bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated rearing system proposal for Cantareus aspersus in experimental orchards: Growth models
Authors: Garcia Anton , Barba Cecilio , Aragón Manuel , León Jose M , De-Pablos-Heredero Carmen , Gonzalez Ana
Published: September 2021

An integrated rearing system for Cantareus aspersus under environmental conditions in an experimental orchard is proposed. In this study, the natural behaviour, circadian rhythms and suitable rearing conditions of the edible snail were optimised to produce homogeneous growth and low variability. The growth was standardised, and growth pattern fit was assessed with various models. One thousand fry were cultured in the orchard, and a random sample of 100 snails were measured weekly for 23 weeks. The rearing system had the following characteristics: snails and earthworms were included in the experimental rearing orchard; a homogeneous group of juvenile snails of the same age and size and high rearing density (500 snails/m2) was used; snails were fed with layers mash ad libitum; and mixed and fringes vegetation was planted in the orchard. A commercial size of 60% of snails was achieved in 21 weeks and 95% in 23 weeks. The different models showed a good fit, and the quadratic model obtained the best fit. This experimental snail orchard proposal can be extended to other areas, although it must be corrected according to different environmental conditions and fit to other species of interest. This experimental model could constitute a viable alternative to traditional models of animal experimentation with mammals, and given its high adaptability, it could be applied in different fields of science.
Assessing a Welfare Program's Effects on Social Mobility in Brazil's “Golden Age”: The Intersectionality of Race, Gender, and Redistributive Social Programs in Two Brazilian Cities
Authors: Kaknes Elizabeth
Published: September 2021

How do welfare programs affect beneficiaries' perceptions of social mobility? This paper uses the case of Brazil's Bolsa Família Program to assess whether, how, and to what degree the welfare program affects beneficiaries' views of their potential social mobility. It makes a key contribution to the understanding of social mobility by incorporating the role that race and gender play in beneficiary respondent's evaluation of social mobility. Use of an original field survey undergirds the finding that, in contrast to conventional understandings of Brazilian racial and social dynamics, beneficiary status operates differently for Afro-Brazilian and White beneficiaries, as well as for male and female beneficiaries. Specifically, that the program has significant empowerment effects for White women beneficiaries, but that it does not affect the evaluations of Afro-Brazilian women.
The ‘Selfish Element’: How Sperm and Egg Donors Construct Plausibly Moral Accounts of the Decision to Donate
Authors: Gilman Leah
Published: September 2021

Multiple sociological studies have demonstrated how talk of ‘good’ motives enables people to maintain the presentation of a moral self in the context of stigmatised behaviours. Far fewer have examined why people sometimes describe acting for the ‘wrong reasons’ or choose to qualify, or reject, assumptions that they are motivated by a desire to ‘do good’. In this article, I analyse one such situation: sperm donors who describe being partially motivated by a ‘selfish’ desire to procreate, a motive which these same men frame as morally questionable. I argue that such accounts are explicable if we consider the (gendered) interactional and cultural contexts in which they are produced, particularly the way interactive contexts shape the desirability and achievability of plausibility and authenticity. I suggest that analysis of similar social phenomena can support sociologists in better understanding the complex ways in which moral practices are woven into social interactions.
Developing the Concept of Belonging Work for Social Research
Authors: Kuurne (née Ketokivi) Kaisa , Vieno Atte
Published: September 2021

This article continues the conceptual work of developing a process-oriented perspective on belonging by taking up the active engagement of affiliation (and disaffiliation) as an undertheorised yet necessary aspect of accomplishing belonging. In developing the concept we draw on Marx’s notion of work as material activity in forms of life and the sociological concepts of face-work and emotion work. We conceptualise belonging work as relational work concerned with shaping situational interactions; webs of relationships; social boundaries; and materials and rhythms as dimensions of belonging. This work is conditioned by social categorisations and patterns of inclusion and exclusion through which it takes place in relation to specific forms of life. The concept of belonging work offers a theoretically integrative and sensitising concept that highlights the relational dynamics of belonging, providing insight and inspiration to social researchers inquiring into the work of belonging and its associated social consequences throughout the research process.
A Case of Parotid Gland Fistula After Microtia Reconstruction Successfully Treated With Botulinum Toxin Type A
Authors: Zhang Bo , Xu Suqi , Li Gaofeng , Ding Wei , Long Xiren , Fu Anqi
Published: September 2021

Parotid gland fistula after microtia reconstruction is relatively rare, with only 3 cases having been reported in the literature. It may be caused by the presence of an accessory parotid gland or surgical damage to parotid gland tissues. The principal treatment is dressing the wound. Here, we report the first case of parotid fistula after microtia reconstruction using a delayed retroauricular flap, which healed following wound dressing and an injection of botulinum toxin type A (CBTXA) into the parotid gland.
The Limits of Shared Panethnic Status: Considering Culture, Age, and Language in Qualitative Research
Authors: Tiamzon Trisha J. , Iwata Miho , Adur Shweta Majumdar
Published: September 2021

The increase of qualitative research in gerontology invites discussion of the effects of researcher positionality on data collection and analysis. Analyses of the interviewing experiences of three researchers who conducted a qualitative study of aging Asian Americans illustrate the complexities of negotiating “insider” status. Despite the interviewers’ shared panethnic status (Asian) with the participants, they experienced different levels of insider status, which were based, in part, on cultural competence related to cultural norms and practices, age hierarchies, and language. This suggests that qualitative researchers should engage in reflexive practices that consider researcher positionality in relation to research participants. Researchers need to pay attention to the possible implications of cultural competence on negotiating insider status and when gathering and analyzing data, similar to considerations of culturally relevant approaches in practical settings.
Development of the Caregiving Burden Scale for Family Caregivers of Children with Cancer
Authors: Çevik Özdemir Hamide Nur , Şenol Selmin
Published: September 2021

Due to the burden of caregiving, family caregivers of children with cancer suffer from physical and psychosocial health problems. The aim of this study was to develop a Caregiving Burden Scale for Family Caregivers of Children with Cancer (CBSFC-CC) and to assess its psychometric properties. A methodological, descriptive study design was conducted. The study sample consisted of 217 family caregivers caring for children with cancer between the ages of 0 and 18 years. The item pool of the scale was created using the Delphi Technique. The Cronbach’s alpha coefficient for the overall scale was 0.93. The item-total score correlations ranged from 0.424 to 0.645. The exploratory factor analysis showed that the scale explained 68.34% of the total variance. The confirmatory factor analysis also showed that the factor loadings of the scale ranged from 0.46 to 0.96. NNFI, CFI, and IFI were found to be > 0.90, and RMSEA was found to be < 0.09. The CBSFC-CC was found to be a good multidimensional instrument for evaluating the burden on family caregivers of pediatric cancer patients. It can be used in clinical practice and research. This tool can be considered to tailor interventions aimed at improving caregiver outcomes.
Propensity matched analysis of minimally invasive versus conventional isolated aortic valve replacement
Authors: Oo Shwe , Khan Amilah , Chan Jeremy , Juneja Sanjay , Caputo Massimo , Angelini Gianni , Rajakaruna Cha , Vohra Hunaid A
Published: September 2021

Objective:

To analyse the early and mid-term outcome of patients undergoing conventional aortic valve replacement (AVR) versus minimally invasive via hemi-sternotomy aortic valve replacement (MIAVR).

Methods:

A single centre retrospective study involving 653 patients who underwent isolated aortic valve replacement (AVR) either via conventional AVR ( n = 516) or MIAVR ( n = 137) between August 2015 and March 2020. Using pre-operative characteristics, patients were propensity matched (PM) to produce 114 matched pairs. Assessment of peri-operative outcomes, early and mid-term survival and echocardiographic parameters was performed.

Results:

The mean age of the PM conventional AVR group was 71.5 (±8.9) years and the number of male ( n = 57) and female ( n = 57) patients were equal. PM MIAVR group mean age was 71.1 (±9.5) years, and 47% of patients were female ( n = 54) and 53% male ( n = 60). Median follow-up for PM conventional AVR and MIAVR patients was 3.4 years (minimum 0, maximum 4.8 years) and 3.4 years (minimum 0, maximum 4.8 years), respectively. Larger sized aortic valve prostheses were inserted in the MIAVR group (median 23, IQR = 4) versus conventional AVR group (median 21, IQR = 2; p = 0.02, SMD = 0.34). Cardiopulmonary bypass (CPB) time was longer with MIAVR (94.4 ± 19.5 minutes) compared to conventional AVR (83.1 ± 33.3; p = 0.0001, SMD = 0.41). Aortic cross-clamp (AoX) time was also longer in MIAVR (71.6 ± 16.5 minutes) compared to conventional AVR (65.0 ± 52.8; p = 0.0001, SMD = 0.17). There were no differences in the early post-operative complications and mortality between the two groups. Follow-up echocardiographic data showed significant difference in mean aortic valve gradients between conventional AVR and MIAVR groups (17.3 ± 8.2 mmHg vs 13.0 ± 5.1 mmHg, respectively; p = 0.01, SMD = −0.65). There was no significant difference between conventional AVR and MIAVR in mid-term survival at 3 years (88.6% vs 92.1%; log-rank test p = 0.31).

Conclusion:

Despite the longer CPB and AoX times in the MIAVR group, there was no significant difference in early complications, mortality and mid-term survival between MIAVR and conventional AVR.
Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?
Authors: Palmowski Yannick , Pumberger Matthias , Perka Carsten , Hardt Sebastian , Hipfl Christian
Published: September 2021

Objective

To examine sonication results in presumed aseptic conversion total hip arthroplasty (THA) after hip fracture fixation and to evaluate its implications on the treatment outcome.

Methods

This retrospective cohort study reviewed the data from presumed aseptic patients that underwent conversion of prior internal fixation of proximal femoral fractures to THA between 2012 and 2018. Microbiological analysis was performed using sonication of osteosynthesis material and tissue samples. Treatment outcome including the occurrence of periprosthetic joint infection (PJI) was recorded.

Results

A total of 32 patients were included in the study. Of these, five patients (15.6%) had positive intraoperative cultures. The mean follow-up following conversion THA was 43.0 months (range, 19.0–91.5 months). Sonication was positive in three patients (9.4%), all of whom were deemed contaminated and did not develop PJI. Tissue cultures were positive in two patients (6.3%). One patient with Enterococcus faecalis received antibiotic treatment and did not develop PJI. Another patient with growth of Cutibacterium acnes that was initially classified as a contaminant later developed acute PJI caused by the same pathogen. Overall, PJI occurred in two patients (6.3%) after conversion THA.

Conclusion

Sonication of internal fixation devices did not add diagnostic value in clinically aseptic conversion THA. Further studies are needed to better understand the relevance of unexpected positive cultures, and to develop diagnostic criteria for the management of these patients.
Involvement of Felis catus papillomavirus type 2 in the tumorigenesis of feline Merkel cell carcinoma
Authors: Ito Soma , Chambers James K. , Sumi Ayumi , Yamashita-Kawanishi Nanako , Omachi Tetsuo , Haga Takeshi , Nakayama Hiroyuki , Uchida Kazuyuki
Published: September 2021

Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine tumor. We recently demonstrated that cats with MCC often have other proliferative cutaneous lesions, such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Based on this finding, we hypothesize that Felis catus papillomavirus (FcaPV) is involved in the development of MCC in cats, similar to SCC and BCC. To investigate this hypothesis, the presence of FcaPV nucleic acid and immunoreactivity for tumor suppressor proteins were examined in 21 feline MCC cases. Polymerase chain reaction using FcaPV type-specific primers detected FcaPV2 DNA in 20/21 samples of MCC. The complete FcaPV2 sequence was characterized in one case. In situ hybridization for FcaPV2 E7 revealed punctate nuclear signals within tumor cells in 19/21 MCC. Increased immunoreactivity for p16CDKN2A protein and decreased immunoreactivity for retinoblastoma (pRb) and p53 proteins were observed in 20/21 MCC. These results suggest that feline MCC cases are infected with FcaPV2 and the subsequent inhibition of pRb and p53 induced by integrated viral oncogenes is associated with feline MCC tumorigenesis, similar to other PV-induced proliferative cutaneous lesions. On the other hand, the single case of FcaPV2-negative MCC showed strong p53 immunoreactivity, suggesting mutations in p53 caused by cancer inducers other than FcaPV2 infection in this case. The present study suggests FcaPV2 as a cause of feline MCC.
Intravenous Infusion of Sterile Water for the Treatment of Hypernatraemia
Authors: Ramaswamykanive H. , Greaves J.
Published: September 2021

Little research has been carried out into the infusion of intravenous sterile water for the treatment of hypernatraemia, and it remains a contentious issue. We conducted a review of the literature and extract results following an extensive search of Medline 1946, Embase 1974, ProQuest, evidence-based practice resources, national and international guideline sites and the publications of various professional bodies. The review is presented on the infusion of sterile water (hypotonic fluid) to lower serum sodium level in those circumstances when enteral supplementation of water is not possible, such as in postoperative patients or when other isotonic fluids (such as 5% dextrose in water infusion) are less than ideal—for example, hyperglycaemic patients on an insulin infusion. Absence of guidelines has limited the use of sterile water, even as an off-label drug when it can be administered relatively safely via a central line.
Rapidly Growing Mycobacterium tuberculosis in the Form of Empyema Necessitans: A Case Report
Authors: Chang Stephanie H. , Choe June , Ghandehari Sara , Chaux George E. , Chung Alice P. , Ramzy Danny , Megna Dominick J. , Falk Jeremy A. , Zakowski Phillip C.
Published: September 2021

We present a case of rapidly growing disseminated Mycobacterium tuberculosis (MTB) that presented as an empyema necessitans (EN) in a 65-year-old woman with a single right lung transplant admitted for progressive dyspnea. While hospitalized, she had daily fevers and was found to have a right-sided chest wall abscess and pleural effusion. Acid-fast bacilli cultures from the abscess and pleural fluid grew MTB within 4 and 6 days, respectively. Blood cultures later grew MTB as well. Upon initiation of rifampin, isoniazid, pyrazinamide, and ethambutol, she developed hemorrhagic pancreatitis and distributive shock secondary to antituberculosis medications and disseminated MTB. Noteworthy features of this case include the rapid rate of MTB culture growth in less than a week, the development of a likely donor-derived MTB EN, and the clinical challenges of MTB screening and MTB infection management in a solid organ transplant recipient.
Why Should We Care What Extremists Think? The Contribution of Emic Perspectives to Understanding the “right-wing extremist” Mind-Set
Authors: Pilkington Hilary
Published: September 2021

This article considers the implications of the mainstreaming of ‘right-wing extremism’ for what, and whom, we understand as ‘extreme’. It draws on ethnographic research (2017-2020) with young people active in movements routinely referred to in public and academic discourse as ‘extreme right’ or ‘far right’. Based on interviews, informal communication and observation, the article explores how actors in the milieu understand ‘extremism’ and how far this corresponds to academic and public conceptualisations of ‘right-wing extremism’, in particular cognitive ‘closed-mindedness’. Emic perspectives are not accorded privileged authenticity. Rather, it is argued, critical engagement with them reveals the important role of ethnographic research in gaining insight into, and challenging what we know about, the ‘mind-set’ of right-wing extremists. Understanding if such a mind-set exists, and if it does, in what it consists, matters, if academic research is to inform policy and practice to counter socially harmful practices among those it targets effectively.
Modeling, calculation, and analysis of torsional vibration characteristics of the hydrodynamic transmission system in engineering vehicle
Authors: Ma Wenxing , Xie Dapeng , Wang Zhihao , Ran Zilin , Liu Chunbao , Wang Songlin
Published: September 2021

According to the typical working conditions of a loader and considering the complexity of the working conditions, the hydrodynamic transmission powertrain system was modeled in this study. Because the hydrodynamic torque converter is a flexible fluid transmission component in the transmission system, this study proposes and establishes equivalent variable damping and equivalent variable stiffness models of the hydrodynamic torque converter. Based on this, a torsional vibration simulation model of the loader with variable damping and stiffness is proposed, and the frequencies and amplitudes of the torsional resonance modes of the transmission system varying with engine speed and hydrodynamic torque converter speed ratio are obtained. It is determined that the variable stiffness of the hydrodynamic torque converter has little effect on the natural frequency of the vehicle, and taking variable damping and stiffness as input, the natural frequency and resonance points of the transmission system can be calculated more accurately. The simulation modeling and calculation approach are experimentally verified, and the simulation results are valid and closer to the real resonance.
Safety of a high-speed train passing by a windbreak breach under different wind speeds
Authors: Sun Zhuang , Hashmi Syeda Anam , Dai Huanyun , Li Guiyu
Published: September 2021

A derailment phenomenon could take place on the windward side of a 120 km/h high-speed train when it runs by a breach, between two windbreak walls, subjected to a normal wind speed of 32 m/s. To study the safety of a high-speed train under different normal speeds of crosswind, six wind speeds are investigated; 32 m/s, 28 m/s, 25 m/s, 20 m/s, 15 m/s, and 10 m/s. The wind forces and moments of the moving train are calculated using the Unsteady Reynolds-averaged Navier-Stokes (URANS) model, which are then applied to the train multi-body dynamics. The pressure fields around the train passing by the breach are analysed, which gives a reasonable explanation for the fluctuation of the wind loads. After an analysis on the response of the train, it is apparent that the risk of derailment on the windward side is much greater than the risk of overturning. The lateral distance of the first wheelset increases towards the windward side as along with the yaw angle of the wheelset, which increases as well with wind speeds of higher than 20 m/s.
Do remittance and renewable energy affect CO2 emissions? An empirical evidence from selected G-20 countries
Authors: Jamil Khalid , Liu Dunnan , Gul Rana Faizan , Hussain Zahid , Mohsin Muhammad , Qin Guangyu , Khan Farman Ullah
Published: September 2021

The study aims to compare CO2 emissions, renewable energy, trade openness, gross domestic product (GDP), financial development (FD), and remittance in selected G-20 countries. The study carried out fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) models for estimation covering annual data from the year 1990–2019. LM tests detected the cross-section dependency while stationarity of the variables was checked through Levin-Lin-Chu and Im-Pesaran-Shin tests along with Hansen's Covariate-Augmented Dickey Fuller (CADF) test in the presence of cross-section dependency. The panel unit root tests reported that all variables became stationary after converting them into the first difference. The Panel Cointegration and Wester-Lund test examined the existence of long-run equilibrium nexus among selected variables in the context of G-20 countries. The study's findings show that there is a significant and negative relationship between renewable energy and CO2 emissions. It was proven in two models that the economic growth of selected G-20 countries has a positive relationship with CO2 emissions. Furthermore, findings indicate that the coefficient of financial development is positive and significantly impacts CO2 emissions. The remittances have a significant positive effect on CO2 emissions, while trade openness has an insignificant impact on CO2 emissions in both models. This research will enlighten policymakers, researchers, governments, and environmentalists toward attaining a sustainable environment by wisely consuming remittances and renewable energy resources.
Evaluating the relative operational performance of wind power plants in Indian electricity generation sector using two-stage model
Authors: Kumar Rajeev , Khetrapal Pavan , Badoni Manoj , Diwania Sourav
Published: September 2021

Nowadays, to fulfill growing power requirements at reasonable prices, like other European countries, the Indian electricity market is now more oriented towards renewable energy resources. Today, the wind energy industry has grown from a marginal activity to a multi-billion-dollar business in India's power production sector because of its comparatively safer and positive environmental features. Though, there are several wind energy power plants generating electricity in India's different geographical locations, assessing their performance is a crucial task and an important target for stakeholders. In the present study, an attempt is made to quantitatively assess the relative operational efficiencies of 14 wind power plants in India during 2016–2017 to 2019–2020 employing a two-stage data envelopment analysis Tobit model. Further, the sensitivity analysis is implemented in the present study to assess the robustness and efficacy of the data envelopment analysis models with different combinations of inputs and outputs. Data envelopment analysis results indicate that 14% of India's wind power plants were operated at the most productive scale during the observed period 2016–2017 to 2019–2020. The Tobit regression results indicate that the wind turbines’ age adversely affects production efficiency. In contrast, the site elevation has a significant positive impact on the operational efficiency of wind power plants. Findings from the present study may help stakeholders and policy regulators in the wind industry to identify the key factors influencing the performance of ongoing wind power plants in India and optimize operational strategies and policies.
Analysing Indonesia’s infrastructure deficits from a developmentalist perspective
Authors: Kim Kyunghoon
Published: September 2021

This paper analyses the performance and appropriateness of the Indonesian government’s ‘good governance’ institutional reform aimed at stimulating infrastructure construction. During the 15 years after the 1997 Asian financial crisis, the government attempted to strengthen formal institutions with the goal of improving public investment efficiency and attracting private investors. By analysing policies in the construction industry in terms of company registration, procurement and state enterprises, the paper finds that the outcome was far from what was expected by technocratic-bureaucratic reform promoters as interest groups frequently succeeded in capturing the new institutional system. This paper then challenges the dominant narrative that overwhelmingly blames incomplete institutional reform for Indonesia’s slow infrastructure construction. Given the inherent market failure and political challenges in institutional reform, the paper argues that passive developmentalist policies, which resulted in conflictual state–business relations and insufficient public investment, were a prime cause that then set the stage for the emergence of state-led infrastructure development strategy from the mid-2010s.
Contorting transformations: Uneven impacts of the U.S.–Mexico automotive industrial complex
Authors: Crossa Mateo
Published: September 2021

Contrary to the triumphalist rhetoric that describes the automotive industry as a lever for both regional development in North America and industrial upgrading in Mexico, this article argues that the formation of the Mexico–U.S. automotive complex has instead been consolidated on the basis of longstanding processes of uneven regional development. To make this argument, the paper examines how global economic restructuring, trade policies, domestic economic development processes, transnational firm decision making and the maintenance of the geopolitical border have reproduced extreme wage differences between the United States and Mexico, resulting in the creation of a regional automotive sector that is both highly integrated and highly unequal. In this scenario, both nations are home to profoundly different industrial landscapes: the U.S. hosts the highest value-added links of the production chain, monopolizing processes of innovation and scientific and technological knowledge production, while in contrast, Mexico manufactures the most labour intense and lowest value-added links of the automotive production chain. From this perspective, the Mexican economy can be essentially understood as an export manufacturing platform which derives its ‘competitiveness’ from the aggressive industry maintenance of low wages.
Workplace Support for Employees in Recovery From Opioid Use: Stakeholder Perspectives
Authors: Imboden Rachel , Frey Jodi J. , Bazell Alicia T. , Mosby Amanda , Ware Orrin D. , Mitchell Clifford S. , Cloeren Marianne
Published: September 2021

The dual challenges of COVID-19 and the opioid epidemic have heightened the need of Maryland workplaces for accessible resources and supports. This paper describes efforts of the Workplace PROSPER (Partnering to Reduce Opioid Stigma and Support Employment in Recovery) project team to explore opioid-related state employment needs from Key Stakeholder perspectives. Discussion revealed significant overlap between the needs identified by stakeholders and pre-existing recovery friendly initiatives in other states. However, this convening identified the need for increased training of medical professionals in communicating about work capacity and safety as well as for resources to support family members of individuals with Opioid Use Disorder and model programs for hiring individuals in recovery. Next steps include the creation and dissemination of a survey to obtain a broader base of feedback and the development of a robust set of online recovery resources for Maryland employers and employees.
Embodied Ethics: Phenomenology of the NICU Nurse’s Touch
Authors: Lemermeyer Gillian
Published: September 2021

This study was a phenomenological exploration of the ethics of the nurse’s touch in the Neonatal Intensive Care Unit (NICU). I explore several examples of touching encounters as gathered from NICU nurses through interview and observation, and organize the lived meanings around several thematic statements. These include the learning touch: finding a way to hold the baby, the marking touch: when touch lingers long after physical contact, the missing touch: touching without physical contact, the gnostic touch: the possibility of knowing an other and ourselves, and the call of touch: drawn to hold. Exploring the touching gestures of NICU nurses discloses the relational ethics inherent to caring practices. By attempting to articulate these practices, the hope is that the significance and contribution of the nurse’s touch might be recognized and brought forward to our individual and professional consciousness, conversations, and curricula.
Resilience in Adolescence, Disability, and Gender
Authors: Bizuneh Shambel Molla
Published: September 2021

Introduction: Disabled adolescents are facing the adversity of life like social expectations, academic, and economic demands. Objective: This described deaf and female adolescents’ resilience with their respective counterparts using the Connor–Davidson Resilience Scale (CD-RISC-25). The resilience of disabled and female adolescents was not adequately addressed in the study province, Dangila, Amhara-Ethiopia. Methods: The study was conducted on 160 adolescent (80 deaf [40 female] and 80 hearing [40 female]) students who were selected based on multistage sampling. Quantitative and qualitative data collections were made through the questionnaire as well as interview. The study used mean, standard deviation, independent t-test and ANOA, and simple description for data analysis. Result: The results revealed that hearing adolescent students’ average resilience score was significantly greater than deaf students. It was also shown that female adolescent students’ level of average resilience score was found significantly less than their counterparts. Analysis of variance revealed that there was a significant difference in resilience score among deaf female, deaf male, hearing female, and hearing male adolescent students in which deaf female adolescent students resilience score was the lowest. Conclusion: The difference in resilience between deaf and hearing students signified deaf students’ capability to cope with stressors and academic demands was less than their counterparts, and the resilience of deaf female students was found the lowest among the groups. This calls for health and psychological professional and families to provide adequate support for deaf and female adolescents to develop resilience.
Infant with Clefts Observation Outcomes Instrument (iCOO): A New Outcome for Infants and Young Children with Orofacial Clefts
Authors: Edwards Todd C. , Heike Carrie L. , Kapp-Simon Kathleen A. , Jones Salene M. , Leroux Brian G. , Stueckle Laura P. , Bellucci Claudia Crilly , Rosenberg Janine M. , Albert Meredith , Aspinall Cassandra L. , Patrick Donald L.
Published: September 2021

Objective

We evaluated the measurement properties for item and domain scores of the Infant with Clefts Observation Outcomes Instrument (iCOO).

Design

Cross-sectional (before lip surgery) and longitudinal study (preoperative baseline and 2 days and 2 months after lip surgery).

Setting

Three academic craniofacial centers and national online advertisements.

Participants

Primary caregivers with an infant with cleft lip with or without cleft palate (CL  ±  P) scheduled to undergo primary lip repair. There were 133 primary caregivers at baseline, 115 at 2 days postsurgery, and 112 at 2 months postsurgery.

Main Outcome Measure(s)

Caregiver observation items ( n = 61) and global impression of health and function items ( n = 8) across eight health domains.

Results

Mean age at surgery was 6.0 months (range 2.7-11.8 months). Five of eight iCOO domains have scale scores, with Cronbach’s alphas ranging from 0.67 to 0.87. Except for the Facial Skin and Mouth domain, iCOO scales had acceptable intraclass correlation coefficients (ICCs) ranging from 0.76 to 0.84. The internal consistency of the Global Impression items across all domains was 0.90 and had acceptable ICCs (range 0.76-0.91). Sixteen out of 20 (nonscale) items had acceptable ICCs (range 0.66-0.96). As anticipated, iCOO scores 2 days postoperatively were generally lower than baseline and scores 2 months postsurgery were consistent with baseline or higher. The iCOO took approximately 10 min to complete.

Conclusions

The iCOO meets measurement standards and may be used for assessing the impact of cleft-related treatments in clinical research and care. More research is needed on its use in various treatment contexts.
Postoperative Use of Ketorolac Improves Pain Management and Decreases Narcotic Use Following Primary Cleft Palate Surgery
Authors: Dudley Samuel , Spence Matthew , Frederick Robert , Stocks Rosemary
Published: September 2021

Objective

To study the efficacy and safety profile of ketorolac in cleft palate surgery.

Design

Retrospective analysis of patients who underwent primary cleft palate surgery and received either postoperative ketorolac or opioids.

Setting

Tertiary care children's hospital.

Patients, Participants

Eighty-nine patients enrolled who were all younger than 36 months of age, not dependent on a gastrostomy tube, with no history of bleeding disorders, and had undergone their primary cleft palate procedure by one specific surgeon between January 2010 and June 2019.

Interventions

n/a.

Main Outcome Measure

Morphine equivalent dose (MED), Face, Legs, Activity, Cry, Consolability (FLACC) score, length of stay (LOS), total oral intake (mL), total oral intake/LOS, and postoperative adverse events between ketorolac and no ketorolac groups.

Results

MED, FLACC score, and LOS were significantly lower in the ketorolac group compared to the no ketorolac group. One patient in the ketorolac group had a bleeding event.

Conclusions

Use of ketorolac significantly decreased narcotic usage and pain scores as reported by the FLACC score. Moreover, postoperative bleeding was rare in both ketorolac and no ketorolac groups.
The Role of Demographic Data Bias in the Under-Provision of Retail: A Quasi-Experimental Case Study of Low Food Access Neighborhoods in Twenty-Five Southern Metros
Authors: Graves William , Zhang Yi
Published: September 2021

Municipal policy attempting to remediate low food access neighborhoods tends to focus on improving demand conditions in these neighborhoods. We investigate the role of two fundamental measures of food demand (population and income) and the biases inherent in these data in creating low food access neighborhoods. Population and income data were collected for a 1-mile radius surrounding seventy-one grocery desert sites in Southern U.S. metro areas, those results were compared to thirty-eight low-income, non-desert sites in the same metros. No significant difference between the demand characteristics of desert and non-desert sites was found in our sample—suggesting that policy may need to be refocused on issues other than demand metrics. In addition, we detected significant demand underestimation bias from one source commonly used by grocery stores. Given these findings we believe that parcel level characteristics such as visibility, accessibility, and buildability may play a larger role in remediating low food access than addressing demand conditions.
Application of tri-hybridized carbonaceous nanocutting fluids in an end milling operation by the minimum quantity lubrication technique
Authors: Vignesh S. , Mohammed Iqbal U.
Published: September 2021

This paper is concentrated on the exploration of carbonaceous nanocutting fluids with the concept of tri-hybridization with improved lubricative and cooling properties by using multi-walled carbon nanotubes, hexagonal boron nitride , and graphene nanoparticles with neat cold-pressed coconut oil in a fixed volumetric proportion. The rheological properties of the nanofluids were studied to assess their performance in real-time end milling operations using an AA7075 work piece on a CNC lathe machine under a minimum quantity lubrication environment. At the outset, the carbonaceous nanofluids gave good performance when compared to conventional cutting fluids. Furthermore, the surfaces of the tribo-pairs and the chips formed were analyzed using a profilometer and high-end microscopes. The results obtained from the experiments confirm that the tri-hybridized carbonaceous nanolubricant has reduced the cutting force, tool wear, and surface roughness when correlated to monotype nanofluids. The scanning electron microscope images of the surface and tool were studied and it was found that the surface quality was maintained while end milling with tri-hybridized carbonaceous nanofluid. Improvement of ∼17%, 20% and 25% in cutting forces, surface roughness and tool wear was found in tri-hybrid fluid when compared to other fluids. Thus, the present work indicates that the addition of carbon-based nanoparticles with coconut oil has offered better performance and is found to be a credible alternative to existing conventional cutting fluids.
Differences in antibiotic prescriptions between direct-to-consumer telehealth and telehealth in the emergency department
Authors: Yao Peter , Gogia Kriti , Clark Sunday , Hsu Hanson , Sharma Rahul , Greenwald Peter
Published: September 2021

Background

Telemedicine, which allows physicians to assess and treat patients via real-time audiovisual conferencing, is a rapidly growing modality for providing medical care. Antibiotic stewardship is one important measure of care quality, and research on antibiotic prescribing for acute respiratory infections in direct-to-consumer telemedicine has yielded mixed results. We compared antibiotic prescription rates for acute respiratory infections in two groups treated by telemedicine: (1) patients treated via a direct-to-consumer telemedicine application and (2) patients treated via telemedicine while physically inside the emergency department.

Methods

We included direct-to-consumer telemedicine and emergency department telemedicine visits for patients 18 years and older with physician-coded International Classification of Diseases, Tenth Revision acute respiratory infection diagnoses between November 2016 and December 2018. Patients in both groups were seen by the same emergency department faculty working dedicated telemedicine shifts. We compared antibiotic prescribing rates for direct-to-consumer telemedicine and emergency department telemedicine visits before and after adjustment for age, sex, and diagnosis.

Results

We identified a total of 468 acute respiratory infection visits: 191 direct-to-consumer telemedicine visits and 277 emergency department telemedicine visits. Overall, antibiotics were prescribed for 47% of visits (59% of direct-to-consumer telemedicine visits vs 39% of emergency department telemedicine visits; odds ratio 2.23; 95% confidence interval 1.53–3.25; P < 0.001). The difference in antibiotic prescribing rates remained significant after adjustment for age, sex, and diagnosis (odds ratio 2.49; 95% confidence interval 1.65–3.77; P < 0.001).

Conclusion

Patients seen by the same group of physicians for acute respiratory infection were significantly more likely to be prescribed antibiotics by direct-to-consumer telemedicine care compared with telemedicine care in the emergency department. This work suggests that contextual factors rather than evaluation over video may contribute to differences in antibiotic stewardship for direct-to-consumer telemedicine encounters.
World regional differences in outcomes for patients with peripheral artery disease: Insights from the EUCLID trial
Authors: Norgren Lars , North Rebecca , Baumgartner Iris , Berger Jeffrey S , Blomster Juuso I , Hiatt William R , Jones W Schuyler , Katona Brian G , Mahaffey Kenneth W , Mulder Hillary , Patel Manesh R , Rockhold Frank W , Fowkes F Gerry R
Published: September 2021

Regional variations exist in the epidemiology of peripheral artery disease (PAD), in comorbidities, use of secondary prevention, and outcomes. Large studies of these variations in worldwide populations are rare. The EUCLID (Examining Use of tiCagreLor In peripheral artery Disease) trial included 13,885 patients with PAD from four geographical regions (Central/South America, Europe, Asia, North America) and compared monotherapy with ticagrelor and clopidogrel. Inclusion criteria were either an ankle–brachial index < 0.80 or a prior revascularization. The primary efficacy endpoint was time to first occurrence of any event in the composite of cardiovascular death, myocardial infarction, or ischemic stroke and did not differ between the study arms. This post hoc analysis of EUCLID confirmed that regional differences occurred in the inclusion criteria with more prior revascularization in North America (73.9%) and Asia (72.5%) compared with Central/South America (34.0%) and Europe (51.6%). The characteristics of patients also differed. Prior amputation at baseline was most frequent in Central/South America (6.3%) compared with other regions (1.6–2.8%). A history of stroke was most common in Asia, coronary heart disease in North America, and diabetes in Central/South America compared with other regions. The incidence of outcomes in patients with PAD varied by region. North America had the highest rate of the primary combined endpoint (5.97 events/100 patient-years). Corresponding rates were 4.80, 3.95, and 3.87 for Asia, Europe, and Central/South America, respectively. Hospitalization for acute limb ischemia (events/100 patient-years) was most frequent in Europe (0.75) and North America (0.74) compared with Asia (0.60) and Central/South America (0.33). Adjustment for inclusion criteria and relevant PAD characteristics did not have a major impact on these regional differences. Further adjustment for concomitant disease, risk factors, and preventive medication modified the regional differences only marginally. In conclusion, substantial regional differences were found in cardiovascular and limb outcomes in patients with PAD and were not explained by variation in the category of included patients, concomitant disease, risk factors, and prevention. Such differences, which may be due to variation in other factors such as background population rates or clinical care, need to be considered when designing and interpreting large international studies (ClinicalTrials.gov Identifier: NCT01732822).
Elevated temperature erosive wear behavior of superalloy coatings deposited using cold spray technology
Authors: Padmini BV , Mathapati Mahantayya , Niranjan HB , Sampathkumaran P , Anand Kumar S , Padmavathi G
Published: September 2021

The boiler tube components in thermal power plants and steam generating systems suffer from erosion and corrosion problems and are even today posturing a grave threat to industries, resulting in forced outages. Unrelenting efforts to decrease the components’ maintenance costs have been made by protecting with coatings. Among the various coating methodologies are thermal spray, chemical vapour deposition (CVD), physical vapour deposition (PVD), etc., in vogue. However, recently, the additive manufacturing-based cold spray technique is gaining interest among material scientists, incorporating high-velocity impacts associated with the low-temperature regime. Nickel-based superalloy Inconel 625 has been chosen and cold sprayed on The American Society of Mechanical Engineers (ASME) T11 and T22 boiler steels. The coated surface is characterized by scanning electron microscopy and energy dispersive X-ray analysis (EDAX), X-ray diffraction, micro-hardness, and elemental X-ray mapping techniques. The solid particle erosion studies have been carried out both at room and an elevated temperature of 700 °C as per American Society for Testing and Materials (ASTM) standard for 30°C and 90 °C impact angles. An optical profilometer has been used to evaluate the erosion volume loss. The results showed that the coated samples exhibit superior erosion resistance than the uncoated samples at both room and elevated temperatures. The erosion data obtained have been substantiated using scanning electron microscopy by analyzing the damage features and correlating with the erosion data.
High-resolution mass spectrometry reveals a complex ganglioside pattern and novel polysialylated structures associated with the human motor cortex
Authors: Ica Raluca , Munteanu Cristian VA , Vukelic Zeljka , Zamfir Alina D
Published: September 2021

We have developed here a superior methodology based on high-resolution mass spectrometry for screening and fragmentation analysis of gangliosides extracted and purified from the human motor cortex . The experiments, conducted on a nanoelectrospray Orbitrap mass spectroscope in the negative ion mode, allowed the discrimination in the native mixture extracted from human motor cortex of no less than 83 different gangliosides, which represents the highest number of structures identified so far in this brain region. The spectral data, acquired in high-resolution mass spectrometry mode with a remarkable sensitivity and an average mass accuracy of 4.48 ppm, also show that the gangliosidome of motor cortex is generally characterized by species exhibiting a much higher degree of sialylation than previously known. Motor cortex was found dominated by complex structures with a sialylation degree ≥3, exhibiting long saccharide chains, in the G1 class. Fucogangliosides and species with the glycan chain elongated by either O-acetylation and/or acetate anion attachments were also detected; the later modification was for the first time discovered in this brain region. Of major significance is the identification of hepta and octasialylated species of GS1 and GO1 type, which are among the structures with the longest oligosaccharide chain discovered so far in the human brain. In the last stage of research, tandem mass spectrometry performed by higher energy collision dissociation provided structural data documenting the occurrence of GT1b (d18:1/20:0) isomer in the human motor cortex.
Endovascular Management of Unused Fenestrations or Branches in Fenestrated/Branched Aortic Endograft
Authors: Tan Kong Teng , Mafeld Sebastian Charles , Lindsay Thomas Fook
Published: September 2021

Fenestrated and branched aortic endograft (F/B EVAR) has become a widely accepted technique in the management of aneurysmal aortic pathology. However, intra-procedurally in some situations, there are F/B that remain unused because of target vessel occlusion or failure to cannulate the target artery. Leaving the F/B open will result in an ongoing endoleak, unless treated at the time. Herein we described the necessary considerations and several endovascular techniques to occlude these fenestrations and branches in this situation.