bluuebunny/crossref_metadata_2025 huggingface dataset:
Given-Find-In Order To-Subjected To (GFIS) method for the problem statement in set-based design
Authors: Fernández-Caballero Juan Carlos , Hernández-Luna Alberto A. , Sobek Durward K. , Ramírez-Mendoza Ricardo A.
Published: June 2023

The Given-Find-Solution (GFS) method is a widely used procedure to systematically understand “what the problem is” in engineering problems. Nevertheless, the GFS method does not provide a clear guide on how to handle uncertainty, feasibility, and preference for design problems. Addressing this issue is crucial since the designer usually requires making assumptions to be able to propose functional solutions. The Given-Find-In Order To-Subjected To (GFIS) method and roadmap are here proposed to systematically state a design problem and requirements using fuzzy desirability functions to handle uncertainty, feasibility, and preference. The GFIS method lists the parameters, variables, specifications, restrictions, and preferences to facilitate the decision-making process. A comparative study was conducted with undergraduate students from Tecnológico de Monterrey enrolled in the course Design Methodologies. The students solved a band brake design problem before and after applying the GFIS method, and their performance was compared. The results showed a significant improvement in their decision-making ability, their capability to find feasible solutions, and the time required to make a design proposal.
Subjective Well-Being Across the Sectors: Examining Differences in Workers’ Life Satisfaction and Daily Experiential Well-Being
Authors: Qu Heng , Robichau Robbie Waters
Published: June 2023

Research on cross-sector differences has long demonstrated that workers in public and nonprofit sectors are more prosocially and intrinsically motivated, which in turn shapes their work behavior and outcomes, but little evidence exists on how public service employment is associated with workers’ life quality outside of the organizational context. Using cross-sectional data pooled from the Well-being Module of the American Time Use Survey, we investigate whether sectors of employment can predict workers’ subjective well-being (SWB) beyond the work domain. The results suggest public servants across all levels of government as well as nonprofit organizations experience higher life satisfaction than their for-profit counterparts. However, there are different patterns in daily experiential well-being across levels of government. Further analyses by work and non-work days demonstrate that work itself is likely to be a key factor affecting workers’ daily experience across sectors. Implications for theory and practice are discussed.
Barriers and Facilitators of Palliative Care in Older Adults With Heart Failure: A Qualitative Content Analysis
Authors: Gholami Motlagh Farzaneh , Nobahar Monir , Bahrami Masoud
Published: June 2023

Objectives: The progressive and unpredictable course of heart failure (HF) has made the provision of palliative care (PC) services to older adults with HF a serious challenge. This study aimed to explain the barriers and facilitators of PC in older adults with HF. Methods: This qualitative study was conducted using the content analysis approach. A sample of 15 participants, including 6 patients, 2 family caregivers, and 7 healthcare team members (4 nurses, a psychiatric nurse, a nutritionist, and a PC physician) were selected by purposive sampling over 10 months (November 21, 2020 to September 1, 2021). The data were collected using semistructured in-person interviews until data saturation and analyzed with conventional qualitative content analysis. Results: The findings revealed the main category of “neglecting the provision of PC,” with 4 subcategories of “weak organizational structure,” “poor social support,” “older adults’ and healthcare teams’ poor knowledge,” and “limited financial resources” as the barriers of PC and the main category of “enjoying support potentials” with 3 subcategories of “the cooperation of the government, benefactors, and nongovernmental organizations,” “empathy from the family and relatives,” and “benefiting from the presence of healthcare workers” as PC facilitators. Conclusions: The findings of this study explained the barriers and facilitators of PC in older adults with HF. Removing the barriers and supporting the facilitators give older adults with HF better access to PC. Therefore, to expand PC centers for older adults with HF, health system officials, and policy-makers should pay attention to organizational infrastructures and remove the barriers at organizational, social, educational, and economic levels with the cooperation of governmental organizations, benefactors, and nongovernmental organizations.
Noninvasive Cardiac Output Monitoring (NICOM) in the Critically Ill Patient Undergoing Endotracheal Intubation: A Prospective Observational Study
Authors: Smischney Nathan J. , Stoltenberg Anita D. , Schroeder Darrell R. , DeAngelis Jillian L. , Kaufman David A.
Published: June 2023

Background: Cardiovascular instability occurring during endotracheal intubation (ETI) in the critically ill is a commonly recognized phenomenon. However, this complication has not been evaluated in terms of the physiological cause (ie, decreased preload, contractility, or afterload) leading to the instability. Thus, the aim of the current investigation was to describe the hemodynamics occurring during ETI with noninvasive physiologic monitoring and to collect preliminary data on the hemodynamic effects of induction agents and positive pressure ventilation. Methods: A multicenter prospective study enrolling adult (≥18 years) critically ill patients undergoing ETI with noninvasive cardiac output monitoring in a medical/surgical intensive care unit from June 2018 to May 2019 was conducted. This study used the Cheetah Medical noninvasive cardiac output monitor to collect hemodynamic data during the peri-intubation period. Additional data collected included baseline characteristics such as illness severity, peri-intubation pharmacologic administration, and mechanical ventilation settings. Results: From the original 27 patients, only 19 (70%) patients had complete data and were included in the final analysis. Propofol was the most common sedative 8 (42%) followed by ketamine 6 (32%) and etomidate 5 (26%). Patients given propofol demonstrated a decrease in total peripheral resistance index (delta change [dynes × s/cm−5/m2]: −2.7 ± 778.2) but stabilization in cardiac index (delta change (L/min/m2]: 0.1 ± 1.5) while etomidate and ketamine demonstrated increases in total peripheral resistance index (etomidate delta change [dynes × s/cm−5/m2]: 302.1 ± 414.3; ketamine delta change [dynes × s/cm−5/m2]: 278.7 ± 418.9) but only etomidate resulted in a decrease in cardiac index (delta change [L/min/m2]: −0.3 ± 0.5). Positive pressure ventilation resulted in minimal changes to hemodynamics during ETI. Conclusions: The current study demonstrates that although propofol administration leads to a decrease in total peripheral resistance index, cardiac index is maintained while etomidate leads to a decrease in cardiac index with both etomidate and ketamine increasing total peripheral resistance index. These hemodynamic profiles are minimally affected by positive pressure ventilation. Study registration: ClinicalTrials.gov ID, NCT03525743.
Multi-domain Mapping design Method of Automatic Disassembly Equipment for Small Electromechanical Products
Authors: Yang Chen , Zhang Xiufen
Published: June 2023

The design of automatic disassembly equipment for small end-of-life (EOL) electromechanical products is difficult and time-consuming. To deal with these problems, a novel automatic disassembly equipment design method for small EOL electromechanical products based on axiomatic design and modular design is presented. To realize the mapping from disassembly knowledge to the functional requirements of automatic disassembly equipment, a transfer mapping model from the structure to disassembly methods of small EOL electromechanical products is constructed based on polychromatic sets, which are regarded as the key information of the customer domain. Furthermore, a multi-domain mapping model of the automatic disassembly equipment is constructed through axiomatic design, and the mapping from the customer domain to the functional domain and then to the structure domain in the design process of automatic disassembly equipment is gradually realized. Based on the information in the structure domain, the related modules of the automatic disassembly equipment are divided and designed. Finally, taking a power strip and a set-top box as the experimental objects, the proposed method is applied to the design of automatic disassembly equipment. The results prove that the proposed method improves the design efficiency of automatic disassembly equipment and has strong universality.
Investigation on post-weld heat treatment (PWHT) inputs for controlling average fusion zone hardness in fibre laser-welded modified 9Cr–1Mo steel
Authors: Rakesh Sivakumar , Raghuraman Srinivasan , Venkatraman Ramamoorthi
Published: June 2023

Post-weld heat treatment (PWHT) generally relieves stress and enhances weldments’ mechanical properties. Optimisation of PWHT parameters is very much needed to control the process parameters for achieving the desired property requirements. In this research, the PWHT parameters for laser-welded P91 steel were optimised using the response surface methodology-based Box–Behnken methodology. Tempering temperature, heating rate and holding time are considered the input parameters and using analysis of variance (ANOVA), their impact on average fusion zone hardness has been analysed. The results indicate that the hardness values are highly influenced by temperature followed by holding time. A parametric combination of 780°C tempering temperature, 6 hours holding time, and 200°C/h heating rate have evolved as the optimal solution. The autogenous nature of the welding process resulted in a heterogeneous microstructure with untempered lath martensite structure showing precipitate dissolution in the as-welded fusion zone, ultimately resulting in a high average fusion zone hardness of 502 HV0.3, whereas PWHT with the optimal solution resulted in an average fusion zone hardness value of 252 HV0.3. The decrease in hardness value followed by heat treatment is primarily due to the tempering process, which resulted in precipitation within and over the grain boundaries. The validation experiment result using the optimum combination of parameters has been observed to be aligned significantly with the expected values, indicating the adequacy of the developed model.
Investigation of the effect of different welding parameters on tensile properties and failure modes of non-alloyed steel produced by powder metallurgy
Authors: Elitas Muhammed , Erden Mehmet Akif
Published: June 2023

Resistance spot welding was implemented to unalloyed steel produced by powder metallurgy method at different welding parameters in this study. Other welding parameters are constant, but electrode force values are 0.21–0.28–0.35 kN and welding current values are 9–10–11 kA. The effects of different welding parameters on microhardness, nugget diameter, tensile shear force, and failure mode were investigated. Consequently, the tensile shear force increased as welding current and electrode force up to a certain value increased. When critical electrode force value was exceeded, tensile shear force decreased, although nugget diameter increased. Compared to the base material, a decrease in tensile shear force has occurred in resistance spot welded joints. Except for values higher than the critical electrode force value, a linear relationship was determined between the nugget diameter, tensile shear force, and microhardness. Two different failure modes were observed, namely sheet transverse failure and partial interfacial failure.
Power battery third-party reverse logistics provider selection: Fuzzy evidential reasoning
Authors: Zheng Chaoyu , Peng Benhong , Zhao Xuan , Wei Guo , Wan Anxia , Yue Mu
Published: June 2023

Massive power batteries (PBs) are crucial to new energy vehicle enterprises. Due to Extended Producer Responsibility (EPR), the third-party reverse logistics provider selection(3PRLPs) process has become an important decision to save cost. This paper uses an innovative combination of qualitative analysis and quantitative data integration to address the PB 3PRLPs problem by using Failure Modes and Effects Analysis (FMEA) and fuzzy evidential reasoning (FER). Firstly, the possible failures and potential effects in the PB 3PRLPs are identified by the FMEA to determine criteria and importance grades. Subsequently, AHP is utilized to calculate the criteria weight based on the importance of grades. FER is creatively applied to address the intersection of assessment grades and allocate the belief degree (BD) of the interaction to fuse heterogeneous data. Additionally, sensitivity analysis is done to look into the stability of the sequencing. Compared with other methods, the proposed method not only solves the subjectivity of AHP weighting but also manipulates probabilistic and fuzzy uncertainties for multi-criteria decision-making (MCDM). This method is useful in quantitatively analyzing the 3PRLPs problem and in providing auxiliary decision support for enterprises.
Business Success Is for the Healthiest: An Analysis of Small-scale Entrepreneurs in Mumbai, Maharashtra
Authors: Talukdar Bedanga , Roy Archana K.
Published: June 2023

This study aimed to investigate the current health status of entrepreneurs and its impact on business performance. For the present study, a primary survey was conducted in Mumbai, from February to August 2018. A total sample of 540 self-employed migrants running small-scale business, whose last usual place of residence was different from the place of interviewing and was residing in Mumbai for more than 3 years were interviewed. The health of entrepreneurs was captured by assessing their self-reported health. Health has evolved as a paramount predictor in entrepreneur’s business success. Effects of health are multi-facet on business operations. Entrepreneurs, reporting to experiencing excellent status of health, were found to have higher man hours and working days as compared to relatively bad health. Findings from regression suggests respondents with a fair state of health were less likely to have a higher level of monthly income than respondents with excellent health. The study found a statistically significant association between physical activity, self- reported good health, and monthly income. Small-scale entrepreneurs engaged in the informal labour market often practice sedentary behaviour; henceforth, there is a pressing need to sensitise them to the importance of active physical activity, which shall reduce the risk of developing stress.
Clinical Application of Thromboelastography in Patients With Severe Fever With Thrombocytopenia Syndrome
Authors: Li Yingbo , An Changjuan , Xue Peng , Ni Lina , Yu Xia , Qu Jiangli , Yao Yingjie , Yu Chengyong
Published: June 2023

Aim

To investigate the clinical application of thromboelastography (TEG) in severe fever with thrombocytopenia syndrome (SFTS).

Methods

One hundred and fifty-seven patients with SFTS were included in the study. The participants were distributed into 3 groups; A, B, and C. And 103 patients in group A met the clinical criteria as they exhibited slight liver and kidney dysfunction. Group B consisted of 54 patients with SFTS who were critically ill while group C was a healthy control group with 58 participants.

Results

Patients with SFTS exhibited lower coagulation than the healthy participants. Group B patients exhibited significantly lower coagulation compared to group A. There was no significant difference in platelet count and fibrinogen content between patients in group A and group B, but platelet aggregation function and fibrinogen activity were significantly lower in group B patients.

Conclusion

Our results suggest that it is risky to solely rely on platelet count and the fibrinogen in SFTS. Monitoring of TEG and other coagulation indexes should be emphasized.
Routine Lupus Anticoagulant Sensitive aPTT Testing Can Prevent Unnecessary LA Testing
Authors: Smit Bob , Hudig Francisca , Venhuizen Jan-Hendrik , Haitjema Saskia , Limper Maarten , Urbanus Rolf , Huisman Albert
Published: June 2023

Even though routine screening of the general hospital population is discouraged, medical laboratories may use a “lupus sensitive” activated partial thromboplastin time test (aPTT) with phospholipid concentrations that are susceptible to inhibition by lupus anticoagulant (LA), to screen for the presence of LA. If deemed necessary, follow-up testing according to ISTH guidelines may be performed. However, LA testing is a laborious and time-consuming effort that is often not readily available due to a lack of automation and/or temporary unavailability of experienced staff. In contrast, the aPTT is a fully automated test that is available 24/7 in almost all medical laboratories and is easily interpreted with the use of reference ranges. In addition to clinical signs, the result of an LA sensitive aPTT may thus be used to lower the suspicion of the presence of LA and reduce costly follow-up testing. In this study, we show that a normal LA sensitive aPTT result may be safely used to refrain from LA testing in the absence of strong clinical suspicion.
Multi-omics Pathways Workflow (MOPAW): An Automated Multi-omics Workflow on the Cancer Genomics Cloud
Authors: Nguyen Trinh , Bian Xiaopeng , Roberson David , Khanna Rakesh , Chen Qingrong , Yan Chunhua , Beck Rowan , Worman Zelia , Meerzaman Daoud
Published: June 2023

Introduction:

In the era of big data, gene-set pathway analyses derived from multi-omics are exceptionally powerful. When preparing and analyzing high-dimensional multi-omics data, the installation process and programing skills required to use existing tools can be challenging. This is especially the case for those who are not familiar with coding. In addition, implementation with high performance computing solutions is required to run these tools efficiently.

Methods:

We introduce an automatic multi-omics pathway workflow, a point and click graphical user interface to Multivariate Single Sample Gene Set Analysis (MOGSA), hosted on the Cancer Genomics Cloud by Seven Bridges Genomics. This workflow leverages the combination of different tools to perform data preparation for each given data types, dimensionality reduction, and MOGSA pathway analysis. The Omics data includes copy number alteration, transcriptomics data, proteomics and phosphoproteomics data. We have also provided an additional workflow to help with downloading data from The Cancer Genome Atlas and Clinical Proteomic Tumor Analysis Consortium and preprocessing these data to be used for this multi-omics pathway workflow.

Results:

The main outputs of this workflow are the distinct pathways for subgroups of interest provided by users, which are displayed in heatmaps if identified. In addition to this, graphs and tables are provided to users for reviewing.

Conclusion:

Multi-omics Pathway Workflow requires no coding experience. Users can bring their own data or download and preprocess public datasets from The Cancer Genome Atlas and Clinical Proteomic Tumor Analysis Consortium using our additional workflow based on the samples of interest. Distinct overactivated or deactivated pathways for groups of interest can be found. This useful information is important in effective therapeutic targeting.
Digitalization, stress, and social worker–client relationships during the COVID-19 pandemic
Authors: Nordesjö Kettil , Scaramuzzino Gabriella
Published: June 2023

The COVID-19 pandemic has dramatically changed the possibilities for people to interact and communicate. This article examines Swedish social workers’ experiences of the extent to which the COVID-19 pandemic has affected the use of digital tools in their work, and whether this use has affected the social worker–client relationship and their stress levels. The article draws on a web survey (N  =  541) via a quantitative analysis of responses and a qualitative analysis of answers to an open-ended question.

Findings

Most respondents agreed on experiencing increased use of digital tools in the relationship with the clients, increased skills in using digital tools, and a more positive view of digital tools in the social worker–client relationship. However, experiences on whether stress levels had increased and the relationship with the clients worsened, were divided. Age correlates positively with increased stress levels, and social workers working with social assistance, as well as women, are more likely to agree on that the relationship with the clients has worsened. Responses from open-ended questions highlight a rapid shift where social workers have gained a more positive view of digital tools, that video meetings can increase efficiency and flexibility, but also work environment problems.

Applications

This article contributes with useful insights into how the use of digital tools during the COVID-19 pandemic has changed and affected stress and the social worker–client relationship. It can support discussions on the future implementation of digital tools in social work after the pandemic.
An enhanced empirical Fourier decomposition method for bearing fault diagnosis
Authors: Zhu Danchen , Liu Guoqiang , Wu Xingyu , Yin Bolong
Published: June 2023

To address the problem that bearing fault signals are usually contaminated by strong background interference due to multiple structures and complex transmission paths, which affects accurate fault feature extraction, an enhanced empirical Fourier decomposition technique was proposed in this paper. First, in order to weaken the influence of transmission path, the trend-line-extraction-based method was utilized in advance, which suppressed the signal distortion and background noise interference. Then, to achieve the appropriate parameter for the empirical Fourier decomposition, the correlation-coefficient-based decomposition number selection approach was constructed to avoid the existence of irrelevant modal functions. The band improvement strategy was proposed to reduce the invalid frequency bands with too narrow bandwidth during the decomposition process, the weighted harmonics significant index was utilized as the target, and the optimal modal components were also determined. Last, the fast Fourier transform was employed, and the bearing fault signatures were accurately detected. The simulation and experimental bearing fault signals were used for analysis; with the help of some comparisons, the analyzed results show that this method can effectively extract the fault characteristics of rolling element bearing from strong background interference.
Total Transfemoral Branched Endovascular Thoracoabdominal Aortic Repair (TORCH2): Short-term and 1-Year Outcomes From a National Multicenter Registry
Authors: Mario D’Oria , Alessandro Grandi , Giovanni Pratesi , Gianbattista Parlani , Rocco Giudice , Mauro Gargiulo , Nicola Mangialardi , Roberto Chiesa , Sandro Lepidi , Luca Bertoglio , Martina Bastianon , Rita Carbonaro Anna , Ciro Ferrer , Enrico Gallitto , Orsola-Malpighi S. , Grando Beatrice , Giacomo Isernia , Andrea Melloni , Miguel Mena Vera Jorge
Published: June 2023

Objective:

The use of steerable sheaths to allow total transfemoral access (TFA) of branched endovascular repair (BEVAR) of thoracoabdominal aortic aneurysms has been proposed as an alternative to upper extremity access (UEA); however, multicenter results from high-volume aortic centers are lacking.

Materials and Methods:

The Total Transfemoral Branched Endovascular Thoracoabdominal Aortic Repair (TORCH2) study is a physician-initiated, national, multicenter, retrospective, observational registry (Clinicaltrials.gov identifier: NCT04930172) of patients undergoing BEVAR with a TFA for the cannulation of reno-visceral target vessels (TV). The study endpoints, classified according to Society for Vascular Surgery reporting standards, were (1) technical success; (2) 30-day peri-operative major adverse events; (3) 30-day and midterm clinical success; (4) 30-day and midterm branch instability and TV-related adverse events (reinterventions, type I/III endoleaks).

Results:

Sixty-eight patients (42 males; median age: 72 years) were treated through a TFA. All the centers included their entire experience with TFA: 18 (26%) used a homemade steerable sheath, and in 28 cases (41%), a stabilizing guidewire was employed. Steerable technical success was achieved in 66 patients (97%) with an overall in-hospital mortality of 6 patients (9%, 3 elective cases [3/58, 5%] and 3 urgent/emergent cases [3/12, 25%]) and major adverse event rate of 18% (12 patients). Overall, 257 bridging stents were implanted; of these, 225 (88%) were balloon-expandable and 32 (12%) were self-expanding. No strokes were observed among the patient completing the procedure from a TFA. One patient (2%) who failed to be treated completely from a TFA and needed a bailout UEA suffered an ischemic stroke on postoperative day 2. There were 10 (15%) major access-site complications. At 1-year follow-up, overall survival was 80%, and the rate of branch instability was 6%.

Conclusions:

A TFA for TV cannulation is a safe and feasible option with high technical success preventing the stroke risk of UEA. Primary patency at midterm seems comparable to historical controls, and future larger studies will be needed to assess potential differences with alternative options.

Clinical Impact

Using a transfemoral approach for retrograde cannulation of reno-visceral branches is feasiable, safe and effective, thereby representing a reliable alternative for BEVAR interventions.
Epileptic Neurons Know JAK/STAT3
Authors: Kumari Shikha , Brewster Amy L.
Published: June 2023

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Trends in utilization and outcomes of mechanical thrombectomy for cerebral venous thrombosis: A National Inpatient Sample study
Authors: Wahood Waseem , Rizvi Ahraz Ahsan , Patel Vikram , Narain Shreya , Cloft Harry , Rabinstein Alejandro A , Brinjikji Waleed
Published: June 2023

Background and purpose

Cerebral venous thrombosis (CVT) is usually treated with systemic anticoagulation, but mechanical thrombectomy (MT) and local infusion of a thrombolytic agent have been proposed as an alternative therapy. In this study, we analyze National Inpatient Sample (NIS) to determine the trends of MT including discharge other than home (DOTH) and mortality.

Material and methods

Healthcare Utilization Program-NIS (HCUP-NIS) was queried between 2005 and 2018 for CVT and MT. Cochran–Armitage test was conducted to assess linear trend of proportion of utilization and DOTH of MT. Multivariable logistic regression was conducted to assess odds of undergoing MT among CVT admissions, odds of in-hospital mortality, and DOTH for all admissions involving MT for CVT.

Results

A total of 1331 (1.56%) admissions involved MT out of 85,370 CVT cases. Utilization of MT had an upward trend of 0.13% ( p < 0.001) per year. Trend in proportion of incidence of DOTH among MT admission remained stationary (trend: 0.70%; p = 0.417). Patients with cerebral edema (odds ratio [OR]: 4.34; p < 0.001) or hematological disorders (OR: 2.28; p < 0.001) were more likely to receive MT for CVT. Additionally, patients with coma (OR: 3.17; p = 0.023) or cerebral edema (OR: 4.40; p = 0.001) had higher odds of mortality.

Conclusion

There was an increasing trend of utilization of MT. Proportions of DOTH among MT procedures, however, remained stable. Patients with greater risk factors, including hematological disorders and cerebral edema, were more likely to undergo MT. Among patients treated with MT, those with coma or cerebral edema were more likely to die.
Moro Women's Participation and Legitimation in the Bangsamoro Peace Process
Authors: Jopson Teresa Lorena
Published: June 2023

Moro women's participation in the Bangsamoro peace process between the Philippine government and the Moro Islamic Liberation Front (MILF) illuminates some feats and challenges to the UN Women, Peace and Security Agenda (2000) of improving women's lives post-conflict. From interviews, secondary literature, and document analysis, I found that Moro women's participation secured legal benefits for women in the peace agreements and legitimised the Bangsamoro peace negotiation to observers. Yet consistent with the MILF's push for self-determination, the negotiating panels reserved particulars of women's rights as a post-peace agreement agenda, for discussion within the Bangsamoro. I argue that Moro women's participation in the peace talks opened the space to realise, but does not guarantee, feminist goals of better living conditions for marginalised women and sustainable peace in the negotiation's implementation.
Wayfinding in Complex Medical Facilities: The Indexicality of Directional Arrows
Authors: Rooke Clementinah Ndhlovu , Rooke John Alfred , Tzortzopoulos Patricia , Koskela Lauri
Published: June 2023

Objectives, Purpose, or Aim:

The aim of this article is to contribute to the better design of wayfinding systems by explicating the indexical properties of directional arrows and their consequences for wayfinding behavior.

Background:

The challenges associated with designing for the wayfinding needs of the different groups of users continue to be documented with the poor design of built environments being largely to blame for the wayfinders’ inability to navigate complex settings. Directional arrows have been found to be especially problematic in such settings.

Methods:

Ethnographic data were collected and analyzed over a period of 3 years in three overlapping phases. The unique adequacy requirement of methods, which stipulates that the methods used to produce a description of a situation should originate from the situation they describe, was adopted.

Results:

Directional arrows derive their meaning from the position they occupy within the physical environment and from three sources: the spatial configuration of the setting, the positioning of the sign within the setting, and the directional arrow itself. The affordance closest to the sign will be taken as the one which the sign refers to. Wayfinders treat that affordance as being indicated by the arrow until such time as it becomes apparent that it is not.

Conclusions:

In response to the need to find lasting solutions to the enduring problems of wayfinding, this article demonstrates how better design of wayfinding systems can be achieved by explicating the indexical properties of directional arrows and their consequences for wayfinding behavior.
Is It Safe for Us to Be Together Again? Identity, Trust, and Perceived Risk at Mass Events During the COVID-19 Pandemic
Authors: Morton Thomas A. , Power Séamus A.
Published: June 2023

Three years after the outbreak of COVID-19, governments are still working toward a return to “normal life.” Yet, the twin forces of ongoing disease threat and progressively relaxing restrictions raise important questions about whether, where, and when people feel safe. We analyzed data from post-event surveys of participants at live events held across Denmark between June and November 2021 ( nindividuals = 4,932; nevents = 79). Consistent with the social identity model of risk-taking, identification with the audience, trust in others, and felt safety were interrelated. Multi-level modeling revealed that audiences responded to the heightened risk posed by crowds after COVID-related attendance restrictions were lifted, but also that individual differences in identification blunted the connection between crowd density at events and individual feelings of trust and safety. These findings point to a potential identity-based slippage between felt safety and actual safety in the context of collective participation and disease threat.
How two wrongs may make a right, but four do not – The interesting case of Dutch employers’ liability
Authors: Visscher Louis
Published: June 2023

Dutch employers’ liability for workplace accidents is a very interesting topic, not only from a legal perspective, but also from a law and economics one. It is one of the few systems in Europe where liability is still based on the fault of the employer, whereas most countries apply a form of strict/no-fault liability or a system of no-fault insurance. It is interesting because the Dutch Civil Code explicitly refers to prevention of work-related losses. Law and economics focuses exactly on the behavioural incentives that are provided by tort liability, instead of on the compensation aspect. In this article, I provide an answer to the question of how Dutch employers’ liability compares to the law and economics desiderata. At first glance, the design of this type of liability (fault liability) is contrary to what law and economics would advocate (strict liability). In addition, the level of care that courts require from the employer seems to be excessively high. Interestingly, both characteristics together result in a situation which, from a law and economics perspective, is almost indistinguishable from the desired strict liability. So, two wrongs may make a right: the ‘wrong’ choice for fault liability combined with the ‘wrong’ level of due care results in the ‘right’ application of (quasi) strict liability. Therefore, at least in theory, employers receive the correct behavioural incentives, which induce them to take the optimal level of care and activity. However, when we subsequently turn our attention to employees, things look less perfect. Law and economics scholars argue that in situations where not only the tortfeasor but also the victim can influence accident probability, both parties should receive behavioural incentives. This implies that a rule of strict liability should be accompanied by a defence of contributory or comparative negligence. The Dutch employer liability regime contains a defence of intent or wilful recklessness on the part of the employee. From a law and economics perspective, this defence provides inadequate incentives to the employee, which is a third wrong. An often-heard response to this line of reasoning is that tort victims will receive behavioural incentives for fear of being involved in an accident in the first place, so the lack of a full defence of contributory or comparative negligence is not problematic. If this is true, then the damages the victims receive do not make them ‘whole’, which introduces a fourth wrong: uncompensated losses. This second set of two wrongs does not make a right, because if victims receive incomplete compensation, tortfeasors do not fully pay for the losses they have caused. This may reduce the behavioural incentives the tortfeasors receive, who may hence not choose optimal levels of care and activity after all.
Pain with neuropathic characteristics after surgically treated lower limb fractures: Cost analysis and pain medication use
Authors: Png May Ee , Costa Matthew L , Petrou Stavros , Achten Juul , Knight Ruth , Bruce Julie , Keene David J
Published: June 2023

Introduction

Neuropathic pain is prevalent among people after lower limb fracture surgery and is associated with lower health-related quality of life and greater disability. This study estimates the financial cost and pain medication use associated with neuropathic pain in this group.

Methods

A secondary analysis using pain data collected over six postoperative months from participants randomised in the Wound Healing in Surgery for Trauma (WHiST) trial. Pain states were classified as pain-free, chronic non-neuropathic pain (NNP) or chronic neuropathic pain (NP). Cost associated with each pain state from a UK National Health Service (NHS) and personal social services (PSS) perspective were estimated by multivariate models based on multiple imputed data. Pain medication usage was analysed by pain state.

Results

A total of 934 participants who provided either 3- or 6-months pain data were included. Compared to participants with NP, those with NNP (adjusted mean difference -£730, p = 0.38, 95% CI −2368 to 908) or were pain-free (adjusted mean difference -£716, p = 0.53, 95% CI −2929 to 1497) had lower costs from the NHS and PSS perspective in the first three postoperative months. Over the first three postoperative months, almost a third of participants with NP were prescribed opioids and 8% were prescribed NP medications. Similar trends were observed by 6 months postoperatively.

Conclusion

This study found healthcare costs were higher amongst those with chronic NP compared to those who were pain-free or had chronic NNP. Opioids, rather than neuropathic pain medications, were commonly prescribed for NP over the first six postoperative months, contrary to clinical guidelines.
The use of interleukin-23 inhibitors to treat immune-related psoriasis induced by immune checkpoint inhibitors and in patients with active cancer: A case series and review of the literature
Authors: Fournier Cynthia , Butler Marcus Otho , Sauder Maxwell Benjamin
Published: June 2023

Immune checkpoint inhibitors have revolutionized cancer treatment but can induce immune-related adverse events including psoriasis. Managing immune-related psoriasis or psoriasis in a cancer setting is challenging with a lack of safety data. We describe three patients receiving interleukin-23 inhibitors to manage psoriasis in an active cancer setting, including one with immune-related psoriasis. Interleukin-23 inhibitors were effective for all patients. While being on interleukin-23 inhibitors, one patient had cancer partial response, one had deep partial response but then progressed and died from her melanoma, and one suffered melanoma progression.
Parties, Civil Society and Democratic Deepening: Comparing India, Brazil and South Africa
Authors: Heller Patrick
Published: June 2023

Despite being among the most successful democracies in the Global South, India, Brazil and South Africa have all recently experienced democratic crises. I argue that these democratic crises result from the formation of social coalitions that have been willing to subvert democratic institutions and practices in order to preserve or restore their social and economic privileges. In structural terms, these reactions are tied to the unresolved problem of the incorporation of popular classes. This problem has in turn been mediated by the balance between political and civil society. In India and South Africa that balance has favoured the dominance of mass-based nationalist parties that have thwarted democratic deepening. In Brazil, a more balanced relationship between civil society and political society has favoured the partial incorporation of the popular classes.
Gujarat 2022 Elections: Explaining BJP’s Hegemony
Authors: Jaffrelot Christophe , Langa Mahesh
Published: June 2023

The Bharatiya Janata Party’s (BJP’s) victory in the 2022 Gujarat state elections not only broke a record but also reversed the trend that was resulting in Congress’ growing effectiveness election after election. This time, the Congress registered its worse performance ever, largely because of the entry of a new player, the Aam Aadmi Party (AAP), but also because of the progress of the BJP. The ruling party is stronger than ever because of its ideology, its organization and, more importantly, its leader, Narendra Modi. These assets allow the BJP to get support across caste, classes and sub-regions like never before. Its rise, however, challenges democracy in different ways, not only its ‘OBCisation’ is not a synonym of plebeinization in terms of class, but its strategy of equating religious majority and political majority and to systematically undermine the opposition tends to make the BJP ‘the only game in town’.
Pilot Testing of the MyCog Assessment: Rapid Detection of Cognitive Impairment in Everyday Clinical Settings
Authors: Curtis Laura M. , Batio Stephanie , Benavente Julia Yoshino , Shono Yusuke , Nowinski Cindy , Lovett Rebecca M. , Yao Lihua , Gershon Richard C. , Hosseinian Zahra , Wolf Michael S.
Published: June 2023

Cognitive impairment (CI) and dementia can have profound social and emotional effects on older adults. Early detection of CI is imperative both to the identification of potentially treatable conditions and to provide services to minimize the effects of CI in cases of dementia. While primary care settings are ideal for identifying CI, it frequently goes undetected. We tailored a brief, iPad-based, cognitive assessment (MyCog) for primary care settings and piloted it in a sample of older adults. Eighty participants were recruited from an existing cohort study and completed a brief, in-person interview. CI was determined based on a diagnosis of dementia or CI in their medical record or based on a comprehensive cognitive battery performed within the past 18 months. MyCog had a sensitivity of 79% and specificity of 82%, offering a practical, scalable, primary care assessment for the routine case finding of cognitive impairment and dementia.
Pandit Jawaharlal Nehru: His Other Side
Authors: Paddayya K.
Published: June 2023

A quasi-official campaign is currently afoot in India to denigrate Jawaharlal Nehru, belittling his role in the freedom struggle and in the shaping of India, post-1947. It is, therefore, necessary for us to go to the record, especially Nehru’s own writings. He represented a brilliant combination of a profoundly sympathetic appraisal of the past wisdom of India with a close relationship with India’s poorest of the poor. He did so with a full commitment to a scientific temper and a vision of a secular, rational democratic free India. This essay attempts to illustrate these facts by quotations from his own writings and statements.
The Naths of Bengal and Their Marginalisation During the Early Medieval Period
Authors: Debnath Kunal
Published: June 2023

This article is about the Naths (also known as Yogi, Jogi and Jugi) of Bengal and the evidence about the depression of their status that occurred during the early medieval times. Today the householder Naths, who maintain a caste framework, are quite distinct from the ascetic branch of the Nath Sampradaya (community). The householder Naths were apparently degraded by the smarta-ruled Brahmanical society during the twelfth century, the marginalisation being multidimensional—social, political, economic and cultural. Because of their backwardness, the householder Naths were put among Other Backward Castes by the Central government and West Bengal state government in the 1990s. Thus, the householder Naths endure ambiguous identities—claiming high caste status themselves but placed in the Sudra varna by others. This article is an attempt to investigate the historical background of the marginalisation of the householder Naths in Bengal.
Integrating Persons With Lived Experience in Opioid Use Disorder Education: A Small Group Exercise and Patient Panel
Authors: Serota David P , Tookes Hansel E , Tomita-Barber Jasmine , Bartholomew Tyler S , Forrest David W , St. Onge Joan , Ford Henri , Taldone Sabrina
Published: June 2023

OBJECTIVES

Based on increasing drug overdose deaths and a shortage of healthcare professionals trained in the management of opioid use disorder (OUD), it is imperative to improve health professional education in addiction medicine. This small group learning exercise and patient panel was designed to provide first year medical students with insights into the lives of people with OUD—through a lens of harm reduction—and to connect biomedical knowledge to the core values and professional themes of their doctoring courses.

METHODS

Facilitators were assigned to each small group of 8 students for the harm reduction-centered Long and Winding Road small group case exercise. This was followed by a patient panel of 2 to 3 persons with OUD. The small group was conducted with first-year medical students as a virtual training session due to the COVID-19 pandemic. Students completed pre- and post-session surveys about agreement with statements pertaining to the learning objectives.

RESULTS

The small group and patient panel were delivered over 8 sessions and attended by all first-year medical students (N = 201). Survey response rate was 67%. Post-session, there was significantly greater agreement with knowledge on all learning objectives compared to pre-session. Two relevant multiple-choice questions on the medical student final exam were answered correctly by 79% and 98% of students.

CONCLUSION

Centering on people with lived experience, we completed small groups and patient panels to introduce concepts of OUD and harm reduction to first year medical students. Pre- and post-session surveys showed short-term achievement of the learning objectives.
Visibilising Invisible Population: e-Shram Portal and Essentiality of Internal Migration Database in India
Authors: Rajput Kuldeepsingh , Rajan S. Irudaya
Published: June 2023

Despite their contribution in boosting the economy, internal migrants remain invisible to policymakers. The sudden lockdown imposed by the Indian government post-COVID-19 and internal migrants’ unpreparedness created a deplorable and unprecedented situation for them in various cities. The crisis has reinforced the need to understand the dynamics and intersectionality of mobility and the disaggregated database of migrants. It has also called for implementing a comprehensive migration policy for internal workers. To create a credible database, registration of internal migrants should be the first and foremost task for policymakers. To this end, steps have been taken to set up an ‘e-Shram Portal’, an initiative of the central government of India directed by the Supreme Court. This article aims to shed light on the need for identification and registration of internal migrants so that their importance in policymaking is realised and the government could address the challenges involved in the process. Integrating migrants into development is a comprehensive and challenging process.
Whole-genome identification and expression profiling of growth-regulating factor (GRF) and GRF-interacting factor (GIF) gene families in Panax ginseng
Authors: Wang Ping , Xiao Ying , Yan Min , Yan Yan , Lei Xiujuan , Di Peng , Wang Yingping
Published: June 2023

Background

Panax ginseng is a perennial herb and one of the most widely used traditional medicines in China. During its long growth period, it is affected by various environmental factors. Past studies have shown that growth-regulating factors (GRFs) and GRF-interacting factors (GIFs) are involved in regulating plant growth and development, responding to environmental stress, and responding to the induction of exogenous hormones. However, GRF and GIF transcription factors in ginseng have not been reported.

Results

In this study, 20 GRF gene members of ginseng were systematically identified and found to be distributed on 13 chromosomes. The ginseng GIF gene family has only ten members, which are distributed on ten chromosomes. Phylogenetic analysis divided these PgGRFs into six clades and PgGIFs into two clades. In total, 18 of the 20 PgGRFs and eight of the ten PgGIFs are segmental duplications. Most PgGRF and PgGIF gene promoters contain some hormone- and stress- related cis-regulatory elements. Based on the available public RNA-Seq data, the expression patterns of PgGRF and PgGIF genes were analysed from 14 different tissues. The responses of the PgGRF gene to different hormones (6-BA, ABA, GA3, IAA) and abiotic stresses (cold, heat, drought, and salt) were studied. The expression of the PgGRF gene was significantly upregulated under GA3 induction and three weeks of heat treatment. The expression level of the PgGIF gene changed only slightly after one week of heat treatment.

Conclusions

The results of this study may be helpful for further study of the function of PgGRF and PgGIF genes and lay a foundation for further study of their role in the growth and development of Panax ginseng.