bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral Cavity Cancer Outcomes in Remote, Betel Nut-Endemic Pacific Islands
Authors: Narayanan Ajay M. , Finegersh Andrey F. , Chang Mary P. , Orosco Ryan K. , Moss William J.
Published: June 2020

Background:

Oral cavity carcinomas individually are the fifth-leading cause of overall cancer mortality in the Northern Mariana Islands, which is likely a representative statistic for many other betel-nut-endemic Pacific islands. Factors associated with survival have been minimally evaluated in this region. The purpose of this study is to further characterize oral cavity carcinoma outcomes and associated prognostic factors in the United States commonwealth of the Northern Mariana Islands (CNMI).

Methods:

A single-institution retrospective review was undertaken for 81 patients diagnosed with head and neck cancers at the CNMI’s only regional hospital complex from 2005 to 2019. A subset of patients diagnosed with oral cavity carcinoma was further evaluated for survival outcomes. Cox proportional hazard regressions were performed to evaluate for variables associated with survival.

Results:

A majority of patients had cancer of the oral cavity (64/81, 79%). Fifty-five of these patients had sufficient data for review. The average age at the time of diagnosis was 48 and over half were diagnosed with stage IV disease (29/55, 53%). Five-year overall survival (OS) was 49.5% (95% CI, 33.3-63.7%). Factors associated with worse OS were lymph node metastases at presentation ( P = .031), higher overall stage (III or IV vs I or II, P = .016), and higher T-stage (III or IV vs I or II, P = .027). Those who used betel nut were diagnosed at a significantly younger age than those who did not (47.2 vs 55.4, P = .001).

Conclusions:

The head and neck cancer burden in the CNMI is dominated by betel nut related oral cavity disease that is characterized by delayed presentations in younger patients and decreased OS. Future studies are indicated to improve health literacy as well as to investigate the potential for screening programs.
On the Cost of Detection Response Task Performance on Cognitive Load
Authors: Biondi Francesco N. , Balasingam Balakumar , Ayare Prathamesh
Published: June 2020

Objective

This study investigates the cost of detection response task performance on cognitive load.

Background

Measuring system operator’s cognitive load is a foremost challenge in human factors and ergonomics. The detection response task is a standardized measure of cognitive load. It is hypothesized that, given its simple reaction time structure, it has no cost on cognitive load. We set out to test this hypothesis by utilizing pupil diameter as an alternative metric of cognitive load.

Method

Twenty-eight volunteers completed one of four experimental tasks with increasing levels of cognitive demand (control, 0-back, 1-back, and 2-back) with or without concurrent DRT performance. Pupil diameter was selected as nonintrusive metric of cognitive load. Self-reported workload was also recorded.

Results

A significant main effect of DRT presence was found for pupil diameter and self-reported workload. Larger pupil diameter was found when the n-back task was performed concurrently with the DRT, compared to no-DRT conditions. Consistent results were found for mental workload ratings and n-back performance.

Conclusion

Results indicate that DRT performance produced an added cost on cognitive load. The magnitude of the change in pupil diameter was comparable to that observed when transitioning from a condition of low task load to one where the 2-back was performed. The significant increase in cognitive load accompanying DRT performance was also reflected in higher self-reported workload.

Application

DRT is a valuable tool to measure operator’s cognitive load. However, these results advise caution when discounting it as cost-free metric with no added burden on operator’s cognitive resources.
The Power of the Platform: Place and Employee Responses to Organizational Change
Authors: Stensaker Inger G. , Balogun Julia , Langley Ann
Published: June 2020

This inductive study explores how place influences collective sensemaking and employee responses during organizational change. The empirical setting of our study is an offshore oil platform undergoing changes that involve standardizing operational practices and relocating personnel as two organizations merge. We analyze the narratives of two employee groups and show how employees located onshore construct progressive change narratives, enabling them to adapt to change, while employees located on the offshore oil platform construct regressive narratives leaving them romanticizing the past and struggling to accept change. Our findings illustrate how the manipulation, reconfiguration, and exploitation of place has implications for employees’ capacities to accept and adapt to change.
Self-Reported Experiences of Racial Discrimination Among African Americans in Upstate New York
Authors: Alio Amina P. , Lewis Cindi A. , Elder Heather , Norwood Wade , Mufhandu Kingdom , Keefer Michael C.
Published: June 2020

Racial discrimination in the United States continues to adversely affect health outcomes to the detriment of African Americans. To assess the experiences of residents of a metropolitan community with high rates of racial health disparities in upstate New York, we conducted a survey to measure the primary reasons for discrimination and their experiences with daily and lifetime discrimination, reactions to these experiences, and coping mechanisms. Of the 739 individuals who completed the survey in 2012, 71.5% self-reported as Black or African American. This article focuses on the experiences of Blacks or African Americans, among whom 76.2% reported having experienced racial discrimination at some point in their life. Respondents with higher levels of education and higher income were more likely to report experiencing racial discrimination at work, while for those with a high school education or less it was on the street or public spaces. The burden of these experiences affected individuals by making life more difficult and interfering with a productive life. In light of the known impact of racial discrimination on individual and population health and well-being, it is crucial that efforts to address social and health disparities take into account the high rates of experiences of racism.
The Left-Digit Bias: When and Why Are Consumers Penny Wise and Pound Foolish?
Authors: Sokolova Tatiana , Seenivasan Satheesh , Thomas Manoj
Published: June 2020

Consumers’ price evaluations are influenced by the left-digit bias, wherein consumers judge the difference between $4.00 and $2.99 to be larger than that between $4.01 and $3.00, even though the numeric differences are identical. This research examines when and why consumers are more likely to fall prey to the left-digit bias. The authors propose that the left-digit bias is stronger in stimulus-based price evaluations, wherein people see the focal price and the reference price side by side, and weaker in memory-based price evaluations, wherein people have to retrieve at least one price from memory. This is because in stimulus-based price evaluations, people tend to rely on perceptual representations of prices without rounding them. In memory-based price evaluations, they rely more on conceptual representations, which makes them more likely to round the prices. Results from six studies—five experiments and a scanner panel study—support the hypothesis that the left-digit bias is stronger in stimulus-based evaluations. These results inform managers about when to use left-digit pricing and characterize fundamental differences between stimulus-based and memory-based evaluations.
Urban robotic experimentation: San Francisco, Tokyo and Dubai
Authors: While Aidan H , Marvin Simon , Kovacic Mateja
Published: June 2020

Advances in robotics, artificial intelligence and automation have the potential to transform cities and urban social life. However, robotic restructuring of the city is complicated and contested. Technology is still evolving, robotic infrastructure is expensive and there are technical, trust and safety challenges in bringing robots into dynamic urban environments alongside humans. This article examines the nascent field of ‘urban robotics’ in three emblematic yet diverse national-urban contexts that are leading centres for urban robotic experimentation. Focusing on the experimental application of autonomous social robots, the article explores: (i) the rationale for urban robotic experiments and the interests involved, and (ii) the challenges and outcomes of creating meaningful urban spaces for robotic experimentation. The article makes a distinctive contribution to urban research by illuminating a potentially far-reaching but under-researched area of urban policy. It provides a conceptual framework for mapping and understanding the highly contingent, spatially uneven and socially selective processes of robotic urban experimentation.
Real and fake data in Shanghai’s informal rental housing market: Groundtruthing data scraped from the internet
Authors: Harten Julia Gabriele , Kim Annette M , Brazier J Cressica
Published: June 2020

China’s planned mega-cities contain hidden, informal housing markets. We analyse Shanghai’s ‘group rental’ market in which formal commercial and residential units have been illegally converted into extremely crowded dormitories. In 2016, we collected more than 33,000 online classified advertisements for beds in group rental apartments and find that this market serves a specific demographic with robust preference order patterns. Furthermore, groundtruthing fieldwork revealed that the scraped online data misrepresented the market. Therefore, we also collected a second set of ‘real’ market data for comparative analysis. The study highlights both the exciting possibilities and the limitations of using online content to study informality.
Effective Teaching and Examination Strategies for Undergraduate Learning During COVID-19 School Restrictions
Authors: George Marcus L.
Published: June 2020

On Friday, March 13, 2020, all school teaching in the Republic of Trinidad and Tobago, West Indies was suspended until further notice because of the novel coronavirus COVID-19 pandemic. This immediately jeopardized the completion of course content at the University of the West Indies, St. Augustine campus. This article presents effective teaching and examination strategies that can be utilized in teaching undergraduates during COVID-19 school restrictions. The introductory digital electronics course of the Department of Electrical and Computer Engineering at the University of the West Indies will be utilized to demonstrate the merits of these strategies. The research will focus on demonstrating that the teaching methodologies utilized avoided the student performance from degrading below what has been experienced in the past 5 academic years. Student feedback on the methodology utilized is also incorporated in this article to highlight key benefits gained by students.
Mobilizing solidarity in factory occupations: Activist responses to multinational plant closures
Authors: Gibbs Ewan , Kerr Ewan
Published: June 2020

Factory occupations are rare and sporadic events which shed light on the processes associated with the collective mobilization of workers’ power. This article utilizes Kelly’s agential and Atzeni’s structural explanations of worker mobilization to examine two disputes which took place during Britain’s long experience of deindustrialization: the occupations of Caterpillar’s tractor factory in Uddingston, Scotland, during 1987 and Vestas’ wind turbine plant on the Isle of Wight during 2009. Each occupation shared the context of multinational divestment and collective workforce grievance based on a common perception that their plant was economically viable and vital to the local economy. However, contrasting sources of leadership mobilized this sentiment in each case: union stewards from within Caterpillar, socialist activists from outside at Vestas. The article concludes that an effective explanation of occupations must synthesize structural and agential factors, emphasizing the coalescing role of activist networks and workers’ perceptions of their labour’s social utility.
Perceived Responsiveness Increases Tolerance of Attitude Ambivalence and Enhances Intentions to Behave in an Open-Minded Manner
Authors: Itzchakov Guy , Reis Harry T.
Published: June 2020

Can perceived responsiveness, the belief that meaningful others attend to and react supportively to core defining feature of the self, shape the structure of attitudes? We predicted that perceived responsiveness fosters open-mindedness, which, in turn, allows people to be simultaneously aware of opposing evaluations of an attitude object. We also hypothesized that this process will result in behavior intentions to consider multiple perspectives about the topic. Furthermore, we predicted that perceived responsiveness will enable people to tolerate accessible opposing evaluations without feeling discomfort. We found consistent support for our hypotheses in four laboratory experiments (Studies 1–3, 5) and a diary study (Study 4). Moreover, we found that perceived responsiveness reduces the perception that one’s initial attitude is correct and valid. These findings indicate that attitude structure and behavior intentions can be changed by an interpersonal variable, unrelated to the attitude itself.
“My Kids Are My Priority”: Mothers’ Decisions to Evacuate for Hurricane Irma and Evacuation Intentions for Future Hurricanes
Authors: Brodar Kaitlyn E. , La Greca Annette M. , Tarlow Naomi , Comer Jonathan S.
Published: June 2020

Although families with children are particularly vulnerable in hurricanes, little is known about factors affecting families’ evacuation decisions. Following Hurricane Irma, we evaluated multiple factors potentially influencing mothers’ evacuation decisions and evacuation intentions for future hurricanes. Mothers of children under 18 years (N=536) completed an online survey assessing sociodemographic, hurricane-related, family, and psychological factors, as well as intentions regarding future evacuation. Logistic regression analyses identified factors associated with increased evacuation likelihood. Mothers’ reported reasons for evacuating highlighted family and psychological factors as most critical in decision-making. Mothers who evacuated for Irma or experienced more Irma-related loss/disruption reported significantly greater intention to evacuate for future hurricanes than mothers who did not. Mothers prioritize the safety and comfort of their children and keeping their family together when deciding whether to evacuate. Developing a Family Disaster Plan may facilitate evacuation decisions.
Galectin-3 protects against ischemic stroke by promoting neuro-angiogenesis via apoptosis inhibition and Akt/Caspase regulation
Authors: Wesley Umadevi V , Sutton Ian C , Cunningham Katelin , Jaeger Jacob W , Phan Allan Q , Hatcher James F , Dempsey Robert J
Published: June 2020

Post-stroke neurological deficits and mortality are often associated with vascular disruption and neuronal apoptosis. Galectin-3 (Gal3) is a potent pro-survival and angiogenic factor. However, little is known about its protective role in the cerebral ischemia/reperfusion (I/R) injury. We have previously shown significant up-regulation of Gal3 in the post-stroke rat brain, and that blocking of Gal3 with neutralizing antibody decreases the cerebral blood vessel density. Our current study demonstrates that intracerebral local delivery of the Gal3 into rat brain at the time of reperfusion exerts neuroprotection. Ischemic lesion volume and neuronal cell death were significantly reduced as compared with the vehicle-treated MCAO rat brains. Gal3 increased vessel density and neuronal survival after I/R in rat brains. Importantly, Gal3-treated groups showed significant improvement in motor and sensory functional recovery. Gal3 increased neuronal cell viability under in vitro oxygen–glucose deprivation conditions in association with increased phosphorylated-Akt, decreased phosphorylated-ERK1/2, and reduced caspase-3 activity. Gene expression analysis showed down regulation of pro-apoptotic and inflammatory genes including Fas-ligand, and upregulation of pro-survival and pro-angiogenic genes including Bcl-2, PECAM, and occludin. These results indicate a key role for Gal3 in neuro-vascular protection and functional recovery following ischemic stroke through modulation of angiogenic and apoptotic pathways.
Combined therapy with bronchial artery embolization and tranexamic acid for hemoptysis
Authors: Lee Hyoung Nam , Park Hong Suk , Hyun Dongho , Cho Sung Ki , Park Kwang Bo , Shin Sung Wook , Soo Do Young
Published: June 2020

Background

While most previous studies have viewed tranexamic acid as a bridging or temporary therapy, our preliminary study offers insights into the combined therapy of antifibrinolytic agent with endovascular treatment for hemoptysis.

Purpose

To investigate the feasibility and safety of combined therapy, to analyze factors affecting the outcomes of combined therapy, and to compare the effectiveness of combined therapy between groups with different etiologies.

Material and Methods

Between January 2011 and December 2014, 64 patients (33 men, mean age 64.6 years) underwent combined therapy for hemoptysis. The median follow-up time was 14.7 months (range 174–2435 days). Patients were divided into a tuberculosis group (GroupTB, n=37) and a non-tuberculosis group (Groupnon-TB, n=27).

Results

Embolotherapy was technically successful in 62/64 (96.9%) cases. The immediate clinical success rate was 96.8% (60/62). The short-term and long-term recurrence rates were 12.9% (n=8) and 19.4% (n=12), respectively. The one-, two-, and four-year recurrence-free survival rates were 61%, 49%, and 32%, respectively. There was no significant survival difference between the two groups. Suboptimal embolization was a significant risk factor for immediate clinical failure (odds ratio 29.624, P = 0.023). Optimal embolization (hazard ratio [HR] 0.199, P = 0.023) and older age (HR 0.956, P = 0.013) were significantly associated with lower recurrence risk.

Conclusion

Combined therapy is an effective and safe treatment modality for hemoptysis of various etiologies, with potential benefits for short-term recurrence vis-a-vis current literature evidence. Suboptimal embolization was the most important modifiable risk factor for treatment failure and recurrence after combined therapy.
Attempted and Completed Parricides in South Africa, 1990–2019
Authors: Moen Melanie , Shon Phillip
Published: June 2020

Previous studies of parricide have been carried out predominantly in a Western context, in North America, Australia, and Western Europe. To date, only a handful of studies in parricide have been conducted in continental Africa. Previous studies in Ghana and Zimbabwe note that there may be culture-specific ways in which parricides may be shaped by the norms and cultural beliefs systems within those respective countries. Missing from the literature is an examination of parricides in South Africa. Using newspapers and court records, this article examines the offense and offender characteristics of parricides in South Africa. Our findings suggest that residential patterns of families may shape the offense characteristics found in South African parricides.
Improved regularized extreme learning machine short-term wind speed prediction based on gray correlation analysis
Authors: Yue Wang , Yonggang Li , Binyuan Wu
Published: June 2020

Accurate wind speed prediction is of great significance to the stable operation of the power grid when large-scale wind power is connected to the grid. This article proposes a new multi-step wind speed combination prediction model based on gray correlation analysis. First, the gray correlation analysis is performed on wind speed–related attributes, the more relevant attribute factors are selected as the input set of the prediction model, and the regularized extreme learning machine improved by the cuckoo optimization algorithm is used to perform multi-step prediction of wind speed. Then, an error self-tuning model is established to further improve the prediction accuracy. Finally, the measured results of different wind farms and seasons are selected to simulate the prediction effect of the proposed model, and the prediction accuracy and generalization ability of the proposed model are verified through comparative analysis.
Microscopic and chemical characterization of PVC tube used for dialysis lines: A new approach
Authors: Petrachi Tiziana , Arnaud Gaëlle F , Roncioni Simone , Resca Elisa , Veronesi Elena , Dominici Massimo , Tomasi Aldo , Cuoghi Aurora
Published: June 2020

Polyvinylchloride is universally agreed upon to be the material of choice for tubings and for containers for medical application. Many alterations of the chemical/physical surface conditions, mainly due to an altered extrusion process, could influence its biocompatibility by promoting platelet aggregation. Biocompatibility and safety of the medical device must be preserved, also monitoring the migration of additives within polyvinylchloride during the diffusion process. A large variety of methods are used to verify the correct composition and extrusion of polyvinylchloride but, generally, they need long experimental time and are expensive. The aim of the study is to propose a simple, economic and rapid approach based on Fourier transform-infrared spectroscopy and Coomassie Blue staining. The method has been used to detect chemical and morphological defects caused by an altered extrusion process on 20/75 polyvinylchloride tubings in a blind test. This approach positively identified altered samples in 80% of the cases. The suggested approach represents a reliable and versatile method to detect and monitor surface defects by an easy, inexpensive and reproducible method.
Investigation of residual stresses induced by composite forming using macro-micro simulation
Authors: Wu Qi , Yoshikawa Nobuhiro , Morita Naoki , Ogasawara Tomotaka
Published: June 2020

As the thickness of a composite differs significantly from the size of a representative volume element, composite is studied at both micro- and macroscales. In this study, the synergy between the prescribed displacement boundary and massively parallel computing enables end users to model a composite described in the micro-meter scale and take into account the global influence of the forming process. After validating the software and material models, the residual stresses of a sandwich thermoplastic composite caused by the dynamic thermomechanical forming process were simulated. The results of the macro-micro simulation revealed that the micro structure of a composite consisting of continuous carbon fiber and thermoplastic that have significantly different material properties has a weak impact on temperature distribution throughout the thickness, but exerts a significant influence on the distribution of in-plane stresses. The stresses within a representative volume element at the top and bottom surfaces of the composite layer were further studied to explain the effect of the temperature gradient on the simulated stresses along with the axial and transverse directions of the fiber. The results of this study provide a practical method to reveal actual residual stresses feasibly and efficiently.
Relationship Between Lower Limb Muscle Strength and Future Falls Among Community-Dwelling Older Adults With No History of Falls: A Prospective 1-Year Study
Authors: Porto Jaqueline Mello , Cangussu-Oliveira Luciana Mendes , Freire Júnior Renato Campos , Vieira Flávio Tavares , Capato Luana Letícia , de Oliveira Bruna Garcia Medeiros , de Abreu Daniela Cristina Carvalho
Published: June 2020

Objective: To investigate whether lower limb muscle strength could be a risk factor for the first fall among nonfaller community-dwelling older adults. Method: Hip, knee, and ankle peak torque (PT) was measured with an isokinetic dynamometer in 101 older adults with no history of falls in the previous year. Next, the authors followed up the participants on a monthly basis by telephone contact to determine the occurrence of fall episodes over a period of 1 year. Multivariate logistic regression adjusted for confounding variables was applied to assess the relationship between falls and lower limb PT. Results: there was no association between lower limb PT and future falls ( p > .05). Conclusion: Based on these results, it is important to identify other factors that predispose older adults with no history of falls to falling for the first time, so that early and effective preventive strategies may be elaborated.
Inclusion and Exclusion in Establishing the Delmar Loop Transit-Oriented Development Site
Authors: Baker Dwayne Marshall
Published: June 2020

This research uses St. Louis, Missouri’s proposed Delmar Loop Transit-oriented development (TOD) site as a case study to identify how private interests overshadow overall inclusivity within a TOD space. Through content analysis and interviews, I reveal how establishing the TOD site aims to expand the existing entertainment district, but excludes the site’s predominately black and more transit-dependent West End neighborhood in TOD planning activities. Recognizing how different spaces and residents are excluded in ongoing TOD planning processes aims to highlight the spaces and residents most at risk for future displacement—pointing planners to areas of needed interventions.
Evaluation of the toxic effect of silver nanoparticles and the possible protective effect of ascorbic acid on the parotid glands of albino rats: An in vivo study
Authors: Taghyan Salma Awad , Messiry Hend El , Zainy Medhat Ahmed El
Published: June 2020

This study aimed to evaluate the toxic effect of silver nanoparticles (AgNPs) on the parotid glands (PGs) of albino rats histologically and ultrastructurally and assess the possible protective effect of ascorbic acid as an antioxidant. Thirty male albino rats weighing between 150 mg and 200 mg were divided into three groups: the control group (C1) contained 10 rats that received 2 mg/kg (body weight (bw)) of aqueous nitrate buffer by intraperitoneal (IP) injection daily for 28 days; the AgNPs group contained 10 rats that received 2 mg/kg (bw) IP AgNPs daily for 28 days; and the AgNPs-vitamin C group contained 10 albino rats that received 2 mg/kg (bw) AgNPs IP daily for 28 days with oral administration of 100 mg/kg (bw) vitamin C in drinking water daily for 28 days. The PG acinar and ductal cells of the AgNPs group showed signs of toxicity and degeneration characterized as pleomorphic nuclei, binucleation, cytoplasmic vacuolations, and stagnated secretion in the ductal lumen. In addition to degenerated mitochondria, dilated rough endoplasmic reticulum and lysosomes were filled with AgNPs ( p < 0.001). The AgNPs-vitamin C group showed significantly less degenerative changes histologically and ultrastructurally compared to the AgNPs group ( p = 0.002). AgNPs produced significant toxic effects on the PG of albino rats, presumably through the generation of reactive oxygen species and toxic ion release, and administration of vitamin C was shown effective in decreasing these toxic effects.
Exercise, Flourishing, and the Positivity Ratio in Seventh-Day Adventists: A Prospective Study
Authors: Leibow Michael S. , Lee Jerry W. , Morton Kelly R.
Published: June 2020

Purpose:

Flourishing and mental health in the prediction of health behaviors such as exercise has been understudied. Positive emotions may promote, and negative emotions hinder protective health behaviors; however, the direction of these associations is unclear. The objective here was to investigate possible associations prospectively.

Design:

Longitudinal cohort study.

Setting:

National

Sample:

The Biopsychosocial Religion and Health Study of Seventh-day Adventists provided longitudinal data from 2006 to 2007 and 2010 to 2011 (n = 5789).

Measures:

Flourishing was based on 6 measures of social functioning (positive social exchanges, negative social exchanges, religious emotional support given, received, and anticipated, and negative interactions) and 4 measures of psychological functioning (mastery, self-esteem, spiritual meaning, and perceived stress). The positivity ratio was the ratio of positive to negative emotions assessed with the Positive and Negative Affect Schedule.

Analysis:

Linear multiple regression and mediation.

Results:

Flourishing worked indirectly through the positivity ratio to predict a later increase in exercise over the course of 3 to 5 years. Tests of mediation suggest that the association of flourishing with later exercise was indirect through an increased ratio of positive to negative affect. Initial exercise frequency was also associated with later improved flourishing and positivity ratio scores over the same period.

Conclusion:

The association of mental health and exercise is likely bidirectional. Exercise improves mental health, and those that have better psychosocial functioning have better mood and are more likely to increase exercise behaviors over time. Exercise is likely integral to mental health in mid to late life.
Unilateral Spouse Therapy to Reach the Treatment-Resistant Alcohol Abusing Partner: A Randomized Controlled Trial
Authors: Ager Richard D. , Yoshioka Marianne R. , Adams Kathryn Betts
Published: June 2020

Purpose:

The aim of this research was to implement and evaluate unilateral family therapy (UFT) for alcohol abuse, an approach that assists the nonalcoholic spouse to induce their alcohol-abusing partner to enter treatment and/or reduce drinking.

Method:

Forty-two nonalcohol-abusing spouses participated in this randomized control trial, and 13 no-treatment spouses served as an additional comparison group. Repeated measures analysis over four time periods evaluated change in abuser alcohol use and spouse psychological, marital, and role induction (e.g., enabling) variables, whereas χ2 analyses evaluated alcohol abuser treatment entry.

Results:

The findings suggest that UFT is successful in facilitating abuser treatment entry, drink reduction as well as long-term improvement in the spouse’s psychological health, and marital functioning.

Conclusions:

Given the high numbers of treatment-resistant alcohol abusers in need of treatment and the related distress of their spouses, UFT represents an important approach for practitioners.
The Concerns and Experience of Decision-Making Regarding Do-Not-Resuscitate Orders Among Caregivers in Hospice Palliative Care
Authors: Chiang Ching-Chun , Chang Shu-Chuan , Fan Sheng-Yu
Published: June 2020

A do-not-resuscitate (DNR) order is an important end-of-life decision. In Taiwan, family caregivers are also involved in this decision-making process. This study aimed to explore the concerns and experiences regarding DNR decisions among caregivers in Taiwan. Qualitative study was conducted. Convenience sampling was used, and 26 caregivers were recruited whose patients had a DNR order and had received hospice care or hospice home care. Semi-structured interviews were used for data collection, including the previous experiences of DNR discussions with the patients and medical staff and their concerns and difficulties in decision-making. The data analysis was based on the principle of thematic analysis. Four themes were identified: (1) Patients: The caregivers respected the patients’ willingness and did not want to make them feel like “giving up.” (2) Caregivers’ self: They did not want to intensify the patients’ suffering but sometimes found it emotionally difficult to accept death. (3) Other family members: They were concerned about the other family members’ opinions on DNR orders, their blame, and their views on filial impiety. (4) Medical staff: The information and suggestions from the medical staff were foundational to their decision-making. The caregivers needed the health care professionals’ supports to deal with the concerns from patients and other family members as well as their emotional reactions.
Factors Influencing Timely Preparation of Alveolar Bone Grafting: A Survey of the ACPA
Authors: Jodeh Diana S. , Pringle Aleshia J. , Crisp Taryl , Rottgers S. Alex
Published: June 2020

Objective:

To identify factors that are commonly felt to impact a team’s ability to ensure patients are orthodontically and dentally prepared for alveolar bone grafting at the appropriate time.

Design:

Cross-sectional survey.

Setting:

American Cleft Palate-Craniofacial Association (ACPA)-approved multidisciplinary cleft teams.

Participants:

Cleft team coordinators.

Interventions:

Cleft team coordinators were asked to complete the survey.

Results:

Fifty-three team coordinators from the 167 ACPA-certified cleft teams completed the survey (response rate = 32%). The majority (83.02%) of cleft teams feel having a case manager increases or would increase the rate of timely bone graft preparation. Orthodontic and dental coverage varied greatly between teams with university/hospital employed dentists and volunteer private practice orthodontists representing the most frequent models. The reported percentage of patients seeking regular dental and orthodontic care with providers affiliated with the team did not correlate with the likelihood of timely bone graft preparation ( P = .17; P = .43). Great variability was noted in the manner and frequency of team communication with families during orthodontic bone graft preparation. The presence of a designated case manager on the team was not significantly associated with the percentage of patients who were reported to be orthodontically prepared for bone graft surgery ( P = .25).

Conclusion:

Within our survey data, there is great variability noted in factors that may potentially impact orthodontic bone graft preparation. The majority of teams felt that a case manager did or would help with this process, however, our study does not support this fact. Significant recall bias concerning the success of bone graft preparation may affect these results.
Risk Factor Evaluation for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa in Community-Acquired Pneumonia
Authors: Lewis Paul O.
Published: June 2020

Background:

The 2019 community-acquired pneumonia guidelines recommend using recent respiratory cultures and locally validated epidemiology plus risk factor assessment to determine empirical coverage of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa.

Objective:

To develop a methodology for evaluating local epidemiology and validating local risk factors for P aeruginosa and MRSA.

Methods:

This multicenter, retrospective cohort evaluated adult patients admitted for pneumonia. Risk factors for MRSA and P aeruginosa were evaluated using multivariable logistic regression and reported as adjusted odds ratios (aORs).

Results:

There were 10 723 cases evaluated. Lung abscess/empyema had the highest odds associated with MRSA (aOR = 4.24; P < 0.0001), followed by influenza (aOR = 2.34; P = 0.01), end-stage renal disease (ESRD; aOR = 2.09; P = 0.006), illicit substance use (aOR = 1.7; P = 0.007), and chronic obstructive pulmonary disease (COPD; aOR = 1.26; P = 0.04). For P aeruginosa, the highest odds were in bronchiectasis (aOR = 6.13; P < 0.0001), lung abscess/empyema (aOR = 3.36; P = 0.005), and COPD (aOR = 1.84; P < 0.0001). Isolated COPD without other risk factors did not pose an increased risk of either organism.

Conclusion and Relevance:

Influenza, ESRD, lung abscess/empyema, and illicit substance use were local risk factors for MRSA. Bronchiectasis and lung abscess/empyema were risk factors for Pseudomonas. COPD was associated with MRSA and Pseudomonas. However, isolated COPD had similar rates of MRSA and Pseudomonas pneumonia compared with the total population. This study established a feasible methodology for evaluating local risk factors.
Gastrointestinal Tract Plasmablastic Lymphoma in HIV-Infected Adults: A Histopathological Review
Authors: Mwazha Absalom , Nhlonzi Gamalenkosi Bonginkosi , Mazengenya Pedzisai
Published: June 2020

Background.

Plasmablastic lymphoma (PBL) is an aggressive B-cell lymphoma that is characterized by the expression of plasma cell antigens and loss of pan B-cell antigens. The neoplasm is extensively reported in the oral cavity and anorectal region but rarely in the gastrointestinal tract, where only isolated case reports and small case series have been reported. In the current study, morphologic, immunohistochemical, and molecular features of 17 cases of gastrointestinal tract PBL were reviewed.

Methods.

Ten-year retrospective study that reappraised the histomorphological and immunophenotypical profiles of HIV-associated PBLs in the gastrointestinal tract.

Results.

The mean age of the study patients was 41 years with a 3:1 ratio of males to females. The most common site of tumor origin was the small intestine (42%), followed by the stomach (29%) and the colon (29%). Majority of the cases showed a predominant diffuse (82%) growth pattern. Immunoblasts and plasmablasts were observed in all cases. Plasmacytic differentiation was seen in 5 (29%) cases. Additional observations not previously described or emphasized in literature includes pseudo-alveolar growth pattern, centroblast-predominance, multinucleated giant cells, and clear cell change. Immunohistochemistry revealed absence of pan B-cell antigens and expression of plasma cell antigens in all cases. Epstein-Barr virus–encoded RNA was expressed in 53% of the cases.

Conclusions.

This study highlights the spectrum of histopathological features seen in gastrointestinal tract PBLs. Awareness of this entity and its histopathological features in the gastrointestinal tract is essential for making a timely and accurate diagnosis and improving patient outcomes.
Nonlinear vibration of full-filled fluid corrugated sandwich functionally graded cylindrical shells
Authors: Nguyen Thi Phuong , Nguyen-Thoi Trung , Tran Duy Kien , Ho Duc Tuan , Vu Hoai Nam
Published: June 2020

This article proposes a semianalytical approach for the nonlinear free and forced asymmetric vibration of corrugated sandwich functionally graded cylindrical shells containing fluid under harmonic radial load. The corrugation is considered with two types: trapezoidal corrugation and round corrugation. By using the Donnell shell theory, taking into account the geometrical nonlinearity of von Kármán and an equivalent model for corrugated structures, the governing equations of shell are established. The nonlinear motion equations are reduced to nonlinear differential equation in terms of time by applying the Galerkin procedure. The numerical investigations for the nonlinear dynamic response of cylindrical shells are obtained by using the fourth-order Runge–Kutta method. Numerical results show the very large effects of corrugation and fluid on the natural frequency and nonlinear vibration behavior of shells.
Post-Qualitative Inquiry: Four Balancing Acts in Crafting Alternative Stories to Live By
Authors: Rautio Pauliina
Published: June 2020

Post-qualitative inquiry can be seen to challenge—not fix—at least four elements of what Elizabeth St. Pierre calls conventional humanist qualitative inquiry: the nature of data, the role of methods, the quest for increasing clarity, and the idea of an individual “voice.” In conducting post-qualitative research rather than offering replacements for these or completely renouncing them, I outline four key balancing acts. Unless understood as continuous acts of balancing, post-qualitative inquiry runs a risk of being identified as yet another isolated fortress of righteousness.
Intraoperative identification of persistent left superior vena cava with intracavitary electrocardiogram during venous port insertion: A report of eight cases
Authors: Jheengut Yogesh , Fan Boqiang
Published: June 2020

Persistent left superior vena cava is a rare congenital anomaly, occurring in 0.3% to 0.5% of general population and up to 10% in patients with congenital heart disease. This anomaly is usually discovered incidentally during central venous catheterization from left side. Since 2015, we have identified eight cases of persistent left superior vena cava out of a total of 2637 patients who had left sided venous port insertion in our department. The persistent left superior vena cavae were identified with the aid of intracavitary electrocardiogram. The characteristic finding was an initial negative P-wave (in lead II), followed by a biphasic P-wave pattern during catheter insertion. All the ports worked properly, with a total catheter dwelling time of 2586 days (range: 96–756 days, mean: 323.25 days), and no catheter-related complication was observed. However, because of the paucity of clinical evidence, we should still be prudent in the long-term use of venous ports in persistent left superior vena cava.
Thalamic energy dysfunction is associated with thalamo-cortical tract damage in multiple sclerosis: A diffusion spectroscopy study
Authors: Ricigliano Vito AG , Tonietto Matteo , Palladino Raffaele , Poirion Emilie , De Luca Alberto , Branzoli Francesca , Bera Geraldine , Maillart Elisabeth , Stankoff Bruno , Bodini Benedetta
Published: June 2020

Background:

Diffusion-weighted 1H magnetic resonance spectroscopy (DW-MRS) allows to quantify creatine-phosphocreatine brain diffusivity (ADC(tCr)), whose reduction in multiple sclerosis (MS) has been proposed as a proxy of energy dysfunction.

Objective:

To investigate whether thalamic ADC(tCr) changes are associated with thalamo-cortical tract damage in MS.

Methods:

Twenty patients with MS and 13 healthy controls (HC) were enrolled in a DW-MRS and DW imaging (DWI) study. From DW-MRS, ADC(tCr) and total N-acetyl-aspartate diffusivity (ADC(tNAA)) were extracted in the thalami. Three thalamo-cortical tracts and one non-thalamic control tract were reconstructed from DWI. Fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD), reflecting microstructural integrity, were extracted for each tract. Associations between thalamic ADC(tCr) and tract metrics were assessed using linear regression models adjusting for age, sex, thalamic volume, thalamic ADC(tNAA), and tract-specific lesion load.

Results:

Lower thalamic ADC(tCr) was associated with higher MD and RD of thalamo-cortical projections in MS (MD: p = 0.029; RD: p = 0.017), but not in HC (MD: p = 0.625, interaction term between thalamic ADC(tCr) and group = 0.019; RD: p = 0.320, interaction term = 0.05). Thalamic ADC(tCr) was not associated with microstructural changes of the control tract.

Conclusion:

Reduced thalamic ADC(tCr) correlates with thalamo-cortical tract damage in MS, showing that pathologic changes in thalamic energy metabolism are associated with structural degeneration of connected fibers.
Development and psychometric properties of the Multiple Sclerosis Knowledge Assessment Scale: Rasch analysis of a novel tool for evaluating MS knowledge
Authors: Bessing Barnabas , Honan Cynthia A , van der Mei Ingrid , Taylor Bruce V , Claflin Suzi B
Published: June 2020

Background:

Multiple sclerosis (MS)-related knowledge is an important evaluation metric for health education interventions. However, few MS knowledge assessment tools are currently available for use.

Objectives:

This study aims to develop a reliable and valid Multiple Sclerosis Knowledge Assessment Scale (MSKAS) for use in the MS community and the general public.

Methods:

The MSKAS was developed using a Delphi study methodology and was administered to participants in the first open enrolment of the Understanding Multiple Sclerosis (UMS) online course. Rasch analysis was used to examine its psychometric properties and develop the final scale.

Results:

Experts from across the MS community participated in the development of the MSKAS, resulting in an initial scale of 42 items. Five hundred and forty-three UMS participants completed the MSKAS; 89% were female and 30% were people with MS. The final unidimensional 22-item scale has a person separation index of 2.16, a person reliability index of 0.82, an item separation index of 11.19, and a Cronbach’s alpha (kr-20) test reliability of 0.87.

Conclusion:

The MSKAS is a unidimensional scale with good construct validity and internal consistency. The MSKAS has the potential to be useful for the assessment of MS knowledge in research and clinical practice.
Computationally efficient evaluation of optimum homogeneous charge compression ignition operating range with accelerated multizone engine cycle simulation
Authors: Garcia-Guendulain Juan Manuel , Ramirez-Barron Alejandro , Riesco-Avila José Manuel , Whitesides Russell , Aceves Salvador M
Published: June 2020

The very intensive calculations necessary to define a performance map requiring evaluation of over a hundred individual operating points can be efficiently conducted with accelerated multizone for engine cycle simulation, leading to a definition of regions of acceptable and optimum homogeneous charge compression ignition operation. Accelerated multizone for engine cycle simulation has the virtue of enabling accurate evaluation of many operating conditions based on thermal stratification data from a single fluid mechanics run at motored conditions. This is possible because thermal stratification is more sensitive to engine geometry than to operating conditions. In this article, accuracy of accelerated multizone for engine cycle simulation is demonstrated by comparison with experimental data for iso-octane homogeneous charge compression ignition operation over a broad range of lean equivalence ratios (0.14–0.28). The validated accelerated multizone for engine cycle simulation model is then applied to generating a performance map for an engine controlled by appropriately adjusting equivalence ratio and internal exhaust gas recirculation. Regions of acceptable and optimum combustion are identified. It is finally demonstrated that while indicated mean effective pressure remains low for optimum homogeneous charge compression ignition operation (1–4 bar), this is sufficient for a large fraction of typical driving in light-duty vehicles. Much driving including idle can therefore be done in homogeneous charge compression ignition mode at high efficiency and low (essentially zero) NO x and particulate matter emissions.
Encoder-based weak fault detection for rotating machinery using improved Gaussian process regression
Authors: Ma Zhipeng , Zhao Ming , Chen Shuai , Guo Dong
Published: June 2020

Encoder signal analysis has proven to be a novel and cost-effective tool for the health monitoring of rotating machinery. Nevertheless, how to effectively detect the potential fault utilizing encoder information, especially at an early stage, remains a challenging issue. In light of this limitation, an improved Gaussian process regression analysis is proposed for the weak fault detection of rotating machinery via encoder signal. In this article, the Gaussian process regression model is first introduced to estimate the instantaneous angular speed and its confidence interval. Subsequently, to improve the robustness of Gaussian process regression under weak fault conditions, a spectral density complex kernel is constructed through modeling the spectral density with a mixture of Gaussians. Finally, built upon the eigenvalue decomposition, the optimal inference approach of improved Gaussian process regression is proposed. Compared with other regression methods, the major contribution is that the new method not only enhances the weak fault-related features but also sets their confidence interval adaptively. Using the proposed improved Gaussian process regression, the interference components are suppressed, while the fault-related instantaneous angular speed outliers are accurately detected. In addition, the significance of fault can be quantitatively evaluated according to the confidence level of the improved Gaussian process regression. The simulated and experimental analyses manifest that the proposed improved Gaussian process regression method can effectively identify the early weak fault. It may offer an effective tool for early fault detection of rotating machinery in industrial applications.