesion and group emotional variability altered the shape of the trajectory. Using an experience sampling method approach, we gathered 402 daily observations from 84 workers in a period that included a specific stressful event, the opening of a one-night “theme dinner” restaurant that catered to dinner guests from the general public. We used latent growth curve modeling to investigate the change of strain among employees over time. The results showed that indicators of strain displayed inverted U-shaped trajectories (i.e., strain increased before and decreased after the stressful event) and that group cohesion and emotional variability affected the starting value and the change trajectory of strain. By investigating strain on a daily basis and considering group-based influences in response to discrete stressful events, this study provides significant implications to the hospitality literature and suggestions to hospitality managers on how to alleviate the impact of strain among their workforces.
Social Connectivity During the COVID-19 Pandemic: Disparities among Medicare Beneficiaries
Authors: Jacobs Molly , Ellis Charles
Published: July 2021

Purpose

Social connections are essential for health and well-being at all ages and may be especially important for promoting health in later life. Maintaining social connections, however, became increasingly difficult during the COVID-19 pandemic when stay-at-home orders were enacted, and social distancing became necessary. This study examines the social connectivity among Medicare beneficiaries during the COVID-19 pandemic highlighting the importance technological availability, income, and race.

Methods

Data from the 2020 Medicare Beneficiaries Survey COVID supplement was used to evaluate social connectedness during the spring and fall of 2020. Binomial logistic regression evaluated the relationship between feelings of social connectedness and race/ethnicity, urban status of residence, income, availability of household technologies, internet access, and chronic conditions.

Results

Lower social connectivity is significantly correlated with race and income. Blacks had a nearly 30% higher likelihood of feeling socially disconnected than other racial groups. Individuals with chronic conditions, particularly cancer, were significantly more likely to feel socially disconnected. Internet access and the availability of technological devices decreased the odds of feeling socially disconnected by 20% and 15% respectively.

Conclusion

The COVID-19 pandemic decreased the social connectedness of many vulnerable groups specifically Blacks, those living with chronic conditions, and individuals with limited access to technology. While it is outside the scope of the current study, additional research is needed to determine how to address the social and psychological impacts of the COVID-19 pandemic among elderly Americans.
PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study
Authors: Ganesh Ravindra , Ghosh Aditya K. , Nyman Mark A. , Croghan Ivana T. , Grach Stephanie L. , Anstine Christopher V. , Salonen Bradley R. , Hurt Ryan T.
Published: July 2021

Objective

Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status.

Methods

A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain.

Results

The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%).

Conclusion

Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.
Central Sensitization Phenotypes in Post Acute Sequelae of SARS-CoV-2 Infection (PASC): Defining the Post COVID Syndrome
Authors: Bierle Dennis M. , Aakre Christopher A , Grach Stephanie L. , Salonen Bradley R , Croghan Ivana T. , Hurt Ryan T , Ganesh Ravindra
Published: July 2021

Objective

To develop and implement criteria for description of post COVID syndrome based on analysis of patients presenting for evaluation at Mayo Clinic Rochester between November 2019 and August 2020.

Methods

A total of 465 patients with a history of testing positive for COVID-19 were identified and their medical records reviewed. After a thorough review, utilizing the DELPHI methods by an expert panel, 42 (9%) cases were identified with persistent central sensitization (CS) symptoms persisting after the resolution of acute COVID-19, herein referred to as Post COVID syndrome (PoCoS). In this report we describe the baseline characteristics of these PoCoS patients.

Results

Among these 42 PoCoS patients, the mean age was 46.2 years (median age was 46.5 years). Pain (90%), fatigue (74%), dyspnea (43%), and orthostatic intolerance (38%) were the most common symptoms. The characteristics of an initial 14 patients were utilized for the development of clinical criteria via a modified Delphi Method by a panel of experts in central sensitization disorders. These criteria were subsequently applied in the identification of 28 additional cases of suspected PoCoS. A 2-reviewer system was used to analyze agreement with using the criteria, with all 28 cases determined to be either probable or possible cases by the reviewers. Inter-reviewer agreement using these proposed defining criteria was high with a Cohen’s alpha of .88.

Conclusions

Here we present what we believe to be the first definitional criteria for Post COVID syndrome. These may be useful in clinical phenotyping of these patients for targeted treatment and future research.
Behavioral Cost of Managerial Decisions Under Risk Perception and Culture: A Comparative Study Between the United States and Pakistan
Authors: Dar Nishwa Iqbal , Shah Syed Zulfiqar Ali , Ahmed Zeeshan
Published: July 2021

The study is an attempt to find the reasons for biased behavior of overconfident managers while making financial decisions on behalf of shareholders. The study further seeks the ways to resolve the problems faced by firms due to such biased decision-making. For this purpose, quantitative research method is used to uncover the new information for better understanding of study. The comparative analysis has been done through survey-based data collected from executives/managers of firms listed on Pakistan Stock Exchange and New York Stock Exchange. The results indicate that overconfidence bias plays a significant role in managerial decisions for Pakistan compared with U.S. managers. This study applied mediation and moderation tests and found the significant mediating role of risk perception for overconfidence bias and manager decisions. The study further checked moderating role of cultural value, that is, the role of uncertainty avoidance between overconfidence bias of managers and risk perception. Hence, the role of cognitive biases and bounded rationality is undeniable for managerial decision-making and ultimate behavioral cost that firms have to pay due to undesired outcomes of situations. Consequently, this study has reached to extract the hidden facts and solutions to the observed issues for developed and emerging economy’s firms through cultural differences.
Understanding Instructors’ Cognitive Structure Toward the Academic Use of Social Network Sites: The Means–End Chain Theory
Authors: Al-Abdullatif Ahlam Mohammed , Aladsani Hibah Khalid
Published: July 2021

Employing social network sites (SNSs) for academic purposes has been investigated in the literature; however, there is not enough scientific knowledge about university instructors’ behavioral perceptions and values that drive their academic use of SNSs. Therefore, a systematic cognitive framework, regarding SNSs academic usage, is beneficial to understand these behavioral perceptions. This research utilizes the means–end chain (MEC) analysis approach to investigate university instructors’ cognitive structure toward the academic use of SNSs. It identifies important requirements for the effective academic use of SNSs by recognizing the relationship between the critical features of SNSs and instructors’ perceived values derived from these features. The findings show that seven significant features of SNSs form 45 MECs that appear to be the most useful features used by university instructors for academic purposes. These seven features were found to be cognitively associated with 10 positive benefits, which are crucial to the fulfillment of nine of the instructors’ personal values. Of the seven features, following others and being a group member were used most frequently by instructors in their academic practices. These two features were of significant value for the instructors to achieve a sense of accomplishment. The findings have practical implications for instructors and educational institution policy makers to enhance the effectiveness of SNSs use in academic settings.
Social Interaction and Entrepreneurial Intention: An Empirical Investigation for China
Authors: Huang Xiaobing , Chen Meng , Liu Xiaolian , Mensah Isaac Kofi
Published: July 2021

This article investigates the impact of social interactions on household entrepreneurial behavior using the data of the China Family Finance Survey (CHFS) in 2015. The results show that social interaction has a positive influence on household entrepreneurship. More social interactions are associated with a higher likelihood of participating in both business and agricultural entrepreneurship. Moreover, the positive effect of social interaction on entrepreneurship increases with the relaxation of financial constraints faced by households. Finally, entrepreneurship is more motivated by social interaction for women than men. The results obtained in the benchmark are testified to be reliable after addressing the potential endogeneity of social interactions and using a different regression method.
Blended Learning for Diverse Classrooms: Qualitative Experimental Study With In-Service Teachers
Authors: Ashraf Muhammad Azeem , Tsegay Samson Maekele , Meijia Yang
Published: July 2021

The concept of blended learning, a combination of online and face-to-face learning, has become popular in educational settings. Using qualitative methods, this study investigates the role of blended learning and in-service teachers’ perceptions. Blended learning was used for 19 in-service teachers during their summer degree program at a Chinese university. After the course, teachers were asked to write their reflections on blended learning, its role in diverse classrooms, and using it in their teaching career. The results showed that the teachers appreciated the use of blended learning for diversity, but they were against adopting it in their teaching due to limited pedagogical skills and the exam-oriented education system in China. Moreover, some teachers believed that traditional teaching is more effective for providing students with the necessary knowledge, while blended learning was viewed as difficult to manage. The study provides a better understanding of teachers’ perception of blended learning which contributes to global educational development.