bluuebunny/crossref_metadata_2025 huggingface dataset:
Entropy generation on EMHD Darcy-Forchheimer flow of Carreau hybrid nanofluid over a permeable rotating disk with radiation and heat generation: Homotopy perturbation solution
Authors: Ramasekhar Gunisetty , Reddy P. Bala Anki
Published: August 2022

The intention of this article is to explore the entropy generation of the Carreau hybrid nanofluid in a permeable rotating disk in the presence of thermal radiation, heat generation, and viscous dissipation. By applying the self-similarity variables, the partial differential equations are converted into ordinary differential equations and then the homotopy perturbation method is performed. Graphene oxide (Go) and Silver (Ag) are nanoparticles and kerosene oil as a base fluid is considered. Compared to the numerical technique (Runge-Kutta method), the homotopy perturbation method generates more precise and dependable results. The influence of sundry parameters is exhibited graphically for velocity, temperature, entropy generation, Bejan number, skin friction coefficient, and Nusselt number. The higher values of the Weissenberg number enhance the velocity profile and the opposite nature is observed in the porosity parameter. The entropy generation increases for larger values of the thermal radiation and electric field parameters. Carreau nanofluid expands under higher stress on the surface of the wall than Newtonian fluid. This type of problem would be used for electric devices and solar thermal systems. Moreover, the selected nanoparticles Graphene oxide and Silver play an important role in the biofunctionalization of protein, antibacterial, and anticancer therapy.
Unleashing the mechanism between technological and behavioural aspects of green supply chain management: An environmental sustainability agenda
Authors: Xiao Yuanzhi , Sun Ruiqi , Gao Ke
Published: August 2022

As a result of emerging climate change trends, businesses and organizations are becoming more concerned about environmental sustainability. In this context, green supply chain management (GSCM) approaches are expanding globally. Based on institutional and sociotechnical systems theory, the conceptual model of this research highlights a mediation of two GSCM types, namely technological and behavioral practices, as well as the moderation of organizational pressure on institutional performance. The hypotheses were evaluated using the structural equation modeling (SEM) method, obtaining data from 563 Chinese firms. This study's categorization of technological and behavioral GSCM practices and results add to the literature on GSCM. The empirical findings indicate that the technological GSCM practices considerably affect behavioral practices. Moreover, GSCM technological and behavioral practices have a substantial effect on institutional performance. GSCM behavioral practices mediate the link between technological GSCM practices and institutional performance. The outcomes also reveal that organizational pressure moderates the association between GSCM technological GSCM practices and institutional performance. These results show that companies in emerging economies should prioritize the behavioral GSCM practices to successfully apply the technological GSCM practices to achieve compelling financial, social, and environmental performance.
Effect of evidence-based information management and practice training on librarians’ critical thinking: A randomized educational trial
Authors: Esmaeilzad Sima , Gavgani Vahideh Zarea , Zarei Atefeh , Familrouhany Seyed Ali Akbar
Published: August 2022

Critical thinking is one of the most important elements in making the right decision in every profession. Evidence based practice shows potential to empower the critical thinking skills of practitioners. The aim of this study was to determine the effect of evidence-based information management and practice (EBIMP) training course on the promotion of medical librarians’ critical thinking. This study is a randomized double-blind educational trial in the form of a parallel trial. A sample of 60 librarians were recruited nationwide in the study through the volunteer enrollment to the evidence-based information management and practice training course. Intervention group received a 10-module virtual course focusing on evidence-based information management. But the control group received a basic course of evidence-based medicine. The courses were delivered through virtual learning system and data was collected through California Standard Critical Thinking Skills Questionnaire Form B (CCTST). Data were analyzed with Covariance Analysis (ANCOVA), Chi-square (χ²), Kolmogorov-Smirnov and Levin tests, and t-test, using SPSS 25. The findings showed that the critical thinking skills of participants after training of the information management and evidence-based practice (EBIMP) had significant improvement in the intervention group compared with the control group regarding the “inference” (4.86 ± 1.94 vs 4.20 ± 1.32), “assessment” (7.90 ± 1.77 vs 5.90 ± 1.70), “Inductive reasoning” (8.67 ± 2.32 vs 6.37 ± 1.87), “deductive reasoning” (6.47 ± 2.04 vs 5.77 ± 1.97) subskills. Education of evidence-based information practice could be effective in promotion of critical thinking skills of medical librarians. This study suggests evidence-based information practice to be added to the curriculum of medical library and information science fields.

Trial registration: This study was registered with number 9000.1v1 in Registry of Efficacy and Effectiveness Studies (REES).
Networked Urban Governance: A Socio-Structural Analysis of Transport Strategies in London and New York
Authors: da Cruz Nuno F. , Rode Philipp , McQuarrie Michael , Badstuber Nicole , Robin Enora
Published: August 2022

This paper investigates urban governance empirically by applying social network analysis methods to data gathered through structured interviews in London and New York. We explore how decisions are made in complex institutional environments inhabited by various types of actors. Owing to the time-consuming data collection and treatment processes, the research zooms in on transport. The comparative approach enabled the detection of different structural features in the governance networks shaping transport strategies in both cities. The perceived relative power, influence, dependence and/or affinity between the actors involved is discussed based on network attributes. The evidence suggests that transport governance in London is more centralised (and, arguably, more technocratic and integrated), in the sense that a few prestigious entities are clearly more prominent. In New York the institutional environment is typified by many checks and balances (and, arguably, more democratic and fragmented), where central actors are less obvious.
Contribution of an anticancer drug compounding robot in reducing the risks of manual preparation in a hospital pharmacy unit specialized in oncology
Authors: Cherif Chefchaouni Ali , Boudina Yassine , Chennaq Meryem , Belahcen Mohammed Jaouad , Rahali Younes
Published: August 2022

Introduction

In the last few years, pharmaceutical technology has evolved. In the field of oncology pharmacy, robots for the preparation of anti-cancer drugs have appeared to progressively replace manual preparation. The objective of this study is to evaluate the contribution of the robot in reducing the risk of manual preparation.

Methods

The study was conducted at the pharmacy of the National Institute of Oncology in Rabat (May–August 2021). The method used to compare the two types of preparation is the method of analysis of failure modes, their effects and their criticality (FMECA). It will calculate the criticality index (CI = severity × frequency × detectability). The risks have been categorized into human, technical, and environmental risks.

Results

The anticancer drugs reconstitution step was the most critical in manual preparation (CI = 126.7) and robotic preparation (CI = 40.7). The robot has made it possible to reduce several CIs of manual preparation including: musculoskeletal disorders of pharmacy operators −93 (89%), error in cancer drug and diluent selection −72 (60%), as well as lack of traceability −145 (97%).

Conclusion

The preparation robot has made it possible to reduce many of the risks of manual preparation, and constitutes an important advance in the field of oncology pharmacy.
KRAS-targeted therapy in the treatment of non-small cell lung cancer
Authors: Yun Jina , Nakagawa Reid , Tham Kenneth
Published: August 2022

Objective

KRAS mutations are one of the most common driver mutations in non-small cell lung cancer. Though previously believed to be an undruggable target, recent advances in therapeutics have seen new targeted agents against KRAS mutations. The objective of this article is to review currently available and upcoming KRAS-targeted treatments.

Data sources

Currently available trials examining KRAS-targeted therapy in non-small cell lung cancer were examined by searching for the keyword “ KRAS inhibitors.” The pivotal trials for sotorasib and adagrasib were reviewed for this article.

Data summary

Mutated KRAS can be challenging to target for a variety of reasons. In 2021, the US Food and Drug Administration approved sotorasib for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer with KRAS G12C mutation as determined by a Food and Drug Administration-approved test, who have received at least one prior systemic therapy. A multicenter, single-group, open-label, phase 2 trial was able to demonstrate that sotorasib was able to demonstrate objective response, progression-free survival, and overall survival in this patient population. A phase 3 trial comparing sotorasib to docetaxel in the subsequent-line treatment of KRAS G12C non-small cell lung cancer is currently ongoing. There are other KRAS-targeted agents currently under study, including adagrasib, with growing interest in targeting KRAS downstream pathways.

Conclusion

Further trials need to be conducted in order to identify other targeted agents for KRAS and the appropriate place in therapy among currently approved treatments for non-small cell lung cancer.
A scoping review of the effects of classroom acoustic conditions on primary school children’s mental wellbeing
Authors: Mealings Kiri
Published: August 2022

The aim of this scoping review was to systematically map research on the effect of classroom acoustic conditions on children’s mental wellbeing and identify existing gaps in knowledge to inform future research. This scoping review followed the PRISMA-ScR protocol. A comprehensive search of four online databases (ERIC, PubMed, Scopus, and Web of Science) was conducted using the search term classroom AND (acoustic* OR noise OR reverb*) AND (“mental health” OR emotion OR wellbeing OR “quality of life” OR anxiety OR depression). Peer-reviewed papers were included if they were written in English, included children in the primary school age range (i.e. 5–12 years), and included a measure of children’s mental wellbeing. Six papers met the criteria to be included in the review. Overall, this review suggests that poor classroom acoustic conditions can negatively affect children’s mental wellbeing. Given the small number of studies, future research suggestions are proposed to fill current gaps in knowledge.
Discussing the unspoken: A qualitative analysis of online forum discussions on mental health problems in young Moroccan-Dutch migrants
Authors: van de Beek Madelien H. , Landman Erwin , Veling Wim , Schoevers Robert A. , van der Krieke Lian
Published: August 2022

Migrants and their offspring are at increased risk of developing mental disorders. Previous research has shown associations between adverse social factors (e.g., discrimination, lack of social support) and mental health problems in migrants, but it is unknown how these associations are understood by migrants themselves. In this study, we aimed to gain explorative insight into the way young Moroccan-Dutch people experience their social environment, and how they relate this social environment to the development of mental health problems. At www.marokko.nl , the largest online discussion platform for young Moroccan-Dutch people, contributors discuss a broad variety of subjects, including societal, cultural, religious, and mental health issues. Combining deductive and inductive approaches to qualitative data analysis, we analysed 22 forum discussions at marokko.nl about mental health problems, after which data saturation was reached. Contributors described feeling isolated and experiencing discrimination in their social environment. Contributor comments identified social challenges arising from Dutch society, Dutch culture (e.g., being too individualistic), Moroccan culture (e.g., strict parenting style), and living between these two cultures. These social challenges are perceived to be associated with mental health problems. Furthermore, we created a model describing the different types of explanations contributors used for mental health problems, being: religious (e.g., possession); medical (i.e., a bio-psycho-social cause); or a combination of both. This model can help clinicians in delivering culturally sensitive mental health care. Lastly, this study shows the taboo on mental health problems in the Moroccan-Dutch population and the opportunity to open up in the online environment.
Effects of a CFD-improved dimple stepped-lip piston on thermal efficiency and emissions in a medium-duty diesel engine
Authors: Wu Angela , Cho Seokwon , Lopez Pintor Dario , Busch Stephen , Perini Federico , Reitz Rolf D.
Published: August 2022

Diesel piston-bowl shape is a key design parameter that affects spray-wall interactions and turbulent flow development, and in turn affects the engine’s thermal efficiency and emissions. It is hypothesized that thermal efficiency can be improved by enhancing squish-region vortices as they are hypothesized to promote fuel-air mixing, leading to faster heat-release rates. However, the strength and longevity of these vortices decrease with advanced injection timings for typical stepped-lip (SL) piston geometries. Dimple stepped-lip (DSL) pistons enhance vortex formation at early injection timings. Previous engine experiments with such a bowl show 1.4% thermal efficiency gains over an SL piston. However, soot was increased dramatically [SAE 2022-01-0400]. In a previous study, a new DSL bowl was designed using non-combusting computational fluid dynamic simulations. This improved DSL bowl is predicted to promote stronger, more rotationally energetic vortices than the baseline DSL piston: it employs shallower, narrower, and steeper-curved dimples that are placed further out into the squish region. In the current experimental study, this improved bowl is tested in a medium-duty diesel engine and compared against the SL piston over an injection timing sweep at low-load and part-load operating conditions. No substantial thermal efficiency gains are achieved at the early injection timing with the improved DSL design, but soot emissions are lowered by 45% relative to the production SL piston, likely due to improved air utilization and soot oxidation. However, these benefits are lost at late injection timings, where the DSL piston renders a lower thermal efficiency than that of the SL piston. Energy balance analyses show higher wall heat transfer with the DSL piston than with the SL piston despite a 1.3% reduction in the piston surface area. Vortex enhancement may not necessarily lead to improved efficiency as more energetic squish-region vortices can lead to higher convective heat transfer losses.
Taking rulers' interests seriously: The case for realist theories of legitimacy
Authors: Cross Ben
Published: August 2022

In this article I defend a new argument against moralist theories of legitimacy and in favour of realist theories. Moralist theories, I argue, are vulnerable to ideological and wishful thinking because they do not connect the demands of legitimacy with the interests of rulers. Realist theories, however, generally do manage to make this connection. This is because satisfying the usual realist criteria for legitimacy – the creation of a stable political order that transcends brute coercion – is usually necessary for rulers to preserve their rule.
Potential and limitations of NARX for defect detection in guided wave signals
Authors: Tu Xin L , Pyle Richard J , Croxford Anthony J , Wilcox Paul D
Published: August 2022

Previously, a nonlinear autoregressive network with exogenous input (NARX) demonstrated an excellent performance, far outperforming an established method in optimal baseline subtraction, for defect detection in guided wave signals. The principle is to train a NARX network on defect-free guided wave signals to obtain a filter that predicts the next point from the previous points in the signal. The trained network is then applied to new measurement and the output subtracted from the measurement to reveal the presence of defect responses. However, as shown in this paper, the performance of the previous NARX implementation lacks robustness; it is highly dependent on the initialisation of the network and detection performance sometimes improves and then worsens over the course of training. It is shown that this is due to the previous NARX implementation only making predictions one point ahead. Subsequently, it is shown that multi-step prediction using a newly proposed NARX structure creates a more robust training procedure, by enhancing the correlation between the training loss metric and the defect detection performance. The physical significance of the network structure is explored, allowing a simple hyperparameter tuning strategy to be used for determining the optimal structure. The overall detection performance of NARX is also improved by multi-step prediction, and this is demonstrated on defect responses at different times as well as on data from different sensor pairs, revealing the generalisability of this method.
Nonlinear-Lamb-wave-based plastic damage detection assisted by topologically designed metamaterial filters
Authors: Liu Ze , Shan Shengbo , Cheng Li
Published: August 2022

Owing to their high sensitivity to material microstructural defects, nonlinear guided waves (NGWs) show great promise for the early detection of incipient damages, conducive to numerous structural health monitoring (SHM) applications. In an SHM system, however, inevitable non-damage-related nonlinear sources exist, which may overwhelm the damage-induced nonlinear components and in turn jeopardize the practical efficacy of the detection methodology. Therefore, these deceptive nonlinear interferences need to be mitigated or eliminated as much as practically possible. By embracing the concept of metamaterials, a wave filtering device, referred to as a meta-filter (MF), is developed in this paper. The MF is constructed through mounting periodic stubs on the surface of the structure under inspection to condition the probing signals under the second harmonic Lamb-wave-based SHM paradigm. Through topological optimization, the MF enables ultra-wide stop bands to eliminate the second harmonic Lamb waves of the probing waves while preserving their strong fundamental wave components. The band structure and the underlying mechanism, alongside the MF-enabled wave properties, are numerically investigated. Upon tactically introducing deceptive nonlinear sources such as the nonlinear adhesive bonding layers in a piezoelectric transducer-activated SHM system, the performance of the MF is examined from the SHM perspective, which is finally validated experimentally using a metal specimen containing local plasticized incipient damage. Results demonstrate that the designed MF allows for flexible selection of the excitation frequency on one hand, and entails significant enhancement of the detection ability of the NGW-based SHM system on the other hand owing to the customized band features arising from the topological optimization.
Minimum noise amplitude deconvolution and its application in repetitive impact detection
Authors: Fang Bo , Hu Jianzhong , Yang Cheng , Chen XueMing
Published: August 2022

Blind deconvolution (BD) is an effective technology for rotating machinery fault detection because it significantly weakens noise and reduces the interference of the system transmission path. This paper analyses the possible shortcomings of several popular BDs in detecting repetitive impacts hidden in rotating machinery signals. Then a new index named periodic noise amplitude ratio (PNAR) is defined to measure the noise level of fault signals. Minimum noise amplitude deconvolution (MNAD) is a new BD algorithm based on PNAR minimization. Unlike the existing BDs, MNAD does not focus on the impacts with certain randomness in their moments of occurrence but enhances the repetitive impact characteristics by weakening the defined periodic noise. MNAD is particularly suitable for detecting repetitive impacts hidden in cyclostationary signals. Simulation analysis and experimental results show that MNAD adaptively determines one or more resonance bands generated by repetitive impacts and has a good suppression effect on the noise in the resonance bands. The implementation of MNAD is available in MATLAB community.
A baseline-free stress monitoring strategy based on acoustoelastic Lamb waves using PWAS array
Authors: Shi Weijia , Li Jiaxin , Zhao Bo , Tan Jiubin
Published: August 2022

In this article, the baseline-free stress monitoring methodology has been proposed. Initially, it is theoretically and experimentally proven that the impact of the external stress on the phase velocity of the Lamb waves varies with the Lamb wave propagation direction in isotropic materials. The Lamb wave propagation time difference in the specific directions can be subsequently used to calculate the existing stress. The proposed methodology can be therefore eliminated from the usage of the referential ideal echo data under zero residual stress condition, which is however the origin of the stress measurements for the existing methods. Then, a semi-analytical finite element model is established to calibrate the stress coefficient of the homogeneous prestress waveguide. The piezoelectric wafer active sensors array is finally applied to excite and receive the Lamb wave signal in the specially designed directions. Experimental verification indicates that the maximum absolute error of the stress measurement is 4.7 MPa within the external stress range from 20 to 100 MPa. It is supposed that the proposed methodology is a promising alternative for structural quality assessment and safety assurance.
Two-level fusion of multi-sensor information for compressor blade crack detection based on self-attention mechanism
Authors: Song Di , Shen Junxian , Ma Tianchi , Xu Feiyun
Published: August 2022

Nowadays, acoustic and vibration signals have been widely used to detect crack and its degree on compressor blades for non-destructive evaluation and structural health monitoring. Due to complex working conditions and interference of strong noise, single signal-based methods reach unsatisfactory accuracy. To improve the reliability and accuracy of crack detection, the two-level fusion method based on Mahalanobis distance (MD) and self-attention mechanism is proposed based on multi-acoustic, vibration, and acoustic emission information. First, the MD is calculated to measure the similarity between raw samples and group, which can fuse the same type of samples in data level. Then, the processed raw and data-level fusion samples are inputted to one-dimensional convolutional neural network, and the preliminary decisions are obtained. Finally, the decision-level fusion based on self-attention mechanism and credit assignment is proposed to modify and correct the preliminary decisions. The compressor experiments are implemented to test the proposed method under single and mixed working conditions with strong noise intensity. Further, the results illustrate that the proposed method can accurately detect crack for compressor blades. By comparing with other data fusion approaches, the advantage of the proposed method is validated under complex conditions.
Policy and Policy Response on the Court: A Theoretical and Empirical Examination of the Three-Point Line Extension in Basketball
Authors: Ehrlich Justin A. , Ghimire Shankar , Sadler Thomas R. , Sanders Shane D.
Published: August 2022

This paper considers recent and historical changes in the three-point line distance at the NCAA and NBA levels as an example of policy change with highly-measurable outcome(s). The paper presents several empirical tests describing a point-maximizing basketball team's optimal allocation of two-point and three-point shots. It does so primarily in the context that the NCAA Men's Basketball three-point line was extended from 20′9″ to 21′9″ in advance of the 2019–20 season, and similar analysis for the NBA in the 1990s. We find that a three-point line extension significantly lowers three- and two-point shot proficiency, while decreasing (increasing) three-point (two-point) shot volume.
Facile fabrication of flexible alginate/polyaniline/graphene hydrogel fibers for strain sensor
Authors: Wu Yu , Zhou Sihao , Yi Jie , Wang Dongsheng , Wu Wen
Published: August 2022

Continuous production of conductive hydrogel fibers has received extensive interests due to their wide application in strain sensors. In this paper, we report on the fabrication of continuous alginate/polyaniline/graphene hydrogel fibers by the in situ polymerization and wet spinning methods. The obtained hydrogel fiber with good flexibility, high water absorbability (11.37 g/g), proper resistivity (220 Ω·m ) and stable resistance changes at both low strain (10%) and high strain (20% and 50%) could be used as a working strain sensor for a wearable human movements monitor. The conductive alginate/polyaniline/graphene hydrogel fiber shows highly sensitive, flexible, and recoverable (90% retention after five cycles) properties when monitoring palm, elbow, and knee movements. This kind of hydrogel with high elasticity and high sensitivity provides a possibility for the preparation of electromechanical sensors.
A systematic review of research on the relationship between school leadership and student achievement: An updated framework and future direction
Authors: Özdemir Nedim , Gümüş Sedat , Kılınç Ali Çağatay , Bellibaş Mehmet Şükrü
Published: August 2022

This systematic review sought to expand our knowledge of the increasing research studies focusing on the empirical link between school leadership and student achievement. Using five different data sources (Scopus, WoS, ERIC, Google Scholar, and Retrospective Reference Harvesting Procedure), we created a data set of 144 journal articles. Descriptive analysis of bibliographic data and content analysis of full texts were employed in the review process. The results revealed instructional leadership as the most frequently used school leadership model in the relevant research. There has been a growing tendency to use the direct effect model with the increase in the studies from non-English speaking western societies. Indeed, the use of rational and organizational variables has dominated the mediating effect studies, while moderating effect studies as well as exploratory and explanatory type of studies have not received much attention. Based on these results, a framework representing the broader picture of the current research on the relationship between school leadership and student learning is provided. In addition, several recommendations were made, aiming to build the research capacity in furthering our understanding of how school leadership practices impact student learning and achievement.
Cognitive Training: A Field in Search of a Phenomenon
Authors: Gobet Fernand , Sala Giovanni
Published: August 2022

Considerable research has been carried out in the last two decades on the putative benefits of cognitive training on cognitive function and academic achievement. Recent meta-analyses summarizing the extent empirical evidence have resolved the apparent lack of consensus in the field and led to a crystal-clear conclusion: The overall effect of far transfer is null, and there is little to no true variability between the types of cognitive training. Despite these conclusions, the field has maintained an unrealistic optimism about the cognitive and academic benefits of cognitive training, as exemplified by a recent article (Green et al., 2019). We demonstrate that this optimism is due to the field neglecting the results of meta-analyses and largely ignoring the statistical explanation that apparent effects are due to a combination of sampling errors and other artifacts. We discuss recommendations for improving cognitive-training research, focusing on making results publicly available, using computer modeling, and understanding participants’ knowledge and strategies. Given that the available empirical evidence on cognitive training and other fields of research suggests that the likelihood of finding reliable and robust far-transfer effects is low, research efforts should be redirected to near transfer or other methods for improving cognition.
Lifting the lid on Pandora’s box: Putting professional curiosity into practice
Authors: Phillips Jake , Ainslie Sam , Fowler Andrew , Westaby Chalen
Published: August 2022

Professional curiosity has recently become a ‘buzzword’ in the field of probation and social work. However, little research has sought to understand what professional curiosity means definitionally, conceptually or operationally. In this article, we analyse interview data from 49 probation practitioners in England and Wales to explore what professional curiosity means in the context of probation and what the main barriers are to enacting professional curiosity. We argue that professional curiosity is primarily used to assess risk and that practitioners face multiple barriers to its enactment which are rarely acknowledged or dealt with in policy and practice guides. These barriers fall into three groups: structural, relational and emotional. We conclude the article by examining the findings through the lens of neo-liberalism and probation values. The article therefore extends knowledge of professional curiosity operationally while also seeking to explain its position in a neo-liberal policy context. This research has important implications for policy and practice. Rather than simply asking practitioners to ask questions and be on the lookout for disguised compliance, probation providers should recognise and acknowledge these barriers to practice.
Criticality in undergraduate education: Is a non-critical classroom experience a lesson in deceit?
Authors: Halx Mark D
Published: August 2022

This article is an exploration of the potential of a more purposeful application of criticality in undergraduate classrooms. Conventional pedagogy, often lecture-based, does not prepare students well for life, a career, or service toward the common good. A more critical approach in the classroom stimulates critical thinking, critical consciousness, and critical being. Criticality in teaching and learning allows for an honest assessment of history, culture, and the reality of human interactions. It positions students well for career success and strong civic engagement. It also serves to refresh and enhance faculty understanding of established material. Criticality in the classroom redounds to the wellbeing of the institution, the community it serves, as well as advancing knowledge itself with the enrichment of new perspectives. Anything less is at best a repetitive exercise of fact regurgitation, or at worst, outright deception.
Primary versus delayed ureteroscopy for ureteric stones: A systematic review and meta-analysis
Authors: Alsawi Mohammed , Nalagatla Sarika , Ahmad Nafees , Chandiramani Ashwini S , Mokool Leenesh , Nalagatla Sarath K , Somani Bhaskar , Aboumarzouk Omar M , Amer Tarik
Published: August 2022

Background:

Ureteric colic is a major clinical and economic burden on the National Health Service. There has been a recent paradigm shift to consider definitive surgery as the primary intervention at the time of initial presentation.

Objective:

To systematically evaluate the outcomes of primary/emergency ureteroscopy versus delayed/elective ureteroscopy.

Methods:

We performed a critical review of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials–CENTRAL, CINAHL, Clinicaltrials.gov, Google Scholar and individual urological journals in April 2020. A robust database search was performed using a combination of the terms ‘primary ureteroscopy’, ‘immediate ureteroscopy’, ‘delayed ureteroscopy’ and ‘emergency ureteroscopy’. Adult patients (> 16 years) with ureteric stones presenting as an emergency were included.

Results:

Twelve studies met the inclusion criteria, with 4 studies directly comparing primary/emergency to delayed/elective ureteroscopy for an acute presentation of ureteric colic. Across the studies, 1708 patients underwent primary/emergency ureteroscopy for ureteric calculi and 990 underwent delayed ureteroscopy. No significant differences in stone-free rates were found between both groups with primary/emergency achieving 85% and delayed/elective 91% ( p = 0.68). The majority of stones treated were located in the distal ureter in both groups. Overall, there were no differences in complications between the groups ( p = 0.42) or major complications (0.17). However, there were fewer minor complications in the primary URS group ( p = 0.02). Ureteral catheter or double-J stent insertion was used in 71% of delayed/elective ureteroscopy cases, compared to 46.8% of primary/emergency cases (p = 0.001). For patients undergoing primary/emergency ureteroscopy, 6.4% patients required auxiliary procedures. In the delayed/elective group, 7.6% required further definitive treatment (NS).

Conclusion:

Primary ureteroscopy is a safe and feasible procedure, when performed in suitable patients in the acute setting. It is associated with significantly lower stent usage, equivalent stone clearance, no increase in overall or major complications including sepsis, and fewer minor complications when compared to delayed/elective ureteroscopy. Prospective studies will do well to explore this area further but on current evidence, primary ureteroscopy is the safe procedure.

Level of evidence:

Not applicable
Design, implementation and evaluation of a postgraduate workshop on cross-border healthcare in Europe – Mixed methods research
Authors: Beuken Juliëtte A , Bouwmans Mara EJ , Dolmans Diana HJM , Hornstra Steven PA , Vogt Lina , Verstegen Daniëlle ML
Published: August 2022

Introduction

In European border regions, healthcare providers join forces to make full use of the potential of healthcare. Trainees need to be aware of the challenges and opportunities of cross-border healthcare. To increase such awareness, a workshop was designed, implemented and evaluated. The workshop was entitled ‘Creating cross-border collaborators’ and combined elements of contextual, collaborative and reflective learning. The aim of the study was to understand how this workshop enhanced trainees’ awareness of challenges and opportunities of cross-border healthcare.

Methods

Using a mixed-methods approach, focus-group interviews (QUAL) were held with trainees ( N = 16) and trainees ( N = 13) completed a survey (QUAN) about their workshop experiences. The workshop was held three times for three different groups of trainees.

Results

Quantitative analysis (of surveys) demonstrated increased self-reported awareness of cross-border healthcare. All learning principles contributed to this awareness, however reflective learning slightly less. Qualitative analysis (of focus-group interviews) unearthed the following four themes: (1) Attention to cross-border healthcare fostered awareness of its complexity; (2) real-life examples stimulated recognition of challenges and opportunities; (3) discussions in interdisciplinary and international groups helped to see different perspectives; and (4) reflection made trainees think about their own role and perspective. Quantitative and qualitative data are strongly cohered.

Conclusion

According to participating trainees, a workshop with elements of contextual, collaborative and reflective learning did improve trainee awareness of cross-border healthcare. This study highlights that theoretical insights into learning can and should inform the design and evaluation of workshops.
Redesigning Kidney Care for the Anthropocene: A New Framework for Planetary Health in Nephrology
Authors: Rajan Tasleem , Amin Syed Obaid , Davis Keefe , Finkle Neil , Glick Naomi , Kahlon Bhavneet , Martinusen Dan , Pederson Kristen , Samanta Ratna , Tarakji Ahmad , Stigant Caroline
Published: August 2022

Climate change is one of the greatest threats to human health in the 21st century. The human health impacts of climate change contribute to approximately 1 in 4 deaths worldwide. Health care itself is responsible for approximately 5% of annual global greenhouse gas (GHG) emissions. Canada is a recent signatory of the 26th United Nations Climate Change Conference (COP26) health agreement that is committed to developing low carbon and climate resilient health systems. Kidney care services have a substantial environmental impact and there is opportunity for the kidney care community to climate align clinical care. We introduce a framework of redesigned kidney care and describe examples of low carbon kidney disease management strategies to expand our duty of care to the environment which completes the triple bottom line of optimal patient outcomes and cost effectiveness in the Anthropocene.
Heart Failure Caregiver Burden and Outcomes: A Systematic Review
Authors: Suksatan Wanich , Tankumpuan Thitipong , Davidson Patricia M.
Published: August 2022

Introduction/Objective:

This review aimed to summarize articles describing caregiver burden and the relationship between health outcomes as well as describing interventions focusing on this population.

Methods:

The review used the PRISMA statement and Whittemore and Knafl guidelines. The search engines Scopus, PubMed, Ovid (PsycINFO), and CINAHL were searched for articles published in English.

Results:

This review included 30 studies that met the criteria. Physical, psychological, and social factors were associated with HF caregiver burden. HF caregiver interventions included health education, post-discharge home visits, phone calls, counseling, and support groups that demonstrated some potential to reduce the caregivers’ burden.

Discussion:

Healthcare provider team should screen for caregiver burden and promote healthy behaviors, and strategies to improve quality of life. Further studies should include caregivers as care team members and embed social networking in the interventions for reducing HF caregiver burden. The caregivers’ burden could influence the poor outcomes of care, including physical, psychological, societal, and functional dimensions. Future interventions should develop to alleviate HF caregiver burden.
Fasten Your Seatbelts: A Case Study on Online Travel Portals in India
Authors: Venkatesh Shreyas , Majumder Mrinmoy
Published: August 2022

This case unravels the market dynamics and consolidation of online travel portals in India whose strong buoyant force ushered a new era for the Indian start-up ecosystem. Several talented and risk-taking individuals followed the vestiges of global technology start-ups and found avenues amalgamating technologies and customers’ need for better services. Based on existing narratives and secondary data, this case delves deep into the decision dilemma covering a wide range of challenges such as capital crunch, market forces, and nuances of mergers and acquisitions (M&A). Furthermore, this case helps in understanding the decisions and the rationale behind them in a high growth start-up ecosystem.
Territorializing local public policy: Building social muscle, sustaining participation in food system transformation
Authors: Brent Zoe W
Published: August 2022

This article focuses on experiences of engagement with public institutions to explore the nature of local level state-society relations that might enable the construction of food sovereignty. It illustrates how peasants and activists struggling for food sovereignty can benefit from and shape the impact of a variety of institutional supports to enable food system transformation. It draws on the concept of territorialized food systems, to illustrate the importance of considering the what and the how of policy and on feminist social reproduction theory to add nuance and depth to how we think about the process of leveraging public policy to enable food sovereignty. I develop the concept of social muscle to describe some of the ways that social movements try to build strength and resilience in order to navigate contradictions as they arise in this process. I argue that territorializing food systems can help reclaim control over food policy at the local level, but it also requires coordination among a range of diverse actors. A feminist analytical lens helps to visibilize this diversity of actors, understand and overcome some of the barriers to participation in policy processes that they may face. Finally, I suggest that no political opportunity can be seized upon or sustained without social muscle, which is required to guide policy making towards the construction of food sovereignty and which needs to be constantly strengthened.
Polychromatic Aqueous and Vitreous Crystals Due to Phacolytic Glaucoma in a Patient With Marfan Syndrome and Lens Dislocation
Authors: Lains Ines , Ung Cindy , Gong Dan , Parikh Deep , Eliott Dean
Published: August 2022

Purpose: To describe a patient with Marfan syndrome and crystalline lens luxation who developed phacolytic glaucoma with polychromatic crystals in the anterior chamber and vitreous. Methods: We present a retrospective case report. Results: A 58-year-old man with Marfan syndrome and crystalline lens luxation since childhood presented with 2 days of pain in the left eye. The visual acuity was 20/30 OS with an aphakic contact lens, and the intraocular pressure (IOP) was 31 mm Hg. Polychromatic crystals were evident in the anterior chamber and vitreous. The retina was attached. Despite medical treatment, the IOP remained elevated; therefore, a pars plana vitrectomy and lensectomy were performed. At the last follow-up, the IOP was normal and the retina remained attached. Conclusions: Phacolytic glaucoma can be seen in eyes with a subluxated or luxated mature or hypermature lens. In these rare cases, iridescent crystals can be observed in the aqueous and vitreous. Vitrectomy with lensectomy is the definitive treatment.
Reconstruction of Two Wall Orbital Fractures: Experience With the 3D Titan Implant and Intraoperative Computed Tomography
Authors: Holan Cole A. , Yan Derek J. , Hancock Ellen , Harshbarger Raymond
Published: August 2022

Background:

Orbital fractures are common in maxillofacial trauma and have varying anatomical deficits depending on the mechanism of injury. Orbital floor fractures are most common, but many patients suffer from two wall-floor and medial wall defects. Precise reconstruction and positioning of the orbital implant post traumatic injury can be technically challenging, especially in two wall fractures. We present our experience using the 3D Titan implant on a series of 7 patients with combined medial wall and orbital floor fractures.

Methods:

A retrospective chart review was performed of patients with combined medial wall and orbital floor fractures treated with 3D Titan between February 2016 and June 2020. The inclusion criteria were unilateral combined medial and orbital floor fractures due to traumatic etiologies, no previous history of orbital trauma, age older than 18 years, a contralateral healthy orbit, and a clinical follow-up of at least 1 month. Variables and outcomes included patient age, gender, mechanism of injury, visual defects, post-op infections, enophthalmos, proptosis, and diplopia. An O-arm intraoperative CT scanner was used to verify the implant position.

Results:

Ten patients presented with combined medial wall and orbital floor fractures, 3 were lost to follow-up. There were 6 men and 1 woman, and their ages ranged from 24 to 57 (mean age 38). Follow-up time ranged from 4 to 52 weeks, and a mean of 20 weeks. None of the patients experienced intraoperative complications such as hemorrhage, soft tissue incarceration, or acute optic neuropathy. No patients had postoperative infection or any change in visual acuity. All patients had satisfactory implant positioning as verified by intraoperative CT.

Conclusions:

The prefabricated design of the 3D Titan along with use of intraoperative CT guidance allows for efficient and precise reconstruction of combined medial wall and orbital floor fractures.
Drug Interactions Associated With Therapies for Pulmonary Arterial Hypertension
Authors: Narechania Shraddha , Malesker Mark A.
Published: August 2022

Objective: To evaluate the potential for drug interactions with therapies for pulmonary arterial hypertension (PAH). Treatments include calcium channel blockers, phosphodiesterase type 5 inhibitors, endothelin receptor antagonists, guanylate cyclase stimulators, prostacyclin analogues, and prostacyclin receptor agonists. Data Sources: A systemic literature search (January 1980-December 2021) was performed using PubMed and EBSCO to locate relevant articles. The mesh terms used included each specific medication available as well as “drug interactions.” DAILYMED was used for product-specific drug interactions. Study Selection and Data Extraction: The search was conducted to identify drug interactions with PAH treatments. The search was limited to those articles studying human applications with PAH treatments and publications using the English language. Case reports, clinical trials, review articles, treatment guidelines, and package labeling were selected for inclusion. Data Synthesis: Primary literature and package labeling indicate that PAH treatments are subject to pharmacokinetic and pharmacodynamic interactions. The management of PAH is rapidly evolving. As more and more evidence becomes available for the use of combination therapy in PAH, the increasing use of combination therapy increases the risk of drug-drug interactions. Pulmonary arterial hypertension is also associated with other comorbidities that require concomitant pharmacotherapy. Conclusion: The available literature indicates that PAH therapies are associated with clinically significant drug interactions and the potential for subsequent adverse reactions. Clinicians in all practice settings should be mindful that increased awareness of drug interactions with PAH therapy will ensure optimal management and patient safety.