bluuebunny/crossref_metadata_2025 huggingface dataset:
Significance of Stefan Blowing and Convective Heat Transfer in Nanofluid Flow Over a Curved Stretching Sheet with Chemical Reaction
Authors: Manjunatha P. T. , Chamkha Ali J. , Punith Gowda R. J. , Naveen Kumar R. , Prasannakumara B. C. , Naik Shraddha M.
Published: September 2021

The applications of fluid flow with Newtonian heating effect include conjugate heat conveyance around fins, petroleum industry, and heat exchangers designing. Motivated from these applications, an attempt has been made to analyze the stream of viscous nanomaterial subjected to a curved
stretching sheet. Also, heat and mass transport mechanism due to a chemical reaction, Brownian and thermophoresis motion are discussed. The equations of the mathematical model are formulated by considering the Newtonian heating and Stefan blowing conditions at the boundary. These modelled
equations are then changed to a system of nonlinear equation involving ordinary derivatives of a function by means of suitable similarity transformations. Further, shooting technique with Runge-Kutta-Fehlberg-45 process is utilized to solve the reduced equations. Outcomes disclose that, the
gain in Stefan blowing parameter escalates the liquid velocity. The intensification in chemical reaction rate parameter deteriorates the concentration gradient. The rise in Schmidt number and thermophoresis parameter drops the mass transfer rate. The increased values of Newtonian heating parameter
with respect to thermophoresis parameter decays the heat transport rate.
Prevalence of smartphone addiction and its correlates in a sample of Egyptian university students
Authors: Okasha Tarek , Saad Ahmed , Ibrahim Islam , Elhabiby Mahmoud , Khalil Sherien , Morsy Mahmoud
Published: September 2021

Background:

Smartphone addiction is considered currently as a public health concern especially among university students.

Aim:

The study assesses the prevalence of smartphone addiction and its sociodemographic and psychiatric correlates among Egyptian university students.

Methods:

A random sample of 1,380 undergraduate Egyptian university students from different universities were assessed using the smartphone addiction short scale, Beck depression Inventory, Beck anxiety Inventory, Pittsburgh sleep Quality Index, and Columbia suicide severity scale.

Results:

About 59% are smartphone addicts without any gender difference, we find a highly significant relation between smartphone addiction and depression, anxiety, sleep disturbance, smoking, and suicide.

Conclusion:

our study adds to the existing literature regarding the magnitude of smartphone addiction and its relationship with different psychiatric disorders.
“She Took Care of Us and She Went Through a Lot”: Emotional Availability, Emotional Support, and Millennials’ Gendered Understandings of Parenting
Authors: Dalessandro Cristen
Published: September 2021

In the United States, parenting pressures are growing for both mothers and fathers. Thus, it is important to investigate how younger generations may make sense of parenting in ways that could either reduce, or exacerbate, gender inequalities. In this article, interviews with 60 millennials discussing their experiences with their parents reveal that emotional support and emotional availability are key normative parenting expectations. However, disparate gender norms also factor into millennials’ stories about their parents’ efforts. These millennials often criticize fathers for sometimes being too absent, authoritarian, or ego-driven while they understand mothers as constrained by fathers’ bad behaviors yet still bound by expectations to be emotionally available and supportive in appropriately gendered ways. In millennials’ stories, emotional support and availability are seemingly gender neutral and millennials expect both fathers and mothers to live up to these expectations. However, broader structural gender norms challenge the apparent neutrality of parenting expectations.
Impact of minimal invasive extracorporeal circulation on perioperative intravenous fluid management in coronary artery bypass surgery
Authors: Ellam Sten , Räsänen Jenni , Hartikainen Juha , Selander Tuomas , Juutilainen Auni , Halonen Jari
Published: September 2021

Objective:

Compare the use of blood products and intravenous fluid management in patients scheduled for coronary artery bypass surgery and randomized to minimal invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC).

Methods:

A total of 240 patients who were scheduled for their first on-pump CABG, were randomized to MiECC or CECC groups. The study period was the first 84 hours after surgery. Hemoglobin <80 g/l was used as transfusion trigger.

Results:

Red blood cell transfusions intraoperatively were given less often in the MiECC group (23.3% vs 9.2%, p = 0.005) and the total intravenous fluid intake was significantly lower in the MiECC group (3300 ml [2950–4000] vs 4800 ml [4000–5500], p < 0.001). Hemoglobin drop also was lower in the MiECC group (35.5 ± 8.9 g/l vs 50.7 ± 9 g/l, p < 0.001) as was hemoglobin drop percent (25.3 ± 6% vs 35.3 ± 5.9%, p < 0.001). Chest tube drainage output was higher in the MiECC group (645 ml [500–917.5] vs 550 ml [412.5–750], p = 0.001). Particularly, chest tube drainage in up to 600 ml category, was in benefit of CECC group (59.1% vs 40.8%, p = 0.003). ROC curve analysis showed that patients with hemoglobin level below 95 g/l upon arrival to intensive care unit was associated with increased risk of developing postoperative atrial fibrillation (POAF) (p = 0.002, auc = 0.61, cutoff <95, sensitivity = 0.47, positive predictive value = 0.64).

Conclusion:

MiECC reduced the intraoperative need for RBC transfusion and intravenous fluids compared to the CECC group, also reducing hemoglobin drop compared to the CECC group in CABG surgery patients. Postoperative hemoglobin drop was a predictor of POAF.
Predictors to forgo resuscitative effort during Covid-19 critical illness at the height of the pandemic : A retrospective cohort study
Authors: Mesfin Nathan , Fischman Alexandra , Garcia Michael A , Johnson Shelsey , Parikh Raj , Wiener Renda Soylemez
Published: September 2021

Background:

Early in the Covid-19 pandemic, there was uncertainty regarding critical illness prognosis and challenges to traditional face-to-face family meetings. Ethnic minority populations have suffered disproportionately worse outcomes during the pandemic, which may in part relate to differences in end-of-life decision-making.

Aim:

Characterize patterns of and factors associated with decisions to forgo resuscitative efforts, as measured by do-not-resuscitate orders, during critical illness with Covid-19.

Design:

Retrospective cohort with medical record abstraction.

Setting/participants:

Adult patients diagnosed with SARS-Cov-2 virus via polymerase chain reaction and admitted to the intensive care unit at an academic hospital, which cares for the city’s underserved communities, between March 1 and June 7, 2020 who underwent invasive mechanical ventilation for at least 48 hours.

Results:

In this cohort ( n = 155), 45% were black people, and 51% spoke English as their primary language. Median time to first goals-of-care conversation was 3.9 days (IQR 1.9–7.6) after intensive care unit admission. Overall 61/155 patients (39%) transitioned to do-not-resuscitate status, and 50/62 (82%) patients who died had do-not-resuscitate orders. Multivariate analysis shows age and palliative care involvement as the strongest predictors of decision to instate do-not-resuscitate order. There was no association between race, ethnicity, or language and decisions to forego resuscitation.

Conclusions:

During this time of crisis and uncertainty with limited resources and strained communication, time to first goals of care conversation was shorter than in pre-pandemic studies, but rates of foregoing resuscitation remained similar, with no differences observed by race, ethnicity, or language. This study suggests that early palliative care involvement and non-traditional communications, including videoconferencing, to facilitate goals of care conversations could have mitigated potential disparities in end-of-life decision making patterns during the pandemic.
Perspectives of board-certified healthcare chaplains on challenges and adaptations in delivery of spiritual care in the COVID-19 era: Findings from an online survey
Authors: Kwak Jung , Rajagopal Shilpa , Handzo George , Hughes Brian P , Lee Moon
Published: September 2021

Background:

The COVID-19 pandemic has posed significant challenges for healthcare systems to meet patients’ and families’ complex care needs, including spiritual care needs. Little data are available about spiritual care delivery in light of the pandemic.

Aim:

This study examined the impact of COVID-19 on spiritual care by healthcare chaplains in the United States.

Design:

An online survey of 563 board-certified chaplains was conducted from March to July 2020. The survey, designed to identify chaplains’ roles in facilitating conversations about goals of care, included an open-ended question asking how COVID-19 affected chaplaincy practices; 236 chaplains responded. Quantitative data and written qualitative responses were analyzed using descriptive analysis and content analysis, respectively.

Setting/participants:

Majority of participants were white (88%), female (59%), Protestant (53%), and employed full time (86%). Almost half were working in community hospitals (45%) and designated to one or more special units (48%) including ICU, palliative care, and oncology.

Results:

Three major themes emerged from chaplains’ qualitative responses: (1) COVID-19—related risk mitigation and operational changes; (2) impact of social distancing guidelines; and (3) increased need for and provision of psychosocial and spiritual support.

Conclusions:

Chaplains reported that COVID-19 challenges contributed to greater social isolation, and mental health concerns for patients, families, and healthcare staff, and substantially changed the way healthcare chaplains provided spiritual care. With evolving healthcare contexts, developing safer, more creative modes of spiritual care delivery while offering systematic support for chaplains can help meet the increasing psychosocial and spiritual needs of patients, families, and healthcare team members.
A qualitative comparison of care home staff and palliative care specialists’ experiences of providing end of life care to people living and dying with dementia in care homes in two countries: A focus group study
Authors: Handley Melanie , Parker Deborah , Bunn Frances , Goodman Claire
Published: September 2021

Background:

Palliative care for people with dementia dying in care homes is an important aspect of long-term care. Whilst there is consensus about the principles of palliative care, less is known about how care home staff negotiate and influence decisions around end of life and how organisational context shapes that process.

Aim:

To explore the views and experiences of care home staff and palliative care specialists on end of life care in care homes and understand how care home settings affected palliative care provision in England and Australia.

Design/participants:

Eight focus groups in Australia and England with care home staff and palliative care specialists ( n = 49). Reflexive thematic analysis was undertaken.

Findings:

Australian participants reported collaboration between care home staff, visiting professions and family members though case conferences. English participants discussed resident-focussed involvement from specialists that was less formally organised. Negotiating roles and responsibilities in end of life care; the importance of relationships to overcome deficiencies in formal processes; and the legitimacy and authority of advance care planning at times of crisis were recurring themes. The organisation and embedding of end of life care in processes and practices of care homes differed; this closely linked to care home procedures in Australia but was less apparent in England.

Conclusion:

In both countries, partnership working was recognised and valued as key to effective palliative care. Work that enables care home staff to identify challenges with visiting professionals, such as agreeing priorities for care and negotiating their shared responsibilities, may lead to context-sensitive, sustainable solutions.
In-vitro Comparative Assessment of Antibacterial and Anti-adherent Effect of Two Types of Surface Modificants on Stainless Steel Orthodontic Brackets Against Streptococcus mutans
Authors: Math Mrunmaye , Shah Alok G. , Gangurde Parag , Karandikar Anita G. , Gheware Anjali , Jadhav Bhagyashree S.
Published: September 2021

Objective:

Comparative evaluation of antibacterial and anti-adherent properties of surface-modified stainless steel (SS) orthodontic brackets against Streptococcus mutans ( S. mutans).

Materials and Methods:

The study was conducted on 120 SS orthodontic McLaughlin, Bennett, Trevisi (MBT) 0.022″ slot by Leone, Italy. Orthodontic brackets that constituted the sample size were divided into 6 groups, consisting of 20 samples each in two control (non-surface coated) and four experimental groups. The experimental group’s surface coatings were photocatalytic zinc oxide (ZnO) and photocatalytic titanium oxide (TiO2), which were carried out by radiofrequency (RF) magnetron sputtering method for surface modification. Brackets were subjected to microbiological tests against S. mutans. For anti-adherence, weight change, pre- and postexposure, was evaluated to gauge the adherence of bacteria and colony-forming units/milliliter (CFU/mL) count measuring the survival rate of bacterial cells for antibacterial activity.

Results:

The TiO2-coated group showed statistically significant anti-adherence ( P-value < .05) against S. mutans than control and ZnO groups. The CFU count of TiO2 group was lower than control as well as ZnO group.

Conclusion:

TiO2 is superior to ZnO and should be continued to be considered for surface modification of orthodontic brackets against White Spot Lesions (WSLs) and gingivitis.
Improving the tensile property calculations with plastic zone radius measurements in depth-sensing spherical indentation tests
Authors: Zhang Tairui , Li Jianxun , Sun Xun , Shang Xiandong , Wang Weiqiang
Published: September 2021

Depth-sensing spherical indentation tests (SITs) have been widely used in tensile property calculations, but the accuracy and reproducibility of calculations may be significantly influenced by displacement measurement errors. Taking two representative tensile property calculation methods as examples, namely the analytical and numerical methods, the rationale as to why accurate and reproducible tensile property calculations cannot be expected from the depth-sensing SITs was discussed in detail. Subsequently, the proportional limit σ0 calculation from plastic zone radius rp measurements, which was analytically developed in the expanding cavity model (ECM) and experimentally measured by digital image correlation (DIC), was introduced to enhance the accuracy and reproducibility of the two representative methods. Principles for setting the strain threshold εth were established, and factors influencing the σ0 calculation from rp measurements were investigated through the optical system, the friction condition, the hardening behaviors of specimen materials, and the indentation depth. Through finite element calculations, it was proven that tensile property calculations at the existence of displacement measurement errors, particularly the constant error from the origin correction, can be significantly improved with the introduction of rp measurements. Similar findings were also observed in experiments on four metals that exhibited different hardening behaviors.
Impacts of Holding Area Policies on Shared Autonomous Vehicle Operations
Authors: Twumasi-Boakye Richard , Cai Xiaolin , Joshi Chetan , Fishelson James , Broaddus Andrea
Published: September 2021

Shared mobility has an important role in supporting existing transportation options in cities. However, when not deployed carefully, shared services may have operational inefficiencies such as low occupancies and increased deadheading. One reason is the spatio-temporal variance in the distribution of urban trip demand, which may lead to an unbalanced fleet displaced in cities thus unable to serve requested trips. Strategically siting holding areas (depots for dispatching and relocating fleets) could help improve fleet performance. Therefore, this paper considers shared autonomous vehicle (SAV) fleet operations by modeling the impacts of different holding area policies on service performance. Modeling and comparing multiple holding area policies for tactically deploying SAVs is novel, and the insights from this paper can inform service providers on how to site holding areas for improved performance. We develop a model of SAV fleet with pooling in the City of Toronto, with 27,951 total SAV trip requests across a 16-h period. We then integrate four holding area policies estimated using different spatial clustering methods, centralized positioning, and existing taxi stands. Findings indicate that using agglomerative clustering results in superior SAV fleet performances (average passenger waiting times reduced by about 20% compared with the worst performing policy), with increased served demand and reduced deadheading. A single holding area at a high trip density location yields efficient service performance at lower fleets but struggles to serve sparse demand (producing worst results); this method may suffice for operating SAV services within a small geofence with high trip densities.
Comparing Micro- and Macro-Level Rheological Properties of Polymeric and Reclaimed Asphalt Pavement-Modified Asphalt Binders
Authors: Bagchi Tandra , Hossain Zahid , Ziaur Rahaman Mohammed , Baumgardner Gaylon
Published: September 2021

Multi-scale evaluation of the rheological and mechanical properties of asphalt binder has substantial importance in understanding the binder’s micro- and macro-scale properties. This study compares the macro- and micro-scale mechanistic properties of asphalt binders. Test samples used in this study include performance grade binders (PG 64-22) from two different sources along with their modified counterparts. The modifiers include polyphosphoric acid (PPA), styrene-butadiene-styrene (SBS), a combination of SBS and PPA, and reclaimed asphalt pavement. To achieve the goal of this study, atomic force microscope technology was utilized to estimate the asphalt binder’s micro-mechanical properties (e.g., Derjaguin, Muller, Toropov modulus and deformation). On the other hand, data on the macro-scale properties—such as rutting factor (G*/sinδ), consistency and penetration—of the selected binders were analyzed and compared with the aforementioned micro-level properties. The comparative analyses indicated that the micro-mechanical properties of asphalt binders followed a linear trend with the macro-scale properties. The findings of this study are expected to help researchers and pavement professionals in modeling asphalt materials when multi-scale effects are deemed to be necessary.
Exploratory Examination of How Race and Criminal Record Relate to Housing Instability Among Domestic Violence Survivors
Authors: Engleton Jasmine , Sullivan Cris M. , Hamdan Noora
Published: September 2021

Housing instability is a critical concern in the United States, and domestic violence (DV) survivors are a group at high risk for experiencing housing instability or of becoming unhoused. Prior research has also identified having a criminal record (CR) as being a major barrier to obtaining stable housing, and this is truer for Black and Latinx people compared to their White counterparts. No study has examined whether comparable trends exist among survivors of DV, a group also at elevated risk of having a CR, sometimes related to their experience of abuse. The current exploratory study included 305 unhoused or unstably housed female DV survivors who had sought out DV support services. Multivariate regressions explored if survivor race and CR were separately linked to greater housing instability. CR was then explored as a potential moderator in the relation between race and housing instability. Results revealed that DV survivors with a CR faced greater housing instability than those without a CR, Black and Latina survivors experienced greater housing stability than did White survivors, and CR did not moderate the relation between race and housing instability. The racial differences were unexpected and are discussed in light of methodological limitations. This is the first study to date to explore the role of CR possession on housing instability for DV survivors.
Benchmarks of Equality? School-Wide Positive Behavioral Interventions and Supports and the Discipline Gap
Authors: Barclay Christopher M. , Castillo Jose , Kincaid Don
Published: September 2021

In U.S. schools, Black and Latinx youth receive disciplinary action at rates greater than their White peers. In the context of systemic racism in the United States, proposed systemic solutions such as school-wide positive behavioral interventions and supports (SWPBIS) should be evaluated for their effectiveness in producing more equitable school discipline. In light of mixed evidence for a SWPBIS–equity relationship, this study examined the merits of five SWPBIS elements demonstrating promise in the literature or underexamined potential for reducing discipline rates and disparities for Black and Latinx students in a sample of 322 SWPBIS-implementing schools serving a total of 292,490 students (19% Black, 28% Latinx) in a southeastern state. Multiple linear regression results indicated that higher fidelity to SWPBIS Classroom Systems was related to lower discipline risk for all students, including Black and Latinx students, but not more equitable discipline practices. Higher fidelity to SWPBIS Expectations was related to higher suspension risk among Black students, whereas higher levels of Recognition were related to more equitable suspension practices. No significant relationships were observed between Lessons and Data Analysis and disciplinary rates or equity. Implications for the research and practice of SWPBIS are discussed in the context of promoting more equitable and socially just discipline practices.
The enemy within: The legitimating role of local managerial elites in the global managerial colonization of the Global South
Authors: Toivonen Aurélie , Seremani Tapiwa
Published: September 2021

This paper contributes to the drive to decolonize management and organization knowledge by unpacking the role played by indigenous managerial elites in the global managerial colonization of the Global South. We focus on the narratives managerial elites construct to legitimate managerialism to a dissenting population. We conducted an ethnographic study of efforts by members of the city council of Yaoundé, in Cameroon to implement and legitimate a global managerial intervention. Our findings show that to successfully legitimate the imposition of managerialism to a dissenting populace, managerial elites construct hybrid narratives. These hybrid narratives are not ignorant of the local context and are particularly potent because of the manner in which they factor in some local concerns, making the managerialist intervention more palatable to locals and yet continuing to impose a foreign way of life.
Governance of Marwari capital: Daily living as a decolonial ‘matrix-of-praxis’ intermeshing commercial, religious and familial spheres
Authors: Mohnot Jitesh , Pratap Sankalp , Saha Biswatosh
Published: September 2021

This paper is a narration on practices of unlimited liability Marwari businesses of a textile town in Western India. Although depicted as an ‘outdated’ form of incorporation, these businesses were surprisingly resilient prompting us to engage in exploration of their ways of doing business. We deployed Mignolo’s concept of colonial-matrix-of-power to anchor our interpretive sense-making of enactments of our participant businessmen. The daily doings of the businessmen and their families enacted a ‘way of life’, Marwaripan. Activities created an intermesh across ‘local’ spaces of family, business and religion, constituting, what we call, a decolonial matrix-of-praxis. It created a ‘local’ form of Marwari governance where circulation and access to capital depended on extensively (and labouriously) negotiated construction of ‘status’ within open spaces of ‘enunciation’. However, preserving Marwaripan also required arduous striving and collective toil to continuously construct subjectivities based on customary dharma through a communitarian pedagogy that could wean away actors from the state driven pedagogy of regular schools.
Sami-digital storytelling: Survivance and revitalization in Indigenous digital games
Authors: Nijdam Elizabeth “Biz”
Published: September 2021

This article examines how digital games on Sami culture can draw attention to Indigenous issues when produced in collaboration with Sami community members. Through a case study that probes the design, game mechanics, and user experience of Gufihtara eallu (2018), this article frames Indigenous digital games and game development as a form of digital storytelling that is able to educate players on Indigenous knowledge systems and intangble cultural heritage. By looking at the way Gufihtara eallu engages Sami oral traditions in particular, this article demonstrates how digital games are capable of embodying Indigenous methodologies in such a way as to not flatten understandings of Indigenous traditions to a mythologized historical moment; instead, games produced by and for Indigenous people are capable of presenting storytelling traditions as contemporary, interactive, and constantly evolving, incorporating traditional themes as much as contemporary issues that are being perpetually redefined by modern Sami experience and new technologies.
Severe versus less severe intimate partner violence: Aggressors and victims
Authors: Aguilar Ruiz Raúl , González Calderón María José , González García Abel
Published: September 2021

In order to study the differences between severe intimate partner violence (S-IPV) and less severe intimate partner violence (LS-IPV), reports by 16,385 women who had suffered some type of abuse in 2016 and 2017 were analysed by means of the Police Risk Assessment Questionnaire. Chi-square tests indicate that S-IPV aggressors present criminological features to a significantly greater extent and are more likely to perpetrate various types of violence against their partners (for example, sexual aggression, death threats, degrading treatment, and controlling behaviour). Their behaviours seem to depend more on their beliefs and attitudes than on any possible psychopathological disturbance. Likewise, the victims of S-IPV are significantly more likely to report substance abuse, isolation from their environment, and vulnerability due to a mental disorder or disability; furthermore, they are less likely to report their abusers and continue with the judicial process. Therefore, efforts must be focused on fighting isolation, guaranteeing access to assistance and support services, and protecting victims during the processing of the criminal investigation. Professionals must also be alert to conflicts between partners linked to emotional breakdown and apply the relevant risk-management strategies, especially in cases with a history of mistreatment of women and an increase in violence severity.
Expression Characteristics and Clinical Correlations of BRD1 in Colorectal Cancer Samples
Authors: Li Zhou , Wang Junjie , Ji Yuzhu , Song Fangzhou
Published: September 2021

The incidence of colorectal cancer (CRC), as well as subsequent patient mortality, has increased in the last decade; an unhealthy diet is considered to be the leading cause. Previous studies have shown the potential of the bromodomain containing 1 ( BRD1) gene as a therapeutic target for CRC based on its specificity; however, the genetic mode of action and expression in CRC cells are yet to be investigated. In this study, target genes were screened from single-cell transcriptome sequencing data, and the collected clinical specimens were subjected to immunohistochemistry (IHC) to identify the protein expression of target genes; the results were verified in the GSE17536 array set. Receiver operating characteristic curves (ROC) and overall survival (OS) were used to test target genes as biomarkers and independent predictive markers for CRC. Based on these results, BRD1 was screened as a target gene, and IHC results showed that BRD1 protein expression in CRC was higher than that in normal tissues and was significantly upregulated in poorly differentiated (PD) CRC. ROC analysis showed that the area under the curve in the collected clinical specimens and GSE17536 were 0.6062 and 0.6094, respectively. OS analysis showed that higher BRD1 protein expression was associated with a significantly shorter survival time. In conclusion, BRD1 expression was positively correlated with PD CRC and negatively correlated with OS, indicating that BRD1 could predict the differentiation state of CRC and may be a novel predictive biomarker.
Computed Tomography and Magnetic Resonance Imaging Overlay in the Spine for Surgical Planning: A Technical Report
Authors: Perez Alberto A. , Yoon Edward S. , Iyer Sravisht , Lafage Virginie , Sandhu Harvinder , Schwab Frank , Albert Todd J. , Qureshi Sheeraz , Kim Han Jo , Katsuura Yoshihiro
Published: September 2021

Background: Computed tomography (CT) and magnetic resonance imaging (MRI) studies are used separately for surgical planning of spine surgery. Advanced techniques exist for creating CT-MR fusion images, but at this time these techniques are not easily accessible for large-scale use. Technique: We propose a simple graphical technique for CT-MR image overlay, for use in the surgical planning of spinal decompression and guidance of intraoperative resection. The proposed technique involves overlaying a single cross-section from anatomically comparable MRI and CT studies on any software with basic image editing functions. Results: We demonstrate CT-MR fusion images of 8 patients of the senior author in which the technique was used. We found that it can also be referenced intraoperatively for navigation.Conclusions: Compared to other techniques, our proposed method can be easily implemented by clinicians to create simple CT-MRI fusion images that can be useful for preoperative planning and intraoperative navigation.
Investigation of cycle skipping methods in an engine converted to positive ignition natural gas engine
Authors: Tunçer Erdal , Sandalcı Tarkan , Karagöz Yasin
Published: September 2021

In this study, a single cylinder of 1.16 L, naturally aspirated engine was converted to a spark ignition engine, which was a diesel engine operating with natural gas as fuel. By placing electronic throttle, electronic ignition module, gas fuel injectors and proximity sensors on the test engine, the engine has been turned into a positive ignition engine that can work with natural gas as fuel, thanks to the electronic control unit developed by our project team. Then, in the study performed, different cycle skipping strategies were experimentally investigated at a constant engine speed of 1565 rpm, in accordance with the generator operating conditions. Engine performance, emissions (CO, HC, and NOx), and combustion characteristics (cylinder pressure, rate of heat release, etc.) of cycle skipping strategies were experimentally investigated with natural gas as fuel in Normal, 3N1S, 2N1S, and 1N1S engine operating modes. According to the results obtained, specific fuel consumption, CO and HC values improved in all cycle skipping operating conditions, except for NOx, but the best results were obtained in 2N1S operating conditions; it was concluded that the specific fuel consumption, CO and HC values improved by 11.19%, 61.89%, and 65.60%, respectively.
Influence of Processes of Change on Stages of Change for Smoking Cessation
Authors: Ahmad Asrar , Singh Jagwinder
Published: September 2021

Tobacco smoking is the leading cause of death in the world, accounting for more than eight million casualties. To reduce the prevalence of smoking, government and nongovernment players use interventions to reduce smoking and/or incite smoking cessation. These interventions are based on behavior change models. Foremost among those models is the Transtheoretical Model of Behavior Change developed by Dr Prochaska. The transtheoretical model theorizes that smoking cessation is a stage-wise change. This change is enabled by a set of processes of change. The current study identifies the relationship between two basic constructs of the model: processes of change and stages of change. The study also identifies the relative importance of different processes of change in different stages of change. Data analysis from this study shows that different processes of change have a differing influence on various stages of change. Experiential processes have a significant influence on the precessation stages and lack significant influence on the postcessation stages. On the contrary, behavioral processes have a significant influence on the postcessation stages and lack significant influence on the precessation stages.
Confidence to Return to Play After ACL Reconstruction: An Evaluation of Quadriceps Strength Symmetry and Injury Mechanism in Male Athletes
Authors: Straub Rachel K. , Della Villa Francesco , Mandelbaum Bert , Powers Christopher M.
Published: September 2021

Background:

After anterior cruciate ligament reconstruction (ACLR), diminished quadriceps strength symmetry and reduced psychological readiness to return to play (RTP) increase the risk for subsequent injury. Although the relationship between quadriceps strength symmetry and psychological readiness to RTP has been reported to be influenced by injury mechanism in female athletes, it is unclear whether such a relationship exists in male athletes.

Hypothesis:

Quadriceps strength symmetry would be positively associated with greater psychological readiness to RTP after ACLR, regardless of injury mechanism.

Study Design:

Retrospective cohort.

Level of Evidence:

Level 3 (cohort study).

Methods:

Sixty male patients completed strength testing and the Injury-Psychological Readiness to Return to Sport Scale (I-PRRS) at an outpatient clinical facility as part of return to sport testing after ACLR. Linear regression analysis was used to assess the relationship between the I-PRRS and the independent variables of interest (quadriceps strength symmetry and injury mechanism).

Results:

For all patients combined, no symmetry × mechanism interaction was found ( P = 0.11). A significant positive relationship was found between quadriceps strength symmetry and the I-PRRS score ( P < 0.001, R2 = 0.31), after adjusting for time post-ACLR and injury mechanism.

Conclusion:

Greater quadriceps strength symmetry was associated with greater psychological readiness to RTP after ACLR in male athletes. In contrast to what has been reported in female athletes, this relationship was independent of injury mechanism.

Clinical Relevance:

Given the potential negative consequences of quadriceps strength deficits on one’s confidence to RTP, the need to restore quadriceps symmetry during the postoperative period is readily apparent. Low confidence or low psychological readiness to RTP may be indicative of quadriceps strength asymmetry or poor physical function in general.
Rapid design and implementation of a virtual pain management programme due to COVID-19: a quality improvement initiative
Authors: Williams Deborah , Booth Gregory , Cohen Helen , Gilbert Anthony , Lucas Andrew , Mitchell Chloe , Mittal Gayatri , Patel Hasina , Peters Tamsin , Phillips Mia , Rudge Will , Zarnegar Roxaneh
Published: September 2021

Background:

The COVID-19 pandemic interrupted the delivery of face-to-face pain services including pain management programmes in the United Kingdom with considerable negative impact on patients with chronic musculoskeletal pain. We aimed to develop and implement a remotely delivered pain management programme (PMP) using video-conferencing technology that contains all the core components of a full programme: the ‘virtual PMP’ (vPMP). By reporting on the process of this development, we endeavour to help address the paucity of literature on the development of remote pain management programmes.

Methods:

The vPMP was developed by an inter-disciplinary group of professionals as a quality improvement (QI) project. The Model for Improvement Framework was employed with patient involvement at the design phase and at subsequent improvements. Improvement was measured qualitatively with frequent and repeated qualitative data collection leading to programme change. Quantitative patient demographic comparisons were made with a patient cohort who had been on a face-to-face PMP pathway.

Results:

Sixty-one patients on the PMP waiting list were contacted and 43 met the criteria for the programme. Fourteen patients participated in three vPMP cycles. Patient involvement and comprehensive stakeholder consultation were essential to a robust design for the first vPMP. Continued involvement of patient partners during the QI process led to rapid resolution of implementation problems. The most prominent issues that needed action were technical challenges including training needs, participant access to physical and technological resources, participant fatigue and concerns about adequate communication and peer support.

Conclusion:

This report demonstrates how a remotely delivered PMP, fully in line with national guidance, was rapidly developed and implemented in a hospital setting for patients with chronic musculoskeletal pain. We also discuss the relevance of our findings to the issues of cost, patient experience, patient preferences and inequities of access in delivering telerehabilitation for chronic pain.
Consumer Value Preferences in Healthcare: Insights for Value-centred Management
Authors: Saxena Sumit , Amritesh  , Misra Subhas C.
Published: September 2021

Advances in healthcare service research emphasize a value-driven approach in healthcare by pressing the need to acknowledge what matters to the patient against the conventional approach of what should be provisioned in the service. This research study adopts a consumer-centric perspective of value creation, and explores consumer value preferences in healthcare services, using netnography of online consumer reviews of cancer patients. Six different types of consumer value are identified, which carry varying consumer expectations. These are excellence, novelty, spirituality, ethics, privacy and control. The research findings confirm that all types of consumer values are not positive; rather, there is a presence of positive and negative (or must-be) elements. Privacy and ethics are identified as the negative or must-be type of consumer value, which creates not much satisfaction, but their absence is dissatisfying. Novelty and control are identified as positive value types whose absence may not be that problematic, but their enhancement creates greater customer satisfaction. The findings provide shreds of evidence to the claim that all value types are not positive, and consumers often make trade-offs between positive and negative value types while evaluating services. Future research is suggested in different healthcare contexts (e.g., chronic vs. non-chronic disease) to develop value-centred management strategies.
Proteome analysis identified proteins associated with mitochondrial function and inflammation activation crucially regulating the pathogenesis of fatty liver disease
Authors: Zhang Letian , Liu Tingjun , Hu Chengzhang , Zhang Xuan , Zhang Qin , Shi Kerong
Published: September 2021

Background

Fatty liver disease prevalently occurs in commercial postpartum dairies, resulting in a worldwide high culling rate because of their subsequent limitations of production and reproduction performance.

Results

Fatty liver-specific proteome and acetylome analysis revealed that energy metabolism suppression closely associated with mitochondrial dysfunction and inflammation activation were shown to be remarkable biological processes underlying the development of fatty liver disease, furthermore, acetylation modification of proteins could be one of the main means to modulate these processes. Twenty pivotal genetic factors/genes that differentially expressing and being acetylation modified in liver were identified and proposed to regulate the pathogenesis of fatty liver dairies. These proteins were confirmed to be differentially expressing in individual liver tissue, eight of which being validated via immunohistochemistry assay.

Conclusions

This study provided a comprehensive proteome and acetylome profile of fatty liver of dairy cows, and revealed potential important biological processes and essential regulators in the pathogenesis of fatty liver disease. Expectantly, understanding the molecular mechanisms of the pathogenesis of fatty liver disease in dairies, as an animal model of non-alcoholic fatty liver disease (NAFLD) in human beings, which is a clinico-pathologically defined process associated with metabolic syndrome, could inspire and facilitate the development of efficacious therapeutic drugs on NAFLD.
Laypeople perception and interpretation of simulated life-threatening bleeding: a controlled experimental study
Authors: Prytz Erik , Phillips Rachel , Lönnqvist Susanna , Friberg Marc , Jonson Carl-Oscar
Published: September 2021

Introduction

First aid performed by immediate responders can be the difference between life and death in the case of trauma with massive bleeding. To develop effective training programs to teach bleeding control to laypersons, it is important to be aware of beliefs and misconceptions people hold on bleeding and severity of bleeding situations.

Method

A controlled study was conducted in which 175 American college students viewed 78 video clips of simulated bleeding injuries. The volume of blood present (between 0 and 1900 ml), rate of blood flow, and victim gender were systematically varied within participants. Participants were asked to rate injury severity, indicate the appropriate first aid action, and estimate the amount of time until death for the victim.

Results

Though the Stop the Bleed® campaign recommends training laypeople to treat 165 ml of blood loss as life threatening, participants largely rated this volume of blood loss as minimal, mild, or moderate and estimated that the victim had just under one hour to live. Increased blood loss was associated with increased recommendations to use a tourniquet. However, in the 1900 ml conditions, participants still estimated that victims had around 22 minutes to live and approximately 15% recommended direct pressure as the intervention. Severity ratings and recommendations to use a tourniquet were also higher for the male victim than the female victim.

Conclusions

Injury classification, intervention selection, and time to death-estimations revealed that training interventions should connect classifications of blood loss to appropriate action and focus on perceptions of how much time one has to respond to a bleeding. The study also revealed a gender related bias in terms of injury classification and first aid recommendations. Bleeding control training programs can be designed to address identified biases and misconceptions while building on existing knowledge and commonly used terminology.
The impact of social network change and health decline: a qualitative study on experiences of older adults who are ageing in place
Authors: Ouden Willeke Vos-den , van Boekel Leonieke , Janssen Meriam , Leenders Roger , Luijkx Katrien
Published: September 2021

Background

Older adults prefer to age in place. Social network change and health decline challenge ageing in place, as stressors that make age-related advantages disappear. The aim of this study was to explore social network change and health decline and its impact on older adults who are ageing in place.

Method

In-depth interviews (n = 16) were conducted with older adults who were ageing in place and who were experiencing health decline and social network change. Procedures for grounded theory building were followed to analyse the interviews with respondents who were discharged from the hospital less than 4 months ago (n = 7). Narrative analysis was conducted to reach a deeper understanding of the expected complexity of experiences of this targeted sample.

Results

Results encompass a typology with four types of impact: A. Sneak preview of old age, B. Disruptive transition into old age, C. Drastically ageing, and D. Steadily ageing. Additionally, indications were found that older adults should be able to move along the four types of impact and ideally could end up in quartile D, experiencing little or no impact at all (anymore).

Conclusion

The results present an optimistic view on the possibilities of older adults to continue ageing in place despite experiencing unavoidable and uncontrollable stressors in life. Also, the results provide leads for practice, to develop an action perspective for home care nurses and gerontological social workers to determine and reduce the impact of social network change and health decline on older adults who are ageing in place. Suggestions for further research would be to unravel how to detect temporal setbacks in successful ageing in place.
General health, healthcare costs and dental care use of elderly with a natural dentition, implant-retained overdenture or conventional denture: an 8-year cohort of Dutch elderly (aged 75 and over)
Authors: Bakker Mieke H. , Vissink Arjan , Raghoebar Gerry M. , Peters Lilian L. , Visser Anita
Published: September 2021

Background

Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design.

Methods

This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures.

Results

At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures.

Conclusions

It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).