bluuebunny/crossref_metadata_2025 huggingface dataset:
Shock tube experimental studies on the ignition delay of n-heptane/ethanol fuel blends with acetaldehyde (CH3CHO) and oxynitride (NO/NO2) additives
Authors: Yang Can , Li Yuhang , Wang Weiye , Cheng Xiaobei
Published: March 2022

In recent studies around low-temperature combustion (LTC) engines, it has been found that the incomplete oxidation products (IOP) within exhaust gas recirculation (EGR) presents non-negligible chemical effects. However, IOP generally has complex ingredients, and little literature available conducts quantitative and comparative studies on the effects of these ingredients. In this paper, CH3CHO, which is considerably abundant, and NO, which is most active, are selected as typical ingredients of IOP, and their effects on ignition delay times of n-heptane/ethanol fuel blends are studied experimentally in a shock tube covering the equivalence ratios of 0.5, 1, 1.5, temperature range of 900–1200 K, and pressure of 10 atm. Experimental results show that both CH3CHO and NO/NO2 (part of NO is inevitably converted to NO2) promote ignition, and the promoting effect of NO/NO2 is stronger than CH3CHO . It is consistent for both CH3CHO and NO/NO2 that the higher the concentration or, the lower the equivalence ratio, the greater the promoting effect. The difference is that the promoting effect of CH3CHO weakens with temperature increasing, while the promoting effect of NO/NO2 strengthens. Besides, the promoting effect of NO2 is weaker than that of NO, and NO2 even begins to inhibit ignition at temperatures below 960 K. In addition, it follows chemical kinetic analysis that both CH3CHO and NO/NO2 accelerate the decomposition of fuel by producing more OH radicals during the ignition stage. Although the additives are in trace amounts, the OH produced by their early involvement in reactions can effectively accelerate the ignition, which indicates the non-negligible chemical effects of IOP in EGR.
Drawing the researcher into data: drawing as an analytical tool in qualitative research
Authors: Jellema Pleuntje , Annemans Margo , Heylighen Ann
Published: March 2022

In qualitative research, visual methods often entail engaging with images as the subject of analysis. Yet, images may be of value also as a means of analysis. This article reflects on this analytical value in relation to drawings. To this end, the authors explore drawings made by researchers in various phases of qualitative research. Drawings made ‘in the margin’ are put centre stage to better understand their role in data analysis. They allow revisiting situations; and they supplement the audio-to-text act of transcribing. Actively drawing involves and stimulates a sensory engagement with the phenomena under study and the data. Drawings furthermore play an important role in arranging and re-arranging concepts when formulating conclusions. Examples highlight how researchers may explicitly incorporate drawing in data analysis to harness the potential of a multisensory skill set and engage with transcribing in new ways.
Exploring protest tourism motivations: The case of Hong Kong
Authors: Shim Changsup , Park Yae-Na , Lee Choong-Ki , Sik Kim Young , Michael Hall Colin
Published: March 2022

Protest tourism is visiting a destination with the major aim of viewing or participating in protests. This qualitative study examined the motivations of Hong Kong protest tourists as a starting point for future exploration of distinctions between this emerging type of tourism and other existing categories. Five primary motivations were revealed. Two push motivations were the desire to (1) have special, new experiences that few others have experienced; and (2) experience tourist offerings first-hand. Three pull motivations were created by sites providing tourists the opportunity to (i) see a one-time historical event; (ii) share the moment with local citizens, even if indirectly; and (iii) experience real-time events with a local guide. The findings point to unique temporal and geographic aspects of the interplay between protest tourist motivations and the unique merging of the subject and object of tourism, shedding light on how different tourism experiences can be framed.
What will happen to my mom? A grounded theory on nurses’ support of relatives’ end-of-life decision-making process for residents living with dementia in long-term care homes
Authors: Daneau Stéphanie , Bourbonnais Anne , Legault Alain
Published: March 2022

Background

Relatives of an older person living in a long-term care home with advanced-stage dementia must often make important and difficult decisions, including ones that impact the resident’s end-of-life. Healthcare professionals must support them in this decision-making process. The aim of this study was to propose a theory on nurses’ support of relatives who make end-of-life decisions for a resident living with dementia in a long-term care home.

Method

A constructivist grounded theory approach was used, with a theoretical sample of nine nurses and 10 relatives whom we met for face-to-face interviews. Three documents on end-of-life care, which were available in the study setting, were also included. The analysis was carried out using the method proposed by Charmaz.

Findings

The findings highlight the importance of building a strong and trusting relationship between nurses and relatives. Furthermore, exploring the refusal of palliative or end-of-life care, supporting relatives’ need to witness firsthand the condition of the person living with dementia, and education at a “good” time are useful interventions that nurses can make to support relatives’ decision-making.

Conclusion

Better support of relatives in end-of-life decision-making improves the well-being of relatives and older people living with dementia alike.
Heterogeneous data fusion for the improved non-destructive detection of steel-reinforcement defects using echo state networks
Authors: Wootton Adam J , Day Charles R , Haycock Peter W
Published: March 2022

The degradation of roads is an expensive problem: in the United Kingdom alone, £27 billion was spent on road repairs between 2013 and 2019. One potential cost-saver is the early, non-destructive detection of faults. There are many available techniques, each with its own benefits and drawbacks. This paper builds upon the successful processing of magnetic flux leakage (MFL) data by echo state networks (ESNs) for damage diagnostics, by augmenting ESNs with the depth of concrete cover as part of a data fusion approach. This fusion-based ESN outperformed a number of non-fusion ESN comparators and a previously used analytical technique. Additionally, the fusion ESN had an optimal threshold value whose standard deviation was three times smaller than that of the nearest alternative technique, potentially prompting a move towards automated defect detection in ‘real-world’ applications.
Indigenous Women’s Experiences of Lateral Violence: A Systematic Literature Review
Authors: Jaber Lindsey , Stirbys Cynthia , Scott Jesse , Foong Emma
Published: March 2022

The purpose of this systematic literature review (SLR) was to methodically integrate peer-reviewed findings regarding lateral violence within Indigenous communities, with particular attention to the experiences of Indigenous women. Lateral violence describes aggression within systemically exploited groups. Interpretations from eligible articles were informed by intersectionality theory and post-colonial theory. Eligibility criteria included quantitative and qualitative peer-reviewed articles on lateral violence within Indigenous communities. Only articles that were primary sources, available to download in English, and published between 2000 and 2021 were included. Samples did not need to consist of Indigenous women exclusively, but Indigenous women had to be included. First, advanced searches were conducted in five databases (Academic Search Complete, PsycINFO, Indigenous Peoples: North America, ProQuest: Sociology Collection, and ERIC). Second, a multidisciplinary index (Google Scholar) was searched. Third, 23 peer-reviewed journals specializing in Indigenous topics were systematically searched. Lastly, forward and backward snowballing techniques were implemented. Articles were appraised following PRISMA-P guidelines. Ten articles passed the eligibility criteria. Findings suggest that lateral violence within Indigenous communities is a complex social concern, with participants disclosing both survivorship and contribution to lateral violence. Within Australian and Canadian contexts, lateral violence experiences are prevalent and persistent occurrences. Lateral violence is a controversial and taboo topic and is often silenced or normalized within Indigenous communities. For this reason, further research is warranted to raise awareness of lateral violence to disrupt the cycle of internalized oppression.
Performance analysis of socks produced by auxetic yarns for protective applications
Authors: Khalid Rida , Jamshaid Hafsa , Mishra Rajesh , Ma Pibo , Zhu Guocheng
Published: March 2022

The present work reports application of auxetic yarns in development of abrasion resistant socks which can be used for better serviceability without shoes even on rough surfaces. Socks used in the current research were produced by using helical auxetic yarns which consist of different combinations of high performance and conventional materials e.g. Kevlar P-AR (para-aramid), cotton, elastomeric yarn, polyamide (PA6) and polyester with same linear density of 74 Tex. Three different types of fabrics were produced e.g. flat knit, sandwich half terry short and sandwich half terry long. For investigating the auxeticity, all samples were subjected to tensile loading and the resulting change in their thickness was measured. Abrasion resistance and other comfort related properties e.g. air permeability, vertical wicking and absorbency were also evaluated. The influence of different yarn combinations, twist levels and fabric types on abrasion resistance and breathability of socks were investigated by using fractional (half) factorial design. Statistical analysis was performed for the obtained results by using analysis of variance. Conventional socks samples were also produced in all fabric types for comparison with the auxetic materials. From the results it was concluded that the overall abrasion resistance of auxetic yarn-based sock is higher than conventional cotton sock. Results also revealed that abrasion resistance was increased by 46% in flat knit socks sample, 50% in sandwich half terry short sample and 58% in sandwich half terry long sample as compared to conventional cotton sock. In addition to this all the socks samples exhibited good comfort/breathability properties.
Driving Errors Predicting Pass/Fail On-Road Assessment Outcomes Among Cognitively Impaired Older Drivers
Authors: Krasniuk Sarah , Mychael Diane , Crizzle Alexander M.
Published: March 2022

Older drivers with cognitive impairment (CI)/dementia make significantly more driving errors than healthy controls; however, whether driving errors are predictive of pass/fail outcomes in older drivers with CI/dementia are unclear. This study determined the driving errors that predicted failing an on-road assessment in drivers with CI. We retrospectively collected comprehensive driving evaluation data of 80 participants (76.1 ± 9.3 years) from an Ontario driving assessment center. Adjustment to stimuli (area under the curve [AUC] = 0.88), lane maintenance (AUC = 0.84), and speed regulation errors (AUC = 0.85) strongly predicted pass/fail outcomes. Worse performance on the Trails B (time) and Useful Field of View® (Subtest 2, Subtest 3, and risk index) were significantly correlated with adjustment to stimuli ( p < .05), lane maintenance ( p < .05), and speed regulation errors ( p < .05). Adjustment to stimuli, lane maintenance, and speed regulation errors may be critical indicators of failing an on-road assessment in older drivers with CI. Prioritizing these errors may help identify at-risk drivers.
Stroke Rehabilitation: Recent Progress and Future Promise
Authors: Skidmore Elizabeth R. , Shih Minmei
Published: March 2022

Significant advancements in acute stroke medical management have changed stroke rehabilitation. In addition, an ever-changing health care ecosystem and heightened awareness of continued and new challenges requires that the occupational therapy profession consider new, innovative, and pragmatic approaches to measurement, intervention, and health services research, and clinical practice. The profession must elevate the focus and rigor of research examining occupation and participation after stroke, and their associations with health. Intervention research must progress beyond early phase pilot studies to a robust collection of meaningful large multisite studies that demonstrate the effectiveness of our interventions and the effectiveness of wide-scale implementation to ensure quality and consistent delivery of evidence-based practices in occupational therapy. These studies must address the accessibility of these practices for all people who have sustained stroke, and particularly those people who are most vulnerable to inaccessible stroke rehabilitation service delivery systems.
Differential Effects of Speech and Language Therapy and rTMS in Chronic Versus Subacute Post-stroke Aphasia: Results of the NORTHSTAR-CA Trial
Authors: Zumbansen Anna , Kneifel Heike , Lazzouni Latifa , Ophey Anja , Black Sandra E. , Chen Joyce L. , Edwards Dylan , Funck Thomas , Hartmann Alexander Erich , Heiss Wolf-Dieter , Hildesheim Franziska , Lanthier Sylvain , Lespérance Paul , Mochizuki George , Paquette Caroline , Rochon Elizabet , Rubi-Fessen Ilona , Valles Jennie , Wortman-Jutt Susan , Thiel Alexander ,   on behalf of the NORTHSTAR-study group
Published: March 2022

Background & objective

Contralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5–45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chronic aphasia (>6 months post-stroke) designed to compare the effectiveness of the same rTMS protocol in both phases.

Methods

Sixty-seven patients with left middle cerebral artery infarcts (28 chronic, 39 subacute) were recruited (01-2014 to 07-2019) and randomized to receive rTMS (N = 34) or sham stimulation (N = 33) with SLT for 10 days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment. Chronic and subacute results were compared.

Results

Adverse events were rare, mild, and did not differ between groups. Language outcomes improved significantly in all groups irrespective of treatment and recovery phase. At 30-day follow-up, there was a significant interaction of stimulation and recovery phase on naming recovery ( P <.001). Naming recovery with rTMS was larger in subacute (Mdn = 1.91/IQR = .77) than chronic patients (Mdn = .15/IQR = 1.68/ P = .015). There was no significant rTMS effect in the chronic aphasia group.

Conclusions

The addition of rTMS to SLT led to significant supplemental gains in naming recovery in the subacute phase only. While this needs confirmation in larger studies, our results clarify neuromodulatory vs training-induced effects and indicate a possible window of opportunity for contralesional inhibitory stimulation interventions in post-stroke aphasia.

NORTHSTAR trial registration

https://clinicaltrials.gov/ct2/show/NCT02020421 .
Wireless power transfer and energy harvesting in distributed sensor networks: Survey, opportunities, and challenges
Authors: Ijemaru Gerald K , Ang Kenneth Li-Minn , Seng Jasmine KP
Published: March 2022

Distributed sensor networks have emerged as part of the advancements in sensing and wireless technologies and currently support several applications, including continuous environmental monitoring, surveillance, tracking, and so on which are running in wireless sensor network environments, and large-scale wireless sensor network multimedia applications that require large amounts of data transmission to an access point. However, these applications are often hampered because sensor nodes are energy-constrained, low-powered, with limited operational lifetime and low processing and limited power-storage capabilities. Current research shows that sensors deployed for distributed sensor network applications are low-power and low-cost devices characterized with multifunctional abilities. This contributes to their quick battery drainage, if they are to operate for long time durations. Owing to the associated cost implications and mode of deployments of the sensor nodes, battery recharging/replacements have significant disadvantages. Energy harvesting and wireless power transfer have therefore become very critical for applications running for longer time durations. This survey focuses on presenting a comprehensive review of the current literature on several wireless power transfer and energy harvesting technologies and highlights their opportunities and challenges in distributed sensor networks. This review highlights updated studies which are specific to wireless power transfer and energy harvesting technologies, including their opportunities, potential applications, limitations and challenges, classifications and comparisons. The final section presents some practical considerations and real-time implementation of a radio frequency–based energy harvesting wireless power transfer technique using Powercast™ power harvesters, and performance analysis of the two radio frequency–based power harvesters is discussed. Experimental results show both short-range and long-range applications of the two radio frequency–based energy harvesters with high power transfer efficiency.
Posterior Approach With Small Incision Is a Safe Alternative to Anterior Approach for Hamstring Autograft Harvest in Adolescents
Authors: Aitchison Alexandra H. , Schlichte Lindsay M. , Heath Madison R. , Fabricant Peter D. , Green Daniel W.
Published: March 2022

Background:

There are potential drawbacks and complications associated with using the anterior approach to harvest the hamstring tendon as an autograft source for anterior cruciate ligament (ACL) and medial patellofemoral ligament (MPFL) reconstruction. A posterior harvest technique has been described as an alternative to an anterior approach in skeletally mature patients. The 2 approaches have not been compared in adolescents.

Purpose:

We sought to compare the incision size and harvested tendon length produced by anterior and posterior hamstring harvest techniques in an adolescent population.

Methods:

After obtaining consent, we prospectively collected data on a consecutive series of 115 adolescents undergoing ACL or MPFL reconstruction, including the length of the incision and of the harvested hamstring tendon. Demographic information including age, sex, and body mass index (BMI) was collected at the time of surgery.

Results:

The mean age at the time of surgery was 14.3 ± 1.8 years (range: 9–21 years), and 43% (N = 50) of participants were male. Of the 115 hamstring autografts, 26 were harvested anteriorly and 89 were harvested posteriorly. Neither mean semitendinosus length nor mean gracilis length was significantly different when harvested anteriorly versus posteriorly. The posterior harvest group had a mean incision length that was significantly smaller than that of the anterior harvest group. No iatrogenic nerve injuries or neurovascular complications were observed in either group.

Conclusion:

A posterior incision for hamstring autograft harvest provided an alternative approach in adolescents, which resulted in a 20% smaller incision than an anterior approach. For procedures such as MPFL reconstruction that do not require concomitant anteromedial work, posterior hamstring harvest may be used to improve cosmesis while producing viable hamstring autograft tissue for surgical reconstruction.
Using Repertory Grids as a Tool for Mixed Methods Research: A Critical Assessment
Authors: Hadley Gregory , Grogan Myles
Published: March 2022

When used in an informed and careful manner, the repertory grid technique offers mixed methods researchers a way to quickly gain a deeper understanding of their participants’ concerns, issues, and worldviews. This paper critically assesses the potential contributions of the repertory grid technique when used in mixed methods research. After providing a background survey and description of this relatively little-known research instrument, the strengths and limitations of repertory grids are considered. This report discusses some of the ways that this technique can significantly enhance the quality of the data collected from research participants within the three core models of the mixed method design framework.
Establishment of a clinical nurse specialist-led, virtual aneurysm surveillance clinic
Authors: Bourke M , Williams N , Dowdall J , Barry MC
Published: March 2022

Background

The COVID-19 pandemic has necessitated significant changes to the manner in which healthcare is delivered. Chief among these has been the need to rapidly adopt virtual, or telephone clinics as a means of reducing unnecessary patient exposure to hospitals and clinical care settings. We were greatly aided in our adoption of virtual clinics by our experience in the establishment and maintenance of a Clinical Nurse Specialist-led, virtual clinic for both abdominal aortic (AAA) and extra-aortic aneurysm (EAA) surveillance within our department since 2016. Patients undergoing surveillance for abdominal aortic aneurysm (AAA) require frequent and lifelong clinical review. Previous studies have shown that post-operative surveillance in particular is critical in prolonging survival in AAA patients and in the early detection of late complications particularly following endovascular repair (EVAR). Poor compliance with EVAR surveillance has been shown to result in worse outcomes

Aim

The aim of this study was to evaluate the success of a nurse-led virtual clinic programme in terms of the safe management of patients undergoing AAA surveillance in a nurse-led virtual clinic.

Results

Over the course of the 4-year period from 2016 to 2019, 1352 patients were enrolled in the virtual aneurysm surveillance clinic. The majority of patients each year were male, ranging from 78.2% in 2016 to 85.2% in 2017. The majority of patients encountered the service owing to pre-operative surveillance of an AAA, with this group comprising at least 65% of the total cohort of patients each year. Over the course of the 4-year period of the virtual clinic there were 1466 patient encounters. Each ambulatory day care centre (ADCC) attendance normally costs the hospital €149. Therefore, a total saving of €218,434 resulted from this initiative alone. No patient presented as an emergency with a ruptured aneurysm during the time period studied.

Conclusion

Patients with AAA can be safely kept under surveillance in a nurse-led virtual clinic. Our experience with this model of care proved to be particularly advantageous during the period of the early COVID-19 pandemic.
Eptifibatide bridging therapy for staged carotid artery stenting and cardiac surgery: Safety and feasibility
Authors: Caton M Travis , Narsinh Kazim H , Baker Amanda , Amans Matthew R , Hetts Steven W , Rapp Joseph H , Ianuzzi James C , Tseng Elaine , Gasper Warren J , Cooke Daniel L
Published: March 2022

Background

Prophylactic carotid artery stenting (CAS) is an effective strategy to reduce perioperative stroke in patients with severe carotid stenosis who require cardiothoracic surgery (CTS). Staging both procedures (CAS-CTS) during a single hospitalization presents conflicting demands for antiplatelet therapy and the optimal pharmacologic strategy between procedures is not established. The purpose of this study is to present our initial experience with a “bridging” protocol for staged CAS-CTS.

Methods

A retrospective review of staged CAS-CTS procedures at a single referral center was performed. All patients had multivessel coronary and/or valvular disease and severe carotid stenosis (>70%). Patients not previously on aspirin were also started on aspirin prior to surgery, followed by eptifibatide during CAS (intraprocedural bolus followed by post-procedural infusion which was continued until the morning of surgery). Pre- and perioperative (30 days) neurologic morbidity and mortality was the primary endpoint.

Results

11 CAS procedures were performed in 10 patients using the protocol. The median duration of eptifibatide bridge therapy was 36 h (range 24–288 h). There was one minor bleeding complication (1/11, 9.1%) and no major bleeding complications during the bridging and post-operative period. There was one post-operative, non-neurologic death and zero perioperative ischemic strokes.

Conclusions

For patients undergoing staged CAS-CTS, Eptifibatide bridging therapy is a viable temporary antiplatelet strategy with a favorable safety profile. This strategy enables a flexible range of time-intervals between procedures.
Teachers’ perceptions and strategies in the development of intercultural communicative competence: The case of international school teachers in Iran
Authors: Estaji Masoomeh , Tabrizi Sarvenaz
Published: March 2022

This study explored international school teachers’ views and experiences on how the teachers’ and students’ intercultural communicative competence perceptions could be developed. In the study, nine teachers working in international schools in Iran were selected through purposive sampling to be part of a semi-structured interview. The interview questions were designed by the researchers, drawing on Yildiz’s (2016) and Zhou’s (2011) checklists. Based on the results, teachers found being knowledgeable about other cultures, flexible, and open-minded as significant elements for developing the teachers’ intercultural communicative competence. Teachers also referred to the school’s curriculum and the student’s life experiences as the most influential factors in developing the students’ ability to communicate effectively.
Predictors of clinically significant prostate cancer in biopsy-naïve and prior negative biopsy men with a negative prostate MRI: improving MRI-based screening with a novel risk calculator
Authors: van Riel Luigi A.M.J.G. , Jager Auke , Meijer Dennie , Postema Arnoud W. , Smit Ruth S. , Vis André N. , de Reijke Theo M. , Beerlage Harrie P. , Oddens Jorg R.
Published: March 2022

Purpose:

A pre-biopsy decision aid is needed to counsel men with a clinical suspicion for clinically significant prostate cancer (csPCa), despite normal prostate magnetic resonance imaging (MRI).

Methods:

A risk calculator (RC) for csPCa (International Society of Urological Pathology grade group (ISUP) ⩾ 2) presence in men with a negative-MRI (Prostate Imaging–Reporting and Data System (PI-RADS) ⩽ 2) was developed, and its performance was compared with RCs of the European Randomized Study of Screening for Prostate Cancer (ERSPC), Prostate Biopsy Collaborative Group (PBCG), and Prospective Loyola University mpMRI (PLUM). All biopsy-naïve and prior negative biopsy men with a negative-MRI followed by systematic prostate biopsy were included from October 2015 to September 2021. The RC was developed using multivariable logistic regression with the following parameters: age (years), family history of PCa (first- or second-degree family member), ancestry (African Caribbean/other), digital rectal exam (benign/malignant), MRI field strength (1.5/3.0 Tesla), prior negative biopsy status, and prostate-specific antigen (PSA) density (ng/ml/cc). Performance of RCs was compared using receiver operating characteristic (ROC) curve analysis.

Results:

A total of 232 men were included for analysis, of which 18.1% had csPCa. Parameters associated with csPCa were family history of PCa ( p < 0.0001), African Caribbean ancestry ( p = 0.005), PSA density ( p = 0.002), prior negative biopsy ( p = 0.06), and age at biopsy ( p = 0.157). The area under the curve (AUC) of the developed RC was 0.76 (95% CI 0.68–0.85). This was significantly better than the RCs of the ERSPC (AUC: 0.59; p = 0.001) and PBCG (AUC: 0.60; p = 0.002), yet similar to PLUM (AUC: 0.69; p = 0.09).

Conclusion:

The developed RC (Prostate Biopsy Cohort Amsterdam (‘PROBA’ RC), integrated predictors for csPCa at prostate biopsy in negative-MRI men and outperformed other widely used RCs. These findings require external validation before introduction in daily practice.
Are we closer to being able to select patients with node-positive hormone receptor-positive breast cancer who can safely omit chemotherapy?
Authors: Taylor Caitlin , Meisel Jane , Kalinsky Kevin
Published: March 2022

The treatment of hormone receptor-positive, HER2-negative breast cancer has become increasingly individualized, thanks to the development of genomic testing. Gene expression assays provide clinicians and patients with both prognostic and predictive information regarding breast cancer recurrence risk and potential benefit of chemotherapy. While the ability to tailor therapy based on clinicopathologic and genomic factors has enabled a growing number of women to forego chemotherapy, several questions remain regarding how best to apply genomic assay results across varying subgroups of women. Here, we review the role of genomic assays for patients with both lymph node-negative and lymph node-positive breast cancer, and how these assays may help us more precisely select patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer with or without lymph node involvement who can safely omit chemotherapy in the future.
Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes: One-Year Results From the SENCE Study
Authors: Van Name Michelle A. , Kanapka Lauren G. , DiMeglio Linda A. , Miller Kellee M. , Albanese-O’Neill Anastasia , Commissariat Persis , Corathers Sarah D. , Harrington Kara R. , Hilliard Marisa E. , Anderson Barbara J. , Kelley Jennifer C. , Laffel Lori M. , MacLeish Sarah A. , Nathan Brandon M. , Tamborlane William V. , Wadwa R. Paul , Willi Steven M. , Williams Kristen M. , Wintergerst Kupper A. , Woerner Stephanie , Wong Jenise C. , DeSalvo Daniel J.
Published: March 2022

Objectives:

Achieving optimal glycemic outcomes in young children with type 1 diabetes (T1D) is challenging. This study examined the durability of continuous glucose monitoring (CGM) coupled with a family behavioral intervention (FBI) to improve glycemia.

Study Design:

This one-year study included an initial 26-week randomized controlled trial of CGM with FBI ( CGM+FBI) and CGM alone ( Standard-CGM) compared with blood glucose monitoring (BGM), followed by a 26-week extension phase wherein the BGM Group received the CGM+FBI ( BGM-Crossover) and both original CGM groups continued this technology.

Results:

Time in range (70-180 mg/dL) did not improve with CGM use (CGM+FBI: baseline 37%, 52 weeks 41%; Standard-CGM: baseline 41%, 52 weeks 44%; BGM-Crossover: 26 weeks 38%, 52 weeks 40%). All three groups sustained decreases in hypoglycemia (<70 mg/dL) with CGM use (CGM+FBI: baseline 3.4%, 52 weeks 2.0%; Standard-CGM: baseline 4.1%, 52 weeks 2.1%; BGM-Crossover: 26 weeks 4.5%, 52 weeks 1.7%, P-values <.001). Hemoglobin A1c was unchanged with CGM use (CGM+FBI: baseline 8.3%, 52 weeks 8.2%; Standard-CGM: baseline 8.2%, 52 weeks 8.0%; BGM-Crossover: 26 weeks 8.1%, 52 weeks 8.3%). Sensor use remained high (52-week study visit: CGM+FBI 91%, Standard-CGM 92%, BGM-Crossover 88%).

Conclusion:

Over 12 months young children with T1D using newer CGM technology sustained reductions in hypoglycemia and, in contrast to prior studies, persistently wore CGM. However, pervasive hyperglycemia remained unmitigated. This indicates an urgent need for further advances in diabetes technology, behavioral support, and diabetes management educational approaches to optimize glycemia in young children.
Determining Losses in Jet Injection Subcutaneous Insulin Delivery: A Model-Based Approach
Authors: McHugh Alexander D. , Chase J. Geoffrey , Knopp Jennifer L. , Zhou Tony , Holder-Pearson Lui
Published: March 2022

Objective:

Accurate, safe glycemic management requires reliable delivery of insulin doses. Insulin can be delivered subcutaneously for action over a longer period of time. Needle-free jet injectors provide subcutaneous (SC) delivery without requiring needle use, but the volume of insulin absorbed varies due to losses associated with the delivery method. This study employs model-based methods to determine the expected proportion of active insulin present from a needle-free SC dose.

Methods:

Insulin, C-peptide, and glucose assay data from a frequently sampled insulin-modified oral glucose tolerance test trial with 2U SC insulin delivery, paired with a well-validated metabolic model, predict metabolic outcomes for N = 7 healthy adults. Subject-specific nonlinear hepatic clearance profiles are modeled over time using third-order basis splines with knots located at assay times. Hepatic clearance profiles are constrained within a physiological rate of change, and relative to plasma glucose profiles. Insulin loss proportions yielding optimal insulin predictions are then identified, quantifying delivery losses.

Results:

Optimal parameter identification suggests losses of up to 22% of the nominal 2U SC dose. The degree of loss varies between subjects and between trials on the same subject. Insulin fit accuracy improves where loss greater than 5% is identified, relative to where delivery loss is not modeled.

Conclusions:

Modeling shows needle-free SC jet injection of a nominal dose of insulin does not necessarily provide metabolic action equivalent to total dose, and this availability significantly varies between trials. By quantifying and accounting for variability of jet injection insulin doses, better glycemic management outcomes using SC jet injection may be achieved.
Treatment of Persistent Post-traumatic Diplopia – An Algorithmic Approach to Patient Stratification and Operative Management
Authors: Reddy Sashank K. , Colakoglu Salih , Yoon Joshua S. , Bhoopalam Myan , Merbs Shannath L. , Manson Paul N. , Grant Michael P.
Published: March 2022

Study Design

Retrospective chart review of revisional orbital surgery outcomes in patients with diplopia from prior operative treatment of orbital trauma.

Objective

Our study seeks to review our experience with management of persistent post-traumatic diplopia in patients with previous orbital reconstruction and present a novel patient stratification algorithm predictive of improved outcomes.

Methods

A retrospective chart review was performed on adult patients at Wilmer Eye Institute at Johns Hopkins Hospital and at the University of Maryland Medical Center who underwent revisional orbital surgery for correction of diplopia for the years 2005–2020. Restrictive strabismus was determined by Lancaster red-green testing coupled with computed tomography and/or forced duction. Globe position was assessed by computed tomography. Seventeen patients requiring operative intervention according to study criteria were identified.

Results

Globe malposition affected fourteen patients and restrictive strabismus affected eleven patients. In this select group, improvement in diplopia occurred in 85.7% of cases with globe malposition and in 90.1% of cases with restrictive strabismus. One patient underwent additional strabismus surgery subsequent to orbital repair.

Conclusions

Post-traumatic diplopia in patients with prior orbital reconstruction can be successfully managed in appropriate patients with a high degree of success. Indications for surgical management include (1) globe malposition and (2) restrictive strabismus. High resolution computer tomography and Lancaster red-green testing discriminate these from other causes that are unlikely to benefit from orbital surgery.
Fragment response of unreinforced concrete masonry walls subjected to blast loading
Authors: Hatfield John E , Pezzola Genevieve L , Walker Robert E , Stephens Catherine S , Davidson James S
Published: March 2022

Very few methods are available for predicting the secondary fragment velocity and secondary fragment production of ungrouted and nonreinforced concrete masonry unit (UGNR CMU) walls when subjected to blast loading. Existing approaches often require large computational resources or fail to predict secondary fragment velocity accurately. This paper presents an engineering-level analysis methodology that can be rapidly implemented to predict the velocity of fragments from UGNR CMU walls subjected to blast loading. The theoretical background and need for the methodology are discussed. Results from the analytical methodology are compared to results from two full-scale experiments and four quarter-scale experiments. A strong correlation is demonstrated between the experimental results and the analytical methodology.
A cocreational approach to nation branding: The case of Chile
Authors: Miño Pablo , Austin Lucinda
Published: March 2022

This case study examines Marca Chile’s nation branding campaign “Chile Que te Quiero” (Chile, I Really Love You). The campaign, that ran between 2016 and 2018, aimed to facilitate dialogue among Chileans around their shared national symbols, traditions, and cultural artifacts to cocreate meaning around their nation brand. In this article, we propose that professionals working in nation branding campaigns should act as facilitators of dialogue among different publics within a country to find points of convergence and divergence around what constitutes the identity of their nation. The key role of dialogue and cocreation of meaning within public relations scholarship is explored.
Utilization of youth-friendly reproductive health service and associated factors among youth in Aleta Wondo town, southern Ethiopia, 2020
Authors: Amaje Elias , Daniel Eyasu , Tefera Kebede , Sirage Nurye
Published: March 2022

Background:

Youth faces various sexual and reproductive health problems in developing countries like Ethiopia. Major health problems like unintended pregnancy, unsafe abortion, and sexually transmitted infections are common among youth in Ethiopia. This study aimed to determine the level of utilization of youth-friendly reproductive health services and associated factors among youth in Aleta Wondo town, southern Ethiopia, from 20 to 30 June 2020.

Methods:

A community-based cross-sectional study was conducted among youths of Aleta Wondo town from 20 to 30 June 2020. A total of 421 study participants were selected from households of selected kebeles in the town by using a systematic random sampling method. Data were collected using structured pretested face-to-face interviewer-administered questionnaires. The data were entered using Epi-data version 4.4.2 and exported to SPSS version 25 for analysis. Bivariate and multivariate logistic regression models were used to determine factors significantly associated with the utilization of youth-friendly reproductive health services. Adjusted odds ratio and 95% confidence interval with p value of <0.05 were considered to declare statistical significance.

Results:

The level of utilization of youth-friendly reproductive health services was 32.8% (95% confidence interval = 28.0%–37.0%). Youth-friendly service utilization was significantly associated with being female gender (adjusted odds ratio = 2.20, 95% confidence interval = 1.34–3.62), living alone (adjusted odds ratio = 2.99, 95% confidence interval = 1.48–5.77), who had not ever discussed with their parents (adjusted odds ratio = 0.46, 95% confidence interval = 0.27–0.81), have visited service required and missed service (adjusted odds ratio = 1.96, 95% confidence interval = 1.19–3.24), and have sexual partner (adjusted odds ratio = 4.52, 95% confidence interval = 2.75–7.44).

Conclusion:

Youth-friendly reproductive health service utilization among youth Aleta Wondo town was low. Factors like gender, current living place, have ever discussed in reproductive health issues with their parents, have visited health facility and missed service, and having sexual partner were predictors of youth-friendly service utilization. It is better to work in collaboration with youth clubs and schoolteachers to scale up youth-friendly service.
The Challenges of Diagnosing Nondilated Obstructive Uropathy: A Case Report
Authors: Shahzad Muhammad Asim , Baxi Pravir V. , Rodby Roger A.
Published: March 2022

Rationale:

Nondilated obstructive uropathy (NDOU) is a rare cause of acute renal failure reported in less than 5% of cases of obstructive uropathy. It is typically associated with intrapelvic malignancies and diseases causing retroperitoneal lymphadenopathy and retroperitoneal fibrosis. As these conditions may prevent radiographic dilation of the collecting system, the diagnosis of NDOU may be missed by usual diagnostic testing.

Presenting concerns of the patient:

We present a case of acute anuric renal failure in a middle-aged woman with metastatic breast cancer associated with abdominal and retroperitoneal lymphadenopathy. Acute kidney injury was initially deemed secondary to drug-induced acute tubular necrosis (ATN) from bisphosphonate; however, there remained a high clinical suspicion of NDOU due to the presence of enlarged retroperitoneal lymph nodes on CT abdomen and pelvis with concerns for encasement of bilateral renal pelvic regions and ureters.

Diagnoses:

The patient underwent a retrograde pyelogram which demonstrated questionable narrowing bilaterally at the level of the renal pelvices. This led to an even stronger clinical suspicion of NDOU and urology service was consulted for evaluation.

Intervention:

Bilateral ureteral stents were placed by urology which led to robust urine output and rapid reversal of renal failure over the next 24 to 48 hours.

Outcomes:

Despite 2 weeks of anuria and hemodialysis, this patient’s creatinine came back to her baseline. She was able to discontinue hemodialysis and her creatinine stabilized at 88.4 μmol/L (1 mg/dL).

Teaching points:

Nondilated obstructive uropathy is rare but important diagnosis that requires a high clinical suspicion in the appropriate clinical scenario. The lack of dilatation is believed to be related to encasement of the collecting system by tumor, fibrosis, or as in our case metastatic retroperitoneal lymphadenopathy. As this diagnosis cannot be overlooked, aggressive direct visualization or even intervention with internal or external stenting may be required to both diagnose and treat this condition.
Unexplained Gait and Balance Changes: A Case Report of Myxoma Mitigation in a Breast Reduction Patient
Authors: Clements Madison A. , Gallagher Susan , Herrmann Glenn E.
Published: March 2022

In Fall 2020, a female physical therapist (PT) developed mild changes in gait, infrapatellar tendon pain, and lateral patellar tracking. As a PT in good physical condition, she did not access her employer’s occupational health clinic but instead she self-treated. Two months after symptom onset and self-treatment, she was diagnosed with an intramuscular myxoma within her left vastus lateralis, the largest muscle within the quadricep. The employee was at risk of slips, trips, and falls as the mass grew. Due to the location and increasing size of the mass, the employee required surgical treatment. Healthcare workers, particularly those who provide treatment, are likely to self-treat rather than seek assistance from the occupational health professional. The employee was seen by a plastic surgeon for an unrelated medical condition which is when the myxoma was diagnosed. Further delay may have led to occupational injury associated with the balance and gait disturbances. Opportunity exists for the occupational health professional to provide a review of services, including screening for musculoskeletal changes associated with occupational injury such as those described herein. This is especially important among those healthcare workers who tend to self-treat.
Construction of a Tool to Predict Overall Survival of Patients With Primary Spinal Tumors After Surgical Resection: A Real-World Analysis Based on the Surveillance, Epidemiology, and End Results Database
Authors: Huang Zhangheng , Tong Yuexin , Kong Qingquan
Published: March 2022

Background

We aim to construct a practical clinical prediction model to accurately evaluate the overall survival (OS) of patients with primary spinal tumors after primary tumor resection, thereby aiding clinical decision-making.

Methods

A total of 695 patients diagnosed with a primary spinal tumor, selected from the Surveillance, Epidemiology, and End Results (SEER) database, were included in this study. The Cox regression algorithm was applied to the training cohort to build the prognostic nomogram model. The nomogram’s performance in terms of discrimination, calibration, and clinical usefulness was also assessed in the internal SEER validation cohort. The fitted prognostic nomogram was then used to create a web-based calculator.

Results

Four independent prognostic factors were identified to establish a nomogram model for patients with primary spinal tumors who had undergone surgical resection. The C-index (.757 for the training cohort and .681 for the validation cohort) and the area under the curve values over time (both >.68) showed that the model exhibited satisfactory discrimination in both the SEER cohort. The calibration curve revealed that the projected and actual survival rates are very similar. The decision curve analysis also revealed that the model is clinically valuable and capable of identifying high-risk patients.

Conclusions

After developing a nomogram and a web-based calculator, we were able to reliably forecast the postoperative OS of patients with primary spinal tumors. These tools are expected to play an important role in clinical practice, informing clinicians in making decisions about patient care after surgery.
Business Communication Lessons in Agility: Introduction to the Special Issue on the COVID-19 Pandemic
Authors: Mayfield Jacqueline , Mayfield Milton
Published: March 2022

This introduction explains our vision, inclusion criteria, and mission for a curated issue about business communication and COVID-19. We focus on the big picture of communication agility lessons from a VUCA (volatility, uncertainty, complexity, and ambiguity) environment. We also present a definition and a typology of agile business communication, largely drawn from the papers in this collection. These manuscripts investigate COVID-19 organizational communication measures and related strategies plus their outcomes across diverse stakeholders in multiple countries. Drawing from these contributions and other research, we conclude by outlining an agile business communication research agenda. Finally we inaugurate a new IJBC column, Spotlight on a Thought Leader in Business Communication.