bluuebunny/crossref_metadata_2025 huggingface dataset:
Entropy generation of peristaltic Eyring–Powell nanofluid flow in a vertical divergent channel for biomedical applications
Authors: Basha HT , Sivaraj R
Published: May 2021

Exploring the movement of blood in a blood vessel has been fascinated by clinicians and biomedical researchers because it is predominant in cell tissue engineering, drug targeting and various treatments like hypothermia, hyperthermia, and cancer. It is noticed that numerous non-Newtonian rheological fluids like Carreau fluid, tangent hyperbolic fluid, Eyring–Powell fluid and viscoelastic fluid manifest the characteristics of blood flow. Further, the investigation of entropy generation can be used to raise the performance of medical equipments. Consequently, the present mathematical model scrutinizes the transport characteristics and entropy generation of the peristaltic Eyring–Powell nanofluid in a permeable vertical divergent channel in the presence of dissipation and linear radiation. The non-similar variables are employed to convert the dimensional partial differential equations into dimensionless form which are tackled by the Homotopy perturbation method. The impacts of emerging parameters like Eyring–Powell parameters, left and right wall amplitudes, thermophoresis, mean flow rate, radiation, permeability parameter, Brownian motion, Eckert number, Hartman number on Eyring–Powell nanofluid axial velocity, temperature, and concentration are manifested. Present results disclose that the thermal Grashof number highly inflates the pressure rise. Eyring–Powell nanofluid temperature reduces for uplifting the linear radiation parameter. Growing values of the non-uniform parameter lead to move the trapping bolus towards the left and right wall. The total entropy generation diminishes for magnifying the temperature difference parameter.
Effect of pre-swirl nozzle closure modes on unsteady flow and heat transfer characteristics in a pre-swirl system of aero-engine
Authors: Liu Gaowen , Lei Zhao , Lin Aqiang , Feng Qing , Chen Yan
Published: May 2021

The pre-swirl system is of great importance for temperature drop and cooling air supply. This study aims to investigate the influencing mechanism of heat transfer, nonuniform thermodynamic characteristics, and cooling air supply sensitivity in a pre-swirl system by the application of the flow control method of the pre-swirl nozzle. A novel test rig was proposed to actively control the supplied cooling air mass flow rate by three adjustable pre-swirl nozzles. Then, the transient problem of the pre-swirl system was numerically conducted by comparison with 60°, 120°, and 180° rotating disk cavity cases, which were verified with the experiment results. Results show that the partial nozzle closure will aggravate the fluctuation of air supply mass flow rate and temperature. When three parts of nozzles are closed evenly at 120° in the circumferential direction, the maximum value of the nonuniformity coefficient of air supply mass flow rate changes to 3.1% and that of temperature changes to 0.25%. When six parts of nozzles are closed evenly at 60° in the circumferential direction, the maximum nonuniformity coefficient of air supply mass flow rate changes to 1.4% and that of temperature changes to 0.20%. However, different partial nozzle closure modes have little effect on the average air supply parameters. Closing 14.3% of the nozzle area will reduce the air supply mass flow rate by 9.9% and the average air supply temperature by about 1 K.
A significant improvement of thromboses treated by a new oral anticoagulant in an 11-year-old girl with systemic lupus erythematosus associated antiphospholipid syndrome: A case report
Authors: Chiang Yen-Jung , Hu Ya-Chiao , Chiang Bor-Luen
Published: May 2021

Pediatric venous thrombosis is associated with a variety of chronic diseases. Antiphospholipid syndrome (APS) is one of them and is commonly related to systemic lupus erythematosus (SLE). Warfarin is the mainstream of anticoagulation treatment in pediatric APS currently but it needs close monitoring and frequent dose adjustment. New oral anticoagulants (NOAC) is one of the innovative options in recent years but there is a lack of report in secondary prevention of deep vein thrombosis (DVT), especially pediatric APS. Herein we reported the significant therapeutic effect of edoxaban in a 11-year-old girl of newly diagnosed SLE and APS, who had deep vein thrombosis as the initial presentation.
Neoliberal Governmentality and Low-Wage Migrant Labour in India and Singapore
Authors: Dutta Mohan J.
Published: May 2021

Drawing on a digital ethnography and in-depth interviews conducted with low-wage migrant workers in hyper-precarious working conditions amidst ongoing neoliberal transformations in India and Singapore, this manuscript offers a comparative framework for examining the limits of pandemic communication. Interrogating the ideology of behaviourism that forms the dominant approach, the narratives point to the organizing role of structures as sites of labour exploitation. The exploitative labour conditions constitute the backdrop amidst which the migrant workers negotiate their health and well-being.
A novel year for human rights in Queensland
Authors: Costello Sean
Published: May 2021

In a year of challenges from the novel coronavirus, the new Queensland Human Rights Act was applied in unexpected ways. Its new complaints process was particularly tested by hotel quarantine restrictions. Nonetheless, geographic and demographic differences between Queensland and other human rights jurisdictions are also emerging as especially relevant to how human rights protection will be applied in the state, particularly a new Australian right to health and the cultural rights of Aboriginal and Torres Strait Islander peoples.
Craniofacial Growth Analysis of Individuals With and Without Cleft Lip and Palate in Colombia
Authors: Téllez-Conti Carolina , Mora-Diaz Ingrid Isabel , Díaz-Báez David , Ocampo-Arias Isomar Josefina , Jiménez-Luna Norma Edith , Niño-Paz Juan Camilo , González-Carrera María Clara
Published: May 2021

Introduction:

Craniofacial growth is a dynamic and unpredictable process influenced by genetic and environmental factors, presenting phenotypic and gender differences.

Objective:

Evaluate the differences in craniofacial growth and development in a group of Colombian individuals with complete unilateral and bilateral cleft lip and palate (CLP) and without CLP, classified by gender and age.

Setting and Sample Population:

Five hundred forty-one profile radiographs of 126 patients with unilateral CLP, 126 with bilateral CLP, and 289 without CLP. All patients of affected groups had a history of CLP correction surgery without nasoalveolar molding with orthopedic and orthodontic treatments.

Materials and Methods:

This cross-sectional study was performed comparing 8 cephalometric measurements on radiographs, 5 linear/3 angular. Analysis was performed by median and interquartile range for all cephalometric measurements. Comparison between the groups was performed using Kruskal-Wallis and Mann-Whitney U, with a 95% confidence.

Results:

Significant differences between the groups of patients with and without CLP, between types of clefts and genders. The skeletal structures of patients with CLP were smaller than those of control but improved with growth. Patients with unilateral CLP presented flat profiles and predominant class III malocclusions, while patients with bilateral CLP, at early ages, were class II and in the prepubertal stage, the values were progressively negative until the end of the growth period, suggesting class III. Patients with CLP presented posteroinferior rotation of the mandible, vertical measurements increased, and deflection of the cranial base.

Conclusion:

Given their growth alterations, patients with CLP benefit from orthopedic and orthodontic treatment.
Alliance With an Unguided Smartphone App: Validation of the Digital Working Alliance Inventory
Authors: Goldberg Simon B. , Baldwin Scott A. , Riordan Kevin M. , Torous John , Dahl Cortland J. , Davidson Richard J. , Hirshberg Matthew J.
Published: May 2021

The working alliance may be relevant in unguided smartphone-based interventions, but no validated measure exists. We evaluated the psychometric properties of the six-item Digital Working Alliance Inventory (DWAI) using a cross-sectional survey of meditation app users ( n = 290) and the intervention arm of a randomized trial testing a smartphone-based meditation app ( n = 314). Exploratory factor analysis suggested a single-factor solution which was replicated using longitudinal confirmatory factor analysis. The DWAI showed adequate internal consistency and test–retest reliability. Discriminant validity was supported by a lack of association with social desirability, psychological distress, and preference for a waitlist condition. Convergent validity was supported by positive associations with perceived app effectiveness and preference for an app condition. Supporting predictive validity, DWAI scores positively predicted self-reported and objective app utilization. When assessed at Weeks 3 or 4 of the intervention, but not earlier, DWAI scores predicted pre–post reductions in psychological distress.
Bendamustine-induced nephrogenic diabetes insipidus – A case report
Authors: Desjardins Audrey , Le-Nguyen Viviane , Turgeon-Mallette Léa , Vo Chloé , Boudreault Jean-Samuel , Rioux Jean-Philippe , Feng Xue , Veilleux Amélie
Published: May 2021

Introduction

In patients with relapsed or refractory lymphoma, high-dose chemoimmunotherapy with subsequent autologous hematopoietic cell transplantation (HCT) is a standard of care. Bendamustine, an alkylating agent, is used in the BeEAM (bendamustine, etoposide, cytarabine, melphalan) protocol for conditioning therapy before autologous HCT in patients with relapsed or refractory lymphoma who are eligible for transplant. There is no consensus regarding an optimal salvage regimen and the approach varies according to toxicity.

Case report

We present a case of partial nephrogenic diabetes insipidus after receiving bendamustine, as part of the BeEAM protocol. Management and outcome: The patient was managed with parenteral fluid administration and intranasal desmopressin before the condition resolved on its own.

Discussion

We summarize published reports of bendamustine-induced diabetes insipidus.
Trastuzumab-emtansine induced pleural and pericardial effusions
Authors: Lombardi Jeffrey , Lory Pauline , Martin Nils , Mayeur Didier , Combret Sandrine , Grandvuillemin Aurélie , Boulay Charlène , Schmitt Antonin
Published: May 2021

Introduction

Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate which combine trastuzumab (T), a monoclonal antibody targeting the human epidermal growth factor receptor-2 (HER2), and a cytotoxic molecule derived from maytansine (DM1).

Case report

We report the first case of T-DM1-associated pleural and pericardial effusions three weeks after the second course of T-DM1 in a patient with breast cancer. Drug-induced pleural and pericardial effusions was implicated in the absence of other etiologies. The Naranjo Scale indicated a probable drug-induced adverse reaction. Management & outcome: The patient fully recovered after thoracentesis and discontinuation of T-DM1. The patient has reported no side effect after the sixth course of trastuzumab.

Discussion

To our knowledge, this is the first case in the literature of bilateral pleural and pericardial effusions in a patient treated with T-DM1. The successful initiation of treatment with trastuzumab following withdrawal of T-DM1 suggests that emtansine played a role in the development of bilateral pleural and pericardial effusions. We hypothesize that the patient’s condition was a result of a local inflammatory reaction to emtansine by direct toxicity.
Mathematical simulation of elastoplastic deformation in cubic materials with an account of anisotropic bulk compressibility
Authors: Krivosheina MN , Tuch EV
Published: May 2021

It was shown for the first time that when modelling the deformation of materials with cubic symmetry (at full stress), the rotation of the computational axes leads to the identification of anisotropic volumetric compressibility. Loading of the materials with cubic symmetry of properties in the directions not coincided with the main directions (for example, 011) allows one to detect 75% cases of the auxetic single crystals (i.e. with negative Poisson’s ratio). In these cases, the negative volumetric compressibility has anisotropy, in contrast to the volumetric compressibility calculated along the crystallographic axes for cubic materials. Anisotropy of the volumetric compressibility leads to anisotropy of velocities of propagation of body waves. This paper considers several elastoplastic problems for a cubic material with different orientations of a coordinate system about its crystallographic axes. The behaviour of such a material under dynamic loads is modelled with an account of anisotropic bulk compressibility to provide the same anisotropy of bulk wave velocities in the elastic and plastic ranges and a uniform pressure function at the elastic-to-plastic strain transition. For each orientation of the coordinate system and respective planes, different values at the indicatrices of elastic constants are specified, and this specifies different deformation processes in cubic materials. Such an effect is demonstrated by solving three problems in three-dimensional (3D) statements approximating the following processes: (1) one-dimensional elastoplastic deformation in a thin target impacted by a thin plate; (2) uniform compression in a spherical body under pulsed hydrostatic pressure; and (3) 3D elastoplastic deformation in a cylindrical body striking a rigid target in view of anisotropic bulk compressibility. The problems were solved numerically using original programs based on the finite element method modified by GR Johnson for impact problems. Solving problems in a 3D formulation makes it possible to take into account the dependences of the direction of the elastic and plastic characteristics of the material, as well as the velocities of propagation of elastic and plastic waves from that direction. The simulation results suggest that for cubic materials, changing the orientation of two coordinate axes in a plane changes the strains along all three axes, including those perpendicular to this plane. It is concluded that anisotropic bulk compressibility in cubic materials should be allowed for by mathematical models of their elastic and plastic deformation. We demonstrate that the orientation of a computational coordinate system for cubic materials should be in those directions in which their deformation is analysed in each particular case.
Parallel encryption of input and output data for HPC applications
Authors: Lapworth Leigh
Published: May 2021

A methodology for protecting confidential data sets on third-party HPC systems is reported. This is based on the NIST AES algorithm and supports the common ECB, CTR and CBC modes. The methodology is built on a flexible programming model that delegates management of the encryption key to the application code. The methodology also includes a fine-grain control over which arrays on the files are encrypted. All the stages in an encrypted workflow are investigated using an established CFD code. Benchmarks are reported using the UK national supercomputer service (ARCHER) running the CFD code on up to 18,432 cores. Performance benchmarks demonstrate the importance of the way the encryption metadata is treated. Naïve treatments are shown to have a large impact on performance. However, through a more judicious treatment, the time to run the solver with encrypted input and output data is shown to be almost identical to that with plain data. A novel parallel treatment of the block chaining in AES-CBC mode allows users to benefit from the avalanche properties of this mode relative to the CTR mode, with no penalty in run-time.
Are you really using Yarning research? Mapping Social and Family Yarning to strengthen Yarning research quality
Authors: Atkinson Petah , Baird Marilyn , Adams Karen
Published: May 2021

Yarning as a research method has its grounding as an Aboriginal culturally specified process. Significant to the Research Yarn is relationality, however; this is a missing feature of published research findings. This article aims to address this. The research question was, what can an analysis of Social and Family Yarning tell us about relationality that underpins a Research Yarn. Participant recruitment occurred using convenience sampling, and data collection involved Yarning method. Five steps of data analysis occurred featuring Collaborative Yarning and Mapping. Commonality existed between researcher and participants through predominantly experiences of being a part of Aboriginal community, via Aboriginal organisations and Country. This suggests shared explicit and tacit knowledge and generation of thick data. Researchers should report on their experience with Yarning, the types of Yarning they are using, and the relationality generated from the Social, Family and Research Yarn.
Digital innovation and funeral practices: Māori and Samoan perspectives during the COVID-19 pandemic
Authors: Enari Dion , Rangiwai Byron William
Published: May 2021

The COVID-19 worldwide pandemic has caused the world to stop. It has disrupted traditional funeral processes for Māori and Samoan peoples. Their collective ways of mourning were particularly affected, as social distance restrictions and travel bans meant they were unable to physically gather in large numbers. Despite the disruption caused by COVID-19, digital innovation has meant these groups have been able to remain socially connected, at a physical distance. This cohort has also been able to maintain collective interconnectivity with their family and friends during times of grief. Through the digital space, funerals are still able to be a communal time of mourning, support and comfort. As insider researchers, we present our stories, chants and oratory during times of sorrow, while centring our collective digital resilience.
Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country
Authors: Mathew Thomas , Thomas Kurian , K John Saji , Venkatesh Shruthi , Nadig Raghunandan , Badachi Sagar , Souza Delon D , Sarma GRK , Parry Gareth J
Published: May 2021

Background:

Rituximab is reserved for treating refractory myasthenia gravis (MG) patients. Here we report our experience with rituximab in AChR antibody positive generalized MG (gMG) and impending myasthenic crisis (IMC).

Methods:

This retrospective, observational study, conducted at a tertiary care, neuroimmunology clinic, analyzed the data of patients with AChR antibody positive gMG, treated with rituximab between 1st January 2016 and 30th October 2018.

Results:

Eleven patients with AChR antibody positive gMG received rituximab. Mean age of the cohort was 50.54 ± 18.71 years with 9 males. Seven out of 11 patients received rituximab in the early stage (<2 years from onset) and had good response to treatment. Four of the 5 patients with IMC improved with rituximab alone. In the 10 patients who regularly followed up, there was a significant difference between the QMG scores at baseline and at 1, 2, 6, 12, and 18 months ( P < .0001).

Conclusion:

Rituximab appears to be a potentially effective early treatment option for AChR antibody positive generalized MG and impending myasthenic crisis.
Adapting to context: Creative strategies of video streaming services in Nigeria
Authors: Simon Godwin Iretomiwa
Published: May 2021

This article examines the contextual challenges that characterize the video on demand (VOD) market in Africa. It provides critical analysis of the creative strategies employed by Nigeria-based streaming services to navigate the peculiar business environment on the continent. This research is on the background of the poor Internet infrastructure and economic divides in many African countries including Nigeria. Streaming services operating in these markets must understand a context where Internet access is complicated on the levels of availability and/or affordability, including significant lack of confidence in e-payment facilities. All these, together with epileptic power supply and poor standard of living, indicate that streaming services must innovate to capture subscribers within the continent. Despite the harsh operational environment, streaming services in Nigeria have continued to increase in number within the past 5 years. This is attributed to the transnational reach of the streaming services as they are patronized by Africans in diaspora across the globe, while they also enjoy popularity within African countries. This article specifically focuses on the innovative strategies employed by Nigerian streaming services to operate within their African markets in the context of their peculiar challenges. In so doing, it extends extant scholarship about Internet-distributed video using the African context. This article is situated within the Media Industry Studies framework and draws from semi-structured interviews with 7 streaming executives in Nigeria and 10 creative professionals in the Nigerian Video Film Industry (Nollywood). It also relies on desk research of press reports, industry publications, as well as the interfaces of streaming portals. This article underscores the necessity of contextualized research with the digital turn in video distribution. Through contextualized analysis of VOD market realities in a less studied terrain like Africa, it aligns with scholarly call to expand theories of Internet-distributed video to marginal contexts.
Consensually nonmonogamous parent relationships during COVID-19
Authors: Manley Melissa H , Goldberg Abbie E
Published: May 2021

During the COVID-19 pandemic, parents in consensually nonmonogamous (CNM) relationships navigated public health directives to social distance and avoid contact between households. Many parents practicing CNM share romantic, sexual, and coparenting relationships across households, and the pandemic introduced challenges and opportunities for innovation in maintaining connection. This qualitative study sought to explore the experiences, challenges, and adaptations of CNM parents, using survey and interview data from 70 US parents collected between May and December 2020. Thematic analysis highlighted that many parents spent less time with non-cohabiting partners and more time with cohabiting partners and children, but also adapted via creative strategies such as incorporating partners into a quarantine pod, inviting partners to move in, or connecting over technology. These data illuminate the diverse ways that CNM parents engaged in and “queered” family and partner relationships during the pandemic.
The trauma burden on a tertiary surgical intensive care unit during the lockdown period in South Africa: A retrospective observational study
Authors: van Zyl Albert GP , Ahmed Nadiya , Davids Ryan
Published: May 2021

Background

Trauma places a significant burden on scarce South African critical care resources. The impact of the lockdown period in 2020 on these resources has not been studied. Restrictions on citizen movement and alcohol sales during the lockdown period presented a unique time period to investigate the burden of trauma on a low–middle-income country tertiary hospital intensive care unit.

Methods

A retrospective observational analysis of all patients admitted to a tertiary hospital surgical intensive care unit during the lockdown period in 2020, compared to the same time period in 2019 and 2018. Data were analysed to detect if a significant difference was present in the number of trauma admissions, length of stay and mechanisms of trauma.

Results

A significant decrease in the number of trauma admissions to ICU in 2020 was observed as compared to 2018 and 2019 during the same period ( p = <0.001), with a reduction of nearly 50%. The incidence of trauma admissions was lower in all individual lockdown levels in 2020 as compared to 2018 and 2019, and the lowest incidence was recorded in level 5 of 2020. There was no difference among the length of stay of trauma patients in ICU in 2018, 2019 and 2020. There was no difference between the incidence of trauma admissions during lockdown level 3 (with and without alcohol sales) in 2020 compared to 2018. The profile of penetrating and non-penetrating trauma over the 3 years was the same ( p = 0.22). There were no interactions between years, lockdown periods and penetrating trauma ( p = 0.22).

Interpretation

There was a significant decrease in the trauma burden presented to the surgical ICU during the lockdown period in 2020. Levels with the strictest restrictions on movement and alcohol use had the greatest measurable impact. The decreased number of trauma patients admitted in 2020 was comparable to the national trend of decreased trauma numbers recorded in all levels of the national healthcare system.
Inconspicuous adaptations to climate change in everyday life: Sustainable household responses to drought and heat in Czech cities
Authors: Ferenčuhová Slavomíra
Published: May 2021

Adaptation to climate change is often understood as a top-down decision-making and policy-implementing process, as well as application of expert knowledge, to prevent or reduce its (locally specific) negative consequences. In high-income societies, adaptation at the household level then frequently refers to adopting technological fixes distributed through the market, sometimes at a considerable cost. Informed by a study in the context of Central Europe, this article aims to discuss different practices of households and individuals that do not require increased consumption of energy or materials, but still help adapting to climate change in some of its local expressions, such as heatwaves and drought. They were described by participants in focus groups in six cities in the Czech Republic. I argue that such ‘inconspicuous adaptations’ emerge without connection to the climate change debate, or without deeper knowledge about the issue. Yet, they should not be overlooked as unimportant and short-term ‘coping responses’ and underestimated in this debate. They are part and parcel of the ongoing process of societal adaptation to climate change.
Naive, connected, and counselor tween girl identity groups: Consumption practices and social identity constructions within consumer culture
Authors: Weber Tiziana Brenner Beauchamp , Francisco Maffezzolli Eliane C.
Published: May 2021

This research identifies the relationship between consumption practices and the construction of social identity among tweens in a Brazilian context. Using consumer culture theory and social identity theory, we employed 80 h of observation, 9 interviews, and projective techniques with fifteen girls. Three social identity groups were acknowledged: naive, connected, and counselors. These groups revealed different identity projects, such as the integration and maintenance within the social group of current belonging, the access to the social group with the greater distinctions, the generation of differentiable and positive distinctions (both intra- and intergroups), and the expression and consolidation of identity and its respective consumption practices. This research contributes to the consumption literature that relates to consumer identity projects. The findings reveal a current resignification of girlhood and exposes tweens’ consumption practices as a direct mechanism of the expression and construction of their social identities. These are mechanisms of social identity construction as mediated by group relations through the processes of access, maintenance, integration, differentiation, and distinction.
Domestic institutions, growth and global justice
Authors: Armstrong Chris
Published: May 2021

According to one prominent theory of development, a country’s wealth is primarily explained by the quality of its institutions. Leaning on that view, several political theorists have defended two normative conclusions. The first is that we have no reason for concern, from the point of view of justice, if some countries have greater natural resource endowments than others. The second is that proposals for redistribution across borders are likely to be superfluous. Advocates of global redistribution have not yet grappled with these momentous arguments, or shown whether, and how, they might be rebuffed. This article does just that.
Gas pipeline event classification based on one-dimensional convolutional neural network
Authors: An Yang , Ma Xueyan , Wang Xiaocen , Qu Zhigang , Zhu Xixin , Yin Wuliang
Published: May 2021

Pipeline block and pipeline leak may lead to serious accidents and cause huge economic losses, which have been urgent problems for gas transportation. In this work, active acoustic pulse-compression technology is first introduced to detect and locate these two anomalous events. The matched filtered signals are then normalized and input into one-dimensional convolutional neural network to achieve classification of not only pipeline block and pipeline leak but also normal event such as pipeline elbow which causes acoustic wave reflection as well. Neural network parameter optimization has also been carried out as well as the comparison with long- and short-term memory network. Experimental results demonstrate that compared with long- and short-term memory network, one-dimensional convolutional neural network has an improvement in efficiency due to the great reduction of running time. For non-aliasing pipeline events, both of the models can reach 100% classification accuracy. For aliasing pipeline events, despite the shorter time series and fewer features, the classification accuracy of one-dimensional convolutional neural network still reaches 100.00%, but that of long- and short-term memory network is only 93.89%. Furthermore, the smoothing and slight fluctuation of receiver operating characteristic curve and the high value of area under curve also verify the stability and good classification performance of the proposed trained model. Therefore, the one-dimensional convolutional neural network shows significant performance for pipeline events classification and has considerable potential and application prospect in gas pipeline safety monitoring.
Social Abuse in Intimate Partner Relationships: A Hybrid Concept Analysis
Authors: Park Sihyun , Jeon Jaehee
Published: May 2021

Belongingness is a basic human need. The violation of this need has been described in numerous studies on intimate partner violence (IPV). However, it has not been conceptually defined. Therefore, this study aimed to develop and analyze the concept of social abuse in intimate partner relationships. A hybrid model of concept analysis was used for this study consisting of three phases: theoretical, fieldwork, and analytic. In the theoretical phase, a systematic literature review was performed to obtain a working definition of social abuse. In total, 20 articles that met the inclusion criteria were included in the analysis. The findings from the theoretical phase were refined and confirmed by qualitative data collected from the fieldwork phase. In the analytical phase, four attributes of social abuse emerged: cutting off the victim’s social relations, limiting the victim’s social engagement, interfering with the victim’s social relations, and closely watching the victim’s social interactions. Possessiveness, escalating suspicion, allegations of infidelity, and fear that the victim will leave were identified as antecedents of social abuse in perpetrators. Additionally, the experience of social abuse had negative consequences on victims’ social relationships, mental health, and help-seeking behaviors. This study extends the theoretical framework of IPV and implies a strong need to educate victims and their social acquaintances on social abuse.
Association of Postangioplasty Femoropopliteal Dissections With Outcomes After Drug-Coated Balloon Angioplasty in the Femoropopliteal Arteries
Authors: Giannopoulos Stefanos , Strobel Aaron , Rudofker Eric , Kovach Christopher , Schneider Peter A. , Armstrong Ehrin J.
Published: May 2021

Purpose:

Balloon angioplasty for the treatment of femoropopliteal lesions is often complicated by postangioplasty dissections. While dissections are known to affect patency and reintervention after balloon angioplasty, the association between dissections and major adverse limb event (MALE) after drug-coated balloon (DCB) angioplasty remains uncertain. Thus, the postangioplasty dissection and bailout stenting patterns were investigated.

Materials and Methods:

This was a single-center retrospective study enrolling patients with de novo femoropopliteal lesions treated with DCB with/without stenting. Postangioplasty target vessel dissection was graded based to the coronary artery classification grades A-F, with grade C-F considered “severe.” Cox regression analysis was performed to examine the association of dissection severity with outcomes during 2-year follow up, among nonstented cases.

Results:

In 85.3% of the cases (N=203/238) a postangioplasty dissection was observed. The average dissection length was 55.57 mm (SD 36.71 mm), with 1 dissection present in 91.8% (N=180/196) and 2 or more dissections present in 8.2% (N=16/196). Dissection severity was grade A (19.8%), B (20.6%), C (23.1%), D (10.9%), E (10.1%), and F (0.8%). Bailout stenting was required in 40.4% of the patients, being more prevalent among grade C and grade E cases. Among 142 nonstented cases, dissections were present in 85.2%. A total of 75 (52.8%) of these dissections were grade A and B, while 46 (32.4%) were grade C to F. Among nonstented cases, grade C (hazard ratio [HR] 5.83; 95% CI 1.25 to 27.31; p=0.025) and grade D (HR 6.32; 95% CI 1.39 to 28.86; p=0.017) vs grade A dissections were associated with a higher risk for 2-year MALE. Multivariate analysis adjusting for several lesion characteristics demonstrated a statistically significant higher risk for 2-year MALE among the severe dissection group (HR 2.94; 95% CI 1.27 to 6.79; p = 0.012). Interestingly, the risks of limb loss (HR 1.30; 95% CI 0.22 to 7.79; p=0.774) and repeat revascularization (HR 0.95; 95% CI 0.40 to 2.26; p=0.905) during follow-up were similar between the 2 groups.

Conclusion:

This study indicated that nonstented moderate and severe postangioplasty dissections after DCB angioplasty were associated with higher risk for MALE. Future studies are needed to validate our results and determine other dissection characteristics (eg, total dissection length, lumen area, total number of dissections) that may affect the efficacy of DCB.
Maximal Voluntary Breath-Holding Tele-Inspiratory Test in Patients with Chronic Obstructive Pulmonary Disease
Authors: Hedhli Abir , Slim Azza , Ouahchi Yassine , Mjid Meriem , Koumenji Jamel , Cheikh Rouhou Sana , Toujani Sonia , Dhahri Besma
Published: May 2021

Maximal voluntary inspiratory breath-holding time (MVIBHT) has proved to be of clinical utility in some obstructive ventilatory defects. This study aims to correlate the breath-holding time with pulmonary function tests in patients with chronic obstructive pulmonary disease (COPD) and to determine the feasibility of using a breath-holding test in assessing the severity of COPD.

A cross-sectional study including male patients with stable COPD were conducted. Patients with respiratory comorbidities and severe or unstable cardiac diseases were excluded. Patients were interviewed and examined. Six-minute walk test (6MWT) and plethysmography were performed.For MVIBHT collection, the subject was asked to inspire deeply and to hold the breath as long as possible at the maximum inspiratory level. This maneuver was repeated three times. The best value was used for further analysis.

A total of 79 patients (mean age: 64.2 ± 8) were included in this study. The mean value of MVIBHT was 24.2 ± 8.5 s. We identified a positive and significant correlations between MVIBHT and forced vital capacity ( r = .630; p < .001) as well as MVIBHT and forced expiratory volume in 1 s (FEV1%) ( r = .671; p < .001). A significant inverse correlation with total lung capacity ( r = −.328; p = .019) and residual volume to total lung capacity ratio ( r = −.607; p < .001) was noted. MVIBHT was significantly correlated to the distance in the 6MWT ( r = .494; p < .001). The mean MVIBHT was significantly different within spirometric grades ( p < .001) and GOLD groups ( p = .002). At 20.5 s, MVIBHT had a sensitivity of 72% and specificity of 96% in determining COPD patients with FEV1 <50%.

Our results provide additional evidence of the usefulness of MVIBHT in COPD patients as a pulmonary function parameter.
Mechanical thrombectomy versus medical care alone in large ischemic core: An up-to-date meta-analysis
Authors: Jiang Qianmei , Wang Huaishun , Ge Jian , Hou Jie , Liu Ming , Huang Zhichao , Guo Zhiliang , You Shoujiang , Cao Yongjun , Xiao Guodong
Published: May 2021

Objective

We compared outcomes and adverse events of thrombectomy versus medical management in acute ischemic stroke (AIS) patients with baseline large infarct core.

Methods

We searched Ovid MEDLINE(R) ALL, Cochrane Library Clinical Controlled Trials and EMBASE from inception to January 2021 for studies comparing thrombectomy and medical management alone in AIS patients who had ASPECTS <=7 or ischemic core volume >=50 ml. Imaging modalities to valuate ASPECTS and core volume were without restriction. The functional outcome was measured by mRS (modified Rankin Scale) score 0-2 at 90 days or discharge. The safety end point included the rates of mortality and sICH (symptomatic intracranial hemorrhage) or PH2 (parenchymal hematoma type 2).

Results

Fourteen studies with a total of 2547 patients (thrombectomy n = [1197]; medical care alone [n = 1350]) fulfilled our criteria. As for patients with low ASPECTS, pooled results indicated a higher odds of good functional outcome (OR = 3.47; 95% CI 1.99 to 6.07; P < 0.0001, I2=66%) and a lower risk of mortality (OR = 0.62; 95% CI 0.46 to 0.83; P = 0.001, I2=32%) in thrombectomy group compared with no thrombectomy group, but the risk of sICH or PH2 did not differ between two groups. As for patients with large core volume, both functional outcome and safety end point between two groups showed no statistically significant difference.

Conclusion

Thrombectomy remained safe and effective by careful selection in patients with low ASPECTS. More studies were warranted to explore contraindications for mechanical thrombectomy in AIS patients, especially in patients with large core volume.
Instructional leadership as a controlling function in secondary schools in Rangwe Sub County, Kenya: Influence on students’ learning outcomes
Authors: Juma John James , Ndwiga Zachary N , Nyaga Milcah
Published: May 2021

This research article reports on instructional leadership as a controlling function in secondary schools. All the 41 secondary schools in Rangwe Sub County were included in the study and the targeted respondents were teachers and principals. A purposive sampling method was used to select the respondents from each school. A principal self-rating questionnaire, a teacher perception questionnaire, and a document analysis checklist were used for data collection. The collected data was analyzed using descriptive statistics, independent samples T-test, and regression analysis test. The study found that school principals engaged their deputies, heads of department, and directors of studies to conduct their day-to-day instructions in their schools. It was also revealed that classroom visits and observation of teaching and learning significantly influence student learning outcomes in secondary schools. The study concluded that involving the expertise of immediate juniors in day-to-day instructions is an effective way of implementing instructional leadership roles of the school principals in secondary schools. The study, therefore, advocates for the school principal becoming the overall instructional supervisor and instructional improvement catalyst.
Serial memory for landmarks encountered during route navigation
Authors: Hilton Christopher , Wiener Jan , Johnson Andrew
Published: May 2021

The present study demonstrates similarities between route learning and classical tests of serial order memory. Here, we investigated serial memory for landmarks in a route learning task, in younger and older adults. We analysed data from a route learning task with 12 landmarks. Participants (88 younger and 77 older) learned a route using either a Fixed Learning (3 exposures to the route) or Flexible Learning (repeated exposures until successful navigation was achieved) procedure. Following route learning, participants completed Immediate Free Recall (IFR) and Free Reconstruction of Order (Free RoO) of the landmarks. We show clear acquisition of sequence memory for landmarks for both age groups, with Free RoO producing a bowed serial position curve. IFR produced recency effects but no primacy effects in fixed learning, with recency reduced following flexible learning for both age groups. Younger adults displayed a primacy bias for the first item recalled in both learning conditions, as did the older adults in the flexible learning condition. In contrast, older adults displayed a recency bias in the fixed learning condition. Evidence of contiguity in IFR was present only for younger adults in the flexible learning condition. Findings are broadly consistent with results from typical short-term list learning procedures and support the universality of sequence learning effects, which we demonstrate are generalisable to a navigation context.
A tactical periodisation model for Gaelic football
Authors: Mangan Shane , Collins Kieran , Burns Con , O’Neill Cian
Published: May 2021

Tactical Periodisation is a training methodology, originally developed for soccer, that focuses primarily on the systems of play that a team intends to use in competition. It has been popularised by successful European coaches and subsequently has been proposed as a model to follow for other sports such as rugby union and tennis in more recent times. Gaelic football is an amateur sport that has similarities to soccer and rugby union. To date no training periodisation model has been proposed for Gaelic football. The aim of this article was to present a Tactical Periodisation model for Gaelic football, taking the sport’s game structure, physical and technical demands and amateur status into account.
Clinico-radiologic features and therapeutic strategies in tumefactive demyelination: a retrospective analysis of 50 consecutive cases
Authors: Vakrakou Aigli G. , Tzanetakos Dimitrios , Evangelopoulos Maria-Eleptheria , Argyrakos Theodore , Tzartos John S. , Anagnostouli Maria , Andreadou Elissavet , Koutsis Georgios , Velonakis Georgios , Toulas Panagiotis , Gialafos Elias , Dimitrakopoulos Antonios , Psimenou Erasmia , Stefanis Leonidas , Kilidireas Constantinos
Published: May 2021

Aims:

Our goal was to expand the spectrum of clinico-radiologic characteristics and the possible therapeutic choices in patients with tumefactive demyelinating lesions (TDLs).

Methods:

A retrospective analysis of 50 patients with at least one TDL was performed at an academic neurology center (2008–2020).

Results:

Our cohort comprised mostly women (33/50) with a mean age of 38 years at TDL onset. The mean follow-up time was 76 months. The mean Expanded Disability Status Scale score at TDL onset and at the latest neurological evaluation was 3.7 and 2.3, respectively. We subcategorized the patients into seven groups based mainly on the clinical/radiological findings and disease course. Group A included patients presenting with a Marburg-like TDL ( n = 4). Groups B and C comprised patients presenting with monophasic ( n = 7) and recurrent TDLs ( n = 12), respectively. Multiple sclerosis (MS) patients who subsequently developed TDL ( n = 16) during the disease course were categorized as Group D. Group E comprised patients who initially presented with TDL and subsequently developed a classical relapsing–remitting MS without further evidence of TDL ( n = 5). Groups F ( n = 2) and G ( n = 4) involved MS patients who developed TDL during drug initiation (natalizumab, fingolimod) and cessation (interferon, fingolimod), respectively. Regarding long-term treatments applied after corticosteroid administration in the acute phase, B-cell-directed therapies were shown to be highly effective especially in cases with recurrent TDLs. Cyclophosphamide was spared for more aggressive disease indicated by a poor response to corticosteroids and plasma exchange failure.

Conclusion:

Tumefactive central nervous system demyelination is an heterogenous disease; its stratification into distinct groups according to different phenotypes can establish more efficient treatment strategies, thus improving clinical outcomes in the future.
Patient-Tailored Decision Support System Improves Short- and Long-Term Glycemic Control in Type 2 Diabetes
Authors: Augstein Petra , Heinke Peter , Vogt Lutz , Kohnert Klaus-Dieter , Salzsieder Eckhard
Published: May 2021

Background:

The increasing prevalence of type 2 diabetes mellitus (T2D) and specialist shortage has caused a healthcare gap that can be bridged by a decision support system (DSS). We investigated whether a diabetes DSS can improve long- and/or short-term glycemic control.

Methods:

This is a retrospective observational cohort study of the Diabetiva program, which offered a patient-tailored DSS using Karlsburger Diabetes-Management System (KADIS) once a year. Glycemic control was analyzed at baseline and after 12 months in 452 individuals with T2D. Time in range (TIR; glucose 3.9-10 mmol/L) and Q-Score, a composite metric developed for analysis of continuous glucose profiles, were short-term and HbA1c long-term measures of glycemic control. Glucose variability (GV) was also measured.

Results:

At baseline, one-third of patients had good short- and long-term glycemic control. Q-Score identified insufficient short-term glycemic control in 17.9% of patients with HbA1c <6.5%, mainly due to hypoglycemia. GV and hyperglycemia were responsible in patients with HbA1c >7.5% and >8%, respectively. Application of DSS at baseline improved short- and long-term glycemic control, as shown by the reduced Q-Score, GV, and HbA1c after 12 months. Multiple regression demonstrated that the total effect on GV resulted from the single effects of all influential parameters.

Conclusions:

DSS can improve short- and long-term glycemic control in individuals with T2D without increasing hypoglycemia. The Q-Score allows identification of individuals with insufficient glycemic control. An effective strategy for therapy optimization could be the selection of individuals with T2D most at need using the Q-Score, followed by offering patient-tailored DSS.