bluuebunny/crossref_metadata_2025 huggingface dataset:
Stable Numerical Implementation of a Turbulence Scheme with Two Prognostic Turbulence Energies
Authors: Mašek Ján , Ďurán Ivan Bašták , Brožková Radmila
Published: March 2022

In this paper, we present a new and more stable numerical implementation of the two-energy configuration of the Third Order Moments Unified Condensation and N-dependent Solver (TOUCANS) turbulence scheme. The original time-stepping scheme in TOUCANS tends to suffer from spurious oscillations in stably stratified turbulent flows. Because of their high frequency, the oscillations resemble the so-called fibrillations that are caused by the coupling between turbulent exchange coefficients and the stability parameter. However, our analysis and simulations show that the oscillations in the two-energy scheme are caused by the usage of a specific implicit–explicit temporal discretization for the relaxation terms. In TOUCANS, the relaxation technique is used on source and dissipation terms in prognostic turbulence energy equations to ensure numerical stability for relatively long time steps. We present both a detailed linear stability analysis and a bifurcation analysis, which indicate that the temporal discretization is oscillatory for time steps exceeding a critical time-step length. Based on these findings, we propose a new affordable time discretization of the involved terms that makes the scheme more implicit. This ensures stable solutions with enough accuracy for a wider range of time-step lengths. We confirm the analytical outcomes in both idealized 1D and full 3D model experiments.

Significance Statement

The vertical turbulent transport of momentum, heat, and moisture has to be parameterized in numerical weather prediction models. The parameterization typically employs nonlinear damping equations, whose numerical integration can lead to unphysical, time-oscillating solutions. In general, a presence of such numerical noise negatively affects the model performance. In our work, we address numerical issues of the recently developed scheme with two prognostic turbulence energies that have more realism and physical complexity. Specifically, we detect, explain, and design a numerical treatment for a new type of spurious oscillations that is connected to the temporal discretization. The treatment suppresses the oscillations and allows us to increase the model time step more than 4 times while keeping an essentially non-oscillatory solution.
Review of Existing Standards, Guides, and Practices for Raman Spectroscopy
Authors: Ntziouni Afroditi , Thomson James , Xiarchos Ioannis , Li Xiang , Bañares Miguel A. , Charitidis Costas , Portela Raquel , Lozano Diz Enrique
Published: March 2022

Over the past decades Raman spectroscopy has been extensively used both on an industrial and academic level. This has resulted in the development of numerous specialized Raman techniques and Raman active products, which in turn has led to the adoption and development of standards and norms pertaining to Raman unit’s calibration, performance validation, and interoperability. Purpose of the present review is to list, classify, and engage in a comprehensive analysis of the different standards, guides, and practices relating to Raman spectroscopy. Primary aim of the review is to consider the commonalities and conflicts between these standards and norms and to identify any missing aspects. Standardization in the field of Raman spectroscopy is dominated by the work of American institutions, namely, the American Society of Testing Materials (ASTM or ASTM International), with several active standards in place pertaining to terminology, calibration, multivariate analysis, and specific applications, and the National Institute of Standards and Technology (NIST), providing numerous certified reference materials, referred to as standard reference materials. The industrial application of Raman spectroscopy is dominated by the pharmaceutical industry. As such, pharmacopoeias provide not only important information in relation to pharmaceutical-related applications of Raman spectroscopy, but also invaluable insight, into the basic principles of Raman spectroscopy and important aspects that include calibration, validation, measurement, and chemometric analysis processes, usually by referring to ASTM and NIST standards. Given the fact that Raman spectroscopy is a modern and innovative field, the standardization processes are complex and constantly evolving. Despite the seemingly high number of existing standards, the standardization landscape is incomplete and has not been modernized according to the developments in Raman spectroscopy techniques in recent years. This is evident by the lack of protocols for numerous areas as well as by the fact that some of the existing standards have not been updated to reflect the advances in the technique. Therefore, it is important for the Raman community to actively engage in and contribute to a modernization process that will result in updating existing and introducing new terms, protocols, and guides. Indeed, the development of optimized common standards would be extremely beneficial and would further foster the development and application of Raman spectroscopy techniques, most notably those of surface enhanced Raman spectroscopy and low-resolution portable analyzers.
‘You Collared a Maiden Young Ireland in this House’: The Patriotism of Dom Francis Sweetman and His School – Mount St Benedict, Gorey, Co. Wexford
Authors: Brunning Diane
Published: March 2022

‘What you in England call “politics” we call “patriotism”’ Dom John ‘Francis’ Sweetman (1872–1953) replied in 1919 to the Abbot of Downside’s reminder that he had previously been instructed ‘not to take public part in politics’. Although Sweetman complied with Cuthbert Butler’s order to resign from the executive of the North Wexford Sinn Fein, his ongoing ‘patriotism’ continued to cause problems for the Irish monk and his English monastery. In 1925, following a succession of complaints to Rome by the Bishop of Ferns which included the charge Sweetman had ‘organised and encouraged military activities against the Free State Government’, Downside closed his school. This paper provides an account of how the 1916 Easter Rising affected Sweetman and his school, describes how Sweetman’s political activities affected Downside’s plan to establish an English Benedictine monastery in Ireland and, examines his involvement in the Irish War of Independence and Civil War.
Design guidelines for hybrid continuous/discontinuous carbon fibre laminates
Authors: Evans Anthony D , Turner Thomas A , Harper Lee T , Warrior Nicholas A
Published: March 2022

Combining discontinuous carbon fibre moulding compounds with unidirectional (UD) non-crimp fabric has been studied as a potential solution for producing cost effective composite structures, with short cycle times via compression moulding. The tensile stiffness and strength of a composite with a hybrid fibre architecture were found to be up to 60% and 110% higher, respectively, than the baseline discontinuous fibre moulding compound, when 20% (by vol.) of UD fibres were aligned in the primary loading direction. However, stress concentrations arising from the dissimilar material properties can result in the strength of the hybrid architecture being reduced to below that of the baseline composite if the UD fibres are not incorporated effectively. This paper focusses on optimising the stress transfer within the transition zone (inter-material interface) between the UD material and the discontinuous fibre moulding compound, when local isolated patches of continuous fibre are used rather than full coverage plies. This is key if hybrid architectures are to be adopted for structural applications, minimising the stress concentration effects from the UD ply ends, whilst maintaining the low cycle times and costs associated with compression moulding. Following aerospace laminate design guidelines, a range of step sizes and joint configurations have been considered for different ply drop strategies, minimising the magnitude of the stress concentration at the UD ply ends. Results indicate that the step length must be at least 20 times the thickness of the UD ply to ensure the bending strength at the joint is the same as the baseline discontinuous fibre material. An ‘alternating joint' yields 18% higher bending strengths than a conventional ‘stepped joint’ design, as the stress concentrations at the dropped ply ends are reduced in comparison to the inherent stress concentrations within the discontinuous fibre material.
Engineering the geometry of novel yarns for flexible, hybrid composites Part I: Multiple breaks
Authors: Alshukur Malek , Stylios George
Published: March 2022

This study reports on the development of a novel form of yarn reinforcement for making super tough, flexible composites. The concept is based on the rupturing of components of the composite yarn many times before totally breaking. The composite yarn structure has a configuration of three main components − helical, straight and sinusoidal. The components are not restricted by the type of raw material, and any type of fibre or blend can be used. Experimentally, the hollow-spindle spinning system was used to make nine variants of this composite yarn. These variants were tested for their tensile behaviour at an extension rate of 250 mm/min. It was found that the core component of two of the nine variants had eight breakages, while the core component of the remaining variants had four to five breakages before the final break of the core component. The main mechanism that allows the core component yarn to break so many times is a locking applied to it by the wrapping yarn during stretching. The gain in strength for these variants was 21–81% in comparison with a typical twistless composite yarn. Flexible composites made of such yarn configurations can find numerous uses in construction, geotextiles, ballistic protective garments, aerospace, automotive and shipping industries.
Vocal Accommodation and Perceptions of Speakers’ Prestige and Dominance
Authors: Dippong Joseph , Kalkhoff Will , Jamil Cayce
Published: March 2022

Research on the causes and consequences of vocal accommodation is accumulating rapidly in social psychology, but important puzzles remain. Recent work has shown that patterns of vocal accommodation among actors engaged in competitive interactions (e.g., debates) are related to audience perceptions of their relative dominance but not prestige. This makes intuitive sense, but it remains unclear how audience perceptions of actors’ relative dominance and/or prestige are impacted in cooperative group interactions and whether and to what extent audience perceptions agree with actors’ own perceptions. Building on past theory and research on vocal accommodation, we address these methodological questions by analyzing data from two experimental studies. Results reveal that for cooperative interactions involving two actors, vocal accommodation is associated with actor and observer perceptions of dominance and prestige, but not to an equal extent. For actors, vocal accommodation is more strongly predictive of their perceptions of each other’s relative prestige. For observers, vocal accommodation is more strongly predictive of their perceptions of actors’ relative dominance. We offer an explanation for the difference and provide directions for future research.
Primary and metastatic primitive neuroectodermal tumor of the heart: A systematic review
Authors: Hajsadeghi Shokoufeh , Iranpour Aida , Amouei Erfan , Tehrani Nasim Hoshangian , Ghavidel Alireza , Ziaie Hossein , Asadi Omolbanin , Moradians Vahan , Tayebi Ali , Mestres Carlos-A. , Manqoutaei Sanaz Abdollahzade
Published: March 2022

Objective

Primary and metastatic primitive neuroectodermal tumors of the pericardium are uncommon. Two cases are presented and discussed.

Methods

The cases of a 17- and 38-year-old male patients with neuroectodermal tumors of the pericardium are presented. In addition, a systematic review was performed according to the Preferred Reporting Items and checklist for Systematic reviews and Meta-Analyses (PRISMA). All selected articles’ quality assessment was done using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports.

Results

The systematic review yielded 29 patients with primary or metastatic PNET. Two patients underwent cardiac transplantation. It seems that unlike considering total resection in other organs, pericardiectomy in PNET patients with pericardial origin may lead to further invasion of the lesions, and it is not recommended. The average disease-free follow-up was 10 months. The combination of neoadjuvant and adjuvant chemotherapy along with surgery and radiotherapy offered the best disease-free outcomes.

Conclusion

Neuroectodermal heart tumors are rare, aggressive tumors requiring chemotherapy and radiotherapy in association with tumor resection surgery to have the best disease-free duration.
Business unpredictability, improvisation and business network commitment in small and medium-sized enterprise market entry
Authors: Hilmersson Mikael , Johanson Martin , Papaioannou Stylianos , Lundberg Helene
Published: March 2022

Market entry performance is critical during internationalisation; prevailing views suggest that firms need to carefully plan their entry before putting the plan into action. This article focuses on three attributes affecting the possibility and usefulness of making a pre-planned market entry: unpredictability, improvisation and business network commitment. We develop six hypotheses tested on a sample of 250 entries; our main finding is that improvisation plays a mediating role in relation to performance in unpredictable markets. The analysis reveals that the relationship between unpredictability and network commitment is not significant, while the effect of unpredictability on market entry performance is negative. These findings suggest implications for internationalisation and international entrepreneurship theory. For managers and entrepreneurs, we show that unpredictability weakens market entry performance, a negative effect that can be mitigated if the entrant firm improvises.
The influence of accounting information system on management control effectiveness: The perspective of SMEs in Yemen
Authors: Al-Hattami Hamood Mohammed , Kabra Jawahar D
Published: March 2022

In today’s competitive market, SMEs need to realize that accounting information system (AIS) can enhance management control effectiveness (MCE) - one of the areas necessary for their survival and success. This paper aimed to measure the influence of AIS success on MCE among SMEs of Yemen, a less developed country, as research and knowledge are very limited in such context. Data were collected from 315 SME owners and managers via a questionnaire. SmartPLS 3 software was employed for data analysis. The results concluded positive links between AIS success and MCE. Specifically, the results revealed that AIS information quality, system quality, and usage positively impact MCE; quality of information and system are essential drivers of AIS usage and satisfaction; user satisfaction positively influences AIS usage. Interestingly, the quality of service showed to be insignificant in the context of AIS. Moreover, user satisfaction showed no significant impact on MCE. This research is deemed one of the first to introduce empirical evidence on the influence of AIS success on MCE among SMEs in Yemen, as a less developed country context.
Assessment of the reporting quality of resistance training interventions in randomised controlled trials for lower limb tendinopathy: A systematic review
Authors: Burton Ian , McCormack Aisling
Published: March 2022

Objectives

1. To describe what exercises and intervention variables are used in resistance training interventions in randomised controlled trials for lower limb tendinopathy 2. To assess completeness of reporting as assessed by the Consensus on Exercise Reporting Template (CERT) and the Toigo and Boutellier framework. 3. To assess the implementation of scientific resistance training principles. 4. To assess therapeutic quality of exercise interventions with the i-CONTENT tool.

Data sources

We searched MEDLINE, CINAHL, AMED, EMBase, SPORTDiscus, and the Cochrane library databases.

Review methods

Systematic review of randomised controlled trials that reported using resistance exercises for lower limb tendinopathies.

Results

We included 109 RCTs. Eccentric heel drops were the most common exercise (43 studies), followed by isotonic heel raises (21), and single leg eccentric decline squats (18). Reporting of exercise descriptor items from the Toigo and Boutellier framework ranged from 0–13, with an average score of 9/13, and only 7 studies achieved a full 13/13. Reporting of items from the CERT ranged from 0–18, with an average score of 14/19. No study achieved a full 19/19, however 5 achieved 18/19. Scoring for resistance training principles ranged from 1–10, with only 11 studies achieving 10/10. Reporting across studies for the i-CONTENT tool ranged from 2–7, with an average score of 5 across included studies. A total of 19 studies achieved a full 7/7 score. Less than 50% of studies achieved an overall low risk of bias, highlighting the methodological concerns throughout studies.

Conclusion

The reporting of exercise descriptors and intervention content was generally high across RCTs for lower limb tendinopathy, with most allowing exercise replication. However, reporting for some tendinopathies and content items such as adherence was poor, limiting optimal translation to clinical practice.
Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review
Authors: Fu Yu , Chapman Emma J , Boland Alison C , Bennett Michael I
Published: March 2022

Background:

Patients with chronic obstructive pulmonary disease (COPD) face limited treatment options and inadequate access to palliative care.

Aim:

To provide a pragmatic overview of clinical guidelines and produce evidence-based recommendations for severe COPD. Interventions for which there is inconsistent evidence to support their use and areas requiring further research were identified.

Design:

Practice review of guidelines supported by scoping review methodology to examine the evidence reporting the use of guideline-recommended interventions.

Data sources:

An electronic search was undertaken in MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Database of Systematic Reviews, complemented by web searching for guidelines and publications providing primary evidence (July 2021). Guidelines published within the last 5 years and evidence in the last 10 years were included.

Results:

Severe COPD should be managed using a multidisciplinary approach with a holistic assessment. For stable patients, long-acting beta-agonist/long-acting muscarinic antagonist and pulmonary rehabilitation are recommended. Low dose opioids, self-management, handheld fan and nutritional support may provide small benefits, whereas routine corticosteroids should be avoided. For COPD exacerbations, systematic corticosteroids, non-invasive ventilation and exacerbation action plans are recommended. Short-acting inhaled beta-agonists and antibiotics may be considered but pulmonary rehabilitation should be avoided during hospitalisation. Long term oxygen therapy is only recommended for patients with chronic severe hypoxaemia. Short-acting anticholinergic inhalers, nebulised opioids, oral theophylline or telehealth are not recommended.

Conclusions:

Recommended interventions by guidelines are not always supported by high-quality evidence. Further research is required on efficacy and safety of inhaled corticosteroids, antidepressants, benzodiazepines, mucolytics, relaxation and breathing exercises.
Enhancing Local Service Effectiveness Through Purpose-Oriented Networks: The Role of Network Leadership and Structure
Authors: Uster Anna , Vashdi Dana , Beeri Itai
Published: March 2022

The public administration literature has demonstrated that the manner in which a network is led is related to its effectiveness. However, why this relationship occurs and whether it is dependent on external circumstances remain unclear. Relying on Provan and Milward's framework of interorganizational network effectiveness and the neo-institutional approach to local leadership, we propose that the manner in which the local authority leads the local network is related to the network's structure, which, in turn, influences its effectiveness. We also propose that this association is contingent on the characteristics of the local authority in which the network exists. Using a sample of 586 network participants from 68 Israeli networks, we demonstrate that the degree to which the local authority is centralized explains the link between the network's leadership and its effectiveness, but only in local authorities with a high socioeconomic status (SES). In addition, we find that in Israeli Arab municipalities such centralization is counterproductive, impeding the network's effectiveness. We discuss the theoretical and practical implications of these findings.
Z-score regression model for coronary artery diameter in healthy Chinese Han children
Authors: Yang Yanzhang , Wang Li , Yang Yanfang , Wu Xiaojing , Xu Lijin , Bi Changbo
Published: March 2022

Background

Coronary artery distension and aneurysm are complications of Kawasaki disease in children.

Purpose

To develop a Z-score regression model for coronary artery diameter in children that could be used as reference.

Material and Methods

This retrospective analysis included children with normal heart structure between March 2013 and April 2017. Body surface area (BSA) was calculated. The diameters of the right coronary, left main coronary, left anterior descending, and circumflex arteries were measured by echocardiography. Pearson correlation analysis was used to establish linear, exponential, logarithmic, power, and square root regression models.

Results

The analysis included 509 children (280 boys) aged 1 day to 15.2 years. Coronary artery diameters were significantly correlated with age, height, body mass, BSA, and [Formula: see text] (r = 0.663–0.826; P < 0.05), with a stronger correlation for [Formula: see text] than BSA ( P < 0.05). The adjusted determination coefficients ([Formula: see text]) were higher for the exponential and square root models than for the other models ( P < 0.05). The random error term variance was constant for the exponential model ( P > 0.05), and processing with the weighted least-square methods eliminated heteroscedasticity in the other models. The Z-scores were normally distributed for the exponential and square root models ( P > 0.05).

Conclusion

Overall, the square root model was the optimal equation for the calculation of coronary artery Z-score in Chinese Han children. This model could be used to facilitate the diagnosis of coronary artery distension in children with suspected Kawasaki disease.
The new whole state system: Reinventing the Chinese state to promote innovation
Authors: Zhang Lin , Lan Tu
Published: March 2022

This article joins interdisciplinary efforts to problematize dichotomous thinking (i.e. state vs. market, East vs. West, and new vs. old) in existing discourses concerning state capitalism. Focusing on the New Whole State System in relation to tech companies owned by Tsinghua University, we analyze the actually existing state capitalism in China as a spatiotemporally specific and conjuncturally situated assemblage of discourses, policies, and practices. We show that under both the Old Whole State System (1950s–1970s) and New Whole State System (mid-2000s onward) eras, the Chinese state, reacting to foreign economic and geopolitical pressures, attempted to graft a centralized innovation system onto preexisting decentralized governance structures, concentrating resources to promote selected strategic industries. Unlike the Old Whole State System, the New Whole State System relies on new policy tools characterized by state-led financialization and state–private fusion. The evolution of New Whole State System as an assemblage reveals that, contrary to the dominant geo-imaginary, the Chinese state is not monolithic, unchanging, and culturally essentialist. Rather, it is actively engaged in global debates about, and in contested experiments with expanding the state's role in the economy in response to global, conjunctural crises of overproduction and financialization. By foregrounding this non-Western country/region’s internal debate about its own development trajectory, its uneven success in overcoming uneven development, and its interaction with the rest of the world, we propose an alternative perspective that contributes both theoretically and methodologically to the epistemologically Euro-American centric literature of state capitalism.
Fare-Capping Impact Analysis Using Mobile Ticket Data
Authors: Morrissey Amelia , Oke Tolu
Published: March 2022

In the wake of the COVID-19 pandemic, transit agencies experienced ridership and revenue losses alongside operating cost increases. At the same time, transit was further highlighted as an essential public good alongside essential workers who relied on transit to conduct a range of services in critical industries, thus emphasizing the role of transit in promoting accessibility, equity, and economic opportunity. In grappling with the current volatile environment, including the ongoing travel and financial uncertainties from the pandemic, transit agencies have attempted to delicately balance fares and financing. In turn, many have considered progressive fare policies such as fare capping. For transit agencies seeking innovative fare changes, fare impact and equity analyses are necessary to better understand how riders respond to fares and changes in fares, and how changes to fares and ridership affect accessibility, equity, revenue, and funding. With the increased use of mobile ticketing, small to mid-sized transit agencies now have access to detailed rider behavior data that can be used to estimate rider responses to fare structure changes. In this paper, we present a multinomial logit fare product choice model that uses rider insight from a sample of mobile ticketing data to account for switching between fare products. We apply the model to forecast the ridership response to incremental fare changes and fare capping.
Methodology for Predicting MAP-21 Interstate Travel Time Reliability Measure Target in Virginia
Authors: Babiceanu Simona , Lahiri Sanhita
Published: March 2022

This study develops a target setting methodology for the (Moving Ahead for Progress) MAP-21 Interstate Travel Time Reliability Measure of “Percent of the Person-Miles Traveled on the Interstate that are Reliable” (PMTR-IS). The study uses data specific to Virginia for a set of independent variables (Hourly Volume, and Volume/Capacity Ratio, Truck Percentage, Equivalent Property Damage Only Rate, Lane Impacting Incident Rate, Number of Lanes, Presence of Safety Service Patrol, Terrain, Urban Designation) to predict whether a MAP-21 reporting segment is reliable. This is used to estimate predicted PMTR-IS with the MAP-21 specified formula. CART (classification and regression trees) models were used with 1,536 different configurations. Of the four best performing models, one was selected using engineering judgement. Datasets from 2017 and 2018 were used for training, and from 2019 and 2020 for testing. The predicted and calculated PMTR-IS were compared, and the error percentage was lower than 1% for 2019, which can be considered negligible. The 2020 error rate was higher and can perhaps be attributed to unusual reliability because of the impacts of the pandemic on travel. Sensitivity analyses revealed that the predicted PMTR-IS is reactive to capacity increase in unreliable sections at a local level, slower to respond to local AADT (annual average daily traffic) increase, and stable to small statewide AADT oscillations. The authors recommend using this methodology for target setting, taking into consideration the state authorities’ other strategic priorities.
Analysis of E-Ticketing Technology for Inspection Performance and Practicality on Asphalt Paving Operations
Authors: Tripathi Amit , Patel Dhaivat , Sturgill Roy , Dadi Gabriel B.
Published: March 2022

E-construction is becoming increasingly attractive in the highway construction industry as the industry faces reductions in staffing and resources. Specifically, the addition of e-construction methods can offer a boost in efficiency and safety in resurfacing projects. Electronic ticketing (e-ticketing), paver-mounted thermal profiling, and intelligent compaction were recently incorporated into a study coordinated by the Kentucky Transportation Cabinet, United States, to assess these e-construction technologies on two resurfacing projects. This study aimed to investigate the accuracy of the data collected and the time savings that come with the incorporation of technology in construction. This manuscript focuses explicitly on the performance of e-ticketing, since it showed the most promising results during the study. An analysis of the data shows that e-ticketing offers the same data typically collected from traditional tickets. E-ticketing reduced the amount of time needed to retrieve material tickets and facilitated comparisons of theoretical tonnages to actual tonnages, in the same manner as traditional approaches. Inspectors also reduced their exposure to hazardous jobsite conditions through the use of e-ticketing, while contractors strengthened their operational efficiency. It is crucial that all stakeholders involved in e-ticketing projects practice partnering and collaboration to take advantage of the benefits of this emerging technology. This paper’s primary contribution is to document lessons learned and to evaluate the performance of e-ticketing technology in relation to safety, time savings, remote inspections, and accuracy compared with traditional practices on an asphalt paving project.
Economic Evaluation of Early Psychosis Interventions From A Canadian Perspective
Authors: Tarride Jean-Eric , Blackhouse Gord , Abdel-Baki Amal , Latimer Eric , Mulvale Gillian , Cooper Brian , Langill Gord , Milinkovic Deborah , Stennett Rosain , Hurley Jeremiah
Published: March 2022

Background

Compared to treatment as usual (TAU), early psychosis intervention programs (EPI) have been shown to reduce mortality, hospitalizations and days of assisted living while improving employment status.

Aims

The study aim was to conduct a cost-benefit analysis (CBA) and a cost-effectiveness analysis (CEA) to compare EPI and TAU in Canada.

Methods

A decision-analytic model was used to estimate the 5-year costs and benefits of treating patients with a first episode of psychosis with EPI or TAU. EPI benefits were derived from randomized controlled trials (RCTs) and Canadian administrative data. The cost of EPI was based on a published survey of 52 EPI centers in Canada while hospitalizations, employment and days of assisted living were valued using Canadian unit costs. The outcomes of the CBA and CEA were expressed in terms of net benefit (NB) and incremental cost per life year gained (LYG), respectively. Scenario analyses were conducted to examine the impact of key assumptions. Costs are reported in 2019 Canadian dollars.

Results

Base case results indicated that EPI had a NB of $85,441 (95% CI: $41,140; $126,386) compared to TAU while the incremental cost per LYG was $26,366 (95% CI: EPI dominates TAU (less costs, more life years); $102,269). In all sensitivity analyses the NB of EPI remained positive and the incremental cost per LYG was less than $50,000.

Conclusions

In addition to EPI demonstrated clinical benefits, our results suggest that large-scale implementation of EPI in Canada would be desirable from an economic point of view .
Chance, Orientation, and Interpretation: Max Weber’s Neglected Probabilism and the Future of Social Theory
Authors: Strand Michael , Lizardo Omar
Published: March 2022

The image of Max Weber as an “interpretivist” cultural theorist of webs of significance that people use to cope with a meaningless world reigns largely unquestioned today. This article presents a different image of Weber’s sociology, where meaning does not transport actors over an abyss of meaninglessness but rather helps them navigate a world of Chance. Retrieving this concept from Weber’s late writings, we argue that the fundamental basis of the orders sociologists seek to understand is not chaos. Action is rendered interpretable, rather, to the extent persons orient themselves to possibilities and probabilities, which remain real but unknowable. In this framework, interpretation and probability are allies, not antagonists. Weber’s systematic use of the probabilistic notion of Chance as a central resource for concept formation and sociological explanation seriously challenges current understandings of probability as a purely statistical, atheoretical concern. We outline the conceptual difference it makes when basic categories of sociology are understood as rooted in Chance, and we point to the larger implications of Weber’s probabilism for contemporary debates around issues of prediction, action, and interpretation.
Efficacy of Levetiracetam and Phenobarbital as First-Line Treatment for Neonatal Seizures
Authors: Verwoerd Carmen , Limjoco Jamie , Rajamanickam Victoria , Knox Andrew
Published: March 2022

High neonatal seizure burden is associated with worsened neurodevelopmental outcomes. We compared the efficacy of initial treatment with levetiracetam vs phenobarbital for maintaining low seizure burden in a retrospective cohort of 25 neonates monitored with video electroencephalography (EEG). Video EEG tracing were reviewed and paired with medication bolus times to determine seizure burden after treatment. Initial cumulative dose of phenobarbital was 20 mg/kg in all but 1 case; initial cumulative dose of levetiracetam ranged from 50 to 100 mg/kg. Eleven of 17 (65%) patients sustained seizure burden <10% following initial treatment with levetiracetam, compared with 5 of 8 (63%) with phenobarbital. Thirteen (76%) patients treated with levetiracetam had sustained seizure burden <20% compared with 6 (75%) treated with phenobarbital. The phenobarbital group showed a larger absolute reduction in average seizure burden in the hour before and after treatment (−24.3  vs −14.2 minutes/h). Six of 17 (35%) patients treated with levetiracetam remained seizure free after initial treatment, compared with 2 of 8 (25%) patients treated with phenobarbital. Initial treatment with levetiracetam was associated with shorter average time to seizure freedom (15 vs 21 hours). None of these results were statistically significant. Cumulative doses of levetiracetam 100 mg/kg were well tolerated and associated with substantial decrease in seizure burden in several cases. Levetiracetam remains a promising first-line treatment for neonatal seizures; additional randomized controlled trials evaluating the effects of high-dose levetiracetam on seizure burden and long-term outcomes are warranted.
Physicians’ Perspectives on Presurgical Discussion and Shared Decision-Making in Pediatric Epilepsy Surgery
Authors: Samanta Debopam , Ostendorf Adam P , Singh Rani , Gedela Satyanarayana , Elumalai Vimala , Hoyt Megan Leigh , Perry M. Scott , Bartolini Luca , Curran Geoffrey M
Published: March 2022

Objective: To qualitatively explore the approach of pediatric epilepsy providers when counseling regarding surgical options for epilepsy, presenting risks and benefits of surgery, overcoming resistance to surgery, and fostering shared decision making with patients and families. Methods: We conducted in-depth interviews with 11 academic clinicians (5- neurologists, 5- epileptologists, 1- neurosurgeon) from a Level 4 pediatric epilepsy center to explore how physicians communicate and pursue surgical decision-making. Results: A blended inductive-deductive analysis revealed three key themes (with subthemes) of presurgical discussions: (1) Candidate selection and initial discussion about epilepsy surgery (neurologists compared to epileptologists, the timing of the discussion, reluctant families) (2) Detailed individualized counseling about epilepsy surgery (shared decision-making [enablers and barriers] and risk-benefit analysis [balancing risks and benefits, statistical benefit estimation, discussion about SUDEP, prognostication about cognitive and behavioral outcomes, risks of surgery]) (3) Tools to improve decision-making (educational interventions for patients and families and provider- and organization-specific interventions). Significance: Presurgical discussions lack uniformity among physicians who treat epilepsy. Despite general interest in collaborative decision-making, experts raised concern about lack of exposure to communication training and clinical tools for optimizing decision-making, a high number of families who do not feel equipped to share the decision making leaving the decision-making entirely to the physician, and paucity of practical resources for individualized risk-benefit counseling. Clinical practice guidelines should be developed to reduce existing practice variations in presurgical counseling. Further consensus is needed about when and how to initiate the conversation about epilepsy surgery, essential components of the discussion, and the utility of various tools to improve the utilization of epilepsy surgery.
Capillary Refill Technology to Enhance the Accuracy of Peripheral Perfusion Evaluation in Sepsis
Authors: Gillespie Jordan , Hansen Matthew , Samatham Ravi , Baker Steven D. , Filer Scott , Sheridan David C.
Published: March 2022

Background: Monitoring of capillary refill time (CRT) is a common bedside assessment used to ascertain peripheral perfusion in a patient for a vast array of conditions. The literature has shown that a change in CRT can be used to recognize life-threatening conditions that cause decreased perfusion, such as sepsis, and aid in resuscitation. The current practice for calculating CRT invites subjectivity and produces a highly variable result. Innovative technology may be able to standardize this process and provide a reliable and accurate value for use in diagnostics and treatment. This study aimed to assess a new technology (DCR by ProMedix Inc.) for rapid, bedside, and noninvasive detection of CRT. Methods: This was a secondary analysis of a prospective observational study evaluating the accuracy of new technology towards CRT-guided diagnosis of sepsis. It was carried out in the adult emergency departments (ED) of an academic tertiary care medical center. Patients seeking care in the ED were determined eligible if they were > 18 years in age and exhibited chief complaints suggestive of possible sepsis. The CRT produced by the technology was compared to the gold standard manual waveform assessment. Results: 218 consecutive subject enrollments were included and multiple measurements were made on each patient. Data with irregular waveforms were excluded. A total of 692 waveforms were evaluated for CRT values by a pair of trained PhD biomedical engineers. The average age of the cohort was 50.62 and 51.4% female. Results showed a Pearson correlation coefficient of 0.91 for the device CRT compared to the CRT gold standard. The Pearson correlation coefficient for the two independent engineering review of the waveform data was 0.98. This device produces accurate, consistent results and eliminates the subjectivity of CRT measurements that is in practice currently.
Toward a Gender-Inclusive Complete Streets Movement
Authors: McAndrews Carolyn , Schneider Robert J. , Yang Yicong , Kohn Genevieve , Schmitz Andrew , Elliott Forrest , Pittner Jessica , Purisch Hans
Published: March 2022

Research offers ample insights into how people of different genders could experience transportation systems in equitable ways, but gender equity is still not part of mainstream transportation practice. We propose that Complete Streets could serve as an implementation system to advance gender equity. We provide empirical information, gender concepts, and regional cases from literatures on gender and transportation, multimodal travel, and public space to support this call to action. We find that a gender-aware Complete Streets movement would: 1) implement gender-specific tools and data; 2) address social environments and infrastructure; and 3) establish a gender-inclusive agenda to reform transportation policy.
Evidence from the nonlinear autoregressive distributed lag model on the asymmetric influence of the first wave of the COVID-19 pandemic on energy markets
Authors: Armeanu Daniel Stefan , Gherghina Stefan Cristian , Andrei Jean Vasile , Joldes Camelia Catalina
Published: March 2022

The COVID-19 pandemic remained a global risk factor and integrated into various means in the functioning of companies, economies and financial markets. Therefore, this paper investigates how COVID-19 influences the energy market in the main financial markets (China, France, Germany, Italy, Spain and the United States), using time series from February 28, 2020, to November 3, 2020. The goal of this research is to investigate the asymmetric impact of COVID-19 from leading financial markets on energy commodities. In this regard, the non-linear auto-regressive distributed lag (NARDL) framework is employed to capture the long-run asymmetric reactions. The econometric design allows to explore the long-term asymmetric reactions of dependent variables through positive and negative partial sum decompositions of changes in the explanatory variables. The quantitative results show a significant long-run asymmetric interdependence between the number of new SARS-CoV-2 incidence and mortality and the daily percent change in close price of future contracts pertaining to Brent oil, crude oil WTI, carbon emissions, gasoline RBOB, heating oil, Chukyo kerosene, and natural gas. Furthermore, no asymmetry is found in the case of ethanol and fuel oil futures. The novelty of this article is the study of the impact of COVID-19 on the energy sector during the first two waves of COVID-19 by applying the NARDL model that allows to capture long-term asymmetric reactions. Certainly, further research on this topic is necessary due to the permanent shifts in the pandemic, as well as the availability of longer data periods on COVID-19.
The meaning of democracy in an era of good governance: Views of representation and their implications for board composition
Authors: Stenling Cecilia , Fahlén Josef , Strittmatter Anna-Maria , Skille Eivind Å.
Published: March 2022

Contemporary sport governance contexts are marked by a trend towards efficiency-based board composition and an increasing use of instruments aimed to (re)shape boards. Yet, democratic governance is integral to many countries’ sport systems, and research tells us that representation still matters in sport governance. Considering this, the aim with this paper is to provide researchers and practitioners with a vocabulary to understand and address issues of representation in board composition. The paper builds on interviews with nomination committee representatives of 62 Swedish national sport federations (NSFs). The analysis provides insights into the meaning and implications of four distinct views of representation, along with an interpretation of potential responses to board-shaping instruments engendered by these views.
Understanding Medication Adherence in Bhutanese Refugees With Diabetes in a Midwestern City
Authors: Timsina Muna K. , Peltzer Jill N. , Pokharel Yashashwi , Peterson JoAnn M. , Schwartz Lori J. , LeMaster Joseph W.
Published: March 2022

Introduction:

Bhutanese refugees have a higher prevalence of type 2 diabetes but are less likely to achieve medication adherence and glycemic control. The purpose of this project was to understand factors affecting diabetes medication adherence in this population.

Methodology:

This was a qualitative project using focus groups of adult Bhutanese refugees with type 2 diabetes ≥18 years old and hemoglobin A1C ≥8% and their caregivers from a family medicine clinic at the University of Kansas. Data were analyzed using content analysis.

Results:

A total of 23 individuals participated. Three themes emerged from data analysis: desire to engage in care but face multiple barriers, family and community support invaluable for health, and considerations for culturally contextual person-centered care. Participants provided specific recommendations to address the barriers, with emphasis on improving health literacy.

Discussion:

Integrating the identified factors can foster person-centered, culturally congruent care to improve diabetes medication adherence in Bhutanese refugees.
Experiences Following Amputation among Amputees and Their Caregivers: An Exploratory Study in a Developing Country
Authors: Ohenewa Esther , Yendork Joana Salifu , Amponsah Benjamin
Published: March 2022

Amputation is necessitated following an accident or a medical condition often to save a patient's life. Despite the existence of the procedure and the rising number of amputees in the Ghanaian context, the emotional experiences of both amputees and their caregivers following amputation has been largely ignored. This qualitative exploratory study explored the emotional experiences of amputees and their caregivers following amputation. Using a semi-structured interview guide, ten (10) amputees and ten (10) caregivers were interviewed. Findings revealed that caregivers and amputees experienced a built up of negative emotions following amputaion. There were slight disparities in the negative emotions experienced by amputees and their caregivers. However, for both amputees and their caregiver, the experience of gratitude and news breaking method influenced their emotional experiences. Implications of the findings are discussed.
What are the Soft Tissue Risk Factors for Obstructive Sleep Apnea in Patients with Down's Syndrome?
Authors: Stanbouly Dani , Steinberg Barry , Chuang Sung-Kiang
Published: March 2022

Objective

To determine the risk factors and their respective magnitudes for developing Obstructive Sleep Apnea (OSA) in Down syndrome (DS) patients.

Design

Retrospective cohort study.

Patients

The 2016 Kids’ Inpatient Database (KID) was queried to identify all patients diagnosed with DS.

Main Outcome Measures

The primary predictor variables were tonsillar hypertrophy (TH), adenoidal hypertrophy (AH), Hypertrophy of Tonsils & Adenoids (HTA), Laryngeal Stenosis (LS), Hypotonia, Glossoptosis, Congenital Laryngomalacia (CL), and Overweight & Obesity (OO). The primary outcome variable was OSA.

Results

The final sample consisted of 18,181 patients with a diagnosis of DS. Relative to patients aged 0-5, patients aged 6-10 (OR 3.5, P < 0.01), 11-5 (OR 3.4, P < 0.01), and 16 & above (OR 3.6, P < 0.01) were each independently associated with increased odds of OSA. Further, TH (OR 23.2, P < 0.01), AH (OR 20.3, P < 0.01), HTA (OR 64.2, P < 0.01), glossoptosis (OR 5.0, P < 0.01), CL (OR 4.3, P < 0.01), and OO (OR 3.7, P < 0.01) were all independent risk factors for OSA.

Conclusions

The presence of hypertrophied tonsils and adenoids together was the strongest risk factor for OSA. DS patients aged six and above were at risk for OSA development relative to younger patients. Patients with DS should be tested for OSA, which otherwise will deteriorate their existing comorbidities.