bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of different featured tools on machining accuracy in electrochemical milling
Authors: Mishra Koushik , Sarkar Biplab Ranjan , Bhattacharyya B
Published: December 2019

Drawbacks of electrochemical machining can be conquered to a large extent with the introduction of electrochemical milling technique. In this method, a simple shaped tool follows a predetermined tool path and material gets removed atom-by-atom from anode workpiece by electrochemical reactions through layer-by-layer approach. Keeping in mind the rising trend of electrochemical milling technique, this research work focuses to investigate the impact of major process parameters of electrochemical milling, for example, feed rate and milling layer depth on foremost responses like material removal rate and width overcut during electrochemical milling of Nimonic-263 alloy. In this research work, three different types of featured tools have been utilized and for each tool, ANSYS simulation has been carried out for analysing their impact on machining accuracy. Furthermore, these obtained simulated results have been confirmed by experimentation. Finally, an attempt has been made to produce more accurate ‘L’-shaped features on Nimonic-263 alloy with the aid of tool rotation and inner-spraying featured tools. This study confirms that mixed electrolyte, that is, NaCl(1M) + NaNO3(1M), tool rotation with internal flushing, number of outlets and the structure of the end face of the tool generate excellent machining accuracy with super finished surface with Ra value in the order of 0.07–0.08 µm during electrochemical milling of Nimonic-263 alloy.
Examining the Role of Policy and Cultural Determinants on Sectoral Export Competitiveness: Evidences from India
Authors: Kumar Deepak , Kumar Shubham , Sengupta Keya , Giri Tapas K.
Published: December 2019

Exports are affected by several economic, political, social and cultural determinants. The objective of this study is to examine the role of policy and cultural determinants on export competitiveness for different sectors, estimate the technical efficiency (TE) and suggest focus areas to improve exports. The study uses the method of stochastic frontier analysis on the bilateral trade of India over the period 2000–2016. The result findings highlight that there is underutilization and ambiguous effect of trade agreements for all sectors except intermediate goods (IGs). Foreign direct investments outflow has positive results for all the sectors with capital goods getting benefitted the most. TE of exports shows positive trends for IGs, negative trend for raw materials, and mixed trend for consumer goods and capital goods sectors. IGs show the best export competitiveness, whereas RMs have the highest export potential. The results underline India’s progress in integrating with the global supply chain through increasing TE in exports of IGs.
Physical Activity During Pregnancy and Postpartum Low Back Pain: A Prospective Cohort Study in Vietnam
Authors: Ha Vo Van Anh , Zhao Yun , Pham Minh Ngoc , Binns Colin W. , Nguyen Cong Luat , Nguyen Phung Thi Hoang , Chu Tan Khac , Lee Andy H.
Published: December 2019

Low back pain (LBP) is a universal public health problem for all age groups, related to the upright stance of humans. Postpartum LBP is more common and can lead to limitations to women’s daily activity. Knowledge about preventing postpartum LBP is limited, and the relationship between prenatal physical activity (PA) and LBP remains inconclusive. We conducted a prospective cohort study of 1807 singleton pregnant Vietnamese women to investigate the association between prenatal PA and postpartum LBP using logistic regression analyses. The prevalence of postpartum LBP was 12.3% (n = 222). Women reporting LBP spent more hours sitting per week. Relative to the lowest level of total PA, the highest level was associated with reduced odds of postpartum LBP (odds ratio = 0.55; 95% confidence interval = 0.38-0.80). Inverse associations with LBP were also observed for light intensity, moderate-to-vigorous intensity, household/caregiving, occupational, and transportation activities. Overall, prenatal PA was inversely associated with postpartum LBP in Vietnamese women.
Comparative Toxicities of Neoadjuvant Chemotherapy With or Without Bevacizumab in HER2-Negative Breast Cancer Patients: A Meta-analysis
Authors: Wang Bi-Cheng , Fu Chen , Xie Lin-Ka , Kuang Bo-Hua , Zhao Yan-Xia
Published: December 2019

Background: The addition of bevacizumab to neoadjuvant chemotherapy improves the pathological complete response rate of human epidermal growth factor 2 (HER2)-negative breast cancer patients. However, the characteristics of adverse events associated with the use of bevacizumab should receive more attention from clinicians. Objective: This meta-analysis aimed to detect the adverse events of adding bevacizumab to neoadjuvant chemotherapy compared with neoadjuvant chemotherapy alone in HER2-negative breast cancer patients. Methods: PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically accessed to find eligible studies from January 1, 2000, to October 20, 2019. Reference lists were searched for additional studies. Pooled risk ratios for adverse events of bevacizumab were meta-analyzed. Results: Overall, 6 of 829 initially identified studies met the inclusion criteria, with 4681 patients randomized (2321 in the bevacizumab plus neoadjuvant chemotherapy group and 2360 in the neoadjuvant chemotherapy group). The incidence of grade ≥3 hypertension, left-ventricular dysfunction, mucositis, febrile neutropenia, infection, pain, hand-foot syndrome, hemorrhage, and neutropenia significantly increased in patients treated with bevacizumab plus neoadjuvant chemotherapy. However, adding bevacizumab to neoadjuvant chemotherapy was not associated with increasing the incidences of grade ≥3 proteinuria, dyspnea, heart failure, peripheral neurotoxicity, thrombosis, thrombocytopenia, fatigue, leucopenia, vomiting, nausea, and diarrhea. Conclusion and Relevance: Adding bevacizumab to neoadjuvant chemotherapy to treat HER2-negative breast cancer patients increased adverse events. However, most adverse events are clinically manageable. Patients, therefore, need to be monitored carefully for hypertension, left-ventricular dysfunction, mucositis, febrile neutropenia, infection, pain, hand-foot syndrome, hemorrhage, and neutropenia when treated with bevacizumab and neoadjuvant chemotherapy simultaneously.
Double harmonically excited nonlinear vibration of viscoelastic piezoelectric nanoplates subjected to thermo-electro-mechanical forces
Authors: Ebrahimi Farzad , S Hosseini S Hamed
Published: December 2019

The objective of the present paper is to comprehensively study the nonlinear frequency response of viscoelastic piezoelectric nanoplates exposed to dual harmonic external excitation and thermo-electro-mechanical loads. To achieve this goal, firstly, a piezoelectric nanoplate resting on a viscoelastic foundation is modeled. Secondly, using the nonlocal piezoelectricity theory, Kelvin–Voigt model, von Karman nonlinear relations and Hamilton’s principle, the nonlinear governing differential equation of motion is derived. In the next step, employing the Galerkin technique and multiple time scales method, the partial differential equation is transformed to an ordinary one and solved. Finally, the modulation equation of viscoelastic piezoelectric nanoplates for combinational excitation is obtained. Emphasizing the effect of dual harmonic excitation and thermo-electro-mechanical loads on nonlinear frequency response of the system, jump and resonance phenomena are discussed. A detailed parametric study is conducted to examine the effect of nonlinearity, damping coefficient, nonlocal parameter, combinational excitation, electric voltage, initial stress and thermal environment.
The Psychometric Properties of the Minnesota Tobacco Withdrawal Scale Among Patients With Mental Illness
Authors: Al-Mrayat Yazan D. , Okoli Chizimuzo T. C. , Studts Christina R. , Rayens Mary K. , Hahn Ellen J.
Published: December 2019

Background and Objectives:

Approximately 65% of psychiatric inpatients experience moderate-to-severe nicotine withdrawal (NW), a set of symptoms appearing within 24 hr after an abrupt cessation or reduction of use of tobacco-containing products in those using nicotine daily for at least a couple of weeks. The Minnesota Tobacco Withdrawal Scale (MTWS) is a widely used instrument for detecting NW. However, the psychometric properties of the MTWS have not previously been examined among patients with serious mental illness (SMI) undergoing tobacco-free hospitalization. The objective of this study was to examine the validity and reliability of the MTWS among patients with SMI during tobacco-free psychiatric hospitalization.

Methods:

Reliability was tested by examining Cronbach’s α and item analysis. Validity was examined through hypothesis testing and exploratory factor analysis ( N = 255).

Results:

The reliability analysis yielded a Cronbach’s α coefficient of .763, an inter-item correlations coefficient of .393, and item-total correlations between .291 and .691. Hypothesis testing confirmed the construct validity of the MTWS, and an exploratory factor analysis yielded a unidimensional scale.

Conclusion:

The MTWS demonstrated adequate reliable and valid psychometric properties for measuring NW among patients with SMI. Nurses and other health-care professionals may use this instrument in clinical practice to identify patients with SMI experiencing NW. The MTWS is psychometrically sound for capturing NW during tobacco-free psychiatric hospitalization. Future research should examine the efficacy of the MTWS in measuring NW in this population over an extended period of hospitalization.
Differences in anxieties and social networks in a group-matched sample of autistic and typically developing students transitioning to university
Authors: Lei Jiedi , Ashwin Chris , Brosnan Mark , Russell Ailsa
Published: December 2019

Transitioning to university can be anxiety-provoking for all students. The relationship between social anxiety, autistic traits and students’ social network structure, and perceived support is poorly understood. This study used a group-matched design where autistic students ( n = 28) and typically developing students ( n = 28) were matched on sex, age (17–19 years), ethnicity, pre-university academic performance and degree subject at university. Autistic students reported greater transition to university worries, and a smaller social network size compared to typically developing students, though perceived similar levels of support from their social networks. Autistic and typically developing students showed differential patterns of association with both autistic traits and social anxiety. Broader clinical and practical implications of findings are discussed.
Owning our madness: Contributions of Jamaican psychiatry to decolonizing Global Mental Health
Authors: Hickling Frederick W.
Published: December 2019

The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country’s only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change. The mental health challenge for descendants of African people enslaved in Jamaica is to reverse the psychological impact of 500 years of European racism and colonial oppression and create a blueprint for the decolonization of GMH. The core innovations were the gradual downsizing and dismantling of the colonial mental hospital and the establishment of a novel community mental health initiative. The successful management of acute psychosis in open medical wards of general hospitals and a Diversion at the Point of Arrest Programme (DAPA) resulted in the reduction of stigma and the assimilation of mental health care into medicine in Jamaica. Successful decentralization has led to unmasking underlying social psychopathology and the subsequent development of primary prevention therapeutic programs based on psychohistoriographic cultural therapy and the Dream-A-World Cultural Therapy interventions. The Jamaican experience suggests that diversity in GMH must be approached not simply as a demographic fact but with postcolonial strategies that counter the historical legacy of structural violence.
Enablers and obstacles to implementing remote monitoring technology in cardiac care: A report from an interactive workshop
Authors: Diaz-Skeete Yohanca , Giggins Oonagh M , McQuaid David , Beaney Paul
Published: December 2019

An ageing population and chronic disease are putting pressure on the Irish health system. The field of eHealth is rapidly evolving and has the potential to become an important component of healthcare, but there appears to be a gap currently between research in this field and the integration of eHealth technology into clinical practice. During the eHealth Ireland Ecosystem Conference held in April 2018, a workshop was conducted to explore the barriers and facilitators to the adoption of eHealth technology, particularly remote monitoring systems in community and home cardiac care. Participants included clinicians, academic researchers, technologists, patient advocates, policy makers, and representatives from the health service. The conversations in the workshop pivoted around why technology systems in cardiac care rarely moved beyond the research project stage and what can be done to address this issue. The discussions in the workshop focused around the lack of funding available, the need for reimbursement models, the lack of awareness about remote monitoring, the angst about who is responsible for the data generated, the design of systems, regulatory standards, and the increasing demand on services, education, and patient empowerment.
Digital touch for remote personal communication: An emergent sociotechnical imaginary
Authors: Jewitt Carey , Leder Mackley Kerstin , Price Sara
Published: December 2019

This article makes legible emergent social imaginaries of digital touch for remote communication in personal relationships, with attention to digital touch interfaces. It draws on data from rapid prototyping research workshops with apprentice professionals embedded within digital communication. Touch is discussed with respect to four analytical themes: materiality, body, emplacement and temporality. We illustrate how participants’ past and present experiences and future visions of remote digital touch thread through these themes and weave together to form a hegemonic, emergent sociotechnical imaginary of digital touch. The article contributes to social debates within digital personal remote communication by foregrounding touch, the material and the sensorial. The article’s novel interdisciplinary framework (combining design-based rapid prototyping with a multimodal and multi-sensorial analysis within the frame of the sociotechnical imaginary) also contributes to methodology around future-facing phenomena, prior to the process of their solidification into material, political formations.
Conspicuous non-consumption in tourism: Non-innovation or the innovation of nothing?
Authors: Sørensen Elin Brandi , Hjalager Anne-Mette
Published: December 2019

Referring to current phenomena and consumer behaviour in tourism, this article develops the concept of conspicuous non-consumption. It addresses the deliberate avoidance of (over)spending during holidays and states that this behaviour may be just as conspicuous and provide social signals that are just as strong as those connected to the consumption of expensive luxury goods. The conceptual development is based on a combination of the two dichotomies of ‘consumption versus non-consumption’ and ‘conspicuous versus inconspicuous’, resulting in four conceptually distinctive categories of behaviour: conspicuous consumption, conspicuous non-consumption, inconspicuous non-consumption and conspicuous non-consumption. The latter, conspicuous non-consumption, is of special interest in this article, exemplified through personal vignettes. Explorative readings of travel blogs lead to the identification of five themes that characterize conspicuous non-consumption in tourism: ‘identity building’, ‘recycling, upcycling and repurposing’, ‘spiritualizing’, ‘retreating and detoxing’ and ‘slowing down’. Usually, tourism innovation policies are characterized by a ritual growth compulsion, and do not celebrate non-consumption, which is found to be synonymous with non-innovation. This is a paradox for the timely modernizing of tourist services and destinations. Increasingly, there is a need to reorient innovation and to give consideration to how the innovation of ‘nothing’ can also undergo a distinctive progression and even contribute positively to tourism economies. This article highlights the entry points for innovation at the tourism business and destination levels.
Participatory action research: Promoting partnership between a social work team and mothers of hemophiliac children
Authors: Yang Jing
Published: December 2019

This article focuses on a participatory action research project as a process for improving social work practice and empowering mothers with hemophiliac children. Four stages of the action research are presented in this study. The research played a critical consciousness-raising and capacity-building role facilitating the mothers’ transformation from passive victims to active subjects. In addition, participatory action research contributed to identifying the emerging needs of families with hemophiliac children and improving the quality of social work services. We concluded that participatory action research is an effective way to empower disadvantaged people. This research methodology also facilitates social work practice in a non-traditional field. It is argued that participatory action research as a way of empowering the vulnerable also entails risks as attempts to redistribute power may earn further stigmatization and discrimination, especially from those whose existing power is challenged. Social work, as a profession committed to a more just and equal society, should be wary of this further stigmatization and insist on principles of social justice, human rights, collective responsibility, and respect for diversity. The article concludes by examining the limitations of employing participatory action research and makes recommendations for future programs.
Impact of light spectrum and photosynthetic photon flux density on the germination and seedling emergence of Okra
Authors: Degni BF , Haba CT , Dibi WG , Gbogbo YA , Niangoran NU
Published: December 2019

Light's impact on many crop species and vegetables has been deeply studied in recent years but there are still some economic and technical issues to overcome. Thus, the impact of light spectrum and photosynthetic photon flux density from light-emitting diodes on the germination and seedling emergence of Okra has been investigated in this study. Different light treatments have been applied to Okra seeds using a factorial design of three levels of light spectrum and three levels of photosynthetic photon flux density; these three levels of light spectrum are defined by their peak wavelengths at 635 nm (R635), 457 nm (B457) and 521 nm (G521) and are, respectively, in the red, blue and green region of the visible spectrum; levels of photosynthetic photon flux density are 100 µmol m−2 s−1, 200 µmol m−2 s−1 and 300 µmol m−2 s−1. Results show significant interactions between light spectrum and photosynthetic photon flux density on mean germination time, mean germination rate, uncertainty of germination and seedling emergence height. R635 shows a better mean germination rate and less uncertainty and dispersion than B457 and G521. Seedlings that emerged under photosynthetic photon flux density of 300 µmol m−2 s−1 are significantly shorter than those that emerged under 100 µmol m−2 s−1 and 200 µmol m−2 s−1.
Psychological Mind-Set and Student Success: The Importance of Internal Locus of Control in Students Who Overachieve
Authors: Micomonaco Justin P. , Espinoza Benjamin D.
Published: December 2019

Improving student success outcomes such as persistence and graduation rates remains a priority for higher education institutions, scholars, and advocates. Recent scholarly work argues for more qualitative work in this area to develop a deeper understanding of the issue and to identify more effective ways to increase college completion rates across all populations. This study examines student success by focusing on an understudied population in the literature: overachievers. We define overachievers as students who matriculate in the lowest quartile of an institution’s standardized test score range but are selected and persist as honors students after their first collegiate semester. This phenomenological study highlights the prevalence of a strong internal locus of control among overachievers. Using Bean and Eaton’s student success model as a framework, we explore how our participants operationalized an internal locus of control to achieve academic success in college and consider how higher education institutions can promote this mind-set and its related practices among students on their campuses.
Calcaneal Osteomyelitis: Current Treatment Concepts
Authors: McCann Michael J. , Wells Ashleigh
Published: December 2019

Calcaneal osteomyelitis can be a debilitating disease if proper treatment protocols are not initiated. This literature review details the epidemiology, clinical, diagnostic, and prognostic factors, and medical management in those who developed this disease.
From Standard of Care to Personalized (Art of) Medicine: Two Novel GABA-A Receptor β3 Subunit Mutations Associated With Epilepsy Syndromes
Authors: Velisek Libor
Published: December 2019

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Literature Review on the Incidence of Primary Stapler Malfunction
Authors: Makanyengo Samwel Okoth , Thiruchelvam Dhan
Published: December 2019

Background. Surgical stapling devices are known for their reliability and convenience. A letter to health care professionals published by the US Food and Drug Administration in March 2019 highlighted the increasing number of adverse events associated with surgical staplers. Driven by a case of stapler malfunction during an elective laparoscopic sleeve gastrectomy, we performed a literature review to investigate the incidence of primary stapler malfunction. We also discuss the common types and an approach to its management. Methods. PubMed, MEDLINE, and EMBASE databases were searched for articles discussing surgical stapler malfunction. Twelve studies were selected that described the incidence and/or consequences of primary stapler malfunction. A narrative synthesis was performed. Results. From observational studies, the incidence ranged from 0.022% to 2.3%. A prospective survey reported that 86% of laparoscopic surgeons either had personal experience with or knew of surgeons who experienced stapler malfunction, implying a higher incidence. Underreporting has been an issue as manufacturers can get exemptions from public reporting. Significantly, higher malfunctions have been reported after exemptions were lifted. The most common types of stapler malfunction are stapler misfire and stapler locking. Major morbidity and mortality have been reported. Conclusion. Surgeons are increasingly reliant on technological innovations. Stapling failure occurs and it is imperative to be aware of this. Given the high volume of stapler use, a high percentage of surgeons are likely to encounter this problem in their career. It is important to have an approach to the prevention and management of this potentially catastrophic complication.
Petitioning for empire in Napoleonic Europe
Authors: Palacios Cerezales Diego
Published: December 2019

Petitions, loyal addresses, plebiscites, and other displays of popular consent accompanied most episodes of the revolutionary and Napoleonic expansion of France between 1789 and 1814. Petitioning had been adapted and transformed in France during the revolution, through which it became associated to popular sovereignty. Historians have often studied popular mobilisation through the prism of the conquest of rights, thereby pitting subordinate groups against entrenched ruling classes. This article surveys a different development, as French revolutionary administrators and generals, and Napoleon himself, adapted and reconfigured petitioning as a top-down tool for territorial expansion and empire-building, using it to invoke the supposed popular acquiescence to their reconfiguration of the political map of Europe. French propaganda portrayed these initiatives within the same interpretative framework that discussed the value of other, more autonomous, petitions. This work will thus analyse the paradox of top-down-controlled mobilisations that, at the same time, reinforced the symbolic pre-eminence of popular consent and participation.
The challenge of recognising sepsis: Future nanotechnology solutions
Authors: Claxton Andrew , Papafilippou Lana , Hadjidemetriou Marilena , Kostarelos Kostas , Dark Paul
Published: December 2019

The urgent need to start anti-infective therapeutic interventions in suspected sepsis, and the lack of specific time-critical diagnostic information often lead to the widespread administration of broad-spectrum antimicrobial therapies, increasing the risk of unwanted patient harms and contributing to rising pathogen antimicrobial resistance. Nanotechnology, which involves engineering at the nanoscale, allows for the bespoke development of diagnostic solutions with multi-functionality and high sensitivity that has the potential to help provide time-critical information to make more accurate diagnoses and treatment decisions for sepsis. Nanotechnologies also have the potential to improve upon the current strategies used for novel biomarker discovery. Here we describe some of the current limitations to identifying sepsis and explore the potential role for nanotechnology solutions.
Why Do People With Depression Use Faulty Emotion Regulation Strategies?
Authors: Yoon Sunkyung , Rottenberg Jonathan
Published: December 2019

Why do people with psychopathology use less adaptive and more maladaptive strategies for negative emotions if such usage has self-destructive consequences? Although researchers have examined the reasons for people’s engagement in maladaptive “behaviors,” such as nonsuicidal self-injury, surprisingly little attention has been paid to the reasons why people might endorse maladaptive emotion regulation (ER) strategies. This article addresses this question, focusing on the case of depression, evaluating an array of 10 possible explanations. After considering the existing evidence, we provide a blueprint to help the field reach stronger conclusions about depression and other forms of psychopathology. Better understanding of the origins of healthy/unhealthy ER has implications for clinical science, clinical practice, as well as their integration.
The evolution of physical activity promotion. Are we entering a liquid age?
Authors: Abu-Omar Karim , Gelius Peter , Messing Sven
Published: December 2019

In order to counteract risk factors for non-communicable diseases, promotion of physical activity has become increasingly relevant. This article outlines recent developments in this field, adopting a perspective based on Zygmunt Bauman’s concepts of liquid modernity and liquid life. Five trends in physical activity promotion are identified: (Trend 1) The expansion of physical activity recommendations from a narrow focus on exercise to a broad concept of 24-h movement guidelines, (Trend 2) the increasing number of population groups targeted by these recommendations, (Trend 3) the ascent of efforts for physical activity promotion to the global level, (Trend 4) the emancipation of physical activity promotion from an add-on to a stand-alone public health topic, and (Trend 5) the ongoing conflict between sport, health and other sectors about the leading role in physical activity promotion. Based on these developments, physical activity might be classified as ‘liquid’ in Bauman’s sense, that is, as being elusive and in a constant state of flux.
Retrospective Analysis of Patients With Acute Invasive Fungal Rhinosinusitis in a Single Tertiary Academic Medical Center: A 10-Year Experience
Authors: Vengerovich Gennadiy , Echanique Kristen A. , Park Ki Wan , Wells Christine , Suh Jeffrey D. , Lee Jivianne T. , Wang Marilene B.
Published: December 2019

Background

Acute invasive fungal rhinosinusitis (AIFRS) is an aggressive, potentially fatal disease that can spread rapidly to the orbit and intracranial structures causing significant mortality and morbidity.

Objective

In this study, we present a 10-year experience from a tertiary academic medical center of patients presenting with AIFRS. Data on presentation, mortality rate, comorbidities, surgical, and medical management were analyzed.

Methods

A retrospective chart review was performed in a tertiary academic medical center of patients with AIFRS from January 2009 through February 2019. Data collected included demographics, presenting symptoms, comorbidities, immunosuppression status, endoscopic and imaging findings, orbital and intracranial complications, surgical and medical management, as well as outcomes and mortality.

Results

A total of 34 patients were identified. In our series, mortality was noted to be 61.8%, excluding patients who were lost to follow-up. The most common presenting symptoms included facial pain, ophthalmologic complaints, headaches, and proptosis. Only 4 of the 34 patients did not undergo surgical intervention, as they were not deemed surgical candidates; they all succumbed to their disease. Twenty-six of the 30 surgical patients (86.7%) underwent endoscopic sinus surgery, 8 underwent an open approach (26.7%), while 7 patients underwent orbital exenteration (23.3%). All patients had surgical pathology consistent with AIFRS. Fungal species isolated from culture included Aspergillus, Mucor/ Rhizopus, Candida, Cunninghamella Scedosporium boydii, Paecilomyces, and Scopulariopsis. Medical therapies included intravenous amphotericin B, caspofungin, posaconazole, voriconazole, isavuconazole, and micafungin.

Conclusion

AIFRS was associated with 61.8% mortality in our series of 34 patients over the past 10 years. Early diagnosis, as well as rapid and aggressive surgical and medical management, is necessary for optimal outcomes in this devastating disease.
Histopathologic Influences of Tissue Eosinophilia Among Chronic Rhinosinusitis Patients
Authors: Ganti Ashwin , Brown Hannah J. , Kuhar Hannah N. , Gattuso Paolo , Ghai Ritu , Mahdavinia Mahboobeh , Batra Pete S. , Tajudeen Bobby A.
Published: December 2019

Background

A subset of chronic rhinosinusitis (CRS) patients demonstrates tissue eosinophilia on structured histopathology. Prior studies have suggested that these patients are at increased risk for recurrent disease. The goals of this study are to identify histopathologic features of CRS patients with tissue eosinophilia and compare the influence of tissue eosinophilia to the effects of age and revision surgery on histopathology.

Methods

A structured histopathology report was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery. Binomial logistic regression analysis was conducted to evaluate the association of age at diagnosis, tissue eosinophil count, and history of revision surgery with histopathology variables.

Results

A total of 281 CRS patients were included, of which 106 had tissue eosinophilia. Regression analysis demonstrated that tissue eosinophilia was associated with degree of inflammation (odds ratio [OR] 5.744; P <  .001), neutrophilic infiltrate (OR 1.882; P =  .020), basement membrane thickening (OR 3.561; P <  .001), squamous metaplasia (OR 3.315; P <  .001), fibrosis (OR 2.246; P =  .002), presence of Charcot–Leyden crystals (OR 20.700; P =  .004), and eosinophilic aggregates (OR 34.172; P <  .001). Age and history of revision surgery were not significant predictors of histopathology variables on multivariate analysis.

Conclusion

Tissue eosinophilia appears to be the predominant driving factor of histopathologic changes irrespective of previous sinus surgery or age at diagnosis. These findings may have important implications for postsurgical management and prognosis for patients with tissue eosinophilia presenting for revision surgery.
Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping
Authors: Lin Chaoqun , Chen Lukui
Published: December 2019

Objective:

The effects of repeated lumbar puncture and continuous lumbar cistern drainage on the cognitive function of patients with aneurysmal subarachnoid hemorrhage were compared and analyzed.

Methods:

Retrospective analysis was performed on 59 patients with aneurysmal subarachnoid hemorrhage treated at our Neurosurgery Department between October 2017 and October 2018. According to the hemorrhagic cerebrospinal fluid drainage mode after aneurysm clipping, the patients were divided into the following two groups: the repeated lumbar puncture drainage (Group A, n = 28) and continuous lumbar cistern drainage (Group B, n = 31). Before and 1 month after surgery, the cognitive function of the patients was scored using the Montreal Cognitive Assessment Scale. Scores of 27~30 were defined as normal, and scores of < 27 as cognitive impairment.

Results:

The incidences of cognitive impairment were 46% (13/28) and 32% (10/31) for Groups A and B, respectively, before surgery, but the difference was not significant ( P > 0.05). The incidences of cognitive impairment were 35% (10/28) and 12% (4/31) for Groups A and B, respectively, at 1 month after surgery, with significant difference ( P < 0.05).

Conclusion:

Compared with repeated lumbar puncture, continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage significantly reduced the incidence of cognitive impairment after aneurysm clipping.
Antecedents of Cause Marketing: An Assessment of Psychographic and Demographic Factors on the Consumer’s Purchase Behaviour
Authors: Gupta Shruti
Published: December 2019

Cause marketing initiatives are increasingly becoming the prominent aspect of the marketing mix; a lot of companies are jumping into the bandwagon primarily to distinguish themselves in the homogeneous markets. However, it is only a recent phenomenon that the companies are beginning to appreciate how corporate giving may be adopted as an effective strategy to market their products in the competitive markets. This article is aimed at examining the effect of psychographics and demographics on the buying behaviour of the consumer. It identifies the various factors that drive the behaviour of the consumer exposed to a customer relationship management (CRM) initiative and examine the impact of the same on the attitude, perception and purchase intention of the consumer. This, in turn, provides valuable insights to the academicians and the practitioners as to how to communicate and what to emphasise while designing their cause marketing communication initiatives.
Exploring Job and Family Satisfaction: Scale Validation and Role of Demographic Variables
Authors: Jain Sarika , Nair Shreekumar K.
Published: December 2019

Satisfaction from job is considered as an important variable for study with respect to sales employees. By virtue of their job profile, sales employees are required to respond to multiple demands from multiple stakeholders both at work and family front which eventually lead to negative outcomes such as stress. This in turn results in lesser satisfaction both in work and family domains. Although job satisfaction gets highlighted across researches (especially in western context), family satisfaction still remains a subject of negligence in sales related researches. The present study aims to validate the Job and Family satisfaction in Indian context by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) using analysis of moment structures (AMOS) software. The results of the data analysis conform the findings of previous literature. Further, this study explored the impact of demographic variables on job and family satisfaction of sales employees. The study contributed to the sales management literature by identifying the key demographic variables that can have an effect on sales employee's job and family satisfaction. Results indicated that sales employee satisfaction from job is associated with both work (tenure in an organization, hierarchy and annual salary) as well as family related domains (marital status). However, family satisfaction is primarily dependent on family related factors. Implications of these findings are discussed.
The Costs of Implementing Vaccination With the RTS,S Malaria Vaccine in Five Sub-Saharan African Countries
Authors: Sicuri Elisa , Yaya Bocoum Fadima , Nonvignon Justice , Alonso Sergi , Fakih Bakar , Bonsu George , Kariuki Simon , Leeuwenkamp Oscar , Munguambe Khatia , Mrisho Mwifadhi , Were Vincent , Sauboin Christophe
Published: December 2019

Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of the expanded program on immunization at all levels in each country were interviewed on the resources required for implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach setting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the countries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions. This study provides relevant information for donors and decision makers about the cost of implementing RTS,S. Variations within and across countries are important and the unknown future price per dose and wastage rate for this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation.
Patients’ priorities in a reminiscence and legacy intervention in palliative care
Authors: Hesse Michaela , Forstmeier Simon , Ates Gülay , Radbruch Lukas
Published: December 2019

Background:

Reminiscence is used in a range of different interventions in palliative care, for example, Dignity Therapy or Life Review. However, literature has focused mainly on the methodology, and little has been published on patients’ priorities and primary concerns.

Objective:

This study looks at themes emerging in a reminiscence intervention with patients confronted with a life-limiting disease. Interviews were audiotaped and transcribed verbatim. Transcripts were analysed using thematic analysis.

Setting/subjects:

Seventeen patients who were receiving palliative care at the University Hospital Bonn participated in interviews reviewing parts or phases of their lives.

Results:

Patients expressed satisfaction and a sense of well-being with the intervention. Major themes emerging in the interviews were the factors involved in the development and expression of personality, such as character-forming influences, self-image, self-awareness, and philosophy of life. Talking about personality was entangled with influences from growing up, qualification/job, partner/spouse, children, resources, twists of fate/crossroads, and coping.

Conclusion:

The topics emerging from the interviews differed from the scope of guiding questions in common reminiscence methods like Life Review or Dignity Therapy. The underlying motivation of patients seemed to be the search for identity and continuity in one’s life.
Proton Pump Inhibitors in the Elderly Hospitalized Patient: Evaluating Appropriate Use and Deprescribing
Authors: Mehta Nishila , Martinez Guasch Fernando , Kamen Corey , Shah Sumesh , Burry Lisa D. , Soong Christine , Mehta Sangeeta
Published: December 2019

Background: Proton pump inhibitors (PPIs) are often prescribed for elderly patients without appropriate indication, or for longer durations than recommended. Objective: To review appropriateness of PPI use prior to and in hospital, and deprescribing rates across different hospital units. Methods: Retrospective analysis of patients ≥65 years admitted to 5 acute care units: intensive care unit, acute care for elderly, orthopedics, surgery, and medicine. Patients who were “non-naive” (prehospital PPI use) or “naive” (new PPI initiated in hospital) users were included. For both groups, demographics, reason for admission, length of stay, comorbidities, name and number of home medications, PPI name, dose and indication, and PPI discharge instructions were collected. For naive patients, duration of in-hospital use and prescriber specialty was recorded. Results: Among non-naive patients (n = 377), for 37 patients (10%), the indication for a PPI was not appropriate, and for 92 patients (24%), the indication was unclear. Most patients had their home PPI continued while in hospital (87%) and at discharge (90%). Among naive (n = 93) patients, for 8 patients (9%), the indication for a PPI was not appropriate, and for 25 (27%) patients, the indication was unclear. PPI was prescribed to only 16 (18%) by the gastrointestinal consult service. Most patients had their new PPI continued at discharge (74%); only 7 (9%) were discharged with a plan to reassess PPI indication. Conclusion: PPIs are infrequently deprescribed during hospital admission, despite inappropriate or unclear indications for use. Thorough medication reconciliation, documentation of PPI indication and duration, and institutional focus on deprescribing are encouraged.
Longitudinal assessments of plasma ADAMTS13 biomarkers predict recurrence of immune thrombotic thrombocytopenic purpura
Authors: Sui Jingrui , Cao Wenjing , Halkidis Konstantine , Abdelgawwad Mohammad S. , Kocher Nicole K. , Guillory Bryan , Williams Lance A. , Gangaraju Radhika , Marques Marisa B. , Zheng X. Long
Published: December 2019

Immune thrombotic thrombocytopenic purpura (iTTP) is primarily caused by immunoglobulin G (IgG)–type autoantibodies that bind and inhibit plasma ADAMTS13 activity and/or accelerate its clearance from circulation. Approximately 50% of patients with iTTP who achieve initial clinical response to therapy experience recurrence (ie, exacerbation and/or relapse); however, a reliable biomarker that predicts such an event is currently lacking. The present study determines the role of longitudinal assessments of plasma ADAMTS13 biomarkers in predicting iTTP exacerbation/recurrence. Eighty-three unique iTTP patients with 97 episodes from the University of Alabama at Birmingham Medical Center between April 2006 and June 2019 were enrolled. Plasma levels of ADAMTS13 activity, antigen, and anti-ADAMTS13 IgG on admission showed no significant value in predicting iTTP exacerbation or recurrence. However, persistently low plasma ADAMTS13 activity (<10 U/dL; hazard ratio [HR], 4.4; 95% confidence interval [CI], 1.6-12.5; P = .005) or high anti-ADAMTS13 IgG (HR, 3.1; 95% CI, 1.2-7.8; P = .016) 3 to 7 days after the initiation of therapeutic plasma exchange was associated with an increased risk for exacerbation or recurrence. Furthermore, low plasma ADAMTS13 activity (<10 IU/dL; HR, 4.8; 95% CI, 1.8-12.8; P = .002) and low ADAMTS13 antigen (<25th percentile; HR, 3.3; 95% CI, 1.3-8.2; P = .01) or high anti-ADAMTS13 IgG (>75th percentile; HR, 2.6; 95% CI, 1.0-6.5; P = .047) at clinical response or remission was also predictive of exacerbation or recurrence. Our results suggest the potential need for a more aggressive approach to achieve biochemical remission (ie, normalization of plasma ADAMTS13 activity, ADAMTS13 antigen, and anti-ADAMTS13 IgG) in patients with iTTP to prevent the disease recurrence.
Estimation of greenhouse gas emission factors based on observed covariance of CO2, CH4, N2O and CO mole fractions
Authors: Haszpra László , Ferenczi Zita , Barcza Zoltán
Published: December 2019

Background

Covariances among major anthropogenic greenhouse gases were studied during three cold-air pool episodes in the Pannonian Basin to better constrain their emission factors for Europe.

Results

On the base of observed covariance between carbon dioxide, methane, carbon monoxide and nitrous oxide atmospheric dry air mole fraction in a region of the Pannonian (Carpathian) Basin during three cold-air pool episodes in January–February 2017, emission factors relative to carbon dioxide were determined. For the determination of the emission of carbon dioxide, a simple boundary-layer budget model was compiled. The model gave 6.3 g m−2 day−1 carbon dioxide emission for the footprint area of the measurements on average for the period of the episodes. The 6.7–13.8 nmol μmol−1, 0.15–0.31 nmol μmol−1 and 15.0–25.8 nmol μmol−1 ratios for CH4:CO2, N2O:CO2 and CO:CO2, respectively, correspond to 15.3–31.7 mg m−2 day−1 methane, 0.9–2.0 mg m−2 day−1 nitrous oxide and 60.0–103.4 mg m−2 day−1 carbon monoxide emissions for the region. These values are somewhat higher than the officially reported bottom-up annual national averages for Hungary, which are explained by the winter conditions and intensive domestic heating.

Conclusions

The study indicated the high share of biomass burning in residential heating in rural environment that results in high carbon monoxide emission relative to that of carbon dioxide. It also indicated that the actual emission factor for nitrous oxide may exceed the range given in the guidelines for inventory compilation, which should be taken into account in reporting. It is shown that even a simple boundary-layer budget model might give realistic emission estimation under cool-air pool episodes.