bluuebunny/crossref_metadata_2025 huggingface dataset:
Assisted Living Residents’ Sense of Belonging and Psychosocial Outcomes
Authors: Park Innah , Veliz Philip T. , Ingersoll-Dayton Berit , Struble Laura M. , Gallagher Nancy A. , Hagerty Bonnie M. , Larson Janet L.
Published: February 2020

Little is known about the psychosocial adjustment of older adults in the assisted living environment. A sense of belonging has been linked to psychological health and a lack of belonging could lead to loneliness. We conducted a cross-sectional descriptive study to examine relationships between social engagement, sense of belonging, and psychological outcomes. Seventy female and 30 male assisted living residents participated. The mean age was 83.9 (range 65–99) years. Structural equation modeling (SEM) revealed that older age, higher physical function, and greater sense of belonging were associated with fewer negative psychosocial outcomes (depression and loneliness) and that sense of belonging functioned as a mediator between social engagement and psychosocial outcomes. Additional work is needed to fully understand how sense of belonging and other factors influence psychosocial outcomes.
Effectiveness of interventions aimed at improving the sexuality of women with multiple sclerosis: a systematic review
Authors: Esteve-Ríos Antonio , Garcia-Sanjuan Sofia , Oliver-Roig Antonio , Cabañero-Martínez María José
Published: February 2020

Objective:

To evaluate the effectiveness of interventions aimed at improving the sexuality of women with multiple sclerosis.

Data sources:

MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Embase and the Cochrane Library, as well as doctoral thesis databases Teseo and ProQuest Dissertations & Theses Global and the grey literature database Opengrey were searched, last on 15 October 2019. Journals related to the topic were also consulted. The bibliographic references of the articles included were reviewed.

Method:

Studies were selected if they included women with multiple sclerosis in whom interventions aimed at reducing sexual dysfunction were applied. Data extraction was carried out by two independent reviewers. The Jadad scale was used to evaluate the methodological quality of the studies included.

Results:

In total, 12 clinical trials were selected, and 611 patients were examined. Studies were classified into six interventions: sexual therapy (4), pharmaceutical drugs (3), pelvic floor exercises (2), yoga (1), mindfulness (1) and vaginal devices (1). Most of them improved some primary outcomes of sexual dysfunction such as lubrication, arousal, desire or orgasm. Pain was the most common secondary outcome evaluated and it became better in two studies including sexual therapy and in one intervention with pelvic floor exercises. Tertiary outcomes such as anxiety or depression were rarely examined, and they improved with sexual therapy and with OnabotulinumtoxinA.

Conclusion:

Sexual therapy, administration of OnabotulinumtoxinA, pelvic floor muscles exercises alone or combined with electrostimulation and the use of clitoral devices could be the most recommended interventions to improve the sexuality in women with multiple sclerosis.
Pulmonary tuberculosis in a cohort of forensic autopsies: a preliminary study from Saudi Arabia
Authors: Madadin Mohammed , Menezes Ritesh G. , Al Tamimi Dalal M. , Kharoshah Magdy A. , Al Hamad Mohammad , Al-Nasser Mona , Al Madani Osama M.
Published: February 2020

Aims

The purpose of this study was to identify any cases of previously undiagnosed pulmonary tuberculosis during autopsy.

Methods

This prospective study investigated a cohort of deceased individuals that underwent a full external and internal postmortem examination at the Forensic Medicine Centre, Dammam, Saudi Arabia. Gross pathology, histopathology and molecular pathology were used to identify pulmonary tuberculosis in forensic autopsy samples from the lungs.

Results

A total of 82 cases autopsied were included in the study. The mean ± SD age of the study cohort was 35.5 ± 10.3 years (range, 20–80 years). Males ( n = 70; 85.37%) outnumbered females. The deceased were from 15 different countries. The number of Saudis was 16 (19.51%). The maximum number of non-Saudis was from India with 26 cases (31.71%). There were no cases of undiagnosed pulmonary tuberculosis detected for the first time at autopsy.

Conclusions

Although the prevalence of pulmonary tuberculosis in forensic autopsy cases in this preliminary study was nil, we recommend further studies to be conducted on a larger scale and in different autopsy centres throughout Saudi Arabia to get an insight into the burden of clinically undiagnosed tuberculosis in the entire country.
Efficacy of intracuff lidocaine in reducing coughing on tube: a systematic review and meta-analysis
Authors: Peng Fei , Wang Maohua , Yang Huihuang , Yang Xiaoli , Long Menghong
Published: February 2020

Objective

To investigate the efficacy of intracuff lidocaine in reducing coughing and other endotracheal tube side effects and so ensure a smooth extubation process.

Method

PubMed, EMBASE, and Cochrane Library databases were systematically searched for all randomised controlled trials (RCTs) published before June 30, 2019 that investigated the efficacy of intracuff lidocaine, with or without sodium bicarbonate, in reducing coughing and other complications related to endotracheal intubation. A random-effects model was used to conduct a meta-analysis to assess the relative risks (RRs) of the incidence of these intubation-related side effects.

Results

11 studies involving 843 patients were included in the meta-analysis. Compared with control groups (i.e., saline or air), intracuff lidocaine groups (alkalinized or non-alkalinized) had a significantly reduced incidence of coughing on tube. Similarly, intracuff lidocaine groups were more effective than control groups in reducing the incidence of other intubation-related complications.

Conclusion

Intracuff alkalinized or non-alkalinized lidocaine significantly reduced coughing and other intubation-related complications during the extubation process.
(Neo)Liberal populism and Ireland’s ‘squeezed middle’
Authors: Meade Rosie R. , Kiely Elizabeth
Published: February 2020

Acknowledging definitional problems associated with the concept of ‘populism’, this article shifts the analytic gaze away from actors or politics that are conventionally characterised as populist, on to an analysis of the doing of populism by those who typically evade the populist label. Tracing the discursive construction of the ‘squeezed middle’ in Irish mainstream media and parliamentary debates between January 2014 and March 2019, the authors analyse how this signifier was mobilised to fuel and foment ressentiment among middle-earning taxpayers. This article analyses how the discourses of the ‘squeezed middle’ functioned ideologically, as a form of anti-welfare populism, redirecting blame for middle-class ontological and material insecurities on to unemployed welfare recipients who were depicted as immoral, lazy and insulated from hardship. This article highlights how populism operates from the so-called moderate centres of liberal democracy and not exclusively from the political margins. Irish political and media narratives of the ‘squeezed middle’ are seen as part of a larger project whereby damaging myths about the unemployed are propagated in service of ideological class warfare; legitimising neoliberal austerity and normalising unequal economic relations.
The experiences of people with severe mental health conditions participating in the Occupation Matters Programme: An interpretative phenomenological analysis
Authors: Newport Alison , Clarke Channine
Published: February 2020

Introduction

The Occupation Matters Programme is an occupational therapy intervention promoting recovery in people with severe mental health conditions, adapted from the Lifestyle Redesign© approach. With the increasing demand for mental health services and the United Kingdom’s current financial position, there is reason to research the Occupation Matters Programme.

Method

Interpretative phenomenological analysis provided a rich account of the experience of the Occupation Matters Programme, eliciting the service user voice. Four participants participated in semi-structured interviews following session 10 and at the completion of the 20-week programme. Data analysis followed the step-by-step interpretative phenomenological analysis guidelines, enabling themes to be identified that reflected participants’ experiences.

Findings

Three major themes were revealed: connecting with others; experiencing an opened-up world through a temporary project and finding a place in the world through a changing sense of self. Three participants described a temporary improvement in their mental health at the halfway point, which became more permanent by the completion of the programme.

Conclusions

This study suggests that the Occupation Matters Programme was influential in the participants’ recovery journeys and provides evidence for Wilcock’s Doing, Being, Belonging and Becoming framework. It encourages occupational therapists to concentrate on occupation-centred practice, occupational integrity and implementing all four aspects of Wilcock’s framework.
Improving Railway Operational Efficiency with Moving Blocks, Train Fleeting, and Alternative Single-Track Configurations
Authors: Diaz de Rivera Adrian , Dick C. Tyler , Evans Leonel E.
Published: February 2020

With installation of positive train control (PTC) on many U.S. rail corridors, Class I railroads may soon leverage these investments in communications network infrastructure to implement “advanced PTC” systems incorporating moving blocks. Train control with moving blocks can benefit operating strategies that dispatch fleets of multiple trains running at minimum headways. On single-track corridors with passing sidings long enough to hold multiple trains, fleeting may increase the efficiency of train meets, reduce train delay, and yield incremental capacity benefits. Alternative single-track configurations with fleet-length sidings at double the spacing of conventional single-train sidings can facilitate these operating strategies while minimizing additional track infrastructure and associated capital and maintenance costs. To investigate the operational synergies between moving blocks, fleeting, and longer but less frequent sidings, Rail Traffic Controller software is used to simulate and compare the delay performance of train operations on representative rail corridors for different combinations of fleeting strategy, train control system, siding configuration, and freight traffic composition. Operating fleets in conjunction with moving blocks produces the lowest overall train delay in specific cases of low schedule flexibility and heterogeneous traffic. With more efficient meets, moving blocks and/or fleeting primarily benefit low priority trains that typically wait for opposing traffic during train meets. Such incremental line capacity benefits have short-term financial consequences as they allow additional capital investments in double track to be deferred. Knowledge of train delay performance under moving blocks and fleeting will aid railway practitioners evaluating investments in advanced PTC systems and track infrastructure expansion.
Effect of Diagnosed Sleep Disorders on Baseline Concussion Symptom, Cognitive, and Balance Assessments in Collegiate Athletes
Authors: McAllister-Deitrick Jamie , Trbovich Alicia M. , Broglio Steven P. , McCrea Michael , McAllister Thomas W. , Kontos Anthony P.
Published: February 2020

Background:

Symptoms, cognition, balance, and other domains are commonly assessed at baseline testing as part of comprehensive preseason evaluations among collegiate student-athletes. Although approximately 27% of college students have at least 1 sleep disorder, researchers have yet to examine the role of a preexisting sleep disorder on preinjury baseline performance.

Purpose:

To compare athletes with and without a reported history of diagnosed sleep disorders on commonly used baseline concussion assessments.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 666 National Collegiate Athletic Association student-athletes completed baseline measures including the Balance Error Scoring System (BESS), Brief Symptom Inventory–18 (BSI-18), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post-Concussion Symptom Scale (PCSS), Sport Concussion Assessment Tool–5th Edition (SCAT5), and Standardized Assessment of Concussion (SAC). There were 333 athletes with a history of diagnosed sleep disorders who were matched on age, sex, sport, and concussion history to 333 athletes with no history of diagnosed sleep disorders. Participants in both groups had a mean age of 19.89 ± 1.36 years and included 182 (54.7%) male athletes, and 126 (37.8%) reported a history of ≥1 concussions.

Results:

A series of 1-way analyses of covariance with Bonferroni corrections revealed significant group differences on the BESS (F1,559 = 8.88; P < .01); BSI-18 somatization (F1,640 = 18.48; P < .01), depression (F1,640 = 18.78; P < .01), anxiety (F1,640 = 19.42; P < .01), and global severity index (F1,640 = 27.18; P < .01); PCSS (F1,424 = 29.42; P < .01); SCAT5 symptom number (F1,634 = 28.79; P < .01) and symptom severity (F1,634 = 31.74; P < .01); and SAC (F1,578 = 4.36; P = .037). Specifically, while the sleep disorder group did perform better on the BESS, they also reported higher symptoms on the BSI-18, PCSS, and SCAT5 and performed worse on the SAC. There were no group differences on ImPACT performance.

Conclusion:

Collegiate student-athletes with diagnosed sleep disorders reported elevated affective and concussion symptoms at baseline that could affect the interpretation of postinjury impairments and symptoms. Based on the small effect sizes of our findings, however, the magnitude of these differences is of questionable clinical significance. Still, clinicians should consider diagnosed sleep disorders as reported during preparticipation sports physical examinations when interpreting baseline and postinjury concussion assessments.
Are Households in Kiribati Nutrition Secure? A Case Study of South Tarawa and Butaritari
Authors: Eme Paul Eze , Kim Nick D. , Douwes Jerone , Burlingame Barbara , Foliaki Sunia , Wham Carol
Published: February 2020

Background and Objectives:

This study assessed the nutritional status among householders in urban South Tarawa and rural Butaritari in Kiribati.

Methods and Study Design:

In this cross-sectional study, we assessed energy and nutrient intakes, food variety scores, and dietary diversity scores of men and women from 468 households randomly selected in South Tarawa (n = 161) and Butaritari (n = 307) using a 24-hour dietary recall. Nutrient adequacy ratios and mean adequacy ratios of selected nutrients were also determined from 3-day weighed food records collected among participants living in a further 28 households from South Tarawa (n = 29) and Butaritari (n = 44).

Results:

Based on the 24-hour dietary recall, the average energy intake for men and women was 2536 kcals and 2068 kcals, respectively. Carbohydrate (CHO), fat, and protein intakes for men and women were 332.5 g, 76.5 g, and 130.4 g and 291.7 g, 55.1 g, and 103.5 g, respectively. The mean and standard deviation of household Food Variety Score and Dietary Diversity Score was 3.90 ± 1.25 and 5.44 ± 1.92, respectively. Intakes of vitamin A, calcium, and iron, and zinc were notably deficient in both locations, with the urban participants having lower intakes of vitamin B-1, vitamin B-2, magnesium, and potassium than their rural counterparts. Mean sodium intakes exceeded recommendations for all age groups in South Tarawa except children aged 4 to 6 years.

Conclusions:

Food consumption patterns of the households in South Tarawa and Butaritari reflected high consumption of nontraditional diets and refined foods, which manifested in inadequate micronutrient intake estimates and low dietary diversity: strong risk factors for noncommunicable diseases such as obesity and diabetes.
Factors affecting the effectiveness and success of retrograde holmium laser endopyelotomy as the primary treatment of ureteropelvic junction obstruction in adults
Authors: Kartal Ibrahim , Çimen Sertaç , Karakoyunlu Nihat , Sandıkçı Fatih , Eraslan Aşır , Yalçınkaya Fatih
Published: February 2020

Purpose:

To evaluate the factors affecting the effectiveness, safety, and success of retrograde holmium:yttrium–aluminum–garnet laser endopyelotomy as the primary treatment of ureteropelvic junction obstruction in adults.

Methods:

Adult patients who underwent retrograde holmium:yttrium–aluminum–garnet laser endopyelotomy as the primary treatment of ureteropelvic junction obstruction between January 2012 and June 2016 at our clinic were retrospectively analyzed. Success was defined as the relief of symptoms and the resolution of obstruction, as assessed via radiography. Factors affecting success were analyzed, such as the clinical characteristics, procedural outcomes, complications, and the type of ureteroscopy used in the procedure.

Results:

Procedural success was achieved in 29 (74.4%) out of 39 patients, with a mean age of 38.3 ± 12.3 years during a median follow-up duration of 44 (33–65) months. Failure occurred at a median of 4.5 (3–22) months. It was detected that the presence of primary obstruction, ipsilateral kidney function being >30% of normal, and the length of obstruction being <1 cm positively affected procedural success ( p = 0.009, p = 0.011, and p = 0.019, respectively). In the postoperative period, two Grade I and four Grade II complications were observed according to the Clavien–Dindo classification. There was a difference only in the operation time between semirigid (24) and flexible ureteroscopes (15), with the operation time being shorter with the use of a semirigid ureteroscope than with the use of a flexible uteroscope ( p < 0.001).

Conclusion:

Retrograde holmium:yttrium–aluminum–garnet laser endopyelotomy is a minimally invasive method that can be used effectively and safely as the primary treatment of patients with ureteropelvic obstruction, when long-term results are also taken into consideration. The decision of performing laser endopyelotomy should be made after a detailed evaluation of the characteristics of the patient as well as of the obstruction.
Precarity and Development: Production and Labor Processes in the Informal Economy in India
Authors: Bhattacharya Snehashish , Kesar Surbhi
Published: February 2020

We take off from the recent critiques of precarity as an emerging global phenomenon to argue that the processes of precarity in the Global North and the Global South need to be analytically distinguished to bring forth their specificities. We further argue that such an analysis challenges the idea of development as transition, as is prevalent in much of the literature. We focus on the informal economy in India to show that the notion of precarity conceptually involves three distinct aspects of production and labor processes—“non-capitalist” petty commodity production (PCP), subcontracted PCP, and informal wage-labor. We argue that these dimensions have their own particularities that have distinct implications for the process of capitalist development in India. We contend that reproduction of these informal spaces during a period of high economic growth unsettles the imaginary of development as transition.
Waste management of deconstructed External Thermal Insulation Composite Systems with expanded polystyrene in the future
Authors: Heller Niklas , Flamme Sabine
Published: February 2020

External Thermal Insulation Composite Systems (ETICS), mainly comprised of expanded polystyrene (EPS) as the insulating material, have been used to insulate facades of buildings for the past few decades. In Europe, waste from ETICS deconstruction is currently disposed of in waste incineration facilities or landfills. Although the current quantities of ETICS waste are small, disposal of the increasing quantities of waste is posing a problem in some countries. New recycling strategies, such as the physico-chemical recycling of EPS or reutilisation of material and energy of all ETICS components in cement plants, offer the possibility of a circular economy for ETICS waste in the future. However, this would require a waste management chain from the construction site to the utilisation plant with appropriate waste treatment. To assess this concept further, this study documented dismantling efforts at different construction sites and conducted large-scale trials for ETICS waste treatment. The results of this study will allow the selection of suitable processing units and will be applied in a model developed by the IWARU Institute to determine economically and ecologically advantageous waste management routes that can be used to handle ETICS waste in the future.
Transgender and Nonbinary Experiences of Victimization in Health care
Authors: Kattari Shanna K. , Bakko Matthew , Langenderfer-Magruder Lisa , Holloway Brendon T.
Published: February 2020

Transgender and nonbinary (TNB) individuals experience high rates of myriad types of victimization, including in health care settings. Many TNB people avoid medical visits for fear of mistreatment and, when they do visit a provider, report negative experiences (e.g., denial of services, misgendering, verbal abuse). These negative experiences are heightened for TNB individuals who have an intersecting marginalized identity (e.g., low socioeconomic status, disability). Using data from the 2015 United States Transgender Survey, the largest survey of TNB individuals in the United States to date, the present study examines differential experiences of victimization in health care settings by TNB identity and other demographics (i.e., race, age, class, educational level, disability). A series of multivariate logistic regressions were run to determine adjusted odds ratios (AORs) for TNB individuals recently (i.e., in the past year) experiencing four forms of victimization: (a) doctor/health care provider used harsh or abusive language; (b) doctor/health care provider was physically rough or abusive; (c) patient was verbally harassed in health care setting; and (d) patient experienced unwanted sexual contact in health care setting. Frequency of victimization varied by gender identity and type of victimization; the most prevalent form was verbal harassment by a doctor/provider (5.84%) and the least prevalent was unwanted sexual contact in a health care setting (1.20%). Although findings varied by form of violence, generally, regression models demonstrated elevated odds of experiencing some form of health care victimization for those who were transgender compared with genderqueer, biracial/multiracial compared with White, low income compared with higher income, and disabled compared to non-disabled. In addition, odds ratios for victimization increased with age and, for some forms, increased with low educational attainment. We discuss the need for increased mandatory trainings for providers to reduce discriminatory and violent behavior toward TNB patients, as well as intersectional research to better ascertain the extent and nuance of victimization within TNB health care.
The Issue of Trust in Shaping the Job Involvement, Job Satisfaction, and Organizational Commitment of Southern Correctional Staff
Authors: Lambert Eric G. , Keena Linda D. , Haynes Stacy H. , Ricciardelli Rose , May David , Leone Matthew
Published: February 2020

While the issue of trust is theoretically essential for the effective operation of correctional organizations, few researchers have examined how the different types of trust are related to salient outcomes for staff. In this study, we examined the effects of coworker, supervisor, and management trust on the job involvement, job satisfaction, and organizational commitment of 322 Southern U.S. correctional staff. The types of workplace trust, however, varied in their effects. Specifically, multivariate analysis indicated only management trust had a significant positive effect on job involvement, but both coworker trust and management trust had significant positive effects on job satisfaction, whereas both supervisor trust and management trust had significant positive effects on organizational commitment. The current findings support the overall contention that workplace trust plays an important role in shaping prison staff job involvement, job satisfaction, and organizational commitment. The results underscore the need for improving perceptions of trust in the workplace, particularly management trust.
Applying a Medical Wellness Group Visit Model to a Community Setting Yielding Weight Loss and Improved Laboratory Results
Authors: Dong Kimberly R. , Flavin Lila , Hawkins Kerri , Altman Wayne
Published: February 2020

Purpose:

To determine the feasibility of applying a medical wellness group (WG) model to a community setting to improve cardiometabolic health.

Design:

This quasi-experiment was designed to compare individuals participating in the WG to participants in the control group who received general lectures on nutrition, physical activity, and sleep.

Setting:

A suburb north of Boston, Massachusetts.

Participants:

Forty-five adults were in the WG and 10 in the control group.

Intervention:

Fourteen weekly 90-minute sessions, led by a physician and dietitian, focusing on nutrition, physical activity, and sleep, compared to controls receiving two 30-minute general wellness lectures provided within 3 months.

Measures:

Pre- and postweight, waist circumference, hemoglobin A1C (HbA1c), and serum lipids; a survey measuring beliefs, attitudes, and intentions related to behavioral change.

Analysis:

T tests examined the mean change in biometric measurements. The Wilcoxon test was used to compare the ordinal questions in baseline and final survey results. The Mann-Whitney test was used to compare final survey results between groups.

Results:

The WG demonstrated desirable difference-in-difference between groups in weight ( P < .001), waist circumference ( P < .001), and total cholesterol ( P = .03) compared to the control group. Mean change of HbA1c and triglycerides was not different between groups. Survey results showed that attitudes, perceived behavioral control, and feeling supported about wellness behaviors significantly improved from baseline to final visit in the WG ( P = .002; P = .019, P = .006, respectively), but not among controls.

Conclusion:

Wellness groups are feasible and provide high levels of support and accountability that empower people to make behavioral changes to improve health.
What price to pay? The trade-off between independence and influence in European regulation
Authors: Ruffing Eva
Published: February 2020

This article asks whether the strengthened, institutionalised role that some European agencies play in delegated decision-making endangers their actual independence. In some particular sensitive policy domains, such as pharmaceuticals security, financial markets and energy, European agencies exist which are formal agenda-setters in delegated decision-making, meaning that the European Commission can either accept or reject their proposals but is hardly allowed to change them. These procedures were established to guarantee particularly expert-based decision-making. However, the article argues that under these conditions, the Commission will be eager to interfere with the agencies’ proposal preparation to ensure that the proposal is in line with its position, thereby weakening the de facto independence of agencies. Such procedures come, therefore, with unexpected effects in practice. However, the article demonstrates that these effects vary with organisational resources on the agencies’ and the Commission’ side and the expected constraining effects of the decisions taken.
The interaction of multiple drivers of intra-organizational change in ministerial administrations: A study of three decades of structural reforms in the Austrian Ministry of Agriculture
Authors: Lichtmannegger Christina , Tobias Bach
Published: February 2020

Administrative reform policies cutting across several sectors are commonplace in the public sector. However, reform policies do not necessarily result in organizational change. This article examines intra-organizational change within the Austrian Ministry of Agriculture in a longitudinal case study covering a period of three decades, which allows us to study short-term and long term-effects of administrative reforms. Whereas existing research mainly uses single-factor explanations for inter- and intra-organizational change, this article emphasizes the interplay of various drivers of organizational change within government organizations. In analytical terms, we draw on the multiple streams framework to study intra-organizational decision-making which is embedded in government-wide administrative reform policies. We find that reform leads to intra-organizational change when a political entrepreneur is able to couple solutions and problems in a decision window, which may happen decades after the initial reform attempts, underscoring that short-term reform failure may turn into success in a long-term perspective.
An improved integrated navigation method based on RINS, GNSS and kinematics for port heavy-duty AGV
Authors: Fu Zhuang , Feng Xin , Duan Xiaoming , Fu Zeyu
Published: February 2020

The current navigation methods for port heavy-duty automated guided vehicle mainly include the antenna radar-transponder navigation and the global navigation satellite system. However, the former has a huge cost and the latter will generate multi-path error easily. To avoid these problems, an improved integrated navigation method based on single-axis rotating inertial navigation system, global navigation satellite system and kinematics is proposed. First, the rotating inertial navigation system/ global navigation satellite system and rotating inertial navigation system/Kinematics integrated navigation methods generate corresponding estimates and filtering error covariances through their respective extended Kalman filter filters, and then the two sets of results are fused by the optimal weighted voting fusion method. The proposed method is applied to a heavy-duty automated guided vehicle for engineering verification. Without multi-path error, the navigation accuracy is 1.8–2.98 times higher than that of the traditional global navigation satellite system navigation. In the case of multi-path error, the improved method still has high fault tolerance and high navigation accuracy. The accuracy of this method satisfies the requirements of port heavy-duty automated guided vehicle, which can greatly reduce the number of transponders and has high practical value.
Development of a variable mode valve actuation system for a heavy-duty engine
Authors: Wang Yang , Long Wuqiang , Cui Jingchen , Tian Hua , Meng Xiangyu , Wang Xin , Xu Duo
Published: February 2020

A new variable mode valve actuation system for a heavy-duty engine was proposed and designed in this paper. The variable mode valve actuation system can significantly enhance braking safety and improve fuel economy and emission of heavy-duty engines through flexible switching among four-stroke driving mode, two-stroke compression-release braking mode, and cylinder deactivation mode on a conventional four-stroke engine. The switching was controlled by four-stroke driving modules and two-stroke braking modules, both of which have two operation states: effective state and failure state. For the control of the multi-cylinder engine, all cylinders can be divided into several groups, and all the four-stroke driving modules in the same group were controlled by one solenoid valve, as well as all the two-stroke braking modules were controlled by another solenoid valve. A hydraulic-mechanical multi-body dynamics model was established to investigate the switching response of the variable mode valve actuation system. The results indicated that when the engine operated at 2000 r/min, the switching of the four-stroke driving module and the two-stroke braking module required 30 °CA and 101 °CA at most, respectively. In addition, to avoid the conflict between the four-stroke driving valve lift and the two-stroke braking valve lift, the switching between the four-stroke driving mode and the two-stroke compression-release braking mode must have a reasonable sequence. The variable mode valve actuation system has an excellent switching response and it is convenient for the control of the multi-cylinder engine. Therefore, the variable mode valve actuation system has a good application prospect for heavy-duty engines.
Disease activity and damage in hospitalized lupus patients: a Sabah perspective
Authors: Selvananda S , Chong Y Y , Thundyil R J
Published: February 2020

Objective

Systemic lupus erythematosus (SLE) is a complex multi-systemic autoimmune disease with variable levels of activity that may wax and wane within the same patient over the years. In view of the scarcity of data about lupus in the East Malaysian population, we aimed to study the disease activity and damage index in patients with SLE hospitalized in a tertiary center in Sabah, East Malaysia.

Methods

We retrospectively studied all patients with SLE admitted from 1 January 2013 to 31 December 2015. Demographic data, clinical features, treatment received, SLEDAI and SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) criteria and outcomes were collected.

Results

There were 108 patients studied whereby 88.9% were females. They had a mean age of 31.4 ± 11.02 years at admission and were multiethnic in origin. The mean number of ACR criteria for SLE was 5.03 ± 1.5 at the time of diagnosis. There were 158 hospitalizations during the 3 years. The main causes of hospitalization were flare of SLE (66.5%), infection (57.6%), renal biopsy (15.5%) and others (11.4%). Active nephritis (65%), cutaneous (44.4%) and hematological involvement (40.2%) were the three commonest manifestations. There was concurrent flare of SLE and infection in 41.1% of the admissions. The mean SLEDAI score at admission was 10.8 ± 7.20, with a mean SLEDAI of 9.3 ± 6.9 in those without damage and 11.9 ± 7.21 in those with damage ( p-value = 0.026). The median SLICC score was 1 with a mean of 0.93 ± 1.07. There were nine deaths (5.6%) during the study period and all patients were females. Compared with those who survived, they had a significantly higher SLEDAI score of 15.80 ± 8.2 ( p-value = 0.0207) and a SLICC score of 2.70 ± 1.6 ( p-value <0.001).

Conclusion

SLE is more common among the indigenous population of Sabah, the Kadazan-Dusun, which has not been shown before this study. Disease characteristics were, however, similar to reports from the Asia-Pacific region. Acute flare of SLE and infection remained the main causes of admission and readmissions and was present in 44.4% of the mortalities in our cohort.
Social partner involvement in collective skill formation governance. A comparison of Austria, Denmark, Germany, the Netherlands and Switzerland
Authors: Emmenegger Patrick , Seitzl Lina
Published: February 2020

Dual vocational education and training (VET) with social partner involvement in its governance can typically be found in collective skill formation systems. This article reviews the diversity of collective skill formation systems with a particular focus on their systemic governance. In particular, we look at the actors involved as well as how the systemic governance is organised in terms of corporatist decision-making bodies. The article shows that there are important cross-national differences. First, the social partners do not always participate in the decision-making at the political-strategic level. Second, social partner involvement is not always on equal terms (parity), with trade unions in some cases being less strongly involved. Third, differences in VET governance are particularly pronounced at the technical-operational level. Empirically, the article focuses on the five prototypical collective skill formation systems Austria, Denmark, Germany, the Netherlands and Switzerland.
The rhetoric of Europeanisation of dual vocational education and training in Spain
Authors: Martín Artiles Antonio , Lope Andreu , Barrientos Daniel , Moles Benjamí , Carrasquer Pilar
Published: February 2020

This article has two objectives: to analyse the implementation of dual vocational education and training (VET) in Spain and to study the school-to-work transition of young people who complete dual VET. The article draws on a study that was based on 43 interviews, a discussion group and document analysis. The results show that dual VET has been implemented through a school-based model, as opposed to the firm-based ‘German’ model. Participants may be employed on the basis of training contracts or internships. Whichever approach was taken, we found that young people who have completed dual VET enjoy a rapid school-to-work transition.
Making Come-Alive and Keeping Un-Alive: How People Relate to Self-Guided Web-Based Health Interventions
Authors: Holter Marianne T. S. , Ness Ottar , Johansen Ayna B. , Brendryen Håvar
Published: February 2020

Health interventions delivered online (self-guided web-based interventions) may become more helpful through a person-to-program “working alliance.” In psychotherapy, the working alliance signifies a therapeutically useful client–therapist relationship and includes an emotional bond. However, there exist no theories of how program users relate to online programs, or that explain a person-to-program bond theoretically. Addressing this gap, we conducted qualitative interviews with and collected program data from users of a self-guided web-based intervention. Taking a grounded theory approach, the analysis arrived at a model of relating based on two relational modes— making come-alive and keeping un-alive. Different combinations of these modes could describe a range of ways of relating to the program, including a nonsocial interaction, a semi-social interaction, and a semi-social relationship. A person-to-program bond is explained by the model as an experienced supportive social presence, enabled by making come-alive and a positive program interaction.
Social Support and Women’s Reproductive Decision Making: Testing Emergent Fit of “Optimizing Support for the Preservation of Self”
Authors: Clarke Stefanie , McKenzie Hayley , Lamaro Haintz Greer , Graham Melissa
Published: February 2020

Despite the strong association between social support and positive health outcomes, little is understood about its role in women’s reproductive decision making. Developing insight into how women perceive, mobilize, and experience social support is critical to understanding their lived experiences of reproductive decision making and to implementing appropriate supporting structures to help women realize their reproductive choices. In this study, emergent fit with existing inductive research on the phenomenon of reproductive support is discussed. The existing theory of “optimizing social support for the preservation of self” and its underpinning categorical framework is maintained, but the extant categorical themes were all nuanced, refined, replaced, or removed to better reflect the support phenomenon among a wider cohort of women. This article builds on the existing knowledge base by producing a substantive theory of “optimizing social support for the preservation of self” with wider applicability.
Fitting in, Standing Out, and Doing Both: Supporting the Development of a Scholarly Voice
Authors: Ismail Arif , Ansell Gwen , Barnard Helena
Published: February 2020

What scholars call “writing” actually involves writing, reading, talking, thinking, and engaging. Yet how academic writing develops through this recursive, social process, is imperfectly understood. Although participating in academic gatherings like colloquia and international conferences can help researchers find a scholarly voice, not all new scholars have the opportunity to participate in such gatherings and the learnings they offer. Especially for those scholars, their academic writing must be consciously developed. We examine the process by which a new South African management scholar, supported by his writing coach, developed an academic voice. Analyzing their 15-month long communication (emails and summaries of conversations), we find three interweaving processes. Coaching guides the new scholar first to learn to fit in by becoming aware of genre conventions through practical writing-to-learn and show-and-tell coaching tactics. Then the challenge is to stand out by forcing tough trade-offs and intensifying the focus on novelty. Ultimately the scholar must do both, negotiating the tension between them. Our article provides evidence of how the emergence of self-reliant scholarly writing can be supported. This process is especially salient in developing country contexts with few enculturating opportunities, but we suggest that it applies more broadly, opening avenues for future theorizing.
Gendered Meanings of Leadership: Developing Leadership Through Experiential Community-Based Mentoring in College
Authors: Pascale Amanda Blakewood , Ohlson Matthew
Published: February 2020

Background: Employers consider strong leadership skills among highly desirable qualities for new hires. To meet the needs of today’s complex workforce, colleges and universities have increased opportunities for experiential learning for students. However, it is not known how students make meaning of these experiences in context with their personal backgrounds and experiences. Purpose: This study examines how women and men in college make meaning of leadership and leaders through experiential community-based mentoring participation. Methodology/Approach: A two-step qualitative content analysis of reflective journals, with a sample of 20 students utilizing the constant comparative method, is used to generate overarching themes. A second qualitative analysis compares how men and women understand leadership differently. Findings/Conclusions: Findings reveal that, despite a shift in the leadership literature away from hierarchical or trait models toward transformational, relational models that are typically more inclusive of women, our participants still made meaning of leadership and leaders in ways that were more closely aligned with antiquated understandings of leadership. Implications: Recommendations including use of experiential learning as a tool to intentionally increase leadership development and efficacy for women and men in college are discussed.
Vibration control of nonlinear three-dimensional length-varying string with input quantization
Authors: Xing Xueyan , Yang Hongjun , Liu Jinkun , Wang Shuquan
Published: February 2020

This article studies the stability problem for a three-dimensional string with variable length in the case of input quantization. A nonlinear partial differential equation model is used to depict the dynamic characteristics of the length-varying flexible string with distributed variable parameters. The control signals are effectively mapped from a continuous region to a discrete set of numerical signals before being transmitted through communication channels using quantizers. With no information about quantizers, the vibration of the string is eliminated under the proposed adaptive quantized control despite of the actuator degradation, and the stability of the closed-loop system is demonstrated based on the Lyapunov’s direct method. Simulation results are supplied to show the effectiveness of the presented control strategy.
The impact of tumor regression grade on long-term survival in locally advanced rectal cancer treated with preoperative chemoradiotherapy
Authors: Sakin Abdullah , Sahin Suleyman , Sengul Samanci Nilay , Yasar Nurgul , Demir Cumhur , Geredeli Caglayan , Erhan Selma Sengiz , Akboru Mustafa Halil , Cihan Sener
Published: February 2020

Purpose

The aim of this study is to investigate the prognostic effect of tumor regression grade (TRG) on long-term survival in locally advanced rectal cancer treated with preoperative chemoradiotherapy.

Methods

Medical records of 182 patients with locally advanced rectal cancer, who were treated with preoperative chemoradiotherapy followed by surgery between 2002 and 2016, were retrospectively reviewed. TRG was classified into five categories based on the pathological response as follows – TRG1: no viable cancer cell, TRG2: single cancer cell or small groups of cancer cells, TRG3: residual tumor outgrown by fibrosis, TRG4: residual tumor outgrowing fibrosis, TRG5: diffuse residual tumor without regression. TRG1, (TRG2+TRG3), and (TRG4+TRG5) were grouped as complete response, intermediate response, and no response, respectively.

Results

Of the 182 patients with locally advanced rectal cancer, 112 (61.5%) were male. The mean age was 54.4 (range, 25–87) years. The total number of patients in complete response, intermediate response, and no response group was 24 (13.2%), 105 (57.7%), and 53 (29.1%), respectively. The corresponding five-year relapse-free survival and overall survival rates were 79.8%–92.3%, 74.7%–79.4%, and 55.7%–55.8%, respectively (p < 0.05 for relapse-free survival, p < 0.05 for overall survival). According to ypTNM stage, there was no significant difference in relapse-free survival among TRG groups in ypStage I and II patients (p > 0.05). In ypStage III patients, relapse-free survival was 62 months in no response group vs. not reached in intermediate response group (p < 0.05). According to the ypTNM, there was no significant difference in overall survival among TRG groups in ypStage I, II, and III patients (p > 0.05). In the multivariate analysis, pathological complete response was found to be an independent variable for relapse-free survival and overall survival (hazard ratio (95% confidence interval), 0.34 (0.17–6.77), 0.39 (0.18–0.83), respectively).

Conclusion

This study showed that patients with pathological complete response to preoperative chemoradiotherapy had longer relapse-free survival and overall survival rates than those with residual disease.
Toxicity, risk factors and management of cisplatin-induced toxicity: A prospective study
Authors: Ben Ayed Wiem , Ben Said Azza , Hamdi Adel , Mokrani Amina , Masmoudi Yosri , Toukabri Imen , Limayem Imen , Yahyaoui Yosra
Published: February 2020

Background and propose

Cisplatin is a cytotoxic drug that triggers several toxicities. However, nephrotoxicity and ototoxicity remain major clinical limitations. The aim of our study was to evaluate the incidence of chemotherapy toxicity induced by cisplatin and to analyze the influence of risk factors in the Tunisian population.

Methods

We performed a prospective descriptive study in a period of four months. Patients were eligible if they had pathologically confirmed malignancies and treated with cisplatin-regimen chemotherapy. Nephrotoxicity and digestive toxicity were graded according to the World Health Organization toxicity scale and ototoxicity was scored clinically according to the Common Terminology Criteria for Adverse Events (CTCAE). Multivariate logistic regression analysis was performed to evaluate the influence of clinical variables on cisplatin-induced toxicity.

Results

A total of 150 patients were included. Forty-four percent of patients developed cisplatin-regimen toxicity: 15% developed cisplatin-induced nephrotoxicity, 9% cisplatin-induced ototoxicity and 27% digestive toxicity. In the multivariate analysis, age >65 years (OR= 6.129, p = 0.010), metastatic cancer (OR = 0.171, p = 0.007) and cumulative dose (OR= 1.004 mg/m2; p = 0.042) were strong predisposing factors for CDDP-induced nephrotoxicity. The cumulative dose was an independent prognostic indicator for digestive toxicity (OR = 0.997, p = 0.002).

Conclusion

In our study, age >65 years and metastatic cancer were risk factors for cisplatin-induced nephrotoxicities. We also found the correlation between cumulative dose and nephrotoxicity or digestive toxicity.