bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Implementation of a GIS-Based Active Route Visualization Tool to Facilitate Equitable Planning for Walking and Cycling Routes in Small Communities
Authors: Cordero Fernando , LaMondia Jeffrey
Published: May 2023

Active transportation modes such as walking and bicycling have demonstrated several benefits for health, the environment, the economy, and road safety. However, the transportation planning process in rural areas rarely incorporates this mode of transportation. In fact, many small and rural towns lack the resources, experience, and capabilities to conduct detailed modeling of active transportation. In response, this research developed an Active Route Visualization (ARV) Tool to support planning and decision making in small cities and rural towns. By incorporating a modified three-step modeling process that used active trip rates developed from the 2017 National Household Travel Survey, the ARV Tool provided a map that highlighted the daily volumes of active travel in the community and ranked the roadway segments that had greater potential to support walking and bicycling. This research demonstrated application of the ARV Tool in the city of Atmore, AL. Implementation of the tool was valuable in this rural city as it supported a community coalition effort in partnership with the Alabama Cooperative Extension System to promote active transportation. In this process, the community coalition reviewed and discussed the ARV Tool outputs and provided invaluable local knowledge and feedback that were incorporated into the action plans. Small and rural towns can benefit from an easy-to-use, practical, and data-driven tool that provides insights to initiate discussions to identify priorities and opportunities for active transportation.
The War in Ukraine and the End of the American Financial Order?
Authors: Grabel Ilene
Published: May 2023

The crises of 1997–98, 2008, and the pandemic accelerated contradictory changes in global financial governance. Taken together, the change and stasis propelled by these crises is coalescing around a fragmented “post-American financial order.” The war in Ukraine represents another inflection point. The war has facilitated the reassertion of American financial power and cooperation among rich nations. However, like previous crises, the war is creating fissures in financial governance. The landscape offers risks and opportunities against a backdrop of heightened financial fragilities, authoritarianism and fascism, inequalities, devastation associated with the pandemic and war, and climate crisis. In such moments, Hirschman’s “possibilism” is both elusive and necessary. In this context, we might aspire to “permissive multilateralism s” rather than nostalgia for a new Bretton Woods.

JEL Classification: F02, F51
Imperialism and the Ukraine War
Authors: Kotz David M.
Published: May 2023

This article uses the Marxist theory of imperialism to analyze the war in Ukraine that broke out in March 2022. It analyzes the evolution of the socioeconomic system of post-Soviet Russia, the evolving relationship between post-Soviet Russia and the US government, and the history of relations between Russia and Ukraine. It considers the role of nationalist ideology in Russia both before and after the demise of the Soviet Union. The article concludes that a relation of inter-imperialist rivalry played a key role in the conflict that led to the war in Ukraine.

JEL Classification: B51, N40, P52
Gangrenous Bowel Obstruction Managed With Local Tumescent Anesthesia and MAC
Authors: Akkary Ehab , Tomlin Brett , Almoukadem Mohamed , Friedberg Barry
Published: May 2023

Since the mid-1980s, Klein’s tumescent anesthesia has been used routinely in different surgical specialties such as cosmetic surgery, dermatology, vascular surgery, reconstructive plastic surgery, and breast surgery. The tumescent anesthesia technique was developed by Dr Jeffrey Klein, a board-certified dermatologist. The technique was first published in 1987. Tumescent means “swelling.” This technique involves injection of an ultra-dilute lidocaine and epinephrine solution into the surgical planes offering multiple advantages including, but not limited to, postoperative analgesia, reduced blood loss, and avoidance of general anesthesia. The standard liter of Klein’s solution contains lidocaine 1 g, epinephrine 1 mg, and sodium bicarbonate 12.5 mg. Multiple modifications and variations have been implemented and used over the years, an evolution from Klein’s original description. While tumescent anesthesia started in liposuction procedures, its application has now extended into a wider variety of procedures and specialties. In this article, we present a case of tumescent anesthesia in a critically ill general surgery patient who presented with an acute life-threatening surgical emergency. The patient was assessed to be a very high risk for general anesthesia, and after collaborative discussion between the surgical and anesthesia teams and taking informed consent from the patient, the decision was made to proceed with surgery under monitored intravenous sedation with tumescent anesthesia. The patient had an uneventful recovery and survived a very high mortality surgical emergency. He was subsequently discharged back to his nursing home in stable condition. Tumescent anesthesia has become tremendously popular in cosmetic surgery. Tumescent anesthesia allows patients to have surgical procedures in an ambulatory setting, avoid general anesthesia, and allow for better pain control postoperatively. While tumescent anesthesia is used in other specialties, the field of general surgery has not widely adopted tumescent anesthesia. Many general surgeons and anesthesiologists are not familiar with the technique and how to implement it in their practice. It is of utmost importance to understand the pharmacokinetics of tumescent solution and safe implementation. Tumescent anesthesia with monitored anesthesia care is here reported as an alternative to general anesthesia in the care of a moribund patient with multiple comorbidities requiring open abdominal surgery. Close cooperation between the surgeon and the anesthesiologist made the successful conduct of this case possible.
A Qualitative Assessment of Social Norms Related to Seeking Help for Intimate Partner Violence in Honduras
Authors: Leyton Alejandra , Meekers Dominique , Hutchinson Paul , Andrinopoulos Katherine , Chen Xiaojin
Published: May 2023

Intimate partner violence (IPV) is a major public health issue in Honduras and other low- and middle-income countries, with few victims seeking help. While structural factors, such as lack of services and economic barriers, are often cited as reasons for not seeking help, social and cultural factors may also play a role. This study aims to describe the normative social environment that may hinder women’s help-seeking behaviors for IPV. Thematic analysis was conducted on data from four focus group discussions with 30 women at a busy health center in urban Tegucigalpa, Honduras. Data were coded inductively and themes were identified deductively using the theory of normative social behavior and its components (descriptive and injunctive social norms, expected outcomes, and groups of reference). Four themes emerged: social norms and expected outcomes that discourage IPV help-seeking; factors that determine the direction of a social norm, either discouraging or encouraging help-seeking; groups of reference for IPV victims; and society sets women up for failure. Social norms, expected outcomes, and groups of reference hinder women’s help-seeking behavior after IPV. These findings have significant implications for designing effective interventions and policies to support women and their families affected by IPV.
Do Shy Individuals Engage in Cyber Aggression? The Multiple Mediation of Passive Use and Relative Deprivation and the Moderation of Moral Sensitivity
Authors: Zhao Jinzhe , Guo Zhen , Jiao Liying , Yu Mengke , Shi Huiyue , Xu Yan
Published: May 2023

Shyness has been shown to be linked to aggression. However, whether this relationship occurs in cyberspace and the mechanisms that might affect it are largely unexplored. Based on the social fitness model, the current study examined the relationship between shyness and cyber aggression, as well as the mediating roles of passive use and relative deprivation. Moreover, according to the integration of the social information processing model and moral domain theory, moral sensitivity serves as a moderator in the direct and indirect links between shyness and cyber aggression. A total of 700 Chinese college students ( M age = 18.68, 53.57% women) participated in the current study and completed multiple questionnaires, namely, the Shyness Scale, Cyber-Aggression Scale, Passive Use of Social Network Site Scale, Relative Deprivation Scale, and Ethical Sensitivity Scale. The results showed that shyness was positively associated with cyber aggression through the multiple mediating effects of passive use and relative deprivation. Additionally, moderated mediation analysis indicated that moral sensitivity moderated the direct and indirect relationship between shyness and cyber aggression. A high level of moral sensitivity weakened the association of shyness with cyber aggression and the association of relative deprivation with cyber aggression, supporting the moderated mediation model. This study implicates the underlying mechanisms of the relationship between shyness and cyber aggression and preventative interventions to reduce the risk of cyber aggression.
Impact of Promotional Videos on Public Perception of Pharmacy Services
Authors: Rangi Paige , Marra Carlo , Scahill Shane , Anwar Mudassir
Published: May 2023

Background: Promotional videos are an effective means of marketing products or services in this era of social media. However, little is known if such videos can be a useful tool to promote pharmacy services. Objective: To assess the impact of promotional videos on public awareness of the health services provided by New Zealand pharmacists. Methods: This experimental study used an online questionnaire and promotional videos developed by the Pharmaceutical Society of New Zealand as an intervention to assess the public’s perspectives about pharmacy services before and after the intervention. The survey was sent out to 1 127 randomly selected members of the public aged 18 and above from all over New Zealand. Data were analysed using descriptive statistics and thematic analysis. Results: A total of 313 participants completed the survey. The majority (95.8%) had not heard of the promotional videos before. However, 84.3% found the videos informative and nearly three-quarters (74.1%) reported a change in their perception of pharmacy services after watching the video. Similarly, 63.2% reported that they or a family member would be more likely to visit a pharmacy in the future after watching the promotional video. Less than half (40%) of the participants reported that the videos were too long and only 11.5% found them boring. Conclusion: The PSNZ videos were found to be an effective tool for educating New Zealanders on different pharmacy services and the pharmacy profession, however, there is a need to choose the advertising platform carefully so as to enhance the coverage.
Sacubitril/Valsartan Does Not Change the Use and Dose of Loop Diuretics in Patients With Heart Failure With Reduced Ejection Fraction
Authors: Kido Kazuhiko , Bianco Christopher , Caccamo Marco , Hashiguchi Masayuki , Choo Lyn Yuen , Sokos George
Published: May 2023

Background: There is no standard approach for managing the use or dose of loop diuretics after initiating sacubitril/valsartan. Objective: To investigate longitudinal trends in loop diuretic therapy use and doses during the initial 6 months following sacubitril/valsartan initiation. Methods: This retrospective cohort study included adult patients who were initiated on sacubitril/valsartan in cardiology clinics. Inclusion criteria were patients diagnosed with heart failure with reduced ejection fraction (ejection fraction ≤40%) and initiated on sacubitril/valsartan in an outpatient setting. We investigated longitudinal trends in the prevalence of loop diuretic use and furosemide equivalent dose at baseline, 2 weeks, 1 month, 3 month and 6 months following sacubitril/valsartan initiation. Results: A total of 427 patients were included in the final cohort. Compared to the baseline loop diuretic use and dose, there were no significant longitudinal changes in the prevalence of loop diuretic use or the furosemide equivalent dose over the 6 months following sacubitril/valsartan initiation. The use of sacubitril/valsartan was not significantly associated with reductions in the use or dose of loop diuretics over a 6-month follow-up period. Conclusion: The use of sacubitril/valsartan did not significantly change the use or dose of loop diuretics over 6-month follow-up period. Initiation of sacubitril/valsartan may not need a pre-emptive loop diuretic dose reduction.
Exosomes From Adipose-Derived Stem Cells Suppress the Progression of Chronic Endometritis
Authors: Wang Bin , Li Li , Yu Ruizhu
Published: May 2023

Chronic endometritis (CE) is closely linked to the reproductive failure. Exosome (Exo)-based therapy is proposed as an encouraging strategy in inflammation-related disorders; however, little work has been devoted to its usage in CE therapy. An in vitro CE was established by administration of lipopolysaccharide (LPS) in human endometrial stromal cells (HESCs). The cell proliferation, cell apoptosis, and inflammatory cytokine assays were performed in vitro, and the efficacy of Exos derived from adipose tissue–derived stem cells (ADSCs) was evaluated in a mouse model of CE. We found that Exos isolated from ADSCs could be taken up by HESCs. Exos elevated the proliferation and inhibited apoptosis in LPS-treated HESCs. Administration of Exos to HESCs suppressed the content of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β). Moreover, Exos exposure repressed the inflammation stimulated by LPS in vivo. Mechanistically, we demonstrated that Exos exerted their ant-inflammatory effect via miR-21/TLR4/NF-kB signaling pathway in endometrial cells. Our findings suggest that ADSC-Exo-based therapy might serve as an attractive strategy for the treatment of CE.
ESG Controversies and Firm Performance in India: The Moderating Impact of Government Effectiveness
Authors: Mendiratta Anita , Singh Shveta , Yadav Surendra Singh , Mahajan Arvind
Published: May 2023

The study investigates the impact of environment, social and governance (ESG) controversies on firm performance in India. Utilizing a sample of 1,024 firm-year observations of Indian firms from 2007 to 2018, the study reports that ESG controversies reduce firm performance. Further, after introducing the interaction effect of government effectiveness, the ESG controversies maintain a similar negative influence on performance. Additionally, the interaction effect of government effectiveness and ESG controversies negatively affects performance in response to ESG controversies. The study conducts a sample-split analysis that indicates the moderation effect of government effectiveness is significantly negative only in the post-CSR mandate period. This study is novel in analysing insights on government effectiveness moderation impact on firm performance in response to ESG controversies.
Negotiating In(security): Agency and Adaptation Among Zimbabwean Migrant Women Working in the Informal Sector in South Africa
Authors: Mutambara Victoria M. , Naidu Maheshvari
Published: May 2023

The deepening levels of poverty in Zimbabwe have resulted in high numbers of Zimbabwean women migrating to South Africa in the hopes of securing better wages and job security. Most of these migrants end up working in the informal sector with limited income, high levels of insecurity, and a lack of protection against gender-based violence and xenophobia. Regardless of the adversities that these women encounter, they often display resilience and adaptability. Based on semi-structured interviews with 22 Zimbabwean migrant women, this article documents how these migrant women navigated some of the vulnerabilities and challenges they encountered. Instead of always being constrained by different structures of violence, this article unpacks the women’s strategies to ensure their survival.
The effects of active music interventions on cognitive function and neuropsychiatric symptoms in patients with dementia: A systematic review and meta-analysis
Authors: Bugos Jennifer A. , Lu Linda , Chen Liwei , Torres Miranda Rose , Gbadamosi Ayo A.
Published: May 2023

Active music interventions represent one promising nonpharmacological intervention; however, the effects of these interventions are not well understood. This systematic review and meta-analysis examined the effects of active music interventions on cognitive function and neuropsychiatric symptoms in patients with dementia. Four independent database searches revealed 747 independent studies that were filtered by article type, topic, and relevancy, based on inclusion criteria. Nine randomized controlled trials (RCTs) were selected for inclusion and were assessed for quality using the Cochrane Risk of Bias tool. Results of the meta-analyses revealed those receiving an active music intervention scored significantly higher than controls on the Mini-Mental State Exam and reported fewer neuropsychiatric symptoms as denoted by the Neuropsychiatric Inventory, post-intervention. There is a need for additional RCTs with consistent standardized cognitive measures to compare dosage, duration, and intervention type (e.g., instrumental or vocal) across domains. Future research is necessary to distinguish the benefits of active music interventions on cognitive function and neuropsychiatric symptoms (e.g., agitation, depression) in patients with dementia.
Population health challenges and evaluative thinking: Rapid responses in the time of COVID-19
Authors: D’Onise Katina , Pontifex Katherine
Published: May 2023

There are multiple complex challenges that the population health sector faces to improve the health of the community, and the sector must work efficiently and effectively to make the most of the committed funds, sometimes in contexts of uncertainty. This article explores, through the case study of the South Australian COVID-19 Vaccine Hesitancy Project, the application of pillars from the Lean Start-up model of setting a clear vision, and creation of a series of minimum viable products to enable work with the community to commence as quickly as possible. This article draws parallels between this corporate model and the notion of evaluative thinking as well as adaptive evaluation approaches, demonstrates the interest from population health program and policy actors in adaptive practices and proposes a continuing opportunity for the evaluation profession in this space.
An objective and subjective study on global active control of engine noise in a car
Authors: Zhu Liping , Zhong Xu , Wang Hao , Qiu Xiaojun , Wu Sheng , Mao Dongxing
Published: May 2023

The work tests and analyzes the engine noise distribution in a car with and without active control, where the car’s built-in loudspeakers are used as secondary sources to attenuate the engine noise inside the whole cabin. To analyze the sound field in detail, the noise level at 52 microphones on the passenger ears’ plane is measured and presented. The distributions of the primary overall noise, first four order noise of the engine, and the sound field generated by the subwoofer at engine orders’ frequencies are reported, and the noise reductions corresponding to overall engine noise and each order’s noise are analyzed. Besides, jury test is presented and compared with the calculated loudness of residual noise to evaluate the acoustic comfort improvement of the system. The experiment results show that the overall noise reduction is achieved inside the whole cabin by controlling the first four orders’ engine noise. The average noise reduction of the measurement area inside the cabin is 6.2 dB and 2.9 dBA. Besides, 93% of the participants feel the acoustic comfort is improved with the active noise control system on.
Redispensing of expensive oral anticancer medicines: A practical application
Authors: Akgöl Kübra , van Merendonk Lisanne N , Barkman Hannerieke J , van Balen Dorieke EM , van den Hoek Hester L , Klous Marjolein G , Hendrikx Jeroen JMA , Huitema Alwin DR , Beijnen Jos H , Nuijen Bastiaan
Published: May 2023

Introduction

Increasing use of expensive oral anticancer medicines comes with the downside of a financial and environmental burden, partially caused by unused medication. Returned oral anticancer medicine to the pharmacy could be considered for redispensing providing guaranteed quality. This study aimed to identify and implement quality aspects and criteria for redispensing oral anticancer medicine in daily pharmacy practice.

Methods

A systematic analysis was conducted to determine the eligibility of oral anticancer medicine for redispensing. Over a one-year period, the number of returned oral anticancer medicine accepted for redispensing was quantified, and the reduction in financial waste and environmental burden calculated based on this assessment.

Results

Four categories of quality aspects were identified for determining the eligibility of oral anticancer medicine for redispensing: Product presentation suitability (stability characteristics, storage requirements), physical condition (unopened or opened secondary or primary packaging, visual appearance), authentication (Falsified Medicines Directive, confirmation of initial dispense, recall), and additional aspects (remaining shelf life, period of storage in uncontrolled conditions). A standardized procedure for redispensing was implemented in daily pharmacy practice. During the study period, 10,415 oral anticancer medicine dose units out of 13,210 returns (79%) were accepted for redispensing. The total value of oral anticancer medicine accepted for redispensing was €483,301, accounting for 0.9% of the total value dispensed during this period. Furthermore, the potential reduction in environmental burden was estimated at 1132.1 g of potent active pharmaceutical ingredient.

Conclusions

By implementing strict procedures considering all relevant quality aspects, redispensing of oral anticancer medicine can be successfully implemented into daily pharmacy practice, resulting in a significant reduction in financial waste and environmental burden.
Stimuli-responsive shell theory
Authors: Lee Jeong-Ho , Park Harold S , Holmes Douglas P
Published: May 2023

Soft matter mechanics generally involve finite deformations and instabilities of structures in response to a wide range of mechanical and non-mechanical stimuli. Modeling plates and shells is generally a challenge due to their geometrically nonlinear response to loads; however, non-mechanical loads further complicate matters as it is often not clear how they modify the shell’s energy functional. In this work, we demonstrate how to form a mechanical interpretation of these non-mechanical stimuli, in which the standard shell strain energy can be augmented with potentials corresponding to how a non-mechanical stimulus acts to change the shell’s area and curvature via the natural stretch and curvature. As a result, the effect of non-mechanical stimuli to deform shells is transformed into effective external loadings, and this framework allows for the application of analytical and computational tools that are standard within the mechanics community. Furthermore, we generalize the effect of mass change during biological growth to account for its effect on the stress constitution. The theory is formulated based on a standard, stress-free reference configuration which is known a priori, meaning it can be physically observed, and only requires the solution of a single-field equation, the standard mechanical momentum or equilibrium equation, despite capturing the effects of non-mechanical stimuli. We validate the performance of this model by several benchmark problems, and finally, we apply it to complex examples, including the snapping of the Venus flytrap, leaf growth, and the buckling of electrically active polymer plates. Overall, we expect that mechanicians and non-mechanicians alike can use the approach presented here to quickly modify existing computational tools with effective external loadings calculated in this novel theory to study how various types of non-mechanical stimuli impact the mechanics and physics of thin shell structures.
Comparison of topographic outcomes between HPMC based and vitamin E TPGS based riboflavin solutions after corneal cross-linking
Authors: Balıkçı Ayşe Tüfekçi , Ulutaş Hafize Gökben
Published: May 2023

Purpose

To compare the visual and topographic results between patients who underwent epithelium-off cross-linking using riboflavin solutions compounds hydroxypropyl methylcellulose (HPMC) 1.1% and D-alpha-tocopheryl polyethylene-glycol 1000 succinate (VE-TPGS).

Methods

In this study, 37 eyes treated with HPMC and 29 eyes treated with VE-TPGS were evaluated retrospectively. Spherical equivalent (SE), refractive cylinder, corrected distance visual acuity tests (CDVA), corneal topography indices (flat and steep meridians’ keratometry (K1 and K2)), maximum keratometry (K max), central, thinnest, and apical corneal thicknesses, the front and back keratoconus vertex index (KVf, KVb), and the surface asymmetry index of the front and back surface (SIf, SIb), and endothelial cell density were compared at baseline and postoperative follow-up visits (1, 3, 6, and 12months).

Results

At the end of the 12th-month, K1, K2, and Kmax were decreased in both groups. In comparison to baseline, there was a decline in the HPMC group in the 3rd- month Kmax change, an increase was observed in the VE-TPGS group. In the 12th-month KVb change, an increase was observed in the HPMC group compared to the baseline, while a decrease was observed in the VE-TPGS group. The other parameters did not show a statistically significant difference between the groups (p > 0.05).

Conclusion

At the end of 12 months, both riboflavins were effective in stopping the progression of keratoconus and were safe for endothelium. Although both riboflavins provide a decrease in keratometry values, it can be said that VE-TPGS is superior to HPMC in correcting the ectasia on the posterior corneal surface.
Research on time-varying meshing stiffness of wind turbine gearbox considering tooth surface wear
Authors: Mo Shuai , Hu Qingsen , Liu Meng , Wang Lei , Bao Heyun , Cen Guojian , Huang Yunsheng
Published: May 2023

The time-varying meshing stiffness (TVMS) is an important element of the gear system. In this paper, the TVMS of each gear set of a wind turbine gearbox is calculated based on the principle of potential energy method, where wear is the most likely failure in the operation of a wind turbine gearbox. Therefore, the Archard wear model is brought into it, and theoretically the analytical formula of stiffness considering tooth wear is derived, and the time-varying wear depth is deduced as the natural wind speed keeps changing and the input torque of the wind turbine gearbox keeps changing. The interrelationship between gear tooth wear and meshing pressure angle and number of meshes is studied in depth, and the TVMS of each gear set under wear is calculated using the modified tooth profile model. The results show that the tooth profile wear depth is related to the gear meshing angle, and the tooth profile wear depth becomes larger as the number of meshes increases, thus reducing the TVMS of the wind turbine, and the TVMS shows irregular fluctuations under time-varying wear.
“The Depressed” and “People with Anxiety” therapists’ discursive representations of patients with depression and anxiety in Danish Psychiatry
Authors: Bryde Christensen Anne Bryde , Dyrloev Karoline , Hoej Michaela , Poulsen Stig , Reinholt Nina , Arnfred Sidse
Published: May 2023

Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners’ discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a “training discourse,” within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes “favorized” over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists’ general critical attitudes toward the psychiatric system and in relation to broader societal tendencies.
3D printed passive end-effector for industrial collaborative robotic arms
Authors: Nicolini L. , Sorrentino A. , Castagnetti D. , Spaggiari A.
Published: May 2023

The work focuses on the design and prototyping of a novel end-effector for a collaborative robotic arm allowing to grab and drag industrial packages without lifting them. The proposed solution consists of a passive 3D-printed end-effector manufactured using carbon fibre reinforced Onyx material. Thanks to the entirely passive mechanical actuation that exploits the compliance of the main chassis, this end-effector features a simple, scalable, and inexpensive structure. This lightweight end-effector is specifically designed for small and low payload collaborative robotic arms. Specifically, the proposed end-effector includes three main parts. First, a thin blade, with the main function of separating boxes that are close to each other. Second, a rocker arm - rod mechanism, which allows an opposable bracket to be moved in order to grab the correspondent package. This is proportionally and passively actuated by the contact pressure between the package, during its grip, and a paddle (third part), which is composed of a flat leverage and three flexural springs to counterbalance the pushing force. This paddle and the main body of the gripper were designed as a single part exploiting 3D printing manufacturing capabilities. Moreover, we implemented a Simscape dynamic model that predicts the functionality of the end-effector during standard operations. The work shows how to design, develop and validate a new low cost, passive end-effector mainly oriented to collaborative robots. The final prototype demonstrates its entire functionality, and proves fabricability through 3D printing, thus minimizing production costs, weight, and time.
Analysis of an Australian death database of people with intellectual disability living out of the family home: Place of death and associated variables
Authors: Wiese Michele Y. , Stancliffe Roger J. , Durvasula Seeta , Piepers Daniel W. , Wilson Nathan J.
Published: May 2023

This study reports on a five-year data set about the deaths of 599 individuals in New South Wales Australia, who at the time of their death were living in out-of-home care. Analysis aimed to: i) gain a clearer understanding of place of death for people with intellectual disability; and ii) identify and analyse associated variables to investigate how well they predict place of death for this population. Hospital admissions, polypharmacy and living situation were the strongest standalone predictors of place of death. A hospital death was more likely if the target population were subject to polypharmacy, lived in a group home, had a moderate intellectual disability or had GORD. Death, and place of death, is an issue requiring individual consideration. This study has identified some of the variables that need attention when supporting people with intellectual disability to have a good death.
Social (in)justices during the educator developmental appraisal process: A post-apartheid South African case study
Authors: Perumalsamy Venie , Perumal Juliet , Naidoo Parvathy , Taliep Naiema
Published: May 2023

Globally, the appraisal of educators remains a contested issue as the process, which aims to provide support and development to educators, is generally considered a punitive measure for educators. Within the South African context, the Integrated Quality Management System is used to evaluate educators. Drawing on Fraser’s theories of social justice, this article explores the perspectives of 11 educators regarding educator developmental appraisal in post-apartheid South Africa as a catalyst for social (in)justice. Data was collected through semi-structured interviews and analysed using critical discourse analysis. This article highlights the importance of social justice practices in enhancing learner achievement and foregrounds the (in)justices often witnessed during the appraisal process. Findings reveal that the developmental appraisal process has the potential to promote social justice; however, contextual factors seem to be hindering the successful implementation of the appraisal process.
Validity and reliability of a new portable and cost-effective photoelectric cells device for measuring vertical jump performance: “The ADR Jumping”
Authors: Rodrigo-Carranza Victor , Lopez-Torres Olga , Fernandez-Elias Valentin E , Gomez-Ruano Miguel-Angel , Guadalupe-Grau Amelia
Published: May 2023

The vertical jump is one of the most used testing movements to assess athlete’s physical performance and fatigue status in several sports. However, low-cost, portable, field-based, and reliable methods are needed to measure jumping performance. The aim of the current investigation was to assess the validity and reliability of a new photoelectric cells device (ADR) for measuring the vertical jump height. Twenty-three trained male participants (age: 24.8 ± 5.2 years, body mass: 74.2 ± 7.3 kg; height: 1.76 ± 0.04 m) performed four maximal countermovement jumps (CMJ). Flight time-derived jump height was extracted simultaneously from three devices including a force plate (FP) (Kistler Quattro-Jump, criterion measurement) and two photoelectric cells (PC) devices (ADR and Optojump). The ADR mean CMJ height measurements demonstrated substantial validity compared to both FP and Optojump ( r = 0.98 p < 0.01). Intraclass correlation coefficients (ICCs) for reliability were classified as good to excellent for the three devices (0.986–0.994). All devices showed similar coefficients of variation (CV%), classified as very good (3.21–3.85), whereas observed standardized typical error values (STE) were small (1.29–1.39). The ADR Jumping device can be considered an affordable, reliable, and valid method to measure vertical jump height thereby making it a practical resource for coaches when monitoring the training process.
Food sufficiency, an approach rooted in the ethics of Epicurus: Analysis framework and research agenda
Authors: Hémar-Nicolas Valérie , Hedegaard Liselotte
Published: May 2023

Against the backdrop of an ecological crisis, we must transform our consumption patterns to ensure long-term sustainability. By reducing the negative impact of our food on health and the social and biospheric environment, food sufficiency is one way to achieve this transformation. However, this raises a major question about the compatibility of food sufficiency with pleasure – that is, one traditional pillar of ‘eating well’. At the crossroads of philosophy and marketing, this theoretical research draws on Epicurus’s ethics to address this issue. It highlights the importance of Epicurean consumer value as a fundamental element of both individual and collective ‘eating well’. In addition, it proposes an analysis framework that shows how an approach to food sufficiency that prioritises the satisfaction of essential needs can provide access to this value. Finally, the article proposes a detailed research agenda that outlines research avenues and managerial implications.
Mpox Case Reports in an Urban Homeless Population and a Proof of Concept for a Street-Based Mobile Mpox Vaccination Clinic
Authors: Zeien Justin , Vieira Jaime , Hanna Jeffery , Surendra Likith , Stenzel Jake , Ramirez Alma , Miller Catherine , Rosales Cecilia
Published: May 2023

Mpox is a new public health outbreak that particularly threatens the homeless population. Street Medicine Phoenix (SMP) is a student-led interprofessional volunteer organization that provides medical care and other essential services to individuals experiencing homelessness in Phoenix, Arizona. In addition to core services such as wound care; health screenings (blood pressure and blood glucose.); vision screenings; HIV testing; naloxone education and distribution; flu, COVID-19, and Hepatitis A vaccinations; and community resource referrals, SMP began offering mpox education and vaccination at outreach events. During an outreach event shortly after the onset of the mpox outbreak, SMP identified 2 suspected mpox cases. Accordingly, SMP has partnered with the Maricopa County Public Health Department to set up mobile mpox vaccination clinics on the streets outside of Phoenix Arizona’s largest homeless shelter. We share the details of these 2 cases along with our early efforts vaccinating individuals experiencing homelessness for mpox via our mobile vaccination clinic. Our experiences demonstrate the importance of community agencies providing direct outreach to underserved populations where they are at, particularly the homeless population, to address public health concerns such as emerging disease outbreaks like mpox. In addition, these cases highlight the potential significant impact that street medicine programs can have on their respective homeless communities in the context of infectious disease mitigation and emphasize the importance of partnerships with local health departments.
Compassion and Trauma: Occupational Health Experiences of Certified Medical Interpreters in Five U.S. States
Authors: Graves Janessa M. , Ross Nicole , Gonzalez Carmen , Moore Megan , Denson Vicki , Vavilala Monica S.
Published: May 2023

Medical interpreters play a vital role in fostering understanding and ensuring safety and transparency in healthcare for patients with non-English language preference. Limited research describes work-related experiences of medical interpreters. The purpose of this research was to explore perceptions of occupational health and safety among medical interpreters. A structured, online survey was administered to all certified medical interpreters in Hawaii, New York, New Jersey, California, and Texas. Participants described occupational experiences as an interpreter via an open-ended question. Responses were coded using qualitative thematic analysis. Response text was reviewed, a codebook of descriptive themes developed, and data thematically coded and summarized. Of 981 potential participants, 199 responded (20.3% response rate). Four main themes were identified: Professionalism and Role, Work-Related Challenges, Approaches to Mitigate Vicarious Trauma, and The Rewarding Nature of the Job. Respondents described compassion fatigue, vicarious trauma, intentional emotional distancing from clients, and loneliness. Respondents identified needs for workplace support to ensure professionalism and safeguard interpreter safety. Medical interpreters appreciate their work, yet face challenges, including compassion fatigue and vicarious trauma. Employers and healthcare institutions should support the occupational and emotional needs of medical interpreters as a vital member of the healthcare team.
Asymptomatic Coccidioidal Meningitis Relapse: A Demon in Disguise
Authors: Kooner Lovedip , Heidari Arash , Johnson Royce
Published: May 2023

Coccidioides spp is a soil-dwelling, dimorphic fungus that causes coccidioidomycosis. It is endemic to the western hemisphere. Although primarily a respiratory disease, it can also cause a myriad of clinical manifestations, from asymptomatic disease to meningitis. In fact, Coccidioides species is probably the most common etiologic agent of long-term meningitis in California and Arizona. Early diagnosis and treatment are critical to avoid fatal complications. With treatment, the cerebral spinal fluid analysis may return to normal. Relapse of coccidioidal meningitis is usually suspected with recurrence of meningitis symptoms. The patient is a 53-year-old man with a 2-decade history of coccidioidal meningitis who was diagnosed with an asymptomatic relapse of coccidioidal meningitis.
Exploring the Quality of Narrative Feedback Provided to Residents During Ambulatory Patient Care in Medicine and Surgery
Authors: Leclair Rebecca , Ho Jessica S. S. , Braund Heather , Kouzmina Ekaterina , Bruzzese Samantha , Awad Sara , Mann Steve , Zevin Boris
Published: May 2023

OBJECTIVES

The transition to competency-based medical education (CBME) has increased the volume of residents’ assessment data; however, the quality of the narrative feedback is yet to be used as feedback-on-feedback for faculty. Our objectives were (1) to explore and compare the quality and content of narrative feedback provided to residents in medicine and surgery during ambulatory patient care and (2) to use the Deliberately Developmental Organization framework to identify strengths, weaknesses, and opportunities to improve quality of feedback within CBME.

METHODS

We conducted a mixed convergent methods study with residents from the Departments of Surgery (DoS; n = 7) and Medicine (DoM; n = 9) at Queen's University. We used thematic analysis and the Quality of Assessment for Learning (QuAL) tool to analyze the content and quality of narrative feedback documented in entrustable professional activities (EPAs) assessments for ambulatory care. We also examined the association between the basis of assessment, time to provide feedback, and the quality of narrative feedback.

RESULTS

Forty-one EPA assessments were included in the analysis. Three major themes arose from thematic analysis: Communication, Diagnostics/Management, and Next Steps. Quality of the narrative feedback varied; 46% had sufficient evidence about residents’ performance; 39% provided a suggestion for improvement; and 11% provided a connection between the suggestion and the evidence. There were significant differences between DoM and DoS in quality of feedback scores for evidence (2.1 [1.3] vs. 1.3 [1.1]; p < 0.01) and connection (0.4 [0.5] vs. 0.1 [0.3]; p  =  0.04) domains of the QuAL tool. Feedback quality was not associated with the basis of assessment or time taken to provide feedback.

CONCLUSION

The quality of the narrative feedback provided to residents during ambulatory patient care was variable with the greatest gap in providing connections between suggestions and evidence about residents’ performance. There is a need for ongoing faculty development to improve the quality of narrative feedback provided to residents.
Synthesis of glycine-mediated CuO–Fe2O3–MgO nanocomposites: Structural, optical, and antibacterial properties
Authors: Alnahari Hisham , Al-Sharabi Annas , Al-Hammadi AH , Al-Odayni Abdel-Basit , Alnehia Adnan
Published: May 2023

Multi-phase metal oxides nanocomposites (NCs) have attracted considerable attention due to their extraordinary properties and novel applications over monometallic ones. Hence, trimetallic oxides nanoparticles (NPs) are preferred because of their immensely improved optical, catalytic, and biological properties, but few materials have been reported. Besides, glycine is an excellent structure-directing agent for NPs production with tailored physicochemical properties. Thus, in this work, a novel tri-phase CuO–Fe2O3–MgO (1:1:1) NCs was prepared via a sol-gel method in the presence of glycine as a fuel. The obtained NCs were characterized by Fourier transmission infrared, X-ray diffraction (XRD), Scanning electron micrographs, and UV-Vis. The XRD analysis emphasized the formation of NCs with monoclinic CuO, cubic MgO, hexagonal Fe2O3, and tetragonal CuFe2O4 crystals. The average crystallite size (D) was in the order of 10th of nm as computed by Scherrer method, with ternary phase seemingly affect the straightforward influence of glycine fuel concentration on the final crystallite sizes. UV-Vis analysis indicates two optical energy bandgaps which increased as glycine concentration increase. The antibacterial test against Staphylococcus aureus and Escherichia coli bacteria revealed comparable activity to that of Azithromycin standard drug, which increased with glycine concentration increase. The glycine-based tailored structural, optical, and biological properties of such trimetallic NCs making them of considerable candidate for certain applications development, possibly electronics and antibiotics; a case that encourage further investigations.
Design and Analysis of a Novel Shoulder Exoskeleton Based on a Parallel Mechanism
Authors: Niu Lianzheng , Guo Sheng , Song Majun , Wu Yifan , Qu Haibo
Published: May 2023

Power-assisted upper-limb exoskeletons are primarily used to improve the handling efficiency and load capacity. However, kinematic mismatch between the kinematics and biological joints is a major problem in most existing exoskeletons, because it reduces the boosting effect and causes pain and long-term joint damage in humans. In this study, a shoulder augmentation exoskeleton was designed based on a parallel mechanism that solves the shoulder dislocation problem using the upper arm as a passive limb. Consequently, the human–machine synergy and wearability of the exoskeleton system were improved without increasing the volume and weight of the system. A parallel mechanism was used as the structural body of the shoulder joint exoskeleton, and its workspace, dexterity, and stiffness were analyzed. Additionally, an ergonomic model was developed using the principle of virtual work, and a case analysis was performed considering the lifting of heavy objects. The results show that the upper arm reduces the driving force requirement in coordinated motion, enhances the load capacity of the system, and achieves excellent assistance.