bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19)
Authors: Lippi Giuseppe , South Andrew M , Henry Brandon Michael
Published: April 2020

Background

Early studies have reported various electrolyte abnormalities at admission in patients who progress to the severe form of coronavirus disease 2019 (COVID-19). As electrolyte imbalance may not only impact patient care, but provide insight into the pathophysiology of COVID-19, we aimed to analyse all early data reported on electrolytes in COVID-19 patients with and without severe form.

Methods

An electronic search of Medline (PubMed interface), Scopus and Web of Science was performed for articles comparing electrolytes (sodium, potassium, chloride and calcium) between COVID-19 patients with and without severe disease. A pooled analysis was performed to estimate the weighted mean difference (WMD) with 95% confidence interval.

Results

Five studies with a total sample size of 1415 COVID-19 patients. Sodium was significantly lower in patients with severe COVID-19 (WMD: –0.91 mmol/L [95% CI: –1.33 to –0.50 mmol/L]). Similarly, potassium was also significantly lower in COVID-19 patients with severe disease (WMD: –0.12 mmol/L [95% CI: –0.18 to –0.07 mmol/L], I2=33%). For chloride, no statistical differences were observed between patients with severe and non-severe COVID-19 (WMD: 0.30 mmol/L [95% CI: –0.41 to 1.01 mmol/L]). For calcium, a statistically significant lower concentration was noted in patients with severe COVID-19 (WMD: –0.20 mmol/L [95% CI: –0.25 to –0.20 mmol/L]).

Conclusions

This pooled analysis confirms that COVID-19 severity is associated with lower serum concentrations of sodium, potassium and calcium. We recommend electrolytes be measured at initial presentation and serially monitored during hospitalization in order to establish timely and appropriate corrective actions.
Advertising Effectiveness for Multiple Retailer-Brands in a Multimedia and Multichannel Environment
Authors: Danaher Peter J. , Danaher Tracey S. , Smith Michael Stanley , Loaiza-Maya Ruben
Published: April 2020

An important aspect of multimedia advertising effectiveness that remains unexplored is a customer-level analysis of the relative importance of each medium for multiple retailer-brands within a product category. The increasing availability of customer databases for parent companies containing multimedia ad exposures, sales transactions in several purchase channels, and information across multiple retailer-brands now allows for a broader examination of advertising effectiveness. In this research, the authors monitor 4,000 customers over two years, linking their exposure to three media (email, catalogs, and paid search) to their in-store and online purchases for three retailer-brands in the clothing category. They develop a Tobit model for sales response to multimedia advertising that captures within-brand and within-channel correlations and accommodates individual-level advertising response parameters. Due to the very large number of observations (2.4 million) and random effects (60), the authors employ an emerging machine learning technique, variational Bayes, to estimate the model parameters. They find that email and sometimes catalogs from a focal retailer-brand have a negative influence on other retailer-brands in the category, whereas paid search influences only the focal retailer-brand. However, competitor catalogs often positively influence focal retailer-brand sales, but only among omnichannel customers. They segment customers by retailer-brand and channel usage, revealing a sizeable group of customers who shop across multiple retailer-brands and both purchase channels. Moreover, this segment is the most responsive to multimedia advertising.
Exploring the Connection Between End-of-Life Relational Communication and Personal Growth After the Death of a Loved One
Authors: Generous Mark A. , Keeley Maureen P.
Published: April 2020

The purpose of the current investigation was to examine associations between final conversations (FCs; i.e., relational communication with a terminally ill individual from the moment of terminal diagnosis to death) with the outcome of personal growth (PG). A total of 236 individuals who had previously engaged in FCs with a deceased loved one participated in an online survey. Analyses revealed significant, positive associations between the six FCs factors (i.e., messages of love, messages of spirituality/religion, messages of identity, everyday talk and routine interactions, difficult relationship talk, and instrumental death talk) with the PG factors. Implications are discussed along with limitations and future directions.
Electoral Systems and Policy Congruence
Authors: Ferland Benjamin
Published: April 2020

Many studies examined the state of citizen-elite congruence at the party system, legislative and government stages of representation. Few scholars examined, however, whether citizen preferences are adequately represented in enacted policies. The article addresses this gap in the literature and examines the role of electoral systems in fostering citizens-policy congruence. Building on studies of government congruence and responsiveness, we expect levels of policy congruence to be greater under majoritarian electoral systems than under proportional representation electoral systems and as the number of parties in government decreases. In order to test these expectations, we make use of data from the International Social Survey Programme and examine the proportions of respondents whose preferences are congruent with government levels of spending in eight major policy domains. Overall, the results do not support our expectations and indicate that levels of policy congruence are similar across electoral systems and government types. In line with recent works on electoral systems and representation, our findings support the claim that majoritarian and proportional representation electoral systems both have mechanisms which allow governments to represent their citizens similarly.
Constitutionalism and Crisis Narratives in Post-Brexit Politics
Authors: Daly Eoin
Published: April 2020

The Brexit vote has sparked renewed criticism of the United Kingdom’s ad hoc constitutional arrangements, particularly in relation to the status of popular sovereignty. While the people is politically recognised as ‘sovereign’ through the apparent unassailability of its referendum verdict, this sovereignty has no legal foundation or form – thus giving it an elusive, indefinite character. In turn, legal commentators have argued that the lack of a clear conceptual framework for constitutional referendums aggravated the political crisis that followed the vote and that the uncertain nature and authority of referendums represents a distinct source of constitutional crisis in its own right. In this article, I consider how this ‘constitutionalist critique’ of the Brexit referendum, and its ad hoc constitutional framework, reflects a particular conception of liberal constitutionalism as a bulwark against the hazards and vicissitudes of unstructured popular sovereignty. I will argue that this perspective overestimates the capacity of constitutional law to regulate expressions of popular sovereignty via referendums, that it misconceives the character and claim of popular sovereignty more generally, and that it reflects certain characteristics of liberal legalism in its stance towards politics and political contingency.
Physician Specialty and Office Visits Made by Adults With Diagnosed Multiple Chronic Conditions: United States, 2014-2015
Authors: Ward Brian W. , Myrick Kelly L. , Cherry Donald K.
Published: April 2020

Objectives

Adults with multiple chronic conditions (MCCs; ≥2 chronic conditions) account for a substantial number of visits to health care providers. The complexity of a patient’s care, including the number of chronic conditions, may differ by physician specialty. The objectives of this study were to (1) examine differences in physician office visits among adults with MCCs by physician specialty and (2) identify the types of MCC dyads (combinations of 2 chronic conditions) most common among visits to office-based physicians.

Methods

We used data from the 2014-2015 National Ambulatory Medical Care Survey (unweighted analytic sample, n = 61 682), a nationally representative survey of physician office–based ambulatory visits, to examine differences in physician office visits among adults with MCCs by physician specialty. We also identified the most commonly observed MCC dyads among these visits.

Results

During 2014-2015, 40.0% of physician office visits were made by adults with MCCs. Compared with visits for all specialties combined (40.0%), a significantly higher percentage of physician office visits among adults with MCCs were to specialists in cardiovascular disease (74.7%) and internal medicine (57.6%). For all physician specialties except psychiatry, the MCC dyads of hyperlipidemia and hypertension and diabetes and hypertension were among the most commonly observed MCC dyads among visits made by adults with MCCs.

Conclusions

Awareness of these findings may help specialists improve care for adults with MCCs. The recognition among physicians of common MCC dyads is relevant to the care management of persons with MCCs.
Knowledge of Good Samaritan Laws and Beliefs About Arrests Among Persons Who Inject Drugs a Year After Policy Change in Baltimore, Maryland
Authors: Schneider Kristin E. , Park Ju Nyeong , Allen Sean T. , Weir Brian W. , Sherman Susan G.
Published: April 2020

Objectives

Delivering and receiving prompt medical care during an overdose are imperative to ensure survival. Good Samaritan laws encourage people to call 911 during an overdose by providing immunity from selected drug arrests (eg, low-level possession). However, it is unclear whether persons who inject drugs (PWID) are aware of and understand these laws and their implications. We examined awareness among PWID of the 2015 Good Samaritan law in Maryland and their beliefs about whether they could be arrested for calling 911 or having an overdose.

Methods

We surveyed 298 PWID in Baltimore, Maryland. We estimated the proportion who knew what the Good Samaritan law addressed and who believed they could be arrested for calling 911 or overdosing. We used a multivariate model to assess the association between harm-reduction services and knowledge of the Good Samaritan law or beliefs about getting arrested for calling 911 or overdosing.

Results

Of PWID, 56 of 298 (18.8%) knew what the Good Samaritan law addressed, 43 of 267 (16.1%) believed they could be arrested for calling 911, and 32 of 272 (11.8%) believed they could be arrested for having an overdose. After adjusting for demographic characteristics, accessing the syringe services program was associated with accurate knowledge and the belief that PWID could be arrested for calling 911; however, training in overdose reversal was not associated.

Conclusions

Most PWID were unaware of the Good Samaritan law; this lack of awareness is a barrier to preventing overdose deaths. Educating PWID about Good Samaritan laws is essential, and such education should include police to ensure that law enforcement is congruent with Good Samaritan laws and does not perpetuate mistrust between police and PWID.
Expanding English Vocabulary Knowledge through Reading: Insights from Eye-tracking Studies
Authors: Pellicer-Sánchez Ana
Published: April 2020

Students in academic contexts are expected to engage with large amounts of reading and they frequently meet unknown words and phrases in those reading materials. Previous research has shown that second and foreign language learners can acquire some of the unknown vocabulary that they encounter during reading. However, these previous findings were mainly based on scores in off-line, post-reading tests and thus, our understanding of the cognitive processes involved during learning from reading has been rather limited. Technological advancements have made it easier for researchers to explore learners’ online processing behaviour. One of such advancements is eye-tracking, which provides a rich record of online reading behaviour. The last decade has witnessed an unprecedented increase in the number of eye-tracking studies conducted in second/foreign language learning research, with a particular focus on vocabulary learning from reading. This article illustrates how the use of eye-tracking has helped researchers gain a better understanding of the process of vocabulary learning from reading and of the relationship between eye-movements and performance measures. This article discusses recent research findings and identifies directions for future research.
Plain Language Summary: Ménière’s Disease
Authors: Basura Gregory J. , Colandrea Maria , Walsh Sandra A. , Kuch Amy Angie , Monjur Taskin M.
Published: April 2020

This plain language summary explains Ménière’s (pronounced men‐yerz) disease (MD) to patients. The summary applies to patients aged 18 years and older with a suspected diagnosis of definite or probable MD. It is based on the 2020 “Clinical Practice Guideline: Ménière’s Disease.” This guideline uses published research to best advise health care providers and patients on the history and physical examination of patients with MD and how to diagnose and treat them. The guideline includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to facilitate shared decision making between patients and their health care providers.
Selective Importance in Self-Enhancement: Patterns of Feedback Adolescents Use to Improve Math Self-Concept
Authors: McPartlan Peter , Umarji Osman , Eccles Jacquelynne S.
Published: April 2020

We illustrate how early adolescents use different patterns of ability feedback to promote a positive self-concept of ability (SCA) in mathematics. Students can simultaneously use ability appraisals from parents and teachers, while also drawing information from peer, dimensional, and temporal comparisons. Although we find these five sources are equally important for promoting students’ positive SCA, on average, we use a pattern-centered approach to show that students who believe they are good at math often select certain feedback sources as more important to develop this belief. We find that students’ patterns of ability feedback are unstable, with evidence suggesting different patterns may emerge depending on the availability of ability feedback. Findings suggest early adolescents attempting to promote their own positive SCA in mathematics may know to seek different feedback sources depending on their individual circumstances. Implications are discussed through the lens of social comparison theory.
CT-based quantification of short-term tissue shrinkage following hepatic microwave ablation in an in vivo porcine liver model
Authors: Erxleben Christoph , Niehues Stefan M , Geyer Beatrice , Poch Franz , Bressem Keno K , Lehmann Kai S , Vahldiek Janis L
Published: April 2020

Background

Microwave ablation (MWA) is a minimally invasive treatment option for solid tumors and belongs to the local ablative therapeutic techniques, based on thermal tissue coagulation. So far there are mainly ex vivo studies that describe tissue shrinkage during MWA.

Purpose

To characterize short-term volume changes of the ablated zone following hepatic MWA in an in vivo porcine liver model using contrast-enhanced computer tomography (CECT).

Material and Methods

We performed multiple hepatic MWA with constant energy parameters in healthy, narcotized and laparotomized domestic pigs. The volumes of the ablated areas were calculated from venous phase CT scans, immediately after the ablation and in short-term courses of up to 2 h after MWA.

Results

In total, 19 thermally ablated areas in 10 porcine livers could be analyzed (n = 6 with two volume measurements during the measurement period and n = 13 with three measurements). Both groups showed a statistically significant but heterogeneous volume reduction of up to 12% (median 6%) of the ablated zones in CECT scans during the measurement period ( P < 0.001 [n = 13] and P = 0.042 [n = 6]). However, the dimension and dynamics of volume changes were heterogenous both absolutely and relatively.

Conclusion

We observed a significant short-term volume reduction of ablated liver tissue in vivo. This volume shrinkage must be considered in clinical practice for technically successful tumor treatment by MWA and therefore it should be further investigated in in vivo studies.
The association between vitamin D-related gene polymorphisms and hepatitis B virus-related liver cirrhosis
Authors: Wu Jiali , Lin Su , Liu Shiying , Wan Bo , Lin Yehong , Wang Mingfang , Zhu Yueyong
Published: April 2020

Objectives

To investigate the relationship between vitamin D-related gene single nucleotide polymorphisms (SNPs) and hepatitis B-related liver cirrhosis.

Methods

This study included patients with chronic hepatitis B who were admitted to the Liver Research Center of the First Affiliated Hospital of Fujian Medical University from July 2012 to August 2016. SNPs rs1544410 and rs2228570 in the vitamin D receptor gene and rs2282679 in the vitamin D-binding protein gene were detected using the imLDR™ multiple SNP typing kit. Genotype and allele frequencies were compared between groups using the chi-square test or Fisher’s exact test.

Results

A total of 226 patients with hepatitis B virus (HBV) infection were enrolled, including 116 with HBV-related cirrhosis and 110 patients without. The distributions of vitamin D-related gene SNPs in both groups were in accordance with the Hardy–Weinberg equilibrium. There was no significant difference in the frequency or allelic distributions of rs1544410, rs2228570, and rs2282679 between the two groups. Additionally, the SNPs were not associated with the severity of cirrhosis.

Conclusion

No significant connection was identified between vitamin D-related SNPs and HBV-related liver cirrhosis.
Responding to the climate crisis: Green consumerism or the Green New Deal?
Authors: Shanagher Sean
Published: April 2020

This article aims to contribute to the climate crisis debate in Ireland by exploring tendencies in media coverage towards two quite different ‘solutions.’ These might be seen as representing two poles of the current debate—either remaining securely within or departing significantly from the certainties of neoliberalism. The focus in this piece is on critically weighing up the respective strengths of these two responses in the face of climate disruption. I hope to encourage further research on this basis into quantifying media coverage of these and other potential solutions. In 2020, ‘green’ has become a mobile and versatile qualifier, employed by various social groups for a range of ends. I will briefly explore what Kahn has termed ‘green consumerism’ before considering various forms of the Green New Deal (GND).
A study on factors affecting school principals’ competencies in Vietnam’s mountainous provinces
Authors: Le Long Kim , Tran Trung , Le Hien Thu Thi , Le Trinh Tuyet Thi
Published: April 2020

Given principals’ central role in school performance, this study seeks to explore factors that influence school principal competency. The study employed a quantitative research approach. A survey questionnaire was administered to 290 principals across six northwestern mountainous provinces in Vietnam. The questionnaire considered eight areas of principal competency, including self-development and the development of others; school organization and operation; staff development; instructional programme management; education quality assurance management; management of financial resources; engagement with families, community and government; and the school’s strategic planning. Analyses of variance and correlation (Pearson’s r) techniques were used, and the findings demonstrate that principals’ competencies were statistically affected by both internal factors (gender, experience, health, family and IT skills) and external factors (school location, school demographics and school facilities). However, the study found no correlation between principals’ academic qualifications and their competencies.
Size-dependent free vibration and buckling analysis of sigmoid and power law functionally graded sandwich nanobeams with microstructural defects
Authors: Bensaid Ismail , Daikh Ahmed Amine , Drai Ahmed
Published: April 2020

The investigation conducted in this paper aims to study free vibration and buckling behaviors of size-dependent functionally graded sandwich nanobeams. In order to take into account the small size effects, nonlocal elasticity theory of Eringen's is incorporated. Material properties of the functionally graded sandwich beams are supposed to change continuously through the thickness direction according to two forms of the volume fraction of constituents by power law functionally graded material and sigmoid law functionally graded material. These rules are modified to consider the effect of porosity, which covers four kinds of porosity distributions. Two types of sandwich nanobeams were provided: (a) homogeneous core and functionally graded skins and (b) functionally graded core and homogeneous skins. Third-order shear deformation theory without any shear correction factor in conjunction with Hamilton's principle is used to extract the governing equations of motions of porous functionally graded sandwich nanobeams and then solved analytically for two hinged ends. The effects of nonlocal parameter, length to thickness ratios, material graduation index, amount of porosity, porosity distribution shape, on the nondimensional frequency and critical buckling load of the functionally graded sandwich nanobeams made of porous materials are exhibited by a parametric study.
Jacobian approach to the kinestatic analysis of a full vehicle model with application to cornering motion analysis
Authors: Zhou Guofeng , Kim Junwoo , Je Choi Yong
Published: April 2020

The Jacobian approach to the kinestatic analysis of a planar suspension mechanism has been previously presented. In this paper, the theory is extended to three-dimensional kinestatic analysis by developing a full kinematic model and viewing it as a spatial parallel mechanism. The full kinematic model consists of two pairs of the front (double wishbone) and rear (multi-link) suspension mechanisms together with a newly developed ground-wheel contact model. The motion of each wheel of four suspension mechanisms is represented by the corresponding instantaneous screw at any instant. A vehicle is considered to be a 6-degrees-of-freedom spatial parallel mechanism whose vehicle body is supported by four serial kinematic chains. Each kinematic chain consists of a virtual instantaneous screw joint and a kinematic pair representing ground-wheel contact model. The kinestatic equation of the 6-degrees-of-freedom spatial parallel mechanism is derived in terms of the Jacobian. As an important application, a cornering motion of a vehicle is analysed under the assumption of steady-state cornering. A numerical example is presented to illustrate how to determine the optimal locations of strut springs for the least roll angle in cornering motion using the proposed method.
Truck mass estimation method based on the on-board sensor
Authors: Wang Beijia , Wang Hongliang , Wu Lei , Cai Liuliu , Pi Dawei , Wang Erlie
Published: April 2020

Vehicle mass estimation is the key technology to improve vehicle stability. However, the existing mass estimation accuracy is easily affected by the change of road gradient, and there are few studies on the mass estimation method of the light truck. Aiming at this problem, this paper uses sensors to measure road gradient and rear suspension deformation and proposes a sensor-based vehicle mass estimation algorithm. First, factors that affect the mass estimation are analyzed, road gradient error correction method and mass estimation error correction method are established. Besides, the suspension deformation is decoupled from the road gradient. Second, the mass estimation algorithm model was established in Matlab/Simulink platform and compared with the mass estimation iterative algorithm. Finally, the road test was carried out under various conditions, the results show that the proposed mass estimation algorithm is robust, and the accuracy of the mass estimation will not be affected by the sudden change of road gradient.
Optimality considerations for propulsive fuselage power savings
Authors: Seitz Arne , Luisa Habermann Anaïs , van Sluis Martijn
Published: April 2020

The paper discusses optimality constellations for the design of boundary layer ingesting propulsive fuselage concept aircraft under special consideration of different fuselage fan power train options. Therefore, a rigorous methodical approach for the evaluation of the power saving potentials of propulsive fuselage concept aircraft configurations is provided. Analytical formulation for the power-saving coefficient metric is introduced, and, the classic Breguet–Coffin range equation is extended for the analytical assessment of boundary layer ingesting aircraft fuel burn. The analytical formulation is applied to the identification of optimum propulsive fuselage concept power savings together with computational fluid dynamics numerical results of refined and optimised 2D aero-shapings of the bare propulsive fuselage concept configuration, i.e. fuselage body including the aft–fuselage boundary layer ingesting propulsive device, obtained during the European Union-funded DisPURSAL and CENTRELINE projects. A common heuristic for the boundary layer ingesting efficiency factor is derived from the best aero-shaping cases of both projects. Based thereon, propulsive fuselage concept aircraft design optimality is parametrically analysed against variations in fuselage fan power train efficiency, systems weight impact and fuselage-to-overall aircraft drag ratio in cruise. Optimum power split ratios between the fuselage fan and the underwing main fans are identified. The paper introduces and discusses all assumptions necessary in order to apply the presented evaluation approach. This includes an in-depth explanation of the adopted system efficiency definitions and drag/thrust bookkeeping standards.
Islet Transplantation to the Anterior Chamber of the Eye—A Future Treatment Option for Insulin-Deficient Type-2 Diabetics? A Case Report from a Nonhuman Type-2 Diabetic Primate
Authors: Tun Sai Bo Bo , Chua Minni , Hasan Riasat , Köhler Martin , Zheng Xiaofeng , Ali Yusuf , Abdulreda Midhat H. , Juntti-Berggren Lisa , Barathi Veluchamy A. , Berggren Per-Olof
Published: April 2020

Replacement of the insulin-secreting beta cells through transplantation of pancreatic islets to the liver is a promising treatment for type-1 diabetes. However, low oxygen tension, shear stress, and the induction of inflammation lead to significant islet dysfunction and loss. The anterior chamber of the eye (ACE) has gained considerable interest and represents an alternative therapeutic islet transplantation site because of its accessibility, high oxygen tension, and immune-privileged milieu. We have previously demonstrated the feasibility of intraocular islet transplant in mouse and nonhuman primate models of type-1 diabetes and are now assessing its efficacy on glucose homeostasis in a nonhuman primate model of type-2 diabetes. We transplanted allogeneic donor islets (1,500 islet equivalents/kg) into the anterior chamber of one eye in a cynomolgus monkey with high-fat-diet-induced type-2 diabetes. Repeated examinations of the anterior and posterior segments of both eyes were done to monitor the engrafted islets and assess the overall ocular health. Fasting blood glucose level, blood biochemistry, and other metabolic parameters were routinely evaluated to determine the function of the islet graft and diabetes status. The transplanted islets were rapidly engrafted onto the iris and became vascularized 1 month after transplantation. We did not detect changes in intraocular pressure, cataract formation, ophthalmitis, or retinal vessel deformation. A significant lower fasting blood glucose level was observed while the graft was in place, and the transplantation reverts the progression of diabetes. The metabolic markers, hemoglobin A1C and fructosamine, demonstrated improvement following islet transplantation. As a conclusion, intraocular islet transplantation in one eye of a cynomolgus monkey with type-2 diabetes improved its overall plasma glucose homeostasis, as evidenced by short-term measures and long-term metabolic markers. These results further support the future application of the ACE as an alternative site for clinical islet transplants in the context of type-2 diabetes.
A solid polymer electrolyte containing a novel lithium borate salt for all-solid-state lithium-ion batteries
Authors: Xiao Yao , Bao Lixia , Lei Jingxin
Published: April 2020

We prepared a solid polymer electrolyte (SPE) composed of a lithium borate salt and a polymer matrix, which can be employed for all-solid-state lithium-ion batteries. The lithium borate salt was made from lithium cations and bis (maleic acid) borate anions, and exhibits an excellent thermal stability as well as high ionic conductivity. The polymer matrix is an amorphous polymeric material having no crystalline regions, which is beneficial for the movement of lithium ions in the SPE. The polymer matrix also has good mechanical performance and thermal stability. Moreover, the SPE also has a relatively high ionic conductivity.
Nurses’ experience of providing ethical care following an earthquake: A phenomenological study
Authors: Moradi Khalil , Abdi Alireza , Valiee Sina , Rezaei Soheila Ahangarzadeh
Published: April 2020

Background

Ethical care provided by nurses to earthquake victims is one of the main subjects in nursing profession.

Objectives

Given the information gap in this field, the present study is an attempt to explore the nurses’ experience of ethical care provided to victims of an earthquake.

Research design and method

A hermeneutic phenomenological study was performed. The participants were 16 nurses involved in providing care to the injured in Kermanshah earthquake, Iran. They were selected using purposeful sampling, and in-depth and semi-structured interviews were carried out. The transcribed interviews were analyzed based on the hermeneutic approach using the analysis method proposed by Diekelmann et al.

Ethical considerations

The study was approved by the Research Council and Ethics Committee of Urmia University of Medical Sciences, Iran.

Findings

Data analyses revealed four themes and 10 sub-themes that illustrated nurses’ experience of ethical care during earthquake. The themes were (1) Respecting humanistic values (sacrifice, stepping beyond task description, and voluntary work), (2) Commitment to ethics (honesty, confidentiality, and trustworthiness), (3) Respecting dignity of victims (respecting cultural values, maintaining privacy, having humanistic perspective, and effective communication), and (4) Spiritual support (helping patients to do religious rituals Psychological support).

Conclusion

The results showed the nurses’ experience with providing care to earthquake victims. The findings underlined ethics and ethical values in providing nursing care during disasters. It is suggested that special courses on the importance of nursing ethics in critical situations be incorporated into nursing curriculums and in-service educations.
Development and Performance Assessment of a Digital Serious Game to Assess Multi-Patient Care Skills in a Simulated Pediatric Emergency Department
Authors: Luu Cindy , Talbot Thomas B. , Fung Cha Chi , Ben-Isaac Eyal , Espinoza Juan , Fischer Susan , Cho Christine S. , Sargsyan Mariam , Korand Sridevi , Chang Todd P.
Published: April 2020

Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners.

Methods. This was a cross-sectional validation study using a digital serious game VitalSignsTM simulating multi-patient care within a pediatric ED. Subjects completed 5 virtual “shifts,” triaging, stabilizing, and discharging or admitting patients within a fixed time period; patients arrived at cascading intervals with pre-programmed deterioration if neglected. Predictor variables included generic multi-tasking ability, video game experience, medical knowledge, and clinical efficiency with real patients. Outcome metrics in 3 domains measured diagnostic accuracy (i.e. critical orders, diagnoses), efficiency (i.e. number of patients, time-to-order) and critical thinking (number of differential diagnoses); MANOVA determined differences between novice learners and expected expert physicians. Spearman Rank correlation determined associations between levels of expertise.

Results. Ninety-five subjects’ gameplays were analyzed. Diagnostic accuracy and efficiency distinguished skill level between residency trained (residents, fellows and attendings) and pre-residency trained (medical students and undergraduate) subjects, particularly for critical orders, patients seen, and correct diagnoses (p < 0.003). There were moderate to strong correlations between the game’s diagnostic accuracy and efficiency metrics compared to level of training, including patients seen (rho = 0.47, p < 0.001); critical orders (rho = 0.80, p < 0.001); time-to-order (rho = −0.24, p = 0.025); and correct diagnoses (rho = 0.69, p < 0.001). Video game experience also correlated with patients seen (rho = 0.24, p = 0.003).

Conclusion. A digital serious game depicting a busy virtual ED can distinguish between expected experts in multi-patient care at the pre- vs. post-residency level. Further study can focus on whether the game appropriately assesses skill acquisition during residency.
Proposal of a simple and rapid method for the chemotherapy preparations analytical control by spectrophotometry UV-Vis method
Authors: Bennani Ismail , Chentoufi Madiha Alami , Cheikh Amine , Karbane Miloud El , Bouatia Mustapha
Published: April 2020

Introduction

The preparation of anticancer chemotherapy in a hospital must meet several objectives; the first main is the quality, which can be provided by setting up a surveillance system and a quality control of each preparations. The aim of this work is to present a simple, fast and accurate spectrophotometric method for the routine control of cytotoxic preparations.

Materials and methods

This is a study carried out in the cytotoxic preparation unit of the university center of Rabat-Sale children’s hospital in Morocco. All samples of preparations were collected and analyzed daily on the site. After validation of the analytical method with respect to many parameters such as: linearity, accuracy and precision according to ICH Q2 guidelines, samples of cytotoxic preparations collected were assayed.

Results

The results are satisfactory with good level of exactitude, and high precision.

Conclusion

Compared to other techniques, this method can be considered as a useful alternative in the routine quality control of preparations. It can quickly obtain qualitative and quantitative information with instrumentation and inexpensive reagents.
Modelling the employment, income and price elasticities of outbound tourism demand in OECD countries
Authors: Balcilar Mehmet , Aghazadeh Sahar , Ike George N
Published: April 2020

This study examines how employment affects demand for tourism in the short and long run, controlling for the effects of income and relative prices within a panel of 32 Organisation for Economic Co-operation and Development (OECD) countries throughout the 1995–2016 period. To this end, we employ second-generation panel unit root tests, panel cointegration tests and panel data estimation techniques. Panel cointegration tests uncovered a long-run relationship between international tourism expenditure per adult, gross domestic product per adult, effective exchange rates adjusted relative prices and employment to adult population ratio. A particular implication of the result would be that the quality of employment by way of remuneration which is sufficient enough to sustain outbound tourism expenditure does not move in synchrony with workforce expansion. The failure of employment to be a significant determinant of long-run outbound tourism demand may have to do with economic and demographic factors in OECD countries as well as employment business cycles. Diminishing returns to employment, a general decline in the labour income share, a rising inequality of wage distribution among the working population due to relative adjustments in factor intensities as well as an aging population may have played contributory roles to this phenomenon. Therefore, tourism stakeholders should take note of median wage changes of possible departure countries in relation to destination costs when developing marketing frameworks for tourist locations. Moreover, reduction in unemployment rates is only indicative of short-run changes, implying that a significant impact on average tourism demand should not be expected unless average income also rises.
Wild rice protectors: An Ojibwe odyssey
Authors: Bouayad Aurelien
Published: April 2020

On the eve of New Year 2019, the White Earth Band of Ojibwe in Minnesota adopted a Tribal law recognising the intrinsic rights of wild rice. The article intends to explore the many struggles that this Native American community had to endure in the defence of their way of life and of the resources and territories on which they rely. The three `fights' that punctuated this complex ecological controversy will consequently be analysed, looking firstly at Ojibwe’s crusade for access to wild rice based on court cases over off-reservation usufructuary rights from the early 1970s to 1999, before exploring the Tribe’s effort to challenge appropriation of wild rice in the first decade of the 21st century, in the context of scientific and private attempts at patenting and genetically modifying the plant. The final section discusses the innovative legal strategies recently deployed by Ojibwe to retain control over wild rice against the backdrop of Enbridge Line 3 pipeline and the considerable environmental risks that such project represents. Eventually, this investigation provides an eloquent illustration of the role that legal creativity can play in the defence of indigenous communities’ threatened ecologies.
Estimation of the lower cut-off frequency of an anechoic chamber: An empirical approach
Authors: Sushil Singh K , Garg Mohit , Narayanan S
Published: April 2020

This paper deals with the development of an empirical expression to determine the lower cut-off frequency of an anechoic chamber when the source volume, chamber volume, wedge height as well as the major dimensions (i.e., total distance between the source and the chamber wall) are known. The frequency obtained from the empirical expression compares well within ±3% of the lower cut-off frequency obtained from the experiments. The paper also addresses the construction details and calibration procedure of the anechoic chamber. The chamber is calibrated by verifying the inverse square law for different directions from the sound source, and the lower cut-off frequency of the chamber is found to be 315 Hz within ±0.5 dB. Further, the fan broadband noise measurements are made, inside and outside, of the anechoic chamber in order to demonstrate the echo-free nature of the chamber and the spectra clearly shows that the chamber is anechoic for a broad range of frequencies.
Understanding the European Union as a Global Gender Actor: The Holistic Intersectional and Inclusive Study of Gender+ in External Actions
Authors: Debusscher Petra , Manners Ian
Published: April 2020

This article assesses the study of gender equality policies in European Union external actions with a focus on the theoretical and empirical routes to understanding the field in times of crises. It argues that the emerging body of literature on gender in European Union external relations makes it possible to explain, understand, and judge the European Union in global politics by rethinking the nature of power from a gender perspective. The article then argues that to develop gender and European Union external relations in its next decade, it is necessary to rethink the study of the European Union as a global gender actor. This encompasses a reassessment of the ‘European Union’, ‘gender’, and the ‘global’, as well as the development of a holistic macro-, meso-, and micro-analysis. The article concludes by proposing a distinctive theoretical and methodological approach which involves a holistic intersectional and inclusive study of gender+ in European Union external actions.
A Scoping Review of Sport-Based Health Promotion Interventions With Youth in Africa
Authors: Hansell Adam H. , Giacobbi Peter R. , Voelker Dana K.
Published: April 2020

Africa has the highest rates of child mortality and diseases in the world. Research suggests that sport can be an effective way to enhance health knowledge and behaviors among at-risk youth in Africa. Scoping reviews explore both the breadth and depth of a research topic, which allows researchers to conduct a detailed analysis and synthesis of studies to understand how, why, and under what circumstances sport-based interventions are effective. The purpose of this scoping review was to specifically examine the study design, theoretical foundations, sample characteristics, measured and observed outcomes, intervention characteristics, and funding sources identified in previous studies that examined sport as a platform for health promotion with youth in Africa. A total of 916 articles were retrieved from 10 electronic bibliographic databases; 28 studies met the inclusion criteria. Of these, four were randomized controlled trials, while the remaining were open trials with pre-posttest assessments, both with comparison conditions and without. Only 10 studies included a theoretical framework to specifically inform the sport-based intervention implemented. Targeted health outcomes included knowledge and behaviors related to a myriad physical and mental health concerns, such as HIV, clean water use, vaccinations, physical activity, and fitness. Statistically significant improvements were observed in 82% of the studies examined. Our results suggest that sport-based interventions may be effective in improving health knowledge and behaviors among youth in Africa. Recommendations for future research, including methodology and the importance of global partnerships with nonprofit organizations, are discussed.
Income Inequality and State Parties: Who Gets Represented?
Authors: Wright Gerald C. , Rigby Elizabeth
Published: April 2020

Recent studies of representation at the national and state levels have provided evidence that elected officials' votes, political parties' platforms, and enacted policy choices are more responsive to the preferences of the affluent, while those with average incomes and the poor have little or no impact on the political process. Yet, this research on the dominance of the affluent has overlooked key partisan differences in the electorate. In this era of hyperpartisanship, we argue that representation occurs through the party system, and we test whether taking this reality into account changes the story of policy dominance by the rich. We combine data on public preferences and state party positions to test for income bias in parties' representation of their own co-partisans. The results show an interesting pattern in which underrepresentation of the poor is driven by Democratic parties pushing the more liberal social policy stances of rich Democrats and Republican parties reflecting the particularly conservative economic policy preferences of rich Republicans. Thus, we have ample evidence that the wealthy, more often than not, do call the shots, but that the degree to which this disproportionate party responsiveness produces less representative policies depends on the party in power and the policy dimension being considered. We conclude by linking this pattern of influence and “coincidental representation” to familiar changes which define the transformation of the New Deal party system.
Interferon-γ facilitates the synaptic transmission between primary afferent C-fibres and lamina I neurons in the rat spinal dorsal horn via microglia activation
Authors: Reischer Gerda , Heinke Bernhard , Sandkühler Jürgen
Published: April 2020

Recent studies have demonstrated an important role of the pro-inflammatory cytokine interferon-γ in neuropathic pain. Interferon-γ is upregulated in the lumbar spinal cord of nerve-injured rodents and intrathecal injection of interferon-γ has been shown to induce neuropathic pain-like behaviours in naive rodents. A potential mechanism in the pathogenesis of neuropathic pain is a long-lasting amplification of nociceptive synaptic transmission in lamina I of the spinal dorsal horn. Here, we tested the effects of interferon-γ on the properties of the first synapse in nociceptive pathways in the superficial spinal dorsal horn. We performed whole-cell patch-clamp recordings in lamina I neurons in a spinal cord slice preparation with dorsal roots attached from young rats. We determined the effects of acute (at least 25 min) or longer lasting (4–8 h) treatment of the transversal slices with recombinant rat interferon-γ on spontaneous excitatory postsynaptic currents or on monosynaptic Aδ- and C-fibre-evoked excitatory postsynaptic currents, respectively. Prolonged treatment with interferon-γ facilitated monosynaptic C-fibre-evoked excitatory postsynaptic currents and this effect could be blocked by co-application of minocycline an inhibitor of microglial activation. In contrast, Aδ-fibre-evoked excitatory postsynaptic currents were not affected by the prolonged interferon-γ treatment. Acute interferon-γ application in the bathing solution did not change strength of monosynaptic Aδ- or C-fibre synapses in lamina I. However, the rate, but not the amplitude, of spontaneous excitatory postsynaptic currents recorded in lamina I neurons was decreased. This effect could not be blocked by the application of minocycline. Long-lasting treatment of rat spinal cord slices with interferon-γ induced an input specific facilitation of synaptic strength in spinal nociceptive pathways. Enhanced transmission between C-fibres and spinal lamina I neurons was mediated by the activation of microglial cells. We showed that the pro-inflammatory cytokine interferon-γ modifies the processing of information at the first synaptic relay station in nociceptive pathways.