bluuebunny/crossref_metadata_2025 huggingface dataset:
Skills, competencies and literacies attributed to 4IR/Industry 4.0: Scoping review
Authors: Chaka Chaka
Published: December 2020

Much has been said about the fourth industrial revolution (4IR) or Industry 4.0 since its launch in 2011. In addition, certain skills have been touted as specifically 4IR or Industry 4.0 skills. Amidst all this, not much work has been done that focuses on and identifies what those skills are from a cross-disciplinary perspective. The current scoping review study set out to identify skills, competencies and literacies attributed to 4IR/Industry 4.0 by 64 peer-reviewed journal articles drawn from diverse subject disciplines. Three of its findings are worth mentioning. First, skills and competencies attributed to 4IR by the reviewed journal articles are generic soft skills often dubbed the 21st-century skills such as communication, creativity and problem solving. Second, of the hard skills, programming skills feature predominantly as the 4IR skills from the reviewed articles. Thirdly, information literacy is under-represented and under-cited as a skill for 4IR in the reviewed articles.
Design and numerical simulation for the development of an expandable paediatric heart valve
Authors: Kerr Monica M , Gourlay Terence
Published: December 2020

Current paediatric valve replacement options cannot compensate for somatic growth, leading to an obstruction of flow as the child outgrows the prosthesis. This often necessitates an increase in revision surgeries, leading to legacy issues into adulthood. An expandable valve concept was modelled with an inverse relationship between annulus size and height, to retain the leaflet geometry without requiring additional intervention. Parametric design modelling was used to define certain valve parameter aspect ratios in relation to the base radius, Rb, including commissural radius, Rc, valve height, H and coaptation height, x. Fluid-structure simulations were subsequently carried out using the Immersed Boundary method to radially compress down the fully expanded aortic valve whilst subjecting it to diastolic and systolic loading cycles. Leaflet radial displacements were analysed to determine if valve performance is likely to be compromised following compression. Work is ongoing to optimise valvular parameter design for the paediatric patient cohort.
Bringing home the bacon: Testing a moderated mediation model of job insecurity, work–family conflict, and parent–child attachment
Authors: Hongbo Li , Waqas Muhammad , Tariq Hussain , Yahya Farzan
Published: December 2020

Job insecurity, defined as a perceived loss of continuity in a job situation that can span from the loss of some subjectively important job features to the permanent loss of the job itself, has been associated with a number of adverse outcomes at organizational as well as individual levels. However, how it affects employees’ family life has gained relatively less attention. To examine this, based on role stress theory and boundary theory, this study answers how job insecurity affects parent–child attachment; so far, an ignored phenomenon. Besides, this study also investigates how segmentation preference mitigates the adverse effects of job insecurity. Based on time-lagged, 318 dyadic (including 318 parents and 318 kids) data collected from Chinese individuals, we found support for all the proposed relationships, i.e. job insecurity weakens the parent–child attachment through mediating effect of work–family conflict. The findings also conclude that employees’ segmentation preference restricts the adverse effects of job insecurity and weakens its effect on the family domain. In yielding these findings, this study not only highlights the effect of perceived job insecurity on the family domain, the mechanism through which it occurs, and the moderating effect of a given factor but also provides insights to organizations so they could improve employees’ family life. The broader contribution to theory, practical implications, and suggestions for future research are discussed.
Public Service Motivation and Prosocial Rule-Breaking: An International Vignettes Study in Belgium, Germany, and the Netherlands
Authors: Weißmüller Kristina S. , De Waele Lode , van Witteloostuijn Arjen
Published: December 2020

We theorize that people with high Public Service Motivation (PSM) are especially prone to engage in prosocial rule-breaking (PSRB) behavior, which ultimately leads to discriminatory practices, particularly for clients associated with positive affect. We conduct an original vignette study in three countries (Belgium, Germany, and the Netherlands) with 928 observations in total. Our findings provide tentative behavioral evidence on a linear relationship between PSM and the likelihood of PSRB and a strong positive association with client likeability, which is an asymmetric relationship: Negative affect cues have a larger negative effect than positive affect cues have a positive effect on PSRB. Although our results vary across the three country studies regarding the effects of PSM, overall, the results imply that high-PSM individuals have a tendency to being more likely to engage in PSRB and that clients who are perceived as more favorable will receive a less strict application of bureaucratic rules compared to less favorable clients.
Nicotine: A Targeted Therapy for Epilepsy Due to nAChR Gene Variants
Authors: Fox Jordana , Thodeson Drew M. , Dolce Alison M.
Published: December 2020

Objective:

Genetic variants of the neuronal nicotinic acetylcholine receptor (nAChR) cause autosomal dominant sleep-related hypermotor epilepsy. Approximately 30% of autosomal dominant sleep-related hypermotor epilepsy patients are medically intractable. In preclinical models, pathogenic nAChR variants cause a gain of function mutation with sensitivity to acetylcholine antagonists and agonists. Nicotine modifies the activity of nAChRs and can be used as targeted therapy.

Methods:

We reviewed next-generation sequencing epilepsy panels from a single laboratory (GeneDx) from patients at Children’s Medical Center Dallas between 2011 and 2015 and identified patients with nAChR variants. Retrospective review of records included variant details, medical history, neuroimaging findings, and treatment history.

Results:

Twenty-one patients were identified. Four patients were prescribed nicotine patches for intractable seizures. Three of 4 patients had a clinical response, with >50% seizure reduction.

Conclusions:

Treatment with a nicotine patch can be an effective therapy in epilepsy patients with nAChR gene variants. We propose consideration of transdermal nicotine treatment in intractable epilepsy with known nAChR variants as an experimental therapy. Further clinical trials are needed to fully define therapeutic effects.
Characteristics Associated With Being Asked About Violence Victimization in Health Care: A Swedish Random Population Study
Authors: Simmons Johanna , Swahnberg Katarina
Published: December 2020

Recommendations to routinely question patients about violence victimization have been around for many years; nonetheless, many patients suffering in the aftermath of violence go unnoticed in health care. The main aim of this study was to explore characteristics associated with being asked about experiences of violence in health care and thereby making visible victims that go unnoticed. In this study, we used cross-sectional survey data from 754 men (response rate 35%) and 749 women (response rate 38%) collected at random from the Swedish population, age 25–85. Questions were asked about experiences of emotional, physical, and sexual violence from both family, partner, and other perpetrators. Only 13.1% of those reporting some form of victimization reported ever being asked about experiences of violence in health care. Low subjective social status was associated with being asked questions (adj OR 2.23) but not with victimization, possibly indicating prejudice believes among providers concerning who can be a victim of violence. Other factors associated with increased odds of being asked questions were: being a woman (adj OR 2.09), young age (24–44 years, adj OR 6.90), having been treated for depression (adj OR 2.45) or depression and anxiety (adj OR 2.19) as well as reporting physical violence (adj OR 2.74) or polyvictimization (adj OR 2.85). The main finding of the study was that only few victims had been asked questions. For example, among those reporting ≥4 visits to a primary care physician during the past 12 months, 43% reported some form of victimization but only 6% had been asked questions. Our findings underline the importance of continuing to improve the health care response offered to victims of violence.
The Associations Between Sexual Victimization and Health Outcomes Among LGBQA College Students: Examining the Moderating Role of Social Support
Authors: DeLaney Eryn N. , Williams Chelsea Derlan , Mosley Della V. , Hawn Sage E. , Dick Danielle M.
Published: December 2020

Prior studies have demonstrated that sexual minority college students are two to four times more likely to experience sexual victimization (e.g., sexual assault and/or unwanted or uncomfortable sexual experiences) compared to their heterosexual counterparts. However, research that has focused on the detrimental effects of sexual victimization on health outcomes has paid more attention to heterosexual college samples and community-based adults. Understanding how sexual victimization influences mental health and substance use outcomes among lesbian, gay, bisexual, queer, and asexual (LGBQA) emerging adults in college is warranted given that this developmental period represents a critical risk period for trauma exposure, risk behavior, and psychological distress. Thus, the current study tested how sexual victimization was associated with depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and alcohol use disorder (AUD) symptoms among 234 diverse college students who self-identified as LGBQA. Additionally, social support was tested as a moderator. Findings indicated that sexual victimization was related to greater depressive symptoms, PTSD symptoms, and AUD symptoms. In addition, perceived social support moderated the relation between sexual victimization and depressive symptoms, however, in a direction contrary to hypotheses. In particular, higher sexual victimization was associated with greater depressive symptoms among LGBQA students with higher levels of social support ( b = .29, p = .00), and was not significant among LGBQA students with lower levels of social support ( b = .13, p = .26). The current study highlights the need to consider the detrimental effects of sexual victimization on health outcomes among LGBQA college students, as well as the mechanisms through which social support may be influencing these relations.
Child Psychiatric Patients Exposed to Intimate Partner Violence and/or Abuse: The Impact of Double Exposure
Authors: Hultmann Ole , Broberg Anders G. , Axberg Ulf
Published: December 2020

Children’s exposure to intimate partner violence (IPV) and child abuse (CA) is strongly related to later psychological problems. Few studies exist on patients in child and adolescent mental health services (CAMHS) who have been singly or doubly exposed to IPV and/or CA. The overall aim of the current study was to compare self-reported psychiatric symptoms, post-trauma impact, and post-traumatic stress disorder (PTSD) diagnoses among CAMHS patients who had been singly or doubly exposed or had reported no family violence (NoFV). We expected to find more severe symptoms in both singly and doubly exposed patients than in the NoFV group and that double exposure was associated with more severe symptoms than single exposure (to IPV or CA). Finally, we expected to find that higher frequencies of exposure to IPV or CA were related to more psychiatric symptoms, greater post-trauma impact, and a higher likelihood of PTSD diagnosis. We compared psychiatric symptoms, post-trauma impact, and PTSD diagnosis in 578 patients aged 9–17 years with NoFV (n = 287), single exposure (n = 162), and double exposure (n = 129). The influence of gender, age, age of onset, frequency, and traumatic interpersonal events outside the family (IPE) were regressed on psychiatric symptoms, post-trauma impact, and PTSD diagnoses. Patients with double exposure had more severe symptoms than the NoFV group, and patients with single exposure had more trauma-related symptoms than the NoFV group. Double exposure was associated with more severe symptoms than single exposure, and frequency (of exposure to IPV and/or CA) and IPE influenced trauma symptoms and psychiatric symptoms, respectively. Exposure to more than one type of violence is associated with more severe symptoms, but other factors such as frequency of violent acts and IPE are important factors to focus on in future studies and clinical assessment.
Prevalence of Sexual Victimization Among Female and Male College Students: A Methodological Note With Data
Authors: Jouriles Ernest N. , Nguyen Jamie , Krauss Alison , Stokes S. Lynne , McDonald Renee
Published: December 2020

This study provides insight on how sample recruitment methods may affect reported rates of sexual victimization on college campuses. The study compares sexual victimization rates among students who complete surveys after initial requests with those who complete them only after multiple reminders. Using probability sampling methods, undergraduate students from 12 universities were invited to complete a survey on campus violence; initial invitations were followed with up to five reminders. Women ( n = 1,008) and men ( n = 344) who completed surveys were categorized as early, middle, or late responders based on the number of reminders required to convert them from non-responders to responders. About 24.2% of women and 15.6% of men reported sexual victimization in the previous two months. In initial analyses, female early and late responders did not differ on sexual victimization, but males did. Male late responders reported higher rates of sexual victimization than early responders. In sensitivity analyses that re-defined early and late responders, women who were early responders reported more sexual victimization than women who were late responders, while men who were early responders reported less sexual victimization than men who were late responders. These findings suggest that researchers may underestimate sexual victimization rates for male college students unless multiple attempts are made to solicit their participation. Researchers are encouraged to utilize multiple reminders to increase research participation.
Challenges in Treating Mycobacterium chelonae/abscessus Prosthetic Joint Infection
Authors: Singh Divita , Johnson Mikayla , Kitchens Caleah S. , Boone Andrew
Published: December 2020

Prosthetic joint infections (PJIs) remain a major complication of arthroplasty, most of which are caused by Staphylococcus aureus and gram-negative bacteria. Unfortunately, cultures are false negative in upward of 7 percent of patients with suspected PJIs, and commonly in infections caused by rare rapidly growing mycobacterium (RGM) species. Guidelines recommend 6 months of antimycobacterial therapy for bone diseases caused by RGM, with empiric therapy consists of an oral macrolide (clarithromycin or azithromycin) plus tobramycin and imipenem-cilastatin. Definitive treatment of PJI due to RGM should be guided by antimicrobial susceptibility, however, most microbiology laboratories are unable to differentiate between M. chelonae and M. abscessus. Furthermore, treatment of M. chelonae PJI is challenging due to multidrug resistance and the dearth of oral antibiotics for therapy. This case report investigates a patient with PJI caused by M. chelonae and M. abscessus. The initial treatment with imipenem-cilastatin was complicated by drug induced seizures, further limiting therapy options.
Improving the Trustworthiness/Validity of Interview Data in Qualitative Nonprofit Sector Research: The Formative Influences Timeline
Authors: Jones Jennifer A. , Donmoyer Robert
Published: December 2020

Historically, bias has been viewed as a problem with qualitative research, in large part because the researcher is often a qualitative study’s primary (or, in some cases, only) research “instrument.” Even most constructivists who reject traditional notions of scientific objectivity want to produce reasonably accurate reconstructions of their research participants’ interpretations of the social world. In fact, presenting accurate reconstructions is one thing constructivists mean when they talk about a study’s trustworthiness. Various procedures have been developed to minimize bias and ensure trustworthiness. The Formative Influences Timeline (FIT) is one such procedure. This article provides a brief history of bias in qualitative research, describes the FIT and how to use it, and reviews nonprofit research studies that either employed—or could have employed—the FIT to produce data relatively uncontaminated by researchers’ a priori assumptions. The article concludes by acknowledging limitations of the FIT.
Accruals Management to Avoid The Current Ratio Falling Below One: An Empirical Analysis Among Nonprofits
Authors: Lancksweerdt Lode , Van Caneghem Tom , Reheul Anne-Mie
Published: December 2020

This study examines the distribution of the current ratio among large Belgian nonprofit organizations (NPOs). A current ratio falling below one signals (potential) liquidity problems among different types of stakeholders. Consistent with managerial intervention to avoid the current ratio falling below one, we observe significantly more (fewer) observations meeting or just exceeding (falling below) the threshold of one than would normally be expected. This discontinuity around one disappears when considering the distribution of the “pre-managed” current ratio (i.e., the current ratio corrected for abnormal working capital accruals). The latter observation is consistent with managerial intervention in the financial reporting process to avoid the current ratio falling below one. The aforementioned findings are supported by a multivariate regression model revealing significantly higher abnormal working capital accruals for observations having a current ratio equaling or exceeding one, but a pre-managed current ratio falling below one.
Family relations and the economic-metaphysical message of Instruction
Authors: Ben-Dov Jonathan
Published: December 2020

Much of the sapiential treatise Instruction (=4QInstruction) can be read as a systematic attempt to support one basic ideological principle: Each person has a divinely assigned share, and every interaction that requires mixing that share with other agents is a breach of the metaphysical order. This idea was first formulated with regard to Instruction by Menahem Kister. In the present article, I apply this notion to the prologue (preserved in 4Q416 1) and to the sections on family relations (parents, wife) in 4Q416. These latter cases explore the financial relations within a family and align them with the overall principle of Instruction. The various sections highlight the person’s spirit as a commodity, intertwined with the life and capital of that person. The literary focus is on the phenomenology of the spirt, as it shifts during various transactions. The biblical allusions in these sections are explained along the same line of argument.
Data management for developing digital twin ontology model
Authors: Singh Sumit , Shehab Essam , Higgins Nigel , Fowler Kevin , Reynolds Dylan , Erkoyuncu John A , Gadd Peter
Published: December 2020

Digital Twin (DT) is the imitation of the real world product, process or system. Digital Twin is the ideal solution for data-driven optimisations in different phases of the product lifecycle. With the rapid growth in DT research, data management for digital twin is a challenging field for both industries and academia. The challenges for DT data management are analysed in this article are data variety, big data & data mining and DT dynamics. The current research proposes a novel concept of DT ontology model and methodology to address these data management challenges. The DT ontology model captures and models the conceptual knowledge of the DT domain. Using the proposed methodology, such domain knowledge is transformed into a minimum data model structure to map, query and manage databases for DT applications. The proposed research is further validated using a case study based on Condition-Based Monitoring (CBM) DT application. The query formulation around minimum data model structure further shows the effectiveness of the current approach by returning accurate results, along with maintaining semantics and conceptual relationships along DT lifecycle. The method not only provides flexibility to retain knowledge along DT lifecycle but also helps users and developers to design, maintain and query databases effectively for DT applications and systems of different scale and complexities.
Surface integrity in laser-assisted machining of Ti6Al4V
Authors: Kalantari O , Fallah MM , Jafarian F , Hamzeloo SR
Published: December 2020

In laser-assisted machining (LAM), the laser source is focused on the workpiece as a thermal source and locally increases the workpiece temperature and makes the material soft ahead of the cutting tool so using this method, the machining forces are reduced, which causes improving the surface quality and cutting tool life. Machinability of advanced hard materials is significantly low and conventional methods do not work effectively. Therefore, utilizing an advanced method is inevitable. The product life and performance of complex parts of the leading industry depends on surface integrity. In this work, the surface integrity features including microhardness, grain size and surface roughness (Ra) and also the maximum cutting temperature were investigated experimentally in LAM of Ti-6Al-4V. According to the results, cutting speed has inverse effect on the effectiveness of LAM process because with increasing speed (15 to 63 m/min), temperature decreases (524 °C to 359 °C) and surface roughness increases (0.57 to 0.71 μm). Enhancing depth of cut and feed has direct effect on the process temperature, grain size, microhardness and surface roughness.
Manufacturing of stable hydrophobic surface on rare-earth oxides aluminium hybrid composite
Authors: Sharma Vipin Kumar , Kumar Vinod , Joshi Ravinder Singh
Published: December 2020

Hydrophobic surfaces have shown promising applications in the field of energy, medicines, transportation and aerospace. Currently used materials including metals, alloys and metal matrix composites have shown hydrophilic behaviour and require some alternatives materials in order to make them hydrophobic. However, these alternatives materials go down in severe environmental conditions. Instead of alternative materials to be called as surface modifier, the addition of lanthanides series rare-earth-oxides (REOs) as reinforcement for class of aluminium hybrid composites is studied for their effect on hydrophobic properties. Wettability behavior analysis between the aluminium liquid matrix and Al2O3/SiC reinforcement can be improved by the addition of REOs. Results showed that the contact angle of composites with Al2O3/SiC reinforcement lies in the range of 87.94° to 98.52°. Whereas addition of 2.5 wt % REO raised the contact angle above 100.78°. The hybrid composites with REOs show better corrosion resistant properties due to better hydrophobicity. As REO ceramics have better mechanical, thermal and chemical properties as compared with polymer-based materials, they can be applied to the industrial conditions involving exposure to elevated temperature or abrasive wear without degradation of the water repelling properties. The water repellency of the aluminum based hybrid composites improved with the incorporation of rare earth nano-particles as per the Cassie-Baxter Model.
An experimental study of rotor-stator wake unsteadiness in a multistage axial compressor
Authors: Li Jun , Hu Jun , Zhang Chenkai
Published: December 2020

The flow in a multistage axial compressor is highly unsteady, three-dimensional and turbulent. The interaction between compressor blade rows results in rotor/stator wake unsteadiness, which is not typically considered in the computational fluid dynamics (CFD) models. To gain depth and insight into the inner flow mechanism in multistage compressors, specifically the wake variability driven by the rotor/stator and stator/stator interactions, a compound total-pressure pneumatic probe with both high and low response-frequency were designed and manufactured. Unsteady rotor and stator wake measurements between blade rows for the third stage were carried out with this probe installing on a 3-DOF displacement mechanism, to deepen the knowledge of unsteady interactions in the embedded stages of a four-stage low-speed axial compressor. By performing frequency spectrum analysis and ensemble-average methods, higher spectral magnitude of the blade passing frequency (fBPF) and higher root mean square values of total pressure (PtRMS) at both sides of the stator wake region caused by the shedding of upstream boundary layer are revealed. In addition, the high-order harmonics are strengthened by the stator/stator interactions, especially near the blade tip. The individual contributions of rotor geometry variations/interactions of the upstream rotor wakes and the effects of downstream stator potential modulation to the wake variations can be understood.
Thermal and structural response of aerospike mounted on blunt-nose body
Authors: ZhunHyok Zhang , CholJin Won , CholUk Ri , CholJin Kim , RyongSop Kim
Published: December 2020

The inclusion of aerospike on blunt nose body of hypersonic vehicle has been considered to be the simplest and most efficient technique for a concurrent reduction of both aeroheating and wave drag due to hypersonic speed. However, the thermal and mechanical behavior of aerospike structure under the coupling effect of aerodynamic force and aeroheating remains unclear. In this study, the thermal and structural response of aerospike mounted on the blunt nose body of hypersonic vehicle was numerically simulated by applying 3 D fluid-thermal-structural coupling method based on loosely-coupled strategy. In the simulation, the angle-of-attack and the spike’s length and diameter are differently set as α = 0°–10°, L/D = 1–2 and d/D = 0.05–0.15, respectively. Through the parametric study, the following results were obtained. Firstly, the increase of vehicle’s angle-of-attack and spike’s length unfavorably affect the thermal and structural response of aerospike. Secondly, the increase of spike’s diameter can improve its structural response characteristic. Finally, the aerospike with the angle-of-attack of 0° and the length and diameter of L/D = 1 and d/D = 0.15, respectively, is preferred in consideration of the effect of flight angle-of-attack and spike’s geometrical structure on the thermal and structural response of spike and the drag reduction of vehicle. The numerical calculation results provide a technical support for the safe design of aerospike.
A novel system identification algorithm for quad tilt-rotor based on neural network with foraging strategy
Authors: Wang Zhigang , Lyu Zhichao , Duan Dengyan , Li Jianbo
Published: December 2020

Quad tilt-rotor(QTR) UAV is a nonlinear time-varying system in full flight mode. It is difficult and inaccurate to model the nonlinear time-varying system, which cannot fully reflect the problem of controlling input and system response output in the full flight mode. In order to solve the above problems, a novel neural network model was adopt to identify the nonlinear time-varying system of quad tilt-rotor in full flight mode. An adaptive learning rate algorithm based on foraging strategy is proposed based on the global error BP neural network. Corresponding to the nonlinear time-varying system, BP neural network is set as the time-invariant system structure with constant network structure and continuously changing weights at multiple times, and the nonlinear input-output relationship under the time-varying system is jointly described by fitting the network at all times. The extended Kalman filtering algorithm is used to track the network connection weights by modifying the network weights at the current moment with the input and output data at the next moment. The final identification result shows that the smaller mean square error of both only transition process and full flight mode, shows that using this optimization algorithm can well describe the input and output characteristics of the nonlinear time-varying systems. When the same network structure is adopted, no matter for transition mode or full mode, the BP optimization algorithm based on foraging strategy is better than the global BP algorithm for system identification of the full mode quad tilt-rotor. Therefore, when the BP neural network based on foraging strategy is adopted, the same network structure can be adopted to systematically identify the full mode of quad tilt-rotor by changing the weight.
Sir Hew Strachan and the Study of the First World War
Authors: Boff Jonathan
Published: December 2020

Sir Hew Strachan is the most influential British historian of the First World War of his generation. Not only has Strachan transcended intra-disciplinary boundaries and national borders within his own work, but he has tirelessly encouraged others, both within and outwith academia, follow in his footsteps. The result is an approach to the history of the First World War which is truly global and multi-faceted. While still rooted in a firm grasp of the detail of military operations, it thus incorporates the newest techniques and approaches to exemplify the best of the new ‘history of warfare’.
Does Globalisation Influence Employment? Empirical Investigation on Individual as well as Panel of South Asian Countries
Authors: Das Ramesh Chandra , Ray Kamal
Published: December 2020

Debate on globalisation versus protectionism was relevant in long back, though prevailing consensus construing protectionism saves job in the short run and slows economic growth in the long run. The objective of the study is to examine empirically whether globalisation affects overall employment generation in the South Asian countries during the period 1991–2016 in individual as well as panel of countries. Having no long-run associations in the majority of the countries, results support that the change in globalisation index makes a cause to change in employment only for Bhutan, while change of growth rate of employment makes a cause to change in the rate of globalisation for Maldives and Nepal. Further, the dynamic panel study fails to establish any long-run relationships between globalisation and employment of the countries of the region. However, in the short run, globalisation makes a cause to employment in the panel format, which is highly unlikely to happen in case of the individual countries. Thus, extent of globalisation and employment generation in the South Asian countries do not have strong inter relationships.
Effects of Trade Reform on Health and Tourism Sectors of the Reforming Country
Authors: Mandal Biswajit , Chattopadhyay Soumyadip , Prasad Alaka Shree
Published: December 2020

Health trade and related tourism have become prevalent in recent times, particularly in countries where quality medical services are provided at a relatively low cost. Therefore, using a competitive general equilibrium trade model, this article theoretically attempts to find possible complementarity between the health sector and the tourism sector in a small open developing economy. While exploring the results, this article also finds the effect of trade reform on factor prices, per unit factor requirement and output of different sectors of the economy. Capital owners are seen to lose with trade reform, while labours and doctors gain. Eventually, both health and tourism sectors are found to be complementary in nature. However, expansion of these sectors is conditional on factor intensity assumption. Following this, we briefly touch upon the possible effects of deglobalisation in such an economy. We find that capitalists gain, whereas both doctors and labours suffer loss. Complementarity between health and tourism sectors persists, and the size of different sectors is again found to depend on factor intensity.
Analysis of Financial Performance of Public Sector Banks in India: CAMEL
Authors: Singh Yudhvir , Milan Ram
Published: December 2020

Public sector banks have been merged by the government in the last few years. This is the rationale behind conducting this study. The purpose of this article is to determine the factors affecting the performance of public sector banks in India and the interrelationship between bank-specific determinants and performance of public sector banks. In this article, we shall analyse the financial data of all the public sector commercial banks for a period spread across 11 years (2009–2019); Capital adequacy, Assets quality, Management efficiency, Earning, and Liquidity (CAMEL) has been used as a performance determinant; system generalised method of moments (GMM) analysis has been used to find the effect of determinants on the performance measurement of public sector banks; and CCA (canonical correlation analysis) has been used to find the interrelationship between the bank-specific determinants and the performance of public sector banks. The finding has important implications in terms of performance in the banking sector. Certain limitations of this study are: It is based on secondary data. The study only covers the financial aspects and not the non-financial aspects. It is found that the asset quality is negatively related with performance of public sector banks. Liquidity and inflation are inversely related to performance of public sector banks in India. Capital adequacy is positively related with banks’ performance, but inversely related with banks’ interest margin. GDP growth has a significant positive impact on banks’ performance, but inversely related with banks’ interest income. Inflation rate is inversely related with banks’ performance. Banking sector reforms are insignificantly related with banks’ performance.
Topical capsaicin versus topical ibuprofen in acute musculoskeletal injuries: A randomized, double-blind trial
Authors: Akgol Gur Sultan Tuna , Dogruyol Sinem , Kocak Abdullah Osman , Sanalp Menekse Tugba , Akbas Ilker , Betos Kocak Meryem , Cakir Zeynep
Published: December 2020

Background:

Acute musculoskeletal pain is one of the common causes of emergency admissions. Topical analgesics are an easily tolerated option in the treatment of these pains.

Objective:

This study aimed to compare the efficacy of topical capsaicin and topical non-steroidal anti-inflammatory drugs in acute musculoskeletal injuries.

Methods:

In this prospective, randomized, controlled, double-blinded study, patients were allocated to two groups—the topical non-steroidal anti-inflammatory drug (n = 60) and topical capsaicin (n = 59). For both groups, the first dose treatment was applied as a thin layer in the emergency department to a maximum area of 5 × 5 cm. The remaining doses were administered at home by the patients for 72 h. The initial visual analog scale scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the visual analog scale scores, clinical response to the treatment, and side effects were evaluated.

Results:

The proportional reduction in visual analog scale scores for topical capsaicin was significantly higher, especially at 36 and 72 h. These rates were 0.75 (95% confidence interval: 0.77–1.42; p = 0.029) and 9.08 (95% confidence interval: 1.02–17.14; p = 0.028) at 36 h, respectively. At 72 h, they were 1.27 (95% confidence interval: 0.48–2.05; p = 0.002) and 17.07 (95% confidence interval: 8.39–25.76; p < 0.001), respectively. In the topical capsaicin group, the clinical response to treatment was significantly higher (p = 0.001). Treatment-related systemic side effects were experienced only in the topical non-steroidal anti-inflammatory drug group (1.7%).

Conclusion:

Topical capsaicin can be used safely in patients presenting to the emergency department with acute pain with its high analgesic efficacy and absence of systemic side effects.
International Students’ Experience of Medical Training in an English-Speaking European Country
Authors: McGarvey Alice , Karivelil Deepak , Byrne Elaine
Published: December 2020

European medical schools are recruiting increasing numbers of international students. This study explores the impact of cultural backgrounds and language on the transition of international medical students to the clinical years of their training when they are predominantly based in hospitals and interacting with health professional staff and patients. A mixed-methods study was undertaken, incorporating 31 peer interviews and a focus group discussion and the development and conducting of an online survey ( n = 144; 50% response rate). We compared levels of social adjustment and integration between the students on a regional basis. Overall students adjusted well, but there were statistically significant regional differences in social adjustment and integration. The impact of communication difficulties from a language and cultural practice perspective was a dominant challenge highlighted, as was the differences in hospital culture and interprofessional communication norms. International medical students experience many challenges and benefits from studying in a multicultural environment. More nuanced demographic data need to be collected on admission to assist in potentially identifying those who may experience difficulties with academic and daily life transitions. In addition, all students in a multicultural environment would benefit from a program of acculturation for personal and career development.
Life in 90 words: opportunities for person-centred care amidst COVID-19
Authors: Theodoros Theo , Wyder Marianne , Lombardo Chiara , Dark Frances , Joseph Anup M , Steginga Anne , Locke Sharon , Kinsella Kieran , Kar Ray Manaan
Published: December 2020

Objective:

Coronavirus disease 2019 and the consequent public health and social distancing measures significantly impacted on service continuity for mental health patients. This article reports on contingency planning initiative in the Australian public sector.

Methods:

Ninety-word care synopses were developed for each patient. These formed the basis for guided conversations between case managers and consultant psychiatrists to ensure safe service provision and retain a person-centred focus amidst the threat of major staffing shortfalls.

Results:

This process identified vulnerable patient groups with specific communication needs and those most at risk through service contraction. The challenges and opportunities for promoting safety and self-management through proactive telehealth came up repeatedly. The guided conversations also raised awareness of the shared experience between patients and professionals of coronavirus disease 2019.

Conclusion:

There is a parallel pandemic of anxiety which creates a unique opportunity to connect at a human level.
Sources of Distress for Residents With Chronic Critical Illness and Ventilator Dependence in Long-Term Care
Authors: Howard A. Fuchsia , Crowe Sarah , Choroszewski Laura , Kovatch Joe , J. Haynes Adrianne , Ford Joan , Beck Scott , Haljan Gregory J.
Published: December 2020

Limited understanding of the psychological challenges experienced by individuals with chronic critical illness hampers efforts to deliver quality care. We used an interpretive description approach to explore sources of distress for individuals with chronic critical illness in residential care, wherein we interviewed six residents, 11 family members, and 21 staff. Rather than discuss physical symptoms, sources of distress for residents were connected to feeling as though they were a patient receiving medical care as opposed to an individual living in their home. The tension between medical care and the unmet need for a sense of home was related to care beyond the physical being overlooked, being dependent on others but feeling neglected, frustration with limited choice and participation in decision making, and feeling sad and alone. Efforts to refine health care for individuals with chronic critical illness must foster a sense of home while ensuring individuals feel safe and supported to make decisions.
Enhancing Care for Long-Term Care Residents Approaching End-of-Life: A Mixed-Methods Study Assessing a Palliative Care Transfer Form
Authors: Baetz-Dougan Madelaine , Reiter Leora , Quigley Laura , Grossman Daphna
Published: December 2020

Background:

Many barriers exist in providing quality end-of-life care in long-term care (LTC), including transitions of care between acute care and LTC. Transfer forms can be beneficial in ensuring resident’s end-of-life care needs are coordinated between different settings. The NYGH-LTC Transfer Form is a newly developed tool created to enhance care for residents transferred from acute care back to their LTC home for end-of-life.

Study Aim:

Assess the perceived ease of use, usefulness, and care-enhancing potential of the NYGH-LTC Transfer Form by interprofessional LTC staff.

Methods:

The study population included interprofessional staff members at 2 LTC homes in Toronto, Canada. Quantitative data was obtained through surveys and qualitative data was obtained through focus groups.

Results:

There were a total of 34 participants. 79.4% of participants agreed the form was easy to use and 82.4% agreed it would improve care. Subgroup analysis demonstrated that participants with greater than 20 years experience were less likely to agree that it would improve care (p = 0.01). Qualitative analysis generated 4 themes: 1) Strengths, 2) Areas of Improvement, 3) Information Sharing, and 4) Communication.

Conclusions:

The NYGH-LTC Transfer Form was overall well-evaluated. The form was seen as most useful for those with less experience or less confidence in palliative care. Communication was identified as a major barrier to successful transitions of care and increased bidirectional verbal communication is needed in addition to the form.
Efficacy of Staged Oronasal Fistula Reconstruction and Improved Bone Graft Survival in Cleft Patients Undergoing Secondary Reconstruction
Authors: Awad Amanda N. , Watman Olivia F. , Nguyen Brittany N. , Kanth Aditi M. , Adetayo Oluwaseun A.
Published: December 2020

Objective:

To evaluate the efficacy of the senior author’s technique of staged reconstruction in patients with recalcitrant oronasal fistulas.

Design:

A retrospective review of the Pediatric Plastic Surgery Cleft & Craniofacial Surgery Database of cases from September 2013 to December 2018 was conducted.

Patients:

A total of 31 patients who had previously undergone >1 surgical attempt to repair a fistula or patients who have failed >1 attempt at bone graft were included in this study. All patients were referrals from outside facilities.

Main Outcome Measures:

Primary outcomes examined included fistula recurrence, infection rates, ability to proceed with second stage bone grafting after first stage fistula takedown and reconstruction, and bone graft loss.

Results:

Charts of 1053 patients were reviewed and 31 (2.94%) cases met inclusion criteria for this study. Nineteen (61.3%) of these patients proceeded with the second stage of reconstruction and 100% did not experience any graft loss. Seven patients who completed the first stage are undergoing orthodontic optimization prior to bone grafting. The remaining 5 are adult patients not interested in pursuing bone grafting. All 31 patients with recurrent and recalcitrant fistulas had successful fistula reconstruction with our approach, despite multiple previous failed reconstructions.

Conclusions:

The 2-staged reconstructive approach described herein effectively resulted in resolution of prior recurrent recalcitrant fistulas and resulted in eventual bone grafting. By employing this technique, we report successful fistula repair and bone grafting in patients who had previously undergone multiple surgical reconstructions.
A Case of Adenomyoepithelioma With a Pleomorphic Adenoma-Like Component of the Male Breast
Authors: Harada Jotaro , Horiguchi Shin-ichiro , Ishiba Toshiyuki , Kubota Hoshiho , Ichida Miyu , Sakurai Natsuko , Arai Hideo , Motoi Toru , Aruga Tomoyuki , Hishima Tsunekazu
Published: December 2020

Adenomyoepithelioma (AME) of the male breast is a rare tumor characterized by biphasic proliferation of gland epithelial cells and myoepithelial cells. Though pleomorphic adenoma (PA) is also known to be an epithelial-myoepithelial tumor in the breast, and these tumors are considered to exist on the same spectrum by some authors, to the best of our knowledge, there have been no reports of a clear transition from AME to PA in the male breast. Therefore, the case of an 85-year-old man with AME with PA-like components is presented.
Advancing the Conceptualization and Measurement of Psychological Need States: A 3 × 3 Model Based on Self-Determination Theory
Authors: Huyghebaert-Zouaghi Tiphaine , Ntoumanis Nikos , Berjot Sophie , Gillet Nicolas
Published: December 2020

Based on Self-Determination Theory (SDT), this research aimed to investigate whether employees’ psychological need states could be expanded from two (need satisfaction and frustration) to three (need satisfaction, frustration, and unfulfillment). Relying on exploratory structural equation modeling (ESEM) and bifactor-ESEM, this research also offered to test the construct validity of the Psychological Need States at Work-Scale (PNSW-S) and to explore its criterion-related validity. Results from two studies and three distinct samples of employees (French and English speaking) provided support for the unfulfillment of the needs for autonomy, competence, and relatedness to be modeled as a distinct need state when tested alongside the satisfaction and frustration of those three needs. Moreover, results indicated that the different need states appeared to stem from distinct experiences (perceived supervisors’ supportive and thwarting behaviors) and that these need states had well-differentiated effects in terms of employee functioning (job satisfaction, job boredom, and work-related rumination). Our research therefore deepens our understanding of the nature of psychological need states in the workplace and offers a multidimensional instrument allowing to simultaneously assess not only need satisfaction and frustration, but also need unfulfillment. It also indicates that SDT’s explanatory framework may be expanded from two to three need processes to explain the effect of the socio-contextual environment on individual functioning.
Multi-Omics Analysis Identifying Key Biomarkers in Ovarian Cancer
Authors: Li Ju-Yueh , Li Chia-Jung , Lin Li-Te , Tsui Kuan-Hao
Published: December 2020

Ovarian cancer is one of the most common malignant tumors. Here, we aimed to study the expression and function of the CREB1 gene in ovarian cancer via the bioinformatic analyses of multiple databases. Previously, the prognosis of ovarian cancer was based on single-factor or single-gene studies. In this study, different bioinformatics tools (such as TCGA, GEPIA, UALCAN, MEXPRESS, and Metascape) have been used to assess the expression and prognostic value of the CREB1 gene. We used the Reactome and cBioPortal databases to identify and analyze CREB1 mutations, copy number changes, expression changes, and protein–protein interactions. By analyzing data on the CREB1 differential expression in ovarian cancer tissues and normal tissues from 12 studies collected from the “Human Protein Atlas” database, we found a significantly higher expression of CREB1 in normal ovarian tissues. Using this database, we collected information on the expression of 25 different CREB-related proteins, including TP53, AKT1, and AKT3. The enrichment of these factors depended on tumor metabolism, invasion, proliferation, and survival. Individualized tumors based on gene therapy related to prognosis have become a new possibility. In summary, we established a new type of prognostic gene profile for ovarian cancer using the tools of bioinformatics.