bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental and Economic Effects of Fuel Savings in Driving Phase Resulting from Substitution of Light Metals in European Passenger Car Production
Authors: Türe Yiğit , Türe Cengiz
Published: April 2021

The European Union (EU), which realizes one-quarter of the automobile production in the world, has made legal regulations to minimize fuel consumption and CO2 emissions in the automotive sector, to prevent global warming and climate change. Life cycle analysis for passenger cars revealed that 90% of this effect is caused by the driving phase of the vehicles. One of the practices used in the automotive industry to minimize the impact of these factors is to reduce the vehicle mass as much as possible. Aluminum (Al) and magnesium (Mg) are increasingly preferred lightweight materials, since the weight is a critical design element for automobile production. This study aims to evaluate the environmental and economic impacts of fuel consumption, fuel expense, and CO2 emission resulting from the driving cycle by creating a mathematical model of the weight savings achieved with Al and Mg substitution in the passenger car fleet produced in the EU. The results show that the average weight reduction per vehicle achieved by substituting light metals in passenger car production in the EU over the past 20 years has reached approximately 11.2% and that the positive effect on fuel consumption and CO2 emissions in the driving cycle will contribute to environmentally and economically sustainable road transport.
Full Scale Evaluation of Surface Treatments for Airfield Concrete Pavement Repair
Authors: Doyle Jesse D. , Jefcoat Jennifer A. , Ordaz Margarita , Rutland Craig A.
Published: April 2021

Surface deterioration of concrete pavements requires maintenance. Highway and airfield pavements exhibit many of the same maintenance issues, but airfields have several additional unique issues and requirements. Among these are petroleum contamination on aircraft parking areas and a high potential for failed concrete or maintenance materials to damage aircraft. To address these issues, commercially available surface-applied treatment products were assessed for use on concrete pavements with particular focus on the special requirements of airfields. Fourteen products encompassing numerous chemistries were evaluated in a full-scale field experiment. The specific objectives of this study were to investigate materials for field application issues, adhesion to concrete (for both clean and oil contaminated concrete), the ability to seal cracks, behavior under aircraft traffic loads including surface friction, and durability over time with exposure to environmental conditions. Test strips of each material were applied to deteriorated concrete slabs. Half of the concrete was intentionally contaminated with oil while the other half was left clean. Simulated aircraft traffic was applied and periodic visual observations and surface friction measurements were made. Two years after material application, a final visual assessment was made. Many of the products performed well on clean concrete; however, oil contaminated concrete detrimentally affected many of them. Of the fourteen products evaluated, two of the epoxy based materials clearly emerged as the best performing.
Family Firm Heterogeneity: A Definition, Common Themes, Scholarly Progress, and Directions Forward
Authors: Daspit Joshua J. , Chrisman James J. , Ashton Triss , Evangelopoulos Nicholas
Published: April 2021

While progress has been made in recent years to understand the differences among family firms, insights remain fragmented due, in part, to an incomplete understanding of heterogeneity and the scope of differences that exist among family firms. Given this, we offer a definition of and review the literature on family firm heterogeneity. A latent semantic analysis of 781 articles from 33 journals identified nine common themes of family firm heterogeneity. For each theme, we review scholarly progress made and highlight differences among family firms. Additionally, we offer directions for advancing the study of family firm heterogeneity.
The new strategic agenda for value transformation
Authors: van der Nat Paul B
Published: April 2021

The model for value-based healthcare introduced in 2006 by Porter and Teisberg is still relevant, but it is incomplete. Porter and Teisberg put a strong focus on measuring outcomes, but how to use these measurements to actually improve quality of care has not been described. In addition, value-based healthcare as originally introduced neglects that a true shift from volume to patient value requires a change in culture and way of working of healthcare professionals. The original strategic agenda for value transformation (in short: ‘value agenda’) consists of six elements: organize into Integrated Practice Units (1), measure outcomes and costs for every patient (2), move to bundled payments for care cycles (3), integrate care delivery systems (4), expand geographic reach (5), and build an enabling information technology platform (6). For value-based healthcare to become a reality, the strategic agenda needs to be extended with four elements. First, healthcare providers need to set up a systematic approach for value-based quality improvement. Second, value needs to be integrated in patient communication. Third, we should invest in a culture of value delivery. And fourth, we should build learning platforms for healthcare professionals based on patient outcome data. Best practices on value-based healthcare implementation are working on these four elements in addition to the original value agenda. In conclusion, a new strategic agenda for value transformation is proposed that combines the vision of the founders of value-based healthcare with implementation experience in order to support healthcare providers in their shift to become value-based.
New chronostratigraphic records of the early-to-middle Holocene in the north-central region of Chile indicate Andean foothills housed hunter-gatherers during pulses of extreme aridity
Authors: Grasset Sebastián , Nuevo-Delaunay Amalia , Álvarez José , Maldonado Antonio , Méndez César
Published: April 2021

The scarcity of middle Holocene radiocarbon dates in different regions of the Andes has been interpreted as an indicator of discontinuity in human occupations in response to adverse environmental conditions due to marked aridity. In the subtropical Andes of north-central Chile and adjacent areas, this paucity has been detected in radiocarbon ages between 8000 and 6000 cal BP. A systematic programme of cave excavations with detailed chronologies in the Combarbalá area in the Andean western foothills at 31°S allows questioning the role these spaces and ecosystems played for hunter-gatherers throughout the Holocene. The elusive record of dateable material has been addressed by excavating deposits under rock-shelters which tend to trap sedimentary material. This dataset has been compared with the available climate records and shows a collation between the onset of various site chronologies during the early-to-middle Holocene and periods of extreme aridity. The organization of mobility and the role of Andean foothills for hunter-gatherer settlements is reviewed. Resource availability in the area, namely fresh water supply, good-quality toolstones, faunal resources, and shelters, attracted mobile populations to these environments as indicated by our records as well as others in the broader region.
Zhuyu Annao decoction promotes angiogenesis in mice with cerebral hemorrhage by inhibiting the activity of PHD3
Authors: Wu L , Hu Y , Jiang L , Liang N , Liu P , Hong H , Yang S , Chen W
Published: April 2021

Some traditional Chinese decoctions, such as Zhuyu Annao, exert favorable therapeutic effects on acute cerebral hemorrhage, hemorrhagic stroke, and other neurological diseases, but the underlying mechanism remains unclear. This study aimed to determine whether Zhuyu Annao decoction (ZYAND) protects the injured brain by promoting angiogenesis following intracerebral hemorrhage (ICH) and elucidate its specific mechanism. The effect of ZYAND on the nervous system of mice after ICH was explored through behavioral experiments, such as the Morris water maze and Rotarod tests, and its effects on oxidative stress were explored by detecting several oxidative stress markers, including malondialdehyde, nitric oxide, glutathione peroxidase, and superoxide dismutase. Real-time quantitative RT-PCR and WB were used to detect the effects of ZYAND on the levels of prolyl hydroxylase domain 3 (PHD3), hypoxia-inducible factor-1α (HIF-1α), and vascular endothelial growth factor (VEGF) in the brain tissues of mice. The effect of ZYAND on the NF-κB signaling pathway was detected using a luciferase reporter gene. A human umbilical cord vascular endothelial cell angiogenesis experiment was performed to determine whether ZYAND promotes angiogenesis. The Morris water maze test and other behavioral experiments verified that ZYAND improved the neurobehavior of mice after ICH. ZYAND activated the PHD3/HIF-1α signaling pathway, inhibiting the oxidative damage caused by ICH. In angiogenesis experiments, it was found that ZYAND promoted VEGF-induced angiogenesis by upregulating the expression of HIF-1α, and NF-κB signaling regulated the expression of HIF-1α by inhibiting PHD3. ZYAND exerts a reparative effect on brain tissue damaged after ICH through the NF-κB/ PHD3/HIF-1α/VEGF signaling axis.
Testing for treatment effect in covariate-adaptive randomized trials with generalized linear models and omitted covariates
Authors: Li Yang , Ma Wei , Qin Yichen , Hu Feifang
Published: April 2021

Concerns have been expressed over the validity of statistical inference under covariate-adaptive randomization despite the extensive use in clinical trials. In the literature, the inferential properties under covariate-adaptive randomization have been mainly studied for continuous responses; in particular, it is well known that the usual two-sample t-test for treatment effect is typically conservative. This phenomenon of invalid tests has also been found for generalized linear models without adjusting for the covariates and are sometimes more worrisome due to inflated Type I error. The purpose of this study is to examine the unadjusted test for treatment effect under generalized linear models and covariate-adaptive randomization. For a large class of covariate-adaptive randomization methods, we obtain the asymptotic distribution of the test statistic under the null hypothesis and derive the conditions under which the test is conservative, valid, or anti-conservative. Several commonly used generalized linear models, such as logistic regression and Poisson regression, are discussed in detail. An adjustment method is also proposed to achieve a valid size based on the asymptotic results. Numerical studies confirm the theoretical findings and demonstrate the effectiveness of the proposed adjustment method.
Investigating the Mediating Relationship Between Sustainability Orientations and Sustainable Performance in the SME Context of Tunisia
Authors: Abdulaziz-al-Humaidan Abdullah , Ahmad Noor-Hazlina , Islam Md Shamimul
Published: April 2021

The purpose of this study is to investigate the mediating role of corporate social responsibility (CSR) in between the sustainability orientation of managers and sustainable performance of small and medium enterprises (SMEs) in Tunisia. Besides that it aims to explore the impact of managers’ sustainability orientation on CSR practices, and how these activities could affect economic, social and environmental performance. The data have been collected by survey questionnaires from the owners and managers of SMEs across the manufacturing sector in Tunisia. Partial least square structural equation modelling statistical method has been used to analyse the research model using the software SmartPLS 3. The results reveal that CSR mediate the relationship between managers’ sustainability orientations and sustainability performance (except economic dimension). Moreover, the results also found that owners’ orientations towards sustainability positively influence CSR, and CSR also positively affect social and environmental sustainable performance. However, this study does not find a significant causal effect between CSR and economic sustainable performance. This study contributes to the Upper Echelon Theory by extending via empirical evidence with respect to sustainability, strategic, tactical orientations, CSR and sustainable performance. The limitations and direction for future research have been stated in this study.
The Public’s Perceptions of Government Officials’ Communication in the Wake of the COVID-19 Pandemic
Authors: Bickham Shaniece B. , Francis Diane B.
Published: April 2021

Early news coverage in the US about the COVID-19 pandemic focused on information released from local, state and federal government officials. With an emphasis on US government at these levels, this study examined whether the public’s credibility perceptions and trust in government, along with message exposure, influenced their adherence to information from the government about (a) stay-at-home orders, (b) social distancing and (c) COVID-19 testing. Source credibility theory and situational crisis communication theory provided the theoretical framework for this study. Through the survey data analysis, we investigated communication preferences in the wake of the pandemic and whether credibility perceptions differed according to the level of government. Survey findings revealed that message exposure influenced respondents’ perceived credibility of and trust in government officials during and after the stay-at-home order. Finally, practical implications regarding recommended communication strategies based on the findings were discussed.
Vietnam’s Regional Security Perceptions and Priorities: Role of India
Authors: Mishra Rahul
Published: April 2021

Over the past several decades, India and Vietnam have consolidated their relationship through bilateral engagements, which have been complemented by the Association of Southeast Asian Nations (ASEAN)-led multilateral mechanisms such as the East Asia Summit, ASEAN Regional Forum, ASEAN Defence Ministers’ Meeting Plus and the India-led Mekong–Ganga Cooperation (MGC). Building up on their traditionally strong relations, India and Vietnam have widened and deepened their defence and strategic links in recent years, which is manifested in joint trainings, military exercises and defence Lines of Credit offered by India. Since the 1990s, especially over the last decade, both India and Vietnam have made strategic readjustments to elevate their respective bilateral ties with like-minded countries bringing about new commonalities in their politico-strategic visions and policies. Like India, Vietnam too is trying to bring the multilateral and multi-dimensional Indo-Pacific agenda to the mainstream of its foreign policy calculations, facilitated by greater warmth in ties with Japan and the US. Vietnam’s embracing of the Indo-Pacific is also in sync with ASEAN’s Outlook on Indo-Pacific. It also aligns well with Vietnam’s long-standing policy of ‘Three Nos’, expanded to four in its 2019 Defence White Paper. While recent developments in the South China Sea have exacerbated Vietnam’s growing anxieties vis-à-vis China, considering its trade interlinkages and dependence on China (and Russia), it is apparent that Vietnam is not yet ready to uproot its multilayered linkages with China and get on board the ‘Quad Plus’ initiative that is perceived as an overtly anti-China coalition of democracies. India–Vietnam ties, therefore, must rely on the bilateral plank along with ASEAN-linked mechanisms, MGC and the Indo-Pacific construct while trying to develop concerted actions through deeper cooperation with Japan and the US. In short, any initiative to include Vietnam in a Quad Plus mechanism without sufficiently developing synergies with individual countries would not yield desired outcomes. This article argues that India–Vietnam ties would benefit most by attaching their bilateral pillar of relationship with the ASEAN- and Indo-Pacific-centred inclusive multilateral mechanisms while gradually engaging the US, Japan and other potential partners in suitable frameworks.
The Importance of Being a Compassionate Leader: The Views of Nursing and Midwifery Managers From Around the World
Authors: Papadopoulos Irena , Lazzarino Runa , Koulouglioti Christina , Aagard Magdeline , Akman Özlem , Alpers Lise-Merete , Apostolara Paraskevi , Araneda-Bernal Julieta , Biglete-Pangilinan Sylvia , Eldar-Regev Orit , González-Gil Maria Teresa , Kouta Christiana , Krepinska Radka , Lesińska-Sawicka Małgorzata , Liskova Miroslava , Lopez-Diaz Alba Lucero , Malliarou Maria , Martín-García Ángel , Muñoz-Solinas Mara , Nagórska Małgorzata , Ngunyulu Roinah Nkhensani , Nissim Sara , Nortvedt Line , Oconer-Rubiano Ma. Florinda , Oter-Quintana Cristina , Öztürk Candan , Papp Katalin , Piratoba-Hernandez Blanca , Rousou Elena , Tolentino-Diaz Maria Ymelda , Tothova Valerie , Zorba Akile
Published: April 2021

Introduction:

Despite the importance of compassionate leadership in health care, many of the existing publications do not account for the effect of culture. The aim of this study is to explore the views of nursing and midwifery managers from different countries in relation to the definition, advantages, and importance of compassion.

Methodology:

A cross-sectional, descriptive, exploratory online survey was conducted across 17 countries, containing both closed and open-ended questions. Data from N = 1,217 respondents were analyzed using a directed hybrid approach focusing only on qualitative questions related to compassion-giving.

Results:

Four overarching themes capture the study’s results: (1) definition of compassion, (2) advantages and importance of compassion for managers, (3) advantages and importance of compassion for staff and the workplace, and (4) culturally competent and compassionate leadership.

Discussion:

Innovative research agendas should pursue further local qualitative empirical research to inform models of culturally competent and compassionate leadership helping mangers navigate multiple pressures and be able to transculturally resonate with their staff and patients.
Antibody-Mediated Rejection Management Following Lung Transplantation
Authors: Neuhaus Kristen , Hohlfelder Benjamin , Bollinger Jessica , Haug Marcus , Torbic Heather
Published: April 2021

Background

Although antibody-mediated rejection (AMR) is described in other solid organ transplant populations, the literature describing the management following lung transplantation is limited.

Objective

The purpose of this study is to evaluate the management strategies of AMR in lung transplant recipients.

Methods

This single-center, retrospective study described the management of AMR in adult lung transplant recipients who received treatment with rabbit antithymocyte globulin, bortezomib, rituximab, intravenous immune globulin (IVIG), and/or plasmapheresis between September 2015 and June 2019.

Results

A total of 270 medication orders for 55 patient admissions were included in the primary outcome analysis. The most commonly used regimen consisted of IVIG, plasmapheresis, and rituximab (49.1%; n = 27), followed by IVIG and plasmapheresis alone (27.3%, n = 15). A total of 51 patients (93%) received plasmapheresis as part of their AMR treatment, with a median of 4 [3, 5] sessions per encounter; 86% of patients with positive donor-specific antibodies (DSAs) had a reduction in DSAs following AMR treatment. Overall, 23.5% of patients had noted allograft failure or need for retransplantation. A total of 10 patients died during the AMR treatment hospital admission, and an additional 11 patients died within 1 year of the initial encounter.

Conclusion and Relevance

This represents the largest report describing management strategies of AMR in lung transplant recipients. Although practice varied, the most commonly used regimen consisted of plasmapheresis, IVIG, and rituximab.
Managing Anticipatory Grief in Family and Partners: A Systematic Review and Qualitative Meta-Synthesis
Authors: Majid Umair , Akande Adedoja
Published: April 2021

Almost every person is affected by grief at some point during their lifetime. However, the majority of grief research has focused on the experiences and perspectives of individuals after loss. Grief can be expected or unexpected depending on the nature of loved one’s death. Like postdeath grief, individuals who expect the impending loss of a loved one may feel uncertainty, fear, and sadness, which can lead to a number of adverse outcomes on their health. Some research labels the predeath experience as anticipatory grief (AG). In this qualitative systematic review, we analyze 13 studies to examine how caregivers of terminally ill patients experience AG. First, we identify the four stages of AG: time of diagnosis, transition to hospice care, nearing death, and the moment of death. We highlight the characteristics of each stage and the coping mechanisms that family used to navigate them. Second, we discuss how AG influences family and partner roles and responsibilities. We also examine the interplay between caregiving motivations and activities, and the four stages of AG. We consider the relationship between AG, caregiving, and postdeath adjustment, including physical and mental health outcomes.
Anxious, Apart, and Attentive: A Qualitative Case Study of Overseas Filipino Workers’ Families in the time of COVID-19
Authors: Cleofas Jerome Visperas , Eusebio Ma. Cristina SC. , Pacudan Ellen Joy P.
Published: April 2021

Cognizant of the nature and type of family as factors that affect the experience and coping of its members, this study sought to examine the impact of the pandemic on overseas Filipino workers’ (OFW) families using a qualitative instrumental case study of four OFW families. Three themes emerged from the analysis: (1) worry over the conditions of the distant family members, (2) disruptions in plans and family relationships, and (3) monitoring and caring from a distance. From these findings, it could be reflected that despite the negative effects of the pandemic, OFW families can recreate patterns over time to retain their familial relations and routines and protect members from coronavirus and its consequences.
Disability-Responsive Adaptations: Child–Parent–Relationship Therapy for Children With Disabilities
Authors: Rodríguez Mónica , Tapia-Fuselier Jose Luis , Ceballos Peggy , Agarwal Sarah
Published: April 2021

Children with disabilities have unique and often specialized needs. The parents of children with disabilities play an integral and sometimes challenging role in supporting, advocating, and caring for their children. This article introduces an evidence-based approach to work with parents of children with disabilities that focuses on strengthening the relationship between the parent and child through child–parent–relationship therapy (CPRT). Disability-responsive adaptations and recommendations are provided for CPRT, specifically for deaf and hard-of-hearing children, children with physical disabilities, and children with autism spectrum disorder.
Concurrent Childhood Experiences Impact Underage Substance Use
Authors: Broadbent Eliza , Miller Jacob Read , Cheung Aaron , Rollins Elizabeth Mathews , Novilla Lynneth Kirsten B. , Downing Melissa Stanfill , Crandall AliceAnn
Published: April 2021

Adverse and advantageous childhood experiences (ACEs and counter-ACEs) during adolescence are understudied. This study examined how childhood experiences affect youth tobacco/alcohol use. Participants included 489 U.S. adolescents (baseline 10–13 years; 51% female) from the first five waves of the Flourishing Families Project. Results of the cross-lagged model showed ACEs were predictive of early tobacco use only. Counter-ACEs in wave two and wave three predicted, respectively, decreased tobacco and decreased alcohol use in the following wave. Counter-ACEs were also correlated with reduced alcohol and tobacco use in later waves. These findings indicate the salience of counter-ACEs over ACEs in persistent and late adolescent substance use, though ACEs may be important to consider to prevent very early initiation of tobacco.
On the statics and dynamics of granular-microstructured rods with higher order effects
Authors: Nejadsadeghi Nima , Misra Anil
Published: April 2021

Granular-microstructured rods show strong dependence of grain-scale interactions in their mechanical behavior, and therefore, their proper description requires theories beyond the classical theory of continuum mechanics. Recently, the authors have derived a micromorphic continuum theory of degree n based upon the granular micromechanics approach (GMA). Here, the GMA is further specialized for a one-dimensional material with granular microstructure that can be described as a micromorphic medium of degree 1. To this end, the constitutive relationships, governing equations of motion and variationally consistent boundary conditions are derived. Furthermore, the static and dynamic length scales are linked to the second-gradient stiffness and micro-scale mass density distribution, respectively. The behavior of a one-dimensional granular structure for different boundary conditions is studied in both static and dynamic problems. The effects of material constants and the size effects on the response of the material are also investigated through parametric studies. In the static problem, the size-dependency of the system is observed in the width of the emergent boundary layers for certain imposed boundary conditions. In the dynamic problem, microstructural effects are always present and are manifested as deviations in the natural frequencies of the system from their classical counterparts.
Pulmonary Artery Aneurysm Associated With Severe Pulmonary Hypertension in a Patient Presenting for Double Lung Transplant: Review of a Rare Disorder and Role of Transesophageal Echocardiography
Authors: Arain Faisal D. , Gilbride Victoria A.
Published: April 2021

Pulmonary artery aneurysm (PAA) is a rare disorder that may be classified as congenital, acquired, or idiopathic, in the case of unclear etiology. When associated with severe idiopathic pulmonary arterial hypertension, such a case of PAA may present to the operating room as an indication for lung transplantation. In this article, we present such a case of a patient with a giant main and right PAA that underwent a double lung transplant. We describe the pathophysiology and natural course of this PAA and discuss the role of intraoperative transesophageal echocardiography in the management of patients with this rare diagnosis.
The Beautiful and the Fit Reap the Spoils: Body Image as a Condition for the Positive Effects of Electronic Media Communication on Well-being Among Early Adolescents
Authors: Krogh Søren Christian
Published: April 2021

The effects of electronic media communication (EMC) and social media on young people’s health and well-being remain under debate, with no conclusive evidence on the connection between the two. By using data on 1,843 early adolescents aged 12–17 years provided by the Danish Health Behaviour in School-aged Children study and ordinary least squares (OLS) regression models and by measuring the intensity of EMC instead of the time spent on social media, the study finds that early adolescents tend to experience greater feelings of well-being with a higher intensity of EMC. However, this relationship is conditional. A negative perceptual body image acts as a moderator of the relationship between the intensity of EMC and well-being, whereas the positive relationship between EMC disappears under the condition of a negative body image. These findings provide nuance to the debates on the ways in which EMC affects young people.
The social positions of taste between and within music genres: From omnivore to snob
Authors: Nault Jean-François , Baumann Shyon , Childress Clayton , Rawlings Craig M
Published: April 2021

Are higher status cultural tastes in the modern United States better described as being inclusive and broad or exclusive and narrow? We construct an original dataset in response to conflicting answers to this question. We fill a major gap in the literature on cultural tastes by simultaneously considering taste for both musical genres and artists within genres. By examining the compositional balance of respondents’ taste portfolios, we reconcile seemingly incommensurate theoretical frameworks of class homology and omnivorousness. The results indicate that an omnivorous disposition to music is a relatively middle-status position in the social structure. In contrast, positions characterized by higher levels of cultural capital map onto exclusive and narrower tastes for consecrated culture.
Secular trends in functional abilities, health and psychological well-being among community-dwelling 75- to 95-year-old cohorts over three decades in Helsinki, Finland
Authors: Öhman Hanna R. , Karppinen Helena , Lehti Tuuli E. , Knuutila Mia T. , Tilvis Reijo , Strandberg Timo , Kautiainen Hannu , Pitkala Kaisu H.
Published: April 2021

Background: Life expectancy has increased markedly in the past decades. Thus, it is of great importance to understand how people are ageing and if the trajectories of health and disability are changing over time. This study aimed to examine trends in functional abilities and health in independent cohorts of people aged 75–95 over three decades. Methods: This Helsinki Ageing Study consists of repeated cross-sectional postal surveys examining independent cohorts of old people (75, 80, 85 and 90+ years old). This study combined data from four waves (1989, 1999, 2009 and 2019). Results: In the most recent wave, there was an increase in the portion of participants who were able to walk outdoors easily (75-year-olds p=0.03, 80-year-olds p=0.002, 85-year-olds p<0.001; p for linearity for the study year effect, all adjusted for sex). Fewer people in the youngest age group (75-year-olds) needed daily help from another person in 2019 compared to the earlier waves ( p=0.02 for linearity for the study year). Over the past three decades, the proportions of self-reported good mobility have risen 8.7% (95% confidence interval (CI) 2.3–15.1) in 75-year-olds, 11.7% (95% CI 3.9–19.6) in 80-year-olds and 20.1% (95% CI 10.7–29.4) in 85-year-olds, after adjusting for sex. Furthermore, in 2019, more people rated their health as good and scored better in psychological well-being than in the previous waves among 75-, 80- and 85-year-olds. However, no improvements were found among 90+-year-olds in any of these variables. Conclusions: People between 75 and 85 years old are presently feeling and functioning better than their predecessors. This may be an important objective for both economics and health policy.
Multiple psychosocial work exposures and well-being among employees: prospective associations from the French national Working Conditions Survey
Authors: Bertrais Sandrine , HÉRault Nora , Chastang Jean-FranÇOis , Niedhammer Isabelle
Published: April 2021

Aims: Working conditions, especially psychosocial work factors (PWFs), are thought to influence mental health outcomes among working populations, but there have been few studies on well-being per se. We assessed the prospective associations between a wide variety of occupational factors, including PWFs, multiple exposure to these factors, and well-being among employees in France. Methods: This study was based on a nationally representative sample of 15,776 employees, including 6595 men and 9181 women, followed up from 2013 to 2016. Psychological well-being was assessed using the WHO-5 Well-Being Index. Occupational factors included 20 PWFs, 4 factors related to working time/hours, and 4 physical work exposures. The associations of occupational exposures with poor well-being were estimated using weighted robust Poisson regression models in men and women separately. Results: Among the employees who rated their well-being as good in 2013, 10.3% of men and 16.8% of women had a poor well-being 3 years later. Most PWFs in 2013 were associated with poor well-being in 2016 among women, and half of them among men. An increase in the risk of poor well-being with the number of PWFs was found. Noise exposure was associated with poor well-being in women. Conclusions: The occupational factors associated with psychological well-being were mainly those related to the psychosocial work environment. A linear association was observed between the number of exposures to PWFs and well-being. Preventive policies focused on PWFs may be beneficial for well-being. More attention should be given to multiple exposures to these factors.
Blockchain for drug traceability: Architectures and open challenges
Authors: Uddin Mueen , Salah Khaled , Jayaraman Raja , Pesic Sasa , Ellahham Samer
Published: April 2021

Pharmaceutical supply chain (PSC) consists of multiple stakeholders including raw material suppliers, manufacturers, distributors, regulatory authorities, pharmacies, hospitals, and patients. The complexity of product and transaction flows in PSC requires an effective traceability system to determine the current and all previous product ownerships. In addition, digitizing track and trace process provides significant benefit for regulatory oversight and ensures product safety. Blockchain-based drug traceability offers a potential solution to create a distributed shared data platform for an immutable, trustworthy, accountable and transparent system in the PSC. In this paper, we present an overview of product traceability issues in the PSC and envisage how blockchain technology can provide effective provenance, track and trace solution to mitigate counterfeit medications. We propose two potential blockchain based decentralized architectures, Hyperledger Fabric and Besu to meet critical requirements for drug traceability such as privacy, trust, transparency, security, authorization and authentication, and scalability. We propose, discuss, and compare two potential blockchain architectures for drug traceability. We identify and discuss several open research challenges related to the application of blockchain technology for drug traceability. The proposed blockchain architectures provide a valuable roadmap for Health Informatics researchers to build and deploy an end-to-end solution for the pharmaceutical industry.
Civil society – Politically engaged or member-serving? A governance perspective
Authors: Bolleyer Nicole
Published: April 2021

Which types of civil society organizations are politicized as indicated by regular political engagement and why? If they are, how wide-ranging are their political action repertoires? This article proposes an ‘organizational governance perspective’ on civil society organizations’ political engagement by arguing that organizations resembling traditional ‘voluntary associations’ are less likely to be politicized and to employ a broad political action repertoire than those resembling highly professionalized ‘voluntary agencies’. Applying event count regressions to new data from four recent population surveys widely substantiates the proposed perspective, thereby challenging prominent arguments about the detrimental effects of professionalization and state dependency on organizations’ ability to contribute to democratic representation.
The media turn in African environmentalism: the Niger Delta and oil’s network forms
Authors: Iheka Cajetan
Published: April 2021

African ecologies and the various media forms devoted to them remain marginal in the bourgeoning discourse of ecomedia studies despite the implication of the continent in mineral extraction, wildlife conservation, and the dumping of toxic wastes, just to mention a few examples. Turning to media focusing on Nigeria’s Niger-Delta region, the author argues that African cultural forms are crucial for extending the frontiers of ecomedia studies and for apprehending the perversities of oil culture. His analysis of a mural in Ireland’s Mayo County featuring the environmental activist Ken Saro-Wiwa (2005), the music video for Timaya’s ‘Dem Mama’ (2006), and Victor Ehikhamenor’s art installation, The Wealth of Nations (2015), shows that they deploy the visual in protesting the commodifying logic of oil extraction. This article adopts an infrastructural approach toward media as it underscores how oil consecrates the selected cultural objects as network forms. Focusing on African materials extends the geography and archive of ecomedia studies, but it has methodological implications too. The author orients scholarship in the environmental humanities toward working across media, encouraging the field to adopt ecological relationality as both the matter and the method.
The crystal reveals the whole: medieval dreamscapes and cinematic space as virtual media
Authors: Griffiths Alison
Published: April 2021

This article examines the rich visual culture of the medieval period in order to better understand dreaming as a kind of visual thought experiment, one in which ideas associated with cinema, such as embodied viewing, narrative sequencing, projection, and sensory engagement, are palpable in a range of visual and literary works. The author explores the theoretical connections between the oneiric qualities of cinema and the visual culture of medieval dreams, dealing in turn with the following themes: (i) media and mediation; (ii) projection and premonition; (iii) virtual spatiality; and (iv) automata and other animated objects. The wide swath of medieval literary dream texts, with their mobile perspectives, sensory plentitude, and gnostic mission, resonate with the cinematic in the structuring of the gaze. Investigating the codes of medieval culture provides us with an unusually rich episteme for thinking about how the dreamscapes of the Middle Ages evoke media dispositifs. Opening up these thought lines across distinct eras can help us extrapolate similarities around ways of imagining objects, spaces, sensations of embodied viewing or immersion, reminding us that our contemporary cinematic and digital landscapes are not divorced from earlier ways of seeing and believing. Whether stoking religious fear and veneration or providing sensual pleasure as in Le Roman de la Rose, the dreamworlds of the Middle Ages have bequeathed us a number of an extraordinarily rich creative works that are the imaginative building blocks of media worlds-in-the-making, as speculative in many ways as current discourses around new media.
The marketisation of education and the democratic deficit
Authors: Säfström Carl Anders , Månsson Niclas
Published: April 2021

This article deals with the question of what has happened to ‘the public’ in the Swedish education system during the last three decades. In our search for an answer we illuminate and discuss how the process of marketisation, together with the learnification and individualisation of education, replaced ‘the public’ from public education with the logic of the market place. To shed some further light on the current discourse on Swedish education, we contrast two principles in education and teaching, the aristocratic principle and the democratic principle. According to the aristocratic principle, education is about fixating and reproducing existing power relations as the cornerstone of a well-ordered society. According to the democratic principle of education, equality is the cornerstone of a well-ordered democratic society. Considering the shift in the very infrastructure of the Swedish educational system, we arrive at the conclusion that the principles in education and teaching are characterised by the aristocratic principle, rather than those we have characterised as democratic principles. The educational message is clear: upcoming generations are to accept the rules of the market economy and play the game accordingly.
Building literacy skills of urban poor women through the Each One Enable One approach
Authors: Aggarwal Savita , Kher Jagriti , Vaid Neeti , Kaur Manpreet
Published: April 2021

Education is fundamental to learning and is a pre-requisite for development. It is also imperative for sustained growth and development of a nation. There is still a long way to go for India in achieving Goal 4 and 5 of the UN Sustainable Development Goals quality education and gender equality by 2030. Despite several government initiatives and literacy programmes, a gender gap in literacy of 17% still persists. A collective effort is required to address these gaps , as women constitute two-thirds of the illiterate population in India. The present study has been conducted to assess the outcome of an adult literacy programme ‘Each One Enable One’ by undergraduate students at a college of the University of Delhi, targeted at women from poor socio-economic backgrounds residing in the neighbourhood of students. The study was conducted across 11 districts of Delhi, the Capital city of India, using a sample of 150 women. The results have revealed that literacy programme led to statistically significant gains in the overall literacy scores of women in Reading, Writing and Arithmetic and enhanced self-confidence of women. The study has highlighted the positive outcome of the Each One Enable One Program and has provided evidence for the need to upscale such initiatives.
Novel Technique for the Treatment of Type Ia Endoleak After Endovascular Abdominal Aortic Aneurysm Repair
Authors: Kasprzak Piotr M. , Pfister Karin , Kuczmik Waclaw , Schierling Wilma , Sachsamanis Georgios , Oikonomou Kyriakos
Published: April 2021

Purpose

Open surgical repair of type Ia endoleak after endovascular aortic aneurysm repair/sealing (EVAR/EVAS) is associated with significant perioperative mortality and morbidity. Current endovascular redo techniques face limitations, especially when the infrarenal landing zone is inadequate and the previous endograft is rigid and features a short or no main body. We present a novel concept for the treatment of type Ia endoleak using a custom-made branched device.

Technique

The 5-branch-device (Cook Medical, Bloomington, IN, USA) consists of a nitinol skeleton with branches, covered with a low-profile polyester fabric loaded in an 18F sheath. The device features a minimum of 2 proximal sealing stents and includes branches for renovisceral vessels as well as an additional 8 mm branch for the contralateral iliac limb. Implantation and sealing in the renovisceral vessels is carried out in standard fashion, using transfemoral and transaxillary access. Distal sealing is achieved by tapering the branched component into the ipsilateral iliac limb and using a bridging balloon-expandable or self-expandable stent-graft through the additional branch to the preexisting contralateral iliac limb.

Conclusion

Treatment of type Ia endoleak with a new custom-made device enables sufficient proximal seal while minimizing suprarenal aortic coverage and facilitates adequate component overlap. The low profile branched design accommodates implantation through the preexisting endograft and catheterization of target vessels.
Efficacy and Safety of Endoscopic Nasopharyngectomy Combined With Low-Dose Radiotherapy for Primary T1-2 Nasopharyngeal Carcinoma
Authors: Zhang Benjian , Li Yiliang , Weng Jingjin , Huang Bo , Ban Molu , Lan Guiping , Lu Yu , Luo Jianhui , Qu Shenhong , Si Yongfeng
Published: April 2021

Aim:

Intensity-modulated radiotherapy (IMRT) is a widely accepted therapy for nasopharyngeal carcinoma (NPC), but it inevitably brings out radiation-related complications and seriously affects the quality of life (QoL). Endoscopic nasopharyngectomy (ENPG) has been successfully conducted in locally recurred NPC, but few studies evaluated its application in early NPC. This study aims to assess the feasibility and safety of ENPG combined with low-dose radiotherapy (LDRT) in T1-2 NPC.

Patients and Methods:

We recruited 37 newly diagnosed localized T1-2 NPC patients who voluntarily accepted ENPG +LDRT from June 2013 to September 2016. Meanwhile, the data of 132 T1-2 NPC patients treated with IMRT were collected and used as control group. The survival outcomes, QoL score and late RT-related sequelaes were compared between the 2 groups.

Results:

After a median follow-up of 54 months, only 1 patient in ENPG+LDRT group died along with hepatic metastases. The 5-year overall survival, distant metastasis-free survival, local relapse-free survival and regional relapse-free survival in ENPG+LDRT group were 97.3%, 97.3%, 100% and 100%, which were not statistically different from the control group (97.7%, 90.2%, 95. 5%, 97.0%, respectively, all P > 0.05). In comparison with IMRT group, ENPG+LDRT exhibited better QoL and less rate of late RT-related sequlaes including hearing loss (53.8% vs 27.0%, P = 0.005), xerostomia (46.2% vs 24.3%, P = 0.023) and dysphagia (25.8% vs 8.1%, P = 0.024).

Conclusions:

ENPG+LDRT provided satisfactory survival outcomes, and improved the QoL and reduced the incidence of sequelae for T1-2 NPC patients.
The Prevalence and Risk Factors for Peripheral Arterial Disease in Adults Living With Human Immunodeficiency Virus
Authors: Rerkasem Amaraporn , Sripan Patumrat , Pongtam Sasinat , Ounjaijean Sakaewan , Kulprachakarn Kanokwan , Wongthanee Antika , Chaiwarith Romanee , Supparatpinyo Khuanchai , Salee Parichat , Arworn Supapong , Rerkasem Kittipan
Published: April 2021

Adult patients with human immunodeficiency virus (HIV) appear to be at high risk of cardiovascular disease (CVD). Peripheral arterial disease (PAD) is particularly concerning as it is associated with myocardial infarction and stroke. Nevertheless, the incidence of PAD is still unknown. The authors prospectively recruited HIV-infected patients from the outpatient clinic of the Department of Internal Medicine in our center. We assessed ankle-brachial index (ABI) using the VaSera system™ (Fukuda Denshi Co., Ltd). Patients were grouped into 3 ABI levels: an ABI ≤0.90 was considered abnormal and evidence of PAD, an ABI 1.0 to 1.40 was considered normal, and 0.91 to 0.99 was considered borderline. Cardiovascular risk factors were compared across all 3 levels of ABI and were analyzed using multivariate ordinal logistic regression. Eight hundred ninety-two patients were recruited. The mean age was 42.9 ± 10.0 years and 458 (51.4%) were males. There were 704, 149, and 39 patients in the normal, borderline, and abnormal ABI groups, respectively. The latter group of 39 patients was considered to have PAD, yielding a prevalence of 4.37% (95% confidence interval [CI] 3.21-5.93). Sex ratio, age, education levels, smoking rate, body mass index (BMI), blood pressure, prevalence of comorbidities with hypertension and coronary heart disease, median triglyceride level, reduced kidney function and HIV-1 RNA undetectable ratio, duration of HIV diagnosis, and duration on antiretroviral treatment were significantly different among 3 ABI subgroups. Independent risk factors associated with PAD were being female (odds ratio [OR]: 2.86; 95% CI: 1.94-4.22), being <30 years of age (OR: 4.66; 95% CI: 2.78-7.81), being overweight (BMI 25-25.9; OR: 0.39; 95% CI: 0.20-0.76), being obese (BMI: 30; OR: 3.53; 95% CI: 1.51-8.22), having a diastolic blood pressure ≥80 mmHg (OR: 0.50; 95% CI: 0.35-0.71), and having detectable HIV-1 RNA ≥20 copies/mL (OR: 1.85; 95% CI: 1.13-3.03). In conclusion, the prevalence of PAD in HIV-infected Thais was 4.37% in infected patients on therapy attending outpatient clinics. For this population, PAD appears to be relatively poorly correlated with traditional risk factors of CVD.