bluuebunny/crossref_metadata_2025 huggingface dataset:
Large Program Cost Estimating: Nuanced Implementation Assumptions Make Non-Nuanced Impacts
Authors: Galante Giuliana , Bruzzone Anthony
Published: July 2020

Transformative transportation programs often comprise discrete complex projects to deliver an overall vision. Even with substantial benefits, the cost, complexity, and risk of the entire program often creates a “sticker-shock” reaction that dominates public discussion. When escalation is factored into the program, costs can appear unreasonable or not financeable. In this scenario, benefits and costs are never discussed in a parallel (and equal) basis. If this leads to more delay, escalation creates an ever-more expensive output, leading to ever less support for the transformative program.

Aviation and highway industries often deliver their programs as discrete projects of independent utility (for example, an additional lane of highway, or a new airport terminal). Rail and bus transit infrastructure projects, in contrast, are usually presented as the entire program (new vehicles, infrastructure, stations, facilities) even if some aspects of the program could be presented as a discrete project. By focusing on the program, rather than projects, transit proposals present stretch delivery dates and feature mountains of escalated costs. This paper uses the recent Boston North-South Rail Link (NSRL) Reassessment (Massachusetts, U.S.) as a case study. An examination is made of the potential benefits of packaging the program to advance independent but complementary projects. The expectation is that this approach reduces escalation, resulting in overall program cost savings in real dollars. While further research to validate this premise is suggested, the concepts of the paper can be used to reassess traditional megaproject schedule and delivery assumptions, reducing the identified cost escalation over the years.
Determining Optimum Transit Signal Priority Implementation Locations on a Network
Authors: Bayrak Murat , Guler S. Ilgin
Published: July 2020

Transit signal priority (TSP) can be used to improve bus operations at intersections. However, implementing TSP can often increase the delay of non-transit modes. Therefore, it is necessary to evaluate the effects of TSP both on car and bus operations to determine optimal locations to equip with TSP to improve network operations. To do so, the link transmission model is used to evaluate the travel times of both cars and buses on the network while accounting for dynamic queuing and queue spillover. This method is then used to evaluate different combinations of locations for TSP implementation and to determine the optimal configuration that can minimize the total travel time of network users, including bus and car passengers. The sensitivity of the proposed algorithm to demand level, changes in transit network, implementation strategy, and solution method are also evaluated. For all tested scenarios, the TSP configurations found to be optimum achieve a significant reduction of total bus passenger travel time while creating minimal effect on total car travel time. The results reveal that in general, not all intersections should be equipped with TSP, and intersections that carry high demand within a network are promising locations for TSP implementation to reduce the total travel time of network users. Additionally, it is found that the total travel time of network users can be further decreased by only activating TSP for buses with more than a certain number of on-board passengers.
On thinking: Open letter to Hannah Arendt
Authors: Heller Agnes , Roberts David , Beilharz Peter
Published: July 2020

Thesis Eleven is honoured to be able to publish this text by our late friend and mentor Agnes Heller. It was secured in the period before her recent death, and is published now posthumously in her memory. Echoing her earlier text written as an Imaginary Preface to Arendt’s Totalitarianism, it responds to themes in the later text, The Life of the Mind. These were among the most eminent of the minds referred to later as Women in Dark Times. Their connection was not only institutional, via the New School, but represented a deep and ongoing affinity and critical engagement in political and philosophical terms. The imaginary letter arcs around issues and questions indicated by Cicero, Kant, Heidegger and Wittgenstein, including matters of republicanism, rhetoric and the question of thinking. Best of all, it shows Agnes Heller at work, at her best: it shows her thinking. Like Arendt, she offers inspiration, provocation, through thinking.
Potential utilization of commercial waste in Jakarta as alternative fuel by cement industry
Authors: Kusuma Muhammad Angga , Nassour Abdallah , Nelles Michael , Ragossnig Arne
Published: July 2020

As the capital city of Indonesia, Jakarta had a population of 10.2 million in 2015 that generated 6200 metric tonnes (Mt) day−1 of municipal waste in the 2017–2019 period. In the composition of the waste, as much as 9% is contributed by the commercial sector. This research focuses on five shopping areas in Jakarta (commercial areas (CAs)). The five CAs produce 110 Mt of waste per day and 79% of them are disposed of in landfills. 95% of the waste is a combustible fraction which can be used as an alternative fuel by the cement industry because the fraction has a low heating value of around 24 MJ kg−1. It is estimated that in one year, the CAs can produce about 34,500 Mt of alternative fuel with 820 TJ of energy. Approximately, the resulting energy savings are 2.6% which is equal to approximately 35,500 Mt of coal. In addition, the utilization of alternative fuel can reduce carbon dioxide emissions by 1.7% or 50,000 Mt.
The Small-Group Ministry Movement of the Last Four Decades
Authors: Atkinson Harley , Rose Joshua
Published: July 2020

The modern small-group movement emerged in the 1960s as small groups slowly began to replace the Sunday school as the preferred context for doing Christian formation in the local church. This article summarizes the development of the small-group ministry movement of the last four decades, addresses the current state of small groups in the church, and concludes with brief comments on the future of small groups in the church.
Innovation in the Canadian health system
Authors: Noseworthy Tom
Published: July 2020

The essence of human ingenuity is creation and novel ideas that result in collective and desired impact. Indeed, innovation is foundational to life in a changing world. In no situation today is this more relevant than in health systems, whether they be challenged to maintain population health, threatened by impending disasters, or expected to respond to the ever-expansive demand and inexorable course of those with chronic diseases. This article discusses health system innovation and its trajectory. It focuses on clinical innovation as a means of achieving high-level performance within a learning health system model. Examples of innovation in Canada are used to illustrate successful approaches worthy of broader consideration and pan-Canadian attention.
Recognizing Excellence in Knowledge Dissemination: The Nursing Journal Hall of Fame
Authors: Nicoll Leslie H.
Published: July 2020

Nursing knowledge and innovations are disseminated primarily through peer-reviewed publications in scholarly journals. At the present time, there are approximately 250 journals in the profession of nursing, representing all specialties and an international, global focus. Of this group, 25 have been honored by induction into the Nursing Journal Hall of Fame, which was established by the International Academy of Nursing Editors in 2018. This article introduces the Hall of Fame and the journals that have been inducted to date. Hall of Fame journals have a sustained publication history of 50 years or more and represent excellence in nursing through the articles published and journal editorial leadership. Studying the history of this group of journals reveals trends within different specialties as well as the profession of nursing overall. For many of the journals, there were particular editors who were visionary and transformative. Knowing their stories is important for the historical record of nursing publication. Celebrating nursing journal history through the Hall of Fame and understanding the unique leadership role of nursing editors, past and present, is an important and fitting tribute to nursing knowledge during the Year of the Nurse and Nurse Midwife in 2020.
Portable Chest Radiography Through Glass During COVID-19 Pandemic—Initial Experience in a Tertiary Care Center
Authors: Rai Archana , Ditkofsky Noah , Hunt Bryce , Dubrawski Margaret , Deva Djeven , Mathur Shobhit
Published: July 2020

Background:

Portable chest radiograph for COVID-19 positive patients and persons under investigation can be acquired through glass doors or walls of isolation rooms to limit exposure to the pathogen and conserve resources.

Purpose:

To report our initial experience with acquiring portable chest radiographs through glass doors of isolation rooms.

Methods:

Only 1 of 2 radiology technologist team members donned personal protective equipment and stayed inside the isolation room, while the second technologist and the radiography unit remained outside during the procedure. First hundred radiographs acquired through glass at the emergency department of our institute formed the “through glass radiograph” group. Hundred consecutive portable chest radiographs performed in a conventional manner formed the “conventional radiograph” group for comparison. Imaging database and feedback from operations leader were used to identify occurrences of a failed procedure. Suggestion of repeating the study and comments related to quality of the study were recorded from the reports of the staff radiologist.

Results:

There was no instance of failed acquisition, nondiagnostic examination, or suggestion of repetition in both groups. No significant difference in the number of reports with quality related remarks ( P > .05) was found between the 2 groups. Radiography through glass doors was associated with increased suboptimal positioning related remarks in radiology reports ( P < .05). No significant association was identified among other comments about image quality.

Conclusion:

Our initial clinical experience suggests that the acquisition of portable chest radiographs through the glass doors of isolation rooms is technically feasible and results in diagnostic quality studies.
Making high quality care an organisational strategy: Results of a longitudinal mixed methods study in Australian hospitals
Authors: Balding Cathy , Leggat Sandra
Published: July 2020

Significant resources are spent on monitoring and improving the quality and safety of hospital care; however, evidence suggests that this investment is achieving disproportionately limited results. Accreditation and expectations of funders have focused hospital service quality management on compliance, with an over emphasis on the ‘control’ aspect of Juran’s Quality Trilogy. This study compared the impact of the implementation of a strategic quality management system with existing compliance-focused quality management systems in a sample of Australian hospitals. Through action research, mixed methods data were tracked and compared implementation progress and outcomes between four experimental and four control hospitals from 2015 to 2017. While three years was not enough time to observe quality changes resulting from the implementation, three experimental hospitals made high quality care a strategic priority for their organisation and developed organisation-wide processes to achieve it. These hospitals demonstrated that including a strategic quality planning component in quality system design and implementation, as advocated by Juran but absent in many hospital quality systems, was a positive lever for staff commitment to delivering consistently high quality care.
Performance evaluation of simple radial fin design for single phase liquid flow in microchannel heat sink
Authors: Qidwai Mohammad Owais , Hasan Mohammad Muzaffarul , Khan Noor Zaman , Ariz Mohd
Published: July 2020

This paper numerically investigates heat transfer performance and characteristics in single-phase liquid cooling in microchannels with radial arrangement of fins having inherent symmetry to mitigate the problem of flow maldistribution. The effects of number of fins, channel depth and flow rate on Nusselt number and substrate temperature are obtained. The relative thermal performance and overall efficiency are compared with respect to two different base cases having minimum number of channels and minimum channel depth. For increasing values of flow rate and channel depth, contradicting effects in terms of temperature uniformity are obtained. By varying only number of channels, has no significance until it is coupled with channel depth, which suggests that aspect ratio of inlet cross-sectional area should be considered as a significant factor which is capable of generating secondary flows in single phase liquid flows. The overall efficiency of case with 70 number of channels, 200 µm depth and 15 ml/min is found to be highest.
Multi-injection turbine housing for turbine performance improvement: A numerical and experimental analysis
Authors: Liu Hao , Liu Zheng , Romagnoli Alessandro , Martinez-Botas Ricardo F , Rajoo Srithar , Padzillah Muhamad H
Published: July 2020

Secondary flow injection is a way which allows for the efficiency of a turbomachine to be increased further, after blade design optimizations have already been performed. In this paper, a novel method for improving turbine performance using secondary flow injection through an injection slot over the turbine shroud is investigated. Numerical simulations were conducted on a mixed-flow turbocharger turbine to test the effectiveness of secondary flow injection. An optimization was performed at peak efficiency at 50% turbine design speed to determine the injection setup which gives the highest turbine efficiency. Single-passage simulations for the optimized point showed an increase in efficiency of 2.6 percentage points compared to the baseline turbine. Flow analysis shows that injection partially blocks the flow passage near the blade tip, forcing turbine passage flow to migrate towards the hub. This apparently weakens the hub suction side separation vortex and reduces entropy generation from the vortex. Experimental testing was conducted and used for validation of full-stage turbine computational fluid dynamics (CFD) simulation results. Full-stage turbine CFD results show that with inlet nozzle vanes, secondary flow injection did not result in any visible improvement in the internal flow field and entropy generation, but overall efficiency can be improved by up to 2.28 percentage points at a velocity ratio of 0.75. Without nozzle vanes, however, secondary flow injection resulted in an efficiency improvement of up to 6.79 percentage points by weakening the hub suction side separation vortex and reducing its associated losses. Injection on the vaneless turbine configuration also resulted in a roughly 2 percentage point improvement in the peak turbine efficiency over the vaned turbine configuration. This might be due to more flow energy available to be extracted by the rotor from reduced losses due to the lack of nozzle vanes.
Exploring the topic structure and evolution of associations in information behavior research through co-word analysis
Authors: Deng Shengli , Xia Sudi , Hu Jiming , Li Hongxiu , Liu Yong
Published: July 2020

This study aims to reveal the distribution of topics, and the associations among them, in information behavior research from 2009 to 2018. Working with a collection of 6744 publications from the Web of Science database, co-word analysis is used to investigate the overall topic structure, the associations among the topics, and their evolution in different years, which is supplemented by visualization with science maps. The results uncovered an unbalanced distribution of topics, and that the topics cluster into six communities representing subdivisions of this field: information behavior in patient-centered studies; information interaction in the digital environment; information literacy in health and academic contexts; health literacy on the Internet; information behavior in child-centered studies; and information behavior in medical informatics. The findings supplement and provide refinements to work on the state of this field, and help researchers obtain an overview of the past decade to guide their future work.
CD40 and CD72 expression and prognostic values among children with systemic lupus erythematosus: a case–control study
Authors: Asmiyou Abtisam , Bakr Ashraf M , Shahin Doaa A , Wahba Yahya
Published: July 2020

Systemic lupus erythematosus (SLE) is a chronic disease with proven interactions between immune system components, including both humoral- and cell-mediated immunity, as well as co-stimulatory and inhibitory molecules such as CD40 and CD72. Here, we investigated CD40 and CD72 expression on B cells of SLE children and assessed their prognostic values. We conducted a preliminary case–control study in Mansoura University Children's Hospital, Egypt from September 2018 to January 2020 including 27 SLE children and 27 healthy controls. We assessed cases during initial flare and after remission. Flow cytometry analysis was carried out for all participants for CD40 and CD72 expression of B cells. During flare, SLE cases had statistically significant higher CD40 and lower CD72 expression in comparison with controls ( p < 0.001). After remission, the number of CD40+ B cells significantly decreased ( p < 0.001), while the number of CD72+ B cells significantly increased ( p < 0.001) in comparison with flare. We reported non-significant positive correlations between CD40 expression and SLE Disease Activity Index (SLEDAI; p = 0.347 during flare and p = 0.653 after remission) and negative correlations between CD72 expression and SLEDAI ( p = 0.34 during flare and p = 0.044 after remission). No significant differences were detected between renal histopathology classes with regard to CDs expression on B cells ( p = 0.45 for CD40 and p = 0.63 for CD72). In conclusion, CD40+ B cells and CD72+ B cells could be considered as markers of paediatric SLE flare and remission, respectively.
Reference-based pattern-mixture models for analysis of longitudinal binary data
Authors: Lu Kaifeng
Published: July 2020

Pattern-mixture model (PMM)-based controlled imputations have become a popular tool to assess the sensitivity of primary analysis inference to different post-dropout assumptions or to estimate treatment effectiveness. The methodology is well established for continuous responses but less well established for binary responses. In this study, we formulate the copy-reference and jump-to-reference PMMs for longitudinal binary data using a multivariate probit model with latent variables. We discuss the maximum likelihood, Bayesian, and multiple imputation methods for estimating the treatment effect under the specified PMM. Simulation studies are conducted to evaluate the performance of these methods. These methods are also illustrated using data from a bipolar mania study.
Perceived susceptibility to developing cancer and screening for colorectal and prostate cancer: A longitudinal analysis of Alberta’s Tomorrow Project
Authors: Gilfoyle Meghan , Chaurasia Ashok , Garcia John , Oremus Mark
Published: July 2020

Introduction

To assess the association between perceived susceptibility of developing cancer and being screened via sigmoidoscopy/colonoscopy and prostate-specific antigen, respectively.

Methods

Participants aged 35–69, who resided in Alberta, Canada, were enrolled into the study between 2000 and 2008. We used general linear mixed models, adjusted for age, marital status, work status, education, family history and place of residence, to explore the association.

Results

Perceived susceptibility of developing cancer was associated with both screening tests at baseline and a maximum of 14-year follow-up: (i) colorectal cancer screening – adjusted odds ratios were 1.97 (95% CI = 1.52–2.55) per one-unit increase in participants' personal belief in susceptibility to cancer, and 1.03 (95% CI = 1.00–1.04) per one-percent increase in participants’ estimate of their own chance of developing cancer; (ii) prostate cancer screening – adjusted odds ratios were 1.36 times greater (95% CI = 1.07–1.72), and 1.02 times higher (95% CI = 1.01–1.03), for each respective perceived susceptibility measure.

Conclusion

Health promotion can focus on targeting and heightening personal perceived susceptibility of developing cancer in jurisdictions with low screening rates for colorectal or prostate cancer.
Effects of a Youth-Engaging Intervention on Illegal Sales by Tobacco Retailers Near Schools in Thailand
Authors: Phetphum Chakkraphan , Noosorn Narongsak
Published: July 2020

This study assessed the effects of youth-engaging interventions on illegal sales by tobacco retailers near schools in Thailand. The youth were educated and engaged in the planning and implementation of a program to reduce tobacco retailers’ illegal sales in the Uttaradit Municipality, Thailand. Intervention components included community education, retailer education, and direct approaches to tobacco retailers. A study included a pretest-posttest control group. The 6-month intervention focused on 114 tobacco retailers. The posttest showed that the percentage of tobacco retailers violating the retail law decreased: tobacco product displays at points of sales decreased from 67.5% to 23.7%, single cigarette sales declined from 71.1% to 36.0%, and tobacco sales to minors decreased from 74.6% to 5.3%. Asking for identification or the buyer’s age before selling tobacco increased from 33.3% to 78.1%. The intervention led to a significant reduction in the violation of tobacco retail laws near schools.
Social capital networks in sports spectatorship and participation
Authors: Gemar Adam
Published: July 2020

The relationship between social capital and sport has been an increasing focus of scholarly literature in recent decades. However, very few of these studies consider social capital alongside theories of cultural consumption. Even fewer seek to assess the place of social capital in sports spectatorship. Taking primarily a Bourdieusian and neo-Bourdieusian theoretical approach, this study seeks to rectify these gaps by analysing three key components of social capital – social network size, social network prestige and social network variety – and how they relate to patterns of sports spectatorship and participation. Results indicate that the type of social capital that is most predictive seems to rely heavily upon the nature of the cleavages between cultural patterns of sports engagement. While the size of social network seems most universally applicable to predict sports engagement generally, network variety also seems to be highly applicable to the most omnivorous engagement profiles. Finally, network prestige appears applicable to some highbrow profiles of sports engagement.
The influence of music training on motoric inhibition in German preschool children
Authors: Degé Franziska , Patscheke Hanne , Schwarzer Gudrun
Published: July 2020

The aim of our experiment was to investigate the effect of a music training program on motoric inhibition in German preschoolers. Studies have shown that in children, music lessons and inhibition are associated, and that music training might have the potential to improve inhibition. Improving executive functions is particularly useful in young children as they are highly relevant for success in school. We conducted an intervention study to investigate the potential impact of music training on motoric inhibition, establish causality, and demonstrate the usefulness of music training to enhance motoric inhibition. In particular, we compared the effects of two interventions, one involving music and the other sport, on motoric inhibition. In total, 25 preschoolers (15 girls, 10 boys) were randomly assigned to the two training programs. Preschoolers were trained three times per week for 20 minutes over a period of 14 weeks. Inhibition was assessed before and after the 14-week intervention period. We used the “statue” subtest of the NEPSY II, a developmental neuropsychological assessment for children, to measure inhibition. Analysis of variance with repeated measures revealed a significant interaction between intervention type (music vs. sport) and time (pre- vs. post-test). The music training, but not the sports training program, led to improved inhibition. Our findings suggest that a music training program can enhance inhibition in preschoolers.
Organizational Policies and Personnel Factors That Are Incentives for and Challenges to Collaboration as Identified by Statewide Transition Supervisors
Authors: Oertle Kathleen Marie , Bobroff Sheryl , Sax Caren L.
Published: July 2020

In the United States, the Individuals With Disabilities Education Improvement Act (2004) and the Rehabilitation Act of 1973 as amended in the Workforce Innovation and Opportunity Act (2014) require special educators and vocational rehabilitation counselors to plan and coordinate transition services for students with disabilities. Regardless of the legislative mandates, major challenges remain for effective collaboration. The purpose of this study was to investigate statewide special education and vocational rehabilitation counseling transition supervisors’ insights on the policies that promote or present barriers to effective collaboration. Forty-eight statewide transition supervisors wrote a total of 175 comments that were analyzed using inductive content analysis. Organizational and personnel factors were identified, and specific examples of noteworthy indicators of collaboration are presented. Recommendations are offered to address the lack of policies and incentives for transition collaboration.
The Ontario Disability Support Program Work Exit Process: Parallels to a Hostage Negotiation
Authors: Lahey Pamela , Kirsh Bonnie , Tompa Emile , MacDermid Joy , Gewurtz Rebecca E.
Published: July 2020

There is a lack of empirical data on the experiences of people with mental illness (PMI) who transition from welfare to work and how policy programs are designed to facilitate this outcome. We explore the factors that facilitate or hinder PMI from exiting disability income support programs in Ontario, Canada. Drawing on a grounded theory approach, we examine the process of exiting the Ontario Disability Support Program (ODSP). Data were collected from semi-structured interviews with current and former recipients with mental illness, service providers who support current and former recipients, and ministry staff. A metaphor for the work exit process emerged with four embedded themes: (a) picking yourself back up, (b) breaking the rules to get ahead, (c) stabilizing illness for employment success, and (d) displaying resiliency and resourcefulness for successful exits. The main finding is that system supports are not the determining factors in a successful transition. Rather, participants describe how recipients exit for employment by leveraging personal resources to successfully transition off income support benefits. A system redesign is needed to address the inherent tension between social and health programs if the policy intent is to promote successful welfare-to-work transitions for PMI.
Axicabtagene Ciloleucel: Clinical Data for the Use of CAR T-cell Therapy in Relapsed and Refractory Large B-cell Lymphoma
Authors: Halford Zachery , Anderson Mary Kate , Bennett Lunawati L.
Published: July 2020

Objective

To evaluate the literature for axicabtagene ciloleucel (axi-cel), a first-in-class chimeric antigen receptor (CAR) T-cell therapy, in the treatment of relapsed/refractory (r/r) large B-cell lymphoma (LBCL).

Data Sources

We conducted a PubMed (inception to June 22, 2020) and ClinicalTrials.gov search using the following terms: CD19, chimeric antigen receptor, and lymphoma.

Study Selection and Data Extraction

All retrospective and prospective studies evaluating the use of axi-cel in LBCL were reviewed.

Data Synthesis

In the pivotal ZUMA-1 trial, axi-cel exhibited unprecedented overall and complete response rates of 83% and 58%, respectively. With a median follow-up of 27.1 months, 39% of patients had ongoing responses. Furthermore, postmarketing retrospective analyses found similar response rates in a more clinically diverse LBCL patient population. Novel CAR T-cell therapy elicits unique and potentially life-threatening toxicities that include cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS). Studies reported grade ≥3 CRS in 7% to 14% of patients and grade ≥3 ICANS in 31% to 55% of patients.

Relevance to Patient Care and Clinical Practice

Axi-cel was the first US Food and Drug Administration–approved genetically engineered autologous CAR T-cell agent in r/r LBCL, representing an important milestone and paradigm shift in cancer treatment. Adoptive T-cell immunotherapy is a breakthrough treatment modality requiring careful patient selection, multidisciplinary collaboration, comprehensive patient counseling, and expert training to ensure optimal treatment.

Conclusions

The initial and ongoing results with axi-cel are encouraging, but long-term safety and efficacy data are lacking. Additional studies are required to identify axi-cel’s ideal place in LBCL therapy.
Effectiveness of Quetiapine as a Sedative Adjunct in Mechanically Ventilated Adults Without Delirium
Authors: Ohman Kelsey L. , Schultheis Jennifer M. , Kram Shawn J. , Cox Christopher E. , Gilstrap Daniel L. , Yang Zidanyue , Kram Bridgette L.
Published: July 2020

Background:

Quetiapine is an atypical antipsychotic that is commonly used in the Intensive Care Unit (ICU). The utility of quetiapine as a sedative adjunct has not yet been evaluated, but has been described previously in studies evaluating quetiapine for delirium or delirium prophylaxis.

Objective:

To determine if adjunctive use of quetiapine reduces sedative dosage requirements among mechanically ventilated adults without delirium.

Methods:

This retrospective intrapatient comparator study included all mechanically ventilated adults admitted to a medical ICU who received quetiapine between July 1, 2013, and July 1, 2018. The primary outcome was the change in sedative dosage requirements over 24 hours following quetiapine initiation. Secondary outcomes included change in sedative dosage requirements 48 hours postquetiapine initiation, opioid dosage requirements 24 hours postquetiapine initiation, percent time at goal for both pain and sedation scores, depth of sedation, and QTc.

Results:

A total of 57 patients were included in the study cohort. There was no significant difference in 24-hour cumulative doses of propofol ( P = 0.10), dexmedetomidine ( P = 0.14), or benzodiazepines ( P = 0.14). During the 48-hour treatment period, there was a significant increase in dexmedetomidine requirements ( P = 0.03). There were no differences in 24-hour opioid dosage requirements, percent time at goal pain or sedation scores, depth of sedation, or QTc following quetiapine initiation.

Conclusion and Relevance:

Adjunctive use of quetiapine was not associated with a significant reduction in sedative dosage requirements 24 or 48 hours following initiation among mechanically ventilated adults without delirium.
Hydroxychloroquine in COVID-19 Therapy: Protection Versus Proarrhythmia
Authors: Stremmel Christopher , Kellnar Antonia , Massberg Steffen , Kääb Stefan
Published: July 2020

In recent months, the new coronavirus SARS-CoV-2 has emerged as a worldwide threat with about 4.2 million confirmed cases and almost 300 000 deaths. Its major clinical presentation is characterized by respiratory symptoms ranging from mild cough to serve pneumonia with fever and potentially even death. Until today, there is no known medication to improve clinical symptoms or even prevent or fight the infection. The search for a useful vaccination is ongoing and it will probably not be available before the end of 2020. In this review, we highlight hydroxychloroquine (HCQ) as a potential agent to prevent coronavirus disease 2019 (COVID-19) and reduce as well as shorten clinical symptoms. Moreover, it might serve as a potential post-exposition prophylaxis. Although it has been used in the treatment of rheumatoid arthritis, discoid or systemic lupus erythematosus, and malaria prophylaxis and therapy for decades, knowledge on HCQ as a potential treatment for COVID-19 is limited and multiple clinical trials have just emerged. Especially, rare HCQ side effects which were of minor importance for use in selected indications might gain major relevance with population-wide application. These rare side effects include retinopathy and—even more important—QT prolongation leading to sudden cardiac death by malignant arrhythmias.
Nurse Practitioner Role and Practice Environment in Primary and in Nonprimary Care in California
Authors: Winter Shira , Chapman Susan A. , Chan Garrett K. , Duderstadt Karen , Spetz Joanne
Published: July 2020

Between 2008 and 2016, there was an increase in nurse practitioners in specialty care. This study explores some differences in role and practice environment between primary care and nonprimary care nurse practitioners in the domains of time spent on activities, barriers to providing care, working to scope of practice, full skill utilization, and satisfaction. This cross-sectional quantitative study, based on data from the 2017 Survey of California Nurse Practitioners and Certified Nurse Midwives, found that nurse practitioners in nonprimary care practices have lower odds of reporting time as a barrier to practice, lower odds of reporting practice to full scope, and higher odds of reporting a hierarchical or supervisory relationship with the physician. Future exploration of these differences may shed light on ways to promote nonprimary care practice environments to foster more effective collaboration and fewer barriers to providing care.
Legitimizing Potential “Bad News”: How Companies Disclose on Their Tension Experiences in Their Sustainability Reports
Authors: Haffar Merriam , Searcy Cory
Published: July 2020

The practice of corporate sustainability is beset with compromise; it involves inevitable tensions across competing social, environmental, and economic objectives, across a wide range of divergent stakeholders and across time. The purpose of this study is to determine whether, and why, companies are reporting on tensions decisions in their sustainability reports. This study relies on a group of the largest companies in Canada and analyzes sustainability reports and interviews with sustainability managers. The study finds that 92% of all reporting companies in the sample had encountered sustainability tensions but had failed to disclose these discussions explicitly in their reports. Evidence of these accounts are nevertheless present in the implicit (or latent) content of the reports, surrounded by “legitimizing talk”—affirmations of the companies’ commitment to, and demonstration of sustainability principles. These findings highlight the negative light in which many companies perceive tensions (as “bad news”) and the potential legitimacy threat that their disclosure poses.
Comparison of corneal biomechanical changes after LASIK and F-SMILE with CorVis ST
Authors: Abd El-Fattah Eman A , El Dorghamy Alaa A , Ghoneim Ahmed M , Saad Hisham A
Published: July 2020

Purpose:

To evaluate changes in corneal biomechanics after LASIK and F-SMILE.

Setting:

Elite Eye Center, Tanta, Egypt.

Design:

Prospective, randomized, unmasked, interventional comparative case series.

Patients and methods:

A total of 60 eyes were equally divided into two groups; group A: received LASIK and group B: received F-SMILE. Pentacam and CorVis ST parameters were compared before and 6 months after procedures. P ⩽ 0.05 was used for significance of results.

Results:

bIOP decreased by 0.762 ± 1.211 mmHg in group A ( p = 0.092), and by 2.52 ± 1.389 mmHg in group B ( p < 0.001) and the difference between groups became significant ( p = 0.001). A1 increased significantly in group A only ( p = 0.036); while A2 decreased insignificantly in both groups. DAR increased significantly in both groups ( p < 0.001, p = 0.022), but the difference between groups remained insignificant ( p = 0.461). IR increased significantly in group A only ( p < 0.001) and the difference between groups became significant ( p = 0.026). ARTH decreased in both groups ( p = 0.245, p = 0.695) and the difference remained insignificant ( p = 0.928). SP-A1 decreased in group A by 8.89 ± 1.38 mmHg/mm ( p = 0.637), and by 32.6 ± 4.39 mmHg/mm in group B ( p < 0.001) and the postoperative difference between groups was significant ( p = 0.013). CBI increased significantly in group A ( p < 0.001), but insignificantly in group B ( p = 0.098) and postoperative difference between groups was highly significant ( p < 0.001). A significant correlation was found between change in CCT and corresponding changes in DAR, IR, and ARTH after surgery in both groups.

Conclusion:

The significant differences between groups postoperatively as regards bIOP ( p = 0.001), IR ( p = 0.026), SP-A1 ( p = 0.013), and CBI ( p < 0.001) indicate stiffer corneas after F-SMILE and suggest less influence on corneal biomechanics than LASIK.
Assessing Imageability of Port Cities Through the Visibility of Public Spaces: The Cases of Famagusta and Limassol
Authors: Özgece Nezire , Edgü Erincik , Ayıran Nezih
Published: July 2020

Characteristics of port cities are significantly different than inland cities since they have a spatial relation with water. Waterfronts, main urban squares, and major streets are specified as the predominant components affecting socio-spatial configurations.

The research assumes that the imageability of port cities, which refers to “port city identity” in this research, is associated with the visibility of these key public spaces. The port cities of Famagusta and Limassol—the current major port cities of divided Cyprus—were selected to be evaluated on the specified public spaces to reveal this association.

The specified spaces are scrutinized through both the space syntax methodology and land-use and movement patterns in relation to visibility parameters. The results show that Limassol is more successful than Famagusta in terms of imageability, as it presents higher spatial and social visibility of public spaces, which also strengthens its port city identity.
Marketing, congestion, and demarketing in Utah’s National Parks
Authors: Drugova Tatiana , Kim Man-Keun , Jakus Paul M
Published: July 2020

Utah’s Mighty 5 ad campaign was designed to attract out-of-state visitors to southern Utah’s five National Parks (NPs). Using the synthetic control method, we find the campaign to have contributed to rapid visitation growth at Arches, Canyonlands, and Capitol Reef NPs. No ad campaign effect was found for Bryce Canyon and Zion NPs, which implies that recent increased visitation at these parks has been driven by the national trends and not the Mighty 5 promotion. Arches, Bryce Canyon, and Zion currently suffer from excess demand (congestion), and the US National Park Service is actively engaged in visitor management efforts to mitigate the environmental pressures associated with overvisitation. The state has responded to congestion by crafting a new “demarketing” campaign to provide a more tailored tourism experience aimed at increasing the value of a visit and diverting potential tourists to high-quality alternative sites selected to match visitor interests.
Social Prescribing as ‘Social Cure’: A longitudinal study of the health benefits of social connectedness within a Social Prescribing pathway
Authors: Wakefield Juliet Ruth Helen , Kellezi Blerina , Stevenson Clifford , McNamara Niamh , Bowe Mhairi , Wilson Iain , Halder Moon Moon , Mair Elizabeth
Published: July 2020

We examined whether the Social Cure (SC) perspective explains the efficacy of a Social Prescribing (SP) pathway which addresses healthcare needs through enhancing social connections. Data were collected at pathway entry from patients with long-term health conditions, or who felt isolated/lonely/anxious ( N = 630), then again 4 months later ( N = 178), and 6-9 months later ( N = 63). Being on the pathway was associated with increased group memberships between T0 and T1. The relationship between increased group memberships and quality-of-life was serially mediated by belonging, support and loneliness. This study is the first to show SP enhances health/well-being via SC mechanisms.
A queer boundary: How sex and BDSM interact for people who identify as kinky
Authors: Sprott Richard A , Vivid Jules , Vilkin Ellora , Swallow Lyle , Lev Eliot M , Orejudos Julius , Schnittman Danny
Published: July 2020

Few studies have systematically examined the relationship between kink behaviors and sexual behaviors, yet even these preliminary studies indicate that the relationship is complex and that there is a notable diversity in how people construct the boundaries of sex and kink and the relationship between them. As part of a grounded theory study of kink identity, the current study examined how 70 kink-identified participants from Northern California discussed their experience and understanding of the relationship between kink and sex in interviews conducted in 2014 and 2015. Findings indicated seven themes: kink flowing into sex, kink as spice for sexual interactions, kink and sex as connection and intimacy, kink and sex as an expression of erotic energy, kink and sex as an expression of power exchange, kink as spiritual, and kink as freedom. Findings indicated that sexual orientation and gender identity may influence how people understand and experience the relationship between kink and sex.
Passive space design, building environment and thermal comfort: A university building under severe cold climate, China
Authors: Dai Jin , Jiang Shuguang
Published: July 2020

In this paper, the building environment and the thermal comfort of occupants were investigated at a university building located in severe cold climate zone in the northwest of China during winter, transition and summer. First, in the two typical weather days of the year, the thermal environment of the Shihezi University building with atrium and courtyard was measured on the spot to investigate the impact of passive space design on the thermal environment of the building. Second, a questionnaire survey was used to report occupants’ subjective thermal perception and environmental variables were measured simultaneously. A total of 1346 valid subjective questionnaires and measurement data were obtained. The results showed that the thermal neutral temperature analysed by linear regression in winter, transition and summer were 24.42°C, 24.64°C and 28.10°C, respectively. The thermal comfort temperature range was from 19.59 to 29.44°C (winter) and 23.32 to 28.52°C (transition and summer). The occupants’ preference temperature was 25.14°C and 24.35°C in winter and transition. The adaptive behaviours of clothing adjustment and opening windows were closely correlated to the indoor operative temperature. Third, the correlation between indicators of thermal comfort, including subjective feelings and objective factors was also analysed.
Transport and trajectory of cough-induced bimodal aerosol in an air-conditioned space
Authors: Zhang Bo , Guo Guangyu , Zhu Chao , Ji Zhiming , Lin Chao-Hsin
Published: July 2020

Aerosol generated from a human cough can be a potential major indoor health risk due to the possible transmission of infectious respiratory diseases to surrounding individuals within the same room and even could spread out via air-ventilation/conditioning systems. This study aims to investigate the transport characteristics and trajectory of coughed aerosols under the influence of conditioned air ventilation as well as near-by human breathing zone using computational fluid dynamics (CFD). An experimental system consisting of air-conditioned space with multiple inlets and outlets, a cough simulator and a receiver was built to validate the CFD predictions. The comparison is in good agreement. The CFD model was established as a transient three-dimensional multiphase multicomponent Eulerian–Lagrangian model and numerically solved using commercial software ANSYS Fluent. Both gas and liquid phases were modelled as multicomponent mixtures. With this CFD model, the indoor transport and trajectory of coughed aerosols can be accounted for the distributions of portions inhaled by each manikin, deposited on surfaces of manikins and chamber walls, as well as recirculated back into the ventilation system. Results reveal that the aerosol source location and the ambient air movement can be crucial factors of aerosol trajectory in terms of direct and indirect influence.
Making focus groups accessible and inclusive for people with communication disabilities: a research note
Authors: Trevisan Filippo
Published: July 2020

Participating in focus groups can be challenging for people with communication disabilities. Given that more than 1 in 10 adults has a communication disability, focus groups that overlook their needs exclude a large part of the population. This research note makes a unique contribution toward creating more inclusive focus groups by discussing a variety of strategies employed in a recent study of political participation among Americans with disabilities that included a high proportion of participants with communication disorders. Universal design principles can support the “mainstreaming” of communication disabilities in focus group research, contributing to more inclusive and representative social science scholarship.
Law in action: Local-level prostitution policies and practices and their effects on sex workers
Authors: Di Ronco Anna
Published: July 2020

This article comparatively analyses city-based prostitution policies and practices and their effects on sex workers in countries that have adopted a partial criminalization model of intervention towards prostitution – Belgium and Italy. The two case studies selected for this research – the cities of Antwerp (Belgium) and Catania (Italy) – were chosen for their adopted local approach towards prostitution in designated red-light districts (RLDs): whereas prostitution has been collaboratively governed in Antwerp, it has simply been tolerated in Catania. By considering the factors that have led to the development of prostitution policies and practices in these two cities, and their characteristics both within and outside the two cities’ RLDs, this article compares and analyses the effects produced on sex workers across city areas. The study revealed a number of similarities between the two local cases considered: local practices towards sex work in both cities have been shaped by urban regeneration in RLDs, and by concerns about nuisance and crime across city areas (irregular immigration and trafficking, in particular); in all instances, they have had similar exclusionary effects on sex workers – and especially on the migrant women among them. The study also identified two key differences in the practices towards prostitution adopted in these two cities: they differed in the level of access to support services offered to sex workers and in the pervasiveness of proactive police control. The article concludes by arguing that all these local practices – including the ones that are seemingly different – ultimately converge in their ethos: they reinforce the socially constructed status of migrant sex workers as either law-breakers or trafficked victims to be subject to control and, in the latter case, also protection.