bluuebunny/crossref_metadata_2025 huggingface dataset:
“The Pain Doesn’t Have to Control You.” A Qualitative Evaluation of Three Pain Clinics Teaching Nonopioid Pain Management Strategies
Authors: Braverman Marc T , Volmar Karen M , Govier Diana J
Published: September 2022

Purpose

To explore factors related to effectiveness of nonpharmacological treatment for opioid-dependent patients suffering with chronic pain.

Approach

A qualitative study incorporating individual interviews and focus group interviews.

Setting

3 rural Oregon nonopioid pain management clinics.

Intervention

A 10-week nonpharmacological educational program incorporating cognitive-behavioral therapy, movement therapy, mindfulness, and other skills.

Participants and methods

Across sites, we conducted 9 individual interviews with clinic staff and 3 focus group interviews with 34 patients who had participated in the course. Thematic analysis was used to identify themes within and across respondent groups.

Results

Analysis revealed 4 primary themes: program goals; program benefits; characteristics of patients who benefit from the program; coordination of clinic experiences with other care. Several primary findings can be highlighted. The clinics focused on improving patients’ quality of life, while opioid use reduction was a potential secondary benefit, driven by patients. Major program benefits included enhanced pain self-management skills, patients’ greater assertiveness in communications with healthcare providers, and, in numerous cases, opioid use reduction. Participants were unanimous that predisposition toward active self-management of one’s pain was an essential factor for positive outcomes. Patients reported considerable variability in providers’ understanding of their clinic participation.

Conclusion

Nonpharmacological approaches for treating chronic pain can be effective for many patients. Clinics teaching these approaches should be more fully integrated into the healthcare system.
Sites of Educational Conflict
Authors: Apple Michael W.
Published: September 2022

Books for and in schools are commodities. They form a central part of the political economy of publishing. They are also, profoundly, sites of cultural and ideological conflict. While always there, there are periods when these economic and ideological conflicts are even more powerful. This is just such a time. This reality asks us to also examine places in school buildings that might (often wrongly) seem to some people to be “less important.” Among these places is the school library as a resource, a teaching device, an access point to things seen as controversial, a mirror of conflicts and economic and political transformations, and for many students, at times a sanctuary. American Public School Librarianship: A History provides us with a richly sourced account of the development of a key pedagogic site in schools and of many of the personal, institutional, and political reasons why they do—and do not do—certain things.
Personalized design strategy of vehicle steer-by-wire characteristics considering driving style
Authors: Zou Songchun , Luan Zhongkai , Zhao Wanzhong , Wang Chunyan
Published: September 2022

In order to meet the needs of drivers with different driving styles and improve driving comfort and safety, a personalized design strategy of vehicle steer-by-wire (SBW) characteristics considering driving style is proposed in this paper. Firstly, based on the driver hardware-in-the-loop test bench, the driver’s driving characteristic data is collected under double lane change condition. Then, the K-means clustering algorithm is adopted to classify the driver’s driving style into cautious type, general type and radical type. Based on this, combined with the clustering results and grid search method, the support vector machine algorithm is used to construct the driving style identification model. Finally, considering the driving style, vehicle stability and steering wheel alignment characteristics, the driver personalized variable steering ratio strategy is designed based on the ideal transmission characteristics, and the personalized SBW performance is analyzed under step condition and sinusoidal condition. The results indicate that the proposed personalized design strategy of vehicle SBW characteristics considering driving style can not only accurately identify driving style, but also meet the needs of drivers with different driving styles for vehicle response.
Metaphor and the scientific method: Why Lacan’s perspective isn’t helpful yet
Authors: Thibodeau Paul H.
Published: September 2022

Keefer (2022) argues that theoretical commitments to conceptual metaphor theory (CMT) impede research on metaphor in psychology. To jumpstart the field, he suggests adopting Lacan’s perspective. I disagree with this argument for a few reasons. First, CMT has a much more nuanced place in current research on metaphor than it would seem from the target article. Second, the field does engage with the hypotheses enumerated by Keefer: that metaphors emerge from a complex web of associations, have unconscious influence, and reflect deep-seated motivations. I review how contemporary research has approached these questions and show how the constraints cited in Keefer’s article stem from the field’s commitments to the scientific method and the computational theory of mind, rather than CMT. Finally, contrary to how they are framed in Keefer’s article, I argue that these constraints have enabled scientific progress to date and limit the impact of Lacan’s perspective moving forward.
Flatness tracking control scheme of rehabilitation exoskeleton robot with dynamic uncertainties
Authors: Bououden Soraya , Brahmi Brahim , Rahman Mohammad Habibur , Saad Maarouf
Published: September 2022

Artificial limbs are new robotic devices created to help stroke victims in the rehabilitation process. In this article, we focus our work on applying passive, active or assistive control strategies to provide a physical assistance and rehabilitation by a 7-degree-of-freedom exoskeleton robot with nonlinear uncertain dynamics and unknown bounded external disturbances due to the robot user’s physiological characteristics. The flatness controller combined with time-delay estimation is designed for the 7-degree-of-freedom exoskeleton robot called ETS-MARSE (Ecole de Technologie Supérieure—Motion Assistive Robotic-exoskeleton for Superior Extremity) in order to ensure a passive rehabilitation exercises with a high level of tracking accuracy and robustness against the uncertainty constraints. The stability analysis of such systems is proven using the Lyapunov–Krasovskii functional theory. This approach is illustrated by experimental results with healthy human to highlight the efficiency of the suggested controller scheme.
An experimental and finite element analysis of 3D printed honeycomb structures under axial compression
Authors: Kaveloglu Serdar , Temiz Semsettin
Published: September 2022

The present study focuses on maximum compressive force of honeycomb structures produced from polylactic acid (PLA) and acrylonitrile butadiene styrene filament using an Ultimaker hot plate 3D printer. A honeycomb structure with an equal surface area and three different cell sizes and wall thickness was designed. The samples were produced with a cell width (d) of 6 mm, 9 mm, 12 mm, a cell wall thickness (t) of 0.8 mm, 1.2 mm, 1.6 mm and a cell height (h) of 10 mm, 20 mm and 30 mm for each cell width, respectively. The produced samples were weighed in order to calculate their porosity percentages. During the compression test, the highest compressive force was obtained from the samples produced from PLA filament with a cell height of 10 mm, a width of 12 mm and a wall thickness of 1.6 mm. Similarly, a detailed finite elements analysis of three structures with different cell widths and thicknesses using ANSYS® software yielded results similar to the experimental study. ANSYS® results were reliable in the range of approximately 81–98%. Thus, although the cell width in honeycomb structures with an equal surface area was increased using both experimental and finite elements method, it was observed that the wall thickness was directly proportional to a higher maximum compressive force.
Does Risk Propensity of Investors Affect the Heuristic Choice of SRI Portfolio Selection?—A Comparison between a Market Portfolio and SRI Portfolio
Authors: Panja Soma
Published: September 2022

From the last few years, awareness of socially responsible investments (SRI) investment is increasing in India. Study in SRI portfolio is gaining importance in finance research. To select an optimum portfolio (SRI or non-SRI), the investor should have basic knowledge about the weights. It is found that equal weight does not always give the desired result to the investors. An investor can also define the weight function heuristically based on their risk propensity to avoid the criticality in statistical calculation. The present article tries to get a heuristic optimum portfolio by comparing the SRI and non-SRI portfolios based on the risk-taking ability of the investors. Two types of investors are considered–optimistic and pessimistic. SENSEX and GREENEX are considered as non-SRI and SRI portfolios respectively. The main aim of the study is to see what type of investors get near optimum solutions if they go for SRI investment. After the analysis, it is found that the pessimistic investors’ decision is nearer to the optimum solution as compared to the optimistic investors’ decision if they go for SRI investment. So, it can be said that the pessimistic investors’ investment decision is better when compared to the optimistic investors in SRI investment.
Women Entrepreneurs in Circular Bio-economies
Authors: Rawat Prigya , Singh Vinay
Published: September 2022

Women entrepreneurship is an inherent part of management compositions that stakeholders employ extensively to decipher ecumenical challenges. Given the status, the question occurs what it takes to transform women into entrepreneurs, particularly in circular bio-economies, before exploiting the entrepreneurial opportunities available with circular bio-economies, the collective efforts needed in the women entrepreneurship sphere. Research in this course was conducted based on expert opinion using the total interpretive structural modelling (TISM) technique. It depicts the twelve elements along with their causal relationship in the digraph with bold and transitive links. The study reveals that the hierarchical structural framework (digraph) is divided into six layers and three components stand in the first position. They are pro-social behaviour, emotional attachment, quality family fabrications, whereas technology transfer is at the bottom of the model. Further, in MICMAC analysis, all the elements are classified into autonomous, dependent, driving and linkage headings. A proper enhancement of these variables can augment several functions of the stakeholders.
Defining Clinical Social Work and its Implications for Practice
Authors: Bloeser Katharine , Sanner Cara , Henkel Jennifer
Published: September 2022

Purpose: There is limited research on social work licensing especially the profession's attempts to define clinical social work practice. This article seeks to investigate definitions of clinical social work for clinical licensure in the United States. Methods: Statutes were searched and cross-referenced with data from the Association of Social Work Boards to determine (1) categories of licensure per state, (2) supervised practice hour requirements for clinical licensure, and (3) definitions of supervised practice to obtain clinical licensure. Results: To date, 15 licensing boards limit or require supervised clinical social work practice hours towards licensure to include psychotherapy. In most of these jurisdictions, the definition of clinical social work excludes other forms of direct practice, like case management or medical social work, as not meeting criteria for clinical licensure. Conclusions: These definitions have implications for practitioners and social work's role in addressing social determinants of health and trauma-informed care.
Development of PharmPAL: A Collaborative Practice Pharmacy Clinic in Ambulatory Palliative Care
Authors: Bacon Molly , Kematick Benjamin , Suliman Iman , Scullion Bridget , Chua Isaac , Given Sarah , Lally Kate
Published: September 2022

Background

Increased access to interprofessional palliative care is needed in ambulatory oncology settings. To achieve this, Dana-Farber Cancer Institute launched a collaborative drug therapy management clinic, PharmPAL, where credentialed advanced practice pharmacists lead independent patient visits.

Methods

As part of a pilot project focused on clinical innovation, we analyzed PharmPAL referrals and pharmacist interventions between July 2020 and June 2021. We extracted referral patterns, patient hospitalizations, and deaths from the electronic medical record. Outpatient palliative care clinicians completed a survey to determine pharmacist needs and overall satisfaction with PharmPAL.

Results

From July 2020 to June 2021, PharmPAL constituted 4.7% (299/6305) of all outpatient palliative care encounters. Most palliative care clinicians (86% [6/7]) reported a desire to increase PharmPAL availability. No patient hospitalizations or deaths were attributed to PharmPAL visits.

Conclusion

PharmPAL increased access to palliative care services. All clinicians reported satisfaction with PharmPAL. We continue to assess the impact PharmPAL has on clinic operations and provider satisfaction.
A More Relevant MBA: The Role of Across-the-Curriculum Delivery of Intercompetency Coursework in Aligning the Required Curriculum With Required Managerial Competencies
Authors: Amblee Naveen , Ertl Hubert , Dhayanithy Deepak
Published: September 2022

Despite their widespread popularity in the United States, MBA programs have received considerable and sustained criticism. The chief complaint is that MBA graduates lack key skills required to be competent managers, and the main suspect has been identified as a less than relevant curriculum. Previous studies determined that the required MBA curriculum did a poor job of delivering the managerial competencies prized by incumbent managers. However, these researchers suspected that across-the-curriculum delivery of managerial competencies could mitigate this misalignment. This study advances the field by implementing an intercompetency approach, by including previously excluded coursework, and by using an updated dataset. The results show that the required curriculum of MBA programs in the United States is on average more closely aligned with the prescribed coverage benchmarks than previously believed, and that across-the-curriculum delivery of content via intercompetency coursework substantially aids in this alignment. The findings have actionable implications for program managers, faculty members, and researchers in the field of graduate management education.
Transitional Care for Patients With Portal Hypertension: A Multicenter Study of Intervention for Post-TIPS Patients
Authors: Yang Rumei , Xu Yin , Hou Weiwei , Wang Ling , Xiao Shuping , Li Chunhong , Shao Hongyan , Fei Xiaoyan , Wang Zhongmin
Published: September 2022

To explore the application effect of transitional nursing in patients with TIPS. A total of 368 patients were allocated to control group (conventional care) and intervention group (conventional care combined with transitional care). The Child–Pugh scores, blood ammonia levels, compliance behavior, medication compliance, and adverse event incidence rates were compared at 1, 3, 6, 9, and 12 months post-TIPS. There were significant differences in compliance behavior scores, Child–Pugh scores for group effects, time effects, and group × time interaction between the two groups at 1, 3, 6, 9, and 12 months post-TIPS, significant differences in blood ammonia levels at 9 months, and incidence of postoperative adverse events at 12 months after TIPS. Post-TIPS transitional care interventions increased patients’ access to scientifically informed nursing, significantly improved patients’ compliance behavior and health and decreased the incidence of postoperative adverse events.
The Incarnation of the Eternal Son: Fitting, not Necessary
Authors: Hinlicky Paul R.
Published: September 2022

In this contribution the author responds to Bruce Marshall's Thomist critique of Barth's theology, at the cost of a certain revision of Barth's mature exploration of the “being-for-others” of the eternal Son in CD IV/1. Affirming the eternity of the Son, the Logos asarkos and thus of the immanent Trinity, socially modeled, the article argues that this revision follows the cutting-edge of Barth's thought and provides a dispositional ontology which both allows for a properly divine mutability in the incarnation and at the same time preserves the freedom of reconciling grace.
Lonely at Home: Exploring Factors Associated with Loneliness Among Female Students at Home During COVID-19 Lockdown in India
Authors: Narain Shruti , Maheshwari Saurabh
Published: September 2022

The present study explores loneliness among female students who stayed at home during the COVID-19 lockdown. Recent research has shown a sharp rise in the self-reported incidences of loneliness, especially among females during the lockdown imposed in most regions around the globe. The studies have also shown that those with lower self-control and a negative self-image are more vulnerable to negative emotional and behavioral outcomes. Therefore, it would be interesting to see how are these aspects related to loneliness among young females that too in a patriarchal society such as India. Whether family dynamics have any impact on mitigating loneliness or not has also been investigated. For this purpose, an online survey was conducted on 1023 female students of various universities/colleges across India. The results show that loneliness is found less among the females who showed better self-control, positive self-image, and good family relationship. Though household work engagement can keep females busy, it has little to do with their feeling of loneliness. The study indicates that living with family members is not enough to deal with loneliness. Rather it requires a good relationship with family members, self-control, and a positive self-image. Hence, to deal with the loneliness issues that youth are facing at present, family connectedness and constructive self-view need to be (re)established to prevent loneliness from causing severe mental problems.
The Rise of Total Ankle Arthroplasty Use: A Database Analysis Describing Case Volumes and Incidence Trends in the United States Between 2009 and 2019
Authors: Karzon Anthony L. , Kadakia Rishin J. , Coleman Michelle M. , Bariteau Jason T. , Labib Sameh A.
Published: September 2022

Background:

Ankle arthrodesis has been the mainstay treatment for end-stage ankle arthritis. The popularity of total ankle arthroplasty (TAA) has been on the rise due to improved implant design and postoperative outcomes. The purpose of this study was to describe the basic epidemiology and trends of annual procedure volumes and incidence in the general American population as well as in different population subgroups from 2009 to 2019. We hypothesize that the incidence of TAA has significantly risen while the median length of hospital stay has decreased nationwide.

Methods:

The IBM MarketScan database was queried for patients who underwent TAA from January 2009 to December 2019 based on Current Procedural Terminology coding. Population estimates from the US Census Bureau were used to calculate the annual incidence of TAA. Procedural volume and incidence were calculated for annual sums, gender, age subgroups, inpatient and outpatient TAA, as well as in four statistical geographic regions in the United States. Median length of hospital stay was calculated and trended annually for inpatient TAA.

Results:

A total of 41,060 primary TAAs were identified in the database from 2009 to 2019, in which 52.5% were performed in males. Annual volumes increased by 136.1%, from 2180 to 5147 procedures nationwide. Incidence reported per 100 000 population increased by 120.8%. Both inpatient and outpatient procedures have increased, by 242.5% and 86.6%, respectively. Median length of hospital stay decreased from 3 days in 2009 to 1 day in 2019 and did not differ between genders. Growth in incidence was demonstrated in males and females above the age of 54 years with the largest growth in annual incidence found between 65 and 74 years. Incidence rose in the South and West of the United States by 111.8% and 136.5%, respectively.

Conclusion:

We found that annual volumes and incidence rates of primary TAA has increased between 2009 and 2019. Although both inpatient and outpatient surgery have become more frequent, inpatient volumes and incidence have increased almost 3 times more than those of outpatient surgery. Length of hospital stay decreased over the study years. When adjusted for the same study period, the cumulative annual growth rates of TAA were found to be 2 times greater than total knee arthroplasty and 3.6 times greater than total hip arthroplasty.

Level of Evidence:

Level III, retrospective database review.
Searching for Home: Autoethnographic Reflections of a Black Girl
Authors: Riddick Breonna (Bree)
Published: September 2022

Stories serve as entry points—bringing us together and bringing us to ourselves. Critical autoethnography bridges the space between scholarship and personal storytelling as a method of theorizing. Holman Jones explains, “The ‘critical’ in critical autoethnography reminds us that theory is not a static or autonomous set of ideas, objects, or practices. Instead, theorizing is an ongoing process that links the concrete and abstract, thinking and acting, aesthetics, and criticism . . . ” Through autoethnography from a critical perspective, I share stories of silence, grief, fear, loss, and rediscovery as a Black woman in a world where the values of White supremacy run rampant. Through narrative performance, I trace my experiences of race, place, gender, childhood, and movement into adulthood. I describe my sense of feeling pulled away from my roots and the beginning of my process of reclamation. Boylorn shares with us, “Our stories are not our own, and we constantly negotiate entrances and exits in the stories of others and in the delicate balance between our public and private lives. Our life stories often mimic the way our lives are lived: layered, complicated, interconnected, with blurred lines of distinction.” Without stories, we cannot heal.
Blair Performing as Orwell Performing as . . .
Authors: Badley Graham Francis
Published: September 2022

In this narrative, I identify seven main roles which Eric Arthur Blair performs throughout his life. Blair-Orwell is shown as enacting or faking or impersonating such characters in his own life-drama as Class Warrior, Imperial Policeman, Autoethnographer, Womaniser, Soldier, Socialist, and Political Writer.
Reviewer Resources: Confirmatory Factor Analysis
Authors: Nye Christopher D.
Published: September 2022

Confirmatory factor analyses (CFA) are widely used in the organizational literature. As a result, understanding how to properly conduct these analyses, report the results, and interpret their implications is critically important for advancing organizational research. The goal of this paper is to summarize the complexities of CFA models and, therefore, to provide a resource for journal reviewers and researchers who are using CFA in their research. The topics covered in this paper include the estimation process, power analyses, model fit, and model modifications, among other things. In addition, this paper concludes with a checklist that summarizes the key points that are discussed and can be used to evaluate future studies that incorporate CFA.
Impact of a hybrid medical care model in the rheumatoid arthritis patient-reported outcomes: A non-inferiority crossover randomized study
Authors: Guaracha-Basáñez Guillermo A , Contreras-Yáñez Irazú , Estrada González Vivian A , Pacheco-Santiago Lexli D , Valverde-Hernández Salvador S , Pascual-Ramos Virginia
Published: September 2022

Objective

Patients and physicians can naturally adopt hybrid healthcare models that combine face-to-face consultations with telemedicine. The study's objective was to compare the impact of two healthcare interventions, hybrid care modality and face-to-face consultation, on the patient-reported outcomes of rheumatoid arthritis patients, during the COVID-19 pandemic.

Methods

Consecutive outpatients reincorporated to a clinic previously in lockdown were invited to a non-inferiority, randomized study (October 2020–-May 2022). Patients were randomized to 6 months of face-to-face consultation or hybrid care modality (intervention period-1) and then the converse modality (intervention period-2). The primary outcome was disease activity/severity behavior (Routine Assessment of Patient Index Data 3). Additional patient-reported outcomes were disability (Health Assessment Questionnaire Disability Index), quality-of-life (World Health Organization quality of life questionnaire-brief version), adherence and satisfaction with medical care, and treatment recommendation. Sample size calculation established 55 patients/healthcare interventions.

Results

There were 138 patients invited to participate, 130 agreed and 121 completed their study participation. Sixty-one and 60 patients respectively, received face-to-face consultation and hybrid care modality over intervention period-1. Patients were primarily middle-aged females (90.1%), with (median, IQR) 12 (9–16) years of education, long-standing disease, working (62.8%), receiving disease-modifying anti-rheumatic drugs (96.7%), and corticosteroids (61.2%). Patients had low disease activity (median Routine Assessment of Patient Index Data 3: 2.7) and Health Assessment Questionnaire Disability Index score that translated into the absence of disability, while quality of life was compromised. Baseline characteristics were similar between patients assigned to each healthcare intervention. Differences in Routine Assessment of Patient Index Data 3 behavior were below the non-inferiority margin. Results considered the order in which patients received the intervention and baselines scores, and extended to the patient-reported outcomes left.

Conclusions

Hybrid care modality was non-inferior to in-person consultations in achieving patient-reported outcomes during the COVID-19 pandemic in rheumatoid arthritis patients.
Eleven years of teledermoscopy in the Netherlands: A retrospective quality and performance analysis of 18,738 consultations
Authors: van Sinderen Femke , Tensen Esmée , Lansink Rick AB , Jaspers Monique WM , Peute Linda WP
Published: September 2022

Introduction

Teledermoscopy supports and enhances the early detection of skin lesions by general practitioners in primary practice through remote consultation with dermatologists. Teledermoscopy has been a regular health service in Dutch primary care since February 2009. Teledermoscopy quality and performance outcomes on Dutch general practitioner primary care 11 years after its implementation were assessed.

Methods

Dutch primary care teledermoscopy consultation data was retrospectively analysed on timestamps and responses on non-mandatory evaluation questions posed to the general practitioner and teledermatologist during the teledermoscopy consultation process. Anonymized data (February 2009–February 2020) was extracted from a Dutch teledermoscopy service database. The timestamps and evaluation questions data were subject to the teledermoscopy quality and performance outcomes. A limited cost evaluation was performed.

Results

A total of 18,738 teledermoscopy consultations were sent by 1341 general practitioners (February 2009–February 2020). For 3908 (31.9%) teledermoscopy consultations, the general practitioner requested second opinion advice which led to 712 (18.2%) extra teledermoscopy referrals of patients who would not have been referred without teledermoscopy, including skin cancer teledermoscopy diagnoses. The general practitioner followed the teledermatologists’ advice on patient referral for 8813 (88.5%) patients, reported 97.3% of the teledermoscopy consultations as helpful and 95.1% as instructive, referred 68.0% less patients with teledermoscopy availability, referred overall 59.4% less patients, and needed 5.4 minutes (median) for sending a teledermoscopy consultation. Teledermatologist's median answer and response time was 2 minutes and 2.4 hours, respectively. The estimated cost reduction was €144.18 ($164.65) (50.2%) per teledermoscopy patient.

Discussion

Teledermoscopy is a useful service in general practitioner practice for requesting dermatologist advice in primary care settings to support the detection of skin lesion at an early stage and at lower costs. Teledermoscopy could also decrease the burden of secondary dermatology care since general practitioners reported that they did not refer the majority of patients to a dermatologist after the teledermoscopy consultation compared to their initial referral decision. General practitioners reported the teledermoscopy system as helpful and instructive which could contribute to enhancement of their dermatological knowledge.
Tele-ECP: A feasible telemedicine-based approach to extracorporeal photopheresis
Authors: Castillo-Aleman Yandy Marx , Ann-Martinez May , Victorino-Roque Jay Mary Rose , Othman Jekhsi , Ventura-Carmenate Yendry
Published: September 2022

The acquisition of telecommunication technologies in clinical practices is transforming medical care capabilities, whereas applying telemedicine in apheresis medicine has resulted in the revolutionary concept of “telapheresis.” This manuscript aims to describe the regulatory landscape of telapheresis by presenting the first “tele-ECP” (telemedicine-based approach to extracorporeal photopheresis) reported in the United Arab Emirates. The tele-ECP procedure was done successfully in a patient with chronic graft-versus-host disease, who, despite having one vascular access-related adverse event, it was solved promptly without further complications. Therefore, this telemedicine-based approach arose as a feasible practice, but required direct physical contact with other trained and privileged/credentialed staff.
Nationwide implementation of a centralised telemedicine platform in Singapore to fight the COVID-19 pandemic
Authors: Kok Ta Wei Kevin , Chong Si Jack , Yau Wen Kien Joachim , Raj Kumar Praveen , Chua Swee Boon Raymond
Published: September 2022

Introduction

This study aims to share the experience of the Ministry of Health (Singapore) in deploying a centrally managed Telemedicine service to triage, and manage COVID-19 cases in the community during the COVID-19 Omicron wave.

Material and methods

Data from the deployed telemedicine system, Telemedicine Allocation and Reconciliation System, over a 14-week period (3 January 2022–10 April 2022) was analysed to determine the safety and efficacy of both the (i) National COVID-19 sorting logic algorithm and (ii) the use of a centralised telemedicine platform with privacy protection in a pandemic.

Results

There was a total of 47,754 children (aged 1–11 years old), 75,702 adolescents and adult patients (aged 12–69 years old) and 55,774 geriatric patients (aged > = 70 years old) who were directly managed by this platform. Amongst them, 64,961 were from the higher-risk special populations (pregnant, end-stage renal failure and immunocompromised and geriatric population). The total number of patients requiring escalations to public health institutions were 4212. This accounts for 1.32%, 3.00% and 2.35% of the children, teenagers and adults, and geriatric population respectively.
Psychomotor agitation and irritability in adolescents with manic episode: Clinical data from three inpatient units
Authors: Turan Serkan , Ermiş Çağatay , Eray Şafak , Ağaç Nilay , Aksoy Sena , Yüksel Ayşe Sena , Bezir Karaca Ayça , Güler Duru , Tunçtürk Mustafa , Çıray Remzi Oğulcan , Mutlu Caner , Karaçetin Gül , Youngstrom Eric A , İnal Neslihan
Published: September 2022

Objectives

We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample.

Methods

Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained. Psychomotor agitation was defined as a score of ≥3 on the YMRS “Increased Motor Activity––Energy” item, irritability as a score of ≥4 on the YMRS ‘irritability’ item, and severity anchors of speech and thought disturbance on the YMRS ‘6 and 7’ items.

Results

Previous manic episodes ( p = 0.013), involuntary hospitalization ( p = 0.006), psychotic features ( p = 0.001), formal thought disorder ( p = 0.010) and aggressive/disruptive behavior ( p = 0.021) were more frequent in the Mania+IA group. Conversely, depressive episodes ( p = 0.006) and family history of depression ( p = 0.024) were more frequent in the Mania-IA group. The Mania+IA had poorer functioning at the time of discharge.

Conclusions

Irritability and agitation were closely related to complications, psychotic symptoms and thought disorder. Assessment and monitoring of psychomotor agitation and irritability may help child and adolescent psychiatrists to predict clinical difficulties and appropriate interventions.
Resilience factors during the Coronavirus pandemic: Testing the main effect and stress buffering models of optimism and positive affect with mental and physical health
Authors: Venkatesh Harshitha , Osorno Amber M , Boehm Julia K , Jenkins Brooke N
Published: September 2022

This study investigates associations between resilience factors (optimism and positive affect) and self-rated health during the COVID-19 pandemic. Longitudinal data were collected ( N = 292) across five assessments. Multilevel modeling tested main effects of the resilience factors and how they interacted with stress to predict health. Greater optimism and positive affect were prospectively associated with fewer depressive symptoms ( ps < 0.01) and a lower burden of physical health symptoms ( ps <0.01). Positive affect interacted with stress to predict depressive symptoms ( p < 0.05), suggesting a stress buffering effect. These findings suggest that resilience factors may improve health during COVID-19.
Equivalent linearization and parameter optimization of isochronous-pendulum tuned mass damper
Authors: Huang Chen , Huo Linsheng , Li Hongnan
Published: September 2022

The isochronous-pendulum tuned mass damper (IPTMD) with curved supports was proposed to eliminate the loss of vibration control performance induced by large swing angles in our previous study. However, the nonlinearity caused by the IPTMD leads to difficulty in its parameter optimization. To overcome this issue, an approach based on the equivalent linearization method (ELM) and genetic algorithm (GA) is proposed in this paper to facilitate the optimal design of the IPTMD. First, based on the pseudo excitation method, the nonlinear IPTMD system is equivalent to a linear one using the ELM. The numerical results demonstrate that the equivalent linearization model of the IPTMD is fairly precise to approximate the original nonlinear IPTMD. Then the optimal design based on the H∞ norm and GA is performed to compute the design parameters of the IPTMD, which can minimize the peak response of the main structure. Additionally, to evaluate the effectiveness of the proposed approach, the optimal parameters are applied to compute the dynamic response of a tall building installed with the IPTMD under different earthquakes. The numerical results reveal that the optimized IPTMD can reduce the displacement of the tall building effectively.
The critical role of peer reviewers: Challenges and future steps
Authors: el-Guebaly Nady , Foster John , Bahji Anees , Hellman Matilda
Published: September 2022

The critical role of peer reviewers in the publishing process is examined. Examples of typical challenges are provided, including the relative lack of rewards for this important task. Particular attention is paid to the need to consider the diversity of the peer reviewers recruited and impediments to the selection beyond Areas of Competence, often due to the small available pool. Finally, recommendations for improvement are suggested.
Gambling and Gambling Problem Perception Questionnaire as a tool to evaluate professionals’ attitudes towards problem gamblers and training programmes in Japan
Authors: Katayama Munenori , Kobara Keiji , Shirakawa Norihito
Published: September 2022

Aim: To develop and measure the psychometric properties of the Gambling and Gambling Problem Perception Questionnaire (GGPPQ); a scale to evaluate professionals’ attitudes towards people with problem gambling in the Japanese context. Data collection: We held 12 workshops in Japan targeted at mental health professionals who consult people with gambling problems. Participants completed the survey before the workshop. Some were also asked to complete the survey after the workshop to measure workshop influence. Setting: Public and private healthcare facilities in all 47 prefectures of Japan. Participants: Medical doctors, nurses, social workers, clinical psychologists, and other professionals working in the aforementioned facilities ( n = 653, response rate = 98.5%). Measurements: licence; knowledge about gambling and gambling problems (questionnaire); self-rating of knowledge and general confidence for helping problem gamblers; years of practice; frequency of working with clients; experience in attending workshops; overall satisfaction with the workshop. Results: A five-factor structure extracted by exploratory factor analysis showed a good fit by confirmatory factor analysis (CFI = .973, TLI = .967, RMSEA = .060, AIC = 28913.6, BIC = 29110.8). The GGPPQ showed good internal consistency and good concurrent validity with participants’ self-rating of their knowledge, general confidence, frequency of working with clients who have gambling problems, and experience in attending workshops. The workshop had a positive influence on participants’ attitudes. Japan's unique gambling industry and lack of training opportunities on problem gambling were assumed to have influenced the psychometric properties of the measurement tool. Conclusion: The GGPPQ is a valid tool to measure the attitudes of healthcare professionals towards people with gambling problems, as well as workshop effectiveness in Japan.
Characteristics analysis and optimization design of bridge crane based on improved particle swarm optimization algorithm
Authors: Wang Yahui , Ma Chaojie , Wang Chong , Zhang Huipeng , Fan Suxiang
Published: September 2022

Large redundant metal structures have high stability with large cost. An excellent mechanical structure should have the lower weight when satisfying its stability. Aiming at the large redundancy of the main beam metal structure of the double-beam bridge crane, the paper extracts six important parameters to determine its quality, and the corresponding value is set. The orthogonal test table is designed to calculate the strength and stiffness. In order to avoid resonance, the fixed vibration frequency and excitation frequency are calculated. The experimental results are fitted to obtain the six parameters of the quality, strength, stiffness, and natural frequency. Moreover, particle swarm optimization algorithm is used to solve the multi-objective optimization mathematical model with the design quality as the goal and the stiffness, strength, and easy resonance interval as constraints. In view of the long calculation time and poor convergence of particle swarm optimization algorithm, a module that limits the particle forward speed is added and the generation conditions of particles are redefined. The improved particle swarm algorithm shows that the first-order vibration frequency of the main beam increases from 18 Hz to 27.55 Hz. It improves the stability of the overall structure and avoids resonance with the motor frequency. Under the condition of satisfying the stability of the main beam, the quality of the main beam is reduced from 1.23 tons to 0.53 tons, with a reduction of 6%.
Investigations on an active pre-chamber ignition system in a combustion chamber
Authors: Russwurm Tim , Peter Andreas , Strauß Lukas , Rieß Sebastian , Wensing Michael
Published: September 2022

Pre-chamber ignition systems are one way to enable homogeneous lean or dilute combustion. Both strategies can significantly increase the efficiency of spark ignition engines. Spark initiated combustion in the pre-chamber produces hot gases that rapidly enter the cylinder and ignite the diluted charge at multiple points. Active ignition systems with fuel in the pre-chamber can directly influence the composition of the pre-chamber to ensure good ignition properties and sufficient ignition energy. This paper shows results from a novel test facility that enables investigations on the jet propagation of an active pre-chamber inside a constant pressure vessel. Thereby, the background mixture inside the vessel is variated between λ = 1.0 and λ = 2.0. With a special designed single-hole pre-chamber the flame propagation of a single pre-chamber jet is measured both in direction of the transfer port and perpendicular to this direction. Compared to spark ignition under equal ambient conditions (350°C, 10 bar), the pre-chamber combustion propagates around eight times faster in direction of the transfer port and 60% faster in radial direction. Until λ = 1.6, the flame propagation speed in radial direction can be kept on the level of a stoichiometric spark ignition. The simultaneous record of OH*-chemiluminescence and high-speed Schlieren imaging shows that the dominant ignition mechanism of a passenger-car sized pre-chamber is jet ignition according to the classification of Biswas. In stoichiometric cylinder conditions, a rich pre-chamber hampers the ignition in the main chamber whereas in lean operation points the scavenging of the pre-chamber with a rich λ = 0.8 mixture is beneficial. These measurements indicate how the disrupted flame front of a pre-chamber jet increases the turbulence and enhances the flame propagation. The highest recorded propagation speed occurs in stoichiometric conditions both in the pre-chamber and in the combustion module.
Modelling heat transfer and fluid flow in a ship engine room using CFD analysis to evaluate and improve ventilation
Authors: Salmani Amir , Hosseini Seyed Farokh , Khani Hasan
Published: September 2022

Considering that about 90% of international trade is transported via sea and ship ventilation systems consume between 3.5% and 5.5% of the ship’s rated power, ship energy consumption is of particular interest and modelling and enhancing ventilation systems are vital to reducing and optimising energy consumption. Using Computational Fluid Dynamics (CFD) simulation, modelling heat transfer and airflow patterns helped us improve the ventilation system and temperature distribution, provide thermal comfort for staff and equipment, and increase energy efficiency. We discussed the radiation effect in CFD analysis; it affected wall temperatures significantly and temperature contours to some extent; it raised air temperatures by 3 K and wall temperatures by 14 K in some areas; this issue has not been considered in previous analyses. Considering seven different engine room configurations, we analysed temperature distribution, air terminal streamlines and other parameters to choose the best. We examined four energy-saving plans for the best configuration, and airflow was reduced by 13.8% and fan power by 36% based on the temperature distribution. By improving the engine room ventilation system, average engine room temperature, heat removal efficiency, combustion air temperature, and temperature distribution developed. The analysis of air terminals included assessing their streamlines, determining areas they circulated, and customising their airflow; in addition to vertical and horizontal air terminals at the top or bottom of the engine room, we also examined a separate air terminal for engine combustion air, this tool has been used very little before.
A Systematic Review of Community-Level Protective Factors in Children Exposed to Maltreatment
Authors: Jean-Thorn Arianne , Tremblay-Perreault Amélie , Dubé Valéry , Hébert Martine
Published: September 2022

Childhood maltreatment and neglect are associated with a host of negative outcomes. Yet, some children show resilience despite their exposure to these traumatic events. Several protective factors have been documented in the literature, but few studies focus on protective factors in the child’s community that can promote resilience. The purpose of this review was to provide a comprehensive portrait of the impact of community protective factors on the resilience of abused and neglected children. The databases PsycNet and PubMed were used to screen the literature relying on the following inclusion criteria: (1) published in English or in French; (2) report empirical and quantitative data; (3) include a minimum sample size of 30 participants; (4) rely on a sample of maltreated children or adolescents under the age of 24; (5) examine the associations between community protective factors and indicators of psychological adaptation; and (6) include outcome measures that assessed either positive adaptation or the absence of symptomatology in participants. Of the 9,553 articles identified, 44 studies met the eligibility criteria for inclusion in this review. Although many protective factors show significant results, several methodological limitations remain to be examined to affirm that these community variables have a significant impact on the level of resilience of maltreated children. Since child maltreatment is a systemic issue, it remains important to fully understand how community protective factors operate on the resilience of these children as it can greatly inform practitioners and community institutions on how to intervene with populations at risk of maltreatment.
Narrative Review of Risk Assessment of Abdominal Aortic Aneurysm Rupture Based on Biomechanics-Related Morphology
Authors: Ren Shuqi , Guidoin Robert , Xu Zaipin , Deng Xiaoyan , Fan Yubo , Chen Zengsheng , Sun Anqiang
Published: September 2022

An abdominal aortic aneurysm (AAA) is a typical aortic disease with serious complications. In clinical practice, the decision to intervene in treatment depends on the rupture risk of AAA. Therefore, monitoring the progression of the disease and accurately assessing the rupture risk is of great importance for its treatment. Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. However, using computational fluid dynamics (CFD) to simulate the biomechanical environment is a cumbersome and time-consuming process, which is inadequate to meet the needs of clinical monitoring and quick decisions. While the hemodynamic environment of AAA is heavily dependent on geometry, more and more biomechanics-related morphological parameters have been raised and validated. In this review, we summarized typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment, including maximum diameter, deformation rate, saccular index, asymmetry, AAA volume, tortuosity, and intraluminal thrombus (ILT), providing a reference for clinical preoperative risk assessment.

Clinical Impact

Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. To meet the need for clinical monitoring and rapid decision making, the typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment have been summarized, which provide a reference for clinical preoperative risk assessment of AAA.