bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-time application of IMC-PID-FO multi-loop controllers on the coupled tanks process
Authors: Chekari Tassadit , Mansouri Rachid , Bettayeb Maamar
Published: January 2021

The coupled tanks process is a two input-two output system. It presents a nonlinear behavior and interactions characteristic. After the nonlinear model is obtained, it is linearized around an operating point. A fractional-order proportional–integral–derivative based on the internal model control paradigm (1DOF-IMC-PID-FO) multi-loop controller is determined without considering the interactions, and a fractional-order proportional–integral–derivative based on the 2-degree-of-freedom internal model control structure (2DOF-IMC-PID-FO) multi-loop controller is determined by considering the interactions. Thus, an interactions reduction effect controller is calculated. Both controllers are implemented on a real-time process using the Real Time Windows Target of MATLAB. The objective of the control is to maintain the water level in the lower tanks at desired values. In the experiment, setpoint tracking and disturbance rejection tests are carried out to assess the performance of both 1DOF and 2DOF-IMC-PID-FO multi-loop controllers.
Optimized fault detection using bond graph in linear fractional transformation form
Authors: Ouziala Mahdi , Touati Youcef , Berrezouane Sofiane , Benazzouz Djamel , Ouldbouamama Belkacem
Published: January 2021

This article deals with the optimal robust fault detection problem using the bond graph in its linear fractional transformation form. Generally, this form of the bond graph allows the generation of two perfectly separate analytical redundancy relations, that are used as residual and threshold. However, the uncertainty calculation method gives overestimated thresholds. This may, for instance, lead to undetectable faults. Therefore, enhancing the robustness of fault detection and isolation algorithms is of utmost importance in designing a bond graph–based fault detection system. The main idea of this article is to develop optimized thresholds to ensure an optimal detection, otherwise this article proposes a method to detect tiny magnitude faults concerning parameter’s uncertainties. This work considers the issue of optimal fault detection as an optimization problem of the gap between the residuals and its threshold. New uncertainty values will be calculated in a way that these estimated parameters ensure the desired optimized gap between residuals and thresholds. These estimated uncertainty values will be used to generate optimized adaptive thresholds. Through these thresholds, we increase the sensitivity of the residuals to tiny magnitude faults, and we ensure an optimal and early detection.
Association of PER2 gene single nucleotide polymorphisms with genetic susceptibility to systemic lupus erythematosus
Authors: Dan Yi-Lin , Zhao Chan-Na , Mao Yan-Mei , Wu Qian , He Yi-Sheng , Hu Yu-Qian , Xiang Kun , Yang Xiao-Ke , Sam Napoleon Bellua , Wu Guo-Cui , Pan Hai-Feng
Published: January 2021

The circadian clock plays a crucial role in the progress of systemic lupus erythematosus (SLE). In this study, we performed a case-control study to explore the association between Period 2 (PER2) gene single nucleotide polymorphisms (SNPs) and the susceptibility of systemic lupus erythematosus (SLE). A total of 492 SLE patients and 493 healthy controls were included. The improved multiple ligase detection reaction (iMLDR) was used for genotyping. The correlations between four SNPs of PER2 (rs10929273, rs11894491, rs36124720, rs934945) and the genetic susceptibility and clinical manifestations of SLE were analyzed. Significant differences were observed in the distributions of allele frequencies and genotype under dominant model in rs11894491 between SLE patients and controls ( p = 0.030, p = 022, respectively). We hypothesized that PER2 gene SNPs was related to the genetic susceptibility and clinical manifestations, implying the potential role of PER2 in the pathogenesis of SLE.
Resolution of huge thrombi in bilateral ventricles caused by severe lupus cardiomyopathy
Authors: Liu Xinyi , Lei Song , Huang He , Wu Yu , Hu Zhang-Xue
Published: January 2021

Ventricular thrombus is an uncommon, severe condition with high morbidity and mortality. Simultaneous left and right ventricular thrombi caused by lupus myocardiopathy have not been previously reported in the literature. This case presents a 42-year-old woman who has bilateral ventricular thrombi with reduced left ventricular ejection fraction (35.4%) and acute kidney injury. Pro-brain natriuretic peptide was >35000 pg/mL. Systemic lupus erythematosus was confirmed based on multiorgan injuries including malar rash, anemia, renal injury, positive antinuclear, anti-Smith antibodies, and decreased complements. Renal biopsy revealed lupus nephritis class III + V. Low molecular weight heparin, steroids, and mycophenolate mofetil were initiated, after which the patient experienced transient numbness in the right limbs and hemoptysis. She then recovered quickly and improved significantly with recovery of left ventricular systolic function (left ventricular ejection fraction 46%) and the eventual disappearance of thrombi. Simultaneous left and right ventricular thrombi are rare but life-threatening condition, prompting consideration of myocardiopathy caused by autoimmune diseases such as lupus. Timely treatment with immunosuppressants and anticoagulants may resolve the thrombi and improve cardiac function.
(Mis)Conceptualising Empowerment: Flaws in Community-driven Development Project Design
Authors: Carrick-Hagenbarth Jessica
Published: January 2021

Development institutions have adopted models of community development that prioritise empowerment. However, many of these models have transformed a collective, process-oriented understanding of empowerment into one that focuses on individual outcomes and results all too often in project failure. This article presents a case study of a World Bank community-driven development (CDD) project implemented in agrarian settlements in north-eastern Brazil. Using mixed methods, the article finds that because this CDD approach failed to conceptualise power differences, stemming from education, income and the rural–urban divide, it overlooked the disadvantage marginalised communities would have when interacting with technical agencies and soliciting contractors. The power differences created by these inequities enabled those very technical agencies and contractors intended to support CDD subprojects to take advantage of participant communities through providing low-quality services and products. The project also failed to provide quality technical assistance for a duration sufficient to develop the skills community members required to carry out successful, productive subprojects. These findings suggest that CDD projects need to incorporate a broader conception of empowerment that addresses group-level power differences to transform the relations between participants and those on whom they depend, and thereby contribute to project success.
Single-double chains micromechanical model and experimental verification of MR fluids with MWCNTs/GO composites coated ferromagnetic particles
Authors: Xu Zhao-Dong , Sun Chun-Li
Published: January 2021

Magnetorheological (MR) fluid is a typical intelligent material which is widely adopted in the mitigation of civil engineering structures, and it is normally composed of nano-sized or micro-sized iron particles, carrier fluids and additives. Because of the complexity of its composition, it is one of the research hotspot to propose a micromechanical model which can effectively describe the micromorphological transformation as well as characteristics of MR fluids. In this study, a single-double chains micromechanical model of MR fluids is proposed by taking into consideration of the influence of volume fraction and magnetic induction on the microstructure evolution of MR fluids based on the coupled field as well as magnetic dipole theory. Additionally, the shear yield stress test of the self-prepared MR fluids with multi-wall carbon nanotubes(MWCNTs) and graphene oxide (GO) composites coated ferromagnetic particles is carried out by MCR302 rotational rheometer and the results have been compared with the theoretical values of the single-double chains micromechanical model to verify the effectiveness and accuracy of the proposed model.
Scale of Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis: A Psychometric Study in Brazil
Authors: Lira Marta Nunes , Sousa Clemente Neves , Wanderley Maria Carolina Medeiros , Pessoa Natália Ramos Costa , Lemos Kelly Cristiane Rocha , Manzini Carlene Souza Silva , Nicole Andressa Garcia , Morais Sheila Coelho Ramalho Vasconcelos , Frazão Cecília Maria Farias de Queiroz , Ramos Vânia Pinheiro , Teles Paulo , Ribeiro Olga Maria Pimenta Lopes , Dias Vanessa Filipa Ferreira , de Souza Lara Helk , Ribeiro Rita Cássia Helú Mendonça , Magalhães Anna Luiza Pereira , de Sá Basílio Lins Silvia Maria , Pressi Maira Maria Trevisan , Dourado Polyana Bezerra Mendonça , Delgado Millena Freire , Mendonça Ana Elza Oliveira , Pinheiro Jacielly Andes Araújo , Ozen Nurten
Published: January 2021

The purpose of this study was to evaluate the psychometric properties of the Brazilian Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis. Cross-sectional validation study, followed the recommendation provided by Sousa and Rojjanasrirat. Content validity, explanatory and confirmatory factor analyses used to check validity and Cronbach’s alpha was the reliability measure. Three hundred hemodialysis patients with arteriovenous fistula were included in the study. The expert committee assessed the content validity. Exploratory factor analysis confirmed the same two-factor structure found for the original scale, explaining 60.10% of the variance. Such solution was checked by confirmatory factor analysis with Cronbach’s alpha equal to 0.920, 0.810, and 0.884 for the overall scale, the self-care in management of signs and symptoms and the self-care in prevention of complications subscales respectively. The scale has good psychometric properties to assess self-care behaviors and can be used with Brazilian patients on hemodialysis with arteriovenous fistula.
Material playgrounds: opening an ontology of active matter
Authors: Mojica Laura
Published: January 2021

Rietveld’s conception of artistic practices and artworks allows us to engage with nature in a radically different manner: in a way that is more active and alive than we routinely do within the practices of philosophy and cognitive sciences. I argue that Rietveld’s material playgrounds allow us to challenge our understanding of matter as purely passive and devoid of agency; they show us that nature’s existence is a unique, raw, and powerful occurrence that intrinsically has a horizon of open possibilities.
Development of IoT—enabled data analytics enhance decision support system for lean manufacturing process improvement
Authors: Abd Rahman Mohd Soufhwee Bin , Mohamad Effendi , Abdul Rahman Azrul Azwan Bin
Published: January 2021

For over three decades, production firms have extensively espoused lean manufacturing (LM) approach for constantly enhancing their operations. Of late, due to the fusion of physical and digital systems within the Industry 4.0 evolution, production systems can upgrade by applying both notions and lift operational excellence to a new high. This is primarily the reason why digital business transformation has gained significance. Moreover, Industry 4.0 that is led by data assures huge strides in output. The sheer volume of pertinent data from the production systems employing servers, sensors, and cloud computing have made the data exchange procedure more gigantic and intricate. However, conventional systems do not extensively support LM in the context of Industry 4.0. Moreover, the previous studies by researchers in the same field, shown that there was no standard platform to manage the new technologies in LM. This study presents a discussion on the interrelated framework about the way Industry 4.0 has transformed production into an industry focusing on connective mechanisms and platforms which utilize data analytics from the real world. The theoretical framework proposed in this paper integrates LM, data analytics, and Internet of Things (IoT) to enhance decision support systems in process improvement. Data analytics in simulation is employed through Internet of Things to improve bottleneck problems by maintaining the principle of LM. The main information flow route within LM decision support system is demonstrated in detail to show how the decision-making process is done. The decision support mechanism has undergone up-gradation and the suggested framework has shown that the assimilated components could function together to augment the output.
Impact of oncology pharmacist services on humanistic outcome in patients with breast cancer
Authors: Khadela Avinash , Bhikadiya Vishal , Vyas Bhavin
Published: January 2021

Objective

This study aims to investigate the change in quality adjusted life-years (QALYs) after providing oncology pharmacist services to assess its impact on humanistic outcome.

Methods

It was a prospective, single-centered study conducted for a period of two years at Bharat cancer Hospital and Nirali memorial radiation center, Surat. Patients were recruited into the control group (CG) and the intervention group (IG). The oncology pharmacist services (OPS) were provided only to the IG. The humanistic outcome was measured by incorporating the EQ-5D-5L instrument to calculate quality-adjusted life-years (QALYs) in both the groups. Patients have been provided with the EQ-5D-5L questionnaire at the pre-determined intervals i.e. before the commencement of chemotherapy and then after every chemotherapy cycle till the completion of treatment. The analysis was carried out using descriptive analysis (frequency distribution for categorical variables and measures of central tendency (median and average) and dispersion (std. deviation) for quantitative variables).

Results

A total of 230 patients were screened and from them 105 patients were recruited, out of which 54 patients were in CG and 51 patients in IG. AC regimen followed by weekly paclitaxel was prescribed in majority of the patients (CG: 59.3%; IG: 60.8%) followed by AC-TRA and AC regimen alone. The majority of patients in the CG were facing improper administration of pre-medication (83.3%), lack of knowledge regarding chemo-mixing, counselling in nursing staff (66.7%) and a sub-therapeutic dose of anti-emetics (37%). The baseline QALY at the inception of chemotherapy was 0.040 and 0.014 in CG and IG, respectively. After the completion of the 6 chemotherapy cycle, the QALY was found to be 0.042 and 0.043 in CG and IG, respectively.

Conclusion

The study has demonstrated that the improvisation in QALY after provision of oncology pharmacist services reflect the positive impact of oncology pharmacist on humanistic outcomes. The study also provided the opportunity to identify the thrust area where more clinical pharmacy exposure is needed in order to improve patient care.
Vineyards Assessed Under a Biophysical Approach: Findings From the Biohydrology and TERRAenVISION Meetings
Authors: Marqués María José , Remke Alexander , Rodrigo-Comino Jesús
Published: January 2021

During the Biohydrology 2019 (24-27 July 2019, Valencia, Spain) and TERRAenVISION 2019 (2-7 September 2019, Barcelona, Spain) meetings, the scientific sessions joined reputed scientists around the world. Innovative debates during these scientific sessions about vineyards focused on the use of new technologies to assess soil erosion and nutrient losses, benefits or damages generated by tillage, the use of cover crops, and the introduction of organic farming. Among all the high-quality posters and oral presentations in these 2 abovementioned conferences, 3 groups from different countries with an extended list of publications decided to publish their new findings on the special issue: Vineyards Assessed Under a Biophysical Approach.
Classification and detection of cavitation, particle contamination and oil starvation in journal bearing through machine learning approach using acoustic emission signals
Authors: Poddar Surojit , Tandon Naresh
Published: January 2021

The ability to classify condition-monitoring data and make a decision can be imparted to a computer through the machine learning approach. In this article, the acoustic emission signals emerging from journal bearings under normal operating conditions and faulty states, namely cavitation, particle contamination and oil starvation, have been classified to develop fault-prediction model using the machine learning approach. Furthermore, an application has been developed that takes acoustic emission data as input and diagnoses the category of faults besides triggering an alarm under faulty states.
A multiple sclerosis disease progression measure based on cumulative disability
Authors: Manouchehrinia Ali , Kingwell Elaine , Zhu Feng , Tremlett Helen , Hillert Jan , Ramanujam Ryan
Published: January 2021

Background:

Existing severity measurements in multiple sclerosis (MS) are often cross-sectional, making longitudinal comparisons of disease course between individuals difficult.

Objective:

The objective of this study is to create a severity metric that can reliably summarize a patient’s disease course.

Methods:

We developed the nARMSS – normalized ARMSS (age-related MS severity score) over follow-up, using the deviation of individual ARMSS scores from the expected value and integrated over the corresponding time period. The nARMSS scales from −5 to +5; a positive value indicates a more severe disease course for a patient when compared to other patients with similar disease timings.

Results:

Using Swedish MS registry data, the nARMSS was tested using data at 2 and 4 years of follow-up to predict the most severe quartile during the subsequent period up to 10 years total follow-up. The metric used was area under the curve of the receiver operating characteristic (AUC-ROC). This resulted in measurements of 0.929 and 0.941. In an external Canadian validation cohort, the equivalent AUC-ROCs were 0.901 and 0.908.

Conclusion:

The nARMSS provides a reliable, generalizable and easily measurable metric which makes longitudinal comparison of disease course between individuals feasible.
Cost analysis of a remote patient monitoring programme for post-discharge patients with type 2 diabetes
Authors: Michaud Tzeyu L , Hill Jennie L , Estabrooks Paul A , Su Dejun
Published: January 2021

Introduction

Assessing costs of an evidence-based health promotion programme is crucial to understand the economic feasibility of adopting or sustaining the programme. This study conducted a cost analysis of a remote patient monitoring (RPM) programme to enhance the post-discharge management of type 2 diabetes.

Methods

Using retrospective data collected during RPM implementation from September 2014 to February 2018, we estimated the costs of implementing an RPM in the primary care setting. Measures included total and average annual costs, costs per participant who was enrolled or completed the programme, and costs per person-day. We further conducted sensitivity and scenario analyses to examine variations in estimated programme costs associated with varying programme efficiencies and alternative personnel compositions of the RPM team.

Results

The total RPM implementation costs were estimated at US$4,374,544 with an average annual programme costs of US$1,249,870, which translated to US$3207 per participant ( n = 1364) completing the three-month programme. The per person-day cost was averaged at US$24 (182,932 person-days). Sensitivity and scenario analyses results indicate that the sustainment costs were approximately US$1.6 million annually and the per-person-day costs were between US$21 and US$29 with each nurse coach on average serving a panel of 62–93 patients.

Conclusion

The implementation and sustainment costs of an RPM programme, estimated under various assumptions of programme efficiency and care team compositions, as exemplified in this study, will help healthcare organizations make informed decisions in budgeting for and sustaining telehealth programmes to enhance diabetes management.
Psychological distress and neuroticism among Syrian refugee parents in post-resettlement contexts
Authors: Khamis Vivian
Published: January 2021

This study examined the contributions of parents’ characteristics, normative stressors, coping strategies, and social support to psychological distress and neuroticism among 1000 Syrian refugees. The conditions of being older, mothers, partnered parents, and resettlement in Lebanon increased the risk of mental health problems. Mental health problems decreased with fathers’ employment, large families, and time spent in the host country. Types of daily stressors had differential effects on psychological distress and neuroticism. While emotion-focused coping increased psychological distress and neuroticism, the use of problem-focused coping, and informational support reduced neuroticism. The clinical and policy implications of these conclusions were discussed.
Static and dynamic size optimization of nonlinear continuous structure based on fully stressed design
Authors: Wu Shan , He Haoxiang , Chen Yifei
Published: January 2021

In order to realize the fully stressed criterion, that is, the stress of the nonlinear engineering structure is uniform along the height direction under the action of wind load or ground motion, the section size of the continuous structure is optimized based on mechanical analysis. The engineering structure is simplified as a continuous cantilever with variable cross-section, and its material constitution is nonlinear. The wind load and ground motion are represented by three kinds of horizontal static loads: uniform load, inverted triangle load, and inertia force related load. In order to meet the needs of different projects, hollow circular section and box section are designed, respectively. By establishing different expressions of section moment, the optimal section size distribution is solved. Then the optimal stiffness distribution of nonlinear structure is proposed. The correctness of the theory is verified by the finite element method. The results are suitable for the elastic and elastic-plastic stages of the structure, and are effective for both static loads and dynamic actions. The optimal section size distribution and structural shape are different under different loads. Finally, a practical design example is shown.
The role of flexibility and complexity in response to regulatory change: A case study of innovation in a major Danish financial institution
Authors: Bentzen Eric , Freij Åke , Varnes Claus J
Published: January 2021

The link between regulations and innovation is puzzling. Some studies point to higher innovation performance as an effect of regulation, whereas other researchers disagree. A literature review shows empirical inquiries into various industries, with the financial sector attracting significant attention. The review also points to a company’s responses’ flexibility and complexity as variables mediating the relationship between regulation and innovation performance. These variables remain underexplored as empirical objects of analysis on a company level in the financial sector. By applying a case study research strategy, 100 launched financial service innovations’ performance is compared with qualitative data assessing flexibility and complexity in the project work, leading to the launch of these products into the marketplace by a major Danish financial company. Finally, these data are quantitatively tested with a multinomial logit model. The results contribute to the differing views on how regulations influence innovation by showing links between high flexibility and low complexity in firm response for improved innovation performance. Increased complexity, in turn, impedes performance. Hence, specific innovation efforts from management are critical for striking the right balance between flexibility and complexity to achieve success in connection with regulatory changes.
An animated story created by a group of young children
Authors: Undheim Marianne , Hoel Trude
Published: January 2021

This paper contributes to the contemporary focus on literacy and digital stories in early childhood education and care (ECEC) institutions. When a group of young children create an animated story together, they might collaborate, both with their peers and with their teacher. By drawing on social semiotic multimodal perspectives as the theoretical framework, the purpose of this paper is to describe and explore how different modalities and narrative devices contribute to the development of an animated story created by six children (aged 4-5 years) and a teacher in collaboration. The study is a qualitative case study, focusing on contemporary events in a Norwegian kindergarten. The empirical material consists of video-recorded field observations of the process as well as the final product. Through an inductive exploration of the development of verbal narrative, three analytical strands are identified: i) verbal narrative in the final product, ii) multimodal narrative in the final product, and iii) narrative devices applied by the children during the process. The findings demonstrate the importance of including and considering the process, the product, narrative devices and all the modalities—in particular the kineikonic mode—when creating an animated story with young children. An implication of these findings is for ECE teachers and researchers to acknowledge and integrate all the various aspects that contribute to the final product when young children create animated stories.
Weighing the options: Service user perspectives on homeless outreach services
Authors: Bond Lynden , Wusinich Christina , Padgett Deborah
Published: January 2021

On a single night in 2018, over 194,000 individuals experienced unsheltered homelessness across the United States. Homeless outreach programs are often a first point of contact for these individuals, providing essential services, including connecting them to emergency shelter. Guided by the socio-rational choice model, this qualitative study aimed to address two questions: 1) How do experiences with outreach workers affect the way individuals experiencing unsheltered homelessness determine the utility of services offered by outreach programs? 2) What specific factors related to outreach interactions are involved in street homeless individuals’ decision to utilize or reject services from homeless outreach programs? Thirty-eight semi-structured interviews were conducted with street homeless individuals who had experience with homeless outreach in New York City. Interviews were first coded using a template approach followed by the use of a theory-guided approach for further analysis. Five main themes were identified that provided an understanding of individuals’ decision to engage with outreach services: credibility, transparency, offering choices, bureaucracy, and opportunity cost. This study provides insight into unsheltered individuals’ perspectives on homeless outreach workers and programs and offers suggestions for implementing micro- and macro-level changes to better meet the needs of our homeless neighbors.
The scarred body: A personal reflection of self-injury scars
Authors: Gunnarsson Nina Veetnisha
Published: January 2021

Self-injury is deemed a pathology and a deviant practice that is not socially sanctioned and culturally accepted as soothing and healing the self. The marked female body is also pathologized and perceived as deviant; hence, having self-inflicted scars may easily lead to social stigma, shame, and the need to hide the scars. In this personal reflection I explore how self-inflicted scars can have the same meaning as self-injury to control the self and act as self-expression, and how the marked female body can be a resistance to the cultural idea of femininity. I draw upon my own personal experiences of self-inflicted scars and how these scars have become intertwined with my identity. I have carved or burnt my body in different situations and from different moods in the past, but they are all with me at the present and will be with me in the future. Without the scars, I am not the person that others see me as or I see myself as. I sometimes feel that I would be nothing without my scars.
Social Orientation in the Luteal Phase: Increased Social Feedback Sensitivity, Inhibitory Response, Interpersonal Anxiety and Cooperation Preference
Authors: Wang Jia-Xi , Zhuang Jin-Ying , Fu Lulu , Lei Qin
Published: January 2021

Cyclical fluctuations of the ovarian hormones estrogen (E2) and progesterone (PROG) have multiple effects on reproduction and development. However, little is known about the roles of E2 and PROG in women’s social behaviors. Here, based on evolutionary theory suggesting social sensitivity and inhibition ability are conductive to maintaining social relationships, we provide evidence for the association between menstrual phases and social orientation. In Study 1, 78 women provided saliva samples and reported their intensity of behavioral activation/inhibition system (BAS/BIS) and interpersonal sensitivity at either of two phases of the menstrual cycle: late follicular phase (FP), and mid-luteal phase (LP). A significant between-subject association emerged, revealing that women with higher PROG levels reported higher levels of social feedback sensitivity, and women with relatively high PROG levels showed a positive association between their E2 levels and inhibitory response. In Study 2, 30 women reported their interpersonal anxiety and finished the social value orientation (SVO) measures at both late FP and mid-LP. A significant within-person effect emerged: women in the mid-LP, which is characterized by higher PROG levels, reported higher levels of interpersonal anxiety and SVO. In sum, these findings revealed that women’s social orientation could fluctuate naturally with ovarian hormones across the menstrual cycle.
An experimental and numerical study of epoxy-based Kevlar-basalt hybrid composites under high velocity impact
Authors: Amirian Azizolrahman , Rahmani Hossein , Moeinkhah Hossein
Published: January 2021

In this paper, the high velocity impact (HVI) behavior of epoxy-based Kevlar-Basalt hybrid composites was studied experimentally and numerically. The composite specimens were manually placed in nine layers classified into six types of stacking sequences: non-hybrid, sandwich hybrid, and intercalated hybrid. The impact tests were conducted by using a ballistic apparatus at three different energy levels: 150 J, 200 J, and 250 J, and the amount of absorbed energy was calculated based on input velocity and residual velocity of the projectile. The results demonstrated that hybridization improves the behavior of composites in high velocity impacts compared to that of specimen that are not hybridized. The absorption of sandwich hybrids on average increased 23.25% and 11.3% compared to pure Basalt and Kevlar, respectively. Moreover, the intercalated hybrids showed an efficiency of about 35.6% and 21.76% better than that of pure Basalt and Kevlar, respectively, in absorbing energy. The same energy absorption pattern was observed in numerical simulation performed in ABAQUS/Explicit. Also, the highest amount of energy absorption and the lowest residual velocity as well as damage occurred when Kevlar was attacked by the projectile and the layers were intercalated.
Ultrasound of the Median Nerve in the Surgical Treatment of Severe Carpal Tunnel Syndrome
Authors: Melton William , Soong Maximillian , Paci Gabrielle , Clair Brian , Blanchet Dayana , Ho Doreen
Published: January 2021

Background

High-resolution ultrasound (HRU) has demonstrated utility in the diagnosis and treatment of carpal tunnel syndrome (CTS) by measuring the cross-sectional area (CSA) of the median nerve. We investigated whether HRU could be helpful in evaluating outcomes of carpal tunnel release in patients with severe CTS.

Methods

Patients greater than 18 years of age with severe CTS on electrodiagnostic (EDX) studies and scheduled to have carpal tunnel release were enrolled. At baseline visit within 6 weeks preoperatively, HRU was used to measure median nerve CSA at the carpal tunnel inlet and forearm, and the wrist/forearm ratio (WFR) was calculated. Patients also completed the Boston Carpal Tunnel Questionnaire (BCTQ). Ultrasound and BCTQ were repeated at 6 weeks and 6 months postoperatively.

Results

Twelve patients completed the study (average age, 69 years; range, 52-80 years). The WFR improved significantly at 6 weeks and reached normal levels at 6 months. The CSA at the wrist also improved at 6 months, although this did not reach statistical significance ( P = .059). Boston Carpal Tunnel Questionnaire symptoms and function scores improved significantly at 6 weeks and 6 months.

Conclusions

High-resolution ultrasound provides an objective assessment of surgical outcomes in cases of severe CTS, demonstrating normalization of WFR in our series of successful cases. Future study of poor outcomes may help determine whether improvement in WFR and CSA can provide reassurance and support for observation rather than reoperation. Ultrasound also provides anatomical evaluation and may be helpful in cases with medicolegal or psychosocial issues while potentially being less costly and better tolerated than EDX or magnetic resonance imaging.
Diagnostic Performance and Advanced Imaging Reduction With Digital Tomosynthesis in Scaphoid Fracture Management
Authors: Perloff Eric , Cole Keegan , Sternbach Sarah , Rosenbaum Andrew , Quinn David
Published: January 2021

Background

Management of scaphoid fractures often requires advanced imaging to achieve accurate diagnoses and appropriate treatment. Digital tomosynthesis (DTS) is a cross-sectional imaging modality that may be used to substitute magnetic resonance imaging or computed tomographic scans. The purpose of this study is to: (1) determine the diagnostic accuracy of DTS in occult scaphoid fractures; and (2) report on the reduction of other advanced imaging when using DTS.

Methods

From May 2014 to October 2017, the charts of all patients who underwent scaphoid tomogram were retrospectively reviewed. The diagnostic accuracy of DTS for occult fracture was compared with 2-week follow-up plain films. To measure the reduction in utilization of advanced imaging, it was determined whether DTS eliminated the need for advanced imaging by providing adequate information regarding the clinical question.

Results

A total of 78 patients underwent scaphoid tomography in this time frame: 39 for occult fracture, 33 for fracture union, 5 for fracture morphology, and 1 for hardware positioning. For the detection of occult fracture, DTS had a sensitivity of 100%, specificity of 83%, positive predictive value of 64%, and negative predictive value of 100%. Advanced imaging was not used in 35 of the remaining 39 patients based on the results obtained by DTS. In patients who did receive advanced imaging, 83% of tomograms provided conclusive diagnostic information.

Conclusions

Digital tomosynthesis increases the diagnostic sensitivity of occult scaphoid fractures, reducing unnecessary immobilization and advanced imaging. Digital tomosynthesis provides clinical detail beyond plain film, which reduces the need to obtain advanced imaging when assessing union, fracture pattern, and hardware placement.
The modified frailty index-11 predicts medium-term outcomes after endovascular revascularisation for chronic limb threatening ischaemia in Asian patients
Authors: Soon Shereen XY , D’Çruz Reuban , Yap Charyl JQ , Tay Wei Ling , Chng Siew Ping , Choke Edward TC , Chong Tze Tec , Wong Ting Hway , Tang Tjun Y
Published: January 2021

Objective

The aim was to evaluate the utility of frailty, as defined by the modified Frailty Index-1 1 (mFI-11) on predicting outcomes following endovascular revascularisation in Asian patients with chronic limb-threatening ischaemia (CLTI).

Methods

CLTI patients who underwent endovascular revascularisation between January 2015 and March 2017 were included. Patients were retrospectively scored using the mFI-11 to categorise frailty as low, medium or high risk. Observed outcomes included 30-day complication rate and unplanned readmissions, 1-, 6- and 12-month mortality, and ambulation status at 6- and 12 months post-intervention.

Results

A total of 233 patients (250 procedures) were included; 137 (58.8%) were males and the mean age was 69.0 (±10.7) years. 202/233 (86.7%) were diabetic and 196/233 (84.1%) had a prior diagnosis of peripheral arterial disease (PAD). The mean mFI-11 score was 4.2 (±1.5). 28/233 (12.0%), 155/233 (66.5%), and 50/233 (21.5%) patients were deemed low (mF-11 score 0–2), moderate (mFI-11 score 3–5) and high (mFI-11 score 5–7) frailty risk, respectively. High frailty was associated with an increased 12-month mortality (OR 8.54, 95% CI 1.05–69.5; p = 0.05), 30-day complication rate (OR 9.41, 95% CI 2.01–44.1; p < 0.01) and 30-day unplanned readmission (OR 5.06, 95% CI 1.06–24.2; p = 0.04). Furthermore, a high score was associated with a significantly worse 6- (OR 0.320, 95% CI 0.120–0.840; p = 0.02) and 12-month (OR 0.270, 95% CI 0.100–0.710; p < 0.01) ambulatory status.

Conclusion

The mFI-11 is a useful, non-invasive tool that can be readily calculated using readily available patient data, for prediction of medium-term outcomes for Asian CLTI patients following endovascular revascularisation. Early recognition of short- and mid-term loss of ambulation status amongst high-frailty patients in this challenging cohort of patients could aid decision-making for whether a revascularisation or amputation-first policy is appropriate, and manage patient and caregiver expectations on potential improvement in functional outcome.
Developing a core outcome set for hand fractures and joint injuries in adults: a systematic review
Authors: Deshmukh Sandeep Rajiv , Mousoulis Christos , Marson Ben A. , Grindlay Douglas , Karantana Alexia ,   the Core Outcome Set for Hand Fractures and Joint Injuries in Adults Group, Deshmukh Sandeep Rajiv , Grindlay Douglas , Jerosch-Herold Christina , Karantana Alexia , Leighton Paul , Marson Ben A , Montgomery Alan A , Mousoulis Christos , Rodrigues Jeremy N , Trickett Ryan
Published: January 2021

This study identifies the treatment outcome domains used in recently published studies on the treatment of hand fractures and joint injuries with the aim to inform development of a core outcome set. Seven databases were searched from January 2014 to March 2019 for randomized and quasi-randomized studies and large prospective observational studies. We identified 1777 verbatim outcomes in 160 eligible studies. From the verbatim outcomes we distinguished 639 unique outcomes, which we categorized into 74 outcome domains based on the World Health Organization International Classification of Functioning, Disability, and Health framework. The primary outcome was appropriately identified in only 65% (72/110) of randomized and quasi-randomized controlled trials. Of the 72 studies with a primary outcome identified, 74% (53/72) had an appropriate power calculation. The vast heterogeneity in outcome selection across studies highlights the need for a core outcome set of what outcomes to measure in future clinical research on hand fractures and joint injuries.
Kinematics of the wrist in Kienböck’s disease: a four-dimensional computed tomography study
Authors: MacLean Simon B. M. , Bain Gregory I.
Published: January 2021

We studied the kinematics of 20 wrists affected by Kienböck’s disease using four-dimensional computed tomography (4-D-CT) scanning. Degenerative changes progressed from the lunate facet to the scaphoid fossa at the radiocarpal articulation, then involved the midcarpal joint. Lunate fracture types included coronal (14/20), sagittal (10/20) and ligament attachment-types (8/20). Findings specific to dynamic scanning included the nutcracker phenomenon (12/20), anterior radiolunate impingement (7/20), internal instability of the lunate (6/20), ulnar styloid triquetral impingement (3/20) and dynamic proximal row instability (2/20). Ulnocarpal translocation was found in 4/20 cases. Dynamic 4-D-CT has helped us to identify a subset of pathology in Kienböck’s disease on assessment of static imaging. Better understanding of these phenomena can improve our understanding of symptoms and may help direct surgical treatment.

Level of evidence: IV
Olfactory Perception and Different Decongestive Response of the Nasal Mucosa During Menstrual Cycle
Authors: Bogdan Maja S. , Slavic Danijel O. , Babovic Sinisa S. , Zvezdin Biljana S. , Kolarov Violeta P. , Kljajic Vladimir L.
Published: January 2021

Background

Sex hormones are known to have some influence on nasal functions, but their effect on the decongestive response of the nasal mucosa during menstrual cycle is still undetermined.

Objectives

The aim of this study was to examine the nasal physiology, the interconnectedness of olfactory and respiratory nasal function and the decongestive response of the nasal mucosa during menstrual cycle.

Methods

This study included 101 healthy women aged 23.26 ± 4.81 years with a regular menstrual cycle. The nasal respiratory function and the decongestive response of the nasal mucosa were examined by rhinomanometry. Subjective sense of nasal obstruction and the subjective odor intensity were assessed by standardized questionnaires. The odor identification ability was assessed by Sniffin’ Sticks test.

Results

Statistically significant higher values of nasal resistance (0.311 ± 0.107 Pa/cm3/s) and NOSE score (11.893 ± 13.83) were observed in the ovulatory phase compared to the luteal (0.281 ± 0.084 Pa/cm3/s and 9.029 ± 11.12). An odor identification test score was significantly higher in luteal phase (12.476 ± 1.48) compared to the ovulatory phase (11.971 ± 1.51), opposite of odor intensity. The difference of nasal resistance before and after decongestion was significantly higher in ovulatory phase (0.105 ± 0.097 Pa/cm3/s) compared to the luteal (0.084 ± 0.079 Pa/cm3/s). Correlation between subjective and objective parameters of the examinated nasal functions was not statistically significant in any menstrual phase.

Conclusion

In the population of women studied, total nasal resistance and NOSE score were significantly lower in the luteal phase of the menstrual cycle. Odor identification was significantly higher in the luteal phase but odor intensity significantly higher in the ovulatory phase. The decongestive response of nasal mucosa was better in the ovulatory phase of the menstrual cycle.
Left Out But “In Control”? Culture Variations in Perceived Control When Excluded by a Close Other
Authors: Kimel Sasha Y. , Mischkowski Dominik , Miyagawa Yuki , Niiya Yu
Published: January 2021

Research and theorizing suggest two competing—yet untested—hypotheses for how European Americans’ and Asians’ feeling of being “in control” might differ when excluded by a close other (e.g., a good friend). Drawing on different national contexts (i.e., United States, Japan), cultural groups (i.e., Japanese, Asian/Asian Americans, European Americans), and exclusion paradigms (i.e., relived, in vivo), four separate experiments ( N = 2,662) examined feelings of control when excluded by a close- or distant-other. A meta-analysis across these experiments indicated that Asians and Asian Americans felt more in control than European Americans when the excluder was a close other. In contrast, no consistent pattern emerged when the excluder was a distant other. This research has implications for cultural variations in aggressiveness as well as health and well-being following exclusion’s threat to perceived control.
Exploring Factor Validity of 20-Item Toronto Alexithymia Scale (TAS-20) in Albanian Clinical and Nonclinical Samples
Authors: Arenliu Aliriza , Krasniqi Brikena , Kelmendi Kaltrina , Statovci Shukrije
Published: January 2021

This study aims to examine the factor structure and validity of the Albanian TAS-20 (Toronto Alexithymia Scale) using a sample comprised of 342 students and 196 patients from a psychiatric clinic. Based on a literature review of studies of confirmatory factor analysis (CFA), three types of models were tested: first-order models with method factors and covariances, a second-order model with method factors and covariances, and nested models with method factors and covariances. The findings suggest that a three-factor correlated model with method factors was the best and most parsimonious solution for the clinical sample, exhibiting adequate levels of performance based on the goodness of fit criteria. However, regarding the student sample, the nested three-factor model with method factors and covariances demonstrated a superior fit when compared with the other tested models. Although the total scale of difficulty identifying feelings (DIF) and difficulty describing feelings (DDF) scores provided sound internal consistency, the externally oriented thinking (EOT) subscale did not. Nonetheless, as the CFA suggests the plausibility of negatively keyed items in the method factors, further interpretation of this scale is suggested. This study concludes that the TAS-20 of the Albanian language is appropriate for research purposes, and further research is needed for its application for clinical practice.
Emotions in Learning, Teaching, and Leadership: A Bibliometric Review of Asian Literature (1990–2018)
Authors: Karakus Mehmet , Usak Muhammet , Ersozlu Alpay
Published: January 2021

This study aims to map the Asian literature on emotions in learning, teaching, and leadership through a review of published research in Web of Science Core Collection. In all, 862 articles published between 1990 and 2018 were retrieved and analyzed. Bibliographic coupling of the countries, bibliographic coupling of the authors, co-occurrences of author keywords, bibliographic coupling of the journals, and bibliographic coupling of the institutions were extracted through bibliographic visualization methods. All the h-classics publications were also reviewed and categorized according to their topics. People’s Republic of China (Hong Kong), Israel, Turkey, and Cyprus are the countries with most relevant evidence. The top authors are found to be D.W Chan and M. Zembylas, while emotional intelligence, empathy, burnout, emotion, and self-efficacy have been the most frequently studied concepts. Teaching and Teacher Education and Journal of Educational Psychology are the journals with prominent pertinent influence. Education University of Hong Kong, Chinese University of Hong Kong, and Ben-Gurion University of the Negev are the institutions with the most notable influence. The current situation and research trends are discussed in the article.