bluuebunny/crossref_metadata_2025 huggingface dataset:
Pluralist Ethnobiology: Between Philosophical Reflection and Transdisciplinary Action
Authors: Nieves Delgado Abigail , Ludwig David , El-Hani Charbel
Published: September 2023

In the introduction to this special issue on ethnobiology and philosophy, we consider how the included papers show that ethnobiology is an inherently pluralist project that has a unique potential to foster inter- and transdisciplinary perspectives on issues such as the complex multispecies relations between humans and non-humans that one finds in livelihood practices such as farming and fishing, in conservation management, or in industrial resource extraction, which need to be addressed to deal with planetary challenges from climate change to food inequality. We also argue that a pluralist ethnobiology moves beyond priority disputes between different disciplines by recognizing that its foundations are inherently diverse but still embraces intellectual synthesis that brings insights from various fields together. We provide, finally, an overview of the contributions to the special issue.
Applying the results of a U.S.-based national resilient design education study in the field and the classroom during disaster recovery operations
Authors: Smith Gavin , Nguyen Mai Thi
Published: September 2023

This article discusses the results of a study assessing the state of disaster resilient design education at U.S. colleges and universities including architecture, building sciences, land use planning, landscape architecture, and engineering. Based on our findings, we describe proposed future directions for resilient design education, including drawing lessons from a disaster recovery case study titled the Hurricane Matthew Disaster Recovery and Resilience Initiative (HMDRRI). This two-year student and faculty engagement effort assisted six hard-hit under-resourced communities based on a set of needs identified by participating jurisdictions that were not being addressed by governmental or non-profit agencies and organizations. Understood in the context of the study, HMDRRI has been used to address identified educational shortfalls found in our research and to further the goals of two graduate certificate programs advancing disaster resilience. The key aims of both programs are to build the skills required of the next generation of researchers and practitioners to better understand the complexities of disaster recovery and to apply that experiential knowledge to help improve disaster recovery processes and outcomes throughout their careers.
Does urbanization depend on in-migration? Demography, mobility, and India's urban transition
Authors: Randolph Gregory F
Published: September 2023

The urban transition is generally imagined as a large-scale permanent migration of people from villages to cities. The formation of new cities is also theorized as occurring through the migration of people. However, recent scholarship implies that parts of India may be witnessing an urbanization process that depends on natural population growth rather than in-migration. This claim carries significant implications for urban theory, but it has never been tested empirically. This article addresses that gap by examining migration patterns in India alongside urbanization—measured in terms of densification of population and built-up area and an economic transition away from agriculture. I find that certain parts of the country, notably the eastern Indo-Gangetic Plain, are exhibiting all the trends constitutive of urbanization even as they experience negative net migration—a phenomenon I term “urbanization from within.” My analysis also highlights that these same regions see high rates of temporary out-migration—suggesting that human mobilities may play a role in the in situ urbanization of rural settlements, but not in the ways that foundational urban and development theories would predict. I discuss the inequalities of India's economic transition and its spatial regime of social welfare as possible causal underpinnings of the trends I observe. The article's findings suggest that urban social scientists should reevaluate long-held assumptions about the relationship between urbanization and migration in the context of 21st-century urban transitions.
The double-whammy trauma: Narrative and counter-narrative during COVID–Floyd
Authors: Alexander Jeffrey C
Published: September 2023

Written in the early months of the COVID pandemic, and in the midst of the second wave of Black Lives Matters protest, this article suggests that Americans experienced these shocking social events as a double-whammy cultural trauma, as deeply troubling to their collective identity as nation. How the trauma played out would determine the near-term future of American politics. Were the poor and non-white the principal victims of the double whammy, or were white Americans and the ‘hard-working middle class’ actually the injured parties? Who was the trauma’s perpetrator? Was it China, inadequate healthcare, government bureaucracy, or Trump and ‘know-nothing’ populism? The performances that provided the most felicitous answers to such questions would determine whether the country moved to the left or the right in the months before the Presidential election that would take place before year’s end.
Prediction of consolidation quality in laser-assisted AFP and effect of blank quality on stamp forming
Authors: Seefried Kilian , Bezerra Renato , Drechsler Klaus
Published: September 2023

This paper presents a parameter study into the thermoplastic-automated fibre placement process. The material used was carbon fibre-reinforced LM-PAEK unidirectional tape. The overall objective of this investigation was the derivation of regression models to describe and predict the consolidation quality of laminates in dependence on the main process parameters of the lay-up process. Furthermore, post-consolidation by stamp forming was investigated to analyse the impact of the initial quality of the blank on post-forming laminate quality. With the parameter study performed, prediction models for the degree of bonding and crystallinity could be derived. In addition, a more comprehensive understanding of the process parameter influences and the definition of parameter limits to distinguish between rapid and in situ lay-up processes was achieved. Furthermore, the potential of the process chain consisting of rapid lay-up and stamp forming for producing high-quality laminates was demonstrated for the investigated LM-PAEK tape.
Effect of Auricular Acupressure in Management of Constipation in Palliative Care Patients
Authors: Biçak Ayik Derya , Can Gülbeyaz
Published: September 2023

Objectives: This experimental randomized-controlled study was performed to define the efficacy of auricular acupressure (AA) in the management of constipation developing in palliative care patients. Methods: According to the pre-prepared randomization list, 44 patients were included in the experimental group and 46 patients were included in the control group. Routine clinical treatment and care implementation were maintained in the patients in both groups. AA was performed for 4 weeks in patients in the experimental group. During the study, to determine the complaints of the patients regarding constipation, the information in the daily patient chart was examined at least 5 times by interviewing with the patient/patient's relative in the clinic and/or via phone call, and the results were recorded in the patient chart and data collection forms. The independent variable of the study is AA application, and the dependent variables are constipation and quality of life. Results: It was determined that there was no statistically significant difference between the daily defecation frequency of the 2 groups during the first 11 days. However, after the 12th day, the daily stool frequency of the experimental group was higher compared to the control group and this difference obtained between the 2 groups was statistically significantly different. AA was effective in decreasing laxative use. Conclusion: This intervention increased stool frequency, reduced physical and psychosocial symptoms, anxieties, and improved stool satisfaction and it was an effective approach to improving the quality of life. It is recommended that the daily use of AA should be evaluated. The healthcare providers including nurses, patients, and patient relatives should be trained regarding AA.
School administrators’ experiences implementing a college and career readiness reform initiative
Authors: Erin Biolchino
Published: September 2023

This paper shares results from a qualitative interview study about site- and district-level administrators' experiences and perceptions implementing a significant college and career readiness reform initiative. Linked Learning (LL) is one college and career readiness reform that has been growing in the U.S. and internationally in recent years. Linked Learning began in 2009 with nine school districts in CA, and currently there are 659 LL pathways across 20 states and 3 countries (Linked Learning Alliance, 2023). Twenty administrators from California schools and districts were interviewed using a protocol developed using Curry's (1992) model of reform implementation and institutionalization and the four core components of Linked Learning. Four significant themes emerged from the data related to advice that administrators shared for implementing a comprehensive school reform: know your stuff, follow your passion, plan your route, and build your team. Overall, these administrators recommended that the reform initiative within an organization should start with the hiring process to build a knowledgeable, passionate team and that personnel, including leaders, need support and training in order to effectively move a reform from the implementation to the institutionalization stage.
Static and dynamic behaviour of aluminium infiltrated ceramic foam at high volume fraction
Authors: Ramalingam Sindhumathi , Vijayan Krishnaraj , Nampoothiri Jayakrishnan , Achuthamenon Sylajakumari Prasanth
Published: September 2023

Ceramics are used in ballistic protection applications for their high hardness and compressive strength; however, they are brittle and shock-sensitive. Co-continuous ceramic composite (C4) infused with a ductile phase can compensate for the brittleness of the ceramic and increase energy absorption with a potential weight reduction in comparison with present multilayer armours. Nevertheless, the research on C4 for armour applications is in its infant stage. This article aims to investigate the energy absorption characteristics of C4 composites with ballistic grade Al5083 infiltrated into different volume fractions of SiC foam (10PPI, 20PPI and 30PPI). The infiltrated C4 samples have 13, 15 and 18 volume percent of SiC in 10PPI-C4, 20PPI-C4 and 30PPI-C4 respectively. The uniaxial compression test of C4 samples revealed that 30PPI-C4 samples have 135 times high compression strength than ceramic preforms and hardness of C4 also enhanced by 13% for 30PPI-C4 samples. The gas gun impact and Split Hopkinson Pressure Bar (SHPB) tests on the 30PPI-C4 specimens reveals that their specific energy absorption (SEA) are 78% and 30% higher than those of 10PPI-C4 and 20PPI-C4 respectively.
Experimental study on ultrasonic vibration assisted grinding of GCr15SiMn bearing steel
Authors: Ma Mingyang , Xiang Daohui , Lei Xiaofei , Peng Peicheng , Yuan Zhaojie , Li Yanqin , Gao Guofu , Jiao Feng , Zhao Bo
Published: September 2023

Many problems of GCr15SiMn high-carbon chromium bearing steel have been found in the ordinary grinding (OG) process. Aiming at the problems of high grinding force, low residual compressive stress and low surface quality, ultrasonic machining technology is combined with OG. The test of ultrasonic vibration assisted grinding (UVAG) GCr15SiMn high carbon chromium bearing steel is carried out. The residual stress, surface roughness, grinding force, and surface morphology are analyzed by changing machining parameters. The research showed that as the grinding depth and feed speed become larger, the grinding force increased, when the spindle speed rises, the grinding force becomes smaller. In the test range, with the ultrasonic amplitude from small to large, the grinding force from large to small. The ultrasonic grinding force is 27.8% lower than that of OG. The surface roughness increases with increasing grinding depth and feed speed and decreases with increasing spindle speed and ultrasonic amplitude, and at an amplitude of 6 μm, the surface roughness is reduced by 27% compared to OG. When the feed speed and grinding depth are lowered or the ultrasonic amplitude is increased, the surface residual compressive stress is increased. Compared to OG, it is increased by more than 13.5% under the same parameters. At the same time, the phenomenon of burrs and surface tears can be reduced, and the surface quality of the workpiece becomes better.
Experimental investigation on bamboo fiber reinforced epoxy polymer composite materials developed through two different techniques
Authors: Barman Parthapratim , Dutta Polash P , Bardalai Monoj , Dutta Partha P
Published: September 2023

In this study, the thermos-mechanical characteristics of bamboo fiber-reinforced epoxy polymer composites made by compression molding and hand lay-up techniques are discussed. A lab-scale compression molding machine was fabricated for this purpose using the scrap materials of the Central workshop of Tezpur University, India. To find the suitable NaOH concentration for bamboo fiber strip treatment, bamboo strips were treated with 5, 8, 12, and 15 wt.% NaOH solutions for 12 h in each sample. It is determined that 12 wt.% NaOH treated bamboo strips were optimal for the fabrication of composites by single fiber tensile test, single fiber pull-out test, scanning electron microscopy (SEM), and Fourier transforms infrared spectroscopy (FTIR). Alkali treatment improved the interfacial strength with epoxy resin. It is seen that 8, 12, and 15 wt.% NaOH treated bamboo fiber strips become more compatible with the resin. The investigation explored the effects of mechanical and thermal characteristics of composites fabricated by the two different fabrication techniques. The thermal behavior of composites was investigated using thermogravimetric analysis (TGA). The Mechanical properties of composites produced by compression molding machine are found to be better than the hand lay-up method.
An energy saving rule-based strategy for electric-hydraulic hybrid wheel loaders
Authors: Wang Feng , Wen Qunya , Xu Bing
Published: September 2023

Recently, hybrid electric vehicles are getting popular as they are both clean and efficient. As one of the hybrid electric powertrains, the battery powered parallel electric-hydraulic hybrid powertrain (PEHHP) is zero emission and has better drive performance. But the energy use of the PEHHP highly depends on the control strategy. A proper energy management strategy is critical for torque distribution and hybrid powertrain efficiency improvement. In this paper, a real-time rule-based strategy is proposed to determine the torque distributions of the PEHHP. The proposed rule-based strategy is based on the component efficiency analysis. And it optimizes the electric motor operating points. Experiments are conducted to show the operation results of the parallel electric-hydraulic hybrid wheel loaders. The powertrain energy use of the proposed rule-based strategy is close to that of the global optimal dynamic programing strategy, with energy use gaps of 2.99%, and 6.10% in simulation and experiment respectively.
Thermo-hydraulic performance augmentation in residential heating applications using a novel multi-fluid heat exchanger with helical coil tube insertion
Authors: Almasri Belal , Mishra Sudhansu S , Mohapatra Taraprasad
Published: September 2023

This study proposes a heat transfer augmentation technique using a brazed helix tube (BHT) fabricated from a helical tube with precision brazing between coil turns in a novel multi-fluid heat exchanger (NMFHE) for simultaneous heating of water and air using solar energy. The thermo-hydraulic performance of the present NMFHE for residential heating of water (CW) and air (CA) using hot water (HW) is tested experimentally. Nusselt number and friction factor for fluid flow inside the NMFHE are calculated as the thermo-hydraulic measure relating to variations in flow rate, inlet temperature, and flow configuration. Optimal flow parameters for overall optimized performances that is, maximum heat transfer and minimum pressure drop in NMFHE are determined using the Taguchi Grey relational approach. NMFHE performs efficiently in the Counterflow (cold water reverse) flow configuration with HW flow rate of 100 LPH, CW flow rate of 200 LPH, and HW inlet temperature of 70°C. The CW flow rate has the greatest impact on both the Nusselt number and friction factor, with a contribution of 82.37% and 93.42%, respectively. A confirmation test has been conducted to validate the findings, revealing a significant performance improvement of 32.19% when using the Grey relational grade model.
Spatial analysis of carbon emission effect of financial development in Africa: The role of energy and socioeconomic factors
Authors: Espoir Delphin K , Mudiangombe Benjamin M , Sunge Regret , Alola Andrew A
Published: September 2023

The need to mitigate global warming has led policymakers and other stakeholders to see further understanding of the driving forces behind CO2emissions. Financial development has been identified among the most influential factors. However, its importance has not been well explored in developing countries, especially in Africa. Several studies have explored the CO2emissions-effects of financial development in Africa but focused on the temporal aspect and overlooked the spatial dependence which has the potential to influence the estimated marginal effects. In so doing, they consider each country as an island which tends to suggest that there are no spatial spillover effects that could originate from countries’ proximity. In this study, such an inaccurate assumption is relaxed by deploying a spatial Durbin model to explore the spatial dependence in the financial development-CO2emissions nexus for 52 African countries between 1995 and 2017. Our results reveal a significant positive direct effect (0.020) on financial development in a given country and a significant positive indirect effect (0.074). Thus, our estimated marginal effects show a positive and significant total effect (0.095), indicating that a 1% increase in financial development will result in a net increase of CO2emissions of about 0.095%. This finding implies that financial development contributes negatively to the surge of CO2emissions in Africa. While the environmental Kuznets curve hypothesis is validated in the continent, renewable energy utilization is found to posit significant environmental effects. This finding is crucial to policymakers as it stands as a reminder about the role of the neighbourhood in designing and implementing environmentally friendly policies that aim at reducing pollution in Africa.
Renewable energy generation, agricultural value added and globalization in relation to environmental degradation in the five most populous countries in Asia
Authors: Ali Arshad , Xiangyu Guo
Published: September 2023

This study aims to examine the impact of globalization, renewable energy generation, and agricultural value addition on the ecological footprint (EF) and carbon emissions (CO2) of selected five most populous countries in Asia during the period 1975–2020. The Westerlund cointegration test supports long-term cointegration relationships among the considered variables in selected countries. The long-term elasticity results of the mean group, augmented mean group, and common correlated effects mean group estimators clearly show that agricultural value added and globalization make significant contributions to the ecological footprint and carbon emissions of the five most populous countries in Asia. However, renewable energy generation significantly reduces the ecological footprint and carbon emissions. Moreover, the impact of gross domestic product (GDP) on ecological footprint and carbon emissions is significantly positive while the impact of GDP2 on ecological footprint and carbon emissions is significantly negative, thus validating the inverted U-shaped Environmental Kuznets Curve hypothesis for specific Asian densely populated countries. The results of the causality test indicated a two-way causality between renewable energy generation and ecological footprint, supporting the feedback hypothesis. There is also a two-way causal relationship between agricultural value added and ecological footprint. Overall, these empirical results show that renewable energy plays a prominent role in combating environmental pollution in selected densely populated Asian countries. Thus, these countries should achieve their sustainable development goals by cultivating existing renewable energy generation policies. Moreover, specific densely populated countries in Asia should encourage clean energy production and consumption in the agricultural sector, and increased investment in renewable energy can improve environmental quality and agricultural production.
Congenital Hepatic Arteriovenous Malformation: Often Missed Cause for Neonatal Pulmonary Arterial Hypertension
Authors: Bhoojata G , Laxman S , Rao PV Rama
Published: September 2023

Congenital hepatic arteriovenous malformations (AVM) are extremely rare, with an incidence of less than 1 in 1 hundred thousand, and the literature is limited to only a few case reports. They are characterised by an abnormal arterial connection to a fistulous venous connection within the liver. This results in high flow, low resistance circulation that causes high output cardiac failure. We report a late-preterm male newborn who presented with respiratory distress and signs of cardiac failure on day 1 of life. The newborn is diagnosed with hepatic AVM as the cause of severe pulmonary arterial hypertension (PAH) and cardiac failure. This case report, along with the literature review, emphasises the need for a high index of suspicion to look for hepatic AVM in a newborn presenting with unexplained PAH and cardiac failure and also discusses different management strategies for hepatic AVM.
Validation of a multiplex microsphere immunoassay for detection of antibodies to Trypanosoma cruzi in dogs
Authors: Rodriguez Carlos A. , Busselman Rachel E. , Shen Huifeng , Saunders Ashley B. , Tarleton Rick , Hamer Sarah A.
Published: September 2023

The vector-borne protozoan parasite Trypanosoma cruzi causes Chagas disease in humans, dogs, and many other mammalian hosts. Canine Chagas disease is increasingly diagnosed in dogs of the southern United States where triatomine insect vectors occur, and there are limited veterinary testing options; only the indirect fluorescent antibody (IFA) test is offered at a single accredited diagnostic laboratory. We evaluated a multiplex microsphere immunoassay (MIA) for the detection of antibodies against T. cruzi in dogs and compared it with existing serologic methods to establish cutoff values and relative sensitivity and specificity. We tested 135 canine sera that had been characterized using the IFA and off-label use of 2 commercial rapid assays with our multiplex MIA against 12 antigens: 9 T. cruzi antigens, a negative control recombinant protein (green fluorescent protein, GFP), a Leishmania antigen, and a canine parvovirus antigen (used as an antibody control given near-ubiquitous parvoviral vaccination). The median fluorescence intensity (MFI) ratio between each T. cruzi antigen and GFP was calculated for every sample. Samples with an antigen:GFP MFI ratio > 4 SDs above the mean of 25 known-negative sera were considered positive to that antigen. Samples testing positive to ≥ 2 antigens were considered positive for T. cruzi antibodies. Compared to the IFA, our multiplex MIA had a relative sensitivity of 100% and specificity of 97.0%. Given its precision, high-throughput format, potential for automation, and lack of subjective interpretation, our multiplex MIA should be considered a valid and improved assay for T. cruzi antibodies in dogs.
Prediction of Preterm Birth among Infants with Orofacial Cleft Defects
Authors: Ludorf Katherine L. , Benjamin Renata H. , Canfield Mark A. , Swartz Michael D. , Agopian A. J.
Published: September 2023

Objective

To develop risk prediction models for preterm birth among infants with orofacial clefts.

Design

Data from the Texas Birth Defects Registry for infants with orofacial clefts born between 1999-2014 were used to develop preterm birth predictive models. Logistic regression was used to consider maternal and infant characteristics, and internal validation of the final model was performed using bootstrapping methods. The area under the curve (AUC) statistic was generated to assess model performance, and separate predictive models were built and validated for infants with cleft lip and cleft palate alone. Several secondary analyses were conducted among subgroups of interest.

Setting

State-wide, population-based Registry data.

Patients/Participants

6774 infants with orofacial clefts born in Texas between 1999-2014.

Main Outcome Measure(s)

Preterm birth among infants with orofacial clefts.

Results

The final predictive model performed modestly, with an optimism-corrected AUC of 0.67 among all infants with orofacial clefts. The optimism-corrected models for cleft lip (with or without cleft palate) and cleft palate alone had similar predictive capability, with AUCs of 0.66 and 0.67, respectively. Secondary analyses had similar results, but the model among infants with delivery prior to 32 weeks demonstrated higher optimism-corrected predictive capability (AUC = 0.74).

Conclusions

This study provides a first step towards predicting preterm birth risk among infants with orofacial clefts. Identifying pregnancies affected by orofacial clefts at the highest risk for preterm birth may lead to new avenues for improving outcomes among these infants.
Understanding Family Violence From a Therapeutic Lens
Authors: Williams Amber D
Published: September 2023

Mitigating and understanding family violence is the cornerstone of this paper. Family violence can happen for multiple reasons without any exclusivity. A firsthand account of how I experienced violence in my life will be discussed to give meaning to my worldview and therapeutic lens. Exploration of family violence theories ranging from the ecological model to feminist theory will be conducted. Comprehending sexual minority violence must become a priority to move the conversation forward and emphasize inclusivity. Family violence ethical components are considered. Conclusively, understanding family violence fully prepares a therapist to deal with various presenting problems daily.
Assessment of Specific Learning Disabilities and Intellectual Disabilities
Authors: Fletcher Jack M. , Miciak Jeremy
Published: September 2023

We review literature related to the assessment and identification of Specific Learning Disabilities (SLD) and Intellectual Disabilities (ID). SLD and ID are the only two disorders requiring psychometric test performance for identification within the group of neurodevelopmental disorders in Diagnostic and Statistical Manual – 5. SLD and ID are considered exclusionary of one another, but the processes for assessment and identification of each disorder vary. There is controversy about the identification and assessment methods for SLD, with little consensus. Unlike ID, SLD is weakly related to full-scale IQ, and there is insufficient evidence that the routine assessment of IQ or cognitive skills adds value to SLD identification and treatment. We have proposed a hybrid method based on the assessment of low achievement with norm-referenced tests, instructional response, and other disorders and contextual factors that may be comorbid or contraindicative of SLD. In contrast to SLD, there is strong consensus for a three-prong definition for the identification and assessment of ID: (a) significantly subaverage IQ, (b) adaptive behavior deficits that interfere with independent living in the community, and (c) age of onset in the developmental period. For both SLD and ID, we identify areas of controversy and best practices for identification and assessment.
Prognostic Values of Prothrombin Time and Inflammation-Related Parameter in Acute Ischemic Stroke Patients After Intravenous Thrombolysis with rt-PA
Authors: Zhao Jingru , Dong Lipeng , Hui Shuo , Lu Fan , Xie Yanzhao , Chang Yanzhong , Yang Baoming
Published: September 2023

In previous studies, prothrombin time (PT), systemic inflammation response index (SIRI) and systemic immune inflammation Index (SII) levels might be the prognostic factors for patients with ischemic stroke. However, the association between these coagulation and inflammation biomarkers and prognosis in patients with acute ischemic stroke (AIS) who undergo intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) remains unclear and needs further study. Thus, this study aimed to investigate the relationship between these biomarkers and clinical prognosis after IVT in AIS patients. We included patients at the Hebei general hospital diagnosed with AIS who received standard-dose IVT with rt-PA from September 2017 to August 2022. Demographic information, vascular risk factors, laboratory test results, and other stroke-related data were collected for analysis. Clinical outcomes included short-term outcome at 24 h and functional outcome at 3 months. We enrolled 281 patients in this study. In total, 16 patients had END within 24 h, and 106 patients had an unfavorable outcome at the 3-month visit. In the multivariate analysis, PT level (OR = 1.833; 95% CI: 1.161–2.893; P = 0.009), SIRI level (OR = 2.166; 95% CI: 1.014–4.629; P = 0.046) and SII level (OR = 1.002; 95% CI: 1.000–1.003; P = 0.021) were independently associated with 3-month poor outcome in AIS patients with IVT. In conclusion, the higher PT, SIRI and SII levels were independently associated with poor prognosis in AIS patients after IVT. Additionally, PT, SIRI and SII all can be novel short-term prognostic biomarkers for AIS patients treated with IVT.
Dose reduction and toxicity of lenalidomide-dexamethasone in multiple myeloma: A machine-learning prediction model
Authors: Maray Iván , Álvarez-Asteinza Cristina , Fernández-Laguna Clara Luz , Macía-Rivas Lola , Carbajales-Álvarez Mónica , Lozano-Blazquez Ana
Published: September 2023

Purpose

Lenalidomide remains an effective drug for multiple myeloma, but it is often associated with adverse events and requires dose adjustments. The objective of this study was to propose a model for predicting whether a patient would require dose adjustment.

Methods

This retrospective observational study included patients treated with lenalidomide and dexamethasone from June 2014 to September 2018 at a tertiary hospital. Demographic variables, patient functional status, disease, analytical data specific to myeloma, and treatment-related variables were collected. Univariate and machine learning (logistic regression and classification and regression trees model) analyses were also performed. Kaplan–Meier analysis was used to determine the time of toxicity onset. Only lenalidomide (and not dexamethasone) related dose reductions are included.

Results

A total of 64 patients received lenalidomide-dexamethasone. 69% (44) required dose reduction or discontinuation of treatment due to lenalidomide-related adverse events. The median time between treatment beginning and lenalidomide dose reduction or discontinuation was 8.0 months (95% CI: 6.0–17.0). Age, platelet count, and neutrophil count were related to dose reduction in the univariate model. In the multivariate models, age and neutrophil count were significant in the logistic regression model, renal clearance, and neutrophil count in the classification and regression trees model.

Conclusion

Elderly patients and those with low bone marrow reserves are prone to dose-limiting adverse events. This study can aid in making follow-up, prophylaxis, and dosing decisions to achieve better pharmacotherapeutic results.
A Systematic and Visual Overview of 25 Years of the Journal of Service Research: The Journey Continues
Authors: Wetzels Martin , Grewal Dhruv , Wetzels Ruud
Published: September 2023

When Journal of Service Research (JSR) completed its fifth lustrum in 2022, it offered an ideal opportunity to celebrate the present, review the past, and look forward to the service research community’s future. In reference to JSR’s specific aims to be rigorous, multidisciplinary, managerially relevant, and impactful, the current mixed-method study examines its evolution, thereby offering guidance for further research in the service domain. A newly identified, underlying topical structure embeds 15 research themes; it also reveals increasing disciplinarity among JSR publications’ theoretical roots, affirming the multidisciplinary focus the journal has achieved. Regarding academic impact, JSR accounts for around one-eighth (12.4%) of the service articles but nearly one-third of citations (30.0%) in the service domain. Similarly, in terms of practical impact, with a share of approximately 24.0% in the service articles that received media coverage, JSR publications are responsible for around 37.1% of the service domain’s media mentions. To increase these impacts, service scholars can use the insights generated herein to identify and pursue trajectories that warrant additional exploration.
Reclaiming Healthcare’s Healing Mission for a Sustainable Future
Authors: Berry Leonard L. , Yadav Manjit S. , Hole Michael K.
Published: September 2023

Healthcare in the United States has reached a point where it is unsustainable for the long term, particularly for the poor, the elderly, and healthcare workers (HCWs) themselves. We propose a framework for making U.S. healthcare more sustainable, whereby the service returns to its core mission of healing. The framework casts that healing mission in broadly applicable, practical terms, whereby leaders of healthcare organizations and in the wider for-profit, not-for-profit, and governmental healthcare ecosystem take concrete steps to improve outcomes for patients and HCWs. Those steps involve aligning healthcare resources, incentives, and policies with the core mission of healing and then implementing change in specific ways that particular organizations have already shown are achievable and sustainable. We use those examples to illustrate how healing-oriented innovations in healthcare delivery get deployed and how progress toward sustainability then ensues. Lessons from these efforts can be tailored to individual healthcare contexts and institutions—and then applied on a national scale. The discussed initiatives can also guide the direction of future research on healthcare sustainability.
Efficacy and safety of intense pulsed light of upper and lower eyelids in Meibomian gland dysfunction: A prospective multicentric study
Authors: Benitez-del-Castillo Jose Manuel , López-Pérez María Dolores , Cano-Ortiz Antonio , Peris-Martinez Cristina , Pinar-Sueiro Sergio , Gessa-Sorroche Maria , García-Franco-Zuñiga Carmen , Iradier Maria T , Amesty Maria A , Burgos-Blasco Barbara
Published: September 2023

Purpose

To demonstrate that intense pulsed light therapy (IPL) of the upper and lower eyelids with meibomian gland expression (MGX) is effective in improving dry eye disease due to meibomian gland dysfunction (MGD).

Methods

Patients with ocular discomfort (Ocular Surface Disease Index -OSDI- above 13) and signs of MGD were recruited. All patients underwent OSDI, visual acuity (VA), intraocular pressure, Schirmer test, meibography, non-invasive tear breakup time (NITBUT), slit-lamp examination (corneal and conjunctival staining, hyperemia, gland expressibility, and meibum quality), tear osmolarity and lipid layer thickness. IPL was performed with Optima IPL (Lumenis Ltd.) following a standardized protocol on upper and lower eyelids of both eyes, with inferior eyelid MGX. Patients received four sessions separated by two weeks each. Four weeks after, examinations were repeated.

Results

160 patients (320 eyes) were included, of which 108 (67.5%) were women and mean age was 59.2 ± 15.08 (range 20–89). After four sessions, VA, OSDI, tear osmolarity, lipid layer thickness, NITBUT, hyperemia, corneal and conjunctival staining, gland expressibility, meibum quality, inferior eyelid Meiboscore and Schirmer test improved (all, p < 0.027). Changes in OSDI, initial and average NITBUT increased with dry eye disease severity (according to OSDI). Increased pre-treatment OSDI, hyperemia, corneal and conjunctival staining and Schirmer test were associated with an improvement in OSDI (all, p < 0.040). No adverse events were noted.

Conclusions

The combination of IPL on upper and lower eyelids with MGX is safe and effective for the treatment of MGD. Patients with severe dry eye disease present greater improvements.
Understanding and interpreting CNN's decision in optical coherence tomography-based AMD detection
Authors: Azoad ahnaf S. M. , Saha Sajib , Frost Shaun , Atiqur Rahaman G. M.
Published: September 2023

Introduction

Automated assessment of age-related macular degeneration (AMD) using optical coherence tomography (OCT) has gained significant research attention in recent years. Though a list of convolutional neural network (CNN)-based methods has been proposed recently, methods that uncover the decision-making process of CNNs or critically interpret CNNs’ decisions in the context are scant. This study aims to bridge this research gap.

Methods

We independently trained several state-of-the-art CNN models, namely, VGG16, VGG19, Xception, ResNet50, InceptionResNetV2 for AMD detection and applied CNN visualization techniques, namely, Grad-CAM, Grad-CAM++, Score CAM, Faster Score CAM to highlight the regions of interest utilized by the CNNs in the context. Retinal layer segmentation methods were also developed to explore how the CNN regions of interest related to the layers of the retinal structure. Extensive experiments involving 2130 SD-OCT scans collected from Duke University were performed.

Results

Experimental analysis shows that Outer Nuclear Layer to Inner Segment Myeloid (ONL-ISM) influences the AMD detection decision heavily as evident from the normalized intersection (NI) scores. For AMD cases the obtained average NI scores were respectively 13.13%, 17.2%, 9.7%, 10.95%, and 11.31% for VGG16, VGG19, ResNet50, Xception, and Inception ResNet V2, whereas, for normal cases, these values were respectively 21.7%, 21.3%, 16.85%, 10.175% and 16%.

Conclusion

Critical analysis reveals that the ONL-ISM is the most contributing layer in determining AMD, followed by Nerve Fiber Layer to Inner Plexiform Layer (NFL-IPL).
Pregnancy outcomes in the medical management of glaucoma: An international multicenter descriptive survey
Authors: Kaufman Aaron R , Ali Al-Djasim Leyla , Rivkin Angeline C , Al-Futais Muneera , Venkataraman Ganesh , Vimalanathan Menaka , Sahu Abhipsa , Ahluwalia Navjot Singh , Shakya Rakesh , Vajaranant Thasarat Sutabutr , Wilensky Jacob T , Edward Deepak P , Aref Ahmad A
Published: September 2023

Purpose

To determine if glaucoma medications are associated with pregnancy and/or postnatal complications.

Methods

Multicenter descriptive survey. Subjects were female patients 18–45 years who were previously pregnant with a diagnosis of glaucoma or ocular hypertension prior to pregnancy. Chart review queried diagnosis, glaucoma severity, and race. Survey questions were asked for each pregnancy and queried pregnancy age, medications used, and pregnancy outcomes/complications.

Results

114 pregnancies of 56 patients (mean 2.0 pregnancies per patient) were included. Three pregnancies with therapeutic abortion were excluded from further analysis. Mean age during pregnancy was 29.1 ± 5.7 years. Of the 111 pregnancies, 20 (18.0%) used no medications and 91 (82.0%) used at least one medication. Medications were topical carbonic anhydrase inhibitors (n = 45), beta-blockers (n = 55), alpha-agonists (n = 56), and prostaglandin analogues (n = 28). Outcomes were: preterm contractions/labour (6.3%), miscarriage (4.5%), stillbirth (4.5%), induction of labour (11.9%), emergency/unplanned caesarean delivery (13.9%), neonatal intensive care unit (NICU) stay (15.8%), congenital anomalies (8.1%), and low birth weight (10.9%). Fisher exact test assessed outcome associations with individual agents, use of any agent, and different number of agents. Alpha-agonist use was associated with NICU stay: 25.5% rate ( p = 0.012) in alpha-agonist use. Most of the alpha-agonist use NICU stays occurred in pregnancies with third trimester use. All other associations were not statistically significant.

Conclusions

The data from this survey suggest an overall favourable safety profile for topical glaucoma medications in pregnancy, but further investigation is needed. Caution should be employed regarding third trimester alpha-agonist use owing to association with NICU stay.
Long-term complications according to silicone oil type. A single center cohort study
Authors: Vidal-Oliver Lourdes , Mataix Boronat Jorge , Palacios Pozo Elena , López-Prats M Jesús , Desco Esteban M Carmen
Published: September 2023

Purpose

To study the incidence of macular edema (ME), ocular hypertension (OHT), emulsification and migration to the anterior chamber (AC) of silicone oil (SO) in patients after complex retina surgery, stratified by SO type.

Methods

Retrospective, cohort study. Patients who underwent retina surgery with SO injection and extraction in our center were included. We compared the complication rates of ME, OHT, emulsification and migration to the AS according to SO type (1300cSt, 5700cSt and heavy SO). Data on age, sex, emulsification time, duration of the tamponade, previous retina surgeries and diagnosis were also gathered and included in a multivariate analysis.

Results

We included 163 patients (mean age of 64.8 years; mean duration of the tamponade: 11 months). Rates of emulsification, ME, OHT and SO migration to the AC were similar in all groups ( p = 0.998, 0.668, 0.915 and 0.360). ME was the most frequent complication (33.3–47.8%), which resolved after SO extraction in 77.6% of cases. The majority of cases with OHT persisted (61.7%). Emulsification was related to younger age (OR 0.94) and longer duration of the tamponade (OR 1.04). The odds of SO migration to the AC increased with emulsification (OR 2.78), recurrent retinal detachment (OR 0.99) and aphakia (OR 4.05).

Conclusions

We propose SO extraction as the preferred treatment for ME during SO tamponade. SO extraction should be performed sooner in younger patients to avoid emulsification. In selected patients, we suggest a longer duration of the tamponade up to 11 months with a reasonable safety profile, regardless of the SO type.
A Brazilian case of exudative perifoveal vascular anomalous complex responsive to aflibercept intravitreal injections
Authors: Cunha de Souza Eduardo , Tombolini Beatrice , Sacconi Riccardo , Bandello Francesco , Querques Giuseppe
Published: September 2023

Purpose

To report a case of exudative perifoveal exudative vascular anomalous complex (ePVAC) in a Brazilian healthy patient that underwent a complete resolution after aflibercept intravitreal injections.

Case description

A 41-year-old healthy Brazilian man complained of acute central vision loss in his right eye (RE). Fundus examination showed a perifoveal hemorrhagic aneurysmal lesion, accompanied by several hard exudates in RE. On fluorescein angiography, these abnormalities showed a progressive hyperfluorescence with surrounding leakage. Optical coherence tomography (OCT) revealed a deep, perifoveal hyporeflective cystic space with a hyperreflective wall and hyperreflective material inside of fibrin-like aspect. Around this aneurism, intraretinal hyporeflective spaces suggestive of exudation were detected. Nor pathological flow signal, or telangiectatic dilations were evidenced on OCT-angiography. Therefore, a diagnosis of exudative ePVAC in RE was hypothesized. After an initial observation, the patient underwent three monthly aflibercept intravitreal injections (0.05 ml/2 mg), with a significative anatomical and functional improvement after two weeks from first dose. On last follow-up at five months from baseline, patient experienced no evidence of new exudation and a stable visual acuity.

Discussion

Placental growth factor (PlGF) may impact on pericytes’ dropout, and thus on ePVAC development. In contrast to the other anti-VEGF drugs, aflibercept is the only molecule contrasting PlGF. Therefore, aflibercept would act on ePVAC not as an anti-VEGF drug, but rather as an anti-PlGF one.

Conclusion

This report encouraged the use of aflibercept as a therapeutic option for ePVAC. Further studies are required to confirm our result and the impact of PlGF on ePVAC pathogenesis.
Depression and anxiety as mediators of the relationship between sleep disturbance and somatic symptoms among adolescents on a psychiatric inpatient unit
Authors: Laumann Laura E , Lee Jerin , Blackmon Jaime Elizabeth , Delcourt Meaghan L , Sullivan Matthew C , Cruess Stacy E , Cruess Dean G
Published: September 2023

Background: This study investigated the relationship between sleep disturbance and somatic symptoms among adolescents residing on a psychiatric inpatient unit. Given the evidence that sleep disturbance may precede the onset of depression and anxiety and the clear associations between mood and somatic symptoms, depression and anxiety were considered as potential mediators of this relationship. Gender was tested as a potential moderator of the relationship between sleep disturbance and depression and anxiety, respectively. Method: A convenience sample of 83 adolescents completed a packet of self-report measures after admission to the unit. Measures assessed depression, sleep disturbance, anxiety, and somatic symptoms. Mediation and moderation analyses were conducted using SPSS PROCESS macro. Results: With anxiety included as a covariate, the overall indirect effect of sleep disturbance on somatic symptoms through depression was significant. No significant moderation effects were found, although females reported significantly higher levels of sleep disturbance, depression, anxiety, and somatic symptoms than males. Conclusions: Results indicated that depression mediated the relationship between sleep disturbance and somatic symptoms above and beyond the effects of anxiety. These findings suggest that interventions aimed at reducing the negative effects of sleep disturbance should also target mood in this population. Individual differences including gender should be considered when developing interventions.
Cultures of (im)mobile entanglements
Authors: Cabalquinto Earvin , Leurs Koen
Published: September 2023

What does the increased reliance on digital communication technologies by migrants, refugees, asylum seekers, migrant communities, governments and researchers reveal about the benefits, limits and politics of everyday mobile and immobile experiences during the pandemic? This introduction to the special issue on cultures of (im)mobile entanglements addresses this inquiry, alongside ten articles covering themes of governance and surveillance, agency and negotiated subjectivities, translocal and transnational solidarity, as well as doing research in pandemic times. Critically engaging with both mobility and immobility in the intersecting field of mobilities and migration research, the special issue centres a multidimensional and multi-scalar perspective on the deep interlinking of various modes of mobilities and stasis in and beyond spatial and temporal conditions mediated by politically and culturally structured digitalization. It endeavours to create a vantage point to critically examine the mobility–immobility continuum as informed by power relations, hierarchies and inequalities in a networked and global society.