bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Key Issues in the Evaluation of Character Education
Authors: McGrath Robert E.
Published: August 2021

This article summarizes issues in defining character education (CE) that are relevant to program development and evaluation. No authoritative definition exists for CE, but several features seem prominent. These include a focus on enhancing civic, moral, self-regulatory, and/or intellectual virtues; and (at least implicitly) prioritizing the shaping of participant identity over teaching skills. Within these broad parameters, programs vary widely in their targets and interventions. They can also vary in terms of emphasizing the same or individualized elements of character across students. The discussion finishes with a summary of elements of a CE program, and a call for well-planned evaluations.
Observational Analysis of Lateral Preference in Kumite Initiation: A Starting Point in the Longitudinal Programming of Formative Karate
Authors: Sastre Vanessa , Lapresa Daniel , Arana Javier , Ibáñez Rafael , Teresa Anguera M.
Published: August 2021

We used observational methodology to analyze lateral conditioning in the technical-tactical performance of high level 8–9-year-old karatekas, specifically in relation to the guard action that supports the technical action and the body segment with which it is performed. We designed an ad hoc observation instrument to analyze lateral preference in the technical-tactical actions that take place during the kumite. We relied on LINCE software for data registration, and we found good inter-observer reliability, calculated with Cohen's Kappa coefficient. Generalizability Theory supported the homogeneity of the behavior deployed by these combatants. Our results represent a starting point in the longitudinal programming of karate. By relating our results and those of other studies that have addressed lateral performance in formative karate in the kumite modality, we are able to draw a roadmap of a karateka's path towards the equilaterality that is inherent in an elite competitor: (a) the 8-9 year old karateka must overcome a conditioned lateral prevalence by adopting a forward non-dominant leg guard so as to then attack with the dominant body segment; (b) the eqilateral use of the right or left fist must occur later, between the 12–13 year age group and the senior category; and (c) there will then be less decisive lateral conditioning in the execution of offensive leg techniques.
Urban Segregation in a Nordic Small Town in the Late-Seventeenth Century: Residential Patterns in Sortavala at the Eastern Borderland of the Swedish Realm
Authors: Katajala Kimmo , Härkönen Antti
Published: August 2021

The general view of urban segregation in pre-modern towns has been that the wealthy lived near the administrative and economic center(s), while the poor were pushed to the limits of the town. This approach has been questioned by studies proving that urban spaces were socially mixed. This dilemma has been studied here by examining in detail the urban segregation in one small town, Sortavala, at the eastern borderland of the Swedish realm. The analysis shows that the town space was bipolarly segregated. The “gentry,” officeholders and the like, lived near the market square and town hall; the wealthy burghers along the main street. However, even the poorest taxpayers lived among the wealthy and those of high social rank. The segregation was relative: the proportion of the wealthy grew in the grid plan in the town center; the settlements growing “freely” outside the original grid plan were for the poor only.
Improving Student Skills and Career Readiness Through Targeted and Embedded Instruction
Authors: Troisi Jordan D.
Published: August 2021

Background

Psychology students can and sometimes do develop skills and career readiness in their courses, but these outcomes are rarely made explicit.

Objective

This research jointly examines how two potential factors may improve student skills and career readiness: explicit instruction on skill development in an advanced laboratory course, coupled with an embedded staff person from the institution’s career center.

Method

Changes in self-reports of skills and career readiness from pretest to posttest were examined for the course designed to improve these outcomes, as well as in a comparison group of similarly qualified students.

Results

Students in the course targeting skill development and career readiness improved on these outcomes over time. The comparison group did not improve.

Conclusion

These findings show promise for the impact of direct skill instruction and embedded staff on student career–related outcomes.

Teaching Implications

Instructors would serve their students well by pointing out the skills they are developing, when they are developing them, and their usefulness. Other implications for embedding staff, including feasibility, are discussed.
Surgery as a Last Resort for Persistent Auricular Perichondritis
Authors: Forozidou Evropi , Poutoglidis Alexandros , Tsetsos Nikolaos , Kilmpasanis Adamantios , Fyrmpas Georgios
Published: August 2021

Auricular perichondritis is a severe bacterial inflammation of the cartilaginous part of the external ear sparing the lobule and the tragus. Prompt diagnosis and treatment are necessary to avoid necrosis of the underlying cartilage and permanent auricular deformity. Management includes antibiotics and nonsteroidal anti-inflammatory drugs. Surgery to control the inflammation is sometimes necessary. Wide cartilage and subcutaneous tissue debridement with preservation of the helical rim to minimize the resulting auricular deformity is necessary.
Contingency and Mysticism from Economics to Finance: Knight, Ayache, DeLillo
Authors: Sjol Jordan
Published: August 2021

The recent history of finance has been widely portrayed, by both critics and practitioners, as a story about risk. As pointed out by Mary Poovey, focusing on risk entails forgetting uncertainty. In this paper, I argue forgetting uncertainty leads to an inability to distinguish between rational and mystical modes of financial thinking. Using literary-theoretical analysis, I read three exemplary texts across each other: Frank Knight’s seminal 1921 treatise, Risk, Uncertainty, and Profit, which helped justify the modern corporate financial form; Elie Ayache’s 2010 The Blank Swan, a philosophical account of derivatives trading that exemplifies more recent developments in finance; and Don DeLillo’s 2013 Cosmopolis, a novel that remediates the structures of thought implied by the other texts’ philosophical commitments. This textual nexus allows me to explicate the characteristic form of financial mysticism, rendering it visible against claims that derivatives and financial theory have fully rationalized finance.
Miyazaki Hayao’s Animism and the Anthropocene
Authors: Yoneyama Shoko
Published: August 2021

The need for a reconsideration of human-nature relationships has been widely recognized in the Anthropocene. It is difficult to rethink, however, because there is a crisis of imagination that is deeply entrenched within the fundamental premises of modernity. This article explores how ‘critical animism’ developed by Miyazaki Hayao of Studio Ghibli can address this paucity of imagination by providing alternative ways of knowing and being. ‘Critical animism’ emerged from the fusion of a critique of modernity with informal cultural heritage in Japan. It is a philosophy that perceives nature as a non-dualistic combination of the life-world and the spiritual-world, while also emphasizing the significance of place. Miyazaki’s critical animism challenges anthropocentrism, secularism, Eurocentrism, as well as dualism. It may be the ‘perfect story’ that could disrupt the existing paradigm, offering a promise to rethink human-nonhuman relationships and envisaging a new paradigm for the social sciences.
Uneven and combined state capitalism
Authors: Alami Ilias , Dixon Adam D
Published: August 2021

This article contributes to the development of state capitalism as a reflexively critical project focusing on the morphology of present-day capitalism, and particularly on the changing role of the state. We bring analytical clarity to state capitalism studies by offering a rigorous definition of its object of investigation, and by demonstrating how the category state capitalism can be productively construed as a means of problematising the current aggregate expansion of the state’s role as promoter, supervisor and owner of capital across the world economy. Noting some of the geographical shortcomings of the field, we outline an alternative research agenda ‘uneven and combined state capitalist development’ which aims at spatialising the study of state capitalism and revitalising systemic explanations of the phenomenon. Rather than the negation of an abstract model of free-market capitalism, or the rise of a nationally scaled variant of capitalism, we posit contemporary state capitalism as a global process of restructuring of the capitalist state (including in its liberal form) underpinned by secular transformations in the materiality of surplus-value production, such as the consolidation of new international divisions of labour driven by automation and labour-saving technologies. The political mediation of these transformations results in the combined expansion of state-capital hybrids and of muscular forms of statism, which develop in inter-referential and cumulative forms across territory, producing further state capitalist modalities. This is a particularly potent dynamic in contemporary state capitalism, and its tendency to develop in a spiral that both shapes and is shaped by world capitalist development.
Imagining a future in the austerity city: Anticipated futures and the formation of neoliberal subjectivities of youth in Ireland
Authors: van Lanen Sander
Published: August 2021

This paper explores what anticipated futures of disadvantaged urban youth can reveal about the contemporary and future consequences of austerity. As austerity has disrupted several transitions associated with adulthood, such as finding work and moving out of the parental home, it affects how young adults imagine their future. Young adults living in neighbourhoods of concentrated deprivation were particularly vulnerable to such disruptions. Therefore, this paper builds on semi-structured interviews with youth from Knocknaheeny (Cork) and Ballymun (Dublin) in Ireland to present two vignettes reflecting dominant narratives on anticipated futures. First, a narrative that embraces neoliberal logic, where young adulthood is the basis for future success through dedicated hard work rather than a phase of exploration of possible futures. Second, a narrative of “acceptance” where youth imagines the future to “go on” from the present and becomes a source of anxiety or resignation. This paper shows that combining vignettes with interview data presents two benefits. First, they illuminate the complex and sometimes contradictory stories of youth making sense of their present, past and future. Second, comparing and contrasting the vignettes to multiple participant stories can disentangle roles of location, class, gender and other differentiations. In conclusion, the paper stresses the importance of imagined futures for understanding everyday geographies of austerity as anticipated futures surface in everyday practices, behaviour, and attitudes.
A survey of current management of neuromuscular block and reversal in Australia and New Zealand
Authors: Olesnicky Benjamin L , Lindberg Andrew , Marroquin-Harris Frank B , Ren Kerrie
Published: August 2021

In recent years there has been a significant investment in education on the management of neuromuscular blockade and increased availability of sugammadex in anaesthetic practice. This survey aimed to examine contemporary practice of Australian and New Zealand anaesthetists in managing neuromuscular blockade and its reversal. A web-based, voluntary survey was distributed to a cohort of 1000 Fellows of the Australian and New Zealand College of Anaesthetists. We received 229 completed responses (survey response rate of 23%). Seventy-one percent (95% confidence interval (CI) 64% to 76%) of the survey respondents thought that 5% or fewer of the patients in their hospital display clinically significant postoperative paralysis. Only 35% (95% CI 18% to 29%) thought that quantitative neuromuscular twitch monitors should be used to monitor neuromuscular block, and the dose and time given for reversal agents was often inconsistent with published recommendations. Sugammadex was the preferred reversal agent for 78% (95% CI 72% to 83%) of survey respondents, but they indicated that cost remains a significant barrier to its widespread uptake. Despite the low response rate, this survey identified that some reported practices in Australia and New Zealand deviate from guidelines and current recommendations in the management of neuromuscular blockade. If the respondents are representative of the broader anaesthetic community, there appears be a greater preference for sugammadex over neostigmine for reversal of neuromuscular blockade.
Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions
Authors: Hosseini-Nik Hooman , Bayanati Hamid , Souza Carolina A. , Gupta Ashish , McInnes Matthew D. F. , Pena Elena , Revah Giselle , Seely Jean M. , Dennie Carole
Published: August 2021

Purpose:

To assess the diagnostic accuracy of limited chest ultrasound in detecting pneumothorax following percutaneous transthoracic needle interventions using chest X-ray (CXR) as the reference standard.

Methods:

With IRB approval, after providing consent, asymptomatic patients after percutaneous transthoracic needle interventions were enrolled to undergo limited chest ultrasound in addition to CXR. A chest Radiologist blinded to the patient’s prior imaging performed a bedside ultrasound, scanning only the first 3 anterior intercostal spaces. Pneumothorax diagnosed on CXR was categorized as small or large and on ultrasound as grades 1, 2, or 3 when detected in 1, 2, or 3 intercostal spaces, respectively.

Results:

38 patients underwent 36 biopsies (34 lungs, 1 pleura, and 1 mediastinum) and 2 coil localizations. CXR showed pneumothorax in 13 patients. Ultrasound was positive in 10 patients, with 9 true-positives, 1 false-positive, 4 false-negatives, and 24 true-negatives. The false positive results were due to apical subpleural bullae. The false-negative results occurred in 2 small apical and 2 focal pneumothoraces at the needle entry sites. Four pneumothoraces were categorized as large on CXR, all of which were categorized as grade 3 on ultrasound. Sensitivity and specificity of US for detection of pneumothorax of any size were 69.23% (95%CI 38.6%, 90.1%) and 96.0% (95%CI 79.6%, 99.9%), and for detection of large pneumothorax were 100% (95%CI 39.8%, 100%) and 100% (95%CI 89.7%, 100%).

Conclusions:

Results of this prospective study is promising. Limited chest ultrasound could potentially replace CXR in the management of postpercutaneous transthoracic needle intervention patients.
Survey Fraud and the Integrity of Web-Based Survey Research
Authors: Levi Ronli , Ridberg Ronit , Akers Melissa , Seligman Hilary
Published: August 2021

Compared to traditional paper surveys, online surveys offer a convenient, efficient, and socially distant way to conduct human subjects research. The popularity of online research has grown in recent decades. However, without proper precautions, false respondents pose a serious risk to data integrity. In this paper, we describe our research team’s own encounter with survey fraud, steps taken to preserve the integrity of our study, and implications for future public health research.
Effect of non-annealed and annealed ZnO on the optical properties of PVC/ZnO nanocomposite films
Authors: Al-Shawabkeh Ali F , Elimat Ziad M , Abushgair Khaleel N
Published: August 2021

The goal of this study was to investigate the optical properties of the prepared polyvinyl chloride (PVC)/zinc oxide (ZnO) nanocomposite films. The PVC/ZnO nanocomposite films consist of the addition of different concentrations with both non-annealed ZnO nanoparticles and ZnO nanoparticles annealed at temperature of 700°C. The PVC/ZnO nanocomposite films by weight concentrations of (0 wt.%, 2.5 wt.%, 5 wt.% and 10 wt.%) have been prepared by the casting method. The optical absorbance and transmittance values of the composites films were measured in the wavelength range between (250 to 1100 nm) at room temperature by using the UV-1800 Shimadzu spectrophotometer. The optical properties (absorption coefficient, dielectric constant, refractive index, and optical conductivity) have been investigated by the ultraviolet (UV) spectrophotometer. The optical parameters (direct optical energy gap, excitation energy for electronic transitions, the dispersion energy, static refractive index, static dielectric constant, optical oscillator strengths, the moments of optical spectrum, linear optical susceptibility, third-order nonlinear optical susceptibility, nonlinear refractive index, high-frequency dielectric constant, the carrier concentration to the effective mass ratio, the long wavelength refractive index and the plasma frequency) were calculated. The results showed that the optical properties behavior of the PVC/ZnO nanocomposite films was found to be dependent on the ZnO concentration, and photon wavelength. In addition, the results of the study show that the optical parameters can be influenced by alter the concentration of the nonannealed and annealed a ZnO nanoparticle in the PVC polymer matrix.
Proximate or Primary Source? How Multiple Layers of News Sources on Social Media Predict News Influence
Authors: Jang Jeong-woo
Published: August 2021

News shared on social media presents multiple layers of sources, from reputable news organizations to individual users who share news on social media. A web-based experiment investigated (a) whether the influence of a primary news source (news organization) on viewers decreases as it becomes less proximate with the presence of a more immediate source (individual user who shared news), and (b) if so, how the evaluations of both sources, along with a varying degree of issue relevance, affect viewers’ agreement with news position. Participants read one news article either shared on Facebook by a well-known celebrity or directly posted onto a news website. The perceived credibility of news organizations predicted viewers’ agreement with the news position, but only when the news was presented on a news web page so that the news organization was shown as the proximate source. When multiple sources were displayed, the influence of news organization credibility disappeared when the given news lacked personal relevance.
Effects of tip air injection on the aerodynamic stability of an axial flow compressor with total pressure distortion
Authors: Tu Baofeng , Zhang Xinyu , Li Liang , Hu Jun
Published: August 2021

The compressor is a critical component that determines the aerodynamic stability of an aero-engine. Total pressure inlet distortion decreases the thrust and shrinks the stability margin, thus inducing severe performance degradation or even flameout. Generally, tip air injection is used to reduce the adverse influence of total pressure inlet distortion on the aerodynamic stability. In the present work, an experimental investigation on the effects of tip air injection on the stability of a two-stage low-speed axial compressor with total pressure inlet distortion was carried out. A flat baffle generated the total pressure distortion at the inlet of the compressor. The stall margin of the compressor was reduced significantly by the total pressure distortion. When the dimensionless insertion depth of the flat baffle was 0.45, the stall margin decreased to 11.4%. Under the total pressure inlet distortion, tip air injection effectively improved the distortion resistance capability of the compressor. The circumferential layout of the nozzle played a critical role in the stability expansion effect of tip air injection under the inlet flow condition of the total pressure distortion. The modal wave disturbance was likely to occur in the distortion-affected region (the low-pressure region and the mixing region). Tip air injection did not inhibit the generation of the modal wave but restrained the development of the modal wave into the stall cell. It improved the low-speed compressor’s tolerance to the modal wave and allowed a higher amplitude modal wave to occur.
Intensified job demands, stress of conscience and nurses' experiences during organizational change
Authors: Heikkilä Mikko , Huhtala Mari , Mauno Saija , Feldt Taru
Published: August 2021

Background:

Nurses frequently face ethically demanding situations in their work, and these may lead to stress of conscience. Working life is currently accelerating and job demands are intensifying. These intensified job demands include (1) work intensification, (2) intensified job-related planning demands, (3) intensified career-related planning demands, and (4) intensified learning demands. At the same time, many healthcare organizations are implementing major organizational changes that have an influence on personnel.

Aim:

The aim of the study was to investigate the association between intensified job demands and stress of conscience, and whether their association is moderated by organizational change experiences among nurses. Experiences of organizational change may expose employees to stress of conscience or serve as a buffer because employees appraise, involve, and cope with changes differently.

Research design:

Questionnaires measuring stress of conscience, intensified job demands, and organizational change experiences were completed by nurses (n = 511) in a healthcare district undergoing a major organizational change.

Ethical considerations:

Throughout, the study procedures were implemented according to the guidelines of the Finnish National Board on Research Integrity and the 1964 Helsinki Declaration and its later amendments. According to the Finnish regulations, because participation was voluntary, informed consent was requested, and participants were advised of their right to withdraw from the study at will. No permission from an ethics committee was necessary.

Findings:

Work intensification and personal worry considering organizational change were associated with more severe stress of conscience among nurses. Nurses’ experiences of managements’ competent handling of organizational change buffered the association between work intensification and stress of conscience.

Conclusions:

During organizational changes, management may alleviate nurses’ stress of conscience by proper communication and support procedures.
Country of Origin Effect on Purchase Intention Towards Italian Luxury Fashion: Mediating Role of Brand Perception and Social Status
Authors: Kumar Sandeep , Gautam Amit
Published: August 2021

Economic growth, urbanization and higher disposable incomes have helped to propel growth of luxury fashion in India. Indian customers attach luxury fashion with their social status. Therefore, a need was felt to understand the drivers of purchase intention for luxury fashion goods. The purpose of study is to explain the role of factors which have influence on purchase intention for luxury fashion brands. The research tries to identify the mediating effect of brand perception and social status on interrelationship between country of origin (COO) and purchase intention. The data were collected by means of structured questionnaires from a total of 400 Indian customers residing in the Delhi NCR. Structural equation modelling has been used to find the outcomes. COO, brand perception and social status were found to significantly influence customer purchase intention. However, mediation effect of brand perception was found in relation between COO and purchase intention. Mediation effect of social status also exists in relation between COO and purchase intention. Brand perception and social status sequentially mediate the relationship between COO and purchase intention.
Politics of Development in Pakistan: From the Post-Independence Modernization Project to ‘Vision 2025’
Authors: Abbasi Aliya
Published: August 2021

This article critically analyses Pakistan’s development project since its independence in 1947 up till Vision 2025 of 2014. Vision 2025 aspires to ‘inclusive growth’ through the expansion of the market as the basis for a ‘people-centric’ approach to development. Based on a critical evaluation of Pakistan’s development trajectory, I argue that a reliance on economic growth via liberal capitalism to address poverty has failed in Pakistan. Post-independence aspirations of decent livelihoods became disrupted by the development project, which evolved through Cold War politics. Premised upon the privileging of liberal capitalism, this modernization project was executed by authoritarian regimes that initiated new processes of dispossession and accentuated existent inequalities. Moreover, a critical analysis of Pakistan’s development crises must consider how poverty intersects with social inequality justified through zat or caste to reproduce entrenched positions of privilege and disadvantage. Mainstream Pakistani society comprises an efficacious trope of inequality normalized through the ‘othering’ of poor families, resistance to which is misrepresented as a lack of character and industry. Impoverished communities bear disproportionate costs of development, which compel them to find shelter in segregated communities in slums and earn a living as servants, vendors and through begging, including children on the streets. In the wake of neo-liberal policy reforms, the Benazir Income Support Programme provides temporary monetary relief to some but leaves intact the underlying causes of worsening inequality. A critical discussion of Pakistan’s development trajectory challenges the ideological premises of Vision 2025 and its promise of universal wellbeing.
Maternal Preferences for Approach and Language Use During Antenatal Counseling at Extreme Prematurity: A Pilot Study
Authors: Arzuaga Bonnie H. , Holland Erica , Kulp David , Williams David , Cummings Christy L.
Published: August 2021

Introduction:

Counseling families at risk for extremely preterm birth presents significant challenges to providers due to the uncertainty of infant outcomes.

Aim:

To determine lay-public parental preferences for approaches to prenatal counseling and preferred descriptive terminology usage by providers when discussing an anticipated extremely preterm delivery.

Methods:

This exploratory pilot study recruited parents through social media to participate in a survey centered around a hypothetical delivery at 23 weeks. Questions assessed participants’ understanding of medical terminology and preferences for terminology, discussion topics, and approaches to decision-making related to anticipated extremely preterm birth.

Results:

A total of 142 (72%) parents participated. Understanding of medical compared with nonmedical terminology was limited ( P < .01). Parents had stronger preferences for the use of certain words and terminology over others. They preferred discussions focused on the possibility of infant survival and information about intensive care, over general statistics, and outcome percentages. Most would choose attempted stabilization and neonatal intensive care unit care in this hypothetical case.

Discussion/Conclusions:

Parents have preferences regarding physician communication and approaches to decision-making around extremely preterm delivery, which may offer guidance to providers during counseling.
The Lived Experience of Nurses Caring for Patients Diagnosed With Intravenous Drug Use–Associated Infective Endocarditis in Appalachia: A Phenomenological Study
Authors: Todt Kendrea L. , Thomas Sandra P.
Published: August 2021

Background:

The number of patients admitted with infective endocarditis (IE) from intravenous drug use (IVDU) in Appalachia is increasing, a direct downstream effect of the opioid crisis. Extant literature highlights the pejorative attitudes health care workers have toward patients with substance use disorder, with nurses among the most punitive. Rather than describe attitudes, the purpose of this study was to describe the lived experiences of nurses caring for patients diagnosed with IE from IVDU in Appalachia.

Aims:

To describe an unexplored phenomenon in Appalachia to inform nursing practice, nursing education, and health policy.

Method:

Qualitative phenomenological study using the University of Tennessee method based on the tenets of Maurice Merleau-Ponty. Nine nurses (ages 29-53 years) recruited using purposive and snowball sampling participated in unstructured phenomenological interviews.

Results:

The essential meaning or central theme of the nurse experience working with these patients was a sense of hopelessness/hope, with four interrelated themes derived from the central theme: (1) guarding/escaping, (2) responsibility and revulsion, (3) apathy/empathy, and (4) grief and sorrow/cold and unemotional. Universally, nurses perceived caring for this population as futile, feeling a sense of powerlessness to change the outcome.

Conclusions:

These care experiences frustrated nurses, who described being physically and emotionally drained. To improve care delivery and improve patient outcomes, emphasis must be placed on nurse addiction education and standardizing nurse to patient with substance use disorder ratios to decrease work-related stress on nurses.
A comparative study of type 1 neovascularization: Neovascular age-related macular degeneration versus pachychoroid neovasculopathy
Authors: Altinisik Muhammed , Kurt Emin , Sonmezer Pinar , Kayikcioglu Ozcan , Ilker Suleyman Sami
Published: August 2021

Purpose:

This study aimed to compare type 1 choroidal neovascularization (CNV) characteristics in eyes with pachychoroid neovasculopathy (PNV) and neovascular age-related macular degeneration (nAMD) using optical coherence tomography angiography (OCTA).

Methods:

Treatment naive 23 eyes of 23 patients with PNV and 24 eyes of 24 patients with nAMD were evaluated. The height of pigment epithelial detachment (PED) and the central macular thickness were determined. OCTA sensitivity, CNV area, morphological patterns, and retinal superficial capillary plexus vessel density (SCP-VD) values were compared. The frequency of quiescent CNV, subretinal hyperreflective exudation (SHE), subretinal/intraretinal fluid, serous PED, double-layer sign (DLS), and pachyvessels were noted.

Results:

CNV was detected on OCTA in 83.3% of nAMD eyes and 91.3% of PNV eyes ( p = 0.66). Indistinct pattern was more common (74% vs 50%) and the CNV area (mm2) was smaller in PNV (0.77 ± 0.54 vs 1.57 ± 1.43) but did not reach significant levels ( p = 0.27 and 0.33 respectively). SCP-VD was similar between the groups ( p = 0.38). Statistically significant differences were found between groups in age and subfoveal choroidal thickness ( p < 0.05). DLS and pachyvessels were found to be more frequently in PNV ( p < 0.05). However, both groups had similar rates of quiescent CNV, SHE, subretinal/intraretinal fluid, and serous PED ( p > 0.05).

Conclusion:

Morphological features, area, and activation findings of type 1 CNV may play a limited role in differentiating nAMD and PNV cases.
Parent-led strategies supporting personal well-being when caring for a child with a life-limiting condition: A scoping review
Authors: Oakley Sarah , Dunbar Helena , de Vries Kay
Published: August 2021

The objectives of this review were to identify strategies initiated by parents of children with life-limiting conditions to support their own well-being at home and to describe the impact of these strategies on parental well-being. A systematic scoping review was performed using PRISMA-ScR guidelines, identifying 15 relevant studies that fit the inclusion and exclusion criteria. There were no studies that specifically assessed how parents support their own well-being; however, the 15 identified studies did provide pertinent data secondary to the primary aims of each study. This resulted in the identification of 14 parent-initiated strategies which were grouped thematically into 4 categories: (i) social experience and peer support, (ii) information and management techniques, (iii) reframed perspectives and (iv) prioritising own needs. Overall, there was some evidence of parents initiating specific, individualised and useful strategies to supporting their well-being. Notably lacking was any empirical evaluation as to the effectiveness of these strategies and the wider factors associated with them. Further research is required to assess how parents support their personal well-being in daily life and how these strategies can be implemented alongside service-initiated support to ensure full parental well-being.
Predictors of successful weight loss in children treated at a community hospital–based tertiary care pediatric weight management program
Authors: C McSweeney Zina , McSweeney Morgan D , Huang Shirley H , G Hill Samareh
Published: August 2021

Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital–based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.
Development of a zero-dimensional method for thermodynamic analysis and NOx calculation in the prechamber of a lean-burn gas engine
Authors: Oppl Thomas , Pirker Gerhard , Wohlthan Michael , Wimmer Andreas
Published: August 2021

Significant improvements in the power density and efficiency of lean-burn large gas-engines with a prechamber and their high flexibility in meeting fluctuating power requirements illustrate the potential for using these engines in stationary power generation and in the transportation sector. Since these engines have comparatively low CO2 and NOx-emissions, they are seen as a promising solution to meet stricter emission standards. However, current combustion concepts for these engines must be enhanced to improve their performance and emission behavior; simulation methods play a major role in this process. It is critical to know and understand the fundamental processes and their relationships in the prechamber and main combustion chamber; conducting detailed analyses makes this possible. Zero-dimensional methods are suitable for these analyses. Due to their shorter calculation times, they allow extensive parameter variations to be investigated. Common methods in this area are limited to calculating performance and emission related values only in the main combustion chamber. Since a considerable share of NOx-emissions from high-performance lean-burn gas-engines arise in the prechamber, it is imperative to conduct a separate thermodynamic analysis of the prechamber and its interaction with the main combustion chamber. This paper presents a zero-dimensional method with which NOx-emissions from the prechamber can be calculated separately from the emissions of the main combustion chamber. To this end, it is necessary to conduct thermodynamic analyses of both the chambers and to consider their interaction. The measurement data for development and validation of this method is provided by tests on a single-cylinder engine with separate cylinder-pressure indication for both the chambers. Based on the results of the analyses, it can be determined to what extent each of the two systems is involved in the formation of nitrogen-oxides. With knowledge of the origin of NOx-emissions, measures may be enacted that reduce total NOx-emissions.
Radiotherapy for Primary Tracheal Carcinoma: Experience at a Single Institution
Authors: Zeng Ruifang , Wang Hanyu , Cai Xiaohui , Guo Xiaoqiong , Ping Yanan , Yang Qiuyuan
Published: August 2021

Background:

There is limited understanding of tracheal carcinoma (TC) because of its rarity. We examined the efficacy of radiotherapy (RT) for patients with primary TC.

Methods:

We analyzed the records of 32 patients with primary TC who received RT at our center between November 1996 and December 2016.

Results:

Thirteen patients received adjuvant RT and 18 received definitive RT. Eight patients achieved complete remission (CR) after definitive RT. Among all patients, the 5-year overall survival (OS) rate was 46.9% and the locoregional progression free survival (LRPFS) rate was 68.1%. Univariate analysis indicated the 5-year OS was better in those with adenoid cystic adenocarcinoma than squamous cell carcinoma ( P = 0.001); the 5-year LRPFS was better in patients who received surgical resection than those who did not (92.9% vs 46.4%, P = 0.013) and in patients who received postoperative RT than in those who received definitive RT (91.7% vs 50.1%, P = 0.038). A sub-group univariate analysis indicated the 5-year PFS was better for those who received at least 68 Gy of radiation (44.4% vs 13.0%, P = 0.044). Patients who achieved CR had a better 5-year PFS than those who did not (57.1% vs 10%, P = 0.006). No patients had a toxicity of grade 3 or more.

Conclusions:

Adjuvant and definitive RT are safe and effective treatments for TC. Patients who received dosages of 68 Gy or more and who had complete tumor regression following definitive RT seemed to have better long-term survival.
Providing Comfort through Music to People Amidst the COVID-19 Pandemic as a Humanitarian Disaster
Authors: Situmorang Dominikus David Biondi
Published: August 2021

Hopefully, through this article, mental health workers, such as counselors, psychologists, psychiatrists, nurses, doctors, religious leaders, and social workers, can consider music as a good alternative in the midst of this COVID-19 pandemic. It is hoped that mental health workers who are currently struggling to care for everyone's psychological health in their respective countries can provide comfort through collective music activities.
Research Ethics Consultation in Nursing Studies
Authors: Kane Chikako , Sakaguchi Satoshi , Chuma Masayuki , Yagi Kenta , Takechi Kenshi , Aoe Yuki , Takagai Tomoko , Yanagawa Hiroaki
Published: August 2021

Despite the importance and acceptance of research ethics consultation as an entity in many medical research areas, little is known about its status in nursing research. Focusing on inquiries from nurse researchers, we retrospectively analyzed records of integrated clinical research consultation, provided by members of the Clinical Research Center independently of the research ethics committee, at a Japanese university hospital during 2018–2019. Among various consultations in nursing studies ( n = 101), 43 were related to research ethics. The main issues in research ethics consultation were compatibility with guidelines ( n = 28; 65%) and application of ethics review ( n = 12; 28%). Future studies should investigate international settings and address the relevance of research ethics consultation to promote proper nursing studies.
Improved Energy Efficiency of Mixed Convection Heating Process in Eccentric Annulus
Authors: Khaoula Ben Abdelmlek , Fayçal Ben Nejma
Published: August 2021

This paper deals with a numerical study of mixed convection heat transfer in horizontal eccentric annulus. The inner cylinder is supposed hot and rotating, however the outer one is kept cold and motionless. The numerical problem was solved using COMSOL Multiphysics® which is based on finite element method. The resolution of the partial differential equations was conducted through an implicit scheme with the use of the damped Newton’s method. The present numerical analysis concerns the effect of eccentricity, rotation speed and Rayleigh number on the flow patterns, heat transfer rate, and energy efficiency of the process. It was found that the heat transfer rate increases with the increase of Rayleigh number. In addition, the heat transfer rate drops with the increase of rotation speed. Finally, we have demonstrated that maximum energy efficiency is achieved not only with higher Rayleigh number but also it is maximum with small eccentricity.
The prognostic value of serum bilirubin in colorectal cancer patients with surgical resection
Authors: Jia Zhangjun , Zhu Zeyu , Wang Ying , Ding Jing , Lin Zhenzhong , Zhang Yanyan , Li Zhipeng
Published: August 2021

Purpose

Serum bilirubin plays an important role in antioxidant and anticancer processes. The inverse association between serum bilirubin and cancer risk have been widely reported in multiple cancers. The aim of this retrospective study was to investigate the prognostic impact of serum bilirubin in colorectal cancer patients undergoing surgical resection.

Methods

The value of serum bilirubin including total bilirubin, direct bilirubin, and indirect bilirubin were tested at pre-operatively in 330 colorectal cancer patients. The optimal cut-off values for these three biomarkers were determined by X-tile program. The relationship between serum bilirubin and outcomes were examined using Kaplan–Meier curves log-rank test, univariate and multivariate cox regression. Moreover, a number of risk factors were used to form a nomogram for evaluating risk of survival.

Results

The optimal cut-off points of serum total bilirubin, direct bilirubin, and indirect bilirubin were 19.5 μmol/L, 5.0 μmol/L and 8.1 μmol/L, respectively. Elevated total bilirubin and direct bilirubin were significantly associated with overall survival in surgical colorectal cancer patients. Additionally, predictive nomogram including total bilirubin and direct bilirubin for overall survival was established for predicting overall survival in surgical colorectal cancer patients.

Conclusions

These findings indicated that preoperative elevated total bilirubin and direct bilirubin could be considered as independent prognostic biomarkers for poor overall survival of colorectal cancer patients.
Resuscitation orders in the perioperative setting: A survey of knowledge, practices and perceptions among consultant and trainee anaesthesiologists
Authors: Crowe Ann-Marie , Marsh Brian
Published: August 2021

Background

As advance healthcare directives gain clarity in state legislation in Ireland, anaesthesiologists will come across patients with resuscitation orders that will demand interpretation when encountered perioperatively. Studies show variable perceptions among anaesthesiologists towards the binding nature of resuscitation orders in the context of anaesthesia provision. Currently, knowledge, perceptions and practices of anaesthesiologists in Ireland towards such orders are not known.

Methods

A cross-sectional online survey was distributed to anaesthesiologists in adult teaching hospitals.

Results

In this cohort, 65.9% of those surveyed did not know if there was a local hospital policy advance healthcare directive containing, do not attempt resuscitation, decisions in the perioperative period in their current hospital; 57.7% did not know if there was a policy for not for resuscitation orders; 74.8% did not know if there are guidelines for the management of patients with resuscitation orders. Irrespective of the presence of an order stating otherwise, 43.9% would initiate resuscitation in the event of any arrest occurring in theatre, with 66.7% initiating resuscitation if secondary to iatrogenesis.

Conclusions

By uncovering low self-perceived levels of knowledge and mixed perceptions towards resuscitation orders, the authors hope that the study initiates much-needed conversations on the topic, particularly at a time when advance healthcare directives find a more firm legal footing in Ireland.
Sacred memory, creole orientalism and India in the plantationscape of Mauritius
Authors: Rajkomar Sraddha Shivani
Published: August 2021

This article disentangles the relationship between memory and the sacred through the life and selected writings of Léoville L’Homme (1857–1928), who rose to prominence as poet and journalist in the 19th century as sugar production expanded in the Indian Ocean island of Mauritius. A man of colour and a Christian, L’Homme instrumentalised genealogy, cultural memory and the sacred in the vindication of exclusive forms of social justice in what I call the Mauritian plantationscape. His carefully-crafted sacred memory project, heavily modulated by French and British Orientalism, and characterised by tension between memory and the sacred, resulted in the perpetuation of discursive and colonial injustice against India, the homeland of his grandmother, and Indian indentured labourers. After identifying signs of trauma underlying his strained cultural memory landscape and implication, I argue that the organic creolisation present in the colony intervenes to turn the Hindu Goddess Sita, with whom L’Homme sought poetic intimacy, into a symbol of desire for India. This symbol impels an intercultural dialogue where Christianity and Hinduism meet to repair and bestow a reparative vector upon sacred memory. Intercultural dialogue creolises Orientalism, L’Homme’s primary portal into Indian cultural memory, and Creole Orientalism impedes cultural erasure. This sacred and inherently gendered creole cultural memory matrix redresses L’Homme’s relationship with India, his Otherness and Indian cultural memory. It injects an ethical economy in his activism that promises new definitions of a Mauritian collective ahead of decolonisation which remain germane to considerations of identity in the multicultural island’s post-colonial era.
Local anaesthetics: Theoretical aspects
Authors: Allen Gareth , Butler Rebecca
Published: August 2021

Local anaesthetics are frequently used in both primary and secondary care. These agents transiently reduce the nervous conduction of nociceptive signals, reducing sensations of pain. In primary care, local anaesthetics are often used for minor surgical procedures. However, there are other uses for these agents. It is important to understand the issues encountered when using local anaesthetics in primary care. This review will cover clinical use, relevant pharmacology and adverse effects of the different local anaesthetic preparations.