bluuebunny/crossref_metadata_2025 huggingface dataset:
Left Cardiac Sympathetic Denervation Monotherapy in Patients With Congenital Long QT Syndrome
Authors: Niaz Talha , Bos J. Martijn , Sorensen Katrina B. , Moir Christopher , Ackerman Michael J.
Published: November 2020

Background:

Videoscopic left cardiac sympathetic denervation (LCSD) is an effective antifibrillatory, minimally invasive therapy for patients with potentially life-threatening arrhythmia syndromes like long QT syndrome (LQTS). Although initially used primarily for treatment intensification following documented LQTS-associated breakthrough cardiac events while on beta-blockers, LCSD as 1-time monotherapy for certain patients with LQTS requires further evaluation. We are presenting our early experience with LCSD monotherapy for carefully selected patients with LQTS.

Methods:

Among the 1400 patients evaluated and treated for LQTS, a retrospective review was performed on the 204 patients with LQTS who underwent LCSD at our institution since 2005 to identify the patients where the LCSD served as stand-alone, monotherapy. Clinical data on symptomatic status before diagnosis, clinical, and genetic diagnosis, and breakthrough cardiac events after diagnosis were analyzed to determine efficacy of LCSD monotherapy.

Result:

Overall, 64 of 204 patients (31%) were treated with LCSD alone (37 [58%] female, mean QTc 466±30 ms, 16 [25%] patients were symptomatic before diagnosis with a mean age at diagnosis 17.3±11.8 years, 5 had [8%] ≥1 breakthrough cardiac event after diagnosis, and mean age at LCSD was 21.1±11.4 years). The primary motivation for LCSD monotherapy was an unacceptable quality of life stemming from beta-blocker related side effects (ie, beta-blocker intolerance) in 56/64 patients (88%). The underlying LQTS genotype was LQT1 in 36 (56%) and LQT2 in 20 (31%). There were no significant LCSD-related surgical complications. With a mean follow-up of 2.7±2.4 years so far, only 3 patients have experienced a nonlethal, post-LCSD breakthrough cardiac event in 180 patient-years.

Conclusions:

LCSD may be a safe and effective stand-alone therapy for select patients who do not tolerate beta-blockers. However, LCSD is not curative and patient selection will be critical when potentially considering LCSD as monotherapy.
Pros and Cons of Left Bundle Branch Pacing
Authors: Ravi Venkatesh , Hanifin Jillian L. , Larsen Timothy , Huang Henry D. , Trohman Richard G. , Sharma Parikshit S.
Published: November 2020

Background:

Left bundle branch pacing (LBBP) has recently emerged as a promising alternative modality for conduction system pacing. However, limited real-world data exists on the advantages and complications associated with LBBP. We analyzed the Rush conduction system pacing registry on LBBP to assess the success rates and complications associated with LBBP.

Methods:

All patients with an indication for permanent pacemaker or cardiac resynchronization therapy that underwent LBBP for various reasons from June 2018 to April 2020 were included in the analysis.

Results:

A total of 57 of 59 patients underwent successful LBBP (success rate 97%). The average follow-up duration was 6.2±5 months. The implanted devices included 38 dual-chamber pacemakers, 17 cardiac resynchronization therapy defibrillators, and 2 cardiac resynchronization therapy pacing systems. The most common reason for performing LBBP was a high His-Bundle pacing threshold (n=23) at implant. The mean LBBP capture threshold at implant was 0.62±0.21 V at 0.4 ms which remained stable during follow-up at 0.65±0.68 V at 0.4ms. In 21 patients with cardiomyopathy, there was a significant improvement in left ventricle ejection fraction from 30±11% to 42±15%. A total of 7 lead-related complications (12.3%) were noted in the follow-up period. Three patients (5.3%) required lead revision during the follow-up period. Interventricular septal perforation occurred (as late sequela) after 2 weeks in one patient.

Conclusions:

LBBP can be achieved with a high success rate and low capture thresholds. Left ventricular dysfunction improved significantly during follow-up. Lead-related complications were relatively common occurring in 12.3% of initially successful implants. Lead revision was required in 3 (5%) of patients.
How Patients With Heart Failure Perform Daily Life Activities
Authors: Mapelli Massimo , Salvioni Elisabetta , Bonomi Alice , Gugliandolo Paola , De Martino Fabiana , Vignati Carlo , Berna Giovanni , Agostoni Piergiuseppe
Published: November 2020

Background:

Cardiopulmonary exercise test and 6-minute walking test are frequently used tools to evaluate physical performance in heart failure (HF), but they do neither represent activities of daily living (ADLs) nor fully reproduce patients’ symptoms. We assessed differences in task oxygen uptake, both as absolute value and as percentage of peak oxygen consumption (peakVO
2
), ventilation efficiency (VE/VCO
2
ratio), and dyspnea intensity (Borg scale) in HF and healthy subjects during standard ADLs and other common physical actions.

Methods:

Healthy and HF subjects (ejection fraction <45%, stable conditions) underwent cardiopulmonary exercise test. All of them, carrying a wearable metabolic cart, performed a 6-minute walking test, two 4-minute treadmill exercises (at 2 and 3 km/h), and ADLs: ADL1 (getting dressed), ADL2 (folding 8 towels), ADL3 (putting away 6 bottles), ADL4 (making a bed), ADL5 (sweeping the floor for 4 minutes), ADL6 (climbing 1 flight of stairs carrying a load).

Results:

Sixty patients with HF (age 65.2±12.1 years; ejection fraction 30.4±6.7%, peakVO
2
14.2±4.0 mL/[min·kg]) and 40 healthy volunteers (58.9±8.2 years, peakVO
2
28.1±7.4 mL/[min·kg]) were enrolled. For each exercise, patients showed higher VE/VCO
2
ratio, percentage of peakVO
2
, and Borg scale value than controls, while absolute values of task oxygen uptake and exercise duration were lower and higher, respectively, in all activities, except for treadmill (fixed execution time and intensity). Differently from Borg Scale data, metabolic values and exercise time length changed in parallel with HF severity, except for ADL duration in very short (ADL3) and composite (ADL1) activities. Borg scale values correlated with percentage of peakVO
2
.

Conclusions:

During ADLs, patients self-regulated activities in parallel with HF severity by decreasing intensity (VO
2
) and prolonging the effort.
Death of a Partner and Risks of Ischemic Stroke and Intracerebral Hemorrhage: A Nationwide Danish Matched Cohort Study
Authors: Fenger‐Grøn Morten , Paulsen Møller Ida , Schou Pedersen Henrik , Frost Lars , Sandbæk Annelli , Davydow Dimitry S. , Johnsen Søren P. , Vinter Nicklas
Published: November 2020

Background

Stress has been reported to trigger stroke, and the death of a loved one is a potentially extremely stressful experience. Yet, previous studies have yielded conflicting findings of whether bereavement is associated with stroke risk, possibly because of insufficient distinction between ischemic stroke (IS) and intracerebral hemorrhage (ICH). We therefore examined the associations between bereavement and IS and ICH separately in contemporary care settings using nationwide high‐quality register resources.

Methods and Results

The study cohort included all Danish individuals whose partner died between 2002 and 2016 and a reference group of cohabiting individuals matched 1:2 on sex, age, and calendar time. Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) and corresponding 95% CIs during up to 5 years follow‐up. During the study period, 278 758 individuals experienced partner bereavement, of whom 7684 had an IS within the subsequent 5 years (aHR, 1.11; CI, 1.08–1.14 when compared with nonbereaved referents) and 1139 experienced an ICH (aHR, 1.13; CI, 1.04–1.23). For ICH, the estimated association tended to be stronger within the initial 30 days after partner death (aHR, 1.66; CI, 1.06–2.61), especially in women (aHR, 1.99; CI, 1.06–3.75), but the statistical precision was low. In absolute numbers, the cumulative incidence of IS at 30 days was 0.73 per 1000 in bereaved individuals versus 0.63 in their referents, and the corresponding figures for ICH were 0.13 versus 0.08.

Conclusions

Statistically significant positive associations with partner bereavement were documented for both IS and ICH risk, for ICH particularly in the short term. However, absolute risk differences were small.
From Online Gathering to Collective Action at the Criminal Court
Authors: Le Bail Hélène , Chuang (莊雅涵) Ya-Han
Published: November 2020

Since 2010, Chinese residents and Chinese French citizens have denounced unequal treatment in French society, especially focusing on the lack of preventative measures taken against racially targeted violent robberies. In 2016, a major demonstration brought together around 30,000 people, marking a turning point in the activists’ cause. The second generation took a clearly more active role in this protest and (re)framed the demonstrators’ claims to emphasize the structural racism that lies behind the violence aimed at their communities. Since then, the descendants of Asian migrants have developed initiatives to fight against stereotypes and related acts of violence. Based on qualitative research into different forms of collective action, this article highlights how some have engaged in online campaigns to highlight the stereotypes and everyday racism associated with Asian populations, and others have engaged with the legal process to see that petty crimes are recognized as acts of racism.
Chaplaincy as a Reframing and Expansion of Youth Ministry – Initiating and Developing an Occupational Standards Ecumenical Project in the UK for Chaplaincy with Ages 5–25
Authors: Nash Sally , Nash Paul , Roberts Nigel
Published: November 2020

Sometimes churches and Christian groups encounter scepticism or even hostility when they seek to engage with children, young people or young adults (cypya) within their community and have sought models and approaches that would be both accepted and understood. Chaplaincy is one way that some have sought to reframe mission and ministry. Chaplaincy is a distinctive ministry with a long history across many sectors but with no common core understanding. The Centre for Chaplaincy with Children and Young People embarked on a project to develop occupational standards for chaplaincy with cypya through convening a group consisting of chaplaincy leaders from denominations and organizations. The reason for developing occupational standards is to address issues of definition, credibility, measurement, accountability, training, development and audit framework. This article describes the process, underpinning values and theology and presents the twelve standards.
Freire’s Christian Pedagogy in the Professional Narrative of UK Youth Work
Authors: Clyne Allan Robertson
Published: November 2020

This article celebrates the 50th anniversary of Paulo Freire’s Pedagogy of the Oppressed. It responds to the current youth work environment within the UK by examining the differing attitudes and treatment of Freire and his pedagogy within this melded arena. It reveals youth ministry’s and Christian faith-based youth work’s limited engagement with Freire and explains the secularisation of his ideas within the wider youth work field, how they were isolated from his faith, subjugated to the work of Carl Rogers and latterly rebranded as secular Marxist. In contrast, this piece suggests that Paulo Freire’s work should be recognised as a pedagogy drawn from his Christian faith. It concludes by relating his work to Liberation Theology and introduces an interpretation of conscientização as a Christian pedagogy. While Anglo-centric it aims to motivate a discussion amongst Christian faith-based youth workers around the globe, particularly those who contend with the secularisation of Freire’s work.
Coating of Epimedii Folium Water Extract onto TiO2 Nanotube Surfaces Promotes Differentiation and Proliferation of Osteoblasts
Authors: Wu Fengfeng , Xu Juntao , Jin Mingchao , Jiang Xuesheng , Xu Yan , Li Jianyou , Li Xiongfeng , Nie Jiangbo , Yan Shigui , Wang Guorong
Published: November 2020

The surface modification of titanium is effective in promoting osseointegration and is widely used in the treatment of bone diseases. Epimedii Folium (EF) plays an important role in the treatment of metabolic bone diseases. However, few studies have so far been reported on their
combined use in such treatments. In the present study, EF water extract was coated onto the surface of TiO2 nanotubes (TNT) by electrochemical anodization to obtain EF-TNT. Through analysis of surface morphology characteristics, it was demonstrated that EF was successfully coated
on the surface of TiO2 nanotubes. In vitro drug release data suggested that the quantity of EF water extract released was a significant quantity over 4 days, reaching a total of 80%, the release continuing in total for approximately 2 weeks. By using scanning electron microscopy
and immunofluorescent staining, it was found that, EF-TNT more strongly promoted adhesion, proliferation, and differentiation of MC3T3-E1 osteoblasts compared with Ti and TNT. Quantitative reverse transcript polymerase chain reaction (qRT-PCR) analysis indicated that the expression of key
genes for proliferation and differentiation of osteoblasts, such as COL1a1, ALP, OPN, and Runx2, were up-regulated by EF-TNT. Network pharmacology analysis suggested that EF water extract not only regulated the proliferation and differentiation of osteoblasts but
also caused a regulatory effect on osteoclasts via multiple signaling pathways, such as RANKL-RANK-induced signaling and TGF-β signaling. These findings indicate that the EF-TNT promotes differentiation and proliferation of osteoblasts, and represents considerable potential for
use in clinical applications.
Book review: Sheldon Pollock and Benjamin Elman (Eds.): What China and India Once Were: The Pasts That may Shape the Global Future
Authors: Bhoothalingam Ravi
Published: November 2020

Sheldon Pollock and Benjamin Elman (Eds.): What China and India Once Were: The Pasts That may Shape the Global Future; (Penguin Random House India, 2018); pp. 365, hardcover. ISBN 978-06-70091-34-8, Price: ₹799.
Hot under the collar: A latent measure of interstate hostility
Authors: Terechshenko Zhanna
Published: November 2020

The majority of studies on international conflict escalation use a variety of measures of hostility including the use of force, reciprocity, and the number of fatalities. The use of different measures, however, leads to different empirical results and creates difficulties when testing existing theories of interstate conflict. Furthermore, hostility measures currently used in the conflict literature are ill suited to the task of identifying consistent predictors of international conflict escalation. This article presents a new dyadic latent measure of interstate hostility, created using a Bayesian item-response theory model and conflict data from the Militarized Interstate Dispute (MID) and Phoenix political event datasets. This model (1) provides a more granular, conceptually precise, and validated measure of hostility, which incorporates the uncertainty inherent in the latent variable; and (2) solves the problem of temporal variation in event data using a varying-intercept structure and human-coded data as a benchmark against which biases in machine-coded data are corrected. In addition, this measurement model allows for the systematic evaluation of how existing measures relate to the construct of hostility. The presented model will therefore enhance the ability of researchers to understand factors affecting conflict dynamics, including escalation and de-escalation processes.
Histories of transport and communication in South Asia: A first review
Authors: Sinha Nitin
Published: November 2020

History of transport and communication has surely entered an exciting phase of research in South Asia. The authors of the select titles as well as others working on related fields have been exploring different facets of, what could broadly be labelled as, “transport and communication” history of South Asia. This review article looks at some of the recent writings in the fields of technology, transport, and railways to map the newness in South Asia's transport history. While doing this, it also suggests some possible future areas of research, which will surely build upon these insightful works. In particular, this review essay covers the themes of technology and its scale, questions related to modernity, and imperialism. It makes a plea for going beyond “railway-centrism” towards exploring the intersectional fields of infrastructural histories.
Why smallholder farms’ practices are already agroecological despite conventional agriculture applied on market-gardening
Authors: Razanakoto Onjaherilanto R , Raharimalala Sitrakiniaina , Sarobidy Eddy J Randriamihary Fetra , Rakotondravelo Jean-Chrysostome , Autfray Patrice , Razafimahatratra Hanitriniaina M
Published: November 2020

According to experts, agroecology gathers agricultural practices that improve resource efficiency, that strengthen resilience and that secure social equity and responsibility. The diffusion of this set of principles may innovate in most developed countries where conventional agriculture is widespread but may be questionable by agrarian society of sub-Saharan African country like Madagascar. The Itasy Region has developed there vegetable crops for marketing purpose. Part of the Itasy agricultural practices may be assimilated to conventional ones, justifying research and development action dedicated to the promotion of agroecology. However, a question arises: Are farmers who benefit from conventional agriculture interested in reducing chemical input to meet major principles of agroecology? A research project called SECuRE has deliberately chosen the peri-urban area of Itasy to perform a survey to 171 households that are representative of smallholder farms inside two Communes of Arivonimamo, a District of Itasy. This paper aims to assess how far agroecological practices may be integrated or intensified in their farming systems despite a long-term effect of conventional agriculture. As major results, among smallholder farms’ strategy, use of fertilizer is determining agricultural income. Organic fertilizer application is mandatory for almost all the diversified crops whereas mineral fertilizer secures global agricultural margins by smallholder farms. Organic fertilizer sources are managed at farming system scale by associating livestock and by using crop residue to limit as possible export of nutrients on soil by crops. This strategy includes the territorial management of fertility from extended grassland that remains for common use. Finally, whatever the training they may have attended or inherited from parents, farmers grow-up in experience and improve agricultural practice in long term. This study concludes that market-gardening in Itasy mobilizes reduced chemical input at farm scale. Agroecology is quite widespread there according to most of the principles advanced by experts.
Is Liberal Socialism Possible? Reflections on “Real Utopias”
Authors: Katznelson Ira
Published: November 2020

This essay, written in memory of Erik Olin Wright (1947–2019), explores the possibility of liberal socialism. Wright sought to rescue both liberalism and socialism from their demonstrated capacity for depredation. His legacy challenges reformers to proceed with the audacity of real, and realistic, utopianism together with an awareness that, unfortunately, the obverse of an appealing utopianism always beckons.
Is Electronic Multitasking Always Viewed as a Counterproductive Meeting Behavior? Understanding the Nature of the Secondary Task
Authors: De Bruin Rushika , Barber Larissa K.
Published: November 2020

This project explored social evaluations of electronic multitasking during work meetings, including factors that may affect whether it is seen as a counterproductive meeting behavior. We used an experimental vignette design to test whether social evaluations (norm violating, agency, and communalism) of a hypothetical coworker’s electronic multitasking differed by whether the secondary task was relevant to the meeting (Study 1; N = 274) or ambiguous (Study 2; N = 188). Observers evaluated task-irrelevant multitasking as more of a norm violation and less communal compared to task-relevant multitasking, and work-related tasks were evaluated as more agentic than nonwork-related tasks. Ambiguous tasks were also rated as more agentic than task-irrelevant multitasking. Taken together, our results show that the nature of the secondary task reduces negative perceptions of coworkers’ electronic multitasking behavior during meetings. However, electronic multitasking for any purpose, even if relevant, was generally judged negatively consistent with expectations for a counterproductive meeting behavior.
Avoiders and Embracers: Attitudes towards L1 Use by Indonesian EFL Student Teachers
Authors: Werang Elisabet Andriyanti , Harrington Michael
Published: November 2020

This study compares the attitudes of Indonesian student teachers to the use of Bahasa Indonesia (BI) in primary and secondary school English classrooms to that of the instructors in their teacher training programmes. It also examines the metacognitive orientations the student teachers have towards its use in their future teaching. Questionnaire responses by student teachers finishing their final-year practicum (N=75) from seven university programmes showed two distinct attitude sets toward BI use. Approximately 40% were ‘Avoiders’ who intended to use BI never or only occasionally, while another 20% were ‘Embracers’ who intended to use it regularly or often. There was a demonstrable relationship between the intended use and the practice and attitudes of the instructors the students had in the teacher training programme. Avoiders were more likely to have programme teachers who avoided BI use, while Embracers were the opposite. The student teachers also displayed a strong sense of agency in approaching future BI use. Although more explicit attention to the topic in the teacher training curriculum was welcomed, the majority also felt confident they could deal on their own with the challenges presented by future BI use. Potential effects on responses of practicum class size and school level were examined, but neither was significant. An important finding from the study for teacher training programmes is the effect, intentional or incidental, that teacher educator behaviour may play in shaping student teacher attitudes.
Writing Class In and Out: Constructions of Class in Elite Businesswomen’s Autobiographies
Authors: Adamson Maria , Johansson Marjana
Published: November 2020

This article explores how meanings of class are constructed in elite businesswomen’s autobiographies. It extends existing sociological studies of elites in two ways. First, by theorising the cultural mechanisms that contribute to the reproduction of business elites, and second, by examining the hitherto under-researched gendered aspects of the reproduction of business elites, and the legitimisation of wealth. We show how these autobiographical texts acknowledge class yet render it irrelevant through discursive repertoires of ordinariness, a universal gender struggle and the unimportance of wealth. We argue that in doing so the genre of elite businesswomen autobiographies contributes to the cultural erasure of class, perpetuating messages that contribute to the creation of a cultural milieu in which class and wealth inequalities remain unquestioned. In an economic context where social disparities continue to grow, the article importantly furthers our understanding of the cultural means by which a plutocratic elite holds on to power.
Efficacy and Complications of Microsurgical Neurovascular Decompression in 55 Patients With Hemifacial Spasm
Authors: Compagnon Chloé , Labrousse Marc , Brenet Esteban , Chays André , Bazin Arnaud , Kleiber Jean‐Charles , Dubernard Xavier
Published: November 2020

Objective

To analyze the efficacy and complications of microvascular decompression for hemifacial spasm.

Study Design

Retrospective study.

Setting

Regional hospital.

Methods

Fifty‐five patients with hemifacial spasm were treated by microvascular decompression. All patients with hemifacial spasm who underwent retrosigmoid microvascular decompression from May 2004 to January 2017 were included. Patients with no conflict on preoperative magnetic resonance imaging or with an alternate diagnosis were excluded.

Results

The overall cure rate was 83.64%, with an average follow‐up of 7.4 years. A left‐sided hemifacial spasm was a healing‐promoting factor (P =. 01). The median healing was 0.03 months, and the mean was 6 months. The efficacy remained high in the medium term (88% at 3 years), long term (90.24% at 5 years), and very long term (90.48% at 8 years). The recurrence rate was 9.8%. Favorable criteria included a right‐sided spasm (P =. 01) and an average age of 62 years (P =. 03). The specific complications were permanent facial palsy (3.63%), unilateral deafness (5.45%), and hearing loss (3.63%). No death was reported. Regarding the quality of life of the patients, 94.7% had a modified HFS‐8 postoperative score of 0 (Hemifacial Spasm 8 Quality of Life Scale).

Conclusion

Microvascular decompression for hemifacial spasm is an effective and lasting technique. Its low rate of complications and the considerable quality‐of‐life improvement should lead surgeons to propose it to patients as soon as botulinum toxin injections become ineffective or poorly tolerated.
One-year experience of bedside percutaneous VA-ECMO decannulation in a high-ECMO-volume center in Hong Kong
Authors: Au Shek-Yin , Chan Kwong-Shun , Fong Ka-Man , Leung Pui-Wah Rowlina , Ng Wing-Yiu George , So Sheung-On , Leung Kit-Hung Anne
Published: November 2020

Background:

When veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support can be terminated, open repair of arteriotomy wounds in operating theaters is the standard of practice. Comparable outcomes by percutaneous decannulation using different closure devices have been reported. However, transport of the critically- ill, man-power and timeslots of operating theaters could be saved if decannulation was performed at bedside.

Method:

Bedside percutaneous arteriotomy wound closure became our default method of decannulation since November 2018. We reviewed our 1-year data to evaluate if such practice could be safely adopted in a local high-ECMO-volume center.

Results:

Between November 2018 and October 2019, 25 patients had their VA-ECMO terminated at the bedside. Twenty-one patients (84%) had successful decannulation. For those who failed, emergency open repair resulted in no additional complications. Two ProGlide devices were used in 15 (71.4%) patients and three were used in 6 (28.6%) patients. The procedure time was 27 (15–45) min. The median blood loss was 300 mL (250–400). Minor complications were found in 4 (19.1%) patients, including two arterial clot formation, one pseudoaneurysm and one wound infection. There were no other major complications.

Conclusion:

Our 1-year experience showed that percutaneous bedside VA-ECMO decannulation was feasible to commence in a local large-ECMO-volume center.
What drives news sharing behaviour among social media users? A relational communication model from the social capital perspective
Authors: Apuke Oberiri Destiny , Omar Bahiyah
Published: November 2020

This study modelled the online environmental factors that drive news sharing behaviour, using social capital theory (SCT). An online survey was used to obtain data from 385 WhatsApp users in Nigeria, analysed with structural equation modelling-partial least squares (PLS). The study’s results suggest that social interaction ties, sense of belonging, reciprocity, homophily and trust positively predict news sharing behaviour. Specifically, social interaction ties was the strongest predictor of news sharing behaviour followed by sense of belonging and reciprocity. This study also found a positive association between age and news sharing and a non-significant association with gender. Hence, news sharing should also be viewed as a form of social cohesion from the relational communication perspective. This study has some interesting implications for theoretical advancement. Firstly, it extends the motivations for news sharing beyond the predominant personal motivations highlighted in the literature. Secondly, it contributes to social capital theory by incorporating homophily to form the cognitive aspect of social capital. Thirdly, it extends the application of SCT to comprehend news sharing behaviour on social media platforms (SMPs). Finally, it explores news sharing behaviour beyond the predominant Asian, European and US contexts.
“Hanging in a balance”: A qualitative study exploring clinicians’ experiences of providing care at the end of life in the burn unit
Authors: Bayuo Jonathan , Bristowe Katherine , Harding Richard , Agbeko Anita Eseenam , Wong Frances Kam Yuet , Agyei Frank Bediako , Allotey Gabriel , Baffour Prince Kyei , Agbenorku Pius , Hoyte-Williams Paa Ekow , Agambire Ramatu
Published: November 2020

Background:

Although the culture in burns/critical care units is gradually evolving to support the delivery of palliative/end of life care, how clinicians experience the end of life phase in the burn unit remains minimally explored with a general lack of guidelines to support them.

Aim:

To explore the end of life care experiences of burn care staff and ascertain how their experiences can facilitate the development of clinical guidelines.

Design:

Interpretive-descriptive qualitative approach with a sequential two phased multiple data collection strategies was employed (face to face semi-structured in-depth interviews and follow-up consultative meeting). Thematic analysis was used to analyze the data.

Setting/participants:

The study was undertaken in a large teaching hospital in Ghana. Twenty burn care staff who had a minimum of 6 months working experience completed the interviews and 22 practitioners participated in the consultative meeting.

Results:

Experiences of burn care staff are complex with four themes emerging: (1) evaluating injury severity and prognostication, (2) nature of existing system of care, (3) perceived patient needs, and (4) considerations for palliative care in burns. Guidelines in this regard should focus on facilitating communication between the patient and family and staff, holistic symptom management at the end of life, and post-bereavement support for family members and burn care practitioners.

Conclusions:

The end of life period in the burn unit is poorly defined coupled with prognostic uncertainty. Collaborative model of practice and further training are required to support the integration of palliative care in the burn unit.
Knowledge as Determinant of Healthy-Eating Among Male Postgraduate Public Health Students in a Nigerian Tertiary Institution
Authors: Dada Samuel Oluwasogo , Oyewole Oyediran Emmanuel , Desmennu Adeyimika Titilayo
Published: November 2020

Unhealthy eating, which is quite prevalent among the adult population globally, is a major risk factor for Non-Communicable Diseases. Men have the tendency to visit food vendors without recourse to body nutrients requirement, health and expectations as potential change agents. The study was thus designed to investigate the knowledge and practices of healthy eating among male public health students in a Nigerian tertiary institution. Data was collected from 161 consenting respondents. Knowledge of healthy eating was assessed on a 25-point knowledge scale; score ≥19 was rated good, <19≥12 fair and <12 poor. Practices of healthy eating were assessed using a 34-point practice scale; score ≥26 was rated good and <26 poor. Patterns of eating was determined using food frequency questionnaire; descriptive and inferential statistics were carried out at α=0.05. Respondents’ age was 28.9 ± 5.5 years; they were mostly Christian (87.0%), Yoruba (69.6%) and 21.1% were married. Their body mass index was 23.1 ± 3.1kg/m2, monthly income ranged between N5000 and N300,000, 2.5% smoked tobacco/cigarette and 28.0% consumed alcohol. Good knowledge was observed among 52.2% of the respondents, 37.9% had good healthy eating practices, 49.7% did not eat breakfast everyday while only 13.7% consumed fruits and vegetables daily. The most reported factors influencing choice of food included health maintenance and food availability. Respondents’ knowledge and practices relating to healthy eating was significant. Knowledge of healthy eating was average and practice was poor among the study population. Strategic health education and behaviour change communication could motivate male students for healthy eating.
Health Literacy in Korean Adults and Korean American Immigrants: Implications for Achieving Health Equity
Authors: Chung Soondool , Lee Hee Yun , Lee Miwoo , Chung Semi
Published: November 2020

Health literacy is necessary to understand health information and make appropriate decisions regarding one’s health. This study aims to investigate (1) the health literacy level of Korean citizens and Korean American (KA) immigrants in the United States and (2) factors that influence health literacy across three age groups. A quota sampling method was used to collect cross-sectional survey data from 404 Korean participants and 404 KA immigrants. Andersen’s behavioral model was used as the theoretical framework for this study. Overall, Korean participants had a higher mean score on health literacy than did the KA immigrants. Only one of predisposing and enabling factors were significant variables influencing health literacy in KA immigrants, while several predisposing, enabling and need factors were significantly associated with health literacy in Korean adults. Our findings indicate that both countries need to have a community-based health literacy educational program that is tailored to each age group.
Ideas and Ideals of Asceticism in the Buddhacarita of Aśvaghoṣa
Authors: Sharma Gaurav
Published: November 2020

This article explores the ideas and ideals of asceticism by analysing the description of the ascetic practices and the āśrama in the Budhhacarita of Aśvaghoṣa. Although kāvya literature paints vivid pictures in front of our eyes and can give us valuable historical information, usually scholars and historians undermine its potential as a source to study the past. The kāvyas are vibrant than usually thought about and gives more chance and content to a historian to analyse and contextualise. The Buddhacarita of Aśvaghoṣa is an earliest extant kāvya work and a testimony of the fact that literature allows a poet to describe, comment, mock and sometimes reflect over the ideas and ideals of the society which he lives in. Through a very compelling narrative, Aśvaghoṣa presents the story of Sarvārthasiddha’s journey to enlightenment and his first-hand experience of what ascetic resolves are, how ascetics live, what are their goals and aspirations and finally the realisation that this old treaded path is not going to help him. The article analyses Sarvārthasiddha’s search for true recluse and tries to understand dialogues, dissensions, confluences and dichotomies between Buddhism and Brahmanism as portrayed by Aśvaghoṣa. Asceticism is a fascinating theme to explore and the story of the Buddhacarita of Aśvaghoṣa makes it more animated and alive.
The Effect of Calcium Supplementation on Body Weight Before and During Pregnancy in Women Enrolled in the WHO Calcium and Preeclampsia Trial
Authors: Cormick Gabriela , Betrán Ana Pilar , Harbron Janetta , Seuc Armando , White Cintia , Roberts James M. , Belizán Jose M. , Hofmeyr G. Justus
Published: November 2020

Introduction:

Obesity is a major and challenging public health problem. The aim of this substudy is to evaluate the effect of calcium supplementation on body weight in women recruited in the Calcium and Preeclampsia trial.

Methods:

Women were recruited before pregnancy and randomized to receive a calcium supplement containing 500 mg of elemental calcium or placebo until 20 weeks’ gestation; all women received 1.5 g from 20 weeks until delivery.

Results:

A total of 630 women conceived during the study, 322 allocated to calcium and 308 to placebo. Among these, 230 allocated to calcium and 227 allocated to placebo had information on body weight at baseline and at 8 weeks' gestation. During the study period, women allocated to calcium had a mean weight increase of 1.1 (SD ±5.5) kg, whereas those allocated to placebo had a mean increase of 1.5 (SD ±6.1) kg, a mean difference of 0.4 kg (95% −0.4 (−1.4 to 0.6); P = .408). Women classified as obese at the start of the trial had a lower body weight gain at 8 weeks’ gestation (1.0 kg; 95% CI: −3.2 to 1.2; P = .330) and at 32 weeks’ gestation (2.1 kg; 95% CI: 5.6-1.3; P = .225) if they received calcium as compared to placebo. However, none of these differences were statistically significant.

Conclusion:

The smaller increase in body weight found in women supplemented with 500 mg elemental calcium daily is quantitatively consistent with previous studies. However, in this study, the difference was not statistically significant.
The Impact of Small Regional Economic Development Commissions: Is There Any Bang After Just a Few Bucks?
Authors: Morin Tyler , Partridge Mark
Published: November 2020

Despite substantial funding going to regional economic development programs, little is known about the benefits of some of the smaller, place-based programs. The authors extend the literature on regional commissions by analyzing the economic gains to the Delta Regional Authority (DRA). The DRA was founded in 2000 to provide enhanced development aid to 252 lower Mississippi Valley counties. Using data from 1997 to 2016, the authors assess the DRA’s impact on employment, income, migration, and poverty. One-to-one propensity score matching is used to generate counterfactual counties. Because of the endogenous nature of the treatment, the authors instrument for counties being included in the DRA using a dummy for whether the county is within the lower Mississippi watershed. The ensuing results reflect an estimation of the intent-to-treat benefits of the DRA. The authors find that the DRA is associated with income gains and decreases in unemployment; however, it has no impact on poverty or migration.
An adaptive parameters adjustment and planning method for robotic belt grinding using modified quality model
Authors: Chen Bing , Qi Junde , Zhang Dinghua
Published: November 2020

As a kind of ﬂexible manufacturing system, the machining quality of a robotic belt grinding system is related to a variety of factors with strong time variation, which easily leads to process fluctuations and affects the final quality. Therefore, it is a great challenge to control the quality precisely during the whole grinding procedure. Focusing on this problem, an adaptive parameters adjustment and planning method for robotic belt grinding using the modified quality model is proposed in this paper. Firstly, the correlation analysis method of grinding parameters in time domain is presented based on an improved-Mahalanobis distance. The response surface methodology (RSM) is utilized to construct the quality prediction model, and furtherly the parameter sensitivity function, which can characterize the influence degree of different parameters on the grinding quality, is introduced to calculate the Mahalanobis distance for improving the accuracy of the correlation analysis method. Secondly, based on the correlation analysis, a conversion method from the old samples into the new samples space is presented using vector field smoothing algorithm (VFS), then the modified grinding quality model can be re-established adopting the new samples. Furtherly, taking the problem of poor robotic response rate into consideration, a multi-parameters collaborative planning method under the smoothness constraint is developed using particle swarm optimization (PSO) algorithm, which can avoid the parameter mutation and improve the process stability. Finally, belt grinding experiments on a curved surface were carried out based on the robotic grinding platform. The results show that the approach can improve the grinding shape accuracy, which verify the effectiveness of the proposed methods.
Prediction models for specific energy consumption of machine tools and surface roughness based on cutting parameters and tool wear
Authors: Su Yu , Li Congbo , Zhao Guoyong , Li Chunxiao , Zhao Guangxi
Published: November 2020

The specific energy consumption of machine tools and surface roughness are important indicators for evaluating energy consumption and surface quality in processing. Accurate prediction of them is the basis for realizing processing optimization. Although tool wear is inevitable, the effect of tool wear was seldom considered in the previous prediction models for specific energy consumption of machine tools and surface roughness. In this paper, the prediction models for specific energy consumption of machine tools and surface roughness considering tool wear evolution were developed. The cutting depth, feed rate, spindle speed, and tool flank wear were featured as input variables, and the orthogonal experimental results were used as training points to establish the prediction models based on support vector regression (SVR) algorithm. The proposed models were verified with wet turning AISI 1045 steel experiments. The experimental results indicated that the improved models based on cutting parameters and tool wear have higher prediction accuracy than the prediction models only considering cutting parameters. As such, the proposed models can be significant supplements to the existing specific energy consumption of machine tools and surface roughness modeling, and may provide useful guides on the formulation of cutting parameters.
Mission reliability-oriented integrated scheduling optimization model by combining production planning and maintenance activities
Authors: Gu Changchao , He Yihai , Chen Zhaoxiang , Han Xiao , Zhou Di , Zhang Anqi
Published: November 2020

Machine utilization and production efficiency of manufacturing systems can be effectively improved through reasonable production scheduling. Traditionally, production scheduling and maintenance planning are considered as two independent issues, but it may lead to a suboptimal solution that is unable to maximize the productivity of the manufacturing system. Therefore, a mission reliability-oriented integrated scheduling model that considers production planning and maintenance activities is proposed. Firstly, the mission reliability that takes into account product type and equipment performance is defined to characterize production rhythm. Secondly, the maintenance strategy based on machine degradation cumulative failure and stochastic failure is proposed to guarantee the mission reliability of the machine effectively. Thirdly, an integrated scheduling model is established with the goal of minimizing total operational time, and Genetic algorithm is tailored to find the best production scheduling plan. Finally, a case study and comparative study of the cylinder head manufacturing system are presented to demonstrate the effectiveness of the proposed method. Results show that the proposed method is more suitable for production practice than the previous production scheduling strategy.
The ultra-high efficiency gas turbine engine, UHEGT, Part II: A numerical study on reducing the stator blade surface temperature by indexing fuel injectors and using film cooling
Authors: Ghoreyshi Seyed M , Schobeiri Meinhard T
Published: November 2020

In the Ultra-High Efficiency Gas Turbine Engine, UHEGT (introduced in our previous studies) the combustion process is no longer contained in isolation between the compressor and turbine, rather distributed within the axial gaps before each stator row. This technology substantially increases the thermal efficiency of the engine cycle to above 45%, increases power output, and reduces turbine inlet temperature. Since the combustion process is brought into the turbine stages in UHEGT, the stator blades are exposed to high-temperature gases and can be overheated. To address this issue and reduce the temperature on the stator blade surface, two different approaches are investigated in this paper. The first is indexing (clocking) of the fuel injectors (cylindrical tubes extended from hub to shroud), in which the positions of the injectors are adjusted relative to each other and the stator blades. The second is film cooling, in which cooling holes are placed on the blade surface to bring down the temperature via coolant injection. Four configurations are designed and studied via computational fluid dynamics (CFD) to evaluate the effectiveness of the two approaches. Stator blade surface temperature (as the main objective function) along with other performance parameters such as temperature non-uniformity at rotor inlet, total pressure loss over the injectors, and total power production by rotor are evaluated for all configurations. The results show that indexing presents the most promising approach in reducing the stator blade surface temperature while producing the least amount of total pressure loss.
Adaptive nonlinear observer–based sliding mode control of robotic manipulator for handling an unknown payload
Authors: Li Guiying , Wang Shuyang , Yu Zhigang
Published: November 2020

This article presents the control synthesis of robotic manipulators with an unknown constant payload. A novel nonlinear disturbance observer with an adaptive scheme is designed to estimate the external force induced by the unknown constant payload. A general design procedure for designing the gain of the nonlinear observer is developed rather than the time-consuming trials and error to choose proper gain. The nonlinear observer gain is designed using an adaptive technique to extend the applicability of the disturbance observer. The stability of the proposed observer is established using Lyapunov method under certain conditions. The proposed nonlinear disturbance observer will be integrated with the sliding mode control to substantially alleviate the chattering problem. Also, simulation results are presented to verify the effectiveness of the proposed methods.
Experiential Learning in the Large Classroom Using Performative Pedagogy
Authors: Donovan Paul , Hood Alison
Published: November 2020

Experiential learning (EL) is widely believed to lead to enhanced student engagement. This form of learning, however, may be difficult to implement in the large class sizes so common today. This case study describes an initiative involving performative pedagogy using interdisciplinary teaching and learning in an undergraduate class of 150 students from a change management module in the School of Business and an ensemble performance module in the Music Department in an Irish University. The students utilized acting, music, dance, and role-play in a large enrolment setting. Postprogram surveys and focus group interviews of students found that students responded positively to the initiative. Students also rated the class as more engaging than other subjects in which they were registered. Reflective essays written by students showed evidence of deep reflection and learning and these formed the basis for our discussion of the implications of this approach for management education. Future research should examine the effects of performative learning on student performance in terminal examinations.