bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of Coriolis force and radial stretch on the convective instability characteristics of the Bödewadt flow
Authors: Mukherjee Dip , Sahoo Bikash
Published: May 2021

The Bödewadt boundary-layer flow is induced by the rotation of a viscous fluid rotating with a constant angular velocity over a stationary disk. In this paper, the Bödewadt boundary-layer flow has been studied in the presence of the Coriolis force to observe the effect of radial stretch of the lower disk on the flow. For the first time in the literature, a numerical investigation of the effects of both stretching mechanism and the Coriolis force on the flow behaviour and on the convective instability characteristics of the above flow has been carried out. In this paper, the Kármán similarity transformations have been considered in order to convert the system of PDEs representing the momentum equations of the flow into a system of highly non-linear coupled ODEs and solved numerically to obtain the velocity profiles of the Bödewadt flow. Then, a convective instability analysis has been performed by using the Chebyshev collocation method in order to obtain the neutral curves. From the neutral curves it is observed that radial stretch has a globally stabilising effect on both the inviscid Type-I and the viscous Type-II instability modes. This underlying physical phenomena has been verified by performing an energy analysis of the flow. The results obtained excellently supports the previous works and will be prominently treated as a benchmark for our future studies.
A gravitational torque-compensated 2-DOF planar robotic arm design and its active control
Authors: Bulut Yalçın , Conkur Erdinc Sahin
Published: May 2021

Serial robot manipulators have their servo motors with reduction gears on the link joints. When it comes to hyper-redundant robots, this kind of joint actuation mechanism cannot be implemented since this makes hyper-redundant robots too heavy. Instead, cable driven mechanisms are preferred. However, the positioning accuracy is negatively affected by the cables. This paper addresses the positioning accuracy problem of cable driven hyper-redundant robots by employing a 2-DOF robotic arm whose modules are counter-balanced. While the actuators connected to the base actively do most of the work using cables and springs, light and compact actuators connected to the links produce precise motion. The method will result in compact, light and precise hyper-redundant robotic arms. The above-mentioned procedure governed by a control software including a 2D simulator developed is experimentally proved to be a feasible method to compensate the gravitational torque successfully.
Self-excited vibration of a 3-

P

RR planar parallel robot
Authors: Zhu Xuxian , Qiu Zhicheng , Xie Lingbo , Zhang Xianmin
Published: May 2021

Self-excited vibration of parallel robots can seriously affect the motion performance and damage the mechanical structure. In order to study the self-excited vibration characteristics of a 3-PRR (where P and R represent the prismatic and revolute joints respectively and the underlined letter represents the actuated joint) planar parallel robot, dynamic model is firstly established and the singularity is analyzed theoretically. Then the dynamic characteristics at internal and boundary singularities are both explored experimentally. The motion form and generating mechanism of the self-excited vibration are researched. The influencing factors on vibration frequency are obtained and the self-excited vibration during trajectory tracking motion is analyzed. Finally, a singularity escaping strategy is proposed and tested. Theoretical analysis and experimental results show that the performance of parallel robot deteriorates dramatically at singularities. Nevertheless, the parallel robot can pass through the internal singularity successfully with optimized load and motion speed so that the workspace can be expanded. The 3-PRR planar parallel robot exhibits self-excited vibration at internal singularities, which is mainly caused by the singularity, self-regulation of motors and the closed-chain coupling effect. The vibration frequency is mainly determined by singular configuration and the structural parameters. The parallel robot can maintain self-excited vibration state while carrying out trajectory tracking under a singular attitude angle. Moreover, the proposed singularity escaping strategy is verified to be feasible so that the self-excited vibration can be eliminated effectively.
Two-layer laser clad coating as a replacement for chrome electroplating on forged steel
Authors: Christoforou Peter , Dowding Robert , Pinna Christoforou , Lewis Roger
Published: May 2021

Chrome plating is one of many surface engineering techniques used for corrosion resistance, as well as a protective coating against surface damage in load bearing applications, with surface hardness in the region of 1000 Hv. Laser cladding is an alternative hardfacing technique often chosen for corrosion resistance and for increasing the surface hardness of components, through thick clad coatings. The application of chrome plating and other similar surface engineering techniques for thick coatings can be inefficient and costly with practical process limitations. The objective of this case study was to investigate the feasibility of replacing the chrome plated layer of a rod mill pinion, made of forged steel, with a Nickel-based Tungsten-Carbide (Ni-WC) composite layer and an intermediate layer of Inconel 625. Mechanical properties were obtained using microhardness and nanoindentation techniques. Three-point bend tests were performed on test specimens from a pinion sample, in order to observe crack propagation resistance, a challenging task due to the curved geometry of the pinion sample and the difference in thickness between the existing and proposed coating layers. Crack development was captured, and plastic deformation was quantified with the use of Digital Image Correlation (DIC). In bending it was found that the bond between the composite coating, Inconel 625 and the steel substrate provided improved resistance to axial crack propagation, where the composite coating could withstand more than twice the bending tool displacement than the chrome electroplating.
Error modeling and singularity analysis of planar parallel mechanisms using optimized expression of joint clearances and link deformation
Authors: Ding Jianzhong , Wang Chunjie
Published: May 2021

A fast error modeling method is proposed to analyze the pose deviation of 3-RPR planar parallel mechanisms with multiple revolute joint clearances. The pose error arisen from clearances and limb deformation is modeled from the point of inverse kinematics and estimated numerically. Manipulator poses are represented by elements of the Lie group SE(2) and the discontinuous deformation of limbs due to clearances are modeled by the Heaviside function, which is then approximated with the hyperbolic tangent function. After establishing the error model, an efficient error compensation method is introduced. The proposed error modeling and accuracy analysis method are validated by case study of a 3-RPR mechanism. The results show that the hyperbolic tangent function runs faster than the step function and it provides better convergence. Finally, the singularity of the 3-RPR mechanism with load is analyzed and the results reveal the effects of loads and clearances on mechanism singularities.
High temperature wear performance of laser cladding maraging steel with low nickel on AISI H13 steel
Authors: Jiang Wei , Wang Shuqi , Wang Lan
Published: May 2021

H13 steel is prone to insufficient high temperature wear resistance due to thermal wear under high temperature conditions. To improve high temperature wear resistance of H13 steel, the maraging steel coating with low-nickel was successfully prepared owing to excellent thermal stability. Sliding wear tests at 400, 500 and 600 °C were carried out for the laser cladding coating and H13 steel to comparatively investigate their high temperature wear performance and mechanism. The microstructure, phases, hardness and thermal stability of the maraging steel coating were also studied. The results showed that the maraging steel coating possessed excellent high temperature wear resistance and effectively improved the high temperature wear resistance of H13 steel by laser cladding. The superior thermal stability of maraging steel played an important role in improving its high temperature wear resistance.
Mobility and singularity analyses of a symmetric multi-loop mechanism for space applications
Authors: Li Chuanyang , Angeles Jorge , Guo Hongwei , Yan Huiyin , Tang Dewei , Liu Rongqiang , Deng Zongquan
Published: May 2021

A symmetric, double-tripod multi-loop mechanism (DTMLM), for aerospace applications, is the subject of this paper. Its mobility and singularity are analyzed, while introducing a novel tool, the cell-division method for singularity analysis, applicable to multi-loop mechanisms. The key principle of this method lies in replacing the singularity analysis of the original multi-loop mechanism with: (1) that of an equivalent simpler parallel mechanism; (2) the constraint analysis between loops; and (3) the singularity analysis of simpler kinematic subchains. Then, the mechanism is transformed into a simpler, equivalent parallel mechanism with three identical kinematic subchains. Its mobility and singularity are analyzed based on screw algebra, which leads to a key conclusion about the geometric properties of this mechanism. Results show that: (a) the DTMLM has three degrees of freedom (dof), i.e., two rotational dof around two intersecting axes lying in the middle plane of the mechanism, and one translational dof along the normal to the said plane (2R1T); and (b) the singularities of the 3-RSR parallel mechanism are avoided in the DTMLM by means of prismatic joints, singularities in the DTMLM occurring on the boundary of its workspace. Thus, the DTMLM has a 2R1T mobility everywhere within its workspace. When a set of multi-loop mechanisms of this kind are stacked as modules to assemble a multi-stage manipulator for space applications, the modules can be designed so that, under paradigm operations, all individual loops operate within their workspace, safe from singularities.
Non-linear response and buckling of imperfect laminated composite plates under in-plane pulse forces
Authors: Kumar Rajesh , Singh Vishal , Patel SN , Dey Tanish
Published: May 2021

This study presents a semi-analytical solution of the non-linear dynamic response, shock spectrum, and dynamic buckling of an imperfect angle-ply laminated composite plate under various types of in-plane pulse forces. The laminated composite plate is modeled using a higher-order shear deformation theory and von-Kármán geometric nonlinearity. The non-linear governing partial differential equations (PDEs) of imperfect laminated composite plates are derived via Hamilton’s principle. Using Galerkin’s method, the non-linear PDEs are transformed into non-linear algebraic equations for the static stability problems and non-linear ordinary differential equations for the dynamic problem such as dynamic response, shock spectrum, and dynamic buckling. The buckling load of the plate is obtained through the associated eigenvalue problem. The static failure load of the composite plate is evaluated using the post-buckling analysis based on the Tsai-Wu failure criterion. The dynamic response and shock spectrum of the composite plate are determined via Newmark’s method. The dynamic failure load of the plate is evaluated using Newmark’s method based on the Tsai-Wu failure criterion. Dynamic buckling is to be characterized by dynamic load factor (DLF), which is represented as the ratio of the dynamic failure load to the static failure load. Based on the pulse/shock duration time, the pulse forces are divided into three loading regimes known as impulsive, dynamic, and quasi-static. The study revealed that the DLF values are > 1, < 1, and [Formula: see text]1 respectively for the case of impulsive, dynamic, and quasi-static loading regimes of pulse force. The influences of various types of in-plane pulse forces, amplitude and time duration of pulse forces, and amplitude of initial geometric imperfections on the non-linear dynamic response, shock spectrum, and dynamic buckling behavior of the laminated composite plate are addressed in detail. The results will help in the appropriate design of the laminated composite plate against dynamic buckling.
KBR during the Covid pandemic: Accelerated roll-out of the digital strategy and preparations for a museum opening
Authors: Lammens Sara
Published: May 2021

The covid pandemic forced KBR, Belgium's national library, to close its doors to the public and staff on March 18, 2020. The opening of a new museum had to be postponed. But ultimately, the covid closure led to an accelerated rollout of KBR's digital strategy.
The usefulness of biomarkers in diagnosis of asbestos-induced malignant pleural mesothelioma
Authors: Tanrıverdi Zübeyde , Meteroglu Fatih , Yüce Hande , Şenyiğit Abdurrahman , Işcan Mümtaz , Unüvar Songül
Published: May 2021

Introduction:

Malignant pleural mesothelioma (MPM) is a malignant tumor that is associated mostly with asbestos exposure. The present study was to evaluates the diagnostic value of neopterin, periostin, YKL-40, Tenascin-C (TNC), and Indolamine 2,3-dioxygenase (IDO) as noninvasive markers of malign pleural mesothelioma.

Methods:

Included in the study were 30 patients diagnosed with malign pleural mesothelioma, and 25 people as a control group. Biomarker levels were determined using an enzyme immunoassay . A Mann-Whitney U test and Spearman correlation methods were used for the statistical analysis.

Results:

All evaluated biomarkers were found to be significantly higher in the MPM group than in the control group ( p < 0.05). There was no effect of such variables as gender, age or MPMsubtype on the parameters ( p > 0.05) in the patient group. All biomarkers were positively correlated with each other ( p < 0.001).

Conclusions:

The current non-invasive biomarkers that can be used in the diagnosis of MPM yielded significant results and can make important contributions to the early diagnosis of MPM.
Tertiary eating disorder services: is it time to integrate specialty care across the life span?
Authors: Allison Stephen , Wade Tracey , Warin Megan , Long Randall , Bastiampillai Tarun , Looi Jeffrey C L
Published: May 2021

Objective:

Australian tertiary eating disorder services (EDS) have a divided model of care, where child and adolescent mental health services (CAMHS) support patients until the age of 18 years, and thereafter, adult mental health services (AMHS) provide care. Consumers and carers have criticised this divided model because the age boundary occurs during the peak period of onset and acuity for eating disorders. Most CAMHS patients are lost to specialty follow-up around age 18, increasing the risks of relapse and premature mortality from eating disorders, since young women (aged 15–24) have the highest hospitalisation rates from anorexia nervosa. The current article is a commentary on the transition gap and possible service designs.

Conclusions:

Eating disorders require access to specialty treatment across the life span. The Australian Federal Government has expanded all-age care through the 2019 Medicare Benefit Schedule (MBS) eating disorder plans. Some new MBS patients require a rapid step-up in care intensity to a tertiary EDS, thereby increasing demand on the public sector. State/Territory Governments should strengthen EDS using the ‘youth reach-down’ model, where AMHS extend EDS to age 12. Vertical service integration from 12 to 64+ facilitates continuity of care for the duration of an eating disorder.
Estimating Craniofacial Growth Cessation: Comparison of Asymptote- and Rate-Based Methods
Authors: Hardin Anna M. , Knigge Ryan P. , Oh Hee Soo , Valiathan Manish , Duren Dana L. , McNulty Kieran P. , Middleton Kevin M. , Sherwood Richard J.
Published: May 2021

Objective:

To identify differences between asymptote- and rate-based methods for estimating age and size at growth cessation in linear craniofacial measurements.

Design:

This is a retrospective, longitudinal study. Five linear measurements were collected from lateral cephalograms as part of the Craniofacial Growth Consortium Study (CGCS). Four estimates of growth cessation, including 2 asymptote- (GCasym, GCerr) and 2 rate-based (GCabs, GC10%) methods, from double logistic models of craniofacial growth were compared.

Participants:

Cephalometric data from participants in 6 historic longitudinal growth studies were included in the CGCS. At least 1749 individuals (870 females, 879 males), unaffected by craniofacial anomalies, were included in all analyses. Individuals were represented by a median of 11 images between 2.5 and 31.3 years of age.

Results:

GCasym consistently occurred before GCerr and GCabs consistently occurred before GC10% within the rate-based approaches. The ordering of the asymptote-based methods compared to the rate-based methods was not consistent across measurements or between males and females. Across the 5 measurements, age at growth cessation ranged from 13.56 (females, nasion-basion, GCasym) to 24.39 (males, sella-gonion, GCerr).

Conclusions:

Adolescent growth cessation is an important milestone for treatment planning. Based on our findings, we recommend careful consideration of specific definitions of growth cessation in both clinical and research settings since the most appropriate estimation method may differ according to patients’ needs. The different methods presented here provide useful estimates of growth cessation that can be applied to raw data and to a variety of statistical models of craniofacial growth.
Impact of Opioid Administration in the Intensive Care Unit and Subsequent Use in Opioid-Naïve Patients
Authors: Krancevich Niki M. , Belfer Julie J. , Draper Heather M. , Schmidt Kyle J.
Published: May 2021

Background

Opioids are a mainstay of therapy for patients in the intensive care unit (ICU) as part of the analgesia-first approach to sedation. Despite knowledge of acute consequences of opioid based analgosedation, less is known about the potential long-term consequences, including the effect of opioid administration in the ICU on subsequent opioid use in opioid-naïve patients.

Objective

To evaluate the relationship between ICU opioid administration to opioid-naïve patients and subsequent opioid use following discharge.

Methods

A query of the electronic medical record was performed to identify opioid-naïve adult patients admitted directly to an ICU. Patients who received continuous intravenous infusion of fentanyl, hydromorphone, or morphine were screened for inclusion into the analysis.

Results

Of the 342 patients included for analysis, 164 (47.1%) received an opioid at hospital discharge. In total, 17 of the 342 patients (5.0%) became long-term users, noted to be more common in patients who received an opioid prescription at discharge (8.7% vs 1.6%; P = 0.006). Neither total ICU morphine milligram equivalent (MME) nor average daily ICU MME administration were found to correlate with daily MME prescription quantity at discharge ( R2 = 0.008 and R2 = 0.03, respectively). Following control for potentially confounding variables, total ICU MME administration remained an insignificant predictor of subsequent receipt of an opioid prescription at discharge and long-term opioid use.

Conclusion and Relevance

This study failed to find a significant relationship between ICU opioid use in opioid-naïve patients and subsequent opioid use. These findings highlight the need to focus on transitions points between the ICU and discharge as potential opportunities to reduce inappropriate opioid continuation.
Postmortem Assessment of Isolated Congenital Heart Defects Remains Essential Following Termination of Pregnancy
Authors: Struksnæs Camilla , Blaas Harm-Gerd K , Eik-Nes Sturla H , Tegnander Eva , Vogt Christina
Published: May 2021

Objectives

To investigate the correlation between prenatal ultrasound (US) and autopsy findings in pregnancies terminated due to isolated congenital heart defects (CHDs), including CHDs associated with heterotaxy syndrome.

Materials and methods

The material consists of 67 fetuses with prenatally detected isolated CHDs or CHDs associated with heterotaxy syndrome at a tertiary center in Norway between 1985 and 2014. The main CHDs were categorized into subdiagnoses of CHDs in accordance with ICD-10. The US and autopsy findings were categorized according to degree of concordance.

Results

Gestational age at termination was 12 + 0–22 + 6 weeks. Hypoplastic left heart syndrome was the most common main diagnosis among the 67 fetuses (32.8%). There was full agreement between US and autopsy findings in 97.4% (222/228) of all subdiagnoses. The discrepant findings in three fetuses had no influence on the decision to terminate the pregnancy.

Conclusions

The correlation was high between prenatal US and postmortem findings in fetuses with isolated CHDs. Meticulous assessment of cardiac anatomy is particularly necessary when the decision to terminate relies on isolated CHDs. The trend of earlier termination challenges verification of diagnoses at autopsy. Consequently, the fetus should be examined at a tertiary center with fetal medicine specialists, pediatric cardiologists and perinatal pathologists.
Hospitality and Tourism Scholarship in Africa: A Literature-Based Agenda for Future Research
Authors: Senbeto Dagnachew Leta , Köseoglu Mehmet Ali , King Brian
Published: May 2021

This study examines Africa-related tourism and hospitality literature over the past 35 years (1984 to 2019), taking account of themes, methodologies, geographies, and collaboration structures. The authors identified and analyzed 1,182 published articles from 27 journals using advanced bibliometric to provide a deeper analysis than has been provided previously of tourism and hospitality scholarship in Africa. This article offers an up-to-date systematic overview of Africa-related tourism knowledge production and dissemination. Prominent features of the knowledge domain are discussed—destination management, travel psychology and sociology, sustainability, sociocultural issues, economy, tourism investment and economy, accommodation and hotels in Africa. The authors discussed further research, current and emerging tourism issues, and more diverse approaches toward research focus, methodologies, and geographical structures.
Three-dimensional thermohydrodynamic analysis of the effects of textured main bearing on lubricant density and viscosity in internal combustion engines
Authors: Ahmadkhah Anvar , Kakaee Amir H
Published: May 2021

This paper is focused on the effects of the textured surface along with lubricant feed pressure and temperature variation to calculate the lubrication characteristics (viscosity and density) of the main bearings in internal combustion engines. In a three-dimensional numerical analysis simulation, a thermohydrodynamic model was developed, which considered the thermal effects of the fluid–solid interface components. In the analysis, the viscosity–temperature equation was used at different lubricant feed pressures and temperatures. By using color image segmentation methods, the density and viscosity contour on the two rotating walls (shaft and bearing wall) in the cavitation regions were quantitatively and qualitatively compared. The textured surface and lubricant feed pressure had significant effects on reducing the cavitation region over the shaft and bearing surface. Compared with the untextured bearing, the presence of texture over the bearing surface in the same temperature and pressure conditions increased the amount of total heat transfer to the lubricant fluid in the range of the maximum value of 73% and minimum value of 11%. Promoting the average heat transfer coefficient was a factor in reducing thermal stresses and high-temperature points in the rigid parts of the bearing system.
The effect of textual glosses on L2 vocabulary acquisition: A meta-analysis
Authors: Zhang Chao , Ma Rong
Published: May 2021

Despite the growing interest in incorporating textual glosses into second language (L2) reading in hypermedia and paper media, no agreements have been reached as to whether and what extent a textual gloss facilitates L2 learners’ vocabulary acquisition in hypermedia and paper media. The present study meta-analysed the overall effects of textual glosses and different glossing types (i.e. language, location, and mode) on L2 vocabulary acquisition, as well as the moderation effects on the variability of L2 vocabulary acquisition effect sizes. Based on a comprehensive search, 20 studies involving 2,291 participants that have quantitatively documented the changes of L2 vocabulary gains through a pre-and-post textual glosses design were identified and coded in order to retrieve moderator variables. The results show the following: (1) textual glossing has a medium effect on L2 vocabulary acquisition; (2) the effect of textual glosses on L2 vocabulary acquisition persists over time; (3) glossing location and glossing mode significantly impact the effect of textual glosses on L2 vocabulary acquisition but glossing language has no definite effect; and (4) outcome measure is the only moderator variable among the three influencing factors on vocabulary acquisition. These results are further discussed with reference to existing studies and theory of second language acquisition.
Moderating effects of decision autonomy and culture novelty on the relationship between expatriate manager leadership styles and host country managers’ job satisfaction: Evidence from the global hotel industry
Authors: Takeuchi Riki , Qian Cuili , Chen Jieying , Shay Jeffrey P
Published: May 2021

While the use of expatriate managers to control and manage the foreign subsidiary is well recognized, there is a paucity of literature that considers how expatriate managers’ leadership behaviors affect host country nationals (HCNs). By incorporating leadership contingency perspective into expatriation literature, we examine the boundary conditions of two leadership (planning and consulting) behaviors on HCN managers’ job attitude (i.e., job satisfaction). Specifically, we investigate the moderating effects of decision autonomy and culture novelty of expatriate managers on the aforementioned relationships, using survey data collected from 103 expatriate general managers and 276 HCN managers working in nine American-based multinational hotel chains and found both planning and consulting leadership behaviors to be positively related to HCN managers’ job satisfaction. Decision autonomy and culture novelty acted as boundary conditions of such relationships such that decision autonomy moderated the planning-job satisfaction relationship while culture novelty moderated the consulting-job satisfaction relationship.
Journalists and Depressive Symptoms: A Systematic Literature Review
Authors: MacDonald Jasmine B. , Hodgins Gene , Saliba Anthony J. , Metcalf Debra Ann
Published: May 2021

Mental health research focusing on journalists has largely tended to give precedence to trauma exposure and subsequent symptoms of posttraumatic stress disorder. However, there are several occupational factors that may be associated with the development of depressive symptoms in journalists. This systematic literature review aims to provide a concise, comprehensive, and systematic review of the quantitative literature relating to journalists’ experiences of depressive symptoms. The systematic literature review method adopted was based on that prescribed by Fink and contains three main elements: sampling the literature, screening the literature, and extracting data. Key terms were developed and used to source appropriate studies from several electronic databases, a hand search of reference lists was conducted, and authors were contacted to suggest examples of their own work not yet sampled. The sample included 13 quantitative studies reported in English language. Journalists most at risk of experiencing depressive symptoms had (1) greater exposure to work-related and personal trauma, (2) experienced threats to themselves or their family, and (3) reduced levels of family and peer support, social acknowledgment, and education. An area for further investigation is the prevalence and experiences of specific depressive disorders within the journalist population. There are a number of theoretical and methodological issues that can be addressed in future research.
Exploring the Impact of Coordination in Human–Agent Teams
Authors: Schneider Michael , Miller Michael , Jacques David , Peterson Gilbert , Ford Thomas
Published: May 2021

Teaming permits cognitively complex work to be rapidly executed by multiple entities. As artificial agents (AAs) participate in increasingly complex cognitive work, they hold the promise of moving beyond tools to becoming effective members of human–agent teams. Coordination has been identified as the critical process that enables effective teams and is required to achieve the vision of tightly coupled teams of humans and AAs. This paper characterizes coordination on the axes of types, content, and cost. This characterization is grounded in the human and AA literature and is evaluated to extract design implications for human–agent teams. These design implications are the mechanisms, moderators, and models employed within human–agent teams, which illuminate potential AA design improvements to support coordination.
Rare, epilepsy-related disorder including intellectual disability – A scoping review of caregivers’ identified information needs
Authors: Tschamper Merete Kristin , Systad Silje
Published: May 2021

Persons with rare, epilepsy-related disorders often have intellectual disability and need long-term care. Informal and formal caregivers need information in order to care for the persons in a safe way.

Aims:

The aims of this review were: (1) to obtain an overview of caregiver-reported information needs; and (2) to investigate if there are information needs that are unique for caregivers of persons with rare epilepsies.

Method:

We followed the scoping review framework outlined by Arksey and O’Malley and the preferred reporting items outlined by PRISMA.

Results:

Among the 17 articles that met the inclusion criteria, 5 included caregivers of persons with rare epilepsies. Categories of information needs: (1) Medical information; (2) Information on how to cope with emotional distress; (3) Experiential information from peers; and (4) Interdisciplinary information exchange. The need for disorder-specific information seemed particularly important for caregivers of persons with rare epilepsies.

Conclusion:

There is a need for further studies, particularly on formal caregivers’ information needs.
Extraintestinal manifestations at baseline, and the effect of tofacitinib, in patients with moderate to severe ulcerative colitis
Authors: Rubin David T. , Reinisch Walter , Greuter Thomas , Kotze Paulo G. , Pinheiro Marcia , Mundayat Rajiv , Maller Eric , Fellmann Marc , Lawendy Nervin , Modesto Irene , Vavricka Stephan R. , Lichtenstein Gary R.
Published: May 2021

Introduction:

Extraintestinal manifestations (EIMs) in patients with ulcerative colitis (UC) are common. Tofacitinib is an oral, small molecule Janus kinase inhibitor for the treatment of UC. We evaluated the efficacy of tofacitinib in patients with EIMs, and the impact of tofacitinib on EIMs in patients with UC in the OCTAVE clinical program.

Methods:

Data from two 8-week induction studies (OCTAVE Induction 1 and 2) and a 52-week maintenance study (OCTAVE Sustain) were analyzed. The effect of tofacitinib on efficacy outcomes stratified by EIM status, proportion of predefined prior and active EIMs at baseline, and change from baseline in EIMs were determined at the end of the treatment period (weeks 8 or 52), or at early termination.

Results:

At baseline of OCTAVE Induction 1 and 2, and OCTAVE Sustain, 27.0% and 9.0% of patients had a history of EIMs (prior or active), respectively. Patients treated with tofacitinib 10 mg twice daily (BID) achieved remission and had endoscopic improvement in all studies, irrespective of any history of EIMs. A greater proportion of patients had active peripheral arthritis at baseline of OCTAVE Induction 1 and 2 versus OCTAVE Sustain. In OCTAVE Induction 1 and 2, similar proportions of tofacitinib and placebo-treated patients with active peripheral arthritis experienced either no change (81.3% and 85.7%, respectively) or an improvement (15.6% and 14.3%, respectively). By week 52 of OCTAVE Sustain, improvements in active peripheral arthritis were only observed in tofacitinib-treated patients (16.7% and 33.3% with tofacitinib 5 and 10 mg BID, respectively).

Conclusion:

Any history of EIMs did not influence the efficacy of tofacitinib 10 mg BID for induction or maintenance of UC. The most common active EIM was peripheral arthritis, for which many patients in OCTAVE Induction 1 and 2, and OCTAVE Sustain, reported improvement or no change from baseline with tofacitinib treatment. Clinicaltrials.gov:NCT01465763 ; NCT01458951; NCT01458574
Islands of (in)security in the Anthropocene
Authors: Grove Kevin
Published: May 2021

In this response, I think through some implications of Chandler and Pugh’s typology of relational ontologies and onto-epistemologies for how we might engage the question of security in the Anthropocene. In doing so, I highlight how their poetic treatment of islands challenges relational thought on the Anthropocene to confront its own embodied and contextual limitations. I suggest here that taking island poetics seriously brings into focus latent desires for security against indeterminacies that the problematic of the Anthropocene—the crisis of modernity—introduces.
The possibility of islands in the Anthropocene
Authors: Wakefield Stephanie
Published: May 2021

David Chandler and Jonathan Pugh’s (2021) article proposes a new critical research agenda to examine how islands are being mobilized as central sites of the Anthropocene. In that vein, this commentary proposes that islands are central to the Anthropocene not only as sites of relational entanglement but of disentanglement as well. Delinking island territories produced by separating from networks and processes deemed harmful represents an important area for future critical research.
Cognitively targeted transperineal prostate biopsy in patients with previous abdominoperineal excision of the rectum
Authors: Kailavasan M , Khan M
Published: May 2021

Introduction:

Prostate biopsy is performed using an ultrasound probe placed in the rectum with either a transrectal or, increasingly popular, transperineal approach. This is not possible in patients with abdominoperineal excision of the rectum due to the lack of rectum. In our case series, we present a technique for prostate biopsy in this cohort and our outcomes.

Method:

The study population consisted of three consecutive patients who presented to our institution between 2018–2019 with an elevated level of prostate-specific antigen, a history of abdominoperineal excision of the rectum and undergone multiparametric magnetic resonance imaging of the prostate at our institution before a biopsy. Transperineal prostate biopsies were performed under general anaesthesia using a curved uniplanar ultrasound transducer with an attached guide to stabilise the needle. Free-hand biopsies were taken using an 18-gauge biopsy needle with an automatic spring-driven device. Multiple biopsy cores were directed to multiparametric magnetic resonance imaging target areas by visual registration.

Results:

Three men with a median age of 69 years (range 68–75 years) were included in this case series with serum index prostate-specific antigen values between 6.5–14 ng/ml. All three patients had Prostate Imaging Reporting and Data System 5 lesions identified on multiparametric magnetic resonance imaging scans. All three men were diagnosed with clinically significant prostate cancer (>Gleason grade group 2). On average, 13 biopsy cores (range: 12–15) were obtained with a median core length of 9 mm (range: 6–20 mm). All patients were discharged home on the day of the procedure and had none had postoperative complications.

Conclusion:

The use of multiparametric magnetic resonance imaging and cognitive targeted transperineal biopsy provides an option for diagnosing prostate cancer in this challenging group of patients. Level of evidence: 4
Data as asset? The measurement, governance, and valuation of digital personal data by Big Tech
Authors: Birch Kean , Cochrane DT , Ward Callum
Published: May 2021

Digital personal data is increasingly framed as the basis of contemporary economies, representing an important new asset class. Control over these data assets seems to explain the emergence and dominance of so-called “Big Tech” firms, consisting of Apple, Microsoft, Amazon, Google/Alphabet, and Facebook. These US-based firms are some of the largest in the world by market capitalization, a position that they retain despite growing policy and public condemnation—or “techlash”—of their market power based on their monopolistic control of personal data. We analyse the transformation of personal data into an asset in order to explore how personal data is accounted for, governed, and valued by Big Tech firms and other political-economic actors (e.g., investors). However, our findings show that Big Tech firms turn “users” and “user engagement” into assets through the performative measurement, governance, and valuation of user metrics (e.g., user numbers, user engagement), rather than extending ownership and control rights over personal data per se. We conceptualize this strategy as a form of “techcraft” to center attention on the means and mechanisms that Big Tech firms deploy to make users and user data measurable and legible as future revenue streams.
Under the shadow of the giants: The ASEAN in search of a common strategy in a fluid and perilous Indo-Pacific region
Authors: De Castro Renato Cruz
Published: May 2021

This article examines how the ASEAN is managing the quintessential security challenges of the 21st century, particularly China’s emergence as a regional power, its expansive territorial claim in the South China Sea, and the US–China strategic rivalry in the Indo-Pacific region. As an organization tackling these security concerns, the ASEAN lacks the essential mechanism for conflict resolution, operates through informal diplomacy and moral suasion, and relies on consensus in making decisions. As a result, China has effectively divided the association during the talks on the peaceful settlement of the South China Sea dispute. China is currently formulating with the ASEAN a Code of Conduct of Parties in the South China Sea. All the same, China has made sure that any future agreement with the ASEAN imposes no constraints on its expansionist moves in the contested waters, and contains provisions that benefit its interests in the long run. Meanwhile, US–China strategic competition has prompted the ASEAN to think of ways to deal with this potential security threat. However, the association has failed to come up with a common strategy. In conclusion, this article argues that China’s emergence as a regional power, its maritime expansion into the South China Sea, and the US–China geopolitical contest are testing both the capacity and the limits of the ASEAN in resolving these security issues.
The Medicine Wheel Revisited: Reflections on Indigenization in Counseling and Education
Authors: Robertson Lloyd Hawkeye
Published: May 2021

Indigenization involves relating traditional cultures to modern methods, concepts, and science to facilitate their use by those populations. Despite attempts to indigenize both the practice of counseling and the content of educational curricula, mental health and educational deficits in Amerindian communities have remained. This article suggests indigenization in the North American context is often based on a reified view of culture that discounts naturalistic and scientific approaches, and that this dynamic inhibits progressive cultural change at institutional and community levels. A secular approach to indigenization is proposed that relates modern conceptual thought to traditional cultures in a way that is consistent with traditional constructs. The medicine wheel, traditional to North American Great Plains cultures, is applied to counseling to illustrate how concepts found in aboriginal cultures could inform modern practice with wider applications to curriculum development. Related tensions involving interpretations of aboriginal spiritualities and modernity are discussed.
A semi-systematic literature review, identifying research opportunities for more sustainable, receiver-led inbound urban logistics flows to large higher education institutions
Authors: Zunder Thomas H.
Published: May 2021

This paper reports a semi-systematic literature review, identifying research opportunities for more sustainable, receiver-led, inbound logistics flows to large Higher Education Institutions (HEIs).

Methods

The literature - a body of 229 works - was reviewed using online scholarly databases: the NOVELOG toolkit database; a CASP checklist; followed by re-reading of the refined set of works. A two-stage approach was deployed: first scoping, using a semi-systematic approach, then a narrative review, guided by the systematic review in terms of literature survey and selection.

Findings

The field was found to be emergent, with 77% of all articles published after 2011. Key concepts were identified and grouped as recurring, or with noticeable gaps - and therefore suitable for further research. The key gaps identified as worthy of note at this stage were: urban freight and procurement activity; private purchasing behaviour; HEIs and freight; barriers to sustainable procurement; engaging with Action Research in purchasing and supply chain management; little or no theory development; and the use of electric vehicles (EVs) in freight.
Preoperative anxiety and its association with patients’ desire for support - an observational study in adults
Authors: Salzmann Stefan , Rienmüller Stephen , Kampmann Stefan , Euteneuer Frank , Rüsch Dirk
Published: May 2021

Background

Preoperative anxiety is prevalent and has harmful effects on postoperative outcomes. However, to date, it is still unclear (i) to what extent patients perceive preoperative anxiety as emotionally distressful, (ii) whether patients would welcome support from anesthesiologists in coping with their anxiety, and (iii) whether anxiety scores are useful for everyday clinical practice to determine patients’ need for support.

Methods:

1082 patients scheduled to undergo elective procedures under general anesthesia were eligible for this cross-sectional study carried out at a university hospital.

Preoperative anxiety, resulting in emotional distress, and patients’ desire for anesthesiologists’ support in coping with their anxiety were assessed dichotomously (no vs. yes) and analyzed descriptively. The intensity of anxiety was evaluated using the Amsterdam Preoperative Anxiety and Information Scale (range 4–20). Associations between the intensity of anxiety and the resulting desire for support were analyzed using logistic regression. Receiver operating characteristic analyses were performed to identify anxiety levels that best predict desire for support.

Results

Among the 1000 (537 female;M(SD) 57 (18) years) subjects evaluated, 493 (318 (65 %) female) reported anxiety. Anxiety was associated with emotional distress in 320 (65 %) and desire for support in 291 (59 %) patients. Increased preoperative anxiety levels were associated with higher rates of desire for support (B= 0.270; odds ratio 1.31 [95 % CI 1.22–1.41]). An anxiety score > 9 was best to predict a desire for support (sensitivity 0.861, specificity 0.724). However, desire for support was even present in some patients with lowest anxiety scores (5 or 6).

Conclusions

All patients undergoing surgery should be screened for preoperative anxiety and the resulting desire for support to be able to determine who would welcome support. Anxiety scoring tools do not seem to be useful to identify these patients. By helping patients experience less preoperative anxiety, anesthesiologists may not only reduce patients’ emotional distress but also have a positive impact on postoperative outcome.

Trial registration

German Clinical Trials Register (DRKS 00013319, 23 November 2017).
Natural history and prognostic implications of left ventricular end-diastolic pressure in reperfused ST-segment elevation myocardial infarction: an analysis of the thrombolysis in myocardial infarction (TIMI) II randomized controlled trial
Authors: Khan Arshad A. , Al-Omary Mohammed S. , Collins Nicholas J. , Attia John , Boyle Andrew J.
Published: May 2021

Background

The aim of the current study is to assess the natural history and prognostic value of elevated left ventricular end-diastolic pressure (LVEDP) in patients with ST-segment elevation myocardial infarction (STEMI) after reperfusion with thrombolysis; we utilize data from the Thrombolysis in Myocardial Infarction (TIMI) II study.

Methods

A total of 3339 patients were randomized to either an invasive (n = 1681) or a conservative (n = 1658) strategy in the TIMI II study following thrombolysis. To make the current cohort as relevant as possible to modern pharmaco-invasively managed cohorts, patients in the invasive arm with TIMI flow grade ≥ 2 (N = 1201) at initial catheterization are included in the analysis. Of these, 259 patients had a second catheterization prior to hospital discharge, and these were used to define the natural history of LVEDP in reperfused STEMI.

Results

The median LVEDP for the whole cohort was 18 mmHg (IQR: 12–23). Patients were divided into quartiles by LVEDP measured during the first cardiac catheterization. During a median follow up of 3 (IQR: 2.1–3.2) years, quartile 4 (highest LVEDP) had the highest incidence of mortality and heart failure admissions. In the cohort with paired catheterization data, the LVEDP dropped slightly from 18 mmHg (1QR: 12–22) to 15 mmHg (IQR: 10–20) (p = 0.01) from the first to the pre-hospital discharge catheterization.

Conclusions

LVEDP remains largely stable during hospitalisation post-STEMI. Elevated LVEDP is a predictor of death and heart failure hospitalization in STEMI patients undergoing successful thrombolysis.

Graphic abstract
Clinical characteristics and longitudinal changes of patients with non-alcoholic fatty liver disease in 2 decades: the NAGALA study
Authors: Okamura Takuro , Hashimoto Yoshitaka , Hamaguchi Masahide , Obora Akihiro , Kojima Takao , Fukui Michiaki
Published: May 2021

Background

In this study, to clarify the evolving background of people with non-alcoholic fatty liver disease (NAFLD), we compared the current prevalence of NAFLD with that of 2 decades ago.

Methods

We included two cohorts. The past cohort was from 1994 to 1997 and included 4279 men and 2502 women. The current cohort was from 2014 to 2017 and included 8918 men and 7361 women. NAFLD was diagnosed by abdominal ultrasonography.

Results

The prevalence of NAFLD increased in both genders throughout these 2 decades (18.5% in the past cohort and 27.1% in the current cohort for men; and 8.0% in the past cohort and 9.4% in the current cohort for women). The prevalence of hyperglycemia increased, whereas the prevalence of low high-density lipoprotein cholesterol levels and hypertriglyceridemia significantly decreased. There was no significant difference in the mean body mass index. Multivariate analysis revealed that the prevalence of obesity and body mass index were significantly associated with the prevalence of NAFLD in both the past and current cohorts.

Conclusions

The incidence of NAFLD significantly increased throughout these 2 decades, and obesity is the most prevalent factor. Thus, body weight management is an essential treatment option for NAFLD.