bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictions of the design decisions for vehicle alloy wheel rims using neural network
Authors: Topaloğlu Anıl , Kaya Necmettin , Öztürk Ferruh
Published: August 2022

The weight and modal performance of the vehicle wheels are two essential factors that affect the driving comfort of a vehicle. The main objective of this study is to present an efficient approach to reduce the weight and enhance the modal performance of the wheel by reducing the design time and computational cost. The alloy wheel rim is often used for lightweight wheel design. In this study, an approach is presented for the lightweight design of alloy wheel rims. An intelligent approach based on neural networks (NNs) is introduced to predict the optimum design parameters of the wheel rim during the wheel design phase and to improve the wheel optimization process. The Latin hypercube and Hammersley designs of the experimental methods were used to obtain a training dataset with finite element analysis. The NN and multiple linear regression (MLR) models were trained to predict the weight, first-mode frequency, and displacement values. A multi-objective genetic algorithm was employed to optimize the design decisions based on the predicted values. It was used to compute the optimum results with both the NN and MLR models for a better prediction accuracy of the wheel rim design parameters. The proposed approach allows designers to optimize design decisions and evaluate design modifications during the early stages of the wheel development phase. The surrogate-based optimization method plays an important role in the wheel rim optimization process, particularly when the optimization model is established based on computationally expensive finite element simulations, testing, and prototypes. The results show the effectiveness of the NN-combined genetic optimization approach in predicting the responses and optimizing the design decisions for the alloy wheel rim design by reducing engineering time and computational cost.
Modelling and analysis of longitudinal-vertical coupling dynamics for the tracked vehicle on uneven roads
Authors: Guo Zhiqiang , Zhao Sihai , Luo Junlin
Published: August 2022

In this paper, a longitudinal-vertical coupling dynamic model of a tracked vehicle under uneven road conditions is established. The torsion suspension forces and torques generated by the torsion bar springs and torsion shock absorbers are considered in the present model. The tracked vehicle’s longitudinal acceleration and velocity change at the same time as the vehicle heaves under the excitation of uneven road terrain. The vehicle’s longitudinal-vertical coupling dynamics are explained elementarily by analysing the longitudinal and vertical dynamics of a road wheel based on the road wheel force model. From the coupling tracked vehicle model, the dynamic responses of the vehicle in the vertical and pitch directions as well as the longitudinal direction are investigated. The vehicle dynamics characteristics are compared with those obtained by Recurdyn simulation. The results indicate that the proposed dynamic model performs well in predicting the dynamic characteristics of the tracked vehicle on uneven roads. By means of the coupling dynamic model, the influences of vehicle speed and road conditions on the vehicle’s longitudinal dynamics are further studied. It has been found that both a higher velocity and a larger roughness coefficient will lead to a negative longitudinal acceleration with larger absolute value.
Model predictive control for active vibration suppression of hybrid electric vehicles during mode transition
Authors: Huang Ying , Wang Jian , Yue Yunpeng , Yang Long
Published: August 2022

To realize a rapid and comfortable mode transition process from pure electric mode to hybrid mode (E-H), this study proposes an innovative control strategy which combines open-loop control with model predictive control to regulate the E-H process for a P2.5 configuration hybrid electric vehicle. Firstly, a detailed vehicle longitudinal dynamic model is established and the mode transition process is divided into four phases to reveal the control problems. Based on this model, a strategy combining open-loop control with model predictive control is developed. The open-loop control is adopted before the clutch is locked in order to speed up the transition process and limit the vehicle jerk. The model predictive control (MPC) is adopted after the clutch is locked to actively suppress the vibration caused by the abrupt change of clutch torque at the moment of clutch lock-up. Finally, simulation and hardware-in-the-loop test demonstrate that the proposed strategy for mode transition can achieve both switching rapidity and riding comfort. The algorithm robustness is also discussed and the signal transmission delay influence caused by controller area network (CAN) is studied.
Experimental investigation into the aerodynamic and aeroacoustic performance of bioinspired small-scale propeller planforms
Authors: Moslem Foad , Masdari Mehran , Fedir Kirchu , Moslem Behzad
Published: August 2022

The multi-rotors have a limited operational period and generate too much noise, which is insufficient for complex tasks and adversely affects humans’ and animals’ health. Nevertheless, their market has become increasingly popular. Therefore, low-noise products are more competitive, and aerodynamic and acoustic improvements are critical. This investigation aims to design a small bioinspired propeller with the same power input as a conventional propeller to achieve the same or better aerodynamic performance while decreasing noise. Accordingly, an experiment investigated the impacts of operation conditions and varied geometric parameters on six small propellers' aeroacoustic performances with a unique planform shape inspired by five insects and one plant seed, such as Blattodea, Hemiptera, Hymenoptera, Neuroptera, Odonata, and maple seed. Each propeller was operated at eleven rotational speeds ranging from 3000 to 8000 RPM with no freestream velocity for simulating hover conditions. Compared to the baseline propeller, the results demonstrate that all bioinspired propellers produce more thrust for the same power supply, reduce harmonic and broadband noise, and provide a better noise level. Also, their rotational speed is lower and their figure of merit is higher than the baseline propeller at hover flight with 3N thrust. They all outperform the baseline propeller in terms of hover efficiency at all thrust values considered. Besides, the Neuroptera propeller is more efficient than other propellers, decreasing 5.5 W of power and reducing 7.9 dBA at hover flight with 3N thrust and 1.5 meters distance, compared to the baseline propeller.
A comprehensive review of outdoor thermal comfort in urban areas: Effective parameters and approaches
Authors: Aghamolaei Reihaneh , Azizi Mohammad Mehdi , Aminzadeh Behnaz , O’Donnell James
Published: August 2022

Increased urban air temperature considerably affects the health, comfort and consequently the quality of life in urban spaces. Urban design and planning studies, therefore, face an increasing challenge as they aim to improve Outdoor Thermal Comfort (OTC) and microclimate conditions of urban environments. Analysing OTC is more challenging when compared to indoor thermal comfort since a wider range of interrelated parameters exists in outdoor environments. Therefore, this research aims to classify urban studies that investigate OTC by conducting a comprehensive review based on key metrics such as approaches taken, methodologies and spatial and temporal scales. By extracting the key findings, this research forms an integrated framework of these metrics that presents a thorough view of the OTC concept in the context of climate-sensitive studies. Furthermore, this research elaborates on the main two groups of parameters affecting OTC including environmental and human-based parameters. Exploring the intricate inter-relationships of these two groups of parameters clarifies their contribution to OTC. Results of this study help architects and urban planners to improve their climate-sensitive strategies and support the decision-making process by providing a comprehensive perspective about different aspects of OTC. Finally, recommendations for future research are outlined.
Beyond an abstract and technical conception of psychotherapy: The indispensable role of practical wisdom
Authors: Fowers Blaine J. , Novak Lukas F. , Calder Alexander J. , Sommer Robert K.
Published: August 2022

The work of psychotherapy is complex and seems to resist algorithmic formulation. Psychotherapy theory, technique, and research help to manage this complexity to some degree, but clinical excellence also seems to require clinical judgment, and this judgment cuts across therapeutic theories. However, the content and process of clinical judgment remain relatively untheorized, often relegated to the “art of psychotherapy.” This article focuses on elucidating clinical judgment in terms of the neo-Aristotelian concept of practical wisdom, which includes recognizing what is salient, integrating multiple considerations, infusing emotional experience with reason, and pursuing an intervention plan with discernment and flexibility. The argument is that practical wisdom provides a rich description of the work of clinically adept therapists by more clearly portraying therapists’ decisions and activities than the general, unsystematic concept of clinical judgment or in terms of the many theories of psychotherapy.
Importance of temporality and context in relation to life habit restrictions among patients with systemic lupus erythematosus: A psychosocial qualitative study
Authors: Aim Marie-Anastasie , Queyrel Viviane , Tieulié Nathalie , Chiche Laurent , Faraut Julien , Manet Cécile , Schleinitz Nicolas , Harlé Jean-Robert , Jourde-Chiche Noémie , Dany Lionel
Published: August 2022

Objective

Life habits (LH) encompass an individual’s engagement in daily activities such as nutrition, fitness, personal care, communication, housing, and mobility, along with his/her social role (responsibility, interpersonal relationships, community life, education, employment, and recreation). This qualitative study explores the nature and context of LH restrictions in systemic lupus erythematosus (SLE) individuals across their SLE journey.

Methods

Narrative interviews were conducted with adult SLE patients. Interview transcripts were subjected to a thematic content analysis, using the Disability Creation Process model as a framework.

Results

Forty participants were interviewed. Three major themes were highlighted: (1) Temporality, capabilities, and environmental contexts: although all participants experienced LH restrictions at some point, the expression of these limitations depended on the individual’s and SLE disease characteristics as well as on temporal (time of life and lupus course) and environmental (material, social, and societal) contexts. (2) Identity issues, illness stigma, and (fear of) discriminations: LH were discussed through the lens of participants’ social roles and identities. While illness stigma can influence social relations, it is also expressed at a societal level. (3) Masking and minimizing strategies: due to illness stigma and fear of discrimination, participants developed strategies to manage their relationships, including masking and minimization. Their use was both advantageous and disadvantageous regarding LH.

Conclusions

For individuals with SLE, LH restrictions must be considered as an ongoing process that takes place within specific contexts. Our findings provide many opportunities for interventions that can benefit patients and their families, as well as healthcare providers.
Panoramic social minds: Social minds manipulations in ‘A Mother’
Authors: Zhang Zhijun , Liu Shisheng
Published: August 2022

‘A Mother’ by Joyce tells of Mrs. Kearney’s effort in enhancing her daughter’s musical reputation during the Irish Revival, revolving around a conflict between Mrs. Kearney and a male-dominated group at concerts. Although some studies tend to view Mrs. Kearney as a dominant female and others take her as a victim of gender discrimination, there is no interpretation from the perspective of social minds. This article aims at using social mind theory to explore how the characters manipulate social minds against each other for their own purposes. It is found that Joyce deploys ‘covert double cognitive narrative’, a new paradigm of social minds, to propel the plot, and utilizes behaviourist narration and dialogue predominantly in rendering social minds. Therefore, this new perspective commands a panoramic view of the social minds manipulations in ‘A Mother’. Tracing the social minds this way is essential in understanding the story, shedding light on the Irish cultural paralysis of the time.
Jamal Dairy Farm: Technology Adoption Challenges
Authors: Siddique Muhammad Imran , Jajja Muhammad Shakeel Sadiq
Published: August 2022

This case clinically analyses the dynamics of the dairy sector and its core foundations, without which it is impossible to run this enterprise successfully. The prime focus is to understand the prerequisites of establishing a sustainable and profitable dairy farm considering the most critical climate factor. It provides guidelines for good dairy farming practices, challenges, and probable measures to address the obstacles. Most importantly, this case presents the execution of a mixed blend of existing and modern dairy farm practices considering prevalent constraints in the sector. The differences in breed, feed, nutrition, animal welfare, environment, and technology between the leading dairy-producing countries and developing countries (like Pakistan) are highlighted. Finally, the case suggests good dairy farming practices adopted in the local context to operate a dairy farm efficiently.
Cosserat modeling for deformation configuration of shape memory alloy unimorph actuators
Authors: Kennedy Scott , Vlajic Nicholas , Perkins Edmon
Published: August 2022

Shape memory alloys (SMAs) can contract their length via a crystalline phase transition that is dependent upon their temperature and stress state. SMAs have been used as linear micro-actuators due to their high strength to weight ratio and compact structure. However, the relatively low linear contraction ([Formula: see text]4%–5% in length) limits their use. To remedy this, the SMA can be offset from a passive structure, which acts to magnify the deformation. The resulting amount of deformation depends upon the material properties and geometry of both the SMA and the passive structure. In this work, geometrically exact beam theory (also known as Cosserat theory) is coupled with SMA constitutive relations to model the maximum deformation configuration of these actuators. Four of these actuators of various lengths were fabricated and tested to verify the model. For the four actuators tested, the mean squared error between the experimental results and the Cosserat model were between 0.0702 mm (0.1% error) for the shortest actuator (66 mm in length) and 3.59 mm (2.7% error) for the longest actuator (135 mm in length). These results show that the closed form solution derived for this Cosserat beam model can accurately model the deformation of these active structures.
Trauma and Abuse Among Incarcerated Girls in the United States and Costa Rica
Authors: Maki Weller Nicole , de Mezerville-López Claire M. , Pérez-Ramírez Berenice , Ochoa Theresa A.
Published: August 2022

Incarcerated girls have disproportionately higher rates of physical, emotional, and sexual abuse compared with their nonincarcerated peers. Failure to address this trauma and abuse can lead to mental health disabilities such as anxiety, depression, post-traumatic stress disorder, and anti-social behaviors. Many girls who experience trauma engage in criminal behaviors as a response to these unresolved issues. The punitive nature of correctional confinement only exacerbates their mental health disabilities. This article examines the correctional confinement experiences for girls with mental health disabilities in the United States, where there is a large population of incarcerated girls, and Costa Rica, a country with fewer incarcerated girls. Policy changes are suggested to minimize the punitive nature of correctional confinement and to enhance the services and support systems available to incarcerated girls with mental health disabilities.
The Efficacy and Safety of Sacubitril-Valsartan for the Treatment of Heart Failure in Adults: A Meta-Analysis
Authors: Tian Qingshan , Xiong Zhiping , Fan HouDe , Ning Ting , Zheng ZhenZhong
Published: August 2022

Objective:

The current meta-analysis reviews the different randomized controlled trials (RCTs) on the use of sacubitril-valsartan (SV) thoroughly and assesses its effectiveness and safety as a drug for heart failure.

Data Sources:

Relevant articles for meta-analysis were searched from PubMed, MEDLINE, and Central databases using appropriate keywords.

Study Selection and data extraction:

Studies were included as per the predefined PICOS criteria. Demographic summary and event data change in heart conditions after drug intake and adverse effects of drugs under both the SV and control arms were determined. The risk of bias and comparative drug efficiency in terms of diagnostic odds ratio (OR) and risk ratio (RR) were determined using RevMan software.

Data Synthesis:

Ten RCTs with total 18 164 heart failure patients were included according to the inclusion criteria from the year 2015 to 2022. Included studies have patients of different age groups treated with either SV or control. For the change in number of patients with heart conditions after drug intake, we obtained the pooled OR of 0.80 (95% CI, 0.71-0.91) and pooled RR of 0.92 (95% CI, 0.88-0.96). The OR value less than 1 is indicative of high efficiency of SV in lowering the number of heart patients. All these values are statistically significant ( P < 0.05) and suggested better recovery of patients with SV as compared with the control drugs with minimal risk and side effects.

Conclusions:

The present evidence shows that SV is effective in the treatment of heart failure, reducing hospitalization and cardiovascular mortality, and that the adverse effects are comparable or fewer than those associated with other drugs used for this indication.
Workplace Violence Prevalence and Reporting in Home Health Care: A Cross Sectional Survey
Authors: Small Tamara F. , Gillespie Gordon L. , Hutton Scott , Davis Kermit G. , Smith Carolyn R.
Published: August 2022

Workplace violence (WV) is a significant occupational hazard for home health care workers (HHCWs). HHCWs are frequently exposed to Type II (customer/client) WV incidents but minimal evidence exists about exposure to Type III (coworker) WV and exposure to Type IV (personal relationship) WV is unknown. Furthermore, exposure to WV incidents is often underreported by HHCWs. The Haddon Matrix guided this research study. A cross- sectional research design was used with HHCWs (n = 50) working in Southwest Ohio in April 2020. HHCWs completed the Workplace Violence Reporting Survey, a 76-item tool used to estimate the frequency and reporting of WV incidents. Data were analyzed using frequencies, percentages, means, and standard deviations. HHCWs were 86% female (n = 43). Patients (28.3%) followed by their families (17.4%) and intimate partners (10.9%) are the primary aggressors of verbal abuse. The incident was too minor (6.5%), no action would be taken (6.5%), and it’s part of the job (4.3%) are major reasons HHCWs underreported WV. Type II WV is most pervasive when the aggressor is the patient. HHCWs experience physical assault and sexual abuse in their work environment. HHCWs underreported verbal abuse and physical assault when the aggressor was an intimate partner.
Necrotizing scleritis due to Hormographiella aspergillata
Authors: Lamas-Francis David , Llovo-Taboada Jose , Navarro Daniel , Touriño Rosario , Rodríguez-Ares Teresa
Published: August 2022

Purpose

To report the management and outcome of a case of necrotizing scleritis due to Hormographiella aspergillata.

Methods

Case report.

Results

A 79-year-old woman developed scleral inflammation following accidental trauma with a gorse plant in her left eye. An abscess formed at the site of the injury, which was surgically drained. Filamentous fungi were identified from the abscess contents, and oral voriconazole and topical voriconazole and natamycin drops were prescribed. Phenotypic analysis confirmed the presence of Hormographiella aspergillata, with low minimum inhibitory concentrations (MIC) for voriconazole and amphotericin B. Two weeks later the patient presented with an area of necrotizing scleritis which required surgical debridement and scleral grafting. Three months later, the scleral inflammation had resolved leaving an area of scleromalacia.

Conclusions

Hormographiella aspergillata is a common environmental fungus that has recently emerged as a human pathogen and a rare cause of scleritis. To the best of our knowledge, this is the first report of scleritis in which a pure culture of H. aspergillata was obtained. Successful management poses a challenge as there are limited reports on antifungal susceptibility and a combination of medical and surgical treatment is often required.
The association between vascular access satisfaction and quality of life and depression in maintained hemodialysis patients
Authors: Li Meng-Ting , Wu Min , Xie Qing-Lei , Zhang Liu-Ping , Lu Wen , Pan Meng-Jiao , Yan Xiao-Wei , Zhang Lan , Zhang Ling , Wang Yue
Published: August 2022

Background:

Vascular access (VA) is known to be critical for the survival of patients on maintained hemodialysis (MHD) treatment. However, the association between VA satisfaction and psychiatric state in MHD patients is still not fully elucidated. Thus, the aim of this study is to evaluate the relationship among VA satisfaction, health-related quality of life (HRQOL) and depression in MHD patients with different VA types.

Methods:

This cross-sectional study was conducted at two dialysis centers with MHD-dependent patients. The Short Form Vascular Access Questionnaire (VAQ) was administered to estimate the level of MHD patients’ satisfaction with their VA. HRQOL was assessed using the Short Form 36 (SF-36) questionnaire. Depression was assessed using the Zung’s self-rating depression scale (SDS).

Results:

Of the total 252 patients, AVF was used by 84.13%, AVG was used by 2.78%, and TCC was used by 13.09%. There was no significant difference in satisfaction and SDS scores by access type in patients with AVF, AVG, and TCC. However, HRQOL was worst in patients with TCC, and highest in the AVF group. Further analysis showed that VAQ scores in the domains of overall and dialysis-related complications exhibited a negative correlation with HRQOL. And SF-36 HRQOL scores, including the total score, PCS and MCS, were all negatively correlated with SDS scores ( p < 0.05). The results of multivariable analyses found that VAQ scores in the domains of overall score and physical symptom, and total score of HRQOL influenced the depression.

Conclusions:

In the present study, no significant difference in satisfaction scores by access type was found in patients with AVF, AVG, and TCC. The HRQOL score was higher in patients with AVF than in those with AVG or TCC. And the result suggested a negative association between HRQOL and depression. Vascular access satisfaction and HRQOL might be risk factors for the presence of depression in MHD patients.
Confirmation of pleural displacement of central venous catheter tip in an infant, by bedside contrast injection
Authors: Kumar Ketan , Mathew Joseph L , Sodhi Kushaljit S
Published: August 2022

A 14-week infant, with respiratory distress since birth, was referred to our institution. Chest radiography and ultrasonographic examination confirmed right-sided diaphragmatic eventration. Owing to difficulty in securing a peripheral venous access, a double-lumen 4-Fr central venous catheter (CVC) was inserted into the right internal jugular vein, under ultrasonographic guidance. Aspiration of blood from both ports confirmed intravascular placement. A frontal radiograph done after the procedure showed the catheter tip in the right atrium, hence it was withdrawn to a level just below the carina. Surgical plication of the right dome of the diaphragm was performed, following which an intercostal tube was placed. After 3 days, there was increased drainage of clear fluid. Biochemical analysis ruled out exudative effusion, hence displacement of the CVC into the pleural cavity was suspected. A frontal chest radiograph was done to confirm this, but it did not suggest CVC tip displacement. Bedside ultrasonography was done but the CVC tip could not be visualized. The patient was too unstable to perform a chest CT scan or echocardiography. Therefore, a bedside chest radiograph was taken while injecting 1 ml of iohexol (diluted with 4 ml of normal saline) into the CVC. This showed the contrast leaking out of the CVC, flowing into the mediastinal pleural space, and ultimately into the ICD tube, confirming displacement of the CVC tip. The catheter was immediately removed, and an alternate venous access was established.
Defending hegemony: From climate change mitigation to adaptation on the Great Barrier Reef
Authors: Nyberg Daniel , Wright Christopher
Published: August 2022

The catastrophic consequences of climate change are now evident with extreme weather events impacting communities and ecosystems. Against calls within civil society for dramatic decarbonisation, the continued expansion of the fossil fuel industry is constructed by governments and business as ‘common sense’. By analysing the political process surrounding the 2016 and 2017 coral bleaching of the Great Barrier Reef, we show how a fossil fuel hegemony has been upheld against the counter-hegemonic forces of environmental critique and the catastrophic bleaching events. By distinguishing between politics (i.e. strategies, practices and discourses) and the political (i.e. the antagonism constitutive of societies), we explain what different hegemonic practices achieve in the process of establishing and defending hegemony. In our case, this resulted in downplaying emissions mitigation and emphasising local climate change adaptation. Through the political process, business solutions and self-regulation were presented as the logical response to the climate crisis.
Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care
Authors: von Weinrich Philipp , Kong Qingxia , Liu Yun
Published: August 2022

Introduction

The popularity of video consultations in healthcare has accelerated during the COVID-19 pandemic. Despite increased availability and obvious benefits, many patients remain hesitant to use video consultations. This study investigates the relative importance of the consultation mode compared to other attributes in patients’ appointment choices in Germany.

Methods

A discrete choice experiment was conducted to examine the influence of appointment attributes on preferences for video over in-clinic consultations. A total of 350 participants were included in the analysis.

Results

The level of continuity of care (46%) and the waiting time until the next available appointment (22%) were shown to have higher relative importance than consultation mode (18%) and other attributes. Participants with fewer data privacy concerns, higher technology proficiency, and more fear of COVID-19 tended to prefer video over in-clinic consultations. The predicted choice probability of a video over a typical in-clinic consultation and opting out increased from <1% to 40% when the video consultation was improved from the worst-case to the best-case scenario.

Conclusion

This study provides insight into the effect of the consultation mode on appointment choice at a time when telemedicine gains momentum. The results suggest that participants preferred in-clinic over video consultations. Policymakers and service providers should focus on increasing the level of continuity of care and decreasing the time until the next available appointment to prompt the adoption of video consultations. Although participants preferred to talk to their physician in person over consulting via video per se, the demand for video consultations can be increased significantly by improving the other appointment attributes of video consultations such as the level of continuity of care.
Classroom environment and willingness to communicate in English: The mediating role of emotions experienced by university students in China
Authors: Li Chengchen , Dewaele Jean-Marc , Pawlak Mirosław , Kruk Mariusz
Published: August 2022

The present study examines the direct and indirect relationships between classroom environment (CE), L2 (second/foreign language) learner emotions (i.e. enjoyment, anxiety and boredom), and their willingness to communicate (WTC) in classes for English as a foreign language (EFL). Participants were 2,268 university students in China. Pearson correlation analyses showed significant correlations between CE, L2 emotions, and WTC, with effect sizes ranging from small to large. In addition, the three L2 emotions were found to mediate the relationship between CE and WTC in parallel, with enjoyment having the largest mediating effect, followed by anxiety and boredom. The findings offer insights into how to improve students’ WTC in an L2.
The sad clown paradox: A theory of comic transcendence
Authors: Smith Daniel R
Published: August 2022

One prevailing cultural sensibility of our time is a concern with the state of our mental health, another is our obligation and desire for a good ‘sense of humour’. At present the two are conflated, most often through a long-standing cultural trope: the sad clown paradox – those who make us laugh the most tend to be the most prone to mental health problems. This article views the ‘sad clown paradox’ as less about the peculiarity or exceptional status of a comedian's mind, more about how the cognitive burdens of modernity are rendered bearable and collectively recognised in thought and sentiment by humour. Accounts of comedy and mental health conflate good comedy with mental anguish. By unpacking this knotted relationship, it is argued that comedian's humour performs a way for contemporary people to deal with modernity's fragmentary character of life from within their own inner worlds and selves.
Unconventional harm reduction interventions for Minor-attracted persons
Authors: Appel Jacob M.
Published: August 2022

Minor-attracted persons raise multiple ethical and legal challenges. Sexual contact between adults and children is justly prohibited on child welfare grounds. Advances in technology raise the prospect of interventions for minor-attracted persons that have the potential to reduce harm to children by diverting would-be offenders to other endeavors that nonetheless may generate moral disgust This essay examines three of these potential harm reduction technologies (sex robots, haptic devices and synthetic child pornography) and raises the possibility that their use can be justified and their acceptance morally obligatory if doing so reduces harm to real children.
Possible Causes of Leaks in the Transfer Pipeline: Student Views at the 19 Colleges of The City University of New York
Authors: Logue A. W. , Oka Yoshiko , Wutchiett David , Gentsch Kerstin , Abbeyquaye Stephanie
Published: August 2022

Only 11% of community college (associate's-degree) students transfer vertically and obtain a bachelor's degree within six years, despite over 80% originally intending to do so. These leaks in the transfer pipeline disproportionately affect students from underrepresented groups, who are more likely to attend community colleges and to leak out of the pipeline. To obtain insights about how to decrease these leaks, a survey was distributed to all City University of New York undergraduates; 31,511 responded. The survey concerned students’ life and academic circumstances, as well as their information about and views on transfer. Analyses particularly compared responses of never-transferred associate's and bachelor's students and vertical transfer students. The results suggest multiple actions that higher education can take to decrease the pipeline leaks and increase higher education equity, including by increasing transfer students’ belongingness, course availability, credit transfer, financial support, information, and time efficiency.
Respectful maternity care and associated factors among mothers who gave birth at public health institutions in South Gondar Zone, Northwest Ethiopia 2021
Authors: Ferede Wassie Yazie , Gudayu Temesgen Worku , Gessesse Dereje Nibret , Erega Besfat Berihun
Published: August 2022

Introduction:

Respectful maternity care is essential for improving maternal and neonatal health. Lack of respectful maternity care during childbirth services is one of the deterrents to women seeking facility-based deliveries. It is a health system failure and a violation of women’s rights. There is limited data on respectful maternity care during childbirth and maternity care in Ethiopia, particularly at rural health facilities. But studies have shown that many women from rural areas were more likely to report disrespect and abuse than urban residents.

Objective:

This study aims to assess respectful maternity care and associated factors among mothers who gave birth at health institutions in the South Gondar zone, northwest Ethiopia, 2021.

Methods:

A multicenter institutional-based cross-sectional study design was conducted among mothers who gave birth at South Gondar Zone public health institutions, from 1 February to 30 March 2021. Six hundred twenty-two study participants were selected by using systematic random sampling. The data were collected through face-to-face interviews using a pretested and semi-structured questionnaire. Data were entered into Epi-Data version 4.6 and exported to SPSS version 23 for analysis. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance.

Result:

A total of 611 participants were included in the study with the response rate of 98.2%. The study revealed that only 39.4%, of (95% confidence interval: 35.4–43.2) women received respectful maternity care. Completed secondary education (adjusted odds ratio: 2.47, 95% confidence interval: 1.35–4.50), having antenatal care follow-up (adjusted odds ratio: 0.098, 95% confidence interval: 0.03–0.34), planned pregnancy (adjusted odds ratio: 3.21, 95% confidence interval: 1.69–6.08), cesarean section delivery (adjusted odds ratio: 0.47, 95% confidence interval: 0.25–0.89), and daytime delivery (adjusted odds ratio: 1.9, 95% confidence interval: 1.33–2.72)) were significantly associated with respectful maternity care.

Conclusion and Recommendation:

Only two out of five women received respectful maternity care during childbirth. Completed secondary education, having antenatal care follow-up, pregnancy intended/wanted, daytime delivery, and cesarean section delivery were identified factors. Therefore, giving emphasis to creating awareness of care providers on the standards and categories of respectful maternity care, improving care provider–client discussion, monitoring, and reinforcing accountability mechanisms for health workers to improve respectful maternity care during labor and childbirth were recommended.
Marielle restored? Mortuary graphisms, memory and ritual in intersectional and anti-racist responses to necropolitical violence in Rio de Janeiro
Authors: Bizarria Julio , Gomes Edlaine de Campos
Published: August 2022

This article discusses mortuary memory and ritual among subalternised populations, in their struggle against necropolitical violence, in the city of Rio de Janeiro, as of the late 2010s. The case study analyses the conception, vandalisation and restoration of two graffiti works, made by Brazilian artists Panmela Castro and Simone Siss, with a decisive contribution from Malala Yousafzai. These works, made in honour of the late Councillor Marielle Franco, are often celebrated as material memories of the intersectional and anti-racist resistance against the mounting authoritarianism of the Brazilian socio-political regime. Yet, they are also confronted by discourses that seek to delegitimise Black and intersectional bodies as effective members of Brazilian society, deeming them disposable and unworthy of mourning. The analysis highlights the importance and the agency of mortuary graphisms as factors of mobilisation and memorial (in)justice, which question and destabilise hegemonic narratives concerning the racialised character of Brazilian society.
Therapeutic benefits of distal ventricular pacing in mid-cavity obstructive hypertrophic cardiomyopathy
Authors: Malcolmson James W. , Hughes Rebecca K. , Joshi Abhishek , Cooper Jackie , Breitenstein Alexander , Ginks Matthew , Petersen Steffen E. , Mohiddin Saidi A. , Dhinoja Mehul B.
Published: August 2022

Introduction:

Hypertrophic cardiomyopathy (HCM) patients with left ventricular (LV) mid-cavity obstruction (LVMCO) often experience severe drug-refractory symptoms thought to be related to intraventricular obstruction. We tested whether ventricular pacing, guided by invasive haemodynamic assessment, reduced LVMCO and improved refractory symptoms.

Methods:

Between December 2008 and December 2017, 16 HCM patients with severe refractory symptoms and LVMCO underwent device implantation with haemodynamic pacing study to assess the effect on invasively defined LVMCO gradients. The effect on the gradient of atrioventricular (AV) synchronous pacing from sites including right ventricular (RV) apex and middle cardiac vein (MCV) was retrospectively assessed.

Results:

Invasive haemodynamic data were available in 14 of 16 patients. Mean pre-treatment intracavitary gradient was 77 ± 22 mmHg (in sinus rhythm) versus 21 ± 21 mmHg during pacing from optimal ventricular site (95% CI: −70.86 to −40.57, p < 0.0001). Optimal pacing site was distal MCV in 12/16 (86%), RV apex in 1/16 and via epicardial LV lead in 1/16. Pre-pacing Doppler-derived gradients were significantly higher than at follow-up (47 ± 15 versus 24 ± 16 mmHg, 95% CI: −37.19 to −13.73, p < 0.001). Median baseline NYHA class was 3, which had improved by ⩾1 NYHA class in 13 of 16 patients at 1-year post-procedure ( p < 0.001). The mean follow-up duration was 4.6 ± 2.7 years with the following outcomes: 8/16 (50%) had continued symptomatic improvement, 4/16 had symptomatic decline and 4/16 died. Contributors to symptomatic decline included chronic atrial fibrillation (AF) ( n = 5), phrenic nerve stimulation ( n = 3) and ventricular ectopy ( n = 1).

Conclusion:

In drug-refractory symptomatic LVMCO, distal ventricular pacing can reduce intracavitary obstruction and may provide long-term symptomatic relief in patients with limited treatment options. A haemodynamic pacing study is an effective strategy for identifying optimal pacing site and configuration.
Risk factors for hip displacement in cerebral palsy: A population-based study of 121 nonambulatory children
Authors: Terjesen Terje , Horn Joachim
Published: August 2022

Purpose:

The aim was to evaluate which clinical and radiographic variables are independent (true) risk factors for hip subluxation in nonambulatory children below 5 years of age with cerebral palsy.

Methods:

Patients were recruited from a population-based hip surveillance program. Inclusion criteria were birth during 2002–2006, age below 5 years, and gross motor function classification system levels III–V. In all, 121 children (71 boys) met these criteria. Gross motor function classification system was level III in 29 patients, level IV in 28, and level V in 64. Anteroposterior radiographs at diagnosis and during follow-up were assessed, and only the worst hip of each patient was used for the analyses. The mean age at the initial radiograph was 2.5 years (range: 0.7–4.9 years), and the mean follow-up time was 4.0 years (range: 0.5–11.8 years).

Results:

At the last follow-up, 67 children had a clinically significant hip displacement, defined as migration percentage ≥40%. Univariable regression analysis defined these risk factors: gross motor function classification system level V, spastic bilateral cerebral palsy, initial migration percentage, yearly rate of migration percentage progression, and initial acetabular index. When these variables were analyzed with multivariable regression in 107 patients with initial migration percentage <50% and follow-up ≥1.0 year, the independent risk factors were initial migration percentage (p = 0.003) and yearly rate of migration percentage progression (p < 0.001).

Conclusion:

The parameters that need to be assessed in hip surveillance in children below 5 years of age are initial migration percentage and rate of migration percentage progression. Acetabular index and femoral head–shaft angle might be useful later for decision-making regarding choice of treatment.

Level of evidence:

Level II, development of diagnostic criteria.
Outcomes for patients with infantile idiopathic scoliosis by casting table type
Authors: Marrache Majd , Prasad Niyathi , Thompson George H , Li Ying , Glotzbecker Michael , Sponseller Paul D
Published: August 2022

Purpose:

Serial casting is an effective treatment for infantile idiopathic scoliosis. The most common casting table types are Mehta, Risser, and spica tables. We compared major curve correction between patients with infantile idiopathic scoliosis treated using pediatric hip spica tables versus Risser or Mehta tables.

Methods:

In this multicenter retrospective study, we included 52 children younger than 3 years (mean ± standard deviation age, 1.6 ± 0.68 years) treated with ≥2 consecutive casts for infantile idiopathic scoliosis between September 2011 and July 2018. We compared major curve angle (measured using the Cobb method) before and after treatment and improvement in curve angle between the spica tables group ( n = 12) and the Risser or Mehta tables group ( n = 40). The primary outcome was the difference in percentage correction of the major curve according to radiographs taken after first casting and at final follow-up.

Results:

The mean major curve was 47° ± 18° before casting. A median of six casts (range: 2–14) were applied. Mean follow-up after treatment initiation was 22 months (range: 7–86 months). At baseline, the major curve was significantly larger in the spica tables group (58°) than in the Risser or Mehta tables group (43°) ( p = 0.01). We found no differences in the percentage curve correction in the spica tables group versus Risser or Mehta tables group after first casting or at final follow-up.

Conclusion:

Serial casting was associated with substantial major curve correction in patients with infantile idiopathic scoliosis. Curve correction did not differ between patients treated with a spica table versus a Risser or Mehta table.

Level of Evidence:

Level III, retrospective cohort study
Sinonasal Papillomas: 10-Year Retrospective Analysis of Etiology, Epidemiology, and Recurrence
Authors: Archang Maani , Chew Leila , Han Albert Yoon-Kyu , Sajed Dipti , Vorasubin Nopawan , Wang Marilene
Published: August 2022

Objectives

To examine the epidemiology, subtypes, trends over time, and predictive factors for recurrence and malignant transformation of sinonasal papillomas.

Methods

A retrospective chart review of 118 patients with sinonasal papillomas from 2009 to 2019 was conducted at the University of California, Los Angeles. This study is a follow-up to a previously published study from 2000 to 2009 at the same academic center.

Results

The mean age was at presentation was 58.5 years, with a 2:1 male to female ratio, and average follow-up of 30.1 months. The rate of recurrence after complete resection was 19% with an average of 32.6 months to recurrence. The time to recurrence followed a bimodal distribution with 57% of cases recurring within 24 months (mean = 10) and 43% from 40 to 103 months (mean = 61). The proportion of the inverted papillomas rose from 38% in 2000-2004 to 89.6% in 2015-2019. Patients presenting at a younger age had a higher chance of recurrence (mean age 52 with recurrence vs. 61 without recurrence). Age did not correlate with histopathologic transformation in surgical pathology. Furthermore, histopathological transformation did not raise the chance of recurrence. Smoking, alcohol use, chronic rhinosinusitis, and allergic rhinitis were not associated with any of the outcome measures in this study. The most significant factor predicting recurrence, beside age at presentation, was the history of two or more prior sinus surgeries for papillomas or other reasons (OR = 3.52 and 5.81).

Conclusion

This study explored the features of sinonasal papillomas as well as the risk factors for recurrence and transformation. Younger age at presentation and two or more prior surgeries for papillomas were associated with recurrence. Time to recurrence followed a bimodal distribution, with late recurrences happenning from 40 to 103 months after surgery, emphasizing the importance of long-term follow-up for timely resection of tumors and prevention of malignancy.
Feline intralenticular Encephalitozoon cuniculi: three cases from California
Authors: Lin Joie , Nell Barbara , Horikawa Taemi , Zarfoss Mitzi
Published: August 2022

Case series summary

Three domestic shorthair cats from California presented to veterinary ophthalmologists with immature cataracts. Other presenting clinical signs included corneal edema, anisocoria, anterior uveitis, elevated intraocular pressure, blepharospasm and/or lethargy. All patients were immunocompromised due to concurrent diseases and/or immunomodulatory drugs. Diagnostics included serial comprehensive ophthalmic examinations with tonometry, ocular ultrasound, electroretinogram and testing for other causes of feline uveitis. Testing for Encephalitozoon cuniculi included serology, histopathology and/or PCR of aqueous humor, lens material or paraffin-embedded whole eye. Treatments included antiparasitic medication, anti-inflammatory medication and supportive care in all three cases. Surgical treatment included enucleation (one case), bilateral phacoemulsification and unilateral intraocular lens placement (one case) and bilateral phacoemulsification with bilateral endolaser ciliary body ablation and bilateral intraocular lens implantation (one case). Both cats for which serologic testing for E cuniculi was performed were positive (1:64–1:4096). In all cats, diagnosis of intraocular E cuniculi was based on at least one of the following: lens histopathology or PCR of aqueous humor, lens material or paraffin-embedded ocular tissue. The clinical visual outcome was best in the patient undergoing phacoemulsification at the earliest stage of the cataract.

Relevance and novel information

Encephalitozoon cuniculi should be considered as a differential cause of cataracts and uveitis in cats in California, the rest of the USA and likely worldwide.
The Yin and Yang Model of Value Co-Creation in the Non-Profit Sector
Authors: Klafke Renata , Didonet Simone
Published: August 2022

This study describes the process and elements presented in a value co-creation process between non-profits and donors, as well as the outcomes of this interaction. The study includes semi-structured interviews with managers and donors, as well as first-hand observation and notes from the telemarketing department of two health-related non-profits (NPOs). To represent the interaction between actors, the Yin and Yang model of value co-creation is proposed. In relation to the outcomes of this relationship, despite the elements of co-creation value that are highlighted in the literature, that is, dialog and transparency, other relevant components stood out more in this context, such as trust and reputation. This research broadens the literature in the field of NPOs, since most researches on value co-creation are centered on the private sector and focus the analysis on the end user, which in the non-profit sector of health care would be the patient. Otherwise, this research focuses on a resource integrator actor, that is, the donor. Managerial contributions and future research directions are also presented.