bluuebunny/crossref_metadata_2025 huggingface dataset:
Drain Placement During Bariatric Surgery, Helpful or Harmful?
Authors: Gray Edward C. , Dawoud Fakhry , Janelle Meredith , Hodge Michael
Published: August 2020

Introduction

Routine drain placement is still widely used in both sleeve gastrectomy (SG) and Roux en Y gastric bypass (REYGB). There is mounting evidence that drains may increase complication risk without preventing reoperation or other complications.

Methods

Data from 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use File was evaluated for drain use during laparoscopic REYGB and SG. Primary outcomes were superficial and deep surgical site infections (SSI), reintervention/reoperation, and readmission. Preoperative patient risk factors were also compared to evaluate for association with drain placement.

Results

A total of 148 260 patients fit the inclusion criteria. Drains were used in 23 190 (15.6%) cases and not used in 125 070 (84.4%). Drain placement during surgery was associated with increased odds of superficial SSI, deep incisional SSI, and organ space SSI. Patients with drains were found to have increased odds of requiring at least 1 reoperation or intervention within 30 days of surgery. Preoperative risk factors associated with drain placement included diabetes mellitus, a history of chronic obstructive pulmonary disease, and oxygen dependence. Smokers were slightly less likely to have a drain placed. There was no significant association with chronic steroid and immunosuppressant usage.

Conclusion

There is mounting data against drain placement during bariatric surgery. Prior studies using MBSAQIP data have shown an increased complication rate with drains, and our data set supports the idea that drains may increase complications after surgery. While no randomized prospective trials have been performed looking at drain usage in bariatric surgery, the growing retrospective data certainly inform against the regular use of drains.
The Impact of Virtual Crossmatch on Cold Ischemic Times and Outcomes Following Kidney Transplantation
Authors: Aslam Sadaf , Buggs Jacentha , Wyatt Kasey , Kumar Ambuj , Rogers Ebonie , Watson Robert
Published: August 2020

Background

Prolonged cold ischemic time (CIT) in deceased donor kidney transplantation (DDKT) has been associated with adverse graft outcomes. Virtual crossmatch (VXM) facilitates reliable prediction of crossmatch results based on the profile of human leukocyte antigen antibodies of the recipient and the donor in reduced time compared with a physical crossmatch (PXM). We hypothesized a shorter CIT since the implementation of the VXM in recipients of DDKT.

Methods

We conducted a retrospective cohort study of consecutive adult recipients of DDKT. The data were analyzed for differences in CIT before and after the implementation of VXM.

Results

After the exclusion of 59 recipients (age less than 18 years and/or CIT ≥ 20 hours), our study compared outcomes of 81 PXMs from February to June 2018 against 68 VXMs from February to June 2019. There were no statistical differences between groups based on donor age ( P = .09), donor type ( P = .38), kidney donor profile index ( P = .43), or delayed graft function ( P = .20). Recipients with VXM were older (58 vs 51 years , P = .002) and had a higher estimated post-transplant survival score (59% vs 46% , P = .01). The CIT was significantly lower for the VXM group ( P = .04).

Conclusion

Our study demonstrated a significantly shorter CIT with VXM in DDKT recipients. Our study was limited with small sample size, but the trend of increased graft survival with higher estimated post-transplant scores and older recipients is encouraging as the donor pool expands with marginal kidneys and national sharing.
Do Public and Private Project Infrastructure Expenditure in States Contribute to the Economic Growth of Nation? Evidences from India
Authors: Edison J. C. , Singla Harish Kumar
Published: August 2020

The purpose of the article is to find the effect of public expenditure (GI) and private project expenditure (PI) in different states on state gross domestic product (SGDP) and national gross domestic product (NDGP). The study also attempts to examine the sectors that contribute the most in growth of state and nation. The selected sectors in the study include manufacturing, mining, services, power, construction and infrastructure and irrigation. Data of all states and four union territories (UTs) for GI and PI in selected sectors are collected and a panel is formed. Four different regression equations are developed. The estimation is done using two-step Arellano–Bover/Blundell–Bond’s dynamic panel data to account for endogeneity and heteroscedasticity. The results suggest there exist two clusters of states in India. First cluster is of 13 states, which contributes towards the economic growth of nation and the other cluster is 16 states and UTs that do not contribute towards the economic growth of nation. The states that contribute towards the economic growth of nation do it primarily through private investment in the service sector.
Poor physical and mental health predicts prolonged grief disorder: A prospective, population-based cohort study on caregivers of patients at the end of life
Authors: Lenger Maja Krarup , Neergaard Mette Asbjoern , Guldin Mai-Britt , Nielsen Mette Kjaergaard
Published: August 2020

Background:

The health of caregivers can be affected during end-of-life caregiving. Previous cross-sectional studies have indicated an association between poor health status and prolonged grief disorder, but prospective studies are lacking.

Aim:

To describe physical and mental health status in caregivers of patients at the end of life, and to investigate whether caregivers’ health status during caregiving predict prolonged grief disorder.

Design:

A population-based prospective survey was conducted. Health status was measured in caregivers during caregiving (SF-36), and prolonged grief disorder was assessed 6 months after bereavement (Prolonged Grief-13). We calculated mean scores of health status and explored the association with prolonged grief disorder using logistic regression adjusted for age, gender and education.

Setting/participants:

The health in caregivers of patients granted drug reimbursement due to terminal illness in Denmark in 2012 was assessed during caregiving and 6 months after bereavement ( n = 2125).

Results:

The SF-36 subscale ‘role-physical’ concerning role limitations due to physical health, the ‘mental health’ component score, and all ‘mental health’ subscales showed significantly worse health in the participants than in the general population. Both poor physical health (adjusted OR: 1.05 (95% CI: 1.04–1.07)) and poor mental health (adjusted OR: 1.09 (95% CI: 1.07–1.11)) predicted prolonged grief disorder.

Conclusion:

Caregivers scored lower on one physical subscale and all mental health measures than the general population. Prolonged grief disorder was predicted by poor physical and mental health status before bereavement. Future research is needed on the use of health status in systematic assessment to identify caregivers in need of support.
Long-Term Results of a Modified Removable Expansion Plate to Increase Arch Length: A Series of 10 Cases
Authors: Banker Alka M. , Muchhadia Rahul P. , Desai Bhagyashree B. , Shah Priyanka A.
Published: August 2020

Crowding, protrusion, and class II or end-on occlusion are malocclusions frequently associated with a narrow transverse dimension. The goal of expansion is to reduce the need for extractions in permanent dentition through elimination of arch length discrepancies as well as correction of bony base imbalances. Gaining arch length makes the subsequent fixed appliance treatment easier and shorter. Palatal expansion is usually achieved by using fixed rapid maxillary expansion, but because of the complexity, cost, and increased laboratory steps, this step is sometimes omitted. We have modified the design and screw activation protocol of the removable Schwarz plate in such a way that it gives efficient and stable expansion as well as arch perimeter gain with simpler mechanics. We present the long-term results of 10 such cases treated with this modified expander followed by fixed appliances.
Novel Metal Auxiliary (Device) to Prevent Cross-contamination of Elastomeric Modules
Authors: Kohli Sarvraj S. , Kohli Virinder Singh
Published: August 2020

Emerging and prevalent infectious pose a significant threat to all stakeholders in the orthodontic office, namely, treating orthodontists, clinical assistants, and the patients. Due diligence must be applied to prevent further transmission of disease and infections. The elastomeric modules are one of the most frequent components of the fixed appliance. This clinical aid puts forth a novel clinical tip to prevent cross-contamination of and from elastomeric modules.
Sustaining municipal parks in an era of neoliberal austerity: The contested commercialisation of Gunnersbury Park
Authors: Smith Andrew
Published: August 2020

This paper analyses a potentially path shaping moment for the UK’s public parks by analysing a pivotal case study of park neoliberalisation. Like many municipal parks, Gunnersbury Park in West London is experiencing the effects of local government budget cuts. Governance, policy and physical changes have been introduced to reduce dependence on public funding and the result is a more commercially oriented park. This case is used to better understand how the period of neoliberal austerity 2010–2019 reshaped municipal parks. The paper highlights concerns over the transparency and accountability of the social enterprise that now manages Gunnersbury Park. It also shows how neoliberalisation and commercialisation are manifested in the park landscape: free events are replaced with ticketed ones, spaces for sport are transformed into bookable facilities, cafes are taken over by corporate chains and playgrounds are supplemented with paid entry alternatives. One of the main consequences is the financial and symbolic exclusion of those unable or unwilling to pay. The paper explores who has contested the recent changes, and why. Opponents are dismissed as idealistic NIMBYs but, by refusing to accept the post-political inevitability of park neoliberalisation, they are helping to ensure Gunnersbury Park remains a public and open space. The case is contextualised by situating it within a review of new park governance arrangements across London, and by comparing neoliberalisation processes here with those affecting New York parks. Ultimately, the research highlights the pitfalls of shifting away from the public funding and public management of municipal parks.
Deep Reinforcement Learning-Based Vehicle Driving Strategy to Reduce Crash Risks in Traffic Oscillations
Authors: Li Meng , Li Zhibin , Xu Chengcheng , Liu Tong
Published: August 2020

The primary objective of this study is to propose a deep reinforcement learning-based driving strategy for individual vehicles to mitigate oscillations and optimize traffic safety in stop-and-go waves. A deep deterministic policy gradient (DDPG)-based driving strategy, which requires information that is directly obtained by in-vehicle sensors, is proposed for system performance optimization. Two typical scenarios were simulated based on simulation software (SUMO): (i) the leading vehicle slowed down according to real trajectory data to produce one oscillation; (ii) the leading vehicle conducted several abrupt decelerations with various degrees of disturbance to produce multiple oscillations. The DDPG agents interacted with the SUMO platform to determine the optimal acceleration of vehicles that can reduce crash risks in various stop-and-go waves. The results showed that the proposed DDPG-based driving strategy successfully reduced the crash risk by 68.9%–78.4%. Scenarios with different penetration rates of DDPG agents and in various flow rates were compared to test the effect of the proposed strategy. The DDPG-based driving strategy reduced crash risk more with the increase of penetration rate and this strategy performed better when applied in the scenario with a high traffic flow rate. The proposed strategy is compared with the adaptive cruise control and jam-absorbing driving strategies. Results showed the proposed strategy outperformed other oscillation mitigating strategies in reducing crash risks.
Exploring Individual Preferences and Willingness to Pay for Mobility as a Service
Authors: Polydoropoulou Amalia , Tsouros Ioannis , Pagoni Ioanna , Tsirimpa Athena
Published: August 2020

This paper discusses demand and willingness to pay for mobility as a service (MaaS) plans. Given the rising popularity of the MaaS concept, research exploring preferences and demand for such services is valuable to researchers and policy makers as well as other involved stakeholders and mobility operators. This research investigates individual preferences for MaaS utilizing data collected via questionnaire surveys from Greater Manchester, United Kingdom. The surveys collected socio-demographic data and data in relation to individuals’ attitudes and typical mode use patterns, while stated preference data were also obtained by designing menu-based stated preference experiments where the respondents were able to create their ideal MaaS plan. A hybrid choice model is developed to explore user choices toward MaaS, while distributed willingness to pay values are estimated. A latent variable that captures the latent predisposition of people toward using multiple modes of transport is constructed. The results indicate that individuals who are more prone to using multimodal mobility options are willing to pay more for being offered both traditional and emerging mobility services as part of a monthly MaaS plan. Considering that the implementation of MaaS is still at an immature phase, while research efforts in relation to the demand for MaaS are limited, the results of this paper provide significant insights into individuals’ preferences toward MaaS and the heterogeneity between different user segments, and could be exploited to formulate valuable plans and contribute to the successful implementation of MaaS.
Multi-Player Dynamic Game-Based Automatic Lane-Changing Decision Model under Mixed Autonomous Vehicle and Human-Driven Vehicle Environment
Authors: Yu Yuewen , Liu Shikun , Jin Peter J. , Luo Xia , Wang Mengxue
Published: August 2020

The lane-changing decision-making process is challenging but critical to ensure safe and smooth maneuvers for autonomous vehicles (AVs). Conventional Gipps-type algorithms lack the flexibility for practical use under a mixed autonomous vehicle and human-driven vehicle (AV-HV) environment. Algorithms based on utility ignore the reactions of surrounding vehicles to the lane-changing vehicle. Game theory is a good way to solve the shortcomings of current algorithms, but most models based on game theory simplify the game with surrounding vehicles to the game with the following vehicle in the target lane, which means that the lane-changing decision under a mixed environment is not realized. This paper proposes a lane-changing decision-making model which is suitable for an AV to change lanes under a mixed environment based on a multi-player dynamic game theory. The overtaking expectation parameter (OEP) is introduced to estimate the utility of the following vehicle, OEP can be calculated by the proposed non-lane-based full velocity difference model with the consideration of lateral move and aggressiveness. This paper further proposes a hybrid splitting method algorithm to obtain the Nash equilibrium solution in the multi-player game to obtain the optimal strategy of lane-changing decision for AVs. An adaptive cruise control simulation environment is developed with MATLAB’s Simulink toolbox using Next Generation Simulation (NGSIM) data as the background traffic flow. The classic bicycle model is used in the control of involved HVs. Simulation results show the efficiency of the proposed multi-player dynamic game-based algorithm for lane-changing decision making by AVs under a mixed AV-HV environment.
Effect of process parameters on micro flexible deep drawing of stainless steel 304 cups utilizing floating ring: Simulation and experiments
Authors: Irthiea Ihsan , Mahmood Zaid
Published: August 2020

Due to its simplicity, versatility of process and feasibility of prototyping, using flexible tools in sheet forming seems appropriate for producing cups at microscales. This article presents a novel micro deep drawing technique in which a cooperation of a floating ring, as a primary rigid die, with a rubber pad, as a main flexible die, is employed for forming micro-cups. The function of the floating ring is to overcome minor wrinkles that commonly occur at flange portion, while the flexible die is to complete the forming stroke. The influence of initial sheet thickness, drawing ratio, punch corner radius and rubber height is studied through simulations and experiments. Furthermore, three size scales are adopted to investigate the possibility of using the proposed technique under different process dimensions. The code ABAQUS/Standard is utilized to build the finite element models and thereafter micro-forming experiments are carried out to verify the numerical results. For this purpose, a special setup is developed to be compatible with simulation models. The results show that the formed cups are characterized by very accurate dimensions, high surface quality, homogeneous wall thickness distribution in terms of maximum thinning and thickening and relatively large aspect ratio.
Investigation of the effect of abrasive belt constant force grinding based on mechanical decoupling tool system
Authors: Xie Guohong , Zhao Ji , Wang Xin , Liu Huan , Mu Yan , Zhang Yang
Published: August 2020

In the abrasive belt grinding process, there are factors affecting the machining stability, efficiency, and quality. Based on the analysis of the grinding process, the normal force in the contact area between the abrasive belt and the workpiece is a major factor. By comparing constant force and non-constant force grinding, the results imply that keeping the grinding force constant will achieve desired material removal and better surface quality. The phenomenon of over- and under-cutting of the workpieces can also be avoided by a constant normal force. In this article, a controllable and flexible belt grinding mechanism accompanied with a mechanical decoupling control strategy is built and tested. Afterward, a detailed comparison is made between the traditional force-position coupling system and the proposed decoupling control system. The proposed control system suppresses the interference between the position and force control systems. The contact force is directly measured and controlled without detecting the position of other components in the tool system. The complexity of the control system is thereby reduced. Finally, several grinding experiments are carried out. The standard deviation and coefficient of variation of the measured normal force are kept within 0.25 and 0.02, respectively. The experiment results reveal that the mechanical decoupling system performs well in force control compared with the traditional force-position coupling system. In addition, the surface roughness Ra < 0.4 μm, the surface quality of the workpiece is improved significantly with the constant force controller.
Dependency of critical damping on various parameters of tapered bidirectional graded circular plates rested on Hetenyi medium
Authors: Heydari Abbas , Li Li
Published: August 2020

In industrial machinery and automobiles the critical damping plates are used as shock absorbers to dampen system and return rest position, in the shortest period of time. The paper is focused on the effects of various parameters on critical damping of a complicated system including a tapered bidirectional graded circular plate subjected to radially variable in-plane pre-load and rested on visco-Hetenyi elastic medium with semi-rigid restraint. By employing a Chebyshev-Ritz method, dependency of critical damping is investigated for the first time on various parameters including bidirectional arbitrary material gradation, variable in-plane pre-load, Hetenyi elastic medium parameters, tapering, semi-rigid restraint and Poisson’s ratio. For the Chebyshev-Ritz method developed here, the proper scale factor and orthogonal shifted Chebyshev polynomials of the first kind without auxiliary function requirement are used. The conventional rule of mixture and Mori-Tanaka homogenization scheme are used to model transverse gradation. The characteristic equation is calculated by vanishing determinant of the total potential energy Hessian. An equivalent ABAQUS model is introduced to eliminate necessity of complicated modeling of original structure.
Numerical investigation of refrigerant outgassing in the screw pump of a hermetic reciprocating compressor oil supply system
Authors: Braga VM , Barbosa JR , Deschamps CJ
Published: August 2020

This paper reports an investigation on the phenomenon of refrigerant outgassing in the screw pump of a hermetic reciprocating compressor oil supply system. The interfacial mass transfer between the refrigerant and the lubricating oil is modelled by means of a cavitation model based on the Rayleigh-Plesset equation, for cases of fixed and variable mass fractions of refrigerant dissolved in the lubricant. The influence of compressor speed and compressor crankcase pressure is evaluated by comparing the lubricant volumetric flow rate and the lubricant volume fraction field for each condition. The results reveal that significant outgassing of refrigerant may take place in the oil pump, reducing the lubricant flow rate supplied by the pump.
Misinterpreting proxy data for paleoclimate signals: A reply to Srivastava and Jovane, 2020
Authors: Shukla Tanuj , Mehta Manish , Dobhal Dwarika Prasad , Bohra Archna , Pratap Bhanu , Kumar Anil
Published: August 2020

Srivastava and Jovane (2020) have made several comments on our assessment of proxy data and challenged the outcome of Shukla et al. (2020) based mainly on interpretation of environmental magnetic parameters. We respond to their criticisms and re-evaluate our paper, remove ambiguities and validate our conclusions through additional proxies (grain-size and geochemistry). We welcome their comments and do not entirely rule out their interpretation for magnetic mineralogy. We highlight the importance of proxy validation for high-energy environments like Chorabari lake. However, single proxy data correlation is likely to produce biased results with no relevant meaning. The objective of our study was to understand complexities in the glacial-climate system by reconstructing late-Holocene climate variations using the glacial lake sediment records from the Mandakini River Basin, Central Himalaya, India. We presented the complexities in Shukla et al. (2020), and this was also highlighted by Srivastava and Jovane (2020). In response, we provide additional justification of proxy response and substantiate our results with present-day estimates from the Chorabari glacier valley. We disagree with the thesis put forward by Srivastava and Jovane (2020) in their conclusion as they overemphasize the interpretation of a single proxy. We maintain that the investigation of present-day glacial settings is an important precursor of paleoclimatic data interpretation and that this supports our conclusions. We will try to incorporate the important suggestions of Srivastava and Jovne (2020) relating to the interpretation of magnetic data in future work.
In Vitro Generation of Red Blood Cells from Stem Cell and Targeted Therapy
Authors: Zhou Ping , Ouchari Mouna , Xue Yun , Yin Qinan
Published: August 2020

Red blood cell (RBC) transfusion is a common therapeutic intervention, which is necessary for patients with emergency or hematological disorders to reduce morbidity and mortality. However, to date, blood available for transfusion is a limited resource, and the transfusion coverage system still depends on the volunteer-based collection system. The scarcity of blood supplies commonly develops because of local conditions that transiently affect collection. Moreover, donor-derived infectious disease transmission events also remain a risk. Thus, there is a huge demand for artificial blood. The production of cultured RBCs from stem cells is slowly emerging as a potential alternative to donor-derived red cell transfusion products. In this concise review, we summarize the recent in vitro expansion of RBCs from various stem cell sources, targeted therapy, prospects, and remaining challenges.
Bio 3D Conduits Derived from Bone Marrow Stromal Cells Promote Peripheral Nerve Regeneration
Authors: Yurie Hirofumi , Ikeguchi Ryosuke , Aoyama Tomoki , Tanaka Mai , Oda Hiroki , Takeuchi Hisataka , Mitsuzawa Sadaki , Ando Maki , Yoshimoto Koichi , Noguchi Takashi , Akieda Shizuka , Nakayama Koichi , Matsuda Shuichi
Published: August 2020

We previously reported that a nerve conduit created from fibroblasts promotes nerve regeneration in a rat sciatic nerve model. This study aims to determine whether a nerve conduit created from bone marrow stromal cells (BMSCs) can promote nerve regeneration. Primary BMSCs were isolated from femur bone marrow of two Lewis rats, and cells at passages 4–7 were used. We created seven Bio 3D nerve conduits from BMSCs using a Bio-3D Printer. The conduits were transplanted to other Lewis rats to bridge 5-mm right sciatic nerve gaps (Bio 3D group, n = 7). We created two control groups: a silicone group (S group, n = 5) in which the same nerve gap was bridged with a silicone tube, and a silicone cell group (SC group, n = 5) in which the gap was bridged with a BMSC injection. Twelve weeks after transplantation, nerve regeneration was evaluated functionally and morphologically. In addition, PKH26-labeled BMSCs were used to fabricate a Bio 3D conduit that was transplanted for cell trafficking analysis. Electrophysiological study, kinematic analysis, wet muscle weight, and morphological parameters showed significantly better nerve regeneration in the Bio 3D group than in the S group or SC group. In immunohistochemical studies, sections from the Bio 3D group contained abundant S-100-positive cells. In cell trafficking analysis, PKH26-positive cells stained positive for the Schwann cell markers S-100, p75NTR, and GFAP. Bio 3D nerve conduits created from BMSCs can promote peripheral nerve regeneration in a rat sciatic nerve model through BMSC differentiation into Schwann-like cells.
İbtisam Lale Atahan (1946–2007): The first female Turkish physician in the discipline of radiation oncology
Authors: Erkal Eda Yirmibeşoğlu , Ersoy Nermin
Published: August 2020

Female physicians started to earn up their deserved places as late 1970’s in the historically male predominant Radiation Oncology community. The first female physician emerging as a leading scientist in the Discipline of Radiation Oncology was Professor İbtisam Lale Atahan, who untimely passed away in 2007. This eulogy attempts to shine the light on her life, achivements and legacy.
Crude Oil Volatility Transmission Across Food Commodity Markets: A Multivariate BEKK-GARCH Approach
Authors: Thenmozhi M. , Maurya Shipra
Published: August 2020

This study examines the time-varying price risk transmission in the nexus between crude oil and agricultural commodity prices in the context of non-grain-based biofuel producing country. Analysis of the short- and long-run dynamics of volatility in both spot and futures markets of maize, soybean and wheat and crude oil prices using the multivariate BEKK-GARCH model, indicate volatility spillover from wheat futures to crude oil futures in the short run and from crude oil futures to futures markets of maize, soybean and wheat in the long run. The spot market linkage of selected commodities is weaker compared to futures market, wherein maize spot volatility transmits to crude oil spot market in the longer period and no spillover between crude oil-food spot market is observed in the short run. The hedge ratios indicate that a dynamic hedging strategy is crucial for efficient risk management and the portfolio weights in futures market are more than the spot market. The results reveal that cross-market volatility spillover is more evident in the futures market, while own past conditional volatility is more significant in spot price discovery and risk transmission is evident among food commodities futures markets.

JEL Codes: G13, G14, Q11, Q18, Q02
Assessing the Distinctive Contributions of Simulation & Gaming to the Literature, 1970-2019: A Bibliometric Review
Authors: Nguyen Uyen-Phuong , Hallinger Philip
Published: August 2020

Background. Founded in 1970, Simulation & Gaming has emerged as the leading journal in this field of educational research. Given the centrality the journal’s influence, scholars have periodically reflected on the Journal’s contributions towards enhancing and refining both research and practice in educational simulation and gaming.

Aims. This systematic review aimed to quantitatively document the distinctive contributions of S&G to research and practice on simulations and games over the past 50 years. The review sought to identify the geographic distribution of publications, influential authors and documents published in the Journal, the intellectual structure of the literature, and topics of recent interest.

Method. The authors used the Scopus search engine to identify 1,427 research articles and reviews published in Simulation & Gaming from 1970 through the end of 2019. Bibliometric analyses included descriptive statistics, citation and co-citation and keyword co-occurrence analysis.

Results. The review found that while the Journal has increased its geographical breadth impressively, the majority of Simulation & Gaming publications continue to be authored by scholars located in Anglo-American-European societies. The review also found that the Journal has become a prime venue for disseminating inter-disciplinary research on simulation and games. Nonetheless, business simulation/gaming surfaced as the dominant focus in the Journal’s content. Analysis of the intellectual structure of the knowledge base confirmed that the field is theoretically anchored in theories of social cognitive and experiential learning. Temporal keyword analysis identified active learning, game design, technology-enhanced simulations and games, and sustainability as topical clusters of recent interest to authors in Simulation & Gaming.
Severe Antithrombin Deficiency May be Associated With a High Risk of Pathological Progression of DIC With Suppressed Fibrinolysis
Authors: Wada Hideo , Honda Goichi , Kawano Noriaki , Uchiyama Toshimasa , Kawasugi Kazuo , Madoiwa Seiji , Takezako Naoki , Suzuki Kei , Seki Yoshinobu , Ikezoe Takayuki , Iba Toshiaki , Okamoto Kohji
Published: August 2020

The frequency of severe antithrombin deficiency (SAD) was examined in the hematopoietic disorder-, infectious-, and basic-types of the disseminated intravascular coagulation (DIC). A posthoc analysis of 3008 DIC patients (infectious-type, 1794; hematological disorder-type, 813; and basic-type, 401) from post-marketing surveillance data of thrombomodulin alfa was performed. The clinical features of patients and outcomes were compared between patients with and without SAD, using an antithrombin cutoff value of 50%. Patients with SAD accounted for 40.4% of infectious-type DIC, 8.0% of hematopoietic disorder-type DIC, and 26.7% of basic-type DIC. There was no significant difference in thrombin–antithrombin complex levels between patients with and without SAD. The decreased fibrinogen level and differences in clinical features were significantly greater but the increases in fibrinolytic markers were significantly lower in patients with SAD than in those without. The 28-day survival rate was significantly lower in patients with SAD than in those without. Severe antithrombin deficiency was observed in all types of DIC, including hematopoietic disorders. Both hypofibrinolysis and hypercoagulability in patients with SAD may cause multiple organ failure and poor outcomes.
Microparticles and Nucleosomes Are Released From Parenchymal Cells Destroyed After Injury in a Rat Model of Blunt Trauma
Authors: Hayakwa Mineji , Ooyasu Takayoshi , Sadamoto Yoshihiro , Saito Tomoyo , Yoshida Tomonao , Katabami Kenichi , Wada Takeshi , Maekawa Kunihiko , Ieko Masahiro
Published: August 2020

We investigated the relationships between circulating procoagulants and trauma severity, including cellular destruction, and the effects of thrombin generation on procoagulants in a rat blunt trauma model. The rats were subjected to tumbling blunt trauma, where they were tumbled for 0, 250, 500, or 1000 revolutions. Creatine kinase, nucleosome, and microparticle plasma levels increased gradually with trauma severity. Strong interrelationships were observed among creatine kinase, nucleosome, and microparticle levels. Time to initiation of thrombin generation shortened with increasing trauma severity. In accordance with trauma severity, prothrombin activity decreased, but the thrombin generation ratio increased. Time to initiation of thrombin generation and the thrombin generation ratio correlated with creatine kinase levels. In an in vitro study, a homogenized muscle solution, which included massive nucleosomes and microparticles, showed accelerated thrombin generation of plasma from healthy subjects. Procoagulants, such as microparticles and nucleosomes, are released from destroyed parenchymal cells immediately after external traumatic force, activating the coagulation cascade. The procoagulants shorten the time to initiation of thrombin generation. Furthermore, although coagulation factors are consumed, the thrombin generation ratio increases.
Earthquake response of the train–slab ballastless track–subgrade system: A shaking table test study
Authors: Cao Licong , Yang Changwei , Zhang Jianjing , Zeng Pengyi , Li Sifeng
Published: August 2020

Earthquake is one of the major factors that provoke train derailment. To investigate dynamic responses of the train–slab ballastless track–subgrade system and derailment features of the train subjected to earthquake, a first large-scale shaking table test on this system was carried out in China. The loaded seismic wave is an earthquake wave of Zhengzhou Yellow River Bridge Site provided by the China Earthquake Administration. It was observed that the elevation of subgrade and embankment could magnify acceleration responses, and the transverse amplification effect of the elevation in soil was more pronounced than the vertical amplification effect. The acceleration response of a track slab was weaker than that of the top subgrade because of integrality and rigidity of the track slab. The bogie shows a shock-absorbing effect in the transverse direction. When the input amplitude was not larger than 0.14 g, the transverse and the vertical acceleration of the rail increased with rising earthquake amplitudes and fluctuated later. Meanwhile, the current stopping threshold for trains is conservative because the derailment factor was less than 0.8 and the peak lateral displacement of wheels was much smaller than the cross-sectional size of the rail model under a 0.12 g earthquake excitation. The current stopping threshold in codes could be reasonable in view of limited quantity and limited types of loaded earthquake in the test. The critical derailment condition of trains was 0.23 g when the Zhengzhou Yellow River Bridge Site earthquake was loaded, and the displacement analysis showed that it would be a great danger for train safety.
Resolution of high-output cardiac failure secondary to high flow radiocephalic fistula by precision banding under ultrasound guidance: A case report
Authors: Wan Ziming , Mboya Vincent N , Lai Qiquan , Tu Bo , Zhou Yu , Chen Ling , Chen Bo
Published: August 2020

Background:

The creation of dialysis shunt affects hemodynamic and cardiac function. High-output cardiac failure may occur if dialysis access volume flow is greater than 1500 to 2000 mls/min. To resolve symptoms of cardiac failure due to high flow dialysis shunt requires flow reduction procedure. We describe successful resolution of symptoms of heart failure due to excessive flow dialysis access by adopting precision banding, totally under vascular ultrasound guidance without angiography.

Case:

Hemodialysis adult patient uses the right arm radiocephalic fistula for 4 years. Recently, the patient presented with symptoms of high-output cardiac failure, including dyspnea, palpitations, fatigue, and orthopnea. The cardiac unit excluded all other causes of cardiac failure and referred the patient to our center for further evaluation. Ultrasonography revealed high blood volume flow measuring 3100 mls/min at brachial artery, marking high flow fistula and the underlying cause of cardiac failure. Juxta-anastomotic segment of fistula vein was identified; 3 mm diameter balloon was advanced to the juxta-anastomotic segment and maximally inflated. Two precision bandings were made on this segment, 1 to 2 cm apart with flow reduction to 691 mls/min. All steps of the procedure were done under ultrasound guidance without angiography. All symptoms were significantly alleviated immediately following the procedure. The patient was discharged after 48 h of monitoring. At 6 months, the patient was stable, no recurrence of high flow access, no signs or symptoms of cardiac failure, and the flow was 1119 mls/min.

Conclusion:

This case demonstrates that the precision banding procedure is feasible under ultrasound guidance, and the procedure is safe and effective in resolution of cardiac failure due to high flow radiocephalic fistula.
Acceptability and Feasibility of Group Interpersonal Therapy (IPT-G) for Depressed HIV+ Postpartum Adolescents Delivered by Community Health Workers: A Protocol Paper
Authors: Yator Obadia , Khasakhala Lincoln I , John-Stewart Grace , Kumar Manasi
Published: August 2020

Introduction:

Postpartum depression affects mothers at 4 to 6 weeks after delivery. Adolescent pregnancy can lead the expectant girl to drop out of school, receive poor obstetric care, and family support. Adolescent mothers are prone to severe postpartum depression as compared to older women. Early sexual initiation increases the risk of unintended pregnancies and potentially increases HIV exposure. WHO recommends Group interpersonal psychotherapy (IPT-G) as an evidence-based intervention for use in both primary care and community settings. We will assess the acceptability and feasibility of community health workers (CHWs), delivering IPT-G among postpartum adolescents (PPA) living with HIV.

Method:

This is a pilot feasibility study testing CHWs’ delivery of IPT-G to postpartum adolescents and young women living with HIV who will be attending the prevention of mother-to-child HIV transmission (PMTCT) clinics in 2 primary care health centers. Young women aged 15 to 24 years and 6 to 12 weeks postpartum will be eligible for participation. Our study is a two-arm intervention implementation study with one receiving group IPT and another one treatment-as-usual (TAU). We intend to treat the TAU group so that we will offer IPT-G post-intervention. There will be 2 groups running in the 2 facilities. Depression will be assessed using the Edinburgh postnatal depression scale (EPDS); those with EPDS >10 become eligible for the intervention. Besides, HIV-related stigma would be screened using HIV/AIDS Stigma Instrument (HASI–P), and social functioning rated using the World Health Organization’s Disability Assessment Schedule 2.0 (WHODAS 2.0). CHWs will deliver IPT-G for 8 sessions (1 session per week). The intervention group will receive immediate IPT-G, and the wait-list control group will receive deferred IPT-G as part of our intent to treat the group.

Primary outcome measure and analysis:

Descriptive statistics will be used to compare changes in depressive symptoms, HIV-related stigma, and social functioning between baseline and 8 weeks, and between 16 weeks and 24 weeks. The changes will be explored along with the differences between intervention and treatment as usual groups reporting effect sizes (Cohen’s d). Longitudinal continuous outcome variables across the time points will be analyzed using the Generalized Linear Model. For qualitative data, any emerging themes from KIIs and FGDs will be identified: framework matrixes, queries, and cross-tabulations will be used to analyze and interpret the data in view of assessing acceptability and feasibility of IPT-G.

Ethics and dissemination

The Kenyatta National Hospital-University of Nairobi approved this study of Nairobi Ethics and Research Committee (Approval No. P97/02/2018). The findings will be published in peer-reviewed journals and also shared with Kenya’s National AIDS Control Council.
The state of labor in the Democratic Party coalition
Authors: Bucci Laura C , Reuning Kevin
Published: August 2020

Since the New Deal, labor has been a key member of the Democratic coalition. As unions decline, their centrality to the Democratic Party has also diminished. At the same time, state variation in party preferences, party strength, and the types of unions that remain has led some unions to become involved in Republican politics. In this manuscript we investigate how central unions are in party networks using state legislative donation data from 2000–2016. We find that union contributions are associated with increasing centrality to the Democratic Party, while business interest contributions are associated with unions being less central. Only union membership rates are related to labor’s position in the Republican network. This work has implications for how we consider which groups are under a party’s umbrella. While labor may spend more money, it cannot keep pace with business groups in the party coalition.
Patient activation in adults with chronic conditions: A systematic review
Authors: Newland Pamela , Lorenz Rebecca , Oliver Brant J
Published: August 2020

Patient activation is an important aspect of self-management for adults with chronic non cancerous health conditions (CHC). However, there is limited evidence about which measures of patient activation and healthrelated quality of life are most useful to clinicians. This systematic review examined regarding the types of measures used to evaluate a patient’s readiness for self-management including patient activation and healthrelated quality of life (HRQOL). Two such as measurements are the Patient Activation Measure (PAM) and overall PROMIS® Global health. Ten articles were identified which included measurement of patient activation and HRQOL. The results indicate that HRQOL is evaluated with various measurement tools. Most researchers agree that patient activation and the measurement of global HRQOL positively contribute to successful self-management strategies.
Defining “the marijuana problem”: An Analysis of the Polish daily press, 2015–2016
Authors: Kępski Piotr
Published: August 2020

Aim:

This study analyses discourses on marijuana in the Polish daily press and explores ways of defining “the marijuana problem” during a debate about legalisation of medical marijuana.

Methods:

384 press articles published in three national newspapers in 2015–2016 were analysed. The method used was discourse analysis. The theoretical background was social constructionism, including Spector and Kitsuse’s four-stage constructionist model of defining social problems.

Results:

The study shows that marijuana problems were mainly constructed through criminal and politically medical discourses. In addition to celebrity and pop culture discourses, recreational marijuana use discourses and social problems discourses were identified.

Discussion:

The marijuana problem can be defined differently through various discourses. Definitions pertain to diverse marijuana meanings ranging from a negative marijuana-as-drug, through an ambivalent recreational marijuana up to a positively valued medical marijuana. The research pointed out that, from a discursive standpoint, the marijuana problem may be viewed as a complex network of relations between particular discourses, marijuana meanings, claim-makers and the media.

Conclusion:

Different definitions of the marijuana problem are constructed through a dynamic discursive and social process. Various claim-makers try to impose their meanings on marijuana. Mass media are not neutral. They also participate in defining the marijuana problem.
Familiar grammars of loss and belonging: curating trans kinship in post-dictatorship Argentina
Authors: Rizki Cole
Published: August 2020

On 24 March 1976, the Argentine military staged a coup d’état and established dictatorship. To eliminate radical left activists, the armed forces perpetrated mass civilian murder until democratic transition in 1983. The Mothers of Plaza de Mayo emerged, protesting their children’s disappearance by mobilizing portraiture to make visible familial rupture and indict the state. This article examines the archival exhibit, Esta se fue, a esta la mataron, esta murió (2017), which displayed trans women’s vernacular photographs and family albums from the 1970s–1980s, the same years as dictatorship. Analyzing the exhibit’s curatorial choices and the photographs’ material and haptic qualities, this article reads the exhibit alongside the Mothers’ iconic activist visual culture and national narratives of family loss. In doing so, the author suggests the exhibit renders trans sociality familial and familiar to a national viewing public, thereby reinterpreting Argentine history by installing trans subjects as proper subjects of national mourning.
The role of liberal arts in a skills economy: A case study in Oman
Authors: Hemmy Kirsten , Mehta Sandhya Rao
Published: August 2020

This study focuses on the place and role of the humanities, especially the liberal arts in emerging economies which rely vastly on the development of national skills and expertise. It is based on one example of a publicly funded university in Oman where the urgency of creating a skilled workforce has led to an exercise in aligning higher education with the creation of an employable pool of skilled graduates. Given a variety of social, cultural and administrative considerations, the role of an English program has been challenged for its capacity to address changing market requirements. Based on current students, alumni, and faculty perceptions and recommendations, this study investigates the possible immediate and far-reaching goals of an English program in a tertiary educational institution and suggests ways in which liberal education could be rearticulated to align itself with rapidly changing realities for students and the community.