bluuebunny/crossref_metadata_2025 huggingface dataset:
Complete embolisation of the proper hepatic artery for delayed haemorrhage after pancreaticoduodenectomy: a case report
Authors: Wu Youwei , Dai Junlong , Shen Junyi , Zhang Xiaoyun , Peng Wei , Li Chuan , Wen Tianfu
Published: October 2020

Postpancreatectomy haemorrhage (PPH) is a rare and life-threatening complication that can occur after pancreaticoduodenectomy (PD). Recently, radiological intervention has become a first-line approach for the diagnosis and treatment of late PPH in haemodynamically stable patients. Surgical intervention should be performed in haemodynamically unstable patients. We report the case of a 54-year-old man who underwent PD for ampullary carcinoma. On postoperative day (POD) 20, he developed a late PPH in the context of pancreatic fistula that was accompanied by hypotension and tachycardia. Therefore, emergency relaparotomy was performed, but the bleeding site was not detected due to severe adhesions in the surgical field. Thus, urgent angiography was performed immediately, and active bleeding was detected from the distal part of the proper hepatic artery. Coil embolisation of the proper hepatic artery trunk was successfully performed. No intrahepatic abscess or liver failure was subsequently observed, and the patient left our hospital on POD 27. This case shows that radiological intervention is a first choice for the diagnosis and treatment of haemodynamically stable late PPH and that it also might still be a first choice and also be safer and more effective than surgical intervention even with unstable haemodynamics.
Effects of Visual Activity Schedule on Decreasing Transition Latency
Authors: Pence Rachel B. , Allday R. Allan , Spriggs Amy D. , Lane Justin D.
Published: October 2020

A visual activity schedule (VAS) was used with a 7-year-old African-American (Non-Hispanic) male at-risk for school failure. An ABAB withdrawal design was used to assess the effectiveness of a VAS on decreasing latency during transitions. Results indicated that a VAS decreased transition latency between activities and reduced teacher prompting associated with the transitions. Limitations of this study and implications for practitioners and researchers are provided.
Both sides of the Paycheck: Recommending Thrift to the Poor in Job Readiness Programs
Authors: Hennigan Brian , Purser Gretchen
Published: October 2020

This article documents how job readiness programs—as anchors of the devolved organizational landscape of neoliberal poverty governance in the United States—endeavor to instill within the poor not simply the virtue of work, but the virtue of thrift, and thus orient them to “both sides of the paycheck.” Using a comparative ethnographic study of two community-based, government-funded nonprofit job readiness programs, we show that this pedagogic focus on budgeting is central to the overall goal of conditioning clients to embrace and endure a degraded labor market. Recognizing that most participants will remain poor with or without low-wage employment, these programs suggest that it is as crafty consumers that participants may retake control of their lives. Despite the programs’ differing target populations and racialized and gendered logics, both attempt to accommodate participants to the dictates of the neoliberal economic order: jobs are hard to find and, even if you get one, wages will not be enough.
Evaluation of a Pharmacist-Driven Protocol for the Treatment of Opioid-Induced Constipation
Authors: Tryson Alexander R. , Hennessey Erin K. , Crannage Andrew J.
Published: October 2020

Background:

Opioid-induced constipation (OIC) treatment guidelines recommend over-the-counter laxatives as first-line therapy, followed by treatment with a peripherally-acting mu-opioid receptor antagonist (PAMORA) in refractory patients.

Objective:

To evaluate the ability of a pharmacist-driven OIC protocol to promote increased scheduled laxative use prior to escalation to PAMORA therapy.

Methods:

This retrospective, single-center cohort study evaluated patients 2 years pre- and post-protocol implementation. The primary outcome was the difference in the percentage of patients receiving 2 scheduled laxatives for ≥ 2 days prior to PAMORA therapy pre- and post-protocol. Secondary outcomes included difference in time to first bowel movement after PAMORA initiation, difference in total number of laxative/PAMORA doses administered, and difference in overall estimated total cost. Data was analyzed using chi-squared tests and Student’s t tests.

Results:

Three-hundred patients were included (150 patients in the pre and post-protocol groups). In the pre-protocol group, 53 patients (35%) received 2 scheduled laxatives for 2 days prior to naloxegol/methylnaltrexone compared to 96 patients (64%) in the postprotocol group (p < 0.0001). One-thousand twenty-one scheduled laxative doses were given pre-protocol versus 1625 doses post-protocol. Average time to first bowel movement was similar between groups (17.7 hours vs 16.0 hours p = 0.441). Estimated total cost of OIC reversal therapy decreased from $20,896.95 to $13,405.47.

Conclusion:

A pharmacist-driven OIC protocol is associated with an increase in the use of scheduled laxatives prior to PAMORA administration and decreased overall estimated total cost. A larger, prospective study is necessary to assess if this promotes more efficacious OIC.
Pharmacoeconomic, Medication Access, and Patient-Satisfaction Analysis of a Pharmacist-Managed VTE Clinic Compared to Primary Care Physician Outpatient Therapy
Authors: Howell Chandler Wayne , Walroth Todd A. , Beam Daren M. , Geik Christopher A. , Howell Molly M. , Macik Monica R. , Schmelz Andrew N. , DiRenzo Baely M.
Published: October 2020

Venous thromboembolism (VTE) is a common medical condition often treated with direct oral anticoagulants (DOACs). Current literature supports outpatient treatment of select, low-risk VTE patients by a pharmacist with DOACs; however, no studies exist to demonstrate if a pharmacist-managed VTE clinic provides financial benefit compared to physician-managed outpatient care. To compare the financial implications and patient satisfaction of pharmacist-managed VTE care versus outpatient VTE care by a primary care physician. A single-center retrospective chart review was conducted on all patients seen at a pharmacist-managed VTE clinic for safety and reimbursement outcomes between August 1, 2018 and July 31, 2019. These data points were used to assess the primary endpoint of net gain per patient visit and secondary outcomes, including patient satisfaction score. The primary outcome median (IQR) for net gain per visit was $16.57 (16.57, 16.57) for the pharmacist-managed group and $64.37 (47.04, 64.37) in the physician-managed group with a 95% CI of 39.13-47.80. The median cost to the organization per visit was $4.96 (4.96, 4.96) for the pharmacist-managed group and $39.41 (23.65, 39.41) for the physician managed group with a 95% CI of 26.57-34.45. Statistical difference was also found for a secondary outcome of percentage of days covered for the pharmacist-managed group compared to the physician managed group, median (IQR) 100% (76,100) vs 92.2% (67.2, 98.9) respectfully, with a p-value of 0.043. The pharmacist-managed VTE clinic, although financially sustainable, provides significantly less net revenue per patient than physician managed clinics, demonstrating the need for increased payer recognition for pharmacists.
Narrating homes in process: Everyday politics of migrant childhoods
Authors: McDonnell Susan
Published: October 2020

This article considers participation by migrant children in home-making as a practice of everyday politics, which is both agentic and interdependent. It highlights the contested and fluid nature of the concept of ‘home’, and the multiple resources involved in its constitution. It focuses on one child’s meaning-making work in the context of idealised notions of home foregrounding the nuclear family, privacy and fixity. It argues that his narratives, intersected by those of his mother, tactically re-territorialise an institutional site by constructing belongings through relationships, encounters and movements.
Characterization of MWCNTs-polystyrene nanocomposite based strain sensor
Authors: Singla Tarun , Pal Singh Amrinder , Kumar Suresh , Singh Gagandeep , Kumar Navin
Published: October 2020

The usage of nano phase materials for strain sensing applications has attracted attention due to their unique electromechanical properties. The nanocomposite as piezo-resistive films provides an alternative for the realization of strain sensors with high sensitivity than the conventional sensors based on metal and semiconductor strain gauges. In this work, polymer based nano-composite with carbon nanotubes as filler were developed. The multi-walled carbon nanotubes/polystyrene (MWCNTs/PS) nano-composite films were prepared with different wt.% of CNTs using solution mixing method. Field emission scanning electron microscopy technique was carried out to investigate the morphology and dispersion of CNTs in the nano-composite sample. Fourier transform infrared spectroscopy technique was employed to characterize the bonds present in the prepared nano-composite. The electrical response of the composite films was recorded in the form of current-voltage (I-V) characteristics using source meter. The electromechanical response of the nano-composite films with different wt.% of filler CNTs was recorded by applying uni-axial tensile load. The electromechanical responses were then analyzed to obtain gauge factor for the strain sensitivity. The highest gauge factor of 133 was recorded during tensile testing of the nano-composite with 3 wt.% of CNTs fillers.
GIS-based spatial modelling of COVID-19 death incidence in São Paulo, Brazil
Authors: Urban Rodrigo Custodio , Nakada Liane Yuri Kondo
Published: October 2020

Seeking to understand the socio-spatial behaviour of the COVID-19 virus in the most impacted area in Brazil, five spatial regression models were analysed to assess the disease distribution in the affected territory. Results obtained using the Spearman correlation test provided evidence for the correlation between COVID-19 death incidence and social aspects such as population density, average people per household, and informal urban settlements. More importantly, all analysed models using four selected explanatory variables have proven to represent at least 85 per cent of reported deaths at the district level. Overall, our results have demonstrated that the geographically weighted regression (GWR) model best explains the spatial distribution of COVID-19 in the city of São Paulo, highlighting the spatial aspects of the data. Spatial analysis has shown the spread of COVID-19 in areas with highly vulnerable populations. Our findings corroborate reports from the recent literature, pointing out the need for special attention in peripheral areas and informal settlements.
Joint analysis of recurrence and termination: A Bayesian latent class approach
Authors: Xu Zhixing , Sinha Debajyoti , Bradley Jonathan R
Published: October 2020

Like many other clinical and economic studies, each subject of our motivating transplant study is at risk of recurrent events of non-fatal tissue rejections as well as the terminating event of death due to total graft rejection. For such studies, our model and associated Bayesian analysis aim for some practical advantages over competing methods. Our semiparametric latent-class-based joint model has coherent interpretation of the covariate (including race and gender) effects on all functions and model quantities that are relevant for understanding the effects of covariates on future event trajectories. Our fully Bayesian method for estimation and prediction uses a complete specification of the prior process of the baseline functions. We also derive a practical and theoretically justifiable partial likelihood-based semiparametric Bayesian approach to deal with the analysis when there is a lack of prior information about baseline functions. Our model and method can accommodate fixed as well as time-varying covariates. Our Markov Chain Monte Carlo tools for both Bayesian methods are implementable via publicly available software. Our Bayesian analysis of transplant study and simulation study demonstrate practical advantages and improved performance of our approach.
Are franchisees more prone to employment standards violations than other businesses? Evidence from Ontario, Canada
Authors: Easton Mark D , Noack Andrea M , Vosko Leah F
Published: October 2020

Using an administrative dataset from the Ontario Ministry of Labour, we investigate three hypotheses about employment standards violations among franchised businesses: (1) franchisees have a higher probability of violating employment standards than other businesses, (2) franchisees have a higher probability of monetary/wage-related ES violations than other businesses, and (3) franchisees have a lower probability of repaying monetary/wage-related violations than other businesses. The results of our statistical models suggest that overall, franchisees are indeed more likely to violate ES, have a higher probability of monetary/wage-related violations, and are less likely to repay such violations. However, the results vary substantially by industry. While franchisees had only marginally higher probabilities of an ES violation in two of the seven industry-groups examined, five of the seven industries showed substantially higher probabilities of a monetary violation. The results also show that franchisees in three industry groups (retail, accommodation and food services, and education, public administration, healthcare and social services) are particularly prone to monetary violations.

JEL codes: J83, J88, J89
Toward Defining Healthcare Simulation Escape Rooms
Authors: Anderson Mindi , Lioce Lori , M. Robertson Jamie , O. Lopreiato Joseph , A. Díaz Desiree
Published: October 2020

Background.

Escape rooms have been adapted from a range of educational purposes across disciplines, including healthcare simulation. The use of this technique has become increasingly popular among industry and faculty members. We sought to clarify the characteristics of healthcare simulation escape rooms in order to work toward a shared mental model and definition.

Methods.

A scoping review of the literature with an environmental scan of websites and other public information was performed to identify concepts which describe educational and healthcare simulation escape rooms to differentiate between and determine key features and scope of this clinical education tool to provide an interprofessional definition. Twenty-three references were used.

Results.

Healthcare simulation escape rooms share many of the characteristics of those being used for education and may be utilized for teaching a variety of skills. These may be conducted either within a simulation scenario, within the simulation/simulated environment, and/or with associated equipment. It is essential that the development and implementation of these escape rooms follow design standards of best practice for healthcare simulation for optimal learning. Only one definition of simulation escape rooms was found.

Discussion.

While similar to escape rooms utilized in other forms of education, there are principal differences between those escape rooms and ones used in healthcare simulation. Key features include utilization of core healthcare simulation principles, including providing a safe and realistic learning environment.

Conclusion.

Escape rooms may be used to engage learners in a simulation experience. It is important to differentiate between true simulation escape rooms and escape rooms that do not reflect healthcare simulation-based learning experiences. An expanded definition is provided, as reflected by the literature review, to provide a clearer understanding of the term as applied to healthcare simulation and enhance repeatable studies to advance the science of healthcare simulation.
Supporting Diverse Learners with Autism Through a Culturally Responsive Visual Communication Intervention
Authors: Bateman Katherine J. , Wilson Sarah Emily
Published: October 2020

Rates of inclusion for children with disabilities continue to increase. Schools are also experiencing an increase in culturally and linguistically diverse students. As such, the diversity of children in classrooms across the country continues to dramatically shift and teachers are challenged to implement culturally responsive and relevant interventions. Social skills are a significant area of development for which children with disabilities frequently require intervention. Yet, important considerations regarding cultural awareness and relevancy should be made when implementing social skills interventions as research emphasizes the necessity of diverse representation in interventions. This column discusses the implementation and cultural considerations of a visual communication support used to increase social engagement among children during mealtimes.
Bone Growth Capacity of Human Umbilical Cord Mesenchymal Stem Cells and BMP-2 Seeded Into Hydroxyapatite/Chitosan/Gelatin Scaffold in Alveolar Cleft Defects: An Experimental Study in Goat
Authors: Bangun Kristaninta , Sukasah Chaula L. , Dilogo Ismail H. , Indrani Decky J. , Siregar Nurjati Chairani , Pandelaki Jacub , Iskandriati Diah , Kekalih Aria , Halim Jessica
Published: October 2020

Objective:

To evaluate bone regeneration in alveolar defects treated with human umbilical cord–derived mesenchymal stem cells (hUCMSCs), hydroxyapatite/chitosan/gelatin (HA/CS/Gel) scaffold, and bone morphogenic protein-2 (BMP-2) in Capra hircus models.

Design:

Randomized posttest-only control group design.

Setting:

Animal Hospital at Bogor Agricultural Institute.

Participants:

Healthy and equally treated 24 female Capra hircus/goats.

Intervention:

Animals were randomly assigned to 3 experimental group design (iliac crest alveolar bone graft/ICABG [control], HA/Cs/Gel+BMP-2 [ Novosys], and HA/Cs/Gel+BMP-2+UCMSCs). Graft materials were implanted in surgically made alveolar defects.

Main Outcome Measures:

Postoperative functional score and operating time were assessed. New bone growth, bone density, inflammatory cells recruitment, and neoangiogenesis were evaluated based on radiological and histological approach at 2 time points, week 4 and 12. Statistical analysis was done between treatment groups.

Results:

Operating time was 34% faster and functional score 94.5% more superior in HA/Cs/Gel+BMP-2+hUCMSC group. Bone growth capacity in HA/Cs/Gel+BMP-2+UCMSCs mimicked ICABG, but ICABG showed possibility of bone loss between week 4 and 12. The HA/Cs/Gel+BMP-2+UCMSCs showed early bone repopulation and unseen inflammatory cells and angiogenesis on week 12.

Discussion and Conclusion:

The HA/Cs/Gel+BMP-2+hUCMSCs were superior in enhancing new bone growth without donor site morbidity compared to ICABG. The presence of hUCMSCs in tissue-engineered alveolar bone graft (ABG), supported with paracrine activity of the resident stem cells, initiated earlier new bone repopulation, and completed faster bone regeneration. The HA/Cs/Gel scaffold seeded with UCMSCs+BMP-2 is a safe substitute of ICABG to close alveolar bone defects suitable for patients with cleft lip, alveolus, and palate.
Msx1 Heterozygosity in Mice Enhances Susceptibility to Phenytoin-Induced Hypoxic Stress Causing Cleft Palate
Authors: Park Jinsil , Nakatomi Mitsushiro , Sasaguri Masaaki , Habu Manabu , Takahashi Osamu , Yoshiga Daigo , Matsuyama Kae , Kataoka Shinji , Toyono Takashi , Seta Yuji , Peters Heiko , Tominaga Kazuhiro
Published: October 2020

Objective:

Cleft palate is among the most frequent congenital defects in humans. While gene–environment multifactorial threshold models have been proposed to explain this cleft palate formation, only a few experimental models have verified this theory. This study aimed to clarify whether gene–environment interaction can cause cleft palate through a combination of specific genetic and environmental factors.

Methods:

Msx1 heterozygosity in mice ( Msx1+/−) was selected as a genetic factor since human MSX1 gene mutations may cause nonsyndromic cleft palate. As an environmental factor, hypoxic stress was induced in pregnant mice by administration of the antiepileptic drug phenytoin, a known arrhythmia inducer, during palatal development from embryonic day (E) 11 to E14. Embryos were dissected at E13 for histological analysis or at E17 for recording of the palatal state.

Results:

Phenytoin administration downregulated cell proliferation in palatal processes in both wild-type and Msx1+/− embryos. Bone morphogenetic protein 4 ( Bmp4) expression was slightly downregulated in the anterior palatal process of Msx1+/− embryos. Although Msx1+/− embryos do not show cleft palate under normal conditions, phenytoin administration induced a significantly higher incidence of cleft palate in Msx1+/− embryos compared to wild-type littermates.

Conclusion:

Our data suggest that cleft palate may occur because of the additive effects of Bmp4 downregulation as a result of Msx1 heterozygosity and decreased cell proliferation upon hypoxic stress. Human carriers of MSX1 mutations may have to take more precautions during pregnancy to avoid exposure to environmental risks.
Personality and Cognitive–Emotional Variables in Spanish Children and Adolescents With and Without Cleft Lip and/or Palate
Authors: Guillén Ana Ruiz , Olmo María José González , Puente Cecilia Peñacoba , Maroto Martín Romero
Published: October 2020

Objectives:

To analyze personality (Big Five Model) and cognitive–emotional variables in children and adolescents with a cleft lip/palate (s) in comparison to an equivalent peer sample without an orofacial cleft.

Design:

Cross-sectional study with data collected using self-reported questionnaires over 2 years.

Setting:

Data were collected during visits to health center dental clinics.

Patients:

Children and adolescents (aged 8-18 years) with nonsyndromic CL/P (n = 60) and without a cleft (n = 60).

Method:

Patients completed questionnaires with assistance as needed from a member of the research team.

Main Outcome Measures:

Children’s Perceived Self-Efficacy, Cognitive Emotion Regulation Questionnaire (child version), Big Five Questionnaire for Children, and Alexithymia Questionnaire for Children.

Results:

When accounting for age, children with CL/P had normative self-efficacy and cognitive–emotional regulation strategies, with the protective factor of significantly lower rumination than peers. Children with CL/P were significantly lower on the Big Five personality areas of conscientiousness, openness to experience, extraversion, and agreeableness along with significantly higher neuroticism. They were similarly significantly higher than peers for alexithymia.

Conclusion:

Children with CL/P showed strengths in self-efficacy typical of peers and less use of some maladaptive coping strategies; however, they also had higher levels of alexithymia and risk factors associated with the Big Five Model of personality. Strategies may be clinically useful that maximize areas of strength to support children with CL/P in expressing their emotions to reduce alexithymia, coping with of negative affect, and building assertiveness.
Local damage identification of high-strength circular concrete-filled steel tubes under low cycle fatigue
Authors: Bai Yongtao , Yue Yanchao , Chen Yao , Luo Dong , Wang Yuhang , Zhang Yi
Published: October 2020

This paper investigates the low cycle fatigue (LCF) induced damages of high-strength circular concrete-filled steel tubular (CFT) beam-columns subjected to nonstationary loading history. The test specimens are fabricated by ultra-thin walled steel tubes with 2 mm in thickness to clarify the vulnerability concerning fatigue failure, and to evaluate the fatigue life of slender and over-design circular CFT beam-column members. Experimental results indicated that the specimens with a large D/t ratio together with thin-walled steel tubes tend to trigger highly-concentrated local buckling at column bottom where sequentially experienced premature fractures due to low cycle fatigue and the fragmentation of concrete infill. This complex LCF-induced failure mode can be identified by developing a new damage detection technique using polymer optical fiber sensors with distributed placement. It is found that the sequence of variable amplitudes during LCF history plays significant influences on the accumulation of plastic deformation which is not necessarily correlated to the sequence of nonstationary loading history induced by earthquake ground motions. Moreover, the epistemic uncertainty of variable amplitude of displacement demonstrates considerable influences on fatigue life with variable displacement amplitudes.
Tyrosine kinase inhibitors in the treatment of metastatic renal cell cancer patients with early cytokine intolerance: TURCOS, a Turkish national, prospective observational study
Authors: Benekli Mustafa , Gumus Mahmut , Ozkan Metin , Dane Faysal , Elkiran Emin T. , Cicin Irfan , Sevinc Alper , Aliustaoglu Mehmet , Isikdogan Abdurrahman , Meydan Nezih , Oksuzoglu Berna , Ozyilkan Ozgur , Artac Mehmet , Ozdemir Feyyaz , Kilickap Sadettin
Published: October 2020

Objective

Cytokines have been the mainstay of treatment in metastatic renal cell cancer (mRCC) for decades before the introduction of tyrosine kinase inhibitors (TKIs), which dramatically changed the therapeutic landscape in these patients. This observational study was designed to evaluate use of TKIs in the treatment of cytokine-intolerant mRCC patients.

Methods

A total of 151 cytokine-intolerant mRCC patients who were treated with TKIs (sunitinib, pazopanib and sorafenib) were enrolled in this prospective, non-interventional, multi-center observational study at 16 oncology centers across Turkey. Mean (SD) age was 61.3 (11.1) years and 74.8% were males. Data on duration of TKI treatment was the primary outcome measure. Additionally, overall response rate (ORR), progression free survival (PFS), overall survival (OS) and safety data were recorded.

Results

Median duration of treatment was 8.2 months at a median follow up of 17.9 months. ORR and disease control rate were 12.5% and 70.8%, respectively. Median PFS and OS were 7.5 months (95%CI: 6.4–10.4) and 27.3 months (95%CI: 17.6–27.3) with no significant difference among three TKI agents in terms of treatment duration, ORR, PFS and OS. The most common adverse events excluding progression-which was the protocol requirement were diarrhea (13.6%), asthenia (13.6%) and hand-foot syndrome (12.6%). Dose modifications were required in 30.5% of the patients and 15% discontinued TKIs because of toxicity.

Conclusions

Our findings confirm the efficacy and safety profile of TKIs in the first-line treatment of mRCC patients intolerant to cytokine treatment. There was no significant difference among three TKI agents in terms of treatment duration, ORR, PFS and OS. Trial registration: TURCOS ClinicalTrials.gov Identifier: NCT01585974. Registered April 25, 2012.
Multidirectional pattern of hair growth with carflizomib use for multiple myeloma
Authors: Tuler Shahaf , Kaur Jaspreet , Delaware Suzette , Dasanu Constantin A
Published: October 2020

Introduction

Extensive use of novel therapies for multiple myeloma has been accompanied by intriguing toxic side effects affecting various organs and organ systems. Although skin effects with some of these medications have been well-documented, hair changes are fairly rare.

Case report

We report herein a unique case of a patient with myeloma who developed multidirectional pattern of scalp hair growth starting at 14 months into treatment with cafilzomib. This pattern of hair growth had not previously been described in the literature. Management and outcome: The patient had a near-complete response to caflizomib, and continues on this maintenance treatment regimen to the present day. There has not been any change in the unusual hair appearance and texture.

Discussion

A score of 5 on the Naranjo nomogram makes the causality relationship between carfilzomib use and the multidirectional hair growth probable. The mechanism by which carfilzomib causes this hair change remains to be elucidated.
Estimates for the constant in two nonlinear Korn inequalities
Authors: Malin Maria , Mardare Cristinel
Published: October 2020

A nonlinear Korn inequality estimates the distance between two immersions from an open subset of [Formula: see text] into the Euclidean space [Formula: see text], [Formula: see text], in terms of the distance between specific tensor fields that determine the two immersions up to a rigid motion in [Formula: see text]. We establish new inequalities of this type in two cases: when k = n, in which case the tensor fields are the square roots of the metric tensor fields induced by the two immersions, and when k = 3 and n = 2, in which case the tensor fields are defined in terms of the fundamental forms induced by the immersions. These inequalities have the property that their constants depend only on the open subset over which the immersions are defined and on three scalar parameters defining the regularity of the immersions, instead of constants depending on one of the immersions, considered as fixed, as up to now.
Community Health Worker Training Curricula and Intervention Outcomes in African American and Latinx Communities: A Systematic Review
Authors: Adams Leslie B. , Richmond Jennifer , Watson Sable N. , Cené Crystal W. , Urrutia Rachel , Ataga Onome , Dunlap Phenesse , Corbie-Smith Giselle
Published: October 2020

In recent years, community health workers (CHWs) have emerged as key stakeholders in implementing community-based public health interventions in racially diverse contexts. Yet little is known about the extent to which CHW training curriculums influence intervention effectiveness in marginalized racial and ethnic minority communities. This review summarizes evidence on the relationship between CHW training curricula and intervention outcomes conducted among African American and Latinx populations. We conducted a literature search of intervention studies that focused on CHW public health interventions in African American and Latinx populations using PubMed, PsycINFO, ERIC, CINAHL, EMBASE, and Web of Science databases. Included studies were quantitative, qualitative, and mixed methods studies employed to conduct outcome (e.g., blood pressure and HbA1c) and process evaluations (e.g., knowledge and self-efficacy) of CHW-led interventions. Out of 3,295 articles from the database search, 36 articles met our inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary intervention health outcomes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that described training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training features. These findings suggest that CHW training may positively influence intervention effectiveness but additional research using more robust methodological approaches is needed to clarify these relationships.
Understanding and Addressing Latinx COVID-19 Disparities in Washington State
Authors: Baquero Barbara , Gonzalez Carmen , Ramirez Magaly , Chavez Santos Erica , Ornelas India J.
Published: October 2020

The COVID-19 pandemic has exposed, and intensified, health inequities faced by Latinx in the United States. Washington was one of the first U.S. states to report cases of COVID-19. Public health surveillance shows that 31% of Washington cases are Latinx, despite being only 13% of the state population. Unjust policies related to immigration, labor, housing, transportation, and education have contributed to both past and existing inequities. Approximately 20% of Latinx are uninsured, leading to delays in testing and medical care for COVID-19, and early reports indicated critical shortages in professional interpreters and multilingual telehealth options. Washington State is taking action to address some of these inequities. Applying a health equity framework, we describe key factors contributing to COVID-19–related health inequities among Latinx populations, and how Washington State has aimed to address these inequities. We draw on these experiences to make recommendations for other Latinx communities experiencing COVID-19 disparities.
Prevalence of Venous Thromboembolism in Kumasi: A Postmortem-Based Study in a Tertiary Hospital in Ghana
Authors: Ossei Paul Poku Sampene , Owusu Isaac Kofi , Owusu-Asubonteng Gerald , Ankobea-Kokroe Frank , Ayibor William Gilbert , Niako Nicholas
Published: October 2020

Background:

There is a dearth of publications on the prevalence of venous thromboembolism in Ghana. Knowledge of the prevalence of venous thromboembolism, which is often undetected clinically, will help save lives as appropriate interventions can be made as well as provide a general clue to clinicians on detecting venous thromboembolism and pulmonary embolism.

Methods:

The study employs a retrospective design with data extracted from the Autopsy Daybook of the Pathology unit, Komfo Anokye Teaching Hospital, 2009 to 2016. Data on patients’ demographics were retrieved to establish diagnoses and age and gender distribution. Analysis was made of pulmonary embolism and deep vein thrombosis as a cause of death recorded on death certificates using the criteria of the International Classification of Diseases, version 10.

Results:

A total of 150 cases of deep vein thrombosis and/or pulmonary embolism were available for the study period and the results showed an average age of 45.3 years with a standard deviation of 19.96. The ages ranged between 3 years and 96 years with the age group 31 to 40 years being the modal age group. Males recorded the highest number of cases with 92 (59.35%) compared to females with 63 (40.65%). Respiratory disorders, of which pneumonia is the most prevalent, are the leading clinical condition that is often misdiagnosed in place of pulmonary thromboembolism.

Conclusion:

VTE is a major health problem especially among the elderly, but unfortunately the clinical diagnosis is usually missed by clinicians hence the need to maintain a high suspicion index.
Mathematical modeling and optimization of tribological behaviour of Al 7075 based hybrid nanocomposites
Authors: Kannan C , Ramanujam R , Balan ASS
Published: October 2020

Many industrial applications necessitate lightweight materials that possess better tribological behaviour. Whilst aluminium based nanocomposites are proposed owing to their lightness, their tribological characteristics must be improved which are dominantly influenced by the selection of reinforcements, manufacturing process and heat treatments. In this research, an aluminium hybrid nanocomposite is produced using a novel molten salt processing and subjected to different heat treatments. Their tribological behaviour is assessed under different operating conditions viz. load, sliding velocity and material condition of the pin. Regression models are formulated to predict the tribological behaviour of developed hybrid composite under different heat treatments. The most significant parameter and optimum level for each of these operating parameters are determined using analysis of variance, main and interaction plots and response surface methodology in the end. The integrated approach helps in deciding the optimum parameter setting for the development of nanocomposite with ameliorated tribological behaviour. Under the optimized conditions, the hybrid nanocomposite could able to reduce the wear resistance by about 63% and the coefficient of friction by 18.5% than unreinforced alloy.
Ageism in the era of digital platforms
Authors: Rosales Andrea , Fernández-Ardèvol Mireia
Published: October 2020

Ageism is the most invisible form of discrimination. While there is some awareness of gender, racial, and socioeconomic discrimination on digital platforms, ageism has received less attention. This article analyzes some tools that are frequently embedded on digital platforms from an old-age perspective, in order to increase awareness of the different ways in which ageism works. We will firstly look at how innovation teams, following homophilic patterns, disregard older people. Secondly, we will show how ageism tends to be amplified by the methods often used on digital platforms. And thirdly, we will show how corporate values are often against usability issues that mainly affect people with a low level of (digital) skills, which is more common among older people. Counterbalancing the abusive power control of the corporations behind digital platforms and compensating for the underrepresentation of groups in less favorable situations could help to tackle such discrimination.
“Welcome to our neighbourhood”: Collective confidence in contact facilitates successful mixing in residential settings
Authors: Stevenson Clifford , Turner Rhiannon , Costa Sebastiano
Published: October 2020

Over the past decade, increasing attention has been paid to the antecedents of intergroup contact and, in particular, self-efficacy to engage in intergroup encounters. Contact self-efficacy has been shown to reduce intergroup anxiety and increase willingness to engage in future contact, and is influenced by the positive contact experiences of other group members. However, this work has neglected the collective nature of self-efficacy and, indeed, has typically counterposed the effects of contact and collective efficacy upon group behaviour. We highlight the potential role that collective efficacy can play in facilitating intergroup contact and propose a new concept to capture this phenomenon: collective confidence in contact (CCIC). Using data from two neighbourhood surveys in contrasting areas of Nottingham City, (UK), we show in our first survey ( n = 124) that CCIC is predicted by group identity and that this, in turn, predicts intergroup contact and feelings. In a second survey ( n = 232), we show that the effects of identity and support on CCIC are further mediated by a reduction in intergroup anxiety. We propose that the concept of CCIC returns the understanding of contact to the intergroup level, thereby allowing issues of group identity and the generalisation of contact effects to be investigated more directly.
Fatigue crack growth behavior of rib-to-deck double-sided welded joints of orthotropic steel decks
Authors: Liu Yang , Chen Fanghuai , Wang Da , Lu Naiwei
Published: October 2020

Innovative double-sided welding is expected to improve the fatigue resistance of rib-to-deck welded joints of orthotropic steel decks (OSDs). Welding crack-like defects are the crucial issue affecting the fatigue performance of rib-to-deck double-sided welded joints. This study presents a numerical simulation of three-dimensional (3D) mixed mode fatigue crack growth behavior of rib-to-deck double-sided welded joints of OSDs. Maximum tensile stress theory and equivalent stress intensity factor (SIF) were used to simulate mixed mode fatigue cracks growth. The Paris law model was employed to predict the fatigue life. Fatigue cracks of rib-to-deck double-sided welded joints were characterized by the presence of mixed mode cracks of modes I (open), mode II (shear), and mode III (tear), which was dominated by mode I. The equivalent SIF was found to be complex at the growth stage with the maximum value at the two ends of the crack front and the minimum value at the midpoint of the crack front. The crack shape became flatter in the later phase of the crack growth. The fatigue crack surface underwent deflections during crack growth, making the final crack shape exhibiting the characteristic of a spatial curved surface. The initial crack geometry showed a significant impact on the fatigue life.
The seismic performance of precast short-leg shear wall under cyclic loading
Authors: Du Xiuli , Wu Min , Liu Hongtao
Published: October 2020

In order to study the seismic performance of precast short-leg shear wall connected by grouting sleeves (PSSW), the three-dimensional numerical model was established by using the experiment of PSSW subjected to low cyclic loading. Based on good agreement between numerical results and experimental results, the numerical analysis models with different structural parameters of axial compression ratio and splicing position were designed in detail, and the effects of various parameters on the seismic performance of PSSW were analyzed. The results show that the PSSW exhibits wide and stable hysteresis loops, indicating a satisfactory hysteretic performance and an excellent energy consumption capacity. With the increase of the axial compression ratio, the shear capacity of horizontal splice seam is improved, but the ductility coefficient and total energy consumption decrease obviously. The most disadvantageous position of PSSW can be effectively avoided by changing the position of the post pouring seam. The bearing capacity of the specimens is basically stable, and the energy consumption increases significantly, so the post pouring seam of precast wall is recommended to be far away from the bottom section of the wall. In addition, the failure mechanism of different splicing positions was analyzed in detail.
The learning trajectory of emerging professionalism: A Finnish student teacher negotiating world-view education and early childhood education and care superdiversity
Authors: Lamminmäki-Vartia Silja , Poulter Saila , Kuusisto Arniika
Published: October 2020

This article examines the learning trajectory of the emerging professionalism of Finnish early childhood education and care student teachers, focusing in particular on their professionalism in early childhood education and care world-view education in the context of cultural and world-view superdiversity. Of specific interest here is what students postulate as meaningful in their professional learning processes and why, and what kinds of directions this value-learning process has taken. The data was generated over a year-long learning process in a group with seven early childhood education and care students and six in-service early childhood education and care teachers through survey responses, reflective learning diaries and retrospective in-depth interviews with the students. Using the Kuusisto and Gearon (2017a) value-learning-trajectory model as an analytical tool, the findings are presented through an in-depth case study depicting one student’s learning throughout the process and across the data sets. To conclude, the conceptual working model is developed further to depict the development of emergent early childhood education and care teacher professionalism with a particular focus on world-view education and early childhood education and care superdiversity.
An experimental study of the injection strategies on engine performance of the butanol/biodiesel dual-fuel Intelligent Charge Compression Ignition mode
Authors: Zhao Wenbin , Zhang Yaoyuan , Huang Guan , Li Zilong , Qian Yong , He Zhuoyao , Lu Xingcai
Published: October 2020

Intelligent Charge Compression Ignition (ICCI) combustion mode is a novel dual-fuel combustion strategy that has been proposed recently. In ICCI combustion mode, two fuels with different reactivity are directly injected during the intake stroke and compression stroke, respectively, to achieve flexible reactivity gradient and equivalence ratio stratification. In this study, experiments were conducted on a single-cylinder diesel engine to investigate the effects of butanol direct injection strategies on the engine running with ICCI combustion mode at a constant speed of 1500 r/min and medium load. Results showed that ICCI combustion mode was composed of premixed heat release and diffusion heat release. In compare, the percentage of premixed heat release was higher than the diffusion heat release. With fixed biodiesel direct injection timing (SOI2), retarding butanol single injection timing (SOI1) would delay combustion phasing while not distinctively affect ignition timing. SOI1 showed significant effect on the thermal efficiency and engine emissions. Indicated thermal efficiency (ITE) decreased at first and then slightly increased with retarding of SOI1, while the nitrogen oxides (NOx) emissions were always at low levels. As the butanol second direct injection timing (SOI1-2) retard and the corresponding energy ratio increase, more butanol entered into the crevice/squish regions, leading to the increase of unburned hydrocarbon (HC) and carbon monoxide (CO) emissions. EGR strategy helps to significantly reduce NOx emissions without affecting ITE although penalized HC and CO emissions are resulted in. The optimum butanol direct injection strategies were butanol single direct injection, especially in the early SOI1, in which the thermal efficiency was higher and emissions were at very low levels (NOx  < 0.4 g/kW h).
Contextualist political theory about multiculturalism in a post-multiculturalist context
Authors: Lægaard Sune
Published: October 2020

Many theorists of multiculturalism have proposed contextualism as an approach particularly suited for theorizing multiculturalism. The so-called Bristol School of Multiculturalism (BSM) is characterized by a ‘bottom up’ and claims-based approach eschewing appeal to abstract political principles. Tariq Modood has articulated this contextualist approach as a version of Michael Oakeshott’s idea of politics as ‘the pursuit of intimations’. The question is how such an approach fares when applied to the specific political and social context characteristic of, especially European, political reality of the last 10–15 years. Political opposition to multiculturalism at ideological and rhetorical levels has characterized this context. At the legal level, many of the laws and rules in place actually protecting minority groups have furthermore not had the form of group rights or policies of recognition proposed by multiculturalist theories. The question therefore arises whether a contextualist approach that takes its point of departure in the facts of such a context can deliver a justification of a recognizable multiculturalist political theory. This is a version of the general problem of critical distance facing contextualism. Modood’s version of the approach appeals to the internal diversity of traditions to answer this problem. However, this leads to additional questions about the nature of the theory and the way in which it is action-guiding. Consideration of these questions qualifies the understanding of in which sense the BSM approach is contextual.
Patient involvement in the development of the Danish surgical breast cancer patient pathway – An action research project
Authors: Zøylner Ingrid Annette , Kirkegaard Pia , Christiansen Peer Michael , Lomborg Kirsten
Published: October 2020

Although patient involvement is on the political agenda, the influence on clinical practice is poorly described. The aim of this study was to explore and evaluate the participatory process of involving patients and relatives in development of a surgical breast cancer patient pathway. The overall design was insider action research and included two Danish surgical breast cancer clinics. In dialogue meetings patients, relatives, and healthcare professionals (HCPs) discussed suggestions for improving the pathway. Patients and relatives were satisfied with the pathway organisation in general. However, suggestions related to information, communication, and choice of treatment were presented. In response to this, a patient decision aid was developed, tested, and implemented, and HCPs increased focus on male relatives, and made minor changes to the pathway. Participants were satisfied with the participatory process, however, recommendations for future dialogue meetings included shortening the follow-up period, using a skilled facilitator, reminding HCPs being open-minded, and emphasizing for patients and relatives that participation may require a surplus of mental resources. Overall, recommendations on patient involvement obtained from this project could, due to their general relevance, be implemented in clinical settings other than breast cancer. Furthermore, action research proved a suitable design for research on patient involvement.