bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of Prothrombin Complex Concentrates Use in Apixaban and Rivaroxaban Associated Intracranial Hemorrhages
Authors: Ibarra Francisco
Published: May 2021

Study Objective:

Summarize the studies evaluating the use of 4-factor prothrombin complex concentrates in the management of apixaban and rivaroxaban associated intracranial hemorrhages.

Methods:

A PubMed literature search was conducted for articles published between 2013 and 2020 which contained the following terms in their title: (1) apixaban, rivaroxaban, or factor Xa inhibitor*, and (2) prothrombin complex concentrate*.

Results:

Eighteen observational studies were included. When a ∼25 units/kg (range: 25-26.9 units/kg) non-activated 4 factor prothrombin complex concentrate dose was administered, the hemostatic effectiveness rates were ≥ 79% in 2/4 studies that utilized the Sarode et al criteria, in comparison to 4/5 studies that administered a 50 units/kg dose. The mortality rates were < 20% in 7/9 studies with hemostatic effectiveness rates ≥ 79%. Mortality rates were lower in the studies demonstrating higher hemostatic effectiveness rates and including patients with higher Glasgow coma scale scores and lower intracerebral hemorrhage volumes. Overall, the thromboembolic event rates were 0-18%, with 16/18 studies demonstrating rates ≤ 10%. The thromboembolic event rates were not dose or agent dependent.

Conclusion:

Rates of hemostatic effectiveness were influenced by the definition of hemostatic effectiveness, dose administered, and patient severity. Studies suggest that higher doses may result in higher hemostatic effectiveness rates without increasing the risk of experiencing a thromboembolic event. This review may be used by providers to modify or validate their reversal strategy approach until well designed studies are available.
The Clinical Pharmacy Specialists’ Role in Antihypertensive Management Surrounding Bariatric Surgery in a Veterans Affairs Population
Authors: O’Neill Jessica L. , Pinkney Rachel A. , Hurren Kathryn M.
Published: May 2021

Background:

No guidelines exist for de-escalating antihypertensive medications surrounding bariatric surgery. This study analyzed clinical pharmacy specialist (CPS) management of antihypertensive medications in patients undergoing bariatric surgery at a Veterans Affairs medical center.

Objectives:

The primary objective was to describe the CPS role in antihypertensive management surrounding bariatric surgery through evaluation of number of CPS encounters, number and type of antihypertensive medications and medication interventions by CPSs and all other providers, over 5 time periods between a pre-operative assessment and up to 6 months post-operatively.

Methods:

Electronic medical records of patients taking antihypertensive medication who underwent bariatric surgery between 1/1/2014 and 2/27/2018, had primary care through our facility, and at least 1 encounter with a CPS were reviewed.

Results:

Forty patients were included out of 221 screened. There were 109 total medication interventions in 37 patients. CPSs provided 60 medication interventions (55% of total interventions) in 26 patients. Mean antihypertensive agents per patient was 2.18 at baseline versus 0.95 at 6-months post-operative. Dihydropyridine calcium channel blockers had the highest discontinuation rate. Thiazide diuretics were most commonly discontinued prior to surgery and angiotensin converting enzyme inhibitors were discontinued more steadily over the study duration. Nineteen patients (48.7%) had blood pressure <140/90 mmHg and were off all antihypertensive medications at the final CPS encounter.

Conclusion:

The results of this small study support the role of CPSs in antihypertensive medication management surrounding bariatric surgery.
Hybrid stimulations and perversions in public service innovation
Authors: Sønderskov Mette , Rønning Rolf , Magnussen Siv
Published: May 2021

Innovation has been highlighted as a magic formula that can solve deep-seated, emerging complex social and economic problems in the public service sector. However, public innovation efforts face both drivers and barriers. Innovation depends on context, and currently different competing governance paradigms’ influence has attracted growing academic and political interest regarding the potential of public service innovation. Today, new public governance (NPG) has been suggested as an alternative paradigm to classic public administration (CPA) and new public management (NPM), as the focus of attention has shifted from traditional hierarchical forms of government and market-based competition strategies to interactive- and collaborative-based governance. In this paper, we discuss how elements from different governance paradigms interact, support and undermine one another in terms of innovation in hybrid organisations. Although hybridisation has been described in extant studies on administrative welfare reforms, it barely has been examined in the public innovation literature. This is a theoretical paper based on a scoping review; however, we use the Norwegian Labour and Welfare Administration (NAV) as an illustrative case to explain how hybridisation may lead to both stimulations and perversions regarding the development, implementation and spread of public service innovation. Finally, the paper reflects on how public leaders can handle hybridity within their organisational units.
Performance enhancing for a highly loaded tandem cascade by endwall incoming vortex–corner separation interaction
Authors: Cao Zhiyuan , Gao Xi , Song Cheng , Zhang Xiang , Zhang Fei , Liu Bo
Published: May 2021

In highly loaded tandem compressor cascades, corner separations can still exist. In order to eliminate corner separations in highly loaded tandem compressor cascades, incoming vortex–corner separation interaction mechanism was investigated. Different schemes of the vortex generators, which located at different pitchwise locations and could generate vortexes with different rotation directions, were designed and investigated numerically. Results show that, severe corner separation occurred at the front blade passage of the tandem cascade; by utilizing flow control method of incoming vortex–corner separation interaction, the corner separation could be reduced significantly. The optimal control effect of incoming vortex on corner separation was achieved with anticlockwise rotation and the vortex generator is located right ahead of the leading edge of tandem cascade, a maximum loss coefficient reduction of 21.8% being achieved. Different from single blade configuration, the boundary layer of tandem cascade was regenerated at rear blade suction surface due to the injection flow from blade gap between the two blades. Though corner separations could be reduced at both conditions, the loss of tandem cascade with clockwise incoming vortex is higher than that with anticlockwise vortex, and a smaller corner separation region at suction surface was achieved by utilizing clockwise vortex. The mechanism was that anticlockwise incoming vortex reduced the corner separation but increased secondary flow, while clockwise vortex enhanced passage vortex and decreased secondary flow. For clockwise incoming vortex near pressure surface, the vortex would be divided into two parts at the leading edge of rear blade, one would go through the blade gap and deteriorate flow fluid near rear blade suction surface, the other flowed downstream along pressure surface. The rotation direction of different incoming vortexes became the same as the passage vortex at rear blade passage of tandem cascade, which was mainly due to the effect of secondary flow.
Optimal design of an asymmetrical parallel mechanism
Authors: Wu Mengli , Zhang Yue , Yue Xianqu , Lv Dongyang , Chen Mo , Wang Xuhao , Zhang Jun
Published: May 2021

Aiming at the aircraft composite skin grinding, a Three-DOF Asymmetrical Mechanism (TAM) is proposed to replace manual grinding. Considering asymmetrical characteristics of the TAM, the linear superposition principle is adopted to derive the total stiffness matrix of the mechanism. The driving force curves of numerical calculation and simulation are almost coincident; thus the correctness of the dynamic model is verified. The global kinematics condition number index is established with the velocity ellipsoid method. Similarly, the global stiffness performance evaluation index is constructed according to the stiffness ellipsoid method. Moreover, a new global acceleration dexterity index is proposed to overcome the limitations of the dynamics ellipsoid method. Based on the above models and performance indices, a new optimization method is proposed which combines both single and multi-objective optimization. Among the method, the multi-objective optimization is carried out with normalized weighted sum algorithm and genetic algorithm. This optimization method can not only improve the convergence speed, but also balance the weight of different performance indices. After optimization, the kinematics, stiffness and dynamics performance are significantly improved by contrast with the initial performance atlas. Therefore, the results indicate the effectiveness of the multi-objective optimization method.
Public libraries in times of Covid-19
Authors: Neyra Ezio
Published: May 2021

This article deals with the way in which, because of the pandemic caused by COVID-19, the National Library of Peru found ways to continue creating spaces, physical, virtual or remote, of access to information and culture. The article understands this right as a fundamental right of people, which must not be diminished and which, on the contrary, must be promoted even in times of emergency or pandemic.
Exit-shape effect of film holes at pressure side on trailing edge cutback film cooling characteristics
Authors: Pu Jian , Wang Jian-Hua , Song Wei , Wu Wei-Long
Published: May 2021

Pressure side (PS) cutback structure has been widely employed in modern turbine blade trailing edge (TE) cooling design. However, hot gas flows around lip of TE slot to generate an impingement to cutback, resulting in a rapid decay of film cooling effectiveness and hence thermal damage of entire TE. Proper angled-ejections upstream of TE can suppress the downstream effectiveness-decay. Therefore, in present work, five types of film-holes were designed to discuss the effect of exit-shape of film-hole on TE film cooling characteristics, inlet boundary layer profile, fluid-interactions, discharge behaviors and total pressure losses. The studied models included cylindrical-hole, common and laidback fan-shaped film-holes, and converging slot-holes with two different exit-to-inlet area ratios ( ARs). The solo cutback cooling was chosen as a reference. Thermal tests were conducted in a hot wind tunnel featuring a simplified TE test section by infrared thermal technique. Engine-similar mainstream-to-coolant temperature ratio of 2.0 was controlled. Comparisons of experimental results revealed that the converging slot-holes can obtain the highest film cooling effectiveness at TE region and overall cooling effectiveness at PS film-plate, but the slightest increase of total pressure losses. Flow measurements using Particle Image Velocimetry technique indicated the converging slot-holes can modify the inlet boundary layer profile, suppress effectively the impingement of mainstream and change the flow separation features at cutback. In addition, applying shaped-holes can effectively suppress the flow ingestion under low coolant amounts. However, relative to the exit-shape effect, the coolant amount plays a more important role on the aerodynamic and thermal characteristics of TE cooling.
What a social investment ‘litmus test’ must address: A response to Plavgo and Hemerijck
Authors: Parolin Zachary , Van Lancker Wim
Published: May 2021

Throughout the past decade, the notion that social policy should be applied as a tool to enhance the productive capacity of families, rather than to smooth consumption, has gained considerable traction under the moniker of social investment (SI). Against lingering critiques of the usefulness of SI research, Plavgo and Hemerijck primarily present bivariate, cross-sectional correlations of national-level outcomes to provide what they call a ‘social investment litmus test’. They conclude that SI policies are effective at achieving ‘positive returns in employment and poverty mitigation’. They also present evidence to suggest that ‘passive’ income supports are not effective at reducing poverty and promoting employment. Given the importance of their claims and the pre-eminence of SI in recent social policy literature, we feel compelled to respond and clarify that the authors’ findings do not support their conclusions. In doing so, we (1) review the central claims from the authors’ study, (2) provide evidence as to why the authors’ findings do not support their claims of a ‘social investment litmus test’, and (3) propose a path forward for a more critical assessment of the performance of policies labelled as SI.
William Taylor, Peninsular War surgeon and deputy inspector of hospitals at Waterloo
Authors: Cooper Max , Whiston Ben , Fernandes Carl
Published: May 2021

William Taylor was a British army surgeon remembered for his role as deputy inspector of hospitals (DIH) at Waterloo serving under Sir James Grant MD (1778–1852). No biography of Taylor exists beyond his entry in Drew's records of commissioned officers in the medical services of the British Army. Taylor appears to have been a Scotsman and is first noted as a hospital mate in 1795. He joined the 10th Royal Dragoons (Hussars from 1806) as an assistant surgeon in 1797. He is recorded at Guildford (1800) and Brighton (1803). He was made surgeon in August 1803. A further reference to Taylor, deduced from the title of “regimental surgeon,” is documented at Lewes, Sussex, in 1808. Taylor served with the 10th Hussars in the Peninsular and Challis’ roll call records his service at the Battles of Sahagún (21 December 1808) and Benavente (29 December 1808). Taylor was transferred to the staff on 20 June 1811 and made DIH on 25 July 1811. He was put on half-pay before being reinstated for Waterloo. Taylor retired on half-pay in February 1816 and died at Turnham Green on 9 January 1820. His Waterloo medal was sold in 2006.
God, Metaphysics, and the Discourse of Theology
Authors: Swain Scott R.
Published: May 2021

In chapter 4 of his book, God in Himself, Steven Duby grounds theology’s use of metaphysical language and concepts in Scripture’s prior usage of such language and concepts. The following article seeks to fortify Duby’s argument by showing how the discourse of the gospel subversively fulfills the quest of Greco-Roman philosophy and religion to ground divine worship in a proper understanding of the divine nature.
Unravelling Pathophysiology of Neurological and Psychiatric Complications of COVID-19 Using Brain Organoids
Authors: Ng Jing-Han , Sun Alfred , Je Hyunsoo Shawn , Tan Eng-King
Published: May 2021

Neuropsychiatric manifestations of coronavirus disease 2019 (COVID-19) have been increasingly recognized. However, the pathophysiology of COVID-19 in the central nervous system remains unclear. Brain organoid models derived from human pluripotent stem cells are potentially useful for the study of complex physiological and pathological processes associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as they recapitulate cellular heterogeneity and function of individual tissues. We identified brain organoid studies that provided insight into the neurotropic properties of SARS-CoV-2. While SARS-CoV-2 was able to infect neurons, the extent of neurotropism was relatively limited. Conversely, choroidal epithelial cells consistently showed a high susceptibility to SARS-CoV-2 infection. Brain organoid studies also elucidated potential mechanism for cellular entry, demonstrated viral replication, and highlighted downstream cellular effects of SARS-CoV-2 infection. Collectively, they suggest that the neuropsychiatric manifestations of COVID-19 may be contributed by both direct neuronal invasion and indirect consequences of neuroinflammation. The use of high throughput evaluation, patient-derived organoids, and advent of “assembloids” will provide a better understanding and functional characterization of the neuropsychiatric symptoms seen in post-acute COVID-19 syndrome. With advancement of organoid technology, brain organoids offer a promising tool for unravelling pathophysiologic clues and potential therapeutic options for neuropsychiatric complications of COVID-19.
Numerical and experimental investigations on sandwich panels made with eco-friendly components under low-velocity impact
Authors: Oliveira Pablo , Kilchert Sebastian , May Michael , Panzera Tulio , Scarpa Fabrizio , Hiermaier Stefan
Published: May 2021

A low-velocity impact characterisation of a sustainable sandwich panel based on upcycled bottle caps as circular honeycomb is conducted. The recycled core aims to develop an alternative route of reusing waste bottle caps disposed in landfills. Ecological alternatives to skin (recycled PET foil) and adhesive (bio-polyurethane) are also compared with classic components (aluminium skin and epoxy polymer). A low-cost reinforcement (cement particles) is also proposed to enhance the mechanical strength of the panel. The samples are tested at several levels of impact energy, according to the type of skin, to observe their effect on mechanical behaviour. Metal skins achieve higher impact loads and energy absorption compared to PET foil. The bio-adhesive leads to a similar or enhanced maximum impact load and energy absorption compared to the epoxy adhesive. Specific properties highlight the promising performance of the bio-based adhesive with aluminium skins, reaching increments of up to 378%. The cement increases the maximum load and reduces the duration of the impact event, leading to lower energy absorption. The unreinforced epoxy polymer shows a visible adhesive peeling off from aluminium skin, while particle inclusions lead to reduced overall delamination. Biopolymer exhibits marginal adhesive debonding and stable deformation, revealing a progressive failure. In general, PET samples show core shear failure due to rupture of the skin. Crack propagation in PET samples made with biopolymer adhesive is reduced at lower energy levels. The results evidence the promising application of bottle caps in a more sustainable honeycomb core to build eco-friendly structures.
Bending analysis of functionally graded sandwich plates using the refined finite strip method
Authors: Naghavi Mohammad , Sarrami-Foroushani Saeid , Azhari Fatemeh
Published: May 2021

In this study, static analysis of functionally graded (FG) sandwich plates is performed using the finite strip method based on the refined plate theory (RPT). Two types of common FG sandwich plates are considered. The first sandwich plate is composed of two FG material (FGM) face sheets and a homogeneous ceramic or metal core. The second one consists of two homogeneous fully metal and ceramic face sheets at the top and bottom, respectively, and a FGM core. Differential equations of FG sandwich plates are obtained using Hamilton's principle and stiffness and force matrices are formed using the finite strip method. The central deflection and the normal stress values are obtained for a sinusoidal loaded FG sandwich plate and the accuracy of the results are verified against those obtained from other theories such as the classical plate theory (CPT), the first-order shear deformation theory (FSDT), and the higher order shear deformation theory (HSDT). For the first time, this study presents a finite strip formulation in conjunction with the RPT to analyze FG Sandwich plates. While the proposed method is fast and simple, it is capable of modeling a variety of boundary conditions.
Covid-19 Preparedness and Response Capability: A Case Study of the Hanoi Primary Healthcare System
Authors: Van Hoang Minh , Tran Anh Tuan , Vu Trang Thu , Duong Tuan Kim
Published: May 2021

This study examined the coronavirus disease 2019 (COVID-19) preparedness and response of the health system (HS) in Hanoi, Vietnam, and identified enabling factors and barriers. This cross-sectional, mixed-methods study was conducted in 4 urban and peri-urban districts that included some wards with COVID-19-positive cases and some without. The US Centers for Disease Control and Prevention (CDC) analytical frameworks were used. Overall, 10% of health facilities (HFs) failed to fully implement COVID-19 risk determination; 8.8% failed to fully implement stronger community partnerships with local stakeholders to support public health (PH) preparedness; 35% and 2.5% incompletely implemented and did not implement evaluation of PH emergency operations, respectively; 10% did not identify communication channels to issue public information, alerts, warnings, and notifications; 25% incompletely implemented identification, development of guidance, and standards for information; 72.5% had good preventive and treatment collaboration; and 10% did not fully implement procedures for laboratory testing and reporting results. Enablers included sufficient infrastructure and equipment, strong leadership, and good cross-public-sector collaboration with police and military forces. Barriers included workforce constraints, overburdened and inconsistent reporting systems, inappropriate financial mechanisms, ambiguous health governance, and lack of private-sector engagement. Nonetheless, the HS preparedness and response were satisfactory, although further coordinated efforts in evaluation, coordination, communication, and volunteering remain necessary.
Reliability, construct and concurrent validity of a smartphone-based cognition test in multiple sclerosis
Authors: Lam KH , van Oirschot P , den Teuling B , Hulst HE , de Jong BA , Uitdehaag BMJ , de Groot V , Killestein J
Published: May 2021

Background:

Early detection and monitoring of cognitive dysfunction in multiple sclerosis (MS) may be enabled with smartphone-adapted tests that allow frequent measurements in the everyday environment.

Objectives:

The aim of this study was to determine the reliability, construct and concurrent validity of a smartphone-adapted Symbol Digit Modalities Test (sSDMT).

Methods:

During a 28-day follow-up, 102 patients with MS and 24 healthy controls (HC) used the MS sherpa® app to perform the sSDMT every 3 days on their own smartphone. Patients performed the Brief International Cognitive Assessment for MS at baseline. Test–retest reliability (intraclass correlation coefficients, ICC), construct validity (group analyses between cognitively impaired (CI), cognitively preserved (CP) and HC for differences) and concurrent validity (correlation coefficients) were assessed.

Results:

Patients with MS and HC completed an average of 23.2 ( SD = 10.0) and 18.3 ( SD = 10.2) sSDMT, respectively. sSDMT demonstrated high test–retest reliability (ICCs > 0.8) with a smallest detectable change of 7 points. sSDMT scores were different between CI patients, CP patients and HC (all ps < 0.05). sSDMT correlated modestly with the clinical SDMT (highest r = 0.690), verbal (highest r = 0.516) and visuospatial memory (highest r = 0.599).

Conclusion:

Self-administered smartphone-adapted SDMT scores were reliable and different between patients who were CI, CP and HC and demonstrated concurrent validity in assessing information processing speed.
Factors influencing recommendation of sub-Saharan Africa travel products: A Hong Kong–Kenya importance–performance analysis
Authors: Choy Monica WC , Kamoche Ken
Published: May 2021

This study adopts an exploratory sequential mixed method approach to examine perceptions of Hong Kong travel agencies on factors influencing recommendation of Kenya travel products. First, we conducted 32 in-depth interviews with outbound travel practitioners to collect qualitative exploratory data. Based on 39 identified attributes, we then developed a questionnaire well-adapted to the outbound travel practitioners and study purpose. With survey data of 239 travel agency practitioners, we then conducted an importance–performance analysis to rate and analyze six identified factors: Catering and Ancillary Services, Shopping, Tourist Transport Provision and Infrastructure, Hotel Accommodation, Institutional Support, and Destination Image. The results suggest that in a resource-constrained situation, priority should be given to enhancing Tourist Transport Provision and Infrastructure. This article provides a starting point for further research on strategic tourism marketing and management within the underresearched Asia–Africa nexus.
Volunteer tourism and gender: A feminist research agenda
Authors: Almela Marta Salvador , Calvet Núria Abellan
Published: May 2021

The popularity of volunteer tourism has increased since the 1990s, as have empirical studies and academic debates on the topic. Despite the broad topics covered – such as volunteers’ motivations, impacts on the local community, and the role of the sending organisations – approaches based on gender differences and feminism are still uncommon among critical tourism studies. Through a semi-systematic literature review, a variety of topics emerged, such as the gendered reproduction of colonial dynamics in voluntourism; volunteer tourists’ motivations, preferences and differences according to gender; and the expectations around traditional gender roles faced by volunteers, the local community and the sending organisations. This paper proposes a feminist research agenda where knowledge gaps and future lines of investigation are illustrated. Finally, feminist standpoint theory and its implications are discussed to offer a more in-depth exploration of the transformation of gender relationships in voluntourism experiences.
Machine Learning and transcritical sprays: A demonstration study of their potential in ECN Spray-A
Authors: Koukouvinis Phoevos , Rodriguez Carlos , Hwang Joonsik , Karathanassis Ioannis , Gavaises Manolis , Pickett Lyle
Published: May 2021

The present work investigates the application of Machine Learning and Artificial Neural Networks for tackling the complex issue of transcritical sprays, which are relevant to modern compression-ignition engines. Such conditions imply the departure of the classical thermodynamic perspective of ideal gas or incompressible liquid, necessitating the use of costly and elaborate thermodynamic closures to describe property variation and simulation methods. Machine Learning can assist in several ways in speeding up such calculations, either as a compact, trained thermodynamic model that can be coupled to the flow solver, or as a surrogate predictive tool of spray characteristics. In this work, such applications are demonstrated and their performance is assessed against more traditional approaches. Such applications involve the prediction of macroscopic spray characteristics, for example, the spray penetration over time, or the spray distribution in space and time, and predictions of fluid properties for the thermodynamic states encountered in such applications. Macroscopic characteristics can be adequately predicted by relatively simple network structures, involving just a hidden layer of 3–4 neurons, whereas prediction of thermodynamic states requires several layers of 5–20 neurons each. The results of integrating Artificial Neural Networks in transcritical sprays are rather promising; prediction of thermodynamic properties at pressures greater than 1bar has effectively zero error, yielding simulations indistinguishable from standard tabulated approaches with minimal overhead. When used as a regression method for time-histories either of spray characteristics or spray distributions, the results are within experimental uncertainty of similar experiments, not included in the training dataset.
Redistributions of luminance patterns on standard sky types
Authors: Kittler R , Darula S
Published: May 2021

There is insufficient current knowledge on the sky luminance patterns under ISO/CIE standard sky types in absolute luminance physical units in cd.m−2 and the resulting horizontal skylight illuminance in lux at the ground level. This paper explains research results and formulae to enable determination of computer applications which help in any location and time to calculate the distribution of luminance in any sky element on outdoor surfaces or within window solid angles that cause interior illuminance perception problems and, or discomfort glare.
Muslim narratives of desistance among Norwegian street criminals: Stories of reconciliation, purification and exclusion
Authors: Linge Marius
Published: May 2021

Stories about sin, regret and forgiveness are fundamental in Islam and other world religions. Islamic revivalism mediates a redemption narrative tailored to street criminals who want to break with the cycle of stigmatization, imprisonment and violence. Drawing on so-called conversion narratives, this article examines the repertoire of such stories among male street criminals in Norway who turn, or ‘return’, to Islam. I have identified three narrative types: reconciliation, purification and exclusion. I explore the content of these stories and the work they do for tellers and their audiences. Arguably, these narrative types represent forms of desistance that open up and restrict particular paths into Islam and out of street crime.
Emerging Career Realities during the Pandemic: What Does it Mean for Women’s Career Development?
Authors: Barhate Bhagyashree , Hirudayaraj Malar
Published: May 2021

The Problem

Women must often overcome inequitable workplace policies and unsupportive family for career development. Although remote work allows women the freedom to manage both work and family domains, stigma rooted in gender-stereotypes dissuades women from utilizing remote work policies and working flexibly.

The Solution

Working from home during the pandemic, has led to some erosion of the stigma attached to remote work. Through the work/family border theory, we explore the new realities for employees working remotely and its positive impact on women’s career development. We argue, organizations can promote women’s careers by capitalizing on employee’s positive experiences with remote work during the pandemic, and support women’s career development even after the pandemic.

The Stakeholders

Stakeholders for this article include colleagues, supervisors, partners, and spouses, who have the power to influence women’s career development, as well as HRD professionals and organizational leaders who implement policies and practices supporting women’s career development.
Electroacupuncture Plus Auricular Acupressure for Chemotherapy-Associated Insomnia in Breast Cancer Patients: A Pilot Randomized Controlled Trial
Authors: Zhang Jialing , Qin Zongshi , So Tsz Him , Chen Haiyong , Lam Wing Lok , Yam Lo Lo , Yan Chan Pui , Lao Lixing , Zhang Zhang-Jin
Published: May 2021

Objective:

Chemotherapy-associated insomnia is a highly prevalent complaint in breast cancer patients. This study was undertaken to evaluate the safety, feasibility, and preliminary effectiveness of electroacupuncture plus auricular acupressure for chemotherapy-associated insomnia in patients with breast cancer.

Materials and Methods:

In this randomized, wait-list controlled trial, thirty breast cancer patients under or post chemotherapy with insomnia were randomly allocated to the acupuncture or wait-list control group. Participants in acupuncture group received electroacupuncture plus auricular acupressure treatment twice weekly for 6 weeks. Participants in wait-list group received the same regimen of treatment after 6-week of waiting period. Insomnia Severity Index (ISI) served as the primary outcome measurement. Secondary outcomes were sleep parameters recorded with sleep diary and actiwatch, as well as the scores of Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B).

Results:

Twenty-eight participants completed study (13 in the acupuncture group vs 15 in the wait-list control group). At week-6 post-intervention, ISI score change from baseline showed significant between-group difference favoring acupuncture group of −2.9 points (95% CI: −5.2 to −0.6, P = .014). The acupuncture group showed greater improvements in the total sleep time recorded by sleep diary ( P = .026), scores of PSQI ( P = .012), HADS-depression ( P = .020), and FACT-B ( P < .001) compared with the control group. Improvements were maintained at week-10 and week-14 follow-ups.

Conclusions:

Acupuncture is safe, feasible, and effective for chemotherapy-associated insomnia in breast cancer patients under or post chemotherapy. A larger sample size randomized clinical trial is warranted to confirm the present findings.

Clinical Trial Registration:

NCT03762694.
User preference–based QoS-aware service function placement in IoT-Edge cloud
Authors: Mutichiro Briytone , Kim Younghan
Published: May 2021

In the Internet of Things-Edge cloud, service provision presents a challenge to operators to satisfy user service-level agreements while meeting service-specific quality-of-service requirements. This is because of inherent limitations in the Internet of Things-Edge in terms of resource infrastructure as well as the complexity of user requirements in terms of resource management in a heterogeneous environment like edge. An efficient solution to this problem is service orchestration and placement of service functions to meet user-specific requirements. This work aims to satisfy user quality of service through optimizing the user response time and cost by factoring in the workload variation on the edge infrastructure. We formulate the service function placement at the edge problem. We employ user service request patterns in terms of user preference and service selection probability to model service placement. Our framework proposal relies on mixed-integer linear programming and heuristic solutions. The main objective is to realize a reduced user response time at minimal overall cost while satisfying the user service requirements. For this, several parameters, and factors such as capacity, latency, workload, and cost constraints, are considered. The proposed solutions are evaluated based on different metrics and the obtained results show the gap between the heuristic user preference placement algorithm and the optimal solution to be minimal.
Incidence of Sexually Transmitted Infections After Initiating HIV Pre-Exposure Prophylaxis Among MSM in Southern Denmark
Authors: Azarnoosh Masoumeh , Johansen Isik Somuncu , Martin-Iguacel Raquel
Published: May 2021

Pre-exposure prophylaxis (PrEP) is a new preventive treatment for individuals at high-risk for HIV infection, such as men who has sex with men (MSM). Studies have confirmed the efficacy but concerns about the potential induction of risk compensation remains. We aimed to assess the incidence of sexually transmitted infections (STIs) after PrEP initiation as a proxy for sexual risk behavior.

This case-crossover study used data from medical records and from the Danish Microbiology Database from patients who initiated PrEP at the Region of Southern Denmark between 2017 and 2019. Poisson regression was used to assess STI incidence 6 months after PrEP initiation versus the 6 months before. To identify potential risk factors, we compared individuals with an increased STI incidence after PrEP initiation with those without, using logistic regression.

In total, 46 MSM initiated PrEP in the study period. We found a significant increase in the number of positive samples for STI after PrEP initiation (IRR 1.83; 95% CI [1.03, 3.26]) and a tendency for higher incidence of STI episodes (1.67; 95% CI [0.91, 3.13]). The increase was concentrated to a group of users, but no significant correlation was found between increasing incidence and the baseline factors examined.

We observed a degree of risk compensation after the implementation of PrEP among MSM, clustering to a group of users. Our results highlight the importance of frequent STI screening among MSM on PrEP as timely diagnosis could contribute to an overall decrease in STI incidence and incidence among MSM.
Susceptibility of strain-hardening cementitious composite to curing conditions as a retrofitting material for RC beams
Authors: Khan Mohammad Iqbal , Fares Galal , Abbas Yassir Mohammed , Abbass Wasim , Sial Sardar Umer
Published: May 2021

Strain-hardening cement-based composites (SHCC) have recently been developed as repair materials for the improvement of crack control and strength of flexural members. This work focuses on strengthening and flexural enhancement using SHCC layer in tensile regions of flexural members under three different curing conditions. The curing conditions simulate the effect of different environmental conditions prevailing in the central and coastal regions of the Arabian Peninsula on the properties of SHCC as a retrofitting material. In this investigation, beams with SHCC layer were compared to control beams. The beams with SHCC layer of 50-mm thickness were cast. The results revealed that the flexural behavior and the load-carrying capacity of the normal concrete beam specimens under hot and dry environmental conditions were significantly reduced, lowering the ductility of the section. However, compressive strength is comparatively unaffected. Similarly, the hot curing conditions have also led to a notable reduction in the loading capacity of the beam with SHCC layer with a slight effect on its stiffness. On the other hand, steam-curing conditions have shown improvement in load-carrying capacity and a reduction in section ductility of the beam with SHCC layer. It was found that the structural unit retrofitted with SHCC layer was a curing-regime dependent as the tensile and strain-hardening properties of SHCC are highly sensitive to the alteration in the cement hydration process. A normal curing regime was found effective and satisfying the practical, cost, and performance requirements. Accordingly, a normal curing regime could be implemented to retrofit reinforced concrete (RC) beams with SHCC layers as recommended in the study.
Lifestyle Medicine and Climate Change: The Role of Providers in Addressing a Public Health Challenge
Authors: Bernstein Adam , Katz David L.
Published: May 2021

Climate change threatens to undermine efforts to improve human health through lifestyle modification. Lifestyle medicine providers, however, may be well positioned to help patients create new healthful and climate-friendly habits, such as adopting a plant-based diet and limiting or eliminating car travel. Through each provider’s own example and patient engagement efforts, as well as though new technology and the collective action of the American College of Lifestyle Medicine, the broader lifestyle medicine community can play an outsized role in addressing climate change.
Preoperative embolization of jugular paraganglioma tumors using particles is safe and effective
Authors: Helal Ahmed , Vakharia Kunal , Brinjikji Waleed , Carlson Matthew L , Driscoll Colin LW , Van Gompel Jamie J , Link Michael J , Cloft Harry
Published: May 2021

Background

Jugular paragangliomas represent a surgical challenge due to their vascularity and proximity to vital neurovascular structures. Preoperative embolization aids in reducing intraoperative blood loss, transfusion requirements, and improves surgical visualization. Several embolization agents have been used.

Objective

The aim of this study is to evaluate the safety and efficacy of PVA in pre-operative embolization of jugular paragangliomas.

Methods

A retrospective review of all patients who underwent jugular paraganglioma resection with pre-operative embolization between 2000 and 2020 was performed. Pre-operative data including baseline patient and tumor characteristics were documented. Outcomes of preoperative embolization including extent of devascularization and post-embolization complications were recorded. Early and long-term postoperative outcomes were reported.

Results

Twenty-nine patients met study criteria with a median age of 38 years. Average tumor size was 3.4±1.8 cm. The most commonly encountered arterial feeder was the ascending pharyngeal artery followed by the posterior auricular artery. More than 50% reduction in tumor blush was achieved in 25 patients (86.2%). None of the patients experienced new or worsening cranial neuropathy following embolization. Gross total or Near total resection was achieved in 13 patients (44.8%). A STR or NTR was chosen in these patients to preserve cranial nerve function or large vessel integrity. Average intraoperative estimated blood loss was 888 ml, 9 patients (31%) required intra-operative transfusion of blood products. Extent of resection and post-operative complications did not correlate with extent of devascularization.

Conclusion

Pre-operative embolization of jugular paraganglioma tumors with PVA particles is an effective strategy with a high safety profile.
Online path planning for unmanned aerial vehicles to maximize instantaneous information
Authors: Ergezer Halit , Leblebicioğlu Kemal
Published: May 2021

In this article, an online path planning algorithm for multiple unmanned aerial vehicles (UAVs) has been proposed. The aim is to gather information from target areas (desired regions) while avoiding forbidden regions in a fixed time window starting from the present time. Vehicles should not violate forbidden zones during a mission. Additionally, the significance and reliability of the information collected about a target are assumed to decrease with time. The proposed solution finds each vehicle’s path by solving an optimization problem over a planning horizon while obeying specific rules. The basic structure in our solution is the centralized task assignment problem, and it produces near-optimal solutions. The solution can handle moving, pop-up targets, and UAV loss. It is a complicated optimization problem, and its solution is to be produced in a very short time. To simplify the optimization problem and obtain the solution in nearly real time, we have developed some rules. Among these rules, there is one that involves the kinematic constraints in the construction of paths. There is another which tackles the real-time decision-making problem using heuristics imitating human-like intelligence. Simulations are realized in MATLAB environment. The planning algorithm has been tested on various scenarios, and the results are presented.
Global citizenship and the global citizen/consumer: Perspectives from practitioners in development NGOs in Portugal
Authors: Coelho Dalila P , Caramelo João , Menezes Isabel
Published: May 2021

This paper makes an empirical contribution to the debate about the pluralism of global citizenship. This is considered a crucial aspect for research, not only because charity and social justice standpoints coexist, but also in the light of growing examples of neoliberal understandings about global citizenship education and the global citizen. Informed by critical and postcolonial thinking and with a special focus on Andreotti’s discursive orientations, this paper analyses discourses of practitioners of global citizenship education who work in development NGOs in Portugal. Findings suggest that humanist views are predominant, although intertwined with neoliberal and postcolonial perspectives. They also point to an archetypical vision of the global citizen and a prevalence of the responsible citizen-consumer as an agent of social change.
“Small steps, or giant leaps?” Comparing game demands of U23, U18, and U16 English academy soccer and their associations with speed and endurance
Authors: Smalley Ben , Bishop Chris , Maloney Sean J
Published: May 2021

The current study aimed to compare locomotive outputs across English U16, U18 and U23 academy soccer and investigate possible relationships with neuromuscular and aerobic capacities. Participants included 46 outfield players from an English Category Two soccer academy. Global positioning system (18 Hz) data were utilised to analyse locomotive outputs across twenty eleven-a-side matches in each age group. Maximal sprinting speed (MSS) and aerobic speed (MAS) were assessed at the beginning of the season. Absolute total distance (TD), high-speed running (HSR), acceleration and deceleration workloads were higher in U18’s and U23’s vs. U16’s (g = 1.09–2.58; p < 0.05), and absolute sprinting distances were higher in U23’s vs. U16’s (g = 0.96; p < 0.05). In addition, relative HSR outputs were higher in U23’s vs. U18’s (g = 1.84–2.07; p < 0.05). Across the whole cohort, players’ MSS was positively associated with absolute HSR and sprinting distances (ρ = 0.53–0.79; p < 0.05) but not with relative parameters. MAS was positively associated with total distance, decelerations, and both absolute and relative HSR outputs (ρ = 0.33–0.56; p < 0.05). Overall, absolute locomotive outputs were significantly higher in U23’s and U18’s vs. U16’s. Locomotive outputs were also associated with maximal sprinting and aerobic speeds. Thus, training programmes should be tailored to competition demands to optimally prepare each age group for competition and reflect the increasing demands of each level of competition. Further, improving physical fitness (speed and endurance) is likely to drive greater outputs in competition.
Assessing autonomous ship navigation using bridge simulators enhanced by cycle-consistent adversarial networks
Authors: Brandsæter Andreas , Osen Ottar L
Published: May 2021

The advent of artificial intelligence and deep learning has provided sophisticated functionality for sensor fusion and object detection and classification which have accelerated the development of highly automated and autonomous ships as well as decision support systems for maritime navigation. It is, however, challenging to assess how the implementation of these systems affects the safety of ship operation. We propose to utilize marine training simulators to conduct controlled, repeated experiments allowing us to compare and assess how functionality for autonomous navigation and decision support affects navigation performance and safety. However, although marine training simulators are realistic to human navigators, it cannot be assumed that the simulators are sufficiently realistic for testing the object detection and classification functionality, and hence this functionality cannot be directly implemented in the simulators. We propose to overcome this challenge by utilizing Cycle-Consistent Adversarial Networks (Cycle-GANs) to transform the simulator data before object detection and classification is performed. Once object detection and classification are completed, the result is transferred back to the simulator environment. Based on this result, decision support functionality with realistic accuracy and robustness can be presented and autonomous ships can make decisions and navigate in the simulator environment.