bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Dermatomyositis Coexisting with Both Anti-Mi-2 and Anti-NXP-2 Antibodies
Authors: Ito Mitsuru , Moriya Chie , Matsuyama Kanako , Shu En , Hamaguchi Yasuhito , Seishima Mariko
Published: May 2020

Myositis-specific autoantibodies (MSAs) including anti-Mi-2 and anti-nuclear matrix protein 2 (NXP-2) antibodies have been detected in the patients with dermatomyositis (DM), and are useful tools for identifying clinical subsets of DM. MSAs are exclusively found in DM patients. Anti-Mi-2 antibody-positive DM patients show the typical skin lesions and myositis and are rarely associated with internal malignancy and interstitial lung disease (ILD). On the other hand, adult DM patients with anti-NXP-2 antibody often show calcinosis and internal malignancy, but rarely ILD. In addition, anti-NXP-2 antibody-positive DM patients have severe phenotype with myalgia, peripheral edema, and significant dysphagia, but with mild skin lesions. Herein, we report a rare case of classic DM coexisting with both anti-Mi-2 and anti-NXP-2 antibodies, clinically, without ILD or internal malignancy. Our patient had typical skin manifestations, muscle weakness, muscle pain, and general fatigue without calcinosis, peripheral edema, or dysphagia. Thus, the clinical phenotype was similar to anti-Mi-2 antibody-positive DM.
Infektionserkrankungen mit Augenbeteiligung: Diagnose und Beurteilung dank Bildgebung
Authors: Göbel Katja
Published: May 2020

Background: Syphilis, tuberculosis and toxoplasmosis are major infectious diseases worldwide; all of them are multisystem pathologies and share a possible ocular involvement. In this context, a fundamental help for the definitive diagnosis is provided by the ophthalmologist, through clinical evaluation and with the aid of a multimodal imaging examination. Methods: We hereby describe selected cases who came to our attention and were visited in our eye clinic. In all clinics, the use of retinal and optic disc multimodal imaging during ophthalmological evaluation allowed to make a diagnosis of an infectious disease. Results: In our tertiary referral center more than 60 patients with syphilis, tuberculosis and toxoplasmosis have been evaluated in the last two years: In 60% of cases the ophthalmological evaluation was secondary to a previous diagnosis of an infectious disease, while in the remaining cases the ophthalmologist, with the help of a multimodal imaging examination and clinical evaluation, represented the physician who leads to the diagnosis. Conclusion: Our results confirm how in these life-threatening pathologies a prompt diagnosis is mandatory and may benefit from a multidisciplinary and multimodal imaging approach, especially during ophthalmological evaluation.
Retinal Vasculitis Secondary to Durvalumab
Authors: R. Andrade Antonio , Moll-Udina Aina , Martin Ruth , Cilveti Esther , Subirà Olaia , Disfetano Laura , García-Arumí Jose
Published: May 2020

Ocular manifestations are very rarely reported as side effects to checkpoint inhibitors. We present a case of a 64-year-old Caucasian man in treatment with durvalumab for non-small-cell lung carcinoma who presented a retinal vasculitis with macular edema. After three boluses of methylprednisolone, the retinal vasculitis resolved and macular edema improved during follow-up. There was no need for durvalumab to be withdrawn.
Description of the advertisement call of a species without vocal sac: Craugastor gollmeri (Amphibia: Craugastoridae)
Authors: D. ROBERTO IBÁÑEZ , A. CÉSAR A. JARAMILLO , SOLÍS FRANK A.
Published: May 2020

The Central American frogs of the genus Craugastor consist of 113 species (Hedges et al. 2008; Frost 2011). Craugastor gollmeri (Peters) occurs in lowland to highland forests of central Panama, the Caribbean versant of western Panama and eastern Costa Rica, even extending into the Pacific versant in northwestern Costa Rica, within an altitudinal distribution range of 10–1520 m (Savage 2002). At some localities, C. gollmeri has been found to be an usual to common forest species, being primarily a diurnal species that inhabits leaf-litter on the forest floor (Ibáñez et al. 1995; Savage 2002). The snout-vent length (SVL) of adult frogs is 30–36.5 mm in males and 45–54 mm in females (Savage 1987). The males of gollmeri species group lack vocal slits and vocal sac (Savage 1987), and seem incapable of producing vocalizations (Savage 2002). Nonetheless, here we describe the vocalizations given by a male of C. gollmeri in captivity, considered to be advertisement calls (sensu Wells 1977). The role of advertisement calls in species recognition and reproductive isolation has been well established (Wells 2007), hence, the relevance of call characters in anuran phylogenetic and systematic studies (e.g., Hoskin 2004).
Do reflex comments on laboratory reports alter patient management?
Authors: Wilkinson Ben , Whitehead Simon J , George Elaine , Horton Sally , Bellaby Judith , Mohamed Sagal , Ford Clare , Min San San , Gama Rousseau
Published: May 2020

Introduction

Laboratory comments appended on clinical biochemistry reports are common in the UK. Although popular with clinicians and the public, there is little evidence that these comments influence the clinical management of patients.

Methods

We provided reflex automated laboratory comments on all primary care lipid results including, if appropriate, recommendation of direct referral to the West Midlands Familial Hypercholesterolaemia service (WMFHS). Over a two-year period, the number GP referrals from the Wolverhampton City Clinical Commissioning Group (CCG) to the WMFHS were compared with four comparator CCGs of similar population size, who were not provided with reflex laboratory comments.

Results

Over the study period, the WMFHS received more referrals from Wolverhampton GPs (241) than any other comparator CCG (range 8–65) and greater than the combined referrals (172) from all four comparator CCGs.

Conclusion

Targeted reflex laboratory comments may influence the clinical management of patients and may have a role in the identification of individuals with familial hypercholesterolaemia.
Factors Associated With Prolonged Antibiotic Use in the Setting of Suspected Pneumonia and Negative Bronchoalveolar Lavage Cultures
Authors: Pouliot Jonathon D. , Dortch Marcus J. , Givens Gabrielle , Tidwell William , Hamblin Susan E. , May Addison K.
Published: May 2020

Background: Diagnostic criterion for pneumonia includes clinical data and bronchoalveolar lavage cultures (BALCx) to identify pathogens. Although ~60% of BALCx are negative, there may be reluctance to discontinue antibiotics, leading to prolonged antibiotic use (PAU). Objective: The purpose of this study is to compare outcomes of subjects with negative BALCx with PAU versus without prolonged antibiotic use (nPAU). Methods: A retrospective cohort study was conducted including subjects admitted to the intensive care unit (ICU), with suspected pneumonia, and negative BALCx. Data were compared based on length of exposure to antibiotics, PAU (antibiotics >4 days) versus nPAU (antibiotics <4 days). Results: A total of 128 subjects were included, 57 in the PAU group and 71 in the nPAU group. Baseline demographics were similar between groups. Severity of illness measured by multiple organ dysfunction scores at time of bronchoalveolar lavage (BAL) collection to final result showed a statistically significant decrease in the PAU group but not in the nPAU group. No differences were found in ICU days, ventilator-free days, or mortality; however, length of stay was longer for PAU (23 vs. 17, p = .04). In the PAU group, there were fewer BALCx results of “no growth” (23% vs. 45%, p = .04), more positive gram stains (83% vs. 60%, p = .01) and more positive non-BALCx (40% vs. 14%, p = .01). In a multivariate analysis, factors associated with PAU were positive BAL gram stains (adjusted odds ratio [aOR] 3.1, p = .037) and positive non-BALCx (aOR 4.7, p = .002). Conclusion: For subjects with suspected pneumonia and negative BALCx, positive non-BALCx and positive BALCx gram stain influenced the length of exposure of antibiotics.
Feeding Indigenous people in Canada
Authors: (Martens) Tabitha Robin , Dennis Mary Kate , Hart Michael Anthony
Published: May 2020

Historically, hunger was used as a tool of coercion and manipulation, and as a weapon to eradicate Indigenous populations. Through policy decisions, the support for and removal of Indigenous children, and other assimilative practices, social work has contributed to the perpetuation of ‘helping practices’ which damaged Indigenous cultures and well-being. Today, experiences of hunger are still tied to colonialism. There is a need to examine the complex history of feeding Indigenous peoples in Canada and to work to reclaim and heal Indigenous food systems. For social work, this requires an emphasis on Indigenous ways of helping led by Indigenous peoples.
Post-processing and visualization of large-scale DEM simulation data with the open-source VELaSSCo platform
Authors: Morrissey John P , Totoo Prabhat , Hanley Kevin J , Papanicolopulos Stefanos-Aldo , Ooi Jin Y , Gonzalez Iván Cores , Raffin Bruno , Mostajabodaveh Seyedmorteza , Gierlinger Thomas
Published: May 2020

Regardless of its origin, in the near future the challenge will not be how to generate data, but rather how to manage big and highly distributed data to make it more easily handled and more accessible by users on their personal devices. VELaSSCo (Visualization for Extremely Large-Scale Scientific Computing) is a platform developed to provide new visual analysis methods for large-scale simulations serving the petabyte era. The platform adopts Big Data tools/architectures to enable in-situ processing for analytics of engineering and scientific data and hardware-accelerated interactive visualization. In large-scale simulations, the domain is partitioned across several thousand nodes, and the data (mesh and results) are stored on those nodes in a distributed manner. The VELaSSCo platform accesses this distributed information, processes the raw data, and returns the results to the users for local visualization by their specific visualization clients and tools. The global goal of VELaSSCo is to provide Big Data tools for the engineering and scientific community, in order to better manipulate simulations with billions of distributed records. The ability to easily handle large amounts of data will also enable larger, higher resolution simulations, which will allow the scientific and engineering communities to garner new knowledge from simulations previously considered too large to handle. This paper shows, by means of selected Discrete Element Method (DEM) simulation use cases, that the VELaSSCo platform facilitates distributed post-processing and visualization of large engineering datasets.
Communicating About COVID-19: Practices for Today, Planning for Tomorrow
Authors: St.Amant Kirk
Published: May 2020

In times of public health crises, effective information on how to perform daily activities can be central to the stability of local communities. Technical communicators can make important contributions to these situations by developing materials that meet local informational needs. This entry reviews strategies technical communicators can use to address public health challenges on the local level both today and in the future.
Behavioural Insights Teams (BITs) and Policy Change: An Exploration of Impact, Location, and Temporality of Policy Advice
Authors: Mukherjee Ishani , Giest Sarah
Published: May 2020

Behavioural Insights Teams (BITs) have gained prominence in government as policy advisors and are increasingly linked to the way policy instruments are designed. Despite the rise of BITs as unique knowledge brokers mediating the use of behavioral insights for policymaking, they remain underexplored in the growing literature on policy advice and advisory systems. The article emphasizes that the visible impact that BITs have on the content of policy instruments, the level of political support they garner and their structural diversity in different political departments, all set them apart from typical policy brokers in policy advisory systems connecting the science–policy divide.
Efficient dynamic programming in economical cruise control under real-time traffic situations
Authors: Hu Ping , Huang Chuan , Lian Jing
Published: May 2020

In this paper, dynamic programming (DP) economical cruise control algorithms under discrete distance and discrete time strategies are designed to improve battery electric vehicle (BEV) energy consumption and riding comfort. In our experiment, energy consumption of constant-speed driving is reduced by up to 21.6% using the optimum velocity profiles from discrete distance DP. ‘Variable step length and boundary conditions’ are utilized to reduce discrete distance DP processing time by 90.8% with no effect on accuracy. Under discrete time DP, position is introduced as an additional variable, so discrete time DP allows more inputs including real-time preceding vehicle position and traffic information. The experiment results indicate that under traffic situation, discrete time DP further improves energy consumption and riding comfort by avoiding unnecessary stop at intersections compared with discrete distance DP. Further analysis indicates that under properly controlled velocity, the transfer between potential energy and kinetic energy is more efficient than that between potential energy and electric energy. These DP economical cruise control algorithms are effective for BEVs, hybrid electric vehicles and plug-in hybrid electric vehicles. ‘Variable step length and boundary conditions’ method in DP can also be applied in other domains where DP processing time is crucial.
Team Decision Making: The Dynamic Effects of Team Decision Style Composition and Performance via Decision Strategy
Authors: Zhu X. Susan , Wolfson Mikhail A. , Dalal Dev K. , Mathieu John E.
Published: May 2020

As teams continue to become more prevalent in modern-day organizations, researchers and organizations alike can benefit from a more nuanced understanding of teams’ decision-making process, which can ultimately impact organizational effectiveness. Although team processes are conceptualized as dynamic phenomena, they have largely been treated as static in research. In this study, we draw on the input-mediator-output-input and episodic team performance frameworks to advance a theoretical model of the dynamic, reciprocal effects of team rational decision strategy and team performance as well as the role of team composition of individual rational decision style. We sampled 320 participants in 85 teams competing in a 10-week business strategy simulation where teams made weekly strategic decisions that contributed to team performance. Teams composed of individuals with rational decision styles were more likely to adopt rational decision strategies, which led to better team performance. Additionally, results revealed a positive reciprocal effect between rational decision strategy and team performance such that teams with positive prior performance were more likely to engage in subsequent rational decision strategy. As hypothesized, team composition of members’ rational decision style was the primary determinant of team rational strategy during initial stages of team development, but the valence of outcome feedback (i.e., prior performance) took over as the stronger predictor of team rational strategy during later stages of team development. We contribute to the team and decision-making literatures by examining the dynamic process of team decision making and team performance.
Is there a partisan bias in the perception of the state of the economy? A comparative investigation of European countries, 2002–2016
Authors: Okolikj Martin , Hooghe Marc
Published: May 2020

The literature on economic voting starts from the assumptions that citizens have a sufficiently high level of knowledge about their country’s economic situation, and that they vote according to their perception of the state of the economy. However, these assumptions have been challenged as economic perceptions could be plagued by partisan bias. We use the comparative dataset of the European Social Survey to investigate partisan bias in the perception of economic performance. Firstly, we observe that the economic perceptions of both supporters and opponents of governing parties are strongly related to real-life economic indicators such as gross domestic product growth and unemployment levels. Secondly, we find that shifts in economic performance (growth and unemployment) are strongly associated with similar changes in economic perceptions among both supporters of governing parties and opposition parties. There is, however, a significant but limited partisan bias in economic perceptions in countries with high levels of unemployment.
Frontal Ostium Grade (FOG): A New Computer Tomography Grading System for Endoscopic Frontal Sinus Surgery
Authors: Gheriani Heitham , Al‐Salman Rami , Habib Al‐Rahim R. , Javer Amin
Published: May 2020

Objective

The location and size of the frontal sinus ostium are critical in determining surgical difficulty. The more anterior the ostium, the more difficult is the surgical access. We propose a novel computed tomography (CT) grading specific to the anatomical position of the frontal ostium.

Study Design

Observational study followed by a prospective part.

Settings

Tertiary rhinology practice

Subject and Methods

On a specified sagittal CT cut, a vertical line was drawn through the posterior edge of the frontal process of the maxilla (frontal buttress/beak) along its vertical axis (reference [R‐] line). A second (S‐) line was placed at the point of upturn of the skull base. Based on if the S‐line was posterior or anterior to the R‐line, the frontal ostium was graded positive and more easily accessible or negative and thereby more challenging, respectively. If both lines overlapped, then a neutral (0) grading existed.

Results

A total of 297 CTs (594 ostia) were analyzed. In total, 394 (65%) ostia were grade positive, 52 (8.75%) were grade negative, and 103 (17.3%) were grade neutral. Ninety frontal sinusotomies were then performed using this grading system: 48 were positive, 21 negative, and 21 neutral. The average time to complete a frontal sinusotomy was 9.96 minutes for grade positive compared to 11.4 minutes for neutral and 16.05 minutes for grade negative (P <. 005).

Conclusion

This novel anatomical CT grading system is designed to be useful in planning and predicting the level of difficulty in endoscopic frontal sinus surgery.
Sustaining Otolaryngology Services for the Long Haul during the COVID‐19 Pandemic: Experience from a Tertiary Health System
Authors: Tay Joshua K. , Lim Wei Sian , Loh Woei Shyang , Loh Kwok Seng
Published: May 2020

The impact of the COVID‐19 pandemic has been far‐reaching and has profoundly affected the practice of otolaryngology in an unprecedented way. In this commentary, we draw from our experience in the first 90 days of the pandemic and discuss a set of workflow measures, personal protection equipment protocols, and strategic goals that can provide a safe environment for patients and staff to continue managing a significant proportion of patients in the otolaryngology service during the pandemic.
Creation of Educational Videos for Patients Undergoing Nonelective Surgery: Tools for the COVID‐19 Era
Authors: Sell Elizabeth , Chao Tiffany , Shah Mitali , Rajasekaran Karthik
Published: May 2020

Currently, there is a lack of reliable patient‐centric educational videos in otolaryngology. In light of COVID‐19, otolaryngologists have had to see patients through virtual visits and have been encouraged to send patients home after nonelective surgery. Additionally, most hospitals are not permitting patients’ family members and caretakers to enter patient rooms, thus often preventing them from receiving adequate education on postoperative care. Embracing educational videos as a valuable tool will improve communication with patients, especially during the times of COVID‐19 and beyond. The goal of this commentary is to describe our early lessons learned in developing educational videos in a streamlined, efficient, and accessible format that can be shared among all members of the multidisciplinary and design production team. Background on the use of multimedia to reduce patient anxiety and frustration with surgical interventions is provided.
Access to Telemedicine—Are We Doing All That We Can during the COVID‐19 Pandemic?
Authors: Rajasekaran Karthik
Published: May 2020

The COVID‐19 pandemic has resulted in physicians having to switch from in office visits to telemedicine. Unfortunately, physicians and patients did not have adequate time to anticipate barriers to its implementation. Over the last month, one of the major problems has been patient access to telemedicine. Many patients do not own a smartphone or have broadband access. This “digital divide” is not fair to our patients in need—especially those with a cancer diagnosis. Patients deserve access to care. We need to implore insurance companies to provide tablets with wireless capabilities to patients in need.
Clinical Recommendations for Epistaxis Management During the COVID‐19 Pandemic
Authors: D’Aguanno Vittorio , Ralli Massimo , Greco Antonio , de Vincentiis Marco
Published: May 2020

Epistaxis is a common complaint in the general population, and its treatment is a common procedure in emergency departments. In the COVID‐19 era, procedures involving airway management are a particular risk for health care workers due to the high virulence of the virus, the transmission through aerosol, and the risk of contagion from asymptomatic patients. In this article, we propose a simple memorandum of clinical recommendations to minimize the risk of operator infection deriving from epistaxis management. The correct use of personal protective equipment and strict compliance with the behavioral guidelines are essential to reduce the potential risk of infection. In particular, the use of filtering masks is strongly recommended since all patients, including those referring for epistaxis, should be treated as being COVID‐19 positive in the emergency department. The safety of health care workers is essential not only to safeguard continuous patient care but also to limit virus transmission.
We Heart Japan: Fan Citizenship and the Role of Institutions in the Response to Japanese Earthquakes
Authors: Miller Lucy J.
Published: May 2020

The 2011 Great East Japan earthquake and resulting tsunami that devastated the nation created a situation that, through the global flows of media content, necessitated a response from the international anime fan community. This response was shaped by the ethical framework of caring for the community. Performances of fan citizenship reflected this existing community value and the community’s identification with other fans and the people of Japan. Reflecting these identifications, fans took civic action in the form of the ethical modalities of donating money to relief efforts and critiquing community discourse that diverted attention from the disaster. Institutions, like the streaming service Crunchyroll, served to rhetorically define the ethical modalities at play in this context through their institutional role of amplifying performances of fan citizenship.
Ethnic Enclaves, Self-employment, and the Economic Performance of Refugees: Evidence from a Swedish Dispersal Policy
Authors: Andersson Henrik
Published: May 2020

This article estimates the causal effect of residential concentration of co-ethnics (ethnic enclaves) on the probability to start a business among refugees in Sweden. Results indicate that the share of self-employed co-ethnics in the port of entry municipality increases refugees’ probability of entry into self-employment, while the actual share of local co-ethnics has no effect or, in some cases, a negative effect. The results support the conclusion that skills and resources within the local ethnic enclave, particularly skills relevant for self-employment, are crucial for generating new entry into self-employment for refugees, while simply more co-ethnics, plausibly increasing an ethnic market’s size, are of less importance. Moreover, the results suggest that being placed with a larger share of self-employed co-ethnics is negatively related to refugees’ long-term disposable income; however, assuming there is no or little selection of high-ability refugees into self-employment, this negative relationship can be counteracted by the choice of self-employment. The study adds new knowledge on the arguably crucial topic of socio-economic integration of an important group of international migrants — namely, refugees.
Book review: B. D. Chattopadhyaya, The Concept of Bharatavarsha and Other Essays
Authors: Kulke Hermann
Published: May 2020

B. D. Chattopadhyaya, The Concept of Bharatavarsha and Other Essays, Permanent Black, Ranikhet, 2017, x + 238 pp., ₹795.
There is no need to shout to be heard! The paradoxical nature of corporate social responsibility (CSR) reporting in a Latin American family small and medium-sized enterprise (SME)
Authors: Discua Cruz Allan
Published: May 2020

Drawing on the paradox and reciprocal stewardship theory, this study focuses on tensions in corporate social responsibility (CSR) reporting experienced by a family small and medium-sized enterprise (SME) in a developing Latin American country. Prior literature has suggested a prescriptive, tension-free process, led by family members and driven by an interest to protect and enhance the reputation of both the family and the firm. Relying on an in-depth qualitative approach, this study unveils that CSR reporting is not immune to contradictions between familial and external expectations. The findings reveal that religious beliefs can emerge as a strong source of tensions. A reciprocal stewardship perspective allows an understanding of how and why family and non-family members work together and handle paradoxes. A conceptual model is proposed which is based on multiple sources of emergence (family-related, business-related and external sources) and management/avoidance of tensions in CSR reporting, mediated by the types of relationships among family members and between family and non-family members. Implications and opportunities for further research are subsequently presented.
Regulation and ethics in artificial intelligence and machine learning technologies: Where are we now? Who is responsible? Can the information professional play a role?
Authors: Carter Denise
Published: May 2020

Artificial intelligence (AI) and machine learning (ML) technologies are rapidly maturing and proliferating through all public and private sectors. The potential for these technologies to do good and to help us in our everyday lives is immense. But there is a risk that unless managed and controlled AI can also cause us harm. Questions about regulation, what form it takes and who is responsible for governance are only just beginning to be answered. In May 2019, 42 countries came together to support a global governance framework for AI. The Organisation for Economic Co-operation and Development (OECD) Principles on Artificial Intelligence (OECD (2019) OECD principles on AI. Available at: https://www.oecd.org/going-digital/ai/principles/ (accessed 2 March 2020)) saw like-minded democracies of the world commit to common AI values of trust and respect. In Europe, the European Commission’s (EC) new president, Ursula von der Leyen has made calls for a General Data Protection Regulation style. As a first step the EC has published a white paper: ‘On Artificial Intelligence – A European Approach to Excellence and Trust’ (European Commission (2020) Report, Europa, February). In February 2020, the UK government has published a report on ‘Artificial Intelligence in the Public Sector’ (The Committee on Standards in Public Life (2020) Artificial intelligence and public standards. Report, UK Government, February). This article discusses some of the potential threats AI may hold if left unregulated. It provides a brief overview of the regulatory activities for AI worldwide, and in more detail the current UK AI regulatory landscape. Finally, the article looks at the role that the information professional might play in AI and ML.
Process evaluation of ‘Brains Ahead!’: an intervention for children and adolescents with mild traumatic brain injury within a randomized controlled trial
Authors: Renaud M Irene , Klees Carina , van Haastregt Jolanda CM , Catsman-Berrevoets Coriene E , van de Port Ingrid GL , Lambregts Suzanne AM , van Heugten Caroline M
Published: May 2020

Objective:

To investigate whether the ‘Brains Ahead! Intervention for children and adolescents with mild traumatic brain injury’ was implemented as intended. In addition, involvement in and satisfaction with the intervention among patients, caregivers and professionals delivering the intervention were studied.

Design:

Mixed methods, prospective study.

Participants:

Children with mild traumatic brain injury and their caregivers, allocated to the intervention group of the randomized controlled trial in the ‘Brains Ahead!’ study, and the two professionals providing the intervention.

Intervention:

The intervention consists of a standardized and individualized psychoeducational session with written take-home information, and follow-up telephone call(s).

Main measures:

Registration forms, evaluation questionnaires for patients and caregivers and semi-structured interviews for professionals.

Data analysis:

Qualitative data were categorized based on content. Quantitative data were reported as descriptive statistics.

Results:

Fifty-five patients and caregivers out of 60 study-participants attended both sessions. All elements of the intervention were delivered to 53 study-participants. Evaluation questionnaires were completed by 21 of the 31 patients aged 12 years and older, and by 41 caregivers. Overall, the sessions were considered useful by 19 patients, 40 caregivers and both professionals. Reassurance, creating a better understanding and recognition of symptoms were rated as important aspects. On a scale from 1 to 10, the intervention was rated by children, caregivers and professionals with 7.6 (SD 1.2), 8.1 (SD .9) and 8.0 (SD .0), respectively.

Conclusion:

The ‘Brains Ahead!’ intervention was largely implemented as intended and the process evaluation revealed that it is considered feasible according to patients, caregivers and professionals.
Leaving Gangs in Cape Town: Disengagement as Role Exit
Authors: Dziewanski Dariusz
Published: May 2020

A lack of scholarship on gang leaving in Cape Town, South Africa creates the impression that joining gangs is a death sentence. However, this paper shows that gang members can disengage, even amidst the scarcity of an emerging city. It combines life history research with Ebaugh’s (2013) role exit theory in an analysis of the disengagements of 24 former gang participants. Research considers the various stages of out-of-gang transitions, profiling the drivers and impediments to gang exit. Specific focus is placed on understanding how violence both catalyzes and challenges out-of-gang transition during the differential processes of disengagement. Findings indicate a lengthy and challenging transitional process from the point the first doubts emerge to the time a person successfully becomes an ex-gangster. Progress through different phases of gang exit is generally uneven and unpredictable, and carried out in a context with significant social, economic, and security challenges. Still, those interviewed for this study offer compelling examples to show that disengagement is possible. Their journeys yield insights that can be leveraged to design better informed efforts to reduce gang violence—whether in Cape Town, or in other similarly inequality prone and insecure cities around the world.
Synthesis and characterization of sulfonated poly(ether ether ketone)/zinc cobalt oxide composite membranes for fuel cell applications
Authors: Prathap Murali , Poonkuzhali Kulasekaran , Berlina Maria Mahimai , Hemalatha Pushparaj , Paradesi Deivanayagam
Published: May 2020

A new series of polymer composite membranes was fabricated using a linear sulfonated poly(ether ether ketone) (SPEEK) polymer with zinc cobalt oxide (ZCO) as an inorganic filler and evaluated for fuel cell applications. SPEEK was obtained by the direct sulfonation of PEEK using concentrated sulfuric acid, and appropriate quantities of ZCO were loaded into it to yield the polymer composites. Proton nuclear magnetic resonance studies revealed the degree of sulfonation of SPEEK to be 55%, while morphological studies confirmed the successful incorporation of inorganic fillers into the polymer matrix. To evaluate the suitability of the prepared composite membranes for fuel cell applications, their physicochemical properties were studied in detail. The pristine SPEEK membrane exhibited a proton conductivity of 0.009 S cm−1 at 30°C, whereas the values for the composite membranes loaded with 2.5 to 10 wt% of ZCO were in the range 0.012–0.020 S cm−1. Moreover, the composite membranes showed excellent thermal stability up to 370°C. Indeed, the membranes obtained by the incorporation of ZCO into the SPEEK polymer show potential for fuel cell applications.
A service evaluation comparing home-based testing to clinic-based testing for HIV, syphilis and hepatitis B in Birmingham and Solihull
Authors: Banerjee Prita , Madhwapathi Vidya , Thorley Nicola , Radcliffe Keith
Published: May 2020

The sexual health services in the Birmingham and Solihull area of the United Kingdom, called Umbrella, has been offering home-based testing for sexually transmitted infections to patients since August 2015. The aim of this service evaluation was to evaluate the uptake, return rate and new diagnosis rates of home-based testing in comparison with clinic-based testing for human immunodeficiency virus (HIV), syphilis (STS) and hepatitis B. Home-based testing, although popular, had low uptake amongst high-risk groups such as men who have sex with men (MSM), compared to the clinic-based group (1% versus 11%, p < 0.001). This resulted in low positivity rates for HIV (0.02%) and STS (0.17%) and no new cases of hepatitis B in the home-based group. Therefore, our results show that home-based testing is not a cost-effective method of testing for HIV and likely this is also the case for hepatitis B and STS. Our recommendation would be to encourage uptake of home-based testing in high-risk groups such as MSM and Black Africans to improve the diagnosis rates of HIV, STS and hepatitis B. Alternatively, the continuation of home-based blood testing in the Birmingham and Solihull area will need to be reviewed by Umbrella as a cost-saving strategy for the service in the future.
Scaling a radial flow turbine from air to multiple compressible fluids and performance evaluation using computational fluid dynamics
Authors: Vijayaraj K , Singh Punit
Published: May 2020

Many new turbine designs may take large timelines to prove their worth. For getting duty condition at optimum efficiency, one can always scale speed, diameter, if a very efficient benchmark is available. This paper examines the similarity-based scaling strategy to develop radial inflow turbines for different compressible fluids from a well-established NASA radial flow turbine designed and experimentally tested with air as the working fluid. The NASA 1730 air turbine experimental data have been used as the benchmark here and adopted multiple fluids to understand scaling. The considered fluids are supercritical carbon dioxide for the Brayton cycle, helium for the cryogenic liquefaction cycle, and R143a for the organic Rankine cycle. The uniqueness here is to have three types of cycles, viz. closed-loop Brayton cycle, organic Rankine cycle, and cryogenic helium liquefaction cycle, which employ different working fluids, adapting the same NASA turbine geometry. This paper has described the scaling methodology and presented the simulated turbine performance of SCO2, helium, and R143a using computational fluid dynamics. The dimensionless curves for these fluids are plotted on the corresponding experimental characteristics of the NASA turbine. Out of the three fluids, SCO2 showed the perfect Mach number matching for the flow and torque coefficient curves. The Mach number deviations in the case of helium were small, and the variations were slightly higher for R143a. The efficiencies were the highest for R143a, followed by SCO2 and helium. Thus, the scaling was found to be effective in all cases. Thus, the standard turbomachinery space developed for air as fluid can be used effectively for the development of turboexpanders for various cycles with different working fluids without redesigning the entire shape using similarity-based scaling. The benchmark NASA 1730 turbine has proven this in three special cases. This paper is not against designing new machines but is only trying to say that when such good benchmark machines like NASA 1730 turbine is available; designers must use the power of similitude to adapt it to match new fluids and new conditions.
Discharge policies for homeless people and immigrants: Compromising professional ethics
Authors: Hodson Nathan , Glennerster Rose
Published: May 2020

Discharging a homeless patient from hospital raises ethical issues which are compounded when the patient is from outside the United Kingdom. This article begins with an extended case study of a 30-year-old homeless man from Lithuania describing his complex medical and social needs. It is best practice for all homeless patients to have their housing needs planned for prior to discharge, but this is made more difficult by the United Kingdom’s ‘hostile environment’ policy which creates a subclass of homeless people who are not eligible for support. This means healthcare professionals discharge patients back to homelessness, even when this is likely to adversely affect their health and dignity both directly and indirectly through impairing access to care for chronic conditions. Policies in health and social care which compel professionals to treat some patients with second-class care undermine the ethics of healthcare professions.
Awareness and Uptake of Maternal and Child Health Benefit Schemes Among the Women Attending a District Hospital in Coastal South India
Authors: Unnikrishnan Bhaskaran , Rathi Priya , Sequeira Renita Maria , Rao K Kshama , Kamath Swathi , K. Maria Alfam K.
Published: May 2020

Introduction: Maternal and child health (MCH) benefit schemes were introduced to increase institutional deliveries, to reduce out of pocket expenditure, to provide quality care and nutrition to mother and baby and thereby reduce maternal mortality rate and infant mortality rate.

Objective: To assess the awareness and estimate the uptake of benefits regarding various MCH benefit schemes among study participants.

Methodology: A cross-sectional study was conducted at district hospital, Mangaluru, Karnataka, India, among 250 antenatal women and postnatal mothers. They were interviewed using a semi-structured–validated questionnaire. Data were analysed using Statistical Package for Social Science version 11.5.

Result: Awareness for scheme varied, ranging from 94 per cent for Integrated Child Development Service and 0.8 per cent for Rashtriya Bal Swasthya Karyakram. Major source of information being accredited social health activist (40.41%), most of the study participants had a favourable opinion regarding the benefits of MCH schemes. Maximum uptake was seen for Janani Shishu Suraksha Karyakram (100%); however, none of them availed Prasoothi Araike.

Conclusion: Our study showed that the awareness and uptake for different MCH-related schemes varied. Most of the study participants had a favourable opinion about the benefits of MCH schemes. Since awareness for some schemes were low, efforts should be made to increase awareness regarding all schemes by displaying the information. Uptake can be increased by proper channelising the resources.
Performance Analysis of Hospitals in Kerala Using Data Envelopment Analysis Model
Authors: Barpanda Saswat , Sreekumar Neena
Published: May 2020

Performance analysis in any industry plays a vital role in understanding the current scenario and thereby improving the overall efficiency. Using a sample of 20 hospitals randomly selected in Kerala, performance measures of quality were examined as they related to technical efficiency. Efficiency scores for the study hospitals were computed using data envelopment analysis (DEA). The study found that the technically efficient hospitals were performing well as far as quality measures were concerned. DEA can be used to benchmark both dimensions of hospital performance, that is, technical efficiency and quality. The variables selected for the study were divided under input and output measures. Using the DEA model, the factors considered were weighed and analysis was done. The input variables under study are bed number, trained medical staff and services offered. The output variables considered were outpatient rate, mortality rate and number of surgical operations in a month. Through the study, performance of each hospital is measured, and it aims to find out a relation between the input and output variables.
Improved yet Unsafe: An Aquatic Perspective of Indian Infant Mortality
Authors: Banerjee Subhanil , Sar Ashok Kumar , Pandey Shilpa
Published: May 2020

Infant mortality rate (IMR) is an important development indicator and a vital component of millennium development goals (MDGs) set by United Nations Development Programme (UNDP). According to UNDP, so far India has only fared moderately in reducing IMR (Goal 4 of MDGs). India (32) ranks 144th among 196 countries regarding IMR as per the 2017 data availed from World Development Indicators. Its adjacent countries such as Bhutan (25.6), Bangladesh (26.9) and Nepal (27.8) have fared much better regarding infant survival. Numbers within the parentheses indicate the IMR of the respective country. The United Nations Children’s Fund (UNICEF) has identified that IMR among families with better access to improved drinking water sources and toilet is much lower than those bereft of the same. This inference has been drawn from National Family Health Survey 3 data (NFHS III). The present study investigates into the aforementioned relation analysing NFHS IV data. The result depicts that contrary to UNICEF’s findings, IMR increases with better accessibility to improved water sources. Further to this, the article shows that an additional aqua-related practice together with improved drinking water sources might lead to the betterment of IMR for India.
Factors Influencing the Nutritional Status Among Children of 6–11 Years of Age: A Case Study from an Indian Megacity
Authors: Chakraborty Monalisha , Ghosh Saswata
Published: May 2020

The present study was aimed to assess the effect of socio-demographic, economic and dietary factors on nutritional status among children of 6–11 years of age in an urban megacity of India. It was a descriptive cross-sectional study conducted among 251 urban children living in slums, non-slums and squatters of North Kolkata. The study reveals that prevalence of underweight was much higher among children of squatters (66.7%), whereas a significant proportion of children belonged to non-slums were found overweight (23.7%). Although the prevalence of both underweight and overweight was more among girls (16.8% and 34.5%), stunting was found marginally higher among boys (18.9%) than girls (17.7%). The risk of being malnourished increases significantly with increasing number of own siblings, low educational status of mother, improper food intake, etc. Multi-pronged strategies are required to implement comprehensive nutrition–education programme for improving dietary habits among children.
Effectiveness of a Mindfulness-Based Retreat on Distress and Well-Being in Bereaved Parents
Authors: Thieleman Kara , Cacciatore Joanne
Published: May 2020

Purpose:

This study evaluated the effectiveness of a grief-focused mindfulness-based retreat on psychological distress (trauma, anxiety, and depression) and well-being (mindfulness and self-compassion) in bereaved parents.

Method:

A quasi-experimental design with two nonequivalent groups (intervention, comparison) and three observations was used.

Results:

Mixed-model repeated-measures analysis of variance showed significant reductions in distress at posttest in the intervention group, with significant group differences on four of the seven scales. While reductions were maintained at follow-up, group differences were only significant for one trauma subscale. The intervention group showed significant increases in two of the four mindfulness facets (describe and act with awareness) and self-compassion at posttest, although group differences were not significant and gains were not maintained at follow-up. A third mindfulness facet, nonjudge, increased significantly at follow-up, with significant group differences.

Discussion:

This approach shows promise for reducing some areas of distress and improving the nonjudging mindfulness facet in bereaved parents.
Robust approximate constraint-following control design for permanent magnet linear motor and experimental validation
Authors: Huang Kang , Wang Mianhao , Sun Hao , Zhen Shengchao
Published: May 2020

A robust approximate constraint-following control method based on the fundamental equation of Udwadia–Kalaba approach is designed to control the permanent magnet linear motor. The control scheme consists of three parts: the nominal part to suppress any tendency of deviating from the constraints, the second part to deal with any possible initial condition deviation from the constraint manifold and drive the system toward the constraints, and the robust part to compensate for the effect due to uncertainty. Theoretical proof, numerical simulation, and experimental validation have been done to verify the effectiveness of this control method.
Vascular access in COVID-19 patients: Smart decisions for maximal safety
Authors: Scoppettuolo Giancarlo , Biasucci Daniele Guerino , Pittiruti Mauro
Published: May 2020

The 2020 COVID pandemic has forced everyone to update the usual medical procedures and adapt them to a new situation characterized by a high risk of contamination of the health operator. The placement of a venous access device is no exception. In the experience of the vascular access team of our hospital, hit by the COVID epidemic in March 2020, the safety of both the patient and the staff can be ensured by an insertion bundle of few smart strategies, which include choice of long dwelling peripheral catheters (midline catheters) rather than short venous cannulas; use of power injectable peripherally inserted central catheters in the COVID patients in intensive care unit requiring a central line; use of wireless probes—easy to carry, easy to clean—for ultrasound guided venipuncture; avoidance of x-rays, using alternative methods for tip location such as intracavitary electrocardiography or trans-thoracic echocardiography; strict adoption of the barrier precautions recommended by the international guidelines.