bluuebunny/crossref_metadata_2025 huggingface dataset:
An Assessment of the Cues College Students Interpret From a Sexual Partner to Determine They Are Refusing
Authors: Marcantonio Tiffany L. , Valdez Danny , Jozkowski Kristen N.
Published: March 2021

The purpose of this study was to assess the cues college students use to determine a sexual partner is refusing vaginal-penile sex (i.e., refusal interpretations). As a secondary aim, we explored the influence of item wording ( not willing/non-consent vs refusal) on college students’ self-reported refusal interpretations. A sample of 175 college students from Canada and the United States completed an open-ended online survey where they were randomly assigned to one of two wording conditions ( not willing/non-consent vs refusal); students were then prompted to write about the cues they used to interpret their partner was refusing. An inductive coding procedure was used to analyze open-ended data. Themes included explicit and implicit verbal and nonverbal cues. The refusal condition elicited more explicit and implicit nonverbal cues than the not willing/non-consent condition. Frequency results suggested men reported interpreting more explicit and implicit verbal cues. Women reported interpreting more implicit nonverbal cues from their partner. Our findings reflect prior research and appear in line with traditional gender and sexual scripts. We recommend researchers consider using the word refusal when assessing the cues students interpret from their sexual partners as this wording choice may reflect college students’ sexual experiences more accurately.
Dating Aggression among Court-Involved Adolescents: Prevalence, Offense Type, and Gender
Authors: Collibee Charlene , Fox Kara , Folk Johanna , Rizzo Christie , Kemp Kathleen , Tolou-Shams Marina
Published: March 2021

Adolescents involved in the juvenile justice system face a variety of risk factors that are associated with more frequent and severe experiences of aggression within romantic relationships as compared to community samples. The current study examines the nature and characteristics of adolescent dating violence (ADV) among first-time offense court-involved non-incarcerated (CINI) adolescents. A sample of 199 male and female CINI adolescents (58% male; M age = 15.05) who had a first-time, open status (e.g., truancy, curfew violation) and/or delinquent petition (e.g., assault, breaking, and entering). Overall, CINI adolescents reported prevalence rates of ADV consistent with community samples of adolescents. Females reported higher perpetration than did males in the sample of physical abuse and social networking abuse, as well as higher victimization of social networking abuse. Only one difference was found by offense type. CINI females report an increased risk for dating violence, though the cause of these gender differences is unclear. Findings also highlight that risk for ADV does not differ by offense type, suggesting that prevention efforts targeting ADV at the earliest possible intervention point, regardless of first-time offense type or severity, may be especially impactful.
How do male and female Headteachers evaluate their authenticity as school leaders?
Authors: Lee Catherine
Published: March 2021

This article utilises the model of authentic leadership by Bill George et al. to explore the extent to which gender influences teacher leader authenticity in the school workplace. Four male and four female Secondary Heads of School were asked to complete George et al.’s authentic leadership self-assessment tool and provide a written commentary reflecting on and contextualising their performance in five key areas identified by George et al.: Purpose – Passion; Values – Behaviour; Heart – Compassion; Relationships – Connectedness and Self-discipline – Consistency. The responses of the four male teacher leaders were compared with those of the four female teacher leaders and the results show that the male teacher leaders rated themselves more positively than female counterparts in all areas except Relationships – Connectedness. In all five categories the written reflections suggest that male and female leaders have gendered approaches to the notion of authenticity and conceive of school leadership in markedly different ways.
Global flow visualization of transonic cavity flow with various yaw angles
Authors: Huang Chih-Yung , Yeh Chen-Yen , Lin Yun-Fang , Chung Kung-Ming
Published: March 2021

This study experimentally investigated transonic cavity flows with different length-to-depth ( L/ h) ratios and yaw angles. Two rectangular models with L/ h = 6.14 and 21.5 were examined with yaw angles of 10°, 30°, and 45° under a flow of Mach 0.83. The flow was visualized using pressure-sensitive paint (PSP) to obtain the detailed pressure distribution inside the cavity models. The acquired PSP data were compared with experimental data measured using Kulite transducers, and these data showed favorable agreement. Gradual pressure increases inside the cavity model with L/ h = 6.14 were observed from the PSP measurements as open cavity flow. The flow impingement at the bottom of the cavity and the significant pressure rise inside the cavity model with L/ h = 21.5 were observed as closed cavity flow. The present study quantitatively visualized the evolution of the pressure distribution from symmetric to asymmetric for different yaw angles using porous PSP sensors.
An attitude updating algorithm using Picard iteration and higher degree polynomial
Authors: Guo Xiaole , Liu Xixiang , Zhao Miaomiao , Yan Jie , Yang Wenqiang , Li Xu
Published: March 2021

To accurately track body attitude under high dynamic environments, a new attitude updating algorithm for the strapdown inertial navigation system is proposed after further applying higher degree polynomial to the quaternion Picard iteration (QPI) algorithm. With QPI, calculation error introduced by Picard approximation can be eliminated, but the angular rate fitting error introduced by substituting polynomial for angular rate of body will still affect the accuracy of the attitude updating algorithms which are designed based on polynomial model. Hence, a five- rather three-degree polynomial constructing method using four samples of gyro outputs with coning motion constrain is designed and tested. Simulation results indicate the proposed method owns more accuracy than QPI, optimal coning algorithm, and Fourth4Rot under both low and high dynamic environments.
Life Quality Index–based cost–benefit analysis of equipping life preservers aboard airplanes
Authors: Yang Rui-liang , Yang Li-bin , Wang Li-jing , Li Sha , Geng Dong-han
Published: March 2021

The life preservers aboard airplanes play a critical role in ensuring occupant safety in water-related accidents. However, several airlines off-load life preservers to save fuel and costs. In this study, a cost–benefit analysis was performed considering the Life Quality Index to examine the necessity of life preservers aboard aircraft. It was noted that the placement of life preservers aboard airplanes was reasonable and beneficial in the recent 15 years. Although life preservers are primarily required for extended overwater (EOW) operations, the distance from the shoreline for most of the water-related accidents was considerably smaller than that of an EOW operation, and most water-related accidents occurred close to an airport. In other words, air passengers were at risk of water-related accidents, regardless of whether the flight was classified as an EOW flight. Thus, life preservers must be made available for all the occupants on all passenger flights, regardless of the flight path.
Effect of hub clearance of cantilever stator on aerodynamic performance and flow field of a transonic axial-flow compressor
Authors: Zhang Botao , Liu Bo , Mao Xiaochen , Wang Hejian
Published: March 2021

To investigate the effect of hub clearance of cantilever stator on the aerodynamic performance and the flow field of the transonic axial-flow compressor, the performance of single-stage compressors with the shrouded stator and cantilever stator was studied numerically. It is found that the hub corner separation on the stator blade suction surface (SS) was modified by introducing the hub leakage flow. The separation vortex on the SS of the stator blade root at about 10% axial chord length caused by the interaction of the shock wave and boundary layer was also controlled. Compared with the tip clearance size of the rotor blade, the stator hub clearance size (HCS) has a much less effect on the overall aerodynamic performance of the compressor, and there is no obvious effect on the flow field in the upstream blade row. With the increase of HCS, the leakage loss and the blockage degree in the flow field near the stator hub are increased and further make the adiabatic efficiency and the total pressure ratio of the compressor gradually decrease. Meanwhile, the stall margin of the compressor was changed slightly, but the response of the stall margin to the change of the HCS is nonlinear and insensitive. The stator hub leakage flow (HLF) can not only change the flow field near the hub but also redistribute the flow law within the range of the entire blade span. It will contribute to further understand the mechanism of the HLF and provide supports for the design of the cantilever stator of transonic compressors.
Showerhead film cooling injection orientation design on the turbine vane leading edge considering representative lean burn combustor outflow
Authors: Wu Zhuang , Zhu Hui-ren , Liu Cun-liang , Li Lin , Liu Xu-yang
Published: March 2021

The heat transfer performance of showerhead film cooling on the vane leading edge was numerically investigated considering representative lean burn combustor swirling outflow. Three cases with different inflow conditions (uniform inflow, positive swirling inflow, and negative swirling inflow) and three cases with different film injection angles (45°, 90°, and 135°) were studied. As the first study to explore the showerhead film design principle under swirling inflow, a newly designed asymmetrical counter-inclined (45° and 135°) film cooling was also proposed. To examine the design principles, the cooling effectiveness, heat transfer augmentation, and heat flux reduction of the newly designed asymmetrical case were evaluated compared with the traditional symmetrical case. The results show that the swirling inflow introduces obvious radial pressure gradient on the vane. The radial pressure gradient is the key influence factor to deflect the coolant migration, decrease the cooling effect, and degrade the homogeneity. The film with opposite orientation to the radial pressure gradient can weaken the deflect effect. The radial pressure gradient direction differs in different regions, making it impossible for the film with congruent injection orientation to simultaneously resist the pressure gradient on the entire vane. For the new design, the boundary line of the counter-inclined holes is consistent with the twisted stagnation line to guarantee that the injection orientation of all the film holes is opposite to the radial pressure gradient. As expected, the new design can effectively weaken the deflection effect and show uniform film distribution. The higher coolant mass ratio provides more obvious enhancement effect. At coolant mass ratio 3.71% and 4.56%, the overall area-averaged heat flux reduction (Δ q) is increased by 0.311 and 0.576, and the overall area-averaged relative standard deviation is reduced by 12.17 and 11.66 compared with the traditional design. The results have confirmed the adaptability of the film design principle under swirling inflow.
Overcoming Challenges to Surrogate Decision Making for Young Adults at the End of Life
Authors: Lightfoot Nathan , Kirkova Yordanka , Fox Stephen , Alan Sheinei
Published: March 2021

Surrogate decision makers (SDMs) are challenged by difficult decisions at the end of life. This becomes more complex in young adult patients when parents are frequently the SDMs. This age group (18 to 39 years old) commonly lacks advanced directives to provide guidance which results in increased moral distress during end of life decisions. Multiple factors help guide medical decision making throughout a patient’s disease course and at the end of life. These include personal patient factors and SDM factors. It has been identified that spiritual and community group support is a powerful, but inadequately used resource for these discussions. It can improve patient-SDM-provider communications, decrease psycho-social distress, and avoid unnecessary interventions at the end of life.
Multitiered Early Literacy Identification in 3-Year-Old Children in Head Start Settings
Authors: Albritton Kizzy , Stuckey Adrienne , Patton Terry Nicole
Published: March 2021

Three-year-old children are seldom the focus in studies about supplemental early literacy instructional support. This study examines 3-year-old children’s potential need for additional early literacy support, extending and replicating a previous investigation that identified prekindergarten children (i.e., 4-year-olds) in Head Start classrooms for additional tiers of early literacy support. The sample included 143 children from Head Start centers in a southeastern, urban region of the United States who had received both fall and spring administrations of an early literacy screener (i.e., Get Ready to Read! —Revised). Standard scores were used to classify children into three tiers, and child tier movement from fall to spring was analyzed. Results support the feasibility of a tiered approach for examining 3-year-old children’s early literacy instructional needs. This might allow researchers and practitioners to provide intervention to children much sooner, thereby increasing the potential for positive long-term reading outcomes.
Opioid Prescribing Practices in Cleft Lip and Cleft Palate Reconstruction
Authors: Falola Reuben A. , Blough Jordan T. , Abraham Jasson T. , Brooke Sebastian M.
Published: March 2021

Introduction:

Currently, there is no consensus regarding the role of opioids in the management of perioperative pain in children undergoing cleft lip/palate repair.

Method:

The present study evaluated opioid prescribing patterns of surgeon members within the American Cleft Palate-Craniofacial Association surgeons utilizing an anonymous survey.

Results:

Respondents performing cleft lip repair typically operate on patients 3 to 6 months of age (86%), admit patients postoperatively (82%), and discharge them on the first postoperative day (72%). Comparatively, respondents performed palatoplasty between the ages of 10 and 12 months (62%), almost always admit the patients (99%), and typically discharge on the first postoperative day (78%). Narcotics were more frequently prescribed after palatoplasty than after cleft lip repair, both for inpatients (66%; 49%) and at discharge (38%; 22%). Oxycodone was the most prescribed narcotic (39.1%; 41.4%), typically for a duration of 1 to 3 days (81.5%; 81.2%). All surgeons who reported changing their narcotic regimen (34.4% dose, 32.8% duration) after cleft lip repair, decreased both parameters from earlier to later in their career. Similarly, surgeons who changed the dose (32.2%) and duration (42.5%) of narcotics after palatoplasty, mostly decreased both parameters (96%). Additionally, physicians with >15 years of practice were less likely to prescribe opioids in comparison with colleagues with ≤15 years of experience. Ninety-two percent of respondents endorsed prescribing nonopioid analgesics after prescribing cleft surgery, most commonly acetaminophen (85.7%; 85.4%).

Conclusion:

Cleft surgeons typically prescribe opioids to inpatients and rarely upon discharge. Changes to opioid-prescribing patterns typically involved a decreased dose and duration.
Do Urbanized Socioeconomic Background or Education Programs Support Engineers for Further Advancement?
Authors: Alam Gazi Mahabubul
Published: March 2021

Theoretically, education supports improving graduates’ socioeconomic outcomes and careers by injecting citizenship values and making sure they are employable. Evidence confirms that socioeconomic background influences the level of education achieved which in turn greatly shapes the careers of graduates. Relevant knowledges and competencies are the fundamental parameters for career advancement. Ideally, education delivers the knowledge and competencies needed, and engineering is no different in this respect. The role of engineering education is crucial and to remove its associations of being a white-collar job, engineering education programs were developed to help working-class people enter this profession and advance their socioeconomic prospects. While socioeconomic backgrounds of engineering graduates can to some extent guide their career advancement the role of education is the major factor. A number of studies have examined the influence of socioeconomic backgrounds of graduates on career advancement, but none so far have been done for engineering education; particularly in a former British colonial setting. With this in mind the paper is the first to tackle this subject. Multiple techniques were used to collect the data and the findings confirm that engineering education and career advancement are not saliently linked. Not only education, but urbanized socioeconomic backgrounds do greatly govern the career advancement of engineers. A well targeted policy intervention may help engineering education to play a larger and more desirable role.
What Happens to a Black Sheep? Exploring How Multilevel Leader–Member Exchange Differentiation Shapes the Organizational Altruism Behaviors of Low Leader–Member Exchange Minority
Authors: Chen Shangyun , Zhang Cuilian
Published: March 2021

Our study focused on the low leader–member exchange (LMX) minority under the LMX differentiation context. Specifically, based on the group engagement model, we proposed that high LMX relational separation (LMXRS) impairs subordinates’ organizational altruism behaviors through undermining their procedural justice perception; furthermore, such an effect is stronger for low-LMX members in low overall LMX differentiation groups. Using data collected from 4 companies in China that included 49 teams and 273 employees, we demonstrated that high LMXRS entails a lower procedural justice perception and fewer follow-up altruism behaviors, especially for low-LMX members. Moreover, the three-way interaction result showed that the detrimental effect of high LMXRS on low-LMX members’ procedural justice perception and follow-up organizational altruism behaviors is stronger when the group-level LMX differentiation is low. We discussed the theoretical and practical implications of these findings.
Pulmonary Embolism Does Not Have an Unusually High Incidence Among Hospitalized COVID19 Patients
Authors: Gallastegui Nicolas , Zhou Jenny Y. , Drygalski Annette von , Barnes Richard F. W. , Fernandes Timothy M. , Morris Timothy A.
Published: March 2021

Introduction:

Acute respiratory illnesses from COVID19 infection are increasing globally. Reports from earlier in the pandemic suggested that patients hospitalized for COVID19 are at particularly high risk for pulmonary embolism (PE). To estimate the incidences of PE during hospitalization for COVID19, we performed a rigorous systematic review of published literature.

Methods:

We searched for case series, cohort studies and clinical trials from December 1, 2019 to July 13, 2020 that reported the incidence of PE among consecutive patients who were hospitalized for COVID19 in ICUs and in non-ICU hospital wards. To reflect the general population of hospitalized COVID19 patients, we excluded studies in which subject enrollment was linked to the clinical suspicion for venous thromboembolism (VTE).

Results:

Fifty-seven studies were included in the analysis. The combined random effects estimate of PE incidence among all hospitalized COVID19 patients was 7.1% (95% CI: 5.2%, 9.1%). Studies with larger sample sizes reported significantly lower PE incidences than smaller studies (r2 = 0.161, p = 0.036). The PE incidence among studies that included 400 or more patients was 3.0% (95% CI: 1.7%, 4.6%). Among COVID19 patients admitted to ICUs, the combined estimated PE incidence was 13.7% (95% CI: 8.0%, 20.6%). The incidence of ICU-related PE also decreased as the study sample sizes increased. The single largest COVID19 ICU study (n = 2215) disclosed a PE incidence of 2.3% (95% CI: 1.7%, 3.0%).

Conclusion:

PE incidences among hospitalized COVID19 patients are much lower than has been previously postulated based on smaller, often biased study reports. The incidence of “microthrombosis,” leading to occlusion of microscopic blood vessels, remains unknown.
An intelligent multiple-articulated rubber-tired vehicle based on automatic steering and trajectory following method
Authors: Xiao Lei , Wang Ke , Zhou Sheng , Ma Sai
Published: March 2021

For manually driven rubber trams to track, virtual tracks can easily cause driver fatigue. Therefore, based on visual navigation, an automatic steering and trajectory following method are proposed. First, the vehicle kinematic and dynamic model of the Delight Tram is proposed. Then, the automatic steering and trajectory following methods are introduced, which are based on model prediction control and Ackermann steering theory, respectively. Finally, the effectiveness of the proposed methods has been evaluated via both multi-body dynamic simulations and road tests under various working conditions. The results show that the vehicle has excellent steering and trajectory following ability whether in a transient phase or a steady-state circumference. Furthermore, the steering system can stabilize the vehicle in the whole range of design speed, with a smaller computational cost.
Commentary on the Article “How Gentle Must Violence Against Women Be in Order to Not Be Violent? Rethinking the Word ‘Violence’ in Obstetric Settings,” Reframed Within a Critical Discourse Orientation
Authors: Burnett Camille
Published: March 2021

This commentary discusses the Swartz and Lappeman article asking us to rethink the word violence and its potential to “disempower the women that it is meant to empower.” The commentary examines the term violence through a critical lens that underscores the need for critical discourse analysis as a driver to deepening a widely somewhat antiquated definition of violence. It explores the enabling and constraining complexity of identity work associated with using the label of victim and suggests a more comprehensive approach that considers the linkages between intention, practices, structures, and context to foster a more transformative understanding of violence.
Citrobacter braakii CLABSI in a hematopoietic stem cell transplant patient
Authors: Tollkuci Eris , Myers Rebecca
Published: March 2021

Introduction

Citrobacter bacteria are gram-negative anaerobic bacilli commonly found in water, soil, food, and the intestinal tracts of animals and humans. Patients at highest risk of these nosocomial infections include neonates and adults who are ≥65 years of age, debilitated, or immunocompromised. Citrobacter braakii ( C. braakii), specifically, has been reported to cause sepsis in immunocompromised patients. Herein, we describe a case of an allogeneic stem cell transplant (SCT) adult patient with C. braakii bloodstream infection.

Case Report

We report our experience managing a central line-associated bloodstream infection (CLABSI) due to C. braakii in an allogeneic SCT patient. Management and Outcomes: Our patient was initially managed with cefepime. The central venous catheter (CVC) was removed. Blood cultures cleared 24 hours after antibiotic initiation. Therapy was transitioned to oral levofloxacin once susceptibilities resulted.

Discussion

The course of this patient highlights the important relationship between an unusual pathogen, C. braakii, in an immunocompromised allogeneic SCT patient. In our case, the source of the bacteremia was most likely a CLABSI given the positive catheter tip cultures. Although this report describes the successful utilization of cefepime and levofloxacin in the treatment of C. braakii infection, caution should be exercised when choosing empiric antimicrobial therapy as AmpC resistance. This clinical scenario can aid health care providers in making informed treatment decisions when faced with patients diagnosed with this relatively uncommon pathogen. Further reports should be published to determine C. braakii bacteremia management in hematopoietic stem cell transplant patients.
Silicon: A neglected micronutrient essential for bone health
Authors: Rondanelli Mariangela , Faliva Milena A , Peroni Gabriella , Gasparri Clara , Perna Simone , Riva Antonella , Petrangolini Giovanna , Tartara Alice
Published: March 2021

Bone matrix is predominantly made up of collagen, and in vitro and in animal models studies have shown that silicon is linked to glycosaminoglycans and plays an important role in the formation of cross-links between collagen and proteoglycans, determining the beneficial effects on strength, composition, and mechanical properties of bone. However, there are still no precise indications regarding a possible role of silicon on bone health in humans. Given this background, the aim of this narrative review was to consider the effectiveness of silicon dietary intake and silicon dietary supplementation (alone or with other micronutrients), in order to suggest a daily dosage of Si supplementation, on bone mineral density in humans. This review included eight eligible studies: four regarding dietary intake and four considering supplementation with silicon alone or with other nutrients. Despite the number of studies considered being low, the number of subjects studied is high (10012) and the results are interesting. Although to date the available scientific evidences are not considered valid enough to allow to establish an adequate level of Silicon intake, based on extrapolations from the data obtained with studies on animal and human models, it has been suggested that an adequate intake in order to promote beneficial effects for bone could be considered to be around 25 mg silicon/day. As for silicon dietary supplements, it has been shown that the combined treatment with orthosilicic acid (6 mg), calcium, and vitamin D has a potentially beneficial effect on femoral BMD compared to only use of calcium and vitamin D.
Sigma receptor knockdown augments dysfunction and apoptosis of beta cells induced by palmitate
Authors: Ke Mengting , He Guangzhen , Wang Huawei , Cheng Siyuan , Xu Yancheng
Published: March 2021

Sigma-1 receptor (Sig-1R) is located in the endoplasmic reticulum (ER) and clustered on the mitochondria related endoplasmic membranes, which are involved in the regulation of nervous system disease. Here, we designed Sig-1R silence MIN6 cells and studied the influence of Sig-1R silence on beta cells. We showed Sig-1R inactivation in MIN6 cells could not only decrease cell proliferation but also inhibit cell cycle, and this inhibitory effect on cell cycle might be achieved by regulating the FoxM1/Plk1/Cenpa pathway.

 Moreover, Sig-1R deficiency increased MIN6 cells sensitivity to lipotoxicity, exaggerated palmitate (PA)-induced apoptosis, and impaired insulin secretion. On the other hand, ER chaperone GRP78 and ER proapoptotic molecules CHOP increased in Sig-1R knockdown MIN6 cells. The ATP level decreased and reactive oxygen species (ROS) increased in this kind of cells. Furthermore not only GRP78 and CHOP levels, but also ATP and ROS levels changed more in Sig-1R silence cells after cultured with PA. Therefore, Sig-1R deficiency exaggerated PA induced beta cells apoptosis by aggravating ER stress and mitochondrial dysfunction. Together, our study showed that Sig-1R might influence the proliferation, apoptosis, and function of beta cells.
Joint sparsity-biased variational graph autoencoders
Authors: Lawley Lane , Frey Will , Mullen Patrick , Wissner-Gross Alexander D
Published: March 2021

To bring the full benefits of machine learning to defense modeling and simulation, it is essential to first learn useful representations for sparse graphs consisting of both key entities (vertices) and their relationships (edges). Here, we present a new model, the Joint Sparsity-Biased Variational Graph AutoEncoder (JSBVGAE), capable of learning embedded representations of nodes from which both sparse network topologies and node features can be jointly and accurately reconstructed. We show that our model outperforms the previous state of the art on standard link-prediction and node-classification tasks, and achieves significantly higher whole-network reconstruction accuracy, while reducing the number of trained parameters.
The best efficiency point of an axial fan at low-pressure conditions
Authors: Corona Jose J , Mesalhy Osama , Chow Louis , Leland Quinn , Kizito John P
Published: March 2021

In the current work, the objective is to determine the best efficiency point (BEP) of an axial fan using CFD. Analyzing the performance of the fan based upon the parameters chosen can lead to the optimal design of an axial flow fan for aerospace applications where the ambient pressure varies rapidly. The 2-bladed fan chosen for the study is the Propimax 2L which is considered the base fan used for comparison of all the results of the work. The set of parameters tested were fan rotational speed, ambient pressure conditions, blade count, and the airfoil design. All the performance measures were based on overall fan efficiency. The results yield the following: an increased rotational speed led to higher efficiencies, the most efficient ambient pressure of which the fan can perform is 0.7 atm, a 5-bladed fan configuration produced the highest efficiency, and airfoil selection is critical for fan efficiency enhancements. The results demonstrated that at 0.7 atm the fan efficiency is the highest due to the changes in power consumption to the density effect. A key finding in the work is that higher blade counts do not necessarily lead to higher performing axial fans. A high cambered airfoil provided a higher flow rate at free delivery than that of the Propimax 2L design, but the rotorcraft airfoil did not yield favorable results. The analysis is focused on the fan design of cooling of the electromechanical actuators (EMAs).
Radiological evaluation of postoperative osteomyelitis in long bones: Which is the best tool?
Authors: Zhou Andrew Kailin , Girish Milind , Thahir Azeem , Lim Jiang An , Chen Xiaoyu , Krkovic Matija
Published: March 2021

Currently, definitive diagnosis of osteomyelitis involves a combination of clinical signs, symptoms, laboratory tests, imaging modalities and cultures from blood, joint or body fluid. Imaging plays a critical role in the osteomyelitis diagnosis. Each of these tests incurs an additional cost to the patient or healthcare system and their use varies according to the preference of the healthcare professional and the healthcare setup. Imaging plays a critical role in the diagnosis and management of postoperative long bone osteomyelitis, with the aim of reducing long-term complications such as non-union, amputation and pathological fractures. In this review, we discuss the key findings on different radiological modalities and correlate them with disease pathophysiology. Currently, magnetic resonance imaging is the best available imaging modality due to its sensitivity in detecting early signs of long bone osteomyelitis and high soft tissue resolution. Other modalities such as radio-nuclear medicine, computed tomography and ultrasound have been proved to be useful in different clinical scenarios as described in this narrative review.
Living Well With Kidney Disease by Patient and Care-Partner Empowerment: Kidney Health for Everyone Everywhere
Authors: Kalantar-Zadeh Kamyar , Li Philip Kam-Tao , Tantisattamo Ekamol , Kumaraswami Latha , Liakopoulos Vassilios , Lui Siu-Fai , Ulasi Ifeoma , Andreoli Sharon , Balducci Alessandro , Dupuis Sophie , Harris Tess , Hradsky Anne , Knight Richard , Kumar Sajay , Ng Maggie , Poidevin Alice , Saadi Gamal , Tong Allison
Published: March 2021

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.
An Analysis of Causal Relationships Among the Factors Affecting the Performance of a Service Organization
Authors: Sharma Garima , Kumar Pravin
Published: March 2021

In the present scenario, services have the largest domination in consumers’ lives and constitute a large part of the world economy. The researchers and practitioners have given limited research attention to transformative consumer research which affects consumer well-being. In this study, a causal relationship among the factors influencing the performance of an organization providing the transformative services has been analyzed using total interpretive structural modeling (TISM). The factors influencing the services have been identified through the literature review. After identifying the factors, TISM has been used to interpret the direct as well as significant transitive linkages among the factors. The empirical results suggest that top management plays a big role in consumer well-being along with the welfare of society. Devotion toward the well-being of the broader level of society depends on the top management’s commitment toward corporate social responsibility and respect for the rule of laws. These are the major factors influencing the performance of the organization other than employee satisfaction, excellent service quality, use of information technology and e-commerce, and so on.
Trends in Patient, Physician, and Public Perception of Ulnar Collateral Ligament Reconstruction Using Social Media Analytics
Authors: Yu Jonathan S. , Carr James B. , Thomas Jacob , Kostas Julianna , Wang Zhaorui , Khilnani Tyler , Liu Katie , Dines Joshua S.
Published: March 2021

Background:

Social media posts regarding ulnar collateral ligament (UCL) injuries and reconstruction surgeries have increased in recent years.

Purpose:

To analyze posts shared on Instagram and Twitter referencing UCL injuries and reconstruction surgeries to evaluate public perception and any trends in perception over the past 3 years.

Study Design:

Cross-sectional study.

Methods:

A search of a 3-year period (August 2016 and August 2019) of public Instagram and Twitter posts was performed. We searched for >22 hashtags and search terms, including #TommyJohn, #TommyJohnSurgery, and #tornUCL. A categorical classification system was used to assess the sentiment, media format, perspective, timing, accuracy, and general content of each post. Post popularity was measured by number of likes and comments.

Results:

A total of 3119 Instagram posts and 267 Twitter posts were included in the analysis. Of the 3119 Instagram posts analyzed, 34% were from patients, and 28% were from providers. Of the 267 Twitter posts analyzed, 42% were from patients, and 16% were from providers. Although the majority of social media posts were of a positive sentiment, over the past 3 years, there was a major surge in negative sentiment posts (97% increase) versus positive sentiment posts (9% increase). Patients were more likely to focus their posts on rehabilitation, return to play, and activities of daily living. Providers tended to focus their posts on education, rehabilitation, and injury prevention. Patient posts declined over the past 3 years (–28%), whereas provider posts increased substantially (110%). Of posts shared by health care providers, 4% of posts contained inaccurate or misleading information.

Conclusion:

The majority of patients who post about their UCL injury and reconstruction on social media have a positive sentiment when discussing their procedure. However, negative sentiment posts have increased significantly over the past 3 years. Patient content revolves around rehabilitation and return to play. Although patient posts have declined over the past 3 years, provider posts have increased substantially with an emphasis on education.
Ambulatory Surgery vs Overnight Observation for Total Thyroidectomy: Cost Analysis and Outcomes
Authors: Rosen Philip , Bailey Luke , Manickavel Sudhir , Gentile Christopher , Grayson Jessica , Buczek Erin
Published: March 2021

Objective

To compare financial impact between patients undergoing ambulatory (same‐day discharge) vs overnight admission after total thyroidectomy while showing associated surgical outcomes.

Study Design

Retrospective review.

Setting

University of Alabama at Birmingham Medical Center from October 2011 and July 2017.

Methods

Patients undergoing total thyroidectomy without concurrent procedures were selected for review. Demographics, comorbidities, admission status, postoperative outcomes including minor and major complications, charges, and costs were collected. Admission status was categorized as inpatient (admission to hospital ≥1 night) or outpatient (discharged from the postoperative recovery unit). Costs were obtained from all related hospital, clinic, and emergency department visits at the University of Alabama at Birmingham within 30 days of the original surgery. After statistical analysis, outcomes and costs were compared between inpatient and outpatient total thyroidectomy patients.

Results

Of 870 total thyroidectomy patients included for analysis, 367 (42.2%) met outpatient criteria. A total of 169 patients (19.4%) had a complication, and only hypocalcemia occurred significantly more in the inpatient group (14.3% vs 9.26%; P <. 05). No complications occurred more frequently in the outpatient population. There were no mortalities. There was a statistically significant difference between the total cost of inpatient and outpatient thyroidectomies, with outpatient surgery costing on average $2367.27 less per patient (P <. 0001).

Conclusion

Outpatient total thyroidectomy can lead to cost reduction in highly selected patients who have few comorbidities while remaining safe for the patient.
Key Technologies and Development Trends in Advanced Intelligent Sawing Equipments
Authors: Wang Yangyu , Zhang Yongle , Tan Dapeng , Zhang Yongchao
Published: March 2021

As a starting point in equipment manufacturing, sawing plays an important role in industrial production. Intelligent manufacturing equipment is an important carrier of intelligent manufacturing technologies. Due to the backwardness of intelligent technology, the comprehensive performance of sawing equipments in China is obviously different from that in foreign countries. State of the art of advanced sawing equipments is investigated along with the technical bottleneck of sawing machine tool manufacturing, and a new industrial scheme of replacing turning-milling by sawing is described. The key technologies of processing-measuring integrated control, multi-body dynamic optimization, the collaborative sawing network framework, the distributed cloud sawing platform, and the self-adapting service method are analyzed; with consideration of the problems of poor processing control stableness, low single machine intelligence level, no on-line processing data service and active flutter suppression of sawing with wide-width and heavy-load working conditions. Suggested directions for further research, industry implementation, and industry-research collaboration are provided.
Antennal transcriptome analysis of olfactory genes and characterizations of odorant binding proteins in two woodwasps, Sirex noctilio and Sirex nitobei (Hymenoptera: Siricidae)
Authors: Guo Bing , Hao Enhua , Qiao Haili , Wang Jingzhen , Wu Weiwei , Zhou Jingjiang , Lu Pengfei
Published: March 2021

Background

The woodwaspSirex noctilioFabricius is a major quarantine pest worldwide that was first discovered in China in 2013 and mainly harmsPinus sylvestrisvar.mongolicaLitv..S. nitobeiMatsumura is a native species in China and is closely related toS. noctilio. Recently, the two woodwasps species were found attacking theP. sylvestrisvar.mongolicaLitv in succession. The olfactory system is the foundation of insect behavior. Olfactory genes were identified through antennal transcriptome analysis. The expression profiles odorant binding proteins (OBPs) were analyzed with RT-qPCR.

Results

From our transcriptome analysis, 16 OBPs, 7 chemosensory proteins (CSPs), 41 odorant receptors (ORs), 8 gustatory receptors (GRs), 13 ionotropic receptors (IRs), and one sensory neuron membrane protein (SNMP) were identified inS. noctilio, while 15 OBPs, 6 CSPs, 43 ORs, 10 GRs, 16 IRs, and 1 SNMP were identified inS. nitobei. Most of the olfactory genes identified in two species were homologous. However, some species-specific olfactory genes were identified from the antennal transcriptomes, includingSnocOBP13,SnocCSP6,SnocOR26, SnocGR2,SnocIR7inS. noctilioandSnitGR9, SnitGR11, SnitIR17inS. nitobei.In total, 14OBPswere expressed primarily in the antennae.SnocOBP9andSnitOBP9,identified asPBPhomologues, were sex-biased expression in two siricid, but with different pattern.SnocOBP11andSnitOBP11were highly expressed in antennae and clearly expressed in external genitalia.SnocOBP7andSnitOBP7were highly expressed in male genitalia.SnocOBP3andSnocOBP10were highly expressed in female genitalia and male heads, whileSnitOBP3andSnitOBP10did not show obvious tissue bias.

Conclusion

We analyzed 86 and 91 olfactory genes fromS. noctilioandS. nitobei, respectively. Most of the olfactory genes identified were homologous, but also some species-specific olfactory genes were identified, which indicated the similarities and differences of the molecular mechanisms between the two closely-related species. Different expression in the antennae, external genitals or heads, exhibiting an obvious sex bias, suggested their different role in recognizing sex pheromones or plant volatiles. Species-specific expression for several OBPs genes may suggest that they strengthened or lost their original function during species differentiation, resulting in olfactory differences between the two species.
Pathway for enhanced recovery after spinal surgery-a systematic review of evidence for use of individual components
Authors: Licina Ana , Silvers Andrew , Laughlin Harry , Russell Jeremy , Wan Crispin
Published: March 2021

Background

Enhanced recovery in spinal surgery (ERSS) has shown promising improvements in clinical and economical outcomes. We have proposed an ERSS pathway based on available evidence. We aimed to delineate the clinical efficacy of individual pathway components in ERSS through a systematic narrative review.

Methods

We included systematic reviews and meta-analysis, randomized controlled trials, non-randomized controlled studies, and observational studies in adults and pediatric patients evaluating any one of the 22 pre-defined components. Our primary outcomes included all-cause mortality, morbidity outcomes (e.g., pulmonary, cardiac, renal, surgical complications), patient-reported outcomes and experiences (e.g., pain, quality of care experience), and health services outcomes (e.g., length of stay and costs). Following databases (1990 onwards) were searched: MEDLINE, EMBASE, and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two authors screened the citations, full-text articles, and extracted data. A narrative synthesis was provided. We constructed Evidence Profile (EP) tables for each component of the pathway, where appropriate information was available. Due to clinical and methodological heterogeneity, we did not conduct a meta-analyses. GRADE system was used to classify confidence in cumulative evidence for each component of the pathway.

Results

We identified 5423 relevant studies excluding duplicates as relating to the 22 pre-defined components of enhanced recovery in spinal surgery. We included 664 studies in the systematic review. We identified specific evidence within the context of spinal surgery for 14/22 proposed components. Evidence was summarized in EP tables where suitable. We performed thematic synthesis without EP for 6/22 elements. We identified appropriate societal guidelines for the remainder of the components.

Conclusions

We identified the following components with high quality of evidence as per GRADE system: pre-emptive analgesia, peri-operative blood conservation (antifibrinolytic use), surgical site preparation and antibiotic prophylaxis. There was moderate level of evidence for implementation of prehabilitation, minimally invasive surgery, multimodal perioperative analgesia, intravenous lignocaine and ketamine use as well as early mobilization. This review allows for the first formalized evidence-based unified protocol in the field of ERSS.

Further studies validating the multimodal ERSS framework are essential to guide the future evolution of care in patients undergoing spinal surgery.
Risk factors for recurrent wheezing after bronchiolitis in infants: 2-year follow up in China
Authors: Chen Sainan , Gu Wenjing , Wu Min , Hao Chuangli , Zhu Canhong , Shao Xuejun , Wang Yuqing
Published: March 2021

Background

Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the risk factors for the development of recurrent wheezing after bronchiolitis remains controversial. Our study was to investigate risk factors of post-bronchiolitis recurrent wheezing.

Methods

Infants with bronchiolitis were enrolled from November 2016 through March 2017. Nasopharyngeal aspirates were obtained for detection of respiratory viruses which were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) and direct immunofluorescent assay. Serum cytokines including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by flow cytometry. Patients were followed up every 3 months for a duration of 2 years by telephone or at outpatient appointments.

Results

We enrolled 89 infants, of which 81 patients were successfully followed up. In total, 22.2% of patients experienced recurrent wheezing episodes. The proportion of patients with history of eczema, systemic glucocorticoid use and patients with moderate-to-severe disease were significantly higher in the recurrent wheezing group than the non-recurrent wheezing group (83.3% vs 52.4%; 66.7% vs 36.5%; 61.1% vs 33.3%, respectively, all P < 0.05); There were no significant differences between patients with and without recurrent wheezing episodes in the levels of TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α (P > 0.05). Logistic regression analysis showed that history of eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (odds ratio [OR] = 5.622; 95% confidence interval [CI], 1.3–24.9; P = 0.023).

Conclusion

The incidence of recurrent wheezing among infants after contracting bronchiolitis was 22.2% during a 2-year follow-up. History of eczema was the only independent risk factor identified and no correlation was found between the specific virus and disease severity in children with post-bronchiolitis recurrent wheezing.