bluuebunny/crossref_metadata_2025 huggingface dataset:
The dynamics of IT-business strategic alignment: evidence from healthcare information systems implementation
Authors: Sha Xiqing , Chen Jing (Elaine) , Teoh Say Yen
Published: August 2020

Purpose

This study intends to reveal how to manage the dynamic process of information technology business (IT-business) strategic alignment; managing this alignment is an unknown yet critical issue that must be addressed by any firm trying to unleash the business value of their IT investments.

Design/methodology/approach

This study presents our case study of a healthcare organization after healthcare information systems (HIS) implementation and investigates the strategic alignment between the implemented HIS and the organizational strategy from a dynamic perspective.

Findings

Two different patterns of alignment (i.e. an IT-strategy–driven pattern and a business-strategy–driven pattern) are identified, and a process model of the IT-business strategic alignment is developed. Moreover, this study focuses on the social dimension of strategic alignment and examines the role of this dimension, which is critical and fundamental with respect to other dimensions, in achieving strategic alignment.

Research limitations/implications

This paper makes important theoretical contributions to the understanding of strategic alignment by taking a dynamic view of alignment, identifying different patterns of alignment, emphasizing the role of social alignment and developing a comprehensive process model.

Practical implications

From a managerial perspective, managers should periodically scrutinize the IT-business alignment patterns of their organizations and develop dynamic capabilities for strategic alignment.

Originality/value

While most of the literature on the dynamics of strategic alignment have focused on confirming the dynamics of strategic alignment and identifying the factors that create dynamics in alignment, this study examines IT-business alignment as a continuous process over time, thus providing a novel perspective. Moreover, while the role of social alignment and its impact on downstream performance remain unclear in the current literature, this study incorporates the social dimension of alignment to investigate the role of this dimension in achieving IT-business strategic alignment.
Multifaceted functional diversity for multifaceted crop yield: Towards ecological assembly rules for varietal mixtures
Authors: Montazeaud Germain , Violle Cyrille , Roumet Pierre , Rocher Aline , Ecarnot Martin , Compan Frédéric , Maillet Guillaume , Fort Florian , Fréville Hélène
Published: August 2020

Ecological theories suggest that higher plant genetic diversity can increase productivity in natural ecosystems. So far, varietal mixtures, that is, the cultivation of different genotypes within a field, have shown contrasting results, notably for grain yield where both positive and negative mixing effects have been reported. Such discrepancy between ecological theories and agronomical applications calls for a better understanding of plant–plant interactions in crops.

Using durum wheat Triticum turgidum ssp. durum as a model species, we investigated the effect of functional trait composition on productivity and grain quality of varietal mixtures by growing 179 highly diverse genotypes in pure stands and 197 two‐way mixtures in field conditions. We quantified the agronomic performance of the mixtures relative to their components grown in pure stands on two variables related to productivity, vegetative biomass yield and grain yield, and one variable related to grain quality, grain protein content. We then analysed the relationship between the relative performance of the mixtures and their functional composition that we characterized with trait means and trait differences on 19 above‐ and below‐ground traits.

We found that biomass and grain yield increased by 4% overall in mixtures relative to single varieties, but that mixing effects were non‐significant for grain protein content. The combined effects of trait means and trait differences explained 12%, 17% and 22% of the variability of relative grain yield, biomass yield and grain protein content, respectively, with different traits affecting productivity and grain quality. Clustering varieties into functional groups allowed us to identify the most beneficial associations for multifaceted agronomic performance.

Synthesis and applications. Functional traits explained a significant part of the relative agronomic performance of mixtures compared to monocultures (12%–22%, depending on the yield component). They can thus serve as a basis to identify groups of varieties whose combinations are expected to generate positive mixing effects, especially for productivity, and without compromising grain quality. Selection could then target convergence between groups for some traits and divergence between groups for other traits using empirically derived relationships between functional traits and agronomic performance as a guideline.
Harnessing microbial volatiles to replace pesticides and fertilizers
Authors: Thomas Gareth , Withall David , Birkett Michael
Published: August 2020

Global agricultural systems are under increasing pressure to deliver sufficient, healthy food for a growing population. Seasonal inputs, including synthetic pesticides and fertilizers, are applied to crops to reduce losses by pathogens, and enhance crop biomass, although their production and application can also incur several economic and environmental penalties. New solutions are therefore urgently required to enhance crop yield whilst reducing dependence on these seasonal inputs. Volatile Organic Compounds (VOCs) produced by soil microorganisms may provide alternative, sustainable solutions, due to their ability to inhibit plant pathogens, induce plant resistance against pathogens and enhance plant growth promotion. This review will highlight recent advances in our understanding of the biological activities of microbial VOCs (mVOCs), providing perspectives on research required to develop them into viable alternatives to current unsustainable seasonal inputs. This can identify potential new avenues for mVOC research and stimulate discussion across the academic community and agri‐business sector.
Clinical, radiological and pathological outcomes following treatment of primary giant cell tumour of bone with Denosumab
Authors: Murphy Benjamin , Vodanovich Domagoj , Spelman Tim , Gullifer James , Slavin John , Powell Gerard , Pang Grant , Choong Peter
Published: August 2020

Background

Giant cell tumour of bone (GCTOB) is a relatively uncommon, benign, but locally aggressive neoplasm. Denosumab is a fully human monoclonal antibody with inhibitory effects on receptor activator of nuclear factor kappa‐B ligand that has shown early promise as a possible treatment adjuvant for GCTB. However, much is still unknown about its current indications, long‐term effects, the potential risk for rapid relapse and its involvement in sarcomatous transformation.

Methods

We analysed the outcomes of 154 patients with GCTOB. We assessed clinical outcomes via local recurrence free‐survival, metastatic free‐survival and sarcomatous transformation between those treated without Denosumab and those with neo‐adjuvant Denosumab. Our radiological and pathological outcomes were assessed through independent specialist reviews.

Results

Four (19.0%) patients of the neo‐adjuvant group had local recurrence of disease versus 16 (12.0%) patients in the surgery alone group; this results in a 3.62 times increased likelihood of developing local recurrence (P = 0.030). The median time to local recurrence was shorter for the neo‐adjuvant group (421.5 days versus 788.5 days) (P = 0.01). There was no difference between Denosumab and the surgery groups in terms of metastatic disease (P = 0.45). Two patients in our cohort with GCTOB developed sarcomatous transformation, both were treated with Denosumab.

Conclusion

Our use of Denosumab tended to be for those patients who had surgically difficult tumours to halt the progression and allow easier resections. Of concern we noted a trend towards increasing recurrence rates with the potential risk for rapid relapse. Furthermore, two cases experienced sarcomatous transformation, which is a growing area of concern within the literature.
Myopia prevalence in Denmark – a review of 140 years of myopia research
Authors: Hansen Mathias Hvidtfelt , Hvid‐Hansen Anders , Jacobsen Nina , Kessel Line
Published: August 2020

Purpose

To evaluate potential changes in myopia prevalence in Denmark by revising more than 100 years of myopia research.

Methods

A systematic literature search was performed in the PubMed, Embase and Cochrane Library databases. Only studies reporting a myopia prevalence in Denmark were included. Myopia was defined using the definition in individual references. We did not restrict inclusion of studies to specific methods of measuring or evaluating refraction. As refraction changes throughout life, information from available studies was divided in relevant age groups. Chi‐squared test was used when analysing the effect of sex and education on myopia prevalence except when the expected values were beneath 5, where Fisher’s exact test was used. To further compare the effect of sex, we calculated the odds ratio of being myopic for females compared to males.

Results

We identified 29 Danish studies reporting on prevalence of myopia. The studies were performed between year 1882 and 2018. We found no strong evidence of an increase in myopia prevalence in Denmark. Increasing age was associated with an increased myopia prevalence up to the age of 60 years where after the prevalence decreased. Longer education and more intensive educational load were associated with myopia. Fourteen studies compared the prevalence of myopia between males and females and two of these studies found a significant higher prevalence in females.

Conclusion

We evaluated nearly 140 years of myopia research in Denmark and did not find a convincing change in prevalence of myopia which is in contrast to the high prevalence of myopia reported in some parts of the world and the expected rise in myopia as predicted by WHO.
Histone demethylase Jumonji domain‐containing 1A inhibits proliferation and progression of gastric cancer by upregulating runt‐related transcription factor 3
Authors: Ning Ke , Shao Yangguang , He Yuxin , Wang Fei , Cui Xi , Liu Furong , Li Danni , Li Feng
Published: August 2020

The histone demethylase Jumonji domain‐containing 1A (JMJD1A) is overexpressed in multiple cancers and promotes cancer progression. However, the role and mechanism of JMJD1A in gastric cancer (GC) remains poorly understood. Here, we found that JMJD1A could suppress GC cell proliferation and xenograft tumor growth. Using RNA sequencing, we identified runt‐related transcription factor 3 (RUNX3) as a novel target gene of JMJD1A. Mechanistically, we identified that JMJD1A upregulated RUNX3 through co–activating Ets‐1 and reducing the H3K9me1/2 levels at the RUNX3 promoter in GC cells. Functionally, JMJD1A inhibits the growth of GC cells in vivo, which is partially dependent on RUNX3. Moreover, JMJD1A expression was decreased in GC and low expression of JMJD1A was correlated with an aggressive phenotype and a poor prognosis in patients with GC. Importantly, JMJD1A expression was positively associated with RUNX3 expression in GC samples. These studies indicated that JMJD1A upregulates RUNX3 expression via co–activation of transcription factor Ets‐1 to inhibit proliferation of GC cells. Our findings provide new insight into the mechanism by which JMJD1A regulates RUNX3 transcription and suggest that JMJD1A and/or RUNX3 may be used as a therapeutic intervention for GC.
Minimally important differences for interpreting the EORTC QLQ‐C30 in patients with advanced colorectal cancer treated with chemotherapy
Authors: Musoro J. Z. , Sodergren S. C. , Coens C. , Pochesci A. , Terada M. , King M. T. , Sprangers M. A. G. , Groenvold M. , Cocks K. , Velikova G. , Flechtner H.‐H. , Bottomley A. ,   the EORTC Quality of Life, Gastro‐intestinal Groups
Published: August 2020

Aim

The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ‐C30) assesses the health‐related quality of life of patients in cancer trials. There are currently no minimally important difference (MID) guidelines for the EORTC QLQ‐C30 for colorectal cancer (CRC). This study aims to estimate MIDs for the EORTC QLQ‐C30 scales in patients with advanced CRC treated with chemotherapy and enrolled in clinical trials.

Method

The data were obtained from three published EORTC trials that treated CRC patients using chemotherapy. Potential anchors were selected from clinical variables based on their correlation with EORTC QLQ‐C30 scales. Anchor‐based MIDs for within‐group change and between‐group change were estimated via the mean change method and linear regression, respectively, and summarized using weighted correlation. Distribution‐based MIDs were also examined.

Results

Anchor‐based MIDs were determined for deterioration in 8 of the 14 EORTC QLQ‐C30 scales and in 9 scales for improvement, and varied by scale, direction of change and anchor. MIDs for improvement (deterioration) ranged from 6 to 18 (−11 to −5) points for within‐group change and 5 to 15 (−10 to −4) for between‐group change. Summarized MIDs (in absolute values) per scale mostly ranged from 5 to 10 points.

Conclusions

These findings have clinical relevance for the interpretation of treatment efficacy and the design of clinical trials by informing sample size requirements.
Provider perceptions on steroid dosing in AECOPD: Laying the groundwork for steroid stewardship
Authors: Cole Jennifer L. , Smith Sarah
Published: August 2020

Introduction

Steroid overprescribing is well documented in acute exacerbations of COPD (AECOPD). Given the myriad of unwanted side effects of corticosteroids, facilities should implement steroid stewardship efforts. The objective of this project was to evaluate the prescribing habits of steroids in AECOPD for needs assessment and to tailor interventions in a single centre.

Methods

A questionnaire was developed to evaluate practices and beliefs around steroid dosing in a simplified case of uncomplicated AECOPD. There were 31 total responders: 12 inpatient clinicians, 9 medical residents and 10 emergency department (ED) clinicians. All steroid dosing was converted to prednisone equivalents for reporting. Subgroup analysis was conducted between provider groups.

Results

Initial dosing ranged from 40 to 625 mg/day with only four responders (13%) selecting 40 mg/day. Dosing was not significantly different in newer providers ≤4 years’ experience: mean 215 mg versus >4 years’ experience: mean 312 mg (P = 0.23). Less experienced providers selected shorter treatment durations: median 5 days (IQR 5,6) versus 8.5 days (IQR 6,10.5) (P = 0.015). ED providers selected higher doses than non‐ED providers: 447 mg versus 208 mg (P = 0.003). Most responders (81%) selected IV agents over oral steroids. The majority (65%) stated dosing choices were based on prescribing habits/clinical experience, while 36% felt their selections were based on current evidence. Five (16%) of responders correctly identified consensus treatment guidelines and the majority (77%) reported being “very likely” or “somewhat likely” to prescribe lower doses.

Conclusion

Baseline knowledge was a significant barrier to guideline utilisation. Education will need to focus on the evidence behind using lower doses, oral agents and disease severity.
The COVID‐19 pandemic: A community approach
Authors: Cravedi Paolo , Schold Jesse D. , Safa Kassem , Kates Olivia S. , Elfadawy Nissreen , Mannon Roslyn B. , Shah Malay B. , Hammond Sarah P. , Avery Robin , Guerrero Miranda Cesar , Riella Leonardo V. , Jowsey‐Gregoire Sheila , Akalin Enver , Camirand Geoffrey , Alegre Maria‐Luisa , Azzi Jamil
Published: August 2020

An unprecedented global pandemic caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has quickly overwhelmed the health care systems worldwide. While there is an absence of consensus among the community in how to manage solid organ transplant recipients and donors, a platform provided by the American Society of Transplantation online community “Outstanding Questions in Transplantation,” hosted a collaborative multicenter, multinational discussions to share knowledge in a rapidly evolving global situation. Here, we present a summary of the discussion in addition to the latest published literature.
Role of Wnt signaling in dermatofibroma induction phenomenon
Authors: Bennett Sabrina Lichon , Basko‐Plluska Juliana L. , Shea Christopher R. , Bolotin Diana
Published: August 2020

Background

Dermatofibroma (DF) is a common benign skin neoplasm. Induction above DF lesions, including follicular unit induction, is a frequently observed phenomenon. Wnt signaling is known to be critical in hair follicle morphogenesis. Our study assesses the role of Wnt signaling in DF induction by evaluating intracellular localization of β‐catenin in various types of DF induction.

Methods

Archived tissue collected between 1 October 1980 and 1 October 2013 was stained per protocol using hematoxylin and eosin and anti‐β‐catenin monoclonal antibody. Specimens were grouped into categories based on the presence or absence and type of induction. All specimens were scored for nuclear β‐catenin localization.

Results

Of 62 specimens, 42 (68%) showed induction while 20 (32%) showed none. Nuclear β‐catenin staining was detected in 23 (55%) of the induction and in none of the no‐induction specimens (P‐value < 0.001). Types of induction included: 15 (24%) follicular induction, 31 (50%) acanthosis, and 4 (6%) sebaceous induction. For follicular induction, 13 (87%) showed positive nuclear β‐catenin staining compared to 11 (35%) for acanthosis and 1 (25%) for sebaceous induction (P‐value = 0.002).

Conclusion

Our findings support the hypothesis that DFs promote an ectopic activation of Wnt pathway signaling in follicular induction phenomenon.
Stress Echocardiography and Strain in Aortic Regurgitation (SESAR protocol): Left ventricular contractile reserve and myocardial work in asymptomatic patients with severe aortic regurgitation
Authors: D'Andrea Antonello , Sperlongano Simona , Formisano Tiziana , Tocci Giampaolo , Cameli Matteo , Tusa Maurizio , Novo Giuseppina , Corrado Giovanni , Ciampi Quirino , Citro Rodolfo , Bossone Eduardo , Galderisi Maurizio , Giallauria Francesco , Ambrosio Giuseppe , Picano Eugenio
Published: August 2020

Objectives

To analyze left ventricular (LV) myocardial deformation and contractile reserve (CR) in asymptomatic patients with severe aortic regurgitation (AR) at rest and during exercise, and their correlation with functional capacity.

Background

The natural history of chronic AR is characterized by a prolonged silent phase before onset of symptoms and overt LV dysfunction. Assessment of LV systolic function and contractile reserve has an important role in the decision‐making of AR asymptomatic patients.

Methods

Standard echo, lung ultrasound, and LV 2D speckle tracking strain were performed at rest and during exercise in asymptomatic patients with severe AR and in age‐ and sex‐comparable healthy controls.

Results

115 AR patients (male sex 58.2%; 52.3 ± 18.3 years) and 55 controls were enrolled. Baseline LV ejection fraction was comparable between the groups. Resting LV global longitudinal strain (GLS) and myocardial work efficiency (MWE) were significantly reduced in AR (GLS‐15.8 ± 2.8 vs −21.4 ± 4.4; P < .001). Patients with AR and CR− showed reduced resting LV GLS and MWE and increased B‐lines. MWE was closely related to peak effort watts, VO2, LV E/e′, and B‐lines, at a multivariable analysis. Both GLS and MWE were strong independent predictors of CR. A resting LV GLS cutoff of −12% differentiated CR+ and CR− (78% sensitivity and 84% specificity).

Conclusions

The lower resting values of LV GLS and MWE in severe AR asymptomatic patients suggest an early subclinical myocardial damage that seems to be closely associated with lower exercise capacity, greater pulmonary congestion, and blunted LV contractile reserve during stress.
Antiepileptic combination therapy with Stevens‐Johnson syndrome and toxic epidermal necrolysis: Analysis of a Japanese pharmacovigilance database
Authors: Noguchi Yoshihiro , Takaoka Mirai , Hayashi Tsuyoshi , Tachi Tomoya , Teramachi Hitomi
Published: August 2020

Objective

Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune‐mediated diseases characterized by an extensive loss of the epidermal skin layer, often resulting in death. SJS and TEN are often triggered by certain drugs, including antiepileptic drugs (AEDs). Epilepsy is very difficult to treat and often involves the combination of two or more AEDs. In this study, we quantified not only the risk of SJS or TEN associated with single‐AED therapy but also the risk related to concomitant AED treatment using reporting‐derived signals.

Methods

An analysis of the Japanese Adverse Drug Event Report (JADER) database was performed from the first quarter of 2004 to the fourth quarter of 2018. The single‐AED signals were evaluated using the proportional reporting ratio (PRR), and the combination therapy signals were evaluated using Ω shrinkage measure and combination risk ratio (CRR).

Results

SJS signals were associated with 11 AEDs, and TEN signals were related to 12 AEDs. Moreover, the following AED combinations were associated with SJS signals: carbamazepine‐lorazepam (Ω025: 0.33, CRR: 2.18) and fosphenytoin‐lorazepam (Ω025: 0.99, CRR: 39.20). The TEN signals were related to the following combinations: clobazam‐gabapentin (Ω025: 0.35, CRR: 3.14), phenytoin‐gabapentin (Ω025: 0.03, CRR: 2.18), valproic acid–gabapentin (Ω025: 0.15, CRR: 2.25), clobazam‐clonazepam (Ω025: 0.03, CRR: 2.93), clobazam–valproic acid (Ω025: 0.29, CRR: 1.55), fosphenytoin‐lamotrigine (Ω025: 0.05, CRR: 7.37), and lacosamide‐levetiracetam (Ω025: 0.74, CRR: 1.85).

Significance

This study identified two AED combinations that increased the SJS signals and seven combinations that increased the TEN signals. Although AED monotherapies require attention for SJS and TEN, some AED combinations require extra caution.
In vivo quantitative analysis of advanced glycation end products in atopic dermatitis—Possible culprit for the comorbidities?
Authors: Hong Ji Yeon , Kim Min Jeong , Hong Jun Ki , Noh Hyun Ha , Park Kui Young , Lee Mi Kyung , Seo Seong Jun
Published: August 2020

Advanced glycation end products (AGEs) interact with the membrane‐bound receptor for AGEs (RAGE), consequently amplifying the inflammatory response. Soluble receptor for AGE (sRAGE) and endogenous secretory RAGE (esRAGE) act as decoys for AGE and competitively sequester RAGE ligands, thereby serving a cytoprotective role. Our objective was to investigate AGE expression and their receptors in the serum and skin of patients with atopic dermatitis (AD). In this case‐control study, the levels of AGE, sRAGE and esRAGE were measured in the blood samples and corneocytes of 29 adult patients with AD and 12 healthy controls by ELISA. Corneocyte AGE levels increased in the AD group (P = .002). Higher corneocyte AGE levels were observed in the severe AD than in the milder form of AD. No significant difference in serum AGE level was observed in patients with AD and healthy controls. Serum sRAGE markedly decreased in patients with AD (P = .007) and serum esRAGE followed a similar trend. In conclusion, dermal accumulation of AGE in AD may have a role in fuelling skin inflammation. The potential after‐effects of reduced neutralizer on systemic risk need further evaluation.
Centering the Voice of the Client: On Becoming a Collaborative Practitioner with Low‐Income Individuals and Families
Authors: Falicov Celia , Nakash Ora , Alegría Margarita
Published: August 2020

Despite current interest in collaborative practices, few investigations document the ways practitioners can facilitate collaboration during in‐session interactions. This investigation explores verbatim psychotherapy transcripts to describe and illustrate therapist’s communications that facilitate or hinder centering client’s voice in work with socioeconomically disadvantaged populations. Four exemplar cases were selected from a large intervention trial aimed at improving shared decision making (SDM) skills of psychotherapists working with low‐income clients. The exemplar cases were selected because they showed therapist’s different degrees of success in facilitating SDM. Therapist’s verbalizations were grouped into five distinct communicative practices that centered or de‐centered the voice of clients. Communication practices were examined through the lens of collaborative approaches in family therapy. The analysis suggests that cross‐fertilization between SDM and family‐oriented collaborative and critical approaches shows promise to illuminate and enhance the challenging road from clinician‐led to client‐led interactions. This paper also stresses the importance of incorporating relational intersectionality with individuals and families who may not feel entitled to express their expectations or raise questions when interacting with authority figures.
Classification and Regression via Integer Optimization for Neighborhood Change
Authors: Olson Alexander W. , Zhang Kexin , Calderon‐Figueroa Fernando , Yakubov Ronen , Sanner Scott , Silver Daniel , Arribas‐Bel Dani
Published: August 2020

This article applies a method we term “predictive clustering” to cluster neighborhoods. Much of the literature in this direction is based on groupings built using intrinsic characteristics of each observation. Our approach departs from this framework by delineating clusters based on how the neighborhood’s features respond to a particular outcome of interest (e.g., income change). To do so, we leverage a classification and regression via integer optimization (CRIO) method that groups neighborhoods according to their predictive characteristics and consistently outperforms traditional clustering methods along several metrics. The CRIO methodology contributes a novel methodological and conceptual capability to the literature on neighborhood dynamics that can provide useful insights for policymaking.
Decreases in cardiac catheter laboratory workload during the COVID‐19 level 4 lockdown in New Zealand
Authors: Elliott John M. , Crozier Ian G.
Published: August 2020

An increase in coronavirus disease (COVID‐19) infections prompted Level 4 lockdown throughout New Zealand from 25 March 2020. We have investigated trends in coronary and electrophysiology (EP) procedures before and during this lockdown. The number of acute procedures for ST elevation myocardial infarction remained stable. In contrast, the number of in‐patient angiograms and percutaneous intervention procedures fell by 53% compared with the previous 4 weeks in 2020 and by 56% compared with the corresponding period in 2019. Further study is required to determine the reasons for these trends.
Collusive equilibria with switching costs: The effect of consumer concentration
Authors: Roig Guillem
Published: August 2020

I study the ability of two competing firms to set collusive prices in markets where consumers have switching costs. In consumer markets (with a small number of consumers), I find an antifolk result in which collusion, in the presence of switching costs, does not arise with patient firms. Patient firms compete aggressively and consumers expect a large utility. A collusive equilibrium is unstable because a deviating firm incorporates the future consumer utility in its deviating price. Also, consumers have a strategic impact so, with the prospects of large utility, they decide to switch to destabilize the firms' collusive agreement. These results do not eventuate in markets with a large number of consumers. In mass markets (a continuum of consumers), a single consumer lacks a strategic impact to destabilize a collusive agreement and a deviating firm cannot appropriate the consumer utility when deviating from collusion. Collusion, then, becomes straightforward to achieve. We show that for any number of consumers, switching costs make collusion easy to sustain.
Taiwanese Nurses’ Attitudes Towards and Knowledge About Sexual Minorities and Their Behavior of Providing Care to Sexual Minority Patients: Results of an Online Survey
Authors: Wang Ya‐Ching , Chang Shiow‐Ru , Miao Nae‐Fang
Published: August 2020

Purpose

To assess Taiwanese nurses’ attitudes toward and knowledge about sexual minorities, and their awareness and behavior of providing care to sexual minority patients.

Design

A cross‐sectional descriptive design was employed.

Methods

A total of 323 Taiwanese nurses 20 years of age or older completed an online questionnaire between September and November 2019. It included five sections: demographics, the Attitudes Toward Lesbians and Gay Men Scale, Knowledge About Homosexuality Questionnaire, Gay Affirmative Practice Scale, and nurses’ needs for promoting culturally competent care.

Results

Taiwanese nurses held positive attitudes, and demonstrated high levels of awareness and behaviors of providing care to sexual minority patients. However, they had limited knowledge regarding homosexuality. More so, nurses who were older, self‐identified as heterosexuals, were married, had more than 10 years’ work experience, and were Buddhists had poor knowledge about homosexuality. Nurses reported that for providing culturally competent care they required knowledge about sexual minorities’ physical and mental health issues; the populations’ social and welfare resources; communication skills training; privacy; and safe space.

Conclusions

Information on homosexuality and health issues among sexual minority populations, communication skills training, privacy, and safe space should be provided to Taiwanese nurses to improve their abilities to provide culturally competent care and to reduce health inequalities among sexual minorities.

Clinical Relevance

This study’s results could be used as evidence for designing and providing training programs for nurses regarding culturally competent care, and thus promote quality nursing care and decrease difficulties of accessing healthcare services among sexual minority patients.
The Effect of the Medicaid Expansion on Dropout Rates
Authors: Yeung Ryan
Published: August 2020

BACKGROUND

This study investigates how the Medicaid Expansion of the Affordable Care Act affected state high school dropout rates.

METHODS

This study relies on a differences‐in‐differences estimation strategy that is common in program evaluation, especially in education. This method replicates in a regression framework a classic pre‐test post‐test comparison group quasi‐experimental design. The analysis is conducted at the state level, which reduces the precision of the estimates.

RESULTS

States that adopted the Medicaid Expansion had a 0.658 percentage point greater reduction in dropout rates than non‐Expansion states in the year of Medicaid implementation. A back‐of‐the‐envelope calculation suggests that if all the remaining non‐Expansion states adopted Medicaid, there would be a decrease of over 92,500 youths who drop out of high school, representing a drop of 11.2% in the number of dropouts in these states.

CONCLUSION

The Medicaid Expansion of the Affordable Care Act is more than just a health insurance program; it is a dropout prevention program.
Period prevalence and mortality rates associated with hypocholesterolaemia in dogs and cats: 1,375 cases
Authors: Tan A. W. K. , Epstein S. E. , Hopper K.
Published: August 2020

Objectives

To determine the period prevalence of hypocholesterolaemia and the associated mortality rates in dogs and cats at a university teaching hospital. The secondary aim was to identify disease processes associated with hypocholesterolaemia.

Materials and Methods

Medical records over a 5‐year period were reviewed to determine the severity of hypocholesterolaemia and its associated mortality rate. Medical records of animals with moderate to severe hypocholesterolaemia (<2.59 mmol/L in dogs, <1.81 mmol/L in cats) were analysed further. Animals with hospital‐acquired hypocholesterolaemia were identified.

Results

Among 16,977 dogs and 3,788 cats that had at least one cholesterol measurement, the period prevalence of hypocholesterolaemia was 7.0% in dogs and 4.7% in cats. The mortality rate of hypocholesteraemic dogs and cats was 12% in both species which was significantly higher than that of animals with normal serum cholesterol. The degree of hypocholesterolaemia was significantly associated with mortality. Dogs, but not cats, with hospital‐acquired hypocholesterolaemia had a higher mortality rate than those presenting with hypocholesterolaemia. Disease of hepatic, gastrointestinal and lymphoreticular systems were most commonly associated with hypocholesterolaemia, and infectious and neoplastic disease were the most commonly associated pathophysiologic processes in both species. Lymphoma was over‐represented in dogs with neoplasia.

Clinical Significance

Hypocholesterolaemia is not a frequent abnormality but was associated with mortality in this study and may be a negative prognostic indicator. It is not known if hypocholesterolaemia is simply a marker for disease severity, or if it is has active physiologic effects contributing to poor outcomes.
Spatial patterning of soil microbial communities created by fungus‐farming termites
Authors: Baker Christopher C. M. , Castillo Vardaro Jessica A. , Doak Daniel F. , Pansu Johan , Puissant Jérémy , Pringle Robert M. , Tarnita Corina E.
Published: August 2020

Spatially overdispersed mounds of fungus‐farming termites (Macrotermitinae) are hotspots of nutrient availability and primary productivity in tropical savannas, creating spatial heterogeneity in communities and ecosystem functions. These termites influence the local availability of nutrients in part by redistributing nutrients across the landscape, but the links between termite ecosystem engineering and the soil microbes that are the metabolic agents of nutrient cycling are little understood. We used DNA metabarcoding of soils from Odontotermes montanus mounds to examine the influence of termites on soil microbial communities in a semi‐arid Kenyan savanna. We found that bacterial and fungal communities were compositionally distinct in termite‐mound topsoils relative to the surrounding savanna, and that bacterial communities were more diverse on mounds. The higher microbial alpha and beta diversity associated with mounds created striking spatial patterning in microbial community composition, and boosted landscape‐scale microbial richness and diversity. Selected enzyme assays revealed consistent differences in potential enzymatic activity, suggesting links between termite‐induced heterogeneity in microbial community composition and the spatial distribution of ecosystem functions. We conducted a large‐scale field experiment in which we attempted to simulate termites’ effects on microbes by fertilizing mound‐sized patches; this altered both bacterial and fungal communities, but in a different way than natural mounds. Elevated levels of inorganic nitrogen, phosphorus and potassium may help to explain the distinctive fungal communities in termite‐mound soils, but cannot account for the distinctive bacterial communities associated with mounds.
Comparison of versioning methods to improve the information flow in the planning and building processes
Authors: Eriksson Helen , Sun Jing , Tarandi Väino , Harrie Lars
Published: August 2020

Version management is a prerequisite for digital information flow between phases in the planning and building processes. Information evolves over time and many parties retrieve information from the various phases. The aim of this article is to evaluate versioning methods, focusing on geodata buildings in the 3D cadastre process. The main attention in the evaluation is on the comprehensive ISO standard Product Lifecycle Support (PLCS). PLCS is evaluated against two simpler versioning methods, the versioning in CityGML 3.0 and a modified Git versioning method implemented in CityJSON. CityGML 3.0 fulfils all but one requirement and PLCS meets all. The methods vary in complexity; the Git proposal is a simple solution, easy to implement and maintain, while PLCS includes all functionalities and is complex to implement. There is a trade‐off between number of functionalities and complexity, it is therefore important that the intended purpose determines the choice of versioning method.
Development and Simulation of a Magnetohydrodynamic Solar Generator Operated With NaCl Electrolyte Solution
Authors: Jiménez-Flores Steffanie , Pérez-Luna J. Guillermo , Alvarado-Pulido J. Joaquín , Jiménez-González Antonio E.
Published: August 2020

A magnetohydrodynamic (MHD) generator is a device that generates electrical energy through the interaction between a conductive fluid and a magnetic field. This method of direct energy conversion allows the use of a renewable energy source such as solar energy and represents an alternative to tackle the greenhouse effect. This paper presents the development of an MHD solar generator, which is constituted by a solar thermal system and an MHD cell. The solar thermal system consists of a set of tubes with copper fins, connected in parallel and placed inside of a 1 m2 panel. In which, an electrolytic mixture of H2O and NaCl at 20% vol. was introduced as a working fluid. In order to increase the kinetic energy of the fluid, the panel was exposed to solar radiation, where it reached temperatures above 373 K and pressures above 96 kPa. This solar thermal system operates in closed cycle conditions by including a check valve in its inlet–outlet junction; in this way, the fluid travels through the MHD generator. The MHD cell was composed of a block of polytetrafluoroethylene, two cylindrical stainless-steel electrodes, and four neodymium magnets. For simulation purposes, comsol multiphysics was used to reproduce the current density produced by the MHD solar generator. Pressure and temperature quantities obtained experimentally in the MHD cell were employed as boundary conditions. The experimental maximal current density obtained corresponds to 4.30 mA/m2, and the comparison between theoretical and experimental results shows that the model fits fairly well.
Numerical Modeling of CO2 Splitting in High-Temperature Solar-Driven Oxygen Permeation Membrane Reactors
Authors: Pan Heng , Lu Youjun , Zhu Liya
Published: August 2020

H2/CO production via H2O/CO2 splitting powered by concentrated solar energy is a promising pathway for energy conversion/storage. Oxygen permeable membrane reactor serves as an alternative reactor concept for realizing this chemical path with the advantages of continuous production, easy integration, and high product selectivity. In this paper, a mathematical model of steady-state mass and heat transfer coupled with reaction kinetics in the oxygen permeation membrane reactor was established. CO2 splitting in the ceria membrane reactor was simulated and the effects of various factors, including inert/CO2 flow configurations, reaction conditions, and geometric parameters of the membrane, on the CO2 conversion process, were studied. The increase of operating temperature could effectively improve the CO2 conversion ratio, and the effect of decreasing the oxygen pressure of the inert gas is very limited. The oxygen accumulation in the inert gas could lead to considerably high inert demand. Furthermore, conversion-limiting factors were studied under different conditions and there are two critical rate constants of reactions signifying a transition from a chemical kinetics limited conversion to oxygen diffusion limited conversion. This work helps guide reactor design and operate toward achieving the maximum CO2 conversion ratio.
A Novel Workflow for Optimizing Well Placement Under Geomechanical Constraints: A Case Study
Authors: An Cheng , Zhang Peng , Wesley Amanveer , Bardy Gaetan , Hall Kevin , Erdogan Meftun
Published: August 2020

A novel workflow to optimize well placement using geomechanical constraints is introduced to maximize production performance, reduce excessive simulation runs, and minimize drilling constraints by considering the local stress field and the petrophysical properties in a given reservoir. A case study is presented for optimization of horizontal well placement in the Monterey Formation of Miocene Age in California. First, a three-dimensional reservoir model of formation pressure, in situ stresses, petrophysical and rock properties were built from available petrophysical and well log data. Second, numerical modeling using material point method (MPM) was applied to generate the differential stress field, taking into consideration a three-dimensional natural fracture network in the reservoir model. Third, an optimization algorithm which incorporates petrophysical properties, natural fracture distribution, differential stresses, and mechanical stability was used to identify the best candidate locations for well placement. Finally, flow simulations were conducted to segregate each candidate location where both natural and hydraulic fractures were considered. Statistical methods identify optimal well positions in areas with low differential stress, high porosity, and high permeability. Several candidate locations for well placement were selected and flow simulations were conducted. A comparison of the production performance between the best candidates and other randomly selected well configurations indicates that the workflow can effectively recognize scenarios of optimum well placement. The proposed workflow provides practical insight on well placement optimization by reducing the number of required reservoir simulation runs and maximizing the hydrocarbon recovery.
Effect of Argon Concentration on Laminar Burning Velocity and Flame Speed of Hydrogen Mixtures in a Constant Volume Combustion Chamber
Authors: Morovatiyan Mohammadrasool , Shahsavan Martia , Aguilar Jonathan , Mack J. Hunter
Published: August 2020

Hydrogen combustion, coupled with the use of argon as a working fluid, is a promising approach to delivering clean and efficient energy from internal combustion (IC) engines. The use of hydrogen-oxygen-argon (H2/O2/Ar) mixtures in combustion aids in mitigating harmful environmental pollutants and enables a highly efficient energy conversion process. The use of argon as a working fluid decreases the NOx emissions and increases the thermal efficiency of internal combustion engines due to the high specific heat ratio of noble gases. In this study, premixed hydrogen combustion was investigated with the purpose of examining the effect of the full or partial substitution of argon for nitrogen in air on laminar burning velocity (LBV), flame speed, flame morphology, and instability. The experimental approach uses an optically accessible constant volume combustion chamber (CVCC) with central ignition; the spherical flame development was studied using a high-speed Z-type Schlieren visualization system. Moreover, a numerical model was developed to convert the experimental dynamic pressure rise data to laminar burning velocity. Coupling the model to a chemical equilibrium code aids in determining the burned gas properties. Additionally, an image processing technique has been suggested to compute the flame propagation speed. The experimental and numerical investigations indicate that increasing the concentration of argon as the working fluid in the mixture increases the laminar burning velocity and flame speed while extending the lean flammability limit.
Evaluating the Effects of Transient Purge Flow on Stator-Rotor Seal Performance
Authors: Berdanier Reid A. , DeShong Eric T. , Thole Karen A. , Robak Christopher
Published: August 2020

As modern engine designs target higher efficiencies through increased turbine inlet temperatures, critical turbine components are at increased risk of damage from conditions exceeding material melting temperatures. In particular, improperly designed underplatform hardware components are susceptible to damage when hot main gas path flow is ingested into the stator-rotor cavity. While all turbines inherently experience transients during operation, a majority of publicly available turbine studies have been executed using steady operating conditions or inherently transient “blowdown” rigs. For this reason, routine transient events are not well understood. To address this need, the present study utilized a combined experimental and computational approach. The test article is a continuous-duration, one-stage test turbine operating with true-scale engine hardware and seal geometries at engine-representative flow conditions. The nature of the continuous-duration facility uniquely supports the direct assessment of transient events through its ability to transition between steady-state operating conditions. The effects of a transient purge flow were investigated in this study to identify general trends for transient events in a full-scale engine. Results from multiple measurement techniques in the wheelspace region show an interdependence of transient purge flow with a thermal lag of the underplatform hardware. Through experiments conducted at different coolant-to-main gas path temperature ratios, the use of pressure measurements as an indicator of fully purged behavior was introduced, and a thermally driven influence on rim seal performance was quantified. The computational results show good agreement with experimental pressure measurements and provide insight into the physical mechanisms that drive the relationship between pressure and sealing effectiveness measurements observed for the tested geometry.
Adjuvant-free nanofiber vaccine induces in situ lung dendritic cell activation and T
H
17 responses
Authors: Si Youhui , Tian Qiaomu , Zhao Fan , Kelly Sean H. , Shores Lucas S. , Camacho Daniel F. , Sperling Anne I. , Andrade Michael S. , Collier Joel H. , Chong Anita S.
Published: August 2020

Intranasal Q11 nanofiber vaccination activates lung dendritic cell antigen presentation and T
H
17 priming in both lung and lymph nodes.
Nonadiabatic exciton-phonon coupling in Raman spectroscopy of layered materials
Authors: Reichardt Sven , Wirtz Ludger
Published: August 2020

We develop a new computational approach to resonant Raman scattering to study nonadiabatic exciton-phonon scattering.
Single-atom doping of MoS
2
with manganese enables ultrasensitive detection of dopamine: Experimental and computational approach
Authors: Lei Yu , Butler Derrick , Lucking Michael C. , Zhang Fu , Xia Tunan , Fujisawa Kazunori , Granzier-Nakajima Tomotaroh , Cruz-Silva Rodolfo , Endo Morinobu , Terrones Humberto , Terrones Mauricio , Ebrahimi Aida
Published: August 2020

We describe a flexible biosensor, based on Mn-doped MoS
2
, for low-level detection of dopamine in sweat and serum solution.
Fifteen-minute consultation: Point of care ultrasound in the management
of paediatric shock
Authors: Hardwick James A , Griksaitis Michael J
Published: August 2020

The use of point of care ultrasound (POCUS) in the assessment of the
acutely shocked adult patient has been well established for over a decade.
Comparatively, its use in paediatrics has been limited, but this is starting
to change with the recent introduction of Children’s Acute Ultrasound
training. This article highlights the pathophysiology of shock in children
and demonstrates how bedside ultrasound can be used to assist decision
making in the clinical assessment of the neonate, infant or older child
presenting with undifferentiated shock. We discuss a structured protocol to
use when performing the POCUS examination and explain how this could lead to
a more rapid correlation of the ultrasound findings with the underlying
cause of shock.