bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals
Authors: Dudas Lauren M. , Bardes James M. , Wagner Afton K. , White Teresa , Wilson Alison M.
Published: December 2021

Background

Tele-consults provide access to specialized care for a specific question and single point in time. eICU models utilize remote monitoring and ordering but have significant financial burden. We developed a virtual intensive care unit (VICU) for daily input of an intensivist working with local physicians. The purpose was to expand the acute care ability of the critical access hospital (CAH). The study evaluates the impact on the CAH and system.

Methods

The CAH developed an ICU team, led by a hospitalist, who staffed the intensive care unit (ICU). The CAH ICU team rounds daily via a secure video link to provide care in consultation with intensivists based at a university, tertiary care center (TC). A retrospective analysis was conducted 6 months before and after implementation (4/2018-3/2019). Fisher’s exact test was used to compare pre- and post-intervention with significance at P < .04.

Results

After VICU implementation, there were 265 initial daily and 35 follow-up consults. Monthly transfers to a higher level of care decreased from 63 to 57 ( P = .03). Transfers to TC increased from 49.6 to 62.0% ( P = .001). Critical access hospital average monthly census and average monthly inpatient days increased (69 to 130 ( P < .0001) and 158 to 319 ( P < .0001), respectively). Critical access hospital physicians report increased comfort to admit ICU and non-ICU patients due to the program. The total startup cost was $5180. CAH hired 11 providers. There were no unanticipated deaths.

Discussion

VICU implementation resulted in new CAH jobs. The CAH experienced increased inpatient census and revenues (ICU and non-ICU) while decreasing patients transferred out of the system.
Pheochromocytoma Crisis Rescued by Veno-Arterial Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy
Authors: Nakayama Toshihiro , Ito Kyoji , Inagaki Fuyuki , Miyake Wataru , Katagiri Daisuke , Mihara Fuminori , Takemura Nobuyuki , Kokudo Norihiro
Published: December 2021

Pheochromocytoma is a rare catecholamine producing adrenal tumor. Pheochromocytoma crisis is a life-threatening condition inducing multiple organ failure and hemodynamic instability caused by too much catecholamines produced from pheochromocytoma. We report a 59-year-old woman with pheochromocytoma crisis rescued by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), continuous renal replacement therapy (CRRT), and interval tumor resection. In June 2020, the patient was taken to our institution complaining of headache and left lower back pain. The patient developed cardiopulmonary arrest while at the emergency department. After extracorporeal cardiopulmonary resuscitation, the patient required VA-ECMO for hemodynamic support, and subsequently CRRT for catecholamine removal and acute kidney injury. After 1 month of hemodynamic management, the patient underwent left adrenalectomy. The postoperative course was uneventful and she was discharged on postoperative day 23. CRRT would be a safe and feasible option for catecholamine control in patients with acute kidney injury in pheochromocytoma crisis.
Trauma Surgeons’ Perceptions of Resuscitating Lethally Injured Patients for Organ Preservation
Authors: Peetz Allan , Kuzemchak Marie , Hammack Catherine , Guillamondegui Oscar D , Dennis Bradley M, , Eastham Shannon , Meador Keith , Beskow Laura , Patel Mayur
Published: December 2021

Background

Trauma surgeons face a challenge when deciding whether to resuscitate lethally injured patients whose organ donor status is unknown. Data suggests practice pattern variability in this setting, but little is known about why.

Materials and Methods

We conducted semi-structured interviews with trauma surgeons practicing in Level 1 or 2 trauma centers in Tennessee. Interviews focused on ethical dilemmas and resource constraints. Analysis was performed using inductive thematic analysis.

Results

Response rate was 73% (11/15). Four key themes emerged. All described resuscitating patients to buy time to collect more definitive clinical information and to identify family. Some acknowledged this served the secondary purpose of organ preservation. 11/11 participants felt a primacy of obligation to the patient in front of them even after it became apparent, they could not personally benefit. For 9/11 (82%), the moral obligation to consider organ preservation was secondary/balancing; 2/11 (18%) felt it was irrelevant/immoral. Resource allocation was commonly considered. All participants expressed some limitation to resources they would allocate. All participants conveyed clear moral agency in determining resuscitation extent when the goal was to save the patient’s life, however this was less clear when resuscitating for organ preservation. Across themes, perceptions of a “standard practice” existed but the described practices were not consistent across interviewees.

Discussion

Widely ranging perceptions regarding ethical and resource considerations underlie practices resuscitating toward organ preservation. Common themes suggest a lack of consensus. Despite expressed beliefs, there is no identifiable standard of practice amongst trauma surgeons resuscitating in this setting.
How Many Screws to Use: A Report of Outcomes After Surgical Stabilization of Rib Fractures Where less than the Manufacturer Recommended Screw Number Were Applied
Authors: Nowack Timothy , Christie Dudley , Nonnemacher Cory , Buchanan John
Published: December 2021

Surgical stabilization of rib fractures in an effective technique for the management of bony thoracic trauma. However, rib fractures location or morphology may make the placement of the recommended 6 screws impossible. A retrospective analysis of patients receiving SSRF at our facility from 2009–2019 identified cases where less than the recommended screw placement was used. Respiratory complications and hardware integrity were analyzed using follow-up imaging and examinations when available. A total of 62 patients were identified that used less than the recommended number of screws. The majority of these were in the lateral and posterior chest wall positions. 1 pleural effusion, no pneumothoraces, deaths, or hardware dislodgments were identified. While the authors do not advocate for the routine deviation from manufacture recommendations, we concluded that in select circumstances, adequate fixation can be achieved with less than 6 screws across a plated fracture.
Blood Pressure Control and Associated Factors Among Hypertensive Patients Attending Shashemene Referral Hospital, Oromia, Ethiopia
Authors: Anota Aliyi , Nedi Teshome
Published: December 2021

Background:

Hypertension is public health challenge worldwide. It is defined as persistently elevated arterial blood pressure (BP), systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg or use of antihypertensive medication in adults older than 18 years. The aim of this study was to assess blood pressure control and associated factors among hypertensive patients attending the outpatient department of Shashemene Referral Hospital.

Methods:

Hospital based cross sectional study was conducted to determine level of blood pressure control and associated factors among hypertensive patients on medical follow-up. A medical chart review and interview was conducted from July 1 to October 31 2018.

Result:

A total of 325 participants were included in this study with response rate of 320 (98.5%). More than half of study participants were males 171 (53.4%). The mean age of the respondents was 55.10 (SD ± 12.7) years and majority of the respondents 191 (59.7%) were within age of less than 60 years old. The mean Systolic blood pressure (SBP) was 131.80 mmHg (SD ± 20.92) while the mean diastolic blood pressure (DBP) was 82.30 mmHg (SD ± 10.52). About 51.30% of study participants had a controlled SBP and 54.7% had a controlled DBP. The overall control of BP was achieved in 40.3% of the study participants. Multivariable logistic regression analysis showed that age, experience of side effects, frequency of BP measuring, number of antihypertensive drugs used, duration on antihypertensive, source of medication and physical exercise showed significant association with blood pressure control.

Conclusion:

Blood pressure control level among chronic hypertensive patients at outpatient department was low. Age of patients, educational level, experience of side effects, and number of antihypertensive drugs used were important determinant factors associated with blood pressure control among study participants.
Comparison of Higher-Than-Standard to D-Dimer Driven Thromboprophylaxis in Hospitalized Patients With COVID-19
Authors: Chilbert Maya R. , Clark Collin M. , Woodruff Ashley E. , Zammit Kimberly , Lackie Cynthia , Kusmierski Kristen , McGrath Patrick , Fuhrer Gregory , Augostini Anna , Denny Olivia , Ross Nicole , Saber Marissa , DelGuidice Natalie
Published: December 2021

Introduction: Coronavirus disease 2019 is a global health threat often accompanied with coagulopathy. Despite use of thromboprophylaxis in this population, thrombotic event rates are high. Materials and methods: This was a multicenter, retrospective cohort study comparing the safety and effectiveness of thromboprophylaxis strategies at 2 institutions in hospitalized patients with coronavirus disease 2019. Regimen A utilized a higher-than-standard thromboprophylaxis dosage and Regimen B received full-dose anticoagulation for any D-dimer 3 mcg/mL or greater and prophylactic for less than 3 mcg/mL. The primary outcome compared the rate of thrombotic events between treatment groups. Secondary endpoints compared rates of major or clinically relevant non-major bleeding as well as the proportion of patients in each group experiencing thrombotic events within 30 days of discharge. Results: One-hundred fifty-three patients were included in the analysis, 64 receiving Regimen A and 89 receiving Regimen B. Seven (4.6%) thrombotic events occurred, 3 (4.7%) in patients receiving Regimen A, and 4 (4.5%) in Regimen B ( P = 1.0). Twelve patients (13.5%) receiving Regimen B had a bleeding event versus 2 (3.1%) in Regimen A ( P = .04), half of which were major in each group. All patients who bled in either treatment group were receiving mechanical ventilation, and 12 of 14 were receiving full-dose anticoagulation. One patient receiving Regimen A was readmitted with a pulmonary embolism. Conclusions: In this study, the thromboprophylactic regimen impacted bleeding, but no significant difference was seen with thrombotic outcomes. Almost all patients who experienced a bleed were mechanically ventilated and receiving full-dose anticoagulation. The use of full-dose anticoagulation should be cautioned in this population without an additional indication.
Prophylactic Enoxaparin in Critically Ill Trauma Patients: Evaluation of the Initial Dose
Authors: Agedal Kaitlyn J. , Feldman Elizabeth A. , Seabury Robert W. , Darko William , Probst Luke A. , Miller Christopher D. , Cwikla Gregory M.
Published: December 2021

Background: Trauma patients are at increased risk of developing venous thromboembolism given alterations in the coagulation cascade. Chemoprophylaxis with standard dosing of enoxaparin 30 mg subcutaneously twice daily has evolved to incorporate the use of anti-factor Xa (AFXa) trough level monitoring given concerns for decreased enoxaparin bioavailability in this patient population. Current available evidence suggests low rates of goal AFXa trough level achievement with standard enoxaparin dosing. Our study aims to identify the incidence of critically ill trauma patients that did not achieve goal AFXa trough levels and attempts to identify predictors that may influence the lack of achievement of goal levels. Methods: This was a retrospective, cohort analysis performed at a single academic medical center. Adult patients 18 years or older admitted to the surgical intensive care unit secondary to trauma who were initiated on standard prophylactic enoxaparin and had at least 1 AFXa trough level representative of steady state were included. Patient demographics and clinical data were collected, and descriptive statistics were utilized. All statistical tests were 2-tailed and a P < .05 was considered significant. Variables with a P < .10 on univariable analysis were included in a multivariable logistic regression analysis. Results: A majority of our patient population did not achieve goal AFXa trough levels while receiving standard doses of prophylactic enoxaparin (82.4% [108/131]). Sub-target AFXa levels were associated with higher creatinine clearance values. Positive predictors of obtaining target AFXa levels included automobile versus pedestrian mechanism of injury and requiring an enoxaparin dose escalation to at least 40 mg twice daily. Conclusions: Our study found low rates of achievement of goal AFXa trough levels in critically ill trauma patients receiving standard prophylactic enoxaparin dosing. Certain variables were identified as negative and positive predictors for achievement of goal AFXa trough levels, although the biologic plausibility of these predictors is questionable and requires further investigation.
Modeling Occupational Fingernail Onycholysis Disorders in the Population of US Astronauts Who Have Engaged in Extravehicular Activity
Authors: Reid Christopher R. , Charvat Jacqueline M. , Mcfarland Shane M. , Norcross Jason R. , Benson Elizabeth , England Scott , Rajulu Sudhakar
Published: December 2021

Objectives

Spacesuits are designed to be reliable personal spacecraft that preserve the life and well-being of the astronaut from the extremes of space. However, materials, operating pressures, and suit design requirements often result in a risk of musculoskeletal discomfort and injury to various areas of the body. In particular, this investigation looked at fingernails and their risk of developing onycholysis.

Methods

An onycholysis literature review was followed by a retrospective analysis of injury characteristics, astronaut suited training and spaceflight events, hand anthropometry, glove sizing, and astronaut demographics. Multiple logistic regression was used to assess the likelihood of onycholysis occurrence by testing potential risk variables against the dataset compiled from the retrospective data mining.

Results

The duration of event exposure, type of glove used, distance (delta) between the fingertip and the tip of the glove, sex, and age were found to be significantly related to occurrence of onycholysis (whether protective or injurious).

Conclusion

An initial risk formula (model) for onycholysis was developed as a result of this investigation. In addition to validation through a future study, further improvement to this onycholysis equation and spacesuit discomfort and injury in general can be aided by future investigations that lead to better definition of the threshold between safe and risky exposure for each type of risk factor.

Application

This work described a potential method that can be used for EVA spacesuit glove onycholysis injury risk analysis for either iterative glove design or between glove comparisons, such as during a product downselect process.
Theorising work–life balance endeavours as a gendered project of the self: The case of senior executives in Denmark
Authors: Adamson Maria , Muhr Sara Louise , Beauregard T Alexandra
Published: December 2021

Recent work–life balance (WLB) studies offer considerable insight into the challenges and strategies of achieving WLB for senior managers. This study shifts the focus from asking how to asking why individuals are so invested in pursuing a particular kind of WLB. Through analysing 62 life history interviews with male and female senior executives in Denmark, we develop the concept of the gendered project of the self to theorise WLB. We show how for the executives, WLB was not simply an instrumental process of time or role management; instead, pursuing WLB in a certain way was a key part of acquiring and maintaining a particular desired subjectivity or a sense of self as a better person, better worker and better parent. We argue that theorising WLB as the gendered project of the self allows us to explicate the mechanisms through which gendered social and cultural expectations translate into how male and female executives can and want to pursue their WLB goals – first by driving one’s desire for WLB and, second, by shaping and restricting what is desired. In doing so, we highlight the importance of scrutinising the role of broader WLB discourses in shaping the experience and uptake of organisational WLB policies.
Science journalism in Hindi in pre-independence India: A study of Hindi periodicals
Authors: Baksi Sandipan
Published: December 2021

Science journalism in Hindi originated in the late nineteenth century. Hindi literary periodicals provided the first platform for science to be discussed along with literature. The onset of the twentieth century witnessed a remarkable advance in Hindi literary writing, and science writing also flourished with this advance. A remarkable overlap and a complementary relationship between the development of Hindi literature and Hindi commentaries on sciences is evident. Equally important in this context was the backdrop provided by a politically contentious process of evolution of a ‘modern’, ‘standard’ Hindi, and by the anti-colonial freedom movement, yoked to the idea of cultural and economic nationalism. The article surveys certain popular periodicals that regularly published essays and commentaries on science and scientific subjects. These periodicals were instrumental in shaping the popular discourses on science. The article also underlines an overwhelming effort by the intelligentsia to seek a philosophical commensurability between modern science and ‘traditional’ schools of thought. It concludes that the predominance of these characteristics in Hindi science journalism was a reflection of the agenda of the Hindi intelligentsia, shaped by linguistic nationalism framed alongside or in conjunction with a revivalist perspective.
Commodities trade, river transport and colonialism: The Brahmaputra river valley in the nineteenth century
Authors: Sharma Nabanita
Published: December 2021

The article seeks to show how Assam’s riverine environment, and its natural resources, generated and inflected a process of commercialisation in the nineteenth century. Historically, present-day Assam was connected to the rest of the world through the Brahmaputra river and its tributaries. In the early decades of colonial rule, plants such as caoutchouc and tea were discovered in the valley. These developments, together with transportation networks built with state and private capital, heralded a new phase of commerce in the region. A rich scholarship in South Asian history has shown how the river played a crucial role in the economic changes in different regions. The article belongs in that scholarship but stresses the role of the river as an artery of transportation rather than as an agricultural resource. The river system facilitated Assam’s closer integration with the world economy and the colonial regime.
Study on covert administration of medications practices among persons with severe mental illness: A cross-sectional study
Authors: Hegde Prakyath R , Gowda Guru S , Vajawat Bhavika , Basavaraju Vinay , Moirangthem Sydney , Naveen Kumar Channaveerachari , Bada Math Suresh
Published: December 2021

Background:

Covert administration of medication (CoAdM) by caregivers to persons with severe mental illness (SMI) is a commonly observed medication delivery practice in India.

Aims:

This study aims to examine different medication delivery practices adopted by caregivers to provide care to SMI at times of medication refusal.

Method:

This study was conducted at the outpatient department between April 2019 and November 2019. A semi-structured questionnaire was used to interview the caregivers of persons with SMI to assess medication delivery practices.

Results:

A total of 300 caregivers were interviewed. CoAdM was practiced in 96 (32.0%) persons with SMI at least once during their lifetime, and other strategies used were pleading ( n = 105, 35.0%), lying ( n = 10, 3.3%), and threatening ( n = 154, 51.4%). Logistic regression showed that male gender (OR 4.75; CI 1.37–16.46), absent insight (OR 10.0; CI 2.01–47.56), and poor adherence to medication (OR 4.75; CI 1.31–16.92) were significantly associated with CoAdM in the last 1 year. Caregivers perceived significant improvement in self-care ( Z = −4.37, p < .01), interpersonal ( Z = −7.61, p < .01), work ( Z = −5.9, p < .01), family functioning ( Z = −7.82, p < .01) difficult behavior ( Z = −8.27, p < .01), and dependency ( Z = −6.34, p < .01) in persons with SMI with use of CoAdM.

Conclusions:

CoAdM was given to one in three persons with SMI at some point in their lives. Male gender, absent insight and poor adherence were predictive of CoAdM in the last 1 year. Caregiver perceived improvements in self-care, work, interpersonal, family functioning, problem behaviors, and dependency after CoAdM. Policies need to be evolved to serve all stakeholders while keeping these practices in mind.
The biopsychosocial-spiritual factors influencing relapse of patients with schizophrenia
Authors: Maramis Margarita M , Sofyan Almahdy Muhammad , Atika Atika , Bagus Jaya Lesmana Cokorda , Gerick Pantouw Jakobus
Published: December 2021

Objective:

High relapse rate of patients with schizophrenia has a large impact on patients and their families that can be reviewed from biopsychosocial and spiritual factors. Determining all the potential risk factors of relapse in schizophrenia can help increase awareness of physicians, patients, and families. Physicians are the ones who examine patients and have responsibility to manage and educate them and expect to prevent relaps. This study analyze various biopsychosocial and spiritual factors affecting relapse occurrence in patients with schizophrenia.

Methods:

Cross sectional observational analytic study on 226 subjects with schizophrenia in three places in East Java, Indonesia, namely Soetomo Academic Hospital Surabaya (33.2%), Menur Hospital Surabaya (32.7%), and Radjiman Wediodiningrat Mental Hospital Lawang (34.1%) that met the inclusion and exclusion criteria. Data collection including 33 biopsychosocial and spiritual factors and were analyzed using bivariate and multivariate logistic regression.

Results:

Relapse rate within 1 year was 59.73%. There were 12 factors significantly affected the relapse of schizophrenia, namely history of physical disease of mothers during pregnancy ( p < .001; B = 27.31; 95% CI 3.96–188.52), presence of trigger ( p < .000; B = 6.25; 95% CI 2.61–14.96), negative beliefs ( p < .000; B = 4.94; 95% CI 2.10–11.61), hereditary factors ( p < .001; B = 4.84; 95% CI 1.93–12.10), insight ( p < .003; B = 4.27; 95% CI 1.62–11.27), 1-year GAF Scale ( p < .015; B = 3.79; 95% CI 1.30–11.09), response to treatment ( p < .006; B = 3.68; 95% CI 1.45–9.36), family knowledge ( p < .011; B = 3.23; 95% CI 1.31–7.93), history of head trauma ( p < .029; B = 3.13; 95% CI 1.13–8.69), medication side effects ( p < .028; B = 2.92; 95% CI 1.12–7.61), substance use history ( p < .031; B = 2.86; 95% CI 1.10–7.45), and occupation ( p < .040; B = 2.40; 95% CI 1.04–5.52).

Conclusions:

The 12 factors of biopsychosocial-spiritual are determinant to predict the risk of relapse in patients with schizophrenia. These factors should be emphasized in psychoeducation for patients and their families to enable intervention and relapse prevention.
Mental health of Turkish medical students during the COVID-19 pandemic
Authors: Çimen İrem Damla , Alvur Tuncay Müge , Coşkun Bülent , Şükür Nur Ece Öztaş
Published: December 2021

Background:

The coronavirus disease emerged in 2019, spread in Turkey as all over the world rapidly. In this process, young people began to experience some mental problems due to the fear of contagion, as well as some changes in their lifestyles.

Aims:

In this study it is aimed to investigate anxiety and depression levels of medical school students and the factors associated with these mental problems.

Method:

The forms were sent over the internet to the officials responsible for medical education at universities in various regions of Turkey. A total of 2,778 medical faculty students were included in the study. Students were asked to fill out the sociodemographic data form, the Patient Health Questionnaire – 9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) Test.

Results:

Students’ 67.3% were female and 31.7% were male. About 90.2% of the students in the PHQ-9 scale had depressive symptoms in the major depressive disorder (MDD) dimension, and 44.5% in the GAD-7 scale had moderate/severe anxiety symptoms. Gender, being a preclinical student, history of psychiatric treatment in the past, currently receiving psychiatric treatment, death of someone due to pandemic, economic and health situation, perception of mental health were found associated with MDD and Moderate/Severe Anxiety symptoms. Students with Anxiety and MDD reported significantly more anxiety about contamination and negative beliefs about precautions’ sufficiency.

Conclusions:

It was determined that medical school students in our country showed anxiety and depression at a remarkable level during the pandemic. Examining the underlying causes of these high rates will be beneficial in terms of taking precautions during the long-term pandemic. In literature, there are a limited number of studies on this subject in our country, we believe that our study will be useful in future studies to determine the underlying causes of mental illnesses and what can be done to help students.
Improving resilience in mothers with schizophrenic sons: A group movie analysis
Authors: Khodabakhshi-Koolaee Anahita , Manoochehri Mina
Published: December 2021

Background:

Previous studies have demonstrated the positive effects of film screening for raising awareness and improving treatment in various clinical groups. This study not only focused on film screening but also paid special attention to pre-screening group analysis to explore the effectiveness of group movie analysis on mothers with schizophrenic sons.

Methods:

The present study was conducted using a quasi-experimental design with pre-test and post-test and a control group. The research population included all mothers with schizophrenic sons who had enrolled in the Iranian Society Supporting Individuals with Schizophrenia in Tehran in 2021. The participants were 30 mothers with schizophrenic sons who were selected based on the inclusion criteria and were randomly assigned to intervention and control groups. The participants in the intervention group attended 12 film therapy analysis sessions (one session per week). The data were collected using the Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were performed using the analysis of covariance (ANCOVA).

Results:

The results showed a significant difference between the mean scores of resilience for the participants before ( M = 28.89) and after the film therapy analysis intervention ( M = 52.56, F = 6.15, p = .0001).

Conclusion:

Film therapy analysis was effective in improving the resilience of mothers with schizophrenic sons. It seems that movie screening with the group analysis afterward contributed to sharing the experiences of caring for the sick child and creating a sense of empathy in mothers. Thus, group movie analysis can be used as a suitable option to reduce the psychological distress of mothers with schizophrenic sons and improve their quality of life.
High performance biobased pour-in-place rigid polyurethane foams from facile prepared castor oil-based polyol: Good compatibility with pentane series blowing agent
Authors: Omrani Ismail
Published: December 2021

In this paper, biobased and environmentally friendly rigid polyurethane foams (RPUF) from high hydroxyl value castor oil-based polyols have been prepared without the addition of petroleum-based polyols in the formulation. The new Biopolyol with high hydroxyl value was designed on the basis of the analysis of functionality, structure and hydroxyl value relation and synthesized directly from castor oil in a facile one-pot three-step system. A series of Biopolyols with hydroxyl values in the range of 550–650 mg KOH/g were obtained through transesterification, epoxidation, and hydrolysis. The Biopolyol chemical structure was characterized using FT-IR,1H NMR spectroscopies. The formulated blend polyol with amine catalysts and cyclopentane as a blowing agent have good cyclopentane solubility and phase separation between cyclopentane and polyol was not observed after 30 days. The foaming characteristics were evaluated and improved results were obtained. The thermal conductivity, thermal stability, compressive strength, morphology, dimensional stability, density, and foam flow of the RPUFs were characterized. The results are compared with RPUF prepared using standard commercial polyether polyols for pour-in-place RPUFs. The prepared biobased RPUFs from Biopolyol was able to reach the required satisfactory properties for the appliance industry.
Generalized homogenization model of piezoelectric materials for ultrasonic transducer applications
Authors: Hanse Wampo Fidéle Léopold , Ntenga Richard , Effa Joseph Yves , Lapusta Yuri , Ntamack Guy Edgar , Maréchal Pierre
Published: December 2021

Although piezocomposite (PC) materials have increasingly attracted researchers, there is still a need to properly and easily derive their properties. We develop a generalized homogenization model (GHM) that accounts for Smith and Cha approaches to evaluate the equivalent characteristics of piezocomposites. This method could be applied to all connectivities patterns, but restricted herein to 2-2 and 1-3 piezocomposites for comparison with Smith (1-3) and Cha (2-2) analytical results. In the proposed GHM is a parameter θ, is changed for various connectivities. The 1-3 and 2-2 PZT-7A/Araldite D (PCs) data are used and equivalent characteristics of these Pcs are determined as function of volume fraction of PZT-7A piezoelectric. Results show that the electromechanical coefficients are well fitted by Voigt and Reuss models. Results obtained for some parameters show that the proposed GHM is consistent with the analytical existing models used for the 1-3 and 2-2 connectivities and is in line with measured values from Chan and Unsworth (1989). Based on the GHM 2-2 configuration results of piezocomposite materials, the electroacoustic responses of transducers having some of these properties are simulated using the KLM model. A performance trade-off was chosen, resulting in an improved thickness coupling coefficient and a lowered acoustical impedance, and a similar approach as that on a pure PZT-7A.
Extremity Bias in Online Reviews: The Role of Attrition
Authors: Brandes Leif , Godes David , Mayzlin Dina
Published: December 2021

In a range of studies across platforms, researchers have shown that online ratings are characterized by distributions with disproportionately heavy tails. The authors of this study focus on understanding the underlying process that yields such “J-shaped” or “extreme” distributions. They propose a novel theoretical mechanism behind the emergence of J-shaped distributions: differential attrition, or the idea that potential reviewers with moderate experiences are more likely to leave the pool of active reviewers than potential reviewers with extreme experiences. The authors present an analytical model that integrates this mechanism with two extant mechanisms: differential utility and base rates. They show that although all three mechanisms can give rise to extreme distributions, only the utility-based and attrition-based mechanisms can explain the authors’ empirical observation from a large-scale field experiment that an unincentivized solicitation email from an online travel platform reduces review extremity. Subsequent analyses provide clear empirical evidence for the existence of both differential attrition and differential utility.
Neonatal and Postneonatal Death Clustering Among Siblings in Bangladesh: Evidence from Bangladesh Demographic and Health Survey 2017–2018
Authors: Paul Ronak , Rashmi Rashmi , Srivastava Shobhit
Published: December 2021

Despite knowledge of neonatal and postneonatal mortality determinants in Bangladesh, some families continue to lose a larger share of children, a phenomenon known as early-life mortality clustering. This study uses the random intercept Weibull survival regression model to explore the correlation of mortality risk among siblings at the family (or, mother) and community levels. Utilizing the Bangladesh Demographic and Health Survey 2017–2018, we found evidence of death scarring, where children whose previous sibling was not alive at the time of conception had significantly higher odds of neonatal mortality. Moreover, the neonatal (and postneonatal) mortality hazard was highest for children with a birth interval of fewer than 19 months, corresponding to the preceding sibling. The intraclass correlation coefficient's statistically significant values show that neonatal and postneonatal mortality risk is correlated among children of the same family and community. The findings suggest focusing on high-risk families and communities to reduce the mortality level effectively.
From Brexit to COVID-19: The Johnson Government, Executive Centralisation and Authoritarian Populism
Authors: Ward Joseph , Ward Bradley
Published: December 2021

Many commentators have suggested that the first 18 months of the Johnson government were characterised by a propensity to centralise power. However, few accounts have situated the administration in the historical context of the British state or systematically examined these centralising tendencies. This article attempts to address these omissions. First, through a critical assessment of the literature on authoritarian neoliberalism, the concept of ‘executive centralisation’ is developed within the context of the British state. Second, the article applies this revised framework to the early stages of the Johnson government. While a dominant executive is a long-standing feature of the British political system, it is argued that Johnson has pursued a multifaceted centralisation strategy facilitated by the context of Brexit and COVID-19. In identifying the role of consent in this process, the article augments scholarship on ‘authoritarian neoliberalism’ as a moment in neoliberal governance characterised by the ascendance of coercive governing strategies.
Personality, Interpersonal Problems, and Anxiety Among Older Adults
Authors: Noel Olivia R. , Segal Daniel L. , Granier Katie L.
Published: December 2021

Introduction: This study examined relationships between personality disorder (PD) features, Big Five personality traits, and interpersonal problems with anxiety. Method: Older adults ( N = 130) completed the Geriatric Anxiety Scale, Coolidge Axis Two Inventory, Big Five Inventory-2, and Circumplex Scales of Interpersonal Problems. Pearson correlation analyses were used to assess simple relationships between anxiety with PD features (CATI scales), Big Five personality domains (BFI-2 scales), and interpersonal problems (CSIP scales). Multiple linear regression analyses were performed to determine the extent to which the PD scales of the CATI, the personality scales of the BFI-2, and the scales of the CSIP explained variance in anxiety. Results: Anxiety was positively correlated with 13 of 14 PD scales, ranging from .23 (Narcissistic) to .61 (Depressive). Regarding Big Five personality traits, anxiety was negatively associated with Agreeableness (−.23), Conscientiousness (−.30), and Extraversion (−.31) but was positively associated with Negative Emotionality (.56). Regarding interpersonal problems, anxiety was positively related to all eight CSIP scales, ranging from Self-sacrificing (.30) to Distant/Cold (.62). Regression analyses indicated that PD features accounted for the most variance in anxiety symptoms (53%), followed by interpersonal problems (46%), and Big Five personality traits (33%). Discussion: Anxiety appears to be meaningfully associated with PD features, several aspects of Big Five personality traits, and interpersonal problems, suggesting that these variables may play important roles in the development and maintenance of anxiety, or vice versa. Our findings especially speak to the growing awareness of the deleterious impact of PD features on clinical syndromes in later life, as evidenced by strong comorbidities with anxiety.
Occupational Diseases and Perceived Health in Operating Room Nurses: A Multicenter Cross-Sectional Observational Study
Authors: Martí-Ejarque María del Mar , Guiu Lázaro Gemma , Juncal Roser Coutado , Pérez Paredes Salvador , Díez-García Cecilia
Published: December 2021

Background

The surgical environment has multiple factors that could affect nurses’ health. The aim was to determine the effects of the working environment of operating room nurses on their health compared to hospitalization nurses.

Methods

A sample of operating room nurses and hospitalization nurses were included in the study and participated by filling in a self-report survey containing sociodemographic data items, the validated Nordic and SF12 scales and a list of medical conditions.

Results

Three hundred and thirty-one nurses participated in the study. Statistically significant results had obtained for diagnoses of musculoskeletal disorders and contact dermatitis among the operating room nurses.

Conclusion/Application to Practice

Continuous training in ergonomics is essential. Moreover, surgical protocols for preventing infection should be revised, optimizing the chlorhexidine content of soaps to reduce the risk of lesions among the surgical staff.
Who would Iranian Muslims help? Religious dimensions and moral foundations as predictors
Authors: Mikani Mehdi , Tabatabaei Kazem Rasoolzadeh , Azadfallah Parviz
Published: December 2021

Religiosity has been linked with prosocial behavior and a preference for religious ingroups over outgroups. Yet, there are important differences in religious people’s beliefs, values, and practices. Fundamental and quest orientation toward religion may differentially predict intergroup bias in prosociality. Also, individualizing and binding moral foundations may have diverse effects on ingroup and outgroup bias in helping, as moral foundations theory (MFT) suggests that individualizing and binding foundations differ in how much they focus on ingroup and outgroup moral considerations. In this study, we examined the relationship between religious dimensions (quest religion, religious fundamentalism, intrinsic religiosity, and religious activity), moral foundations, prosocial behavior, and intergroup bias in helping. We found evidence for the effect of individualizing foundations, religious fundamentalism, and quest religion above and beyond demographics and other religious dimensions on intergroup bias in helping. Furthermore, there were independent positive effects of individualizing foundations, religious activity, and age, and independent negative effects of female gender and religious fundamentalism on prosocial behavior. This study provides a more nuanced understanding of the relations between religion, prosociality, and moral intuitions in a Muslim context.
A Study of Interracial Differences in Turnover Intentions: The Mitigating Role of Pro-Diversity and Justice-Oriented Management
Authors: Chordiya Rashmi
Published: December 2021

Enhancing racial justice, equity, diversity, and inclusion are the core values of public administration and critical to the functions of public-sector strategic human resources management. However, very limited empirical research has delved into the interracial differences in public sector employees’ turnover intentions and its mitigating factors. Using the 2006–2017 Federal Employee Viewpoint Survey data, the present study aims to contribute toward filling this gap in the literature. The theoretical arguments and empirical findings of this study show that when compared with White employees, Federal Black, Indigenous, and Employees of Color (BIEOC) are significantly more likely to intend to leave their current organizations. However, the likelihood of turnover intentions of Federal employees, particularly, BIEOC can be reduced through institutional interventions anchored in pro-diversity management (e.g., commitment to fostering a racially representative workforce), distributive justice in employment outcomes (e.g., in pay and promotions) and procedural justice in organizational processes (e.g., anti-discrimination practices).
Moral Injury during the COVID-19 pandemic: A delphi model survey of family medicine residents
Authors: Ngo Sean B , Clark Payson J , Parr Sarah E , Thomas Abel R , Dayal Akshat , Sanker Richard , Hess Burritt W , Stull Dillon C
Published: December 2021

Objectives

The objective is to investigate the primary factors that created experiences leading to moral injury in family medicine residents during the COVID-19 pandemic and also to identify any barriers keeping these residents from seeking or receiving help when they experienced moral injury.

Method

A DELPHI model study utilizing three rounds of surveys was conducted at four family medicine residency programs in the United States. Resident responses to Survey 1 generated factors perceived to be causing them moral injury or constituting barriers to their seeking help. Thematic analysis identified common themes which were presented to residents in Survey 2 for rating and justification. Results and feedback from Survey 2 were shared with residents in Survey 3, where residents were prompted to reevaluate their ratings for factors and barriers for the purpose of generating consensus among themselves. A ranked list of factors and barriers was thereby created for the participating sites.

Results

Residents shared several stories about the factors that most pressured them to violate their moral values. The most severe and frequent factors contributing to moral injury involved disruptions to doctor–patient relationships, patient–family relationships, and relationships with other healthcare professionals. Time was the major barrier to residents seeking help.

Conclusion

During times of crisis, moral injury among residents may be minimized by protecting and promoting important clinical and professional relationships with patients, colleagues, and other medical professionals. While residents report that lack of time was the most significant barrier to seeking help, it is unclear how this complicated and ubiquitous problem would be resolved or mitigated.
Controlling foamability of polypropylene/γ-irradiated ethylene acrylic elastomer blends by extent of crosslinking and domain microstructure of elastomer
Authors: Dutta Anindya , Banerjee Debjyoti , Ghosh Anup K.
Published: December 2021

Foams of polypropylene/elastomer blends can often lead to softer foams which may not be desirable every time. Incorporating rigidity to the foams can often be made possible by preferentially crosslinking the elastomer phase prior to blending. Although foamability of polypropylene/elastomer blends has been understood in the scientific community, the influence of the extent of crosslinking in the elastomer phase is not yet understood well. The purpose of this investigation is to identify the influence of the extent of elastomer crosslinking and the blend morphological attributes (achieved by varying screw speed during melt mixing) on foamability of polypropylene/partially crosslinked elastomer blends. Crosslinking of ethylene-acrylic elastomer is carried out using gamma radiation with several doses (0, 12.5, 25, 50 kGy) before melt blending and, subsequently, 10 wt.% of the irradiated elastomers (prior optimized) are mixed with polypropylene in a micro-compounder at three different screw speeds. The microstructure development in blends is characterized by scanning electron microscopy. Frequency sweep rheological analysis is done for selected blends to identify the ease of foamability among the series of blends. Foaming of blends is done with supercritical carbon dioxide in batch mode at three different temperatures. The density reduction along with the microcellular morphology development of blends with foaming is analyzed with the screw speed, the extent of crosslinking, and foaming temperature; furthermore, the individual input parameters (the elastomer domain size, controlled by the screw speed and the extent of crosslinking, controlled by gamma radiation dose) are optimized based on the foam morphology. A uniform and good foamability were achieved at 155 and 160°C for blends with elastomers, irradiated at 12.5 and 25 kGy radiation doses. The lowest density foam (0.37 g/cc) was obtained for polypropylene with 12.5 kGy irradiated crosslinked elastomer mixed at 200 rpm at 160°C foaming temperature. The final elastomer domain dispositions within the foam morphologies are characterized and the plausible foaming mechanism is proposed.
Where do overseas Filipinos intend to retire? The case of Filipinos in Chugoku region, Japan
Authors: Carlos Ma. Reinaruth D. , Plantilla Jeff
Published: December 2021

Migrants nearing retirement age face issues and challenges distinct from those of migrants in their working age. Yet, their well-being has not been fully addressed because of lack of data. Drawing from the results of a survey of Filipinos residing in the Chugoku region in Western Japan ( n = 481), this study contributes to the literature on the aging-migration nexus by exploring migrants’ anxiety toward retirement and intended country of retirement. The results have crucial implications not only on migrants’ plans for retirement but also on the provision of social protection in both the host and the origin countries.
Following the state-owned enterprises: Chinese expatriate construction workers in Zambia
Authors: Yang Beibei
Published: December 2021

Chinese expatriate workers in Africa remain an under-researched and poorly understood group despite their large numbers. Based on data collected through interviews and participant observations during 2013 and 2014 among Chinese expatriate construction workers employed by a large-scale Chinese state-owned construction enterprise in Zambia, this article offers an analysis of their migration experience as it relates to the context of China’s growing economic involvement with Africa. This paper further argues that Chinese state-owned enterprises (SOEs) in Africa function as transnational social organizations to promote Chinese expatriate workers’ migration to Africa and provide them social support and care when they experience difficulties during their sojourn. In this way, the patron–client relationship was formed between Chinese SOEs and Chinese expatriate workers, paralleling the existing employment relationship.