bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of neuro-degenerative disorders using sunflower optimisation algorithm and Kernel extreme learning machine: A case-study with Parkinson’s and Alzheimer’s disease
Authors: Balasubramanian Kishore , Ananthamoorthy NP , Ramya K
Published: December 2021

Parkinson’s and Alzheimer’s Disease are believed to be most prevalent and common in older people. Several data-mining approaches are employed on the neuro-degenerative data in predicting the disease. A novel method has been built and developed to diagnose Alzheimer’s (AD) and Parkinson’s (PD) in early stages, which includes image acquisition, pre-processing, feature extraction and selection, followed by classification. The challenge lies in selecting the optimal feature subset for classification. In this work, the Sunflower Optimisation Algorithm (SFO) is employed to select the optimal feature set, which is then fed to the Kernel Extreme Learning Machine (KELM) for classification. The method is tested on the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and local dataset for AD, the University of California, Irvine (UCI) machine learning repository and the Istanbul dataset for PD. Experimental outcomes have demonstrated a high accuracy level in both AD and PD diagnosis. For AD diagnosis, the highest classification rate is obtained for the AD versus NC classification using the ADNI dataset (99.32%) and local dataset (98.65%). For PD diagnosis, the highest accuracy of 99.52% and 99.45% is achieved on the UCI and Istanbul datasets, respectively. To show the robustness of the method, the method is compared with other similar methods of feature selection and classification with 10-fold cross-validation (CV) and with unseen data. The method proposed has an excellent prospect, bringing greater convenience to clinicians in making a better solid decision in clinical diagnosis of neuro-degenerative diseases.
COVID-19 and policies for care homes in the first wave of the pandemic in European welfare states: Too little, too late?
Authors: Daly Mary , León Margarita , Pfau-Effinger Birgit , Ranci Costanzo , Rostgaard Tine
Published: December 2021

This article examines COVID-19 and residential care for older people during the first wave of the pandemic in 2020, comparing a range of countries – Denmark, England, Germany, Italy and Spain – to identify the policy approaches taken to the virus in care homes and set these in institutional and policy context. Pandemic policies towards care homes are compared in terms of lockdown, testing and the supply of personal protective equipment. The comparative analysis shows a clear cross-national clustering: Denmark and Germany group together by virtue of the proactive approach adopted, whereas England, Italy and Spain had major weaknesses resulting in delayed and generally inadequate responses. The article goes on to show that these outcomes and country clustering are embedded in particular long-term care (LTC) policy systems. The factors that we highlight as especially important in differentiating the countries are the resourcing of the sector, the regulation of LTC and care homes, and the degree of vertical (and to a lesser extent horizontal) coordination in the sector and between it and the health sector.
Considerations on the region of interest in the ROC space
Authors: Lavazza Luigi , Morasca Sandro
Published: December 2021

Receiver Operating Characteristic curves have been widely used to represent the performance of diagnostic tests. The corresponding area under the curve, widely used to evaluate their performance quantitatively, has been criticized in several respects. Several proposals have been introduced to improve area under the curve by taking into account only specific regions of the Receiver Operating Characteristic space, that is, the plane to which Receiver Operating Characteristic curves belong. For instance, a region of interest can be delimited by setting specific thresholds for the true positive rate or the false positive rate. Different ways of setting the borders of the region of interest may result in completely different, even opposing, evaluations. In this paper, we present a method to define a region of interest in a rigorous and objective way, and compute a partial area under the curve that can be used to evaluate the performance of diagnostic tests. The method was originally conceived in the Software Engineering domain to evaluate the performance of methods that estimate the defectiveness of software modules. We compare this method with previous proposals. Our method allows the definition of regions of interest by setting acceptability thresholds on any kind of performance metric, and not just false positive rate and true positive rate: for instance, the region of interest can be determined by imposing that [Formula: see text] (also known as the Matthews Correlation Coefficient) is above a given threshold. We also show how to delimit the region of interest corresponding to acceptable costs, whenever the individual cost of false positives and false negatives is known. Finally, we demonstrate the effectiveness of the method by applying it to the Wisconsin Breast Cancer Data. We provide Python and R packages supporting the presented method.
Gendered Technologies: Youth, Gender and Mobile Phones in Chennai City
Authors: Devadas Vijay
Published: December 2021

This article explores the role of mobile phones in the lives of the youth in the city of Chennai, South India. Drawing on field research, the article argues that the social life of the mobile phone is gendered. The article curates three narratives to make this argument. The first engages with young men and mobile phones and claims that the technology is instrumental in the construction of normative ideas of masculinity. The second explores the ways in which the technology has empowered young women, enabled mobility, and reconstituted female agency. The third examines the regulation and disciplining of women’s use of and access to the technology through the discourse of maanam. The aim of articulating these three narratives is to demonstrate that the mobile phone is a gendered technology.
Why I said #MeToo: An Exploration of the Purpose of Disclosure Among Indian Women
Authors: Naresh Ekasmayi Esha , Pothiyil Dan Isaac , Ravindran Syam Kaithavalappil
Published: December 2021

The surge of sexual abuse disclosures by women during the #MeToo movement raised awareness about an important social issue that has garnered much attention. However, apart from the changes the movement initiated, the issue of why women chose to disclose in the context of the movement has not been extensively examined. Why women disclose such a sensitive topic in the public domain, often via social media, within the Indian cultural context, where matters such as sexual abuse are considered taboo, warrants further examination. This article explores the reasons for disclosure among Indian women participating in the #MeToo movement, through qualitative research, using the interpretative phenomenological approach. The emergent themes include reactions to the injustice, expectations of validation and closure, addressing stigma, initiation of dialogue and social change, as well as expression of solidarity, as the purpose for which disclosures were undertaken.
Role of Family Management in R&D Investments: Indian Evidence
Authors: Singh Gagandeep , Kaur Amanpreet
Published: December 2021

The purpose of the present study is to examine the influence of family management on R&D investments of Indian companies. Panel regression analysis is undertaken on the data of top 200 Indian companies (the final sample got reduced to 179 companies) listed on Bombay Stock Exchange (BSE) over a period of 5 years from 2015 to 2019. The results reveal that family management supports R&D investments. The presence of family members on top management positions have a significant positive influence for both capital R&D expenditures and revenue R&D expenses. Given the restructuring of Indian corporate governance system, the findings recommend continual of family management as Indian way of management as it actively supports research and development investments thereby significantly influencing growth of the firm. The non-family members must support the strategic envision of family managers as the latter are more emotionally linked with the firm. The study contributes to the existing literature by examining the impact of family management on capital R&D expenditures and revenue R&D expenditures separately to gain meaningful insights about the attitude of family owners towards R&D investment decisions.
Structural Investigation of Export Assistance and Performance of Handloom Exporters
Authors: Singh Vishal Kumar , Gautam Amit
Published: December 2021

The previous literature highlighted the importance of export assistance to uplift export activities of small and medium scale enterprises (SMEs). However, those studies could not test the feasibility of introduced export assistance for the targeted population. This study focuses on export assistance provided by the government institutions to the handloom exporters and its relationship with their perceived quantitative export performance. A detailed literature review of the existing export assistance programmes led to the categorization in four aspects, that is, financial support, informational support, facilitating support, and education/training support. A model is proposed based on identified variables depicting the relationship between export assistance and handloom exporters’ perceived quantitative export performance. In order to develop the model, first-order confirmatory factor analysis (CFA) was initially applied for validity measures. Subsequently, second-order CFA was applied due to the presence of multicollinearity among the variables due to the undistinguishable response of the chosen sample units towards export assistance. Thus, the study investigated the relationship of each of the four identified export assistance elements with the quantitative performance of Handloom exporters.
Does Online Dating Promotion Vary Across Cultures? A Cross-cultural Analysis of Homepage Advertisements of Online Dating Services in 51 Countries
Authors: Paul Aditi , Ahmed Saifuddin , Zaluski Karolina
Published: December 2021

This study extends our understanding of the influence of culture on advertising within the novel context of online dating. People around the world have come to depend on online dating services (ODSs) to participate in the dating process. Since the norms and expectations of dating are influenced by a country’s cultural values, we expect ODSs to adapt their advertising messages to be congruent with these values. Using the Pollay–Hofstede framework, we examine the relationship between advertising appeals used by 1,003 ODSs from 51 countries and the cultural dimensions of these countries. Results showed that ODS advertisements appealed to people’s need for relationship, friendship, entertainment, sex, status, design and identity. The use of these appeals was congruent with only the individualism/collectivism and uncertainty avoidance cultural dimensions. Based on these results, we argue that ODS’s overwhelming use of culturally incongruent advertising messages can lead to a global transformation and homogenisation of the dating culture.
Farmland Lease Options in the Rural China: Key Determinants and Policy Implications
Authors: Udimal Thomas Bilaliib , Peng Zhiyuan , Guillaume Niyontezeho
Published: December 2021

The study looks at the factors that influence farmland transfer option in Yunnan province, China. To help achieve this objective, 6,007 households were randomly selected from rural communities. The sample includes households who are engaged in lease-out, lease-in, and those who engage in neither lease-out nor lease-in. The data was analysed using multinomial probit model. The results show that farmland certification and knowledge of land tenure policy have positive impact on both lease-in and lease-out decisions relative to the reference category. Farmland size and years of schooling show negative and positive impact on lease-in and lease-out decisions, respectively, relative to the reference category. The net income of the household and crop insurance have positive and negative effect on lease-in and lease-out decisions, respectively, relative to the base category. The results suggest that price per mu has a positive effect on the lease-out decision relative to the base category. The study broadens the scope of analysis on farmland transfer by considering all the options available to a household in farmland transfer decision taking.
Sex: What Is the Big Deal? Exploring Individuals’ with Intellectual Disabilities Experiences with Sex Education
Authors: Hole Rachelle , Schnellert Leyton , Cantle Gloria
Published: December 2021

This article offers perspectives shared by self-advocates in the first phase of a community-based participatory research project untaken to address barriers that individuals with intellectual disabilities face with respect to sexual health knowledge. Using descriptive qualitative methods, we interviewed 19 individuals with intellectual disability about their experiences and knowledge related to sexual health. The research question guiding this project was: What are self-advocates’ with intellectual disabilities experiences learning about sexual health and sexuality? The findings highlight that participants faced barriers and lack of access to sexual health education, and while they learned about sexual health through formal sexual health education, frequently this knowledge came through lived experience. Finally, the findings underscore that participants knew what they wanted with respect to sexual health education and offered recommendations. The importance of accessible sexual health education for self-advocates that supports their rights and desires to express their sexuality and sexual agency is highlighted.
Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management
Authors: Ohueri Chelsi W , García Alexandra A. , Zuñiga Julie A.
Published: December 2021

Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused ethnography, data were collected from semi-structured interviews and limited participant-observation with a selected subset of participants to gain insight into self-management challenges and facilitators. We conducted interviews and multiple observations with 22 participants with HIV+T2DM over the period of 9 months. Participants experienced numerous barriers to self-management in the areas of diet, medication adherence, and mental health. Social and familial support, as well as consistent access to care, were facilitators for optimal self-management. At the same time participants’ lives were in a unique flux shaped by the dual diagnoses, and therefore, required constant mental and physical adjustments, thus illustrating challenges of managing chronicity.
Evaluation of early de-escalation of empiric antimicrobial therapy in acute leukemia patients with febrile neutropenia at a large academic medical center
Authors: Ly Whitney J , Brown Erin E , Pedretti Zachary , Auten Jessica , Wilson William S
Published: December 2021

Introduction

Recent trials have shown early de-escalation of empiric antimicrobial therapy (EAT) in febrile neutropenia has led to less adverse effects with no difference in patient mortality. In 2019, our institution adjusted internal guidelines to de-escalate EAT after 7 days of intravenous anti-pseudomonal therapy in patients with signs of clinical recovery from febrile neutropenia and no evidence of infection.

Methods

This was a retrospective, single-center, observational, cohort study. Eligible patients were adults with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) who received induction chemotherapy and developed febrile neutropenia without documented infection. Patients were separated based on EAT duration: ≤ 9 days and > 9 days. Empiric antimicrobial therapy was defined as the initiation of an anti-pseudomonal beta-lactam. The primary outcome was the difference in number of EAT-free days. Secondary outcomes included fever recurrence, ICU admissions, fever duration, infections post de-escalation, and Clostridioides difficile infection (CDI).

Results

Forty-four encounters met inclusion. The EAT ≤ 9 days group had 7 more EAT-free days compared to the EAT > 9 days group (p < 0.001). No between-group differences were identified in terms of fever after EAT discontinuation (p = 0.335), ICU admission (p = 0.498), or CDI (p = 0.498). The EAT > 9 days group experienced longer initial fever (p < 0.001) and received addition of resistant Gram-positive coverage (p = 0.014). More patients receiving EAT > 9 days had a diagnosis of AML (p = 0.001).

Conclusions

Shorter EAT duration did not lead to worse outcomes in patients with AML or ALL who received induction chemotherapy and developed febrile neutropenia without a documented infection source.
Radically Ordinary Lives: Young Rural Stayers and the Ingredients of the Good Life in Finnish Lapland
Authors: Adams Ria-Maria , Komu Teresa
Published: December 2021

This article focuses on young people who, despite the general tendency towards youth outmigration in rural areas, have decided to stay in their home town. We explore the agency of young, conscious stayers, as well as the process of staying in the northern Finnish town of Kemijärvi. The stayers’ values and perceptions of the constituents of a good life could be taken as an alternative to the prevailing Western ideal that emphasizes mobility and ambitious educational and career plans, and is, in part, driving young people to leave their rural hometowns. The stayers in this study are active participants in their own fate and are content with their choice of staying. Applying ethnographic methods, we undertake to learn what rural stayers consider the building blocks of a good life in a small-town setting, one offering comparatively limited options in terms of jobs, education and leisure activities.
Stress, Dependence, and COVID-19–related Changes in Past 30-day Marijuana, Electronic Cigarette, and Cigarette Use among Youth and Young Adults
Authors: Clendennen Stephanie L , Case Kathleen R , Sumbe Aslesha , Mantey Dale S , Mason Emily J , Harrell Melissa B
Published: December 2021

Background

Studies show smoking and vaping behaviors increase risk of contracting and worse symptoms of COVID-19. This study examines whether past 30-day youth and young adult users of marijuana, e-cigarettes, and cigarettes self-reported changes in their use of these substances due to the COVID-19 pandemic; and cross-sectional associations between perceived stress, nicotine or marijuana dependence, and COVID-19–related changes in use.

Methods

Participants were 709 past 30-day self-reported substance users from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS; mean age = 19; 58% female; 38% Hispanic, 35% white). Multiple logistic regression models assessed cross-sectional associations between perceived stress and dependence and increased, decreased, or sustained past 30-day use of marijuana, e-cigarettes, and cigarettes due to COVID-19 (e.g., “Has your marijuana use changed due to the COVID-19 outbreak?”). Covariates included age, race/ethnicity, socio-economic status (SES), dependence (exposure: stress), and stress (exposure: dependence).

Results

Most participants reported sustained (41%, 43%, 49%) or increased (37%, 34%, 25%) use of marijuana, e-cigarettes, and cigarettes due to COVID-19, respectively. Participants who reported symptoms of dependence were significantly more likely than their non-dependent peers to report increasing their marijuana (AOR: 1.66; 95% CI: 1.15–2.39) and e-cigarette (AOR: 2.57; 95% CI: 1.38–4.77) use. Those who reported higher perceived stress were significantly more likely to report increasing their marijuana use (AOR: 1.55; 95% CI: 1.01–2.42).

Conclusions

Most youth and young adults did not decrease their substance use amid a global, respiratory disease pandemic. Health messaging and interventions that address the health effects of smoking and vaping as well as factors like stress and dependence that may be barriers to decreasing use are vital in curbing the COVID-19 pandemic.
Channelopathy of Dravet Syndrome and Potential Neuroprotective Effects of Cannabidiol
Authors: Xu Changqing , Zhang Yumin , Gozal David , Carney Paul
Published: December 2021

Dravet syndrome (DS) is a channelopathy, neurodevelopmental, epileptic encephalopathy characterized by seizures, developmental delay, and cognitive impairment that includes susceptibility to thermally induced seizures, spontaneous seizures, ataxia, circadian rhythm and sleep disorders, autistic-like behaviors, and premature death. More than 80% of DS cases are linked to mutations in genes which encode voltage-gated sodium channel subunits, SCN1A and SCN1B, which encode the Nav1.1α subunit and Nav1.1β1 subunit, respectively. There are other gene mutations encoding potassium, calcium, and hyperpolarization-activated cyclic nucleotide-gated (HCN) channels related to DS. One-third of patients have pharmacoresistance epilepsy. DS is unresponsive to standard therapy. Cannabidiol (CBD), a non-psychoactive phytocannabinoid present in Cannabis, has been introduced for treating DS because of its anticonvulsant properties in animal models and humans, especially in pharmacoresistant patients. However, the etiological channelopathiological mechanism of DS and action mechanism of CBD on the channels are unclear. In this review, we summarize evidence of the direct and indirect action mechanism of sodium, potassium, calcium, and HCN channels in DS, especially sodium subunits. Some channels’ loss-of-function or gain-of-function in inhibitory or excitatory neurons determine the balance of excitatory and inhibitory are associated with DS. A great variety of mechanisms of CBD anticonvulsant effects are focused on modulating these channels, especially sodium, calcium, and potassium channels, which will shed light on ionic channelopathy of DS and the precise molecular treatment of DS in the future.
Reducing scrapping of gears by assessment of tip contact threshold torque
Authors: Hjelm Rikard , Ahadi Aylin , Wahlström Jens
Published: December 2021

While striving for more competitive products as well as reaching the Global Sustainable Development Goals, automotive powertrain manufacturers increase the demands on gears, which translates to decreased manufacturing error tolerances. Too tight tolerances may, however, counteract the goal if it leads to increased material and energy consumption due to unjustified scrapping.

This paper presents a method to prevent unjustified scrapping by comparing the severity of different manufacturing error tolerances by means of the tip contact threshold torque. Curve fits are shown to be accurate and helpful to assess the outcome of a produced batch of gears. A case study is made where the method is used with measured data from the industry. It can be concluded from the investigation that considerable amounts of scrapping can be avoided by consideration of the threshold torque.
Home direct-to-consumer telehealth solutions for children with mental health disorders and the impact of Covid-19
Authors: Norman Sierra , Atabaki Shireen , Atmore Kathleen , Biddle Cara , DiFazio Marc , Felten Daniel , Fox Eduardo , Marschall Donna , Newman Julie , Robb Adelaide , Rowland Cecilia , Selekman Rachel , Slovin Ariella , Stein Mark , Strang John , Sable Craig
Published: December 2021

Delivery of mental health treatment in the home can close gaps in care. Telehealth also provides access to healthcare that has been disrupted due to the COVID-19 pandemic. In 2016, a home direct-to-consumer telehealth program was initiated. Mental health encounters made up a significant portion of all telehealth encounters and COVID-19 had a significant impact on accelerating the utilization of telehealth. Telemental health has been more successful at meeting targeted volumes than the overall health system. Of all the mental health diagnoses before and during COVID-19, attention deficit hyperactivity disorder, Autism Spectrum Disorder, and Anxiety Disorder were most common. The direct-to-consumer telehealth program saved patients a significant amount of travel miles and associated time, based on data from the period before COVID-19. Payment reimbursement for direct-to-consumer telehealth professional services was similar to reimbursement for in-person visits. This program demonstrates direct-to-consumer telehealth is a feasible and acceptable care modality for a variety of youth mental health disorders.
Re-examining the History of Human Resource Development Policy in China: From Local Indigenous Phenomena to Global Human Resource Development Knowledge
Authors: Wang Greg G. , Doty D. Harold , Yang Shengbin
Published: December 2021

Problem

The NHRD conception claimed to be based on multiple country-cases through a constructive/interpretive process. However, four of cases focusing on HRD policy in China presented incomplete history of China’s HRD policies, which may have misled the NHRD conception.

Solution

We re-examine China’s history of HRD policy as indigenous phenomena in comparison to the four China-cases. Adopting a similar historical method, we fail to identify the policy pattern reported by the previous cases, thus challenge the NHRD’s constructivist embeddedness. We question the credibility and trustworthiness of the country-based studies as well as the sense-making constructive base of the NHRD ideation. From China’s local phenomenon, we derived a set of HRD assumptions contrary to the existing western-centric assumptions to enrich the global HRD knowledge.

Stakeholders

Theory-minded HRD scholars intended for rigorous and relevant theory development inquiries; practice-oriented HRD practitioners, especially those from western context and working in a non-western HRD context.
Adjunctive Chinese Herbal Medicine Treatment is Associated With an Improved Survival Rate in Patients With Cervical Cancer in Taiwan: A Matched Cohort Study
Authors: Wang Chieh , Lin Kent Yu-Hsien , Wu Mei-Yao , Lin Cheng-Li , Lin Jaung-Geng , Chang Cherry Yin-Yi , Lin Wu-Chou , Yen Hung-Rong
Published: December 2021

Background

Cervical cancer is one of the most common cancers in Taiwan. Some patients take Chinese herbal medicine (CHM). However, very few current studies have ascertained the usage and efficacy of CHM in patients with cervical cancer. The aim of this study was to investigate the benefits of complementary CHM among patients with cervical cancer in Taiwan.

Methods

We included the newly diagnosed cervical cancer patients who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 2000 and 2010. The end of follow-up period was December 31, 2011. Patients who were less than 20 years old, had missing information for age, withdrew from the National Health Insurance (NHI) program during the follow-up period, or only received other TCM interventions such as acupuncture or tuina massage were excluded from our study. After performing 1:1 frequency matching by age and index date, we enrolled 7521 patients in both CHM and non-CHM user groups. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time.

Results

According to the Cox hazard ratio model mutually adjusted for CHM use, age, comorbidity, treatment, and chemotherapeutic agents used, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.29, 95%CI = 0.27-0.31). The survival probability was higher for patients in the CHM group. Bai-Hua-She-She-Cao ( Herba Oldenlandiae, synonym Herba Hedyotis diffusae) and Jia-Wei-Xiao-Yao-San were the most commonly prescribed single herb and Chinese herbal formula, respectively.

Conclusions

Adjunctive CHM may have positive effects of reducing mortality rate and improving the survival probability for cervical cancer patients. Further evidence-based pharmacological investigations and clinical trials are warranted to confirm the findings in our study.
Test and prediction of mechanical properties of Moso bamboo
Authors: Zhou Qishi , Tian Jiefu , Liu Pengcheng , Zhang Hai
Published: December 2021

Moso bamboo has strong mechanical property and high economic efficiency. However, its anisotropy and inhomogeneity will increase the time and cost of mechanical properties testing. Aiming to solve this problem, in this paper, a series of tests were systematically carried out to test the parallel-to-grain compressive resistance, bending resistance, tensile resistance, shear resistance and perpendicular-to-grain compressive resistance, tensile resistance. Then, the characteristic values of mechanical properties of bamboo were analyzed for establishing the relationship between mechanical properties and density of bamboo and finding a kind of conversion method among mechanical properties. The results show that the parallel-to-grain properties of bamboo are better than that perpendicular to the grain. There is a high correlation between Mechanical properties and density of bamboo and can be well fitted by Linear functions. This research provides mechanical properties conversion parameters that can be used to evaluate and predict the properties of the moso bamboo.
Design and analysis of a novel large-range 3-DOF compliant parallel micromanipulator
Authors: Gao Jinhai , Han Xiaoqiang , Hao Lina , Chen Ligang
Published: December 2021

Compared with the traditional rigid mechanism, the flexible mechanism has more advantages, which play an important role in critical situations such as microsurgery, IC (integrated circuit) fabrication/detection, and some precision operating environment. Especially, there is an increasing need for 3-DOF (degrees-of-freedom) compliant translational micro-platform (CTMP) providing good performance characteristics with large motion range, low cross coupling, and high spatial density. Decoupled topology design of the CTMP can easily realize these merits without increasing the difficulty of controlling. This paper proposes a new three DOF compliant hybrid micromanipulator which have large range of motion up to 100 μm × 100 μm × 100 μm in the direction in the dimension of 90 mm × 90 mm × 50 mm, smaller cross-axis coupling (the max coupling only 2.5%) than the initial XY compliant platform in XY axial.
Stability and control of the nonlinear system for tractor with N trailer in the presence of slip
Authors: Jalalnezhad Mostafa , Fazeli Sadegh , Bozorgomid Sina , Ghadimi Mohammad
Published: December 2021

In many engineering systems, it is not enough to merge the system paths to zero at infinite time, but the speed of moving these paths to zero is very important. Estimating this speed can be done using exponential functions. This concept is used in exponential stability definition. The purpose of this paper is to design a controller for problem inputs and implement a system of a car with N to a trailer connected to it. This approach is based on the analysis of the Lyapunov stability method. In the given problem, the purpose of conducting and converging the system considering the slip phenomenon as a primitive uncertainty in the system is toward the desired point. Since the trailer tractor system has limitation constraints in the modeling structure, it is difficult to guarantee the stability of a non-holonomic system. Because no controller designed by the control feedback method can continuously and stable ensure the convergence of the system. If this possibility almost dynamic errors, even adaptive controls do not versatile with the operation of the Lyapunov function, especially in the presence of uncertainties, which is a very important factor in system instability, which requires the development of controllers designed to deal with these disturbances. In the simulated results, this paper not only examines the convergence properties, but also shows the ability to control the system by designing a controller in the presence of a slip phenomenon to strengthen the system in the stability debate.
Whiffletree based supports for self-adjustable hydrostatic bearings
Authors: van Parijs Vincent , Nijssen Joep , van Ostayen Ron
Published: December 2021

Hydrostatic bearings are superior in terms of their friction and load carrying characteristics when compared to contact based bearings, but non-usable in applications with non-constant curvature counter surfaces. A possible solution to this limitation is the introduction of deformable hydrostatic bearings components that cope with these required deformations. To reduce the required deformation of a single bearing pad, multiple pads can be connected through a so-called whiffletree support system. In this work, a symmetric whiffletree based hydrostatic bearing embodiment is introduced. A 2D quasi-static model is introduced that allows for determining the kinetostatic and path following properties of such a type of bearing. Design considerations are given regarding the joint rotational-, normal-, and shear stiffness of each individual joint, as well as basic bearing layout. The potential of a whiffletree suspended bearing is presented through the use of a case study.
Application of Tumor Burden Score for predicting conversion outcome in patients with initially unresectable colorectal liver metastases after first-line systemic therapy
Authors: Peng Jianhong , Liu Yujun , Li Weihao , Lin Yuzhu , Sun Hui , Pan Zhizhong , Wu Xiaojun , Fan Wenhua , Lin Junzhong
Published: December 2021

Background:

Patients with initially unresectable colorectal liver metastases (CRLM) could achieve survival benefit from successful conversion therapy. Recently, Tumor Burden Score (TBS) was proposed as a valuable index to predict outcome following resection of CRLM. The study is aimed to investigate the association of TBS with conversion outcome.

Methods:

A total of 234 patients who underwent first-line treatment in our center were enrolled as training cohort. The validation cohort was developed from 89 patients in our previous study. Cut-off value of TBS was calculated to stratify patients into two groups. Significance test and logistic regression model were used to examine the prediction value of TBS for conversion outcome after first-line systemic therapy. Kaplan–Meier method and Cox proportional hazard model were applied to assess the prognostic value of TBS.

Results:

TBS showed good discriminatory power [area under curve (AUC) 0.726, p < 0.001] with cut-off value defined as 14.3 in training cohort, which was validated in the validation cohort. Increasing TBS was related to adverse chemotherapy response and conversion outcome. Low TBS group had three times higher conversion rate than that in high TBS group (57.3% versus 19.0%, p < 0.001). Multivariate analysis indicated that high TBS [odds ratio (OR) = 3.676, 95% confidence interval (CI) 1.671–8.429, p = 0.002], first-line treatment response as stable disease (SD) or progressive disease (PD) (OR = 9.247; 95% CI 4.736–18.846, p < 0.001), and absence of targeted therapy (OR = 2.453, 95% CI 1.139–5.455, p = 0.024) were three independent risk factors for failure conversion outcome. High TBS was significantly associated with conversion outcome whatever chemotherapy response, addition of targeted therapy, and Kirsten rat sarcoma viral oncogene homolog (KRAS) status. High TBS was also associated with worse overall survival.

Conclusion:

TBS should be applied in clinical practice to predict conversion outcome in patients with initially unresectable CRLM.
Recurrence risk stratification based on a competing-risks nomogram to identify patients with esophageal cancer who may benefit from postoperative radiotherapy
Authors: Chang Xiao , Chen Junqiang , Zhang Wencheng , Yang Jinsong , Yu Shufei , Deng Wei , Ni Wenjie , Zhou Zongmei , Chen Dongfu , Feng Qinfu , Lv Jima , Liang Jun , Hui Zhouguang , Wang Lvhua , Lin Yu , Chen Xiaohui , Xue Qi , Mao Yousheng , Gao Yushun , Wang Dali , Feng Feiyue , Gao Shugeng , He Jie , Xiao Zefen
Published: December 2021

Background:

A reliable model is needed to estimate the risk of postoperative recurrence and the benefits of postoperative radiotherapy (PORT) in patients with thoracic esophageal squamous cell cancer (TESCC).

Methods:

The study retrospectively reviewed 3652 TESCC patients in stage IB-IVA after radical esophagectomy, with or without PORT. In one institution as the training cohort ( n = 1620), independent risk factors associated with locoregional recurrence (LRR), identified by the competing-risks regression, were used to establish a predicting nomogram, which was validated in an external cohort ( n = 1048). Area under curve (AUC) values of receiver operating characteristic curves were calculated to evaluate discrimination. Risk stratification was conducted using a decision tree analysis based on the cumulative point score of the LRR nomogram. After balancing the baseline of characteristics between treatment groups by inverse probability of treatment weighting, the effect of PORT was evaluated in each risk group.

Results:

Sex, age, tumor location, tumor grade, and N category were identified as independent risk factors for LRR and added into the nomogram. The AUC values were 0.638 and 0.706 in the training and validation cohorts, respectively. Three risk groups were established. For patients in the intermediate- and high-risk groups, PORT significantly improved the 5-year overall survival by 10.2% and 9.4%, respectively ( p < 0.05). Although PORT was significantly associated with reduced LRR in the low-risk group, overall survival was not improved.

Conclusion:

The nomogram can effectively estimate the individual risk of LRR, and patients in the intermediate- and high-risk groups are highly recommended to undergo PORT.
Real world experience with minimally invasive wireless percutaneous neuromodulation in a tertiary care centre
Authors: Pushparaj Hemkumar , Chawla Rajiv , Bhargava Deepti , Biswas Shubhabrata , Sharma Manohar L
Published: December 2021

Background

Wireless percutaneous nerve stimulation (PNS) for chronic pain is rapidly evolving in the ever expanding neuromodulation paradigm. Safety and lower risks with a potential of long-term analgesia cannot be over emphasised especially with the ongoing opioid pandemic. PNS with an implanted pulse generator (IPG) has also been shown to provide good benefit, without often unpleasant widespread paraesthesia from conventional spinal cord stimulators.

Aim and Methods

We retrospectively extracted data on all wireless PNS implants in our highly specialised pain neuromodulation centre since initiation of wireless PNS service in August 2019. Patient demographics, pain history, analgesic intake and details on implant follow-up data within 1 year post-implant including pain relief, EuroQol-5 Dimension (EQ-5D) and Patients’ Global Impression of Change (PGIC) scores were extracted. The cases are presented in a narrative format.

Result

A total of five patients were implanted with wireless (Stimwave®) PNS from August 2019 to February 2020. Neuropathic pain was the most common presenting diagnosis. All patients showed >50% pain relief at 3 months. EQ-5D and PGIC did not show any improvement in the subjects. Two of the patients managed to decrease their analgesics after implantation. Similar sustained benefits could not be demonstrated after 1 year.

Discussion

PNS can provide analgesia in appropriately selected cases. Naivety of the technique and procedure might cause some degree of uncertainty. External pulse generator with wireless transmission avoids IPG and tunnelling related side effects, but requires individualised special wearable technology to power the lead. Minimally invasive nature of the technique might be attractive and preferable for patients with complex medical issues, nickel allergy and poor general health who may otherwise be unsuitable for Spinal Cord Stimulation (SCS) with conventional hardware. Robust prospective controlled studies and RCTs in future might provide further insights on utility in other neuropathic pain diagnosis, long-term outcomes and acceptability compared to conventional SCS.
Early use of canakinumab to prevent mechanical ventilation in select COVID-19 patients: A retrospective, observational analysis
Authors: Mastroianni Antonio , Greco Sonia , Chidichimo Luciana , Urso Filippo , Greco Francesca , Mauro Maria V , Vangeli Valeria
Published: December 2021

Introduction

The fully-human monoclonal anti-interleukin (IL)-1β antibody canakinumab may inhibit the production of inflammatory mediators in patients with coronavirus disease 2019 (COVID-19) and the hyperinflammatory response potentially leading to acute respiratory distress syndrome.

Objectives

The goal of our retrospective, observational analysis was to evaluate the safety and efficacy of subcutaneous (s.c.) canakinumab in combination with our standard of care (SOC) treatment of selected patients with COVID-19 with respiratory failure and elevated reactive pro-inflammatory markers.

Methods

Eight participants received two doses of s.c. canakinumab 150 mg (or 2 mg/kg for participants weighing ≤40 kg) in addition to SOC. 12 patients received only SOC treatment.

Results

Canakinumab treatment reduced the need for mechanical ventilation and reduced proinflammatory markers, resulting in an amelioration of the final outcome, with respect to the control group who received SOC alone. The treatment was safe and well tolerated; no adverse events were reported.

Conclusion

The use of canakinumab (300 mg, s.c.) in the early stage of COVID-19 with mild-to-moderate respiratory failure was superior to SOC at preventing clinical deterioration and may warrant further investigation as a treatment option for patients with COVID-19 who experience a hyperinflammatory response in the early stage of the disease.
Development and Exploratory Factor Analysis of the Interventionist Multitiered Systems of Support Multicultural Competence Scale
Authors: Edwin Mary , Bahr Michael W.
Published: December 2021

This article describes the development of a measure of interventionists' competence in implementing culturally responsive multitiered systems of support (MTSS) practices. We ran an exploratory factor analysis (EFA) on a 30-question survey that measured the multicultural competence of 651 school counselors and psychologists in MTSS implementation. The EFA indicated a five-factor structure of the Interventionist MTSS Multicultural Competence Scale (IMMCS): (a) Cultural Knowledge, (b) Cultural Awareness, (c) Cultural Skills, (d) Cultural Appreciation, and (e) Respect for Cultural Differences.
Physical Activity in the Workplace: Does Just Working Meet Activity Recommendations?
Authors: Quinn Tyler D. , Kline Christopher E. , F. Nagle Elizabeth , Radonovich Lewis J. , Barone Gibbs Bethany
Published: December 2021

Background: The physical activity (PA) health paradox hypothesizes that occupational physical activity (OPA) and leisure time PA have differential cardiovascular health effects due to increased cardiovascular load without adequate recovery; however, research describing worker PA lacks high-quality objective OPA measurement. This study aimed to objectively describe PA profiles of men reporting high OPA and make comparisons to aerobic PA and OPA recommendations. Methods: Male food service, material moving, health care, or maintenance workers wore activity (ActiGraph® and activPAL®) and heart rate monitors for 7 days. Participants recorded work, non-work, and sleep times in a diary. PA was operationalized as time spent in sedentary behavior, upright time, light, moderate, vigorous, and moderate-to-vigorous PA during work and non-work hours. PA profiles were described and compared with Centers for Disease Control and Prevention aerobic PA guidelines (≥21.4 minute/day) and OPA recommendations (<30 minute/hour upright and intensity of <30% heart rate reserve). Findings: Nineteen male workers (68% White, age = 46.6±7.9 years) were more active on workdays than non-workdays (sedentary: 492.3 vs. 629.7 minute/day; upright: 462.4 vs. 325.2 minute/day; moderate-to-vigorous PA: 72.4 vs. 41.5 minute/day, respectively; all p < .05). Most participants (17/19) achieved aerobic PA guidelines across all days with more achieving on workdays (19/19) than non-workdays (13/19). OPA often exceeded recommended limits with participants accumulating 39.6±12.2 minutes/work hour upright and 30.3±25.9% of working time >30% heart rate reserve. Conclusions/Application to Practice: Male workers reporting high OPA typically met aerobic PA guidelines but exceeded recommended OPA limits. The long-term health implications of such activity profiles should be investigated.
Epidemiology of paediatric orthopaedic-related trauma injuries sustained across a lockdown period during the COVID-19 pandemic
Authors: Soo Joel ZY , Sio Ruiqin B , Ashik Mohammad , Wong Kenneth PL , Chua Kerk Hsiang , Mahadev Arjandas , Lim Kevin BL , Chew Ee M , Lam KY
Published: December 2021

Objectives

Lockdowns have been implemented by countries to slow down SARS-CoV-2 transmission. Singapore’s lockdown was enforced between 7 April 2020 and 1 June 2020. The objective of this study was to compare the epidemiology of paediatric orthopaedic trauma injuries during and immediately after the lockdown, with a non-pandemic period in 2019.

Methods

All paediatric outpatients and inpatients seen in our hospital following an orthopaedic-related traumatic injury from the 8-week lockdown and 8 weeks post-lockdown were evaluated. Cases for matched periods in 2019 were identified retrospectively for baseline comparison. Patient demographics, venue of injury, anatomic location of injury, caregiver supervision and location of procedures performed in the hospital were assessed.

Results

968 and 2810 injuries were observed in 2020 and 2019, respectively. While the proportion of injuries sustained by pre-schoolers and toddlers increased, those sustained by primary and secondary school children decreased in 2020 ( p < 0.001). Majority of the injuries during the lockdown were sustained at home compared to schools or public recreational facilities ( p < 0.001). Hand (26.2%) and elbow (20.8%) injuries were the most common during the lockdown. The proportion of procedures performed in the Children’s Emergency during the lockdown was more than twice that of the same period in 2019 ( p < 0.001).

Conclusion

Our study showed a 2.9-fold decrease in orthopaedic-related injuries seen during the peri-lockdown period compared to a non-pandemic period. Pre-schoolers seem to be most vulnerable to injuries during the lockdown. Hand and elbow injuries were most common.