bluuebunny/crossref_metadata_2025 huggingface dataset:
Machinability investigation and sustainability assessment in hard turning of AISI D3 steel with coated carbide tool under nanofluid minimum quantity lubrication-cooling condition
Authors: Dash Lalatendu , Padhan Smita , Das Anshuman , Das Sudhansu Ranjan
Published: May 2021

The present research addresses the machinability of hardened die steel (AISI D3, 61HRC) in hard turning using multilayer (TiCN/Al2O3/TiN) coated carbide tool under nanofluid based minimum quantity lubrication-cooling condition, where no previous data are available. Power consumption, flank wear, chip morphology and surface integrity (microhardness, residual stress, white layer formation, machined surface morphology, and surface roughness) are considered as technological performance characteristics to evaluate the machinability. Combined approach of central composite design - analysis of variance, response surface methodology and desirability function analysis have been employed respectively for experimental investigation, predictive modelling and multi-response optimization. With a motivational philosophy of “Go Green-Think Green-Act Green”, the work also deals with energy saving carbon footprint analysis and sustainability assessment to recognize the green manufacturing in the context of safer and cleaner production. under environmental-friendly nanofluid assisted minimum quantity lubrication condition. The quantitative analysis revealed that the cutting speed influenced the power consumption during hard machining (75.78%) and flank wear of coated carbide tool (45.67%); feed rate impacted the surface finish of the machined part (68.8%) significantly. Saw tooth shapes of chip produced due to cyclic cracking. Due to low percentage contribution of error (5.32% to Ra, 6.64% to VB, and 7.79% to Pc), a higher correlation coefficient (R2) was obtained with the quadratic regression model, which showed values of 0.9, 0.88 and 0.92 for surface roughness, flank wear, and power consumption, respectively. Optimization with the highest desirability (0.9173) resulted the optimum machining conditions under NFMQL at the cutting speed of 57 m/min, depth of cut 0.1 mm, feed of 0.07 mm/rev, and insert’s nose radius of 0.4 mm. As a result, under NFMQL tool life was improved by 30.8% and 22.6% in respect of flank wear and surface roughness respectively than when machining with MQL technique by adapting the optimum machining condition. Therefore, using hard nanoparticles-reinforced cutting fluid under minimum quantity lubrication condition in practical manufacturing becomes very promising to improve sustainability.
Coordination control of active front steering and direct yaw moment control based on stability judgment for AVs stability enhancement
Authors: Yao Xinxin , Gu Xianguang , Jiang Ping
Published: May 2021

A coordination control strategy based on stability judgment is presented for autonomous vehicles (AVs) aiming to enhance the handling and stability performance. Firstly, the stability judgment scheme is used to evaluate the real-time stability level of vehicles based on the Self-Organizing Feature Map (SOFM) neural network and K-Means algorithm. Secondly, a coordination controller of active front steering (AFS) and direct yaw moment control (DYC) is designed to track the desired vehicle motion. To enhance the handling and stability of AVs, the weights of AFS and DYC controllers are adaptively adjusted according to the vehicle stability level. Finally, the effectiveness of the proposed method is verified in co-simulation environment of CarSim and Simulink, and a rapid control prototyping test is implemented to evaluate the feasibility and robustness. The results indicate that the stability judgment scheme and coordination control strategy for AVs can not only satisfy the requirements of path tracking accuracy but also enhance the handling and stability performance.
The ultra-high efficiency gas turbine engine, UHEGT, part III: Dynamic behavior of the system in variable performance conditions
Authors: Ghoreyshi Seyed M , Schobeiri Meinhard T
Published: May 2021

This paper investigates the dynamic behavior of an Ultra-High Efficiency Gas Turbine Engine (UHEGT) with Stator Internal Combustion. The UHEGT-technology was introduced for the first time to the gas turbine design community at the Turbo Expo 2015. In developing the UHEGT-technology, the combustion process is no longer contained in isolation between the compressor and turbine, rather distributed in the first three HP-turbine stator rows. Noticeable improvement in the engine thermal efficiency and power along with other performance advantages are brought by this technology. In the current paper, dynamic simulation is performed on the entire gas turbine engine (UHEGT) using the nonlinear dynamic simulation code GETRAN. The simulations are in 2 D (space-time) and include the majority of the engine components including rotor shaft, turbine and compressor, fuel injectors, diffuser, pipes, valves, controllers, etc. The thermo-fluid conservation laws are applied to the flow in each component which create a system of nonlinear partial differential equations that is solved numerically. Two different fuel schedules (steep rise and Gaussian) are applied to all injectors and the engine response is studied in each case. The results show that fluctuations in the fuel flow lead to fluctuations in most of the system parameters such as temperatures, power, shaft speed, etc. However, the shapes and amplitudes of the fluctuations are different and there is a time lag in the response profiles relative to the fuel schedules. It is shown that an increase in average fuel flow in the system leads to a small drop in efficiency due to the cycle change from the design point. Moreover, it is seen that the temperatures usually rise fast with increase of fuel flow, but the system tends to cool down at a slower rate as the fuel is reduced.
Market Cognition: How Exchange Norms Alter Social Experience
Authors: Zaki Jamil , Neumann Eric , Baltiansky Dean
Published: May 2021

Market exchange and the ideologies that accompany it pervade human social interaction. How does this affect people’s beliefs about themselves, each other, and human nature? Here we describe market cognition as social inferences and behaviors that are intensified by market contexts. We focus on prosociality and two countervailing ways in which market cognition can affect it. On the one hand, marketplaces incentivize individuals to behave prosocially in order to be chosen as exchange partners—thereby generalizing cooperation and trust beyond group boundaries. On the other hand, markets encourage a view of people as self-interested and can thus taint people’s interpretation of prosocial actions and erode more communal forms of cooperation. We close by considering how market cognition can become self-fulfilling, altering relationships, communities, and cultural norms.
Visitor restrictions during the COVID-19 pandemic: An ethical case study
Authors: Hartigan Irene , Kelleher Ann , McCarthy Joan , Cornally Nicola
Published: May 2021

To prevent and reduce the transmission of the coronavirus to vulnerable populations, the World Health Organization recommended the restriction of visitors to nursing homes. It was recognised that such restrictions could have profound impact on residents and their families. Nonetheless, these measures were strictly imposed over a prolonged period in many countries; impeding families from remaining involved in their relatives’ care and diluting the meaningful connections for residents with society. It is timely to explore the impact of public health measures on people living in nursing homes from an ethical perspective. In order to foreground the ethical dimensions of the implications of visitor restrictions in nursing homes, we compiled an ethical case that reflects some recent experiences of nursing homes residents and their families, in the Irish Republic. We describe a series of events encountered by a woman and her family during the first wave of the pandemic in 2020 and we deploy an ethical decision-making tool to guide and structure our analysis. Our case analysis draws attention to ethical principles that are relevant to explicating the ethical duties and obligations that arise in relation to the interests, well-being, and safety of residents and their families, as well as nursing home staff and the wider community during a pandemic. These include the right of autonomy, trust, minimising harm, and proportionality. We conclude that a number of different strategies should be adopted by nursing homes and relevant regulatory bodies. This includes honest, regular communication between the nursing home staff, the resident and their family. Central to communications is the resident’s wishes, their current clinical status and the all-important wider public health obligations. National strategies include mass vaccination, the timely provision of guidance documents and interventions from regulatory bodies that are patient-centred, adaptable, and cost effective.
Facebook Ad Engagement: A Cross-cultural Analysis
Authors: Sharma Kavita , Lulandala Emmanuel Elioth
Published: May 2021

The paper analysed cultural differences to explain ad engagement (AE) among Facebook users in India and Tanzania. It uses Hofstede’s model and theory of planned behaviour to examine the differences in cultural values and AE between the two countries and to evaluate AE and its determinants. The paper used a cross-sectional descriptive design to collect data from 700 students from Indian and Tanzanian universities by using self-administered questionnaires. Data were analysed by using an independent sample t-test, Spearman’s Rank correlation coefficient, Multi-group differences test, confirmatory factor analysis (CFA) and structural equation modelling (SEM) methods. These analyses were run in SPSS 20.0 and AMOS 24. The paper confirms cultural convergence for individualism and masculinity values, but significant differences in indulgence and uncertainty avoidance across India and Tanzania were observed. Also, significant differences in AE across the two countries were observed. Moreover, we found that attitude to Facebook advertising, subjective norms and perceived herd behaviour positively determines AE, while perceived intrusiveness determines AE negatively. Indulgence has an insignificant relationship with AE while other cultural values have a significant positive relationship. The paper adopted purposive sampling and limited the scope to Facebook, thus, the findings may lack generalisability to other social media platforms. Hence, multiple-platform ad engagement research is encouraged. The marketing implications from this paper include the development of AE strategies, designing culturally relevant ad content and themes and ad targeting. This paper contributes to the understanding of the relationship between cultural values and users’ engagement with Facebook advertising.
Congenital Arhinia—A Case Report
Authors: Gedam Ruchi , Gholap Siddhant , Golhar Sandeep
Published: May 2021

Congenital arhinia is a seldom defect and may be associated with other facial and systemic defects. It is described as complete absence of nose.

Case Report:

Neonates are obligate nasal breathers but our neonate with complete absence of nose adjusted well to breathing through mouth without any need of urgent ventilator support or tracheostomy.

Conclusion:

Neonates may adapt breathing through mouth and bypass major respiratory support that is oral intubation or tracheostomy.
Education for Sustainable Development in Structural Change Processes Using the Example of the Coal Phase-out in Lusatia
Authors: Beer David Löw , Holz Verena
Published: May 2021

Within socio-economic transformation processes, the task of education is often reduced to short-term economic factors, that is, a suitable qualification profile of the local population. Transformative education should, however, be based on the broader claim that education contributes to successful transformation processes in the sense of facilitating a high and sustainable quality of life within a democratic society. In this article, we look at the transformation process in the German region of Lusatia. Coal, the region’s predominant industry, will be phased out by 2038. We examine what types of programme content might enable learners to participate in the transformation process, and discuss how different educational concepts (education for sustainable development and related approaches including transformative learning, socio-economic and civic education) could be used to develop an educational approach towards the transformation process. We derive competences that students should possess in two areas and provide recommendations for educational processes and policy.
Continuums of Change in a Competence-Building Initiative Addressing End-of-Life Communication in Swedish Elder Care
Authors: Johansson Therese , Tishelman Carol , Cohen Joachim , Eriksson Lars E. , Goliath Ida
Published: May 2021

Conversations about values for the end-of-life (EoL) between residents, relatives, and staff may allow EoL preparation and enable value-concordant care, but remain rare in residential care home (RCH) practice. In this article, longitudinal qualitative analysis was used to explore changes in staff discussions about EoL conversations throughout workshop series based on reflection and knowledge exchange to promote EoL communication in RCHs. We identified three overall continuums of change: EoL conversations became perceived as more feasible and valuable; conceptualizations of quality EoL care shifted from being generalizable to acknowledging individual variation; and staff’s role in facilitating EoL communication as a prerequisite for care decision-making was emphasized. Two mechanisms influenced changes: cognitively and emotionally approaching one’s own mortality and shifting perspectives of EoL care. This study adds nuance and details about changes in staff reasoning, and the mechanisms that underlie them, which are important aspects to consider in future EoL competence-building initiatives.
Developing Suicide Safety Protocols for Qualitative Research as a Universal Equity Practice
Authors: Hawk Mary , Pelcher Lindsay , Coulter Robert W. S. , Henderson Emmett , Egan James E. , Miller Elizabeth , Chugani Carla
Published: May 2021

Qualitative research offers a range of approaches to elucidate the health and social experiences of populations and communities that are historically oppressed and repressed, yet is not without ethical and practical challenges that may have unintended consequences and added risks for certain individuals and communities. As a result of experiences of trauma and environmental factors, many oppressed and repressed populations have disproportionately high rates of suicide, but there are no widely accepted standards or best practices for addressing suicidality while conducting qualitative research. We describe an example of a qualitative interview during which a participant reported thoughts of suicide, even though the study topic was not directly related to mental health or suicide. We describe how the research team responded and present a framework for developing suicide safety protocols when conducing qualitative research with oppressed and repressed populations.
The Safety of Continuous Infusion Propofol in Mechanically Ventilated Adults With Coronavirus Disease 2019
Authors: Witenko Corey J. , Littlefield Audrey J. , Abedian Sajjad , An Anjile , Barie Philip S. , Berger Karen
Published: May 2021

Background:

Propofol is commonly used to achieve ventilator synchrony in critically ill patients with coronavirus disease 2019 (COVID-19), yet its safety in this patient population is unknown.

Objective:

To evaluate the safety, in particular the incidence of hypertriglyceridemia, of continuous infusion propofol in patients with COVID-19.

Methods:

This was a retrospective study at 1 academic medical center and 1 affiliated teaching hospital in New York City. Adult, critically ill patients with COVID-19 who received continuous infusion propofol were included. Patients who received propofol for <12 hours, were transferred from an outside hospital while on mechanical ventilation, or did not have a triglyceride concentration obtained during the infusion were excluded.

Results:

A total of 252 patients were included. Hypertriglyceridemia (serum triglyceride concentration ≥ 400 mg/dL) occurred in 38.9% of patients after a median cumulative dose of 4307 mg (interquartile range [IQR], 2448-9431 mg). The median time to triglyceride elevation was 3.8 days (IQR, 1.9-9.1 days). In the multivariable regression analysis, obese patients had a significantly greater odds of hypertriglyceridemia (odds ratio = 1.87; 95% CI = 1.10, 3.21). There was no occurrence of acute pancreatitis. The incidence of possible propofol-related infusion syndrome was 3.2%.

Conclusion and Relevance:

Hypertriglyceridemia occurred frequently in patients with COVID-19 who received propofol but did not lead to acute pancreatitis. Elevated triglyceride concentrations occurred more often and at lower cumulative doses than previously reported in patients without COVID-19. Application of these data may aid in optimal monitoring for serious adverse effects of propofol in patients with COVID-19.
Development and Validation of the Career Crafting Assessment (CCA)
Authors: Lee Joo Young , Chen Christopher L. , Kolokowsky Eli , Hong Sharon , Siegel Jason T. , Donaldson Stewart I.
Published: May 2021

This research introduces career crafting to describe a set of lifelong career behaviors that individuals engage in when developing their meaningful career paths. The Career Crafting Assessment (CCA), based on the defined criteria of career crafting, was developed to measure the construct and its validity was tested across two studies. Exploratory factor analysis in Study 1 revealed that the CCA is multidimensional, composed of four factors. Confirmatory factor analysis in Study 2 further specified that the CCA is hierarchical, demonstrating a good model fit of a four-factor model with a higher-order factor. Correlational tests indicated that career crafting is positively related to existing career constructs, demonstrating convergent validity. Furthermore, the CCA predicted meaningful work, work engagement, and subjective career success, providing concurrent validity. Finally, a series of hierarchical regression tests revealed that career crafting accounts for more of the variance in meaningful work and work engagement than job crafting but not in subjective career success, partially providing incremental evidence. Overall, study findings suggest that (a) career crafting is a distinct construct, and (b) the CCA is a valid measure for assessing career crafting that can be used to better understand lifelong career behaviors to make one’s career more meaningful and engaging.
Adaptive asymptotic tracking control of uncertain fractional-order nonlinear systems with unknown quantized input and control directions subject to actuator failures
Authors: Sabeti Fatemeh , Shahrokhi Mohammad , Moradvandi Ali
Published: May 2021

This article addresses an adaptive backstepping control design for uncertain fractional-order nonlinear systems in the strict-feedback form subject to unknown input quantization, unknown state-dependent control directions, and unknown actuator failure. The system order can be commensurate or noncommensurate. The total number of failures is allowed to be infinite. The Nussbaum function is used to deal with the problem of unknown control directions. Compared with the existing results, the control gains can be functions of states and the knowledge of quantization parameters and characteristics of the actuator failure are unknown. By applying the backstepping control approach based on the frequency-distributed model, it is proved that all the closed-loop signals remain bounded and the output tracking error converges to the origin asymptotically. Finally, the effectiveness of the proposed controller is demonstrated by two simulation examples.
Demystifying asynchronous I/O Interference in HPC applications
Authors: Tseng Shu-Mei , Nicolae Bogdan , Cappello Franck , Chandramowlishwaran Aparna
Published: May 2021

With increasing complexity of HPC workflows, data management services need to perform expensive I/O operations asynchronously in the background, aiming to overlap the I/O with the application runtime. However, this may cause interference due to competition for resources: CPU, memory/network bandwidth. The advent of multi-core architectures has exacerbated this problem, as many I/O operations are issued concurrently, thereby competing not only with the application but also among themselves. Furthermore, the interference patterns can dynamically change as a response to variations in application behavior and I/O subsystems (e.g. multiple users sharing a parallel file system). Without a thorough understanding, I/O operations may perform suboptimally, potentially even worse than in the blocking case. To fill this gap, this paper investigates the causes and consequences of interference due to asynchronous I/O on HPC systems. Specifically, we focus on multi-core CPUs and memory bandwidth, isolating the interference due to each resource. Then, we perform an in-depth study to explain the interplay and contention in a variety of resource sharing scenarios such as varying priority and number of background I/O threads and different I/O strategies: sendfile, read/write, mmap/write underlining trade-offs. The insights from this study are important both to enable guided optimizations of existing background I/O, as well as to open new opportunities to design advanced asynchronous I/O strategies.
Dog bite wounds in cats: a retrospective study of 72 cases
Authors: Klainbart Sigal , Shipov Anna , Madhala Ori , Oron Liron D , Weingram Tomer , Segev Gilad , Kelmer Efrat
Published: May 2021

Objectives

Bite wounds are a common cause of trauma in cats; nevertheless, large-scale studies of this trauma in cats are lacking. The aims of the present study were to characterise the clinical and clinicopathological findings in these cats, to assess the association of these variables and therapeutic measures with survival, and to assess the association between the animal trauma triage (ATT) score and severity of injuries score (SS) at presentation with survival.

Methods

The medical records of cats presented to a veterinary teaching hospital and two large referral clinics were reviewed retrospectively.

Results

The study included 72 cats diagnosed with canine bite wounds (with the dog attacks having been witnessed). Seventy-one percent of cats suffered multiple injuries, and there was a significant association between the number of injured body areas and survival, and between severity of injury and survival ( P = 0.02 and P = 0.012, respectively). The median ATT scores and SSs for non-survivors were significantly higher compared with survivors ( P <0.0001). There was a strong and significant correlation between ATT scores and SSs ( r = 0.704, P <0.0001). Total protein and albumin were significantly lower and alanine aminotransferase significantly higher in non-survivors compared with survivors ( P ⩽0.032). Fifty percent of cats were treated conservatively, 32% by local surgical debridement and 18% of cats required an exploratory procedure. Cats undergoing more aggressive treatments were significantly less likely to survive ( P = 0.029). Fifty-seven cats (79%) survived to discharge.

Conclusions and relevance

Cats sustaining canine bite wounds have a good overall prognosis for survival to discharge. High ATT score, high SS, multiple body area injuries, penetrating injuries, radiographic evidence of vertebral body fractures and body wall abnormalities, as well as hypoproteinaemia and elevated alanine aminotransferase, are negative predictors of survival.
Ambient Stimuli Perpetuate Nighttime Sleep Disturbances in Hospital Patients With TBI
Authors: Williams Ellita T. , Bubu Omonigho M. , Seixas Azizi , Sarpong Daniel F. , Jean-Louis Girardin
Published: May 2021

Background and Objectives:

The effect of the ambient environment, sound, light, and movement, on the nighttime rest-activity of patients hospitalized with moderate-severe traumatic brain injury (TBI) is poorly understood. The purpose of this study was to examine how sound, light, and movement in these patients’ hospital rooms may contribute to nighttime awakenings.

Methods:

An observational design was used with 18 adult participants on a neuroscience step-down unit diagnosed with moderate-severe TBI. For up to five consecutive nights, actigraphy was used to capture nighttime awakenings while a custom-made multisensory device captured sound, light, and movement exposures in the participant’s room.

Results:

Participants were awake for 24% (or about 3 hr) of the time during the designated nighttime period of 8 pm to 8 am. Average nighttime exposures of sound was 52 dB, light was nine lumens, and movement, measured as a proportion, was 0.28% or 28%. With each stimuli exposure set at its average, there was a 20% probability of participant nighttime awakenings. Clinically meaningful reductions of movement in and out the participant’s room and elevated sound significantly decreases the participant’s probability of nighttime awakenings ( p < .05), but reductions in light did not.

Conclusion:

The ambient environment seems to impede restful sleep in immediate post-injury phase of patients with moderate-severe TBI.
Biosociality in Online Interactions: Youths’ Positioning of the Highly Sensitive Person Category
Authors: Edenroth-Cato Fanny , Sjöblom Björn
Published: May 2021

This article examines how young people in a Swedish online forum and in blogs engage in discussions of one popularized psychological personality trait, the highly sensitive person (HSP), and how they draw on different positionings in discursive struggles around this category. The material is analysed with concepts from discursive psychology and post-structuralist theory in order to investigate youths’ interactions. The first is a nuanced positioning, from which youths disclose the weaknesses and strengths of being highly sensitive. Some youths become deeply invested in this kind of positioning, hence forming a HSP subjectivity. This can be opposed using contrasting positionings, which objects to norms of biosociality connected to the HSP. Lastly, there are rather distanced and investigative approaches to the HSP category. We conclude that while young people are negotiating the HSP category, they are establishing an epistemological community.
Factors influencing the long-term outcome of tunneled hemodialysis catheters
Authors: Demaerel Victor , Vandenbulcke Ruben , Laenen Annouschka , De Vusser Katrien , Buyck Pieter-Jan , Claes Kathleen , Maleux Geert
Published: May 2021

Purpose:

To review the incidence and type of tunneled hemodialysis catheter (THC) complications in a large cohort of patients with end-stage renal disease. Additionally, the longevity of the THC and factors predicting high risk for catheter complications were assessed.

Material and methods:

Between August 2009 and December 2016, a cohort of 538 patients underwent primary THC insertion; in 119 patients, THC was inserted after failed arteriovenous fistula or graft. Patients without available clinical follow-up data ( n = 67) were excluded for further analysis. The Charlson comorbidity index (CCI) was calculated for each patient. The cumulative incidence function (CIF) was used for THC overall longevity, while Cox proportional hazards models were used for risk factor analysis.

Results:

In 352 patients, THC was inserted in a virgin neck. THC-related complications were observed in n = 104 (29.55%) of the patients. Infection occurred in n = 38 (10.80%) and malfunction, related to thrombosis or mechanical damage, in n = 45 (12.78%). Removal of the THC for the purpose of switching to alternative dialysis methods was planned in n = 135 (38.4%). The remaining patients were still alive with a functioning THC ( n = 18; 5.11%) or died ( n = 95; 27%) with a functioning THC. The THC survival rate was 82.67%, 78.13%, 74.15%, 72.96%, 71.02%, and 70.63% on follow-up after 6 months, and after 1–5 years, respectively. Gender, CCI, age, and site of placement of the catheter were found not to affect the life of the catheter.

Conclusion:

The overall complication rate in primary inserted THC was nearly 30% and mainly related to infection and malfunction. THC survival was more than 70% after 5 years, which supports its use for permanent dialysis access, irrespective of gender, CCI, age, and jugular side of THC placement.
Assessment of potential differences between pre-filled and manually prepared syringe use during vascular access device management in a pediatric intensive care unit
Authors: Ceylan Gokhan , Topal Sevgi , Turgut Nuriye , Ozdamar Nihal , Oruc Yeliz , Agin Hasan , Devrim Ilker
Published: May 2021

Background:

Central line-associated bloodstream infection is one of the four primary health-care-associated infections applicable to pediatric intensive care units defined by The Centers for Disease Control and Prevention. According to current guidelines, it is essential to flush vascular access devices before each infusion to assess catheter function and prevent catheter-related complications.

Objective:

This prospective trial aimed to assess the potential differences between pre-filled and manually prepared saline syringe use during vascular access device management in a pediatric intensive care unit.

Methods:

Volunteered registered pediatric intensive care unit nurses were asked to implement the flushing solution to an extension line of a central venous catheter in vitro. After the randomization process with opaque sealed envelopes, they have started either with manual preparation or used sterile pre-filled saline syringes. Sterile application steps forms were used for monitoring the manual preparation of saline syringes versus the pre-filled saline syringes phase. Each volunteer repeated the steps for 3, 5, and 10 mL syringe volumes with the manually prepared and pre-filled saline syringes. After completing the procedures, failed steps and durations were transferred into a database to be analyzed by a blinded investigator.

Results:

A total of 41 nurses volunteered and 123 forms for three attempts per one nurse were filled for each group. In the manual preparation group, the number of at least one failure in the necessary steps was 89 (72.3%) and the same number in the pre-filled syringe group was 6 (4.9%), and significantly lower in the pre-filled saline syringe group ( p < 0.001). The overall time for preparing to flush was 86.0 ± 22.3 s (ranging from 46 to 173 s) for manual prepared syringes and 35.2 ± 9.4 s (ranging from 18 to 100 s) ( p < 0.001) for pre-filled saline syringes.

Conclusion:

Our results demonstrate that the risk for breaking the aseptic no-touch technic was higher in the manual preparation group. We have also demonstrated that the flushing time was shorter with pre-filled syringes compared to manually prepared ones, which may contribute to decreasing the workload of the nurses and may increase the quality of care in the intensive care units. The use of pre-filled saline syringes may decrease the central line-associated bloodstream infections incidence and may increase the quality of care by saving extra time in the pediatric intensive care unit.
COVID-19 and Ventilation in the Home; Investigating Peoples’ Perceptions and Self-Reported Behaviour (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] Study)
Authors: Smith Louise E , Potts Henry WW , Amlȏt Richard , Fear Nicola T , Michie Susan , Rubin G James
Published: May 2021

Ventilating indoor spaces helps prevent COVID-19 transmission. We investigated self-reported rates of opening windows to improve ventilation in the home, perceived effectiveness of opening windows, and confidence that if you wanted to, you could open windows. One in 6 people reported rarely, if ever, opening windows in their home in the last week. Three in 4 people knew that opening windows to improve ventilation was an effective way to prevent the spread of COVID-19 and 5 in 6 were confident that they could open windows in their home. Official messaging should continue to seek to improve knowledge about the effectiveness of ventilation for reducing COVID-19 transmission, and increase the frequency of window opening.
Step up to the Brain Injury Guidelines league: Adoption of Brain Injury Guidelines at a Level III trauma center, A pilot study
Authors: Gribbell Mikalah , Hsu Justin , Krech Laura , Pounders Steffen , Koestner Amy , Haverkamp Jennifer , Burns Kelly , Gawel Jeffrey , Kwazneski Douglas , Iskander Gaby , Gibson Charles , Chapman Alistair
Published: May 2021

Introduction

The Brain Injury Guidelines (BIG) direct surgeons to implement risk-stratified treatment plans for patients with traumatic brain injury (TBI). BIG categorize patients into one of three severity categories, from lowest to highest risk (BIG 1, BIG 2, and BIG 3). BIG empowers physicians to implement standardized treatment plans that limit unnecessary hospitalizations, repeat imaging, and neurosurgical consultation. These guidelines have been studied in Level I trauma centers, but their clinical application has never been studied in a Level III trauma center. In this pilot study, we sought to determine if the BIG can be implemented in a regional trauma center where patients with less severe brain injuries are locally evaluated and treated.

Methods

All TBI patients at a Level III trauma center were stratified using the BIG criteria, where BIG 1 and BIG 2 patients were managed locally and BIG 3 patients were transferred to a Level I trauma center. We conducted a retrospective review using the local trauma database and electronic medical records over a 1-year period when BIG were first protocolized. The primary endpoint included deaths, complications, readmissions, and length of stay.

Results

There were 6 (12.2%) BIG 1, 5 (10.2%) BIG 2, and 38 (77.6%) BIG 3 patients evaluated at the Level III trauma center. All BIG 1 and BIG 2 patients remained at the Level III trauma center, and 33 of the 38 BIG 3 patients were transferred. There were no complications, readmissions, or unexpected transfers within the BIG 1 or BIG 2 patient cohorts.

Conclusion

The BIG criteria can be successfully implemented in a Level III trauma center. A collaborative transfer agreement with a Level I trauma center reduces unnecessary transfers without negatively affecting patient care. The BIG criteria should be considered for well-developed regional trauma systems.
Tourist guides and free tours: A controversial relationship
Authors: Navalón-García Rosario , Mínguez Carmen
Published: May 2021

Like other tourism subsectors, guided tours have been affected by the emergence of the sharing economy. Although this subsector of tourism is not as well known, it constitutes an interesting scenario for studying these new business models and it is also generating debate. This article analyses the uniqueness of the tourist guide services provided through online platforms under the name of free tours. The study includes a bibliographical revision and it is carried out from a qualitative methodology based on a survey conducted among tourist guide professionals and in-depth interviews. The study analyses the point of view of professionals in the guiding sector from 11 European cities subject to common regulations. It aims to determine how they are affected by the free tours as well as to assess their relationship with this new activity, a complex relationship with many controversial elements in terms of labour, tax and organisation. It will be shown that the free tours respond to the trends of contemporary society but are not an expression of the collaborative consumption among equals, but rather an effective marketing strategy.
Tracking and modeling public perceptions toward the reality of COVID-19 pandemic in Nigeria
Authors: Yusuf Abdullahi , Tambuwal Nasiru Ibrahim , Gusau Hadiza Ahmad , Maiyaki Faruk Usman
Published: May 2021

The study tracked and modeled public perceptions toward the reality of COVID-19 pandemic in Nigeria over a 3 month period (10 May to 10 August 2020); 2580 Nigerians across the six geopolitical zones were selected to participate in the study. These participants were selected from various social media platforms and were requested to complete an online survey over a 3-month period. Data were analyzed in three phases: tracking, modeling, and forecasting. We first tracked the respondents’ perceptions in the form of a qualitative response, where seven thematic constructs emerged from content analysis. These constructs were confirmed in the modeling phase, using structural equation modeling after data transformation. The themes were forecast as a single construct to predict possible trends and patterns over the next 3 month period using an autoregressive integrated moving average. Our findings revealed that public perceptions toward the reality of COVID-19 pandemic in Nigeria fall into seven thematic constructs: “scam,” “fake,” “politics,” “business venture,” “exaggeration,” “real,” and “real but manipulated.” These constructs show a steady trend with a random walk pattern, suggesting that perceptions toward the reality of COVID-19 in Nigeria will remain relatively unchanged over the next 3 month period. We recommend, among other things, that massive and intensive sensitization and awareness programs are needed to change the public mindset concerning the reality of the pandemic in Nigeria.
Affective communication: a mixed method investigation into COVID-19 outbreak communication using the Taiwanese government Facebook page
Authors: Lien Chia Yu , Wu Yun-Hsuan
Published: May 2021

The COVID-19 outbreak has created an unprecedented challenge for governments to convey information to the public, and social media has become a critical method of COVID-19 communication in Taiwan.

Objectives:

This study examines a total of 1128 Facebook posts published by Taiwan’s principal health authority from December 1, 2019 to May 31, 2020.

Methods:

Using both qualitative and quantitative approaches, this study investigates strategies used by the Taiwan government to communicate the COVID-19 outbreak and public responses toward these strategies.

Result:

Novel uses of Facebook posts on outbreak communication were identified, including solidarity, reviews of actions, press conferences, and the use of animal and cartoon images. Quantitative results showed that the public responded significantly more frequently to messages generating positive affects, such as posts that reviewed government actions and public efforts; posts that expressed thanks, approval, or comradeship; and posts that paired text with photographs of frontline workers or cute animals.

Conclusion:

These results suggest that, amid a disease outbreak, the public not only look for updated situations and guidelines but also for affective affirmation from government agencies.
Mental Health Assessment of the Frequent Visitor-Part 2: Assessment and Interventions
Authors: Perron Tracy , Jakubowski Tami , Razzi Cathy , Kartoz Connie
Published: May 2021

This article is the second part of a two-part series on mental health in school-age children. The focus of this article is on mental health assessment in the school setting, including the use of screening tools, with a review of common medications prescribed for youth with anxiety and depression. Students with mental health conditions frequently seek refuge in the school health office, many times for psychosomatic complaints such as stomach ache, headache, nausea, and fatigue. School nurses need to be adept to assess mental health and intervene as necessary.
Reimagining the national map
Authors: Rossetto Tania , Lo Presti Laura
Published: May 2021

The map of the nation may be considered a power tool that persists in reproducing exclusive forms of nationalism in response to migration crises. Yet, in this article, we argue that in an era marked by new, rampant rhetoric regarding nationalism, maps are surprisingly among the few spaces left to cultivate progressive imaginaries of cultural diversity and migration as intrinsic, positive features of national experiences. Discussing critical readings of national mappings, we encourage a dialogue between map studies and nation and nationalism studies through the lens of everyday cartographic nationhood. Taking Italy as a context of analysis, the paper considers subject-centred refabrications of national maps (IncarNations), alien phenomenologies of national cartographic objects (AlieNations), and transformative creative cartographies of migrant nations (ContamiNations) to promote an alternative understanding of the national map as a sensitive tool of pluralism in multicultural societies.
Why a critical geopolitics cannot be Confucian
Authors: Gonzalez-Vicente Ruben
Published: May 2021

In this commentary, I welcome An et al.’s (2021) commitment to explore the role of Confucian thought in the contemporary practices of statehood in the People’s Republic of China (PRC). Nonetheless, I also take issue with the authors’ argument that a Confucian geopolitics is needed to replace inadequate ‘Western geopolitical frameworks’. Confucian philosophies promote a hierarchical social order based on authority and subordination, and the way in which they are selectively and strategically utilized in contemporary China represents an important subject of analysis. However, they should not be viewed as a framework of analysis, as they obscure rather than shed light on spatial and class struggles – even in the hybridized stylization endorsed by An et al. Critical political economic and critical geopolitical perspectives with a global theoretical orientation and a knowledge of place and culture offer more promise in the disentangling of state practices and social relations in the PRC.
Adipokine role in physiopathology of inflammatory and degenerative musculoskeletal diseases
Authors: Giardullo Liberato , Corrado Addolorata , Maruotti Nicola , Cici Daniela , Mansueto Natalia , Cantatore Francesco Paolo
Published: May 2021

We performed a systematic literature review to summarize the underlying pathogenic mechanisms by which adipokines influence rheumatological diseases and the resulting clinical manifestations. Increasing evidence display that numerous adipokines may significantly influence the development or clinical course of various rheumatological diseases. Despite the normal anti- or pro-inflammatory role of the cytokines, the serum level varies enormously in various rheumatological diseases. The expression of high levels of pro-inflammatory cytokines such as leptin or visfatin, respectively in systemic lupus erythematosus and in rheumatoid arthritis, represents a negative prognostic factor; other adipokines such as adiponectin, broadly known for their anti-inflammatory effects, showed a correlation with disease activity in rheumatoid arthritis. In the near future pro-inflammatory cytokines may represent a potential therapeutic target to restrain the severity of rheumatological diseases. Further studies on adipokines may provide important information on the pathogenesis of these diseases, which are not yet fully understood. The mechanisms by which adipokines induce, worsen, or suppress inflammatory and degenerative musculoskeletal pathologies and their clinical significance will be discussed in this review.
Therapeutic effects of SKF-96365 on murine allergic rhinitis induced by OVA
Authors: Ba Guangyi , Tang Ru , Sun Xiwen , Li Zhipeng , Lin Hai , Zhang Weitian
Published: May 2021

Introduction:

SKF-96365 is regarded as an inhibitor of receptor-mediated calcium ion (Ca2+) entry. The current study aimed to explore the effects of SKF-96365 on murine allergic rhinitis (AR).

Methods:

Intranasal SKF-96365 administration was performed on OVA induced murine AR. Serum and nasal lavage fluid (NLF) from mice were harvested to assay IgE and inflammatory cytokines using ELISA method. Inflammatory cells were counted and analyzed in NLF. Nasal mucosa tissues were collected from mice and used for HE staining, immunohistochemistry (IHC) staining, and real-time PCR detection.

Results:

SKF-96365 had therapeutic effects on murine AR manifesting attenuation of sneezing, nasal rubbing, IgE, inflammatory cytokines, inflammatory cells, TRPC6 immunolabeling, and TRPC6, STIM1 and Orai1 mRNA levels in AR mice.

Conclusion:

SKF-96365 could effectively alleviate the symptoms of murine AR. SKF-96365 could suppress TRPC6, STIM1, and Orai1 activities, leading to the downregulation of inflammatory cytokines and inflammatory cells in murine AR.
Characteristics and Outcomes of COVID-19 Infection from an Urban Ambulatory COVID-19 Clinic—Guidance for Outpatient Clinicians in Triaging Patients
Authors: Barbhaya Dweep , Franco Stephanie , Gandhi Kejal , Arya Radhika , Neupane Rabin , Foroughi Negar , Oluigbo Nnenna , Fishbein Dawn , Tran Jennifer
Published: May 2021

Background

Coronavirus infection (COVID) presents with flu-like symptoms and can cause serious complications. Here, we discuss the presentation and outcomes of COVID in an ambulatory setting along with distribution of positive cases amongst healthcare workers (HCWs).

Method

Patients who visited the COVID clinic between 03/11/2020 and 06/14/2020 were tested based on the CDC guidelines at the time using PCR-detection methods. Medical records were reviewed and captured on a RedCap database. Statistical analysis was performed using both univariate and bivariate analysis using Fischer’s exact test with 2-sided P values.

Results

Of the 2471 evaluated patients, 846 (34.2%) tested positive for COVID. Mean age of positivity was 43.4 years (SD ± 15.4), 60.1% were female and 49% were Black. 58.7% of people tested had a known exposure, and amongst those with exposure, 57.3% tested positive. Ninety-four patients were hospitalized (11.1%), of which 22 patients (23.4%) required ICU admission and 10 patients died. The overall death rate of patients presenting to clinic was 0.4%, or 1.2% amongst positive patients. Median length of hospital stay was 6 days (range 1-51). Symptoms significantly associated with COVID included: anosmia, fever, change in taste, anorexia, myalgias, cough, chills, and fatigue. Increased risk of COVID occurred with diabetes, whereas individuals with lung disease or malignancy were not associated with increased risk of COVID. Amongst COVID positive HCWs, the majority were registered nurses (23.4%), most working in general medicine (39.8%) followed by critical care units (14.3%).

Discussion/Conclusion

Blacks and females had the highest infection rates. There was a broad range in presentation from those who are very ill and require hospitalization and those who remain ambulatory. The above data could assist health care professionals perform a targeted review of systems and co-morbidities, allowing for appropriate patient triage.
Taking a side between the United States and the People’s Republic of China: Strategic hedging of South Korea and India
Authors: Hwang Wonjae , Ryou-Ellison Hayoun Jessie
Published: May 2021

This paper explores how South Korea and India have taken positions between the United States and the People’s Republic of China over diverse foreign policy issues. By adopting dual engagement and strategic ambiguity as hedging strategies, both regional powers reduce their vulnerability to the influence and pressure of the two great powers. Thanks to their strategic importance and prominence in regional politics enhanced by such strategies, South Korea and India can independently pursue their foreign policy preferences to a great extent. The analysis of voting behavior of these regional powers in the United Nations General Assembly between 1991 and 2018 confirms our expectations.