bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomised phase II trial testing the acceptability and feasibility of a narrative approach to public health communication to increase community engagement with palliative care
Authors: Collins Anna , McLachlan Sue-Anne , Hill Mike , Collins Sue , Philip Jennifer
Published: June 2020

Background:

Communities have limited understanding of palliative care, creating barriers to informed choice around consideration of a full range of care options in the event of serious illness. Few empirically tested interventions are available to educate community about palliative care, and ultimately improve timely access to these services.

Aim:

To test the acceptability (primary outcome), and feasibility of a narrative approach to public health communication seeking to improve attitudes to possible access to palliative care in the event of serious illness.

Design:

Randomised phase II trial with six parallel experimental conditions. Outcomes tested included measures of acceptability, feasibility and change in attitudes to possible access to palliative care post-intervention. Contrasts planned for exploratory testing included format, message content and narrator.

Setting/participants:

Community-based sample of consecutive English-speaking adults who volunteered their participation in response to a study advertisement distributed online through established community groups.

Results:

A narrative approach to public health communication was found to be acceptable to community members, and feasible to deliver online. Exploratory data suggested it immediately improved attitudes towards possible access to palliative care in the event of serious illness, with the narrative detailing a description of the evidence delivered by a healthcare professional appearing to be the most promising strategy.

Conclusions:

This study provides preliminary data to inform a future, longitudinal trial evaluating effectiveness and ultimately other evidence-based, public health approaches to improve community engagement with palliative care. Further studies are required to confirm the generalisability of findings to a broader representative sample and other settings including internationally.
Cardiac metastasis of neuroendocrine tumor of the thymus diagnosed by cardiac magnetic resonance T1 mapping: a case report
Authors: Zhang Jiamin , Zeng Mu
Published: June 2020

Carcinoid heart disease is a late complication of carcinoid syndrome, and imaging can help in the diagnosis of diffuse cardiac metastasis. We herein report a case of diffuse cardiac metastasis of a neuroendocrine tumor of the thymus diagnosed using different imaging modalities. Cardiac magnetic resonance imaging played an important role in the diagnosis. The patient underwent conservative medical treatment and remained able to perform his usual activities of daily living.
Holistic Integration in the Processing of Chinese Characters as Revealed by Electroencephalography Frequency Tagging
Authors: Cai Yazhi , Mao Yudi , Ku Yixuan , Chen Jing
Published: June 2020

It is debated whether perceptual expertise of nonface objects, such as visual words, is indicated by holistic processing, which is regarded as a marker of perceptual expertise of faces. We address this question by frequency-tagged electroencephalography. Different parts of real or pseudo Chinese characters are presented at distinctive frequencies (6 or 7.2 Hz), which induce frequency-tagged steady-state visual-evoked potentials at occipital brain areas. The intermodulation response (e.g., 6 + 7.2 = 13.2 Hz) would emerge when holistic integration takes place. Our results suggest that the intermodulation response to the real characters is left lateralized, which is contralateral to previous findings with faces. Furthermore, at the left occipital area, the intermodulation response to real characters is more prominent than pseudo characters, suggesting that holistic integration is enhanced for real characters than for pseudo ones. Taken together, our findings suggest that holistic integration is potentially a general expertise marker for both faces and non-face objects.
Defining and Analyzing Forceful Gap Behavior at Unsignalized Intersections
Authors: Advani Mukti , Gupta Neelam J. , Velmurugan S. , Madhu Erramppalli , Chandra Satish
Published: June 2020

Under mixed-mode traffic conditions prevailing on Indian roads at unsignalized intersections, it is commonly observed that vehicles entering from minor streets indulge in forceful gap creation/delay for the vehicles moving on the major road. Although this driving behavior has been reported in some of the published studies for Indian traffic conditions, a clear definition of such forceful entries is not available. An attempt has been made in this study to define this forceful entry phenomenon on the basis of changes in the speed of major streets’ vehicles approaching the intersection on a typical case of mixed-traffic environs. In this regard, field observations were recorded through videography to obtain the speed reduction threshold value for categorizing an entry as a forceful entry. To quantify the above, data in relation to various vehicle types approaching intersections and their associated speeds at the reference area were extracted at the approach arms of the intersection. On the basis of observations, collected data were divided into three scenarios: ( 1 ) vehicles on major roads reduce their speed when vehicles are absent on minor roads; ( 2 ) vehicles on major roads reduce their speed when vehicles are waiting on minor roads; and ( 3 ) vehicles on major roads reduce their speed when vehicles from minor roads have accepted the gap/lag for movement. The changes in speed in all the three scenarios were compared to identify forceful entries with the base case of normal traffic flow on the major road without the existence of forceful entry phenomenon. The study revealed that the speed reduction to the extent of 73% is considered as a forceful entry at the selected location. Furthermore, the study estimated the effect of forceful behavior on critical gap at unsignalized intersections.
Changes in aortic pulse wave velocity in peritoneal dialysis do not mirror changes in extracellular water measured by bioimpedance
Authors: Tangvoraphonkchai Kamonwan , Davenport Andrew
Published: June 2020

Background:

Pulse wave velocity is a measurement of arterial stiffness and associated with increased cardiovascular mortality. Previous reports in peritoneal dialysis have linked increased pulse wave velocity with an expansion in extracellular water. As cardiovascular mortality is increased in peritoneal dialysis patient, we wished to determine whether changes in pulse wave velocity mirrored changes in extracellular water.

Methods:

We repeated aortic pulse wave velocity and bioimpedance-derived extracellular water measurements in peritoneal dialysis patients attending for assessment of peritoneal membrane function.

Results:

Sixty-six patients, 41 males (62.1%), mean age of 66.2 ± 13.9 years, median duration of peritoneal dialysis treatment (14.3 (3.1–31.9) months) had repeated measurement 6.4 (5.8–10.2) months apart, with no significant change in aortic pulse wave velocity (10.1 ± 3.2 to 9.9 ± 2.8 m/s). In univariate analysis, the initial aortic pulse wave velocity was associated with extracellular water (r = 0.26, p = 0.034) and serum N-terminal pro brain-type natriuretic peptide (r = 0.25, p = 0.04), and on follow-up, aortic pulse wave velocity with N-terminal pro brain-type natriuretic peptide (r = 0.31, p = 0.01). Aortic pulse wave velocity increased in 50% of patients, and these patients had greater serum C-reactive protein 3(2–10) versus 2(1–4) mg/L, and ferritin (778(444–1099) versus 585(313–811), p < 0.05), but there were no differences in either absolute or adjusted extracellular water. Both log C-reactive protein (odds ratio 4.7 (95% confidence limits 1.3–17.1), p = 0.019) and prescription of calcium channel blockers (odds ratio 4.9 (95% confidence limits 1.2–19.1), p = 0.024) were independently associated with an increase in aortic pulse wave velocity.

Conclusion:

We did not find an independent association between a change in aortic pulse wave velocity and extracellular water, suggesting that changes in aortic stiffness in peritoneal dialysis patients are more complex than simply following changes in extracellular water.
Influence of freeze/thaw cycling on the mechanical performance of resistance-welded carbon fibre/polyphenylene sulphide composite joints
Authors: Rohart Vincent , Lebel Louis L , Dubé Martine
Published: June 2020

This study evaluates the effects of freeze/thaw cycles on the mechanical performance and failure mode of resistance-welded carbon fibre/polyphenylene sulphide composite joints. Dry and moisture-saturated joints are subjected to 1000 temperature cycles varying between –40°C and 82°C. A silane coating is applied on the stainless steel mesh heating element to improve its adhesion with the polyphenylene sulphide polymer. Results show the limited impact that freeze/thaw cycles have on the lap shear strength of joints welded without any coating on the heating element. The silane coating improves the lap shear strength by 32% when no freeze/thaw cycles are applied to the joints. This improvement of 32% reduces when joints are subjected to freeze/thaw cycles but the mechanical performance remains superior to that of joints welded using uncoated heating element. Fracture surfaces show that fibre/matrix and stainless steel/matrix interfaces are both affected by the environmental conditions although it does not translate into lower lap shear strength.
Dyadic Profiles of Health Behaviors Among Korean Baby Boomer Couples
Authors: Kim Bon , Kim Kyungmin , Burr Jeffrey A. , Kim Joohyun , Han Gyounghae
Published: June 2020

Objectives: To address the issue of whether health behaviors are concordant within couples, this study identified dyadic profiles of health behaviors among Korean baby boomer couples ( born 1955–1963). Methods: We analyzed a sample of 1,092 middle-aged couples from the Korean Baby Boomer Panel Study (2014). Latent class analysis and multinomial regression models were conducted to describe underlying health behavior profiles. Results: Four dyadic profiles of health behaviors emerged: (a) concordant—high health-promoting (26%), (b) moderate concordant—compensating (21%), (c) moderate concordant—low engaging (22%), and (d) less concordant—high health-promoting (31%). In addition, couples with higher levels of education, worse health, or better marital quality were more likely to belong to two high health-promoting profiles. Discussion: Encouraging husbands to engage in fewer health-compromising behaviors and acknowledging barriers to health-promoting behaviors for both spouses may contribute to healthier lifestyles among Korean couples.
Combustion behavior and fire security of storage grains before and after mildew
Authors: Wang Jingwen , Yu Heng , Chen Weijian , Cai Wei , Cheng Liang , Wang Junling , Jin Xin , Song Lei , Mu Xiaowei , Hu Yuan
Published: June 2020

Storage grains before and after mildew are first subjected to thermal radiation experiments under different heat radiant flux conditions using a cone calorimeter. The chemical constitution, morphology, operational taxonomic unit analysis, and the degree of mildew of four disaggregated storage grains under the same proceeding conditions are studied. Normal grain and mildewed grain are significantly different in terms of the mounts and species of mold. The peak heat release rate and the total heat release of mildewed grains are higher than that of normal grains. Under different heat radiations, the fire performance index of mildewed grains tends to be lower than that of normal samples, while the fire growth index value is just the opposite. The higher the heat radiation, the less the effect of mold on the fire performance index difference. Besides, the reciprocal of the square root time of sample ignition has a linear relationship with the heat flux.
Conceptualizing U.S. Community Economic Development: Evidence from New York City
Authors: Spicer Jason S. , Casper-Futterman Evan
Published: June 2020

Building from the “Progressive Cities” era toolkit, advocates of community economic development (CED) today deploy a wide range of new and well-established strategies. How can planners make theoretical and practical sense of these varying tactics? Using New York as a case and sociological strategic action field theory as a framing device, we find evidence of three distinct CED logics: exactive/concessionary, localist, and transformative/democratic. We differentiate these logics based on their relationship to neoliberalism and globalization, forces which have shaped CED’s historical development. Awareness of these ideal-type logics may assist planners and CED actors in selecting and coordinating contextually appropriate strategies.
Tomorrow I’ll Be at the Table: Black Geographies and Urban Planning: A Review of the Literature
Authors: Brand Anna Livia , Miller Charles
Published: June 2020

This article reviews the literature on black geographies as it relates to the everyday work of urban planners. We outline the major claims and contributions of this scholarship to deepen our understanding of the relationship between the social and physical worlds. This article argues that this literature is a critical, yet missing, contribution to the field of urban planning because it provides different ways of knowing and understanding the experience of racial difference and therefore challenges us to invite more diverse views to the table and build more informed professional practices, pedagogical foundations, and empirical scholarship.
Violence and Victimization in Interactions Between Male Sex Workers and Male Clients in Mombasa, Kenya
Authors: Valente Pablo K. , Edeza Alberto , Masvawure Tsitsi B. , Sandfort Theo G. M. , Gichangi Peter B. , Restar Arjee J. , Ume Tocco Jack , Vusha Chabeda Sophie , Lafort Yves , Mantell Joanne E.
Published: June 2020

Male sex workers (MSWs) and male clients (MCMs) who engage their services face increased vulnerability to violence in Kenya, where same-sex practices and sex work are criminalized. However, little is known about how violence might arise in negotiations between MSWs and MCMs. This study explored the types of victimization experienced by MSWs and MCMs, the contexts in which these experiences occurred, and the responses to violence among these groups. We conducted in-depth interviews with 25 MSWs and 11 MCMs recruited at bars and clubs identified by peer sex worker educators as “hotspots” for sex work in Mombasa, Kenya. Violence against MSWs frequently included physical or sexual assault and theft, whereas MCMs’ experiences of victimization usually involved theft, extortion, or other forms of economic violence. Explicitly negotiating the price for the sexual exchange before having sex helped avoid conflict and violence. For many participants, guesthouses that were tolerant of same-sex encounters were perceived as safer places for engaging in sex work. MSWs and MCMs rarely reported incidents of violence to the police due to fear of discrimination and arrests by law enforcement agents. Some MSWs fought back against violence enacted by clients or tapped into peer networks to obtain information about potentially violent clients as a strategy for averting conflicts and violence. Our study contributes to the limited literature examining the perspectives of MSWs and MCMs with respect to violence and victimization, showing that both groups are vulnerable to violence and in need of interventions to mitigate violence and protect their health. Future interventions should consider including existing peer networks of MSWs in efforts to prevent violence in the context of sex work. Moreover, decriminalizing same-sex practices and sex work in Kenya may inhibit violence against MSWs and MCMs and provide individuals with safer spaces for engaging in sex work.
Indicators of Criminal Justification or Repentance in a Qualitative Analysis of Inmates Autobiographical Criminal Self–Narratives
Authors: Company-Fernández Alba , Tarancón Pilar , Cruz Ana Rita , Griffith James W. , Ricarte Jorge J. , Barry Tom
Published: June 2020

This study explores the narrative contents obtained from the description of autobiographical memories reported by a sample of incarcerated males that exemplified their most aggressive, transgressive, or criminal selves. Participants were 110 men serving a prison sentence for different types of crimes. Three main phenomena were identified from their stories: the narration of the criminal self, description of the crime (or crimes) committed, and the criminal responsibility attributional processes. The results showed the existence of mechanisms to justify the crime among a large section of participants, whereas the assumption of personal responsibility for the commission of the crime and the consideration of an unfair or excessive sentence were not as frequent. Also, some specific crimes concurred with concrete responsibility attributional processes, especially with the justification of criminal behavior. These findings generate useful information regarding recidivism, resocialization, and the attribution of responsibility among inmates.
Joint Developmental Trajectories of Bullying and Victimization from Childhood to Adolescence: A Parallel-Process Latent Class Growth Analysis
Authors: Zhou Yueyue , Zheng Hao , Liang Yiming , Wang Jiazhou , Han Ru , Liu Zhengkui
Published: June 2020

Previous studies have shown that bullying and victimization can be experienced simultaneously by an individual and can change over time. Understanding the joint longitudinal development of the two is of great significance. We conducted a 4-year longitudinal study to examine the joint developmental trajectories of bullying and victimization, gender and grade differences in trajectory group membership, and changes in specific forms of bullying and victimization (verbal, relational, and physical bullying /victimization) in each trajectory group. A total of 775 children from China participated in our study. The average age of participants at the first wave was 10.90 years ( SD = 1.12), and boys accounted for 69.5% of the sample. Based on mean scores, four distinct joint developmental trajectories of bullying and victimization were found: the involvement group (both bullying and victimization increased from low to high over time, accounting for 7.6% of the total), the desisted group (both bullying and victimization decreased from high to low over time, 6.1%), the victimization group (victimization remained at a high level, whereas bullying remained at a low level for 3 years, 13.2%), and the noninvolved group (bullying and victimization remained at a stable low level, 73.1%). Boys were more likely than girls to belong to the involvement group, desisted group, and victimization group, whereas girls were more likely than boys to belong to the noninvolved group. There was no significant grade difference in the trajectory group. All forms of bullying/victimization were consistent with the overall trend and showed similar levels. These results have important implications for the prevention of and interventions for school bullying.
Nonstandard Employment and Job Satisfaction across Time in China: Evidence from the Chinese General Social Survey (2006–2012)
Authors: Nawakitphaitoon Kritkorn , Tang Can
Published: June 2020

This study examines the association of nonstandard employment with job satisfaction over time in China. An analysis is carried out using the Chinese General Social Survey (CGSS), a large cross-sectional survey that collected data from over 3000 workers across different industries, ownership types and regions in China in 2006, 2008 and 2012. The empirical results show that in 2006, nonstandard employment workers, on average, were less satisfied with their jobs than their counterparts in standard employment, all else being equal. However, these differences in job satisfaction became very small and insignificant in 2008 and 2012. The results from the propensity score matching exercise provide a similar conclusion. These findings suggest that improvements in regulations and employment relations in China have increased job satisfaction for nonstandard employment workers.
Studies on mechanical, thermal and tribological properties of carbon fibre-reinforced boron nitride-filled epoxy composites
Authors: Muralidhara B , Babu SP Kumaresh , Suresha B
Published: June 2020

This research focuses on the static mechanical, thermal and tribological properties of carbon fibre epoxy (CF/Ep) composites filled with boron nitride (BN) micro-filler powder (BN-CF/Ep). The mechanical properties studied were tensile, flexural, interlaminar shear strength and hardness. The thermal properties studied were dynamic mechanical and thermogravimetric analyses which were analysed through dynamic mechanical analyser and thermogravimetric analyser, respectively. The curing ability and dispersion of BN filler in the Ep and composites were investigated through differential scanning calorimetry, Fourier-transform infrared spectra and scanning electron microscopy. The tribological properties focused were three-body abrasion and dry sliding friction and wear conduct. Three-body abrasion tests were studied with silica sand of 212 µm particle size, 30 N load, 2.38 m s−1 sliding velocity and variable abrasive distances of 250 m, 500 m, 750 m and 1000 m. The dry sliding wear tests were performed using pin-on-disc (POD) wear experimental set-up with 60 N load, 3 m s−1 sliding velocity and variable sliding distances of 1000 m, 2000 m and 3000 m. The results followed the trend of BN1% > BN3% > BN5% composites in all mechanical properties. The carbon fabric reinforcement along with the BN-Ep matrix improved enormously all the mechanical properties except impact resistance. Further, it was exhibited that 1 wt% BN into CF/Ep prompts better mechanical properties with predominant damping capacity and thermal stability. Both the dry sand abrasive wear and POD test outcomes revealed that all BN-CF/Ep composites prompt predominant wear resistance. CF along with BN improves enormously the wear resistance with friction coefficient. Further, it was exhibited that 1 wt% BN into CF/Ep in both three-body abrasive and POD tests prompts better wear resistance. Generally speaking, it was presumed that BN-CF/Ep gracefully and successfully improved the mechanical, thermal and tribological properties and morphology of Ep for various mechanical, electrical components and load-bearing applications used in automotive and engineered applications.
Large-scale motion of submerged offset jets issuing from sharp-edged rectangular nozzles
Authors: Nyantekyi-Kwakye B
Published: June 2020

The mean flow, turbulence characteristics, and dynamics of large-scale vortices are investigated for an offset jet issuing from different nozzle expansion ratios using a four-receiver acoustic Doppler velocimeter. The jet was discharged from sharp-edged rectangular nozzles with expansion ratios of 0.24, 0.49, 0.75, and 1.00 at Reynolds number of 5.3 × 104. The decay rate of the maximum mean velocity decreased with increasing expansion ratio due to suppressed lateral entrainment of ambient fluid. The acoustic Doppler velocimeter proved capable of providing high-quality data to investigate the energy spectrum and turbulent structures embedded in the flow. Large-scale vortices dominated the recirculation region compared to the reattachment and developing regions of the jet. Increasing the expansion ratio resulted in larger order of magnitude of the vortices within the recirculation region. The turbulent structures stretched in the lateral direction in regions where smaller-sized structures existed in the streamwise direction and vice versa.
Analysis of ride comfort of a continuous tracked bogie system with variable configuration
Authors: Soodmand Iman , Heidari Shirazi Kourosh , Moradi Shapour
Published: June 2020

In this study, the effect of change in height of a so-called variable configuration of a continuous tracked bogie system on ride comfort performance is investigated. To this end, constraint equations among different vehicle parts are derived recursively, and equations of motion are formulated according to the Newton–Euler equations using the embedding technique. Besides, to model the track as a closed-loop chain, the penalty method has been used instead of loop-closure equations. To mathematically model the contact between tracks, wheels, and the terrain, the continuous contact force model has been employed. To validate the mathematical model, the vehicle dynamic behavior is simulated by the Runge–Kutta method in MATLAB software and compared with those obtained from the identical model, built in RecurDyn software, and the results show good agreement. Moreover, the vibrational behavior of the tracked vehicle is investigated using two different vehicle configurations. This reveals that an increase in vehicle height does not change the vehicle vibrational frequencies. However, it increases the vehicle vibration amplitude and the energy absorbed by the vehicle components and decreases the ride comfort.
Thermo-mechanical coupling behaviour when milling titanium alloy with micro-textured ball-end cutters
Authors: Zheng Minli , He Chunsheng , Yang Shucai
Published: June 2020

The high-speed milling of titanium alloy is a very complex nonlinear dynamic cutting process, and there are mutual coupling effects between multiple physical fields of the tool. Therefore, the thermo-mechanical coupling behavior of micro-textured ball-end milling cutters during the cutting of titanium alloy was studied in depth, combined with theoretical calculations, milling experiments and simulation analysis. First, based on the experimental data of milling titanium alloy, the stress field of the micro-textured ball-end milling cutter was solved. Then, the dimensional method was used to solve the temperature field of the micro-textured ball-end milling cutter. Finally, the thermo-mechanical coupling simulation analysis of the micro-textured ball-end milling cutter was carried out, and the stress concentration area and tool breakage area of the micro-textured ball-end milling cutter under the thermo-mechanical coupling effect are obtained. This in turn gives a theoretical basis for further improving the performance and tool life of micro-textured cutters.
Reinvestigation into railway wheel-track interaction and suspension damage
Authors: Luo Renfan , Vincent David
Published: June 2020

Without considering either velocity or acceleration effects, the current conventional method presented in literature applies the vertical deflection of a wheel centre caused by a flat defect to the Hertzian contact theory. This method has been numerically and theoretically proved to be inappropriate and can incorrectly predict a higher wheel-rail impact force for a low speed than a high speed. Therefore, under a hypothesis of no wheel bouncing and sliding, two new methods, the velocity-based and the acceleration-based have been proposed. The former method takes the wheel centre deflection change in each computational increment from the Hertzian contact theory while the latter applies the wheel centre acceleration caused by the flat in revolutions to the wheel as a force in dynamic simulation, which interprets the speed effects on impacts precisely. A sensitivity study proves that the velocity-based method is unreliable as opposed to the acceleration-based method. A beam/rigid FE model has also been developed to inspect the wheel-track interaction by performing dynamic analysis in the time domain. It has been found out that the impact responses predicted by the FE analysis and the velocity method are similar and the FE results heavily depend on the compute increment, which implies the FE modelling in ABAQUS may be unreliable for this issue with current applied increments. Finally, the results calculated using the acceleration method have been employed to study the suspension/damper torsional stress caused by a wheel flat. This indicates that a wheel flat may lead to potential fatigue damage if without proper maintenance management.
Simulation and experimental results of an unmanned towed system
Authors: Huynh Nghia , Montalvo Carlos
Published: June 2020

This report investigates the flight dynamics of a small-scale (2 ft) towed system using a quadcopter and actively controlled payload. A towed system includes a main driver to propel the system forward connected to a payload via a tether. The towed system here is unique, and in that the driver is a scratch built quadcopter while the payload is also a scratch built actively controlled aircraft. The payload is designed to carry a small instrument that must be sufficiently far away from all interferences created by a quadcopter. A fully non-linear full state model is created and utilized to reveal that oscillations in the payload are decreased with the introduction of a PD controller on the payload. An experimental setup is built to validate simulation results. Experiments show that an actively controlled payload can decrease the attitude oscillations of the payload.
Stress relaxation performance of glass fiber-reinforced high-density polyethylene composite
Authors: Saeed Usman , Al-Turaif Hamad , Siddiqui Muhammad Ehtisham
Published: June 2020

The article presents a study about the stress relaxation by means of time-sensitive interfacial shear stress transfer between the interface of the fiber and matrix. The behavior of stress relaxation of glass fiber (GF)-reinforced high-density polyethylene (HDPE) composites is measured experimentally and then compared with Cox shear-lag analytical model predictions. Furthermore, the effect of supplemented interfacial interaction between the interface of the fiber and matrix is analyzed by the introduction of an interfacial coupling agent called Fusabond M603. In addition, the results showed that the stress relaxation behavior of GF-reinforced HDPE composite can be predicted by using a Cox shear-lag model. On examination, the experimental data and analytical model showed a favorable correlation which can be useful for future applications of the intended products made of polymer-based composites.
Transports of Sick Neonates to a Tertiary Care Hospital: Condition at Arrival and Outcomes
Authors: Chandrashekhar Channanayaka , Doreswamy Srinivasa Murthy , Nataraj Nanda , Panachiyil George Mathew , Babu Tirin
Published: June 2020

Objective: To evaluate the transport system, condition of the baby on arrival, and the outcome of the sick neonates transported to our hospital.

Methodology: This prospective study included 100 neonates referred to our hospital. A pro forma with a questionnaire regarding the transport details was filled with information taken from the parents/attendant accompanying the baby.

Results: A total of 100 number of referrals over a period of 8 months were included. Almost half the referrals were in the first week of life: 74% were term and 26% preterm. Only 28% of the babies were sent with prior communication to our hospital. About 69% babies had a referral document of them, but only 26% had complete information regarding the baby’s illness and prior treatment. The modes of transport used were private ambulance (36%), car (25%), and government ambulance (22%). Few newborns were brought by autorickshaw (12%), bus (3%), and two-wheeler (2%) too. None of the babies were brought with kangaroo mother care (KMC) during transit. Intratransport care included supplemental oxygen (53%) and IV medications (14%). On arrival the transported neonates had problems such as prolonged capillary filling time (78%), hypothermia (72%), respiratory distress (23%), hypoglycemia (14%), needing life support (14%), and apnea (8%). Out of them, 85% improved, 12% were discharged against medical advice, 2% died, and 1% referred.

Conclusion: The study highlights the unaddressed challenges and the scope for improving the transport of sick neonates between hospitals and further emphasizes the need for devising solutions.
Exploring the Internationalization of Zimbabwe’s Higher Education Institutions Through a Decolonial Lens: Postcolonial Continuities and Disruptions
Authors: Thondhlana Juliet , Abdulrahman Hadiza , Chiyevo Garwe Evelyn , McGrath Simon
Published: June 2020

Looking through the history of higher education in Zimbabwe, we argue that the concept of internationalization of higher education is not new to Zimbabwe. Understandings, manifestations, and processes of the phenomenon over time are examined to reveal the nuances of the internationalization process in its current mode of occurrence, in an attempt to not only understand it in its colonial and postcolonial manifestation but to situate it within a wider decolonial project. Using a decolonial lens, this article explores various processes of internationalization in Zimbabwe’s higher education institutions (HEIs), viewing them either as continuities or disruptions. In so doing, we argue that for internationalization in Zimbabwe’s HEIs to fully deliver on its promises, it needs to not only engage with the issues of colonial(ism/ity) but also to understand its particular specificity in the Zimbabwean society, and the effects that this continues to have on internationalization attempts.
How Passion in Entrepreneurship Develops Over Time: A Self-Regulation Perspective
Authors: Lex Maike , Gielnik Michael M. , Spitzmuller Matthias , Jacob Gabriel H. , Frese Michael
Published: June 2020

We adopt a self-regulation perspective to present a model of the development of passion in entrepreneurship. We argue that entrepreneurial self-efficacy and performance influence the two components of passion—positive feelings and identity centrality—over shorter and longer time horizons, respectively. Furthermore, we argue for the recursive effects of passion on entrepreneurial self-efficacy and performance. Three longitudinal studies with measurements over three weeks ( n = 65) and three months ( n = 150 and n = 180) support our hypotheses. We contribute to a theory of passion that integrates the different time horizons over which the components of passion change.
Hydrophilic Polymer in Thrombus Specimens Obtained During Thrombus Aspiration in the Setting of Percutaneous Interventions in Japan
Authors: Miyaoka Masashi , Hatanaka Kazuhito , Nakamura Naoya
Published: June 2020

Although hydrophilic polymer (HP) is used on vascular catheters to prevent medical device–related complications, HP emboli are well established as a potentially fatal iatrogenic phenomenon. HP embolus is thromboembolism by HP, which is mechanically disrupted from catheter during procedure. We reviewed 119 thrombus specimens obtained by percutaneous interventions from the coronary artery, vessels of inferior and superior limbs, cerebral artery, carotid artery, and renal vein. The frequency of HP was 28.6% (34/119 cases); 26.4% (24/91 cases), coronary artery; 50% (6/12 cases), artery of the lower limb; 28.6% (2/7 cases), vein of the lower limb; 0% (0/2), artery of the upper limb; 33.3% (1/3 cases), cerebral artery; 50% (1/2 cases), pulmonary artery; 0% (0/1 case), carotid artery; and 0% (0/1 case), renal vein. The range of numbers and diameter of HP was 1 to 127 per case and 10 to 934 µm, respectively. This is the first study concerning HP in thrombus specimens in Japan. We think that this study is significant because HP in thrombus specimens obtained from coronary artery in Japan seems to be of lower frequency than that of Europe. Although we suspect that the difference was caused by types of catheter, protocol, and procedure time of percutaneous interventions, we could not investigate correlation of HP in thrombus specimens with these factors. For future investigation, we should accumulate thrombus specimens obtained by routine procedure and device to clarify specific device-associated risk of disruption of HP.
S-1 Maintenance Therapy in Extensive Stage Small-Cell Lung Cancer—A Randomized Clinical Study
Authors: Nie Keke , Guo Xiuhui , You Yunhong , Zhuang Xingjun , Zhang Chunling , Ji Youxin
Published: June 2020

Small-cell lung cancer (SCLC) is a recalcitrant cancer for its dismal prognosis although extensive research had been done. Four to 6 cycles platinum-based chemotherapy is the mainstay treatment for the extensive-stage disease; but the role of maintenance treatment is not fully understood. This is a phase 2, open-label study. Patients with extensive-stage SCLC reaching an objective response or stable disease (SD) after induction chemotherapy were randomly assigned (1:1) with a minimization procedure. One group received oral S-1 and the other group received placebo as maintenance treatment until disease progression or unacceptable toxicities. The primary end point of this study was progression-free survival (PFS), and the secondary end points were overall survival (OS), response rates, and toxicities. This study was based on earlier work, the preliminary results was reported on 2019 ASCO annual meeting. A total of 89 patients were enrolled, of whom 45 received S-1 maintenance therapy and 44 received placebo. The median PFS and OS were 6.35 months and 10.82 months in the S-1 group, as compared to 5.98 months and 10.09 months in the placebo group. The PFS was 7.2 months and 5.3 months, and OS was 12.9 months and 10.9 months in patients with an objective response compared to in patients with SD after induction chemotherapy, respectively. S-1 maintenance therapy did not prolong PFS or OS in patients with extensive-stage SCLC; tumor regression rate was the prognostic factor of PFS or OS. Further research with novel agents in the maintenance setting is warranted.
Cardiovascular Risk After Sepsis: Understanding the Role of Statin Indications and the Impact of Clinical Inertia on Prescribing Patterns
Authors: Gupta Vedant A. , Alnabelsi Talal S. , Shringi Sandipan , Leung Steve W. , Sorrell Vincent L.
Published: June 2020

Introduction:

Patients with sepsis have high rates of major adverse cardiovascular events (MACE) in the literature, but the stratification of those at risk has been limited. Statin indicated groups provides clear criteria for therapy, but the risk of MACE after sepsis based on these groups has never been assessed.

Materials and Methods:

This was a retrospective cohort analysis conducted on adult patients admitted from January 1, 2013, to December 31, 2013, with suspected or confirmed sepsis and data available on statin use. Patients’ past medical history; statin use prior, during, or at time of discharge; and occurrence of MACE were recorded from electronic health records.

Result:

A total of 321 patients were screened and 265 were found to have data available on statin use. The mean age of the patients was 59 ± 15 years and 47% were female. Overall, 9% were observed to have a MACE at 1 year, with significantly higher rates in those in a statin indicated group (12.2%). On admission, 174 patients were not taking a statin out of whom 52% were in a statin indicated group. Among those in a statin indicated group who survived to hospital discharge, only 10% not on a statin on admission received a statin on discharge, whereas 89% on a statin on admission received a statin on discharge.

Conclusion:

There is a high risk of MACE after sepsis especially among those in statin indicated groups with significant clinical inertia in prescribing practices.
What Is the Health and Well-Being Burden for Parents Living With a Child With ADHD in the United Kingdom?
Authors: Peasgood Tessa , Bhardwaj Anupam , Brazier John E. , Biggs Katie , Coghill David , Daley David , Cooper Cindy L. , De Silva Cyril , Harpin Val , Hodgkins Paul , Nadkarni Amulya , Setyawan Juliana , Sonuga-Barke Edmund J. S.
Published: June 2020

Objective: To explore the burden associated with childhood ADHD in a large observational study. Methods: We recruited familes with at least one child (6-18 years) with ADHD via 15 NHS trusts in the UK, and collected data from all family members. We made careful adjustments to ensure a like-for-like comparison with two different control groups, and explored the impact of controlling for a positive parental/carer ADHD screen, employment, and relationship status. Results: We found significant negative impacts of childhood ADHD on parents’/carers’ hours and quality of sleep, satisfaction with leisure time, and health-related quality of life (measured by the EuroQol-5D [EQ-5D]). We found a decrement in life satisfaction, mental well-being (as measured by the Short–Warwick Edinburgh Mental Well-Being Scale [S-WEMWBS]), and satisfaction with intimate relationships, but this was not always robust across the different control groups. We did not find any decrement in satisfaction with health, self-reported health status, or satisfaction with income. Conclusion: The study quantifies the impact on the health and well-being of parents living with a child with ADHD using a survey of families attending ADHD clinics in the United Kingdom.
Welfare Implications of Uncertain Social Security Reform
Authors: Nelson Jaeger
Published: June 2020

Policy uncertainty is a type of aggregate risk that has important economic and welfare implications. In this article, I develop a simple general equilibrium overlapping generations model in which households are uncertain as to the type and timing of an inevitable Social Security reform. I document how households’ expectations over the path of future policy influences their behavior. I find that the economic and welfare effects of policy uncertainty are highly sensitive to households’ beliefs over the path of future policy.
Early Ambulation After Injury Is Associated With Increased Muscle Size and Strength
Authors: Higgins Jacob T. , Frazier Susan K. , Lennie Terry , Rayens Mary Kay , Avila Jacob
Published: June 2020

Background:

Trauma and management of injuries can result in reduction or loss of mobility, which can lead to skeletal muscle deconditioning and sustained disability. Prior investigators have examined changes in skeletal muscle due to injury and immobility separately. The muscular consequences of combined immobility and trauma have not been systematically investigated.

Objective:

The purpose of this study was to explore the association of time to first ambulation with skeletal muscle size and strength in patients after major trauma.

Methods:

Adults ( N = 19) admitted for major trauma (Injury Severity Score [ISS] > 15) provided daily measures of muscle size (ultrasound) and strength (dynamometry) during hospitalization. Participants were grouped based on time to first ambulation. Repeated measures analysis of variance was used to compare muscle measures between the groups across 5 days while controlling for age and gender.

Results:

Participants were primarily male (63%) aged 40 ± 17 years with a mean ISS of 21 ± 4. Early ambulation was associated with a 10% increase from baseline in bicep size on Days 3 and 4 and a 15% increase from baseline on Day 5. There were no changes in rectus femoris size in either group. The early ambulation group was significantly stronger than the delayed ambulation group throughout the study in measures taken with the biceps (22%–37%) and quadriceps (26%–46%).

Conclusion:

Early ambulation following major trauma was associated with increased bicep size and greater muscle strength in the biceps and quadriceps muscles over time.
Choroidal neovascularization as a complication of primary vitreous retinal lymphoma
Authors: Ma Ya , Zhao Huiying , Peng Xiaoyan
Published: June 2020

Purpose:

To describe a case of primary vitreous retinal lymphoma (PVRL) complicated with choroidal neovascularization (CNV) and presented with severe macular edema (ME).

Case description:

A 52-year-old female patient was diagnosed with bilateral PVRL. Optical coherence tomography (OCT) showed severe macular edema (ME) and subretinal hyperreflective material in the left eye at the first visit. No sign of choroidal neovascularization (CNV) was found with fundus fluorescein angiography (FFA) or indocyanine green angiography (ICGA). The ME was resolved after standard intraocular chemotherapy, while the subretinal hyperreflective material remained stable. Optical coherence tomography angiography (OCTA) was performed 2 years after chemotherapy. OCTA revealed a well-circumscribed CNV network in the subretinal hyperreflective material.

Conclusion:

It is a rare occurrence that CNV and ME developed in this PVRL patient. The presence of ME is not an exclusion criterion for PVRL. This case should also raise awareness of the importance of OCTA as a method for monitoring intraocular lymphoma during follow-up.
Effect of unilateral vertical transposition of the horizontal rectus muscles on vertical strabismus
Authors: Rossel Mirjam , Bergholz Richard , Salchow Daniel J
Published: June 2020

Purpose:

To study the effect of vertically transposing both horizontal eye muscles of one eye in the same direction on vertical strabismus.

Methods:

Retrospective analysis of 33 patients in whom vertical transposition of the medial and lateral rectus muscles was combined with a recession/resection or recession/plication procedure. Preoperative ocular alignment was compared with that 1 day and 3 months postoperatively.

Results:

Mean preoperative vertical deviation was 7.8 ± 4.3 (median 7.5, range 3–25) prism diopters (PD) at distance and 7.8 ± 4.1 (7, 0–18) PD at near. Vertical transposition of the horizontal rectus muscles averaged 5.6 ± 1.6 mm and reduced the vertical deviation to 3.4 ± 4.2 PD (2, 0–16) at distance and 2.9 ± 3.7 PD (2, 0–14) at near. Mean effect on the vertical deviation was 0.9 ± 0.7 (0.8, –0.8 to 2.13) PD/mm at distance and 0.9 ± 0.9 (0.83, –1 to 3) PD/mm at near, it was similar in patients operated on for esotropia and for exotropia. The surgical effect on the horizontal deviation was 2.1 ± 1.1 PD/mm (distance) and 2.6 ± 1 PD/mm (near). Both the vertical and horizontal surgical dose correlated with the effect in a linear way, but the variability was greater for the vertical transposition.

Conclusions:

Vertical transposition of the horizontal rectus muscles in the same direction allows for correction of vertical strabismus. This procedure may be performed during primarily horizontal strabismus surgery, without operating on an additional extraocular muscle. The transposition distance correlates with the surgical effect but predictability of the effect is limited.
A Qualitative Exploration of Consumers’ Perceived Impacts, Behavioural Reactions, and Future Reflections of the EU Tobacco Products Directive (2017) as Applied to Electronic Cigarettes
Authors: Ward Emma , Anholt Claudia , Gentry Sarah , Dawkins Lynne , Holland Richard , Notley Caitlin
Published: June 2020

Background:

Electronic cigarette regulations included in the Tobacco Products Directive (TPD), Article 20, implemented in Europe by May 2017, aimed to improve safety for e-cigarette consumers, and prevent uptake among non-smokers, particularly young people. Before implementation, there were significant concerns from consumers, industry, and some in the scientific community about the potential negative impact of the TPD on people using e-cigarettes to remain abstinent from smoking. To date, there is limited evidence on how the TPD has affected consumers. This study aimed to add insight into how consumers perceived and experienced the regulations.

Methods:

Qualitative data, collected between March 2018 and March 2019, relating to participant views of the TPD were extracted from 160 interviews/extended surveys of e-cigarette consumers as part of a wider study into e-cigarette use trajectories (ECtra study). Data were thematically analysed.

Results:

Awareness of the TPD among consumers was not universal. Participants’ smoking behaviour did not appear to be influenced by the legislation. Participants were reassured by manufacturing regulations and requirements for ingredients labels. Participants responded negatively to changes perceived to cause inconvenience and extra plastic waste. The product restrictions prompted some participants to purchase non-compliant products illegally, potentially putting their safety at risk.

Conclusions:

E-cigarette regulation should focus on ensuring product safety. Raising awareness of the TPD among consumers and smokers could be beneficial.