bluuebunny/crossref_metadata_2025 huggingface dataset:
involvED: Applying a Scientific Approach to Education Technology Innovation for Promoting Family Engagement in the Schools
Authors: Eck Lindsay B. , Whitley Samuel F.
Published: November 2021

Parent involvement is a reverently studied, crucial concept that impacts overall student achievement. An educational technology tool, involvED, was developed by a School Psychologist and Licensed Clinical Social Worker using principles of behavioral change research and grounded in family systems theory. Incorporating a scientific approach for targeted, meaningful intervention in regards to family involvement allows for addressment of equity gaps by educating underprivileged families on vital skills, including academic readiness, social emotional learning and trauma informed practices and responses, all while providing incentives for various levels of engagement. The researchers hypothesized that by educating families in an efficient, convenient and consistent manner, as well as providing user- selected incentives for engagement, it would not only increase parent attendance at school events, but also increase the academic, social and emotional skills of the child. Positive statistically significant effects were found amongst users of the tool on both dependent variables, event attendance and the academic, social and emotional ratings of the targeted students by the classroom teacher via the SAEBRS. By addressing potential parental skill deficits and incentivizing prosocial behaviors, student outcomes are positively affected, influencing a breadth of stakeholders.
Prevalence and determinants of oral potentially malignant lesions using mobile health in a rural block, northeast India
Authors: Ramesh Rohan Michael , Patrick Sanjana , Lotha Zubemo , Azole  , Aier Atsung , Birur N Praveen
Published: November 2021

In a rural block in North East India, community health workers (CHW) empowered with a mobile phone-based application screened a total of 2,686 participants for Oral Potentially Malignant Lesions (OPMLs), and an oral medicine specialist recommended treatment remotely. Independent risk factors were determined using independent multiple logistic regression models. Nearly 700 (26%) participants were identified with OPMLs. The sensitivity, specificity, positive predictive values, negative predictive values and accuracy of the CHW was 70.3, 88.4, 66.8, 89.9% and 83.7% respectively. Male gender, married status, smokeless tobacco, paan, areca-nut and alcohol consumption were independent predictors of OPMLs, the burden of which in North East India can be attributed to the high consumption of tobacco and non-tobacco products. Such programmes, with the recommendations from remote specialists, will facilitate early detection in remote settings.
Price versus clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model
Authors: De Zarate Matias Ortiz , Mentzakis Emmanouil , Fraser Simon DS , Roderick Paul , Rutter Paul , Ornaghi Carmine
Published: November 2021

Objective

To investigate the relative impact of generic entry and National Institute for Health and Care Excellence clinical guidelines on prescribing using statins as an exemplar.

Design

Retrospective analysis of statin prescribing in primary care and cost simulation model.

Setting

Royal College of General Practitioners Research and Surveillance Centre (RCGP R&SC) database and Prescription Cost Analysis (PCA) database.

Participants

New patients prescribed statins for the first time between July 2003 and September 2018.

Main outcome measures

Shares of new patients prescribed one of the five statins available in the British National Formulary, and cost of prescribing statins to new and existing patients in primary care in England.

Results

General trends of statin’ prescriptions were largely driven by a decrease in acquisition costs triggered by patent expiration, preceding NICE guidelines which themselves did not seem to affect prescription trends. Significant heterogeneity is observed in the prescription of the most cost-effective statin acrossGPs. A cost simulation shows that, between 2004 and 2018, the NHS could have saved £2.8bn (around 40% of the £6.3bn spent on statins during this time) if all GP practices had prescribed only the most cost-effective treatment.

Conclusions

There is potential for large savings for the NHS if new and, whenever possible, ongoing patients are promptly switched to the first medicine that becomes available as generic within a therapeutic class as long as it has similar efficacy to still-patented medicines.
Bengal Partition Refugees at Sealdah Railway Station, 1950–60
Authors: Sengupta Anwesha
Published: November 2021

This article focuses on the Sealdah railway station in Calcutta, West Bengal, as a site of refugee ‘settlement’ in the aftermath of British India’s partition. From 1946 to the late 1960s, the platforms of Sealdah remained crowded with Bengali Hindu refugees from East Pakistan. Some refugees stayed a few days, but many stayed for months, even years. Relying on newspaper reports, autobiographical accounts and official archives, this article elaborates how a busy railway station uniquely shaped the experiences of partition refugees. Despite severe infrastructural limitations, the railway platforms of Sealdah provided these refugee residents with certain opportunities. Many preferred to stay at Sealdah instead of moving to any government facility. However, even for the most long-term residents of Sealdah, it remained a temporary home, from where they were either shifted to government camps or themselves found accommodation in and around Calcutta. The article argues that by allowing the refugees to squat on a busy railway platform for months and years, the state recognised a unique right of these refugees, their right to wait, involving at least some agency in the process of resettling.
Sentenced for the season: Jamaican migrant farmworkers on Okanagan orchards
Authors: Hjalmarson Elise
Published: November 2021

Despite perfunctory characterisation of Canada’s Seasonal Agricultural Worker Program (SAWP) as a ‘triple win’, scholars and activists have long admonished its lack of government oversight, disrespect for migrant rights and indentureship of foreign workers. This article contends that the SAWP is predicated upon naturalised, deeply engrained and degrading beliefs that devalue Black lives and labour. Based on twenty months’ ethnographic fieldwork in the Okanagan Valley, British Columbia, Canada, it reveals the extent to which anti-Black racism permeates, organises and frustrates workers’ lives on farms and in local communities. It situates such experiences, which workers characterise as ‘prison life’, in the context of anti-Black immigration policy and the workings of racial capitalism. This ethnography of Caribbean migrants not only adds perspective to scholarship hitherto focused on the experiences of Latino workers, but it also reinforces critical work on anti-Black racism in contemporary Canada.
A design of machinery learning activity to develop critical thinking
Authors: Sanchez-Londono David , Posada-Ceron Sofia , Barbieri Giacomo , Rodriguez Carlos Francisco
Published: November 2021

In engineering education, it is universally recognized that the development of higher-order thinking skills must be encouraged. On the one hand, the backwards design approach allows for the design of courses or activities focused on learning goals rather than on specific content, establishing basic tools to foster these skills. On the other hand, Bloom’s taxonomy allows for the separation of macro learning goals into specific learning objectives and adequate evidence. This work integrates the two approaches for the development of an active learning activity for a design of machinery course. The activity consists of introducing students to the design of mechanisms, is developed following the backwards design process and Bloom’s taxonomy of learning objectives, and focuses on both technical skills and critical thinking. After designing and testing the activity, the authors found that it allows the acquisition of technical skills in kinematics and kinetics of mechanisms and provides insights for the development of the main components of critical thinking within the machinery design process.
Envisaging global balance-sheet capitalism: The Bank for International Settlements as a collective organic intellectual
Authors: Foster Jack
Published: November 2021

This article examines how the Bank for International Settlements, as a collective organic intellectual of finance capital, has sought to maintain the hegemony of financial globalization in the context of an increasingly fractured global order following the 2007–2009 financial crisis. I show how the Bank for International Settlements’ defence of financial globalization has pivoted around the construction of a new ‘economic imaginary’ of global capitalism in which the global financial cycle, which culminates in systemic financial crises, threatens economic and political stability. Asserting that this cycle can be ‘properly managed’, the Bank for International Settlements has advocated a set of formal shifts in macro-policy frameworks. Focusing on the temporality of economic governance as envisioned by the Bank for International Settlements, I highlight two important dimensions of the organization’s discourse: the reduction of policy to process and the fetishization of policy innovation. Here, the pursuit of principles of ‘good’ economic management is prioritized over the achievement of concrete economic or social outcomes. In traversing this economic imaginary, this article offers insights into how global capitalism and its management are envisioned by elites in the current period of hegemonic disorganization and political-economic turmoil.
Evaluation of Airport Size and Delay Causal Factor Effects on Delay Propagation Dissipation
Authors: Atallah Stephanie , Hotle Susan
Published: November 2021

The International Civil Aviation Organization identifies departure and arrival punctuality as on-time key performance indicators. However, these metrics assume a flight’s delay is a result of either the origin or destination airport, providing limited information on where delay should be mitigated in the U.S. National Airspace System (NAS). This study evaluates the relationship between delay propagation magnitude, delay causal factor, airport size, and charged facility (airport or Air Route Traffic Control Center), to examine if certain delays take longer to dissipate. First, using flights from July 2018, results show that most delay propagation chains originate at large-hub airports. However, these delays were the quickest to recover. Second, this study presents a regression model, predicting total propagated delay using fixed effects based on the weather region where the original delay occurred. Each additional flight affected by downstream delay adds 18.7 min on average to total arrival delay in a propagation chain. Additionally, if weather was the original causal factor, total propagated delay increased by 11.6 min compared with non-weather delays. Lastly, this study compares delay propagation in July 2018 and July 2020. Results show uneven impacts of the coronavirus disease 2019 (COVID-19) across the large-hub airports. Some of the investigated airports did not witness large improvements in average delay per delayed flight, warranting further research in the future. While delay and delay propagation have not been completely eradicated in the NAS during the COVID-19 pandemic, findings suggest that both have significantly declined on average.
Validation of Performance-Based Specifications for Surface Asphalt Mixtures in Virginia
Authors: Habbouche Jhony , Boz Ilker , Diefenderfer Stacey D.
Published: November 2021

The Virginia Department of Transportation (VDOT), like many owner agencies, is interested in ways to facilitate the increased durability of asphalt mixes in an effort to make its roadway network more sustainable, longer lasting, and more economical. The balanced mix design (BMD) method proposes to address this through the incorporation of performance criteria into mix design and acceptance. VDOT has committed to the implementation of the BMD method in an effort to improve asphalt mix performance. The purpose of this study was to continue advancing efforts toward implementation of BMD through the evaluation of 13 asphalt mixes using performance-indicating laboratory tests, validation of the initial performance tests selected for BMD use, and validation of the initial test threshold criteria. Based on the results, the asphalt pavement analyzer (APA) rut test, indirect tensile cracking test (IDT-CT), and Cantabro test were found suitable for continued use in BMD. The current threshold criteria for all three tests were found reasonable based on additional mix testing. The study recommends that APA rut test and IDT-CT results should be compared and correlated to fundamental rutting and cracking tests, respectively, as well as to performance predictions obtained from mechanistic-empirical pavement design simulations, and to field performance for full assurance that test threshold values are appropriate. It was further recommended to evaluate the Cantabro, IDT-CT, and APA rut tests to determine acceptable variability and establish precision statements.
Transit Network Frequency Setting With Multi-Agent Simulation to Capture Activity-Based Mode Substitution
Authors: Ma Ziyi , Chow Joseph Y. J.
Published: November 2021

We propose a bilevel transit network frequency setting problem in which the upper level consists of analytical route cost functions and the lower level is an activity-based market equilibrium derived using MATSim-NYC. The use of MATSim in the lower-level problem incorporates sensitivity of the design process to competition from other modes, including ride-hail, and can support large-scale optimization. The proposed method is applied to the existing Brooklyn bus network, which includes 78 bus routes, 650,000 passengers per day, 550 route-km, and 4,696 bus stops. MATSim-NYC modeling of the existing bus network has a ridership-weighted average error per route of 21%. The proposed algorithm is applied to a benchmark network and confirms their predicted 20% growth in ridership using their benchmark design. Applying our proposed algorithm to their network with 78 routes and 24 periods, we have a problem with 3,744 decision variables. The algorithm converged within 10 iterations to a delta of 0.064%. Compared with the existing scenario, we increased ridership by 20% and reduced operating cost by 25%. We improved the farebox recovery ratio from the existing 0.22 to 0.35, 0.06 more than the benchmark design. Analysis of mode substitution effects suggest that 2.5% of trips would be drawn from ride-hail while 74% would come from driving.
Covid-19 and freedom
Authors: Vogt Henri
Published: November 2021

This article examines the multifaceted nature of freedom in relation to the world’s efforts to cope with the Covid-19 pandemic. The aim is to show that in democratic societies, increasing societal regulation to stop the spread of the virus does not necessarily curtail all possible conceptions of freedom. On the contrary, we can even construct new institutional realms or community-strengthening mechanisms through which some forms of freedom can materialise in an unforeseen manner. The heuristic model that informs the analysis is composed of six different embodiments of freedom.
Real-World Utilization Patterns of Long-Acting Injectable Antipsychotics in Canada: A Retrospective Study
Authors: Agid Ofer , Remington Gary , Fung Carmen , Nightingale Natalie M. , Duclos Marc , Anger Gregory J.
Published: November 2021

Objective: The objective of this study was to analyze the real-world prevalence of long-acting injectable (LAI) antipsychotic use and determine when LAIs are being used in sequencing of antipsychotic medications among Canadian patients with schizophrenia. Methods: This was a retrospective, longitudinal cohort study using Canadian pharmacy prescription data between August 2005 and June 2017. Patients with inferred schizophrenia spectrum disorder were indexed on the date of their first antipsychotic prescription and analyzed for minimum 12 months to track lines of antipsychotic therapy and LAI utilization. Results: A total of 16,300 patients were identified for analysis. 48.2% and 46.0% of index antipsychotic prescriptions were prescribed by a general practitioner/family medicine doctor and psychiatrist, respectively. 1,062 (6.5%) patients used an LAI during the study period. Of those patients, 789 used an LAI within two years of index (74.3% of LAI users; 4.8% of all patients). The majority of LAI use (62.0%) occurred in the third line of therapy or later. 65.0% of patients had tried at least two therapy lines, and most patients reported gaps of six months to one year between treatment lines. Conclusion: Despite their potential to reduce relapse in schizophrenia by improving treatment adherence, this study shows LAIs continue to be under-utilized in Canada. When used, LAIs are positioned late in sequencing of antipsychotic medications, often not initiated until years after diagnosis. Continued preference for oral APs with poor adherence may be negatively impacting prognosis and exacerbating burden of schizophrenia. Efforts should be invested to understand barriers to LAI uptake and advocate for earlier, widespread use of LAIs.
Exploring Insecure Romantic Attachment and Justifications for the Use of Intimate Partner Psychological Aggression in Couples
Authors: Leclerc Marie-Eve , Lafontaine Marie-France , Brassard Audrey , Péloquin Katherine
Published: November 2021

The attachment theory has commonly been used to examine intimate partner psychological aggression (IPPA), but few studies have examined its association with self-reported justifications for one’s own use of IPPA. Behaviors, including the use of IPPA, are influenced, maintained, and function within the context of their justifications, highlighting the importance of investigating these justifications to obtain a clearer picture of IPPA. This study examined whether insecure romantic attachment (i.e., attachment anxiety and attachment avoidance) in both partners of a couple was associated with their justifications for their own use of IPPA. A community sample of 81 mixed-sex couples who reported using IPPA in the last year completed self-reported questionnaires on adult romantic attachment and their justifications for their use of IPPA. Results of a path analysis based on the actor-partner interdependence model revealed moderate positive associations between attachment anxiety and one’s use of internal and external justifications for their IPPA perpetration in men and women. An unexpected dyadic positive association is discussed. These results suggest that the use of justifications for one’s use of IPPA may reflect a strategy of hyperactivation that could contribute to the cycle of psychological aggression. Uncovering the function of these justifications could provide important therapeutic benefits, which are discussed in the study’s implications.
Teachers’ perceptions of their school principal's leadership style and improvement in their students’ performance in specialized schools for students with conduct disorders
Authors: Even Uri , BenDavid-Hadar Iris
Published: November 2021

We examined the relationship between the school principal's leadership style, as perceived by the school teachers, and improvement in the performance of students with special education needs enrolled in specialized schools for students with conduct disorders. Our motivation originates in the increasing trend in their share within the general population and the premise that this unique population may respond differently to school principal leadership style. Datasets on students’ previous performance, students’ background characteristics, teacher profiles, and school features were collected. In addition, a questionnaire on teachers’ perceptions of their school principal's leadership style was distributed. Datasets were collected from 92 teachers who worked in special education needs public schools that specialized in conduct disorders. Using STATA software, we measured multilevel fixed-effects models. We found that the more the school principal is perceived as a transformational leader, the higher the students’ performance. Additionally, secondary school advantaged students (i.e. having a high level of previous performance, high socioeconomic strata), who are taught by more educated teachers, exhibit higher performance compared with their counterparts. Based on our finding, we recommend that policy makers would consider assigning transformational leaders to low-performing schools. In addition, policy makers may want to allocate extra learning resources and to provide access to learning services to support the disadvantaged students’ learning process.
Puerto Rican Student Activism and Enacting Consciousness in Chicago: Learned Lessons and Implications for Practice
Authors: Vélez Ángel L.
Published: November 2021

This research study focuses on how the racialized experiences of second-generation Puerto Rican student activists in Chicago during the social movement era increased their political identity to demand structural changes in secondary and college contexts. Drawing from over a dozen interviews and 100 source materials, this research uncovers the relationship between racialization, political consciousness, and community-engaged student activism. The study concludes by highlighting lessons learned and implications for practice.
Resourceful Actors, Not Weak Victims: Reframing Refugees’ Stigmatized Identity Enhances Long-Term Academic Engagement
Authors: Bauer Christina A. , Boemelburg Raphael , Walton Gregory M.
Published: November 2021

Refugees suffer from a stigmatized identity portraying them as weak, unskilled victims. We developed a brief (~10-min) intervention that reframed refugees’ identity as being, by its very nature, a source of strength and skills. Reading and writing exercises, provided by a university, highlighted how refugees’ experiences helped them acquire skills such as perseverance and the ability to cope with adversity, which could help them succeed in a new country. In Experiment 1 ( N = 93), the intervention boosted refugees’ (a) confidence in their ability to succeed at an imagined university and (b) challenge seeking: Participants were 70% more likely to take on an academic exercise labeled as difficult. In Experiment 2, the intervention, delivered to refugees entering an online university ( N = 533), increased engagement in the online-learning environment by 23% over the subsequent year. There was also evidence of greater course completion. It is possible to reframe stigmatized individuals’ identity as inherently strong and resourceful, helping them put their strengths to use.
Investigation of the anti-inflammatory effects of caffeic acid phenethyl ester in a model of λ-Carrageenan–induced paw edema in rats
Authors: Semis Halil Sezgin , Gur Cihan , Ileriturk Mustafa , Kaynar Ozgur , Kandemir Fatih Mehmet
Published: November 2021

In the present study, it is aimed to evaluate the effects of caffeic acid phenethyl ester (CAPE) against acute paw inflammation induced by carragenan (Carr) at macro and micro levels. Therefore, in this study, 1 hour after administering intraperitoneal of indomethacin (Ind) or CAPE (10 and 30 mg/kg body weight) to Sprague Dawley rats, Carr was injected intraplantarly into their right paws. The paw volumes of the rats were measured with a plethysmometer until the 4th hour. Also, X-ray and thermal camera images were taken to determine edema and temperature changes. At the end of the study, after the paw tissues and serums were taken, oxidative stress and inflammation status were determined using biochemical, molecular, and western blot techniques. In addition, lipid and protein profiles in paw tissue were determined using HPTLC and electrophoresis methods. The results depicted that a high dose of CAPE against Carr-induced inflammation may be almost as effective as Ind used as reference.
Factors Contribute to Project Governance Practices: Case Studies in Malaysian Rural Poverty Housing Projects
Authors: Latiff Abdul Muhaimin Abdul , Jaapar Aini , Isa Che Maznah Mat
Published: November 2021

Poverty alleviation projects are implemented as part of the national development and prosperity agenda. This study aimed to gain an understanding of the factors that contribute to the project governance practices in poverty alleviation efforts for the rural poor in Malaysia, which will lead to better project delivery and the successful outcome of the projects. Multiple case studies were conducted on two public initiative housing assistance projects in rural areas of peninsular Malaysia. It explored how dealing with the rural poor influences public officials in conducting projects through stewardship-governance notion. A qualitative approach through multiple case studies was utilised in this study where multiple sources of evidence were used such as semi-structured interviews with 12 public officials, document analysis and observation. The study discovered five factors that contribute to project governance practices, namely altruistic empathy, intrinsic motivation, effective leadership, learning environment and shared vision where these factors interplay with each other towards the achievement of project outcome. Hence, this article contributes to the dynamic understanding of how public officials embraced motivational factors in conducting their works related to the rural poverty alleviation projects. Appropriate utilisation of project governance practices drives for better project delivery to the target groups.
A Preterm With Disseminated Neonatal Herpes Simplex Virus (HSV) After Kangaroo Mother Care: Role of Prevention and Early Treatment
Authors: Saini Abhishek , Patodia Jyoti , Mittal Jaikrishan
Published: November 2021

Disseminated neonatal herpes simplex virus (HSV) infection represents the most severe form of neonatal herpes, which is associated with high morbidity and mortality. It can be completely prevented and early antiviral treatment can significantly reduce its adverse outcomes. Its early recognition in the neonate can be difficult, since the clinical presentation often mimics bacterial sepsis especially in absence of cutaneous vesicles. We report a case of preterm (twin 1) baby who during the hospital stay developed disseminated neonatal HSV type 1 infection, possibly acquired during kangaroo mother care, as on examination mother was noticed to have herpes labialis. The other twin 2 baby also developed few macular papular rash and was immediately started on antiviral treatment. The purpose of this report is to alert healthcare providers to this potential route of transmission. Furthermore, it is essential to consider neonatal HSV infection in any sick infant who is not responding to standard empirical antibiotic management, even in the absence of herpetic lesions.
The Loss of a Service Dog Through Death or Retirement: Experiences and Impact on Partners
Authors: Kogan Lori R. , Packman Wendy , Currin-McCulloch Jennifer , Bussolari Cori , Erdman Phyllis
Published: November 2021

This study was designed to better understand how service dog partners experience the loss of their service dog. An anonymous survey was distributed to service dog partners who had lost a dog within the last five years. One-way ANOVAs were used to assess loss differences (retirement vs. death) on scores for Centrality of Events Scale, Warwick-Edinburgh Mental Well-Being Scale, Social Constraints Measure, and Self-Compassion Scale. Linear regression was conducted on the total bereavement score to determine the impact of the above assessment measures. We found higher grief scores for those whose service dog died compared to those whose dog retired. Perceptions of social constraints and feelings related to the centrality of the event were predictors of overall grief for those who lost a dog due to retirement; centrality of event feelings predicted grief level for those experiencing a death. Findings suggest a need for grief support for service dog partners.
A field experiment on surface wave isolation by partially embedded periodic pile barriers
Authors: Liu Yan-Zhao , Yu Si-Shun , Liu Ze , Yu Gui-Lan
Published: November 2021

The bandgap characteristics of periodic structures show a great application prospect in seismic isolation and vibration mitigation. A T-shaped partially embedded periodic pile barrier is designed and studied based on the Bloch’s theorem. The proposed structure is fabricated and tested in field experiment to validate the simulation and the isolation performance. Good agreements are observed between the measured and the corresponding simulated results which present effective isolation for surface waves. The influences of the embedded length in the soil and the arrangement of the pile are investigated. The results show that the embedded length is the key parameter affecting the vibration attenuation. The smaller the embedded length, the lower the frequency of attenuation zone, and thanks to the embedded length; the proposed barrier exhibits better performances than the fully embedded and non-embedded barriers in maximum bandgap width, tunability, and feasibility in engineering. Gradient distribution of the embedded length leads to a wider frequency range of attenuation.
Patients’ knowledge and awareness of safe handling of oral anticancer agents at Sultan Qaboos University Hospital in Oman
Authors: Hassan Moataz M , Al-Marzooq Dhabya , Al-Habsi Hanan , Al-Hashar Amna , Al-Khabori Murtadha , Al-Moundhri Mansour , Al-Zakwani Ibrahim
Published: November 2021

Background

Safe handling of oral anticancer agents is of great concern. There is a lack of clear, national guidelines on how patients can safely handle and dispose of unwanted medications. We aimed to evaluate the safe handling, storage, and disposal of oral anticancer drugs among cancer patients and caregivers at home.

Method

This cross-sectional survey of adult cancer patients (or their adult caregivers) used a closed-ended questionnaire from May 2019 to March 2020.

Results

A total of 257 patients (50 ± 15 years; range: 18–93 years) were enrolled; however, only 91% (233/257) reported self-administering oral anticancer medications. Caregivers were more likely to administer oral anticancer agents for patients ≥60 years than those <40 years old (63% vs. 8%; P = 0.001). Most patients (52%; 133/257) did not wash their hands after administering the drug; 74% (164/222) of the respondents reported that their medications were kept in a bedroom cabinet, while 18% (40/222) stored their medications in a refrigerator, and 5% (12/222) in a kitchen cabinet. A total of 55% (68/124) of patients returned their excess oral chemotherapy medications to the hospitals; however, 36% (45/124) disposed of their unused oral chemotherapy drugs in a household garbage container.

Conclusion

While two-thirds of patients stored their oral anticancer medications properly, more than half used inappropriate handling procedures. Disposal practices were inconsistent and did not adhere to the reported international guidelines.
Diabetic ketoacidosis as a hallmark of autoimmune diabetes occurring after two cycles of cemiplimab
Authors: Jouneghani Nasrin Saleh , Phillip John , Dasanu Constantin A
Published: November 2021

Introduction

Clinical indications of immune checkpoint inhibitors have expanded to a variety of malignancies. Nearly 50% of patients with advanced cutaneous squamous cell carcinoma, respond to the programmed-death 1 inhibitor cemiplimab. To date, insulin-dependent diabetes mellitus has been documented with the use of several immune checkpoint inhibitors but not cemiplimab.

Case report

We report herein the first case of a patient with cutaneous squamous cell carcinoma who developed diabetic ketoacidosis and insulin-dependent diabetes mellitus following only two cycles of cemiplimab. A score of 6 on the Naranjo nomogram makes the causality relationship between cemiplimab use and the insulin-dependent diabetes mellitus probable.

Management and outcome

The patient's developed diabetic ketoacidosis was managed with intravenous fluids and intravenous insulin, with a prompt resolution. Cemiplimab was discontinued, and the patient was discharged on long-acting and short-acting insulin therapy, with a follow-up with endocrinology.

Discussion/conclusions

The mechanism by which cemiplimab caused insulin-dependent diabetes mellitus is most likely due to lack of endogenous insulin production in the setting of immune-mediated loss of pancreatic beta-cells. Patients may benefit from fasting blood glucose monitoring and early immune checkpoint inhibitor discontinuation where elevated serum glucose is detected.
Sunitinib induced colitis manifesting as invasive diarrhea in a patient with renal cell carcinoma
Authors: Gündoğdu Yasemin , Deniz Orhan Cem , Saka Didem , Şişman Gürhan , Erdamar Sibel , Köksal İftihar
Published: November 2021

Introduction

Sunitinib is a tyrosine kinase inhibitor that binds to vascular endothelial factor receptor currently used for the treatment of renal cell carcinoma, as well as for several other conditions such as gastrointestinal stromal tumors and pancreatic neuroendocrine tumors. We present a patient with invasive diarrhea who was treated with sunitinib for metastatic renal cell carcinoma.

Case report

Drug induced colitis was confirmed with colonoscopy from histopathological specimens. Clinical recovery of diarrhea was achieved with oral budesonide. Remarkably, the pathologic findings were observed in both the macroscopically normal mucosa and the mucosa with aphthous ulcers in the colon.

Management & outcome

The patient was treated for sunitinib associated diarrhea, after exclusion of the other reasons. Metronidazole and piperacillin/tazobactam treatment were prescribed.

Discussion

Diarrhea is a frequent symptom in patients treated with tyrosine kinase inhibitors, however the described pathologic findings have rarely been reported. Our aim is to emphasize the importance of close follow-up in patients treated with tyrosine kinase inhibitors, and to raise awareness on the management of sunitinib induced colitis.
The FACT : Use of a novel intermittent pneumatic compression device to promote pre-surgery arm vein dilation in patients with chronic renal failure
Authors: Hammes Mary , Desai Sanjay , Lucas John F , Mitta Nivedita , Pulla Abhishek , Mitra Amit
Published: November 2021

Background:

Arteriovenous fistula (AVF) creation and maturation for hemodialysis is globally a topic of importance given the poor results and high costs associated with renal care. Successful AVF (surgical or endovascular) creation requires appropriate superficial veins and quality arteries. Many procedures fail due to initial small veins with limited blood flow capacity and distensibility. Intermittent pneumatic compression has previously shown success in trials to increase superficial veins in patients with end stage renal disease post AVF. The objective of this study is to investigate the role of an intermittent pneumatic device, the Fist Assist®, to dilate cephalic arm veins in patients with advanced chronic kidney disease (CKD) prior to AVF placement.

Methods:

Three centers enrolled subjects from June 2019 through July 2021. Baseline Doppler measurements of the cephalic vein in standard locations the forearm and upper arm with and without a blood pressure cuff were recorded. Patients were instructed and used Fist Assist® on their non-dominant arm for up to 4 h daily for 90 days. At approximately 3 months, Doppler measurements were repeated. The primary endpoint was cephalic vein enlargement with secondary endpoints based on percentage of veins approaching 2.5 mm in the forearm and 3.5 mm in the upper arm.

Results:

Thirty-seven subjects with CKD (mean eGFR 13.8 mL/min) were enrolled and completed the trial. Paired-difference t-tests (one tail) for aggregate data showed significant venous dilation of the cephalic vein in both the forearm and upper arm after use with the Fist Assist® ( p < 0.05). Mean differences in the forearm veins were approximately 0.6 and 1.1 mm in the upper arm cephalic vein after Fist Assist® application. There were no major complications reported by any subject during the trial.

Conclusions:

Fist Assist® use in patients with CKD is effective to enhance vein dilation. Forearm and upper arm cephalic veins increased on average 0.6 and 1.1 mm respectively after Fist Assist® application. This is the first trial to evaluate the effect of intermittent, focal pneumatic compression on pre-surgery vein diameter in patients with advanced CKD before AVF creation.
Defining difficult intravenous access (DIVA): A systematic review
Authors: Bahl Amit , Johnson Steven , Alsbrooks Kimberly , Mares Alicia , Gala Smeet , Hoerauf Klaus
Published: November 2021

Background:

The term “difficult intravenous access” (DIVA) is commonly used but not clearly defined. Repeated attempts at peripheral intravenous catheter (PIVC) insertion can be a traumatic experience for patients, leading to sub-optimal clinical and economic outcomes. We conducted a systematic literature review (SLR) to collate literature definitions of DIVA, with the aim of arriving at an evidence-driven definition.

Methods:

The SLR was designed to identify clinical, cost, and quality of life publications in patients requiring the insertion of a PIVC in any setting, including studies on US-guidance and/or guidewire, and studies with no specific intervention. The search was restricted to English language studies published between 1st January 2010 and 30th July 2020, and the Ovid platform was used to search several electronic databases, in addition to hand searching of clinical trial registries.

Results:

About 121 studies were included in the SLR, of which 64 reported on the objectives relevant to this manuscript. Prevalence estimates varied widely from 6% to 87.7% across 19 publications, reflecting differences in definitions used. Of 43 publications which provided a definition of DIVA, six key themes emerged. Of these, themes 1–3 (failed attempts at PIV access using traditional technique; based on physical examination findings for example no visible or palpable veins; and personal history of DIVA) were covered by all but one publication. Following a failed insertion attempt, the most common number of subsequent attempts was 3, and it was frequently reported that a more experienced clinician would attempt to gain access after multiple failed attempts.

Conclusions:

Considering the themes identified, an evidence-driven definition of DIVA is proposed: “when a clinician has two or more failed attempts at PIV access using traditional techniques, physical examination findings are suggestive of DIVA (e.g. no visible or palpable veins) or the patient has a stated or documented history of DIVA.”
Material Selection Decision-Making Method for Multi-material Lightweight Automotive Body Driven by Performance
Authors: Wang Dengfeng , Li Shenhua
Published: November 2021

This work proposes a material selection decision-making method for multi-material lightweight body driven by performance to achieve that the right materials are used for the correct positions of the automotive body. The internal relationship between performance and mass, cross-sectional shape, wall thickness parameters, and material properties of a thin-walled structure is studied. The lightweight material indices driven by performance are then established. The lightweight material indices and material price are taken as the decision-making criteria for the material selection of automotive body components. A hybrid weighting method integrated with the analytic hierarchy process, fuzzy analytic hierarchy process, and quality function deployment is proposed. The difficulty of quantitatively evaluating the performance requirements of different components of the body is solved using the proposed weighting method combined with the numerical analytical results of the component performance under multiple operating conditions of the automotive body. Then, the weight of the decision-making criteria for material selection is calculated. Grey relational analysis is used to make multicriteria decision-making on a variety of candidate materials to select the best material for body components. After the lightweight material selection of the front longitudinal beam of the automotive body, the frontal collision safety performance of the body is effectively improved, and the mass of the front longitudinal beam is reduced by 45%. Material selection result of the front longitudinal beam indicates that the proposed material selection decision-making method can effectively achieve the fast material selection of components in different positions of the body.
Enhancement of machining and surface quality of quaternary alloyed NiTiCuZr shape memory alloy through ultrasonic vibration coupled WEDM
Authors: Balasubramaniyan C , Rajkumar K , Santosh S
Published: November 2021

NiTiCuZr shape memory alloys (SMA) outperform ternary and binary SMA alloys in terms of functional fatigue and higher temperature performance due to their high cyclic stability and transformation temperatures. Owing to the impairment of the shape memory effect during processing, it is difficult to select a manufacturing process for obtaining design functionality with the required dimensions and surface roughness. In this work, a high-temperature NiTiCuZr SMA was machined using an ultrasonic vibration assisted wire electric discharge machine (USV-WEDM). The machining was conducted using various parameters with a constant ultrasonic vibration of 20 kHz provided on a wire-electrode to evaluate surface roughness (Ra) and material removal rate (MRR). Scanning Electron Microscope (SEM) and Energy Dispersive X-Ray analysis (EDX) were utilized to examine the surface integrity and chemical composition of the machined surfaces. MRR increased by 62% with a steady increase in pulse-on time ( Ton) and applied current ( I), whereas increasing levels of parameters such as pulse-off time ( Toff) and servo voltage (SV) reduced surface roughness ( Ra) by 69%. The results reveal that tool vibration at ultrasonic frequency reduces the surface roughness and improves the material removal rate of the machined NiTiCuZr SMA as compared to that of non-ultrasonic assisted machining conditions. SEM-EDX investigation reveals that the formation of re-solidification and oxide layers during NiTiCuZr machining at high machining parameters results in increased hardness and surface roughness. USV-WEDM is a suitable process for machining SMA alloy without adversely impacting SMA properties.
The role of entrepreneurial orientation in developing SMEs resilience capabilities throughout COVID-19
Authors: Zighan Saad , Abualqumboz Moheeb , Dwaikat Nidal , Alkalha Ziad
Published: November 2021

Through the lens of entrepreneurial orientation, this study investigates operational practices that (small and medium-sized enterprises) have either adopted or improvised to support small and medium-sized enterprises’ resilience in the face of coronavirus disease 2019. Qualitative data were collected through 43 semi-structured interviews with entrepreneurial resource providers, owners and managers of several small and medium-sized enterprises across different industrial sectors in Jordan. The study contributes to the further understanding of small and medium-sized enterprises’ resilience by conceptually advocating a five-pillars practitioner-grounded framework of small and medium-sized enterprises’ resilience capability (efficiency-based capability, adaptive-capability, collaborative-capability, change-capability and learning-capability). Entrepreneurial orientation has been found to transition and mobilise small and medium-sized enterprises’ resilience to survive major disruptions and threats. Entrepreneurial orientation, in this study, grounded on risk-taking, innovation and proactivity, facilitates developing new capabilities that shield the firm against different threats. Practically, the study suggests several recommendations for small and medium-sized enterprises to meet the challenges of coronavirus disease 2019 and similar future major shocks. Notably, the study suggests that small and medium-sized enterprises should balance short-term operational actions with long-term strategic thinking to build a resilience capability pool.
Politics of visual discourse in China: the corruption cartoon
Authors: Chu Yingchi
Published: November 2021

This article investigates single-panel cartoons portraying official corruption in China’s longest- running state-owned cartoon newspaper Cartoon Weekly ( Fengci yu youmo). A total of 433 cartoons are identified as relating to corrupt officialdom between 2012 and 2019 in the wake of Xi Jinping’s anti-corruption signature policy. In contrast with the individualizing critique of political cartooning in liberal democracies, the corpus of corruption cartoons investigated in this article is argued as a didactic form of visual schematization in a pseudo-self-critical discourse typically buttressed by verbal reading instructions. To support this claim, the article addresses its politics of visual discourse by employing Peircean hypoiconicity, consisting of direct resemblance, diagrammatic schematization and metaphoric displacement. Accordingly, the article identifies three major features of corruption cartoons as anonymization of direct resemblance, visual schematization of policy and metaphoric displacement of conventional symbols.
(Computationally) designing out waste: Developing a computational design workflow for minimising construction and demolition waste in early-stage architectural design
Authors: Haeusler Matthias H , Gardner Nicole , Yu Daniel K , Oh Claire , Huang Blair
Published: November 2021

In the architecture, engineering and construction (AEC) industry, waste is oft framed as an economic problem typically addressed in a building’s construction and demolition phase. Yet, architectural design decision-making can significantly determine construction waste outcomes. Following the logic of zero waste, this research addresses waste minimisation ‘at the source’. By resituating the problem of construction waste within the architectural design process, the research explores waste as a data and informational problem in a design system. Accordingly, this article outlines the creation of an integrated computational design decision support waste tool that employs a novel data structure combining HTML-scraped material data and historic building information modelling (BIM) data to generate waste evaluations in a browser-based 3D modelling platform. Designing an accessible construction waste tool for use by architects and designers aims to heighten awareness of the waste implications of design decisions towards challenging the systems of consumption and production that generate construction and demolition waste.
Beyond College Access: An Exploration of the Short-Term Impact of a Dual Enrollment Program
Authors: Johnson Jennifer M. , Paris Joseph H. , Curci Juliet D. , Horchos Samantha
Published: November 2021

The purpose of this qualitative case study is to gain insights into the activities and outcomes associated with participation in the Temple Education Scholars (TES) dual enrollment program, an initiative for seniors attending high school in a large city in the Northeast region of the United States. The objectives of this study are twofold: (1) to inform the design and implementation of dual enrollment programs as a model for facilitating students’ transition from secondary to postsecondary education and supporting their future success in college; and (2) to describe the short-term impact of participation in a dual enrollment program on participants’ choices about postsecondary education. Our analysis revealed the ways that participating in this dual enrollment program shaped students’ attitudes, motivations, and perceptions about college knowledge, college readiness, and college opportunities. Implications for policy and practice are discussed.