bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Social Cohesion in Preventing Child Abuse Among Rural Chinese Left-Behind Children
Authors: Zhang Huiping , Ma Aijia , Li Yali
Published: September 2020

Child abuse is a significant public health issue that can affect children’s physical and mental health. However, few studies have examined rural Chinese left-behind children. The role of social cohesion of rural Chinese communities in the prevention of child abuse remains understudied. The present study aims to investigate certain factors that could reduce child abuse problems, placing a special focus on the protective role of social cohesion, especially for left-behind rural children. Data were collected from a sample of 1,049 school-aged rural children from the largest middle school in China’s Henan Province. It was found that social cohesion directly affected physical abuse and emotional abuse; furthermore, social cohesion was more significantly associated with emotional abuse, whereas sexual abuse was a more significant issue for left-behind children than for those living with their parents. However, the moderating effect of the left-behind status on the association between social cohesion and physical abuse was not significant. Our findings suggest that social cohesion is an important factor for preventing emotional and sexual abuse. Thus, it is necessary to enhance social cohesion in rural Chinese communities with left-behind children to reduce their risk of experiencing child abuse.
Longitudinal Associations Between Sexual Victimization and Substance Misuse Among High School Youth in Colorado
Authors: Mintz Sasha , Ingram Katherine M. , Milliken Anne , Kuehl Tomei , Espelage Dorothy L.
Published: September 2020

There are consistently high rates of sexual victimization and substance misuse among youth in the United States. Although there is a known relation between sexual victimization and substance use, there is a gap in the research regarding the magnitude and temporality of these associations. This study examined whether latent classes of sexual victimization and help-seeking attitudes longitudinally predict intentions of future substance misuse 7–10 months later. Students from nine Colorado high schools ( N = 533; M = age 16 years) completed surveys across two consecutive school semesters. Latent class analysis was used to identify classes of students who experienced at least one form of sexual victimization (e.g., sexual harassment, unwanted sexual contact) according to 13 sexual victimization items, and level of positive attitudes regarding help-seeking for sexual victimization. Classes were compared on demographic characteristics and for distal outcomes of likelihood of future substance misuse (cigarettes, alcohol, cannabis, prescription drugs, and electronic vaping products) using latent class regression, controlling for previous intentions to use. At Time 1, four classes of sexual victimization were identified with two main classes for comparison: low odds of experiencing sexual victimization (60.1% of sample) and high odds of endorsing all forms of sexual victimization (7.7% of sample). The high sexual victimization class had higher proportions of male and transgender students, compared to other classes. At Time 2 (7–10 months later), students in the high sexual victimization class reported a significantly greater likelihood of future cigarette ( p = .017) and prescription drug misuse ( p = .007) when compared to the low sexual victimization class. There was no evidence that having higher positive attitudes towards help-seeking resulted in lower intentions to use substances in the future. These findings highlight that addressing sexual violence in prevention programming may have crossover effects of reducing substance misuse and other forms of violence among youth.
Marketized Mentality, Street Codes and Violence
Authors: Baron Stephen W.
Published: September 2020

The article examines the recent individual level extensions to Institutional Anomie Theory. It explores if a marketized mentality is important to the development of a violent street code that encourages violence as a method of self-enhancement, as well as a factor directly leading to violence. Further, it investigates if the impact of the marketized mentality on violence is moderated by risk-taking and violent peers. It controls for other important factors associated with violence including physical abuse, homelessness, violent victimization, and social bonds. The research utilizes self-report data from interviews with 400 Canadian homeless youth aged 16–24. Results from the OLS regressions indicated that a marketized mentality, along with risk-taking, violent peers, violent victimization, and social bonds predicted levels of support for the street code. The marketized mentality had a direct effect on violence, as well as an indirect effect through the street code. The effect of marketized mentality on violence was also stronger at higher levels of risk-taking and violent peer association. Physical abuse, violent victimization, risk-taking, and violent peers also had direct effects on violence. The findings suggest that a marketized mentality can be adopted even in economically marginal populations leading to the development of violent strategies to fulfill goals. Avenues for future research are offered.
Evaluating the Risk of Developing Thrombocytopenia Within Five Days of Continuous Renal Replacement Therapy Initiation in Septic Patients
Authors: Fay Lauren , Rechner-Neven Georgeanna , Hammond Drayton A. , DeMott Joshua M. , Sullivan Mary Jane
Published: September 2020

Background:

The differential diagnosis for thrombocytopenia in critical illness is often extensive. This study was performed to determine the incidence of thrombocytopenia in septic patients undergoing continuous renal replacement therapy (CRRT) versus those not undergoing CRRT.

Objective:

The primary outcome of this study was to compare the development of thrombocytopenia, defined as a platelet count ≤ 100 × 103/mm3, in septic patients within 5 days of time zero. Time zero was defined as the baseline platelet count upon hospital admission or CRRT initiation.

Methods:

An IRB approved, retrospective cohort study was conducted evaluating thrombocytopenia development in critically ill, septic patients who were initiated on CRRT versus those whom were not. Baseline and clinical characteristics were displayed using descriptive statistics. The primary outcome was evaluated overall and in subgroups of CRRT using Chi-square tests.

Results:

One hundred sixty patients, 80 per arm, were included in the study. Thrombocytopenia development within 5 days occurred more frequently in the renal replacement therapy (RRT) group compared to the control group (67.5% vs. 6.3%, p < 0.001). In the subgroup analysis of the RRT cohort, thrombocytopenia development within 5 days occurred more frequently in the continuous veno-venous hemofiltration (CVVH) group compared to the accelerated veno-venous hemofiltration (AVVH) group (76% vs. 53.3%, p = 0.049).

Conclusion:

There is a high likelihood that septic patients initiated on CRRT will develop thrombocytopenia during their hospital stay. Patients receiving CVVH may develop thrombocytopenia more frequently than those receiving AVVH. Overall, CRRT should remain a differential diagnosis for thrombocytopenia development in this patient population.
Highly efficient and accurate calibration method for the position-dependent geometric errors of the rotary axes of a five-axis machine tool
Authors: Guo Shijie , Tang Shufeng , Jiang Gedong , Mei Xuesong
Published: September 2020

This paper proposes a calibration method for continuous measurements with a double ball bar (DBB) used to identify the position-dependent geometric errors (PDGEs) of the rotary axes of five-axis machine tools. The different DBB installation modes for the rotary axes of the spindle and workbench are established, and the same initial DBB installation position is used for multiple tests. This approach minimizes the number of required DBB installations, which increases the measurement efficiency of the PDGEs of the rotary axes and reduces installation errors. PDGEs identification based on the adaptive least absolute shrinkage and selection operator (LASSO) method is proposed. By assigning coefficients to the PDGEs polynomial, the ill-conditioned problem of the identification process can be effectively avoided, thereby improving the identification accuracy. The measurement and identification methods proposed in this paper are verified by experiments on a five-axis machine tool. After compensation, the PDGEs are obviously reduced and the accuracy indexes of the circular trajectory tests performed under multiaxis synchronous control are obviously improved.
Adaptive data-driven modular control approach to computer aided process planning for manufacturing spiral bevel and hypoid gears
Authors: Rong Kaibin , Ding Han , Tang Jinyuan
Published: September 2020

Machine setting modification has been an increasingly important access to the accurate flank manufacturing geometric accuracy control for spiral bevel and hypoid gears. More recently, machine setting driven integration of the theoretical design and the actual gear manufacturing is gaining more and more attention. In this paper, the traditional machine setting modification is extended to the case when higher-order component of the prescribed ease-off flank topography is investigated in form of high-order polynomial expression. Moreover, the actual gear manufacturing and general measurement are integrated into an adaptive data-driven high-order machine setting modification. In particular, this modification method is used to perform adaptive modular control for computer aided process planning (CAPP). Here, a data-driven operation and optimization is developed for adaptive high-order modification. It mainly includes: (i) Polynomial fitting and its optimization by using overall interpolation based on energy method, (ii) Data-driven ease-off flank parametrization based on the fastest descent Newton iteration method, (iii) adaptive control strategy by considering the sensitivity analysis, and (iv) Levenberg-Marquardt (L-M) based approximation for high-order machine setting modification. Given numerical test can verify the proposed method.
Turning of Austempered Ductile Iron with ceramic tools
Authors: Fernández-Valdivielso A , López de Lacalle LN , Fernández-Lucio P , González H
Published: September 2020

Austempered ductile iron castings (ADI) are characterized by the high strength and resistance to fatigue, impact, and wear. ADI mechanical properties are obtained by performing a heat treatment on ductile iron casting. Thus, the so-called ausferrite microstructure is achieved. However, heat treatment significantly affects ductile casting machinability. A precise determination of ADI microstructure, on the one hand, and to choose correct machining process parameters and tool wear control on the other, are essential to optimize cutting processes and for the introduction of ceramic inserts. Ceramics are an alternative to carbide tools. In this paper, ceramic tools for the dry turning of ADI castings are studied. Thus, different technical ceramics were analyzed, identifying the dominant wear mechanism and evolution. Tool wear rate magnitude was determined indirectly by the variation of cutting force along machining time. Finally, different tests helped to study ceramics wear sensitivity with respect to cutting parameters. Mixed ceramics of Al2O3 with TiC showed the best performance, followed by SiAlON ones.
Sustainable adhesives and adhesion processes for the footwear industry
Authors: Arán-Ais F , Ruzafa-Silvestre C , Carbonell-Blasco MP , Pérez-Limiñana MA , Orgilés-Calpena E
Published: September 2020

The key to sustainable development in the footwear industry through the principles of circular economy lies in taking care of the design, as well as the introduction of innovative and more resource efficient materials and processes to reduce or avoid the use of water, energy, hazardous chemicals and to minimise emissions and waste. In fact, the environmental footprint is already being considered as another requirement of the footwear through eco-design. In this sense, previous studies carried out by INESCOP regarding its environmental impact in terms of carbon footprint showed that 15% of it corresponds to the assembly processes, mainly by adhesive joints, due to their content on organic solvents, hazardous chemicals and polymers from fossil origin.

Therefore, this paper focuses on recent developments carried out by INESCOP on more sustainable adhesives and adhesion processes for the upper-to-sole assembly in the footwear manufacturing process, through different approaches. Firstly, bio-based reactive polyurethane hot melt adhesives have been synthesised using polyols from different renewable sources. Secondly, the use of the low-pressure plasma surface treatment to improve the adhesion of polymeric materials used as soling materials was assessed in order to reduce volatile organic compounds emissions, as well as the use of hazardous chemicals for total automation of the bonding process.
A theoretical solution of the axial stiffness of a cylindrical shell with a circular plate
Authors: Feng Sheng , Yang Baisong , Tian Jiale , Yu Lie
Published: September 2020

A structure of a cylindrical shell with a circular plate end cap is usually used in connect different shaft system and it is necessary to estimate the axial stiffness in order to analyze the vibration of the rotor system. This paper builds the model of this structure. The theoretical solution of the bending deflection of the circular plate and the cylindrical shell are deduced by using the classic theory of plates and shells, and the continuity boundary conditions at the junction of the circular plate and the cylindrical shell. Furthermore, the axial stiffness of the structure is solved through considering the relationship between the external force-bending deformation. Two different boundary conditions for the left side of the cylindrical shell is considered and their axial stiffness varying with the length of the cylindrical shell is calculated. For verification, a finite element model of the structure is built and analyzed. The theoretical results fairly coincide with the finite element ones.
Study of metallurgical changes and mechanical properties of dissimilar weldments developed by interpulse current TIG welding technique
Authors: Yelamasetti Balram , Vardhan T Vishnu , Ramana G Venkat
Published: September 2020

This research manuscript compares the metallurgical changes and mechanical behavior of AISI 316 and Monel 400 dissimilar weldments developed by Interpulse TIG welding process with ERNiCrMo-3 and ER316 filler wires. Metallurgical aspects are envisioned by using optical and scanning electron microscopes. Mechanical behavior of welded joints were studied by conducting tensile and microhardness tests. Metallurgical study has shown that the ERNiCrMo-3 filler weldment divulged completely with austenitic phase structure at the weld zone. Also, at the HAZ of Monel 400 clear grain boundaries with fine grains were observed. The mechanical properties corroborated that the weld strength of ERNiCrMo-3 weldment was found better than the ER316 weldment. Microhardness on the weldment made of ERNiCrMo-3 filler has shown higher values than that of base metals. Weldment made by ER316 was observed to fail near the interface of Monel 400 under tensile test due to the existence of micro-pores and partially melted zones. Further, the metallurgical and mechanical properties are compared with that of the weldment developed by TIG welding process.
Design of variable curvature lane changing control system based on inverse system decoupling
Authors: Liang Xiutian , Zhao Linfeng , Wang Qidong , Chen Wuwei , Xia Guang , Zhang Ruichen
Published: September 2020

At present, the lane changing technology for a single driving environment has been relatively mature, but the actual situations are much more complicated, such as the changing curvature and the changes in road conditions. In this paper, a new lane changing obstacle avoidance control strategy for the variable curvature road was proposed. It has two stages including path planning for variable curvature lane changing and inverse system decoupling (ISD) control for path tracking. The first stage established the lane changing path models for the variable curvature road. A longitudinal-lateral safe distance model was proposed to constrain the safe boundary of the lane changing path. The second stage proposed a dynamic decoupling method for longitudinal and lateral motion based on the inverse system decoupling, a direct yaw moment and active front wheel steering coordinated control method was designed. The inverse system decoupling algorithm can correct the single point preview (SPP) method to improve the stability and the path tracking accuracy in the lane changing obstacle avoidance process. The strategy was simulated by CarSim/Simulink co-simulation, and the experiments were carried out on the hardware-in-the-loop platform. The results show that the proposed control strategy can effectively avoid obstacles when the vehicle is driving on the variable curvature road. Besides, for the different road conditions and the strong non-linearity generated during the lane changing process, the control strategy can reduce the tracking error by a maximum of 32.7%, both the yaw rate and side slip angle can be controlled in a smaller range.
Irreversibility analysis of nanofluid flow in a vertical microchannel with the influence of particle shape
Authors: Sindhu S , Gireesha BJ
Published: September 2020

Augmentation of thermal performance in heat transfer system has become research hotspot nowadays. Numerous techniques are carried out to pick up the effective heat transport mechanism for designing high efficient thermal frameworks which has extensive practical uses in industrial process. In the current study, mixture model has been implemented for better describing the characteristics of nanoparticles in a vertical microchannel. The nondimensional equations are computed by using Runge Kutta Fehlberg method. Effect of heat source, buoyancy force and convective boundary on the thermal system has been demonstrated. The role of spheroidal nanoparticles on thermal conductivity of the conventional fluid has been examined. The causes of irreversibilities in a microchannel due to nanoliquid flow has been reported in the current research work. It is obtained that Aluminum foam has higher thermal field compared to Al2 O3. Entropy generation is reduced by lowering Eckert number and Grashof number. It is explored that nanofluid containing oblate shaped nanoparticels has higher thermal conductivity ratio.
The influence of yaw on the unsteady surface pressures over a two-wheeled landing-gear model
Authors: Graham WR , Gatto A
Published: September 2020

Landing-gear noise is an increasing issue for transport aircraft. A key determinant of the phenomenon is the surface pressure field. Previous studies have described this field when the oncoming flow is perfectly aligned with the gear. In practice, there may be a cross-flow component; here its influence is investigated experimentally for a generic, two-wheel, landing-gear model. It is found that yaw angles as small as 5° cause significant changes in both overall flow topology and unsteady surface pressures. Most notably, on the outboard face of the leeward wheel, large-scale separation replaces predominantly attached flow behind a leading-edge separation bubble. The effect on unsteady surface pressures includes marked shifts in the content at frequencies in the audible range, implying that yaw is an important parameter for landing-gear noise, and that purely unyawed studies may not be fully representative of the problem.
Fuel efficiency optimization of high-aspect-ratio aircraft via variable camber technology considering aeroelasticity
Authors: Guo Liqiang , Tao Jun , Wang Cong , Zhang Miao , Sun Gang
Published: September 2020

In this study, variable camber technology is applied to improve the fuel efficiency of high-aspect-ratio aircraft with aeroelasticity considered. The nonlinear static aeroelastic analyses are conducted for CFD/CSD (computational fluid dynamics/computational structural dynamics) numerical simulations. The RBF (radial basis function) method is adopted for the transmission of aerodynamic loads and structural displacements, the diffusion smoothing method is employed for grid deformation in each iteration of CFD/CSD coupling, and the FFD (free-form deformation) method is introduced for the parameterization of variable camber wing. Based on the aerodynamic characteristic curves under different cambers, the discrete variable camber control matrix for the high-aspect-ratio aircraft during the cruise phase is established. The Fibonacci method is employed to optimize the fuel efficiency by utilizing the control matrix. The results indicate that the drag during the cruise phase is reduced obviously and the fuel efficiency is improved evidently comparing to the original configuration.
A new fault detection scheme based on canonical independent component analysis with application to hot strip mill process
Authors: Zhang Rui-Cheng , Li Yu-Ting , Liang Wei-Zheng , Xiong Wei
Published: September 2020

Aiming at the problems of inaccurate fault detection and error alarm in the process of hot strip mill process, a fault detection scheme of canonical independent component analysis is proposed. The new scheme first uses canonical variable analysis to calculate the canonical variable matrix of observation data, which effectively solves the problem of autocorrelation and cross-correlation. Then the canonical variable matrix is decomposed by independent component analysis to obtain independent elements. Finally, the data are monitored online through constructing statistics. It is proved that the accuracy of the scheme for identifying fault data is reached to 100%, and the misjudgment rate data are reduced to less than 0.6% through the simulation study of the hot strip mill process data.
Efficient two-stage sequential arrays of proof of concept studies for pharmaceutical portfolios
Authors: He Linchen , Du Linqiu , Antonijevic Zoran , Posch Martin , Korostyshevskiy Valeriy R , Beckman Robert A
Published: September 2020

Previous work has shown that individual randomized “proof-of-concept” (PoC) studies may be designed to maximize cost-effectiveness, subject to an overall PoC budget constraint. Maximizing cost-effectiveness has also been considered for arrays of simultaneously executed PoC studies. Defining Type III error as the opportunity cost of not performing a PoC study, we evaluate the common pharmaceutical practice of allocating PoC study funds in two stages. Stage 1, or the first wave of PoC studies, screens drugs to identify those to be permitted additional PoC studies in Stage 2. We investigate if this strategy significantly improves efficiency, despite slowing development. We quantify the benefit, cost, benefit-cost ratio, and Type III error given the number of Stage 1 PoC studies. Relative to a single stage PoC strategy, significant cost-effective gains are seen when at least one of the drugs has a low probability of success (10%) and especially when there are either few drugs (2) with a large number of indications allowed per drug (10) or a large portfolio of drugs (4). In these cases, the recommended number of Stage 1 PoC studies ranges from 2 to 4, tracking approximately with an inflection point in the minimization curve of Type III error.
Investigations on thermo-mechanical properties of organically modified polymer clay nanocomposites for packaging application
Authors: Sudhakar YN , Selvakumar M , Bhat D Krishna
Published: September 2020

Eco-friendly packing polymer materials are in the spotlight but, lack of new biodegradable polymers either natural or synthetic is yet to establish the market more competitively. So, in the present work, clay as a nano-filler is embedded and organically modified in some synthetic and natural polymers which are well established commercially to enhance their biodegradability. The impact of clay on the properties of synthetic polymers namely, poly(methyl methacrylate) (PMMA), poly(vinyl chloride) (PVC), poly(vinyl acetate) (PVAc) and natural polymer cellulose acetate butyrate (CAB) was studied. Results from differential scanning calorimetric (DSC) showed a decrease in the glass transition temperature of organically modified polymer clay nanocomposites (PCC) than pure polymers. Scanning electron microscopy (SEM) displayed a uniform surface with small-sized crystallites distributed on the polymer surface. X-ray diffraction (XRD) spectra revealed the formation of enhanced intercalated structures in PCC. Furthermore, FTIR studies showed that the interlayer bonding (Si–O bands) of pure clay is deformed in PCCs. The tensile strength of PCC increased with an increase in organo-clay loading. This unique mechanical behavior is due to the agglomeration of organo-clay particles. Finally, the biodegradation studies revealed enhanced hydrolytic degradation in PCC than pure polymers. Hence, these PCCs are environmentally friendlier than their pure synthetic polymers without significant compromise in their properties, which makes it suitable for packaging industries.
Acts of Agency: Exploring a Feminist Approach to Abortion Research in Sri Lanka
Authors: Wijesiriwardena Subha , Silva Kimaya de , Divakalala Cayathri , Issadeen Hasanah Cegu
Published: September 2020

In Sri Lanka, abortion continues to be a criminal offence under the Penal Code of 1883. Several attempts have been made to challenge the colonial-era law since the 1990s with no success thus far. This study documents and centres the knowledge of women and transpersons in accessing abortion and sexual health and reproductive health services in Sri Lanka in order to contribute to the conversation on abortion law reform as well as research and advocacy. Our data suggest that the existing legal reforms proposed to the abortion law would be unresponsive to the needs of women and transpersons in Sri Lanka, and that in additional to legal changes, we would need significant social and cultural changes. This study uses feminist research methodologies, building towards a feminist ethics in abortion research.
Gender Variant Children and Institutional Arrangements: Exploring the Phenomenon from South Asian Perspective
Authors: Tiwari Kusha
Published: September 2020

This paper explores and assesses the presence/absence of institutional arrangements in educational settings for addressing the concerns of gender-variant children (GVC) through a sample survey of schools in the three-country context of India, Sri Lanka and Nepal. This research highlights the need for effective regulatory, normative and cognitive structures to address issues of childhood gender variance. With a contextual analysis of recent developments and comprehensive study of data reports in the three countries, the study analyses multiple dimensions of discrimination and bullying of GVC in educational settings. Using qualitative and quantitative methods, this paper highlights causes and issues associated with the problems of GVC as well as affirmative actions and institutional practices required to be implemented in schools in the three-country context. The results and findings provide evidence that academic institutions in India, Sri Lanka and, to some extent, Nepal lack institutional mechanisms to address issues of homophobia, abuse by peer group, mental health issues, emotional challenges, social discrimination, lack of opportunities, lack of monitoring and counselling, micro-level engagements and high dropouts of GVC. This study also charts out futuristic agenda, such as comprehensive mapping of GVC in schools, implementation of effective counselling mechanism, the need to create and adopt basic reference module for educators around gender diversity and variance.
Prioritizing Circular Supply Chain Management Barriers Using Fuzzy AHP: Case of the Indian Plastic Industry
Authors: Khandelwal Chitranshu , Barua Mukesh Kumar
Published: September 2020

This article provides a perspective to implement circular supply chain management (CSCM) in the plastic industry in emerging economies, especially in India. CSCM integrates the philosophy of circular economy (CE) into supply chain management and offers a new view towards sustainability. However, the implementation of CSCM is an arduous task due to the presence of several barriers. Therefore, this study aims to investigate and prioritize barriers to implementing CSCM practices in Indian plastic industries. It employs a two-phase methodology to identify and prioritize the barriers to implementing CSCM. A total of 24 barriers were identified under five major categories through an extensive literature review and experts’ opinions. A fuzzy analytical hierarchy process (AHP) methodology is employed to rank the barriers. The fuzzy framework is considered to handle the uncertainty and vagueness. An empirical case of the Indian plastic industry is taken to illustrate the proposed model. A sensitivity analysis was performed to check the robustness of the model. The results indicate that the lack of tax relaxation policies and poor enforcement of rules and regulations to protect the environment are the most prominent barriers. The finding of this study can act as a stepping stone for managers and policymakers to effective implementation of CSCM.
Assessing Total Quality Management (TQM) Effect on Hospital Performance in Ghana Using a Non-Probabilistic Approach: The Case of Greater Accra Regional Hospital (GARH)
Authors: Essel Ronald Ebenezer
Published: September 2020

Background:

TQM has gained extensive prominence over the last few decades and continue to play a significant role in modern healthcare delivery.

Objectives:

The objective of this empirical inquiry is to explore the nexus between TQM critical success factors implementation and hospital performance by soliciting employee and patient’s views within the Ghanaian context, focusing on Greater Accra Regional Hospital, a prime provider of secondary public healthcare in Ghana.

Methods:

A cross-sectional approach (research design) was espoused for the study which made use of quantitative research techniques for its analysis. The study was based on self-answering structured (close-end) questionnaires completed by 250 respondents selected via convenient sampling. SPSS 25.0 was utilised for data analysis. Statistical analyses include descriptive statistics, principal component analyses, exploratory factor analyses with varimax rotation, reliability analyses, and multivariate regression analyses.

Results:

The study found significant positive relationships between all nine TQM constructs and hospital performance. Findings further revealed that the top management leadership construct contributed most to hospital performance, while training contributed least.

Conclusion:

The study made recommendations that have practical implications for hospital administrators/managers. In this circumstance, findings/recommendations established, should be considered crucial for hospital administrators/managers and policy makers when dealing with decisions affecting TQM assessment by exploring the potential practicability of the nine TQM critical success factors utilised in this study as a pertinent contrivance for initiating continuous service improvement in GARH in particular and Ghana’s public healthcare sector in general.
A Holistic Manure Management Model by Leveraging Dairy Cooperative Network
Authors: Rath Dilip , Joshi Yogesh C.
Published: September 2020

India continues to remain the world’s largest milk producer largely due to the efforts of millions of small and marginal dairy farmers and an efficient dairy value chain established through institutional structures in the form of dairy cooperatives. While the efforts to strengthen dairy value chain are continuing, the potential of dung of dairy animals as a key by-product remains largely unexplored. Animal dung is generally used in India as agriculture input and cooking fuel. Innovation of anaerobic digesters in the last century did provide an option of extracting biogas from dung. At the same time, a proper value addition of bioslurry produced from the biogas does have an immense potential to satisfy fertiliser needs in India. India’s 303 million strong bovine population has the capacity to produce 995 million tonnes of recoverable dung having potential to suffice cooking fuel need of entire rural households, and at the same time can significantly contribute in reducing use of chemical fertilisers by using digestate/slurry as replacement. This article attempts to explore the potential of animal manure as provider of energy and fertiliser. It also deliberates upon the attempt of National Dairy Development Board to establish manure value chain providing remunerative price of animal dung to farmers while satisfying their cooking needs and contributing towards mitigation of adverse environmental impact.
Female Entrepreneurs in the Hospitality Industry: A Panel Causality Analysis of EU Countries
Authors: Ghosh Sudeshna
Published: September 2020

This study investigates the determinants of female entrepreneurship (FE) in the tourism and hospitality industry in 30 European countries. Based on annual observations for the period 2006–2016 and using panel causality techniques, the study explores the impact of tourism receipts, GDP per capita, the Global Entrepreneurial Index (GEI), policies related to institutional and cultural issues, childcare and gender parity related to skills and entrepreneurship on FE. The results of robust second-generation panel methods indicate the existence of long-run cointegration among FE, GDP, tourism receipts and other variables of interest. The long-run elasticities of tourism receipts, GDP, GEI, childcare and the female–male ratio of access to human capital formation in terms of training obtained from the panel fully modified ordinary least squares (FMOLS), panel dynamic ordinary least squares (DOLS) and the pooled mean group estimator (PMG) estimation are significant in the context of FE. The study concludes that pivotal policy interventions are needed to ensure that family policies and procedures, social strategies and tax structures do not discriminate female entrepreneurs.

JEL: C32, C33, J16, O52, Z30
Panic in the Streets—Pandemic and Protests: A Manifestation of a Failure to Achieve Democratic Ideals
Authors: Katner Adrienne , Brisolara Kari , Katner Philip , Jacoby Andrew , Honore Peggy
Published: September 2020

America is at a critical crossroads in history as the COVID-19 pandemic expands. We argue that the failure to respond effectively to the pandemic stems from the nation’s protracted divergence from the democratic ideals, we purport to value. Structural racism and class-based political and economic inequity are sustained through the failings of the nation’s democratic institutions and processes. The situation has, in turn, fostered further inequity and undermined science, facts, and evidence in the name of economic and political interests, which in turn has encouraged the spread of the pandemic, exacerbated health disparities, and escalated citizen tensions. We present a broad vision of reforms needed to achieve democratic ideals which we believe is the most important first step to achieving true political representation, achieving a resilient and sustainable economy, and fostering the health of vulnerable communities, workers, and the planet.
Adapting Uncertainty Reduction Theory for Crisis Communication: Guidelines for Technical Communicators
Authors: Grace Rob , Tham Jason Chew Kit
Published: September 2020

The central components of an interpersonal communication framework such as uncertainty reduction theory can be adapted to design and evaluate crisis communication addressing uncertainty between citizens needing access to services and organizations attempting to manage risk and ensure continuity of operations. Through a content analysis of organizational crisis communication during the COVID-19 pandemic, this article adapts uncertainty reduction theory as an applied, user-centered framework that can guide technical communicators in managing uncertainty during unprecedented crises.
Diagnostic Discordance in Intraoperative Frozen Section Diagnosis of Ovarian Tumors: A Literature Review and Analysis of 871 Cases Treated at a Japanese Cancer Center
Authors: Yoshida Hiroshi , Tanaka Hiroki , Tsukada Takafumi , Abeto Naoko , Kobayashi-Kato Mayumi , Tanase Yasuhito , Uno Masaya , Ishikawa Mitsuya , Kato Tomoyasu
Published: September 2020

Background

This study examined the accuracy and pitfalls associated with frozen section diagnosis of primary ovarian tumors and ovarian metastases based on the 2014 World Health Organization classification (WHO) criteria and proposed improvements from a pathologist’s perspective.

Methods

We microscopically reviewed 871 cases of primary ovarian tumor (N = 802) and ovarian metastasis (N = 69) and compared the results of frozen sections with the final diagnosis. Malignant potential concordance (benign, borderline, or malignant) and specific discordant diagnosis rates were analyzed. Finally, we conducted a unique literature review of specific diagnostic errors in the frozen section diagnosis of primary ovarian tumors.

Results

Of 802 primary ovarian tumors, 50 (6.2%) cases showed discordant diagnoses in which mucinous carcinoma (40.5%), low-grade serous carcinoma (LGSC; 31.3%), and mucinous borderline tumor (18.4%) were frequently misinterpreted. Of 69 ovarian metastases, all 4 cases of low-grade appendiceal mucinous neoplasm (LAMN) were misdiagnosed as primary ovarian mucinous tumor. A literature review revealed that mucinous/serous borderline tumor or carcinoma accounted for approximately 70% of 217 reported discordant diagnoses.

Conclusion

In the present study, the concordance rate of malignant potential of the tumor was comparable to that previously reported. Even in the 2014 WHO classification, primary ovarian mucinous borderline tumor/carcinoma and LGSC still comprised the majority of discordant cases. Grossing methods that reduce sampling error are required. LAMN was frequently misinterpreted as a benign or borderline ovarian mucinous tumor. To prevent this error, a differential algorithm integrating clinical information and gross findings should be developed.
Sociodemographic Characteristics as Predictors of Outcomes in Hepatocellular Carcinoma: A Retrospective Cohort Study
Authors: Beutler Bryce D. , Ulanja Mark B. , Krishan Rohee , Aluru Vijay , Ndukwu Munachismo L. , Hagen Molly M. , Dupin Zachary D. , Willyard Charles E. , Moody Alastair E. , Boampong-Konam Killian , Zell Steven C.
Published: September 2020

Background:

Race, gender, insurance status, and income play important roles in predicting health care outcomes. However, the impact of these factors has yet to be fully elucidated in the setting of hepatocellular carcinoma (HCC).

Methods:

We designed a retrospective cohort study utilizing data from the Surveillance, Epidemiology, and End Results (SEER) program to identify patients diagnosed with resectable HCC (N = 28,518). Demographic factors of interest included race (Asian/Pacific Islander [API], African American [AA], Native American/Alaska Native [NA], or White [WH]) and gender (male [M] or female [F]). Insurance classifications included those having Medicare/Private Insurance [ME/PI], Medicaid [MAID], or No Insurance [NI]. Median household income was estimated for all diagnosed with HCC. Endpoints included: (1) overall survival; (2) likelihood of receiving a recommendation for surgery; and (3) specific surgical intervention performed. Multivariate multinomial logistic regression for relative risk ratio (RRR) and Cox regression models were used to identify pertinent associations.

Results:

Race, gender, insurance status, and income had statistically significant effects on the likelihood of surgical recommendation and overall survival. API were more likely to receive a recommendation for hepatic resection (RRR = 1.45; 95% CI: 1.31-1.61; Reference Race: AA) and exhibited prolonged overall survival (HR = 0.77; 95% CI: 0.73-0.82; Reference Race: AA) as compared to members of any other ethnic group; there was no difference in these endpoints between AA, NA, or WH individuals. Gender also had a significant effect on survival: Females exhibited superior overall survival (HR = 0.89; 95% CI: 0.85-0.93; Reference Gender: M) as compared to males. Patients who had ME/PI were more likely than those with MAID or NI to receive a surgical recommendation. ME/PI was also associated with superior overall survival. Conclusions: Race, gender, insurance status, and income have measurable effects on HCC management and outcomes. The underlying causes of these disparities warrant further investigation.
The Labor of Building Trust: Traditional and Engagement Discourses for Practicing Journalism in a Digital Age
Authors: Zahay Megan L. , Jensen Kelly , Xia Yiping , Robinson Sue
Published: September 2020

This work of rhetorical analysis interrogates the understanding of journalism as a deliberative instrument in democracy. With 42 in-depth interviews and hundreds of pages of text from websites, social media, and trade press articles, we find a major shift occurring in the United States between more traditional reporters and a growing class often calling themselves “engagement specialists.” These engagement-oriented journalists assert a responsibility to relationally engage with citizens in person and online, making space for them in the news production process. These emerging routines of trust-building are informing a new rhetoric around what it means to “do journalism.”
Bringing Feminist Sociological Analyses of Patriarchy Back to the Forefront of the Study of Woman Abuse
Authors: DeKeseredy Walter S.
Published: September 2020

Regardless of their contributions to some of the most important scientific advances in the field, feminist sociological analyses of various types of male-to-female violence that prioritize the concept of patriarchy have leveled off or declined in the last 12 years, especially in North America. This article describes how mainstream work came to dominate the field and suggests a few strategies for challenging the hegemony of orthodox perspectives on sexual assault, beatings, technology-facilitated abuse, and other forms of woman abuse.
Atezolizumab-induced hemolytic anemia – A case report
Authors: Younce Christina M , Lawton Jessica M , Patel Dhimant R
Published: September 2020

Introduction

Atezolizumab is currently the only immunotherapy used in conjunction with nab-paclitaxel for locally advanced or triple negative breast cancer. Limited data is available regarding hemolytic anemia as a side effect of atezolizumab.

Case report

We describe a 59-year-old female with a history of triple negative breast cancer with bone metastases presenting for follow up on Cycle 1, Day 15 of atezolizumab and nab-paclitaxel (100 mg/m2). Patient’s complete blood count (CBC) showed macrocytic anemia, with further workup significant for autoimmune hemolytic anemia (AIHA) attributed to atezolizumab. Management and outcome: Patient was started on a high dose prednisone taper starting at 80 mg daily for 16 days, folic acid 1 mg three times daily, iron sucrose, and darbepoetin alfa. Patient’s counts recovered, and she was able to start Cycle 2 and continued through Cycle 10 without any additional pre-medications.

Discussion

Hemolytic anemia induced by atezolizumab is a rare side effect that was successfully treated in this patient with a prednisone taper.
Exemestane induced cholestatic liver injury – A case report
Authors: Fritzsche Dane , Indorf Amy , Miske Abby , Banda Kalyan
Published: September 2020

Purpose

Exemestane, a steroidal aromatase inhibitor, is an important therapeutic option in the treatment of post-menopausal hormone receptor positive breast cancer. Adverse effects include hot flashes and bone loss, but rarely is hepatotoxicity reported. We report a case of exemestane induced cholestatic liver injury following exemestane initiation.

Case report

A now 77-year-old Caucasian female with primary biliary cirrhosis (PBC), and metastatic hormone receptor positive breast cancer originally diagnosed in 2000 who developed symptoms of pruritus, diarrhea, grade 2 transaminitis, and grade 1 hyperbilirubinemia three weeks after exemestane initiation. Management and outcome: Due to the patient’s signs and symptoms, exemestane was discontinued and the patient was continued on cholestyramine until resolution of her laboratory abnormalities. Approximately a week after discontinuation, the patient was started and maintained on anastrozole without recurrence of her symptoms.

Discussion

Hepatotoxicity with aromatase inhibitors have rarely been reported in clinical trials and to date, instances of exemestane induced hepatotoxicity has only been reported in two case reports. The patient’s history of primary biliary cirrhosis may be an important risk factor for the development of hepatotoxicity from exemestane.
Outcomes with enoxaparin dose reductions during thrombocytopenia in patients with hematopoietic stem cell transplantation (HSCT)
Authors: Lam Jenna , Tavares Erica , Luk Samantha O
Published: September 2020

Introduction

Appropriate dosing of therapeutic anticoagulation during periods of thrombocytopenia remains uncertain for patients undergoing hematopoietic stem cell transplants (HSCT). There is a paucity of literature on treatment outcomes for HSCT patients treated with non-prophylactic, but reduced doses of therapeutic anticoagulation during thrombocytopenia. The primary objective was to determine the incidence of major bleeding events during thrombocytopenia when reduced-dose enoxaparin was administered.

Methods

This is a retrospective review of patients with a venous thromboembolic event (VTE) who underwent HSCT and received reduced-dose enoxaparin during thrombocytopenia at the Massachusetts General Hospital (MGH) from April 1, 2016 to August 31, 2018. Incidence of recurrent VTE and bleeding events for up to one month were investigated. Rates of recurrent VTE and enoxaparin dose adjustments (0.5 mg/kg twice daily vs 1 mg/kg daily) were also reviewed.

Results

Out of 172 patients reviewed, 27 patients met inclusion criteria. There were no recurrent VTEs within one month of initial enoxaparin dose reduction. There was one major bleeding episode that occurred while a patient was on full-dose enoxaparin; believed to be related to cyclophosphamide cardiopulmonary toxicity and resulted in death. There were six non-major bleeding episodes, only one of which was clinically significant and resulted in the discontinuation of enoxaparin.

Conclusion

Our evaluation of therapeutic enoxaparin dose reductions for thrombocytopenia in the HSCT patient population found this practice to be effective in reducing the recurrence of VTE with no major bleeding adverse events. However, the rate of non-significant minor bleeds should be monitored while on reduced-dose enoxaparin.