bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation and optimization of a compact push-pull rubber actuator energized by an outer coil of shape memory wire
Authors: Dragoni Eugenio , Mammano Giovanni Scirè
Published: November 2020

The authors have formerly published the analytical model and finite element validation of a push-pull actuator made by winding a thin shape memory wire on a solid rubber cylinder. The cylinder provides elastic backup for the wire upon cooling down and transforms its circumferential contraction into a magnified axial elongation upon heating up. Building on that study, this paper accomplishes three tasks: (1) build prototype actuators and perform simple tests to validate the theory; (2) develop simple procedures for the optimal design of the actuator starting from high-level engineering specifications; (3) envision how the present concept could be improved by replacing the rubber block with a compliant lattice-like or shell-like scaffold with designed properties to further enhance the axial stroke.
Exploring empowerment of participants and peer workers in a self- managed homeless shelter
Authors: Huber Max A , Brown Louis D , Metze Rosalie N , Stam Martin , Van Regenmortel Tine , Abma Tineke N
Published: November 2020

Self-managed shelters claim that participants who have been homeless are better able to run a shelter than regular providers. Little research has investigated self-managed shelters. In this article, we have described the experiences of participants and peer workers with empowerment processes in Je Eigen Stek (Your own place, JES), a self-managed shelter, based on an eight-year qualitative responsive evaluation.

Findings

We distinguish three clusters of individual experiences: (1) enthusiastic, (2) moderate to critical, and (3) negative, respectively, associated with decreasing engagement with social life in and management of JES. Those not engaged can still benefit materially and from the freedom of choice JES offers, which is generally appreciated. Empowerment provides a useful framework and JES in turn offers new insights into the dialectical nature of empowerment. Empowerment consists of freedom of choice and capacity development and neither should be emphasized over the other. The emphasis in JES is on freedom of choice, which does not automatically lead to developing capacities. Social workers try to balance both aspects of empowerment.

Applications

Our analysis shows how offering freedom of choice can contribute to empowerment, although social workers need to be aware that participants might opt not to work on capacity development.
Influences on ethical decision-making among porn consumers: The role of stigma
Authors: Macleod PJ
Published: November 2020

This paper presents findings from a grounded theory study of consumer ethics among feminists who use porn. It presents a range of exogenous and endogenous factors reported to be influential on ethical decision-making in this context and demonstrates how such factors may be perceived as impeding or facilitating the types of behaviour that consumers consider to be more in keeping with their moral and political beliefs. It furthermore highlights how such influences are often undergirded by seemingly deep-seated stigma around pornography, and often around sex and sexuality at large. The paper concludes that the direct and indirect effects of stigma may present additional obstacles for “fairtrade” and feminist-branded porn projects seeking to leverage consumer demand to support the development of more ethical industry practices. While it has been argued that stigma-reduction efforts can help reduce exploitative practices in the porn industry – by improving sex workers’ ability to demand rights, freedoms, safety, and better labour conditions and remuneration – the analysis from this study suggests that such efforts may also result in secondary benefits. These may be brought about by (a) removing obstacles to the types of consumer practice that could in turn support worker rights and livelihoods, and (b) disrupting rationalisations used to justify consumer choices that threaten to undermine these ends.
Time-domain Markov chain Monte Carlo–based Bayesian damage detection of ballasted tracks using nonlinear ballast stiffness model
Authors: Lam Heung-Fai , Adeagbo Mujib Olamide , Yang Yeong-Bin
Published: November 2020

This article reports the development of a methodology for detecting ballast damage under a sleeper based on measured sleeper vibration following the Bayesian statistical system identification framework. To ensure the methodology is applicable under large amplitude vibration of the sleeper (e.g. under trainload), the nonlinear stress–strain behavior of railway ballast is considered. This, on one hand, significantly reduces the problem of modeling error, but, on the other hand, increases the number of uncertain model parameters. The uncertainty associated with the identified model parameters of the rail–sleeper–ballast system may be very high. To overcome this difficulty, the Markov chain Monte Carlo–based Bayesian model updating is adopted in the proposed methodology for the approximation of the posterior probability density function of uncertain model parameters. Owing to the nonlinear behavior of the system, the model updating is performed in the time domain instead of the modal domain. The applicability of the proposed damage detection methodology was first verified numerically using simulated impact hammer test data in two damaged cases perturbed with Gaussian white noise. Second, impact hammer tests of in situ sleepers in the full-scale in-door ballasted track test panel were carried out to collect data for the experimental verification of the proposed methodology. Artificial ballast damage was simulated under the target concrete sleeper by replacing normal-sized ballast particles (∼60 mm) by small-sized ballast particles (∼15 mm). The proposed methodology successfully identified the location and severity of ballast damage under the sleeper. From the calculated posterior marginal probability density functions of model parameters, one can quantify the uncertainties associated with the damage detection results. The proposed methodology is an essential step in the development of a long-term railway track health monitoring system utilizing train-induced vibration.
Clinical Characteristics of Transarterial Chemoembolization in Treatment of Primary Hepatocellular Carcinoma Complicated With Respiratory Distress Syndrome
Authors: Ruan Ji-Yin , Lin Jia-Tian , Xiong Yu , Chen Zai-Zhong , Chen Jun-Hui , Yu Hong-Jian
Published: November 2020

Objective:

The present study aims to analyze the clinical characteristics and etiology of transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) complicated with acute respiratory distress syndrome (ARDS), in order to improve the early diagnosis rate and cure rate.

Methods:

A total of 816 patients with primary HCC received 2,200 TACE treatments from January 2014 to May 2018. Among these patients, 6 patients developed ARDS after TACE. The clinical data, lesion characteristics, laboratory tests, treatment process and prognosis of 6 patients were retrospectively analyzed.

Results:

The longest lesion diameter ranged within 5.0-10.2 cm (mean: 6.6 cm) in the 6 patients with primary HCC. Among these patients, 4 patients had lesions mainly located in the left lateral lobe of the liver, while 5 patients had no hepatic arteriovenous fistula detected before TACE. Nedaplatin, epirubicin and iodinated oil suspension chemoembolization were used in all 6 patients during TACE, and all of them experienced ARDS symptoms within 24-48 hours after TACE. However, no clear pathogenic bacteria were incubated in the sputum culture after the onset of the disease. Diffused exudative changes of both lungs were found in the chest X-ray, and the oxygenation index (PaO2/FiO2) was within 100-300 mmHg. The symptoms of 6 patients improved after 3-6 days of hormone therapy.

Conclusion:

In this study, we found that although the incidence of ARDS after TACE was low in the treatment for HCC, the symptoms after onset were serious, and the early hormone therapy may be beneficial to improve the prognosis and reduce mortality. Further research with larger samples is still needed to confirm the pathogenesis of ARDS after TACE in the treatment for HCC.
TP53-Associated Ion Channel Genes Serve as Prognostic Predictor and Therapeutic Targets in Head and Neck Squamous Cell Carcinoma
Authors: Sun Jing , Yu Xijiao , Xue Lande , Li Shu , Li Jianxia , Tong Dongdong , Du Yi
Published: November 2020

TP53 mutations are the most occurred mutation in HNSCC which might affect the ion channel genes. We aim to investigate the ion channel gene alteration under TP53 mutation and their prognostic implication. The overall mutation status of HNSCC were explored. By screening the TP53-associated ion channel genes (TICGs), an ion channel prognostic signature (ICPS) was established through a series of machine learning algorithms. The ICPS was then evaluated and its clinical significance was explored. 82 TICGs differentially expressed between TP53WT and TP53MUT were screened. Using univariate regression analysis and LASSO regression analysis and multivariate regression analysis, an ICPS containing 7 ion channel genes was established. A series of evaluation was carried out which proved the predictive ability of ICPS. Functional analysis of ICPS revealed that cancer-related pathways were enriched in high-risk group. Next, for clinical application, a nomogram was constructed based on ICPS and other independent clinicopathological factors. TP53 mutation status strongly affects the expression of ion channel genes. The ICPM we have identified is a strong indicator for HNSCC prognosis and could help with patient stratification as well as identification of novel drug targets.
Effects of a Clinic-Based Exercise Program on Sleep Disturbance Among Cancer Survivors
Authors: Hidde Mary C. , Leach Heather J. , Marker Ryan J. , Peters John C. , Purcell W. Thomas
Published: November 2020

Introduction

Sleep disturbance is the second leading negative side effect reported by cancer survivors, and evidence exists to suggest that exercise may improve sleep for cancer survivors. This study examined changes in sleep following a 3-month, clinic-based exercise program among a diverse group of cancer survivors.

Methods

Single group, pre-post study design. Participants were enrolled in a supervised exercise program which consisted of moderate intensity aerobic and resistance training, twice per week for 3-months. To be eligible, individuals had to be diagnosed with cancer, and undergoing, or within 6-months of completing chemo and/or radiation therapy. Sleep was assessed at pre-and post-program using 3 self-report questions as part of a standard wellness assessment conducted at the program’s facility. Changes in categorical outcomes were evaluated using McNemar and Wilcoxon Signed-Rank Tests.

Results

Participants ( N = 94) were mostly female (68.1%, N = 64), mean age = 54.26 ± 14.26 (20-78), and diagnosed with more than 8 different cancer types. Half ( N = 48, 51.1%) of participants improved on 1 or more of the questions assessing sleep. At post-program, 39% of participants reported that they did not awaken feeling rested versus 48% at pre-program ( P = .08). At post-program, 47% reported awakening ≥1 time per night versus 46% at pre-program ( P = .97), and 17% reported poor or very poor sleep quality at post-program versus 24% at pre-program ( P = .16). There were no differences in demographic, cancer-related, psychosocial, and physical fitness variables between participants who improved on any of the questions assessing sleep versus those who did not.

Conclusions

A clinically implemented exercise program may help some cancer survivors improve sleep, however more studies utilizing validated, objective measures of sleep are needed to confirm effectiveness.
A Review of Natural Therapies Potentially Relevant in Triple Negative Breast Cancer Aimed at Targeting Cancer Cell Vulnerabilities
Authors: Webb Myfanwy Jane , Kukard Craig
Published: November 2020

We reviewed the research into the mechanisms of growth of triple negative breast cancer (TNBC) based on laboratory pre-clinical studies that have shaped understanding of the disease over the past decade. In response to these findings, we propose an approach to potentially prevent cancer metabolic adaptation and recurrence. This paper collates pre-clinical results, first to determine the tumor’s mechanisms of growth and then to source natural substances that could potentially suppress those mechanisms. The results from in vivo and in vitro studies of TNBC were combined first to select 10 primary mechanisms (Hypoxia-inducible factor 1α, Hedgehog, MAPK, MTAP, NF-κ B, Notch, P13K, STAT3, and Wnt signaling pathways plus p53 and POL2A gene expression) that promote TNBC growth, and second to propose a treatment array of 21 natural compounds that suppress laboratory models of TNBC via these mechanisms. We included BRCA mutations in the review process, but only pathways with the most preclinical studies utilizing natural products were included. Then we outlined potential biomarkers to assess the changes in the micro-environment and monitor biochemical pathway suppression. This suppression-centric aim targets these mechanisms of growth with the goal of potentially halting tumor growth and preventing cancer cell metabolic adaptation. We chose TNBC to demonstrate this 5-step strategy of supplementary therapy, which may be replicated for other tumor types.
Bowstring Phenomenon in Renal Artery Aneurysm Exclusion Using a Viabahn Stent Graft
Authors: Saiga Atsushi , Yamamoto Masayoshi , Kondo Hiroshi , Kubota Yoshihiro , Wada Takeshi , Akutsu Akira , Takeuchi Takashi , Koizumi Jun , Uno Takashi
Published: November 2020

A 77-year-old man presented with an incidental finding of right renal artery aneurysm without symptoms. Computed tomography revealed a 22 mm saccular aneurysm with a wide neck at the main renal artery trunk. An 8 × 100 mm Viabahn stent graft (W. L. Gore, Flagstaff, AZ) was deployed by fully pulling back the guiding sheath. However, the deployment knob was not able to be pulled. We returned the guiding sheath to the original position and confirmed the cause was the bowstring phenomenon. Because avoidance of this phenomenon required straightening of the tortuous vessel, the stent graft was deployed by short pull-back of the guiding sheath. Computed tomography after a year revealed no opacification of the aneurysm and the patency of the stent graft.
Five Features to Look for in Early-Phase Clinical Intervention Studies
Authors: Tsay Jonathan S. , Winstein Carolee J.
Published: November 2020

Neurorehabilitation relies on core principles of neuroplasticity to activate and engage latent neural connections, promote detour circuits, and reverse impairments. Clinical interventions incorporating these principles have been shown to promote recovery and demote compensation. However, many clinicians struggle to find interventions centered on these principles in our nascent, rapidly growing body of literature. Not to mention the immense pressure from regulatory bodies and organizational balance sheets that further discourage time-intensive recovery-promoting interventions, incentivizing clinicians to prioritize practical constraints over sound clinical decision making. Modern neurorehabilitation practices that result from these pressures favor strategies that encourage compensation over those that promote recovery. To narrow the gap between the busy clinician and the cutting-edge motor recovery literature, we distilled 5 features found in early-phase clinical intervention studies—ones that value the more enduring biological recovery processes over the more immediate compensatory remedies. Filtering emerging literature through this lens and routinely integrating promising research into daily practice can break down practical barriers for effective clinical translation and ultimately promote durable long-term outcomes. This perspective is meant to serve a new generation of mechanistically minded and caring clinicians, students, activists, and research trainees, who are poised to not only advance rehabilitation science, but also erect evidence-based policy changes to accelerate recovery-based stroke care.
Development and performance study of a natural silk fiber facial mask paper
Authors: Wang Huiling , Zhou Bin
Published: November 2020

Facial masks are beauty products which composed of a facial mask paper and beauty solution. Silk contains the amino acid structure closest to the human skin, and has the skin-friendly, cosmetic and antibacterial functions, but the common method for making nonwoven facial mask paper is not suitable for silk. In this paper, the silkworm’s spinning path is intervened manually to obtain a smart silk facial mask paper (SMC) of controllable thickness, so that the sericin on the silk fiber is well preserved. In the experiment where the SMC is compared with the nonwoven 384-cuprammonium rayon facial mask paper (CRMC) which is the most widely used in the market, it is found that the ways of forming the two facial mask paper are completely different, and therefore the morphologies under SEM are obviously different. The thickness of the SMC is 0.183 mm and the areal weight of it is 38.0 g/m2. It is very close to the CRMC (0.187 mm, 38.4 g/m2). The porosity of the SMC is 84.0%, which is slightly lower than that of the CRMC (86.3%), but its pores are well distributed. Compared with the CRMC, the smart SMC has higher dry and wet strength, lower elongation, slightly lower air permeability and liquid entrainment rate, and better antibacterial performance.
Trajectory planning for unmanned surface vehicles operating under wave-induced motion uncertainty in dynamic environments
Authors: Rajendran Pradeep , Moscicki Travis , Wampler Jared , Ellenrieder Karl von , Gupta S. K.
Published: November 2020

We present a deliberative trajectory planning method to avoid collisions with traffic vessels. It also plans traversal across wavefields generated by these vessels and minimizes the risk of failure. Our method searches over a state-space consisting of pose and time. And, it produces collision-free and minimum-risk trajectory. It uses a lookup table to account for motion uncertainty and failure risk. We also present speed-up techniques to increase performance. Our wave-aware planner produces plans that (1) have shorter execution times and safer when compared to previously developed reactive planning schemes and (2) comply with user-defined wave-traversal constraints and Collision Regulations (COLREGs)
A novel fatigue detection method for rehabilitation training of upper limb exoskeleton robot using multi-information fusion
Authors: Wang Wendong , Li Hanhao , Kong Dezhi , Xiao Menghan , Zhang Peng
Published: November 2020

The utilization of upper extremity exoskeleton robots has been proved to be a scientifically effective approach for rehabilitation training. In the process of rehabilitation training, it is necessary to detect the fatigue degree during rehabilitation training in order to formulate a reasonable training plan and achieve better training efficiency. Based on the integral value of surface electromyography (sEMG), heart rate variability, and instantaneous heart rate, this article proposes a fatigue judgment method for multi-information fusion. Based on the integral value data, the feature extraction of the bioelectrical signals were implemented separately, then the fatigue recognition was conducted using the decision-level data fusion method. The bioelectrical signal acquisition system of electromyogram signals and electrocardiograph signals was developed for upper limb exoskeleton rehabilitation robot, and the acquisition and processing of electromyogram signals and electrocardiograph signals were completed. Finally, the fuzzy logic controller with instantaneous heart rate, heart rate variability, and surface electromyography signal was designed to judge fatigue degree, including the fuzzy device, fuzzy rule selector, and defuzzifier. The moderate fatigue state data were selected for testing, and the experimental results showed that the error of fatigue judgment is 4.3%, which satisfies the requirements of fatigue judgment.
A landscape of micronutrient status in women through the reproductive years: Insights from seven regions in Asia
Authors: Chong Mary Foong-Fong , Bui Chi Thuong , Jaisamrarn Unnop , Pacquing-Songco Debby , Shaw Steven W. , Tam Ching Ting , Bardosono Saptawati
Published: November 2020

Optimal micronutrient status is critical to the health of women, particularly during their reproductive years. A woman’s health and nutritional status during the preconception stage thus has significant implications for pregnancy outcomes and her offspring’s health later in life. In this review, we evaluated micronutrient intakes and status (iron, folate, and vitamin B12) of women in their reproductive years and during pregnancy, along with associated health consequences and dietary causes, across seven regions in Asia, namely, Hong Kong, Indonesia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. A structured literature search, targeting peer-reviewed publication databases, as well as data from international and national sources in the public domain, was conducted. Our review of the nutritional landscape demonstrates that micronutrient deficiency–related conditions, especially anemia and its associated health consequences, are common among Asian women of reproductive age, yet the dietary causes are poorly studied. Inadequate or borderline dietary intake of micronutrients and low consumption of micronutrient supplements were evident, despite existing recommendations, food fortification, and supplementation strategies. Evaluation of current programs through nutrition monitoring and improvement of supplementation strategies, such as supplementing with multiple micronutrients, alongside food-based programs, will help better support the health of women through their reproductive years.
Stimulus novelty, task demands, and strategy use in episodic memory
Authors: Waris Otto , Fellman Daniel , Jylkkä Jussi , Laine Matti
Published: November 2020

Cognitive task performance is a dynamic process that evolves over time, starting from the first encounters with a task. An important aspect of these task dynamics is the employment of strategies to support successful performance and task acquisition. Focusing on episodic memory performance, we: (1) tested two hypotheses on the effects of novelty and task difficulty on strategy use, (2) replicated our previous results regarding strategy use in a novel memory task, and (3) evaluated whether repeated open-ended strategy queries affect task performance and/or strategy use. The present pre-registered online study comprised 161 adult participants who were recruited through the Prolific crowdsourcing platform. We employed two separate 5-block list learning tasks, one with 10 pseudowords and the other with 18 common nouns, and collected recall performance and strategy reports for each block. Using Bayesian linear mixed effects models, the present findings (1) provide some support for the hypothesis that task-initial strategy development is not triggered only by task novelty, but can appear also in a familiar, moderately demanding task; (2) replicate earlier findings from an adaptive working memory task indicating strategy use from the beginning of a task, associations between strategy use and objective task performance, and only modest agreement between open-ended versus list-based strategy reports; and (3) indicate that repeated open-ended strategy reports do not affect objective recall. We conclude that strategy use is an important aspect of memory performance right from the start of a task, and it undergoes development at the initial stages depending on task characteristics. In a larger perspective, the present results concur with the views of skill learning and adaptivity in cognitive task performance.
Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
Authors: Kelly Dearbhla M , Rothwell Peter M
Published: November 2020

With both an aging population and greater post-stroke survival, multimorbidity is a growing healthcare challenge, affecting over 40% of stroke patients, and rising rapidly and predictably with increasing age. Commonly defined as the co-occurrence of two or more chronic conditions, multimorbidity burden is a strong adverse prognostic factor, associated with greater short- and long-term stroke mortality, worse rehabilitation outcomes, and reduced use of secondary prevention. Chronic kidney disease can be considered as the archetypal comorbidity, being age-dependent and also affecting about 40% of stroke patients. Chronic kidney disease and stroke share very similar traditional cardiovascular risk factor profiles such as hypertension and diabetes, though novel chronic kidney disease-specific risk factors such as inflammation and oxidative stress have also been proposed. Using chronic kidney disease as an exemplar condition, we explore the mechanisms of risk in multimorbidity, implications for management, impact on stroke severity, and downstream consequences such as post-stroke cognitive impairment and dementia.
Endotoxemia is associated with an adverse metabolic profile
Authors: Määttä Anne-Mari , Salminen Aino , Pietiäinen Milla , Leskelä Jaakko , Palviainen Teemu , Sattler Wolfgang , Sinisalo Juha , Salomaa Veikko , Kaprio Jaakko , Pussinen Pirkko J
Published: November 2020

Our aim was to analyze whether endotoxemia, i.e. translocation of LPS to circulation, is reflected in the serum metabolic profile in a general population and in participants with cardiometabolic disorders. We investigated three Finnish cohorts separately and in a meta-analysis ( n = 7178), namely population-based FINRISK97, FinnTwin16 consisting of young adult twins, and Parogene, a random cohort of cardiac patients. Endotoxemia was determined as serum LPS activity and metabolome by an NMR platform. Potential effects of body mass index (BMI), smoking, metabolic syndrome (MetS), and coronary heart disease (CHD) status were considered. Endotoxemia was directly associated with concentrations of VLDL, IDL, LDL, and small HDL lipoproteins, VLDL particle diameter, total fatty acids (FA), glycoprotein acetyls (GlycA), aromatic and branched-chain amino acids, and Glc, and inversely associated with concentration of large HDL, diameters of LDL and HDL, as well as unsaturation degree of FAs. Some of these disadvantageous associations were significantly stronger in smokers and subjects with high BMI, but did not differ between participants with different CHD status. In participants with MetS, however, the associations of endotoxemia with FA parameters and GlycA were particularly strong. The metabolic profile in endotoxemia appears highly adverse, involving several inflammatory characters and risk factors for cardiometabolic disorders.
Sustainable performance management using resilience engineering
Authors: Bouloiz Hafida
Published: November 2020

Several efforts have focused on the continuous improvement of firm performance, but many disturbances still occur because of various random failures. Resilience which is the ability to withstand shock and maintain critical function, has been recognized as an important approach to keep a firm operating in varying conditions, even if these conditions are excepted or not. With the objective to further enhance firm performance and be part of a sustainable development, it is necessary to study this performance through the resilience in order to manage all disturbances. The objective of this work is to propose a specific management model able to define the functions and barriers that contribute to the resilience of sustainable performance of firm. In this paper, the methodology is explained in detail, and its application trough textile firm is discussed.
Accuracy and User Performance of a New Blood Glucose Monitoring System
Authors: Klaff Leslie , Shelat Pragathi , Zondorak Diana , Wayland-Smith Amy , Vernes Phil , Richardson James M.
Published: November 2020

Introduction:

Self-monitoring of blood glucose (BG) is important in diabetes management, allowing people with diabetes (PWD) to assess responses to diabetes therapy and to inform if they are attaining their glycemic targets. This study assessed the accuracy and user performance (UP) of a new blood glucose monitoring system (BGMS), CONTOUR®PLUS ELITE, according to International Organization for Standardization (ISO) 15197:2013 criteria and also more stringent criteria.

Methods:

In laboratory Study 1, capillary fingertip blood samples from 100 PWD were evaluated using the new BGMS. In clinical Study 2, 130 PWD had Yellow Springs Instrument (YSI) analyzer reference measurements against subject-obtained fingertip and palm blood, and trial staff-obtained venous blood. The new BGMS was tested with test strips from three different lots. A UP questionnaire assessed ease of use.

Results:

Study 1: 100% of combined accuracy results fulfilled ISO criteria (±15 mg/dL at BG <100 mg/dL; ±15% at BG ≥100 mg/dL); 99.8% fulfilled more stringent criteria (±10 mg/dL at BG <100 mg/dL; ±10% at BG ≥100 mg/dL). Error grid analysis showed that 100% of results were within zone A. Study 2: >98% of subject- and 100% of trial staff-obtained performance results met ISO criteria. Most subjects (>96%) found the BGMS easy to use.

Conclusion:

The new BGMS exceeded minimum ISO 15197:2013-specified standards for both accuracy and UP criteria, along with the more stringent accuracy criteria. These data show that this new BGMS can be a useful tool in managing glycemic control for PWD.
Web Scraping for Hospitality Research: Overview, Opportunities, and Implications
Authors: Han Saram , Anderson Christopher K.
Published: November 2020

As consumers increasingly research and purchase hospitality and travel services online, new research opportunities have become available to hospitality academics. There is a growing interest in understanding the online travel marketplace among hospitality researchers. Although many researchers have attempted to better understand the online travel market through the use of analytical models, experiments, or survey collection, these studies often fail to capture the full complexity of the market. Academics often rely upon survey data or experiments owing to their ease of collection or potentially to the difficulty in assembling online data. In this study, we hope to equip hospitality researchers with the tools and methods to augment their traditional data sources with the readily available data that consumers use to make their travel choices. In this article, we provide a guideline (and Python code) for how to best collect/scrape publicly available online hotel data. We focus on the collection of online data across numerous platforms, including online travel agents, review sites, and hotel brand sites. We outline some exciting possibilities regarding how these data sources might be utilized, as well as discuss some of the caveats that have to be considered when analyzing online data.
Living-donor nephrectomy at Singapore General Hospital: Evolution of surgical techniques over the last two decades
Authors: Aslim Edwin Jonathan , Linn Yun Le , Yang Xinyan , Ng Glenn Yang Han , Lee Chui Wan , Gan Valerie Huei Li
Published: November 2020

Background:

Laparoscopic living-donor nephrectomy is the current epitome of living kidney donation surgery. We review our experience in living-donor nephrectomies over the last 19 years, transitioning from open surgery to hand-assisted laparoscopy to full laparoscopic techniques.

Methods:

We retrospectively identified all living-donor nephrectomies performed at our institution from 1976 to 2018. The donors were categorised according to surgical techniques: open (ODN), hand-assisted laparoscopy (HALDN) and full laparoscopy (LDN). We reviewed changes in donor demographics over the years. Surgical outcomes between groups were compared from 2000 to 2018. We also compared the outcomes of LDN between different time periods to evaluate our learning curve.

Results:

A total of 214 living-donor nephrectomies were performed between 2000 and 2018. The majority were left sided (93%) and had single renal artery anatomy (90%). There were 22 ODN, 20 HALDN and 163 LDN cases. The mean operating time was 84±43, 151±32 and 179±37 minutes for ODN, HALDN and LDN, respectively ( p<0.001). There were no statistically significant differences in mean warm ischaemia times ( p=0.921) and length of hospital stay ( p=0.114) between groups. The overall 30-day surgical morbidity rate was 9.3%, with a major complications rate of 0.9%. The mean warm ischaemia time for LDN was significantly different ( p<0.001) between time periods: 281±260, 184±94 and 140±42 seconds for the periods between 2005–2009, 2010–2014 and 2015–2018, respectively.

Conclusion:

This study confirms the safety of living-donor nephrectomies performed at our institution, a centre with a modest volume of kidney transplants.
Mobile phones in the spread of unreliable information on Twitter: evidence from the 2017 French presidential campaign
Authors: Figeac Julien , Ratinaud Pierre , Smyrnaios Nikos , Cabanac Guillaume , Fraisier-Vannier Ophélie , Salord Tristan , Seffusatti Fanny
Published: November 2020

This article analyzes the spread of unreliable information on Twitter during the 2017 French presidential campaign, focusing on the use of mobile phones with regard to information-sharing behavior. The corpus is composed of 38,346,765 tweets, posted by 2,163,812 supporters of the five main French political parties, from November 25, 2016 to May 12, 2017. We examine more precisely a sub-corpus of tweets (13,044,619) containing links to external information sources, in order to evaluate the different types of information sources and their reliability.

Our research shows that information-sharing behavior within Twitter in France is generally based on reliable information sources, produced by journalists and professional media. However, we highlight that smartphone users tended to share a greater amount of user-generated content, as well as articles from a wider range of alternative political information sources (blogs, activists’ websites); such sources were most likely to publish unreliable information. Thus it appears that users of mobile phones tend to share more unreliable news than those who use Twitter from a computer web browser. Further, we show that this “device effect” on the spread of unreliable information is primarily amplified among the practices of one political community—namely, the far-right party and its network of supporters—which is more likely to organize debate around a larger number of unreliable references. We are claiming here that the design-based interoperability of these unreliable political news and social media applications helps to understand why the French far-right community shared more unreliable information from the Twitter application.
Risk analyses in the intersection between patient and workplace safety: A case study of hazids in para-clinical supporting systems in specialized health care
Authors: Palm Marianne , Moen Leif , Braut Geir Sverre
Published: November 2020

Background:

The aim is to investigate the appropriateness of hazid for performing risk analyses in supporting systems in hospitals.

Methods:

We used a case study approach for evaluating introduction of hazid for the first time in two different university hospital settings. The hazid was performed in a customized way according to the specific needs at the two sites.

Findings:

In both settings studied, the hazid approach revealed several phenomena that were followed up in the ordinary quality improvement work. The results were widely acknowledged as valid as seen from the managerial level. The participants reported that they felt comfortable in the hazid process and were able to freely present their current concerns and perspectives on risks related to their daily work.

Conclusion:

Hazid is basically a meeting between competent workers who elaborate on their own risk picture. It is giving other types of information not gained through other often-used approaches. Specific risk factors can be described in real time as seen by people directly involved, thus circumventing the hierarchy in the organization. The process in itself can trigger improvement actions.

Application to practice:

Hazid can be used for presenting a valid risk picture as seen from below in the organization.
Metachronous neoplasms in patients with laterally spreading tumours during surveillance
Authors: Bogie Roel M. M. , Winkens Bjorn , Retra Sean J. J. , le Clercq Chantal M. C. , Bouwens Mariëlle W. , Rondagh Eveline J. A. , Chang Li‐Chun , de Ridder Rogier , Hoge Chantal , Straathof Jan‐Willem , Goudkade Danny , Sanduleanu‐Dascalescu Silvia , Masclee Ad A. M.
Published: November 2020

Background

Laterally spreading tumours represent a major challenge for endoscopic detection and resection.

Objective

To examine synchronous and metachronous neoplasms in patients with laterally spreading tumours.

Methods

We prospectively collected colonoscopy and histopathology data from patients who underwent colonoscopy in our centre at up to 6 years' follow‐up. Post‐resection surveillance outcomes between laterally spreading tumours, flat colorectal neoplasms 10 mm or greater, and large polypoid colorectal neoplasms, polypoid colorectal neoplasms 10 mm or greater, were compared.

Results

Between 2008 and 2012, 8120 patients underwent colonoscopy for symptoms (84.6%), screening (6.7%) or surveillance (8.7%). At baseline, 151 patients had adenomatous laterally spreading tumours and 566 patients had adenomatous large polypoid colorectal neoplasms. Laterally spreading tumour patients had more synchronous colorectal neoplasms than large polypoid colorectal neoplasm patients (mean 3.34 vs. 2.34, p < 0.001). Laterally spreading tumour patients significantly more often developed metachronous colorectal neoplasms (71.6% vs. 54.2%, p = 0.0498) and colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients (36.4% vs. 15.8%, p < 0.001). After correction for age and gender, laterally spreading tumour patients were more likely than large polypoid colorectal neoplasm patients to develop a colorectal neoplasm with high grade dysplasia or submucosal invasion (hazard ratio 2.9, 95% confidence interval 1.8–4.6). The risk of metachronous colorectal cancer was not significantly different in laterally spreading tumours compared to large polypoid colorectal neoplasm patients.

Conclusion

Patients with laterally spreading tumours developed more metachronous colorectal neoplasms with high grade dysplasia/submucosal invasion than large polypoid colorectal neoplasm patients. Based on these findings endoscopic treatment and surveillance recommendations for patients with laterally spreading tumours should be optimised.
Perceived impact on efficiency and safety of experienced American physician assistants/associates in acute hospital care in England: findings from a multi-site case organisational study
Authors: Drennan Vari M , Calestani Melania , Taylor Francesca , Halter Mary , Levenson Ros
Published: November 2020

Summary

Objectives

To investigate the contribution, efficiency and safety of experienced physician associates included in the staffing of medical/surgical teams in acute hospitals in England, including facilitating and hindering factors.

Design

Mixed methods longitudinal, multi-site evaluation of a two-year programme employing 27 American physician associates: interviews and documentary analysis.

Setting

Eight acute hospitals, England.

Participants

36 medical directors, consultants, junior doctors, nurses and manager, 198 documents.

Results

Over time, the experienced physician associates became viewed as a positive asset to medical and surgical teams, even in services where high levels of scepticism were initially expressed. Their positive contribution was described as bringing continuity to the medical/surgical team which benefited patients, consultants, doctors-in-training, nurses and the overall efficiency of the service. This is the first report of the positive impact that, including physician associates in medical/surgical teams, had on achieving safe working hours for doctors in training. Many reported the lack of physician associates regulation with attendant legislated authority to prescribe medicines and order ionising radiation was a hindrance in their deployment and employment. However, by the end of the programme, seven hospitals had published plans to increase the numbers of physician associates employed and host clinical placements for student physician associates.

Conclusions

The programme demonstrated the types of contributions the experienced physician associates made to patient experience, junior doctor experience and acute care services with medical workforce shortages. The General Medical Council will regulate the profession in the future. Robust quantitative research is now required.
Implementation of Modified Cardiovascular Health Awareness Program for Canadian Adults on a Waiting List for a Family Physician
Authors: Kaczorowski Janusz , Lussier Marie-Thérèse , Girard Magali , Beaulieu-Carbonneau Audrey
Published: November 2020

Introduction

The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular diseases (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary care. Centralized waiting lists and prioritization based on urgency of medical need were created to address this problem. We aimed to assess the acceptability, CVD risk profile, and potential benefits of offering a modified version of CHAP to adults on the waiting list.

Methods

The implementation was conducted in Laval (Canada) between March and June 2016, targeting individuals 40 years of age or older who were registered on the waiting list (GACO) and had a priority code of 3. Participants were invited through a personalized letter to attend sessions in community health centers. During the sessions, participants completed CVD risk profiles, risk of type 2 diabetes questionnaire (CANRISK); had their blood pressure, height and weight as well as waist circumference measured. They also received targeted healthy lifestyle and patient education materials and were referred to local programs including a medical follow-up, when required.

Results

A total of 1976 invitation letters were sent resulting in 281 (14.2%) participants. The average age of attendees was 58.1 (SD = 8.2) and a majority were female (58%, n = 163). A third of participants (34.2%, n = 96) had BP ≥140/90 and 11.4% (n = 32) were classified as having a very high risk for developing diabetes. Almost half (41.6%, n = 117) of participants were referred either to health promotion programs offered by local health authorities, to family physicians (4.6%, n = 13) or emergency departments (1.8%, n = 5) for short-term medical assistance.

Conclusion

Despite low participation rate, many adults on a waiting list had elevated risk for CVD and would greatly benefit from having a regular source of primary care.
Use of a Feedback Survey as a Part of a Wellness Champions Program to Improve Academic Faculty Satisfaction and Burnout: Implications for Burnout in Academic Health Centers
Authors: Locke Amy Beth , Fortenberry Katherine T , Sullivan Erika , Ose Dominik , Tingey Ben , Qeadan Fares , Henson Autumn , Van Hala Sonja
Published: November 2020

Background

Faculty and trainee well-being at academic medical centers is a nationwide concern. In response, the University of Utah Health created a system-wide provider wellness program that used individual faculty champions who were empowered to 1) examine the unique needs of their department or division using a lens of quality improvement, 2) design projects to address well-being, and 3) measure impact of projects addressing well-being. One team used a feedback tool to attempt to improve the well-being of Family Medicine faculty by better understanding challenges and developing a roadmap for action.

Objective

Evaluate the effectiveness of an anonymous feedback tool on faculty well-being.

Methods

The Division of Family Medicine developed and implemented a quarterly anonymous faculty survey to facilitate an ongoing improvement process for faculty wellness in 2016. The faculty survey identified thematic concerns, which were used to develop constructive solutions and systemic changes.

Results

A closed loop feedback structure provided rich faculty input into impacts on burnout and professional well-being. Sense of control (good to optimal) over workload among faculty increased significantly (p = 0.011) from 10% to 42% over one year exhibiting a large effect size (Cohen’s h = 0.751). Faculty burnout, using a single item emotional exhaustion question validated to the Maslach Burnout Inventory, was reduced from 48% to 25% showing a medium effect size (Cohen’s h = 0.490 with p = 0.097). Work related stress was reduced from 72% to 50% demonstrating clinical significance (Cohen’s h = 0.465) but not statistical significance (p = 0.154)—an effect which was more noticeable when comparing means between years (Cohen's d=0.451with p = 0.068). Response rate was 100% in 2016 (29/29) and 92% (23/25) in 2017.

Conclusion

This faculty survey, which has since been adopted by other groups at the University of Utah, could help improve well-being in a variety of health care professions.
Advancing Malaria Prevention and Control in Africa Through the Peace Corps-US President’s Malaria Initiative Partnership
Authors: Henderson Susan J , Belemvire Allison , Nelson Roman , Linn Anne , Moriarty Leah F , Brofsky Emma , Diaw Mamadou , Gittelman David
Published: November 2020

Background

Peace Corps is a US government volunteer service agency which provides trained Volunteers to assist host countries in addressing critical development challenges at the community level. The US President’s Malaria Initiative provides technical expertise and financial resources to reduce malaria morbidity and mortality in focus countries in sub-Saharan Africa.

Objective

We aim to describe the nature of the collaboration between Peace Corps and President’s Malaria Initiative (PMI) and highlight examples of the partnership in select countries.

Methods

We conducted an analysis of retrospective data obtained from Peace Corps and PMI for the years 2014–2019.

Results

Volunteers were able to learn about and work on malaria prevention and control with PMI in three key ways: a malaria-specific training program for staff and Volunteers; malaria-focused small grants; and extension of Volunteer assignments for a third year to support malaria projects. Successful Peace Corps projects supported by PMI, at the community level, were highlighted, with a focus on Rwanda, Benin, Zambia, Madagascar, and Senegal. In Fiscal Year 2019, 1408 Volunteers contributed to malaria prevention activities in 18 Peace Corps programs across Africa, of which 15 were PMI focus countries. While the majority of documented work by Volunteers has involved social and behavior change, there were many other ways to partner with PMI staff.

Conclusion

Each of the proven interventions that PMI supports for malaria prevention and control may have a role for Volunteer involvement. Combined with the technical expertise and the relationships that PMI staff have with national-level counterparts in PMI focus countries, the continued collaboration between Peace Corps and PMI can accelerate the fight against malaria.