bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of hybridization, engine combustion method, and energy management system connectivity on heavy-duty vehicle operation
Authors: Hall Carrie M
Published: January 2021

A wide range of strategies for reducing energy consumption from heavy-duty vehicles have been explored from vehicle electrification to real-time vehicle energy management based on vehicle-to-vehicle and vehicle-to-infrastructure communication. Full electrification of heavy-duty vehicles can be challenging due to current limitations on battery energy density. However, hybridization and the implementation of high efficiency engines present other potential near-term solutions. In contrast to many prior studies that have explored the use of one or two of these techniques, this work discusses the combined influence of hybridization level, engine combustion mode, and connected energy management on fuel efficiency in heavy-duty applications. The impact of hybridization in different driving conditions is quantified and the effectiveness of hybrid powertrain structures with different engine combustion strategies is also explored. Utilizing an alternative combustion strategy can improve fuel efficiency by 5% in conventional and mild hybrids but was found to have a more minimal impact in full hybrids. An additional layer of complexity is also introduced when vehicles have some degree of connectivity and this influence on the energy management method is investigated by comparing control approaches which leverage current and future vehicle speed information. Connectivity and the ability to optimize energy production in real-time was found to be essential in uncertain cases and enable improvements in fuel consumption of up to 12% over baseline cases.
Appreciating Large Classes: Using Appreciative Inquiry to Foster a Hospitable Learning Space for Experiential Learning
Authors: Trinh Mai P. , van Esch Chantal , Martinez Hector A. , Messer Tracey
Published: January 2021

Experiential learning has been documented as an effective method for student learning, yet its use in large-enrollment classes remains limited. Kolb’s experiential learning theory emphasizes that experiential learning requires a hospitable learning space (HLS) that is conducive to learning. In this article, we reframe the challenges to experiential learning in large classes as a failure to create and maintain an HLS, and we propose Appreciative inquiry as one solution to this problem. Appreciative inquiry is an organizational development methodology that practitioners have successfully used to engage large groups to leverage their strengths and resources. First, we describe the HLS as an overarching theoretical framework to address the lack of engagement when conducting experiential learning in large classes. Second, we use the principles of Appreciative inquiry to provide actionable suggestions to instructors facing these challenges. Finally, through the use of appreciative inquiry, we argue that some characteristics of large classes can instead be viewed in an appreciative way as available resources to generate an engaging experiential learning process for students.
Registered Report: Testing Ideological Asymmetries in Measurement Invariance
Authors: Brandt Mark J. , He Jia , Bender Michael
Published: January 2021

People with different ideological identities differ in their values, personality, affect, and psychological motivations. These differences are observed on measures of practical and clinical importance and these differences are the central node tying together theories about the psychology of political ideology; however, they rest on a critical untested assumption: The measures are invariant across ideological groups. Here, we test this assumption across 28 constructs in data from the United States and the Netherlands. Measures are not invariant across ideological divisions. At the same time, estimates of ideological similarities and differences are largely similar before and after correcting for measurement noninvariance. This may give us increased confidence in the results from this research area, while simultaneously highlighting that some instance of noninvariance did change conclusions and that individual items are not always comparable across political groups.
A Comparison of Rate Control Agents for the Treatment of Atrial Fibrillation: Follow-Up Investigation of the AFFIRM Study
Authors: Zaman Ninad , Naccarelli Gerald , Foy Andrew
Published: January 2021

There are limited data from randomized controlled trials comparing rate control agents in atrial fibrillation. Patient-level data from the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial was used to compare outcomes in patients randomized to the rate control arm who were treated with a single rate control agent at baseline. The rate control agents used were beta-blockers, non-dihydropyridine calcium channel blockers, and digoxin. The independent variable for this analysis was the initial study drug used and the dependent variables were time to first hospitalization and time to death from any cause. We analyzed 1,144 out of 2,027 participants assigned to the rate control group who were on a single rate control agent at the start of the trial. There were 485 (42.5%) participants in the beta-blocker group, 344 (30%) in the calcium channel blocker group, and 315 (27.5%) in the digoxin group. All hospitalization and all-cause mortality occurred in 55.9% and 12.5% of those in the beta-blocker group, 58.4% and 16.7% in the calcium channel blocker group, and 55.2% and 21.1% in the digoxin group, respectively. After adjustment for differences in baseline characteristics, there were no significant differences in time to hospitalization or death for any group. In the AFFIRM trial, the initial rate control drug used was not associated with statistically significant differences in time to hospitalization or death after controlling for differences in baseline characteristics. There is limited data at present to guide the selection of rate control agents in patients with atrial fibrillation.
Vibration stability of a cantilevered thin plate with inner fluid circulation
Authors: Wang Yunjie , Yin Yajun , Zheng Gangtie
Published: January 2021

The vibration of a cantilevered thin plate with inner fluid circulation is a typical situation in engineering. The plate’s vibration can be considered a combination of bending motion and torsional motion. With the force generated by the inner fluid circulation on the plate, these two types of motion affect each other and raise the problem of stability. In the present study, the vibration stability of different vibrating pattern thus generated is investigated. It is found that with the increase of the flow velocity, torsional mode frequencies decrease synchronously, whereas their modal shapes remain unchanged, which results in the buckling of the plate. Under the circumstance of coupled vibration, because both bending and torsional modal frequencies vary with the flow velocity, a phenomenon of coupled-mode flutter occurs between a certain pair of modes with frequency orders of (2 k) and (2 k − 1) and vibration becomes unstable.
Consensus of nonlinear multi–agent systems with distributed event–triggered impulsive control
Authors: Tang Wenyan , Li Kun , Wu Jia , Xie Yongfang
Published: January 2021

This study addresses the consensus problem in nonlinear multi-agent systems with the distributed impulsive control method. To decrease communication wastage, a distributed event-triggered impulsive protocol is developed to achieve consensus. In the proposed control method, each agent receives neighbor information and performs impulse control only when its own trigger function exceeds a given tolerance. Then, through the Lyapunov method, the conditions that allow the multi-agent systems reach consensus are analyzed and the Zeno behavior is excluded. Finally, some numerical simulations are performed to validate the effectiveness of the proposed method.
Mathematical modeling and experimental study of damping behavior of a cantilever carbon fiber–reinforced polymer composite hollow member with metal inserts
Authors: Chawla Komal , Ray-Chaudhuri Samit
Published: January 2021

Metal inserts are widely used particularly in bolted connections for joining composite members. In this work, a theoretical basis is provided for analyzing the damping behavior of a cantilever composite square hollow member embedded with metal inserts along its length. Analytic stress solutions around the boundaries of the insert and the member are introduced while deriving the expression of modal damping ratio. Kelvin–Voigt and amplitude-dependent damping models are considered for the formulation. Experiments are performed on the perforated composite tube reinforced with brass, copper, and steel annular inserts subjected to transverse base motion of varying amplitudes. The acceleration responses recorded from the tests are analyzed to evaluate the damping ratio of the fundamental mode. It is observed that the damping ratio evaluated from the experiments matches well with the proposed value. Furthermore, it is found that the damping ratio increases when the holes are reinforced with the inserts. The reason for the increase in damping stems from (i) frictional effect at the boundaries of the insert and the tube and (ii) material damping of the inserts. For example, the damping amplification of the tube with five steel inserts is noted to be around 3.0 and 2.1 times with respect to the unperforated and perforated (with holes) cases, respectively.
Theoretical investigations on the linear and nonlinear damping force for an eddy current damper combining with rack and gear
Authors: Li Shouying , Li Yafeng , Wang Jianzhong , Chen Zhengqing
Published: January 2021

To study the damping characteristics of a new type of eddy current damper with rack and gear recently proposed by the authors, the damping torque for the eddy current damper with rack and gear was theoretically investigated based on some fundamental assumptions, including evenly distributed magnetic field on a conductor plate and no magnetic leakage. A linear relationship between damping torque and velocity was obtained. Numerical simulations by using COMSOL Multiphysics were conducted to evaluate the accuracy of the linear theoretical formula. When angular velocity is less than 30 rad/s, it seems that the linear theoretical results agree well with the numerical results, and maximum relative error between them is about 6.58%. Then, by using COMSOL Multiphysics, a series of parametric studies on damping torque, including the effects of the air gap, the thickness of a back iron plate, the location and number of permanent magnets, and the thickness of a conductor plate, were carried out to further examine the linear theoretical formula. The results show the effects of the air gap and back iron plate on the relative error between linear theoretical and numerical results can be ignored, whereas the location and number of permanent magnets and the thickness of the conductor plate have significant influences on the relative error. Finally, a nonlinear theoretical formula was obtained by introducing three modified coefficients into the linear theoretical formula, and its accuracy was verified in some typical cases. It is proved that there is sufficient accuracy to adopt the nonlinear theoretical formula in preliminary design of the eddy current damper with rack and gear to determine the main structural parameters.
The Relation of Threat Level and Age With Protective Behavior Intentions During Covid-19 in Germany
Authors: Lages Nadine C. , Villinger Karoline , Koller Julia E. , Brünecke Isabel , Debbeler Joke M. , Engel Kai D. , Grieble Sofia , Homann Peer C. , Kaufmann Robin , Koppe Kim M. , Oppenheimer Hannah , Radtke Vanessa C. , Rogula Sarah , Stähler Johanna , Schupp Harald T. , Renner Britta
Published: January 2021

To contain the spread of Covid-19, engagement in protective behaviors across the population is of great importance. The present study investigated protective behavior intentions during the early phases of Covid-19 in Germany (February 2–April 3, 2020) as a function of threat level and age using data from 4,940 participants in the EUCLID project. Results indicated that the intention to engage in social distancing increased sharply with threat level. Intentions for personal hygiene also increased, although to a lesser extent. While age only had a small overall effect on behavioral intentions, differential patterns emerged. After the lockdown was introduced, the impact of age decreased for social distancing and hygiene behavior intentions but increased for seeing a doctor. Since containing the Covid-19 pandemic depends on high adoption rates of protective behaviors, future research should track sustained phases of the pandemic, including the easing of restrictions and possible new waves of infections.
‘You come because it is an interesting place’: The impact of attending a heritage programme on the well-being of people living with dementia and their care partners
Authors: Innes Anthea , Scholar Helen F , Haragalova Jana , Sharma Monika
Published: January 2021

Promoting access to heritage settings has been acknowledged as a way to promote well-being in the United Kingdom for people living with dementia and their care partners. Yet there is a lack of information available internationally on the contribution of heritage sites to promote well-being and social inclusion for those living with dementia. This study addresses this gap by reporting on the impact for 48 people of participating in the ‘Sensory Palaces’ (SP) programme run by Historic Royal Palaces at Hampton Court and Kew Palaces in the United Kingdom. Two primary data sources were used; post-session interviews involving 30 participants (the person living with dementia and/or their care partners), and 131 sets of self-complete pre- and post-session mood questionnaires administered directly before and after SP session attendance. Analysis of the data sets is presented under three themes: enjoyment and engagement; connecting and learning and place, space and time. The findings demonstrate that participants highly valued the heritage sessions and reported positively on the impact this had for their individual well-being and their relationships with one another. This study highlights the opportunity for heritage sites to contribute to promoting well-being for people living with dementia.
Can inner and outer containment counteract pulls and pushes toward delinquency? A test of Walter Reckless’s containment theory
Authors: Janssen Heleen J , Bruinsma Gerben JN , Weerman Frank M
Published: January 2021

The aim of the current study is to provide an empirical test of containment theory of Walter Reckless (1899–1988). The theory proposes that outer and inner containment hold adolescents back from delinquency even when external factors pull and push them toward it. This early control theory was ahead of its time, but never received the empirical attention it deserves. This article outlines the core theoretical concepts and the basic propositions in order to empirically examine their validity. We employed hybrid linear regression analysis using longitudinal survey data of 612 adolescents (12–18 years old) in the city of The Hague, the Netherlands. The results indicate that outer and inner containment can be meaningfully distinguished, and that several but not all propositions of the theory are supported. Inner and outer containment function as a buffer against external pulls and are able to counteract the effect of increases in environmental pulls during adolescence. We conclude that containment theory is still a promising interaction theory that can help us understand why adolescents who experience external pulls toward delinquency are able to resist these influences.
Does rTMS Targeting Contralesional S1 Enhance Upper Limb Somatosensory Function in Chronic Stroke? A Proof-of-Principle Study
Authors: Pundik Svetlana , Skelly Margaret , McCabe Jessica , Akbari Heba , Tatsuoka Curtis , Plow Ela B.
Published: January 2021

Background

Somatosensory deficits are prevalent after stroke, but effective interventions are limited. Brain stimulation of the contralesional primary somatosensory cortex (S1) is a promising adjunct to peripherally administered rehabilitation therapies.

Objective

To assess short-term effects of repetitive transcranial magnetic stimulation (rTMS) targeting contralesional (S1) of the upper extremity.

Methods

Using a single-session randomized crossover design, stroke survivors with upper extremity somatosensory loss participated in 3 rTMS treatments targeting contralesional S1: Sham, 5 Hz, and 1 Hz. rTMS was delivered concurrently with peripheral of sensory electrical stimulation and vibration of the affected hand. Outcomes included 2-point discrimination (2PD), proprioception, vibration perception threshold, monofilament threshold (size), and somatosensory evoked potential (SEP). Measures were collected before, immediately after treatment, and 1 hour after treatment. Mixed models were fit to analyze the effects of the 3 interventions.

Results

Subjects were 59.8 ± 8.1 years old and 45 ± 39 months poststroke. There was improvement in 2PD after 5-Hz rTMS for the stroke-affected ( F(2, 76.163) = 3.5, P = .035) and unaffected arm ( F(2, 192.786) = 10.6, P < .0001). Peak-to-peak SEP amplitudes were greater after 5-Hz rTMS for N33-P45 ( F(2, 133.027) = 3.518, P = .032) and N45-P60 ( F(2, 67.353) = 3.212, P = .047). Latencies shortened after 5-Hz rTMS for N20 ( F(2, 69.64) = 3.37, P = .04), N60 ( F(2, 47.343) = 4.375, P = .018), and P100 ( F(2, 37.608) = 3.537, P = .039) peaks. There were no differences between changes immediately after the intervention and an hour later.

Conclusions

Short-term application of facilitatory high-frequency rTMS (5Hz) to contralesional S1 combined with peripheral somatosensory stimulation may promote somatosensory function. This intervention may serve as a useful adjunct in somatosensory rehabilitation after stroke.
Specific Brain Reorganization Underlying Superior Upper Limb Motor Function After Spinal Cord Injury: A Multimodal MRI Study
Authors: Nakanishi Tomoya , Nakagawa Kento , Kobayashi Hirofumi , Kudo Kazutoshi , Nakazawa Kimitaka
Published: January 2021

Background

We recently discovered that individuals with complete spinal cord injury (SCI) have a higher grip force control ability in their intact upper limbs than able-bodied subjects. However, the neural basis for this phenomenon is unknown.

Objective

This study aimed to investigate the neural basis of the higher grip force control in the brains of individuals with SCI using multimodal magnetic resonance imaging (MRI).

Methods

Eight SCI subjects and 10 able-bodied subjects performed hand grip force control tasks at 10%, 20%, and 30% of their maximal voluntary contraction during functional MRI (fMRI). Resting-state fMRI and T1-weighted structural images were obtained to investigate changes in brain networks and structures after SCI.

Results

SCI subjects showed higher grip force steadiness than able-bodied subjects ( P < .05, corrected), smaller activation in the primary motor cortex ( P < .05, corrected), and deactivation of the visual cortex ( P < .001, uncorrected). Furthermore, SCI subjects had stronger functional connectivity between the superior parietal lobule and the left primary motor cortex ( P < .001, uncorrected), as well as larger gray matter volume in the bilateral superior parietal lobule ( P < .001, uncorrected).

Conclusions

The structural and functional reorganization observed in the superior parietal lobule of SCI subjects may represent the neural basis underlying the observed higher grip force control, and is likely responsible for the smaller activation in the primary motor cortex observed in these individuals. These findings could have applications in the fields of neurorehabilitation for improvement of intact limb functions after SCI.
Prediction of shallow bit position based on vibration signal monitoring of bit broken rock
Authors: Yu Jinping , Zou Deyong
Published: January 2021

The speed of drilling has a great relationship with the rock breaking efficiency of the bit. Based on the above background, the purpose of this article is to predict the position of shallow bit based on the vibration signal monitoring of bit broken rock. In this article, first, the mechanical research of drill string is carried out; the basic changes of the main mechanical parameters such as the axial force, torque, and bending moment of drill string are clarified; and the dynamic equilibrium equation theory of drill string system is analyzed. According to the similarity criterion, the corresponding relationship between drilling process parameters and laboratory test conditions is determined. Then, the position monitoring test system of the vibration bit is established. The acoustic emission signal and the drilling force signal of the different positions of the bit in the process of vibration rock breaking are collected synchronously by the acoustic emission sensor and the piezoelectric force sensor. Then, the denoised acoustic emission signal and drilling force signal are analyzed and processed. The mean value, variance, and mean square value of the signal are calculated in the time domain. The power spectrum of the signal is analyzed in the frequency domain. The signal is decomposed by wavelet in the time and frequency domains, and the wavelet energy coefficients of each frequency band are extracted. Through the wavelet energy coefficient calculated by the model, combined with the mean, variance, and mean square error of time-domain signal, the position of shallow buried bit can be analyzed and predicted. Finally, by fitting the results of indoor experiment and simulation experiment, it can be seen that the stress–strain curve of rock failure is basically the same, and the error is about 3.5%, which verifies the accuracy of the model.
Academic Training, Knowledge, and Perceptions of Physical Activity in Student Pharmacists
Authors: White Nicole
Published: January 2021

Pharmacists are highly effective in providing chronic disease management services in both the community pharmacy and ambulatory clinic settings in large part because of their medication therapy management expertise. Lifestyle medicine, including physical activity, plays a major role in chronic disease prevention and management. As such, physical activity knowledge and counseling skills are an important component of pharmacy student education. However, the literature indicates that pharmacy students may not be receiving adequate training in these areas. The following will describe the academic training, knowledge, and perceptions of physical activity in student pharmacists.
The Problem of Coordination and the Pursuit of Structural Constraints in Psychology
Authors: Kellen David , Davis-Stober Clintin P. , Dunn John C. , Kalish Michael L.
Published: January 2021

Paul Meehl’s famous critique detailed many of the problematic practices and conceptual confusions that stand in the way of meaningful theoretical progress in psychological science. By integrating many of Meehl’s points, we argue that one of the reasons for the slow progress in psychology is the failure to acknowledge the problem of coordination. This problem arises whenever we attempt to measure quantities that are not directly observable but can be inferred from observable variables. The solution to this problem is far from trivial, as demonstrated by a historical analysis of thermometry. The key challenge is the specification of a functional relationship between theoretical concepts and observations. As we demonstrate, empirical means alone cannot determine this relationship. In the case of psychology, the problem of coordination has dramatic implications in the sense that it severely constrains our ability to make meaningful theoretical claims. We discuss several examples and outline some of the solutions that are currently available.
Susac syndrome and pregnancy: a review of published cases and considerations for patient management
Authors: Willekens Barbara , Kleffner Ilka
Published: January 2021

Susac syndrome (SuS) is a rare autoimmune endotheliopathy leading to hearing loss, branch retinal artery occlusions and encephalopathy. Young females are more frequently affected than males, making counselling for family planning an important issue. We reviewed published cases on SuS during pregnancy or in the postpartum period, and selected 27 reports describing the details of 33 patients with SuS. Treatment options and implications for pregnancy and breastfeeding are discussed. We propose new areas for research and suggest a management strategy.
Rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in diffuse large B-cell lymphoma
Authors: Candelaria Myrna , Dueñas-Gonzalez Alfonso
Published: January 2021

Background:

Diffuse large B-cell lymphoma (DLBCL) is the most frequent non-Hodgkin lymphoma worldwide. The current standard of care is chemoimmunotherapy with an R-CHOP regimen. We aim to review the role of this regimen after two decades of being the standard of care.

Methods:

A comprehensive literature review of DLBCL, including the epidemiology, trials defining R-CHOP as the standard of care, as well as dose intensification and dose reduction schemes. Additionally, we briefly review the development of rituximab biosimilars and the addition of targeted drugs to R-CHOP in clinical trials.

Discussion:

R-CHOP cures approximately 70% of DLBCL patients. Dose-dense regimens do not show a benefit in response and increase toxicity. Dose reduction, particularly in elderly patients or with comorbidities, may be a treatment option. DLBCL constitutes a group of diseases that activate different biological pathways. Matching specific treatments to a defined genetic alteration is under development. Rituximab biosimilars have become available to a broader population, particularly in developing countries, where access to treatment is limited because of economic resources.

Conclusion:

DLBCL landscape is heterogeneous. R-CHOP immunochemotherapy has been a standard of care for two decades and cures approximately 70% of cases. Molecular characterization of patients is evolving and may have critical therapeutic implications.
B-cell maturation antigen (BCMA) in multiple myeloma: the new frontier of targeted therapies
Authors: Sanchez Larysa , Dardac Alexandra , Madduri Deepu , Richard Shambavi , Richter Joshua
Published: January 2021

Outcomes of patients with multiple myeloma (MM) who become refractory to standard therapies are particularly poor and novel agents are greatly needed to improve outcomes in such patients. B-cell maturation antigen (BCMA) has become an important therapeutic target in MM with three modalities of treatment in development including antibody–drug conjugates (ADCs), bispecific T-cell engagers (BITEs), and chimeric antigen receptor (CAR) T-cell therapies. Early clinical trials of anti-BCMA immunotherapeutics have demonstrated extremely promising results in heavily pretreated patients with relapsed/refractory MM (RRMM). Recently, belantamab mafodotin was the first anti-BCMA therapy to obtain approval in relapsed/refractory MM. This review summarizes the most updated efficacy and safety data from clinical studies of BCMA-targeted therapies with a focus on ADCs and BITEs. Additionally, important differences among the BCMA-targeted treatment modalities and their clinical implications are discussed.
Mobile bystanders and rubbernecks, disaster tourists, and helpers. Towards a theoretical framework for critically studying action possibilities at accident sites
Authors: Andersson Linus , Sundin Ebba
Published: January 2021

This article addresses the phenomenon of mobile bystanders who use their smartphones to film or take photographs at accident scenes, instead of offering their help to people in need or to assist medical units. This phenomenon has been extensively discussed in Swedish news media in recent years since it has been described as a growing problem for first responders, such as paramedics, police, and firefighters. This article aims to identify theoretical perspectives that are relevant for analyzing mobile media practices and discuss the ethical implications of these perspectives. Our purpose is twofold: we want to develop a theoretical framework for critically approaching mobile media practices, and we want to contribute to discussions concerning well-being in a time marked by mediatization and digitalization. In this pursuit, we combine theory from social psychology about how people behave at traumatic scenes with discussions about witnessing in and through media, as developed in media and communication studies. Both perspectives offer various implications for normative inquiry, and in our discussion, we argue that mobile bystanders must be considered simultaneously as transgressors of social norms and as emphatic witnesses behaving in accordance with the digital media age. The article ends with a discussion regarding the implications for further research.
A New Approach for Diagonal Line Model of Importance-Performance Analysis: A Case Study of Tourist Satisfaction in China
Authors: Chen Jih-Kuang
Published: January 2021

Two types of importance-performance analysis (IPA), quadrant model and diagonal line model, are applied widely. Some studies have described the advantages of the diagonal line model, but multiple studies have reported disadvantages of direct measures of importance, as used in the traditional diagonal line model. In addition, there is no clear rationale for the use of a 45-degree diagonal line as a distinguishing line in the diagonal line model. This study used the partial correlation coefficient-base of attributes corresponding to overall satisfaction to measure a new importance value to replace direct importance in the traditional method. The new diagonal line reflects the average of the slope formed by the impact of various attributes on overall satisfaction, rather than a 45-degree diagonal line. The new approach was successfully applied to determine a management strategy of tourist satisfaction, and the results confirm the rationality of the studied case and were considered reasonable by appropriate managers.
Reliability and Validity of the Adapted Turkish “Students’ Attitudes Towards Addressing Sexual Health Questionnaire” (SA-SH-TR)
Authors: Turan Nuray , Çulha Yeliz , Özdemir Aydin Gülsün , Kaya Hatice
Published: January 2021

The aim of this study is to determine the reliability and validity of the Adapted Turkish “Students’ Attitudes Towards Addressing Sexual Health” questionnaire (SA-SH-TR). This methodological study was conducted in two stages. In the first stage, the language was adapted to Turkish. Second, the reliability of the scale was evaluated. From January 2018 to March 2018, 292 nursing students volunteered to participate in the study. The content validity index of the Turkish version of the questionnaire ranged from 0.76 to 1.00 and was found to be high. Cronbach’s alpha coefficient was 0.89. Removal of Items 11, 12, 14, 16, 17, 18, 20, and 22 would have improved alpha to 0.91. It was observed that the item-total correlation values of the items changed between 0.24 and 0.75. Test–retest interclass correlation coefficient was 0.83. The study findings determined that the Turkish adaptation of the SA-SH-TR was valid and reliable and could be used in nursing research and practice.
Severity of Myocardial Ischemia Is Related to Career Length Rather Than Age Among Professional Firefighters
Authors: Dzikowicz Dillon J. , Carey Mary G.
Published: January 2021

Background:

Ischemic heart disease (IHD) is the major cause of duty-related fatalities in the fire service. Age and career length are not only important risk factors associated with IHD, but are also highly correlated. The aim of this secondary analyses was to assess the relationship between age, career length, and IHD, based on ischemic severity, to identify whether age or career length had a stronger relationship to IHD.

Methods:

This was a secondary, correlational analysis of on-duty firefighters without known cardiovascular or respiratory disease who underwent exercise treadmill testing with 12-lead electrocardiography. Ischemia was defined based on current guidelines. Maximum ST-segment depression was measured to determine IHD ischemic severity. Age, years of employment, demographics, weight, blood pressure were recorded. Multiple correlations were computed between age, career length, and IHD.

Findings:

Twenty-two firefighters were included (96% male, 82% White, 82% overweight or obese, 77% hypertensive). The partial correlation between maximum ST-segment depression and age controlled for career length was not significant ( r = –.392, p = .079). The partial correlation between maximum ST-segment depression and career length controlled for age was statistically significant ( r = .466, p = .033).

Conclusion/Application to Practice:

Career length, not age, moderately correlates with IHD ischemic severity among firefighters. Career length is a proxy measure of occupational exposures which contributes to IHD. When assessing IHD risk in firefighters, health practitioners should consider incorporating the occupational exposure history (i.e., career length) in addition to age when providing risk reduction services.
Inroad of Digital Technology in Education: Age of Digital Classroom
Authors: Singh Mayengbam Nandakishwor
Published: January 2021

Technology has become an integral part of human life, and it has made inroads in the sphere of education. Digital technology is largely reshaping the nature of learning in classroom. Digital classroom is one clear manifestation of this emerging trend. There is a burgeoning academic culture of digital classroom today. It is increasingly incomprehensible for the larger academic community to quench their thirst for knowledge without computer technology. The blending of traditional classroom and digital classroom becomes almost imminent. But it is also equally important to understand the inherent merits and demerits of digital classroom. Use of computer technology can enhance the quality of education, but technology alone cannot be sufficient. The basic challenges lie in entrenching the proper use of benefits provided by digital technology. This article seeks to examine the pros and cons of digital classroom along with the major challenges it poses. The methodology applied for this study is explanatory approach. A theoretical-based research, coupled with practical experiences, through critical analysis of existing literatures on digital classroom is carried out.
Using Students’ Experience to Derive Effectiveness of COVID-19-Lockdown-Induced Emergency Online Learning at Undergraduate Level: Evidence from Assam, India
Authors: Rahman Afzalur
Published: January 2021

The COVID-19 episode has left the institutions worldwide, which were earlier reluctant to change their traditional pedagogical approaches, with no choice than an emergency shift to virtual learning, creating several arguments associated with digital infrastructure, digital divide, digital literacy, technical and pedagogic skills of teachers, digital contents and so on. With this background, this study intended to assess the implementation mechanism of COVID-19-lockdown-induced emergency online learning at undergraduate level in Assam, its effectiveness, and finally the problems faced therein, from the perspective of students’ experience and satisfaction. Primary data were collected from 132 undergraduate students drawn at random from different provincialized colleges in Assam through using a questionnaire in Google Form structured on the basis of available literature. The result revealed that 46.21% students perceive emergency online learning partially effective, 34.09% as effective, and 19.70% as ineffective. Poor Internet connectivity, irregular electricity, high cost in data plans, lack of compatible devices, lack of conducive environment at home, lack of technical and pedagogic skills of teachers, insufficient students’ engagement and so on, turned out to be the main challenges of online learning. Thus, the findings sufficiently yield the need of collaborative effort to improve digital infrastructure, reduce cost involvement and well-structured teachers’ training on pedagogical and technical skills. Creating, adopting and evaluating innovative techniques and tools, student-friendly contents, and above all a positive attitude are next to none measures to be accelerated for inclusive and effective online delivery of higher education in India in coming days.
Psychosocial Dynamics in Attachment Styles Among Runaway Children
Authors: Kapoor Srishti , Panwar Kailash , Wason Kshitija
Published: January 2021

For a child to leave the parental umbrella is an act of rebellion, emotional hurt and physical distancing. Despite being a frequent occurrence, running away from home still remains one of the less addressed problems in India. Factors like lack of communication and attachment to parents, abuse, poverty and peer influence have a crucial role in shaping such behaviours. The present research is an exploratory study to examine these factors with a sample size of 100 runaway children (50 girls, 50 boys) residing in a non-governmental organisation in NCR, Delhi. The mean age of the sample is 14.4 years. Quantitative measures like Inventory of Parents and Peer Attachment (Greenberg, 1987; Gullone & Robinson, 2005 ), Emotional Regulation Questionnaire ( Gross & John, 2003 ), Kind of Person Implicit Theory Scale ( Dweck, 1999 ) and Satisfaction with Life Scale-Child (Gadermann et al., 2012) were used. Findings indicate a significant role of peer attachment versus parental attachment with a clear gender disparity seen in attachment styles. The repercussions of findings are immense to the rehabilitation sector with special focus on creating models of alternative care which could harness these dynamics. How models of rehabilitation could systemically harness peer attachment and create parallel edifices of emotional regulation are other aspects this research focuses upon. The study has implications for intervention-based programmes for runaways as it can help to understand their perils and make positive changes.
Digitisation and Sustainable Development: The Opportunities and Risks of Using Digital Technologies for the Implementation of a Circular Economy
Authors: Kottmeyer Benjamin
Published: January 2021

Digitisation is developing a transformational potential that is profoundly changing people, our societies and the planet. Like any major societal transformation, it offers both, significant opportunities for progress and significant risks with harmful consequences for societies. This paper, therefore, addresses the question: ‘What are the critical social outcomes and concerns flowing from the advances in digitisation on our work environment?’ To discuss the broad research question in sufficient depth, this paper focuses not only on specific critical social outcomes of digitisation but also on how some of them can be mitigated by combining digital tools with the concept of a circular economy (representing the abstract idea of sustainable development). The implementation of blockchain technologies and new business models shows that digital technologies have the potential to close the realisation gap between theory and practice of the circular economy concept by enhancing the information flow and the communication between stakeholders in the value chain. Nonetheless, the implementation of these technologies also entails social and economic risks, such as power abuse or regulatory arbitrage, which should be considered in advance. To avoid jeopardising digital innovations, future research should therefore develop a more holistic and interdisciplinary understanding of the complex interactions to exploit the potential of digitisation for social progress.
Book review: Sharan Kumar Limbale, The Dalit Brahmin
Authors: Das Kalyan Kumar
Published: January 2021

Sharan Kumar Limbale, The Dalit Brahmin (Translated from Marathi by Priya Adarkar). Orient Blackswan, 2018, 206 pp., ₹450 (paperback). ISBN: 9789352872947.
Assessment of chronic disease self-management in patients with chronic heart failure based on the MCID of patient-reported outcomes by the multilevel model
Authors: Tian Jing , Zhao Jinghua , Zhang Qing , Ren Jia , Han Linai , Li Jing , Zhang Yanbo , Han Qinghua
Published: January 2021

Purpose

The minimal clinically important difference (MCID) of a patient-reported outcome (PRO) represents the threshold value of the change in the score for that PRO. It is deemed to have an important implication in clinical management. This study was performed to evaluate the clinical significance of chronic disease self-management (CDSM) for patients with chronic heart failure based on the MCID of the chronic heart failure—PRO measure (CHF-PROM).

Methods

A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from July 2018. Advice of CDSM was provided in written form at discharge to all patients. Information regarding CHF-PROM and CDSM were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of CDSM for CHF-PROM scores, as well as its physical and psychological domains. MCID changes of the PRO were introduced and compared with β values of CDSM obtained from the multi-level models to further evaluate the clinical significance. The STROBE checklist is shown in Additional file 1.

Results

Scores for CHF-PROM improved significantly after discharge. The multilevel models showed that a regular schedule, avoidance of over-eating, a low-sodium diet and exercise increased scores on CHF-PROM. Compared with the MCID, avoidance of over-eating (12.39 vs. 9.75) and maintenance of a regular schedule often (10.98 vs. 9.75), and exercise almost every day (11.36 vs. 9.75) reached clinical significance for the overall summary. Avoidance of over-eating (5.88 vs. 4.79) and a regular schedule almost every day (4.96 vs. 4.79) reached clinical significance for the physical scores. Avoidance of over-eating half of the time (5.26 vs. 4.87) and a regular schedule almost every day (5.84 vs. 4.87) demonstrated clinical significance for the psychological scores.

Conclusions

This study observed an association of avoidance of over-eating and maintenance of a regular schedule with the improvement of CHF-PROM. It provides further evidence for management of heart failure.

Trial Registration: Current Prospective Trials NCT02878811; registered August 25, 2016;https://clinicaltrials.gov/ct2/show/NCT02878811?term=NCT02878811&draw=2&rank=1.
The long-term impact of a chronic total occlusion in a non-infarct-related artery on acute ST-segment elevation myocardial infarction after primary coronary intervention
Authors: Liu Yu , Wang Le-Feng , Yang Xin-Chun , Lu Chang-Lin , Li Kui-Bao , Chen Mu-Lei , Li Na , Wang Hong-Shi , Zhong Jiu-Chang , Xu Li , Ni Zhu-Hua , Li Wei-Ming , Xia Kun , Zhang Da-Peng , Sun Hao , Guo Zong-Sheng , Chi Yong-Hui , He Ji-Fang , Zhang Zhi-Yong , Jiang Feng , Wang Hong-Jiang
Published: January 2021

Objectives

To investigate the long-term outcome of patients with acute ST-segment elevation myocardial infarction (STEMI) and a chronic total occlusion (CTO) in a non-infarct-related artery (IRA) and the risk factors for mortality.

Methods

The enrolled cohort comprised 323 patients with STEMI and multivessel diseases (MVD) that received a primary percutaneous coronary intervention between January 2008 and November 2013. The patients were divided into two groups: the CTO group (n = 97) and the non-CTO group (n = 236). The long-term major adverse cardiovascular and cerebrovascular events (MACCE) experienced by each group were compared.

Results

The rates of all-cause mortality and MACCE were significantly higher in the CTO group than they were in the non-CTO group. Cox regression analysis showed that an age ≥ 65 years (OR = 3.94, 95% CI: 1.47–10.56, P = 0.01), a CTO in a non-IRA(OR = 5.09, 95% CI: 1.79 ~ 14.54, P < 0.01), an in-hospital Killip class ≥ 3 (OR = 4.32, 95% CI: 1.71 ~ 10.95, P < 0.01), and the presence of renal insufficiency (OR = 5.32, 95% CI: 1.49 ~ 19.01, P = 0.01), stress ulcer with gastraintestinal bleeding (SUB) (OR = 6.36, 95% CI: (1.45 ~ 28.01, P = 0.01) were significantly related the 10-year mortality of patients with STEMI and MVD; an in-hospital Killip class ≥ 3 (OR = 2.97,95% CI:1.46 ~ 6.03, P < 0.01) and the presence of renal insufficiency (OR = 5.61, 95% CI: 1.19 ~ 26.39, P = 0.03) were significantly related to the 10-year mortality of patients with STEMI and a CTO.

Conclusions

The presence of a CTO in a non-IRA, an age ≥ 65 years, an in-hospital Killip class ≥ 3, and the presence of renal insufficiency, and SUB were independent risk predictors for the long-term mortality of patients with STEMI and MVD; an in-hospital Killip class ≥ 3 and renal insufficiency were independent risk predictors for the long-term mortality of patients with STEMI and a CTO.
Early stent thrombosis confirmed in a cancer patient receiving regorafenib, despite triple antithrombotic therapy: a case report
Authors: Shoji Keisuke , Zen Kan , Ookura Takashi , Yanishi Kenji , Matoba Satoaki
Published: January 2021

Background

While developments in oncology have lengthened survival in patients with cancer, such patients often develop cardiovascular diseases. Thus, percutaneous coronary intervention (PCI) is frequently undertaken in them. Although stent thrombosis remains a fatal complication in stent-based PCI, worldwide consensus panels tend to recommend shorter duration of dual-antiplatelet therapy. This is based on its clinical efficacy that has resulted from technological innovation. However, there is insufficient discussion on the risk of stent thrombosis in cancer patients with coronary artery disease, especially in those undergoing chemotherapeutic regimens that have a risk for thrombosis, such as regimens with the anti-vascular endothelial growth factor. Presented here is a case of early stent thrombosis that occurred in a cancer patient on regorafenib, despite the administration of triple antithrombotic therapy.

Case presentation

A 66-year-old Japanese male patient received regorafenib for metastatic colorectal carcinoma and apixaban for deep vein thrombosis. Coronary angiography revealed severe stenosis in the proximal left anterior descending artery. A sirolimus-eluting stent was implanted, without malapposition and under-expansion, under intravascular ultrasound guidance while administering a triple antithrombotic therapy (aspirin: 100 mg/day, prasugrel: 3.75 mg/day, and apixaban: 5 mg/day). However, he was admitted to the hospital for exacerbation of heart failure 1 month after PCI. Coronary angiography revealed contrastive defects in the previous stent. Optical frequency domain imaging confirmed stent thrombosis. PCI was successfully performed with perfusion balloon long-inflation. Antithrombotic therapy was enhanced (aspirin: 100 mg/day, ticagrelor: 120 mg/day, and apixaban: 10 mg/day) and regorafenib was discontinued permanently. While ischemic events did not occur thereafter, the patient died due to metastatic carcinoma progression.

Conclusions

This case suggests that anti-vascular endothelial growth factor might contribute to early stent thrombosis, despite triple antithrombotic therapy. Further discussion is needed on the surveillance and management of cancer patients with coronary artery disease receiving chemotherapy, which carries a risk of thrombosis.