bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges to Admitting Residents: Perspectives from Rural Nursing Home Administrators and Staff
Authors: Henning-Smith Carrie , Cross Dori , Rahman Adrita
Published: March 2021

Rural residents are older, on average, than urban residents, with more underlying health conditions and higher rates of disability. Rural nursing homes face unique challenges admitting medically-complex patients and meeting their needs throughout their stay. These challenges may be amplified for certain health conditions. Greater geographic distances also strain transitional care coordination practices with health system referral hubs in urban areas. In this study, we assess perceptions of difficulty rural nursing homes encounter in admitting and serving individuals with dementia, obesity, mental and behavioral health conditions, and medically complex conditions. Using a survey of nursing home administrators located in non-metropolitan counties across the U.S. (n = 209), we assessed the self-reported degree of difficulty identified in serving each of the 4 type of conditions, coupled with qualitative analysis of open-ended questions identifying specific challenges. Rural nursing homes have capacity constraints owing to lower population density, limited financial resources, and unique challenges recruiting and retaining workforce to rural areas. Nursing home administrators reported the most challenges to providing high-quality care to residents with mental and behavioral health challenges, followed by obesity. For specific challenges, administrators focused primarily on staffing concerns, as well as space and equipment needs. Rural nursing home administrators identified challenges related to specific conditions and capacity constraints. To ensure appropriate and high-quality nursing home placement for rural residents, and to minimize the disruption of transitions into nursing home settings, more attention is needed on addressing the constraints identified by rural nursing home administrators in this study.
Influence of Striving for Work–Life Balance and Sense of Coherence on Intention to Leave Among Nurses: A 6-Month Prospective Survey
Authors: Matsuo Maki , Suzuki Eiko , Takayama Yuko , Shibata Shigeko , Sato Kyoko
Published: March 2021

The increase in the elderly population in need of healthcare services has led to a serious shortage in the nursing workforce. To retain a large nursing workforce, a strong work–life balance among nurses is needed along with a healthy work environment. This prospective study investigates the influence of work–life balance and sense of coherence on intention to leave among hospital nurses. A questionnaire survey was conducted with 2239 nurses as a baseline. The explanatory variables included striving for work–life balance behavior, a sense of coherence in terms of personal resources, and work-, organizational-, and individual-related factors. Using a cohort of 1368 valid responses, we measured intention to leave among 975 nurses with whom we were able to follow up 6 months after the baseline survey. We then performed multiple regression analysis. The behavior striving for work–life balance was shown to influence nurses’ intention to leave. Nurses who exhibited less striving for work–life balance behavior showed higher intentions to leave. The sense of coherence was not identified as a factor affecting intention to leave. Securing a comfortable work–life balance would reduce the nurses’ desire to quit the hospital. To reduce nurse turnover, nurse managers should develop support programs that can help nurses achieve a better work–life balance.
A comparison of COVID-19 secondary attack rate in household and close contacts compared to current risk stratification guidelines of the Kerala government
Authors: Rathish Balram , Wilson Arun , Joy Sonya
Published: March 2021

COVID-19 has been found to be highly infectious with a high secondary attack rate with a R0 of 3.3. However, the secondary attack rate based on risk stratification is sparsely reported, if ever. We studied the contact tracing data for two index cases of COVID-19 with some overlap of contacts. We found that 60% of high-risk contacts and 0% of low-risk contacts of symptomatic COVID-19 patients contracted the infection, in keeping with the Kerala government contact risk stratification guidelines.
Cross-dressing and Transgressing: The Queer Body in Madame Satã
Authors: Welsh Marcus D.
Published: March 2021

In Karim Aïnouz’s debut feature film Madame Satã (2002), the protagonist yearns to be a cross-dressing performer. Based on the historical figure João Francisco dos Santos, the protagonist is black, poor, gay, and a criminal in the Brazil of the 1930s. An examination of his body as a nexus of these factors and the film’s portrayal of it in the context of queer theory, film history, and social discourses of gender, race, and class and in cinematic terms demonstrates that, while he is able to express his fluid gender identity temporarily through performance, the protagonist is unable to escape his social position as regulated by the intersectionality of his gender identity with other factors.

En el primer largometraje de Karim Aïnouz, Madame Satã (2002), el protagonista anhela ser un artista travesti. Basado en la figura histórica de João Francisco dos Santos, dicho protagonista es negro, pobre, homosexual y criminal en el Brasil de la década de 1930. El artículo analiza su cuerpo como nexo entre estos factores y la manera en que es representado en la película a partir de una perspectiva teórica queer, de la historia del cine y los discursos sociales de género, raza y clase, así como de la técnica cinematográfica. Si por un lado el personaje es capaz de expresar su fluida identidad de género temporalmente a través de la interpretación, por otro es incapaz de escapar su posición social, la cual está regulada por la interseccionalidad entre su identidad de género y otros factores.
Mao’s Steeltown: Industrial City, Colonial Legacies, and Local Political Economy in Early Communist China
Authors: Hirata Koji
Published: March 2021

This article examines the construction of industrial cities in the early years of the People’s Republic of China (PRC; 1949-) by focusing on Anshan—a major steel city in Manchuria (Northeast China) that had been constructed by the Japanese prior to 1945. I demonstrate that the PRC industrial cities embodied the nature and limits of the new socialist regime’s vision of industrialization. The early PRC overwhelmingly focused its resources on heavy industry, which translated into the financial and bureaucratic superiority of industrial enterprises to city governments. The early PRC industrial cities drew from not only the Soviet urban-planning model but also the legacies of pre-revolutionary regimes, even including imperial Japan. The construction of industrial cities was driven by negotiations among various actors including city officials, enterprise managers, and domestic migrants. Building on the multi-layered local, national, and transnational forces, the industrial city of Anshan was a microcosm of the early PRC.
From the Association of Diabetes Care & Education Specialists: The Role of the Diabetes Care and Education Specialist as a Champion of Technology Integration
Authors: Scalzo Patty
Published: March 2021

It is the position of the Association of Diabetes Care & Education Specialists that diabetes care and education specialists should play a central role in establishing and maintaining technology-enabled care in a variety of practice settings to optimize outcomes for people with diabetes and cardiometabolic conditions. The objectives of this position statement are to outline the role of diabetes care and education specialists as leaders in technology integration and to describe the resources and guidance the Association has developed to facilitate success in this role.
Stakeholder Theory and the Resource-Based View of the Firm
Authors: Freeman R. Edward , Dmytriyev Sergiy D. , Phillips Robert A.
Published: March 2021

We start this article with the exploration of similarities between the resource-based view of the firm (RBV) and stakeholder theory at the time of their origination and then proceed with the conversation on what led to distinct developmental trajectories of the two theories. Though RBV has become a leading paradigm in the strategic management field, we argue that in its current form, RBV is yet incomplete. We suggest there are four aspects that stakeholder theory can offer to inform RBV: normativity, sustainability, people, and cooperation. Reconciling stakeholder theory and RBV is a promising path to advancing our understanding of management, and we provide a two-part guideline to management scholars and practitioners who would be willing to take this path.
Elderly Labour and Unemployment
Authors: Watanabe Minoru , Yasuoka Masaya
Published: March 2021

Several reasons underlie the increased labour participation of older people in Japan. One reason is the subsidy for the labour supply of elderly people. This article presents an examination of how this subsidisation of the labour supply of elderly people affects the labour participation of young and elderly people and unemployment. Consequently, an aging society brought about by an increase in the survival rate and the subsidy for elderly labour raise the employment rate and labour participation rate of elderly people in a temporary equilibrium model. This result is consistent with the real world. However, considering the steady state in a closed economy under which capital accumulation is considered, the effect of this subsidy on the employment rate and labour participation of elderly people is slight because of a decrease in the wage rate.

JEL: J21
Basics of extra corporeal membrane oxygenation: a pediatric intensivist’s perspective
Authors: Das Shubhadeep , Gupta Sandip , Das Debasis , Dutta Nilanjan
Published: March 2021

Extra Corporeal membrane oxygenation (ECMO) is one of the most advanced forms of life support therapy in the Intensive Care Unit. It relies on the principle where an external artificial circuit carries venous blood from the patient to a gas exchange device (oxygenator) within which blood becomes enriched with oxygen and has carbon dioxide removed. The blood is then returned to the patient via a central vein or an artery. The goal of ECMO is to provide a physiologic milieu for recovery in refractory cardiac/respiratory failure. The technology is not a definitive treatment for a disease, but provides valuable time for the body to recover. In that way it can be compared to a bridge, where patients are initiated on ECMO as a bridge to recovery, bridge to decision making, bridge to transplant or bridge to diagnosis. The use of this modality in children is not backed by a lot of randomized controlled trials, but the use has increased dramatically in our country in last 10 years. This article is not intended to provide an in-depth overview of ECMO, but outlines the basic principles that a pediatric intensive care physician should know in order to manage a kid on ECMO support.
Compounded trauma: A qualitative study of the challenges for refugees living with advanced cancer
Authors: Guo Ping , Alajarmeh Sawsan , Alarja Ghadeer , Alrjoub Waleed , Al-Essa Ayman , Abusalem Lana , Mansour Asem , Sullivan Richard , Shamieh Omar , Harding Richard
Published: March 2021

Background:

Although palliative care is now an essential health service under Universal Health Coverage, ensuring access and appropriate care for refugees is a specific challenge for this large population.

Aim:

To identify the needs and experiences of adult refugees in Jordan with advanced cancer and informal caregivers.

Design:

A qualitative study using semi-structured interviews.

Setting/participants:

Participants were purposively sampled at two Jordanian hospitals to achieve heterogeneity by age, gender, country of origin, and primary diagnosis.

Results:

Twenty-nine refugees (22 patients, 7 caregivers) participated, and four themes were generated: (1) Psychological distress and sustaining social support. Refugees often experienced unmet psychosocial needs. However, psychosocial support was reported either absent or limited. (2) Knowledge and uncertainty. Lack of information and poor communication between healthcare providers and patients caused significant distress due to uncertainty. (3) Family anxiety and support roles. Being away from the home country cut patients and caregivers off from their wider social support network, which added increased anxiety and responsibilities to caregivers. (4) Compounded trauma and poverty. Many refugees have experienced trauma related to war that may affect their physical and mental health. They faced serious financial crises caused by the rising cost of medicines and treatment.

Conclusions:

This study reveals the impact of fractured families and networks on social support in advanced cancer, and the compounding trauma of the disease for refugees. Detailed person-centred assessment and emphasis on psychosocial support is essential, and home-based care should not presume community support for patients to remain at home.
Circular RNA PPP1CC promotes Porphyromonas gingivalis-lipopolysaccharide-induced pyroptosis of vascular smooth muscle cells by activating the HMGB1/TLR9/AIM2 pathway
Authors: Liu Jie , Wang Yong , Liao Yaoyun , Zhou Ying , Zhu Jijin
Published: March 2021

Objective

Porphyromonas gingivalis ( Pg) plays a critical role in the occurrence and development of atherosclerosis. Lipopolysaccharide from Pg ( Pg-LPS) could lead to pyroptosis of vascular smooth muscle cells (VSMCs) and induce instability of atherosclerotic plaque. Therefore, pyroptosis of VSMCs could promote the process of atherosclerosis. However, the exact mechanism of Pg-LPS-induced pyroptosis of VSMCs is unclear.

Methods

We determined pyroptosis and expression of interleukin (IL)-1β and IL-18 in VSMCs using 4′,6-diamidino-2-phenylindole staining and ELISA after stimulation by Pg-LPS. We established a knockdown plasmid containing the circular (circ)RNA PPP1CC and transfected it into VSMCs. Luciferase assays were performed to reveal the association between microRNAs miR-103a-3p and miR-107 and circRNA PPP1CC.

Results

Stimulation of Pg-LPS led to pyroptosis of VSMCs. Knockdown of circRNA PPP1CC relieved the Pg-LPS-induced pyroptosis of VSMCs and suppressed the expression of HMGB1, TLR9, AIM2, and cleaved caspase-1. Luciferase assays showed that PPP1CC directly targeted and competitively adsorbed miR-103a-3p and miR-107, weakening the inhibitory effect of these microRNAs on the expression of HMGB1.

Conclusion

Knockdown of circRNA PPP1CC relieved Pg-LPS-induced pyroptosis of VSMCs. Pyroptosis of VSMCs appears to promote atherosclerosis and may represent a novel therapeutic target for its treatment.
An ARMAX-DFIG model based adaptive controller for a wind energy conversion system
Authors: Pradhan Prangya Parimita , Subudhi Bidyadhar
Published: March 2021

This paper presents design of an adaptive model predictive current controller for a Doubly-Fed Induction Generator (DFIG) based Wind Energy Conversion System (WECS). An Autoregressive Moving Average with Exogenous input (ARMAX) model is developed to represent the dynamics of DFIG. The parameter vector of DFIG is estimated by employing the recursive least square algorithm. A predictive current controller based on model predictive concept is designed for output current control of the Rotor Side Converter (RSC) to achieve the desired control performance. Extensive simulation studies are pursued by implementing the proposed controller in MATLAB/SIMULINK environment. The performance of the proposed Adaptive Predictive Current Controller (APCC) is evaluated under various operating conditions such as sub-synchronous speed, synchronous speed, and super-synchronous speed. The performances of the proposed controller are compared with that of the conventional MPC. It is found that the proposed controller exhibits superior performance in terms of improved reference tracking of rotor currents.
Benchmarking Unmanned Aerial Systems-Assisted Inspection of Steel Bridges for Fatigue Cracks
Authors: Dorafshan Sattar , Campbell Leslie E. , Maguire Marc , Connor Robert J.
Published: March 2021

Inspection agencies have been increasingly implementing unmanned aerial systems (UAS) for bridge inspections. Currently, UAS are typically used for long-range monitoring and surveillance tasks, but bridge managers are hopeful that they may be utilized for detailed inspection, such as condition assessments and the inspection of fracture critical members (FCMs) in the near future. As an assistive tool for visual inspections, the accuracy of UAS-assisted inspections is unknown. This study investigates the relationship between the characteristics of the individual inspectors and a set of performance metrics associated with UAS-assisted FCM inspections. Four bridge inspectors used a UAS to inspect a series of full-sized bridge specimens with known fatigue cracks. The inspection videos were later shared with 19 bridge inspectors for a desk review. The performance of each inspector was evaluated and compared with the results from 30 hands-on inspections of the same specimens. The results showed that an inspector’s past experience with UAS, licensure, and academic degree could have a significant influence on one or more of the three defined performance metrics. The comparison between the results of the UAS-assisted inspections and the hands-on inspections revealed that crack detection was comparable. However, the hands-on inspections were more accurate.
Considering Roadway Context in Setting Posted Speed Limits
Authors: Fitzpatrick Kay , Das Subasish , Gates Timothy , Dixon Karen K. , Park Eun Sug
Published: March 2021

The National Cooperative Highway Research Program (NCHRP) Project 17-76 investigated factors that influence operating speed and safety through a review of the literature and an analysis of the relationships for speed, safety, and roadway characteristics on urban/suburban streets. That knowledge, along with a review of existing speed limit setting practices, was used to develop a Speed Limit Setting Procedure (SLS-Procedure) as well as a user manual to explain the SLS-Procedure. In addition, the SLS-Procedure was automated via a spreadsheet-based Speed Limit Setting Tool (SLS-Tool). These products will permit engineers to make informed decisions about the setting of speed limits. The SLS-Procedure is fact based and transparent, relying on a set of decision rules that consider both driver speed choice and safety associated with the roadway. The SLS-Procedure was designed to be applicable across different roadway types and contexts by having a set of unique decision rules for four combinations of roadway types and contexts: limited-access, undeveloped, developed, and full-access facilities. The SLS-Procedure uses the operating speed distribution as a starting point for the suggested speed limit, with the resulting suggested value based on consideration of roadway type, context, safety performance, and other characteristics.
Assessing the Impact of Large-Scale Trends on Ontario’s Pedestrian Fatality Rate
Authors: Plonka Sarah C. , Volo Sara , Byrne Patrick A. , Sinclair Ian , Prabha Thadsha
Published: March 2021

Pedestrian-involved collisions are a key contributor to roadway fatalities in Ontario; pedestrian deaths have been growing as a proportion of total road fatalities. This study aimed first to determine trends in the pedestrian fatality rate in Ontario over time and, second, to assess the impact of select large-scale trends on pedestrian fatalities. Large-scale trends were identified through a review of the literature and hypotheses were tested using Ontario collision data from 2002 to 2016. The following four key areas were assessed for their impact: (1) the aging demographic; (2) the impact of increasing consumer preference for light trucks; (3) the potential for an increase in alcohol-consuming pedestrians associated with a decrease in alcohol-consuming drivers, and; (4) increasing inattention, caused, in part, by pedestrians and drivers using electronic devices. A quadratic model, with a minimum at 2010, best described changes in Ontario’s pedestrian fatality rate, suggesting a transition from a decreasing to increasing trend at that time. Results of the four key areas were: (1) the proportion of pedestrians aged 75 and older being killed has been increasing over time, a trend that can be fully explained by their increased representation in Ontario’s population, a trend which is expected to continue; (2) similarly, the increase in the proportion of pedestrians killed by a light truck can be explained by their increased representation in Ontario’s registered vehicle population; (3) the odds of a pedestrian being alcohol positive have been decreasing over time; and (4) the odds are higher that a driver who kills a pedestrian is inattentive.
Risk Factors for Septic Arthritis After Anterior Cruciate Ligament Reconstruction: A Nationwide Analysis of 26,014 ACL Reconstructions
Authors: Kraus Schmitz Jesper , Lindgren Viktor , Edman Gunnar , Janarv Per-Mats , Forssblad Magnus , Stålman Anders
Published: March 2021

Background:

Septic arthritis (SA) after anterior cruciate ligament reconstruction (ACLR) is a rare yet severe complication. The samples in previous studies have been small and without nationwide coverage, making analysis uncertain with a risk of bias. Conclusions to recommend preventive measures are therefore difficult to draw, and it has not been possible to perform a comprehensive risk factor analysis.

Purpose:

To study the incidence of SA after ACLR in a large, nationwide population and to study the risk factors for SA after ACLR.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

All ACLRs, primary and revision, in the Swedish Knee Ligament Registry between 2006 and 2013 were linked with data from the Swedish National Board of Health and Welfare. The incidence of SA events was determined using entries from the day of surgery until 90 days postoperatively based on diagnosis codes and the prescription of antibiotics. All events of SA were verified via a review of medical records. Risk factors were analyzed based on data from the registries. Descriptive statistics were used to describe the findings, while logistic regression analysis was used for the risk analysis.

Results:

The cohort consisted of 26,014 primary and revision ACLRs. During the study period, 298 events of SA (1.1%) were identified. The high-volume units (≥500 ACLRs during the study period) had a distribution of SA between 2 and 47 (0.2%-2.9%). Independent risk factors of SA were male sex (OR, 1.65; 95% CI, 1.28-2.13), operating time ≥70 minutes (OR, 1.83; 95% CI, 1.42-2.36), hamstring tendon autograft (OR, 2.23; 95% CI, 1.21-4.08), and clindamycin as perioperative antibiotic prophylaxis (OR, 1.94; 95% CI, 1.10-3.41).

Conclusion:

The incidence of SA after ACLR in this nationwide cohort was 1.1%. Male sex, hamstring tendon autografts, and a longer operating time were all independent risk factors for SA. The use of clindamycin as perioperative antibiotic prophylaxis was a risk factor compared with the use of cloxacillin. Some high-volume units had a very low infection rate (0.2%).
Injectable Fibrin/Polyethylene Oxide Semi-IPN Hydrogel for a Segmental Meniscal Defect Regeneration
Authors: Kim Jin-A , An Young-Hyeon , Yim Hyun-Gu , Han Woo-Jung , Park Yong-Beom , Park Hyun Jin , Kim Man Young , Jang Jaewon , Koh Racheal H. , Kim Su-Hwan , Hwang Nathaniel S. , Ha Chul-Won
Published: March 2021

Background:

Meniscal deficiency from meniscectomy is a common situation in clinical practices. Regeneration of the deficient meniscal portion, however, is still not feasible.

Purpose:

To develop an injectable hydrogel system consisting of fibrin (Fb) and polyethylene oxide (PEO) and to estimate its clinical potential for treating a segmental defect of the meniscus in a rabbit meniscal defect model.

Study Design:

Controlled laboratory study.

Methods:

The Fb/PEO hydrogel was fabricated by extruding 100 mg·mL-1 of fibrinogen solution and 2,500 U·mL-1 of thrombin solution containing 100 mg·mL-1 of PEO through a dual-syringe system. The hydrogels were characterized by rheological analysis and biodegradation tests. The meniscal defects of New Zealand White male rabbits were generated by removing 60% of the medial meniscus from the anterior side. The removed portion included the central portion. The Fb/PEO hydrogel was injected into the meniscal defect of the experimental knee through the joint space between the femoral condyle and tibial plateau at the anterior knee without a skin incision. The entire medial menisci from both knees of each rabbit were collected and photographed before placement in formalin for histological processing. Hematoxylin and eosin, safranin O, and immunohistochemical staining for type II collagen was performed. The biomechanical property of the regenerated meniscus was evaluated using a universal tensile machine.

Results:

The Fb/PEO hydrogel was fabricated by an in situ gelation process, and the hydrogel displayed a semi-interpenetrating polymer network structure. We demonstrated that the mechanical properties of Fb-based hydrogels increased in a PEO-dependent manner. Furthermore, the addition of PEO delayed the biodegradation of the hydrogel. Our in vivo data demonstrated that, as compared with Fb hydrogel, Fb/PEO hydrogel injection into the meniscectomy model showed improved tissue regeneration. The regenerated meniscal tissue by Fb/PEO hydrogel showed enhanced tissue quality, which was supported by the histological and biomechanical properties.

Conclusion:

The Fb/PEO hydrogel had an effective tissue-regenerative ability through injection into the in vivo rabbit meniscal defect model.

Clinical Relevance:

This injectable hydrogel system can promote meniscal repair and be readily utilized in clinical application.
Critical Discourse and Critical Reflection in Mezirow’s Theory of Transformative Learning: A Dialectic Between Ontology and Epistemology (and a Subtext of Reflexivity Mirroring My Own Onto-Epistemological Movement)
Authors: Hyde Brendan
Published: March 2021

In this article, I argue that critical discourse in Mezirow’s theory of transformative learning is a constructionist, ontological act that serves to support an individual’s critical reflection, which, in turn, is a constructivist, epistemological act. The notion of onto-epistemology is helpful in bringing to the fore the entanglement of these two concepts, and mirrors my own reflexivity and my own transformative learning process in coming to determine the relationship between constructionism and constructivism, and between critical discourse and critical reflection. It is important that facilitators of adult education are aware of the theory underpinning both of these concepts so that, like myself, their choices in designing learning activities is grounded in, and guided by, theory, enabling them to support and facilitate appropriate learning outcomes.
White Paper: Neuropsychiatric Aspects of Sensitivity to Low-Level Chemicals: A Neural Sensitization Model
Authors: Bell Iris R.
Published: March 2021

The present paper summarizes the proposed time-dependent sensitization (TDS) and partial limbic kindling model for illness from low-level chemicals; reviews and critiques prior studies on CNS aspects of multiple chemical sensitivity (MCS); and outlines possible experimental approaches to future studies. TDS is the progressive and persistent amplification of behavioral, neurochemical, endocrine, and/or immunological responses to repeated intermittent stimuli over time. Partial limbic kindling is a progressive and persistent lowering of the threshold for eliciting electrical afterdischarges, but not motor seizures, in certain brain structures such as amygdala and hippocampus; behavioral consequences include increased avoidant behaviors.

The focus of the paper is the controversial claim of altered sense of smell and illness from low levels of environmental chemicals (i. e., cacosmia), levels that should not have any biologically harmful effects by the rules of classical neurotoxicology. A major perspective of this paper is that the phenomenology of MCS is similar to that of time-dependent sensitization (reverse tolerance) and tolerance as studied in the substance abuse literature.

The TDS model for MCS proposes that neurobiological amplification underlies the symptoms and phenomenology of these patients, including their behavioral features of heightened affective and somatic distress. It is hypothesized that MCS patients, who are mostly women, may be individuals who sensitize to substances rapidly and to the extreme, to the point of aversive symptomatology with less complete capacity for development of tolerance. Possible parallels between MCS and TDS include: (a) initiation by single or multiple intermittent
The Phenomenology of Limbic Kindling
Authors: Gilbert M. E.
Published: March 2021

Kindling is a model of epilepsy whereby repeated administration of brief low-intensity trains of electrical stimulation come to elicit electrographic and behavioral manifestations of seizure. In the absence of overt tissue damage, an animal that has been kindled is rendered in a permanent state of increased susceptibility to seizures. A number of persistent biochemical and physiological alterations in function accompany kindling, some of which may impact upon behavior of the organism for a long period of time despite the absence offurther seizure activation. The sensitivity of limbic structures to kindling may contribute to the behavioral categories of cognition and affect that are particularly impacted by the kindling process. The increased proclivity for seizure disorders that characterizes kindling is not restricted to the initial kindling stimulus, but generalizes to other agents with convulsive properties. This paper provides an overview of the phenomenology of kindling, describes some of the conditions necessary for its induction, and some of the functional alterations that accompany its development and endure when overt convulsive behavior has subsided. Finally, a series of studies in our laboratory is presented which provides evidence of chemically induced kindling by repeated low-level exposure to some pesticides, namely those of the chlorinated hydrocarbon class.
Neurobiological Sensitization Models of Posttraumatic Stress Disorder: Their Possible Relevance to Multiple Chemical Sensitivity Syndrome
Authors: Friedman Matthew J.
Published: March 2021

Neurological sensitization has been proposed as a model for post-traumatic stress disorder (PTSD) (Lipper et al., 1986; van der Kolk, 1987; Friedman, 1988; Post et al., 1988, 1994; Charney et al., 1993). Laboratory paradigms in which repeated exposure to a discrete stimulus is associated with progressive intensification of a neurophysiologic, behavioral, or pharmacologic response has many parallels with the sequence of events that precipitates PTSD.

Investigators with other clinical interests have also been attracted to sensitization models. Specifically, Bell and associates (1992) have proposed that olfactory-limbic kindling is a very good model for understanding the etiology of multiple chemical sensitivity (MCS) syndrome. A number of articles in this volume have addressed the goodness-of -fit between this model and MCS.

My major assignment is to review laboratory data and clinical observations pertinent to sensitization models of PTSD. I will show that although there are intriguing parallels between the two phenomena, one must have great respect for the complexity and polymorphism of both sensitization and PTSD before grasping for simplistic theoretical conclusions. Secondly, I will address the following question; if both PTSD and MCS can be understood as sensitization phenomena, are PTSD patients at greater risk to develop MCS and vice versa? This article is divided into four sections: a) a description of three distinct sensitization phenomena; b) a description of the symptoms of PTSD; c) a review of the applicability of sensitization models to the clinical phenomenology of PTSD; and d) a review of the hypothesis that PTSD patients might be more vulnerable to MCS.
Psychological Bases of Symptom Reporting: Perceptual and Emotional Aspects of Chemical Sensitivity
Authors: Pennebaker James W.
Published: March 2021

The reporting of physical symptoms is influenced to a large degree by psychological processes. Individuals are more likely to notice subtle sensations in environments lacking in stimulation than those demanding external attention. The beliefs or schemas that people hold dictate where and how they attend to their bodies as well. These normal perceptual processes help explain why people are of ten poor at accurately detecting internal physiological activity. Several individual differences are also related to the symptom reporting process. Females are more likely to base their symptom reports on external situational cues than are males. In addition, individuals with chronic anxiety those high in Negative Affectivity (NA) report more symptoms than those low in NA. Finally, individuals who have had traumatic experiences, either in childhood or within 16 months prior to a major symptom reporting episode, tend to be high symptom reporters. Several recommendations are made to help researchers and clinicians distinguish between psychological or perceptual factors with presumed biological effects. One implication of this work is that MCS and allied syndromes should be viewed as both a mental and a physical health problem.
Olfactory (Chemosensory) Event-Related Potentials
Authors: Kobal Gerd , Hummel Thomas
Published: March 2021

Chemosensory event-related potentials (CSERPs) have found their way into a number offields of research where they help to determine the function of both the trigeminal and the olfactory system. The investigation of chemosensory deficits in patients with Parkinson's or Alzheimer's disease is only one of the typical applications. It can be assumed that scientists involved in research on patients with multiple chemical sensitivities will also benefit from having access to objective data covering different aspects of the sense of smell.
The Effects of Father-Perpetration of Maltreatment on Adolescent Health Risk
Authors: Kobulsky Julia M. , Yoon Susan H. , Wildfeuer Rachel , Simonsson Peter , Shin Sunny H.
Published: March 2021

Maltreatment perpetrated by fathers may entail distinct characteristics and threats, and therefore differing effects from maltreatment perpetrated by mothers alone. This study examines the extent to which father perpetration of maltreatment is associated with variability in subsequent adolescent health outcomes relative to mother-alone maltreatment. A sample of youth ( N = 377) with recently completed Child Protective Services investigations concerning reports of maltreatment attributed to fathers and/or mothers was drawn from the second National Survey of Child and Adolescent Well-being. Youth were 11-17 years old ( M = 13.8, SD = 2) at 18-month follow-up. Predictor variables (baseline) included caseworker-reported perpetrator (father vs mother alone), maltreatment type and severity, and co-occurring risk factors (prior reports of maltreatment, caregiver substance use, serious mental health problems, and recent arrest or detention, and intimate partner violence). Outcome measures were youth-reported sexual risk behavior (the number of past-year sexual partners), substance use severity (use of illicit drugs other than marijuana, number of substances used, and CRAFFT raw scores), and parent-to-adolescent physical aggression (minor, moderate, and severe) at 18-month follow-up. Structural equation modeling assessed the effects of father perpetration on outcomes. Father perpetration was prospectively associated with more parent-to-adolescent aggression ( β = 0.16, p = .034) and less sexual risk behavior ( β = −0.17, p = .017) than mother-alone perpetration. Findings suggest protective effects of father perpetration relative to mother-alone perpetration on sexual risk taking but greater risk on further victimization by parents. Future research is needed to replicate findings and examine potential youth gender differences.
Women’s Economic Abuse Experiences: Results from the UN Multi-Country Study on Men and Violence in Asia and the Pacific
Authors: Postmus Judy L. , Nikolova Kristina , Lin Hsiu-Fen , Johnson Laura
Published: March 2021

Economic abuse is a poorly understood form of intimate partner violence but may have far-reaching implications for the financial health of the survivor. Additionally, very little is known about whether depressive symptoms, education, employment, or attitudes about relations between men and women mediate or moderate the relationship between economic abuse and their financial circumstances. The purpose of this study was to answer these two research questions: (a) Is there a relationship between the experience of economic abuse and food insecurity (as a measure of poverty)? (b) Is the relationship between economic abuse and food insecurity impacted by women’s education, women’s and men’s employment, women’s attitudes towards gender relations, or women’s depressive symptoms? We used quantitative data from the “UN Multi-Country Study on Men and Violence,” analyzing data on 3,105 women aged 18–49 years who were interviewed. Initial logistic regressions were conducted followed by introducing moderators and mediators to the model using path analyses to test the relationship between economic abuse and food insecurity in the household. Significant predictors of food insecurity included several types of abuse and partners’ employment, women’s own employment, and education. The only type of IPV not associated with food insecurity was physical abuse. Experiences of economic abuse were associated with a 1.69 times greater likelihood of reporting food insecurity which was higher than experiences of psychological or sexual abuse. Additionally, women’s experiences of economic abuse over their lifetime were significantly associated with an increase in depressive symptoms which in turn was associated with greater likelihood of experiencing food insecurity. Such relationships warrant attention to economic abuse and depressive symptoms as part of the interventions used when working with survivors. Additional research could also help further our understanding of how these variables interact together and how best to address its impact on survivors.
Updates in Hemodynamic Monitoring: A Review for Pharmacists
Authors: Lopez Chelsea N. , Sulaica Elisabeth M. , Donahue Kevin R. , Wanat Matthew A.
Published: March 2021

Vital signs are regularly monitored in hospitalized patients. In the intensive care unit (ICU), traditional non-invasive blood pressure monitoring and telemetry may not provide enough information to determine the etiology of hemodynamic instability or guide intervention. Arterial catheters remain the gold-standard for continuous blood pressure monitoring and are commonly used in ICU patients. Pulmonary artery catheters and central venous catheters are beneficial in select patient populations and provide more advanced and specific information about a patient’s hemodynamics. However, neither are benign and can increase risk of complications such as infection, arrhythmias, pneumothorax and vascular or valvular damage. In the past 10 years, the development of reliable non-invasive (NICOM), or minimally-invasive (MICOM), cardiac output monitoring devices has accelerated. The MICOM devices require an arterial catheter to obtain hemodynamic values, whereas NICOM devices do not require any arterial or venous access. These devices have emerged to be particularly useful in evaluating and managing patients with suspected mixed shock. As these devices become more prevalent, it is imperative that clinical pharmacists become familiar with interpreting this data as it may have a substantial impact on medication selection and optimization. This review will discuss the basics of NICOM and MICOM devices, limitations with these methods of monitoring, and clinical application for pharmacists.
Slant type taper profiling and prediction of profiling speed for a circular profile during in wire electric discharge machining using Hastelloy-X
Authors: Manoj IV , Narendranath S
Published: March 2021

Hastelloy-X a nickel-based alloy used in nozzles, flame holders, turbine blades, turbocharges, jet engine tailpipes, afterburner components etc. having complex tapering profiles. Wire electric discharge machining proves to be the most beneficial machining technique as it provides required accuracy for the components. In the present research, a slant type taper fixture is employed for achieving taper angles as convention tapering have many hindrances like wire bend, angular inaccuracy, guide wear, insufficient flushing and wire breakage etc. and machining a simple circular profile on Hastelloy-X. The behaviour of different output parameters like profiling speed, surface roughness, profile areas, microhardness and recast layer were investigated for various input parameters for machined taper components at 0°, 15° and 30°. The cutting speed override parameter influenced most on the profiling speed and surface roughness. The wire offset parameter was found to be the most significant factor in the case of circular profile areas that were machined. The variation of different output parameters to profiling/cutting speed and taper angle was also highlighted. It is found the recast layer decreased which indicated lesser thermal degradation at higher taper angles at different profiling parameters. This is also validated by the microhardness where the machined surface hardness of taper angular profiles was found to be greater than the 0° profiles. The artificial neural networks and adaptive neuro-fuzzy interference system were used for the prediction of profiling speed. The adaptive neuro-fuzzy interference system was found better in prediction as the percentage error varies between 0–5 per cent. In conclusion, the profiling speed influences both on the accuracy and surface of machined taper circular profiles.
Modelling the longitudinal braking dynamics for heavy-duty vehicles
Authors: Güleryüz İbrahim Can , Başer Özgün
Published: March 2021

This paper establishes a reliable heavy-duty braking system model that can be used for response time prediction and for vehicle braking calculations regarding the legislative requirements. For the response time prediction, a pneumatic system model of a heavy-duty vehicle is constructed by Matlab Simulink in consideration of service brake layout. To ensure the accuracy of system parameters related with pneumatic system response time experiments are conducted on two different 4 × 4 heavy-duty vehicles. The numerically calculated response time results are validated with experimental data. To improve the response time of the vehicle, design modifications are conducted on the pneumatic brake system properties. To check the compliance of the pneumatic brake system design with legislative requirements of UN Regulation 13, heavy-duty vehicle brake system (HVBS) model is developed by using Matlab Simulink. HVBS model is composed of longitudinal vehicle and wheel dynamics, Magic Formula tyre model, wheel slip and the experimentally verified heavy-duty pneumatic system model. The braking performance analyses are conducted by using HVBS model to compare the design alternatives in accordance with the legal requirements in terms of service braking and secondary braking conditions.
Effect of heat input on mechanical and microstructural properties of Inconel 625 depositions processed in wire arc additive manufacturing
Authors: Sarathchandra DT , Davidson MJ
Published: March 2021

Inconel 625 alloy resists corrosion, fatigue and wear at elevated temperatures and hence they are used in aerospace, chemical, petrochemical, marine, and other high-temperature applications. In the present study, single beads of Inconel 625 were deposited using the cold metal transfer (CMT) based wire arc deposition process. Seven heat input conditions were used to study the microstructure and mechanical characteristics. Microstructural characterization was done with optical and scanning electron microscopes while microhardness was measured using the Vickers microhardness testing method. It has been observed that the microstructure of the deposited beads consists of a columnar structure with primary dendrites. Also, intermetallic elements like Niobium (Nb), Molybdenum (Mo), and Laves were formed. It was also observed that the percentage of Nb and Mo increases with heat input. The microhardness increases with an increase in heat input and the maximum hardness was found to be 234.7 HV.
Disturbance observer–based neural flight control for aircraft with switched time-varying distributed delays
Authors: Wu Dawei , Zhou Jun , Ye Hui
Published: March 2021

In this article, the high angle of attack (AOA) maneuver control problem is studied under multiple disturbances and uncertainties. For the first time, the switched distributed delay is constructed to characterize the unsteady aerodynamics. Based on neural networks (NNs) and hyperbolic tangent function, the disturbance observer technique is extended to the nonstrict-feedback system control. To handle the switching problem, time-delay problem, and nonstrict-feedback problem caused by switched distributed delay terms, the Lyapunov–Krasovskii (LK) functional method and a variable separation method are cleverly combined. The proposed LK function can relax the constraints on time-varying delay. Finally, a disturbance observer–based neural finite-time prescribed performance flight control law is developed to improve the flight performance at high AOA, and its effectiveness has been verified through rigorous theoretical analysis and simulation experiments.
Fertility intentions of women living with HIV and their male partners during the perinatal period in rural South Africa
Authors: Mandell Lissa N , Rodriguez Violeta J , Peltzer Karl , Weiss Stephen M , Jones Deborah L
Published: March 2021

Understanding the fertility intentions of people living with HIV can guide safer conception planning and prevention of mother-to-child transmission (PMTCT). Most research has addressed fertility intentions among women, rather than couples, at a single time point. This clinical trial of a PMTCT intervention in rural Mpumalanga province, South Africa, examined longitudinal fertility intentions among perinatal women living with HIV and their male partners. Study assessments and intervention and control sessions were conducted prenatally and postpartum. Longitudinal predictors of participants’ ( n = 360 men, n = 917 women) fertility intentions were similar between sexes. Younger age and male involvement in perinatal care were associated with reporting fertility intentions at both baseline and 12 months postpartum. Having an HIV-positive infant and discussing pregnancy plans with a healthcare provider by 12 months postpartum were associated with incident fertility intentions after reporting no plans for further children at baseline. Results highlight the important role of healthcare providers to educate men and women on issues surrounding conception, as well as the potential for incorporating PMTCT and safer conception education into HIV clinical services.