bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report
Authors: Kawamoto Yuko , Nishihara Tasuku , Aono Jun , Nandate Hideyuki , Hamada Taisuke , Yasuoka Toshiaki , Matsumoto Takashi , Yamaguchi Osamu , Sugiyama Takashi , Yorozuya Toshihiro
Published: December 2021

Perioperative management of pregnant women with heart failure is difficult. Management of anesthesia in pregnant women is especially difficult because all of the currently available choices present challenges. We report a patient with peripartum cardiomyopathy (PPCM) who required an emergent cesarean section and discuss the possible tactics for managing anesthesia. A 40-year-old primipara with severe cardiac and respiratory failure required an emergent cesarean section at 39+1 gestational weeks. Her left ventricular ejection fraction was between 10% and 15%, and she had orthopnea. General anesthesia was planned after inserting sheaths for percutaneous cardiopulmonary support from the femoral artery and vein. However, when the patient was asked to lie down on the operation bed, she panicked and resisted because of labor pain and dyspnea. Therefore, anesthesia was induced instead of the initial plan. Finally, we successfully managed the anesthesia and delivered the newborn. There are no alternatives to general anesthesia in patients with PPCM presenting with orthopnea. Anesthesia induction in the supine position is impossible in such patients owing to dyspnea. Anesthesia should be started with light sedation in the sitting position, and ketamine or low-dose remifentanil may be an option to maintain maternal hemodynamics and prevent neonatal asphyxia.
Carboxypeptidase A3 expression in canine mast cell tumors and tissue-resident mast cells
Authors: Hämäläinen Sanna , Kareinen Lauri , Sukura Antti , Kareinen Ilona
Published: December 2021

Mast cell tumors (MCTs) are one of the most common cutaneous malignancies in dogs. Previous studies have reported expression of mast cell–specific proteases chymase and tryptase in canine cutaneous MCTs and in connective tissue and mucosal mast cells. In humans and rodents, mast cells express an additional specific protease, carboxypeptidase A3 (CPA3). In this article, we describe CPA3 immunoreactivity in connective tissue, visceral, mucosal, and neoplastic mast cells in dogs. Positive immunolabeling for CPA3 was observed in nonneoplastic mast cells in 20/20 formalin-fixed paraffin-embedded normal tissues (skin, liver, spleen, intestine), and in 63/63 MCTs irrespective of their histological grade. CPA3 protein expression was comparable to that of c-kit in both the nonneoplastic and neoplastic mast cells. Three distinct labeling patterns (membranous, diffuse, and focal cytoplasmic) were observed for CPA3 in MCTs. The focal cytoplasmic labeling pattern was associated with high-grade MCTs staged with the Kiupel 2-tier grading criteria. We propose CPA3 as a novel immunohistochemical marker for canine mast cells in health and disease.
Does Menopausal Hormone Therapy, Exercise, or Both Improve Pain and Function in Postmenopausal Women With Greater Trochanteric Pain Syndrome? A 2 × 2 Factorial Randomized Clinical Trial
Authors: Cowan Rachael Mary , Ganderton Charlotte Louise , Cook Jillianne , Semciw Adam Ivan , Long David Michel , Pizzari Tania
Published: December 2021

Background:

Greater trochanteric pain syndrome (GTPS) is a debilitating chronic condition, most prevalent in postmenopausal women. A positive association between high estrogen levels and tendon health may exist, and postmenopausal women have reduced estrogen. Menopausal hormone therapy (MHT) may reduce the incidence of tendon abnormality, particularly when combined with exercise.

Purpose:

To determine the effect of MHT and exercise on tendon pain and function in postmenopausal women with GTPS.

Study Design:

Randomized controlled clinical trial; Level of evidence, 1.

Methods:

Postmenopausal women (N = 132; n = 12, lost to follow-up) with GTPS were randomized into MHT and placebo transdermal cream groups combined with tendon-specific or sham exercise. All groups received education about avoiding gluteal tendon compression and load management throughout 12 weeks of intervention. The primary outcome was the Victorian Institute of Sport Assessment for gluteal tendinopathy (VISA-G), and secondary outcomes were measured at baseline and at 12 and 52 weeks. The Global Rating of Change was assessed at 12 and 52 weeks. A linear mixed-effects model was used to assess differences. Body mass index (BMI) was included as a covariate.

Results:

All participant groups improved over time (baseline vs 12 weeks, P < .001; baseline vs 52 weeks, P < .001). There was no difference among exercise groups measured by all outcomes (VISA-G: baseline, P = .97, mean difference [MD] = 0.10; 12 weeks, P = .49, MD = 2.15; 52 weeks, P = .32, MD = −3.08). There was a significant interaction effect between cream and BMI; therefore, the population was stratified by BMI levels (<25, <30, ≥30). The MHT groups (with exercise and education) had significantly better VISA-G outcomes (baseline, P = .04, MD = −11.20, 95% CI = −21.70 to −0.70; 12 weeks, P < .001, MD = −20.72, 95% CI = −31.22 to −10.22; 52 weeks, P = .002, MD = −16.71, 95% CI = −27.21 to −6.22) and secondary measure scores as compared with placebo at all time points when BMI was <25.

Conclusion:

MHT or placebo combined with tendon-specific or sham exercise plus education reduced pain and increased function for this population. For women with a BMI <25, MHT with any exercise plus education was better than placebo. A targeted exercise or sham exercise strategy is effective when prescribed with education about avoiding gluteal tendon compression and load management.

Registration:

ACTRN12614001157662 (Australian New Zealand Clinical Trials Registry).
A GIS-based multi-criteria decision support model for planning municipal solid waste collection points: A case study of Çağdaş Neighbourhood, Çiğli District, Izmir, Turkey
Authors: Yalcinkaya Sedat , Uzer Sevin
Published: December 2021

This study aims to develop a geographic information system (GIS)-based multi-criteria decision support model to create optimal plans for locating municipal solid waste (MSW) collection points. The model performs a series of consecutive GIS-based spatial analyses to determine alternative plans. Then, it weighs the alternatives considering the social, economic and environmental criteria to determine the optimum solution through analytical hierarchy process. The model was implemented as a case study in Çağdaş neighbourhood of Izmir, Turkey. A total of 42 locations were determined as the optimum collection points out of 245 possible collection points, which yields 39% reduction in collection points compared to the existing system. Total number of waste bins and average walking distance to waste collection points were calculated as 129 and 33 m, respectively. The municipal authority would spend 48.79 $ day−1 on fuel for waste collection and transport. In addition, daily air pollutant emissions generated during the operations were estimated as 2.052 g CO, 0.231 g NMVOC, 8.409 g NOx, 0.954 g N2O, 0.260 g NH3, 0.000227 g Pb and 0.0231 g PM 2.5. The results indicated that 14 out of 69 collection points in the existing collection system were not allocated to any waste source geographically. This study presents a unique method for planning MSW collection points on two key aspects: (1) development of a novel method to determine all possible collection point locations using Thiessen polygons and (2) presenting a holistic planning method considering the impacts of the collection system on the waste generators and waste collectors.
Availability and utilisation pattern of agricultural waste at household level in selected areas of Bangladesh
Authors: Miah MA Monayem , Haque Md Enamul , Bell Richard W , Rahman Md Wakilur , Akhter Sohela , Hossain Md Baktear
Published: December 2021

The use of organic fertilisers and soil amendments are almost universally recommended for improving the organic matter levels and maintaining soil health, but few studies documenting the actual availability and quality of such materials on smallholder farms are available. We selected a case study of 300 households from northern and southern Bangladesh to assess the types of waste materials available for recycling and their usage patterns at household level and we applied a novel approach to empirically identify household waste as input inefficiency in a production context. Northern districts have highly intensive farming systems whereas southern districts have low intensity farming. The total amount of agricultural waste produced at household level was estimated at 822 kg per month. Cow dung contributed about 65% of the total waste followed by animal feed refusal waste (11%), garbage (7%) and kitchen waste (6%). Most of the farmers utilised cow dung and wastes as organic fertiliser and lesser amounts as cooking fuel. Econometric analysis shows that the number of cattle and small ruminant per holding, total area of cultivated land and family size were significant factors that influence the amount of waste production at household level. Each household can reduce the chemical fertiliser cost by Tk. 1463 (US$ 17.84) per month by using compost prepared from household waste. There were ample opportunities for compost/vermicomposting and potential markets. The Department of Agricultural Extension from the public sector and private sector agents might motivate farmers to harvest the potential benefits of agricultural waste through effective management and utilisation.
A Cross-Sectional Study of Job Satisfaction and Intention to Leave Job in Palliative Care in Croatia
Authors: Macuka Ivana , Tucak Junaković Ivana
Published: December 2021

Purpose Stressful and demanding clinical situations may contribute to job dissatisfaction and may even contribute to an intention to leave the job among palliative care (PC) clinicians. Personal and organizational factors may influence the occupational well-being of PC clinicians as well. This study aimed to determine the predictive contribution of personal (communication skills, resilience, religiosity) and organizational (coworkers’ social support, job control) factors in the explanation of PC clinicians job (dis)satisfaction and their intention to leave their job. Methods The study was conducted on a convenience sample of 122 PC clinicians of different disciplines (nurses/technicians, physicians, psychologists, spiritual counsellors/priests, social workers, physical therapists, etc). The sample mainly consisted of nurses (57%). Hierarchical and logistic regression analyses of the results obtained were applied. Results This study indicates that 53% of PC clinicians are satisfied with their daily job and 76% do not intend to leave the job. The results showed no differences in job satisfaction and intention to leave between nurses/technicians and other PC clinicians. A significant negative correlation was found between job satisfaction and intention to leave the job. Communication skills, religiosity and coworkers’ social support, showed as significant predictors of job satisfaction. PC clinicians’ perception of their own difficulties in communicating bad news contributed significantly to job satisfaction and intention to leave the job in palliative care. Conclusion This study suggests that job satisfaction in a palliative care setting is determined by a larger number of personal and organizational factors than the intention to leave the job. Communication skills showed indispensable for providing quality care for dying patients. Skills in communicating bad news to dying patients and their families have emerged as particularly important for PC clinicians’ occupational well-being.
Exploring Specialist Palliative Care Practitioner Perspectives on the Face Validity of the Attitude to Health Change Scales in Assessing the Impact of Life-limiting Illness on Patients and Carers
Authors: Machin Linda , Walshe Catherine , Dunleavy Lesley
Published: December 2021

Background: Identifying and assessing vulnerability and resilience through reflexive reactions and conscious coping responses to life-limiting illness is an important, but rarely assessed, component of care. The novel Attitude to Health Change scales can contribute to this, but require fuller development and testing. Objectives: Exploring face validity of the Attitude to Health Change Scales (patient and carer versions) from the perspective of specialist palliative care professionals. Design: A two-stage study: (i) focus groups to explore experiences of scale use and wording, (ii) online survey to gather preferences on possible scale modifications. Focus group data were analysed using framework analysis. A hermeneutic approach was used to modify the wording of the scales, ensuring adherence to the underpinning concepts used in the design of the scale, congruence with the palliative care context, and simplicity of language. Setting/Subjects: Specialist palliative care practitioners in UK hospice settings who had been involved in pilot use of the scales in clinical practice. Results: 21 practitioners participated in 3 focus groups across 3 UK hospice sites, 9 of those participants responded to the survey. Four themes are presented: the importance and distinctiveness of the scales; maintaining conceptual integrity; ensuring a palliative care focus; and ensuring linguistic clarity. New iterations of the patient and carer versions of the Attitude to Health Change scales were developed. Conclusion: The scales appear to reflect the intended theoretical constructs, and are worded in a way which is congruent with the experience of specialist palliative care practitioners.
Clinical Phenotype of Cerebral Palsy Depends on the Cause: Is It Really Cerebral Palsy? A Retrospective Study
Authors: Metz Charlotte , Jaster Monika , Walch Elisabeth , Sarpong-Bengelsdorf Akosua , Kaindl Angela M. , Schneider Joanna
Published: December 2021

Cerebral palsy is the most common motor disability in childhood. Still, the precise definition in terms of causes and timing of the brain damage remains controversial. Several studies examine the clinical phenotype of cerebral palsy types. The aim of our study was to determine to what extent the clinical phenotype of cerebral palsy patients depends on the underlying cause. We retrospectively evaluated the clinical phenotype, abnormalities during pregnancy, and cerebral palsy cause of 384 patients, treated at Charité-Medicine University, between 2015 and 2017. The cause of cerebral palsy was identified in 79.9% of cases. Causes prior to the perinatal period were, compared to perinatal brain damage, associated significantly with different comorbidities. The term cerebral palsy does not describe a single disease but is an umbrella term covering many different diseases. Depending on the cause, a varying clinical phenotype can be found, which offers great potential in terms of individual treatment and preventing comorbidities.
Diagnostic Sensitivity of Plasma Endothelin-1 for Cerebral Vasospasm After Subarachnoid Hemorrhage, a Multicentre Double-Blind Study
Authors: Bellapart Judith , Nasrallah Fatima , Winearls James , Lassig-Smith Melissa , Stuart Janine , Boots Rob , Winter Craig , Flaws Dylan , Bulmer Andrew , Jones Lee , Laupland Kevin BjØrn
Published: December 2021

The purpose of this study is to establish the diagnostic sensitivity of Endothelin-1 for risk stratification and screening of clinical vasospasm after subarachnoid hemorrhage.

This is a multicentre, observational study, correlating daily blood Endothelin-1 with clinical variables. Binary logistic regression used to examine if Endothelin-1 levels could be used to predict clinical vasospasm. Bivariate modelling used to explore associations between patient characteristics and vasospasm. A Receiver Operating Curve used to explore cut-off values for Endothelin-1. Sensitivity and specificity was used to validate the cut-point found in the pilot study. A total of 96 patients were enrolled over two years. Median Endothelin-1 was higher for patients who experienced clinical vasospasm except for day-5, where median endothelin for patients without vasospasm was higher (3.6 IQR = 5.3), compared to patients with vasospasm (3.3 IQR = 8.5) although differences were not significant. The Receiver Operating Curve analysis confirmed that day-5 Endothelin-1 was not a good indicator of vasospasm, with an area under the curve of 0.506 (95% CI: 0.350-0.663, p = 0.938). The levels of Endothelin-1 in blood do not discriminate patients who may develop symptomatic vasospasm. The high variability in Endothelin-1 levels, aligns with the pathophysiological variability of most biomarkers, decreasing their ability to predict a clinical event.
Delirium in a Tertiary Pediatric Cardiac Intensive Care Unit: Risk Factors and Outcomes
Authors: Koth Andrew M. , Chan Titus , Tjoeng Yuen Lie , Watson R. Scott , Dervan Leslie A.
Published: December 2021

Objective

Delirium is an increasingly recognized hospital complication associated with poorer outcomes in critically ill children. We aimed to evaluate risk factors for screening positive for delirium in children admitted to a pediatric cardiac intensive care unit (CICU) and to examine the association between duration of positive screening and in-hospital outcomes.

Study design

Retrospective cohort study in a single-center quaternary pediatric hospital CICU evaluating children admitted from March 2014-October 2016 and screened for delirium using the Cornell Assessment of Pediatric Delirium. Statistical analysis used multivariable logistic and linear regression.

Results

Among 942 patients with screening data (98% of all admissions), 67% of patients screened positive for delirium. On univariate analysis, screening positive was associated with younger age, single ventricle anatomy, duration of mechanical ventilation, continuous renal replacement therapy, extracorporeal life support, and surgical complexity, as well as higher average total daily doses of benzodiazepines, opioids, and dexmedetomidine. On multivariable analysis, screening positive for delirium was independently associated with age <2 years, duration of mechanical ventilation, and greater than the median daily doses of benzodiazepine and opioid. In addition to these factors, duration of screening positive was also independently associated with higher STAT category (3-5) or medical admission, organ failure, acute kidney injury (AKI), and higher dexmedetomidine exposure. Duration of positive delirium screening was associated with both increased CICU and hospital length of stay (each additional day of positive screening was associated with a 3% longer CICU stay [95% CI = 1%-6%] and 2% longer hospital stay [95% CI = 0%-4%]).

Conclusions

Screening positive for delirium is common in the pediatric CICU and is independently associated with prolonged intensive care unit (ICU) and hospital stay. Longer duration of mechanical ventilation and higher sedative doses are independent risk factors for screening positive for delirium. Efforts aimed at reducing these exposures may decrease the burden of delirium in this population.
Transaction Costs in Planning Literature: A Systematic Review
Authors: Shahab Sina
Published: December 2021

“Transaction costs,” as a well-established theory in New Institutional Economics, has been used to explain and analyze various planning matters for about 30 years since its introduction to planning literature. However, there is no study on how planning-related studies have utilized the theory. This paper conducts a systematic review that aims to develop a better understanding of how transaction-cost theory is used in planning literature. The review shows that while potential contributions and implications of transaction costs have been conceptually discussed in planning literature, the empirical studies have remained limited, particularly concerning the magnitude of such costs in planning systems.
Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making
Authors: Kinchen Elizabeth
Published: December 2021

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.
On variational mode decomposition of wind speed for real-time thermal rating determination in power transmission system
Authors: ElSayed Salah K , Alsharef Mohammad , Metwaly Mohamed K
Published: December 2021

Power transmission line capacity is restricted with the maximum temperature that can withstand without inadmissible of line sag. Regardless of the carried current, the temperature of the transmission line conductors was affected by various weather variables. However, the maximum capacity of the line current known as static thermal rating was determined based on the conservative weather conditions for safe operation, but the restriction of the line capacity may be modified which results in the additional capacity of the line. As a result, real-time thermal rating technique was applied on thermal model of the transmission line. Generally, the information about weather conditions is considered uncertainty, however, the weather variables should be dealt with and studied statistically for determining the accurate rise in the conductor temperature. The real-time thermal rating technique is evaluated using weather variables. The most important parameter is the wind speed, which greatly influence s conductor temperature and implicitly affects power transmission line capacity. Thus, in this study, the real-time thermal rating technique is developed by weather variable model based on the variational mode decomposition technique that applied only on the wind speed for adapting wind speed measurements to produce conservative evaluation of convective cooling on the conductors of power transmission system without violating the maximum operating temperature inside the core of conductors. The developed real-time thermal rating is implemented on sections of the power transmission system of western Saudi Arabia. The developed technique is compared with other techniques to investigate its applicability.
Solar-type periodicities in the climate variability of Northern Fennoscandia during the last three centuries: Real influence of solar activity or natural instability in the climate system
Authors: Ogurtsov Maxim , Helama Samuli , Jalkanen Risto , Jungner Högne , Lindholm Markus , Veretenenko Svetlana
Published: December 2021

Fifteen proxy records of summer temperature in Fennoscandia, Northern Europe and in Yamal and Taymir Peninsulas (Western Siberia) were analyzed for the AD 1700–2000 period. Century-long (70–100 year) and quasi bi-decadal periodicities were found from proxy records representing different parts of Fennoscandia. Decadal variation was revealed in a smaller number of records. Statistically significant correlations were revealed between the timescale-dependent components of temperature variability and solar cycles of Schwabe (~11 year), Hale (~22 year), and Gleissberg (сentury-long) as recorded in solar activity data. Combining the results from our correlation analysis with the evidence of solar-climatic linkages over the Northern Fennoscandia obtained over the past 20 years suggest that there are two possible explanations for the obtained solar-proxy relations: (a) the Sun’s activity actually influences the climate variability in Northern Fennoscandia and in some regions of the Northern Hemisphere albeit the mechanism of such solar-climatic linkages are yet to be detailed; (b) the revealed solar-type periodicities result from natural instability of climate system and, in such a case, the correlations may appear purely by chance. Multiple lines of evidence support the first assumption but we note that the second one cannot be yet rejected. Guidelines for further research to elucidate this question are proposed including the Fisher’s combined probability test in the presence of solar signal in multiple proxy records.
Time paradoxes of neoliberalism: How time management applications change the way we live
Authors: Strzelecka Celina
Published: December 2021

Time management applications aim to coordinate and tame the rhythms of social reality. It transpires, however, that in many cases, they somewhat complicate and impede this process, leading to time paradoxes. Using various theoretical tools developed in the critical studies of time and the critique of neoliberalism, I identify three time paradoxes produced by the applications: remembering to remember, planning to plan, and accelerating acceleration. These three paradoxes were brought up and thoroughly discussed in in-depth interviews with self-selected individuals who constantly face challenges related to personal time management. I highlight how managing time using various applications shapes the experience and meaning of time, makes individuals reorganize their social practices, redefines their memory, and influences their emotions. In conclusion, I reflect on how the tension between linear time and multi-temporality is intertwined with the discussed paradoxes and counter-productivity of time management applications.
Repeated measures discriminant analysis using multivariate generalized estimation equations
Authors: Brobbey Anita , Wiebe Samuel , Nettel-Aguirre Alberto , Josephson Colin Bruce , Williamson Tyler , Lix Lisa M , Sajobi Tolulope T.
Published: December 2021

Discriminant analysis procedures that assume parsimonious covariance and/or means structures have been proposed for distinguishing between two or more populations in multivariate repeated measures designs. However, these procedures rely on the assumptions of multivariate normality which is not tenable in multivariate repeated measures designs which are characterized by binary, ordinal, or mixed types of response distributions. This study investigates the accuracy of repeated measures discriminant analysis (RMDA) based on the multivariate generalized estimating equations (GEE) framework for classification in multivariate repeated measures designs with the same or different types of responses repeatedly measured over time. Monte Carlo methods were used to compare the accuracy of RMDA procedures based on GEE, and RMDA based on maximum likelihood estimators (MLE) under diverse simulation conditions, which included number of repeated measure occasions, number of responses, sample size, correlation structures, and type of response distribution. RMDA based on GEE exhibited higher average classification accuracy than RMDA based on MLE especially in multivariate non-normal distributions. Three repeatedly measured responses namely severity of epilepsy, current number of anti-epileptic drugs, and parent-reported quality of life in children with epilepsy were used to demonstrate the application of these procedures.
Coherence in law: A way to stimulate the transition towards a circular economy? A critical analysis of the European Commission's aspiration to achieve full coherence between chemicals legislation and waste legislation – and product legislation
Authors: de Waal Ida Mae
Published: December 2021

This article examines the (lack of) coherence between the legislative fields that govern the life cycle of materials and products and thus are relevant to the transition towards a circular economy in the EU: EU chemicals, product and waste legislation. After examining the notion of coherence in law, it provides insight into the role of coherence in EU chemicals, product and waste legislation in light of the transition towards a circular economy. The article examines the (possible) issues that exist at the interface between these three legislative fields by reviewing literature and EU policy documents and looks into the relation between these issues and the (lack of) coherence between EU chemicals, product and waste legislation. It is argued that, when looked at in light of the transition towards a circular economy, several issues might be related to a lack of coherence. Nonetheless, the aspiration to achieve full coherence should be looked at critically.
The End of Resilience? Managing Vulnerability Through Temporal Resourcing and Resisting
Authors: Branzei Oana , Fathallah Ramzi
Published: December 2021

We induce a first-person conceptualization of entrepreneurial resilience. Our seven-year, two-study ethnography shows that entrepreneurs enact resilience as a four-step process of managing vulnerability: they richly experience episodes of adversity, self-monitor across episodes, reassess personal thresholds and reconcile challenges with coping skills. Entrepreneurs manage vulnerability by (1) modifying ( stretching and shrinking) objective time and (2) changing their subjective experience of time as working with or against the clock through temporal resourcing or temporal resisting. We extend the theory and practice of entrepreneurial resilience by elaborating the interplay of objective and subjective time in managing vulnerability in recurrent and unprecedented crises.
Detecting damage in rudder stocks under load using electro-mechanical susceptance: Frequency-warping and semi-supervised approaches
Authors: Kexel Christian , Moll Jochen
Published: December 2021

Active piezoelectric transducers are successfully deployed in recent years for structural health monitoring using guided elastic waves or electro-mechanical impedance (EMI). In both domains, damage detection can be hampered by operational/environmental conditions and low-power constraints. In both domains, processing can be divided into approaches (i) taking into account baselines of the pristine structure as reference, (ii) ingesting an extensive measurement history for clustering to explore anomalies, (iii) incorporating additional information to label a state. The latter approach requires data from complementary sensors, learning from laboratory/field experiments or knowledge from simulations which may be infeasible for complex structures. Semi-supervised approaches are thus gaining popularity: few initial annotations are needed, because labels emerge through clustering and are subsequently used for state classification. In our work, bending and combined bending/torsion studies on rudder stocks are considered regarding EMI-based damage detection in the presence of load. We discuss the underpinnings of our processing. Then, we follow strategy (i) by introducing frequency warping to derive an improved damage indicator (DI). Finally, in a semi-supervised manner, we develop simple rules which even in presence of varying loads need only two frequency points for reliable damage detection. This sparsity-enforcing low-complexity approach is particularly beneficial in energy-aware SHM scenarios.
A Qualitative Study of the Role of Palliative Care During the COVID-19 Pandemic: Perceptions and Experiences Among Critical Care Clinicians, Hospital Leaders, and Spiritual Care Providers
Authors: Vesel Tamara , Ernst Emma , Vesel Linda , McGowan Kayla , Stopka Thomas J.
Published: December 2021

Background

Palliative care offers a unique skill set in response to challenges posed by the COVID-19 pandemic, with expertise in advance care planning, symptom management, family communication, end-of-life care, and bereavement. However, few studies have explored palliative care’s role during the pandemic and changes in perceptions and utilization of the specialty among health and spiritual care providers and hospital leaders.

Objective

To explore the utilization, perceptions, and understanding of palliative care among critical care clinicians, hospital leaders, and spiritual care providers during the pandemic.

Design

We conducted a qualitative study employing semi-structured, in-depth interviews.

Setting/participants

We conducted the study at a tertiary academic medical center in Boston, Massachusetts, USA. Between August and October 2020, we interviewed 25 participants from 3 informant groups: (1) critical care physicians, (2) hospital leaders, and (3) spiritual care providers.

Results

Respondents recognized that palliative care’s role increased in importance during the pandemic. Palliative care served as a bridge between providers, patients, and families; supported provider well-being; and contributed to hospital efficiency. The pandemic reinforced participants’ positive perceptions of palliative care, increased their understanding of the scope of the specialty’s practice, and inspired physicians to engage more with palliative care. Respondents indicated the need for more palliative care providers and advocated for their role in bereavement support and future pandemic response.

Conclusion

Findings highlight evolving and increased utilization of palliative care during the pandemic, suggesting a need for greater investment in palliative care programs and for palliative care involvement in public health emergency preparedness and response.
Mental Health Outcomes of Peer-led Therapeutic Adventure for Military Veterans
Authors: Bettmann Joanna Ellen , Anderson Ileana , Makouske Joe , Hanley Adam
Published: December 2021

Background: Skepticism of therapy and stigma are significant barriers for veterans with mental health issues. Therapeutic adventure shows promise in addressing veterans’ mental health needs while circumventing the stigma many veterans face in initiating treatment. Purpose: Given the small group model of therapeutic adventure programs, such programs may be ideal to provide social support for veterans and reduce mental health symptomology. The present study investigated: can a brief peer-led therapeutic adventure program modify veterans’ mental health symptoms? Methodology/Approach: The study's sample included 56 participants attending one Sierra Club Military Outdoors trip lasting at least three days and two nights and involving camping. Participants completed study measurements assessing depression, anxiety, stress, Post-Traumatic Stress Disorder symptoms, substance misuse symptoms, and suicidality at pre-trip, post-trip, one-month post trip, six-months post trip, and 12-months post trip. Six-month and 12-month post-trip data was collected during the COVID-19 pandemic. Findings/Conclusions: Results indicated significant reduction in mental health symptomology from pre-trip to post-trip, but showed few longer-term changes in mental health symptomology. Implications: The present study's findings are consistent with research suggesting improvements in overall psychological well-being immediately following a nature-based intervention and suggest the need for on-going, community-based interventions to support optimally military veterans’ mental health.
A Systematic Scoping Review of Psychological Capital Related to Mental Health in Youth
Authors: Preston Angela , Rew Lynn , Young Cara Calloway
Published: December 2021

Psychological capital (PsyCap) is a term coined in organizational psychology and refers to a person’s development of states that motivate behavior. Also known in the literature as PsyCap, this construct typically refers to positive states of hope, self-efficacy, resilience, and optimism that are amenable to intervention and that are related to subjective well-being and life satisfaction. The aims of this systematic scoping review were to explore how PsyCap is described in youth mental health literature and how PsyCap and mental health are related. Results from four databases were reported following PRISMA guidelines. A total of 772 studies were identified and 16 studies were fully reviewed, including an overall sample of 6,772 youth from six countries. PsyCap has a positive relationship with mental health in youth. Future studies should involve school nurses to validate the constructs that characterize PsyCap and validate an instrument for measuring PsyCap in youth mental health in English.
A Case Report of Mucoepidermoid Carcinoma With Extensive Keratinization in Parotid: Expanding the Morphologic Spectrum
Authors: Kong Mei , Wang Bo , Wang Xiaoxi , Xu Liming
Published: December 2021

Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of salivary glands in children and young adults. Typically, it is composed of squamoid, mucin-producing and intermediate-types cells. However, overt keratinization is rare. To the best of our knowledge, extensive keratinization or keratin pearls in MEC has never been reported. Keratinization or keratin pearls are regard “practically never seen in low-grade MEC”. Herein, we report a case of a 34-year-old woman who presented with a tumor in right parotid gland for 2 months. Microscopically, the tumor was composed of extensive squamous cells with overt keratin pearls, intermediate cells and few scattered mucous cells. MAML2 gene break-apart and CRTC1-MAML2 gene fusion were detected by fluorescence in situ hybridization. This is the first report to describe a MEC case with extensive squamous metaplasia and overt keratin pearls formation, which expands the morphologic spectrum of MEC.
Primary Sclerosing Epithelioid Fibrosarcoma of the Kidney: A Case Report and Review of the Literature
Authors: Peng Yan , Chen Tongbing , Zhang Dachuan , Wu Chao , Lei Ting , Shi Yongqiang , Xia Cunyan , Li Qing
Published: December 2021

Sclerosing epithelioid fibrosarcoma (SEF) is a rare variant of fibrosarcoma. We report one case of primary kidney SEF occurring in a 38-year-old man. Microscopically, epithelioid neoplastic cells are mainly arranged in cords and nests embedded in the dense sclerosing stroma. Diffuse immunohistochemical staining for MUC4 in neoplastic cells and the presence of the EWSR1 gene split by fluorescence in situ hybridization (FISH) analysis confirmed the histological diagnosis. Primary kidney SEF is extremely rare, the differential diagnosis strategy broadly includes a series of tumors with epithelioid morphology and sclerosing matrix, mainly including sclerosing variants of clear cell sarcoma of the kidney (CCSK), renal synovial sarcoma (SS), renal solitary fibrous tumor (SFT), metanephric stromal tumor (MST), sclerosing perivascular epithelioid cell tumor (PEComa), and carcinomas, and immunohistochemical expression of MUC4 and evidence of the EWSR1 gene split are helpful in making a definite diagnosis.
Paradoxes of Ratification: The Nagoya Protocol and Brazilian State Transformations
Authors: Eimer Thomas R. , Donadelli Flavia
Published: December 2021

This article explores the paradoxical behaviour of Brazil in relation to its national and international approaches to the regulations of access to genetic resources and benefits sharing with indigenous and other traditional communities. Brazil was one of the leaders in the international negotiations that led to the UN Nagoya Protocol but only ratified it 11 years later, after remarkable transformations of its internal biodiversity laws. We suggest that the seemingly contradictory behaviour has been shaped by the country’s internal political and ideological changes. This transformation goes hand in hand with substantial changes in state–society relations, particularly with regard to the balance of coalitions’ power between indigenous groups and industrial and agrarian elites. The article builds on the literature on state transformations and relies on the Advocacy Coalition Framework to show the importance of considering the impact of national-level politics on the fate of international agreements.
General Considerations for Diversifying Heparin Drug Products by Improving the Current Heparin Manufacturing Process and Reintroducing Bovine Sourced Heparin to the US Market
Authors: Al-Hakim Ali
Published: December 2021

Heparin is one of the most widely used drugs in the world. It has been described as a lifesaving drug due to its roles in treating many serious diseases and illnesses including kidney dialysis, surgery, cardiac-invasive, heart attack, cardiac arrhythmia, acute coronary syndrome, pulmonary embolism, stroke, deep vein thrombosis, blood clot prevention, and many other related uses. Heparin drug products currently approved in the United States are obtained from porcine intestinal mucosa sourced from pigs, the majority of which is imported from China. However, due to the heparin contamination crisis (2008) and potential shortage and to safeguard the quality of current and future heparin supply chains including raw material, Food and Drug administration (FDA) posted a notification on its website titled “FDA Encourages Reintroduction of Bovine-Sourced Heparin”. This perspective is intended to address the history of regulatory and scientific background of heparin drug products obtained from bovine and porcine sources and general recommendations for improving the quality of current heparin manufacturing process including Critical Quality Attributes (CQA), control management, process control, related tests, limits, etc. Additionally, a general plan with systematic steps is proposed for diversifying heparin supply chains by reintroduction of bovine sourced heparin to the US market.
Relative Wellbeing of Women Maltreated as Children
Authors: Arnell Linda , Källström Åsa , Gunnarsdottir Hrafnhildur
Published: December 2021

This study explores and analyzes how adult women in Sweden exposed to childhood maltreatment describe wellbeing, by using a thematic analysis of 22 semi-structured interviews with women maltreated as children. The results show that wellbeing was described as relative to both social norms and the childhood experiences and constituted four dimensions: Material and/or economic; Social and relational;Emotional; and Physical and/or mental. This study concludes that it is important to consider the relative and multiple ways wellbeing can be experienced and understood and to problematize norms of wellbeing, acknowledging the various ways people appraise their lives.
The Impact of the “Not Now, Not Ever” Recommendations on Police-Reported Domestic Violence in Queensland, Australia
Authors: Hodgkinson Tarah , Harris Bridget
Published: December 2021

In 2014, a taskforce was assembled to address increasing rates of domestic violence in Queensland, Australia. The Not Now, Not Ever report outlines a strategy to address domestic violence through 121 recommendations. This plan for reform resulted in a series of changes, particularly for agencies such as the Queensland Police Service (QPS). This study examines the impact of the recommendations on police-recorded domestic violence incidents in the state. Findings indicate that the changes resulted in an initial significant increase, followed by a significant decreasing trend in police-recorded incidents. However, this impact is not experienced equally across regions and districts.
Effects of superheated steam processing on the physicochemical properties of sea rice bran
Authors: Cao Xiaohuang , Islam Md. Nahidul , Ning Xin , Luo Zhihui , Wang Lei
Published: December 2021

Sea rice bran powder is a new type of instant food additive. Currently, its solubility is low, and its flavor is not pleasant. Superheated steam cooking is a promising treatment in cellulose-rich substances, which essentially improves quality. To gain better sea rice bran powder, physicochemical properties of sea rice bran were investigated using 100 °C, 110 °C, 120 °C, and 130 °C superheated steam treatments for 10, 20, 30, and 40 min. After the treatment, these samples were cooled down, dried, and milled to assess sea rice bran powder's product qualities. Profiles of odor, taste, aroma, and aliphatic acids were determined using e-nose, e-tongue, and gas chromatography–mass spectroscopy. Results revealed that superheated steam brought new profiles of odors and tastes for consumers. Superheated steam treatment was found to decrease swelling capacity. Methane (2,2,4,6,6-pentamethyl, heptane) was seen as a significant odor component, whereas umami and bitterness were considered considerable taste components. Superheated steam treatment retained higher content of aliphatic acids: saturated fatty acids 218–204 mg/100 g and unsaturated fatty acids 830–781 mg/100 g. This study discovered that superheated steam is suitable for processing rice bran as food ingredients; 100 °C-120 °C and 10-30 min could be suggested for suitable cooking sea rice bran.
Vital Service Captivity: Coping Strategies and Identity Negotiation
Authors: Guillemot Samuel , Dyen Margot , Tamaro Annick
Published: December 2021

Nursing homes are the quintessential example of vital service captivity. Consumers need vital services when they can no longer fulfil their basic needs on their own and their only choice is to delegate them to the market (e.g. care services for long-term and chronic illnesses, eating assistance at mealtimes). The service is referred to as ‘captive’ because older people are generally unwilling to use it, and when they have to, their options are limited. For elderly consumers, there is ‘no exit possible’, and as such they must integrate the service into their sense of self. The paper aims to (1) identify strategies for coping with vital service captivity and (2) present the identity negotiation mechanisms that lead people to choose one strategy over another. The study was conducted over a 6-month period in three nursing homes. Data collection includes semi-structured interviews, focus groups, participant observations, and micro-interviews with consumers – elderly residents and their families – and nursing home staff. Its main contribution is to highlight that coping with vital service captivity is a differential process. Consumers implement multiple coping strategies simultaneously, and these strategies are linked to three areas: routinization, socialization, and assimilation of a new social status. Moreover, implementing coping strategies means striking a balance between ‘disengagement’ and ‘engagement’ that not only takes into account former life trajectory, future prospects, and social comparisons, but also any changes in physical or cognitive skills and family support. Understanding these coping strategies and identity negotiation mechanisms highlights some unintended consequences on residents’ well-being, such as the importance of standardizing how the service is organized because it provides a stable framework, or the importance given to the well-being of all stakeholders (other consumers, staff) as a result of the community living situation.